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Ballı FN, Ekinci PB, Kurtaran M, Kara E, Dizman GT, Sönmezer MÇ, Hayran M, Demirkan K, Metan G. Battle of polymyxin induced nephrotoxicity: Polymyxin B versus colistin. Int J Antimicrob Agents 2024; 63:107035. [PMID: 37979889 DOI: 10.1016/j.ijantimicag.2023.107035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 11/08/2023] [Accepted: 11/09/2023] [Indexed: 11/20/2023]
Abstract
OBJECTIVES Nephrotoxicity is the most serious and common adverse effect that limits the use of polymyxins. This study compared polymyxin E (colistin) and polymyxin B regarding drug-related nephrotoxicity. METHODS This study was conducted as a retrospective cohort study in a university hospital between January 2020 and July 2022. Patients older than 18 years and who received colistin or polymyxin B were identified using electronic hospital records. Kidney disease improving global outcome criteria were used for assessing nephrotoxicity. RESULTS A total of 190 patients, 95 in both groups, were evaluated. The incidence of acute kidney injury during the treatment was higher in the colistin group [52.6% (n = 50) and 34.7% (n = 33), P = 0.013]. In patients who were exposed to high-dose, the rate of nephrotoxicity was higher in patients receiving colistin [25% (n = 3) vs. 76.9% (n = 10); P = 0.017]. Nephrotoxicity was reversible in 64.4% (n = 38) of patients and the reversibility rate was similar (70% and 52.6% for colistin and polymyxin; P = 0.248). In the multivariable analysis, colistin treatment [odds ratio (OR): 3.882, 95% confidence interval (95% CI) = (1.829-8.241)], concomitant vasopressor use (OR = 2.08, CI: 1.036-4.179), and age (OR=1.036, CI: 1.014-1.058) were found to be independent markers of nephrotoxicity. CONCLUSION Nephrotoxicity was more common in patients receiving high-dose colistin than polymyxin B. Therefore, the use of appropriate doses of colistin is important in terms of preventing nephrotoxicity. In addition, advancing age and concomitant use of vasopressors contribute to polymyxin-related nephrotoxicity.
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Affiliation(s)
- Fatma Nisa Ballı
- Department of Clinical Pharmacy, Gazi University Faculty of Pharmacy, Ankara, Türkiye; Department of Clinical Pharmacy, Hacettepe University Faculty of Pharmacy, Ankara, Türkiye.
| | - Pınar Bakır Ekinci
- Department of Clinical Pharmacy, Hacettepe University Faculty of Pharmacy, Ankara, Türkiye
| | - Melek Kurtaran
- Department of Clinical Pharmacy, Hacettepe University Faculty of Pharmacy, Ankara, Türkiye
| | - Emre Kara
- Department of Clinical Pharmacy, Hacettepe University Faculty of Pharmacy, Ankara, Türkiye
| | - Gülçin Telli Dizman
- Department of Infectious Diseases and Clinical Microbiology, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Meliha Çağla Sönmezer
- Department of Infectious Diseases and Clinical Microbiology, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Mutlu Hayran
- Department of Preventive Oncology, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Kutay Demirkan
- Department of Clinical Pharmacy, Hacettepe University Faculty of Pharmacy, Ankara, Türkiye
| | - Gökhan Metan
- Department of Infectious Diseases and Clinical Microbiology, Hacettepe University Faculty of Medicine, Ankara, Türkiye
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Baltacı E, Çarkoğlu A, Saraf S, Ergüder T, Ergör G, Hayran M, Hoe C. Understanding the dynamics of compliance to smoke-free policy regulations: Exploring the perspectives of venue owners and staff in Türkiye. Tob Induc Dis 2024; 22:TID-22-11. [PMID: 38235257 PMCID: PMC10792618 DOI: 10.18332/tid/176226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 11/21/2023] [Accepted: 12/01/2023] [Indexed: 01/19/2024] Open
Abstract
INTRODUCTION The study aims to understand the facilitators and barriers associated with enforcing and complying with Türkiye's smoke-free policy from the perspective of hospitality venue owners and employees. METHODS A qualitative open-ended survey was conducted in Istanbul and Ankara in 2021 with 58 respondents from 3 different districts in each city from four types of venues: restaurants, traditional coffee and waterpipe houses, and European-style cafés. The open-ended survey included questions to understand the knowledge, beliefs, and attitudes of respondents about Türkiye's smoke-free policy and their perceptions of the facilitators and/or barriers to smoke-free policy implementation and changes after COVID-19. The data were analyzed using an inductive approach to identify patterns and categorize the data into themes. RESULTS The respondents expressed that the smoke-free policy aimed to protect employees and customers from secondhand smoke (SHS), respect human health, and improve air quality. Findings suggest that the positive attitude of venue owners and staff toward the smoke-free policy serves as a facilitator. However, fear of financial impact, customers' negative attitudes, difficulties in meeting physical requirements, and insufficient enforcement were found to be barriers to implementing the smoke-free policy. The effects of the COVID-19 pandemic were reported as an initial increase in compliance and awareness among customers and staff, but some respondents noted negative changes due to the emotional and financial effects of prolonged restrictions. These challenges have led to decreased attention on the smoke-free policy among venue owners, staff and customers. Respondents' suggested improvements were related to building infrastructure, such as the ventilation systems and educating the public on the harmful health effects of smoking. CONCLUSIONS Despite the general understanding of the dangers of secondhand smoke and the smoke-free policy, this study highlights the challenges in implementing smoke-free policy measures and the continued need to raise awareness about the importance of a 100% smoke-free venue. A comprehensive approach to addressing the tobacco epidemic as a multifaceted public health issue is essential.
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Affiliation(s)
- Ezgi Baltacı
- Heidelberg Institute of Global Health, Faculty of Medicine, Heidelberg University, Heidelberg, Germany
| | - Aslı Çarkoğlu
- Department of Psychology, Kadir Has University, Istanbul, Türkiye
| | - Sejal Saraf
- Johns Hopkins Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States
| | - Toker Ergüder
- Special Initiative on NCDs and Innovation (SNI), World Health Organization Country Office, Ankara, Türkiye
| | - Gül Ergör
- School of Public Health, Dokuz Eylül University, Izmir, Türkiye
| | - Mutlu Hayran
- Cancer Institute, Hacettepe University, Ankara, Türkiye
| | - Connie Hoe
- Johns Hopkins Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States
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Gülçek ÖN, Gülhan B, Kesici S, Kurt Şükür ED, Hayran M, Ozaltin F, Duzova A, Bayrakçı B, Topaloglu R. Long-term kidney follow-up after pediatric acute kidney support therapy for children less than 15 kg. Pediatr Nephrol 2023; 38:3811-3821. [PMID: 37195543 PMCID: PMC10189211 DOI: 10.1007/s00467-023-06013-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 04/24/2023] [Accepted: 04/25/2023] [Indexed: 05/18/2023]
Abstract
BACKGROUND In small children, acute dialysis (pediatric acute kidney support therapy (paKST)) is increasingly used; however, it is challenging for many reasons. We compared clinical characteristics and predictors of long-term outcomes of patients < 15 kg on peritoneal dialysis (PD), hemodialysis (HD), and continuous kidney replacement therapy (CKRT). METHODS Patients with history of paKST (CKRT, HD, PD) weighing < 15 kg and ≥ 6 months of follow-up at Hacettepe University were included. Surviving patients were evaluated at last visit. RESULTS 109 patients (57 females) were included. Median age at paKST was 10.1 months (IQR: 2-27 months). In total, 43 (39.4%) patients received HD, 37 (34%) PD, and 29 (26.6%) CKRT. 64 (58.7%) patients died a median 3 days (IQR: 2-9.5 days) after paKST. Percentages of patients using vasopressor agents, with sepsis, and undergoing mechanical ventilation were lower in those who survived. After mean follow-up of 2.9 ± 2.1 years, 34 patients were evaluated at mean age 4.7 ± 2.4 years. Median spot urine protein/creatinine was 0.19 (IQR: 0.13-0.37) and 12 patients (35.3%) had non-nephrotic proteinuria. Three patients had estimated glomerular filtration rate (eGFR) < 90 mL/min/1.73m2 and 2 (6%) had hyperfiltration. In total 22 patients (64.7%) had ≥ 1 kidney risk factor (elevated blood pressure/hypertension, hyperfiltration, eGFR < 90 ml/min/1.73m2, and/or proteinuria) at last visit. Among 28 patients on paKST < 32 months, 21 had ≥ 1 risk factor (75%), whereas among 6 patients who had paKST ≥ 32 months, one patient had ≥ 1 risk factor (16.7%), (p = 0.014). CONCLUSIONS Patients on paKST who undergo mechanical ventilation and vasopressor treatment should be followed-up more closely. After surviving the acute period, patients on paKST need to be followed-up closely during the chronic stage. A higher resolution version of the Graphical abstract is available as Supplementary information.
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Affiliation(s)
- Ömer Nazım Gülçek
- Faculty of Medicine, Department of Pediatrics, Hacettepe University, Ankara, Türkiye
| | - Bora Gülhan
- Faculty of Medicine, Department of Pediatrics, Division of Pediatric Nephrology, Hacettepe University, Sihhiye, Ankara, Türkiye.
| | - Selman Kesici
- Faculty of Medicine, Department of Pediatrics, Division of Pediatric Intensive Care Medicine, Life Support Center, Hacettepe University, Ankara, Türkiye
| | - Eda Didem Kurt Şükür
- Faculty of Medicine, Department of Pediatrics, Division of Pediatric Nephrology, Hacettepe University, Sihhiye, Ankara, Türkiye
| | - Mutlu Hayran
- Department of Preventive Oncology, Hacettepe University, Ankara, Türkiye
| | - Fatih Ozaltin
- Faculty of Medicine, Department of Pediatrics, Division of Pediatric Nephrology, Hacettepe University, Sihhiye, Ankara, Türkiye
- Nephrogenetics Laboratory, Division of Pediatric Nephrology, Department of Pediatrics, Hacettepe University, Ankara, Türkiye
- Department of Bioinformatics, Institute of Health Sciences, Hacettepe University, Ankara, 06100, Türkiye
| | - Ali Duzova
- Faculty of Medicine, Department of Pediatrics, Division of Pediatric Nephrology, Hacettepe University, Sihhiye, Ankara, Türkiye
| | - Benan Bayrakçı
- Faculty of Medicine, Department of Pediatrics, Division of Pediatric Intensive Care Medicine, Life Support Center, Hacettepe University, Ankara, Türkiye
| | - Rezan Topaloglu
- Faculty of Medicine, Department of Pediatrics, Division of Pediatric Nephrology, Hacettepe University, Sihhiye, Ankara, Türkiye
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Mut M, Adiguzel Z, Cakir-Aktas C, Hanalioğlu Ş, Gungor-Topcu G, Kiyga E, Isikay I, Sarac A, Soylemezoglu F, Strobel T, Ampudia-Mesias E, Cameron C, Aslan T, Tekirdas E, Hayran M, Oguz KK, Henzler C, Saydam N, Saydam O. Extracellular-Vesicle-Based Cancer Panels Diagnose Glioblastomas with High Sensitivity and Specificity. Cancers (Basel) 2023; 15:3782. [PMID: 37568598 PMCID: PMC10417317 DOI: 10.3390/cancers15153782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 07/21/2023] [Accepted: 07/24/2023] [Indexed: 08/13/2023] Open
Abstract
Glioblastoma is one of the most devastating neoplasms of the central nervous system. This study focused on the development of serum extracellular vesicle (EV)-based glioblastoma tumor marker panels that can be used in a clinic to diagnose glioblastomas and to monitor tumor burden, progression, and regression in response to treatment. RNA sequencing studies were performed using RNA isolated from serum EVs from both patients (n = 85) and control donors (n = 31). RNA sequencing results for preoperative glioblastoma EVs compared to control EVs revealed 569 differentially expressed genes (DEGs, 2XFC, FDR < 0.05). By using these DEGs, we developed serum-EV-based biomarker panels for the following glioblastomas: wild-type IDH1 (96% sensitivity/80% specificity), MGMT promoter methylation (91% sensitivity/73% specificity), p53 gene mutation (100% sensitivity/89% specificity), and TERT promoter mutation (89% sensitivity/100% specificity). This is the first study showing that serum-EV-based biomarker panels can be used to diagnose glioblastomas with a high sensitivity and specificity.
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Affiliation(s)
- Melike Mut
- Department of Neurosurgery, Faculty of Medicine, Hacettepe University, Ankara 06230, Turkey; (Ş.H.); (I.I.); (T.A.); (E.T.)
- Institute of Neurological Sciences and Psychiatry, Hacettepe University, Ankara 06230, Turkey;
| | - Zelal Adiguzel
- TUBİTAK, GEBI, Gebze, Kocaeli 41470, Turkey; (Z.A.); (G.G.-T.); (E.K.); (A.S.)
- Faculty of Medicine KUTTAM, Koç University, Davutpaşa Street No. 4 Topkapi, Istanbul 34010, Turkey
| | - Canan Cakir-Aktas
- Institute of Neurological Sciences and Psychiatry, Hacettepe University, Ankara 06230, Turkey;
| | - Şahin Hanalioğlu
- Department of Neurosurgery, Faculty of Medicine, Hacettepe University, Ankara 06230, Turkey; (Ş.H.); (I.I.); (T.A.); (E.T.)
| | - Gamze Gungor-Topcu
- TUBİTAK, GEBI, Gebze, Kocaeli 41470, Turkey; (Z.A.); (G.G.-T.); (E.K.); (A.S.)
| | - Ezgi Kiyga
- TUBİTAK, GEBI, Gebze, Kocaeli 41470, Turkey; (Z.A.); (G.G.-T.); (E.K.); (A.S.)
| | - Ilkay Isikay
- Department of Neurosurgery, Faculty of Medicine, Hacettepe University, Ankara 06230, Turkey; (Ş.H.); (I.I.); (T.A.); (E.T.)
| | - Aydan Sarac
- TUBİTAK, GEBI, Gebze, Kocaeli 41470, Turkey; (Z.A.); (G.G.-T.); (E.K.); (A.S.)
| | - Figen Soylemezoglu
- Department of Pathology, Faculty of Medicine, Hacettepe University, Ankara 06230, Turkey;
| | - Thomas Strobel
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, 1090 Vienna, Austria;
| | - Elisabet Ampudia-Mesias
- Division of Hematology and Oncology, Department of Pediatrics, Medical School, University of Minnesota, Minneapolis, MN 55455, USA; (E.A.-M.); (C.C.)
| | - Charles Cameron
- Division of Hematology and Oncology, Department of Pediatrics, Medical School, University of Minnesota, Minneapolis, MN 55455, USA; (E.A.-M.); (C.C.)
| | - Tulay Aslan
- Department of Neurosurgery, Faculty of Medicine, Hacettepe University, Ankara 06230, Turkey; (Ş.H.); (I.I.); (T.A.); (E.T.)
| | - Eray Tekirdas
- Department of Neurosurgery, Faculty of Medicine, Hacettepe University, Ankara 06230, Turkey; (Ş.H.); (I.I.); (T.A.); (E.T.)
| | - Mutlu Hayran
- Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara 06230, Turkey;
| | - Kader Karli Oguz
- Department of Radiology, Faculty of Medicine, Hacettepe University, Ankara 06230, Turkey;
| | - Christine Henzler
- Minnesota Supercomputing Institute, University of Minnesota, Minneapolis, MN 55455, USA;
| | | | - Okay Saydam
- Division of Hematology and Oncology, Department of Pediatrics, Medical School, University of Minnesota, Minneapolis, MN 55455, USA; (E.A.-M.); (C.C.)
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Tutal O, Gulhan B, Atayar E, Yuksel S, Ozcakar ZB, Soylemezoglu O, Saygili S, Caliskan S, Inozu M, Baskin E, Duzova A, Hayran M, Topaloglu R, Ozaltin F. The Clinical and Mutational Spectrum of 69 Turkish Children with Autosomal Recessive or Autosomal Dominant Polycystic Kidney Disease: A Multicenter Retrospective Cohort Study. Nephron Clin Pract 2023; 148:319-332. [PMID: 36657418 DOI: 10.1159/000528258] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 11/11/2022] [Indexed: 01/20/2023] Open
Abstract
INTRODUCTION Autosomal recessive polycystic kidney disease (ARPKD) is associated with pathogenic variants in the PKHD1 gene. Autosomal dominant polycystic kidney disease (ADPKD) is mainly associated with pathogenic variants in PKD1 or PKD2. The present study aimed to identify the clinical and genetic features of Turkish pediatric ARPKD and ADPKD patients. METHODS This multicenter, retrospective cohort study included 21 genetically confirmed ARPKD and 48 genetically confirmed ADPKD patients from 7 pediatric nephrology centers. Demographic features, clinical, and laboratory findings at presentation and during 12-month intervals were recorded. RESULTS The median age of the ARPKD patients at diagnosis was lower than the median age of ADPKD patients (10.5 months [range: 0-15 years] vs. 5.2 years [range: 0.1-16 years], respectively, [p = 0.014]). At the time of diagnosis, the median eGFR in the ARPKD patients was lower compared to that of ADPKD patients (81.6 [IQR: 28.7-110.5] mL/min/1.73 m2 and 118 [IQR: 91.2-139.8] mL/min/1.73 m2, respectively, [p = 0.0001]). In total, 11 (52.4%) ARPKD patients had malnutrition; 7 (33.3%) patients had growth retardation at presentation; and 4 (19%) patients had both malnutrition and growth retardation. At diagnosis, 8 (16.7%) of the ADPKD patients had malnutrition, and 5 (10.4%) patients had growth retardation. The malnutrition, growth retardation, and hypertension rates at diagnosis were higher in the ARPKD patients than the ADPKD patients (p = 0.002, p = 0.02, and p = 0.0001, respectively). ARPKD patients with malnutrition and growth retardation had worse renal survival compared to the patients without (p = 0.03 and p = 0.01). Similarly, ADPKD patients with malnutrition had worse renal survival compared to the patients without (p = 0.002). ARPKD patients with truncating variants had poorer 3- and 6-year renal outcome than those carrying non-truncating variants (p = 0.017). CONCLUSION Based on renal survival analysis, type of genetic variant, growth retardation, and/or malnutrition at presentation were observed to be factors associated with progression to chronic kidney disease (CKD). Differentiation of ARPKD and ADPKD, and identification of the predictors of the development of CKD are vital for optimal management of patients with ARPKD or ADPKD.
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Affiliation(s)
- Ozum Tutal
- Department of Pediatrics, Hacettepe University, Ankara, Turkey
| | - Bora Gulhan
- Division of Pediatric Nephrology, Department of Pediatrics, Hacettepe University, Ankara, Turkey
| | - Emine Atayar
- Nephrogenetics Laboratory, Division of Pediatric Nephrology, Department of Pediatrics Hacettepe University, Ankara, Turkey
| | - Selcuk Yuksel
- Division of Pediatric Nephrology, Department of Pediatrics, Pamukkale University, Denizli, Turkey
| | - Z Birsin Ozcakar
- Division of Pediatric Nephrology, Department of Pediatrics, Ankara University, Ankara, Turkey
| | - Oguz Soylemezoglu
- Division of Pediatric Nephrology, Department of Pediatrics, Gazi University, Ankara, Turkey
| | - Seha Saygili
- Division of Pediatric Nephrology, Department of Pediatrics, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Salim Caliskan
- Division of Pediatric Nephrology, Department of Pediatrics, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Mihriban Inozu
- Department of Pediatric Nephrology, Ankara City Hospital, Bilkent, Ankara, Turkey
| | - Esra Baskin
- Division of Pediatric Nephrology, Department of Pediatrics, Baskent University, Ankara, Turkey
| | - Ali Duzova
- Division of Pediatric Nephrology, Department of Pediatrics, Hacettepe University, Ankara, Turkey
| | - Mutlu Hayran
- Department of Preventive Oncology, Hacettepe University, Ankara, Turkey
| | - Rezan Topaloglu
- Division of Pediatric Nephrology, Department of Pediatrics, Hacettepe University, Ankara, Turkey
| | - Fatih Ozaltin
- Division of Pediatric Nephrology, Department of Pediatrics, Hacettepe University, Ankara, Turkey
- Nephrogenetics Laboratory, Division of Pediatric Nephrology, Department of Pediatrics Hacettepe University, Ankara, Turkey
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Özdemir G, Gülhan B, Kurt-Şükür ED, Atayar E, Atan R, Dursun İ, Özçakar ZB, Saygılı S, Soylu A, Söylemezoğlu O, Yılmaz A, Bayazıt AK, Kara Eroğlu F, Kasap Demir B, Yüksel S, Tabel Y, Ağbaş A, Düzova A, Hayran M, Özaltın F, Topaloğlu R. The outcomes of renin-angiotensin-aldosterone system inhibition and immunosuppressive therapy in children with X-linked Alport syndrome. Turk J Pediatr 2023; 65:456-468. [PMID: 37395965 DOI: 10.24953/turkjped.2022.735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
BACKGROUND Alport syndrome (AS) is characterized by progressive kidney disease. There is increasing evidence that renin-angiotensin-aldosterone system (RAAS) inhibition delays chronic kidney disease (CKD) while the effectiveness of immunosuppressive (IS) therapy in AS is still uncertain. In this study, we aimed to analyze the outcomes of pediatric patients with X-linked AS (XLAS) who received RAAS inhibitors and IS therapy. METHODS Seventy-four children with XLAS were included in this multicenter study. Demographic features, clinical and laboratory data, treatments, histopathological examinations, and genetic analyses were analyzed retrospectively. RESULTS Among 74 children, 52 (70.2%) received RAAS inhibitors, 11 (14.9%) received RAAS inhibitors and IS, and 11 (14.9%) were followed up without treatment. During follow-up, glomerular filtration rate (GFR) decreased < 60 ml/min/1.73 m2 in 7 (9.5%) of 74 patients (M/F=6/1). In male patients with XLAS, kidney survival was not different between RAAS and RAAS+IS groups (p=0.42). The rate of progression to CKD was significantly higher in patients with nephrotic range proteinuria and nephrotic syndrome (NS), respectively (p=0.006, p=0.05). The median age at the onset of RAAS inhibitors was significantly higher in male patients who progressed to CKD (13.9 vs 8.1 years, p=0.003). CONCLUSIONS RAAS inhibitors have beneficial effects on proteinuria and early initiation of therapy may delay the progression to CKD in children with XLAS. There was no significant difference between the RAAS and RAAS+IS groups in kidney survival. AS patients presenting with NS or nephrotic range proteinuria should be followed up more carefully considering the risk of early progression to CKD.
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Affiliation(s)
- Gülşah Özdemir
- Division of Pediatric Nephrology, Hacettepe University Faculty of Medicine, Ankara
| | - Bora Gülhan
- Division of Pediatric Nephrology, Hacettepe University Faculty of Medicine, Ankara
| | - Eda Didem Kurt-Şükür
- Division of Pediatric Nephrology, Hacettepe University Faculty of Medicine, Ankara
| | - Emine Atayar
- Division of Pediatric Nephrology, Nephrogenetics Laboratory, Hacettepe University Faculty of Medicine, Ankara
| | - Raziye Atan
- Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara
| | - İsmail Dursun
- Division of Pediatric Nephrology, Erciyes University Faculty of Medicine, Kayseri
| | | | - Seha Saygılı
- Division of Pediatric Nephrology, İstanbul University Cerrahpaşa Faculty of Medicine, İstanbul
| | - Alper Soylu
- Division of Pediatric Nephrology, Dokuz Eylül University Faculty of Medicine, İzmir
| | - Oğuz Söylemezoğlu
- Division of Pediatric Nephrology, Gazi University Faculty of Medicine, Ankara
| | - Alev Yılmaz
- Division of Pediatric Nephrology, İstanbul University Çapa Faculty of Medicine, Istanbul
| | | | - Fehime Kara Eroğlu
- Division of Pediatric Nephrology, Dr. Sami Ulus Maternity and Children's Health Hospital, Ankara
| | - Belde Kasap Demir
- Division of Pediatric Nephrology, İzmir Katip Çelebi University, Tepecik Research and Training Hospital, İzmir
| | - Selçuk Yüksel
- Division of Pediatric Nephrology, Pamukkale University Faculty of Medicine, Denizli
| | - Yılmaz Tabel
- Division of Pediatric Nephrology, İnönü University Faculty of Medicine, Malatya
| | - Ayşe Ağbaş
- Division of Pediatric Nephrology, Haseki Training and Research Hospital, İstanbul
| | - Ali Düzova
- Division of Pediatric Nephrology, Hacettepe University Faculty of Medicine, Ankara
| | - Mutlu Hayran
- Department of Preventive Oncology, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Fatih Özaltın
- Division of Pediatric Nephrology, Hacettepe University Faculty of Medicine, Ankara
| | - Rezan Topaloğlu
- Division of Pediatric Nephrology, Hacettepe University Faculty of Medicine, Ankara
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Kalyoncu U, Kasifoglu T, Omma A, Bes C, Cinar M, Emmungil H, Kucuksahin O, Akar S, Aksu K, Yildiz F, Kanitez NA, Erden A, Bilgin E, Dalkilic E, Ermurat S, Hayran M. Derivation and validation of adult Still Activity Score (SAS). Joint Bone Spine 2023; 90:105499. [PMID: 36423781 DOI: 10.1016/j.jbspin.2022.105499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 10/30/2022] [Accepted: 11/07/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Adult-onset Still's disease (AOSD) is a multi-systemic, autoinflammatory disorder. Several activity scores have been proposed but none of them have been adopted universally. Our aim was to create a clinician-friendly activity scoring system by using simple clinical and laboratory parameters. METHODS AODS patients, according to Yamaguchi criteria, were included in this cross-sectional, multicenter study. Derivation and validation cohorts were constituted. Demographic, clinical, and laboratory evaluation at the study visit; patients' and physicians' global assessments of disease activity (both VAS/Likert scale) were recorded. To develop the score, an ordinal logistic regression model was used to determine independent predictors of physicians' global assessments of disease activity. Clinically and statistically significant variables were weighted according to regression coefficients. Then, performance of the score was tested on the validation cohort. RESULTS A total of 197 consecutive AOSD patients (125 in derivation, 72 in validation cohorts) were included. Final Still Activity Score was fever (2 points), arthralgia (2 points, plus 1 point if arthritis was present in≥2 joints), neutrophilia≥65% (1 point) and ferritin≥350ng/mL (1 point) (maximum of 7 points). The SAS yielded an AUC value of 0.98 (0.96-1.00) in the derivation cohort and 0.91 (95%CI: 0.85-0.98) in the validation cohort to discriminate high AOSD activity from moderate-inactive AOSD. The correlation of SAS with PGA was 83% for the derivation cohort and 76% for the validation cohort. CONCLUSIONS SAS has shown a good test performance to distinguish active AOSD patients from others. SAS may be a useful method for evaluating the disease activity of AOSD patients in daily practice.
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Affiliation(s)
- Umut Kalyoncu
- Hacettepe University Medical School Internal Medicine, Rheumatology, Ankara, Turkey
| | - Timuçin Kasifoglu
- Eskişehir Osmangazi University Faculty of Medicine, Rheumatology, Eskişehir, Turkey
| | - Ahmet Omma
- Ankara City Hospital, Rheumatology, Ankara, Turkey
| | - Cemal Bes
- University of Health Sciences, Bakırköy Sadi Konuk Research and Training Hospital, Rheumatology, İstanbul, Turkey
| | - Muhammet Cinar
- Gulhane Training and Research Hospital, Rheumatology, Ankara, Turkey
| | - Hakan Emmungil
- Trakya University Medical School, Rheumatology, Edirne, Turkey
| | | | - Servet Akar
- Izmir Katip Çelebi University, Rheumatology, İzmir, Turkey
| | - Kenan Aksu
- Ege University Medical Faculty, Rheumatology, İzmir, Turkey
| | - Fatih Yildiz
- Van Research and Training Hospital, Rheumatology, Van, Turkey
| | | | - Abdulsamet Erden
- Hacettepe University Medical School Internal Medicine, Rheumatology, Ankara, Turkey
| | - Emre Bilgin
- Hacettepe University Medical School Internal Medicine, Rheumatology, Ankara, Turkey.
| | - Ediz Dalkilic
- Uludağ University Medical School, Rheumatology, Bursa, Turkey
| | - Selime Ermurat
- Uludağ University Medical School, Rheumatology, Bursa, Turkey
| | - Mutlu Hayran
- Hacettepe University Medical School, Preventive Oncology, Ankara, Turkey
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Kansu E, Ward D, Sanchez AP, Cunard R, Hayran M, Huseyin B, Vaughan M, Ku G, Curtin P, Mulroney C, Costello C, Castro JE, Wieduwilt M, Corringham S, Ihasz-Davis A, Nelson C, Ball ED. Extracorporeal photopheresis for the treatment of chronic graft versus host disease. Hematology 2022; 27:785-794. [PMID: 35802815 DOI: 10.1080/16078454.2022.2095884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Chronic graft versus host disease (chronic GVHD) still remains the leading cause of late morbidity and mortality for allogeneic hematopoietic stem cell transplant (allo-HSCT) recipients. In this retrospective study, 53 consecutive allo-HSCT patients with chronic GVHD refractory to corticosteroids were treated with extracorporeal photopheresis (ECP). METHODS This study was performed as a retrospective single-center study. Medical records of a total of 59 patients treated with ECP for chronic GVHD were reviewed. RESULTS Best organ responses to ECP were observed in skin, mouth mucosa, eyes and liver. Overall response rate (ORR) to ECP was 81.2% (CR 17% and PR 64.2%). Overall survival (OS) was 84.9% and 36.7%, at 1 and 3 years, respectively. Female sex appears to have an advantage on ORR. Patients achieving ORR were able to maintain their responses with a prolonged continuation of treatments for +6 and +12 months indicating the benefits of longer ECP treatment. DISCUSSION We found that patients with chronic GVHD who were treated with ECP for 12 months or longer had a higher response rate. Our findings in line with the data reported previously suggest that patients responding to ECP should continue longer therapy schedules to achieve a better and sustained response. In our cohort, long-term ECP therapy was safe and well-tolerated with no significant adverse effects. Best responses were observed in the patients with skin, eye, liver and oral involvement. The ECP procedure offers the advantage relative to the problems with typical immunosuppressive agents. The female sex appeared to have an advantage based on the cumulative probability of the OR after ECP for chronic GVHD.
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Affiliation(s)
- Emin Kansu
- Hacettepe University Cancer Institute, Ankara, Turkey
| | - David Ward
- Division of Nephrology and Hypertension, Apheresis Unit, University of California San Diego Health, La Jolla, CA, USA
| | - Amber P Sanchez
- Division of Nephrology and Hypertension, Apheresis Unit, University of California San Diego Health, La Jolla, CA, USA
| | - Robyn Cunard
- Division of Nephrology and Hypertension, Apheresis Unit, University of California San Diego Health, La Jolla, CA, USA
| | - Mutlu Hayran
- Hacettepe University Cancer Institute, Ankara, Turkey
| | - Beril Huseyin
- Hacettepe University Cancer Institute, Ankara, Turkey
| | - Majella Vaughan
- Division of Blood and Marrow Transplantation, Moores Cancer Center, University of California San Diego Health, La Jolla, CA, USA
| | - Grace Ku
- Genentech, Inc. South San Francisco, CA, USA
| | | | - Carolyn Mulroney
- Division of Blood and Marrow Transplantation, Moores Cancer Center, University of California San Diego Health, La Jolla, CA, USA
| | - Caitlin Costello
- Division of Blood and Marrow Transplantation, Moores Cancer Center, University of California San Diego Health, La Jolla, CA, USA
| | | | - Matthew Wieduwilt
- Division of Blood and Marrow Transplantation, Moores Cancer Center, University of California San Diego Health, La Jolla, CA, USA
| | - Sue Corringham
- Division of Blood and Marrow Transplantation, Moores Cancer Center, University of California San Diego Health, La Jolla, CA, USA
| | - Anita Ihasz-Davis
- Division of Blood and Marrow Transplantation, Moores Cancer Center, University of California San Diego Health, La Jolla, CA, USA
| | - Connie Nelson
- Division of Blood and Marrow Transplantation, Moores Cancer Center, University of California San Diego Health, La Jolla, CA, USA
| | - Edward D Ball
- Division of Blood and Marrow Transplantation, Moores Cancer Center, University of California San Diego Health, La Jolla, CA, USA
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9
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Erçakmak Güneş B, Ilgaz HB, Çiledağ N, Özsoy H, Hayran M, Demiryürek D. Estimating the optimal entry point of the antegrade femoral nailing: Previous and novel morphometric measurements. Acta Orthop Traumatol Turc 2022; 56:81-87. [PMID: 35416157 DOI: 10.5152/j.aott.2022.21107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE This anatomical study aimed to investigate the possible relationships between the proximal femur parameters and verify the optimal entry point in line with the medullary canal. METHODS Both in single image series and 3D-MPR views, 63 femur bones were evaluated. One-millimeter multidetector computed tomography scans were collected and assessed by OsiriX-Lite version 8 and Horos v3.3.5. Entry point locations, projected and true femoral neck-shaft, anteversion, and newly defined nail entrance angles were measured. RESULTS The entry points of 16 femurs were placed at the tip of the greater trochanter, and the remaining 47 femurs were in the trochanteric fossa (i.e., piriformis fossa). Thirty-three of the entry points found in the trochanteric fossa were overlapped by the greater trochanter. When the parameters of the right and left sides were compared, it was found that; projected neck angle, nail entrance angle, and the differences between true neck angle and nail entrance angle were found significantly different. The relationship between nail entrance angle and entry point localization was assessed, and the probability of the entry point being at the tip of the greater trochanter is 63 times greater when the NEA is below 90. CONCLUSION This study has demonstrated that the ideal entry point for straight nails, which is based on the anatomic axis of the femur, is found mainly at the trochanteric fossa, and the greater trochanter overlapped 70.21% of them. LEVEL OF EVIDENCE Level IV, Diagnostic Study.
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Affiliation(s)
| | - Hasan Barış Ilgaz
- Department of Anatomy, Hacettepe University, School of Medicine, Ankara, Turkey
| | - Nazan Çiledağ
- Clinic of Radiology, Abdurrahman Yurtaslan Oncology Hospital, Ankara, Turkey
| | - Hakan Özsoy
- Clinic of Orthopaedic and Traumatology, Memorial Hospital, Ankara, Turkey
| | - Mutlu Hayran
- Department of Preventive Oncology, Hacettepe University, School of Medicine, Ankara, Turkey
| | - Deniz Demiryürek
- Department of Anatomy, Hacettepe University, School of Medicine, Ankara, Turkey
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10
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Yalın İmamoğlu E, Hayran M, Mahir Kayıran S, Zeybek G, Sevük Özümüt S, Karatekin G, Ovalı F, Gürsoy T. Birth Weight Reference Percentiles by Gestational Age for Turkish Twin Neonates. Turk Arch Pediatr 2022; 56:316-321. [PMID: 35005724 PMCID: PMC8655957 DOI: 10.5152/turkarchpediatr.2021.20259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 01/21/2021] [Indexed: 01/27/2023]
Abstract
Aims: In clinical practice, birth weight reference percentiles for singletons are used to evaluate twin births. The utilization of singleton reference percentiles for twins is not appropriate as they experience different growth trajectories. However, Turkey still lacks such references. Our aim was to create gestational age-specific birth weight references for female and male Turkish twins. Materials and Methods: This is a hospital-based, multi-centered, retrospective study. In total, 2544 live-born twins between 2010 and 2019 were included in the study. Gestational age, birth weight, mode of delivery, gender, birth order, chorionicity, maternal age, pregnancy resulting from assisted reproduction techniques, APGAR (Appearance, Pulse, Grimace, Activity, and Respiration) score at 5 minutes, admission to the neonatal intensive care unit (NICU), length of stay in NICU, and death during the NICU stay were recorded. Results: Smoothed reference curves for birth weight by gestational age and separate tables for female and male twin neonates for the 3rd, 10th, 50th, 90th, and 97th percentiles from 26 to 39 weeks of gestational age were constructed. Overall neonatal and infant mortality rates during NICU stay in our twin cohort were 12/1000 and 16/1000, respectively. Conclusion: Twin-specific birth weight nomograms could be helpful as a reference for clinicians to identify high-risk neonates and fetuses who need specialized care. However, further studies with larger series are urgently needed for validation and use of these nomograms in clinical practice.
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Affiliation(s)
- Ebru Yalın İmamoğlu
- Department of Neonatology, Goztepe Training and Research Hospital, SB Istanbul Medeniyet University, Istanbul, Turkey
| | - Mutlu Hayran
- Department of Preventive Oncology, Institute of Oncology, Hacettepe University, Ankara, Turkey
| | | | - Gözde Zeybek
- Department of Pediatrics, Sancaktepe Şehit Prof. Dr. İlhan Varank Education and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Sibel Sevük Özümüt
- Department of Neonatology, Goztepe Training and Research Hospital, SB Istanbul Medeniyet University, Istanbul, Turkey
| | - Güner Karatekin
- Neonatal Intensive Care Unit, Zeynep Kamil Maternity and Children Training and Research Hospital, Istanbul, Turkey
| | - Fahri Ovalı
- Department of Neonatology, Goztepe Training and Research Hospital, SB Istanbul Medeniyet University, Istanbul, Turkey
| | - Tuğba Gürsoy
- Department of Pediatrics, Koç University School of Medicine, Istanbul, Turkey
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11
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Eraktas İ, Ayhan C, Hayran M, Soylu AR. Alterations in forearm muscle activation patterns after scapholunate interosseous ligament injury: A dynamic electromyography study. J Hand Ther 2021; 34:384-395. [PMID: 32620427 DOI: 10.1016/j.jht.2020.03.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 02/26/2020] [Accepted: 03/16/2020] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Case control. PURPOSE OF THE STUDY This study aimed to investigate the alterations seen in the activation patterns of the forearm muscles and to demonstrate the associated functional outcomes, in patients with scapholunate interosseous ligament (SLIL) injury. METHODS The study involved 15 patients with SLIL injury (instability group) and 11 healthy participants (control group). Both groups were evaluated with regard to their pain, grip strength, and upper extremity functional level (disabilities of the arm, shoulder and hand and patient-rated wrist evaluation questionnaires), and they also underwent a dynamic electromyography analysis of their forearm muscle activity. The activation patterns of the extensor carpi ulnaris (ECU), extensor carpi radialis (ECR), flexor carpi ulnaris, and flexor carpi radialis muscles during wrist extension and flexion were recorded by means of surface electromyography. RESULTS In the instability group, the pain severity was higher and the functional level was worse than in the control group (P < .05). Furthermore, during wrist extension, the ECR activity was lower and the ECU activity was higher in the instability group than in the control group (P < .05). CONCLUSION Dynamic stabilization of the wrist, flexor carpi ulnaris, and flexor carpi radialis muscles have been shown to play an active role with ECU and ECR. Increased ECU and decreased ECR activation may pose a potential risk in terms of enhancing the scapholunate gap. We, therefore, propose that appropriate preventive neuromuscular exercise strategies implemented as part of a physiotherapy program for patients with SLIL lesions might increase the contribution of the dynamic stability effect of the relevant muscles.
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Affiliation(s)
- İrem Eraktas
- Bolu Physical Therapy and Rehabilitation Hospital, Bolu, Turkey
| | - Cigdem Ayhan
- Faculty of Health Science, Department of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey.
| | - Mutlu Hayran
- School of Medicine, Department of Preventive Oncology, Hacettepe University, Ankara, Turkey
| | - Abdullah Ruhi Soylu
- School of Medicine, Department of Biophysics, Hacettepe University, Ankara, Turkey
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12
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Çetinkaya PG, Gülhan B, Düzova A, Beşbaş N, Hayran M, Topaloğlu R, Özaltın F. Clinical characteristics of children with congenital anomalies of the kidney and urinary tract and predictive factors of chronic kidney disease. Turk J Pediatr 2021; 62:746-755. [PMID: 33108076 DOI: 10.24953/turkjped.2020.05.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Congenital anomalies of kidney and urinary tract (CAKUT) are the leading causes of chronic kidney disease (CKD) in childhood. Determining the clinical course, outcome, and prognostic factors of this heterogeneous disease group is important to provide appropriate management and follow-up. Therefore, we aimed to identify the risk factors of CKD in CAKUT and the differences in clinical courses between disease subgroups. METHODS Three hundred patients (M/F: 203/97) divided into 16 CAKUT categories were enrolled in the study. Logistic regression and survival analyses were performed to determine the risk factors for CKD that is defined as estimated GFR (eGFR) lower than 90 ml/min/1.73 m2 for at least 6 months. RESULTS The median age of the study population at the time of the diagnosis was 0.6 years (IQR; 0.1-4.0 years). Among available prenatal diagnoses (n= 138), hydronephrosis (HN) (n= 83; 60.1%) and multicystic dysplastic kidney (MCDK) (n= 39; 28.2%) were the most frequently encountered ones. A total of 24 patients had CKD, and 13 of them (54.1%) progressed to end stage renal disease (ESRD). Patients with posterior urethral valve (PUV) had CKD and ESRD more frequently when compared to the other diagnostic groups (p < 0.001 for CKD, and p < 0.001 for ESRD). Furthermore, the PUV subgroup progressed to ESRD (median 3.63 years) earlier than the other subgroups. The diagnosis of PUV, proteinuria on the first admission, vesicoureteral reflux, and oligohydramnios were identified as independent predictors for CKD in the multivariate logistic regression analysis. CONCLUSIONS Knowing predictive factors for CKD in patients with CAKUT is valuable for physicians in order to determine appropriate treatment strategies and prognosis.
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Affiliation(s)
- Pınar Gür Çetinkaya
- Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Bora Gülhan
- Division of Pediatric Nephrology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ali Düzova
- Division of Pediatric Nephrology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Nesrin Beşbaş
- Division of Pediatric Nephrology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Mutlu Hayran
- Department of Preventive Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Rezan Topaloğlu
- Division of Pediatric Nephrology, Hacettepe University Faculty of Medicine, Ankara, Turkey
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13
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Tutal O, Gulhan B, Atayar E, Yuksel S, Ozcakar ZB, Soylemezoglu O, Saygili S, Inozu M, Baskin E, Duzova A, Hayran M, Topaloglu R, Ozaltin F. MO026CLINICAL AND MUTATIONAL SPECTRUM OF CHILDREN WITH AUTOSOMAL RECESSIVE AND AUTOSOMAL DOMINANT POLYCYSTIC KIDNEY DISEASE. Nephrol Dial Transplant 2021. [DOI: 10.1093/ndt/gfab081.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background and Aims
Cystic kidney diseases are a heterogeneous group of chronic renal disease. Autosomal recessive polycystic kidney disease (ARPKD) is generally diagnosed in utero or at birth due to mutations in PKHD1 gene. Autosomal dominant polycystic kidney disease (ADPKD) is the most common inherited kidney disease commonly associated with mutations in PKD1 or PKD2. In this study, we aimed to investigate clinical and genetic features of ARPKD and ADPKD in a group of Turkish patients.
Method
A total of 69 children with genetically confirmed ARPKD (10 females, 11 males) or ADPKD (28 females, 20 males) from seven pediatric nephrology centers were included in this study. Demographic features, family history, clinical and laboratory findings at presentation and during 12 months intervals were collected.
Results
For ARPKD patients, the median age at diagnosis was 10.5 (IQR; 0.75-58.5) months. Consanguinity between parents was present in 11 patients (52.4%). At the time of diagnosis, 14 (66.7%) patients had eGFR<90 ml/min/1.73 m2. Mean duration of follow-up was 4.1±3,7 years. At the last visit, median eGFR was 74 (IQR; 43-126) ml/min/1.73m2. A total of 6 patients (28,6%) underwent a renal replacement therapy (RRT), 3 of them died in infancy and 2 of them had renal transplantation during follow up. All patients had bi-allelic PKHD1 mutation.
For ADPKD patients, the mean age at diagnosis was 5.5±4.6 years. At the time of diagnosis 11 (22.9%) patients had eGFR<90 ml/min/1.73m2. Mean duration of follow-up was 2,7±2.3 years. At the last visit, median eGFR was 114 (IQR; 98-135) ml/min/1.73m2. Only one patient underwent a renal transplantation. A total of 42 patients (87.5%) had a heterozygous PKD1 mutation while 6 (12.5%) had a heterozygous PKD2 mutation. The rate of growth retardation, hypertension at diagnosis and progression to chronic kidney disease (CKD) were higher in patients with PKHD1 mutation than the patients with PKD1 or PKD2 mutation (p < 0.001, p < 0.001 and p = 0.001, respectively). In kidney survival analysis, mutation type, growth retardation at presentation, increased renal echogenity in ultrasonography were found as independent risk factors for progression to CKD.
Conclusion
Cystic kidney diseases are one of the most clinically and genetically heterogenous diseases. Differentiating them and establishing the predictors for CKD development is important to provide appropriate management including choosing appropriate donor in renal transplantation.
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Affiliation(s)
- Ozum Tutal
- Hacettepe University Faculty of Medicine, Department of Pediatrics, Ankara, Turkey
| | - Bora Gulhan
- Hacettepe University Faculty of Medicine, Division of Pediatric Nephrology, Ankara, Turkey
| | - Emine Atayar
- Hacettepe University Faculty of Medicine, Division of Pediatric Nephrology, Nephrogenetics Laboratory, Ankara, Turkey
| | - Selcuk Yuksel
- Pamukkale University Faculty of Medicine, Division of Pediatric Nephrology, Denizli, Turkey
| | - Z Birsin Ozcakar
- Ankara University Faculty of Medicine, Division of Pediatric Nephrology, Ankara, Turkey
| | - Oguz Soylemezoglu
- Gazi University Faculty of Medicine, Division of Pediatric Nephrology, Ankara, Turkey
| | - Seha Saygili
- Istanbul University Cerrahpasa Faculty of Medicine, Division of Pediatric Nephrology, Istanbul, Turkey
| | - Mihriban Inozu
- Ankara City Hospital, Division of Pediatric Nephrology, Ankara, Turkey
| | - Esra Baskin
- Baskent University Faculty of Medicine, Division of Pediatric Nephrology, Ankara, Turkey
| | - Ali Duzova
- Hacettepe University Faculty of Medicine, Division of Pediatric Nephrology, Ankara, Turkey
| | - Mutlu Hayran
- Hacettepe University Faculty of Medicine, Department of Preventive Oncology, Ankara, Turkey
| | - Rezan Topaloglu
- Hacettepe University Faculty of Medicine, Division of Pediatric Nephrology, Ankara, Turkey
| | - Fatih Ozaltin
- Hacettepe University Faculty of Medicine, Division of Pediatric Nephrology, Ankara, Turkey
- Hacettepe University Faculty of Medicine, Division of Pediatric Nephrology, Nephrogenetics Laboratory, Ankara, Turkey
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Özdemir N, Dizdar Ö, Yazıcı O, Aksoy S, Dede DS, Budakoğlu B, Metan G, Alp A, Budakoğlu II, Öksüzoğlu ÖBÇ, Özet A, Kılıçkap S, Turhal NS, Çelik İ, Erman M, Ata N, Çelik O, Hayran M. Clinical features and outcomes of COVID-19 in patients with solid tumors: Turkish National Registry Data. Int J Cancer 2021; 148:2407-2415. [PMID: 33284987 DOI: 10.1002/ijc.33426] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 11/17/2020] [Accepted: 11/23/2020] [Indexed: 12/18/2022]
Abstract
We present demographic, clinical, laboratory characteristics and outcomes of the patients with solid malignancies and novel coronavirus disease (COVID-19) collected from the National COVID-19 Registry of Turkey. A total of 1523 patients with a current or past diagnosis of solid tumors and diagnosed with COVID-19 (confirmed with PCR) between 11 March and 20 May 2020 were included. The primary outcome was 30-day mortality. Median age was 61 (range: 18-94), and 752 (49%) were male. The most common types of cancers were breast (19.8%), prostate (10.9%) and colorectal cancer (10.8%). 65% of the patients had at least one comorbidity. At least one COVID-19-directed therapy was given in 73% of the patients.. Hospitalization rate of the patients was 56.6% and intensive care unit admission rate was 11.4%. Seventy-seven (5.1%) patients died within 30 days of diagnosis. The first multivariate model which included only the demographic and clinical characteristics showed older age, male gender and presence of diabetes and receipt of cytotoxic therapy to be associated with increased 30-day mortality, while breast and prostate cancer diagnoses were associated with lower 30-day mortality. In the second set, we further included laboratory parameters. The presence of leukocytosis (OR 6.7, 95% CI 3.3-13.7, P < .001), lymphocytopenia (OR 3,1, 95% CI 1,6-6,1, P = .001) and thrombocytopenia (OR 3,4 95% CI 1,5-8,1, P = .005) were found to be associated with increased 30-day mortality. Relatively lower mortality compared to Western countries and China mainly results from differences in baseline risk factors but may also implicate the importance of intensive supportive care.
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Affiliation(s)
- Nuriye Özdemir
- Department of Medical Oncology, Gazi University School of Medicine, Ankara, Turkey
| | - Ömer Dizdar
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Ozan Yazıcı
- Department of Medical Oncology, Gazi University School of Medicine, Ankara, Turkey
| | - Sercan Aksoy
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Didem Sener Dede
- Department of Medical Oncology, Anakar Yildirim Beyazit University School of Medicine, Ankara, Turkey
| | - Burçin Budakoğlu
- Department of Medical Oncology, Medikalpark Medical Center, Ankara, Turkey
| | - Gökhan Metan
- Department of Infectious diseases and Clinical Microbiology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Alpaslan Alp
- Department of Clinical Microbiology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Isıl Irem Budakoğlu
- Department of Medical Education and Informatics, Gazi University School of Medicine, Ankara, Turkey
| | - Ömür Berna Çakmak Öksüzoğlu
- Department of Medical Oncology, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Ahmet Özet
- Department of Medical Oncology, Gazi University School of Medicine, Ankara, Turkey
| | - Saadettin Kılıçkap
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Nazim Serdar Turhal
- Department of Medical Oncology, İstanbul Anadolu Medical Center and President of Turkish Medical Oncology Association, Istanbul, Turkey
| | - İsmail Çelik
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Mustafa Erman
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Naim Ata
- Strategy Development Department of the Ministry of Health, Ankara, Turkey
| | - Osman Çelik
- Strategy Development Department of the Ministry of Health, Ankara, Turkey
| | - Mutlu Hayran
- Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
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15
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Bayramoglu A, Erdogan K, Urhan O, Keskinoz EN, Acikel Elmas M, Hayran M, Arbak S. Hair diameter measurements for planning follicular unit extraction surgery (FUE): Is there a correlation between the micrometer caliper and scanning electron microscopy (SEM) findings? J Cosmet Dermatol 2021; 21:1086-1092. [PMID: 33905616 DOI: 10.1111/jocd.14185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/19/2021] [Accepted: 04/23/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Hair shaft diameter is one of the most important factors for the outcome of follicular unit extraction (FUE) surgery. In fact, the hair shaft is elliptical. Therefore, it has a long and short axis. Many hair transplantation surgeons use manual micrometer caliper for gauging hair diameter and use the results in the management of recipient and donor area. AIM In this study, we aimed to identify the dependability of micrometer caliper and also the hair diameter diversity pattern in the donor area. PATIENTS/METHODS Two hundred and seventy hairs were collected from three males with androgenetic alopecia. Hair samples were obtained from the 1 cm2 boxes from superior to inferior at the mid-point of temporal, parietal, and occipital donor areas. The diameter of each hair was measured both with a micrometer caliper and scanning electron microscopy (SEM). RESULTS Average diameter measured by scanning electron microscopy was 83.01 µm for the long axis and 51.51 µm for the short axis. The average value for the micrometer caliper measurement was 53.32 µm. Comparison of micrometer caliper results with the short-axis measurements of SEM revealed a strong significant correlation. The hair diameters from superior, middle, and inferior boxes revealed a tendency to decrease toward the inferior regions. CONCLUSIONS A manual micrometer caliper is a dependable tool for planning FUE surgery, and it measures the short axis of the elliptical hair shaft. Hair diameter tends to decrease toward the inferior regions of the donor area.
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Affiliation(s)
- Alp Bayramoglu
- Department of Anatomy, Faculty of Medicine, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | | | - Oguzhan Urhan
- Department of Electronics and Telecommunications Engineering, University of Kocaeli, Kocaeli, Turkey
| | - Elif Nedret Keskinoz
- Department of Anatomy, Faculty of Medicine, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Merve Acikel Elmas
- Department of Histology and Embryology, Faculty of Medicine, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Mutlu Hayran
- Preventive Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Serap Arbak
- Department of Histology and Embryology, Faculty of Medicine, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
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Esin S, Okuyan E, Gunakan E, Zengin HY, Hayran M, Tohma YA. A novel technique for prediction of preterm birth: fetal nasal flow Doppler. J Perinat Med 2021; 49:319-325. [PMID: 33180051 DOI: 10.1515/jpm-2020-0276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 10/18/2020] [Indexed: 01/20/2023]
Abstract
OBJECTIVES Absence of fetal breathing movements (FBM) has been found to be a good predictor of preterm delivery in symptomatic patients. However, analysis of FBM patterns and Doppler measurement of them for preterm birth prediction have not been performed before. In this study, we aimed to investigate and analyze FBM patterns in symptomatic preterm labor patients by fetal ultrasonography and nasal Doppler. METHODS This was a multicenter, prospective cohort study. Singleton pregnant patients between 24 and 37 gestational weeks diagnosed with preterm labor were included in the study. Patients were evaluated in three groups: no FBM (Group 1), regular FBM (Group 2), irregular FBM (Group3). RESULTS Seventy-three patients were available for the final analysis after exclusion. Preterm delivery rate in 24 h in groups were 91.7, 32.7 and 100%, respectively. The absence of FBM (Group 1) was statistically significant for preterm delivery in for both 24 (91.7 vs. 42.6%, p=0.002) and 48 h (91.7 vs. 49.2%, p=0.006) when compared with fetal breathing positive Group 2 and 3. In fetal nasal Doppler analyses in Group 2, the inspiration/expiration number rate was significantly lower in the patients who delivered in 24 h (0.98±0.2 vs. 1.25±0.57, p=0.015). By using fetal nasal Doppler, combination of absence of FBM or irregular FBM or regular FBM with inspiration number/expiration number (I/E) <1.25 detects 94.6% of patients who will eventually deliver in the first 24 h after admission. CONCLUSIONS Examining FBM patterns and using nasal Doppler may help the clinician to differentiate those who will deliver preterm and may be an invaluable tool for managing preterm labor patients.
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Affiliation(s)
- Sertac Esin
- Department of Perinatology, Baskent University School of Medicine, Ankara, Turkey
| | | | - Emre Gunakan
- Department of Perinatology, Baskent University School of Medicine, Ankara, Turkey
| | - Hatice Yagmur Zengin
- Department of Biostatistics, Baskent University School of Medicine, Ankara, Turkey
| | - Mutlu Hayran
- Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Yusuf Aytac Tohma
- Department of Obstetrics and Gynecology, Baskent University School of Medicine, Ankara, Turkey
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Ozdemir G, Gulhan B, Atayar E, Saygılı S, Soylemezoglu O, Ozcakar ZB, Eroglu FK, Candan C, Demir BK, Soylu A, Yüksel S, Alpay H, Agbas A, Duzova A, Hayran M, Ozaltin F, Topaloglu R. COL4A3 mutation is an independent risk factor for poor prognosis in children with Alport syndrome. Pediatr Nephrol 2020; 35:1941-1952. [PMID: 32394188 DOI: 10.1007/s00467-020-04574-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 04/03/2020] [Accepted: 04/07/2020] [Indexed: 01/14/2023]
Abstract
BACKGROUND Alport syndrome (AS) is an inherited glomerular disease caused by mutations in COL4A3, COL4A4, or COL4A5. Associations between clinical manifestations and genotype are not yet well defined. Our study aimed to define clinical and genetic characteristics, establish genotype-phenotype correlations, and determine prognosis of AS in children. METHODS A total of 87 children with AS from 10 pediatric nephrology centers, whom had genetic analyses performed at the Hacettepe University Nephrogenetics Laboratory between February 2017 and February 2019, were included. Data regarding demographics, family history, clinical and laboratory characteristics, histopathological and genetic test results, treatments, and yearly follow-up results were retrospectively analyzed. RESULTS Of 87 patients, 16% presented with nephrotic syndrome. In patients with nephrotic syndrome, kidney biopsy findings showed focal segmental glomerulosclerosis (FSGS) in 79%, and COL4A3 mutations were the leading genetic abnormality (50%). Twenty-four percent of all patients progressed to chronic kidney disease (CKD). The rate of progression to CKD and the decline in the glomerular filtration rate of the patients with COL4A3 mutation were higher than other mutation groups (p < 0.001 and p = 0.04, respectively). In kidney survival analysis, nephrotic syndrome presentation, histopathology of FSGS, COL4A3 mutations, and autosomal recessive inheritance were found as independent risk factors for earlier progression to CKD. Cyclosporin A treatment did not improve kidney survival. CONCLUSIONS We emphasize that genetic testing is important for patients suspected as having AS. Furthermore, COL4A mutations should be considered in patients with FSGS and steroid-resistant nephrotic syndrome. This approach will shed light on the prognosis of patients and help with definitive diagnosis, preventing unnecessary and potentially harmful medications. Graphical abstract.
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Affiliation(s)
- Gulsah Ozdemir
- Division of Pediatric Nephrology, Faculty of Medicine, Hacettepe University, 06230, Ankara, Turkey
| | - Bora Gulhan
- Division of Pediatric Nephrology, Faculty of Medicine, Hacettepe University, 06230, Ankara, Turkey
| | - Emine Atayar
- Division of Pediatric Nephrology, Nephrogenetics Laboratory, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Seha Saygılı
- Division of Pediatric Nephrology, Faculty of Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Oguz Soylemezoglu
- Division of Pediatric Nephrology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Zeynep Birsin Ozcakar
- Division of Pediatric Nephrology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Fehime Kara Eroglu
- Division of Pediatric Nephrology, Dr. Sami Ulus Maternity and Children's Health Hospital, Ankara, Turkey
| | - Cengiz Candan
- Division of Pediatric Nephrology, Göztepe Training and Research Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Belde Kasap Demir
- Division of Pediatric Nephrology, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Alper Soylu
- Division of Pediatric Nephrology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Selçuk Yüksel
- Division of Pediatric Nephrology, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Harika Alpay
- Division of Pediatric Nephrology, Faculty of Medicine, Marmara University, Istanbul, Turkey
| | - Ayse Agbas
- Division of Pediatric Nephrology, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Ali Duzova
- Division of Pediatric Nephrology, Faculty of Medicine, Hacettepe University, 06230, Ankara, Turkey
| | - Mutlu Hayran
- Department of Preventive Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Fatih Ozaltin
- Division of Pediatric Nephrology, Faculty of Medicine, Hacettepe University, 06230, Ankara, Turkey.,Division of Pediatric Nephrology, Nephrogenetics Laboratory, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Rezan Topaloglu
- Division of Pediatric Nephrology, Faculty of Medicine, Hacettepe University, 06230, Ankara, Turkey.
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18
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Ozdemir G, Gulhan B, Atayar E, Canpolat N, Soylemezoglu O, Ozcakar ZB, Kara Eroğlu F, Candan C, Kasap Demir B, Soylu A, Yuksel S, Alpay H, Agbas A, Duzova A, Hayran M, Ozaltin F, Topaloglu R. P0063CLINICAL CHARACTERISTICS OF PATIENTS WITH GENETICALLY CONFIRMED ALPORT SYNDROME. Nephrol Dial Transplant 2020. [DOI: 10.1093/ndt/gfaa142.p0063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background and Aims
Alport syndrome (AS) is an inherited glomerular basement membrane disease caused by mutations in COL4A3, COL4A4 or COL4A5 genes. Recently, it has been reported that focal segmental glomerulosclerosis (FSGS) can be seen in AS and COL4A mutations can be detected in FSGS. In this study, we aimed to define the clinical characteristics of patients with genetically confirmed AS, in order to establish genotype-phenotype correlation and investigate the effects of different treatment regimes.
Method
A total of 87 pediatric AS patients included in this multicenter study. We retrospectively collected data from medical records and requested other centers to fill out a questionnaire, which included data regarding patient demographic features, family history, clinical and laboratory characteristics at first presentation, histopathological (if available) and genetic tests results, treatments and yearly follow-up results.
Results
A total of 87 (41 female, 46 male) genetically confirmed AS patients (COL4A5, n=43; COL4A3, n=25; COL4A4, n=19) were studied. Mean age at first presentation was 7.6±4.1 years and the median follow-up duration was 4.3 years (IQR 1.9–7.3). 14 (16.1%) of 87 patients presented with nephrotic syndrome (NS); renal biopsy findings showed FSGS in 11 (79%) of 14 patients with NS, and COL4A3 mutations were the most common (n=7, 50%) in this group. Of 14 NS patients, 12 received steroid, 11 received cyclosporine (CsA) and 4 received other immunosuppressives prior to genetic diagnosis. The inheritance pattern of the patients with NS was consistent with ARAS in 10 patients (71.4%), XLAS in 3 patients (21.4%), and ADAS in 1 patient (7.2%). During follow up, glomerular filtration rate (GFR) decreased below 90 ml/min/1.73 m2 in 24 of 87 patients (27.5%). COL4A3 mutations (n=14, 58.3%) were the leading genetic abnormality in patients who progressed to chronic kidney disease (CKD). At the last visit, GFR loss was significantly higher in patients with COL4A3 mutations when compared to patients with COL4A4 and COL4A5 mutations (p=0.04). Among patients with NS, 9 of 14 (64.2%) progressed to CKD. Genetic results of patients with NS who progressed to CKD were COL4A3 in 6 (66.7%), COL4A4 in 2 (22.2%) and COL4A5 in 1 (11.1%) patients. In survival analysis, renal survival rate without CKD was 12.1 years (95% CI: 6.7-17.5). After the first presentation, the 5-year cumulative risk of CKD was 51.8%, 12.6%, and 12.9% in patients with COL4A3, COL4A4 and COL4A5 mutations, respectively (p=0.001). We observed that patients with COL4A3 mutations, ARAS inheritance pattern, histopathology of FSGS or NS presentation progressed to CKD earlier (p<0.001 for COL4A3, p=0.01 for ARAS, p=<0.001 for FSGS, p=0.01 for NS presentation) when compared to those without. CsA treatment did not improve renal survival.
Conclusion
Detailed analyses of data from genetically confirmed Turkish patients with AS provided important clues regarding to the presentation, course and outcomes of the disease. COL4A3 mutations, ARAS inheritance pattern, NS presentation and FSGS finding in renal biopsy are major risk factors for progression to CKD. We recommend genetic testing for patients suspected of having AS. Furthermore, COL4A mutations should be considered in patients with FSGS and steroid resistant NS. This approach will shed light on the prognosis of patients and help with definitive diagnosis, preventing unnecessary and potentially harmful medications.
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Affiliation(s)
- Gulsah Ozdemir
- Hacettepe University Faculty of Medicine, Pediatric Nephrology, Ankara, Turkey
| | - Bora Gulhan
- Hacettepe University Faculty of Medicine, Pediatric Nephrology, Ankara, Turkey
| | - Emine Atayar
- Hacettepe University Faculty of Medicine, Nephrogenetic Laboratory, Ankara, Turkey
| | - Nur Canpolat
- Istanbul University Cerrahpaşa Faculty of Medicine, Pediatric Nephrology, İstanbul, Turkey
| | - Oguz Soylemezoglu
- Gazi University Faculty of Medicine, Pediatric Nephrology, Ankara, Turkey
| | - Z Birsin Ozcakar
- Ankara University Faculty of Medicine, Pediatric Nephrology, Ankara, Turkey
| | - Fehime Kara Eroğlu
- Dr. Sami Ulus Maternity and Children's Health Hospital, Pediatric Nephrology, Ankara, Turkey
| | - Cengiz Candan
- Istanbul Medeniyet University Göztepe Training and Research Hospital, Pediatric Nephrology, İstanbul, Turkey
| | - Belde Kasap Demir
- Tepecik Training and Research Hospital, Pediatric Nephrology, İzmir, Turkey
| | - Alper Soylu
- Dokuz Eylül University Faculty of Medicine, Pediatric Nephrology, İzmir, Turkey
| | - Selcuk Yuksel
- Pamukkale University Faculty of Medicine, Pediatric Nephrology, Denizli, Turkey
| | - Harika Alpay
- Marmara University Faculty of Medicine, Pediatric Nephrology, İstanbul, Turkey
| | - Ayse Agbas
- Haseki Training and Research Hospital, Pediatric Nephrology, İstanbul, Turkey
| | - Ali Duzova
- Hacettepe University Faculty of Medicine, Pediatric Nephrology, Ankara, Turkey
| | - Mutlu Hayran
- Hacettepe University Faculty of Medicine, Preventive Oncology, Ankara, Turkey
| | - Fatih Ozaltin
- Hacettepe University Faculty of Medicine, Pediatric Nephrology, Ankara, Turkey
- Hacettepe University Faculty of Medicine, Nephrogenetic Laboratory, Ankara, Turkey
| | - Rezan Topaloglu
- Hacettepe University Faculty of Medicine, Pediatric Nephrology, Ankara, Turkey
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Yalcin S, Dane F, Oksuzoglu B, Ozdemir NY, Isikdogan A, Ozkan M, Demirag GG, Coskun HS, Karabulut B, Evrensel T, Ustaoglu MA, Ozdemir F, Turna H, Yavuzsen T, Aykan F, Sevinc A, Akbulut H, Yuce D, Hayran M, Kilickap S. Quality of life study of patients with unresectable locally advanced or metastatic pancreatic adenocarcinoma treated with gemcitabine+nab-paclitaxel versus gemcitabine alone: AX-PANC-SY001, a randomized phase-2 study. BMC Cancer 2020; 20:259. [PMID: 32228512 PMCID: PMC7106641 DOI: 10.1186/s12885-020-06758-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Accepted: 03/17/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Combination of gemcitabine and nab-paclitaxel has superior clinical efficacy than gemcitabine alone. Nevertheless, health-related quality of life. (QoL) associated with this combination therapy when administered at first-line in advanced pancreatic adenocarcinoma is unknown. METHODS A total of 125 patients were randomized to combination therapy (1000 mg/m2 gemcitabine + 125 mg/m2 nab-paclitaxel) and single-agent gemcitabine (1000 mg/m2) arms to take treatment weekly for 7 of 8 weeks, and following 3 of 4 weeks, until progression or severe toxicity. Primary endpoints were three-months of definitive deterioration free percent of patients, and QoL. RESULTS Overall QoL analyses showed that 34 and 58.3% of cases in gemcitabine and gemcitabine+nab-P arms had no deterioration in 3rd month QoL scores (p = 0.018). These proportions were 27.3 and 36.6% in 6th month assessments, respectively (p = 0.357). Median overall survivals in combination and single-agent arms were 9.92 months and 5.95 months, respectively (HR: 0.64, 95% CI: 0.42-0.86, p = 0.038). Median progression free survivals in these treatment arms were 6.28 and 3.22 months, respectively (HR: 0.58, 95% CI: 0.39-0.87, p = 0.008). Median time-to-deterioration were 5.36 vs 3.68 months, and objective response rates were 37.1% vs 23.7% (p = 0.009), respectively in combination and single-agent arms. CONCLUSIONS Combination therapy with gemcitabine + nab-paclitaxel had better overall and progression-free survival than gemcitabine alone. Also, combination therapy showed increased response rate without toxicity or deteriorated QoL. Combination treatment with gemcitabine and nab-paclitaxel may provide significant benefit for advanced pancreatic cancer. TRIAL REGISTRATION This study has been registered in ClinicalTrials.gov as NCT03807999 on January 8, 2019 (retrospectively registered).
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Affiliation(s)
- Suayib Yalcin
- grid.14442.370000 0001 2342 7339Hacettepe University Faculty of Medicine, Ankara, Turkey
- grid.14442.370000 0001 2342 7339Hacettepe University Cancer Institute, Ankara, Turkey
| | - Faysal Dane
- grid.16477.330000 0001 0668 8422Marmara University Faculty of Medicine, İstanbul, Turkey
| | - Berna Oksuzoglu
- grid.413794.cDr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Nuriye Yildirim Ozdemir
- grid.413791.90000 0004 0642 7670Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Abdurrahman Isikdogan
- grid.411690.b0000 0001 1456 5625Dicle University Faculty of Medicine, Dyarbakir, Turkey
| | - Metin Ozkan
- grid.411739.90000 0001 2331 2603Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Guzin Gonullu Demirag
- grid.411049.90000 0004 0574 2310Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey
| | - Hasan Senol Coskun
- grid.29906.340000 0001 0428 6825Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Bulent Karabulut
- grid.8302.90000 0001 1092 2592Ege University Faculty of Medicine, İzmir, Turkey
| | - Turkkan Evrensel
- grid.34538.390000 0001 2182 4517Uludag University Faculty of Medicine, Bursa, Turkey
| | - Mehmet Ali Ustaoglu
- grid.414116.70000 0004 0419 1537Lütfi Kirdar Kartal Training and Research Hospital, İstanbul, Turkey
| | - Feyyaz Ozdemir
- grid.31564.350000 0001 2186 0630Karadeniz Teknik University Faculty of Medicine, Trabzon, Turkey
| | - Hande Turna
- grid.506076.20000 0004 1797 5496İstanbul University Cerrahpasa Faculty of Medicine, Bursa, Turkey
| | - Tugba Yavuzsen
- grid.21200.310000 0001 2183 9022Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Faruk Aykan
- grid.9601.e0000 0001 2166 6619İstanbul University Cancer Institute, İstanbul, Turkey
| | - Alper Sevinc
- grid.411549.c0000000107049315Gaziantep University Faculty of Medicine, Gaziantep, Turkey
| | - Hakan Akbulut
- grid.7256.60000000109409118Ankara University Faculty of Medicine, Ankara, Turkey
| | - Deniz Yuce
- grid.14442.370000 0001 2342 7339Hacettepe University Cancer Institute, Ankara, Turkey
| | - Mutlu Hayran
- grid.14442.370000 0001 2342 7339Hacettepe University Cancer Institute, Ankara, Turkey
| | - Saadettin Kilickap
- grid.14442.370000 0001 2342 7339Hacettepe University Cancer Institute, Ankara, Turkey
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20
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Gülhan B, Kanık Yüksek S, Hayran M, Özkaya Parlakay A, Güney D, Akın Kağızmanlı G, Kaygısız H, Tezer H, Şenel E. Infections in Pediatric Burn Patients: An Analysis of One Hundred Eighty-One Patients. Surg Infect (Larchmt) 2019; 21:357-362. [PMID: 31589562 DOI: 10.1089/sur.2019.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Background: Infectious complications are one of the most life-threatening complications and result in substantial mortality and morbidity in children who have been burned. The goal of the study is to assess the risk factors for sepsis in pediatric burn patients in a referral hospital. Methods: This study was performed at the Pediatric Burn Unit of Ankara Child Health and Diseases Hematology Oncology Training and Research Hospital during the period between January 2014 and June 2017. The patients were evaluated for age, sex, burn etiology, burned body surface area (BSA), the presence of inhalation injury, sepsis, positive cultures, the micro-organisms cultured samples, and septic focus. Results: A total of 181 patients were included in the study. The most common cause of burns was scalds in 120 patients (66.3%). Forty-one patients (22.7%) developed health-care-associated infection and sepsis. Gram-negative micro-organisms were isolated in 40 (97.6%) patients (Acinetobacter spp., Pseudomonas aeruginosa, Klebsiella pneumonia) with sepsis. Carbapenem resistance was detected in 31 (93.8%) of 40 patients. Mortality was observed in 11 patients (6.1%) in the group with sepsis. Burn surface area, burn depth, C-reactive protein (CRP) values, mortality, Garcés index, and Baux index were higher in the group with sepsis (p < 0.05). Multiple regression analysis revealed that mechanism of injury (flame), burned BSA ≥25%, C-reactive protein ≥6 mg/dL (area under the curve [AUC]: 0.76 p < 0.001 and AUC: 0.90, p < 0.001, respectively) at admission were independent parameters for development of sepsis in pediatric burn patients. Conclusion: Multi-drug-resistant Pseudomonas aeruginosa and Acinetobacter baumannii were important agents of blood stream infection in burned children. Burned BSA ≥25% and CRP ≥6 mg/dL were risk factors for developing sepsis in pediatric burn patients.
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Affiliation(s)
- Belgin Gülhan
- Department of Pediatric Infectious Diseases, University of Health Sciences, Ankara Child Health and Diseases Hematology Oncology Training and Research Hospital, Ankara, Turkey
| | - Saliha Kanık Yüksek
- Department of Pediatric Infectious Diseases, University of Health Sciences, Ankara Child Health and Diseases Hematology Oncology Training and Research Hospital, Ankara, Turkey
| | - Mutlu Hayran
- Hacettepe University Cancer Institute, Department of Preventive Oncology, Epidemiology, Ankara, Turkey
| | - Aslınur Özkaya Parlakay
- Department of Pediatric Infectious Diseases, University of Health Sciences, Ankara Child Health and Diseases Hematology Oncology Training and Research Hospital, Ankara, Turkey
| | - Doğuş Güney
- Department of Pediatric Surgery, University of Health Sciences, Ankara Child Health and Diseases Hematology Oncology Training and Research Hospital, Ankara, Turkey
| | - Gözde Akın Kağızmanlı
- Department of Pediatric Diseases, University of Health Sciences, Ankara Child Health and Diseases Hematology Oncology Training and Research Hospital, Ankara, Turkey
| | - Hacer Kaygısız
- Department of Pediatric Diseases, University of Health Sciences, Ankara Child Health and Diseases Hematology Oncology Training and Research Hospital, Ankara, Turkey
| | - Hasan Tezer
- Department of Pediatric Infectious Diseases, University of Health Sciences, Ankara Child Health and Diseases Hematology Oncology Training and Research Hospital, Ankara, Turkey
| | - Emrah Şenel
- Department of Pediatric Surgery, University of Health Sciences, Ankara Child Health and Diseases Hematology Oncology Training and Research Hospital, Ankara, Turkey
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Aslan D, Gurbay A, Hayran M, Sengelen M, Pasli D, Huseyin B. Nicotine delivery of e-cigarettes. Turk Thorac J 2019; 21:74. [DOI: 10.5152/turkthoracj.2019.192208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 07/25/2019] [Indexed: 11/22/2022]
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22
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Dizdar O, Guven DC, Guner G, Erman M, Hayran M. Gleason score and docetaxel response in advanced hormone-sensitive prostate cancer: The lower the better. Journal of Oncological Sciences 2019. [DOI: 10.1016/j.jons.2019.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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23
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Sade LE, Hazirolan T, Kozan H, Ozdemir H, Hayran M, Eroglu S, Pirat B, Sezgin A, Muderrisoglu H. T1 Mapping by Cardiac Magnetic Resonance and Multidimensional Speckle-Tracking Strain by Echocardiography for the Detection of Acute Cellular Rejection in Cardiac Allograft Recipients. JACC Cardiovasc Imaging 2019; 12:1601-1614. [DOI: 10.1016/j.jcmg.2018.02.022] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 02/27/2018] [Accepted: 02/28/2018] [Indexed: 11/26/2022]
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Kaplan B, Grau-Perez M, Çarkoglu A, Ergör G, Hayran M, Navas-Acien A, Cohen JE. Smoke-free Turkey: Evaluation of outdoor areas of public places. Environ Res 2019; 175:79-83. [PMID: 31108355 DOI: 10.1016/j.envres.2019.05.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 04/22/2019] [Accepted: 05/02/2019] [Indexed: 06/09/2023]
Abstract
SIGNIFICANCE Secondhand tobacco smoke (SHS) exposure is a major cause of morbidity and mortality around the world. The objective of this study was to evaluate the presence of smoking in outdoor areas of public places in three largest Turkish cities (Istanbul, Ankara, and Izmir). METHOD For this cross-sectional observational study, the Turkish Statistical Institute randomly selected 10 sampling points in each city. Around each sampling point, fieldworkers visited the closest bars/nightclubs, cafes, government buildings, hospitals, restaurants, schools, shopping malls, traditional coffee houses, universities, children's playgrounds, parks and open markets. We observed smoking, ashtrays, and cigarette butts at the outdoor areas of public venues within the urban districts of each city. The fieldwork was conducted in April-May 2016. RESULTS 477 venues were observed, covering 1017 outdoor locations in which 17,737 people were observed. Smoking in outdoor areas ranged from 3.7% around schools to 90% in open markets. Ashtrays were almost ubiquitous in hospitals (95.6%), shopping malls (92.0%), and universities (90.9%). Cigarette butts were more often observed in open markets (100%), shopping malls (96%), universities (95.5%), and parks (93.3%). Smoking at outdoor areas around schools was significantly lower than around other venues. CONCLUSION Smoking in outdoor areas was common in most public places in Turkey except schools. The current indoor SHS legislation should be extended to cover adjacent outdoor areas of public venues in order to effectively protect people from SHS exposure in Turkey.
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Affiliation(s)
- Bekir Kaplan
- Department of Health Behavior and Society, Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, Maryland, USA.
| | - Maria Grau-Perez
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, USA
| | - Asli Çarkoglu
- Department of Psychology, Kadir Has University, Istanbul, Turkey
| | - Gül Ergör
- Department of Public Health, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Mutlu Hayran
- Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, USA
| | - Joanna E Cohen
- Department of Health Behavior and Society, Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, Maryland, USA
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Dizdar O, Demir M, Bozbulut UB, Hayran M, Kars A. Cancer chemotherapy: incidence and predictors of 30-day mortality. BMJ Support Palliat Care 2019:bmjspcare-2019-001807. [PMID: 31272999 DOI: 10.1136/bmjspcare-2019-001807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Revised: 05/27/2019] [Accepted: 06/05/2019] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Thirty-day mortality (30 DM) is a measure of quality of cancer treatment and the predictors for 30 DM are important to identify vulnerable patients who are least likely to benefit from chemotherapy. We assessed the incidence and potential predictors of 30 DM in patients receiving chemotherapy. METHODS All patients who received chemotherapy within an 8-month period in our hospital were assessed. Baseline prechemotherapy clinical features, vital signs, Modified Early Warning Scores (MEWS) and laboratory tests were recorded. Potential predictors of 30 DM were evaluated using multivariate logistic regression analysis. RESULTS Among 4560 patients included, 77 patients (1.7%) died within 30 days of chemotherapy. Patients who died were older (62 vs 58, p=0.002), mostly males (61% vs 43%, p=0.006), had worse Eastern Cooperative Oncology Group performance scores (ECOG PS), and higher MEWS scores compared with those who survived. Multivariate analysis identified age ≥60 years (OR 2.2, 95% CI 1.2 to 4.1, p=0.01), male gender (OR 2.1, 95% CI 1.1 to 3.9, p=0.02), ECOG PS≥3 (OR 3.2, 95% CI 1.1 to 8.8, p=0.03), pulse rate ≥90 bpm (OR 3.8, 95% CI 2.0 to 7.0, p<0.01), systolic blood pressure <110 mm Hg (OR 2.1, 95% CI 1.1 to 4.1, p=0.02), body mass index <25 kg/m2 (OR 2.1, 95% CI 1.1 to 3.8, p=0.02) and haemoglobin< 90 g/L (OR 14.2, 95% CI 4.3 to 46.6, p<0.01) to be associated with increased risk of 30 DM. CONCLUSIONS Along with well-known prognostic factors such as ECOG PS and disease stage, other simple and readily available parameters may predict early mortality after chemotherapy and produce a signal for the physicians to carefully reevaluate vulnerable patients before chemotherapy administration.
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Affiliation(s)
- Omer Dizdar
- Preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Metin Demir
- Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | | | - Mutlu Hayran
- Preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Ayse Kars
- Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
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Güven DC, Dizdar Ö, Akman AC, Berker E, Yekedüz E, Ceylan F, Başpınar B, Akbıyık İ, Aktaş BY, Yüce D, Erman M, Hayran M. Evaluation of cancer risk in patients with periodontal diseases. Turk J Med Sci 2019; 49:826-831. [PMID: 31195790 PMCID: PMC7018248 DOI: 10.3906/sag-1812-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Background/aim In this study, we aimed to assess the cancer risk among patients with periodontal disease. Materials and methods Patients diagnosed with periodontal diseases at Hacettepe University between 2007 and 2012 were included and data on the diagnosis of any cancer after periodontal disease were collected from patient files. The age- and sex-standardized incidence rates (SIRs) were calculated using Turkish National Cancer Registry 2013 data. Results A total of 5199 patients were included. Median follow-up was 7.2 years. Patients with periodontal diseases had 17% increased risk of cancer compared with the expected counts for the corresponding age and sex groups (SIR: 1.17; 95% CI: 1.04–1.3, P = 0.006). The increased cancer risk was statistically significant in women (SIR: 1.24; 95% CI: 1.05–1.45, P = 0.008) but not in men. Among women with periodontal disease, the risks of breast cancer (SIR: 2.19) and head and neck cancer (SIR: 4.71) were significantly increased. Among men, the risks of prostate cancer (SIR: 1.84), head and neck cancer (SIR: 3.55), and hematological cancers (SIR: 1.76) were significantly increased. Conclusion This study showed that periodontal diseases were associated with increased risk of several cancers. Besides other well-known benefits for health, the provision of oral/dental health should be considered and employed as a cancer prevention measure.
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Affiliation(s)
- Deniz Can Güven
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Ömer Dizdar
- Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Abdullah Cevdet Akman
- Department of Periodontology, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Ezel Berker
- Department of Periodontology, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Emre Yekedüz
- Department of Medical Oncology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Furkan Ceylan
- Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Batuhan Başpınar
- Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - İlgın Akbıyık
- Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Burak Yasin Aktaş
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Deniz Yüce
- Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Mustafa Erman
- Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Mutlu Hayran
- Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
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Guven DC, Dizdar O, Alp A, Akdoğan Kittana FN, Karakoc D, Hamaloglu E, Lacin S, Karakas Y, Kilickap S, Hayran M, Yalcin S. Analysis of Fusobacterium nucleatum and Streptococcus gallolyticus in saliva of colorectal cancer patients. Biomark Med 2019; 13:725-735. [PMID: 31157977 DOI: 10.2217/bmm-2019-0020] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Aim: The aim of the study was to examine the prevalence and amount of Fusobacterium nucleatum (Fn), Porphyromonas gingivalis (Pg) and Streptococcus gallolyticus (Sg) in the saliva of colorectal cancer (CRC) patients and controls. Methods: PCR analyses performed in 71 CRC patients and 77 controls. Results: Saliva samples of patients had higher amounts of Fn (p = 0.001) and Sg (p < 0.001) compared with controls. Amount of Fn and Sg were lower in the microsatellite instability (+) group. Evaluation of salivary Sg amount by receiver operating characteristics analysis found to have diagnostic value for CRC (AUC: 0.84, 95% CI: 0.72-0.96). Conclusion: We found higher amounts of Fn and Sg in the saliva of CRC patients. Salivary Sg could helpful in distinction of CRC.
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Affiliation(s)
- Deniz Can Guven
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara 06230, Turkey
| | - Omer Dizdar
- Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara 06230, Turkey
| | - Alpaslan Alp
- Department of Medical Microbiology, Hacettepe University Faculty of Medicine, Ankara 06230, Turkey
| | | | - Derya Karakoc
- Department of General Surgery, Hacettepe University Faculty of Medicine, Ankara 06230, Turkey
| | - Erhan Hamaloglu
- Department of General Surgery, Hacettepe University Faculty of Medicine, Ankara 06230, Turkey
| | - Sahin Lacin
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara 06230, Turkey
| | - Yusuf Karakas
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara 06230, Turkey
| | - Saadettin Kilickap
- Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara 06230, Turkey
| | - Mutlu Hayran
- Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara 06230, Turkey
| | - Suayib Yalcin
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara 06230, Turkey
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Sade LE, Hayran M, Muderrisoglu H. T1 Mapping for Cardiac Allograft Rejection. JACC Cardiovasc Imaging 2019; 12:947-948. [PMID: 31072527 DOI: 10.1016/j.jcmg.2019.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 03/01/2019] [Accepted: 03/05/2019] [Indexed: 11/17/2022]
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Kaplan B, Carkoglu A, Ergor G, Hayran M, Sureda X, Cohen JE, Navas-Acien A. Evaluation of Secondhand Smoke Using PM2.5 and Observations in a Random Stratified Sample in Hospitality Venues from 12 Cities. Int J Environ Res Public Health 2019; 16:ijerph16081381. [PMID: 30999605 PMCID: PMC6518083 DOI: 10.3390/ijerph16081381] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 03/22/2019] [Accepted: 04/12/2019] [Indexed: 11/24/2022]
Abstract
Background: Turkey passed a law banning smoking in all indoor public places in 2008. In response to the indoor smoking restriction, many smokers may have relocated to outdoor areas of venues. The aim of this study was to evaluate air pollution related to SHS exposure in indoor and outdoor areas of hospitality venues in 12 cities in Turkey. Method: In this cross-sectional study, we evaluated hospitality venues in 12 cities in Turkey. In each visited venue, we evaluated a pre-specified number of study locations such as the outdoor area of the main entrance, indoor areas, and patios or other outdoor dining areas, completely or partially covered with window walls. We measured particulate matter 2.5 (PM2.5) in those areas. Results: The fieldworkers visited 72 randomly selected hospitality venues and measured PM2.5 concentrations in 165 different locations (indoor, outdoor, and patios) of those venues. Overall, 2573 people were observed, 909 of them smoking. The median (IQR) PM2.5 concentrations were 95 (39–229) μg/m3 indoors, 25 (13–48) μg/m3 outdoors, and 31 μg/m3 (16–62) in the patios (p < 0.001). After adjustment, each additional smoker was associated with a 2% increase in PM2.5 concentrations in patio air (GMR (95% CI): 1.02 (1.00, 1.05), and a 4% increase in indoor air (GMR (95% CI): 1.04 (1.02, 1.05). Conclusions: There were unhealthy levels of smoking-caused PM2.5 concentrations, not only indoors, but also in the patios of hospitality venues. Legislative efforts to expand the smoke-free legislation to outdoor areas adjacent to indoor public places and an action plan to increase compliance with the smoke-free policy are urgently needed in Turkey.
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Affiliation(s)
- Bekir Kaplan
- Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
| | - Asli Carkoglu
- Department of Psychology, Kadir Has University, Istanbul 34083, Turkey.
| | - Gul Ergor
- Department of Public Health, Faculty of Medicine, Dokuz Eylul University, Izmir 35220, Turkey.
| | - Mutlu Hayran
- Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara 06230, Turkey.
| | - Xisca Sureda
- Social and Cardiovascular Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, 28801 Madrid, Spain.
| | - Joanna E Cohen
- Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, NY 10032, USA.
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Aslan D, Gürbay A, Hayran M, Şengelen M, Paslı D, Hüseyin B. Carbon Monoxide in the Expired Air and Urinary Cotinine Levels of e-Cigarette Users. Turk Thorac J 2019; 20:125-129. [PMID: 30958985 DOI: 10.5152/turkthoracj.2018.18110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 10/01/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVES The aim of this descriptive study was to determine the sociodemographic characteristics of electronic (e)-cigarette users for clarifying the causes of e-cigarette smoking and to identify the carbon monoxide (CO) and urinary cotinine levels of the volunteers. MATERIALS AND METHODS Twenty volunteers who smoked e-cigarettes completed a questionnaire, and their exhaled CO and urinary cotinine levels were measured. An enzyme-linked immunosorbent assay kit was used for cotinine analysis. RESULTS Overall, 85% of the participants were males, 60% were married, and 75% were college/university graduates. The median age of participants was 38.5 years. The participants' main reasons for starting to smoke were peer influence and curiosity. The participants' main reasons for smoking e-cigarettes were to quit and reduce smoking the conventional cigarettes and cost effectiveness. Only three people knew that smoking was harmful to health. The participants' CO levels were measured as a median of 3, lowest of 1, and highest of 22. Cotinine levels were "positive" in all samples. A moderate and statistically significant correlation was found between the amount of fluids used by the participants in 1 day (mL) and cotinine levels in urine specimens (Pearson correlation test, r=0.511, p=0.025). CONCLUSION The study is an important proof of the country's scientific work on e-cigarettes. Preventive strategies should be very strictly implemented for any tobacco products, including e-cigarettes, as they harm individuals and the community.
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Affiliation(s)
- Dilek Aslan
- Department of Public Health, Hacettepe University School of Medicine, Ankara, Turkey
| | - Aylin Gürbay
- Department of Pharmaceutical Toxicology, Hacettepe University Faculty of Pharmacy, Ankara, Turkey
| | - Mutlu Hayran
- Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Meltem Şengelen
- Department of Public Health, Hacettepe University School of Medicine, Ankara, Turkey
| | - Duygu Paslı
- Department of Pharmaceutical Toxicology, Hacettepe University Faculty of Pharmacy, Ankara, Turkey
| | - Beril Hüseyin
- Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
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Atta N, Kilickap S, Yuce D, Hayran M. Reproductive cancer risk factors among relatives of cancer patients in a tertiary oncology center. BMC Cancer 2019; 19:154. [PMID: 30770749 PMCID: PMC6377741 DOI: 10.1186/s12885-019-5350-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 02/04/2019] [Indexed: 12/02/2022] Open
Abstract
Background The aim of this study was to evaluate the prevalence of some gynecological cancer risk factors in a population of female relatives of cancer patients in Hacettepe University Oncology Hospital. Additionally, what are the levels of the women’s awareness /behavior toward available screening tools? Methods An individual cancer risk assessment questionnaire has been developed in the Department of Preventive Oncology, which questions the medical history, health behaviors and cancer awareness, as well as their behavior toward available cancer screening tools. Results The mean age of the study population was 45.7 ± 12.2 years. Median age at menarche was 13 years (IQR, 12–14), 6.9% of the women reported their menarche was before age of 12. About 11.1% of the women had intercourse before age of 18. The median age at first delivery was 22 years. Median BMI was 24.9, with 18.3% of population having obesity. Of the women 65% were current/past smokers. Sixty-two percent of the women had never used condom. About 8% of the women were unaware about mammography and 17.7% about the Pap test. Conclusions This study has documented high tobacco use, low protective condom use and low rates of physical activity. Percentage of some risk factors like early menarche was lower than what was suggested for general Turkish population. Awareness and behavior of the women were better about mammography when compared to the Pap test. Considering our results, some measures should be put in place to increase people’s awareness, and to modify their behavior toward cancer prevention.
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Affiliation(s)
- Nooria Atta
- Department of Obstetrics and Gynecology, Kabul Medical University, Kabul, Afghanistan. .,Department of preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey.
| | - Saadettin Kilickap
- Department of preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Deniz Yuce
- Department of preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Mutlu Hayran
- Department of preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
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Bilgin E, Hayran M, Erden A, Armağan B, Sarı A, Kılıç L, Akdoğan A, Karadağ Ö, Bilgen ŞA, Kiraz S, Ertenli İ, Kalyoncu U. Proposal for a simple algorithm to differentiate adult-onset Still’s disease with other fever of unknown origin causes: a longitudinal prospective study. Clin Rheumatol 2019; 38:1699-1706. [DOI: 10.1007/s10067-019-04455-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 12/24/2018] [Accepted: 01/24/2019] [Indexed: 12/21/2022]
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Tabanlioglu-Onan D, İncel-Uysal P, Hayran Y, Şahin-Dalgiç G, Hayran M, Artüz F, Yalçin B. Dermatoscopic assessment of nailfold capillary abnormalities in Behçet's disease and correlation of the findings with disease activity and severity. DERMATOL SIN 2019. [DOI: 10.4103/ds.ds_10_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Topaloğlu R, Gülhan B, Çelegen K, İnözü M, Hayran M, Düzova A, Ozaltin F. Rituximab for Children With Difficult-to-Treat Nephrotic Syndrome: Its Effects on Disease Progression and Growth. Front Pediatr 2019; 7:313. [PMID: 31417883 PMCID: PMC6682627 DOI: 10.3389/fped.2019.00313] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 07/11/2019] [Indexed: 12/20/2022] Open
Abstract
Background: Since the early 2000s rituximab (RTX) has been thought of as an alternative treatment for steroid-sensitive nephrotic syndrome (SSNS) and steroid-resistant nephrotic syndrome (SRNS). Objective: This study aimed to determine the effects of RTX treatment on disease outcome and growth in pediatric SSNS and SRNS patients. Materials and Methods: The medical records of pediatric SSNS and SRNS patients that began RTX treatment at the mean age of 10.8 ± 5.1 years between 2009 and 2017 were retrospectively reviewed. Additionally, the effect of RTX on growth was evaluated based on patient height, weight, and BMI z scores. Results: The study included 41 children, of which 21 had SSNS and 20 had SRNS. Mean age at diagnosis of NS was 5.8 ± 4.7 years. Mean duration of post-RTX treatment follow-up was 2.3 ± 1.6 years. Among the SSNS patients, 6 and 11 patients were steroid free and calcineurin inhibitor free at the last follow-up visit, respectively. The 1-year cumulative steroid and calcineurin inhibitor doses both decreased after RTX treatment, as compared to before RTX (P = 0.001 and P = 0.015, respectively). The median height z-score at the time of RTX initiation was -1.2 and the median height z-score at the last follow-up visit was -0.6 (P = 0.044). The median BMI z-score decreased from 1.6 (IQR; 0.9-3.0) at the time RTX was initiated to 1.1 IQR; [(-0.7)-2.5] at the last follow-up visit (P = 0.007). At the last follow-up visit 4 SRNS patients had complete remission and 4 had partial remission. The 1-year cumulative steroid dosage in the SRNS patients decreased significantly after RTX, as compared to before RTX (P = 0.001). The median height z-score at the time of RTX initiation was -0.8 and the median height z-score at the last follow-up visit was -0.7 (P = 0.81). The median BMI z-score decreased from 0.3 at the time RTX was initiated to -0.1 at the last follow-up visit (P = 0.11). Conclusion: RTX has a more positive effect on disease outcome and growth in SSNS patients than in those with SRNS.
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Affiliation(s)
- Rezan Topaloğlu
- Division of Pediatric Nephrology, Department of Pediatrics, School of Medicine, Hacettepe University, Ankara, Turkey
| | - Bora Gülhan
- Division of Pediatric Nephrology, Department of Pediatrics, School of Medicine, Hacettepe University, Ankara, Turkey
| | - Kübra Çelegen
- Division of Pediatric Nephrology, Department of Pediatrics, School of Medicine, Hacettepe University, Ankara, Turkey
| | - Mihriban İnözü
- Division of Pediatric Nephrology, Department of Pediatrics, School of Medicine, Hacettepe University, Ankara, Turkey
| | - Mutlu Hayran
- Department of Preventive Oncology, School of Medicine, Hacettepe University, Ankara, Turkey
| | - Ali Düzova
- Division of Pediatric Nephrology, Department of Pediatrics, School of Medicine, Hacettepe University, Ankara, Turkey
| | - Fatih Ozaltin
- Division of Pediatric Nephrology, Department of Pediatrics, School of Medicine, Hacettepe University, Ankara, Turkey.,Nephrogenetics Laboratory, School of Medicine, Hacettepe University, Ankara, Turkey.,Center for Biobanking and Genomics, School of Medicine, Hacettepe University, Ankara, Turkey
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Sağlam A, Esin E, Hayran M, Boyraz B, Üner A. Distribution of lymphomas in Turkey: data of 4239 cases from a single
institution using the WHO classification. Turk J Med Sci 2018; 48:1013-1023. [PMID: 30384569 DOI: 10.3906/sag-1804-107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Background/aim: Lymphoma cases diagnosed at one of the largest tertiary reference centers in Turkey were reviewed and findings were compared to those reported from other regions of the world. Materials and methods: Lymphomas diagnosed between 2000 and 2017 in the pathology laboratory of Hacettepe University were identified. A total of 4239 cases were analyzed. The WHO 2008 classification was used. Results: Hodgkin lymphomas accounted for almost 20% of cases. T-cell lymphomas were much more frequent (23% of our non- Hodgkin lymphoma (NHL) cases) in comparison to all other regions of the world. The reason for this difference was the high frequency of mycosis fungoides (MF) cases. We had significantly more cases of high-grade B-cell lymphoma (43.9% of NHLs) and fewer cases of low-grade B-cell lymphoma (33.5% of NHLs) in comparison to the rates of developed regions of the world and the reverse was true when compared to developing parts of the world. Burkitt lymphoma frequency (4% of NHLs) was also higher than in most parts of the world. Conclusion: Our data reveal that the frequency of MF, Burkitt lymphoma, and Hodgkin lymphoma are considerably higher, whereas follicular lymphoma rates are considerably lower than in most other parts of the world.
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Aydınkarahaliloğlu ND, Aykaç E, Atalan Ö, Demir N, Hayran M. Spontaneous Reporting of Adverse Drug Reactions by Consumers in Comparison with Healthcare Professionals in Turkey from 2014 to 2016. Pharmaceut Med 2018. [DOI: 10.1007/s40290-018-0244-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Fidan K, Göknar N, Gülhan B, Melek E, Yıldırım ZY, Baskın E, Hayran M, Gülleroglu K, Özçakar ZB, Ozaltin F, Soylemezoglu O. Extra-Renal manifestations of atypical hemolytic uremic syndrome in children. Pediatr Nephrol 2018; 33:1395-1403. [PMID: 29610995 DOI: 10.1007/s00467-018-3933-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 02/07/2018] [Accepted: 02/19/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND Atypical hemolytic uremic syndrome (aHUS) is a chronic disease characterized by thrombotic microangiopathy and a high risk of end-stage kidney disease. Dysregulation and/or excessive activation of the complement system results in thrombotic microangiopathy. Interest in extrarenal manifestations of aHUS is increasing. This study aimed to determine the clinical characteristics of patients with extrarenal manifestations of aHUS in childhood. METHODS This study included 70 children with extrarenal manifestations of HUS from the national Turkish aHUS Registry. The demographics, clinical characteristics, genetic test results, all treatments, and renal/hematologic status of aHUS patients with extrarenal involvement were recorded. RESULTS The most common extrarenal manifestation was neurological system involvement (n = 46 [27.2%]), followed by gastrointestinal (n = 20 [11.8%]), cardiovascular (n = 12 [7%]), and respiratory (n = 12 [7%]) involvement. The patients with neurological involvement had a higher mortality rate and a lower estimated glomerular filtration rate (eGFR) than the other patients at last follow-up. Eculizumab (with or without plasma exchange/plasma infusion) treatment increased the renal and hematologic recovery rates. CONCLUSIONS The most common and serious extrarenal manifestation of aHUS is neurological involvement and treatment outcome findings presented herein are important to all relevant clinicians.
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Affiliation(s)
- Kibriya Fidan
- Gazi University, School of Medicine, Department of Pediatric Nephrology, Istanbul, Turkey.
| | - Nilüfer Göknar
- Bezmialem Vakif University, School of Medicine, Department of Pediatric Nephrology, Istanbul, Turkey
| | - Bora Gülhan
- Hacettepe University, School of Medicine, Department of Pediatric Nephrology, Ankara, Turkey
| | - Engin Melek
- Cukurova University, School of Medicine, Department of Pediatric Nephrology, Ankara, Turkey
| | - Zeynep Y Yıldırım
- Istanbul University, School of Medicine, Department of Pediatric Nephrology, Istanbul, Turkey
| | - Esra Baskın
- Baskent University, School of Medicine, Department of Pediatric Nephrology, Ankara, Turkey
| | - Mutlu Hayran
- Hacettepe University, School of Medicine, Department of Pediatric Nephrology, Ankara, Turkey
| | - Kaan Gülleroglu
- Baskent University, School of Medicine, Department of Pediatric Nephrology, Ankara, Turkey
| | - Zeynep B Özçakar
- Ankara University, School of Medicine, Department of Pediatric Nephrology, Ankara, Turkey
| | - Fatih Ozaltin
- Hacettepe University, School of Medicine, Department of Pediatric Nephrology, Ankara, Turkey.,Nephrogenetics Laboratory, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Oguz Soylemezoglu
- Gazi University, School of Medicine, Department of Pediatric Nephrology, Istanbul, Turkey
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Aslan D, Gurbay A, Hayran M, Şengelen M, Pasli D, Chousein B. Expired air- co and urinary cotinine levels of the electronic cigarette users: Descriptive study from Turkey. Tob Prev Cessat 2018. [DOI: 10.18332/tpc/90690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Guven DC, Dizdar O, Akman AC, Berker E, Yekeduz E, Ceylan F, Baspinar B, Akbiyik I, Aktas BY, Yuce D, Erman M, Hayran M. Evaluation of cancer risk in patients with periodontal diseases. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e13571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Deniz Can Guven
- Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Omer Dizdar
- Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Abdullah Cevdet Akman
- Department of Periodontology, Hacettepe University Faculty of Dentistry, Ankara, Turkey
| | - Ezel Berker
- Department of Periodontology, Hacettepe University Faculty of Dentistry, Ankara, Turkey
| | - Emre Yekeduz
- Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Furkan Ceylan
- Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Batuhan Baspinar
- Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ilgın Akbiyik
- Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Burak Yasin Aktas
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Deniz Yuce
- Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Mustafa Erman
- Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Mutlu Hayran
- Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
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Guven DC, Dizdar O, Alp A, Akdogan Kittana FN, Karakoc D, Hamaloglu E, Lacin S, Karakas Y, Kilickap S, Hayran M, Yalcin S. Analysis of Fusobacterium nucleatum, Streptococcus gallolyticus and Porphyromonas gingivalis in saliva in colorectal cancer patients and healthy controls. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e15617] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Deniz Can Guven
- Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Omer Dizdar
- Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Alpaslan Alp
- Department of Medical Microbiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | | | - Derya Karakoc
- Department of General Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Erhan Hamaloglu
- Department of General Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Sahin Lacin
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Yusuf Karakas
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Saadettin Kilickap
- Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Mutlu Hayran
- Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Suayib Yalcin
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
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Dizdar O, Guven DC, Guner G, Erman M, Hayran M. Docetaxel in hormone-sensitive prostate cancer with low Gleason scores: A meta-analysis of randomized controlled trials. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e17032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Omer Dizdar
- Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Deniz Can Guven
- Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Gurkan Guner
- Hacettepe University Cancer Institute, Ankara, Turkey
| | - Mustafa Erman
- Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Mutlu Hayran
- Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
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Kamisli S, Yuce D, Karakilic B, Kilickap S, Hayran M. Cancer patients and oncology nursing: Perspectives of oncology nurses in Turkey. Niger J Clin Pract 2018; 20:1065-1073. [PMID: 29072227 DOI: 10.4103/njcp.njcp_108_16] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND AND AIM Burnout and exhaustion is a frequent problem in oncology nursing. The aim of this study is to evaluate the aspects of oncology nurses about their profession in order to enhance the standards of oncology nursing. MATERIALS AND METHODS This survey was conducted with 70 oncology nurses working at Hacettepe University Oncology Hospital. Data were collected between January-April 2012. Each participant provided a study form comprising questions about sociodemographic information; about difficulties, positive aspects and required skills for oncology nursing; and questions evaluating level of participation and clinical perception of oncology nursing. RESULTS Mean age of nurses was 29.9 ± 5.7 years. More than half of the participants were married (51.4%) and 30% had at least one child. Percent of nurses working in oncology for their entire work life was 75.8%. Most frequently expressed difficulties were exhaustion (58.6%), coping with the psychological problems of the patients (25.7%), and frequent deaths (24.3%); positive aspects were satisfaction (37.1%), changing the perceptions about life (30%), and empathy (14.3%); and required skills were patience (60%), empathy (57.1%), and experience (50%). For difficulties of oncology nursing, 28.3% of difficulties could be attributed to job-related factors, 30.3% to patient-related factors, and 77% of difficulties to individual factors. The independent predictors of participation level of the nurses were self-thoughts of skills and positive aspects of oncology nursing. CONCLUSION According to the findings of this study, nurses declared that working with cancer patients increase burnout, they are insufficient in managing work stress and giving psychological care to patients, but their job satisfaction, clinical skills and awareness regarding priorities of life has increased.
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Affiliation(s)
- S Kamisli
- Department of Preventive Oncology, Hacettepe University Oncology Hospital, Ankara, Turkey
| | - D Yuce
- Department of Preventive Oncology, Hacettepe University Oncology Hospital, Ankara, Turkey
| | - B Karakilic
- Clinical Oncology Unit, Hacettepe University Oncology Hospital, Ankara, Turkey
| | - S Kilickap
- Department of Preventive Oncology, Hacettepe University Oncology Hospital, Ankara, Turkey
| | - M Hayran
- Department of Preventive Oncology, Hacettepe University Oncology Hospital, Ankara, Turkey
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Çelik H, Sciandra M, Flashner B, Gelmez E, Kayraklıoğlu N, Allegakoen DV, Petro JR, Conn EJ, Hour S, Han J, Oktay L, Tiwari PB, Hayran M, Harris BT, Manara MC, Toretsky JA, Scotlandi K, Üren A. Clofarabine inhibits Ewing sarcoma growth through a novel molecular mechanism involving direct binding to CD99. Oncogene 2018; 37:2181-2196. [PMID: 29382926 PMCID: PMC9936921 DOI: 10.1038/s41388-017-0080-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 11/03/2017] [Accepted: 12/01/2017] [Indexed: 01/30/2023]
Abstract
Ewing sarcoma (ES) is an aggressive bone and soft tissue malignancy that predominantly affects children and adolescents. CD99 is a cell surface protein that is highly expressed on ES cells and is required to maintain their malignancy. We screened small molecule libraries for binding to extracellular domain of recombinant CD99 and subsequent inhibition of ES cell growth. We identified two structurally similar FDA-approved compounds, clofarabine and cladribine that selectively inhibited the growth of ES cells in a panel of 14 ES vs. 28 non-ES cell lines. Both drugs inhibited CD99 dimerization and its interaction with downstream signaling components. A membrane-impermeable analog of clofarabine showed similar cytotoxicity in culture, suggesting that it can function through inhibiting CD99 independent of DNA metabolism. Both drugs drastically inhibited anchorage-independent growth of ES cells, but clofarabine was more effective in inhibiting growth of three different ES xenografts. Our findings provide a novel molecular mechanism for clofarabine that involves direct binding to a cell surface receptor CD99 and inhibiting its biological activities.
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Affiliation(s)
- Haydar Çelik
- Department of Oncology, Georgetown University Medical Center, Washington, D.C. 20007
| | - Marika Sciandra
- CRS Development of Biomolecular Therapies, Experimental Oncology Laboratory, Rizzoli Orthopaedic Institute, 40136 Bologna, Italy,PROMETEO Laboratory, STB, RIT Department, Rizzoli Orthopaedic Institute, 40136 Bologna, Italy
| | - Bess Flashner
- Department of Oncology, Georgetown University Medical Center, Washington, D.C. 20007
| | - Elif Gelmez
- Department of Oncology, Georgetown University Medical Center, Washington, D.C. 20007
| | - Neslihan Kayraklıoğlu
- Department of Oncology, Georgetown University Medical Center, Washington, D.C. 20007
| | - David V. Allegakoen
- Department of Oncology, Georgetown University Medical Center, Washington, D.C. 20007
| | - Jeff R. Petro
- Department of Oncology, Georgetown University Medical Center, Washington, D.C. 20007
| | - Erin J. Conn
- Department of Oncology, Georgetown University Medical Center, Washington, D.C. 20007
| | - Sarah Hour
- Department of Oncology, Georgetown University Medical Center, Washington, D.C. 20007
| | - Jenny Han
- Department of Oncology, Georgetown University Medical Center, Washington, D.C. 20007
| | - Lalehan Oktay
- Department of Oncology, Georgetown University Medical Center, Washington, D.C. 20007
| | - Purushottam B. Tiwari
- Department of Oncology, Georgetown University Medical Center, Washington, D.C. 20007
| | - Mutlu Hayran
- Department of Preventive Oncology, Cancer Institute, Hacettepe University, 06800 Ankara, Turkey
| | - Brent T. Harris
- Department of Pathology, Georgetown University Medical Center, Washington, D.C. 20007
| | - Maria Cristina Manara
- CRS Development of Biomolecular Therapies, Experimental Oncology Laboratory, Rizzoli Orthopaedic Institute, 40136 Bologna, Italy,PROMETEO Laboratory, STB, RIT Department, Rizzoli Orthopaedic Institute, 40136 Bologna, Italy
| | - Jeffrey A. Toretsky
- Department of Oncology, Georgetown University Medical Center, Washington, D.C. 20007
| | - Katia Scotlandi
- CRS Development of Biomolecular Therapies, Experimental Oncology Laboratory, Rizzoli Orthopaedic Institute, Bologna, Italy. .,PROMETEO Laboratory, STB, RIT Department, Rizzoli Orthopaedic Institute, Bologna, Italy.
| | - Aykut Üren
- Department of Oncology, Georgetown University Medical Center, Washington, DC, USA.
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Yalcin S, Dane F, Oksuzoglu B, Yildirim N, Isikdogan A, Ozkan M, Demirag G, Coskun HS, Karabulut B, Evrensel T, Ustaoglu MA, Ozdemir F, Turna H, Yavuzsen T, Aykan F, Sevinc A, Akbulut H, Yuce D, Hayran M, Kilickap S. Quality of life study in patients with unresectable locally advanced or metastatic pancreatic cancer treated with gemcitabine in combination with nab-paclitaxel versus gemcitabine alone:ax-panc-sy001: A phase II randomized study. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.4_suppl.346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
346 Background: Although clinical efficacy of gemcitabine in combination with nabpaclitaxel has been shown to be superior to single agent gemcitabine in a randomize phase 3 trial, data are lacking on the quality of life of this combination regimen as first-line therapy in patients with unresectable locally advanced or metastatic pancreatic adenocarcinoma. Methods: We randomly assigned 125 patients with an Eastern Cooperative Oncology Group performance status score of 0 or 1 to receive gemcitabine, 1000 mg/m2 plus nabpaclitaxel 125 mg/m2 or gemcitabine at a dose of 1000 mg per square meter weekly for 7 of 8 weeks and then weekly for 3 of 4 weeks. Treatment continued until disease progression or unacceptable toxicity. The primary end point was 3-months deterioration-free rate (percentage of patients free from definitive deterioration) and quality of life of patients. Results: The median overall survival was 9.92 months in the gemcitabine plus nabpaclitaxel group as compared with 5.95 months in the gemcitabine group (hazard ratio for death, 0.642, 95% confidence interval, 0.422 to 0.866; p < 0.038). Median progression-free survival was 6.28 months in the combination group and 3.22 months in the gemcitabine group (hazard ratio for disease progression, 0.582; 95% CI, 0.391 to 0.866; p < 0.008). The objective response rate was 37.1% in the combination group versus 23.7% in the gemcitabine group (p < 0.009). Median time to deterioration was 3.68 months in the gemcitabine arm versus 5.36 months in the combination arm. More data on quality of life will be presented. Conclusions: As compared with gemcitabine, gemcitabine plus nabpaclitaxel was associated with an overall and progressive free survival advantage, with increased response rate, without increasing toxicity and deterioration of quality of life. Gemcitabine and nabpaclitaxel combination regimen with this form is a preferable option for the treatment of patients with advanced pancreatic cancer Clinical trial information: EudraCT: 2013-004180-32.
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Affiliation(s)
| | | | - Berna Oksuzoglu
- Dr. A.Y. Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Nuriye Yildirim
- Ankara Numune Education and Research Hospital, Ankara, Turkey
| | | | | | - Guzin Demirag
- Ondokuzmayis University Medical Oncology, samsun, Turkey
| | | | | | | | | | - Feyyaz Ozdemir
- Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
| | - Hande Turna
- Istanbul University Cerrahpasa School of Medicine, Istanbul, Turkey
| | - Tugba Yavuzsen
- Dokuz Eylul University Oncology Institute, Izmir, Turkey
| | - Faruk Aykan
- University of Istanbul, Institute of Oncology, Istanbul, Turkey
| | | | - Hakan Akbulut
- Ankara Numune Education and Research Hospital, Ankara, Turkey
| | - Deniz Yuce
- Hacettepe University Cancer Institute, Ankara, Turkey
| | - Mutlu Hayran
- Hacettepe University Cancer Institute, Ankara, Turkey
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Abstract
Aims and background The purpose of the study was to identify prognostic factors that affect survival following bone metastasis in breast cancer patients with first metastases in the skeletal system. Methods and study design We analyzed retrospectively the data of 248 metastatic breast cancer patients whose first distant metastasis was in the skeleton. Results The median age of the patients at diagnosis was 46 years (range, 23–76). Nearly half of the patients were premenopausal (52.4%). The median disease-free survival was 24 months. For most of the patients (221), bone was the sole first metastatic site, and the disease remained confined to the bone in 99 of them. The remaining patients (n = 27) had both bone and visceral metastasis at the time of first relapse. One hundred and fourteen of the patients (46%) had died by the time of analysis. With the median follow-up of 50.5 months from diagnosis, median survival after bone metastasis was 32 months. In univariate analyses, statistically significant predictors for survival after bone metastasis were axillary lymph node status, T stage of disease, hormone receptor status of the primary tumor, the presence of lymphovascular invasion, involvement of skin, the presence of additional nonosseous metastatic sites at the time of bone relapse, and disease-free interval. In multivariate analyses, the presence of additional non-osseous metastatic sites at the time of bone relapse, T stage of disease, hormone receptor status of the primary tumor, and the presence of lymphovascular invasion were found to be significant independent prognostic factors. Conclusions In the result of study, for patients with breast cancer, survival following bone metastasis is affected by secondary prognostic factors such as disease-free interval and extent of metastasis besides primary prognostic factors related to the primary tumor.
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Affiliation(s)
- Ozlem Yavas
- Departments of Medical, Hacettepe University, Institute of Oncology, Ankara, Turkey
| | - Mutlu Hayran
- Departments of Preventive Oncology, Hacettepe University, Institute of Oncology, Ankara, Turkey
| | - Yavuz Ozisik
- Departments of Medical, Hacettepe University, Institute of Oncology, Ankara, Turkey
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Abstract
BACKGROUND Previous studies have noted a possible association between periodontal diseases and the risk of various cancers. We assessed cancer risk in a cohort of patients with moderate to severe periodontitis. METHODS Patients diagnosed with moderate to severe periodontitis by a periodontist between 2001 and 2010 were identified from the hospital registry. Patients younger than 35 years of age or with a prior cancer diagnosis were excluded. The age- and gender-standardized incidence rates (SIR) were calculated by dividing the number of observed cases by the number of expected cases from Turkish National Cancer Registry 2013 data. RESULTS A total of 280 patients were included (median age 49.6, 54% female). Median follow-up was 12 years. Twenty-five new cancer cases were observed. Patients with periodontitis had 77% increased risk of cancer (SIR 1.77, 95% CI 1.17-2.58, p = .004). Women with periodontitis had significantly higher risk of breast cancer (SIR 2.40, 95% CI 0.88-5.33) and men with periodontitis had significantly higher risk of prostate cancer (SIR 3.75, 95% CI 0.95-10.21) and hematological cancers (SIR 6.97, 95% CI 1.77-18.98). CONCLUSION Although showing a causal association necessitates further investigation, our results support the idea that periodontitis might be associated with increased cancer risk, particularly with hematological, breast and prostate cancers.
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Affiliation(s)
- Omer Dizdar
- a Department of Preventive Oncology , Hacettepe University Cancer Institute , Ankara , Turkey
| | - Mutlu Hayran
- a Department of Preventive Oncology , Hacettepe University Cancer Institute , Ankara , Turkey
| | - Deniz Can Guven
- b Department of Internal Medicine , Hacettepe University Faculty of Medicine , Ankara , Turkey
| | - Tolga Birtan Yılmaz
- c Department of Periodontology , Hacettepe University Faculty of Dentistry , Ankara , Turkey
| | - Sahand Taheri
- c Department of Periodontology , Hacettepe University Faculty of Dentistry , Ankara , Turkey
| | - Abdullah C Akman
- c Department of Periodontology , Hacettepe University Faculty of Dentistry , Ankara , Turkey
| | - Emre Bilgin
- b Department of Internal Medicine , Hacettepe University Faculty of Medicine , Ankara , Turkey
| | - Beril Hüseyin
- a Department of Preventive Oncology , Hacettepe University Cancer Institute , Ankara , Turkey
| | - Ezel Berker
- c Department of Periodontology , Hacettepe University Faculty of Dentistry , Ankara , Turkey
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Karakas Y, Dizdar O, Aksoy S, Hayran M, Altundag K. The Effect of Total Size of Lesions in Multifocal/Multicentric Breast Cancer on Survival. Clin Breast Cancer 2017; 18:320-327. [PMID: 29183716 DOI: 10.1016/j.clbc.2017.11.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 09/28/2017] [Accepted: 11/02/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND In this study, we aimed to assess the prognostic performance of determining the T stage according to the total size of lesions compared with the size of the largest lesion in the breast in patients with multifocal/multicentric (MF/MC) breast cancer. PATIENTS AND METHODS The charts of the patients with MF/MC breast cancer who were diagnosed between 2003 and 2014 were reviewed. The T stage of MF/MC tumors was determined according to the largest lesion size (Tmax) as well as the sum of the longest diameters of the lesions (Tsum) in the breast. RESULTS Multifocal/multicentric tumors were identified in 323 of 3890 patients (8.3%) with breast cancer. Ten-year rates of overall survival (OS; 75% and 74%; P = .965) and disease-free survival (DFS; 66% and 61%; P = .817) were similar in patients with unifocal and MF/MC tumors, respectively. When the T stage was determined by summing the sizes of the lesions, the T stage of 67 (20.7%) and 63 (19.5%) patients advanced from T1 to T2 and from T2 to T3, respectively. Thus, the T stage increased in 130 patients (40.2%) according to American Joint Committee on Cancer. Discriminatory ability of Tsum was better than Tmax in terms of OS and DFS, as shown with higher Royston D and Harrel C statistics and Schemper V values. CONCLUSION The new T classification proposed in this report stands out as a better predictive classification particularly in patients with low disease burden.
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Affiliation(s)
- Yusuf Karakas
- Hacettepe University Cancer Institute, Ankara, Turkey
| | - Omer Dizdar
- Hacettepe University Cancer Institute, Ankara, Turkey
| | - Sercan Aksoy
- Hacettepe University Cancer Institute, Ankara, Turkey
| | - Mutlu Hayran
- Hacettepe University Cancer Institute, Ankara, Turkey
| | - Kadri Altundag
- Mustafa Kadri Altundag (MKA) Breast Cancer Clinic, Ankara, Turkey.
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Akin S, Dizdar Ö, Hayran M. Anti-VEGF Therapy in the Treatment of Unresectable Appendiceal Epithelial Neoplasms. Ann Surg Oncol 2017; 24:620. [PMID: 29168096 DOI: 10.1245/s10434-017-6147-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Indexed: 12/13/2022]
Affiliation(s)
- Serkan Akin
- Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey.
| | - Ömer Dizdar
- Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Mutlu Hayran
- Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
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Topaloglu R, Gulhan B, İnözü M, Canpolat N, Yilmaz A, Noyan A, Dursun İ, Gökçe İ, Gürgöze MK, Akinci N, Baskin E, Serdaroğlu E, Demircioğlu Kiliç B, Yüksel S, Övünç Hacihamdioğlu D, Korkmaz E, Hayran M, Ozaltin F. The Clinical and Mutational Spectrum of Turkish Patients with Cystinosis. Clin J Am Soc Nephrol 2017; 12:1634-1641. [PMID: 28793998 PMCID: PMC5628704 DOI: 10.2215/cjn.00180117] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 06/26/2017] [Indexed: 01/24/2023]
Abstract
BACKGROUND AND OBJECTIVES Infantile nephropathic cystinosis is a severe disease that occurs due to mutations in the cystinosis gene, and it is characterized by progressive dysfunction of multiple organs; >100 cystinosis gene mutations have been identified in multiple populations. Our study aimed to identify the clinical characteristics and spectrum of cystinosis gene mutations in Turkish pediatric patients with cystinosis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS We identified the clinical characteristics and spectrum of cystinosis gene mutations in Turkish patients with cystinosis in a multicenter registry that was established for data collection. The data were extracted from this registry and analyzed. RESULTS In total, 136 patients (75 men and 61 women) were enrolled in the study. The most common clinical findings were growth retardation, polyuria, and loss of appetite. None of the patients had the 57-kb deletion, but seven novel mutations were identified. The most common mutations identified were c.681G>A (p.Glu227Glu; 31%), c.1015G>A (p.Gly339Arg; 22%), and c.18_21 del (p.Thr7Phefs*7; 14%). These mutations were associated with earlier age of disease onset than the other mutations. To understand the effects of these allelic variants on clinical progression, the mutations were categorized into two major groups (missense versus deletion/duplication/splice site). Although patients with missense mutations had a better eGFR at the last follow-up visit, the difference was not significant. Patients in whom treatment began at age <2 years old had later onset of ESRD (P=0.02). Time to ESRD did not differ between the patients with group 1 and group 2 mutations. CONCLUSIONS The most common cystinosis gene mutations identified in Turkey were c.681G>A (p.Glu227Glu), c.1015G>A (p.Gly339Arg), and c.18_21 del (p.Thr7Phefs*7). Patients with less severe cystinosis gene mutations tend to have better kidney outcome.
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Affiliation(s)
- Rezan Topaloglu
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
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Celik H, Sciandra M, Flashner B, Gelmez E, Kayraklıoğlu N, Allegakoen DV, Petro JR, Conn EJ, Hour S, Han J, Oktay L, Tiwari PB, Hayran M, Manara MC, Toretsky JA, Scotlandi K, Uren A. Abstract 1933: Discovery of first-in-class small molecule CD99 inhibitors for targeted therapy of Ewing sarcoma. Cancer Res 2017. [DOI: 10.1158/1538-7445.am2017-1933] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Ewing sarcoma (ES) is an aggressive bone and soft tissue malignancy that affects predominantly children and adolescents with a high propensity to metastasize and poor prognosis. CD99 is a transmembrane cell surface protein that is highly expressed on ES cells, and routinely used as a marker for histological diagnosis of ES. We screened small molecule libraries for their binding to recombinant CD99 protein and subsequent selective inhibition of ES cell growth. We identified two structurally similar FDA-approved nucleoside analogues, clofarabine and cladribine that selectively inhibited the growth of ES cells in a panel of 14 ES vs. 28 non-ES cell lines. A significant negative correlation was found in human cell lines between CD99 expression and IC50 values for clofarabine and cladribine. Both drugs inhibited CD99 dimerization and its interaction with downstream signaling components cyclophilin A and PKA-RIIα as well as led to reduced ROCK2 protein expression and migration in ES cells. A membrane-impermeable analog of clofarabine showed similar cytotoxicity in ES cells, suggesting that it can function through inhibiting CD99 alone without any effect on DNA metabolism. Clofarabine and cladribine led to a significant increase in hypodiploid DNA content of ES cells, which was diminished by suppression of CD99 expression. Both drugs drastically inhibited anchorage-independent growth of ES cells, but clofarabine was more effective in inhibiting ES xenografts. Finally, the screening of a set of chemotherapy drugs revealed a synergy for the combination of anti-CD99 drugs and dasatinib in ES cells, which may translate into increased survival and reduced toxicity. Overall, our findings suggest that clofarabine is a good candidate for early phase clinical trials in children with ES.
Citation Format: Haydar Celik, Marika Sciandra, Bess Flashner, Elif Gelmez, Neslihan Kayraklıoğlu, David V. Allegakoen, Jeff R. Petro, Erin J. Conn, Sarah Hour, Jenny Han, Lalehan Oktay, Purushottam B. Tiwari, Mutlu Hayran, Maria Cristina Manara, Jeffrey A. Toretsky, Katia Scotlandi, Aykut Uren. Discovery of first-in-class small molecule CD99 inhibitors for targeted therapy of Ewing sarcoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 1933. doi:10.1158/1538-7445.AM2017-1933
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Affiliation(s)
- Haydar Celik
- 1Georgetown University Medical Center, Washington, DC
| | | | - Bess Flashner
- 1Georgetown University Medical Center, Washington, DC
| | - Elif Gelmez
- 1Georgetown University Medical Center, Washington, DC
| | | | | | - Jeff R. Petro
- 1Georgetown University Medical Center, Washington, DC
| | - Erin J. Conn
- 1Georgetown University Medical Center, Washington, DC
| | - Sarah Hour
- 1Georgetown University Medical Center, Washington, DC
| | - Jenny Han
- 1Georgetown University Medical Center, Washington, DC
| | - Lalehan Oktay
- 1Georgetown University Medical Center, Washington, DC
| | | | | | | | | | | | - Aykut Uren
- 1Georgetown University Medical Center, Washington, DC
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