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Öğe Kardiyovasküleri işlemlerde görüntüleme(Archives of the Turkish Society of Cardiology, 2022) Vatansever Ağca, Fahriye; Babur Güler, Gamze; Gürsoy, Mustafa Ozan; Özden, Özge; Altın, Mert Pehlivan; Kahveci, GökhanKardiyovasküler İşlemlerde GörüntülemeÖğe Increased visinin-like protein-1, YKL-40, lipocalin-2, and IL-23 levels in patients with migraine(TAYLOR & FRANCIS LTD, 2022) Dündar, Ahmet; Cafer, Vugar; Aslanhan, Hamza; Özdemir, Hasan Hüseyin; Yılmaz , Ahmet; Çevik, Mehmet UğurBackground: Migraine is a type of primary headache caused by changes in the trigeminal system and has been reported to be associated with neurovascular inflammation of cerebral and extracerebral vessels. Objective: It is known that inflammation is an important process in the pathogenesis of migraine. It has been shown that the molecules of visinin-like protein 1 (Vilip-1), YKL-40, lipocalin-2 and interleukin (IL)-23 play a role in the inflammatory process. Our aim is to investigate the role of this molecule in the metabolic pathway of migraine disease. Methods: Fifty migraine patients with and without aura in the interictal period were included in the study. Vilip-1, YKL-40, lipocalin-2, and IL-23 levels were measured by ELISA method. Results: Serum vilip-1, YKL-40, lipocalin-2, and IL-23 levels were found to be significantly higher in migraine patients compared to the control group. We found that this molecule increased significantly in migraine subgroups compared to the control group (p < 0.001). A positive significant correlation was found between vilip-1 level and YKL-40 and lipocalin-2 levels in migraine patients. In addition, a positive correlation was observed between visual analogue scale score, number of days with pain and vilip-1 level (p < 0.01). The results of our study showed that activation of inflammatory mediators may play a role in the pathogenesis of migraine disease. In addition, our study is valuable in that inflammatory molecules are high in the interictal period and these biomarkers have never been analyzed in migraine patients. However, we still believe that larger studies are needed to explain the role of vilip-1, YKL-40, lipocalin-2, and IL-23 in the molecular mechanism of migraine disease.Öğe Indirect evaluation of amyloid deposition by ultrasonography and its relationship with MEFV gene mutation in FMF patients(WILEY, 2022) Urfalı, Mine; Yılmaz, Gürkan; Özkul, Bahattin; Urfalı, Furkan ErtürkObjectiveThe most significant complication in familial mediterranean fever (FMF) patients is dysfunction and organ failure developing depending on amyloid deposition in organs. The golden standard for showing amyloid deposition is the biopsy; however, tissue stiffness was examined by shear wave elastography as a non-invasive method in a restricted number of studies conducted, and it is considered that amyloid deposition can be shown indirectly. In our study, we aimed to indirectly evaluate amyloid deposition in organs with Shear wave and Doppler ultrasonography and to reveal its relationship with MEFV gene mutation analysis. Method42 FMF patients with normal thyroid and renal function tests and 35 participants with no FMF symptoms were included in our study. FMF patients were grouped depending on their MEFV mutation analyses. Thyroid, salivary glands, and renal parenchymal tissue stiffness were evaluated by shear wave elastography. Thyroidal artery and both renal artery resistances were evaluated by Doppler ultrasonography. ResultsBoth parotis gland, thyroid and renal parenchymal stiffness and arterial vascular resistances in the patient group were found higher than the control group. A significant difference was not found in any parameters in classification based on gender. Tissue stiffness and vascular resistance values in the patient group with M694V homozygote mutation were found statistically significantly higher than the other mutation groups (p < 0.001). ConclusionOur study shows that identifying genetic mutation type in FMF patients will help determine possibly amyloidosis risk. Imaging of tissue stiffness by shear wave elastography and evaluation of vascular resistance by Doppler can be useful for routine screening of those patients.Öğe Prognostic factors affecting survival in breast cancer patients age 40 or younger(Ondokuz Mayis Universitesi, 2022) Kuru, Bekir; Yürüker, Savaş; Akgün, Can; Karabacak, Ufuk; Özen, NecatiThe aims of this study were to identify the factors affecting survival and disease-free survival (DFS) in invasive breast cancer patients who underwent surgery for breast cancer age 40 or younger. Medical records of 216 women with breast carcinoma at age 40 or younger who underwent surgery at our Institution between October 2005 and May 2017 were retrospectively reviewed. One hundred and eighty eight invasive breast cancer patients that were eligible were categorized according to their clinical and pathological features. Univariate analyses of survival and DFS were performed by the Kaplan-Meier method and the log-rank test. Independent prognostic and predictive factors affecting survival and DFS were assessed by Cox regression proportional hazard method. 10-year survival and DFS were 85 and 74%, respectively. Axillary involvement, pathologic tumor size, HER 2 + subtype and Triple Negative subtype were found to be the prognostic factors that independently affected survival and DFS. The prognosis is worse in patients with axillary involvement, tumors larger than 2 cm, and HER 2+ and Triple Negative subtypes. These adverse prognostic factors should be considered during treatment and follow-up of patients age 40 or younger. © 2022 Ondokuz Mayis Universitesi. All rights reserved.Öğe Novel magnetic embolic MRI imageable particles with anticancer drug release for transcatheter arterial embolization and magnetic ablation(WILEY, 2022) Bekaroğlu, Maide Gökçe; Nurili, Fuad; Caymaz, İsmail; Baş, Ahmet; İşçi, SevimThe aim of the study is to prepare embolic hydroxyl ethyl cellulose (HEC)-polyvinyl prolidone (PVP)-magnetic particles suitable for transcatheter arterial chemoembolization (TACE) procedures, drug delivery, and magnetic hyperthermia. Two different sizes (microsized and nanosized) of iron oxide particles were used to prepare the embolic particles to investigate the embolization and drug delivery properties. Iron oxides were linked with PVP via bridging flocculation process, then outermost layer of the linked particles was coated with HEC in order to load drugs to particles and reach size requirements for a successful TACE procedure. Size of each particle was calibrated to the range that allows easy injections through microcatheters (40-500 mu m). The results showed that the size of the final embolic particles reached around 70 mu m with 82 W/g specific absorption rate (SAR) values for nano-iron oxide particles and 45 mu m with 77 W/g SAR values for micro-iron oxide particles, which are quite suitable for TACE applications. Furthermore, an anticancer drug doxorubicin (DOX) was successfully loaded onto these particles in order to achieve localized chemotherapy at the tumor site. Particles produced in this study, loaded DOX successfully and prolonged drug release time, performed similarly to pure DOX at higher concentration treatments against human breast cancer cell lines, were heatable under applied alternating magnetic fields. In addition, in vivo embolization studies performed using a rabbit renal embolization model, indicated that these particles were easily delivered through microcatheters and were able to embolize the target.Öğe Clinical reflection of pre- and post-COVID-19 symptoms in COVID-19 patients(2022) Demirkol, Barış; Gül, Şule; Çortuk, Mustafa; Koç, Aysu Sinem; İlhan, Umut; Baydili, Kürşad Nuri; Çetinkaya, Erdoğan; Koç, Aysu SinemBackground: Hospitalized or non-hospitalized patients with Coronavirus disease-2019 (COVID-19) may exhibit different symptoms. Different symptoms of patients can give us an idea about the course of the disease. Materials and Methods: A cross-sectional questionnaire study was conducted between August and October 2021. The questionnaire was sent online to patients who had COVID-19 infection with polymerase chain reaction positivity. The following categories were included in the questionnaire: Demographic characteristics, diagnosis date, initial symptoms, predominant symptoms, treatments, presence of hospitalization requirement, ongoing symptoms after the treatment, and symptom duration. Results: Of the 596 patients, 574 (92.4%) were symptomatic at the beginning of the disease. Myalgia, fatigue, and headache were the most prominent initial symptoms. Fever and dyspnea were the most predominant symptoms that compel the patients to apply to the hospital. While dyspnea was significantly higher in hospitalized patients, fever was more common in non-hospitalized patients. Higher mean age, male gender, and comorbidity (especially chronic obstructive pulmonary disease) were found to be factors that increased hospitalization (p<0.01). Fever and fatigue were mostly seen among females, while myalgia was most prominent among men. Four hundred and seventy-seven patients (80%) had post-COVID symptoms and the most common symptoms were getting tired easily, fatigue, myalgia, and cough. However, post-COVID symptoms were most intense in the second month and there were cases with complaints up to one year. Conclusion: The majority of the COVID-19 patients in our study were symptomatic. Dyspnea and fever with higher mean age were more common in patients requiring hospitalization. Post-COVID symptoms may persist for a long time, and long-term monitoring may be beneficial.Öğe Effectiveness of preemptive chlorhexidine digluconate-flurbiprofen spray on postoperative sore throat and hoarseness in patients undergoing rhinoplasty: a retrospective study(PMC PubMed Central, 2022) Kartufan, Fatma Ferda; Yıldırım, Alpaslan; Morkoç, Okan; Çiçek, MüslümBackground In this retrospective study, we aimed to investigate the effect of chlorhexidine digluconate-flurbiprofen spray (Klorhex Plus® oral spray) on postoperative sore throat (POST) and hoarseness (POH) in patients undergoing rhinoplasty. Methodology Patients who underwent rhinoplasty alone in our clinic between April 01, 2021, and February 28, 2022, were enrolled in the study. Patients' demographics such as age, gender, height, and smoking status that could affect sore throat, difficult intubation, and operation time were recorded from the patients' files. Patients were grouped as those who received Klorhex Plus oral spray before the surgery (Klorhex P group) and those who did not (control group). POST and POH were recorded from the patients' postoperative surgery files. Postoperative pain evaluation was performed using the Numerical Rating Scale (NRS) at the postoperative first hour (PPL1h), 12th hour (PPL12h), and first day (PPL1d) from the postoperative nursing files. Results A total of 354 patients who underwent rhinoplasty alone were included in this study. No significant difference was found between the groups in terms of the demographic data. Statistically, PPL1h, PPL12h, and PPL1d were significantly lower in the Klorhex P group compared to the control group (for all, p < 0.001). POST and POH were also significantly higher in the control group (both, p < 0.001). Conclusions The results of this study indicate that Klorhex Plus oral spray is an efficient agent for preemptive analgesia before rhinoplasty. It significantly decreases the postoperative pain level, POST, and POH. However, further comprehensive prospective studies are needed to introduce Klorhex Plus oral spray to rhinology practice.Öğe Akut lösemide nüks öngörüsünde olası şüpheli: trombositopeni(2022) Çetin, İpek Dokurel; Özdemir, Gül Nihal; Çelkan, Tülin Tiraje; Erdoğan, Mehmet Sarper; Apak, HilmiAmaç: Çocukluk çağında, akut lösemi hastalarında nüks gelişmesi s ık olmamakla birlikte, mortalitesi yüksek bir komplikasyon olarak kar şımıza ç ıkmaktadır. Çalışmamızda, çocukluk çağı akut lösemi hastalar ının nüks riskinin öngörüsünde kolaylıkla kullanılabilecek kan belirteçlerinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Kliniğimizde, 20 y ıllık süreçte akut lösemi tanısı alan 279 çocuğun verileri geriye dönük tarandı. Tüm verilerine ulaşılabilen 42 nüks gelişmiş ve 37 nüks gelişmemiş akut lösemi olgusu çalışmaya dahil edildi. Tüm hastaların, tan ı esnasındaki ve takip sürecindeki kan say ımı belirteçleri ve fizik muayene bulguları geriye dönük olarak değerlendirildi. Say ısal değişkenlerin kar şılaştırılmasında, Mann- Whitney U ve T- test kullanıldı. Kategorik değişkenlerin karşılaştırılmasında ise, Ki- kare testi kullanıldı. Bulgular: Nüks gelişen çocuk değerlendirildiğinde; yirmidört çocuk B-hücreli ALL, 10 çocuk T-hücreli ALL, 8 çocuk AML tanısı almıştı. Nüks gelişmeyen olguların ise; 26 çocuk B-hücreli ALL, 10 çocuk T- hücreli ve 1 çocuk AML tanısı almıştı. Remisyon sağlandıktan sonraki izlemde, nüks gelişen 24 hastada ve nüks gelişmeyen dokuz hastada tr ombositopeni görüldü. Tüm hastalar değerlendirildiğinde; remisyon sonrasında, trombositopeni görülen olgularda nüks gelişme riski istatistiksel olarak anlamlı şekilde yüksekti. Remisyon döneminde, ortalama 3.86 hafta devam eden trombositopeni görülen tüm hastalarda nüks geliştiği gözlenmiştir. Sonuç: Çocukluk çağı akut lösemi hastalarının, remisyon dönemindeki iz lemleri esnasında trombositopeni gözlenmesi, öncelikle tedavide kullanılan kemoteröpetiklerin ve olası gelişen infeksiyonların kemik iliğine olan etkisi ile açıklanabilir. Ancak, çalışmamız göstermiştir ki; remisyon dönemi sonrasında geli şen ve üç haftadan uzun süren trombositopeni varlığı nüks gelişiminin öngörüsünde, ulaşımı kolay bir kan belirteci olarak kullanılabilir.Öğe Alpha-lipoic acid intoxication in an adolescent girl:case report and review of the literature(2022) Polat, Sinem; Sönmez, Feruze Turan; Kılıçaslan, ÖnderAlpha-lipoic acid is a widely used medication that does not need a prescription. Although it is safely used in adults, hitherto no safe dose for children has been reported, and there is no known antidote. The medical literature provides four reports of alpha-lipoic acid intoxication in the pediatric population to date. This case-report is the lowest known dose of alpha-lipoic acid intake leading to poisoning in a teenager.Öğe The effect of periodic examination time interval and frequency after “percutaneous coronary intervention” on experiencing second "acute coronary syndrome"(2022) Balaban, Yakup; Coşansu, KahramanThe Effect of Periodic Examination Time Interval and Frequency After “Percutaneous Coronary Intervention” on Experiencing Second "Acute Coronary Syndrome"Öğe Venous leg symptoms in migraineurs: a potential clue on the pathophysiology of migraine(Edizioni Minerva Medica, 2022) Çuğlan, Bilal; Önalan, Ayşenur; Öztürk, Selçuk; Altuntaş, Emine; Demiral, Ahmet B.; Atmaca, Hasan; Altıntaş, Sait; Yetkin, ErtanBACKGROUND: Migraine is a neurovascular disorder which cerebral venous congestion might have role in pathogenesis. The objective was to assess the association between venous disease and migraine by using the Venous Insufficiency Epidemiological and Economic Study-Quality of Life/Symptoms (VEINES-QoL/Sym) questionnaire in migraineurs and non-migraineurs. METHODS: The study was designed as a non-randomized, prospective cohort study and consisted of patients diagnosed with migraine and age-, sex- matched healthy subjects without migraine. All participants were examined for the presence of chronic venous disease (CVD). VEINES-Sym questionnaire was applied to assess venous symptoms. The Migraine Disability Assessment (MIDAS) questionnaire was used to assess the severity of disease in migraineurs. RESULTS: Participants were classified into two groups as migraine-positive group (N.=130) and migraine-negative group (N.=130). Migraine patients and control group were comparable in terms of clinical status and demographic parameters. Total VEINES-Sym score was lower in patients with migraine compared to control group (34.4±8.7, 37.6±8.12, P=0.003, respectively). Additionally, there was a significant negative correlation between VEINES-Sym score and total MIDAS disability score (r=-0.33, P<0.001) and MIDAS severity levels (little or no, mild, moderate, severe) (r=-0.266, P=0.003) of the migraineurs. Logistic regression analysis revealed that VEINES-Sym score is an independent and statistically significant associate of migraine (OR=0.95, 95% CI:0.92-0.98, P=0.001). CONCLUSIONS: We have documented an independent association between migraine and VEINES-Sym score indicating possible pathophysiological link between migraine and CVD. Further studies are warranted to figure out the pathophysiological associations between migraine and venous vascular pathology and peripheral varicose vein. © 2022 EDIZIONI MINERVA MEDICA.Öğe Humoral and cellular immunity to SARS-COV-2 vaccination with BNT162B2 MRNA vaccine in pediatric kidney transplant and dialysis patients(Springer, 2022) Gülmez, Rüveyda; Özbey, Doğukan; Ağbaş, Ayşe; Aksu, Bağdagül; Yıldız, Nurdan; Üçkardeş, Diana; Saygılı, Seha; Yıldırım, Zeynep Yürük; Taşdemir, Mehmet; Kıykım, Ayça; Çokuğraş, Haluk; Canpolat, Nur; Nayır, Ahmet; Kocazeybek, Bekir S.; Çalışkan, SalimHumoral And Cellular Immunity To Sars-Cov-2 Vaccination With Bnt162b2 Mrna Vaccine In Pediatric Kidney Transplant And Dialysis PatientsÖğe COVID-19 infection frequency and clinical course in patients with liver transplantation: results of a single transplant center in Turkiye(TURKISH SURGICAL ASSOC, 2022) Aydın, Osman; Çolakoğlu, Muhammet Kadri; Öter, Volkan; Özgün, Yiğit Mehmet; Pişkin, Erol; Arı, Derya; Kayhan, Meral Akdoğan; Özmen, Mehmet Mahir; Bostancı, Erdal BirolObjective: In this paper, it was tried to determine the incidence of COVID-19, course of the disease, and mortality rate in liver transplant patients by evaluating all patients operated on in our center. In addition, the results of liver transplantation performed in our center during the pandemic period were also presented. Material and Methods: All patients who had undergone liver transplantation in our liver transplant center were questioned about their history of COVID-19 either at their routine controls in the clinic or by phone interview. Results: Our liver transplant unit had 195 registered liver transplantation patients (2002-2020), and 142 of these were still alive and under follow-up. During the pandemic period, 80 patients referred to our outpatient clinic for follow-up, and their records were evaluated retrospectively in January 2021. Among 142 liver transplant patients, a total of 18 (12.6%) COVID-19 patients were identified. While 13 of these patients were males, mean age of the patients at the time of interviews was 48.8 years (22-65 years). Nine of the patients had living donor liver transplant, and the rest had cadaveric liver transplant. The most common COVID-19 associated symptom in the patients was fever. During the pandemic period, 12 liver transplant operations were performed in our center. Nine of them were living donor liver transplantation and the remainder were cadaveric liver transplantations. Two of our patients got COVID-19 positive during this period. One of them who was transplanted after COVID treatment was followed-up in intesive care for a long time and was lost not related to COVID-19. Conclusion: The incidence of COVID-19 is higher in liver transplant patients than in the general population. Nonetheless, mortality rates are low. During the pandemic period, liver transplantation can be continued by following general precautions.Öğe Comparing the success rate of natural cycle and modified natural cycle protocols for frozen-thawed embryo transfer(TAYLOR & FRANCIS LTD, 2022) Aydın, Turgut; Kalem, Müberra Namlı; Bakırarar, Batuhan; Aygün, Elif Ganime; Kalem, ZiyaObjective: The aim of the present study is to compare the effects of Natural Cycle and modified Natural Cycle protocols for frozen-thawed embryo transfer on clinical pregnancy rate and live birth rate. Methods: This prospective randomized controlled trial comprised 145 patients scheduled for frozen-thawed embryo transfer and was conducted at a university hospital between 2019 and 2021. The Natural Cycle protocol was administered to 73 patients and the modified Natural Cycle protocol to 72 patients and the clinical outcome was compared between the groups. The main outcome measure was live birth rate. Results: Baseline characteristics and cycle parameters were similar in both groups. There was no difference in clinical pregnancy rate (58.9% and 54.2%, respectively; p = .565) and live birth rate between the Natural Cycle and modified Natural Cycle groups (49.3% and 48.6% respectively; p = .932). Conclusion: This study established that clinical pregnancy and live birth rates were not affected by natural cycle ovulation being spontaneous or hCG-triggered among patients undergoing frozen-thawed embryo transfer. Thus, the protocol for natural cycle frozen-thawed embryo transfers should be chosen according to the priorities of the patient and the physician.Öğe Non-traumatic Spontaneous Spinal Subdural Hematoma in a Patient with Acute Paraplegia(EMERGENCY MEDICINE PHYSICIANS ASSOC TURKEY, 2022) Sağlık, Ali; Şencan, Fahir; Giray, Tufan Akın; Ocak, TarıkAcute non-traumatic spinal subdural hematoma (SSDH) is a rare clinical condition in the emergency medicine practice and difficult to diagnose during the primary physical examination. It mostly occurs at thoracal vertebra levels due to trauma, use of anticoagulants, medical procedures such as acupuncture, arteriovenous malformations, hematological disorders or space-occupying lesions. Here, we discussed an elderly female patient who was not on anticoagulant and described sudden loss of muscle strength and sensation in both lower extremities. Initial laboratory and imaging including brain computerized tomography (CT) and magnetic resonance imaging (MRI) were in normal range. Patient's secondary examination revealed anesthesia under the T4 dermatome level. Cervical spine-MRI in Spin Eco (SE) T1, Fast Spin Eco (FSE) T2 in sagittal plane; SE T1 weighted in axial and sagittal planes revealed a subdural hematoma significantly compressing the spinal cord on the C7-T1 dermatome segments. Any emergency neurosurgical intervention was not considered and the patient was interned in the neurosurgical clinic for conservative treatment and further examination. Patient, with no progress seen in consecutive MRI scans, was discharged after offering an outpatient check-up. We recommend secondary physical examination in emergency department (ED). In the case of appearance of sensory deficits of certain dermatomes, spine-MRI may lead to put the diagnose early in ED.Öğe Isolated dorsal dislocation of the 5th carpometacarpal joint; a missed injury(EMERGENCY MEDICINE PHYSICIANS ASSOC TURKEY, 2022) Aygün, Ümit; Yazıcı, Alikemal5th carpometacarpal (CMC) joint dislocations of the wrist region are very rare and easily overlooked injuries. In this type of injury, which causes serious functional problems in the hand if not treated appropriately, closed methods are generally used in the treatment. In this study, we present a case with fracture-dislocation of the 5th CMC joint. Fracture-dislocation of the 5th CMC joint of a 25-year-old patient who was admitted to the emergency department due to wrist pain was not noticed. The diagnosis was made during the follow-up of the patient, and the joint was reduced with closed method and fixed with a K wire. No serious problems were encountered in the patient's controls. Undiagnosed 5th CMC joint dislocation disrupts the transverse and longitudinal arches of the hand, so the patient has a weak and painful gripping function. Radiological findings may be unclear on anterior-posterior and lateral views, and additional images may be obtained if in doubt.Öğe Efficacy of multidisciplinary approach in thyroid nodules: analysis of factors used for predicting malignancy(TURKIYE KLINIKLERI, 2022) Kişio?lu, Savaş Volkan; Atacan, Hüseyin; Çakır, Emel; Oğuz, Şükrü; Karaküllükçü, Serdar; Ersöz, Halil ÖnderObjective: To date, numerous molecular tests have been developed for preoperative evaluation of thyroid nodules. Nevertheless, these tests cannot be administered in many centers due to their imprecise diagnoses and high costs. The present study aimed to investigate the effect of making surgical decisions in a panel through a multidisciplinary approach after clinical, ultrasonographic, and pathological evaluation of nodules on the accuracy of the decisions. Methods: The retrospective study included patients with thyroid nodules who underwent preoperative ultrasonography followed by fine-needle aspiration biopsy, which was confirmed by postoperative pathological examinations between January 2017 and January 2019. The relationship between ultrasonography features of nodules and malignancy was analyzed. A comparison was performed between patients who were referred for surgery through the multidisciplinary versus non-multidisciplinary approach. Results: A total of 255 nodules in 211 patients were evaluated in the study. The prevalence of malignancy was 100% in nodules with hypoechogenicity + microcalcification + margin irregularity (P <.001). The likelihood of malignancy was significantly higher in dual combinations of these 3 adverse conditions (P <.001 for all). Margin irregularity was found to be the most predictive model for malignancy (CI: 1.9-13.8, odds ratio: 5.249, P <.001). The multidisciplinary approach was superior to the non-multidisciplinary approach in the detection of malignancy (P =.008). Conclusion: Margin irregularity had the highest predictive value for the detection of malignancy. Employing the multidisciplinary approach in preoperative evaluation of thyroid nodules can be highly effective in detecting malignancy and preventing unnecessary surgery.Öğe Clinical outcomes of cyclin-dependent kinase 4–6 (CDK 4–6) inhibitors in patients with male breast cancer: a multicenter study(Churchill Livingstone, 2022) Yıldırım, Hasan Çağrı; Mutlu, Emel; Chalabiyev, Elvin; Özen, Miraç; Keskinkılıç, MerveBackground: Since breast cancer is less common in men than in women, data on the use of new therapeutic agents, including cyclin-dependent kinase 4–6 (CDK 4–6) inhibitors, are limited in patients with metastatic hormone receptor positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) male breast cancer. Therefore; we aimed to investigate the treatment responses of metastatic HR+, HER2-male breast cancer patients treated with CDK 4–6 inhibitors in a multicenter real-life cohort. Methods: Male patients with a diagnosis of HR+ and HER2-metastatic breast cancer, treated with any CDK 4–6 inhibitor, were included in the study. Demographic and clinical characteristics of the patients were recorded. We aimed to determine progression-free survival (PFS) time, response rates and drug related side effects. Results: A total 25 patients from 14 institutions were recruited. The mean age at diagnosis was 57 years. Median follow-up was 19.53 (95% CI: 14.04–25.02) months. The overall response rate was 60%. While the median PFS was 20.6 months in the whole cohort, it wasn't reached in those using CDK 4–6 inhibitors in first line and 10 months in the subsequent lines (p:0.009). No new adverse events were encountered. Conclusion: In our study, we found that CDK 4–6 inhibitors are effective and safe options in men with HR+ and HER2-metastatic breast cancer as in women. Our results support the use of CDK 4–6 inhibitor-based combinations in the first-line treatment of HR+ and HER2-metastatic male breast cancer.Öğe First-line treatment of patients with HER2-positive metastatic gastric and gastroesophageal junction cancer(Association of Basic Medical Sciences of FBIH, 2022) Aktürk Esen, Selin; Ergün, Yakup; Erol, Cihan; Arıkan, Rukiye; Er, Muhammed MuhiddinFluoropyrimidine+cisplatin/oxaliplatin+trastuzumab therapy is recommended for the first-line treatment of human epidermal growth factor receptor 2 (HER2)-positive metastatic gastric adenocarcinoma. However, there is no comprehensive study on which plati-num-based treatment should be preferred. This study aimed to compare the treatment response and survival characteristics of patients with HER2-positive metastatic gastric or gastroesophageal junction (GEJ) cancer who received f luorouracil, oxaliplatin, and leucovo-rin (mFOLFOX)+trastuzumab or cisplatin and f luorouracil (CF)+trastuzumab as first-line therapy. It was a multicenter, retrospective study of the Turkish Oncology Group, which included 243 patients from 21 oncology centers. There were 113 patients in the mFOLF-OX+trastuzumab arm and 130 patients in the CF+trastuzumab arm. The median age was 62 years in the mFOLFOX+trastuzumab arm and 61 years in the CF+trastuzumab arm (p = 0.495). About 81.4% of patients in the mFOLFOX+trastuzumab arm and 83.1% in the CF+trastuzumab arm had gastric tumor localization (p = 0.735). The median progression-free survival (PFS) was significantly higher in the mFOLFOX+trastuzumab arm (9.4 months vs. 7.3 months, p = 0.024). The median overall survival (OS) was similar in both groups (18.4 months vs. 15.1 months, p = 0.640). Maintenance trastuzumab was continued after chemotherapy in 101 patients. In this subgroup, the median OS was 23.3 months and the median PFS was 13.3 months. In conclusion, mFOLFOX+trastuzumab is similar to CF+trastuzumab in terms of the median OS, but it is more effective in terms of the median PFS in the first-line treatment of HER2-positive metastatic gastric and GEJ cancer. The choice of treatment should be made by considering the prominent toxicity findings of the chemotherapy regimens.Öğe Internal tibial torsion is associated with medial meniscus posterior horn tears(Springer Science and Business Media Deutschland GmbH, 2022) Bayram, Erhan; Şener, Nurullah; Korkmaz, Musa; Yıldırım, Cem; Aydın, Mahmud; Yurdaışık, Işıl; Çetinus, Mahmut ErcanPurpose: Risk factors for meniscal tears play a decisive role in deciding on treatment and rehabilitation. The purpose of this study was to investigate the effect of tibial rotation on medial meniscus posterior horn tears (MMPHTs). Methods: This study is a retrospective case–control study. Fifty patients with meniscal tears and 57 knees with intact meniscus were compared. Tibial rotation, femoral version, tibial slope and knee varus were measured in each participant. Knee osteoarthritis was classified according to the Kellgren–Lawrence classification. Demographic characteristics were noted. Results: There were significant differences in the mean tibial torsion angles and mean mechanical axes between the groups. The mean tibial rotation and mean mechanical axis were 26.3° ± 6.7 and 3.7° ± 2.7 in the MMPHT group and 30.3° ± 8.4 and 2.05° ± 2.7 in the control group, respectively (p = 0.008, p = 0.002). Conclusion: The current retrospective study has shown that tibial rotation is markedly reduced in patients with MMPHTs. Although the actual mechanism is not clear, the internal torsion of the tibia causes a decrease in the foot progression angle and increases the knee adduction moment, which in turn increases the medial tibial contact pressure. Internal torsion of the tibia, such as knee varus, may play a role in the aetiology of MMPHTs by this way. Whilst there was a significant difference in the mean varus and tibial torsion between the groups, there was no significant difference in the mean femoral version or tibial slope. Level of evidence: III.
