Fakülteler / Faculties
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Item Nurses' Practices in Targeted Therapies in Turkey(2015) Kav, Sultan; Atay, Sevcan; 0000-0002-4787-0666; 0000-0003-0361-7498; 25778328; D-9607-2018; V-9745-2019Purpose: The number of targeted agents has increased over the last years. The aim of this study was to explore the current practice and knowledge of nurses about targeted therapies and to identify the gap in their management in Turkey. Methods: Nurses who attended to the oncology nursing educational programs organised by the Turkish Oncology Nursing Association were invited to participate. A total of 187 nurses from 29 cities responded. Data were collected via a 30-item questionnaire on demographics and knowledge and practices on targeted therapies. Following this survey nurses were invited to participate in 'target' courses. Results: More than half of them (57.2%) stated they were willing to receive information on targeted therapies, mostly through in-service education (32.7%). Also, most of them were partly (67.3%) or not satisfied (24.3%) with their knowledge. Only few explained what targeted therapies are and how they work. While most of them responded correctly about how and where to store targeted drugs, few (1.8%) wrote that these agents should be stored in freezer. The majority stated that targeted agents should be prepared like the chemotherapy drugs. Conclusions: Lack of knowledge may cause errors and influence drug effectiveness. Nurses need to be supported with information. This survey revealed the needs in nursing practice over targeted therapies, side-effects and management.Item Procalcitonin as A Biomarker for Infection-Related Mortality in Cancer Patients(2015) Sedef, Ali M.; Kose, Fatih; Mertsoylu, Huseyin; Ozyilkan, Ozgur; 0000-0002-0156-5973; 0000-0002-1932-9784; 0000-0001-8825-4918; 25872114; G-4827-2016; M-9530-2014; AAD-2817-2021Purpose of review Infectious diseases are the second leading cause of death following direct cancer-related complications in the field of oncology. Clinical studies using the classic inflammatory biomarkers, C-reactive protein, erythrocyte sedimentation rate, leukocytosis, and thrombocytosis fail to show a significant correlation between these biomarkers and infection-related mortality. It is therefore crucial to define new biomarkers that are not affected by the primary cancer and precisely show the severity of the infection to help in the decision-making process. Recent findings A significant increase in the number of cancer patients in the past decades has created an exponential increase in the number of immunocompromised patients. Preemptive and typically unnecessary usage of broad-spectrum antibiotics is common during the treatment of these patients and may result in an increase in multidrug-resistant microbial strains. Recent clinical studies suggest that a significant reduction in antibiotic consumption may be achieved by procalcitonin-guided algorithms without sacrificing the outcome of patients with severe infection. Summary In this article, we focus on procalcitonin and its potential role in differentiating cancer and infection-induced inflammation. Using this strategy may significantly reduce the usage of empirical broad-spectrum antibiotics and result in earlier discharge of patients.Item Optimal b Value in Diffusion-Weighted Imaging for Differentiation of Abdominal Lesions(2014) Koc, Zafer; Erbay, Gurcan; https://orcid.org/0000-0003-0987-1980; https://orcid.org/0000-0002-1706-8680; 24115207; S-8384-2016; AAK-5370-2021Purpose: To explore the optimal b value in diffusion-weighted imaging (DWI) for differentiation of benign and malignant abdominal lesions. Materials and Methods: A total of 108 consecutive patients (age 60 +/- 12.5 years) with 127 pathologically confirmed diagnoses of abdominal lesions were included. Single-shot echoplanar imaging (SH-EPI) DWI (1.5T) with seven b values and eight apparent diffusion coefficient (ADC) maps were obtained. The lesions were analyzed visually on DWI and ADC maps for benignity/malignity using a 5-point scale and by measuring the ADC values and ADC lesion/normal parenchyma ADC ratio. ROC analysis was used to evaluate the diagnostic accuracy of ADC for differentiating between benign and malignant lesions. Pathology results were the reference standard. Results: Differentiation between malignant and benign lesions using visual scoring was successful at b values of 600 or higher (sensitivities, specificities, and accuracies were 100/93.8/92.5, 84.7/82.6/80.4, and 94.4/89.7/88.1, respectively, for b600, 800, and 1000). The mean ADC values of malignant lesions were significantly lower than those of benign lesions for all b-value combinations except b0 and 50 s/mm(2) (P = 0.032 for b0 and 50 s/mm(2), P = 0.000 for other b values). The best b-value combination was 0 and 600 s/mm(2) and multiple b2. The lesion/normal parenchymal ADC ratio for b600, b1000, and multiple b2 better distinguished between benign and malignant lesions. Conclusion: In DWI, the optimal b value is 600 s/mm(2); multiple b values of 600 s/mm(2) and higher are recommended to differentiate between benign and malignant abdominal lesions. The lesion ADC/normal parenchyma ADC ratio is more accurate than using lesion ADC only.Item Small Cell Carcinomas of the Bladder Highly Express Somatostatin Receptor Type 2A: Impact on Prognosis and Treatment-A Multicenter Study of Urooncology Society, Turkey(2016) Nese, Nalan; Kumbaraci, Banu S.; Baydar, Dilek E.; Kilicaslan, Isin; Sari, Aysegul A.; Sen, Sait; Gonul, Ipek I.; Kankaya, Duygu; Ozluk, Yasemin; Ermete, Murat; Ozagari, Aysim; Bal, Nebil; Kiremitci, Saba; Yildiz, Kursat; Tuna, Burcin; Sen, Nilay; Yorukoglu, Kutsal; 25906124Small cell carcinoma (SmCC) is a rare and aggressive neuroendocrine carcinoma of the bladder. Neuroendocrine carcinomas expressing somatostatin receptors (SSTR) in other viscera such as lung, pancreas, and gastrointestinal system respond to therapy with somatostatin analogs. In the present study, expressions of SSTRs 1 to 5 including type 2A are investigated by immunohistochemistry (IHC) and their relationship with clinicopathologic factors was evaluated. Hundred primary bladder SmCC cases were collected from 12 centers in Turkey. Forty-three cases were pure SmCC. Other cases had mostly papillary urothelial carcinoma as a second component. The percentage of the SmCC component ranged from 5% to 100%. SSTR-2A expression was membranous, whereas the other receptors showed cytoplasmic staining. The percentages of positive cases for SSTR-1, SSTR-2A, SSTR-3, SSTR-4, and SSTR-5 were 4% (3/75), 61.4% (54/88), 2.4% (2/84), 24.4% (20/82), and 6.25% (5/80), respectively. The percentage of SmCC component was positively correlated with the percentage of SSTR-2A expression (P=0.003) while negatively correlated with patient age (P=0.032). SSTR-2A expression was correlated with survival as a bad prognostic factor (P=0.018). SSTR-1, SSTR-3, SSTR-4, and SSTR-5 expressions did not show any statistical significance with any parameter. In conclusion, although the limited number of cases with adequate term follow-up, SSTR-2A expression could be a prognostic factor and somatostatin analogs therapeutic candidate for SmCCs of the bladder as these tumors show high percentage of SSTR-2A expression.Item A Study on Basic Demographic and Disease Characteristics of Cancer-Diagnosed Syrian Refugees Treated in Tthe Border City of Turkey, Sanliurfa; A Hospital-Based Retrospective Case Series Study(2017) Temi, Yasemin Bakkal; Sedef, Ali Murat; Gokcay, Serkan; Coskun, Hatice; Kaplan, Sedenay Oskeroglu; Ozkul, Ozlem; Mertsoylu, Huseyin; Kose, Fatih; 0000-0002-1932-9784; 0000-0002-0156-5973; 29332358; M-9530-2014; G-4827-2016Purpose: Turkey hosts around 3 million Syrian refugees which is more than any other country in the world. Along with some other adaptation issues like cultural, language, and economic difficulties, significant problems in managing medical problems, chronic diseases like cancer in particular, have to be fixed. However, there are few studies which explore main patient and clinicopathological characteristics in Syrian refugees with cancer. The purpose of this study was to highlight the aforementioned characteristics along with management issues after cancer diagnosis of these patients. Methods: This study was designed as a hospital-based retrospective observational case-series study of 134 Syrian refugees cancer patients between 2015 and 2017. Results: The patient median age was 47.5 years (range 1880). Out of the 134, 102 (76.1%) were female. The most common cancer types were breast (n=57, 42.5%) and gynecological cancers (n=14, 10.4%). The majority of patients were diagnosed at advanced stage (n=60, 44.8%). There were 91 (67.9%) and 43 (32.1%) patients admitted to our center from refugee camps and staying in a house, respectively. The median follow-up was 14 months (range 1-111) and 11 (8.2%) patients died. One and two-year survival rate of the whole group were 93% and 86%, respectively. There were 12 (9%) patients with grade 3-4 hematological and non-hematological toxicities. Neutropenia was the most common grade 3-4 toxicity (n=8, 6%). The patients staying in refugee camp (n=91) or in a house (n=43) finished all planned cycles of chemotherapy with a rate of 71% (n=65) and 79% (n=34), respectively. Statistical analysis failed to show significant relationship between the staying site (either camp or house), chemotherapy compliance rate, grade 3-4 toxicities with p=0.347 and p=0.09, respectively. Conclusion: Our results revealed that breast cancer and gynecological cancers were the most common cancer types which are good candidates for cancer screening. Unfortunately, the majority of patients had cancer diagnosed at advanced stage. However, after diagnosis they could reach all health facilities including surgical operation, radiotherapy, and systemic chemotherapy similar to Turkish cancer patients. Therefore, our results suggested that major problem for the Syrian refugees adapting them into national screening program which may resulted that cancer diagnosis at earlier stage with high cure rate.Item Perspectives in International Palliative Care(2018) Kav, Sultan; Brant, Jeannine M.; Mushani, Tayreez; 0000-0003-0361-7498; 30122428; V-9745-2019OBJECTIVES: To explore an international perspective on the needs and challenges for providing palliative care services, the nurse's role, and building capacity for palliative care. DATA SOURCES: Review of the most up-to-date literature related to global palliative care, cancer and nursing. CONCLUSION: The increase of cancer worldwide has added to the need for nurses to develop skills in palliative and end-of-life care. Despite the numerous global challenges nurses face in providing palliative care, a multitude of opportunities and organizations are available that support nurses. IMPLICATIONS FOR NURSING PRACTICE: Palliative care is a foundation of care for most chronic illnesses globally. Nursing practice requires an awareness of palliative care best evidence to provide expert palliative care for patients with cancer and other chronic illnesses.Item Selective targeting of antiapoptotic BCL-2 proteins in cancer(2019) Timucin, Ahmet Can; Basaga, Huveyda; Kutuk, Ozgur; 0000-0001-9854-7220; 29846950; AAH-1671-2019Circumvention of apoptotic machinery is one of the distinctive properties of carcinogenesis. Extensively established key effectors of such apoptotic bypass mechanisms, the antiapoptotic BCL-2 (apoptosis regulator BCL-2) proteins, determine the response of cancer cells to chemotherapeutics. Within this background, research and development of antiapoptotic BCL-2 inhibitors were considered to have a tremendous amount of potential toward the discovery of novel pharmacological modulators in cancer. In this review, milestone achievements in the development of selective antiapoptotic BCL-2 proteins inhibitors for BCL-2, BCL-XL (BCL-2-like protein 1), and MCL-1 (induced myeloid leukemia cell differentiation protein MCL-1) were summarized and their future implications were discussed. In the first section, the design and development of BCL2/ BCL-XL dual inhibitor navitoclax, as well as the recent advances and clinical experience with selective BCL-2 inhibitor venetoclax, were synopsized. Preclinical data from selective BCL-XL inhibitors, which are currently undergoing extensive testing as a single agent or in combination with other therapeutic agents, were further summarized. In the second section, MCL-1 inhibitors developed as potential anticancer agents were reviewed regarding their specificity toward MCL-1. Explicitly, studies leading to the identification of MCL-1, nonselective and selective targeting of MCL-1, and recently initiated clinical trials were compiled in chronological order. Based on these concepts, future directions were further discussed for increasing selectivity in the design of prosurvival BCL-2 member inhibitors.Item Penetration Depth in Nanoparticles Incorporated Radiofrequency Hyperthermia into the Tissue: Comprehensive Study with Histology and Pathology Observations(2019) Nasseri, Behzad; Kocum, Ismail Cengiz; Seymen, Cemile Merve; Rebiee, Navid; 31432798In present study, the effective penetration of radiofrequency (RF) induced gold decorated iron oxide nanoparticles (GS@IONPs) hyperthermia was investigated. The effective penetration depth of RF also the damage potency of hyperthermia was evaluated during histopathology observations which were done on the chicken breast tissue and hepatocellular carcinoma (HCC) models. The thermal damages are well- documented in our previous cellular study which was engaged with potency of RF hyperthermia in Epithelial adenocarcinoma (MCF-7) and fibroblast (L-929) cells deaths [1]. In recent work, PEGylated iron oxide nanoparticles (IONPs) were used as base platform for gold magnetic nanoparticles (GS@IONPs) formation. The 144.00015 MHz, 180W RF generator was applied for stimulating the nanoparticles. The chicken breast tissue and the hepatocellular tumor model was considered in the experimental section. In histology studies, the structural changes also the effective penetration depth of RF induced nanoparticles was observed through microscopic monitoring of the tissue slices in histology observations (Gazi medical school). The highest damage level was seen in 8.0 mu m tissue slices where lower damages were seen in depth of 1.0 cm and more inside tissue. The histology observations clarified the effective penetration depth of RF waves and irreversible damages in the 2.0 cm inside the tissue.Item A New Imaging Technique for the Diagnosis of Thyroid Cancer: Thyroidography(2019) Aysan, Erhan; Aydin, Ozan; Ercivan, Merve; Aksoy, Direnc; Yavuz, Alp Erdem; 31387418Background: Microcalcifications are the most important diagnostic parameter for thyroid cancer. We developed a new imaging technique based on low dose X-rays that specifically reveal microcalcifications via a new software algorithm. Method: A prospective clinical trial was planned and 45 cases (37 women, 8 men, women/men: 4.6, age range: 17-68, mean age: 43) were included in the study. After total thyroidectomy with standard technique, the fresh thyroid tissues were integrated into the human neck simulator. Raw (DICOM) images were obtained for each tissue sample with a standard mammography device and transformed into new images (thyroidograms) by a new software algorithm. Preoperative ultrasonography (USG) images, DICOM images, and thyroidograms were evaluated in order to observe micro and macrocalcifications by the same experienced radiologist. Results: Twenty-four cases were malignant and 21 cases were benign after histopathologic evaluation. Microcalcification detection with the thyroidography was statistically significant for sensitivity, positive predictive value, negative predictive value, and accuracy (p < 0.05) but not for specificity (p > 0.05) compared to the USG and DICOM images for the malignant and also benign cases. Conclusion: This new imaging technique is hopeful for diagnosis of thyroid cancer according to microcalcification detection and may complement thyroid USG.