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 Editorial: Cell Death and Targeted Cancer Therapies(2022) Bagci-Onder, Tugba; Kutuk, Ozgur; Chonghaile, Triona Ni; Knippschild, Uwe; 000829492900001Item Pancreatic Tumors in Children(2021) Gezer, Hasan Ozkan; Temiz, Abdulkerim; Ezer, Semire; Yazici, Nalan; Demir, Senay; Hasbay, Bermal; Oguzkurt, Pelin; 0000-0002-4635-2613; 0000-0002-4209-9075; 0000-0001-6702-7265; A-4719-2018; AAJ-9529-2021; AAM-5138-2021; AAK-9310-2021Objective: Pancreatic rumors in children are exceedingly rare and hence present diagnostic and therapeutic challenges to pediatric surgeons. In this study, we aimed to present our experiences and treatment outcomes related to these rare tumors. Methods: The clinical data, laboratory investigations, radiological imaging, and the pathology and surgical details of patients with pancreatic tumors who were diagnosed between 2005 and 2019 were retrospectively reviewed. Results: A total of 9 patients (5 men) were included in the study. The most common symptom at the time of presentation was vague abdominal pain. A pancreatic rumor was detected incidentally in 4 patients. All tumors were non-functional primary rumors. Histopathological diagnosis of these tumors were solid-pseudopapillary tumors (n=3), congenital pancreatic cysts (n=3), pancreatoblastoma (n=1), rhabdomyosarcoma (n=1), and an undifferentiated carcinoma (n=1). In addition, 8 patients were treated surgically (through tumor excision, central pancreatectomy + distal pancreaticojejunostomy, distal pancreatectomy, and cystogastrostomy). Two deaths from tumor dissemination were recorded. The patients were followed-up at a mean duration of 72 months (range: 6-120 months). Conclusion: Pediatric pancreatic tumors arc rare and are usually benign in nature. They present symptoms that are often nonspecific. In non-metastatic cases, surgical tumor removal is the preferred method for the treatment. For most tumors, surgical resection is the optimal treatment that may be successfully performed with low morbidity rate when the lesion is either in the body or in the tail of the pancreas. The long-term outcomes with this approach are generally good.Item Magnetically responsive, sorafenib loaded alginate microspheres for hepatocellular carcinoma treatment(2020) Alpdemir, Sukran; Vural, Tayfun; Kara, Goknur; Bayram, Cem; Haberal, Erdem; Denkbas, Emir Baki; 0000-0003-2788-550X; 33010138; ABC-8833-2020This study aimed to develop sorafenib loaded magnetic microspheres for the treatment of hepatocellular carcinoma. To achieve this goal, superparamagnetic iron oxide nanoparticles (SPIONs) were synthesised and encapsulated in alginate microspheres together with an antineoplastic agent, sorafenib. In the study, firstly SPIONs were synthesised and characterised by dynamic light scattering, energy-dispersive X-ray spectroscopy, and scanning electron microscopy. Then, alginate-SPIONs microspheres were developed, and further characterised by electron spin resonance spectrometer and vibrating sample magnetometer. Besides the magnetic properties of SPIONs, alginate microspheres with SPIONs were also found to have magnetic properties. The potential use of microspheres in hyperthermia treatment was then investigated and an increase of about 4 degrees C in the environment was found out. Drug release studies and cytotoxicity tests were performed after sorafenib was encapsulated into the magnetic microspheres. According to release studies, sorafenib has been released from microspheres for 8 h. Cytotoxicity tests showed that alginate-SPION-sorafenib microspheres were highly effective against cancerous cells and promising for cancer therapy.Item Perspectives, fears and expectations of patients with gynaecological cancers during the COVID-19 pandemic: A Pan-European study of the European Network of Gynaecological Cancer Advocacy Groups (ENGAGe)(2020) Ayhan, Ali; Akilli, Huseyin; 33205595; AAJ-5802-2021; AAX-3230-2020Background The impact of the COVID-19 pandemic on European gynaecological cancer patients under active treatment or follow-up has not been documented. We sought to capture the patient perceptions of the COVID-19 implications and the worldwide imposed treatment modifications. Methods A patient survey was conducted in 16 European countries, using a new COVID-19-related questionnaire, developed by ENGAGe and the Hospital Anxiety & Depression Scale questionnaire (HADS). The survey was promoted by national patient advocacy groups and charitable organisations. Findings We collected 1388 forms; 592 online and 796 hard-copy (May, 2020). We excluded 137 due to missing data. Median patients' age was 55 years (range: 18-89), 54.7% had ovarian cancer and 15.5% were preoperative. Even though 73.2% of patients named cancer as a risk factor for COVID-19, only 17.5% were more afraid of COVID-19 than their cancer condition, with advanced age (>70 years) as the only significant risk factor for that. Overall, 71% were concerned about cancer progression if their treatment/follow-up was cancelled/postponed. Most patients (64%) had their care continued as planned, but 72.3% (n = 892) said that they received no information around overall COVID-19 infection rates of patients and staff, testing or measures taken in their treating hospital. Mean HADS Anxiety and Depression Scores were 8.8 (range: 5.3-12) and 8.1 (range: 3.8-13.4), respectively. Multivariate analysis identified high HADS-depression scores, having experienced modifications of care due to the pandemic and concern about not being able to visit their doctor as independent predictors of patients' anxiety. Interpretation Gynaecological cancer patients expressed significant anxiety about progression of their disease due to modifications of care related to the COVID-19 pandemic and wished to pursue their treatment as planned despite the associated risks. Healthcare professionals should take this into consideration when making decisions that impact patients care in times of crisis and to develop initiatives to improve patients' communication and education.