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Objectives: This research aims to identify the effects of premenstrual syndrome (PMS) symptoms on the school exam scores in medical students. Methods: This cross-sectional study was designed at Sakarya University School of Medicine The study included medical students who were in the first, second, and third year of class. In this study, there were 193 male and 100 female students. The study investigated how PMS symptoms affected medical student’s exam scores and school success. All exam scores were recorded during the two-consecutive semester so duration of study was one year. Results: There were 100 female students, and they had five different committee exams for one year. Female student’s exam scores were significantly higher for four committees and an average score of all year. The mean age of female students was 19.9 ±1.5. Acne, nausea/vomiting, sleeping, abdominal bloating, and prurience change had significantly different exam scores compared to the group without these symptoms. Students with acne had substantially higher exam scores than without acne; inversely, the other four symptoms negatively affected exam scores. Conclusion: Some of the PMS symptoms can be more annoying and should change the quality of life more than the other symptoms, so we should define these symptoms to improve our student’s quality of life and school success. doi: https://doi.org/10.12669/pjms.37.4.3931 How to cite this:Bilir F, Akdemir R, Bilir C. Some, but not all of the premenstrual syndrome symptoms affect the medical exam scores in medical students. Pak J Med Sci. 2021;37(4):1190-1195. doi: https://doi.org/10.12669/pjms.37.4.3931 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

OBJECTIVE: To evaluate the mortality rates in patients receiving anticancer therapy in the coronavirus disease-19 (COVID-19) pandemic period. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Department of Medical Oncology, Sakarya University Training and Research Hospital, Sakarya, Turkey, from December 2017 to May 2020. METHODOLOGY: Only patients who received chemotherapy and immunotherapy were selected and enrolled in the study. All patients (n=3,204) were divided into three groups, namely the first group (1st December 2017-31st May 2018, n=918), second group (1st December 2018-31st May 2019, n=1,147), and the pandemic period group (PPG) (1st December 2019-31st May 2020, n=1,139), according to the period during which they received anticancer treatment. The clinical and demographic characteristics and mortality rates of these three groups of patients were compared. RESULTS: The median age of the total of 3,204 patients was 61 (53-69). In this study, 51.1% (n=1,636) were females and 48.9% were males. The mortality rates were 13.5% (n=124) in the first group, 13.4% (n=154) in the second group, and 13.0% (n=148) in the PPG, respectively. Overall mortality rates did not differ among patients with cancer in the three different six-month periods analysed (p = 0.931). CONCLUSION: There was no unexpected increased in mortality rate among patients undergoing cancer therapy during the COVID-19 pandemic as compared to the previous years of the same timeline. No increase in monthly mortality rates among patients receiving anti-cancer treatment were demonstrated during the pandemic period.

Canine mammary gland tumors (CMGTs) are heterogeneous disease and subclassified [sarcomas (S), carcinomas (C), and carcinosarcomas (CS)] according to histopathological differentiation. Photodynamic therapy (PDT) is a promising treatment strategy based on the use of a photosensitizer (PS) activated by light. However, the therapeutic potential of PDT in the treatment of CMGTs has not been investigated, yet. Therefore, the aim of this study was to determine the in vitro protocol of 5-ALA-based-PDT for the treatment of three subtypes of CMGTs, for the first time. The intracellular PpIX florescence intensity was measured for 5-ALA (0.5 and 1 mM). After irradiation with different light doses (6, 9, 12, 18, and 24 J/cm(2)) for two different modes [continuous wave (CW) and pulse radiation (PR)], the cytotoxic effects of 5-ALA (0.5 and 1 mM) on the subtypes (C, S, and CS) of CMGTs were analyzed by WST-1. Finally, the optimal PDT treatment protocol was validated through Annexin V and AO/EtBr staining. Our results showed that 1 mM 5-ALA for 4-h incubation was the best treatment condition in all subtypes of CMGTs due to higher intracellular PpIX level. After irradiation with different light doses, PR mode was more effective in S primary cells at 9 J/cm(2). However, a significant decrease in the viability of C and CS cells was detected at 12 /cm(2) in CW mode (p < 0.05). Additionally, 1 mM 5-ALA induced apoptotic cell death in each subtype of CMGTs. Our preliminary findings suggest that (i) each subtype of CMGTs differentially responds to PDT and (ii) the light dose and mode could play an important role in the effective PDT treatment. However, further studies are needed to investigate the role of the different light sources and PDT-based apoptotic cell death in CMGTs cells.

Background: Indoleamine 2,3-dioxygenase (IDO) inhibition has received much attention in cancer immunotherapy due to its role in immune escape in cancer cells. Additionally, changes in the pro-inflammatory cytokine levels can affect tumor growth and metastasis as well as the effectiveness of immunotherapy. The purpose of this study was for the first time to determine the effects of indoximod as an IDO inhibitor on triple-negative breast cancer (TNBC) and to assess the link between the efficacy of indoximod and IFN-γ or TNF-α stimulation. Methods: The cytotoxic and apoptotic effects of indoximod alone or IFN-γ or TNF-α induction to mimic an inflammatory environment were evaluated by WST-1, Annexin V, cell cycle analysis, and acridine orange (AO)/ethidium bromide (EtBr) staining. Furthermore, the expression levels of IDO1 and PD-L1 expression were analyzed by RT-PCR. Results: Our results demonstrated that indoximod significantly decreased the TNBC cell viability through apoptotic cell death (p < .05). The combination of indoximod and TNF-α was more effective than indoximod and IFN-γ stimulation or indoximod alone in TNBC cells. Additionally, PD-L1 expression level was significantly up-regulated after treatment with indoximod and TNF-α or IFN-γ combinations (p < .05). Conclusions: Indoximod exhibited a therapeutic potential in TNBC cells and pro-inflammatory cytokines could affect the effectiveness of indoximod. However, further studies are required to identify the role of the IDO-associated signaling pathways, the molecular mechanisms of indoximod induced apoptotic cell death, and the relationship between IDO inhibition by IDO inhibitors and pro-inflammatory cytokine levels. WOS:000677935300001 34314307 Q3

To compare enzalutamide (E) and abiraterone acetate (AA) in terms of efficacy, survival and to characterize prognostic factors affecting survival in metastatic castration-resistant prostate cancer (mCRPC) patients. A total of 250 patients treated with E or AA in 5 centers were included. The number of patients with no prostate specific antigen (PSA) decline was higher in the AA group than that in the E group, and the proportion of patients with a PSA decline of ≥ 50% was higher in the E group (p = 0.020). Radiological progression free survival (rPFS) and overall survival (OS) were significantly longer in the E group when compared to that in the AA group (p

Amac: Meme kanseri kadinlarda en sik gorulen ve farkli alt tiplere ayrilan heterojen bir kanser turudur. Bu nedenle, meme kanseri alt tiplerine ozgu tedavi yaklasimlari dikkat cekmektedir. Mevcut calismada, kemik metastazi gorulen kanser tiplerinin tedavisinde klinikte kullanilan ve anti-proliferatif, ve anti-metastatik etkiye sahip oldugu bilinen bir bifosfonat inhibitoru zoledronik asitin (ZOL)’un, iki farkli meme kanseri alt tipinde [MCF-7 (ER+, PR+, HER2-) ve MDA-MB-231 (ER-, PR-, HER2-)] ve HUVEC kontrol hucrelerinde terapotik etkisinin arastirilmasi amaclanmistir. Gerec ve Yontem: ZOL’un (10-100 µM) 24 ve 48 saat boyunca sitotoksik ve apoptotik etkisi WST-1, Annexin V ve hucre siklusu analizleri ile belirlenmistir. Ayrica ZOL’un, hucrelerde ve nukleusda neden oldugu morfolojik degisimler sirasiyla akridin oranj (AO) ve DAPI boyamasi ile goruntulenmistir. Bulgular: ZOL’un MCF-7 hucrelerine gore, MDA-MB-231 hucrelerinde daha fazla anti-proliferatif etkiye ve erken ve gec apoptotik olume neden oldugu analiz edilmistir (p

Background: To compare enzalutamide (E) and abiraterone acetate (AA) in terms of efficacy, survival and prognostic factors affecting survival in metastatic castration-resistant prostate cancer (mCRPC) patients. Methods: A total of 250 patients treated with E or AA in 5 centers were included.Results: The number of patients with no prostate specific antigen (PSA) decline was higher in the AA group than that in the E group, and the proportion of patients with a PSA decline of ≥50% was higher in the E group (p = 0.020). The rate of progression in the AA group (82.2%) was significantly higher than that in the E group (p Conclusion: With longer OS and PFS, E seems to be more suitable for mCRPC patients in the post-docetaxel setting than AA.

Amaç: Bu çalışmanın amacı baş boyun kanserli (BBK) hastalarımızın genel özelliklerini, risk faktörlerini, tedavi modalitelerini gözden geçirmek ve sağkalımlarını hesaplayıp sağkalımı ve tedavi sonuçlarını etkileyen faktörleri değerlendirmekti.Gereç ve Yöntemler: Altmış yedi BBK tanılı hasta değerlendirildi. Çalışmanın verileri Sakarya Üniversitesi Eğitim ve Araştırma Hastanesinde 2011-2020 yılları arasında takipli hastaların dosyalarından elde edildi.Bulgular: Tanı anındaki medyan yaş erkekler 62, kadınlar 50 olmak üzere tüm hastalarda 62 ± 11,42 (aralık: 19-82) idi. En sık yerleşim yeri %55 oranla larinks idi. Sigara ve alkol kullanım oranları sırasıyla %69 ve %18 idi. Sekonder malignite oranı %18 olup en sık görüleni akciğer kanseriydi (%9, n = 6). Hastaların tanı anındaki evreleri 1,2,3 ve 4 sırasıyla %13,45 (n = 9), %22,47 (n = 15), %50,77(n = 34) ve %11,93 (n = 8) idi. Hastaların tanı anında ya da takibi sırasında olmak üzere toplam %42’si metastatikti. Metastaz bölgeleri 13 hastada (%19,45) akciğer, 10 hastada (%15) lenf nodu, 7 hastada (%10,56) kemik, ve 1 hastada (%1,50) karaciğerdi. Lokal rekürrens %27 (n = 18) oranındaydı. Evre 1,2 ve 3 58 hastanın %50’sinde lokal rekürrens ve/veya metastaz gelişmişti. Bu hastaların çoğunluğu evre 3 hastalardı (n = 17 (%59)). Evre 1-2 hastalarda medyan hastalıksız sağkalım 49 ± 29,65 ay (aralık: 0-107 ay) iken evre 3 hastalarda medyan hastalıksız sağkalım 19 ± 10,95 ay (aralık: 0-40 ay) idi. Metastatik birinci seri kemoterapi sonrası medyan progresyonsuz sağkalım 8±3 ay (aralık: 2-14 ay) ve tüm hastalarda medyan genel sağkalım 192±83 ay idi. Sonuç: Çalışmamızda sekonder malignite gelişme oranı hafif yüksekti. Radyoterapi eş zamanlı sisplatin total dozları literatürdeki benzer diğer çalışmalara göre hafifçe düşüktü. En çok tercih edilen metastatik birinci seri kemoterapi kombinasyonu sisplatin/5Fluorourasil/setuximab’tı. Progresyonsuz sağkalım sonuçları literatüre göre hafif yüksekti.

[No Abstract Available], Amgen Ilac Tic Ltd Sti, Turkey

Although positron emission tomography–computed tomography (PET/CT) is widely used for staging, there are limited data available to describe exactly the role of PET/CT metabolic and quantitative parameters for the prediction of disease outcome. A total of 145 patients diagnosed with histology-proven lung carcinoma in the advanced stage were included. According to the exclusion criteria remaining 76 patients (41 of them were adenocarcinoma EGFR wild-type, 35 were squamous non-small cell lung cancer (NSCLC)) were analyzed. Maximum standardized uptake value (SUV(max)) of a primary lesion was only statistically significant parameter with progression-free survival (PFS) in regression analyses in the whole study population as well as for overall survival (OS). According to the tumor histology, squamous cell carcinoma group did not have any significant PET CT parameters for PFS and OS, but adenocarcinoma group had significant PET CT parameters which were primary lesion of SUV max, SUV mean, total lesion glycolysis (TLG), mediastinal TLG and whole body TLG. In adenocarcinoma group, patients with lower than median TLG values had significantly increased overall survival than patients having higher median whole body TLG values (median OS was 11 vs 6.5 months, P = 0.031, HR 2.1), also they had more PFS without statistical significance (median PFS 6.5 vs 4 months, P = 0.3 HR 1.2). The present study showed that PET/CT metabolic parameters give some prognostic information other than staging of NSCLC, but this information was only significant in EGFR-wild type adenocarcinoma. For squamous cell carcinoma, we need to find any driver targets.

Tryptophan (Trp) is one of the important essential amino acids and Kynurenine pathway (KP) is the first and rate limiting step of degrading Trp to active metabolites. Recent studies showed that KP metabolites have antimicrobial and immunosuppressive roles. The main controller enzyme of this pathway is indoleamine-2,3-dioxygenase (IDO). IDO is an intracellular monomeric, heme-containing enzyme that controls the Trp breakdown in the KP. In this review, we discuss IDO functions on cancer progression and prognosis, and possible therapeutic aspects of inhibition of IDO on cancer immunotherapy.

Purpose: Toll-like receptor 4 (TLR4) is over-expressed in breast tumors and thus contributing to the tumor progression and metastasis. Natural products have drawn attention in cancer immunotherapy due to their various biological activities. Curcumin is well investigated in different types of cancer. However, the mechanisms underlying its anti-inflammatory actions have not been extensively elucidated. For this purpose, we explored the inhibitory effects of curcumin on lipopolysaccharide (LPS)-induced TLR4 dependent TRIF signaling pathway in two subtypes of breast cancer cell lines (MCF-7 and MDA-MB-231) in this study. Methods: In this context, the cytotoxicity of curcumin and LPS alone and the combination of curcumin with LPS on these cells was evaluated by WST-1 assay. The expression level of TLR4 and the release of type I interferon (IFN) levels were determined after treatment with curcumin and/or LPS by RT-PCR and ELISA analysis, respectively. Furthermore, the subcellular localization of TLR4 and interferon regulatory factor 3 (IRF3) were detected by immunofluorescence analysis. Results: Curcumin treatment suppressed breast cancer cells viabilities and the activation of TLR4-mediated TRIF signaling pathway by the downregulation of TLR4 and IRF3 expression levels and the inhibition of type I IFN (IFN-α/β) levels induced by LPS. However, curcumin was more efficient in MDA-MB-231 cells than MCF-7 cells owing to its greater inhibitory efficacy in the LPS- enhanced TLR4 signaling pathway. Furthermore, IFN-α/β levels induced by TLR4 and IRF3 were decreased in these cells following curcumin treatment. Conclusions: Consequently, these results demonstrated that the activation of LPS stimulated TLR4/TRIF/IRF3 signaling pathway was mediated by curcumin in breast cancer cells, in vitro. However, more studies are necessary to examine the curcumin’s anti-inflammatory activities on TLR4/MyD88/NF-κB as well as other signaling pathways downstream of TLRs in breast cancer.

Objective: Herein we, for the first time, investigated a potential synergistic effect of nobiletin (NOB) and sorafenib (SOR) on PC-3 prostate cancer and HUVEC control cell lines. Methods: In order to determine the cytotoxic and apoptotic effects of the combination of NOB and SOR, WST-1, Annexin V, and cell cycle analysis were performed. The potential molecular mechanism of apoptotic cell death was assessed by Bax, Bcl-2, CCDN1, Rb1, and CDKN1A gene expression and acridine orange (AO) and DAPI staining. Results: Our results indicated that NOB and SOR combination had a significant inhibitory effect on the viability of PC-3 cells with less toxicity on HUVEC cells than SOR alone (P

Background: Glomerular filtration rate (GFR) measurements are critical in patients with cancer. A variety of methods are used to calculate the estimated GFR. The aim of this study is to investigate whether there is a correlation between these methods and oncologic outcomes according to the stage and treatment agents.Methods: A total of 153 patients were retrospectively recruited. All GFR measurement methods was determined in all patients, before the first cycle of chemotherapy and before the subsequent administrations.Results: In the study population 40% of whom received platinum-based chemotherapy. In this group, overall survival was statistically significant in patients with a CKD-EPI creatinine value of 65 or greater (p:0.023). When we separated the arms according to the stage, there was no relationship between CKD-EPI Cystatin C and progression-free survival in metastatic patients (p: 0.13). In the non-metastatic group, median DFS was 7 months and OS was 13.9 months in patients with CKD-EPI Cystatine C level above 45 (p:0.005).Conclusions: Both CKD-EPI creatinine and CKD-EPI cystatin C were significantly associated with overall survival and disease-free survival in patients receiving platinum-based chemotherapy. When assessed according to the stage, there was a general survival relationship with CKD-EPI cystatin C in the non-metastatic group and in the other groups there was no significant correlation with the estimated GFR measurements., Amaç: Glomerüler filtrasyon hızı (GFR) ölçümleri kanser hastalarında kritiktir. Tahmini GFR’yi hesaplamak için çeşitli yöntemler kullanılır. Bu çalışmanın amacı, bu yöntemler arasında bir korelasyon olup olmadığını araştırmak ve onkolojik sonuçların evre ve tedavi ajanlarına göre değişip değişmediğini araştırmaktır.Metot: Toplam 153 hasta retrospektif olarak tarandı. Tüm hastalarda kemoterapi tedavisinin 1. Siklusu öncesi ve sonraki kemoterapi sikluslarından önce tüm GFR ölçüm metodları hesaplanarak kaydedildi.Sonuçlar: Çalışma populasyonundaki hastaların %40’ı platin bazlı kemoterapi aldı. Bu grupta CKD-EPI kreatinin değeri 65 ve üzerinde olan hastalarda genel sağkalım istatistiksel olarak anlamlıydı (p:0,023). Kolları evreye göre ayırdığımızda metastatik hastalarda CKD-EPI sistatin C ve progresyonsuz sağkalım arasında istatistiksel olarak anlamlı ilişki bulunamadı (p:0,13). Metastatik olmayan grupta CKD-EPI sistatin C seviyesi 45’in üzerinde olan hastalarda ortanca DFS 7 ay ve ortanca OS 13,9 ay olarak bulundu (p:0,005).Tartışma: Platin bazlı kemoterapi alan hastalarda hem CKD-EPI kreatinin hem de CKD-EPI sistatin C genel sağkalım ve hastalıksız sağkalım ile anlamlı olarak ilişkili bulundu. Evrelere göre değerlendirildiğinde, metastatik olmayan grupta CKD-EPI sistatin C ile genel sağkalım arasında anlamlı ilişki bulunmuş olup, diğer gruplarda tahmini GFR ölçüm metotları ile anlamlı korelasyon bulunmadı.

WOS: 000438245400018, Background: PET imaging involves several parameters. However, it is not well known which parameters in each measurable site of tumors may have a greater effect on oncologic outcomes. Method: This study included a total of 42 patients diagnosed with histology-proven NSCLC. Baseline and consecutive FDG-PET scans were carried out 3 weeks before and at least 3 months after treatment, respectively. Results: According to the PERCIST, 9 (21%) patients had Complete Response (CR), and 3 of them underwent surgical resection. Sixteen patients (38%) had Partial Response (PR), and 4 (9.5%) had Stable Disease (SD), the remaining 15 (35%) had Progressive Disease (PD). Patients who responded to the treatment had significantly higher Overall Survival (OS) and Progression Free Survival (PFS), 15 versus 9.5 months and 10 versus 6 months, respectively. The SUVmax values decreased from 12.2 to 3.7 (P=

Obesity appears to be associated with an increased risk of breast cancer (BC) and an inferior oncological outcome at the time of diagnosis, with poor outcomes most prominent in cases of triple-negative BC (TNBC). The present study analyzed serum tumor necrosis factor (TNF)-like weak inducer of apoptosis (TWEAK) and TNF receptor associated factor-6 (TRAF) protein expression levels in 48 patients with non-metastatic BC and 26 obese control patients (without BC). The mean age of the cohort was 52.5 years (range, 35-78 years) and the patients had a median body mass index of 33.5 kg/m2 (range, 30-47 kg/m2). In the study population, 27.1% of BC patients were triple negative and 70.8% were hormone receptor (HR)-positive. Median serum TRAF6 expression was 0.90 ng/ml (range, 0.55-1.53 ng/ml) in the 13 TNBC patients and 0.63 ng/ml (range, 0.49-1.22 ng/ml) in the 35 HR-positive BC patients; thus, TRAF6 expression was significantly higher in the TNBC patients compared with the obese control group (0.90 vs. 0.73 ng/ml; P=0.033). Furthermore, median serum TRAF6 expression levels were significantly higher in HR-negative patients compared with HR-positive patients (0.83 vs. 0.62 ng/ml; P=0.002). The present study demonstrated that serum TRAF6 expression levels were increased in TNBC and HR-negative patients with non-metastatic BC compared with HR- and human epidermal growth factor receptor 2-positive cases or the obese healthy control group. Therefore, elevated TRAF6 expression may be a poor prognostic factor in non-metastatic BC. In addition, we propose that progesterone (PR) negativity may be a more useful poor prognosis factor than estrogen receptor (ER) negativity, as TRAF6 expression levels were higher in the PR-negative patients compared with the ER-negative patients. © 2015, Spandidos Publications. All Rights Reserved., National Natural Science Foundation of China: 30850004

Metronomic chemotherapy&mdash, administration of low-dose chemotherapy&mdash, allows for a prolonged treatment duration and minimizes toxicity for unfit patients diagnosed with advanced non-small-cell lung cancer (nsclc). Oral metronomic vinorelbine at 30 mg thrice weekly was given to 35 chemotherapy-na&iuml, ve patients who were elderly and vulnerable to toxicity and who had been diagnosed with advanced nsclc. Median age in this male-predominant cohort (29:6) was 76 years (range: 65&ndash, 86 years). Histology was squamous cell carcinoma in 21 patients and adenocarcinoma in 14. There were no complete responses and 9 partial responses, for an overall response rate of 26%. Stable disease was seen in 15 patients (43%), and 11 patients (31%) had progressive disease. The 1-year survival rate was 34%, and the 2-year survival rate was 8%. The survival analysis showed a median progression-free survival duration of 4 months (range: 2&ndash, 15 months) and an overall survival duration of 7 months (range: 3&ndash, 24 months). Metronomic vinorelbine had an acceptable efficacy and safety profile in elderly patients with multiple comorbidities who had been diagnosed with advanced nsclc. Metronomic vinorelbine could be a treatment option for elderly patients with poor performance status who are unfit for platinum-based chemotherapy and intravenous single-agent chemotherapy, and who are not candidates for combination modalities.

WOS: 000399505100004 PubMed ID: 28333566 Background: There are insufficient predictive markers for renal cell carcinoma (RCC). Methods: A total of 308 metastatic RCC patients were analyzed retrospectively. Results: The increased hemoglobin (Hb) group had significantly higher progression-free survival and overall survival (OS) compared with the decreased Hb group at 11.5 versus 6.35months (p < .001) and 21.0 versus 11.36months (p < .001) respectively. The 1- and 3-year OS rates were higher in the Hb increased group, i.e., 84% versus 64% and 52% versus 35% respectively. Conclusions: The present study showed that increased Hb levels after tyrosine kinase inhibitor therapy could be a predictive marker of RCC.

Demirtaş, Abdullah Orhan (Balikesir Author), "Introduction. There are controversial results in the risk of atrial fibrillation as well as arrhythmogenic potential of bis-phosphonates. Method. 37 patients and 40 healthy controls were evaluated prospectively with regard to the cardiac side effects related to the use of zoledronic acid (ZA) and its effects on electrocardiography (ECG) parameters. Result. As the basal ECG results of the patients diagnosed with cancer compared with the control group, it was determined that QT maximum was significantly lower, QT minimum was significantly higher. However; it was determined that QT disp, P max, P min, and P disp values were not significantly different. There was no statistically significant difference in P max, P min, P disp, QT max, QT min, QT disp values of the ECG parameters measured from cancer patients, before and 60 minutes after ZA therapy. Conclusion. There were no significant alterations in ECG in the acute period, indicated that ZA had no arrhythmia potential in the early period in patients with no underlying cardiac disease. However: patients receiving ZA should be monitored more closely because of the risk of arrhythmia which may ensue due to hypocalcemia, hypomagnesemia, or other chemotherapeutics. Weywords"

Parathyroid cancers (PTC) are very rare and have a poor prognosis. A 48 year old case with locally invasive PTC that was positive for close surgical removal margin was treated with chemo radiotherapy after surgery. Even though this required bimodal chemo and radio adjuvant therapy, the patient was treated by chemo radiotherapy with some modifications, including oral administration of capestabine. These treatments were well tolerated with minimal side effects, which have proven to be very effective in freeing the patient from the invasive tumor for the following twenty six months of monitoring. This treatment method could be adopted in place of the widely preferred surgical therapy. We believe that this case report will guide future studies concerning with similar cases.

Anahtar kelimeler: Mide kanseri, kemoradyoterapi SUMMARY The Results of Postoperative Chemoradiotheapy in Gastric Carcinoma Patients: Bulent Ecevit University Experience Objective: The treatment results of postopeative chemoradiotherapy in patients with gastric carcinoma were evaluated. Material and Methods: A total of 77 patients with gastric carcinoma, treated with postoperative chemoradiotherapy between 2007-2011, were evaluated retrospectively. Chemoradiotherapy was applied in accordance with the Integroup-0116 study protocol. Total 45 Gy radiotherapy was delivered to the gastric bed and regional lymphatic nodes and 50.4 Gy was given to patients with positive surgical margins after 3-dimensional conformal planning. Results: Forty-six of the patients were male (59.7 %), and 31 of the patients were female (40.3 %) with a median age of 59 (31-78). Median overall survival and disease-fee survival were 28.3, and 21 months, respectively. The 3-year overall and disease-free survival rates were 43.8 % and 41.7 %, respectively. Locoregional recurrence was detected in 10 (13 %), distant metastasis was detected in 22 (28.6 %) and both locoregional and distant metastasis were detected in 3 (3.9 %) of patients. During chemoradiotherapy grade 1-2 hematological toxicity was seen in 23 (30 %) patients, grade 3-4 hematological toxicity in 46 (59.7 %) patients, grade 1-2 gastrointestinal toxicity in 30 (39 %) patients, and grade 3-4 gastrointestinal toxicity in 11 (14.3 %) patients. While in the univariate analysis lymph node stage and percentage of positive lymph nodes were found to be prognostic factors for overall and disease-free survival, in the multivariate analysis type of lymph node dissection and percentage of positive lymph nodes were found to be prognostic factors that are correlated with overall and diseasefree survival.

Over ablasyonu meme kanserinin temel hedeflerinden biridir. Premenopozal kadinlarda overler ostrojen sentezinin ana kaynagidir ve bu nedenle tedavi secenekleri olarak ooferektomi, over radyoterapisi veya hipotalamik- pituiter-overyan aksin baskilayici luteinize hormone analoglari (loprolid asetat, goseralin asetat gibi) bilinmektedir. Cok nadiren bu ajanlar etkili olmayarak LHRH analoglari kullananlarda gebelik gozlenebilir. Biz loprolid asetat (LA) kullanirken gebe kalan meme kanserli bir vaka sunduk. Otuz dort yasinda kadin hasta kemik metastatik meme kanser tanili tamoksifen 10 mg gunde 2 kez ve 28 gunde bir LA 3.75 mg cilt alti ve zolendronik asit 4 mg intravenoz uygulama ile takip edilmekteydi. MAyis 2013'te 7 aydir LA asit kullanmakta iken hastada 3-4 kg kilo artisi, karninda hareket hissi tarifledi ve gebelik tanisi konuldu. Bugune kadar LHRH analoglari ile tedavi altinda iken toplam 4 gebelik vakasi bildirilmistir ancak bu vakalarin hepsi GA kullanmakta idi. Tum vakalar en az 15 aydir GA kullanmakta olup bizim vakamiz en erken donemde LHRH kullanirken gozlenen gebelik vakasiydi. Klinisyenler LHRH kullanan hastalarda gebelik acisindan dikkatli olmali ve hastalari olasi riskler icin bilgilendirmeliler.

Background: Venous thromboembolism (VTE) including the pulmonary embolism and / or deep vein thrombosis is an important cause of morbidity and mortality. Many risk factors had been investigated for VTE and still under investigation. Blood group antigen is one of these factor.Methods: Patients who followed and treated between 2004-2012 in the oncology clinic of Bülent Ecevit University School of Medicine were retrospectively studied.Results: There was no statistically significant difference between the two groups for age, gender and laboratory parameters. The most common type of cancers were colorectal, gynecological and breast cancer. We detected 52% of blood group A in the DVT group and there was no significant difference with the control group (OR 1.3, CI 95%, P 0.37). 0 blood group had detected fewer than control but there was no statistical significance between the groups (OR 0.6 CI 95%, P 0.2).In conclusion, our study showed that, ABO blood group did not have an additional risk factor for the development of DVT in cancer patients. The difference from the other studies is our stud population had only cancer patients. Also, many factors can increase tendency to thrombosis in cancer patients due to cancer., Amaç: Venöz tromboembolizm (VTE) pulmoner embolizm ve/veya derin ven trombozundan oluşan önemli bir morbidite ve mortalite sebebidir. VTE için birçok risk faktörü araştırılma konusu olmuştur ve halen araştırılmaktadır. Kan grubu antijenleri de bu konulardan biridir.Metod: Bülent Ecevit Üniversitesi Tıp Fakültesi Onkoloji kliniğinde 2004-2012 yılları arasında tedavi alan ve takipleri yapılan hasta dosyaları retrospektif olarak incelendi.Bulgular: Her iki grup arasında yaş, cinsiyet ve laboratuar özellikleri arasında istatiksel olarak anlamlı fark saptanmadı. En çok görülen kanser türleri kolorektal, jinekolojik maligniteler ve meme kanseriydi. A kan grubu DVT grubunda %52 oranında saptanmış olup kontrol grubu ile anlamlı fark izlenmedi (OR 1.3, CI %95, P 0.37). 0 kan grubu olanlarda DVT daha az saptanmakla birlikte istatiksel anlam yoktu (OR 0.6 CI%95, P 0.2). Sonuç olarak bizim hasta grubumuzda kan grubunun DVT gelişimi için ek bir risk faktörü katmadığı ortaya konulmuş olup diğer çalışmalardakinden faklı olması da bizim hasta grubunun sadece kanser hastalarından oluşmasına bağlı olabilirdi. Ayrıca kanser hastalarında birçok faktöre bağlı olarak tromboz eğiliminde artış olabilmektedir.

Malignant ascites is a manifestation of end-stage events in a variety of cancers. There is significant lack of possible survival predictors in patients with malignancy-related ascites. Since the Model for End-Stage Liver Disease (MELD)-Na score has been shown to be a feasible and independent prognostic predictor for both short- and long-term outcome in HCC patients, we decided to test its prognostic role in other cancer types with ascites. This is a retrospective study. The outpatient oncology clinic’s records were screened for the period between 2004 and 2011. Eighty-two pancreatic and gastric cancer patients were enrolled into the study. The median age of patients was 59 (±12). Fifty-nine patients had gastric cancer and 23 had pancreatic cancer. Overall survival (OS) was 16.8 (IR, 1–98) months in gastric cancer and 16.3 (IR, 0.5–81) months in pancreatic cancer. There was no statistically significant difference between OS of gastric and pancreatic cancer. Progression-free survival (PFS) was statistically significantly longer in gastric cancer than pancreatic cancer with 16.5 (IR, 0.5–90) vs 6.5 (IR, 0.4–34) months (P = 0.04). Further analysis of data included stepwise multiple regression analysis with the dependent variable “overall survival.” The model had two independent predictors and an R 2 of 82 % and a predicted R 2 of 81 %. Predictors for time to remission were PFS and MELD-Na. The regression equation for the model was: $$ \mathrm{Overall}\;\mathrm{survival}=17.4-0.522\,\,\mathrm{MELD}\text{-}\mathrm{Na} + 0.902\;\mathrm{PFS} $$ In this study we showed that progression-free survival and MELD-Na score are significantly related with overall survival. MELD-Na score can be one of the predictors of the survival and PFS in pancreatic and gastric cancer patients with ascites.

Amaç: Bu çalışmadaki amacımız tiroid fonksiyon bozuklukları ve tiroid antikorları ile hiperemezis gravidarum arasındaki olası ilişkiyi araştırmaktı. Gereç ve Yöntemler: Hiperemezis gravidarumu olan 37 hasta ve 33 sağlıklı kontrol gurubu çalışmada incelendi. Bulgular: Tiroid disfonksiyon sıklığı hiperemezis gravidarumda kontrol grubuna göre anlamlı olarak daha fazla bulundu (%38’e %6, p=0.002). Anti-tiroglobulin düzeyleride anlamlı olarak kontrol grubundan daha yüksekti ( 54 IU/mL’e. 14 IU/mL, p=0.03). Sonuçlar: Hiperemezis gravidarum postpartum tiroid fonksiyon bozuklukları için bir risk faktörü olabilir. Tiroid antikor düzeyleri de özellikle endemik guatr ve/veya iyot replasmanı yapılan bölgedeki gebelerde de mutlaka bakılmalıdır. (J Turkish-German Gynecol Assoc 2011; 12: 140-3), Objective: In this study we investigate the possible relation of thyroid dysfunction and thyroid antibodies to hyperemesis gravidarum. Material and Methods: Thirty-seven patients with hyperemesis gravidarum and 33 healthy controls have been included in this study. Results: Thyroid dysfunction was significantly more common than in controls (38% vs 6%, p=0.002). Thyroglobulin antibodies were also significantly more common in patients with hyperemesis gravidarum than controls (54 IU/mL vs. 14 IU/mL, p=0.03). Conclusion: Hyperemesis gravidarum can be a risk factor for postpartum thyroid dysfunction. Thyroid antibodies must be checked in the hyperemesis population in an endemic goitre region and/or iodine replacement regions. (J Turkish-German Gynecol Assoc 2011; 12: 140-3)

Surgery is the only curative modality but occasionally it can have some long term complication such as short bowel syndrome. We presented a case reporting a 63-year-old man who had subtotal colectomy with liver metastasectomy according to the colon adenocarcinoma, following the couple of months of surgery; he had acute kidney injury without any end-organ damage while he had a regular diet and nutrition. Following the regular treatment of renal failure, colorectal cancer recurrence was excluded and then he was discharged from the hospital with a normal serum creatinine level. The patient was admitted to the nephrology clinic again for acute renal failure within 3 weeks of last admission to the hospital. He also denied the insufficient oral water intake and nutrition, but laboratory examination revealed acute renal failure. We suspected for short bowel syndrome (SBS). Following the hydration, loperamide hydrochloride 10 mg/day was started and the patient was followed up with normal serum creatinine and uric acid levels. To the best of our knowledge, this is the first case report, in which a patient with short bowel syndrome presented with prerenal acute renal failure even though he had sufficient oral intake and nutrition and can be treated with hydration and loperamide hydrochloride.

Address for Correspondence: Dr. Cemil Bilir, Duzce University Faculty of Medicine, Department of Internal Medicine, Duzce, Turkey Phone: +90 380 541 41 07 E-mail: cebilir@yahoo.com Abstract Objective: Menopause age and bone mineral density are positively related and there is a rapid bone loss in the early postmenopausal period. A ratio of 30% of post-menopausal women are affected from osteoporosis developing due to bone loss and this causes 40% risk of fracture in a 50year old woman. Materials and Methods: In this sudy, serum osteocalcin and urine deoxypridinoline levels were analyzed in 102 postmenapausal and 48 healthy premenopausal controls who presented to gynecology outpatient clinic. Bone densitometry was obtained from all postmenopausal women. Postmenopausal patients were further divided into four groups according to time since menopause: 20 years. Results: Mean (SD) age in 48 premenopausal women was 47.7 (3.7) while it was 56.5 (6.8) in 102 post-menopausal women. 34 out of 102 post-menopausal women had surgical menopause due to bilateral oopheroctomy+hysterectomy while the remaining had natural menopause. No significant difference was found in bone-turnover markers between women with surgical and natural menopause. Conclusion: Although there was not a statistically significant difference between bone-turnover markers, bone mineral density stays lower in surgical menopausal patients and this difference disappear only after about 20 years. Also bone turnover markers are usually high up to five years after surgical menopause and return to normal levels after then. Thus, our study suggested that oopheroctomy does not cause additional risk to hysterectomy. We also suggest that there is not a longterm relationship between serum bone turnover markers or bone density and the etiology of menopause. (Turk J Rheumatol 2010; 25: 29-33)

Context: In patients with coexisting iron-deficiency anemia and subclinical hypothyroidism, anemia does not adequately respond to oral iron therapy. Objective: We studied whether iron-deficiency anemia might indicate treatment of subclinical hypothyroidism. Design: Patients were assigned to a control or experimental group: 240 mg/d oral iron alone (iron group) or 240 mg/d oral iron plus 75 μg/d levothyroxine (iron/levothyroxine group). Levels of hemoglobin, hematocrit, red blood cell count, serum iron levels, ferritin, total iron-binding capacity, TSH, and free T4 were measured before and after treatment. Setting: The study was conducted at a university hospital outpatient clinic. Patients: Fifty-one patients with coexisting iron-deficiency anemia and subclinical hypothyroidism participated in the study. Intervention: Patients were treated as described above in either the iron group or the iron/levothyroxine group. Main Outcome Measure: A clinically satisfactory increase in hemoglobin was regarded as successful. Results: Mean hemoglobin levels increased by 0.4 g/dl in the iron group [95% confidence interval (CI) 0.2–0.7, P = 0.001], whereas it increased by a mean of 1.9 g/dl in the iron/levothyroxine group (95% CI 1.5–2.3, P < 0.0001). The increase in serum iron was greater in the iron/levothyroxine group by a mean of 47.6 μg/dl (95% CI 34.5–60.6, P < 0.0001). Increases in hemoglobin, red blood cells, hematocrit, and serum ferritin levels after treatment were statistically significantly greater in the iron/levothyroxine group (P < 0.0001). Starting hemoglobin and increase in hemoglobin were negatively correlated in the iron/levothyroxine group (r = −0.531, P = 0.006). Conclusions: Subclinical hypothyroidism should be treated in iron-deficiency anemia patients when both conditions coexist. This would provide a desired therapeutic response to oral iron replacement and prevent ineffective iron therapy.

We wanted to investigate the possible etiologic factors of cachexia. Forty-six patients diagnosed with cancer cachexia and 34 healthy controls were included in the study. Serum total testosterone, free testosterone, interleukin 1 (IL) alpha and beta, IL6, tumor necrosis factor (TNF) alpha, orexin, galanin, neuropeptide Y, tumor necrosis factor-like weak inducer of apoptosis and tumor necrosis factor receptor-associated factor 6, and C-reactive protein (CRP) levels were investigated. There were 36 male and 10 female patients in the cachexia group, and 24 male and 10 female patients in the control group. Median overall survival (OS) of the cachexia group after the diagnosis of cachexia was 8 (1–25) months. There were statistically significant relationships between OS and BMI, serum CRP, TRAF-6, albumin, and LDH levels in the cachexia group. In addition to cachexia, serum CRP, testosterone, and TNF alpha levels were statistically significantly correlated with OS in refractory cachexia. TRAF-6 levels was significantly correlated with type of cancer (P = 0.02). Although cachexia presents with a multifactorial ethio-pathogenesis, few of them affect the OS. Our novel results were that serum CRP, albumin, LDH, and TRAF-6 levels have a higher association with OS in patients with cancer cachexia compared to the many other parameters. An ongoing cachexia also called refractory cachexia is a recent definition. This end-stage term of cancer duration may be predicted by decreasing serum testosterone and increasing serum TNF alpha levels, as well as serum CRP levels. © 2015, Springer Science+Business Media New York.

Primary metastatic breast cancer (PMBC) comprises 3-10 % of all BCs. PMBC is a heterogeneous disease. To date, little is known about the tumor characteristics, treatment results, and overall survival (OS) of patients with PMBC. Patients were considered to have PMBC if distant metastasis was evident within 3 months of the initial diagnosis of BC. Between September 2007 and April 2013, 466 PMBC patients were included in this study and analyzed retrospectively. The median age of the patients was 50 (18-90) years. Bone/soft tissue metastases were more frequent in the hormone receptor (HR)(+) human epidermal growth factor receptor (HER)2(-) group compared with the HR(-)HER2(-) and HR(-)HER2(+) groups (p < 0.001), whereas visceral organ metastasis was more frequent in the HR(-)HER2(-) and HR(-)HER2(+) groups (p < 0.001). The OS was affected by Eastern Cooperative Oncology Group performance status, tumor histology, receptor status, and the site of metastasis (p < 0.001, p < 0.001, p < 0.001, and p = 0.011, respectively). According to the first-line systemic treatment choices of the patients, the longest median OS was observed in the HR(+)HER2(+) group who received hormonotherapy combined with trastuzumab after chemotherapy (86 months, 95 % CI 23.8-148.1) and the shortest median OS was observed in the HR(-)HER2(-) group who received chemotherapy only (24 months, 95 % CI 17.9-30.0) (p < 0.001). Bisphosphonate therapy or radiotherapy had no significant effect on OS (p = 0.733, 0.603). In multivariate analysis, hormonotherapy, chemotherapy + trastuzumab, trastuzumab + hormonotherapy following chemotherapy, and surgery were the most important prognostic factors for OS, respectively (p < 0.001, p = 0.025, p = 0.027, p = 0.029). The general characteristics of the primary tumor are important for the prognosis and survival of patients with PMBC. Interestingly, patients who underwent primary breast tumor surgery, even those at the metastatic stage upon admission, had the longest survival. © 2014 Springer Science+Business Media New York.

Introduction.We designed this study to evaluate how coagulation parameters are changed in metastatic colorectal cancer (mCRC) patients treated with bevacizumab, irinotecan, 5-fluorouracil, and leucovorin (FOLFIRI).Methods.A total of 48 mCRC patients who initially received bevacizumab with FOLFIRI were eligible for this study. Thirty-four patients were analyzed at baseline and on the 4th, 8th, and 12th cycles of chemotherapy.Results.There were 19 male and 15 female patients. Baseline characteristics of the groups were similar, but women had better overall survival than men (14 months versus 12 months,P=0.044). D-dimer levels decreased significantly after the 12th cycle compared with baseline in men but not in women. Men and women had increased levels of serum fibrinogen at the early cycles, but these increased fibrinogen levels continued after the 4th cycle of chemotherapy only in women. In addition, serum fibrinogen levels did not significantly change, but aPTT levels decreased in men.Discussion.The major finding of this study is that bevacizumab-FOLFIRI chemotherapy does not promote changes in the coagulation system. If chemotherapy treatment and the possible side effects of FOLFIRI-bevacizumab treatment are well managed, then alterations of the coagulation cascade will not have an impact on overall survival and mortality.

Bilir, Cemil/0000-0002-1372-4791 WOS: 000284901300019 PubMed: 19825918 Isolated renal vein thrombosis is very rare without the presence of nephrotic syndrome. It is more common in the newborns and infants. Whereas major risk factors in adults are the procoagulant states such as protein C or S deficiency, factor V Leiden mutation, primary or secondary antiphospholipid syndrome, severe hypothyroidism, and trauma. Here, we report a case of isolated renal vein thrombosis associated with MTHFR-1298 and PAI-1 4G gene mutations. It should be noted that the presence of MTHFR-1298 and PAI-1 4G gene mutations together might be one of the examples of genetic mutation combinations that increase the likelihood of a thrombotic event.

WOS: 000321597900007, Breast cancer is the most common female cancer in the world wide with 30% of all women cancer and second most common cause of cancer death in women. Oncology department of Bulent Ecevit University Faculty of Medicine is the only cancer center in western part of Black Sea region. We investigated retrospectively our data of women breast cancer between the period of 2000 and 2010 in this region. The mean age of the study population was 49.90 +/- 12 years and mean follow-up time was 4 +/- 2 years. The distribution of patients by the age, 25% or patients under 40 years old, 32% between the 40-50 years old and 43% of them over the 50 years old. 92.6% of the patients were presented with a palpable mass. The most common type of breast cancer was invasive ductal carcinoma (IDC) in 312 patients (80%). Prognosis of the study population; 309 patients (80%) are surviving without any disease. Sixty-six patients (17%) had progression, 7 of 390 patients (1,8%) had local recurrence and 15 patients (3.8%) died. While the breast cancer is one of the most commonly seen solid organ tumors in Black Sea region and, based on the literature, no significant differences were observed for prognostic factors, longer life expectancy of the patients with advanced stage disease may be attributed to higher number of patients with hormonal positivity and therapy adherence.

Background: Immune functions and their relation to prognosis in breast cancer patients have become areas of great interest in recent years. Correlations between survival outcomes and peripheral blood flow cytometry parameters are therefore of interest. Here we focused on patients with non-metastatic breast cancer (BC). Materials and Methods: A total of 29 patients with pathological confirmed breast carcinoma and flow cytometry data were assessed for overall survival (OS) and progression free survival (PFS). Results: The median age of the patients was 54 years (range, 29-83). Multivariate analysis revealed that OS was significantly associated with absolute cytotoxic T cell count (95%CI, coef 2.26, p=0.035), tumor size (95%CI, coef -14.5, p 0.004), chemotherapy (95%CI, coef 12.9, p 0.0001), MFI of CD4 (95%CI, coef -5.1, P 0.04), MFI of HLA DR (95%CI, coef -5.9, p 0.008) and tumor grade (95%CI, coef -13, P 0.049) with R-Sq(adj)=67%. Similar findings were obtained for PFS. Conclusions: OS and PFS were significantly associated with tumor grade, tumor size, chemotherapy, MFI of CD4, HLA DR and absolute cytotoxic T cell count. The study revealed that MFI of basic CD markers and absolute cytotoxic T cell number may be a prognostic factors in women with non-metastatic BC.

Bilir, Cemil/0000-0002-1372-4791 WOS: 000302158400002 PubMed: 21825964 Introduction: One of the cardiovascular effects of hyperthyroidism is increased carotid intima media thickness (CIMT). The aim of this study is to investigate the CIMT in patients with Graves' hyperthyroidism and the effect of propylthiouracil (PTU) therapy on CIMT. Method: Twenty-six patients with Graves' hyperthyroidism and 33 healthy controls were included in the study. CIMT was measured at the right and left external carotid arteries in every patient in both groups. CIMT was measured before and after the PTU therapy in patients with Graves' hyperthyroidism. Results: There was a significant difference in CIMT between the group of Graves' hyperthyroid patients and the control group (0.72 versus 0.55 mm, P < 0.0001) at baseline. Twenty-five of 26 patients with Graves' disease were followed up for 18 months prospectively. Euthyroidism has been achieved in 21 patients. After 18 months of treatment, CIMT decreased significantly compared with the baseline values [0.84 (0.54-1.3) to 0.72 (0.50-1.2), change 0.12 mm, P < 0.001]. Conclusion: Graves' hyperthyroidism is associated with atherosclerosis as assessed by CIMT. Treatment of Graves' hyperthyroidism with PTU decreases the CIMT.

INTRODUCTION: Primary dysmenorrhea (PD), which is characterized by painful menstrual cycles, is one of the common clinical problems in young adult women. The aim of this study was to investigate the risk of cardiac arrhythmias in PD patients by using the electrocardiographic (ECG) parameters. METHODS: Forty patients diagnosed with PD and 30 age-matched normal controls were included in this study. ECGs were performed by using 12-leads with 10 mV amplitude and 25 mm/sec velocity. P and QT waves were manually marked along the isoelectric line. P maximum, P minimum, QT maximum and QT minimum were measured on the surface 12-leads ECG, and the P wave and QT dispersions were calculated. RESULTS: There was not any significant correlation of P wave dispersion and QT dispersion between the age, sex, body mass index, hemoglobin, fasting blood glucose or any other laboratory parameters. P wave dispersion was significantly longer in the PD group than the control group (61.4 ± 19 msec versus 57 ± 14 msec, P = 0.01). The P minimum duration was significantly shorter in the PD group compared with the control group (36 ± 16 msec versus 41 ± 9 msec, P = 0.03). QT dispersion was significantly higher in the PD group compared with normal controls (76 ± 23 msec versus 58 ± 16 msec, P = 0.02). CONCLUSION: These results show that PD can be associated with cardiac arrhythmias, especially atrial fibrillation, by increasing P wave dispersion and ventricular arrhythmia risk because of an increased QT interval. © Copyright 2012 Southern Society for Clinical Investigation.

Background: Primary dysmenorrhea is a common disorder among young women, and uterine ischemia plays an important role in pelvic pain. Asymmetric dimethylarginine (ADMA) is accepted as a strong marker of endothelial dysfunction. Objective: To investigate the role of ADMA in primary dysmenorrhea. Methods: Thirty-three patients with primary dysmenorrhea and 29 healthy controls were evaluated in a hospital outpatient clinic-based study. Secondary causes of dysmenorrhea had been ruled out in each patient. LDL cholesterol, triglycerides measured and body mass index were also calculated. Blood samples for determination of ADMA concentration were drawn on the 3rd day of menses in each woman. Groups were compared for statistically significant difference by Mann-Whitney U test. Results: Groups did not differ in age or hormone levels. ADMA level was higher in women with dysmenorrhea compared to healthy controls (Mann-Whitney U test, Z = –2.24, p = 0.025). ADMA levels showed positive correlation with age and erythrocyte sedimentation rate in the first group (Spearman’s rho = 0.360, p = 0.040, and r = 0.379, p = 0.029, respectively). Although erythrocyte sedimentation rate and C-reactive protein (CRP) were positively correlated, no significant correlations were found between high-sensitivity CRP and ADMA level in the first group (Spearman’s rho = 0.048, p = 0.749). Conclusion: ADMA concentrations are elevated in primary dysmenorrhea compared to healthy controls. This suggests that endothelial dysfunction plays a role in primary dysmenorrhea.

Background Elevated anti- Saccharomyces cerevisiae antibody (ASCA) immunoglobulin (IgG) and IgA levels were first described in the serum of Crohn disease patients and have increasingly been reported in other inflammatory diseases. The role of in situ and remote inflammation in atherosclerosis is a major area of interest. In this study, we compared ASCA IgG and IgA levels in acute myocardial infarction (AMI) and controls to investigate the possible role of ASCA in AMI. Methods Serum samples were obtained from 140 consecutive patients who presented to the emergency department with acute chest pain. AMI was diagnosed by electrocardiography and serial enzymes. Patients ruled out for acute coronary event were grouped as controls. ASCA IgA and IgG levels were determined using enzyme-linked immunosorbent assay. Groups were compared for statistically significant difference. Results ASCA IgG titers ranged between 0.1 and 31.0 RIU/mL (mean 4.92) in the AMI group and 0.1 and 6.0 (mean 0.84) in the controls. The groups were found to differ very significantly ( p = .001). ASCA IgA titers ranged between 2.0 and 200.0 RIU/mL (mean 13.73) in the AMI group and 2.0 and 11.5 RIU/mL, (mean 4.25) in controls. The groups differed significantly ( p = .32). AMI and controls were also analyzed for ASCA IgA and IgG positivity. Both groups differed significantly from controls ( p = .013). Conclusion Elevated ASCA IgA and IgG levels as well as ASCA positivity in the AMI might suggest use of ASCA as a marker for atherosclerotic plaque instability. It might also provide a link between inflammatory processes and increased cardiovascular risk. Further studies are needed on a Saccharomyces cerevisiae-based diet, related intestinal colonization, and associated inflammation, autoimmune disorders, and cardiovascular events.

Background Cachexia has long been recognised as an adverse effect of cancer. Cancer cachexia (CC) has three stages of clinical relevance: precachexia, cachexia, and refractory cachexia (RC). Methods This study includes 36 patients diagnosed with CC (of whom 17 patients had RC and remaining 19 had cachexia) at the Department of Medical Oncology, Bulent Ecevit University, and 24 healthy controls, who enrolled between May 2011, and February 2013. Findings We investigated the levels of serum C reactive protein (CRP), IL-1 alfa, IL-1 beta, TNF alfa, and free and total testosterone in male patients with CC. In the group of men with refractory cachexia, serum CRP levels were significantly higher (139 mg/l versus 3.8 mg/l, p = 0.0001) and serum testosterone levels were significantly lower (170 ng/dl versus 450 ng/dl, p = 0.0001) than in the cachexia group. There were no significant differences in the serum levels of IL1 alfa, IL1 beta, TNF alfa, and serum free testosterone levels. Interpretation In RC, there has been a clinically refractory process as a result of end-stage disease. Our study revealed that CRP levels increase and testosterone levels decrease in refractory cachexia. In a pre-cachectic or cachectic patient, basal CRP levels can be followed up and increasing CRP levels and/or decreasing testosterone levels must alert to proceeding to irreversible catabolism, such as RC.

Cardiotoxicity is an uncommon adverse effect of 5-FU treatment. Prevalence of 5- fluorouracil (FU) - induced cardiotoxicity is 2–18%, and represents an interesting clinical challenge.1 A 62 …

WOS: 000236144500039, PubMed ID: 16549562, It is known that insects can cause various clinical effects such as myocardial ischaemia and hypotension from vasospasm and the myocardial toxic effects of the venom and anaphylaxis. Although myocardial ischaemia resulting from centipede sting has been reported once before, myocardial injury has not. In this report, the authors present the case of a 20 year old male patient bitten by a centipede and admitted to the emergency room with chest pain, abnormal electrocardiographic findings, and increased cardiac enzymes ( cardiac troponin T) suggesting acute myocardial infarction.