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WOS: 000454014501235 Background: Increasing evidence leads to a ratiocination that genetic heterogeneity of the lung adenocarcinoma patients with sensitive EGFR mutations may impact clinical responses and outcomes to EGFR-TKIs. Method: We performed targeted NGS with a gene panel covering 416 cancer-related genes to profile genetic characteristics of 69 lung adenocarcinoma patients with activating EGFR mutations and assessed the contribution of targeted NGS to exploration of genetic heterogeneity of such cohort. Result: We detected total 200 actionable genetic alterations (mean 2.9 variations per patient, range: 1-7 variations) in tumor DNA and 140 actionable genetic alterations (mean 2.0 variations per patient, range: 0-5 variations) in matched plasma ctDNA, respectively. The concurrent genes with the highest mutation rate were TP53 (observed in 72.5% patients), other uncommon EGFR mutations (observed in 21.7% patients), EGFR amplification (observed in 20.3% patients), RB1 (observed in 10.1% patients), PIK3CA (observed in 7.2% patients), and MYC (observed in 5.8% patients). NGS provides EGFR mutation detection in plasma with a test sensitivity of 88.2% and specificity of 100.0%.

Yumuk, Perran Fulden/0000-0001-8650-299X; Cicin, Irfan/0000-0002-7584-3868; Arslan, Cagatay/0000-0002-3783-7432; beypinar, i/0000-0002-0853-4096; Turna, Hande/0000-0003-0558-9371; WOS:000492162203082 [No abstract available]

PurposeIn this study, we aimed to describe the real-life practice outcomes of pertuzumab-trastuzumab-taxane (PTT) combination in visceral organ metastatic, trastuzumab-naive breast cancer (BC) patients.MethodsThis study was conducted by Turkish Oncology Group and included 317 patients' data from 36 centers.ResultsMedian age was 51 (22-82). Median PFS was 28.5months, while median OS was 40.3months. Patients with brain metastases (n: 13, 4.1%) had worse PFS (16.8m vs. 28.5m; p=0.002) and OS (26.7m vs. 40.3m; p=0.009). Patients older than 65years of age (n: 42, 13.2%) had significantly lower OS results (19.8m vs. 40.3m; p=0.01). Two hundred sixty-eight patients (86.7%) received docetaxel while 37 patients (11.7%) received paclitaxel. PFS and OS were similar between taxane groups. In eight patients (2.5%), 5-40% ejection fraction decrement from baseline was detected without any clinical sign of heart failure.ConclusionsOur RLP trial included only visceral metastatic, trastuzumab-naive BC patients including cases with brain involvement who received PTT combination in the first-line treatment. Regardless of negative prognostic characteristics, our results are in parallel with pivotal trial. Further strategies for brain metastasis should be developed to improve outcomes despite encouraging results with PTT treatment. Taxane selection can be personalized and endocrine maintenance may further improve outcomes after taxanes were discontinued. To our knowledge, this is the largest scale real-life clinical practice study of pertuzumab-trastuzumab-taxane therapy to date. C1 [Esin, Ece; Oksuzoglu, B.; Erdur, E.; Demirci, U.] Univ Hlth Sci, Dept Med Oncol, Dr AY Ankara Oncol Educ & Res Hosp, Ankara, Turkey. [Bilici, A.] Medipol Univ, Int Hlth Ctr, Dept Med Oncol, Istanbul, Turkey. [Cicin, I.; Kostek, O.] Trakya Univ, Dept Med Oncol, Edirne, Turkey. [Kaplan, M. A.] Dicle Univ, Dept Med Oncol, Fac Med, Diyarbakir, Turkey. [Aksoy, S.; Aktas, B. Y.] Hacettepe Univ, Dept Med Oncol, Fac Med, Ankara, Turkey. [Ozdemir, O.; Alacacioglu, A.] Izmir KC Univ, Ataturk Educ & Res Hosp, Dept Med Oncol, Izmir, Turkey. [Cabuk, D.] Kocaeli Univ, Fac Med, Dept Med Oncol, Izmit, Turkey. [Sumbul, A. T.] Baskent Univ, Dept Med Oncol, Adana Hosp, Adana, Turkey. [Sakin, A.] Istanbul Okmeydani Educ & Res Hosp, Dept Med Oncol, Istanbul, Turkey. [Paydas, S.; Yetisir, E.] Cukurova Univ, Dept Med Oncol, Fac Med, Adana, Turkey. [Er, O.; Basaran, G.] Acibadem MAA Univ, Acibadem Maslak Hosp, Dept Med Oncol, Istanbul, Turkey. [Korkmaz, T.; Oyan, B.] Acibadem MAA Univ, Acibadem Altunizade Hosp, Dept Med Oncol, Istanbul, Turkey. [Yildirim, N.] Dr Ersin Arslan Training & Res Hosp, Dept Med Oncol, Gaziantep, Turkey. [Sakalar, T.] Erciyes Univ, Dept Med Oncol, Fac Med, Kayseri, Turkey. [Demir, H.] Kayseri Educ & Res Hosp, Univ Hlth Sci, Dept Med Oncol, Kayseri, Turkey. [Artac, M.; Karaagac, M.] Necmettin Erbakan Univ, Meram Med Fac, Dept Med Oncol, Konya, Turkey. [Harputluoglu, H.; Bilen, E.] Inonu Univ, Dept Med Oncol, Turgut Ozal Med Ctr, Malatya, Turkey. [Degirmencioglu, S.] Pamukkale Univ, Dept Med Oncol, Fac Med, Denizli, Turkey. [Aliyev, A.] Bezmialem Univ, Dept Med Oncol, Fac Med, Istanbul, Turkey. [Cil, T.; Olgun, P.] Adana City Hosp, Univ Hlth Sci, Dept Med Oncol, Adana, Turkey. [Gumusay, O.] Gaziosmanpasa Univ, Dept Med Oncol, Fac Med, Tokat, Turkey. [Demir, A.] Univ Hlth Sci, Dept Med Oncol, Istanbul Okmeydani Educ & Res Hosp, Istanbul, Turkey. [Tanrikulu, E.; Yumuk, P. F.] Marmara Univ, Dept Med Oncol, Fac Med, Istanbul, Turkey. [Imamoglu, Inanc] Univ Hlth Sci, Ankara Diskapi Educ & Res Hosp, Dept Med Oncol, Ankara, Turkey. [Cetin, B.] RTE Univ, Dept Med Oncol, Fac Med, Rize, Turkey. [Haksoyler, V.] Univ Hlth Sci, Diyarbakir GY Educ & Res Hosp, Dept Med Oncol, Diyarbakir, Turkey. [Karadurmus, N.; Erturk, I.] Univ Hlth Sci, Gulhane Educ & Res Hosp, Dept Med Oncol, Ankara, Turkey. [Evrensel, T.; Yilmaz, H.] Uludag Univ, Dept Med Oncol, Fac Med, Bursa, Turkey. [Beypinar, I.] Afyon Kocatepe Univ, Dept Med Oncol, Fac Med, Afyon, Turkey. [Kocer, M.] Isparta SD Univ, Dept Med Oncol, Fac Med, Isparta, Turkey. [Pilanci, K. N.] Univ Hlth Sci, Dept Med Oncol, Haseki Educ & Res Hosp, Istanbul, Turkey. [Seker, M.; Urun, Y.] Ankara Bayindir Hosp, Dept Med Oncol, Ankara, Turkey. [Urun, Y.] Ankara Univ, Dept Med Oncol, Fac Med, Ankara, Turkey. [Yildirim, N.; Eren, T.] Univ Hlth Sci, Numune Educ & Res Hosp, Dept Med Oncol, Ankara, Turkey.

44th Congress of the European-Society-for-Medical-Oncology (ESMO) -- SEP 27-OCT 01, 2019 -- Barcelona, SPAIN, Cicin, Irfan/0000-0002-7584-3868, WOS: 000491295504209, [No abstract available], European Soc Med Oncol, Japanese Soc Med Oncol

Background: Approximately 5% of all diagnosed non-small cell lung cancer (NSCLC) patients harbor a genetic rearrangement between the ALK and EML4 genes, representing a specific molecular and clinical subgroup (ALK+ NSCLC). To date, upfront treatment with ALK-tyrosine-kinase inhibitors (ALK-TKIs) has replaced chemotherapy in the first line setting for this subset of patients with excellent results, but reliable prognostic markers are lacking. An increased systemic inflammatory response has been shown to be associated with a poor prognosis, and some of the parameters used to characterize this response can easily be measured in clinical practice in several tumor types, but have not been analyzed extensively in ALK+ lung cancer in the era of crizotinib. Method: We reviewed the medical records of all patients with previously treated advanced ALK-positive NSCLC who received crizotinib between January 2013 and March 2018 outside of a clinical trial. Pre-treatment modified Glasgow prognostic score (mGPS), Prognostic Nutritional Index (PNI) and Systemic immune-inflammation index (SII) were calculated. Multivariable logistic regression and Cox proportional hazards models were used to assess the impact of pretreatment mGPS, PNI and SII on overall survival (OS), progression-free survival (PFS), and overall response rate (ORR). Result: 82 patients were treated. Median age was 52.5 years (range; 20e77 years); 42.7% were female. Eighty-four point two percent of patients had an Eastern Cooperative Oncology Group Performance Status (ECOG PS) 1; 17.1% had received 2 prior systemic therapies. The objective response rate was 77.2% (CR+PR). The optimal cutoff levels were 0.09 for mGPS and PNI, 934.7 for SII by ROC curves analysis. Patients in the SII 934.7 grous was significantly correlated with worse PFS and OS by univariate analysis (Figure 1). In multivariate analyses, pretreatment prognostic nutritional index (PNI) 0.09 was independently associated with inferior OS (1 year OS rates, 90.2% vs. 73.7%; HR 2.46, 95% CI 0.88- 4.85; p ¼ 0.035). Additionally, we evaluated the effects of these markers on response prediction. The logistic regression analysis of the predictive factors for the response to crizotinib demonstrated that the mGPS and PNI were associated with inferior ORR (OR: 0.1, 95% CI 0.16-1.04; p ¼ 0.009 and OR: 0.16, 95% CI 0.02-0.55; p ¼ 0.035, respectively). Conclusion: In a cohort of patients with ALK positive NSCLC treated with crizotinib in routine practice, elevated pre-treatment SII was associated with shorter OS and PFS in univariate analysis and PNI was associated with shorter OS in multivariate analyses. Moreover the mGPS and PNI were associated with lower response rates.

Purpose: In this study, we aimed to describe the real-life practice outcomes of pertuzumab–trastuzumab–taxane (PTT) combination in visceral organ metastatic, trastuzumab-naive breast cancer (BC) patients. Methods: This study was conducted by Turkish Oncology Group and included 317 patients’ data from 36 centers. Results: Median age was 51 (22–82). Median PFS was 28.5 months, while median OS was 40.3 months. Patients with brain metastases (n: 13, 4.1%) had worse PFS (16.8 m vs. 28.5 m; p = 0.002) and OS (26.7 m vs. 40.3 m; p = 0.009). Patients older than 65 years of age (n: 42, 13.2%) had significantly lower OS results (19.8 m vs. 40.3 m; p = 0.01). Two hundred sixty-eight patients (86.7%) received docetaxel while 37 patients (11.7%) received paclitaxel. PFS and OS were similar between taxane groups. In eight patients (2.5%), 5–40% ejection fraction decrement from baseline was detected without any clinical sign of heart failure. Conclusions: Our RLP trial included only visceral metastatic, trastuzumab-naïve BC patients including cases with brain involvement who received PTT combination in the first-line treatment. Regardless of negative prognostic characteristics, our results are in parallel with pivotal trial. Further strategies for brain metastasis should be developed to improve outcomes despite encouraging results with PTT treatment. Taxane selection can be personalized and endocrine maintenance may further improve outcomes after taxanes were discontinued. To our knowledge, this is the largest scale real-life clinical practice study of pertuzumab–trastuzumab–taxane therapy to date. © 2018, Springer-Verlag GmbH Germany, part of Springer Nature.

PubMed ID: 27849321, BACKGROUND: The purpose of our study was to retrospectively evaluate traumatic aortic transection patients and their bedside plain chest radiographs for signs of aortic injury. METHODS: Emergency department (ED) patients from a 5-year period with traumatic aortic transection who were over 18 years of age were included in the study. Demographic characteristics, mechanism of trauma, Revised Trauma Score, Glasgow Coma Score, vital signs, physical exam findings, laboratory parameters, length of stay in the ED, and patient outcomes were documented. Bedside plain chest radiograph images were interpreted by 2 emergency medicine specialists and 1 radiologist. RESULTS: Thirty patients, mean age 45.87±16.14 years (70% male), were enrolled. Most common trauma mechanism was motor vehicle accident (53.3%). Agreement rates between emergency medicine specialists and radiologist were found to be “excellent” and “substantial” in identifying mediastinal widening and multiple left sided rib fractures; and “fair” in identifying widened paraspinal line, and transthoracic vertebral fractures. CONCLUSION: Though not completely reliable, bedside plain chest radiographs and physical examination findings may be useful in detecting aortic injury during primary survey when the patient is unstable and cannot be sent for chest computerized tomography. Appropriate further imaging studies should be carried out as appropriate based on patient’s hemodynamic status. © 2016, TJTES.

In this study, the level of relationship between the real growth rate (GR) of the stock pension mutual funds that have been involved in the individual pension system and the variables such as the number of fund participants, the real fund returns, fund operating expenses and share of fund assets to the total assets of the funds are analyzed with panel data methodology. The results have reported that apart from the fund operating expenses, the selected independent variables are statistically significant on the the real GR of the stock pension mutual funds. © 2015, Econjournals. All rights reserved.

In last decades a large number of buildings is being constructed on problematic soils because of rapid urbanization It causes growing earthquake risks in such areas if combined with lack of engineering. Grouting of ground is being employed to improve seismic performance of foundations and its effectiveness has been verified by examination of predominant period of ground vibration and shear wave velocity. The average period and shear wave velocity of ground was changed from 0.58 s to 0.23 s and 374 m/s to 449 m/s, respectively. The improvement of ground properties reached more than 50%. The results show that grouting can improve earthquake performance of seismically weak building foundations. Thus it can be advised to mitigate the seismic risk of existing buildings.

Fluctuations in raw material and product prices have caused manufacturers and consumers to experience serious losses in steel sector as well as in all other sectors. As the number of manufacturers of commodities like coking coal, iron ore and scrap-the main raw materials of steel manufacturing-is less worldwide and their manufacturers do not want to disclose price in an organized market, their future transaction volumes have not developed sufficiently yet. However, future transaction volumes of non-ferrous metals like aluminum, tin etc. that are used as auxiliary raw materials in steel manufacturing have increased fast in organized markets and such style of future transactions have become important in steel manufacturing in terms of cost management. The London Metal Exchange, one of the leading future commodity markets of world, has an important place in management of price risk in steel manufacturing and consumption of derivative transaction contracts. In this study, causality relationship between the price series of non-ferrous metals used as raw materials in steel manufacturing is examined by using Toda and Yamamoto (1995) causality test procedure. Empirical results suggest that aluminum is Granger cause of the other non-ferrous metals. © 2014 Econjournals. All right reserved.

Aim: Our aim was to evaluate the properties of pediatric forensic cases and to discuss the precautions in order to prevent the occurrence of these forensic events.Methods: The patient files and forensic reports of pediatric (age 0-18 years) forensic cases, who were referred to the emergency department in our hospital between January 01, 2009 and December 31, 2011 were retrospectively investigated.Results: A total of 421 forensic pediatric cases with a median age of 9.9±5.5 years were included in the study. Off the cases, 61% (n=257) were male and 47.3% were in 5-14 age group. The type of the events were traffic accident (50.4%), fall (18.3%), stab injuries (10.9%), intoxication (5.9%), pounding (5.0%) and other incidents (9.5%). There were nine cases of suicide attempt (all of them were above 14 years of age) and four cases of physical abuse (three of them were under 15 years of age). After the observation period, 79.8% of the cases were discharged from the emergency department, whilst 20.2% of cases were hospitalized in one of the clinics.Conclusion: Because most of the cases were traffic accident, this situation show us that these injuries are preventable. Prevention and intervention strategies should be developed for providing a safe environment for children. © 2014, Galenos. All rights reserved.

Aim: In this study, we evaluated the consistency between the records made in the hospital automation system as well as the causes of death in the death certificates. Methods: Death certificates for the cases occurred in the hospital and data of the hospital automation system were retrospectively analyzed. Results: Out of 351 cases within a two-year period, 218 (62.1%) were male and the mean age of the cases was 67.1±0.7 years. Our findings showed that 87.5% (n=307) of the deaths in the hospital were among people 60 years of age and older and took place in the intensive care unit and the mean time to death was found to be 15.4±25.4 hours. It was recorded that 23.9% (n=84) of diseases or conditions directly leading to death were heart failure and 19.9% (n=70) of cases were cardiopulmonary arrest. The maximum consistency was found between the first recorded international classification of disease codes and myocardial infarction. Conclusion: Since the accuracy and consistency of death statistics are largely dependent on the nature of the physician-provided data, good knowledge of physicians regarding details on patient records and the causes of death is of great importance.

This paper employs Hong's (2001) causality-in-mean and causality-in-variance tests to investigate the spillovers between business confidence and stock returns for the four economically distressed Southern European countries, namely Greece, Italy, Spain, and Portugal. The sample uses monthly data and covers the period from January 1988 to December 2010. Our causality-in-mean results indicate that there is feedback relationship between stock returns and business confidence in Portugal. The direction of causality-in-mean runs from business confidence to stock returns in Italy, but it is in the reverse direction in the case of Spain. Nevertheless, there is still evidence of a contemporaneous interaction between business confidence and stock returns in both Italy and Spain. On the other hand, causality-in-variance indicate the presence of volatility spillovers from business confidence to stock returns in Portugal, while a causal relationship is found in the current month in the case of Italy. Business confidence causes stock returns only in the mean in Greece. These results indicate that the stock market and business confidence relationship has its own idiosyncratic properties and that the stock market reactions to the current macroeconomic environment and expectations about the future developments might evolve differently in each country. © 2012 John Wiley & Sons, Ltd.

In this study, financial performances of 7 tourism businesses which shares are traded at the Istanbul Stock Exchange (ISE) are analyzed with ELECTRE method, which is one of the multicriteria decision making methods. For that purpose, 10 financial ratios which explain financial performance of businesses are determined and financial ratios are calculated for each business by using the ratio analysis method for the period 2007-2011. Financial ratios calculated for the businesses are turned into points that show general business performance by using ELECTRE method. Then, the calculated performance scores are used for ranking. © Hasan Uygurturk, Turhan Korkmaz, Hilal Uygurturk, 2013.

In this study, we examine the validity of purchasing power parity by applying unit root and co-integration tests which allow structural breaks in Azerbaijan, Kazakhstan, and Kyrgyzstan. Although conventional unit root and co-integration tests results indicate that purchasing power parity does not hold in these countries, we determine the validity of purchasing power parity according to unit root and co-integration tests which allow structural breaks. Also, we conclude that the exchange rate of these countries has been affected by the Russian financial crises of 1998 and that the crisis in question has led to structural breaks in the exchange rates of these countries.

Objectives Studies indicate that emergency physicians (EP) under-evaluate and undertreat the pain experienced by their patients. The objective of this study was to investigate how EPs treat pain in adult patients with limb trauma and to determine if their behavior could be affected by training in the short-term. Methods All consecutive adult patients admitted to the university-based emergency department (ED) within two months were enrolled in the study. The patients were asked to rate their level of pain on the NRS in triage. NRS scores were noted again after 30 minutes and 60 minutes, and on discharge. Patient prescriptions were also tracked to identify any analgesics. After completion of the pre-education phase, four hours of training on pain evaluation and treatment were undertaken under the leadership of experienced staff faculty. The aforementioned outcomes were gathered again in a 30-day period after training and we compared the pre and post training periods. Results A hundred and forty-three patients (81 female) were enrolled in the pre-education phase, and 130 patients (58 female) were eligible for the post-education phase. The mean NRS scores of the females noted on admission were significantly higher than those of the males (7.4±2.3 vs. 6.7±2.5, respectively; p=0.020). Patients included in the first phase received analgesia less frequently (42.7% vs. 70.0%, respectively; p

20th International Mining Congress and Exhibition of Turkey (IMCET 2007) -- JUN 06-08, 2007 -- Ankara, TURKEY, WOS: 000248289300027, All over the world in recent years, energy products are exposed to high price volatility due to the increasing deregulation and liberalization efforts in energy sector, imbalance of supply and demand, increasing needs of energy, storage-delivery problems and etc. Price fluctuations have negative affect on both suppliers and consumers operating in energy markets; as a result, price risk needs to be hedged. One of the effective ways of price risk hedging purposes is using VaR methods. VaR is a generally accepted method that assesses price risk in a single number by using statistical and simulation models. In this study, hypothetical energy futures contracts portfolio's daily risk numbers are measured by VaR methods, namely; Historical Simulation and Monte Carlo Simulation. In order to test success of daily VaR numbers, backtesing method is applied. As a result, it is observed that both Historical Simulation and Monte Carlo Simulation methods meet the requirements of Basel Criterion., Sci & Technol Res Council Turkey, Turkish Coal Enterprises, Eti Mine Works Gen Management, Turkish Hardcoal Enterprises, Yildizlar Holding, Black Sea Copper Works, Eti Copper Corp, Dedeman Holding, Chamber Mining Engineers Turkey

Purpose: The purposes of this study were to investigate the periodontal status and susceptibility to periodontal disease progression of the teeth in contact with removable partial dentures (RPD) and to compare them with control teeth in mouths not restored with a partial denture, by means of both clinical parameters and interleukin (IL)-1beta levels in gingival crevicular fluid. Materials and Methods: Twenty-eight periodontally healthy patients were selected for the study; 14 of them were treated with mandibular Kennedy Class I RPDs, and the other 14 patients were not restored for control. Clinical periodontal measurements were assessed, and crevicular fluid samples were collected from both abutment and control teeth to determine IL-1beta levels, which were measured by enzyme-linked immunosorbent assay. These procedures were performed both at baseline and 9 months after the insertion of the dentures. Results: The wearing of RPDs resulted in statistically higher clinical scores and total IL-1beta levels compared to the baseline examination. In contrast, no statistically significant differences were found between baseline and 9-month examinations in the control group. Conclusion: RPDs are a risk factor for periodontal disease progression because of increased plaque accumulation associated with increased total IL-1beta levels and impaired clinical periodontal parameters.

This research has been made on the long bones of the extremities of the rabbits, Lepus capensis. It has been established in which indicated correlation in very high values the age of this numerically change by optaining non Havers canal, osteon and interval lamellas number presented in the circular area with a hundred enlargement in the cross section took with the decalcify method. According to the results obtained, number of the osteon and the interval lamella in femur, tibia, humerus, radius and ulna has shown the increase with the age. The correlation between the age with this formation is more than r = 0.9. Number of the non Havers canal in these bones with the age has shown a decrease and a negative correlation.