Relationship between Hba1c and blood glucose level in hemodialysis patients with diabetes mellitus

Within in the scope of this study, a researchwas aimed at the relationship between HbA1c markersand blood glucose levels with DM, chronic renal failureand receiving dialysis treatment.Methods: In this study, monthly glucose levels and quarterlyHbA1c markers of 131 patients (53 female, 78 male)receiving dialysis treatment in a private dialysis centerbetween January 1, 2009-July 31, 2010 were evaluatedretrospectively.Results: The average age of 131 cases was 63.3±11.2years (range, 30-91). Gender distribution of the cases: 53female (40.5%), 78 male (59.5%). While the age averageof the females was 62.2±11.2 and the males’ was64.1±11.2. The average glucose level of the females andmales have a correlation to average HbA1c (Female:p<0.001, r=0.761, Males: p<0.001, r=0.743). The averageglucose level of the both case groups have a correlationto average HbA1c (p<0.001, r=0.755). While 32.8%of the examined HbA1c results were observed underthe level 6,5%, and 67.2% of the examined results wereobserved above the level 6.5%. While 18.3% of the preprandialblood glucose levels were obtained under 126mg/dl level, and 81.3% of the results were obtained above126 mg/dl level. It has been observed that the mean bloodglucose level has a correlation to average HbA1c level.Conclusion: The measurement of HbA1c and blood glucose(pre-prandial and postprandial) and the correlationbetween them, by virtue of the fact that, are vitally importantin cardiovascular mortality and morbidity, monitorof DM for the dialysis patients with diabetic nephropathy.Key words: Hemodialysis, diabetes mellitus, HbA1

Hepatosellüler karsinomalı hastalarda p53 kodon 72 ve mdm2 snp309 gen polimorfizimlerinin sıklığı ve tümöre ait karakteristiklerle karşılaştırılması

TEZ7077Tez (Uzmanlık) -- Çukurova Üniversitesi, Adana, 2008.Kaynakça (s.99-111) var.ix, 112 s. : res. ; 29 cm.Background and aims: The p53 tumor suppressor pathway plays an important role in cancer development. Murine double minute 2 (MDM2) gene is playing critical role in regulating tumor suppressor function of this pathway. A single nucleotide polymorphism (SNP) in the MDM2 in the intronic promoter, SNP309 was shown to be associated with both hereditary and sporadic cancers in humans. In addition, the wildtype p53 gene exhibits a polymorphism at codon 72 in exon 4, that causes a substitution of proline for arginine (Arg72Pro) and this substitution was shown to be related with different types of cancers in humans. In this study, we aim to determine the frequency and the association of MDM2 SNP309 and p53 Arg72Pro polymorphism in patients with hepatocellular carcinoma.Amaç: p53 tümör süpressör yolağı kanser gelişiminde önemli rol oynar. Murine double minute 2 (MDM2) geni p53 tümör süpressör yolağının düzenlenmesinde kritik bir role sahiptir. MDM2 geninin intronik promoter'ında bulanan tek nükleotid polimorfizmi, SNP309 T>G'nin hem kalıtsal hemde spdoradik kanserlele ilişkisi olduğu gösterilmiştir. Bununla birlikte wild-tip p53 geninde ekzon 4 kodon 72'de arjinin aminoasitinin prolin aminoasitine dönüşümüne (Arg72Pro) neden olan tek nükleotid polimorfizminin insanda değişik tip kanserlele ilişkisinin olduğu gösterilmiştir. Biz bu çalışmada hepatosellüler karsinomalı hastalarda MDM2 SNP309 ve p53 Arg72Pro polimorfizmlerinin sıklıklarının ve bu polimorfizmlerin tümöre ait karakteristiklerle ilişkisinin araştırılmasını amaçladık.Bu çalışma Ç.Ü. Bilimsel Araştırma Projeleri Birimi Tarafından Desteklenmiştir. Proje No:TF2007LTP1

Metastatik kolorektal karsinomlu hastalarda bevacizumab kullanımının hipertansiyon gelişmesi ve serum vasküler endotelyal büyüme faktörü, nitrik oksit, anjiyotensin II düzeyleri üzerindeki etkisi ve tedaviye yanıt ile olan ilişkisi

Kolorektal kanser dünya genelinde en sık görülen üçüncü kanser olup akciğer kanserinden sonra en sık ölüme yol açan kanserdir(1,2,3) Kanserden ölümlerin yaklaşık %10’nunu oluşturur. Son 20 yılda tarama programları, tanısal yöntemlerdeki, moleküler onkolojide gelişmeler, daha etkin sitotoksik kemoterapiler, hedefe yönelik tedaviler ve kişiye özgü tedavilerin ortaya çıkması ve daha yaygın kullanılmasıyla kolorektal kansere bağlı ölüm sıklığı belirgin olarak azalmıştır. Bu tedavilerden birisi olan bevacizumab her ne kadar bir sitostatik kemoterapi olmasa da mortaliteyle sonuçlanabilecek yan etkilere sahip bir moleküldür. Prognostik ve prediktif belirteçlerin hem sonlanım hem tedaviye yanıtın öngörülmesi hem de toksisitenin engellenmesi açısından önem kazandığı günümüzde biz de bevacizumab kullanan metastatik kolorektal kanserli hastalarda bevacizumab tedavisinin tedavi öncesi ve tedavinin 3. ayında serum VEGF, Nitrik Oksit (NO) ve Anjiyotensin (Ang II) düzeyleri üzerindeki etkisine ayrıca bu durumun hipertansiyon gelişimiyle arasındaki ilişkisini ve tümör yanıtıyla olan ilişkisini araştırdık. Çalışmaya Başkent Üniversitesi Adana Uygulama Araştırma Merkezinde takip edilen 24 metastatik kolorektal kanserli hasta dahil edildi. . Hastaların 15’i (%62,5) erkek, 9’u (%37,5) kadındı. VEGF düzeyleri arasındaki değişim istatiksel olarak anlamlı olarak düşme eğilimi şeklinde saptanırken(p= 0,009), NO ve ANG II düzeyleri açısından istatiksel olarak anlamlı bir farklılık saptanmadı. 6 siklus tedavi sonrası VEGF düzeyleri tümör cevabıyla ilişkili olarak saptandı. (p= 0,014) Hastalar hipertansiyon gelişimi yönünden incelendiğinde 1 hastada (%4.2) hipertansiyon gelişmezken, 5 hastada (%20.8) prehipertansiyon, 15 hastada (%62.5) evre 1 hipertansiyon ve 3 hastada (%12.5) evre 2 hipertansiyon geliştiği saptandı. Proteinüri yönünden incelendiğinde 6 doz tedavi sonrası hastaların 6’sında (%25) mikroalbumüniri geliştiği gözlendi. Genel olarak progresyonsuz sağ kalım ortancası 18.1 ay olarak bulundu. Hiçbir parametrenin hastalıksız sağ kalımla ilişkisi saptanmadı (p> 0.05). Sonuç olarak 6 siklus tedavi sonrası serum VEGF düzeyleri tümör cevabıyla ilişkiliyken, VEGF, NO ve ANG II düzeyleri veya hipertansiyon gelişimi progresyonsuz sağ kalımla ilişkili değildir. Bu konuda daha kesin sonuçlar için daha büyük hasta gruplarında yapılacak daha fazla çalışmaya ihtiyaç olduğu düşünülmektedir

Response to first-line chemotherapy regimen is associated with efficacy of immune checkpoint blockade therapies in patients with metastatic urothelial carcinoma

Background Atezolizumab (ATZ) has demonstrated antitumor activity in previous studies in patients with metastatic platinum-resistant urothelial carcinoma. However, the response rate of ATZ was modest. Therefore, finding biologic or clinical biomarkers that could help to select patients who respond to the immune checkpoint blockade remains important. Patients and methods In this study, we present the retrospective analysis of 105 patients with urothelial cancer treated with ATZ after progression on first-line chemotherapy. Data of patients were obtained from patient files and hospital records. The association between response to first-line chemotherapy and ATZ was using Fisher's exact test. Median follow-up was calculated using the reverse Kaplan-Meier method. OS was estimated by using the Kaplan-Meier method. Results The median follow-up time was 23.5 months. Forty (74.1%) of patients who experienced clinical benefit after firs-line chemotherapy also had clinical benefit after atezolizumab, while only 14 (25.9%) of patients with initial PD after first-line chemotherapy subsequently experienced clinical benefit with ATZ (p = 0.001). The median OS on ATZ of 14.8 and 3.4 months for patients with clinical benefit and progressive disease in response to first-line chemotherapy, respectively (p = 0.001). Three of the adverse prognostic factors according to the Bellmunt criteria were independent factors of short survival: liver metastases {Hazard ratio [HR] = 1.9; p = 0.04}, ECOG PS >= 1 (HR = 2.7; p = 0.001), and Hemoglobin level below 10 mg/dl (HR = 2.8; p < 0.001). In addition, patients with clinical benefit from first-line chemotherapy (HR = 0.39; p < 0.001) maintained a significant association with OS in multivariate analysis. Conclusions Our study demonstrated that clinical benefit from first-line chemotherapy was independent prognostic factors on OS in patients' use of ATZ as second-line treatment in metastatic bladder cancer. Furthermore, these findings are important for stratification factors for future immunotherapy study design in patients with bladder cancer who have progressed after first-line chemotherapy

Prognostic factors in patients with metastatic urothelial carcinoma who have been treated with atezolizumab

Background: In the current study, we evaluated pretreatment prognostic factors foroverall survival (OS) in patients with metastatic urothelial carcinoma who have progressed after first-line chemotherapy in the Expanded-Access Program ofatezolizumab.Methods: In this study, we present the retrospective analysis of 113 patients withurothelial cancer treated with ATZ after progression on first-line chemotherapy.Eligible patients included metastatic urothelial carcinoma patients treated with at leastone course of ATZ. Univariate analysis was used to identify clinical and laboratoryfactors that significantly impact OS. Variables were retained for multivariate analysis ifthey had a statistical relationship with OS (P˂0.1) and were then included the finalmodel if P˂0.05.Results: In univariate analysis, primary tumour location in the upper tract, increasedabsolute neutrophil count (ANC), increased absolute lymphocyte count, neutrophil-tolymphocyte ratio (NLR)>3, liver metastases, baseline creatinine clearance (GFR) 3 (HR¼ 0.474; 95% CI 0.234-0.962; P ¼0.039) and GFR 3 andGFR <60 ml/min. Taken together, these factors can be used for prognostic parametersin clinical trials that use immunotherapy in patients with bladder cancer who haveprogressed after first-line chemotherapy.European Society for Medical Oncolog

Pertuzumab, trastuzumab and taxane combination for visceral organ metastatic patients: Real life practice results

...European Society for Medical Oncology; Japanese Society of Medical Oncolog