Krise der russisch-türkischen Beziehungen 2008-2015

Am 24. November schoss die Türkei einen russischen Kampfbomber vom Typ SU-24 ab, der den türkischen Luftraum verletzt hatte. Das ist als vorrangiger Grund für die nachfolgende spektakuläre Krise in den russisch-türkischen Beziehungen interpretiert worden. Dieser Zwischenfall sollte aber eher als Symptom, denn als Grund für eine erhebliche geopolitische Kehrtwende gesehen werden, die seit 2008 im Gange ist und in der sich Russland und die Türkei bei den militärischen Konflikten in Georgien 2008, in der Ukraine 2014 und in nun Syrien auf gegenüberliegenden Seiten wiederfanden

First-line treatment of patients with HER2-positive metastatic gastric and gastroesophageal junction cancer

Fluoropyrimidine+cisplatin/oxaliplatin+trastuzumab therapy is recommended for the first-line treatment of HER2-positive metastatic gastric adenocarcinoma. However, there is no comprehensive study on which platinum-based treatment should be preferred. This study aimed to compare the treatment response and survival characteristics of patients with HER2-positive metastatic gastric or gastroesophageal junction (GEJ) cancer who received fluorouracil, oxaliplatin, and leucovorin (mFOLFOX)+trastuzumab or cisplatin and fluorouracil (CF)+trastuzumab as first-line therapy. It was a multicenter, retrospective study of the Turkish Oncology Group, which included 243 patients from 21 oncology centers. There were 113 patients in the mFOLFOX+trastuzumab arm and 130 patients in the CF+trastuzumab arm. The median age was 62 years in the mFOLFOX+trastuzumab arm and 61 years in the CF+trastuzumab arm (P = 0.495). 81.4% of patients in the mFOLFOX+trastuzumab arm and 83.1% in the CF+trastuzumab arm had gastric tumor localization (P = 0.735). The median progression-free survival (PFS) was significantly higher in the mFOLFOX+trastuzumab arm (9.4 months vs. 7.3 months, P = 0.024). The median overall survival (OS) was similar in both groups (18.4 months vs. 15.1 months, P = 0.640). Maintenance trastuzumab was continued after chemotherapy in 101 patients. In this subgroup, the median OS was 23.3 months and the median PFS was 13.3 months. In conclusion, mFOLFOX+trastuzumab is similar to CF+trastuzumab in terms of the median OS, but it is more effective in terms of the median PFS in the first-line treatment of HER2-positive metastatic gastric and GEJ cancer. The choice of treatment should be made by considering the prominent toxicity findings of the chemotherapy regimens

Russia-Turkey Relations

ISSN:1863-042

DIFFERENCES BETWEEN PEDIATRIC PULMONARY AND EXTRA-PULMONARY TUBERCULOSIS: A WARNING SIGN FOR THE FUTURE

Introduction: Tuberculosis (TB) remains a major global health problem affecting millions of people annually. Tuberculosis in children has unique features different from adults which makes the diagnosis to be more difficult. The spectrum of the symptoms of TB in children could vary from non-specific symptoms to severe clinical presentations.  In this study, we reviewed our experience at pediatric patients with active TB admitted in a tertiary hospital  and aimed to compare the epide­miological, clinical and microbiological features of  children with  the extra-pulmonary tuberculosis(EPTB) and pulmonary tuberculosis(PTB). Material and methods: Patients under 14 years of age diagnosed with active TB in our unit between December 2008 and September 2013 were included in the study. Data including demographic characteristics, clinical history, microbiology, imaging studies, medications and outcomes of the patients were collected from medical records. Results: A total of 129 cases of active TB were identified.  Ninety-two (78.6%) of the cases had Pulmonary Tuberculosis and 25 (21.4%) of the cases had Extra-pulmonary tuberculosis. The most common signs and symptoms on admission were fever in 40 cases (34.2%) and cough in 81 cases (69.2%). The number of patients without symptoms including fever, cough, malaise and weight loss were significantly higher in EXPTB (72.0%) group when compared with patients in PTB group (13.0%) (p 0.05). The detection rate of source in PTB group (42.4%) was significantly higher than the rate in  EPTB group (20.0%)( p=0.04). In the drug-resistant group, no source of infection could be established in 5 of 9 patients (55.5%). Conclusions: Extra-pulmonary tuberculosis diagnosis is more difficult than Pulmonary tuberculosis in children due to the various problems such as absence of associated pulmonary involvement,  lack of constitutional symptoms and negative tuberculosis exposure history compared to Pulmonary Tuberculosis. New strategies are required for improving the diagnosis of  Extra-pulmonary tuberculosis in childre