Results of paclitaxel (day 1 and 8) and carboplatin given on every three weeks in advanced (stage III-IV) non-small cell lung cancer

BACKGROUND: Both paclitaxel (P) and carboplatin (C) have significant activity in non-small cell lung cancer (NSCLC). The weekly administration of P is active, dose intense, and has a favorable toxicity profile. We retrospectively reviewed the data of 51 consecutive patients receiving C and day 1 and 8 P chemotherapy (CT) regimen in advanced stage NSCLC to evaluate the efficacy and toxicity. METHODS: Patients treated in our institutions having pathologically proven NSCLC, no CNS metastases, adequate organ function and performance status (PS) ECOG 0–2 were given P 112.5 mg/m(2 )intravenously (IV) over 1 hour on day 1 and 8, followed by C AUC 5 IV over 1 hour, repeated in every three weeks. PC was given for maximum of 6 cycles. RESULTS: Median age was 58 (age range 39–77) and 41 patients (80%) were male. PS was 0/1/2 in 29/17/5 patients and stage was IIIA/IIIB/IV in 3/14/34 patients respectively. The median number of cycles administered was 3 (1–6). Seven patients (14%) did not complete the first 3 cycles either due to death, progression, grade 3 hypersensitivity reactions to P or lost to follow up. Best evaluable response was partial response (PR) in 45% and stable disease (SD) in 18%. Twelve patients (24%) received local RT. Thirteen patients (25%) received 2nd line CT at progression. At a median follow-up of 7 months (range, 1–20), 25 (49%) patients died and 35 patients (69%) progressed. Median overall survival (OS) was 11 ± 2 months (95% CI; 6 to 16), 1-year OS ratio was 44%. Median time to progression (TTP) was 6 ± 1 months (95% CI; 4 to 8), 1-year progression free survival (PFS) ratio was 20%. We observed following grade 3 toxicities: asthenia (10%), neuropathy (4%), anorexia (4%), anemia (4%), hypersensitivity to P (2%), nausea/vomiting (2%), diarrhea (2%) and neutropenia (2%). Two patients (4%) died of febrile neutropenia. Doses of CT were reduced or delayed in 12 patients (24%). CONCLUSIONS: P on day 1 and 8 and C every three weeks is practical and fairly well tolerated outpatient regimen. This regimen seems to be comparably active to regimens given once in every three weeks

The forensic evaluation of dental injuries in Istanbul, Turkey

When a person is wounded in Turkey, he first attends hospital for treatment. The hospital is responsible for a report describing his injuries and their treatment and prognosis. The patient is then scanned by a specialist in forensic medicine who provides a final official report. In that report the lesions, the prognosis (including whether the injuries are life threatening or not) and the projected days away from daily activity are shown. In this study 18 317 cases which were examined in the second and the third Specialization Board of the Council of Forensic Medicine during 1996 were analyzed. Among them 112 cases were dental injuries. Dental injuries are reviewed according to their sex, causation, detail of injury, and they are compared to other studies. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved

Deaths of the elderly exposed to violence in Turkey

Due to the socio-cultural and demographical changes that have been taking place in Turkey, differences in types of violence are coming on the scene. The purpose of the present study is to reveal the number of violence deaths and the variation by time in the types of violence resulting in death in the elderly of ages 65 and above in Turkey. Using a retrospective (descriptive) epidemiological method, this study was carried out with 1,326 subjects of ages 65 and above among 17,015 criminal autopsies between years 1996-2001. According to the crime scene investigations, the percentage of deaths caused by firearm injuries increased to 4.0% in 2001 from 1.9% in 1994. The dispersion of the subjects according to autopsy findings were pathologically caused death (32.3%), negative autopsy (20.3%), general body trauma (20.1%) and hanging (6.3%). Changes in the rates of deaths caused by cutting/piercing tool injuries are 1.9% and 4.3%, respectively. Regulations are needed to reinforce and financially support the family, to secure humanely life standards for the elderly, and to ensure homecare to an optimum extent

Clinical importance of discordance of hormone receptors and Her2/neu status after neoadjuvant chemotherapy in breast cancer

WOS: 000347742000004PubMed ID: 25536590Purpose: The aim of this study was to compare the hormone receptors' (HR) and HER2/neu status between core needle biopsy (CNB) and residual tumor after surgery of breast cancer treated with neoadjuvant chemotherapy (NAC), and also to evaluate the impact of discordance and other clinicopathological factors on survival. Methods: Oestrogen receptor (ER), progesterone receptor (PR) and HER2/neu status were evaluated by immunohistochemistry (IHC) on 90 CNBs of primary tumors and surgical specimens after NAC (study group); 53 patients without NAC served as control group, and discordance was compared between the two groups. The association between discordance of HR status after NAC and various other clinicopathological factors was tested with Spearman's test. Results: Pathological complete response (PCR) was achieved in 10 (11.1%) patients after NAC. ER and PR changed significantly more in the study than in the control group. ER and PR discordance was detected in 10 (12.5%) and 17 (21.2%) patients in the NAC group and in 1 (1.8%) and 2 (3.7%) patients in the control group (p=0.04 and p=0.005, respectively). ER discordance was related with HER2/neu change. Furthermore, PR discordance correlated with CNB, ER and treatment response, while HER2/neu discordance was associated with treatment response (p=0.05). ER discordance was found to be an independent prognostic factor for progression-free survival (PFS) (p=0.02). Conclusion: NAC might cause alterations in ER, PR or HER2/neu status in breast cancer, and they should be re-tested in the residual tumor after NAC to optimize adjuvant therapy

Deaths of the elderly exposed to violence in Turkey.

Due to the socio-cultural and demographical changes that have been taking place in Turkey, differences in types of violence are coming on the scene. The purpose of the present study is to reveal the number of violence deaths and the variation by time in the types of violence resulting in death in the elderly of ages 65 and above in Turkey. Using a retrospective (descriptive) epidemiological method, this study was carried out with 1,326 subjects of ages 65 and above among 17,015 criminal autopsies between years 1996–2001. According to the crime scene investigations, the percentage of deaths caused by firearm injuries increased to 4.0% in 2001 from 1.9% in 1994. The dispersion of the subjects according to autopsy findings were pathologically caused death (32.3%), negative autopsy (20.3%), general body trauma (20.1%) and hanging (6.3%). Changes in the rates of deaths caused by cutting/piercing tool injuries are 1.9% and 4.3%, respectively. Regulations are needed to reinforce and financially support the family, to secure humanely life standards for the elderly, and to ensure homecare to an optimum extent

Lactate measurements accurately predicts 1-week mortality in emergency department patients with acute kidney injury.

Background: Studies on prognostic indicators in patients with acute kidney injury are limited. This study investigated 1-week mortality, laboratory and clinical parameters according to the lactate levels in patients with acute kidney injury