The impact of strategic purchasing on supply chain performance of the bottled water industry in Turkey

Efficient and effective supply chain management (SCM) aims to provide high quality products and excellent customer service and is a significant component in obtaining a competitive advantage. Supply chain management has advanced to contain strategic partnership arrangements with suppliers and service providers throughout the supply chain. Every action in the supply chain is important, and downfall at any action - be it of strategy, documentation or performance - can negatively affect business objectives. Plenty of companies now acknowledge that a powerful and solid supply chain is one of the most crucial elements in attaining increased profitability and shareholder value. Effective supply chain management has the ability to manage costs and enhance the compliance with company standards and key performance indicators (KPI). This research examines the relationship between strategic purchasing and supply chain performance (in terms of vendor performance, material quality, and inventory level) of the bottled water industry in Turkey. The results indicate that strategic purchasing is positively related to overall company performance. Keywords: Strategic purchasing, Bottled water industry, Supply chain performance, Turke

Acute Cardiotoxic Effects of Adjuvant Trastuzumab Treatment and Its Relation to Oxidative Stress

Our aim was to evaluate the acute cardiac toxicity of adjuvant trastuzumab treatment and its possible relation to changes in oxidative stress. Electrocardiographic and echocardiographic tissue Doppler imaging (TDI) parameters, activity of antioxidant enzymes (superoxide dismutase; SOD), and products of oxidative stress (malondialdehyde; MDA) were analyzed in 30 patients with early-stage breast cancer who had adjuvant trastuzumab treatment. There was a significant prolongation of QT interval after trastuzumab treatment. There was also a significant decrease in left ventricular ejection fraction (LVEF), TDI-derived S' parameters, and SOD enzyme activity and increase in MDA levels after trastuzumab infusion. There was a positive correlation between changes in SOD activity and LVEF and a negative correlation between changes in MDA levels and LVEF. This study demonstrated a correlation between decreases in LVEF and increases in products of the oxidative stress in patients who had adjuvant trastuzumab treatment

Acute Cardiotoxic Effects of Adjuvant Trastuzumab Treatment and Its Relation to Oxidative Stress

Our aim was to evaluate the acute cardiac toxicity of adjuvant trastuzumab treatment and its possible relation to changes in oxidative stress. Electrocardiographic and echocardiographic tissue Doppler imaging (TDI) parameters, activity of antioxidant enzymes (superoxide dismutase; SOD), and products of oxidative stress (malondialdehyde; MDA) were analyzed in 30 patients with early-stage breast cancer who had adjuvant trastuzumab treatment. There was a significant prolongation of QT interval after trastuzumab treatment. There was also a significant decrease in left ventricular ejection fraction (LVEF), TDI-derived S' parameters, and SOD enzyme activity and increase in MDA levels after trastuzumab infusion. There was a positive correlation between changes in SOD activity and LVEF and a negative correlation between changes in MDA levels and LVEF. This study demonstrated a correlation between decreases in LVEF and increases in products of the oxidative stress in patients who had adjuvant trastuzumab treatment

Impact of pre-angiogenic factors on the treatment effect of bevacizumab in patients with metastatic colorectal cancer

Endothelin-1 (ET-1) and asymmetric dimethylarginine (ADMA) play a major role in tumor growth and metastasis. Our aim was to determine whether there is any association between these endothelial parameters and tumor markers with the clinical outcome of bevacizumab-treated metastatic colorectal cancer (mCRC) patients in terms of response and survival. Pretreatment serum levels of ET-1, ADMA, carcinoembryonic antigen (CEA), and carbohydrate antigen (CA) 19-9 were measured in 36 chemotherapy-naive mCRC patients treated with first-line bevacizumab-based therapy. Additionally, after first cycle of treatment, serum levels of these parameters were reanalyzed. Lower baseline serum ET-1 and ADMA levels were observed in patients responding to bevacizumab-based treatment (respectively, p = 0.037, p = 0.034). Median progression-free survival (PFS) (11 vs. 6 months, p = 0.012) and overall survival (OS) (28 vs 9 months; p = 0.007) were significantly shorter in patients with high pretreatment ET-1 levels. There was a significant decrease in ET-1 and CEA levels after first treatment (p = 0.020, p = 0.012), while ADMA and CA 19-9 levels were not significantly changed. Patients with decreased posttreatment ET-1 levels were shown to have inferior PFS (6 vs 11 months, p = 0.022), but no statistically significant difference was shown with respect to OS (p = 0.141). The effect of bevacizumab on endothelin axis including the biologic basis of decreasing ET-1 levels due to bevacizumab treatment and its association with inferior outcome has to be clarified in prospective trials

Thymoquinone enhances cisplatin-induced neprotoxicity in high dose

Background: Cisplatin-induced nephrotoxicity is an important problem of the cancer treatments. The major bioactive component of Nigella sativa, thymoquinone (TQ) might limit the nephrotoxic effect of cisplatin in low doses. However, it is not clear how it can affect the kidney as an anti-cytotoxic agent when administered in higher doses or in cisplatin co-treatment. Therefore, we examined the in vivo interactions between cisplatin and TQ by measuring serum cystatin C (cys C), creatinine and neutrophil gelatinase-associated lipocalin (NGAL) levels and analyzing the expression status of p53 and NGAL by immunohistochemistry. Methods: Wistar rats were divided into four groups: Control, TQ treatment (group II; 40 mg/kg i.p. for 5 days), cisplatin treatment (group III; 7 mg/kg, i.p. for at day 3) and TQ and cisplatin co-treatment (group IV). Results: Administration of 40 mg/kg TQ had no effect on serum kidney parameters. In cisplatin received group's serum creatinine level was insignificant, but serum Csy C and NGAL levels were significantly increased. All serum creatinine, NGAL and Cys C levels were increased in co-treatment of cisplatin and TQ. Additionally, in this group, renal tubular damage was found significantly higher than both control and only cisplatin-treated groups. The kidney immunohistochemistry staining of NGAL and p53 were significantly more intense in group IV rather than the others. Conclusions: This study showed that the administration of cisplatin and high dose of TQ act synergistically to produce nephrotoxicity and the involvement of apoptotic pathway and proximal tubule damage might be the leading cause of on this effect

Thymoquinone enhances cisplatin-induced neprotoxicity in high dose

Background: Cisplatin-induced nephrotoxicity is an important problem of the cancer treatments. The major bioactive component of Nigella sativa, thymoquinone (TQ) might limit the nephrotoxic effect of cisplatin in low doses. However, it is not clear how it can affect the kidney as an anti-cytotoxic agent when administered in higher doses or in cisplatin co-treatment. Therefore, we examined the in vivo interactions between cisplatin and TQ by measuring serum cystatin C (cys C), creatinine and neutrophil gelatinase-associated lipocalin (NGAL) levels and analyzing the expression status of p53 and NGAL by immunohistochemistry. Methods: Wistar rats were divided into four groups: Control, TQ treatment (group II; 40 mg/kg i.p. for 5 days), cisplatin treatment (group III; 7 mg/kg, i.p. for at day 3) and TQ and cisplatin co-treatment (group IV). Results: Administration of 40 mg/kg TQ had no effect on serum kidney parameters. In cisplatin received group's serum creatinine level was insignificant, but serum Csy C and NGAL levels were significantly increased. All serum creatinine, NGAL and Cys C levels were increased in co-treatment of cisplatin and TQ. Additionally, in this group, renal tubular damage was found significantly higher than both control and only cisplatin-treated groups. The kidney immunohistochemistry staining of NGAL and p53 were significantly more intense in group IV rather than the others. Conclusions: This study showed that the administration of cisplatin and high dose of TQ act synergistically to produce nephrotoxicity and the involvement of apoptotic pathway and proximal tubule damage might be the leading cause of on this effect

Treatment of Metastatic Colorectal Cancer With or Without Bevacizumab: Can the Neutrophil/Lymphocyte Ratio Predict the Efficiency of Bevacizumab?

Background: The purpose of this study was to analyze the predictive value of neutrophil/lymphocyte ratio (NLR) to better clarify which patient groups will benefit the most from particular treatments like bevacizumab. Materials and Methods: A total of 245 treatment-naive metastatic colorectal cancern (mCRC) patients were retrospectively enrolled and divided into 2 groups: 145 group A patients were treated with chemotherapy in combination with bevacizumab, and 100 group B patients were treated as above without bevacizumab. Results: Group A patients had better median overall survival (OS) and progression-free survival (PFS) (24.0 and 9.0 months) than group B patients (20 and 6.0 months) (p=0.033; p=0.015). In patients with low NLR, OS and PFS were significantly longer in group A patients (27 vs 18 months, p=0.001; 11 vs 7 months, p=0.017). Conclusions: We conclude that NLR, a basal cancer related inflammation marker, is associated with the resistance to bevacizumab-based treatments in mCRC patients