Naiv hepatit C enfeksiyonlu hastaların on-altı yıllık prognozu

Objectives: In this study, we aimed to evaluate the clinical course of treatment-naive patients infected with hepatitis C virus (HCV) who were followed up in various centers in Turkey. Materials and Methods: This was a retrospective study performed with the participation of 15 centers. Patients aged 18 years and older with HCV infection were included. Results: A total of 391 treatment-naive patients infected with HCV were included in this study. During the follow-up period, the final values of alanine aminotransferase, aspartate transaminase, and total protein were significantly decreased when compared to the initial values (p<0.001, p<0.001, and p=0.005, respectively). In the study group, 19.2% of the patients underwent liver biopsy and 4.1% underwent transient elastography (FibroScan). An increased histological activity index (HAI) score and fibrosis in the second biopsy were observed in one patient, only increased HAI in two patients and increased fibrosis in one patient, as shown on the FibroScan. In the 16 years of the study period, cirrhosis was radiologically detected in only one patient. Conclusion: Even if rapid progression is not observed, close monitoring of the clinical findings related to liver failure and fibrosis with invasive or non-invasive methods may be useful.Amaç: Bu çalışmada ülkemizin çeşitli merkezlerinde takip edilen naiv hepatit C virüs (HCV) ile enfekte hastaların klinik seyrini değerlendirmeyi amaçladık. Gereç ve Yöntemler: Bu çalışma retrospektif olarak 15 merkezin katılımıyla gerçekleştirilmiştir. Çalışmaya 18 yaş üstü, HCV enfeksiyonu olan hastalar dahil edilmiştir. Bulgular: Çalışmada 391 tedavi-naiv HCV enfeksiyonlu hasta yer almıştır. Hastaların takip süresinde son alanine aminotransferase, aspartate transaminase ve total protein değerleri ilk düzeyine göre önemli düzeyde azalmıştır (sırasıyla p<0,001, p<0,001, p=0,005). Çalışma grubunda hastaların %19,2’sine karaciğer biyopsisi, %4,1’ine elastografi (FibroScan) uygulanmıştır. Takip esnasında bir hastada ikinci biyopside histolojik aktivite indeksi (HAI) ve fibroziste artma, iki hastada sadece HAI’da artma, birinde FibroScan ile fibrozis değerinde artma olduğu gözlenmiştir. Bir hastada 16 yıl içinde radyolojik olarak siroz saptanmıştır. Sonuç: Hızlı progresyon gözlenmemekle birlikte hastaların izleminde karaciğer yetmezliği ile ilgili klinik bulguların ve invaziv veya noninvaziv yöntemlerle fibrozisin yakın takibi yararlı olabilir

Crizotinib efficacy and safety in patients with advanced NSCLC harboring MET alterations: A real-life data of Turkish Oncology Group

Crizotinib is a multikinase inhibitor, effective in non-small cell lung cancer (NSCLC) harboring mesenchymal-epidermal transition (MET) alterations. Although small prospective studies showed efficacy and safety of crizotinib in NSCLC with MET alterations, there is limited real-life data. Aim of this study is to investigate real-life efficacy and safety of crizotinib in patients with advanced NSCLC harboring MET alterations. This was a retrospective, multicenter (17 centers) study of Turkish Oncology Group. Patients' demographic, histological data, treatment, response rates, survival outcomes, and toxicity data were collected. Outcomes were presented for the study population and compared between MET alteration types. Total of 62 patients were included with a median age of 58.5 (range, 26-78). Major histological type was adenocarcinoma, and 3 patients (4.8%) had sarcomatoid component. The most common MET analyzing method was next generation sequencing (90.3%). MET amplification and mutation frequencies were 53.2% (n = 33) and 46.8% (n = 29), respectively. Overall response rate and disease control rate were 56.5% and 74.2% in whole study population, respectively. Median progression free survival (PFS) was 7.2 months (95% confidence interval [CI]: 3.8-10.5), and median overall survival (OS) was 18.7 months (95% CI: 13.7-23.7), regardless of treatment line. Median PFS was 6.1 months (95% CI: 5.6-6.4) for patients with MET amplification, whereas 14.3 months (95% CI: 6.7-21.7) for patients with MET mutation (P = .217). Median PFS was significantly longer in patients who have never smoked (P = .040), have good performance score (P < .001), and responded to the treatment (P < .001). OS was significantly longer in patients with MET mutation (25.6 months, 95% CI: 15.9-35.3) compared to the patients with MET amplification (11.0 months; 95% CI: 5.2-16.8) (P = .049). In never-smokers, median OS was longer than smoker patients (25.6 months [95% CI: 11.8-39.3] vs 16.5 months [95% CI: 9.3-23.6]; P = .049). The most common adverse effects were fatigue (50%), peripheral edema (21%), nausea (29%) and diarrhea (19.4%). Grade 3 or 4 adverse effects were observed in 6.5% of the patients. This real-life data confirms efficacy and safety of crizotinib in the treatment of advanced NSCLC harboring MET alteration

Evaluation of sarcopenia parameters in patients with heart failure with low ejection fraction

Bu çalışma Pamukkale Üniversitesi Bilimsel Araştırma Projeleri Koordinasyon Birimi’nin 03.03.2020 tarih ve 02/05 sayılı kararı ile desteklenmiştir.Kalp yetmezliği, gelişen tanı ve tedavi yöntemlerine karşın günümüzde hala mortalite ve morbiditede ciddi artışa neden olan aşılması zor klinik sendromdur. Avrupa Kardiyoloji Derneği 2016’da yayınladığı kalp yetmezliği kılavuzunda sarkopeniyi, kalp yetmezliğinin önemli bir ko-morbiditesi olarak kabul etmiştir. Sarkopeni son zamanlarda tıp camiasında giderek artan oranda dikkat çekmektedir. Kas kütlesi, kas gücü ve performansı için kullanılan ölçüm yöntemlerinin ve çalışma gruplarının farklılıklarından dolayı popülasyonlarda sarkopeni prevalansı değişmektedir. Biz çalışmamızda DEF-KY olgularında sarkopeni parametrelerini ve DEF-KY olan hastalarda sarkopeni tanısında yol gösterici olabilecek görüntüleme ve laboratuvar yöntemlerini araştırmayı amaçladık. Çalışma Nisan 2020 – Nisan 2021 tarihleri arasında Pamukkale Üniversitesi Hastanesi Kardiyoloji kliniğine başvuran, ekokardiyografide modifiye Simpson metodu ile yapılan ölçümlerde sol ventrikül ejeksiyon fraksiyonu ≤ %35 olan 38 hasta ve kalp yetmezliği olmayan 29 sağlıklı birey ile gerçekleştirilmiştir. Hasta grubunun çalışmaya dahil olma ölçütleri; 60-80 yaş aralığı ve kalp yetmezliği tanısının en az 1 yıldır bulunmasıdır. Sağlıklı kontrol grubunun çalışmaya dahil olma ölçütleri; 60-80 yaş aralığı ve kalp yetmezliğinin bulunmamasıdır. Hasta ve kontrol grubunun çalışmadan dışlanma kriterleri; nutrisyonel bozukluk, evre 4-5 KBH, miyopati, paralizi, kalıcı pacemaker varlığıdır. Hasta ve kontrol grubunda; SARC-F anketi ile sarkopeni taraması, dinamometre ile el kavrama kuvveti, 400 m yürüme testi ile fiziksel performans değerlendirmesi, BIA ile vücut analizi, MRG ile psoas ve paravertebral kas alanları, elisa yöntemi ile inflamatuar parametreler değerlendirilmiştir. Çalışmamızın sonuçlarına göre hasta grubu ile kontrol grubu arasında SARC-F anket puanı, el kavrama kuvveti, 400 m yürüme testi, kas alanları, CRP, IL-1, IL-6, Sistatin-C ve TNF-α değerleri istatistiksel olarak anlamlı fark göstermiştir. MRG ile değerlendirilen kas yağlanmasında anlamlı fark gözlenmemiştir. Sarkopeni tanısı koymak için kas kütlesinin değerlendirilmesinde altın standart tanı yöntemi olan MRG ile kalp yetmezliği hastalarında yapılmış kısıtlı sayıda çalışma vardır. Kalp yetmezliği olan hastalarda sarkopeninin MRG ile değerlendirilmesi için MRG ile yapılan çalışma sayılarının arttırılması sarkopeni tanısında yol gösterici olabilir. Sonuç olarak erken değerlendirme yöntemleri ve etkin tedavi stratejileri oluşturarak, KKY'de sarkopeninin ilerlemesini geciktirebilir ve hastaların yaşam kalitesini iyileştirebiliriz.Despite the developing diagnosis and treatment methods, heart failure (HF) is still a difficult problem causing a serious increase in mortality and morbidity. The European Society of Cardiology accepted sarcopenia as an important co-morbidity of heart failure in the guideline of heart failure published in 2016. Sarcopenia has attracted increasing attention in the medical community recently. The prevalence of sarcopenia varies in populations due to differences in measurement methods and study groups used for muscle mass, muscle strength, and performance. Therefore, in our study, we aimed to investigate the parameters of sarcopenia in patients with HF with reduced ejection fraction (HF-rEF) and imaging and laboratory methods that can guide the diagnosis of sarcopenia in patients with HF-rEF. The study was carried out with 38 patients who admitted to Pamukkale University Hospital Cardiology Clinic between April 2020 and April 2021, whose left ventricular ejection fraction was ≤35 and 29 healthy individuals without heart failure. Patients between the ages of 60-80 and with a diagnosis of heart failure for at least 1 year were included in the study. Patients between the ages of 60-80 and without a diagnosis of heart failure were included in the study as a control group. Patients with malnutrition, stage 4-5 chronic kidney disease, myopathy, stroke and presence of permanent pacemaker were excluded. In the patient and control groups; Sarcopenia screening with SARC-F questionnaire, evaluation of hand grip strength with dynamometer, physical performance assessment with 400 m walking test, body analysis with BIA, psoas and paravertebral muscle areas calculating with MRI, inflammatory parameters of blood analysis with ELİSA method were performed. The results of our study showed that, between the patient group and the control group, the SARC-F questionnaire score, handgrip strength, 400 m walking test, muscle areas, CRP, IL-1, IL-6, Cystatin-C and TNF-α values were statistically significantly different. There was no significant difference in muscle fat that was assessed by MRI. There are a limited number of studies in heart failure patients using MRI, which is the gold standard diagnostic method for evaluating muscle mass to diagnose sarcopenia. More studies with MRI are needed to evaluate sarcopenia in patients with heart failure. As a result, we can delay the progression of sarcopenia in HF and improve the quality of life of patients by establishing early evaluation methods and effective treatment strategies

Primary Pulmonary Actinomycosis Mimicking Malignancy

The diagnosis of primary pulmonary actinomycosis (PPA) is still an important challenge in clinical practice due to its clinical and radiographic similarity with other infections and malignant diseases. Currently, the diagnosis can be only made histopathologically. A 67-year-old male patient was admitted to our clinic with the complaints of cough and hemoptysis for the past two months. His physical examination was non-specific. An increased non-homogeneous density was observed in the middle zone of the left hemithorax on chest X-ray. Thoracic computed tomography revealed a hypodense mass. Positron emission tomography revealed a hypermetabolic activity in the malignant mass. The patient was diagnosed with pulmonary actinomycosis through transthoracic fine needle aspiration biopsy. In conclusion, PPA should be considered in the differential diagnosis in patients with malignancy in the presence of predisposing risk factors

Conjunctival Telangiectasia in a Patient with Ataxia Telangiectasia: A Case Report

The purpose of this paper is to report a 7-year-old patient who developed bilateral conjunctival hyperemia while being under treatment of pneumonia in Pediatric Infectious Diseases Clinic at Sisli Etfal Training and Research Hospital. Ophthalmological examination revealed bilateral conjunctival telangiectasias which were thought to be the ophthalmologic sign of ataxia telangiectasia after considering the other clinical findings, laboratory and imaging results, and family history. (Turk J Oph thal mol 2012; 42: 75-7

Primary Pulmonary Actinomycosis Mimicking Malignancy

The diagnosis of primary pulmonary actinomycosis (PPA) is still an important challenge in clinical practice due to its clinical and radiographic similarity with other infections and malignant diseases. Currently, the diagnosis can be only made histopathologically. A 67-year-old male patient was admitted to our clinic with the complaints of cough and hemoptysis for the past two months. His physical examination was non-specific. An increased non-homogeneous density was observed in the middle zone of the left hemithorax on chest X-ray. Thoracic computed tomography revealed a hypodense mass. Positron emission tomography revealed a hypermetabolic activity in the malignant mass. The patient was diagnosed with pulmonary actinomycosis through transthoracic fine needle aspiration biopsy. In conclusion, PPA should be considered in the differential diagnosis in patients with malignancy in the presence of predisposing risk factors

A rapid method for detection of genetically modified organisms based on magnetic separation and surface-enhanced Raman scattering

In this study, a new method combining magnetic separation (MS) and surface-enhanced Raman scattering (SERS) was developed to detect genetically modified organisms (GMOs). An oligonucleotide probe which is specific for 35 S DNA target was immobilized onto gold coated magnetic nanospheres to form oligonucleotide-coated nanoparticles. A self assembled monolayer was formed on gold nanorods using 5,5'-dithiobis (2-nitrobenzoic acid) (DTNB) and the second probe of the 35 S DNA target was immobilized on the activated nanorod surfaces. Probes on the nanoparticles were hybridized with the target oligonucleotide. Optimization parameters for hybridization were investigated by high performance liquid chromatography. Optimum hybridization parameters were determined as: 4 mu M probe concentration, 20 min immobilization time, 30 min hybridization time, 55 degrees C hybridization temperature, 750 mM buffer salt concentration and pH: 7.4. Quantification of the target concentration was performed via SERS spectra of DTNB on the nanorods. The correlation between the target concentration and the SERS signal was found to be linear within the range of 25-100 nM. The analyses were performed with only one hybridization step in 40 min. Real sample analysis was conducted using Bt-176 maize sample. The results showed that the developed MS-SERS assay is capable of detecting GMOs in a rapid and selective manner