Türkiye’de stoma açılan hastaların kesitsel değerlendirilmesi

Aim: Despite recent technological developments, a stoma formation is needed for the treatment of many diseases, especially in colorectal surgery. Due to the radical principles of cancer treatment, the number of patients living with stoma is increasing. However, there is no study that quantitatively evaluates the stoma patients nationally. In this study, it was aimed to retrospectively evaluate the demographic data, indications, preferred types of stoma and the outcomes of patients who had a stoma formation in our country in the last three years. Method: In our country, there are 3 companies that operate in the field, provide materials for 95% of stoma patients. The data of patients who had a stoma between 2017 and 2019 were collected from these companies retrospectively by protecting personal privacy of patients. The distribution of indications and type of stoma acording to indications were determined. Average age, stoma closure rates and mortality rates were calculated. All data are presented as numbers and percentages and categorical variables are shown as median (minimum-maximum), continuous variables are shown as ± standard deviation. Results: The most common indication for stoma creation was colorectal malignancy (58.4%) and followed by mechanical bowel obstructions (29.6%). Other malignancies (4.16%), inflammatory causes (4.58%), traumatic causes (1.88%) and congenital anomalies (1.17%) constituted a total of 11% stoma indications. It was observed that. ostomies opened due to colorectal malignancy,were closed in 40% of patients with loop ileostomy, 30.1% of patients with loop colostomy, and only 13% of patients with end colostomy. Conclusion: We aimed to obtain a national perspective by evaluating the patients who had a stoma in the last 3 years and to show up the distribution of stoma formation indications in our country. We have determined the demographic data of patients with stoma and calculated the stoma closure and mortality rates according to stoma types. Although this study is a cross-sectional evaluation of patients in the whole country, weak point of our study is there are deficiencies in our evaluation due to the lack of retrospective data. We think that prospective studies should be planned by detailing subgroups.Amaç: Ülkemizde stomalı bireyleri niceliksel olarak inceleyen çalışma henüz bulunmamaktadır. Bu çalışmada ülkemizde son üç yıl içinde stoma açılmış olan hastaların demografik verilerinin, endikasyonlarının, tercih edilen stoma tiplerinin ve hastaların akıbetlerinin retrospektif olarak değerlendirilmesi amaçlanmıştır. Yöntem: Ülkemizde stoma alanında faaliyet göstermekte olan ve stoma hastalarının stoma malzemelerini sağlayan 3 firmanın 2017-2019 yılları arasında, malzeme temin ettiği stoma hastalarının bilgileri, kişisel verilerin gizliliği kurallarına dikkat edilerek retrospektif olarak derlenmiştir. Endikasyona göre hastalara hangi tip stoma açıldığı, bu hastaların cinsiyete göre dağılımı (minimum-maksimum), yaş ortalamaları, stoma kapatılma oranları, ölüm oranları hesaplanmıştır. Bulgular: En sık stoma oluşturma endikasyonunun kolorektal malignite olduğu ve tüm stomaların %58,4’ünü oluşturduğu görüldü. Bunu mekanik barsak tıkanıklıkları (%29,6) takip etmekte idi. Diğer maligniteler (%4,16), enflamatuvar sebepler (%4,58), travmatik sebepler (%1,88) ve doğumsalanomaliler (%1,17) toplamda yaklaşık %11 oranında stoma açılmasına endikasyon oluşturmaktaydı. Kolorektal malignite nedeni ile açılan stomalar değerlendirildiğinde loop ileostomi uygulanan hastların %40’ının, loop kolostomi uygulanan hastaların %30,1’inin stoması kapatılabilmişken, uç kolostomi uygulanan hastaların sadece %13’ünün stomasının kapatıldığı görülmüştür. Sonuç: Ülkemizde son 3 yıl içinde stoma açılmış olan hastaları değerlendirerek ulusal anlamda geniş bir perspektif elde etmeyi amaçladık. Stoma ile yaşamak durumunda olan hastaların demografik verilerini, kaçının stomasının kapatılabildiğini ve stoma tiplerine göre stoma kapatılma ve ölüm oranlarını tespit ettik. Stomalı bireylerin analizini gerçekleştirdiğimiz bu çalışma, ulusal anlamda gerçekleştirilen ilk çalışma olmasına rağmen, retrospektif verilerdeki eksiklikler nedeni ile değerlendirmemizde yetersizlikler mevcuttur. Alt grupların detaylandırılarak, prospektif özellikte çalışmaların planlanması gerektiğini düşünüyoruz

Goal Orientation and Reading Strategy Use of Turkish Students of an English Language Teaching Department

This study aims to investigate qualitatively the role of goal orientation in reading comprehension both in native (L1) and second or foreign languages (L2), and the reading strategy use in L1 and L2 of the Turkish advanced students of an English Language Teaching (ELT) Department in order to understand the pedagogical aspects of reading. The data of this phenomenological study come from one-on-one, semi-structured interviews carried out with 8 Turkish ELT students; 4 preparatory class students, 4 firstyear students, who take a reading course. The results of the study demonstrated that the participants had a variety of goal orientations which lend support to the multiple goal approach that claims the reasons students have for engaging in the academic endeavours influence the goals they adopt. All the students perceive the reading strategies as helpful. The data of the study evidenced that mastery goal oriented, and high mastery and low performance-approach participants use more strategies than the performanceapproach (except for one) and work-avoidant participants. Mastery goal oriented students seemed to be more persistent when they confront a comprehension problem in English. All of them think that there is a necessity to teach reading strategies to the students both in their L1 and L2

Evaluation of prognostic factors and treatment in advanced small bowel adenocarcinoma: report of a multi-institutional experience of anatolian Society of medical oncology (ASMO)

WOS: 000388782200027PubMed ID: 27837629Purpose: Small bowel adenocarcinoma (SBA) is a rare tumor of the gastrointestinal system with poor prognosis. Since these are rarely encountered tumors, there are limited numbers of studies investigating systemic treatment in advanced SBA. The purpose of this study was to evaluate the prognostic factors and systemic treatments in patients with advance SBA. Methods: Seventy-one patients from 18 Centers with advanced SBA were included in the study. Fifty-six patients received one of the four different chemotherapy regimens as first-line therapy and 15 patients were treated with best supportive care (BSC). Results: Of the 71 patients, 42 (59%) were male and 29 (41%) female with a median age of 56 years. Median follow-up duration was 14.3 months. The median progression free survival (PFS) and overall survival (OS) were 7 and 13 months, respectively (N=71). In patients treated with FOLFOX (N=18), FOLFIRI (N=11), cisplatin-5-fluoroura-cil/5-FU (N=17) and gemcitabine alone (N=10), median PFS was 7, 8, 8 and 5 months, respectively, while median OS was 15, 16, 15 and 11 months, respectively. No significant differences between chemotherapy groups were noticed in terms of PFS and OS. Univariate analysis revealed that chemotherapy administration, de novo metastatic disease, ECOG PS 0 and 1, and overall response to therapy were significantly related to improved outcome. Only overall response to treatment was found to be significantly prognostic in multivariate analysis (p = 0.001). Conclusions: In this study, overall response to chemotherapy emerged as the single significant prognostic factor for advanced SBAs. Platin and irinotecan based regimens achieved similar survival outcomes in advanced SBA patients

Evaluation of prognostic factors and treatment in advanced small bowel adenocarcinoma: report of a multi-institutional experience of Anatolian Society of Medical Oncology (ASMO)

Purpose: Small bowel adenocarcinoma (SBA) is a rare tumor of the gastrointestinal system with poor prognosis. Since these are rarely encountered tumors, there are limited numbers of studies investigating systemic treatment in advanced SBA. The purpose of this study was to evaluate the prognostic factors and systemic treatments in patients with advance SBA