Efficacy of subsequent treatments in patients with hormone-positive advanced breast cancer who had disease progression under CDK 4/6 inhibitor therapy

Background: There is no standard treatment recommended at category 1 level in international guidelines for subsequent therapy after cyclin-dependent kinase 4/6 inhibitor (CDK4/6) based therapy. We aimed to evaluate which subsequent treatment oncologists prefer in patients with disease progression under CDKi. In addition, we aimed to show the effectiveness of systemic treatments after CDKi and whether there is a survival difference between hormonal treatments (monotherapy vs. mTOR-based). Methods: A total of 609 patients from 53 centers were included in the study. Progression-free-survivals (PFS) of subsequent treatments (chemotherapy (CT, n:434) or endocrine therapy (ET, n:175)) after CDKi were calculated. Patients were evaluated in three groups as those who received CDKi in first-line (group A, n:202), second-line (group B, n: 153) and ≥ 3rd-line (group C, n: 254). PFS was compared according to the use of ET and CT. In addition, ET was compared as monotherapy versus everolimus-based combination therapy. Results: The median duration of CDKi in the ET arms of Group A, B, and C was 17.0, 11.0, and 8.5 months in respectively; it was 9.0, 7.0, and 5.0 months in the CT arm. Median PFS after CDKi was 9.5 (5.0–14.0) months in the ET arm of group A, and 5.3 (3.9–6.8) months in the CT arm (p = 0.073). It was 6.7 (5.8–7.7) months in the ET arm of group B, and 5.7 (4.6–6.7) months in the CT arm (p = 0.311). It was 5.3 (2.5–8.0) months in the ET arm of group C and 4.0 (3.5–4.6) months in the CT arm (p = 0.434). Patients who received ET after CDKi were compared as those who received everolimus-based combination therapy versus those who received monotherapy ET: the median PFS in group A, B, and C was 11.0 vs. 5.9 (p = 0.047), 6.7 vs. 5.0 (p = 0.164), 6.7 vs. 3.9 (p = 0.763) months. Conclusion: Physicians preferred CT rather than ET in patients with early progression under CDKi. It has been shown that subsequent ET after CDKi can be as effective as CT. It was also observed that better PFS could be achieved with the subsequent everolimus-based treatments after first-line CDKi compared to monotherapy ET.Breast Cancer Consortiu

Tuz stresinin farklı mısır ve sorgum bitkilerinin gelişimi üzerine etkisi

Bu çalışmada tuz stresinin birinci aşama (ozmotik stres) ve ikinci aşama (iyon toksisitesi) etkilerinin bazı mısır hibritleri (Pioneer 3906, SR 03, SR 05 ve SR 12) ile sorghum genotiplerinin (M71, Ji-2731, E-tian, SS79, 2007, Btx 623) gelişimi üzerine etkisini incelemek amaçlanmıştır. Bitkiler hasattan önce altı gün tuz stresine (mısır; 150 Mm, sorghum; 200 mM NaCl) maruz bırakılmış, çalışma kontrollü şartlar altında büyüme odalarında yürütülmüştür. Bütün bitkiler tuz stresi altında bitki büyümesinde azalma göstermiş ancak çeşitler tuz stresine aynı yanıtı vermemişlerdir. Tuza dayanıklı mısır hibritleri (SR 03, SR 05 ve SR 12), tuz stresinin ilk aşamasında tuza hassas çeşitten (Pioneer 3906) daha fazla bitki büyümessi sağlayabilmişlerdir. Ancak, tuz stresinin (150 mM NaCl) ikinci aşamasında SR hibritler Pioneer 3906'ten daha fazla etkilenmişlerdir. Sorghum genotipleri de tuz stresi (200 mM NaCl) altında büyüme performansında farklılık göstermişlerdir. Sorghum çeşitleri arasında 2007 genotipi tuz stresinin ilk aşamasında diğer çeşitlere göre daha dayanıklı bulunmuş iken M71 genotipi tuz stresinin ikinci aşamasında en dayanıklı bulunan çeşittir.It was the aim of this study to investigate effects of the first phase (osmotic stress) and second phase (ion toxicity) of salt stress on the growth of maize hybrids (SR 03, SR 05, SR 12 and Pioneer 3906) and sorghum genotypes (M71, Ji-2731, E-tian, SS79, 2007, Btx 623). The plants were exposed to salt stress (maize; 150 mM, sorghum; 200 mM NaCl) fors ix days until harvest. This study was carried out in a growth chamber under controlled conditions. All plants showed reduction on plant growth under salt stress. However, plants did not show a uniform response to salt stress. The salt-resistant maize hybrids (SR 03, SR 05, SR 12) were able to maintain higher plant growth than sensitive cultivar (Pioneer 3906) in the first phase of salt stress. However, the salt-resistant maize hybrids were effected more than Pioneer 3906 in the second phase of salt stress (150 Mm NaCl). Sorghum genotypes also exhibited difference in growth performance under salt stress (200 mM NaCl). While genotype 2007 were found more resistant than other genotypes in the first phase of salt stress, in the second phase of salt stress M71 were found more resistant than other genotypes

L'écriture au service de la lecture

Certains élèves du cycle 2 présentent des difficultés persistantes dans les apprentissages de la lecture et de l’écriture. Lire et écrire sont deux apprentissages fondamentaux interdisciplinaires. Comment l’écriture pourrait être au service de la lecture ? Cette entrée plus active pourrait-elle répondre aux besoins éducatifs particuliers de ces élèves ? Quelles pourraient être les aides, les adaptations à apporter afin de les amener à franchir les obstacles d’entrée dans la langue écrite

The socıo-demographıc and clınıcal characteristıcs of hospıtalızed cerebral vascular dısease patients in Selçuk unıversity neurology clınıc

Tıpta Uzmanlık TeziÇalışmaya alınan iskemik inme ve geçici iskemik atak tanısı alan 198 hastanın; 97’si (%49) erkek, 101’i (%52) kadın hastalardan oluşmaktaydı. Hastaların yaş ortalamaları 60,048±19,03 idi.İskemik inmede; ileri yaş, aile öyküsü, geçirilmiş inme, hipertansiyon, diabetes mellitus, kalp hastalıkları ve obezite anlamlı bulunan risk faktörleri idi. Hipertansiyon ve aile öyküsü varlığının inme riskini arttıran bağımsız risk faktörleri olduğu saptandı. İskemik inme tanısı alan hastaların en fazla geniş arter aterosklerozu gurubunda olduğu,bu gurubu kardiyoembolik inme ve küçük damar oklüzyonunun izlediği görüldü. Dskemik inme alt tiplerinden kardiyoembolik inme gurubunda mortalite oranının en yüksek olduğu buna karşın küçük damar oklüzyonu gurubunda kaybedilen hasta olmadığı saptandı.Geçici iskemik atak tanısı alan hastalarda iskemik inmedekine benzer şekilde ileri yaş, hipertansiyon, diabetes mellitus, kalp hastalıkları, dislipidemi ve obezite anlamlı bulunan risk faktörleri idi. Ancak geçici iskemik atak için bağımsız risk faktörü tespit edilmedi. Anahtar Kelimeler:İskemik inme, geçici iskemik atak, risk faktörleri.AbstractOf the 198 patients who were diagnosed with ischemic stroke and transient ischemic attack, 97 (49%) were male and 101 (52%) consisted of female patients. The median age was 19.03 ± 60.048.In ischemic stroke, advanced age, family history, previous stroke, hypertension, diabetes mellitus, heart disease and obesity were significant risk factors. The presence of hypertension and family history were identified as independent risk factors that increase the risk of stroke. Patients most frequently had large artery atherosclerosis, this group was followed by cardioembolic stroke and small vessel occlusion. Mortality in patients with cardioembolic stroke had the highest rate. None of the patients with small vessel occlusion was dead. Similar to ischemic stroke patients who diagnosed with transient ischemic attack, advanced age, hypertension, diabetes mellitus, heart disease, dyslipidemia, and obesity were significant risk factors found However, an independent risk factor for transient ischemic attack was not identified. Keywords: Ischemic stroke, transient ischemic attack, risk factors

Investigation of the Frequency of Adenovirus and Rotavirus in Children with Acute Gastroenteritis

Introduction: Viruses are the most common agents in acute gastroenteritis. Rotavirus and adenovirus are the most important viral agents. In our study, the incidence of rotavirus and adenovirus, age, sex and season were investigated in children with gastroenteritis. Materials and Methods: Between January 1, 2017 and January 1, 2018, the data of 1281 patients who were referred by various services and outpatient clinics for the diagnosis of acute gastroenteritis were retrospectively reviewed. Chi-square test was used for the statistical analysis of the distribution of rotavirus and adenovirus according to sex, age groups and seasons. Results: Of the 1281 patients included into the study, 258 (20.1%) had rotavirus antigen positivity and 67 (5.2%) had adenovirus antigen positivity. Of the patients, 548 (42.8%) were females and 733 (57.2%) were males. There was no statistically significant difference in rotavirus positivity rate as regards sex (p> 0.05). Adenovirus positivity was higher in males (6.5%) than in females (3.5%) (p= 0.014). There was no significant difference between rotavirus and adenovirus positivity according to age groups (p> 0.05). Rotavirus positivity was more frequent in spring and winter (p< 0.05) and adenovirus positivity was more frequent in autumn and winter (p< 0.05). Conclusion: Viral agents constitute an important part of gastroenteritis in our region, as well. it is thought that the use of unnecessary antibiotics will be reduced by appropriate diagnosis

A Rare Clinical Presentation Due to Small Cortical Infarction: Isolated Wrist Drop

Isolated wrist drop due to stroke is infrequently observed, and often misdiagnosed as peripheral neuropathy. It is important to make the differential diagnosis correctly because drop hand that results from peripheral pathology requires a completely different treatment strategy than central pathology. In addition, small infarcts are important to identify in order to optimise secondary prophylaxis. In this report, we describe an 83-year-old man, with isolated drop hand due to acute small cortical infarction in the left precentral gyrus and present this situation in light of the literature