Survival outcomes of patients diagnosed with muscle-invasive bladder cancer who showed a response after neoadjuvant chemotherapy and refused radical cystectomy, and patients who had radical cystectomy or received chemoradiotherapy

Introduction. We aimed to compare the survival results of patients with muscle-invasive bladder cancer who responded after neoadjuvant chemotherapy (NAC) and did not accept further treatment and those who underwent radical cystectomy or received chemoradiotherapy (CRT).  Material and methods. The study included 53 patients with non-metastatic muscle-invasive bladder cancer who received NAC between 2009 and 2020. Clinical findings and post-NAC survival analysis were evaluated. Survival analyses of patients who underwent radical cystectomy (RC) after NAC, received CRT, and refused treatment were compared.  Results. The median age at diagnosis was 61 (33–80) years. After NAC, 18 patients (34%) received CRT, 9 patients (17%) underwent RC, and 18 patients (34%) refused further treatment. Complete response (CR) was present in 10 (18.4%) patients, partial response (PR) in 35 (66%) patients, stable disease (SD) in 1 (1.9%) patient, and progression in 7 (13.2%) patients. Median overall survival (OS) was 78 months. Median OS was not reached in the RC arm; it was 97 months in the CRT arm and 78 months in the declined-treatment arm. There was no statistical difference between the arms (p = 0.94). Median disease-free survival (DFS) was 32 months. Median DFS in the RC arm was 30 months, in the CRT arm — 34 months, and 28 months in the declined-treatment arm after NAC. There was no statistically significant difference between the arms (p = 0.74).  Conclusions. We did not find any difference in terms of OS and DFS between patients who after NAC underwent RC, CRT, or refused treatment

Sanat eğitiminde soyutlama eğilimi ve görme probleminin üniversite düzeyindeki araştırması

Bu araştırmanın konusu olan, soyutlama eğilimi ve görme problemi sanat eğitiminin de temel problemleri arasında yer almaktadır. Özünü somut gerçeklerde arayan bir sanat anlayışının kısıtlılığı karşısında, soyutlama basamaklarının görme alanında geliştirilmesi, sanat eğitimi ve bir eylem olarak sanatın kendisini zenginleştirecek niteliktedir. Bu araştırmanın temel problemleri şu sorulara yanıt aranmıştır:1. Sanat eğitiminde görme nasıl başarılır, görmeyi etkileyen unsurlar nelerdir?2. Sanat alanında özgün bir üslup oluşturabilmek, bireyleşebilmek için soyutlama kabiliyeti gerekmekte midir?3. Sanat eğitiminde görmeyi başarabilmek için, tasvirin ötesinde bir öz arayışı gerekli midir?4. Doğa ve insan ilişkisinin; sanat eylemi ve sanat eğitiminde nasıl bir önemi vardır? Sanat alanında soyutlama ve görmeyi başarabilmek için, doğa-insan ilişkisi kurulmalı mıdır?5. Sanat eğitiminde; görmeyi başarabilmek açısından desen etütleriyle doğa araştırmalarının önemi nedir?6.Soyutlama eğilimi ve görme alanının geliştirilmesi sadece sanat eğitiminde mi geçerli olmalıdır? Bu olguların, insanın diğer başarılarıyla olan ilişkisi nedir?--------------------Abstraction tendency and vision problem, which is the subject of this research, are among the main problems of art education. In the face of the limitation of an understanding of art that seeks its essence in concrete realities, the development of abstraction steps in the field of vision is enriched by art education and art itself.The main problems of this research were sought to answer the following questions:1. How is vision achieved in art education? What are the factors that affect vision?2. Is it necessary to have an abstraction ability to create an individual style in the field of art and to become individual?3. Is it necessary to seek a self beyond the description in order to be able to see it in art education?4. The relationship between nature and human; What is the importance of art action and art education? Should the nature-human relationship be established in order to achieve abstraction and vision in the field of art?5. In art education; What is the importance of nature studies with pattern studies in order to achieve vision?6.Is the abstraction tendency and the development of the visual field only valid in art education? What is the relationship between these phenomena and other human successes

A year's retrospective evaluation of patients hospitalized with the diagnosis of ischemic stroke at Kocatepe University Medicine Faculty Neurology Clinic

OBJECTIVE: The aim of this study is to describe the etiological, demographical and clinical features and determine the risk factors of acute ischemic stroke patients, who were hospitalized and treated at Afyon Kocatepe University (AKU) Medical School Neurology Department within a year. METHODS: The stroke subtypes of 104 acute ischemic stroke patients hospitalized at AKU Medical School Neurology Department within a year were classified according to TOAST (Trial of Org 10172 Stroke Treatment) retrospectively. The distribution of risk factors based on gender was evaluated. RESULTS: Of the 104 stroke patients, 49 (47.1%) were males, 55 (52.9%) were females. The age range of the patients was between 23 and 92 and the mean age was 66.79 ± 15.05 years. Stroke was present in the carotid artery perfusion area in 84 patients (80.8%) and in the vertebro-basilar perfusion region in 20 (19.2%) patients. Hypertension, which was found in 61patients (58.7%), was at the top of the risk factors. The difference was statistically significant based on the hypertension, when the risk factors were assessed according to gender. The etiological classification based on the TOAST criteria was as follows: ischemic stroke resulting from small artery disease in 32 (30.8%), cardioembolic stroke in 27 (26%), and great artery atherosclerosis in 22 (21.2%) patients. The etiological factors of 5 (4.8%) patients were rare causes and in 18 (17.3%) no etiology could be found despite the investigation. CONCLUSION: The most important risk factors of ischemic stroke, which is a common entity in the elderly, are hypertension and diabetes mellitus. The strokes caused by small artery diseases are the most common type based on the classification of TOAST criteria. There is limited number of studies evaluating the stroke epidemiology in our country; therefore further studies are needed to assess this issue

Ataxia telangiectasia: A case report and review of the literature

Ataksi Telenjiektazi nadir görülen, otozomal resesif geçişli nörodejeneratif bir hastalıktır. Klinik olarak erken çocukluk döneminde başlayan progresif serebellar ataksi, okulokutanöz telenjiektaziler, değişen oranda hücresel ve hümoral immün yetmezlikler ve buna bağlı olarak artmış kanser riski göze çarpmaktadır. Olgumuz 14 yaşında kadın. Altı yaşına kadar normal büyüme gelişme süreci yaşamış. Altı yaşından itibaren başlayan ve yavaş ilerleyen dengesiz yürüme, peltek konuşma ve okul başarısında düşme yakınmaları ile kliniğimize başvurdu. Her iki sklerada telenjiektaziler dikkati çekiyordu. Bu makalede , ataksi telenjiektazi tanısını koyduğumuz bir olgu nedeniyle , ilgili literatür gözden geçirilerek hastalığın klinik ve patalojik özellikleri sunulmuşturAtaxia telengiectasia is a rare, autosomal recessively trasmitted, neurodegenerative disease. Progressive cerebellar ataxia initiating in the early childhood, oculocutaneous telengiectases, cellular and humoral immunodeficiency and associated with this, an increased risk for cancer is observed clinically. Our case is a 14 years old female patient. She had a normal growth and development period until she was 6 years old. She was admitted to our hospital with a slowly progressing imbalanced walking, lipsing speech and a decrease in success at school. Telengiectases in both scleras were noticed. We presented the clinical and pathological features of ataxia telengiectasia with regard to related literature

Intravenous thrombolytic treatment experiences in patients with acute ischemic stroke at the University of Kocatepe, Neurology Clinics

INTRODUCTION: This study aimed to discuss the results of the intravenous thrombolytic treatment (IV-tPA) to acute ischemic stroke patients, in the light of the literature. METHODS: We performed our study with forty acute ischemic stroke patients who were receiving the IV-tPA in the intensive care unit of our neurology clinic between 2011 and 2015.. The demographic, clinical and radiological data were collected retrospectively. The intracranial hemorrhage detected within 3 months after discharge and neurological status at the end of the 3rd month were evaluated by using modified Rankin scale (MRS) and National Institutes of Health Stroke Scale (NIHSS) scores. The symptom-to-needle time, Alberta stroke programe early computed tomography score (ASPECT) and initial and follow-up scores of NIHSS were analyzed. RESULTS: Fifteen patients were female, twenty-five were male, and the mean age was 66.45±10.56. The initial mean NIHSS score was 13±4.33, whereas it was 4,10±3,37at 3rd month. The initial mean ASPECT score was 8.23±1.20. Symptomatic intracranial hemorrhage was detected in 1 patient and asymptomatic intracranial hemorrhage was detected in 6. The mean symptom-to-needle time was 139,0±48,1 minutes. The neurological disability of 13 patients ( %32.5) were fully recovered at the end of the 3rd month, while 7 patients were died. (% 17,5) The initial NIHSS and ASPECT scores were significantly different between group of patients with a MRS score between 0-2 and between 3-6 (p=0.03 and p=0.006; respectively), while the symptom-to-needle time was not different (p=0.79). DISCUSSION AND CONCLUSION: The results of the current study are in accordance with previous studies in the literature. These results have shown that the IV-tPA treatment is efficient and safe treatment modality in acute ischemic stroke, and reduces disability at the end of the 3rd month

Cognitive Profile of Inpatients

Objective: Cognitive deterioration has negative effects on the duration of a patient’s hospital stay. Pre-recognition of patients’ cogitive characterictics affects treatment success. We want to put forward the cognitive profiles of inpatients.Material and Methods: One hundred-six hospitalized patients over 50 years of age were assessed between 01-15 February 2009. Patients, not coooperative because of loss of consciousness and those who stayed in hospital because of primary cognitive disorder, have been excluded from study. At first evaluation, patients having cognitive deterioration have been re-evalued at a dementia clinic and the patients’cognitive profile identified. Groups with or without cognitive deterioration were compared for demographic properties. Results: Fifty-seven (%53.7) of 106 patients took 24, under 24 score from MMSE. 30 patients (28.3%) of 106 had mild cognitive deficiency. 8 patients (7.5%) had primary dementia syndrome. When groups with and without cognitive deterioration were examined, there was no difference in gender and family history (p=0.48, p=0.58). The mean age of the group with cognitive deterioration was higher, but lower educational level (p=0.008, p=0.006). MMSE scores were orderly 18.7±2.3, 25.5±2.2 (p<0.001). Interestingly, complaints of forgetfulness were higher than normal in the patients (33%, 67%). 71% of patients believed that forgetfullness is not a disease and could not be treated. Conclusion: Cognitive failure are seen more frequently in inpatients. Relatives, responsible for the patient and medical staff are not aware of failure