Capecitabine-cisplatin versus 5-fluorouracil/leucovorin in combination with radiotherapy for adjuvant therapy of lymph node positive locally advanced gastric cancer

WOS: 000445690700030PubMed ID: 30249896Aim of the Study: Although surgery is considered to be curative treatment, recurrence rates are high in gastric cancer. Adjuvant 5-fluorouracil (5-FU) based chemoradiotherapy has been shown to improve the prognosis. We compared tolerability and efficacy of the two different chemotherapy regimens; 5-FU/leucovorin (LV) versus cisplatin with capecitabine (XP) combined with radiotherapy (RT) in the adjuvant therapy of the lymph node positive locally advanced gastric cancer. Materials and Methods: Totally, 104 patients who underwent curative surgery with lymph node resection were evaluated, respectively. Patients were stratified two group based on the adjuvant chemoradiotherapy regimen. Group 1 (n = 46) received XP followed capecitabine with RT (XRT) then XP. Group 2 (n = 58) received 5-FU/LV combined with RT postoperatively. Two groups were compared based on clinicopathological parameters. Factors related with disease-free survival (DFS) and overall survival (OS) were analyzed. Results: Totally, 32 patients had recurrent disease, and there was no difference between two groups. While peritoneal metastasis was more common in XP arm, distant metastasis was commonly seen in 5-FU/LV arm. There was no significant difference between two groups in regard of Grade 3/4 toxicitis; hematologic toxicities were more in 5-FU/LV group than XP arm. In addition, dose modification because of toxicities were more frequent in 5-FU/LV arm (P = 0.003). For all groups, lymph node dissection type was related with DFS, surgical margin and recurrence were important for OS. Conclusion: XP-XRT regimen is well tolerated with lower toxicity compared the standard 5-FU/LV-RT. Although there is no difference with respect to outcome, patients with XP arm without the necessity of intravenous catheter admitted hospital less frequent than bolus5-FU/LV arm

The impact of western physicians on the modernization of Turkish surgery and medicine, 1827-1936

Efforts of modernizing the Ottoman Empire and society started during the 19th century. Initially reforms have been limited by institutions such as the armed forces, faculty of engineering and medicine. For this reason, a large number of western physicians invited to state to take prestigious positions in its few existing medical schools and other state establishments, in particular help with reforming its higher education. After the establishment of young Turkish Republic, western forms of science, medicine, art and literature penetrated the culture and continued to flourish. This article brings to light the efforts of these surgeons, and physicians and tells about their contributions to surgery and medicine in Turkey

Serial Mediation Effects on Relationships among Mobbing, Organizational Cynicism, Job Satisfaction and Turnover Intention: Research on Disabled Individuals in Organizations

More than one billion people in the world are living with disabilities, however, the challenges that these individuals face are not being discussed in the social and business realm. Consequently, there are very studies conducted for disabled employees in organizations. Taking this into consideration, the purpose of this study is to observe the effects of serial mediation among the relationships of mobbing, organizational cynicism, job satisfaction, and turnover intention. The sample of the study was comprised of 184 individuals who have a variety of disabilities such as physical, hearing, speech, and learning difficulties, as well as chronic diseases, working in private and state organizations within different sectors. The data was gathered by survey through convenience and snow ball sampling methods. The 40% disability rate used in the public sector was the determining factor of the inclusion criteria. Individuals that had a disability report at this rate or above were accepted as disabled and considered to be part of the study. The first part of the study comprised of determining the factorial structure of items in the scales utilizing the Confirmatory Factor Analysis (CFA). After examining the fit indices, it was concluded that the data set fit well within the measurement model. Serial multiple mediation analysis was used to test the proposed hypotheses of the study. The findings revealed that mobbing has an indirect effect on turnover intentions via the serial mediating effects of organizational cynicism and job satisfaction. In other words, as mobbing toward disabled workers increases, the level of organizational cynicism also increases. As a result, the job satisfaction decreases and thus results in higher levels of turnover intention in disabled individuals. The importance of looking at work-related problems with a social model approach that suggests that the problems are related to the perspective of the society rather than looking as a deficiency arising from individuals with disabilities has been emphasized once again with this study. The study also sheds light on the importance of creating necessary practices that determine the effects that negative behaviors and attitudes have toward individuals with disabilities within the work environment

Environmental Effects on Milk Yield Traits in Brown Swiss Herd Raised at Mus - Alparslan State Farm in Turkey

WOS: 000266282200024Study was conducted to define the effects of some environmental factors on lactation length and milk production in Brown Swiss cattle reared in Mu Alparslan State Farm. For this aim 768 lactation records belonging 282 cattle between the years of 1989 and 2004 were used. Means of milk production, 305 day milk production and lactation length of the cows in the study were defined as 4002.44 +/- 42.41 kg, 3892.59 +/- 37.34 kg ve 300.51 +/- 1.86 day respectively. Year, season and lactation number significantly affected the milk yield and 305 day milk yield (p < 0.05, P < 0.01). Similarly, statistically significant effects of year and lactation number on lactation length were defined (P < 0.01)

Prognostic markers for metastatic colon cancer patients undergoing multiple metastasectomies

WOS: 000361693500005PubMed ID: 26215062Background/Aims: Following metastasis resection, 5-year survival rate has been reported as approximately 40%. There is no consensus regarding prognostic factors related to progression-free survival after repeated metastasectomies. Materials and Methods: A total of 21 patients with metastatic colorectal cancer who underwent repeated metastasectomies were retrospectively analyzed. The periods between the first and second metastasectomies and that between the second metastasectomy and progression were defined as metastasis-free survival 1 (MFS1) and metastasis-free survival 2 (MFS2), respectively. Univariate analysis was used to analyze factors related to MFS1 and MFS2. Results: Approximately two-thirds of the patients had synchronous metastasis, which were localized mostly in the liver (90%). During a 49-months follow-up, MFS1 was 15.7 (8.4- 23) months and MFS2 was 26.3 (12.3-40.4) months. Systemic chemotherapy followed the first metastasectomy (p=0.01), and the recurrence site (p=0.03) was found to be related to MFS1. Furthermore, the number of metastases during the first metastasectomy (p=0.02), the type of the chemotherapy regimen administered following the first metastasectomy (p=0.04), and the number of metastases before the second metastasectomy ( p=0.03) were significantly related to MFS2. Conclusion: Surgical resection is currently the most effective and curative form of therapy for colorectal metastasis, whenever possible. Repeated metastasectomies can be achieved safely in experienced centers; thus, the operability of the patients should be evaluated by a multidisciplinary approach during treatment

The relationship between positron emission tomography-computed tomography imaging and histopathological features of thyroid incidentalomas detected during follow-up for primary malignancy

WOS: 000470851300023PubMed ID: 31169225Aim of the Study: While the rate of thyroid incidentaloma detected on positron emission tomography (PET) was reported as 4%, the malignancy rate was 14%u50%. We evaluated the thyroid nodules which were detected by PET-computerized tomography (CT) in cancer patients and analyzed the pathological results of those thyroid nodules diagnosed by fine needle aspiration biopsy (FNAB) and their correlation with the maximum standardized uptake (SUVmax) value and PET imaging features. Materials and Methods: FNAB were performed for 40 thyroid incidentalomas. We analyzed the relationship between the histopathological findings and radiological features by Pearson's correlations and Chi-square-Fisher's exact tests to evaluate the factors associated with SUVmax. Results: The median SUVmax values were 5.4 for thyroid nodules. Totally, 14 malignancies were detected by FNAB (35%).The sensitivity and specificity of SUVmax value for diagnosis of malignancy were 87.5% and 52%, respectively. Positive and negative predictive values were 36.8% and 92.8%. The most common malignant and benign pathologies were classic variant papillary carcinoma and benign colloidal nodule. The median SUVmax was the higher in colon cancer thyroid metastasis and oncocytic neoplasia (SUVmax 14.5 and 13.6, respectively). Histopathological type was not related with nodule size but positively associated with categorical SUVmax(r = 0.318, P = 0.04) and negatively correlated with both the density of the thyroid nodule in PET-CT (r = 0.0042, P = 0.01) and density of nodule in ultrasound (USG) (r = 0.305, P = 0.05). Margin of the thyroid nodule in USG (P = 0.007) and internal component of the nodule in PET (P = 0.03) were found to be important factors to differentiate benign or malignant lesion. Conclusion: If the thyroid nodule is detected with flouro-2-deoxy-D-glucose uptake, to differentiate benign nodule from malignant, cytological examination is noteworthy to diagnose the more aggressive type of thyroid nodule and also thyroid metastasis from primary cancer

The clinicopathologic characteristics and prognostic factors of gastroesophageal junction tumors according to Siewert classification

Objective: The treatment of gastroesophageal junction tumors remains controversial due to confusion on whether they should be considered as primary esophageal or as gastric tumors. The incidence of these tumors with poor prognosis has increased, thus creating scientific interest on gastroesophageal cancers. Esophagogastric cancers are classified according to their location by Siewert, and the treatment of each type varies. We evaluated the prognostic factors and differences in clinicopathologic factors of patients with gastroesophageal junction tumor, who have been treated and followed-up in our clinics