COMPARISON OF THE ANTHROPOMETRIC DATA AND NUTRITIONAL CHARACTERISTICS AMONG THE BREASTFED AND FORMULA-FED BABIES AND THE RELATION OF THESE PARAMETERS TO INSULIN AND IGF-1 IN EARLY INFANCY

Amaç: Anne sütü ve formüla ile beslenen erken süt çocukluğu dönemindeki bebeklerin antropometrik verilerinin ve beslenme özelliklerinin karşılaştırılması ve bu verilerle beslenme davranışının ve enerji metabolizmasının düzenlenmesinde görev alan insülin ve IGF-1 hormonları arasındaki ilişkinin araştırılması. Gereç ve yöntem: Dokuz Eylül Üniversitesi Tıp Fakültesi Çocuk Sağlığı ve Hastalıkları Çocuk Polikliniği'ne kontrol amacı ile getirilen ve yaşları 3-4 ay arasında değişen sağlıklı bebekler çalışmaya alındı. Bebekler yalnızca anne sütü (AS) ile beslenenler ve çeşitli nedenlerden dolayı ilk ay içinde anne sütü kesilip formüla ile beslenenler (F) olarak iki gruba ayrıldı; doğum haftaları, doğum ağırlıkları, bebeklerin beslenme özellikleri sorgulandı; vücut ağırlığı, boyu, baş çevresi ve triseps cilt kıvrım kalınlığı (TCKK) ölçüldü ve vücut kitle indeksi (VKİ) hesaplandı. Bebeklerin beslenme öncesi insülin, IGF-1 ve kan şekeri düzeylerini belirlemek üzere venöz kan örnekleri alındı. Bebeklerin 6. ay kontrollerinde, ek gıdalara geçiş zamanı, beslenme özellikleri ve dışkılama paterni sorgulandı; vücut ağırlığı, boyu, baş çevresi ve TSF'si ölçüldü; VKİ, enerji ve protein alımları hesaplandı. Bulgular: Çalışmada yer alan 47 sağlıklı bebeğin (erkek/kız=25/22) 24'ü AS, 23'ü F grubunda idi. İki grup arasında cinsiyet, doğum ağırlığı ve doğum haftası özellikleri bakımından fark yoktu. Üçüncü ayda yapılan ilk değerlendirmede AS grubundaki bebeklerin vücut ağırlığı, boy, TSF, postnatal kilo artışı, beslenme sıklığı ve süresi daha fazla idi (p<0,05). Altıncı ayda AS grubundaki bebeklerin 16'sında (%73), F grubundakilerin 19'unda (%95) ek gıdaya geçilmişti. Ek gıdalardan alınan enerji ve protein F grubunda daha fazla idi (p<0,05). Bu dönemde iki grup arasındaki antropometrik ölçüm farkları ortadan kalkmıştı. Anne sütü ve F grubundaki bebeklerin kan şekeri düzeyleri arasında fark olmamasına ve F grubundakilerin daha zayıf olmalarına karşın, serum insülin düzeyleri F grubunda istatistiksel olarak anlamlı olmamakla birlikte daha yüksek idi. Formüla grubunun ortalama serum IGF-1 düzeyi daha yüksek olarak bulundu (p<0,05). Tüm bebeklerde serum IGF-1 düzeyi arttıkça, 6. ayda ek gıdalardan alınan enerji ve protein miktarı, vücut ağırlığı, VKİ, TCKK ve 3.aydan 6. aya kadar alınan kilo miktarı da artmakta idi (sırasıyla r=0,350, p<0,05; r=0,400, p<0,05; r=0,455, p<0,05; r=0,524, p<0,05; r=0,461, p<0,05). Sonuç: Serumdaki IGF-1 düzeylerinin ikinci üç aylık dönemde enerji, protein ve kilo alımı ile ilişkili olması, bu hormonun ileri yaşlarda vücut ağırlığının düzenlenmesinde önemli rol oynadığını düşündürmektedir. Formüla alan bebeklerde relatif olarak daha yüksek bulunan insülin düzeyleri, bu bebeklerin ek gıdalardan neden daha yüksek enerji ve protein aldıklarının açıklaması olabilir. Objective: Comparison of the anthropometric data and nutritional characteristics among the breastfed and formula-fed babies in early infancy and evaluation of the relation of these parameters to the hormones insulin and IGF-1that are involved in the regulation of nutritional habits and energy metabolism. Materıal and method: Three to four month-old healthy babies evaluated during routine clinical visits in Dokuz Eylül University Medical Faculty Department of Pediatrics were enrolled in the study. The babies were splitted into two groups as breastfed (BF) and formula-fed (FF). Gestational age, birth weight, and nutritional characteristics of the babies were asked; weight, height, head circumference and triceps skin fold thickness (TSF) were measured and body mass index (BMI) was calculated. While fasting venous blood samples of all the babies were obtained for insulin, IGF-1 and glucose measurement. The babies were re-evaluated at 6th postnatal month for weaning time, nutritional characteristics, weight, height, head circumference, TSF, BMI and daily protein intake. Results: There were 47 babies (male/female = 25/22), 24 in BF and 23 in FF groups. Two groups were not different with respect to sex, birth weight and gestational age. Weight, height, TSF, postnatal weight gain, feeding frequency and length were higher in BF group than FF group at first visit in 3-4 months of age (p<0.05). At 6th month, 16 (73%) and 19 (95%) of the babies had weaned in the BF and FF groups, respectively. The energy and protein intake by supplemental foods was higher in FF group (p<0.05). At that time, the differences in anthropometric measurements were over among two groups. Although blood glucose levels were not different among the BF and FF group and the babies in FF group were leaner, serum insulin levels were higher, although not significantly, in FF group. IGF-1 levels were significantly higher in the FF group (p<0.05). As the serum IGF-1 level increased, energy and protein intake by supplemental foods, weight, BMI, TSF and weight gain from 3 to 6 months of age increased in all babies (r=0.350, p<0.05; r=0.400, p<0.05; r=0.455, p<0.05; r=0.524, p<0.05 and r=0.461, p<0.05, respectively). Conclusion: The relation of serum IGF-1 level to energy and protein intake and weight gain in the second 3 month-period of life implies that this hormone play a role in regulation of body weight similar to leptin in later life. Relatively higher levels of serum insulin in FF group might explain the higher energy and protein intake from the supplemental foods in these babies

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

Religious Officials' knowledge, attitude, and behavior towards smoking and the new tobacco law in Kahramanmaras, Turkey

<p>Abstract</p> <p>Background</p> <p>Tobacco control effort should be first started in people that are looked upon as role models for the general population. We aimed to determine the knowledge, attitude, and behavior of religious officials towards smoking and the new tobacco law.</p> <p>Method</p> <p>The study group was comprised of 492 Imams and 149 Quran course instructors working in Kahramanmaras city of Turkey, 641 religious officials in total, and our survey form was applied on 406 (63.3%) of those religious officials who agreed to participate in the study.</p> <p>Results</p> <p>Twenty-eight (6.9%) participants were current smokers and 35 (8.6%) were ex-smokers. 99.8% of the religious officials believed that smoking was harmful and/or prohibited in terms of religion. While 43.6% respondents thought smoking was "<it>haram</it>" (forbidden by Islam), 56.2% believed it was "<it>makruh</it>" (something regarded as reprehensible, though not forbidden by God according to Islam). 85.2% of the participants were aware of the recent tobacco law. 55.5% of the respondents, who were aware of the recent tobacco law, evaluated their knowledge level on the law as adequate, whereas 44.5% evaluated it as inadequate 92.4% of the participants noted that religious officials should play active roles in tobacco control effort.</p> <p>Conclusion</p> <p>Smoking rate among religious officials is much lower than that of general public. In order to help religious officials to take a more active role on this issue, they should be trained on the subject and appropriate platforms should be established.</p