Search

In this study, we investigated the activity of single agent gemcitabine in the second-line setting of non-small cell lung cancer (NSCLC). File records of 21 patients treated with single agent gemcitabine in advanced NSCLC who received one prior chemotherapy including a taxane and platinum combination were retrospectively evaluated. Treatment consisted of IV gemcitabine 1,250 mg/m(2) on days 1 and 8, followed by a 1-week rest repeated every 3 weeks. A partial response was achieved in four (19%) patients. The median response duration was 16 (range, 12-32) weeks. Six (29%) patients had a SD more than 3 months. The median time to progression was 16 (range, 8-32) weeks. No complete response was observed. Median overall survival was 36 weeks for second-line gemcitabine in all patients (95%: CI 5-13 months). Hematological toxicity (all grades) was reported by 9 (42.9%) patients. One (4.75%) patient experienced grade 3/4 neutropenia. Grade 3/4 nausea and vomiting and mucositis were reported in one (4.75%) patient. In conclusion, this study shows that single agent gemcitabine is active and well tolerated as a second-line therapy for advanced NSCLC.

Summary Objectives The aims of this study were to determine nasopharyngeal carriage rates, serotype distribution and antimicrobial resistance patterns of Streptococcus pneumoniae in healthy 0 to 2 year-old infants who live within a rural or urban locale and not attending daycare centers. In order to evaluate the possible impact of pneumococcal conjugate vaccine in this population, coverage of the isolated serotypes by the vaccine was also calculated. Methods The study was conducted on 564 healthy infants attending 2 different well child clinics, one of which is located in an urban region and the other in a rural region. Specimens were collected with nasopharyngeal swabs. Serotyping was performed with standard antisera. Penicillin susceptibility was determined with E -test. Chi-square tests and logistic regression were used for data analysis. Results The pneumococcal carriage rate was 22.5%. Age (>2 months age) [2.98 (1.41–6.29) p =0.004] and presence of another child within the house who attends school [1.72 (1.13–2.62) p =0.01] increased the carriage rate. The most frequently isolated serotypes were 11 (11.8%), 23 (7.9%), 19F (7.1%), 22 (6.3%), 9 (5.5%), 19 (5.5%) and 23B (5.5%). The total coverage of vaccine and vaccine-related serotypes by 7, 11 and 13 valent pneumococcal conjugate vaccines were 51.2, 59.0 and 59.0%, respectively. Of the isolated pneumococci, 10 (8.5%) were intermediately resistant and 8 (6.8%) were highly resistant to penicillin. Conclusion This study provides data about the local carriage rate and serotype distribution of S. pneumoniae strains in Turkish children, which is important in predicting the possible effects of different valent pneumococcal conjugate vaccines in this population.

Summary Aim The goal of this case–control study was to identify the significance of certain risk factors for epilepsy in Turkey. Method A total of 805 cases, aged 1–16 years, followed-up for epilepsy at the Pediatric Neurology Department and a control group consisting of 846 age-matched cases without epilepsy were included in the study. The risk factors examined were gender, neurological impairment, febrile convulsion, head trauma, central nervous system infections, parental consanguinity, family history of epilepsy, prenatal and natal risk and newborn jaundice. Data regarding the investigated epilepsy risk factors were obtained through a questionnaire via personal interviews and the medical records and were assessed using univariate and multivariate analysis. Result Univariate analysis showed an increased risk for epilepsy with a history of atypical febrile seizure (21.97-fold), severe and moderate head injury (27.76- and 7.09-fold respectively), CNS infection (4.76-fold), history of epilepsy in first-, second- or third-degree relatives (6.42-, 3.09- and 2.66-fold, respectively), presence of maternal hypertension (4.31-fold), an apgar score ≤6 at any time (7.78-fold) and neonatal jaundice (3.12-fold). Abnormal neurological signs increased the epilepsy risk 5.92 times in univariate analysis and 30.26 times in multivariate analysis. Conclusion The most important risk factors for epilepsy in this study were neurological impairment, history of atypical febrile seizures, severe head injury and a low apgar score. Other important risk factors were moderate head trauma and a history of epilepsy in the family.

There are many well-defined risk factors for fatal asthma exacerbation; however, few data exist about the link between the severity of asthma and severity of exacerbation. The aim of this study was to determine if there is any patient and disease-related factor that predicts the severity of asthma exacerbation. The retrospective data of asthmatic patients followed up in our clinic were analyzed. Asthmatic patients who had at least one exacerbation were included. Patient and disease characteristics, comorbidities, and compliance were evaluated. We analyzed 335 asthma exacerbations of 189 asthmatic patients. Eighteen patients had intermittent asthma, 115 patients had mild persistent asthma, 45 patients had moderate persistent asthma, and 11 patients had severe persistent asthma. Of the 189 asthmatic patients 8.1% of the exacerbations were mild, 52.5% were moderate, and 39.4% were severe. There was a significant correlation between the severity of asthma and severity of exacerbation (r = 0.32; p < 0.001). When elderly (≥60 years old) and younger (

Older children, adolescents and adults with prolonged cough should be screened for pertussis, because they can be a major source of transmission for infants who are not yet fully immunized. This study aimed to estimate the incidence of pertussis among schoolchildren of 6-14 years old with prolonged cough attending two government primary schools in central Ankara. A questionnaire and an informed consent form were sent to the parents of 1,859 schoolchildren. The former comprised questions regarding sociodemographics, and the presence and duration of cough. Parents of 1,698 (91.3%) schoolchildren returned the questionnaire. Three hundred and eighty three (22.6%) of the schoolchildren had cough for more than two weeks, and 307 (80.2%) of them, whose parents gave consent, were included in the study. Their blood samples were collected twice, with a two-week interval. Anti-pertussis toxin IgG levels were measured by enzyme-linked immunosorbent assay (ELISA). Fifty-one children (16.6%) had evidence of recent pertussis infection documented by either a titer > or = 100 ELISA Unit (EU)/ml in one of two serum samples or seroconversion in paired sera. None of the schoolchildren who had attended health care facilities for cough had been diagnosed as pertussis by a physician. In conclusion, pertussis is evident among older children and adolescents in Turkey, and in order to control the disease, priority should be given to strengthen primary immunization services along with the implementation of booster vaccinations beyond childhood.

This aim of this study was to determine water usage behavior and incidence of diarrhea during the summer months among people in rural areas of Turkey. Information was collected using a questionnaire during face-to-face interviews with people aged 18 years and over in their homes. Diarrhea was detected in 31.7% of the 543 households included in the study in the summer of 2003. The percentage of those living in the study area experiencing at least one bout of diarrhea was 10.0%. The diarrhea episode rate was 18.7%. A logistic regression model of factors that could influence the incidence of diarrhea showed that the reported distance between the septic tank and the well, the total monthly household income and water shortages of longer than 12 h had a significant effect on diarrhea incidence (P < 0.05). The fact that water shortages are the biggest risk factor for diarrhea points to the need for (i) health education to raise awareness and (ii) the supply of equipment to enable households to use both the first running water after a water shortage and the water they have collected during the shortage as drinking water. (C) 2007 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.

Objectives To investigate the effect of pelvicaliceal anatomy on stone formation in patients with solitary upper caliceal stones. Methods The records of patients with solitary upper caliceal stones between 1996 and 2004 were reviewed. After the exclusion of patients with hydronephrosis, major anatomic abnormalities, noncalcium stones, metabolic abnormalities, history of recurrent stone disease, multiple stones, and previous renal surgery, 42 patients (24 male, 18 female) and 42 healthy subjects (22 male, 20 female) with normal results on intravenous pyelography (IVP) were enrolled into the study. With a previously described formula, upper pole infundibulopelvic angle (IPA), infundibular length (IL) and width (IW), and pelvicaliceal volume of the stone-bearing and contralateral normal kidney of patients and bilateral normal kidneys of healthy subjects were measured from IVP. Results Forty-two stone-bearing and 126 normal kidneys (42 contralateral, 84 healthy) were assessed. The mean stone size was 153.47 mm 2 (range, 20 to 896 mm 2 ). There were no statistically significant differences in terms of upper caliceal specifications between stone-bearing and normal kidneys. The mean (± standard deviation) pelvicaliceal volume of 42 stone-bearing and 126 normal kidneys was 2455.2 ± 1380.2 mm 3 and 1845.7 ± 1454.8 mm 3 , respectively ( P = 0.019). These values were 2114 ± 2081.5 mm 3 ( P = 0.34) and 1709.5 ± 989.1 mm 3 ( P = 0.001) for contralateral normal kidneys (n = 42) and normal kidneys of healthy subjects (n = 84), respectively. Conclusions Explanation of the etiology of the upper caliceal stone by the anatomic features is very difficult, and these caliceal anatomic variables (IPA, IL, IW) seem not to be a significant risk factor for stone formation in the upper calyx.

WOS: 000236068000006 PubMed: 16510375 The aim of the present Study was to determine the effects of conjugated equine estrogens (CEE) and selective estrogen receptor modulators (SERM) (tamoxifen [TAM] and raloxifene [RALI) on the expression of steroid receptors-estrogen receptor (ER) and progesterone receptor (PR)-in intact rat uterus, mammary gland, and liver. A total of 24 female rats weighing 250 to 300 g were randomized into 4 groups. Groups 1, 2, 3, and 4 were respectively given conjugated equine estrogen, tamoxifen, raloxifene, and vehicle for a 28-day period. ER and PR expression was detected in tissues of the uterus, mammary gland, and liver. Uterine wet weight and serum estradiol levels were established for all groups. No statistical difference was observed between groups in the ER expression of mammary gland and liver and in the PR expression of uterus, mammary gland, and liver, but differences were noted in serum estradiol levels and uterine ER expression. Serum estradiol levels were lower in the TAM-treated group; differences between the TAM-treated group and the other groups were statistically important (P

Pinarli, Faruk Guclu/0000-0002-3241-2478 WOS: 000239922600015 PubMed: 16923558 Growth impairment is one of the most important late sequelae in childhood malignancies. In the last few years, the contribution of cytotoxic agents to growth retardation has been a subject of investigation. The aim of this study was to evaluate the growth impairment in children treated for non-Hodgkin's lymphoma (NHL). The study group comprised 41 children ( eight girls, 33 boys) treated for NHL with three different chemotherapy protocols. All patients were in remission at the last visit. The control group consisted of 41 healthy age- and sex-matched children. All patients' standing heights and body weights were measured regularly from the time of diagnosis. Growth parameters were measured both at the time of diagnosis and at the end of treatment ( median treatment time: 6 months). Height and weight velocities were calculated at 6 month intervals after the diagnosis until the last visit. The mean height SDS of the patients was -0.66 +/- 1.42 at the diagnosis and 0.29 +/- 1.21 at the last visit. Height SDS of the patients showed a significant improvement at the end of the 2nd year after the diagnosis ( p = 0.005) and at the last visit ( p = 0.022) ( median follow-up time: 48 months after diagnosis). The height velocity SDS increase at the end of the 2nd year was particularly remarkable in short-term protocols such as BFM-90 B-NHL. The sitting height, the sitting height/height ratio and serum insulin-like growth factor-I (IGF-I) levels were found to be lower in the patients than those of control group at the last visit. One can conclude that chemotherapy might cause a reduction in growth velocity during treatment. The cumulative dosages of anti-neoplastic agents and serum IGF-I levels could have been implied in the pathogenesis of growth retardation.

SUMMARY: Background: Sleep complaints are common in end-stage renal disease. We aimed to investigate the relationship between sleep-related complaints and inflammatory cytokines in haemodialysis (HD) patients, and also the effects of HD on sleep patterns and cytokine levels. Methods: Predialysis serum interleukin-1beta (IL-1β), interleukin-6 (IL-6) and tumour necrosis factor-alpha (TNF-α) levels in nine patients with sleep complaints were compared with those of nine patients without sleep complaints and nine healthy controls. Patients with sleep complaints underwent polysomnography the night after HD and the following night. Results: Patients with sleep complaints had significantly higher predialysis IL-1β levels compared with those without and healthy controls (P = 0.004 and P = 0.000, respectively). They also had higher predialysis IL-6 and TNF-α levels than those without sleep complaints; however, the difference was not significant. Patients without sleep complaints had higher mean IL-6 and TNF-α and similar mean IL-1β levels compared with healthy controls (P = 0.001, P = 0.024, P = 0.26, respectively). Obstructive sleep apnoea syndrome (OSAS) was found in six out of nine (66%) patients with sleep complaints. Sleep architecture and cytokine levels did not differ between the two nights. The mean serum IL-1β, IL-6 and TNF-α levels did not differ in the pre- and post-polysomnographic samples. There was no correlation between IL-1β, IL-6 or TNF-α levels and the apnoea-hypopnoea index. Conclusions: Proinflammatory cytokines, IL-1β in particular, might be associated with sleep complaints in HD patients. OSAS is not uncommon in HD patients with sleep-related complaints and sleep architecture does not appear to be effected by the HD procedure itself.

The aim of this cross-sectional study was to determine the prevalence of cerebral palsy (CP) among children in Turkey between the ages of 2 and 16 years. Samples were selected from cities, towns, districts, and villages using the cluster sampling method; 41861 children were selected. Data was collected by parental interview and physical examination. One hundred and eighty-six children were identified with CP. The prevalence of CP was determined as 4.4 per 1000 live births and included postnatally acquired CP. Origin of CP was classified as prenatal in 49 (26.6%), perinatal/neonatal in 34 (18.5%), postnatal in 11 (5.9%), and unclassiflable in 90 participants (48.9%; data was unobtainable for two individuals). Type of CP was diplegia in 39.8% of children, hemiplegia. in 28%, tetraplegia in 19.9%, ataxia in 5.9%, and dyskinetic in 6.4%. Prenatal factors were seen more frequently in the groups with a high socioeconomic status while perinatal factors were encountered more often in those with a low socioeconomic status (p < 0.05). Place of residence and sex had no significant effect on the prevalence of CP (p > 0.05). This cross-sectional study shows that the prevalence of CP in Turkey is higher than that in developed countries but the aetiology is probably similar. Although the high prevalence of CP in Turkey could originate from an increased level of obstetric and neonatal problems, the lack of a possible aetiological factor in approximately half the children suggests that the high level might also be due to other factors, such as genetic disorders.

This study was designed to evaluate the age-specific varicella-zoster virus (VZV) seroprevalence in children less than 5 years old who presented at a healthy child outpatient clinic and to compare the results with the data from other countries. The study was a cross-sectional study determining the prevalence of serum IgG against VZV in children who presented to the Healthy Child Outpatient Clinic of the Gazi University Medical Faculty and who were aged between 9 months and 5 years, in the 3rd-97th percentile as regards height and weight, not suffering from any disease, and without a history of vaccination against varicella. The information on the children was obtained from a questionnaire, by physical examination, and from patient files. Serum samples were obtained from babies and children at 9, 15, 24, 36, 48, and 60 months. The 295 serum samples were kept at -20 degrees C following centrifugation until used for serologic analysis (ELISA). The 292 children of the study group consisted of 168 males (57.5 per cent) and 124 females (42.5 per cent). VZV antibodies were found to be positive in 65 children aged between 9 months and 5 years (22.3 per cent); 22.0 per cent in males and 22.6 per cent in females with no statistically significant difference between the sexes (p > 0.05). The VZV seroprevalence was highest at the 48th and 60th months and this difference was statistically significant (p = 0.000).

This study investigated the changes in brainstem auditory evoked potentials (BAEPs) in acute phase of brucellosis. Twenty-two patients with brucellosis without neurologic involvement and seven patients with neurobrucellosis were included. BAEPs were evaluated before treatment. No patient had a symptom of hearing loss. Patients who had neurologic involvement did not show any abnormalities in their BAEPs recording. This study suggests that patients with brucellosis who are in the acute phase of the disease with or without neurological involvement may have normal BAEPs. BAEPs do not seem to be a sensitive method for central nervous system involvement of brucella patients in the acute phase of the disease.

Vascular endothelial growth factor (VEGF) is used to evaluate the angiogenic activity in breast carcinoma. Nitric oxide (NO) and insulin-like growth factor-I (IGF-I) are also implicated in breast tumorigenesis, including angiogenesis. We measured serum VEGF, IGF-I and nitrate+nitrite levels in 38 patients with metastatic and 23 with nonmetastatic breast cancer and in 16 controls. Serum VEGF and IGF-I levels were higher in patients with metastatic disease than in those with nonmetastatic disease or in controls (P

Cervicogenic headache (CH) is a syndrome which is postulated to originate from nociceptive structures in the neck or head. The anatomical neck or head structures that are responsible for the pain in CH have not been clearly identified, but the pain in these patients probably originates from the structures of the cervical spine. In this study, cervical MRI were studied in 22 patients with cervicogenic headache and 20 control patients who did not have any disease which may effect the bone and muscle structures of cervical region. MRI imaging of cervical vertebra showed a disc bulging in 10 (45.4%) out of 22 patients with CH and in 9 (45.0%) of 20 controls ( P > 0.05). The distribution of pathological lesions in patients and controls were not significantly different ( P > 0.05). As a result, MRI may not be an adequate method to detect pathological findings underlying the aetiology of CH such as nerve roots, intervertebral joints and periosteum.

SummaryPurpose: Tamoxifen, used in breast cancer treatment, may induce hepatic steatosis. It has been suggested that leptin, which has a relationship with body fat stores, may be involved in the pathogenesis of hepatic steatosis. In this study, we compared serum leptin levels in tamoxifen-treated patients with and without hepatic steatosis.Methods: Thirty-four women with breast cancer receiving tamoxifen were included in the study. Serum samples were obtained from the patients before and 3 months after tamoxifen therapy.Results: Increased hepatic steatosis was detected in 15 of 34 (44%) patients after 3 months of tamoxifen therapy. Serum leptin levels were found to be significantly elevated in patients with increased hepatic steatosis (37.3 ± 17.7 to 50.5 ± 22.4 ng/ml, p = 0.023) compared to patients without or stable hepatic steatosis (48.2 ± 20.2 to 42.6 ± 14.9 ng/ml, p > 0.05) after tamoxifen treatment.Conclusion: Leptin may play a role in tamoxifen-induced hepatic steatosis. The exact mechanism involv...

AMAC: Fossa infratemporalis ve fossa pterygopalatina gibi etrafi kemiklerle cevrili olan ve karmasik gozuken yapilarin ogrenciler tarafindan algilanmasi zordur. Bu calismada, adi gecen yapilarin anlasilabilmesinde uc boyutlu anaglif stereo gorsel araci ile iki boyutlu gorsel aracin etkinligi karsilastirildi. GEREC VE YONTEM: Adi gecen bolgelerle ilgili olarak anatomi bolumunde bulunan kadavralar, kuru kafalar ve modellerden elde edilen anaglif stereo goruntuler hazirlandi. Gazi Universitesi Dis Hekimligi Fakultesi 3. Sinif ogrencilerine (88 ogrenci) topografik anatomi derslerinde bir gruba (Grup 1, n=44) uc-boyutlu anaglif stereo goruntuler ve diger gruba da (Grup 2, n=44) iki-boyutlu goruntuler gosterildi. Her sunumun bitiminde ogrencilerin konuyu anlama derecesini saptamak icin sinav yapildi ve geri bildirim formu doldurmalari istendi. Gruplara ait sinav sonuclari ve geri bildirim degerleri Mann Whitney U testi kullanilarak istatistiksel olarak karsilastirildi. BULGULAR: Grup 1’deki ogrencilerin sinav notu ortalamasi 49.7, Grup 2’dekilerin sinav notu ortalamasi ise 24.7 olarak bulundu. Grup 1’in sinav sonuclari ve geri bildirim formunda ders ile ilgili verdikleri puanlar Grup 2 ile karsilastirildiginda daha yuksek bulundu. Bu fark istatistiksel olarak da anlamliydi (p

e14120 Background: We investigate whether there have been differences in disease-free survival (DFS) and overall survival (OS) among patients who were treated with different cytotoxic regimens (flu...

The distribution of IgG antibodies to Bordetella pertussis was investigated in serum samples from 550 subjects, aged 4–24 years, to determine the optimal age for booster immunisation. Levels of antibody to B. pertussis antigens were determined using an ELISA that measures a mixture of pertussis toxin, filamentous haemagglutinin and lipopolysaccharide. Geometric mean titres of anti-pertussis antibodies in subjects aged 4–6 years were significantly lower than those in other age groups, which reflects waning immunity following vaccination. High positive titres in older children and adolescents suggested acquired B. pertussis infection, and booster doses at the ages of 7 and 15 years are therefore suggested.

Background: Peripheral nerve blockade has been using in primer headache treatment for a long time. Our aim in this study was to examine the efficiency of greater occipital nerve (GON) blockade in patients with primary headache especially medical overuse headache.