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Background: Since the presence of sarcopenia in breast cancer patients is associated with increased postoperative complications, it is crucial to know its frequency in the prechemoteraphy period. It has been suggested that there are many factors associated with sarcopenia. This study focused on the frequency of sarcopenia over the pectoralis muscle area obtained in routine breast MRI among Turkish females who were newly diagnosed with breast cancer. Methods: In a prospective study, pectoralis muscle was manually contoured bilaterally, and the cross-sectional area on breast MRI was calculated in newly diagnosed breast cancer patients. The 'Core slices' program was used while calculating SMI. We accepted 7.4 kg/m2 as the threshold value for sarcopenia. Results: Overall, 17 patients (17 %) were sarcopenic. The analysis regarding the detection of sarcopenia in the patient groups < 65 and ≥ 65 years of age was not statistically significant (P

We aimed to evaluate the agreements between the guidelines used for both office blood pressure (OBP) and ambulatory blood pressure monitoring (ABPM). Our secondary aim was to define the best threshold to assess children at risk of left ventricular hypertrophy (LVH). Thresholds proposed by the Fourth Report (FR), European Society of Hypertension (ESH), and American Academy of Pediatrics (AAP) for OBP and the Wühl, ESH, and American Heart Association (AHA) for ABPM were used, and nine different BP phenotype combinations were created. The agreements between the thresholds, the sensitivity of the thresholds, and the BP phenotypes used to predict LVH were determined in 949 patients with different ages and body mass indices (BMIs). The agreements between the guidelines for OBP and ABPM were "good" and "very good" (κ = 0.639; 95% CI, 0.638-0.640, κ = 0.986; 95% CI, 0.985-0.988), respectively. To classify OBP and ABPM into BP phenotypes, we obtained nine different combinations, which had "very good" agreement (κ = 0.880; 95% CI, 0.879-0.880). The sensitivity of AAP for detecting LVH was the highest in12-year-old obese children (S = 75.8, 95% CI, 56.4-89.7). The sensitivity of ABPM in detecting LVH was similar among different age and BMI groups. The sensitivity of different BP phenotypes tended to be higher in the groups where OBP was evaluated according to AAP. The highest sensitivity was detected in the 13- to 15-year-old normal weight group.(S: 88.8, 95% CI, 51.7-99.7). The AAP guideline is more sensitive and decisive for BP phenotypes to detect LVH, especially in normal-weight children ≤ 15 years, while ABPM thresholds for children have limited effect.

The authors have requested that this preprint be removed from Research Square.

Background Pisotriquetral joint (PTJ) disorders are an important cause of ulnar-sided wrist pain but are often underrecognized. Ulnar variance (UV) has been associated with several wrist pathologies. Purpose To determine the effect of UV on PTJ in patients with trauma. Material and Methods A total of 143 patients (77 men, 66 women; mean age=41.64 ± 18.07 years) were included. Patients with fractures, severe and high-energy trauma, arthritic conditions, avascular necrosis, congenital deformity, bone and soft-tissue tumors, suboptimal image quality, and incorrect joint position were excluded. UV and the amount of PTJ subluxation were evaluated using coronal and sagittal computed tomography images. Results PTJ subluxation was divided into five grades. A statistically significant difference was found between the presence of PTJ subluxation and sex ( P = 0.045). PTJ subluxation was more common in men (46.8%) than in women (30.3%). There was no significant difference between the presence of PTJ subluxation and age ( P = 0.758). The patients were also divided into three groups as positive, neutral, and negative UV. A statistically significant relationship was found between the UV and presence of PTJ subluxation ( P = 0.01). PTJ subluxation was significantly less in the neutral (none=51.1%, present=48.9%; P Conclusion PTJ subluxation was found to be less among the groups with neutral and negative UV in our study population. PTJ subluxation is more common in men while there is no relationship with age. UV and gender may be risk factors for PTJ subluxation by affecting force dynamics at the wrist joint.

Multisystemic inflammatory syndrome (MIS-C) diagnosis remains difficult because the clinical features overlap with Kawasaki disease (KD). The study aims to highlight the clinical and laboratory features and outcomes of patients with MISC whose clinical manifestations overlap with or without KD. This study is a retrospective analysis of a case series designed for patients aged 1 month to 18 years in 28 hospitals between November 1, 2020, and June 9, 2021. Patient demographics, complaints, laboratory results, echocardiographic results, system involvement, and outcomes were recorded. A total of 614 patients were enrolled; the median age was 7.4 years (interquartile range (IQR) 3.9-12 years). A total of 277 (45.1%) patients with MIS-C had manifestations that overlapped with KD, including 92 (33.3%) patients with complete KD and 185 (66.7%) with incomplete KD. Lymphocyte and platelet counts were significantly lower in patients with MISC, overlapped with KD (lymphocyte count 1080 vs. 1280 cells x mu L, p = 0.028; platelet count 166 vs. 216 cells x 10(3)/mu L, p < 0.001). The median serum procalcitonin levels were statistically higher in patients overlapped with KD (3.18 vs. 1.68 mu g/L, p = 0.001). Coronary artery dilatation was statistically significant in patients with overlap with KD (13.4% vs. 6.8%, p = 0.007), while myocarditis was significantly more common in patients without overlap with KD features (2.6% vs 7.4%, p = 0.009). The association between clinical and laboratory findings and overlap with KD was investigated. Age > 12 years reduced the risk of overlap with KD by 66% (p < 0.001, 95% CI 0.217-0.550), lethargy increased the risk of overlap with KD by 2.6-fold (p = 0.011, 95% CI 1.244-5.439), and each unit more albumin (g/dl) reduced the risk of overlap with KD by 60% (p < 0.001, 95% CI 0.298-0.559). Conclusion: Almost half of the patients with MISC had clinical features that overlapped with KD; in particular, incomplete KD was present. The median age was lower in patients with KD-like features. Lymphocyte and platelet counts were lower, and ferritin and procalcitonin levels were significantly higher in patients with overlap with KD., NA

Background: The aim of the study was to establish computed tomography (CT) characteristics, distribution and provide normative data about size of normal inguinal lymph nodes in a paediatric population. Materials and methods: Four hundred eighty-one otherwise healthy children (147 girls, mean age: 8.87, range 0-17 years) underwent pelvic CT in the setting of high-energy trauma were included in the study. Both axial and coronal 1.25-mm reconstructions were evaluated for the presence, location (deep or superficial), number, presence of fat attenuation, and shape of the lymph nodes, short-axis diameter of the biggest lymph node for each of right and left inguinal regions. Results: A total of 7556 lymph nodes were detected in 481 subjects (the mean count of superficial and deep inguinal lymph nodes was 13.35 [range 6-23] and 2.36 [range 0-7] per subject, respectively): 15% (1135/7556) deep located, 85% (6421/7556) superficially located, 86.6% (6547/7556) with fat attenuation, 99.2% (7496/7556) oval in shape, 0.8% (60/7556) spherical. The short-axis diameter of the lymph nodes increased with age. Pearson's correlation coefficient for superficial and deep lymph nodes in boys and girls, respectively: 0.538 (p < 0.001), 0.504 (p < 0.001), 0.452 (p < 0.001) and 0.268 (p < 0.001). The mean maximum short-axis diameters in different age groups and gender varied between 6.33 +/- +/- 0.85 mm and 8.68 +/- 1.33 mm for superficial, 3.62 +/- 1.16 mm and 5.83 +/- +/- 1.05 mm for deep inguinal lymph nodes. Conclusions: Inguinal lymph nodes were multiple, commonly contained fat, and were oval in shape. The data determined about inguinal lymph node size in different paediatric age groups may be applicable as normative data in daily clinical CT evaluation practice.

Objective: We aimed to investigate a possible role of the endocrine disruptors phthalates, di-2-ethylhexyl phthalate (DEHP) and mono (2-ethylhexyl) phthalate (MEHP), in polycystic ovary syndrome (PCOS) aetiopathogenesis. We also wished to evaluate the relationship between phthalates and metabolic disturbances in adolescents with PCOS. Methods: A total of 124 adolescents were included. Serum MEHP and DEHP levels were determined by high-performance liquid chromatography. Insulin resistance was evaluated using homeostasis model assessment-insulin resistance, quantitative Insulin Sensitivity Check Index, fasting glucose/insulin ratio, Matsuda index, and total insulin levels during oral glucose tolerance test. Participants were further subdivided into lean and obese subgroups according to body mass index (BMI). Results: Sixty-three PCOS and 61 controls, (mean age 15.2±1.5; range: 13-19 years) were enrolled. Serum DEHP and MEHP concentrations were not significantly different between PCOS and control groups. The mean (95% confidence interval) values of DEHP and MEHP were 2.62 (2.50-2.75) μg/mL vs 2.71 (2.52-2.90) μg/mL and 0.23 (0.19-0.29) μg/mL vs 0.36 (0.18-0.54) μg/mL in PCOS and the control groups respectively, p>0.05. Correlation analysis, adjusted for BMI, showed that both phthalates significantly correlated with insulin resistance indices and serum triglycerides in adolescents with PCOS. Conclusion: Serum DEHP and MEHP concentrations were not different between adolescents with or without PCOS. However, these phthalates are associated with metabolic disturbances such as dyslipidemia and insulin resistance, independently of obesity, in girls with PCOS.

Background/aim: Diagnosing and managing functional mitral regurgitation (MR) is often challenging and requires an integrated approach including a comprehensive echocardiographic examination. However, the effects of volume overload on the echocardiographic assessment of MR severity are uncertain. The purpose of this study was to weigh the effects of volume overload in the echocardiographic assessment of MR severity among patients with heart failure (HF).Materials and methods: Twenty-nine patients with decompensated HF, who had moderate or severe MR, were included in the present study. The volume status and the N-terminal pro-B-type natriuretic peptide (proBNP) levels were recorded and the echocardiographic parameters were assessed. After the conventional treatment for HF, the proBNP levels and the echocardiographic parameters were assessed again.Results: The mean age of the patients was 72 ± 9 years and the average hospitalization time was 10.9 ± 5.9 days. Between the beginning and the end of the treatment, there were significant reductions in the effective regurgitant orifice area (EROA) (0.36 ± 0.09 cm2 to 0.29 ± 0.09 cm2, P < 0.001), vena contracta (VC) (P < 0.001), the regurgitant volume (RV) (P < 0.001), and systolic pulmonary artery pressure (sPAP) (P < 0.001). Conclusion: This is the first study to investigate the relationship of changes in severity of MR with volume-load by monitoring the proBNP levels among patients with HF. The present results demonstrated that volume reduction, as evidenced by a decline in the proBNP levels, was accompanied by a marked reduction in the EROA, VC, and the RV among patients with left ventricular dysfunction.

© 2022 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).Aim: Multisystem inflammatory syndrome in children (MIS-C) may cause shock and even death in children. The aim of this study is to describe the clinical features, laboratory characteristics and outcome of children diagnosed with MIS-C in 25 different hospitals in Turkey. Methods: The retrospective study was conducted between 8 April and 28 October 2020 in 25 different hospitals from 17 cities. Data were collected from patients' medical records using a standardised form. Clinical and laboratory characteristics and outcomes according to different age groups, gender and body mass index percentiles were compared using multivariate logistic regression analysis. Results: The study comprised 101 patients, median age 7 years (interquartile range (IQR) 4.6–9.3); 51 (50.5%) were boys. Reverse-transcriptase polymerase chain reaction (PCR) assay was positive in 21/100 (21%) patients; 62/83 (74.6%) patients had positive serology for SARS-CoV-2. The predominant complaints were fever (100%), fatigue (n = 90, 89.1%), and gastrointestinal symptoms (n = 81, 80.2%). Serum C-reactive protein (in 101 patients, median 165 mg/L; range 112–228), erythrocyte sedimentation rate (73/84, median 53 mm/s; IQR 30–84) and procalcitonin levels (86/89, median 5 μg/L; IQR 0.58–20.2) were elevated. Thirty-eight patients (37.6%) required admission to intensive care. Kawasaki disease (KD) was diagnosed in 70 (69.3%) patients, 40 of whom had classical KD. Most patients were treated with intravenous immunoglobulin (n = 92, 91%) and glucocorticoids (n = 59, 58.4%). Seven patients (6.9%) died. Conclusion: The clinical spectrum of MIS-C is broad, but clinicians should consider MIS-C in the differential diagnosis when persistent fever, fatigue and gastrointestinal symptoms are prominent. Most patients diagnosed with MIS-C were previously healthy. Immunomodulatory treatment and supportive intensive care are important in the management of cases with MIS-C. Glucocorticoids and intravenous immunoglobulins are the most common immunomodulatory treatment options for MIS-C. Prompt diagnosis and prompt treatment are essential for optimal management.

Objective: Panic disorder (PD) is now recognized as a common and important problem in children, and particularly adolescents, and one that can negatively affect daily well-being and educational performance. The aim of this study was to investigate the relationship between heart rate variability (HRV) and the severity of symptoms before and after treatment with psychotherapy and fluoxetine. Methods: The PD study group consisted of 23 children diagnosed with PD and the healthy control (HC) group comprised 27 healthy children. Panic-anxiety symptoms were measured using 2 assessments performed before and after treatment. HRV was evaluated with a 24-hour Holter examination. Results: According to the analysis of the 24-hour, all-day Holter device recordings, the high frequency (HF) and parasympathetic (%) scores in the PD group were lower than those of the HC group (p

Purpose: The aim of this study was to investigate standard of knowledge about adult cardiopulmonary resuscitation according to current guidelines and affecting factors among clinicians working at the Hospital of Erciyes University, Medicine School.Materials and Methods: The study conducted on residences and subspecialty residences who accepted to participate and complete the survey. Overall 303 clinicians who accepted to participate and were accessible for completion of survey were recruited to the study. The survey included 2 sections. The first section included data regarding demographic characteristics and the second part included 20 multiple-choice items with one correct answer prepared based on 2010 American Heart Association Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.. Results: Age, total duration of medical practice and residency positively affected standard of knowledge. Higher number of cardiopulmonary resuscitation performed within prior 6 months and defibrillation performance during cardiopulmonary resuscitation positively affected standard of knowledge. Post-graduate theoretical and practical training positively affect standard of knowledge. Conclusion: Cardiopulmonary resuscitation trainings aiming clinicians should be standardized and updated as well as education during employment should be scheduled to provide access to such programs., Amaç: Bu çalışmanın amacı Erciyes Üniversitesi Tıp Fakültesi Hastaneleri`nde görevli doktorların güncel kılavuzlara göre erişkin kardiyopulmoner resüsitasyon konusundaki bilgi düzeylerinin ve bunu etkileyen faktörlerin araştırılmasıdır.Gereç ve Yöntem: Bu çalışma anket doldurmayı kabul eden asistan hekimler arasında gerçekleştirilmiştir. Çalışmamıza, kliniklerinde ulaşılabilen ve araştırmaya katılmaya rıza gösteren toplam 303 doktor dâhil edilmiştir. Veri toplama formları iki bölümden oluşmaktadır. Anketin ilk bölümünde demografik veriler ve ikinci bölüm seçeneklerinden sadece bir tanesi doğru olan, çoktan seçmeli, Amerikan Kalp Derneği’nin Kardiyopulmoner Resüsitasyon ve Acil Kardiyovasküler Bakım 2010 Kılavuzu temel alınarak hazırlanan 20 adet sorudan oluşturulmuştur. Bulgular: Hekimlerin yaşları, toplam hekimlik ve toplam asistanlık süreleri bilgi düzeyini olumlu etkilemektedir. Son altı ay içerisinde uyguladıkları kardiyopulmoner resüsitasyon sayısının fazla olması ve kardiyopulmoner resüsitasyon esnasında defibrilasyon yapmış olmaları bilgi düzeylerini olumlu etkilemektedir. Mezuniyet sonrası dönemde alınan eğitimler hekimlerin bilgi düzeyini anlamlı olarak artırmıştır. Sonuç: Hekimlere yönelik kardiyopulmoner resüsitasyon eğitim programları standardize edilmeli, güncellenmeli ve çalışanlara bu programların ulaştırılabilmesi için hizmet içi kurslar düzenlenmelidir.

The aim of this study was to evaluate nanoleakage within the different lesion-sealing therapies applied to artificial non-cavitated enamel lesions. Thirty-two human anterior teeth were used. Artificial subsurface enamel lesions were produced on the labial surfaces of teeth. The specimens were then randomly divided into three groups (n=10): Group I- Clinpro Sealant application; Group II- ExciTE F adhesive resin application; and Group III- ICON resin infiltrant application. Each group was further divided into two subgroups: control and thermocycler. Nanoleakage was calculated by the digital image analysis software. In the control and thermocycled groups, there was no statistically significant difference between the Groups I, II, and III (p>0.05). The only significant leakage scores were obtained between the Group III control and thermocycler groups (p=0.027). ICON infiltrant can be used as an alternative to dental adhesives and fissure sealants in the sealing of initial non-cavitated enamel lesions. But the resin may become more affected by the water sorption than other resin materials over time. More studies are needed to evaluate long-term durability of resin infiltrants.

İnsanın sağlığı ve iyi olma hali ile yaşadığı çevrenin kalitesi arasında doğrudan bir ilişki vardır. Özellikle bireylerin çevre kaynaklı yoğun zihinsel bilgiye maruz kaldıkları kentsel alanlarda, çevrenin restoratif kalitesini zenginleştirecek tasarım müdahaleleri iyi oluş hali açısından önem taşımaktadır. Bu çalışma kapsamında 1997 yılında Hartig, Korpela, Evans ve Gärling tarafından geliştirilen Algılanan Restoratiflik Ölçeğinin (ARÖ) Türkçeye uyarlanarak, mekânsal tasarım çalışmalarında kullanılacak bir ölçme aracının alanyazına kazandırılması hedeflenmiştir. Araştırma, peyzaj mimarlığı bölümlerinde eğitim gören 279 lisans öğrencisi ile farklı restoratiflik düzeyinde kategorize edilmiş 9 adet fotoğraf kullanılarak gerçekleştirilmiştir. Ölçeğin kapsam geçerliliği için “Aiken V Formulasyonu” kullanılmıştır. Uyarlanan ölçeğin yapı geçerliğini belirlemek amacıyla yapılan doğrulayıcı faktör analizi sonucunda 26 maddeden ve 4 boyuttan oluşan modelin iyi uyum verdiği bulunmuştur [χ2 (288, N = 279) = 746.67, χ2/sd=2.59, SRMR=.075, CFI=.91, RMSEA=.075]. Cronbach alfa iç tutarlılık katsayısı alt boyutlar için .84- .90 arasında bulunuştur. Sonuç olarak, bu çalışma ARÖ’nün Türkçe formunun geçerli ve güvenilir bir araç olarak kullanılabileceğini göstermiştir., There is a direct relation between human health and well-being and the environment. Design interventions aimed at enhancing the environment’s restorative quality is crucial to well-being, especially in urban environments where individuals are exposed to overwhelming information derived from the physcial environment. The aim of this study is to adapt Perceived Restorativeness Scale -which was developed by Hartig, Korpela, Evans & Gärling in 1997 - to Turkish language to develop a tool to be used in spatial design. The study was carried out with 279 undergraduate landscape architecture students, using 9 colored slides categorized into different restorative levels. “Aiken’s V Formula” was used. Confirmatory factor analysis revealed that the model consisting of 26 items and 4 dimensions fit well [χ2 (288, N = 279) = 746.67, χ2/sd=2.59, SRMR=.075, CFI=.91, RMSEA=.075]. The Cronbach's alpha values for the subscales were .84-.90. Consequently, this study has showed that Turkish version of the PRS can be used as a valid and reliable instrument.

Purpose: To evaluate the effects of meperidine on fascial healing. Methods: Seventy adult male Sprague-Dawley rats divided into 7 groups with 10 rats in each group. One of these groups was determined as the sham group, 3 of the remaining 6 groups as meperidine groups, and 3 as control groups. These were grouped as 1st, 2nd, and 6th weeks. In the anterior abdominal wall of the rat, the skin was detached and a wound model including the peritoneum was created with a median incision. Mice in the meperidine group were injected with meperidine intraperitoneally (IP) 3 × 20 mg/kg meperidine on postoperative days 0, 1 and 2, and 2 × 20 mg/kg meperidine on postoperative days 3, 4, 5, and 6 after surgical intervention. Similar to the control group, an equal volume of saline was administered, corresponding to the doses. After sacrifice, the midline fascia was used for facial tensile strength measurement, and the other for histopathological analysis. Results: When compared, the meperidine and control groups inflammatory cell density was higher in the 1st week (p < 0.05) in the meperidine group, fibroplasia density was found to be higher at the 2nd week in the meperidine group than the control group (p < 0.05) When the tensile strength in the meperidine and control groups were compared, there was no significant difference (p > 0.05) at each of the three weeks. Conclusion: The application of postoperative systemic meperidine affects positively wound healing in the inflammatory stage and fibroplasia without changing the resistance to traction.

Objective: Basal markers [cytokeratin 5/6 (CK5/6) and epidermal growth factor receptor (EGFR)] are used in identifying the basal-like breast carcinoma subtype, which is associated with a poor prognosis. However, the clinicopathological significance in early-stage invasive carcinoma of no special type (IC, NST) has not been well established. Material and Method: In a five-year period, 133 female patients with early-stage IC, NST with a median follow-up time of 89 months were included. The immunohistochemistry-based molecular subtypes were identified according to ASCO/CAP guidelines in 2013. The cutoff values for basal positivity were determined as 10% for each marker. Results: Basal positivity was recorded in 83.3% (5/6) of triple-negative breast cancers, 50% (2/4) of HER2-enriched, 18.6% (13/70) of luminal B, and 8.3% of luminal A (4/48) subtype. CK5/6 and EGFR positivity were significantly associated with ER negativity (p < 0.001). EGFR positive cases were significantly associated with PR negativity and HER2 positivity compared to negative cases. However, basal positivity was not associated with the patient outcome (p = 0.006 and p = 0.004, respectively). Conclusion: Basal positive IC, NSTs were associated with hormone receptor negativity and HER2 overexpression; these patients would therefore be less likely to respond to hormonotherapy and more likely to benefit from anti-HER2 treatment as well as dual-kinase inhibitors. The lack of standardization of the definition of basal marker positivity may contribute to the conflicting results of prognostic studies. Hence, further studies focusing on developing a standard protocol for determining basal marker positivity are needed not only for IC, NST but also for other histological types of breast cancer.

Objective: The risk for atherosclerosis increases in hypothyroidism, although its associated mode of pathogenesis has not been determined yet. Paraoxonase1 (PON1) is an enzyme that is antioxidative and antiatherogenic. This study was planned to determine distributions of PON1 192 and 55 gene polymorphisms in hypothyroid patients and healthy individuals and to investigate the effects of these polymorphisms on PON1 activity and serum lipids.

Amac: Bu calismanin amaci, universite ogrencilerinde sosyal kaygi duzeylerinin belirlenmesi, bunun depresyon, anksiyete ve demografik, sosyo-kulturel ozelliklerle iliskisini arastirmaktir. Materyal ve Metot: Kesitsel tipteki bu calismada, 20112012 egitim- ogretim yilinda, Erciyes Universitesi Saglik hizmetleri Meslek Yuksekokulu’nda 10 farkli programda ogrenim goren 264 (%83.8) ogrenci uzerinde yurutulmustur. Arastirmada veri toplama araci olarak, ogrencilerin demografik-sosyokulturel ozelliklerini iceren kisisel bilgi formu ile Sosyal Kaygi Olcegi, Beck depresyon Olcegi (BDO) ve Beck Anksiyete Olcegi (BAO) kullanilmistir. Iki grubun ortalamalarinin karsilastirilmasinda Mann-Whitney U testi, iki den fazla grup ortalamalarinin karsilastirilmasinda tek yonlu varyans analizi ve/veya Kruskal Wallis testi uygulanmistir. Degiskenler arasindaki iliskinin degerlendirilmesinde sperman korelasyon katsayisi hesaplanmistir. Bulgular: Ogrencilerin “sosyal kaygi” puan ortancasi 33 ( 0-109), alt boyut puani ortancalari ise, “sosyal kacinma” 12.0 ( 6.0-20.75), “elestirilme kaygisi” 14.0 ( 8.0-20.75), “bireysel degersizlik” ise 6.0 ( 2.0-10.0) olarak bulunmustur. Konut tipi mustakil olan ogrencilerin “sosyal kacinma” puani anlamli duzeyde yuksek bulunmustur (p

Amaç: Demir tüm canlıların büyüme ve gelişmesi için son derece önemli olan bir elementtir. Özellikle ilk 6 aylık dönemde infantlar için tek demir kaynağı anne sütü olduğundan anne sütünün demir konsantrasyonu ve buna etki eden faktörleri belirlemek önemlidir. Bu çalışmada annenin demir durumunun, hepsidin düzeyinin ve anne sütüne geçen demir miktarı üzerine etkisi araştırılmıştır. Materyal–Metod: Bu çalışma Mayıs 2013 Kasım 2013 tarihleri arasında Erciyes Üniversitesi Tıp Fakültesi Çocuk Hastanesine başvuran bebeklerin annelerinden süt ve kan örnekleri alınarak yapıldı. Çalışmada herhangi bir sağlık problemi olmayan, yaşları 18 ile 36 arasında değişen, laktasyonun 15. gün ile 18. ay arasında olan ve matür bebek doğuran toplam 240 anneden, 08.00-12.00 saatleri arasında süt ve kan numuneleri alındı. Bulgular: Çalışma grubu hemoglobin, serum demir ve ferritin düzeylerinin normal ve düşük oluşuna göre alt gruplara ayrıldı. Annelerin 194 ünün (%80.8) hemoglobin değeri normal, 46 sının (%19.2) düşük bulundu. Serum demir düzeyine göre sınıflandırıldığında 170 annenin (% 70.8) demir düzeyininin normal, 70 annenin (% 29.2) düşük olduğu tespit edildi. Ferritin düzeylerine göre değerlendirildiğinde 140 annenin (% 58.3) ferritin düzeyinin normal,100 annenin (% 41.7) ferritin düzeyinin düşük olduğu görüldü. Hemoglobin, serum demir ve ferritin ile anne sütü demir konsantrasyonu arasında bir ilişki görülmedi. Hepsidin ile anne sütü demiri arasında pozitif bir korelasyonun olduğu dikkat çekti. Hemoglobin, serum demir ve ferritin düzeylerine göre ayrılan grupların anne sütü demir konsantrasyonları benzer bulundu. Hepsidin düzeyi yüksek olan grubun anne sütü demir konsantrasyonunun daha yüksek olduğu tespit edildi. Sonuç: Annenin demir durumu anne sütüne geçen demir düzeyini etkilemez. Hepsidin yalnızca intestinal demir emiliminde değil aynı zamanda meme dokusunda da demir regülasyonundan sorumlu olan ve süte demir geçişinde etkili olan bir hormondur

Aim: The aim of the present study was to evaluate the associations between infant feeding modalities and metabolic risk factors for urolithiasis in infants. Patients and Methods: A total of 70 infants (

WOS: 000381942800009 PubMed ID: 27525399 The colonization rate of Candida spp. reaches up to 80% in patients who reside in intensive care units (ICUs) more than a week, and the mean rate of development of invasive disease is 10% in colonized patients. Since invasive candidiasis (IC) in ICU patients presents with septic shock and high mortality rate, rapid diagnosis and treatment are crucial. The aim of this study was to assess the relationship between invasive infection and the determination of Candida colonization index (CI) and Candida score (CS) in patients admitted to ICU who are at high risk for IC and likely to benefit from early antifungal therapy. A total of 80 patients (34 female, 46 male; age range: 12-92 years, mean age: 69.57 +/- 16.30) who were in ICU over seven days or longer of Anesthesia Department of Kayseri Education and Research Hospital between April, 2014 and July, 2015 were included in the study. None of the patients were neutropenic. After admission, throat, nose, skin (axillary region), urine, rectal swab and blood cultures have been collected weekly beginning from day zero. Isolation and identification of Candida strains were performed by using conventional mycological methods. CI was calculated as the ratio of the number of culture-positive distinct body sites (except blood culture) to the total number of body sites cultured. CI>0.2 was considered as fungal colonization, while CI=0.5 as intensive colonization. CS value was calculated according to the components including total parenteral nutrition (TPN) (plus 0.908 points), surgery (plus 0.907 points), colonization in multiple areas (plus 1.112) and severe sepsis (plus 2.038 points), and cutoff value for CS was accepted as >2.5. In our study, overall 1009 cultures (mean: 13 cultures per patient) were taken from 80 patients, and yeast growth was detected in 365 (36.2%) of them. Accordingly, among 68 (85%) of 80 patients included, in at least one sample, yeast growth was determined. No yeast growth was observed in the blood cultures. Of 365 yeast-positive cultures, C. albicans was isolated from 184 (50.4%), C. glabrata from 66 (18%), C. parapsilosis from 42 (11.5%), C. tropicalis from 12 (3.3%), C. kefyr from three (0.8%), and C. krusei from one (0.3%) samples, whereas six (1.6%) samples yielded other yeasts (3 Saprochaete capitata, 3 Trichosporon spp.) and 51 (13.9%) samples yielded multiple yeast growth. The highest colonization rates were detected in rectal swabs (27.4%), urine (23.3%) and throat (22.5%) samples. CI value was found as >0.2 in 65% (52/80), and >= 0.5 in 25% (20/80) of the patients, whereas CS value was >2.5 in only 2.5% (2/80) of the patients. In the statistical evaluation, significant correlations were found between fungal colonization (CI> 0.2) and gender (p=0.032) and length of stay in ICU (p=0.004), and between intensive colonization (CI >= 0.5) and gender (p=0.008) and age (p=0.012). However, the correlation between Candida colonization and the presence of underlying diseases, APACHE II score, Glasgow coma scale, invasive procedures, use of extended-spectrum antibiotics, presence of bacterial infections, haemodialysis, transfusion and history of previous hospitalization was not statistically significant. Our results have also indicated a statistically significant relationship between fungal colonization and the positivity of C. albicans, C. glabrata, C. parapsilosis ang C.albicans/C.glabrata (p=0.001, p=0.002, p=0.008 and p=0.028, respectively), emphasizing the importance of species-level identification of Candida isolates. The reason of lacking of IC development in our patients may be explained by their low CI and CS values. In conclusion, monitoring of ICU patients who are at high risk for IC in terms of CI and CS would be beneficial. However it is clear that our data need to be supported by multi-center and high-scale studies.

Background Aspergillus species cause a wide range of diseases in humans, including allergies, localized infections, or fatal disseminated diseases. Rapid detection and identification of Aspergillus spp. facilitate effective patient management. In the current study we compared conventional morphological methods with PCR sequencing, rep-PCR, and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS) for the identification of Aspergillus strains. Materials and Methods A total of 24 consecutive clinical isolates of Aspergillus were collected during 2012–2014. Conventional morphology and rep-PCR were performed in our Mycology Laboratory. The identification, evaluation, and reporting of strains using MALDI-TOF-MS were performed by BioMerieux Diagnostic, Inc. in Istanbul. DNA sequence analysis of the clinical isolates was performed by the BMLabosis laboratory in Ankara. Results Samples consisted of 18 (75%) lower respiratory tract specimens, 3 otomycosis (12.5%) ear tissues, 1 sample from keratitis, and 1 sample from a cutaneous wound. According to DNA sequence analysis, 12 (50%) specimens were identified as A. fumigatus, 8 (33.3%) as A. flavus, 3 (12.5%) as A. niger, and 1 (4.2%) as A. terreus. Statistically, there was good agreement between the conventional morphology and rep-PCR and MALDI-TOF methods; kappa values were κ = 0.869, 0.871, and 0.916, respectively (P < 0.001). Conclusion The good level of agreement between the methods included in the present study and sequence method could be due to the identification of Aspergillus strains that were commonly encountered. Therefore, it was concluded that studies conducted with a higher number of isolates, which include other Aspergillus strains, are required.

This study aimed to investigate adaptation of the modified checklist for autism in toddlers (M-CHAT) in a large community sample in Kayseri, a central Anatolian city in Turkey. The M-CHAT was administered to 2021 parents of healthy toddlers aged 18-30 months by a trained team by face-to-face interview at family health centers. Screen positive children and randomly selected screen negative children were evaluated by a child psychiatrist according to diagnostic and statistical manual of mental disorders, text revision (DSM-IV-TR) criteria and childhood autism rating scale (CARS). Screen positive children were re-evaluated at 3 years of age. The M-CHAT detected both cases of autism spectrum disorders that were diagnosed. Cronbach's alpha was found to be 0.84 for the 23 items and 0.79 for the 6 critical items. Although the M-CHAT originally was designed to be filled by the parents, this study showed that, in Turkey, the M-CHAT can be used as a screening tool by face-to-face interview method at well child visits. (C) 2015 Elsevier Ltd. All rights reserved.

Background/aim: The aim of the Brazelton Neonatal Behavioral Assessment Scale (BNBAS) is to gather a comprehensive profile of neonatal functioning by describing the full range of neonatal behavior, including competencies and strengths, as well as difficulties or deviations. This instrument has proved to be of great clinical value by detecting infants at risk for later developmental problems. This work was conducted methodologically with the aim of a Turkish validity and reliability study of the BNBAS. Materials and methods: The study was conducted in a large tertiary hospital in Turkey. After establishing content and language validity, the BNBAS was applied to 380 newborns aged 1–3 days and test–retest analysis was performed for 60 newborns 52–55 days later in the first phase. The validity and reliability study of the BNBAS included behavior and support subscales, while reflex items were not included. Results: In the study, 5 items were excluded from the original BNBAS after the factor analysis. Cronbach alpha was found as 0.974 (30 items). The behavior subscale consisted of 23 items and the support subscale consisted of 7 items. Newborns showed good overall tone and activity level and low amounts of irritable behavior. Conclusion: It may be recommended to use the BNBAS as a valid and reliable measurement tool in neonatal behavioral evaluation by physicians and nurses.

Background We prospectively compared restrictive and liberal transfusion strategies for critically ill children regarding hemodynamic and laboratory parameters. Methods A total of 180 children requiring packed red blood cells (PRBCs) were randomized into two groups: the liberal transfusion strategy group (transfusion trigger

Objective The aim of the present study was to investigate the association between non sentinel lymph node metastasis (NSLNM) and clinicopathological factors, particularly in the case of sentinel lymph node (SLN) metastasis in one or two, in clinically node negative patients with breast cancer. Methods Between 10/2010 and 10/2014, 350 sentinel lymph node biopsy (SLNB) were performed in patients with histologically proven primary breast cancer in our clinic. The data collection includes the following characteristics: age, pathological tumor size, histological type, histological grade, lymphovascular invasion (LVI), number of positive SLN, size of the SLN metastasis (macrometastasis, micrometastasis, isolated tumor cells), multifocality (MF), extracapsuler invasion (ECI) of the SLN, the estrogen receptor (ER) status, the progesterone receptor (PR) status and the Her 2 receptor status, Ki 67 reseptor status. Data were collected retrospectively and then analyzed. Results A successful SLN biopsy were performed in 345 (98.5%) cases. SLN metastases were detected in 110 (31.8%) cases. These patients then underwent axillary dissection; among these patients, 101 (91.8%) had only one to two positive SLNs. Of the 101 patients with positive SLN biopsies, 32 (31.6%) had metastases in the NSLNs. Univariate and multivariate analysis showed that lymphovascular invasion, extracapsular invasion (ECI), Her-2 receptor positive, and Ki-67 > 14% were related to NSLNM (p Conclusion The predicting factors of NSLNM were LVI, ECI, Ki-67 level, Her-2 reseptor positive and but should be further validated in our institutions, different institutions and different patient groups prospectively.

Introduction: Patient transport has more important side effects in patients in the newborn age group than in other age groups. This study was performed to evaluate the intra-hospital transport of infants in the neonatal intensive care unit(NICU).Methods: A total of 284 babies hospitalized in the neonatal unit and transported inside the hospital were divided into three groups based on their weights at the time of transport. Their places of transport and important changes in the vital functions of the newborn that might have been caused by transport were recorded with a view to understand the vital effects of intra-hospital transport on the newborn.Results: In our unit, the primary reasons for transport were determined to be echocardiography and radiology (26.4% and 25.7%, respectively). In our study, hyperglycemia and hypothermia were among the statistically most significant side effects associated with transport (p0.05). As expected, the complication rate was higher in babies with low weight.Conclusions: Current weight is useful for assessing the risks of untoward outcomes associated with intra-hospital transport. Protecting patients from hypothermia during the time spent outside of the NICU would reduce the risk of complications.

Aim Experimental in vitro studies have shown that bisphenol A affects steroidogenesis, folliculogenesis and ovarian morphology. The aim of this study was to investigate the role of the endocrine disruptor bisphenol A in the aetiopathogenesis of polycystic ovary syndrome (PCOS) in adolescents and its relationship with metabolic parameters, insulin resistance and obesity in this population. Methods A total of 112 girls with PCOS and 61 controls between 13 and 19 years of age were enrolled in the study. Serum bisphenol A levels were measured by high-pressure liquid chromatography. An oral glucose tolerance test was also performed. Results Adolescents with PCOS had markedly increased serum bisphenol A levels (mean: 1.1 ng/mL 95% CI: 1.0–1.2) than controls (mean: 0.8 ng/mL 95% CI: 0.6–0.9, p = 0.001). When we compared the subgroups according to obesity, the main factor determining the significant increase in bisphenol A was the presence of PCOS, but not obesity (p = 0.029). Bisphenol A was significantly correlated with total testosterone (r = 0.52), free testosterone (r = 0.44), dehydroepiandrosterone sulphate (r = 0.37) and Ferriman–Gallwey score (r = 0.43) (p

This study was conducted to determine the effect of an oral mucositis prevention protocol on nutritional status and quality of life for patients undergoing radiation therapy for head and neck cancers. This randomized, controlled, experimental study placed 20 patients in an intervention group where they received an oral care protocol and a nutrition protocol. Thirty patients were placed in the control group. Data were collected through face-to-face interviews using an oral assessment guide, oral evaluation guidelines, an oral toxicity scale, a visual analog scale, a subjective global assessment index, and a quality-of-life scale. As time post-treatment progressed, the prevalence of malnutrition in the intervention group was lower than in the controls group, and the intervention group experienced significantly less pain related to oral mucositis. Similar deteriorations in quality of life were noted in each group.

Background Plasma gelsolin is a circulating actin-binding protein that has a protective role against tissue injuries. Our aim was to compare the baseline levels of gelsolin in premature infants with neonatal outcomes. Methods A total of 32 preterm neonates born at 23–32 weeks of gestation were enrolled in the study. Results Plasma gelsolin levels at 72 h were significantly lower in patients with respiratory distress syndrome, in patients who were administered surfactant therapy and in patients who developed sepsis (P < 0.05). Plasma gelsolin levels at 28 days were significantly lower in patients who developed bronchopulmonary dysplasia and retinopathy of prematurity (P < 0.05). Conclusions Low plasma gelsolin levels in the first postnatal month may be associated with poor outcomes in premature infants.

After experiencing a high rate of carbapenem-resistant Gram-negative bacilli infections in febrile neutropenic patients, a two-stage intervention was introduced in the haematopoietic stem cell transplantation (HSCT) centre. During the first eight months of 2014, carbapenems remained the first choice for the empirical treatment of febrile neutropenia while the use of piperacillin/tazobactam (TZP) was encouraged in patients with stable clinical condition. When blood cultures were reported as negative and the patient was clinically stable the carbapenem/TZP treatment was stopped regardless of continuous fever and neutrophil count. From October 2014, TZP (with prolonged infusion) with or without amikacin replaced carbapenems as the first line therapy of neutropenic fever except for high-risk patients previously known as colonized or infected with extended spectrum beta-lactamase (ESBL) producing Enterobacteriaceae, who presented with severe sepsis, septic shock or nosocomial pneumonia, and recently transferred from the intensive care unit with a high endemicity of multidrug-resistant Gram-negative bacilli. Vancomycin or teicoplanin was used when there was suspicion of septic shock or detection of severe mucositis and central-line associated bacteraemia. The antibacterial therapy was escalated or de-escalated in culture-positive patients according to the antimicrobial susceptibility reports and clinical progress. Daily defined dosages (DDD) per 1000 patient days were calculated for all antibiotics by the hospital pharmacist for each year. A total of 913 admissions with 11,544 patient-days were followed in 2013; and 1,072 admissions with 11,843 patient-days were followed in 2014. The rate of ESBL production in Enterobacteriaceae bacteraemia was as 31.8% in 2013 and 47.3% in 2014. All staphylococci isolated from blood culture were methicillin-resistant for both years. All Enterococcus faecium isolates but one from blood cultures were resistant to ampicillin. The number of the patients who died during hospitalization was 24 in 2013, and 17 patients died in 2014. The DDDs/1000 patient days for imipenem, meropenem, vancomycin, teicoplanin, daptomycin, linezolid, colistin, piperacillin/tazobactam and amikacin in 2013 and 2014 were respectively as follows; 201 vs 19 (p0.001); 1,578 vs 1,092 (p0.001); 533 vs 251 (p0.001); 205 vs 159 (p0.001); 56 vs 14 (p0.001); 76 vs 26 (p0.001); 188 vs 154 (p0.001); 157 vs 254 (p0.001); and 5 vs 41 (p0.001). Our study showed that a febrile neutropenia pathway guided by local epidemiology and international guidelines can reduce the use of antibiotics in haematological cancer or HSCT patients. The sustainability of such an intervention requires strong multidisciplinary cooperation.

The aim of this study was to investigate the effect of end-stage renal disease (ESRD) and diabetes mellitus (DM) on the number of stem cells in the peripheral blood. Sixty-two patients diagnosed with ESRD who had not received dialysis previously, 25 patients with a diagnosis of DM without nephropathy, and 21 healthy volunteers were included in the study. The group diagnosed with ESRD was divided into two groups. The first group (DM-CRD) consisted of 28 patients with DM who had developed chronic renal disease (CRD). The second group (NON-DM-CRD) consisted of 34 patients without DM who had CRD by etiology. The routine complete blood count, renal function, and number of CD34+ cells were determined for all of those involved in the study. The microalbumin/creatinine levels were measured, and glomerular filtration rates were calculated in all patients. The number of CD34+ cells was found to be significantly lower in the DM control group and DM-CRD group compared with the healthy group. No statistically significant difference was found between the NON-DM-CRD and the healthy control group. There was a moderate negative correlation between the ratio of microalbumin/creatinine and the number of CD34+ cells. A significant reduction in the number of CD34+ cells was shown in subjects with DM and ESRD caused by diabetic nephropathy.

Background: In recent years, multidrug-resistant Acinetobacter baumannii has been reported as an important nosocomial pathogen, and treatment options are limited. The aim of this study was to investigate the additional effect of sulbactam on monotherapy with colistin, tigecycline and imipenem in experimental sepsis with carbapenem-resistant A. baumannii in mice. Methods: Sepsis was developed in 8- to 10-week-old BALB/c mice by an intraperitoneal injection of A. baumannii. Antibiotic was given intraperitoneally 2 h after bacterial inoculation. Each experimental group had 15 mice and was divided into 3 subgroups. Mice were sacrificed at 24, 48 or 72 h. Lung, liver, heart and spleen samples were cultured, and homogenates of lung and liver were used to detect the number of colony-forming units per gram. Bacterial clearance was compared in lung and liver at different time points. Results: Imipenem did not decrease the bacterial load, but the other antibiotics showed significant bactericidal activity compared with the control group, and the combination of imipenem with sulbactam decreased the bacterial load in lung and liver. However, the addition of sulbactam to colistin and tigecycline had no significant effect on bacterial counts. Only the addition of sulbactam to imipenem showed better bactericidal activity compared to imipenem alone. Conclusions: These results suggested that combining sulbactam with tigeycline or colistin does not increase the efficiency of these antibiotics.

Aim To investigate the presence of association between nonalcoholic fatty liver disease (NAFLD) and subclinical atherosclerosis using carotid intima media thickness (c-IMT) in obese children and adolescents. Additionally, we wished to investigate the relationship between fatty liver and elevated liver enzymes. Methods A total of 157 obese patients (78 boys and 79 girls, mean age: 11.3 ± 2.6 years, age range: 6–16 years) were enrolled in the study. Aminotransferase, fasting glucose and lipid levels were determined. An oral glucose tolerance test was performed. The c-IMT was measured. Infectious and metabolic causes of elevated liver enzymes were excluded. The diagnosis of NAFLD was based on ultrasound scan. Results Obese patients with NAFLD had markedly increased carotid IMT (mean: 0.48 mm, 95% CI: 0.47–0.49) than those without NAFLD (mean: 0.45 mm 95% CI: 0.44-0.45, p

The purpose of this study was to investigate the prevalence and recurrence of febrile convulsion (FC) and risk factors for development of epilepsy in school children throughout in the Kayseri provincial center.Ten thousand individuals selected using "stratified cluster sampling" from a student population of 259,428 inside the Kayseri Urban Municipality represented the study sample. Fifteen thousand questionnaires were distributed, of which 10,742 (71.6%) were returned. Telephone interviews were performed with the families of the students reported as having undergone FC, and the medical records of patients with a history of hospitalization were evaluated. Data were analyzed on IBM SPSS Statistics 22.0 package program. Significance was set at p 0.05.Prevalence of FC was 4.2% in girls and 4.3% in boys, with a total prevalence of 4.3%. Recurrence of FC was observed in 25.4% of cases. Risk of recurrence increased 7.1 times in subjects with a history of FC in first and second degree relatives, 17.8 times in those with fever interval1 h before convulsion and 17.6 times in those with pre-convulsion body temperature39 °C. Epilepsy developed in 33 (7.2%) cases. Neurodevelopmental abnormality was the most important risk factor for epilepsy (21.1-fold risk increase).Analysis revealed that FC with a good prognosis had a high rate of recurrence and a higher risk of epilepsy than in the general population. The prevalence of FC in the province of Kayseri was closer to that in developed rather than developing countries.

There is no standard treatment option in acute bronchiolitis. 3-7% hypertonic saline (HS) seems to be the effective treatment choice for reducing the hospitalization day.To compare the effect of nebulized 7% HS/salbutamol and 3% HS/salbutamol to 0.9% saline/salbutamol. The primary outcome measure was the effect of study drugs on the length of hospital stay (LOS). Secondary outcome measures were safety and efficacy in reducing the clinical severity score (CSS) at the 24 hours of the study.Prospective, double-blinded randomized clinical study.The study consists of 104 infants. Groups were constituted according to the treatment they received: These are, group A - 0.9% saline/salbutamol, group B -3% HS/salbutamol and group C-7% HS/salbutamol. Heart beat, Bronchiolitis CSS and oxygen saturation of the patients were determined before and after nebulization. The patients were monitored for adverse reactions.Length of hospital stay in group A, B and C were as follows; 72.0 (20-288) hours in group A, 64.0 (12-168) hours in group B and 60.0 (12-264) hours in group C. No significant differences was observed among three groups (p0.05).7% HS and 3% HS does not have any effect to decrease LOS for infants with bronchiolitis.

Amac: Bu arastirmada annelerin bebeklerini anne sutu ile besleme sureleri ve bu surelere etkili olan etmenlerin belirlenmesi amaclandi Gerec ve Yontem: Bu kesitsel calisma 2009 2010 tarihleri arasinda Kayseri rsquo;de gerceklestirildi Calismaya 2855 anne alindi Anne sutu alma suresini etkileyen degiskenlerin belirlenmesinde ldquo;univariate and multiple binary logistic regression rdquo; backward ward analizinden yararlanildi Calisma icin etik kurul onayi 03 04 2007 168 alindi Bulgular: Annelerin 74 9 rsquo;u bebeklerini alti ay sadece anne sutu ile beslediklerini ifade etmislerdir Alti aydan fazla anne sutu alinmasini etkiledigi dusunulen degiskenlerden gestasyonel yas gebelik sayisi anne yasi annenin egitim duzeyi degiskenleri tekli lojistik regresyon analizi sonucu anlamli bulundu Coklu lojistik regresyon analizinde alti aydan uzun sure anne sutu verme orani annenin yasi bir yas arttikca 1 021 kat gestasyonel yas bir hafta arttikca 1 267 kat artmaktaydi Anne ogrenimi ilkogretim ve altinda olanlar yuksek okul olanlara gore 1 558 kat daha fazla anne egitimi ortaokul seviyesinde olanlar yuksek okul olanlara gore 1 475 kat daha fazla alti aydan uzun sure anne sutu verme egilimindeydi Annesi ev hanimi olanlarda annesi calisanlara gore erkek cocuklar kiz cocuklara gore alti aydan uzun sure emzirilmekteydi Cikarimlar: Anne sutuyle besleme oranlarini yukseltmek icin; erken yasta gebelikler engellenmeli dogumlarin miadinda gerceklesmesi saglanmali calisan annelerin emzirmesini tesvik edici uygulamalar gelistirilmeli annelere bebekleri arasinda secim yapmadan esit oranda ozen gostermelerini saglamak uzere egitim destegi saglanmalidir Turk Ped Ars 2012; 47: 99 103

Tumor growth and angiogenic factors are usually overexpressed in colorectal carcinomas. We aimed to assess the prognostic role of VEGF, bFGF, PDGF-AA, EGF, HGF, and E-selectin in patients with metastatic colorectal cancer treated with capecitabine and oxaliplatin (XELOX) chemotherapy protocol. Thirty-eight colorectal cancer patients who had evidence of distant metastasis were enrolled in the study. Angiogenic factors were measured before and after third cycle of chemotherapy. Patients were randomized into three groups, partial response (PR), stable disease (SD), and progressive disease (PD) groups, according to their clinical and radiologic evaluation after three cycles of XELOX chemotherapy. Eighteen patients (47.3 %) achieved partial response, 10 (26.3 %) stable disease, and 10 (26.3 %) progressive disease. VEGF (63.20 Pg/ml vs. 19,79 Pg/ml; p < 0.001), EGF (7.29 +/- A 3.08 Pg/ml vs. 4.79 +/- A 2.05 Pg/ml; p < 0.011), HGF (618.16 +/- A 340.39 Pg/ml vs. 452.02 +/- A 217.18 Pg/ml; p < 0.049), and PDGF-AA (691.68 +/- A 187.10 Pg/ml vs. 404.89 +/- A 168.47 Pg/ml; p < 0.001) were significantly decreased in PR group. PDGF-AA levels were also decreased in SD group (706.66 +/- A 206.66 Pg/ml vs. 389.79 +/- A 143.16 Pg/ml; p < 0,001). HGF levels were significantly increased in PD disease group (449.99 Pg/ml vs. 682.22 Pg/ml; p < 0.046). The baseline E-selectin levels were inversely proportional with overall survival that could be an important prognostic factor at the time of diagnosis. This study demonstrated that tumor growth factors can be helpful to determine colorectal cancer prognosis and overall survival in patients with metastatic disease. VEGF, HGF, EGF, and PDGF-AA levels were decreased in PR group. However, meaningful increment was seen HGF levels in PD group. Angiogenic factors and E-selectin provided unique prognostic information in advanced colorectal carcinoma patients.