Abstract Aim of the work: To evaluate the quality of life (QoL) in Familial Mediterranean Fever (FMF) patients, and determine its association with fatigue, depression, disease severity and other clinical parameters. Patients and methods: Sixty FMF patients were included. QoL was assessed by Short Form-36 (SF-36), depression by Hamilton Depression Scale (HDS), and fatigue by Fatigue severity scale (FSS). Disease severity score and Mutations of the Mediterranean fever (MEFV) gene were assessed. Results: The mean age of patients was 33.73 ± 9.81 years and disease duration 14.6 ± 12.1 years. They were 35 females and 25 males. FMF patients scored significantly higher in FSS (29.9 ± 17.6) and HDS (15.1 ± 8.5) compared to the control (10.6 ± 7.1 and 6.3 ± 9.4; p
The advantage of administering chemotherapy by hepatic arterial infusion is the achievement of high drug concentrations in the liver. Oxaliplatin, irinotecan and 5-flourouracil are active agents in advanced gastric cancer. Therefore a retrospective analysis was performed to investigate the effects of these drugs administered by hepatic arterial infusion in heavily pretreated gastric cancer patients with predominant hepatic metastases. Very limited data about hepatic arterial infusion exist in western gastric cancer patients.Seven patients with advanced gastric cancer were included in the retrospective analysis. All patients had proven progressive disease prior to initiation of hepatic arterial infusion. All had an ECOG performance status of < or =2 and had received at least two previous systemic chemotherapy regimens, including the combination of cisplatin/5-fluorouracil. Patients were given chemotherapy by hepatic arterial infusion: 5-fluorouracil, 600 mg/m2, together with folinic acid, 300 mg/m2/2 h, followed by oxaliplatin, 85 mg/m2/2 h, every 2 weeks.Fifty-four cycles of hepatic arterial infusion (range, 2-21) with a median treatment duration of 6 cycles were administered in 7 patients. The treatment was feasible and safe, no grade 3-4 toxicity was observed. One patient showed stabilization of liver metastases over 7 months. In 6 of the 7 patients there was radiologically proven progressive disease after a median treatment time of 10 weeks.Chemotherapy by hepatic arterial infusion is modestly effective in heavily pretreated gastric cancer patients. Hepatic arterial infusion has a very favorable toxicity profile and can be safely administered even in elderly patients. It might be an additional therapeutic option and should be further investigated. The literature on hepatic arterial infusion in gastric cancer patients is reviewed.
Tüm yazarlarımızla birlikte "Klinikten pratiğe kardiyoloji" kitabının ilk baskısını okuyucuları ile buluşturmanın heyecanını taşıyoruz. 'Klinikten pratiğe kardiyoloji' kitabında hem kardiyoloji hem de kardiyovasküler cerrahi alanlarındaki güncel bilgileri ve yenilikleri okurlarına iletmek amaçlanmıştır. Bu kitapta kardiyolojik ve cerrahi bakış açıları bir araya getirilmiştir. Aynı zamanda pratik hayatta hastaların yandaş sorunlarına yaklaşım açısından da ilgili uzmanlık alanlarından, yazdıkları bölümlerle katkılar alınmıştır. Sağlık kuşkusuz ki bütüncül yaklaşımlarla geliştirilebilir. Ancak artan bilgi birikimi ve gelişen yeni teknikler alt konu başlıklarında uzmanlaşmayı da zorunlu kılmıştır. Günümüzde sağlıkta bütüncül yaklaşım, farklı konularda uzmanlaşmış kişilerin birikimlerini ortak platformlarda paylaşmaları ile sağlanabilir. Bu kitapta kardiyoloji ve kardiyovasküler cerrahi konusundaki bilgi ve tekniklerin bütüncül olarak bir araya getirilmesi hedeflenmiştir. Tüm yazarlarımızca ortak düşümüz kitabın tekrar eden baskılarında bu yaklaşımı güncel bilgilerle daha da geliştirmektir.
Although a high percentage of foetuses with supraventricular tachycardia respond to single or dual antiarrhythmic therapy, on occasion when there is no response to these combination regimens, direct intra-foetal therapy remains the only choice, albeit such an approach carries a potential risk to the foetus.Data with regard to the safety and efficacy of triple antiarrhythmic combination have not been reported before. Here, we present a foetus with intractable tachycardia in whom arrhythmia termination was successfully achieved with triple oral antiarrhythmic therapy.
Bu calismanin amaci, fizik ogretmen adaylarinin mumun yanmasi olayini yanma sartlari acisindan nasil degerlendirdiklerini ortaya cikarmaktir. Calisma Marmara Universitesi Fizik Ogretmenligi Bolumunde tasarim tabanli arastirma olarak yurutulup tamamlanan doktora tezinin bir bolumunu icermektedir. Tez kapsaminda konaklamali kamp deneyiminden cikarilan gercek yasam problemleri sinif icinde cozum surecinden gecirilmistir. Bu arastirmada, kamp atesi deneyimine dayanan, eksik yapilandirilmis kamp atesi probleminin cozum surecinde benzer problem olarak kullanilan mumun yanmasi olayi uzerinde calisilmistir. Bu olay uzerine yapilan butun sinif tartismasinda ve onu takip eden izleme testinde, mumun yanmasi olayinin yanma sartlari acisindan degerlendirildigi bolumlere odaklanilmistir. Butun sinif tartismasi Faraday’in mumlar konusundaki dersleri, cesitli kaynaklardan edinilen bilgiler ve uzman destegi ile sekillendirilerek gercek yasam deneyimi ile iliskili bir sekilde yurutulmustur. Sinif tartismasina ve izleme testine otuz yedi ogrenci katilmis, ilgili veriler nitel icerik analizi ile degerlendirilmistir. Sonuclar kamp atesinin etrafinda yanma olayinin konusulabilir hale gelmesinde, ders tasariminda ara asamalara yer vermenin onemine vurgu yapmaktadir.
Heart rate recovery (HRR) index is a measure which shows indirectly autonomic cardiac function.In this study, it was aimed to investigate heart rate recovery index in patients with chronic idiopathic urticaria which is an inflammatory disorder.The study included 80 participants including 50 patients with chronic urticaria and 30 healthy individuals.All participants underwent treadmill exercise testing in compliance with Bruce protocol.There was no statistically significant difference between the groups included in the study when they were evaluated according to age, gender, fasting blood sugar, lipid profile, resting heart rate, systolic and diastolic blood pressures.All participants had normal 12-lead ECG result and demonstrated sinus rhythm during exercise test.All participants completed exercise testing without complication.Maximum heart rate and metabolic equivalent obtained by exercise stress test, heart rate recovery indices on 1., 2., 3 and 5. minutes were found to be similar in the patient and control groups (p>0.05).Heart rate recovery index is a marker for autonomic nervous system and it can be measured using treadmill exercise test.As a result of this study, it was determined that heart rate recovery index was not affected in patients with chronic idiopathic urticaria.
TPS4138 Background: VEGF inhibition in gastric cancer shows promising improvement of remission rate and progression-free survival (Ohtsu et al., JCO 2011). Pazopanib is an orally available tyrosine kinase inhibitor (TKI) selectively inhibiting VEGFR-1, -2, -3, c-kit and PDGFR. It is approved for treating renal cell cancer. A phase-I trial showed good tolerability of pazopanib with full-dose FOLFOX in solid tumors (Brady et al., ASCO, 2009). FLO is a widely used combination for advanced gastric cancer recommended in national guidelines. Methods: 75 Patients with HER-2-negative locally advanced or metastatic adenocarcinoma of the stomach or the gastro-esophageal junction will be randomized in a 2:1 ratio to A: FLO (F 2600mg/m2 as 24h infusion, L 200mg/m2, O 85 mg/m2) d1 + pazopanib (800mg) d1-14 and B: FLO; repeated for 12 2-week cycles, followed by a maintenance therapy with pazopanib alone in A and an observation period in B until disease progression. Primary endpoint is progression-free survival rate (PFSR) at 6 months, secondary endpoints are PFSR at 9 and 12 months, median PFS, response rate, duration of response, toxicity, tolerability and overall survival. Additionally, we evaluate the predictive and prognostic relevance of PIGF, VEGF, and the respective soluble receptors sVEGFR1 and sVEGFR2 as biomarkers for clinicopathological parameters, clinical response to treatment and tumor volume change. Based on a phase-III trial demonstrating a 6-month PFSR of 44% with FLO (Al-Batran et al., 2008), we estimate a 6-month PFSR of 55% in the experimental group. Given an alpha error of 0.1 and a beta error of 0.2 in a Simon 2-stage minimax design, in the first stage ≥12 of 30 patients need to be progression free at 6 months to continue and after the second stage ≥25 of 50 patients should be progression free at 6 months to justify further evaluation. Randomization is performed to estimate selection bias according to pazopanib-specific exclusion criteria for comparison with historical data. Study protocol received ethics committee approval in November 2011 and is currently recruiting patients in 15 AIO centers.
Bu araştırmanın amacı, okul öncesi öğretmenlerine uygulanan “Öğretmen Eğitim Programı” nın ek desteğe ihtiyacı olan çocuklara “Özbakım Becerileri” nin kazandırılmasına etkisinin belirlenmesidir. Araştırmada tek denekli deneysel desenlerden “denekler arası çoklu yoklama düzeyi deseni” kullanılmıştır. Uygulama, uygulama sonu değerlendirme, genelleme ve izleme verileri kamera kaydı ile toplanmıştır. Araştırma verileri grafiksel olarak analiz edilmiştir. “Öğretmen Eğitim Programı” nın uygulanması sonrasında okul öncesi öğretmenlerinden elde edilen veriler; öğretmenlerin ek desteğe ihtiyacı olan çocuklara “Özbakım Becerileri” ni öğretmeleri için gerçekleşmesi beklenen aşamaları kazandıklarını, genellediklerini ve sürdürdüklerini göstermiştir. Ayrıca bu araştırma kapsamında “Ek Desteğe İhtiyacı Olan Çocuklara Özbakım Becerilerinin Öğretiminde Öğretmen Eğitim Programı”nın yürütülmesi ile ilgili öğretmenlerin görüşleri de değerlendirilmiştir. Öğretmenler, “Öğretmen Eğitim Programı” nın özbakım becerilerinin öğretimine yönelik etkisi ve video model aracılığıyla sunulması anlamında olumlu görüş bildirmişlerdir.