The objective of this study was to identify prognostic factors affecting the recurrence-free survival (RFS) in patients who received a 52-week trastuzumab therapy for HER2-positive early stage breast ...cancer (EBC).
The medical records of all patients with EBC from 10 centers were analyzed. Pathologic and clinical tumor characteristics were evaluated in 424 female patients who received 52 weeks of adjuvant trastuzumab for HER2-positive EBC. Survival was estimated using the Kaplan-Meier method. Univariate analyses of RFS were performed with the log-rank test. Independent prognostic and predictive factors affecting RFS were assessed by Cox regression analysis.
Median follow-up time was 33.1 months (range 9.2-75.9 months). 3-year RFS and overall survival were 87 and 97%, respectively. In multivariate analysis, patients aged 70 years or over (p = 0.017, relative risk (RR) 2.7, 95% confidence interval (CI) 1.19-6.13), patients with > 9 positive lymph nodes (p = 0.001, RR 2.52, 95% CI 1.42-4.46), and those with progesterone receptor-negative tumors (p = 0.006, RR 2.33, 95% CI 1.27-4.27) had worse RFS.
In spite of a 52-week adjuvant trastuzumab treatment, classic poor prognostic factors for invasive EBC remained as such in patients with HER2-positive EBC.
Several studies have now demonstrated that the lymph node ratio (LNR), as a superior indicator of axillary tumor burden to the number of excised nodes. While, about the prognostic value of LNR on the ...the survival of elderly patients is limited. The aim of this retrospective multicenter study is to evaluate the prognostic value of lymph node ratio in elderly patients with node positive breast cancer.
Onehundredeightyfour patient with operable breast cancer, recruited from 17 institutions, were enrolled into the retrospectively study. Eleven potential prognostic variables were chosen for analysis in this study. Univariate and multivariate analyses were conducted to identify prognostic factors associated with survival.
Among the eleven variables of univariate analysis, four variables were identified to have prognostic significance for Overall survival (OS): pathologic tumor size (T), No. of positive nodes (N), LNR and estrogen receptor-positive (ER). Among the eleven variables of univariate analysis, two variables were identified to have prognostic significance for Disease-free survival (DFS): N and LNR. Multivariate analysis by Cox proportional hazard model showed that T, LNR and ER were considered independent prognostic factors for OS. Furthermore, LNR was considered independent prognostic factors for DFS.
In conclusion, the LNR was associated with the prognostic importance for DFS and OS in elderly patients who were administered adjuvant treatments.
Several prognostic factors have been studied in NSCLC, although it is unknown which is most useful. In this study, we aimed to investigate whether pre-treatment serum albumin level has prognostic ...value in patients with Stage IIIB NSCLC.
This cross-sectional study included a total of 204 patients with Stage IIIB NSCLC who met the inclusion criteria. Pre-treatment serum albumin levels and demographic, clinical, and histological characteristics, as well as laboratory variables were recorded. A cut-off value was defined for serum albumin level and the patients were stratified into four groups on thios basis.
The majority of the patients was males and smokers, with a history of weight loss, and squamous histological type of lung cancer. The mean serum albumin level was 3.2±1.7 g/dL (range, 2.11-4.36 g/dL). A cut-off value 3.11 g/dL was set and among the patients with a lower level, 68% had adenocarcinoma and 82% were smokers. The patients with low serum albumin levels had a lower response rate to e first-line chemotherapy with a shorter progression-free survival and overall survival. Multivariate analysis showed that low serum albumin level was an independent poor prognostic factor for NSCLC.
This study results suggest that low serum albumin level is an independent poor prognostic factor in patients with Stage IIIB NSCLC, associated with reduction in the response rate to first-line therapy and survival rates.
Objectives: This study aims to investigate human leukocyte antigen (HLA) allele frequencies of healthy individuals and to determine whether there is an association between the HLA alleles and ABO ...blood groups. Materials and methods: The HLA-A, HLA-B and HLA-DRB1 allele frequency were evaluated in a sample of 450 unrelated individuals at Izmir Tepecik Education and Research Hospital Tissue Typing Laboratory archives. The HLA genotypes of individuals were analyzed by using single-specific primerpolymerase chain reaction (PCR-SSP) or PCR using sequence-specific oligonucleotide (PCR-SSO) methods. Blood groups were evaluated by using microplate agglutination method. Results: The most common alleles were HLA-A*02, HLA-B*35, and HLA-DRB1*11 in each locus. A and O blood groups were most common, respectively. A statistically significant association between HLA and ABO blood groups was found in HLA-B and HLA-DRB1 loci. Conclusion: Our study results confirm the other study findings in the Turkish population and also contribute an additional data for further HLA polymorphisms and anthropological studies. We believe that gaining a better understanding on the HLA allele frequencies would help to constitute national transplantation strategies.Original Abstract: Amac: Bu calismada, saglikli bireylerde insan lokosit antijen (HLA) alel frekanslari tespit edildi ve HLA alelleri ile ABO kan gruplari arasinda bir iliski olup olmadigi irdelendi. Gerec ve yontemler: Izmir Tepecik Egitim ve Arastirma Hastanesi Doku Tipleme Laboratuvari arsivlerinde akrabalik iliskisi bulunmayan 450 bireyden olusan HLA-A, HLA-B ve HLA-DRB1 alel frekanslari degerlendirildi. Bireylerin HLA genotiplemesi tek spesifik primer-polimeraz zincir reaksiyonu (PCR-SSP) ve diziye ozgu oligonukleotid ile PCR (PCR-SSO) yontemleri kullanilarak analiz edildi. Kan gruplari mikroplaka aglutinasyon yontemi ile degerlendirildi. Bulgular: Her lokustaki en yaygin aleller HLA-A*02, HLA-B*35 ve HLA-DRB1*11 idi. A ve O kan gruplari ise sirasi ile en yaygin olanlar idi. HLA-B ve HLA-DRB1 lokuslarinda HLA ve ABO kan gruplari arasinda istatistiksel olarak anlamli bir iliski saptandi. Sonuc: Calismamizin sonuclari, Turkiye nufusunda yapilan diger calisma bulgularini desteklemekle birlikte, HLA cesitliligi ve antropolojik calismalar icin ilave katki saglayacaktir. Insan lokosit antijen alel frekanslarinin daha iyi anlasilmasinin ulusal nakil stratejilerinin olusturulmasina yardimci olacagi kanisindayiz.
Objectives: This study aims to evaluate panel reactive antibody (PRA) results of patients with chronic kidney failure (CKF) and to obtain information about pre-transplantation PRA results and graft ...function of transplanted patients. Patients and methods: We evaluated PRA results of 2,517 patients (1,428 males, 1,089 females; mean age 49.9+ or -14.7; range 2 to 82 years) with CKF on the waiting list and 304 transplanted patients (178 males, 126 females; mean age 41.1+ or -11.4; range 9 to 71 years). Of the PRA tests, 85% and 15% were performed by Luminex and flow cytometric methods, respectively. The final post-transplantation serum creatinine levels and transplantation ages of the patients were recorded. We also assessed glomerular filtration ratio (GFR) for graft functions of transplanted patients. Results: Of the PRA positive patients (40.52%) on the waiting list, 12.55% were class I PRA positive (group 1), 8.78% were class II PRA positive (group 2), and 19.19% were both class I and II PRA positive (group 3). Of the patients, 59.48% were PRA negative (group 4). Pre-transplantation negative PRA results (group 4) were significantly higher among patients who were transplanted from related donor (78.09%) than patients with cadaveric transplantation (48.88%) and patients on the waiting list (59.48%) (p<0.05). Glomerular filtration ratios (GFRs) were higher among patients who were transplanted from related donor for all PRA groups. Of transplanted patients, although GFR values of the patients who had acute rejection episode (ARE) were higher than those without ARE, there was no statistically significant difference in between. Conclusion: Regularized pre-transplantation PRA tests and cautious evaluation of their results constitute great importance to prevent ARE and increase graft survival in Turkey, which is a country with already low organ donation ratios.Original Abstract: Amac: Bu calismanin amaci kronik bobrek yetmezligi (KBY) olan hastalarin panel reaktif antikor (PRA) sonuclarinin degerlendirilmesi ve nakil oncesi PRA sonuclari ile nakil yapilan hastalarin greft fonksiyonu hakkinda bilgi edinildi. Hastalar ve yontemler: Bekleme listesindeki KBY olan 2.517 hastanin (1.428 erkek, 1.089 kadin; ort. yas 49.9+ or -14.7 yil; dagilim 2-82 yil) ve nakil yapilan 304 hastanin (178 erkek, 126 kadin; ort. yas 41.1+ or -11.4 yil; dagilim 9-71 yil) PRA sonuclari degerlendirildi. Panel reaktif antikor testlerinin %85 ve %15'i sirasiyla Luminex ve akim sitometri yontemleriyle yapildi. Hastalarin nakil sonrasi son serum kreatinin duzeyleri ve nakil yaslari kaydedildi. Ayrica, nakil olan hastalarin greft fonksiyonlari icin glomeruler filtrasyon hizi (GFH) incelendi. Bulgular: Bekleme listesindeki PRA pozitif hastalarin (%40.52) %12.55'i sinif I PRA pozitif (grup 1), %8.78'i sinif II PRA pozitif (grup 2) ve %19.19'u hem sinif I hem sinif II PRA pozitif (grup 3) idi. Hastalarin %59.48'i PRA negatif (grup 4) idi. Nakil oncesi negatif PRA sonuclari (grup 4) canli vericiden nakil yapilan hastalarda (%78.09) kadavradan nakil yapilan (%48.88) ve bekleme listesinde olan hastalardan (%59.48) anlamli sekilde daha yuksekti (p<0.05). Glomeruler filtrasyon hizlari tum PRA gruplari icin canli vericiden nakil olan hastalarda daha yuksekti. Nakil yapilan hastalarda akut rejeksiyon atagi (ARA) olanlarin GFR degerleri ARA'si olmayanlardan daha yuksek olsa da aralarinda istatistiksel olarak anlamli farklilik yoktu. Sonuc: Halihazirda organ bagisi oranlarinin dusuk oldugu bir ulke olan Turkiye'de ARE'yi onlemek ve greft sagkalimini artirmak icin duzenli uygulanan nakil oncesi PRA testleri ve bunlarin sonuclarinin dikkatle degerlendirilmesi buyuk onem tasimaktadir.
Amaç: Dünya Sağlık Örgütü, bebeklerin yaşamın ilk altı ayı boyunca sadece anne sütü alarak beslenmesini kuvvetle önermektedir. Bu çalışma bebek dostu bir kuruluştan hizmet alan annelerin ek gıdaya ...başlama zamanları ve nedenlerini araştırmayı amaçlamaktadır.
Gereç ve Yöntem: Bu tanımlayıcı çalışma için seçilen bebek dostu ana çocuk sağlığı aile planlaması (AÇSAP) merkezine altı hafta boyunca muayene veya aşı amacıyla gelen 0-12 ay arası bebeği bulunan toplam 358 anne çalışmaya alındı. Anne ve bebeklerle ilgili olarak açık ve kapalı uçlu sorular içeren yapılandırılmış bir soru formu kullanıldı. Altı aydan büyük bebeklerde biberon ve emzik kullanımı ile ilgili sorular ilk altı aya yönelik sorgulandı. Veriler aynı araştırmacı tarafından yapılan yüz-yüze görüşmelerle toplandı. Çözümlemeler için ki-kare, student's t ve Mann Whitney-U testleri kullanıldı.
Bulgular: Doğumu takiben annelerin %98,9'u anne sütü verirken %44,6'sı altıncı aydan önce ek gıdaya başlamıştı. 0-3 ay arası ek gıdalara başlama sıklığı en yüksek olan zaman dilimiydi. Altı aydan önce ek gıdalara başlanması bebeğin zamanından önce doğmuş olması, altı aydan önce emzik ve biberon kullanması, bebeğe doğum sonrası hastanede mama verilmesi ile ilişkili idi.
Çıkarımlar: Annelerin emzirme sıklığı oldukça yüksek olması yanında ek gıdaya erken dönemde başlanmaktadır. Sağlam çocuk izlemlerinde anneler ek gıdalara başlama zamanı hakkında erken dönemde bilgilendirilmeli, özellikle erken doğmuş bebeklerin anneleri doğru beslenme konusunda desteklenmeli ve annelere emzik ve biberon kullanmamaları tavsiye edilmelidir.
Aim: WHO strictly recommends breastfeeding of new-borns exclusively for the first 6 months. This study aims to explore timing and reasons of the mothers who took service from a baby-friendly mother and child health care unit, to start complementary foods.
Material and Medhod: For a six week period 358 mothers visiting the baby friendly Mother and Child Health Care Center that was chosen for this descriptive study were interviewed. A structured questionnaire that included open and close ended questions was used. For the babies older than 6 months, the questions about using feeding bottles and pacifiers were asked directing the first 6 months. Data was collected by the same researcher and by face to face interviews. Chi-square, student's t test, Mann Whitney-U analysis were used.
Results: Although %98,9 of the mothers were breast feeding after delivery, %44,6 started complementary foods before 6 monthsand the most frequent starting period was 0-3 months. Starting solid foods before six months was significantly related with being term, using pacifiers and feeding bottles before six months and feeding the baby with formula just after birth at the hospial.
Conclusıons: Besides the high frequency of breastfeeding, mothers begin to give solid foods in an early period. During well baby follow-ups mothers should be educated earlier about appropriate timing of complementary foods, especially preterm babies' mothers should be supported about appropriate feeding and mothers should be recommended not to use pacifiers and feeding bottles.
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