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Öğe Comparative assessment of three different second-line regimens in chemotherapy resistant / refractory small-cell lung cancer(Imprimatur Publications, 2021) Hacibekiroglu, Ilhan; Ozkul, Ozlem; Cakir, Emre; Kostek, Osman; Karatas, Fatih; Esenkaya, Asim; Demirci, AysePurpose: Small cell lung cancer (SCLC) patients unresponsive or relapsing within 90 days following frontline chemotherapy have poor prognosis and they should be treated with different chemotherapy regimens other than those used in the first-line regimen. Currently there is no globally accepted standard chemotherapeutic regimen for the treatment of these patients. This retrospective study was designed to compare CAV (Cyclophosphamide, Doxorubicin, Vincristine), weekly topotecan and weekly irinotecan regimens and to evaluate the efficacy of the three regimens in patients with chemotherapy resistant/refractory (CRR) SCLC. Methods: A total of 67 CRR-SCLC patients, who were treated with CAV, weekly topotecan and weekly irinotecan were reviewed for weekly irinotecan (27 for 60 mg/m(2) intravenously on days 1, 8 and 15 of a 28-day cycle, 24 for CAV (Cyclophosphamide 750 mg/m(2) on day 1, Doxorubicin 50 mg/m(2) on day 1 and Vincristine 1.4 mg/m(2) on day 1 every 3 weeks), 16 for weekly topotecan (4 mg/m(2) intravenously on days 1, 8 and 15 of a 28-day cycle). Results: The median follow-up time was 12.45 months, there was no difference about disease control rates (DCR) between three chemotherapy regimens (DCR; 25.9% with irinotecan, 29.2% with CAV and 31.3% with topotecan, p=0.92). Objective response rates (ORR) for irinotecan, CAV and topotecan groups were 3,7%, 8,8%, and 0%, respectively (p=0.63). Median progression free survival (PFS) and overall survival (OS) were similar according to irinotecan, CAV, and topotecan (PFS: 1.93 months, 2.30 months and 3.45 months; OS: 2.89 months, 4.79 months and 5.81 months, respectively). The adverse events were generally mild and manageable for both hematological and nonhematological toxicities in all three arms. Conclusions: Weekly irinotecan, CAV and weekly topotecan are similarly effective and safe chemotherapy protocols for the treatment of CRR-SCLC patients.Öğe Comparison of skeletal muscle mass loss in patients with metastatic colorectal cancer treated with regorafenib or TAS-102(Imprimatur Publications, 2019) Hacioglu, Muhammet Bekir; Kostek, Osman; Kurt, Nazmi; Kucukarda, Ahmet; Gokyer, Ali; Ustabasioglu, Fethi Emre; Karatas, FatihPurpose: To assess whether regorafenib and TAS-102 treatments are associated with a change in Skeletal Muscle Area (SMA) as well as to compare Skeletal Muscle Mass (SMM) loss levels between regorafenib and TAS-102 treatments and prognostic significance in the patients with metastatic colorectal cancer (mCRC). Methods: A total of 36 mCRC patients, who received regorafenib or TAS-102 in the third-line and subsequent settings were assessed in the analysis. SMM changes were assessed with CT scans findings, and they were categorized into two groups as SMM-loss (SMM decrease >= 2%) and SMM-stable (SMM change <2%). Results: The SMM change after regorafenib therapy was significantly worse compared with TAS-102 therapy (p=0.001). The median overall survival (OS) was longer in SMM-stable group than in SMM-loss group (12.8 months; 95%CI:9.8-15.7) vs. 6.4 months; 95%CI:5.2-7.7, respectively;p=0.04). Cox regression analysis showed that SMM loss was independent prognostic indicator for OS (HR, 2.87; 95%CI: 1.07-7.42, p=0.03). Conclusion: Although patients who received regorafenib had more SMM loss than those who received TAS-102, there was no difference in OS between drugs.Öğe Comparison of stress coping attitudes in caregivers for cancer and non-cancer patients on palliative care(Termedia Publishing House Ltd, 2020) Inci, Habibe; Kilincel, Oguzhan; Inci, Fatih; Karatas, Fatih; Adahan, DidemIntroduction: Changes in the social and emotional state of patient caregivers are associated with the individual care burden of the patient rather than the diagnosis of the patient. Our aim was to compare the stress levels and coping attitudes of caregivers who give palliative care to patients with cancer and non-cancer. Material and methods: This non-randomised, controlled study included caregivers providing palliative care to patients diagnosed with cancer and non-cancer in the palliative care unit. The participants were evaluated in respect of age, gender, duration of caregiving, relationship to the patient, marital status, level of education, occupation, psychiatric history, chronic disease history, and smoking status using a data collection form, and the means of coping with stress with the Coping Orientation to Problems Experienced (COPE) scale. Results: Evaluation was made of a total of 80 participants comprising 40 (50%) caregivers of patients diagnosed with cancer and 40 (50%) caregivers of patients not diagnosed with cancer. Female gender, smoking, and caregiving duration were significantly higher (p = 0.009, p = 0.001, p = 0.001, respectively) and educational level was lower (p = 0.022) in the caregivers of non-cancer patients. In the subscales of COPE, the scores of suppressing other activities (p < 0.001), mental disengagement (p = 0.001), and emotion-focussed coping (p = 0.007) were higher in the group of caregivers of non-cancer patients. Conclusions: Because the duration of the cancer patient's need for care is shorter than that of non-cancer patients, this may cause the caregivers of cancer patients to be less able to adapt to the stressful process they experience than the caregivers of non-cancer patients.Öğe Dynamic thiol and disulphide homoeostasis in fibromyalgia(Termedia Publishing House Ltd, 2020) Karatas, Gulsah; Gunduz, Ramazan; Haskul, Ismail; Ustun, Betul; Neselioglu, Salim; Karatas, Fatih; Akyuz, MufitIntroduction: Thiol and disulphide levels are biomarkers that provide useful information about oxidative stress and antioxidant capacity, showing a different homoeostasis in inflammatory and proliferative diseases. We aimed to clarify the possible aetiology of this disease by using thiol and disulphide levels in patients with fibromyalgia, the basis of which has not yet been clearly elucidated. Material and methods: A total of 156 individuals: 86 patients with fibromyalgia and 70 age-matched controls were included in this prospective non-randomised case-control study. Demographic characteristics including smoking status, body mass index (BMI), the duration of complaints, and pain levels were carefully recorded. Dynamic thiol-disulphide homoeostasis in blood samples was determined by an automatic-spectrophotometric method. The Mann-Whitney U and Student's t-test were used to determine the differences between the groups. Results: Sex, BMI, and smoking status were similar between the groups (p = 0.62, p = 0.09, and p = 0.64, respectively). While native thiol levels were found to be high in patients with fibromyalgia (p = 0.018), disulphide levels and the rates of disulphide/native thiol and disulphide/total thiol were significantly low (p = 0.049, p = 0.007, and p = 0.007, respectively). Correlation analysis showed no significant relationship between thiol-disulphide levels and duration of complaints or pain level. Conclusions: Thiol-disulphide balance in fibromyalgia was found to be similar to benign proliferative diseases, suggesting that the underlying mechanism is more likely to be of proliferative pattern rather than inflammatory. Additionally, fibromyalgia is not directly associated with increase in oxidative stress. The molecular mechanisms need to be elucidated.Öğe Dynamic thiol/disulphide homeostasis in patients with Uterine Myoma(Elsevier, 2017) Eroglu, Semra; Haskul, Ismail; Aziz, Vusale; Yurtcu, Engin; Karatas, Fatih; Neselioglu, Salim; Erel, OzcanBackground: The aim of this study is to measure and compare the dynamic thiol and disulphide homeostasis between patients with Uterine Myoma (UM) and healthy subjects. Material and method: A total of 54 patients with UM who were diagnosed by transvaginal ultrasonography and 37 age-and body mass index-matched healthy individuals were included in this study. Thiol/disulphide homeostasis was measured by a novel automatic spectrophotometric method. Results: The mean serum native thiol, disulphide, and thiol levels were statistically lower in UM group than those in the control group [(284.66 +/- 59.41 mu mol/L vs. 320.98 +/- 56.17 mu mol/L, P < 0.0001), (17.27 +/- 5.59 mu mol/L vs. 22.38 +/- 6.93 mu mol/L P < 0.0001) and (319.21 +/- 61.69 vs. 365.76 +/- 61.46 mu mol/L, P < 0.0001), respectively]. There were no statistically significant differences in ratios of the disulphide/native thiol: native thiol/total thiol, and disulphide/total thiol among patients with UM versus healthy control group (P = 0.096, 0.092, 0.092, respectively). Conclusion: It was found that the native thiol, total thiol, and disulphide levels in patients with UM decreased while the ratio of native thiol/disulphide remained unchanged. It is necessary to investigate whether these findings have a role in the etiology and clinical course of the UM. (C) 2017 Elsevier B.V. All rights reserved.Öğe THE EFFECTS OF THE LEVEL OF SPINAL CORD INJURY ON LIFE SATISFACTION AND DISABILITY(Literatura Medica, 2020) Karatas, Gulsah; Metli, Neslihan; Yalcin, Elif; Gunduz, Ramazan; Karatas, Fatih; Akyuz, MufitIntroduction - Spinal Cord Injury (SCI) may often lead to significant disability in affected individuals and reduce life satisfaction. Herein we aimed to investigate the effects of the level of injury on disability and life satisfaction as well as the relation between life satisfaction and disability. Methods - Patients with at least one-year history of SCI were included. Demographic-clinical data of patients were recorded. The Craig Handicap Assessment and Reporting Technique-Short Form (CHART-SF) was used for quantifying the degree of patients' disability. Life satisfaction was assessed by the Satisfaction with Life Scale (SWLS). Results - Of the 76 patients, 21 (27.6%) were tetraplegic and 55 (72.4%) were paraplegic. SWLS was found to be similar in tetraplegic vs. paraplegic patients (P=0.59), whereas CHART parameters such as physical independence, mobility, occupation, and total CHART value were significantly higher in paraplegic patients (P=0.04, P=0.04, P=0.001 and P=0.01, respectively). Social integration was found similarly high in both groups. There was a positive correlation between elapsed time after the injury and CHART physical independence, occupation and the level of economic sufficiency (P<0.01, P<0.01, P=0.01). Excluding the economic sufficiency (P=0.02), there was not any other association between the rest of CHART parameters and SWLS. Conclusions - According to our findings, although the level of injury seems to be influential on disability, it seems to have no significant effect on life satisfaction. Since the only thing that positively affects life satisfaction is economic sufficiency, more emphasis should be placed on regulations that increase the return to work in patients.Öğe The impact of primary tumor localization on survival and treatment outcomes in patients with metastatic colorectal cancer-a multicenter study(Imprimatur Publications, 2019) Sahin, Suleyman; Karatas, FatihPurpose: To investigate the effects of sidedness on survival and treatment outcomes in patients with metastatic colorectal cancer (mCRC), since the accumulated data have increasingly reported that patient with right-sided mCRC are found to be associated with worse overall survival (OS) and poor response to anti-epidermal growth factor receptor (anti-EGFR) agents. Methods: This was a multi-center retrospective analysis of 177 patients with mCRC, who were treated and followed between 2014 and 2018 in different parts of Turkey. Patients were divided into 2 groups according to the primary tumor localization as right or left colon cancer. Clinical and demographic characteristics, treatment outcomes, and survival were analyzed to determine whether there was any association with tumor localization. Results: There were 53 (30%) patients with mCRC in the right group and 124 (70%) in the left group, with no difference between the groups in terms of clinical and demographic characteristics. There was no difference in OS between the left and right side localization in any RAS-mutant mCRC patients (22.1 vs. 27.9 months, respectively, p=0.19), whereas patients with all RAS-wild type tumor in the right colon were associated with a worse OS than left-sided counterparts (19.4 vs 29.9 months, respectively, p =0.01). Multivariate analysis revealed that the right-sided tumor (HR, 1.74; 95% CI: 1.165-2.608; p=0.007), the presence of comorbid disease (HR, 1.58; 95% CI: 1.079-2.321, p=0.019), body mass index (BMI) <25 (HR, 1.61; 95% CI: 1.108-2.352, p=0.013), grade III tumor (HR, 1.65; 95% CI: 1.109-2.457, p=0.014), and being unable to metastasectomy (HR, 2.10; 95% CI: 1.235-3582, p=0.006) were found to be independent predictors of worse survival. Conclusion: While right side localization was an independent negative predictor of survival in patients with mCRC, tumor sidedness was not found to be associated with response to treatment. The worse OS in right localization may be due to the aggressive nature of right-sided colon tumors which show faster progression, since their response to treatment does not appear to be different.Öğe THE IMPORTANCE OF ANTIOXIDANT STATUS IN GASTRIC INTESTINAL METAPLASIA(Soc Medical Biochemists Serbia, 2021) Danis, Nilay; Ozkan, Aysegul; Karatas, Fatih; Cakici, Cagri; Yigitbasi, Turkan; Sevencan, Nurhayat; Kayhan, BurcakBackground: Oxidative stress status in different cancer types was investigated before, but not studied in gastric intestinal metaplasia to the best of our knowledge. Purpose of this study is to examine whether there is a difference between oxidative stress status in patients with intestinal metaplasia (IM) compared to individuals without IM, we compared the serum levels of disulfide (SS), total thiol (TT) and native thiol (NT). Methods: This was a prospective, non-randomized case-control study including 67 patients with histopathologically confirmed IM and 60 individuals demographically matched in terms of age, gender, BMI, smoking status, and chronic diseases as control group. Results: The mean NT, TT and NT to TT (NT/TT) ratios were statistically significantly higher in IM group compared to controls ((351.71 +/- 81.9 mu mol/L vs. 271.82 +/- 54.13 mu mol/L, p=0.000), (391.5 +/- 92.69 mu mol/L vs. 308.59 +/- 55.53 mu mol/L, p=0.000) and (0.89 +/- 0.6 vs. 0.87 +/- 0.29, p=0.022), respectively). The mean SS to TT (SS/TT) ratio was significantly lower in IM group than control group (0.050 +/- 0.31 vs. 0.060 +/- 0.014, P=0.022). Median SS and mean SS/NT ratio was similar in both groups (16.3 (3.3-78) vs. 18.3 (10-32.7), p=0.271 and 0.055 +/- 0.041 vs. 0.070 +/- 0.019, p=0.068, respectively). In ROC analysis, cut off value of SS/NT for IM was found 0.062, in regression analysis, SS/NT <0.062 was found as an independently prognostic marker for IM (OR, 2.38; 95%CI: 1.168-4.865, P=0.017). Conclusions: SS/NT ratio lower than 0.062 was found as an independently prognostic marker for IM. This ratio could help to distinguish which patients should be followed closely for gastric cancer.Öğe Mean platelet volume and platelet distribution width correlates with prognosis of early colon cancer(Imprimatur Publications, 2020) Sakin, Aysegul; Sahin, Suleyman; Sakin, Abdullah; Karatas, Fatih; Samanci, Nilay Sengul; Yasar, Nurgul; Arici, SerdarPurpose: Several platelet indices have been linked to prognosis of various cancers, including metastatic colorectal cancer. The aim of this study was to investigate the prognostic effect of mean platelet volume (MPV) and platelet distribution width (PDW) in early colon cancer (CC) patients. Methods: This retrospective study included early CC patients who were followed up and treated between 2005 and 2017. Relapse free survival (RFS) and overall survival (OS) were determined with respect to several demographic and clinical characteristics of patients, including MPV and PDW. The cut-off value was determined as >8.5 fL for MPV (sensitivity: 67.1%, specificity 54.5%) and <= 16% for PDW (sensitivity: 66.7%, specificity: 60.0%). Results: The study included 394 patients, 53.3% of which were male. Stage I, II, and III patients constituted 8.9%, 46.4%, and 44.7% of the study population, respectively. Among all patients, RFS and OS were significantly longer in patients with MPV <= 8.5 fL and PDW>16 fL (p <0.001 and p=0.011 for MPV, respectively; and p<0.001 and p=0.026 for PDW, respectively). In patients with stage III disease, those with MPV <= 8.5 fL had significantly longer RFS and OS compared to those with MPV >8.5 fL (p<0.001 and p=0.001, respectively). On the other hand, those with PDW>16% had significantly longer RFS than that in those with PDW <= 16 fL, among stage III patients (p<0.001). In multivariate analysis, stage, perineural invasion, lymphovascular invasion, adjuvant treatment, CEA, CA19-9, PDW, and MPV were found the most significant factors affecting RFS. Conclusion: Our study suggests that elevated MPV and decreased PDW appear to be unfavorable prognostic factors in early CC, especially in patients with stage III disease. Considering the wide availability and accessibility of these indices, it is reasonable to designate further larger prospective studies to clarify and verify their potential roles in early CC.Öğe Paclitaxel-induced hepatic steatosis in patients with breast cancer(Imprimatur Publications, 2019) Inci, Fatih; Karatas, FatihPurpose: Paclitaxel has been associated with serum aminotransferase elevations, however, paclitaxel induced hepatosteatosis has not been evaluated systematically. This study assessed the rate of paclitaxel-related hepatosteatosis. Methods: Forty one early breast cancer (BC) patients were included the study. Hepatic ultrasonograpy, demographic features and biochemical liver function tests before and after 12 weeks of paclitaxel were assessed. Results: New-onset hepatosteatosis was developed in 26.7% of the patients. Baseline triglyceride>200mg/dL (OR, 11.25; p=0.015), LDH at baseline > 191.48 IU/L (OR, 4.93; p=0.048), and total bilirubin >0.51 mg/dL after paditaxel (OR, 6.17; p=0.042) were found as independent prognostic markers for new-onset hepatosteatosis. Conclusion: Paclitaxel may induce hepatosteatosis in patients with BC.Öğe Plasma thiols in prostate cancer(Taylor & Francis Ltd, 2020) Sahin, Suleyman; Karatas, Fatih[No abstract available]Öğe The prognostic and predictive significance of serum thiols and disulfide levels in advanced non-small cell lung cancer(Taylor & Francis Ltd, 2020) Karatas, Fatih; Acat, Murat; Sahin, Suleyman; Inci, Fatih; Karatas, Gulsah; Neselioglu, Salim; Haskul, IsmailSerum Total Thiol (TT), Native Thiol (NT), and Disulfide (SS) levels were found significantly lower in benign proliferative pathologies and cancer disease compared to healthy subjects. We conducted this prospective study to investigate the possible predictive and prognostic significance of these markers in non-small cell lung cancer (NSCLC), which is one of the most associated cancers with oxidative stress. This was a non-randomized, prospective, and case-control study of 120 subjects, including 60 patients with metastatic or inoperable NSCLC at the time of diagnosis and 60 demographically-matched controls. Morning fasting venous blood serum samples from both NSCLC and control group were stored at -80 degrees C for equal periods and then TT, NT, and SS levels were measured spectrophotometrically. Serum TT, NT, and SS levels were compared between groups and their relationships with demographic features and survival of NSCLC patients were analyzed. In results, Serum TT, NT, and SS levels were significantly lower in NSCLC patients than those in control group, with a low SS level being an independent indicator of poor survival.Öğe The relationship between depression, anxiety, and pain catastrophising in cancer patients(Termedia Publishing House Ltd, 2020) Inci, Fatih; Inci, Habibe; Kilincel, Oguzhan; Ersoy, Suleyman; Karatas, Fatih; Adahan, DidemIntroduction: Catastrophising is a person's view of an unreasonable belief and a worse situation than exaggerating its consequences. It is defined as individuals believing that their current condition and physical discomfort will worsen each time or that something will be worse than it actually is. The aim of this study was to evaluate the relationship between depression and anxiety and pain catastrophising in cancer patients. Material and methods: Fifty-five cancer patients who were followed and treated in the Oncology Outpatient Clinic were included in the study. The age, gender, marital status, occupation, and psychiatric history of the participants were recorded. A socio-demographic data form, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and the Pain Catastrophising Scale (PCS) were applied to the participants. Results: The mean age of the participants was 59.2 +/- 12.7 years, and 40% were female. When the total BDI and BAI scale scores of cancer patients were evaluated, it was seen that they were not depressed in terms of mean value (p = 0.112), but they were in the anxiety scale (p < 0.05). There was a positive correlation between depression and anxiety, as well as depression and anxiety and pain catastrophising (p < 0.001, r = 0.782). While the PCS subscales helplessness and rumination scores were significantly higher in cancer patients with depression and anxiety (p < 0.001), the magnification score was significantly higher in cancer patients with anxiety (p < 0.001). The Pain Catastrophising Scale total score increased with increasing BDI and BAI severity (p < 0.001), while the BDI and BAI scores were found to be significantly higher in females than males (p < 0.001). Conclusions: It was found that cancer patients were generally not depressed but were anxious, and the catastrophising of pain increased with increasing depression and anxiety severity. Health professionals giving care to cancer patients need to be alert to signs of psychological distress in patients experiencing pain.Öğe Self-esteem, metacognition, and coping strategies in cancer patients: A case-control study(Wolters Kluwer Medknow Publications, 2021) Inci, Habibe; Inci, Fatih; Ersoy, Sueleyman; Karatas, Fatih; Adahan, DidemBackground: Self-esteem refers to a person's positive and negative attitudes towards the self, and metacognition is an upper system providing awareness and direction of events and mental functions. Coping refers to the specific and psychological efforts used to deal with stressful events or the negative effects of the agents of these. The aim of this study was to evaluate self-esteem, metacognition status and coping attitudes in patients with cancer, which is known to have severely destructive psychological effects. Materials and Methods: Fifty adult cancer patients who were followed up in the medical oncology clinic between July 2018 and June 2019 and 50 age- and gender-matched healthy controls as control group were included in this study. All the participants were applied with a sociodemographic data form, the Rosenberg self-esteem scale, the Metacognition Assessment Scale, and the Copying Orientation to Problems Experienced (COPE) inventory, and their results were compared between the groups. Results: The groups comprised 50% females with a median age of 58 (33-82) years. The values related to the degree of participation in discussions, problem-focused coping, active coping, planning, and state of emotional vulnerability were low in the cancer patient group compared to the control group (P < 0.005 for all). The sustaining of their self-image, feeling threatened in interpersonal relationships, and degree of daydreaming were higher, and in the metacognition tests, the positive beliefs related to anxiety, uncontrolled or dangerous negative thoughts, nonfunctional coping, religious coping, joking, reckless behavior, substance use, denial, and mental disengagement scores were higher (P < 0.05 for all). Conclusion: Self-esteem was lower in cancer patients and upper level cognitive functions and problem-focused coping were determined to be worse compared to healthy controls. In the light of these results, psychosocial support given to cancer patients in this respect could contribute to quality of life and social conformity.Öğe An unusual cause of anaemia: Rapunzel syndrome, a case report(Pakistan Medical Assoc, 2020) Ozkan, Aysegul Ertinmaz; Danis, Nilay; Altundal, Mustafa; Sevencan, Nurhayat Ozkan; Karatas, Fatih; Kayhan, BurcakTrichobezoars present with stomach ache and with a mass in the stomach. It's common in the young and middle-aged women having psychiatric disorder, presenting with stomach ache and existence of mass in the stomach. Although it's one of the rare causes of anaemia it should be considered when dealing with cases of chronic and unresponsive anaemia.
