GÝRÝÞ ve AMAÇ: Kolorektal kanser (KRK), tüm dünyada en sýk görülen üç kanser tipi arasýndadýr. KRK hastalarýnýn %10’undan azý herediter KRK sendromlarýný oluþturan germline mutasyonlar ile iliþkilidir. Bu hastalýklarýn baþýnda adenomatöz poliple giden ailesel adenomatöz polipoziste (FAP) APC geni mutasyonlarý gelir. Çalýþmamýzda Türk toplumunda gözlenen APC mutasyonlarýnýn tipini ve yapýsýný belirlemeyi amaçladýk.
YÖNTEM ve GEREÇLER: Kliniðimize FAP nedeniyle 24 hasta baþvurdu. Bu hastalardan çalýþma için periferik kan örneði alýnýp, DNA izolasyonu yapýldý. Sekanslama iþlemi Illumina MiSeq sisteminde yeni nesil dizileme yöntemi ile gerçekleþtirildi. Veri analizleri QIAGEN Clinical Insight (QCITM) üzerinde gerçekleþtirildi.
BULGULAR: 24 hastanýn 6’sýnda (%25) patojenik mutasyon tespit edilirken, bir hastada iki farklý patojenik mutasyon (c.3183_3187delACAAA ve c.163C>T) tespit edildi. c.2309C>G(p.S770*) mutasyonu iki kardeþte tespit edildi. Bunlar dýþýnda c.4393_4394delCC(p.S1465fs*3), c.4405_4406dupCA(p.Q1469fs*5), c.4312delA(p.T1438fs*35), c.3927_3931delAAAGA(p.E1309fs*4) mutasyonlarý tespit edildi.
TARTIÞMA ve SONUÇ: FAP’ýn nedenlerinden olarak en sýk APC genindeki mutasyonlar bildirilmiþtir. Literatürde 2000’den fazla mutasyon yer almaktadýr. Bizim çalýþmamýzda literatür ile uyumlu olarak %25 patojenik mutasyon saptandý. Bu mutasyonlardan 1. ekzondaki c.163C>T (p.Q55*) ile 16. Ekzondaki c.4312delA(p.T1438fs*35), c.4405_4406dupCA (p.Q1469fs*5), ilk defa bizim çalýþmamýzda bildirilmektedir. Yeni mutasyonlarýn bildirilmesi ile genin özellikle 16. ekzon dýþýnda 1. ve 14. ekzonlarýnýn da önemli yer alabileceðini ve yeni mutasyonlarla genin yapýsýnýn daha iyi anlaþýlabileceði görülmektedir.

INTRODUCTION: Colorectal cancer (CRC) is among the three most common types of cancer worldwide. Less than 10% of CRC patients are associated with germline mutations that form hereditary CRC syndromes. APC gene mutations in the familial adenomatous polyposis (FAP) leading to the adenomatous polyp are at the top of these diseases. In our study, we aimed to determine the type and structure of APC mutations observed in Turkish society.

METHODS: 24 patients applied to our clinic for FAP. Peripheral blood sample was collected from these patients and DNA isolated. Sequencing was performed with the new generation sequencing method in the Illumina MiSeq system. Data analyzes were performed on QIAGEN Clinical Insight (QCITM).

RESULTS: Pathogenic mutation was detected in 6 (25%) of 24 patients, while two different pathogenic mutations (c.3183_3187delACAAA and c.163C> T) were detected in one patient. The c.2309C> G (p.S770*) mutation was detected in two siblings. In addition, c.4393_4394delCC (p.S1465fs*3), c.4405_4406dupCA (p.Q1469fs*5), c.4312delA (p.T1438fs*35), c.3927_3931delAAAGA (p.E1309fs*4) mutations were detected.

DISCUSSION AND CONCLUSION: As the main causes of FAP, mutations in the APC gene have been reported most frequently. There are more than 2000 mutations in the literature. In our study, 25% pathogenic mutations were detected in accordance with the literature. Of these mutations, c.163C> T (p.Q55*) in exon 1 and c.4312delA (p.T1438fs*35) in exon 16, are reported for the first time. With the reporting of new mutations, it is seen that especially the 1st and 14th exons besides the 16th exon can take place and the structure of the gene can be better understood with new mutations.

GÝRÝÞ ve AMAÇ: Akut lösemiler kemik iliðinde blastik hücrelerin kontrolsüz çoðalmasý ile karekterize heterojen bir hastalýk grubudur. Tedavi ve hastalýk seyrinde yüksek mortalite ve morbidite görülebilir. Bu hasta grubunde solunum yetmezliði yüksek mortalite ile iliþkili bulunmuþtur. Bu çalýþmada akut lösemi hastalarýnda solunum destek ihtiyacý geliþim oranýnýn, risk faktörlerinin ve prognostik faktörlerin belirlenmesi amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: 2003–2014 yýllarý arasýnda takip edilen tüm akut lösemi hastalarý çalýþmaya retrospektif olarak dâhil edildi.Ekstrapulmoner nedenle solunum desteði ihtiyacý duyan hastalar risk faktörleri ve prognozun belirlenmesi ile ilgili istatistiksel analizlere dâhil edilmediler Hastalarýn demografik özellikleri, solunum destek ihtiyacý oraný ve nedenleri, solunum yetmezliði geliþimi için risk faktörleri ve prognozu etkileyen faktörler belirlendi. Solunum desteði gereken hastalarýn saðkalým analizleri yapýldý.
BULGULAR: Toplam 460 hasta çalýþmaya dahil edildi. Tüm akut lösemi hastalarý arasýnda %30,6 oranýnda solunum desteði verildiði saptandý. En sýk neden pnömoni idi. Solunum yetmezliði geliþme riskini belirlemek için yapýlan çok deðiþkenli analiz sonucunda yaþ, ECOG performans skoru, antibiyotik profilaksisi almamak, nötropenik atak sýrasýnda pulmoner infiltrasyon varlýðý ve indüksiyon ya da reindüksiyon kemoterapileri baðýmsýz risk faktörleri olarak saptandý. Baðýmsýz risk faktörlerinin regresyon katsayýlarýna göre puanlama yapýldý ve 6 puan ve üzeri yüksek riskli olarak belirlendi. Hastalarýn 60 günlük total sað kalým ihtimali % 5,5 olarak hesaplandý.
TARTIÞMA ve SONUÇ: Bu çalýþmada akut lösemi hastalarýnda solunum desteði ihtiyacýnýn oldukça sýk olduðu ve yüksek mortalite ile seyrettiði belirlendi. Yüksek riskli hastalarýn saptanabilmesinin önemli klinik faydalarý olabileceði için geliþtirdiðimiz risk skorlamasý uygun çalýþmalarla valide edilerek klinik pratikte kullanýlabilir.

INTRODUCTION: Acute leukemia is a group of heterogeneous diseases characterized by proliferation of blastic cells in bone marrow. and high mortality and morbidity are seen during the disease and treatment course. In these patients, respiratory failure are found that related to the high mortalities. In this study, we aimed to determine rate of respiratory support, prognostic factors and risk factors for acute leukemia.
METHODS: All acute leukemia patients followed in our center between 2003 and 2014 were included in this study, retrospectively. Extra-pulmonary causes (neurological causes, hemodynamic instability and cardiopulmonary arrest) which were excluded from the statistical calculations for risk analysis and prognosis. Demographic characteristics of patients, respiratory support rate and etiologies, risk factors for respiratory failure and prognostic factors were determined and overall survival of patients who needed respiratory support was determined..
RESULTS: Totally, 460 patients included to the study. The rate of respiratory support was 30.6% (139/460) and pneumonia was the most common cause of respiratory failure. In multivariate analysis, age, ECOG performance status, febrile neutropenia prophylaxis, pulmonary infiltration during neutropenia episode and induction or reinduction chemoterapies were determined as independent risk factors for respiratory failure in acute leukemia. A statistical model for risk prediction was developed based on regression coefficient of independent risk factors, and 6 points and more were considered as high risk. The 60-days overall survival of patients who needed mechanical ventilation was 5.5%.
DISCUSSION AND CONCLUSION: In this study, we found that the need for respiratory support during acute leukemia treatment was quite frequent. As determination of high risk patients may provide important clinical benefits, validation of our risk scoring system by appropriately designed studies has utmost importance.

GÝRÝÞ ve AMAÇ: Bu çalýþmada, arý sütünün Siklofosfamid (CP) ile indüklenmiþ Karaciðer hasarýnýn yol açtýðý histopatolojik deðiþiklikler üzerinde koruyucu etkileri deðerlendirildi.
YÖNTEM ve GEREÇLER: Çalýþmada 32 Wistar albino cinsi sýçan rastgele 4 gruba ayrýldý: Kontrol (0.5 cc serum fizyolojik 16 gün boyunca oral yolla verildi), Arý Sütü Grubu (100 mg / kg arý sütü 16 gün boyunca oral yolla verildi), CP grubu (100 mg / kg intraperitoneal (tek doz) CP enjekte edildi), CP+Arý sütü grubu (100 mg / kg intraperitoneal CP enjekte edildi ve ayrýca 16 gün boyunca 100 mg / kg arý sütü oral yolla verildi). Deneysel çalýþma tamamlandýktan sonra, her bir hayvandan karaciðer dokularý çýkarýldý ve % 10 formaldehit içerisinde fikse edildi. Ardýndan karaciðer dokularý histopatolojik olarak incelendi.
BULGULAR: Kontrol ve Arý sütü ile muamele edilen gruplardaki karaciðer dokusunun morfolojik olarak normal bir histolojik yapýya sahip olduðu gözlendi. Ancak, CP uygulanan grupta hepatositlerde dejenerasyon, sinüzoidal dilatasyon ve inflamasyon gibi toksik etkiler saptandý. CP ile birlikte Arý sütü uygulanan grupta arý sütünün antioksidan özelliði sayesinde karaciðer dokusunda CP kaynaklý yapýsal deðiþiklikleri onardýðý ve toksik etkiye karþý koruduðu tespit edildi.
TARTIÞMA ve SONUÇ: Arý sütü, CP’nin neden olduðu hepatotoksisiteye karþý koruyucu bir doðal ürün olabilir.

INTRODUCTION: The aim of the present study to evaluate the protective effects of Royal Jelly on the changes caused by Cyclophosphamide (CP)- induced liver damage.
METHODS: 32 Wistar albino rats were divided randomly into 4 groups: Control (0.5 cc saline was given orally for 16 days), Royal Jelly group (100 mg / kg Royal Jelly was given orally for 16 days) CP group (100 mg / kg intraperitoneal (singledose) CP was injected), CP+Royal Jelly group (100 mg / kg intraperitoneal CP was injected and also 100 mg / kg Royal Jelly was given orally for 16 days). After the experimental study was completed, liver tissues were removed from each animal and fixed in 10% formaldehyde. And then liver tissues were examined histopathologically.
RESULTS: The liver tissue of the Control with the Royal Jelly treated groups had normal histological structures. However, toxic effects were observed such as degeneration of hepatocytes, sinusoidal dilatation and inflammation in the cyclophosphamide applied group. In the CP with Royal Jelly applied groups, Royal Jelly restored the CP-induced structural alterations in the liver tissue by the way of its antioxidant.
DISCUSSION AND CONCLUSION: Royal Jelly may be a potential preventive natural product against the hepatic toxicity associated with CP therapy.

GÝRÝÞ ve AMAÇ: Akut myeloid lösemi(AML) yaþlý populasyonda sýklýðý artan hematolojik malignitedir. Düþkün ve yaþlý hastalarda düþük yoðunluktaki tedaviler ve destek tedavisi uygun seçenekler olarak öngörülmektedir. On yýllarda hipometile edici ajanlarýn kullanýmý ile tedavi alanýnda olumlu geliþmeler yaþanmýþtýr. Çalýþmamýzýn amacý merkezimizde ileri yaþ AML hastalarýmýzda tedavi protokolu olarak uyguladýðýmýz etoposit ve sitozin arabinozid(AraC) ile güçlendirilmiþ azasitidin(AZA) kombinasyon rejiminin etkinliðini araþtýrmaktýr.
YÖNTEM ve GEREÇLER: Takip ettiðimiz ileri yaþta ve performans durumu nedeni ile yoðun tedaviler için uygun olmayan yeni taný AML hastalarý retrospektif olarak incelenmiþtir. Yaþ, performans durumu, komorbidite açýsýndan benzer iki grup oluþturulmuþ, bir grup (n: 32) AZA-etoposit-AraC kombinasyonu ile tedavi edilirken, diðer grup (n: 32) düþük doz sitozin arabinozid ve/veya hydroksiüre ile tedavi edilmiþtir. Gruplar kendi aralarýnda hematolojik parametreler, takip süresi, yanýt durumu ve sað kalým açýsýndan karþýlaþtýrýlmýþtýr.
BULGULAR: Azasitidin kombinasyonu ile tedavi edilen sekiz hastada tam yanýt veya enaz parsiyel yanýt elde edilmiþtir (p: 0.011). 30 günlük mortalite düþük yoðunluklu tedavi kolunda anlamlý olarak yüksek saptanýrken, toplam sað kalým açýsýndan her iki grupta farklýlýk saptanmamýþtýr (sýrasýyla p: 0.005 and p: 0.092)
TARTIÞMA ve SONUÇ: Yoðun tedavileri alamayan, ileri yaþ ve düþkün hastalar tedavi edilme açýsýndan cesaretlendirilmelidir. Özellikle geliþmekte olan ülkelerde, hipometile edici ilaçlarla pahalý ve ulaþýlmasý zor moleküllerin kombinasyonlarýnýn yanýsýra ucuz ve eriþimi kolay moleküllerin kombinasyonlarýna ihtiyaç vardýr. Yanýt avantajý saðlayan azasitidin-etoposit-sitozin arabinozid kombinasyon tedavisini seçili hastalarda uygulanmasýný öneriyoruz.

INTRODUCTION: Acute myeloid leukemia (AML) is a hematological malignancy that affects the older population. Low intensive therapies and the best supportive care are considered better options for frail and older patients. In last decades treatment approaches have been hopefull with the hypomethylating agents for this population. The aim of this study is to investigate the efficacy of combination therapy including azacytidine (AZA), etopocide and cytosine arabinoside(Ara-C), which is used as standard care for unfit and older AML cases in our hematology department.
METHODS: Retrospectively, we analyzed our newly-diagnosed older AML patients who were ineligible for intensive regimens due to unfit performance status. Groups with similar age, ECOG performance status and comorbidity were compared in terms of hematological parameters, follow-up, response status and survival. While 32 patients were treated with a combined hypomethylating agent protocol, other patients (n: 32) received low intense therapy including low dose Ara-C and/or daily hydroxyurea (HU).
RESULTS: Eight patients who treated with combined protocol achieved complet remission and parsial remission least. (p: 0.011) While 30 day-mortality was found significantly higher in patients treated with the low intense therapy than AZA combined protocol, overall survival was found similar (resp. p: 0.005 and p: 0.092).
DISCUSSION AND CONCLUSION: Treatment should be encouraged for older AML patients who are not eligible for intensive therapy due to comorbidities and poor performance. While combinations of HMA with new investigational therapies are promising strategies, there is a need for the investigation of new combinations of HMA with easily accessible agents for developing countries where expensive new agents are not available. With the survival and response advantage, AZA-etopocide-AraC combination therapy can be a treatment option for selected patients.

GÝRÝÞ ve AMAÇ: Bu çalýþmada prostat kanseri nedeniyle radikal prostatektomi uyguladýðýmýz hastalarýmýzda iðne biyopsisi örnekleri ile radikal prostatektomi örnekleri arasýndaki uyumu deðerlendirmeyi amaçladýk.
YÖNTEM ve GEREÇLER: Retrospektif çalýþmada, Kasým 2010 – Mayýs 2020 tarihleri arasýnda prostat kanseri nedeniyle radikal prostatektomi yapýlan 167 erkek hasta deðerlendirildi. Patolojik tanýlarý merkezimizde yapýlan iðne biyopsisi ile konulan ve radikal prostatektomi öncesi prostat kanserine yönelik herhangi bir tedavi almamýþ hastalar çalýþmaya dahil edildi. Ýðne biyopsileri dýþ merkezde yapýlan 92 hasta, patolojik tanýlarý transüretral rezeksiyon materyali ile konulan 2 hasta ve radikal prostatektomi öncesinde hormonoterapi alan 1 hasta ile radyoterapi alan 1 hasta çalýþma dýþý býrakýldý.
BULGULAR: Çalýþmaya dahil edilen toplam 71 hastanýn yaþ ortalamasý 62.3 ± 6.0 (aralýk, 46 – 75) yýl, taný öncesi ortalama PSA düzeyi ise 10.0 ± 7.6 (aralýk, 3.2 – 48.1) ng/mL idi. 31 (%43.7) hastada parmakla rektal muayenede þüpheli bulgu mevcuttu.
Ýðne biyopsisi örnekleri ile radikal prostatektomi örnekleri arasýndaki Gleason skoru, prognostik grup ve tümör lateralitesi açýsýndan uyum sýrasýyla %66.2, %59.2 ve %74.6 idi.
TARTIÞMA ve SONUÇ: Prostat kanseri tanýsý konulan hastalarda iðne biyopsisi örneklerinin patolojik deðerlendirmesi tedavi yöntemlerinin belirlenmesinde kritik role sahiptir. Bununla birlikte, iðne biyopsisi örneklerinin prostat patolojisini yüksek bir uyumla öngörmediði akýlda tutulmalýdýr.

INTRODUCTION: In this study, we aimed to evaluate the concordance between needle biopsy samples and radical prostatectomy samples in our patients who underwent radical prostatectomy for prostate cancer.
METHODS: In this retrospective study, 167 male patients who underwent radical prostatectomy for prostate cancer between November 2010 and May 2020 were evaluated. Patients whose pathological diagnoses were made by needle biopsy at our center and who did not receive any treatment for prostate cancer before radical prostatectomy were included in the study. 92 patients whose needle biopsies were performed in a different center, 2 patients whose pathological diagnosis was made with transurethral resection material, 1 patient who received hormonotherapy before radical prostatectomy and 1 patient who received radiotherapy were excluded.
RESULTS: The mean age of 71 patients included in the study was 62.3 ± 6.0 (range, 46 - 75) years, and the mean PSA level before diagnosis was 10.0 ± 7.6 (range, 3.2 - 48.1) ng / mL. Suspicious findings were found on digital rectal examination in 31 (43.7%) patients.
The concordance between needle biopsy samples and radical prostatectomy samples was 66.2%, 59.2% and 74.6%, respectively, in terms of Gleason score, prognostic group and tumor laterality.
DISCUSSION AND CONCLUSION: Pathological evaluation of needle biopsy samples has a critical role in determining the treatment methods in patients diagnosed with prostate cancer. However, it should be borne in mind that needle biopsy specimens do not predict prostate pathology with high concordance.

GÝRÝÞ ve AMAÇ: Sistemik inflamasyon ve immün yanýt kanser prognozu ile yakýndan iliþkilidir. Sistemik immün-inflamasyon indeks (SII), prognostik nutrisyonel indeks (PNI) ve C-reaktif protein / albümin oranýnýn (CAO) çeþitli kanserlerde prognostik olduðu bilinmektedir. Bununla birlikte, epitelyal over kanseri (EOK) vakalarýnda, inflamatuar indeksler hakkýnda çok az bilgi vardýr. Bu nedenle biz bu çalýþmada EOK hastalarýnda SII, PNI ve CAO gibi inflamasyon temelli indekslerin prognostik önemini araþtýrdýk.
YÖNTEM ve GEREÇLER: EOK’lu 273 hasta retrospektif olarak çalýþmaya dahil edildi. Klinik deðiþkenlerle progresyonsuz yaþam süresi (PYS) ve genel saðkalým (GS) arasýndaki iliþki Kaplan – Meier yöntemi ile analiz edildi. En iyi sýnýr deðerler ROC eðrisi analizi kullanýlarak belirlendi. SII, PNI ve CAO sýrasýyla 1559, 42.1 ve 3.11 kesme noktalarýna göre sýnýflandýrýldý. GS için deðiþkenlerin prognostik önemi Cox regresyon modeli ile belirlendi.
BULGULAR: EOK hastalarýnda düþük SII (<1559), yüksek PNI (≥42.1) ve düþük CAO (<3.11) daha uzun PYS ve GS süreleri ile iliþkili bulundu. Tek deðiþkenli analizde yaþ, menopoz durumu, ECOG skoru, epitelyal alt tip, evre, SII, PNI ve CAO’nun GS ile anlamlý iliþkisi vardý. Çok deðiþkenli analizde evre, SII ve PNI, GS için baðýmsýz prognostik faktörler olarak bulundu (p <0.001, p <0.024, p <0.006, sýrasýyla).
TARTIÞMA ve SONUÇ: Tedavi öncesi SII ve PNI, EOK hastalarýnda GS’yi predikte etmek için kullanýlabilecek prognostik biyobelirteçlerdir.

INTRODUCTION: Systemic inflammation and immune response are closely related to cancer prognosis. Systemic immune-inflammation index (SII), prognostic nutritional index (PNI) and C-reactive protein/albumin ratio (CAR) are known to be prognostic in various cancer. However, in epithelial ovarian cancer (EOC) cases, there is little information about inflammatory indexes. Therefore, we investigated the prognostic importance of inflammation-based indexes such as SII, PNI and CAR in EOC patients.
METHODS: Two hundred and seventy three patients with EOC were included in this study retrospectively. Relationship between clinical variables with progression-free survival (PFS) and overall survival (OS) were analyzed via Kaplan–Meier method. The best cut-off points were determined using a receiver operating characteristic (ROC) curve analysis. SII, PNI, and CAR were classified based on cutoff points 1559, 42.1 and 3.11, respectively. Prognostic importance of the variables for OS was determined with the Cox regression model.
RESULTS: Low SII (<1559), high PNI (≥42.1) and low CAR (<3.11), were found to be associated with longer PFS and OS times in patients with EOC. In univariate analysis, age, menopausal status, Eastern Cooperative Oncology Group (ECOG) score, epithelial subtype, stage, SII, PNI and CAR were significantly associated with OS. In multivariate analysis stage, SII and PNI were found to be independent prognostic factors for OS (p <0.001, p <0.024, p<0.006, respectively).
DISCUSSION AND CONCLUSION: Pre-treatment SII and PNI are prognostic biomarkers that can be used to predict OS in patients with EOC.

GÝRÝÞ ve AMAÇ: Kanserli hastalarda tümörün kendisine ait ve tedavi iliþkili böbrek yetmezliði geliþebilmektedir. Onkolojik hasta popülasyonunda güncel sýnýflama kriterleri ile akut böbrek yetmezliði epidemiyolojine iliþkin düzenli ve sistematik bilgilere ihtiyaç vardýr. Bu çalýþma kanser hastalarýnda geliþen böbrek yetmezliklerini etiyolojilerine göre sýnýflamak ve risk gruplarýný belirlemek için planlanmýþtýr.
YÖNTEM ve GEREÇLER: Çalýþmaya onkoloji servisine herhangi bir nedenle yatmýþ ve böbrek yetmezliði tespit edilmiþ 100 hasta dahil edildi. Hastalarýn verileri retrospektif olarak incelendi. Böbrek yetmezliði varlýðý RIFLE-AKIN kriterlerine göre belirlendi ve hastalar prerenal, renal ve postrenal böbrek yetmezliði gruplarýna ayrýldý. Eþik eden hastalýklar ve böbrek yetmezliðinin spesifik nedenleri bu üç grup baz alýnarak chi square istatistiksel yöntemi ile karþýlaþtýrýldý
BULGULAR: Solid tümörlü hastalarda en sýk böbrek yetmezliði tipi prerenal nedenlere baðlýydý (%55). Prerenal böbrek yetmezliðinde en sýk spesifik neden oral alým azlýðý ve gastrointestinal kayýptý. Prerenal, renal ve postrenal böbrek yetmezlik gruplarý arasýnda yaþ ortalamalarý (p=0.256), cins (p=0.259), diyabetes mellitus (p=0.739), hipertansiyon (p=0.789) sigara içim (p=0.945) ve kemoterapötik ajan kullanýp kullanmama (p=0.339) sýklýðý açýsýndan önemli bir farklýlýk tespit edilmedi. Bu popülasyonda iskemik akut tubüler nekroz sýklýðýnda bariz bir artýþ gözlendi.
TARTIÞMA ve SONUÇ: Kanserli hastalarda böbrek yetmezliði geliþim nedenleri farklýlýk gösterebilir. Onkolojik hasta popülasyonunda bu nedenlerin iyi dökümente edilmesi, kanserli hastalarýn saðkalým sürelerini uzatabilir. Geliþmekte olan ülkelerdeki kanserli tüm hastalarda, böbrek yetmezliði etiyolojisini güncel bilgilerle deðerlendirecek çok merkezli prospektif çalýþmalara ihtiyaç vardýr.

INTRODUCTION: The aim of this study is to evaluate the etiology of renal failure in patients with solid tumor.
METHODS: The study was included 100 patients with acute renal failure. These patients were selected among hospitalized patients with solid tumor in Dr. Abdurrahman Yurtaslan Ankara Oncology Education and Research Hospital. The data of these patients were analyzed retrospectively. The presence of acute kidney injury was determined according to RIFLE-AKIN criteria. The patients were retrospectively classified into the following 3 groups: Prerenal, renal and postrenal acute kidney injury (AKI) groups. In these groups, specific causes of renal failure and comorbidities such as diabetes, coronary arteria disease etc. were compared using the chi square statistical analyze.
RESULTS: The most common type of renal failure in patients with solid tumor was prerenal acute kidney injury (%55). The most common specific cause in all groups with prerenal AKI was inadequate oral intake and gastrointestinal loss. No significant difference was detected in terms of the average age (p=0.256) and in terms of frequency of sex, diabetes mellitus, hypertension, smoking, whether chemotherapeutic agents in three groups (p=0.259, p=0.739, p=0.789, p=0.945, p=0.339). There was a marked increase in the frequency of ischemic acute tubular necrosis in the study population.
DISCUSSION AND CONCLUSION: The causes of acute renal failure may differ from actuarial estimates in patients with cancer. Complete documentation of these causes in this population with tumor may increase surveys of these patients. In developing countries, multicenter prospective trials are needed to evaluate the etiology of all renal failure in this population.

GÝRÝÞ ve AMAÇ: Endoskopik retrograd kolanjiyopankreatografi (ERCP) pankreatikobiliyer hastalýklarýn taný ve tedavisinde önemli bir yöntemdir. Bu çalýþmada ERCP sonuçlarýnýn, iþlem sýrasýnda yapýlan müdahalelerin, iþlem sonrasý geliþen komplikasyonlarýn ve ERCP sýrasýnda yapýlan müdahaleler ile komplikasyonlar arasýndaki iliþkilerin deðerlendirilmesi amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Çalýþmaya 574 hastaya yapýlan 774 ERCP iþlemi dahil edilmiþ ve vakalar retrospektif olarak incelenmiþtir.
BULGULAR: Endoskopik kanülizasyon %88,4 vakada baþarýlýydý. Ýþlem sonrasý en çok rapor edilen sonuçlar sýrasýyla koledokolitiyazis (%39,5), koledokta darlýk (%22) ve mikrolitiyazis (%20,9) idi. Ýþlem sonrasý klinik olarak anlamlý komplikasyon görülme oraný toplamda %14,8 idi. Pankreatit %9,8, klinik olarak anlamlý kanama %4, kardiyopulmoner komplikasyonlar ise %1,9 oranýnda görüldü. Mortalite oraný %0,9 olarak bulundu. Baþarýsýz kanülizasyon sonucuna sahip vakalarda daha sýk ön kesi yapýldýðý tespit edildi (p=0,000). Ön kesi yapýlan vakalarda kanama ve pankreatit komplikasyonlarý daha sýk tespit edildi (p=0,009; p=0,007). Pankreatik stent uygulanan vakalarda pankreatit komplikasyonu daha sýk tespit edildi (p=0,001).
TARTIÞMA ve SONUÇ: Post-ERCP pankreatit ve kanama riskini azaltmak adýna ön kesi iþlemlinden mümkün oldukça kaçýnýlmasý; baþarýsýz kanülizasyon halinde papillayý daha fazla travmatize etmek yerine iþlemin sonraki bir seansa ertelenmesi; PEP riskini azaltmak amacý ile pankreatik stent takýlmasý iþleminin ise sadece bu konuda çok deneyimli merkezlerce gerçekleþtirilmesi uygun olacaktýr.

INTRODUCTION: Endoscopic retrograde cholangiopancreatography (ERCP) is an important procedure in diagnosis and treatment of pancreaticobiliary diseases. In this study we aimed to evaluate outcomes, procedural interventions, complications and relations between procedural interventions and complications of ERCP procedures.
METHODS: A total of 774 ERCP procedures performed on 574 patients were included and investigated retrospectively in this study.
RESULTS: Endoscopic cannulation was successful in 88.4% of the cases. The most reported outcomes were choledocholithiasis (39.5%), stenosis in the common bile duct (22%) and microlithiasis (20.9%). The incidence of clinically significant procedure related complications was 14.8% in total. Pancreatitis was observed in 9.8% of the cases, clinically significant bleeding was observed in 4% of the cases, and cardiopulmonary complications were observed in 1.9% of the cases. The mortality rate was found to be 0.9%. Pre-cut sphincterotomy technique was found to be more frequently applied in failed cannulation cases (p=0.000). Post-ERCP bleeding and pancreatitis were observed more frequently in cases which pre-cut sphincterotomy technique was applied (p=0.009; p=0.007). Post-ERCP pancreatitis was found to be more frequent in cases which pancreatic stent implantation was performed (p=0.001).
DISCUSSION AND CONCLUSION: It would be appropriate to avoid pre-cut sphincterotomy as much as possible in order to reduce the risk of post-ERCP pancreatitis and bleeding; to postpone the procedure to a latter session in case of failed cannulation instead of traumatizing the papilla further; and prophylactic pancreatic stenting should only be performed in highly experienced centers.

GÝRÝÞ ve AMAÇ: Akciðer kanseri, 2018 yýlý verilerine göre tüm dünyada iki milyonun üstünde yeni vakayla en sýk görülen kanser tipidir ve kansere baðlý ölümlerin %18,4’ünü oluþturur. Oksidatif stres, karsinogenezin tüm basamaklarýnda rol oynayabilir. Bu çalýþmada, KHDAK hastalarýnda taný anýnda antioksidan kapasitenin bir göstergesi sayýlabilecek tiyol-disülfit dengesinin deðerlendirilmesi ve saðlýklý kontrollerle karþýlaþtýrýlmasý amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Yeni taný ileri evre KHDAK olan 43 hasta ve hasta grubuyla yaþ ve cinsiyet açýsýndan uyumlu 50 saðlýklý kontrol çalýþmaya dahil edildi. Hastalarýn tiyol-disülfit homeostaz analizi için gerekli olan kan örnekleri taný anýnda elde edildi. Hasta ve kontrol grubunun serum tiyol ve disülfit örnekleri otomatik spektrofotometrik metod ile ölçüldü. Hastalarýn klinik, radyolojik ve laboratuvar özellikleri kaydedildi.
BULGULAR: Doðal tiyol ve toplam tiyol deðerlerinin hasta grubunda kontrol grubuna kýyasla anlamlý þekilde düþük olduðu gösterildi (p<0,001). Disülfit düzeyleri ve antioksidan kapasite göstergelerinden disülfit / doðal tiyol oraný açýsýndan gruplar arasýnda anlamlý fark saptanmadý. Ortanca genel saðkalým 9,1 ay (1,2 - 37,9 ay) olarak tespit edildi. Tiyol ve disülfit deðerlerinin saðkalým üzerine etkisi saptanmadý.
TARTIÞMA ve SONUÇ: Non-enzimatik antioksidan bileþiklerin baþýnda gelen tiyol bileþiklerinin hasta grubundaki düþük seviyeleri KHDAK patogenezinde üretimi artan ROS’nin eliminasyonu için gösterilen artmýþ kullanýma baðlý olabilir. Süreç içerisinde miktarý azalan antioksidan tiyol bileþikleri ayný zamanda ROS artýþýnýn hem nedeni hem sonucu olabilir. Disülfit deðerlerinin artmamasý artmýþ hücre döngüsüyle iliþkilendirilebilir.

INTRODUCTION: According to 2018 data, lung cancer is the most common cancer type with more than two million new cases worldwide and responsible for 18.4% of cancer-related deaths. Oxidative stress have a major role in every steps of carcinogenesis. In this study, we aimed to evaluate the thiol-disulfide balance, which can be considered as an indicator of antioxidant capacity, in NSCLC patients and to compare it with healthy controls.
METHODS: 43 patients with advanced NSCLC and 50 healthy controls enrolled to study. Blood samples for the analysis of thiol-disulfide homeostasis were obtained at the time of diagnosis in patient group. Serum thiol and disulfide samples of the patient and control groups were measured by automatic spectrophotometric method. Clinical, radiological and laboratory features of the patients were recorded.
RESULTS: Natural thiol and total thiol levels were significantly lower in the patient group compared to the control group (p<0.001). There was no significant difference between the groups in terms of disulfide levels and disulfide / natural thiol ratio which was an indicator of antioxidant capacity. Median overall survival was determined to be 9.1 months (1.2 - 37.9 months). Thiol and disulfide levels had not an effect on survival, significantly.
DISCUSSION AND CONCLUSION: Lower thiol level in patient group might be due to the increased usage for the elimination of ROS which contributes NSCLC pathogenesis. The amount of antioxidant thiol compounds that decrease in the process could be both the cause and the result of the ROS increase. The reason for disulfide values not increasing may be related to increased cell cycle.

GÝRÝÞ ve AMAÇ: Bu çalýþma, kemoterapi uygulanan hastalarda, kemoterapiye baðlý periferal nöropati, günlük yaþam aktivitesi ve yaþam kalitesi arasýndaki iliþkinin incelenmesi amacýyla yapýlmýþtýr
YÖNTEM ve GEREÇLER: Tanýmlayýcý tipteki bu araþtýrmanýn örneklemini Mart 2016- Aðustos 2016 tarihlerinde kemoterapi uygulanan 196 kanser hastasý oluþturmuþtur. Araþtýrmanýn verilerinin toplanmasýnda, Hasta Tanýtým Formu, Katz Günlük Yaþam Aktiviteleri Ölçeði, Enstrümantal Günlük Yaþam Aktiviteleri Ölçeði, EORTC QLQ-30 ve EORTC QLQ – CIPN20 ölçeði kullanýlmýþtýr
BULGULAR: Hastalarýn %62,2’si 46-65 yaþ arasýnda,%50,5’i kadýn, % 83’ü evli, %67,2’si ilköðretim mezunudur. Hastalarýn günlük yaþam aktivitelerinden yýkanma ve giyinmede kýsmen baðýmlýlýk düzeyleri yüksektir. Enstrümantal günlük yaþam aktivitelerinden çamaþýr yýkama, ev iþi yapmada baðýmlýlýk düzeyleri yüksektir. Taný süresi ve kemoterapi kür sayýnýn duyu, motor ve otonomik semptomlarda farklýlýk oluþturduðu belirlendi (p<0.05). Kemoterapiye baðlý periferal nöropati ölçeði ile yaþam kalitesi ölçeðinin genel saðlýk alt boyutu ile fonksiyonel saðlýk durumu arasýnda negatif, semptom skoru arasýnda ise pozitif kolerasyon saptanmýþtýr (p<0.01).
TARTIÞMA ve SONUÇ: Periferal nöropati kanser hastalarýnýn günlük ve enstrümental yaþam aktivitelerinde otonomi kaybýna neden olduðu; duyu, otonomik ve motor fonksiyonlarýný sýnýrladýðý ve yaþam kalitesini olumsuz yönde etkilediði belirlenmiþtir. Kanser hastalarýnda kemoterapiye baðlý nöropatinin günlük yaþam aktivitelerine etkisinin düzenli takip edilmesi, önleyici ve rehabilite edici giriþimlerin planlamasý önerilir

INTRODUCTION: Aim of the study was conducted to assesing the relationship between chemotherapy-induced peripheral neuropathy, daily life activity and quality of life in chemotherapy-treated patients.
METHODS: The sample of this descriptive study consisted of 196 cancer patients who underwent chemotherapy in the Medical Oncology Polyclinic Unit of the Akdeniz University between March 2016 to August 2016 and met the criteria for inclusion in the study. Participant Informed Consent Form, Patient Presentation Form, Katz Daily Activities Activity Scale, Instrumental Daily Activities Activity Scale, EORTC QLQ-30 and EORTC QLQ-CIPN20 scale were used to collect the data of the study.
RESULTS: 62.2% of the patients are between the ages of 46-65, 50.5% are women, 83% are married and 67.2% are primary school graduates. Partly the level of dependence on washing and dressing is higher than the daily activities of the patients. The degree of dependence of the instrumental daily life activities on washing and running errands is high (p<0.05). Sensory, motor and autonomic point averages were also found significantly higher in patients with increasing diagnosis duration and number of cures (p<0.05). Chemotherapy-induced peripheral neuropathy scale mean score and life quality scale subscale were negative between general health subscale and functional health status; Positive colaration was found between the symptom score. (p<0.01).
DISCUSSION AND CONCLUSION: It has been determined that peripheral neuropathy caused by chemotherapy leads to loss of autonomy in daily and instrumental life activities of patients; limits sense, autonomic, motor functions and negatively affects quality of life. It is recommended to regularly monitor the effects of chemotherapy-induced neuropathy on daily life activities in cancer patients and to plan preventive and rehabilitative interventions.

GÝRÝÞ ve AMAÇ: COVID-19 krizi sürecinde kanserli hastalarýnýn bakýmý ile ilgili önemli sorunlar bulunmaktadýr. Bu hasta grubunun hem kanser tedavilerinin gecikmesi ile karþýlaþýlabilecek önemli mortalite riski hem de kemoterapi, radyoterapi, immünoterapi gibi antikanser tedavilerine baðlý geliþebilecek immünsüpresif durumlarý nedeniyle olasý SARS-Cov-2 enfeksiyonu sýrasýnda kötü prognoz ve mortalite riski bulunmaktadýr. Bu nedenle pandemi dönemlerinde kanser hastalarýnýn tedavilerinin devam etmesi ve enfeksiyon riskinin en aza indirilmesi için önemli tedbirler alýnmasý gerekmektedir. Biz de tüm bu sorunlara cevap bulmak amacýyla hastanemiz acil servis, pandemi polikliniði, medikal onkoloji polikliniklerine COVID-19 bulgularý ile baþvurmuþ solid malignite tanýlý hastalarýmýzý retrospektif olarak taramayý amaçladýk
YÖNTEM ve GEREÇLER: 11 Mart 2020 - 11 Mayýs 2020 tarihleri arasýnda Ankara Dr. A. Yurtaslan Onkoloji Eðitim ve Araþtýrma Hastanesi medikal onkoloji polikliniði, acil servis ve pandemi polikliniðine COVID-19 hastalýðý semptom ve/veya bulgularý ile baþvuran ve daha önce solid organ malignitesi tanýsý olan, týbbý onkoloji kliniðimizde takipli 76 hasta retrospektif olarak incelendi.
BULGULAR: Baþvuruda en sýk görülen semptomlar;kuru öksürük (33, %43.4), ateþ (23, % 30.3), yorgunluk (23, %30.3) ve dispne (23, %30.3) idi. Otuz dokuz vakaya (%51.3) COVID-19 rRT-PCR testi yapýldý.Dört hastanýn (%5.2), COVID-19 rRT- PCR testi pozitif sonuçlandý.Bu sayý, ayný dönemde polikliniðimize baþvuran yaklaþýk altý bin kanser tanýlý hastalarýmýzýn % 0.06 ‘sýný oluþturuyordu. rRT-PCR testi pozitif hastalar; evre 2 meme ca, 2. basamak kemoterapi alan mesane ca ve kemonaif evre 4 mide ca olup yoðun bakýma ünitesine yatýþlarý gerekmedi ve iyileþmiþ olarak taburcu olduklarý öðrenildi
TARTIÞMA ve SONUÇ: Bulgularýmýz, mevcut pandemide kanser hastalarýnýn daha kötü seyrini ve mortalitesini desteklememektedir. Bu durumun hastanemizin, onkoloji aðýrlýklý hizmete devam edilmesi nedeniyle nisbeten korunaklý olup aktif covid hastasýnýn takip edilmemesinin
yanýsýra çalýþma sistemimizde yaptýðýmýz önemli deðiþikliklerden dolayý (triyaj, polikliniklerde yer deðiþikliði yaparak sosyal mesafe korunmasý, maske takýlmasý, remisyondaki kontrol hastalarý, kemoterapi öncesi semptom sorgulama ve danýþma için kullanýlan teletýp uygulamalarý gibi) kanser hastalarýnýn hastaneye geliþ sýklýklarýný azaltarak, COVID-19 enfeksiyon riskini azalttýðýmýzý düþünmekteyiz.

INTRODUCTION: Oncologists from all over the world have important problems about the follow up and treatment of cancer patients during the COVID-19 crisis.Cancer patients have a poor risk of prognosis during SARS-Cov-2 infection due to both the significant risk of mortality that can be encountered with delayed cancer treatments and immunosuppressive conditions.We aimed to evaluate solid cancer patients with COVID-19 findings retrospectively to find an answer about the management of these patients during outbreak.
METHODS: Between March 11,2020 and May 11,2020,76 patients who had solid organ malignancy were admitted to the Ankara Dr. A. Yurtaslan Oncology Training and Research Hospital with symptoms suggestive of COVID-19 infection were examined retrospectively.
RESULTS: The most common symptoms at admission were: dry cough, fever.COVID-19 RT-qPCR test was performed in 39 cases.The COVID-19 RT-qPCR test results were positive in four patients.This number constituted 0.06% of 6000 cancer-diagnosed patients admitted to our outpatient clinic.Among the patients who were positive for COVID-19 with RT-qPCR, one patient had stage2 breast carcinoma and was not actively receiving chemotherapy, another had newly-diagnosed stage 4 gastric carcinoma and was treatment-naïve, another was receiving radiotherapy and capecitabine for locally advanced rectal cancer, and the final patient had stage4 bladder cancer and was receiving second-line chemotherapy.Of these four patients, only one patient needed intensive care, while the other three recovered with intensive care-free medical treatment.
DISCUSSION AND CONCLUSION: Our findings do not support previous studies that have resulted in worse prognosis and mortality in cancer patients in the current pandemic.Our tertiary center based on oncology might provided the protection of COVID-19 infection due to non-followed COVID-19 positive patients.In addition, changes in our working system as; triage, displacement in polyclinics, communication by telemedicine with patients in remission, symptom questioning and consultation before chemotherapy, supply less frequency of routine hospital visits of cancer patients resulted reduced the risk of COVID-19 infection.

GÝRÝÞ ve AMAÇ: Grade IV gliom olan glioblastoma multiforme (GBM), yetiþkinlerde en sýk görülen primer beyin tümörüdür. Biyopsi veya rezeksiyonu takiben, radyoterapi (RT) eþ zamanlý ve adjuvan temozolomid (TMZ) kullanýmý (6 kür), yeni teþhis edilmiþ GBM vakalarý için standart tedavi haline gelmiþtir. Orijinal tedavi rejimi 6 kür TEMODAL kullanýmýný içermesine raðmen, bazý merkezler daha iyi sonuç elde etme umuduyla progrese olmayan hastalarda 12 veya daha fazla kür tedavi uygulamaktadýr. Butedavi yaklaþýmý tartýþmalýdýr. Çalýþmamýzýn temel amacý, hastalýksýz saðkalým (DFS) ve genel sað kalým (OS) açýsýndan standart kombine tedavi yaklaþýmý ile tedavi edilen hastalarda TEMODAL tedavisinin uzatýlmasýnýn (6 aydan 12 aya kadar) yararlý olup olmadýðýný belirlemektir.
YÖNTEM ve GEREÇLER: 2012-2019 yýllarý arasýnda retrospektif olarak 180 GBM hastasýný analiz ettik ve çalýþmaya dahil edilme kriterlerini karþýlayan 100 hastayý dahil ettik.
BULGULAR: 100 GBM hastasý geriye dönük olarak incelendi. Medyan OS 21 (18.47-23.52) ay iken, 6 kür TMZ alanlarda 24 (18.21-29.78) ay, 12 kür TMZ alan grupta 22 (18.50-25.49) ay ve adjuvan tedaviyi tamamlayamayanlarda 10 aydý. 6 ve 12 kür TMZ tedavisi arasýnda istatistiksel olarak anlamlý bir fark yoktu (p = 0.55). Adjuvan tedaviyi tamamlayamayan hastalar daha düþük sað kalýma sahipti ve bu grup, 6 ve 12 kür TMZ alan hastalara kýyasla istatistiksel olarak anlamlý bir OS farkýna sahipti (sýrasýyla p = 0.04 ve p = 0.024).
TARTIÞMA ve SONUÇ: Çalýþmamýz, GBM hastalarýnda adjuvan TMZ tedavisinin uzatýlmasýnýn yaþ, performans durumu ve tümör özelliklerinden baðýmsýz olarak ek bir sað kalým avantajý saðlamadýðýný göstermektedir.Ayrýca, standart 6 kür adjuvan tedaviyi tamamlayamayan GBM hastalarýnýn hayatta kalma oranlarý daha düþüktür.

INTRODUCTION: Glioblastoma multiforme (GBM), a grade IV malignant glioma, is the most common primary brain tumor in adults. Following biopsy or resection, radiotherapy (RT) and concomitant and adjuvant temozolomide (TMZ) use (6 cycles) have become the standard of treatment for newly diagnosed GBM cases. Although the original treatment regimen involves the use of 6 cycles of TMZ, some centers administer prolonged treatment up to 12 or more cycles in non-progressive patients in the hope of achieving better outcome. This form of administration is controversial. The main purpose of our study is to determine whether prolonging TMZ treatment (from 6 months to 12 months) is beneficial in patients treated with a standard combined treatment approach in terms of disease-free survival (DFS) and OS.
METHODS: Between 2012-2019 years we analyzed 180 GBM patients retrospectively and included 100 patients who met the criteria for inclusion in the study.
RESULTS: 100 GBM patients were retrospectively examined. Median OS was 21 (18.47-23.52) months overall, while it was 24 (18.21-29.78) months in recipients of 6 cycles of TMZ, it was 22 (18.50-25.49) months in the group receiving 12 cycles of TMZ, and 10 months in those who could not complete adjuvant therapy. There was no statistically significant difference between 6 cycles and 12 cycles of TMZ treatment (p = 0.55). Patients who could not complete the adjuvant therapy had lower survival and this group had a statistically significant OS difference compared to patients receiving 6 and 12 cycles of TMZ (p = 0.04 and p = 0.024, respectively).
DISCUSSION AND CONCLUSION: Our study indicate that prolongation of adjuvant TMZ treatment in GBM patients do not provide an additional survival advantage regardless of age, performance status and tumor characteristics. Additionally, GBM patients who could not complete standard 6-cycle adjuvant treatment have lower survival rates.

GÝRÝÞ ve AMAÇ: Multipl Miyelom (MM) ikinci en sýk görülen hematolojik malignitedir. MM'deki genetik deðiþiklikler kromozomlarýn yapýsýný veya sayýsýný etkileyebilir. t (11; 14) (q13; q32), t (4; 14) (p16; q32), t (14; 16) (q23; q32), hipodiploidi, hiperdiploidi, delesyon 13q (del 13q) veya TP53, MM hastalarýnda gözlenen mutasyonlardan bazýlarýdýr. Bu çalýþmada, myelomalý Türk hastalarda gözlenen genetik deðiþiklikleri incelemeyi amaçladýk.
YÖNTEM ve GEREÇLER: Þubat 2014 ile Kasým 2019 tarihleri arasýnda merkezimizde genetik deðerlendirmesi yapýlan MM hastalarýnýn verileri retrospektif olarak incelendi. Yalnýzca kemik iliði örnekleri konvansiyonel sitogenetik ve floresan yerinde hibridizasyon (FISH) [t (4; 14), t (11; 14), del13q, TP53] ile deðerlendirilen hastalar çalýþmaya dahil edildi.
BULGULAR: Çalýþmaya 100 MM hastasý dahil edildi. 22 (% 22) hastada taný anýnda genetik deðiþiklikler görüldü. En sýk görülen genetik deðiþiklik hastalarýn% 12'sinde görülen del13q idi. MM hastalarýnýn % 8’inde t (11; 14), % 8’inde TP53, % 7’sinde trizomi 7, % 5’inde t (4; 14) ve % 4'ünde trizomi 8 gözlenmiþtir.
TARTIÞMA ve SONUÇ: Tedavi yaklaþýmlarýný optimize etmek için MM hastalarýnýn genetik özelliklerinin sadece taný anýnda deðil takip sýrasýnda da deðerlendirilmesi önemlidir.

INTRODUCTION: Multiple Myeloma (MM) is the second most common hematologic malignancy. Genetic alterations in MM may affect structure or number of chromosomes. Specific translocations like t(11;14)(q13;q32), t(4;14)(p16;q32), t(14;16)(q23;q32), hypodiploidy, hyperdiploidy, deletion 13q (del 13q) or TP53 are some of the mutations observed in MM patients. In this study, we aimed to study the genetic alterations observed in Turkish patients with MM.
METHODS: The data of MM patients whose genetic evaluations were performed at our center between February 2014 and November 2019 were retrospectively analyzed. Only the patients whose bone marrow samples were evaluated by conventional cytogenetics and by fluorescence in situ hybridization (FISH) [t(4;14), t(11;14), del13q, TP53] were included in the study.
RESULTS: 100 patients with MM were included in the study. 22 (22%) patients had genetic alterations at the time of diagnosis. The most often observed genetic alteration was del 13q which was observed in 12% of the patients. t(11;14), TP53, trisomy 7, t(4;14) and trisomy 8 were observed in 8%, 8%, 7%, 5% and 4% of MM patients, respectively.
DISCUSSION AND CONCLUSION: Evaluating the genetic characteristics of MM patients not only at the time of diagnosis but also during the follow up is crucial in order to optimize the treatment aproaches.
Keywords: Multiple myeloma, genetic alterations, conventional cytogenetics

GÝRÝÞ ve AMAÇ: Mesane tümörü nedeniyle açýk radikal sistektomi uygulanan hastalarýn postoperatif kýsa-orta dönemdeki renal fonksiyonlarýndaki deðiþimlerinin deðerlendirilmesi.
YÖNTEM ve GEREÇLER: Çalýþmada Aralýk 2010-Ekim 2019 tarihleri arasýnda mesane tümörü nedeniyle açýk radikal sistektomi uygulanan toplam 76 hastanýn, demografik, operatif ve postoperative verileri ile postoperative 1. gün, 1., 3., 6., 9. ve 12. ay renal fonksiyon deðerlerinin iþlem öncesine göre deðiþimleri deðerlendirildi. Eþ zamanlý nefrektomi uygulanan, preoperatif kronik böbrek yetmezliði nedeniyle diyaliz öyküsü bulunan, tek böbrekli olan ve 1 yýldan daha az takipli hastalar çalýþmaya dahil edilmedi.
BULGULAR: Çalýþmaya toplam 51 hasta dahil edildi. Hastalarýn yaþ ortalamasý 64,31± 8,37 yýl idi. Hastalarýn % 86.3’üne ileal konduit uygulanýrken, %13.7 sine ortotopik mesane uygulandý. Postoperatif renal fonksiyonlar hastalarýn %51 sinde düþüþ gösterirken, %49 ýnda artýþ izlendiði ya da deðiþim izlenmediði tesbit edildi. Preoperatif eGFR 62.70± 23.22 mL/min/1.73 m2 iken postoperatif 1-3 gün, 1. ay, 3, ay, 6.ay, 9.ay, 12. ay eGFR deðerleri sýrasýyla 58.55±28.08, 64.67±26.52, 64.35±23.23, 61.18±24.80, 59.93±21.99 ve 58.09± 22.33 mL/min/1.73 m2 þeklinde kaydedildi. Ýþlem sonrasý 1 yýl içinde yapýlan periyodik eGFR ölçümlerinde peroperatif erken dönemde nisbeten hýzlý eGFR düþüþü izlenirken sonrasýnda kademeli bir deðiþim olduðu görüldü.
TARTIÞMA ve SONUÇ: Kas invaziv ve yüksek risk mesane tümörlerinde açýk radikal sistektomi sonrasý erken dönemde renal fonksiyonlarda ani bozulmalar izlenebilirken sonrasýnda yakýn takip izlemle normal deðerlerine yaklaþtýðý görünmektedir. Morbidite ve mortalitesi yüksek bu prosedür de renal fonksiyonlarýn korunmasý açýsýndan özellikle postoperatif erken dönemde yakýn takip ve izlem önermekteyiz.

INTRODUCTION: To evaluate the postoperative early-mid term renal functions of patients who underwent open radical cystectomy for bladder tumor.
METHODS: In the study, demographic, operative, postoperative data and postoperative 1st day, 1st, 3rd, 6th, 9th and 12th month renal function values of 76 patients who underwent open radical cystectomy due to bladder tumor between December 2010 and October 2019 were evaluated. Patients who underwent concomitant nephrectomy, history of dialysis due to preoperative chronic renal failure, history of solitary kidney and had a follow-up less than 1 year were excluded from the study.
RESULTS: A total of 51 patients were included in the study. The mean age of the patients was 64.31 ± 8.37years. Ileal conduit was applied to 86.3% of the patients, while orthotopic bladder was applied to 13.7%. While postoperative renal functions decreased in 51% of the patients, it was found that there was an increase or no change in 49% of the patients. While preoperative eGFR was 62.70 ± 23.22 mL / min / 1.73 m2, postoperative 1-3 days, 1st month, 3rd month, 6th month, 9th month, and 12th month eGFR values were 58.55 ± 28.08, 64.67 ± 26.52, 64.35 ± 23.23, 61.18 ± 24.80, 59.93 ± 21.99 and 58.09 ± 22.33 mL / min / 1.73 m2, respectively. While the eGFR levels relatively rapid decrease in the early perioperative period, but a gradual change was observed afterward for the periodic eGFR measurements performed within 1 year after the procedure.
DISCUSSION AND CONCLUSION: The rapid deterioration in renal functions can be observed in the early period in muscle-invasive or high-risk bladder tumors after the open radical cystectomy, but it seems to approach normal values with close follow-up. In this procedure with high morbidity and mortality, we recommend close follow-up and care, especially in the early postoperative period, in order to protect renal functions.

GÝRÝÞ ve AMAÇ: Standart kemoterapi dýþýnda otolog kök hücre nakli (OKHN), relaps/refrakter lenfomalý hastalarda en etkili tedavi seçeneklerinden biridir. Lenfoma tedavisi için OKHN uygulanan hastalarýn sonraki dönemde sosyal yaþamda, iþ hayatýnda, cinsel yaþamda ve aile iliþkilerinde bazý zorluklar yaþadýklarý düþünülmektedir. Bu çalýþmanýn amacý, lenfoma tedavisi için OKHN uygulanan hastalarda boþanma sýklýðýný araþtýrmak ve boþanma üzerinde etkisi olabilecek hasta ve tedavi iliþkili faktörleri deðerlendirmektir.
YÖNTEM ve GEREÇLER: Relaps veya refrakter lenfoma nedeniyle OKHN uygulanan, 18 yaþ üstü ve remisyonda olan hastalar çalýþmaya dahil edildi. Çalýþmanýn birincil sonlaným noktasý OKHN sonrasý boþanma sýklýðýný deðerlendirmek, ikincil sonlaným noktasý ise boþanmayla iliþkilendirilebilecek faktörleri ortaya koymaktý.
BULGULAR: Çalýþmaya dahil edilen 95 hastanýn ortanca yaþý 50 (21-69 yaþ) idi. Hastalarýn çoðu erkekti (n: 72,% 75.8). OKHN yapýlan hastalarýn yarýsýndan fazlasý (n: 60,% 63.1) þehir merkezinde yaþarken, 73 (% 69.5) hasta halen çalýþýyordu. Hastalarýmýzýn 80'i (%84.2) halen evliydi; bu hastalarda ortanca evlilik süresi 30.01 yýl (2.5-48.5 yýl) idi. On beþ (% 15.7) bekar hastadan 4'ü (% 4.2) OHKN'den sonra boþanmýþ hastalardan oluþmaktaydý. Cinsiyet, eðitim durumu, çalýþma durumu, ikamet yeri, çocuk sahibi olma ve lenfoma tipinin boþanma riski ile iliþkisi olmadýðý görüldü.
TARTIÞMA ve SONUÇ: Çalýþmamýzda OKHN uygulanan lenfoma tanýlý hastalarda boþanma oraný% 4,2 olarak bulunmuþtur. Sonuçlarýmýza göre lenfoma tipi, cinsiyeti, çalýþma durumu ve eðitim durumu boþanma riski ile iliþkili deðildi. OKHN öncesi dönemden baþlamak üzere aile danýþmanlýðý verilmesi ve psikoonkoloji konsultasyonunun boþanma sýklýðýný azaltabileceði düþünülmüþtür.

INTRODUCTION: Apart from standard chemotherapy, autologous stem cell transplantation (ASCT) is one of the most effective treatment options in patients with relapse/refractory lymphomas. Lymphoma survivors are thought to experience some difficulties in social life, business life, sexual life and family relations after ASCT. The aim of this study is to investigate the frequency of divorce in patients who underwent ASCT for lymphoma and to evaluate the patient characteristics and the treatment-related factors that may affect the divorce.
METHODS: Patients over 18 years of age with a diagnosis of relapsed or refractory lymphoma who underwent ASCT and in remission were included in the study. The primary endpoint of the study was to evaluate the frequency of divorce after ASCT. The secondary endpoint was to reveal the factors that might be associated with divorce.
RESULTS: The median age of 95 patients included in the study was 50 (21-69 years). Most of the patients were male (n: 72, 75.8%). More than half of the patients (n: 60, 63.1%) were living in the city center and 73 (69.5%) patients were still working after ASCT. Eighty (84.2%) of our patients were still married. The median duration of marriage in these patients was 30.01 years (2.5-48.5 years). Of the 15 (15.7%) single patients, 4 (4.2%) were divorced after ASCT. It was observed that gender, educational status, employment status, place of residence, childbearing and lymphoma type were not associated with divorce rates.
DISCUSSION AND CONCLUSION: In our study, the rate of divorce was found 4.2% in lymphoma survivors treated with ASCT. According to our results, lymphoma type, gender, employment status and educational status were not associated with divorce risk. Family counseling and psychooncology consultation starting from the pre-ASCT period can reduce the frequency of divorce.

GÝRÝÞ ve AMAÇ: Enfeksiyonlar kronik lenfositik lösemi (KLL) hastalarýnda mortalite ve morbiditenin en önemli sebeplerindendir. Bu çalýþmada, KLL tanýlý hastalarýmýzýn ana klinik ve biyolojik özellikleri ile birlikte hastalýðýn seyri esnasýnda geliþen enfeksiyonlarý özetlemeye çalýþtýk.
YÖNTEM ve GEREÇLER: Numune Eðitim ve Araþtýrma Hastanesinde Ocak 2000-Mayýs 2019 tarihleri arasýnda KLL tanýsý alan hastalar retrospektif olarak deðerlendirildi
BULGULAR: 204 erkek, 120 kadýn toplam 324 hasta çalýþmaya dahil edildi. Ortanca yaþ 64 (33-91 yýl) saptandý. Takip süresince, %42,9 (n = 139) hasta kemoterapi/immunoterapi ile tedavi edildi ve bu hastalarýn %17,2’ si (n=57) ilk tedaviden sonra nüks etti. Hastalar RAI evresine göre gruplandýrýldý. 267 (%82,4) hasta evre 0-2, 57 (%17,6) hasta evre 3-4 grubundaydý. Akut ve kronik bakteriyel enfeksiyonlar RAI evre 3-4 olan grupta daha sýktý (%50,6 ve %26,6, %7,0 ve %0, sýrasýyla, p<0,001). CTC-AE grade 4-5 enfeksiyon sýklýðý evre 3-4 olan grupta daha yüksekti (p<0,001). Hipogamaglobulinemi ve intravenöz immunglobulin (IVIg) tedavi ihtiyacý evre 3-4 olan grupta daha sýk görüldü (%45,6 ve %18,5, %24,6 ve %9,7, sýrasýyla; p<0,001 ve p=0,002). Immuntrombositopeni evre 3-4 olan grupta daha sýktý (%5,3 ve %0,7, p=0,03). Ortanca toplam sað kalým (OS) 97,6+11,8 ay (%95 CI 74,4-120,8) aydý. Ortanca takip süresi 25,8 ay (1-226,4 ay) saptandý. Evre 3-4 hastalýk grubunda OS anlamlý olarak kýsa bulundu (p<0,001).
TARTIÞMA ve SONUÇ: KLL hastalarýnda, enfeksiyonlarýn tipinin ve ciddiyetinin daðýlýmý evre baðýmlý olmakla birlikte, hastalýðýn her evresinde enfeksiyöz komplikasyonlar sýk görülebilir.

INTRODUCTION: Infections are the leading cause of morbidity and mortality in chronic lymphocytic leukemia (CLL) patients. We aim to summarize the main clinical and biological features of CLL patients diagnosed in our center and infections occurred during their disease.
METHODS: Patients diagnosed with CLL in Numune Training and Research Hospital between January 2000 and May 2019, were retrospectively analyzed.
RESULTS: A total of 324 patients, of whom 204 were male and 120 females, were included. The median age was 64 years (33-91 years). During the follow-up, 42.9% (n = 139) were treated with a chemotherapy/immunotherapy and 17.2% (n=57) of these relapsed after the first line. Patients were analyzed according to Rai stage at diagnosis and were divided into two groups, as stage 0-2 and stage 3-4. Stage 0-2 group involved 82,4% (n=267) and stage 3-4 group 17,6% (n=57) of the patients. Acute and chronic bacterial infections were more frequent among patients with stage 3-4 disease (50.6% vs 26.6% and 7.0% vs 0%, respectively, p<0.001). CTC-AE grade 4-5 infections were higher in the stage 3-4 group (p<0.001). Hypogammaglobulinemia and the requirement of intravenous immunoglobulin (IVIg) therapy were more common in grade 3-4 group (45.6% vs 18.5% and 24.6% vs 9.7%, respectively; p<0,001 and p=0,002). Immune thrombocytopenia was also more frequent in the stage 3-4 group (5.3% vs 0.7%, p=0.03). Estimated median overall survival (OS) was 97.6+11.8 (%95 CI 74.4-120.8) months. The median follow-up time was 25.8 months (1-226.4 months). OS was significantly lower in the stage 3-4 group (P<0.001).
DISCUSSION AND CONCLUSION: Although, the distribution of type and severity of infections are stage dependent in patients with CLL, frequent infections may occur at every stage of the disease.

GÝRÝÞ ve AMAÇ: Pilonidal sinüs hastalýðýnýn cerrahi tedavi halen tartýþmalý olup en iyi tedavi stratejisi hakkýnda görüþ birliði yoktur. Çalýþmamýzda sinüsektomi yöntemi ile kristalize fenol yöntemini karþýlaþtýrdýk.
YÖNTEM ve GEREÇLER: Çalýþmamýz prospektif olarak tasarlanýp retrospektif olarak yapýlmýþtýr. Çalýþmamýzda 2017-2020 yýllarý arasýnda komplike olmamýþ pilonidal sinus hastalýðý nedeniyle opere edilen 164 hasta dahil edildi. Hastalarýn 44’üne kristalize fenol,120’sine sinüsektomi operasyonu uygulandý. Hastalar ortalama 16 ay takip edildi. Hastalarýn yaþ,cinsiyet,operasyon þekli, primer yada nüks varlýðý, sinüs sayýsý, BMI indexleri, sinüs boyutu, kaç farklý alanda sinüs orifisinin olduðu, komplikasyonlarý, antibiotik ve aðrý kesici kullaným süreleri, akýntý süreleri ve kapanma süreleri kayýt edildi.
BULGULAR: Kristalize fenol grubunda 35(%79.5) erkek 9(%20.5) kadýn hasta mevcuttu. Sinüsektomi grubunda ise 105 (%87.5) erkek 15(%12.5) kadýn hasta vardý. Hastalarýn yaþ ortancasý kristalize fenol grubunda 24(17-58), sinüsektomi grubunda 24.5(16-55) idi. Medyan iþe dönüþ süresi her iki grupta da 1 gün olarak bulundu, fakat kristalize fenol grubu daha kýsa sürede iþe döndü(p: 0,039).Sinüsektomi grubunda postoperatif kanama (%14.2)fazlayken kristalize fenol grubunda nüks(%4.5) daha fazla görüldü(p: 0.04). Sinüsektomi grubunda ortanca sinüs boyutu 2.5 cm iken kristalize fenol grubunda 1.3 cm (p<0.01) olarak hesaplandý. Kapanma süreleri her iki grupta da medyan 7 hafta olarak hesaplanýrken istatiksel olarak sinüsektomi grubunda daha geç bulunmuþtur(p<0,01). Seröz akýntý süresi kristalize fenol grubunda 11 gün sinüsektomi grubunda 12 gün olarak hesaplandý(p<0.01). Ampirik antiobitik olarak sinüsektomi grubunda daha çok amoksisilin+klavulanik asit (%89.2), kristalize fenol grubunda ise daha çok siprofloksasin +ornidazol (%59.1) kullanýlmýþtýr(p<0.01).
TARTIÞMA ve SONUÇ: Erken dönem sonuçlarýmýza göre sinüsektomi nüks açýsýndan kristalize fenole göre daha üstün bulunurken, postoperatif kanama açýsýndan kristalize fenol uygulamasý daha efektifdir.

INTRODUCTION: Surgical treatment of Pilonidal Sinus Disease (PSD) is still controversial and there is no consensus on the best treatment strategy. In our study, we compared sinusectomy method with (S) crystallized phenol(CP) method.
METHODS: Our study was designed prospectively and conducted retrospectively. In our study, 164 patients, who were operated for uncomplicated PSD between 2017-2020, were included. 44 of the patients underwent CP and 120 underwent S operation. Patients were followed for an average of 16 months. Age, sex, type of operation, presence of primary or recurrence, number of sinuses, BMI indexes, sinus size, how many different areas of sinus orifices, complications, duration of use of antibiotics and painkillers, discharge times and wound closure times were recorded in these patients.
RESULTS: In the CP group, there were 35 (79.5%) male and 9 (20.5%) female patients. In the S group, there were 105 (87.5%) male and 15 (12.5%) female patients. The median age of the patients was 24(17-58) in the CP group and 24.5 (16-55) in the S group. The median return to work time was 1 day in both groups, but the CP group returned to work in a shorter time period (p: 0.039). Postoperative bleeding was higher in the S group (14.2%) while recurrence was higher in CP Group (4.5%) (p: 0.04). The median sinus size was 2.5 cm in the S group and 1.3 cm (p<0.01) in the CP group. Wound closure times were calculated as a median of 7 weeks in both groups and were statistically later in the group S (p<0.01). Serous discharge duration was calculated as 11 days in the CP group and 12 days in S group (p<0.01). In the S group, amoxicillin+clavulanic (89.2%) were used as empirical antibiotics and ciprofloxacin +ornidazole (59.1%) in the CP group (p<0.01).
DISCUSSION AND CONCLUSION: According to our early results, sinusectomy was found to be superior to crystallized phenol in terms of recurrence, while crystallized phenol application was more effective in terms of postoperative bleeding.

GÝRÝÞ ve AMAÇ: Langerhans hücreli histiyositozis atipik histiyositlerin lokal veya yaygýn olarak kemik, hipofiz bezi, lenf nodlarý,akciðerler ve merkezi sinir sistemi gibi çeþitli dokularda klonal neoplastik çoðalmasý karakterize bir hastalýk grubudur. Merkezimizde takip edilen sekiz LHH olgusu klinik, laboratuvar ve saðkalým açýsýndan retrospektif olarak deðerlendirilmesi ve tedavide vinblastin kemoterapisinin rolünün incelenmesi amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Mayýs 2011 – Eylül 2019 tarihleri arasýnda takipli 8 hastanýn verileriler retrospektif olarak deðerlendirilmiþtir.
BULGULAR: Sekiz hastanýn ortalama yaþý 37 (en küçük 19-en büyük 75) dir. Erkek / kadýn oraný 7/1’dir. Hastalarýn en sýk baþvuru þikayeti %50 oranýnda kemik aðrýsýydý. Hastalarýn klinik evrelemesinde %62.5 ‘sinin tek sistem tutulumu olduðu; %37.5’inin multi-sistem tutulumu saptandý. Tek sistem tutulumlu hastalarýn %60’ýnda tutulum yeri nedeniyle santral sinir sistemi invazyonu açýsýndan riskli bölgelere yerleþtiði görülerek yüksek risk sýnýfýnda deðerlendirildi. Taný amaçlý cerrahi rezeksiyon, tek sistem tutulu %25 hastada tedavi olarak da deðerlendirilmiþtir. Kemoterapi olarak ilk basamakta %37.5 hastada, %12.5 hastada ikinci basamakta vinblastin + metilprednizolon tedavisi tercih edilmiþtir. Radyoterapi %50 hastanýn tedavisinde kullanýlmýþtýr. Hipofizer tutulumlu bir hastamýza indüksiyonu 4 kür kladribin ile yapýlmýþtýr. Tüm hastalar tam yanýtla remisyonda takiptedir Median takip süresi 59 ay ( en az 5 ay – en çok 100 ay ) ‘dýr.
TARTIÞMA ve SONUÇ: Eriþkin baþlangýçlý LHH nispeten iyi seyretmekte olup rezeksiyon, tutulu alan radyoterapisi, sistemik kemoterapi tedavi edilebilmektedir. Vinblastin ve steroid tedavisi sistemik tedavide ilk basamakta etkin ve güvenlidir.

INTRODUCTION: Langerhans cell histiocytosis is a group of diseases characterized by clonal neoplastic proliferation of atypical histiocytes in various tissues such as bone, pituitary gland, lymph nodes, lungs and central nervous system. The aim of this study was to evaluate in terms of clinical, laboratory and survival retrospectively and to examine the role of vinblastine chemotherapy in treatment.
METHODS: Eight cases included in our study between May 2011 and September 2019 and evaluated retrospectively.
RESULTS: The mean age of eight patients is 37 (youngest 19-largest 75). The male / female ratio is 7/1. The most common complaint of patients was bone pain at the rate of 50%. In clinical staging, 62.5% patients had single system involvement, while 37.5% had multi-system involvement. In 60% of patients with a single system involvement, it was assessed in high risk class like central nervous system invasion due to location of involvement. Surgical resection for diagnostic purposes was also evaluated as a treatment in 25% patients with a single system involvement. As chemotherapy, vinblastine+ methylprednisolone treatment was preferred in 37.5% of the firt line treatment and 12.5% was fort he second line treatment. Radiotherapy has been used in the treatment of 50% of patients.Induction of a patient with pituitary involvement was performed with 4 cycles of cladribine. Median follow-up is 59 months (minimum 5 months - maximum 100 months).
DISCUSSION AND CONCLUSION: The clinical course of Adult-onset Langerhans cell histiocytosis is relatively well and can be treated with resection, radiotherapy of involvement area, systemic chemotherapy. Vinblastine and steroid therapy is effective and safe in the first line of systemic therapy.

GÝRÝÞ ve AMAÇ: Perkütan böbrek biyopsisi renal hastalýklarýn taný ve yönetiminde yaygýn olarak kullanýlan güvenli bir yöntemdir. Çalýþmamýzýn amacý, görüntüleme eþliðindeki perkütan böbrek biyopsilerinde iþleme ait kanama riski ile iliþkili faktörleri deðerlendirmektir.
YÖNTEM ve GEREÇLER: Mayýs 2018-Aralýk 2019 tarihleri arasýnda giriþimsel radyoloji kliniðimize yönlendirilerek ultrasonografi eþliðinde perkütan böbrek biyopsisi yapýlan hastalar retrospektif olarak tarandý. Çalýþmaya 18 yaþ üzeri, iþlem öncesi ultrason görüntülemesi ve iþlem sonrasý patoloji bilgileri mevcut olan hastalar dahil edildi. 18 yaþ altý çocuk hastalar ve transplante böbrek biyopsileri çalýþma dýþý tutuldu.
BULGULAR: Çalýþmaya toplam 107 hasta dâhil edildi. Hastalarýn 57’si erkek (%53,3), 50’si kadýndý (%46,7). Hastalarýn yaþ ortalamasý 47,8±15,5 idi. Hastalarýn iþlem öncesi ortalama Hb deðeri 11,2 ±1,7 mg/dl iken iþlem sonrasý ortalama Hb deðeri 11,1±1,7 mg/dl idi. Hastalarýn ortanca Hb düþüþü %4,2 idi. Yapýlan istatistiksel analizde iþlem öncesi ile iþlem sonrasý hemoglobin deðerleri arasýnda anlamlý farklýlýk saptanmadý (p=0,864). Hemoglobin deðerlerindeki düþüþ ile hasta yaþý (p=0,406), böbrek boyutu (p=0,814), parankim ekojenitesi (p=0,175) ve parankim kalýnlýðý (p=0,254) arasýnda anlamlý korelasyon saptanmadý.
TARTIÞMA ve SONUÇ: Ultrasonografi eþliðinde yapýlan böbrek biyopsileri, böbrek hastalýklarýnýn tanýsýnda güvenle kullanýlabilecek bir yöntemdir. Her ne kadar kanama riski taþýsa da, iþlem öncesi uygun deðerlendirme ile bu risk en az seviyeye indirilebilir.

INTRODUCTION: Percutaneous kidney biopsy is a safe method widely used in the diagnosis and management of renal diseases. The aim of our study is to evaluate the factors associated with the risk of bleeding associated with the procedure in imaging-guided percutaneous kidney biopsies.
METHODS: Patients who were referred to our interventional radiology clinic between May 2018 and December 2019 and who underwent ultrasound-guided percutaneous kidney biopsy were retrospectively scanned. Patients above 18 years old who had pre-procedure ultrasound imaging and post-procedure pathology information were included in the study. Pediatric patients under 18 years old and transplanted kidney biopsies were excluded.
RESULTS: A total of 107 patients were included in the study. 57 of the patients were male (53.3%) and 50 were female (46.7%). The mean age of the patients was 47.8 ± 15.5. The mean Hb value of the patients before the procedure was 11.2 ± 1.7 mg / dl, while the mean Hb value after the procedure was 11.1 ± 1.7 mg / dl. The median Hb drop in patients was 4.2%. In statistical analysis, there was no significant difference between hemoglobin values before and after the procedure (p = 0.864). No significant correlation was found between the decrease in hemoglobin values and patient age (p = 0.406), kidney size (p = 0.814), parenchymal echogenicity (p = 0,175) and parenchymal thickness (p = 0,254).
DISCUSSION AND CONCLUSION: Ultrasound-guided percutaneous kidney biopsy is a method that can be used safely in the diagnosis of kidney diseases. Although there is a risk of bleeding, this risk is minimal with appropriate evaluation before the procedure.

GÝRÝÞ ve AMAÇ: Larenks kanseri tüm baþ boyun kanserleri arasýnda en sýk görülen ikinci kanserdir ve önemli bir morbidite ve mortalite nedenidir. Suprakrikoid larenjektomi cerrahisi, larenks fonksiyonlarýnýn mümkün olduðunca korunmasýna imkân veren etkili bir tedavi yöntemidir. Çalýþmamýzda kliniðimizde son 10 yýl içinde yapýlan açýk parsiyel larenks cerrahi vakalarýnýn histopatolojik parametrelerini ve onkolojik sonuçlarýný paylaþacaðýz.

YÖNTEM ve GEREÇLER: Ocak 2009 ve Temmuz 2019 arasýnda kliniðimizde histopatolojik olarak larenks yassý hücreli karsinom tanýsý almýþ ve suprakrikoid larenjektomi cerrahisi uygulanmýþ 47 hastanýn verileri retrospektif olarak incelendi. Hastalarýn sosyodemografik özellikleri, tümör spesmenlerinin histopatolojik özellikleri ve saðkalým analizleri deðerlendirmeye alýndý.

BULGULAR: Hastalarýn 29’unda (%61.7) erken evre larenks kanseri saptanmýþ olup, 18’inde (%38.3) ileri evre larenks kanseri mevcuttur. Larenks kanser 29 olguda (%61.7) glottik yerleþimli olup lenf nodu tutulumu glottik yerleþimli olgularda anlamlý derecede daha az olarak saptanmýþtýr (p< 0.001). 5-yýllýk genel saðkalým %74.5 olarak saptanmýþken, erken ve ileri evre olgularda 5-yýllýk genel saðkalým %88.5 ve %69.2 olarak saptanmýþtýr.
TARTIÞMA ve SONUÇ: Larenks kanseri tedavisinde tedavi baþarýsýnýn deðerlendirilmesinde en önemli iki ölçüt sað kalým süresi ve organ fonksiyonun devamlýlýðýdýr. Larenks kanserlerinin tedavisinde suprakrikoid larenjektomi önemli araçlardan biridir. Cerrahi teknik ve onkolojik kurallara baðlý kalýndýðýnda uygun hastalarda fonksiyonel bir larenksi koruyarak hastalarda kalýcý iyileþme saðlamak mümkündür.

INTRODUCTION: Larynx cancer is the second most frequent head and neck cancer and important cause of morbiditity and mortality. Supracricoid laryngectomy is one of the open partial laryngeal surgerical techniques which is an important tool for treatment of laryngeal cancer. The purpose of this study was to evaluate the oncological outcomes of laryngeal carcinoma patients treated with supracricoid laryngectomy.

METHODS: A total of 47 cases were retrospectively analyzed from two tertiarian head and neck clinics with laryngeal carcinoma that underwent supracricoid laryngectomy from 2009 to 2019. Sociodemographic characteristics, histopathologic characteristics of tumor specimens, and survival analysis were assessed.

RESULTS: Early stage laryngeal cancer was detected in 29 (61.7%) of the patients, and 20 (38.3%) of the patients had advanced laryngeal cancer. In 29 cases (61.7%) larynx cancer was located in glottis and lymph node involvement was found to be significantly less in cases with glottic location (p< 0.001). While 5-year overall survival was 74.5%, 5-year overall survival was 88.5% and 69.2% in early and advanced stage cases.
DISCUSSION AND CONCLUSION: The two most important factors in the determination of successful treatment in treating laryngeal cancer are survival time and preserving laryngeal function. Supracricoid laryngectomy is one of the key tools used in treating laryngeal cancers. Through preserving a healthy larynx in appropriate patients, it is possible to provide permanent improvement while adhering to the surgical technique and oncological rules.

GÝRÝÞ ve AMAÇ: Sitoredüktif cerrahi (SRC) ve hipertermik intraperitoneal kemoterapi (HIPEC) peritoneal mezotelyoma (PM) için önerilen tedavi yaklaþýmýdýr. Burada PM için multimodal tedavi deneyimimizi sunuyoruz.
YÖNTEM ve GEREÇLER: Ocak 2009 ve Aralýk 2017 tarihleri arasýnda otuz sekiz hasta çalýþmaya dahil edildi. Hastalarýn kliniko-patolojik özellikleri, tedavi sonuçlarý, týbbi kayýtlarý ve intraoperatif peritoneal kanser indeksi (PCI) skorlarý geriye dönük olarak analiz edildi.
BULGULAR: Ortanca yaþý 61 (21-80) olan toplam 38 hasta (n = 22 kadýn) deðerlendirildi. 23 hastaya (% 60.5) SRC uygulandý ve 18 hastaya (% 47.3) SRC + HIPEC uygulandý. Postoperatif erken mortal vakalar (6 hasta) hariç tutulduktan sonra, adjuvan tedavi ile tedavi edilen hastalarda daha uzun OS elde edildi (p = 0.03). Morbid seyri olan hastalarda PCI deðeri daha yüksekti. Obezite, diyabetes mellitus (DM) ve CA125 seviyeleri 1000 U / ml'nin üzerinde olan hastalarda morbidite daha yüksekti.
TARTIÞMA ve SONUÇ: Adjuvan kemoterapinin SRC + HIPEC uygulanan PM hastalarýnda OS'yi iyileþtirebileceðini göstermiþtir. Bununla birlikte, DM, yüksek PCI deðeri ve ameliyat öncesi CA125 düzeyleri 1000 IU / ml'nin üzerinde olan PM hastalarýnda çoklu tedavi dikkatle deðerlendirilmelidir.

INTRODUCTION: Cytoreductive surgery (SRC) and hyperthermic intraperitoneal chemotherapy (HIPEC) is the recommended treatment approach for peritoneal mesothelioma (PM). Here we present our multimodal treatment experience for PM.
METHODS: Thirty-eight patients were included in the study between January 2009 and December 2017. Clinico-pathological features and treatment results, medical records and intraoperative peritoneal cancer index (PCI) scores of the patients were analyzed retrospectively.
RESULTS: A total of 38 patients (n = 22 women) with a median age of 61 (21-80) were evaluated. SRC was applied to 23 patients (60.5%) and SRC + HIPEC was applied to 18 patients (47.3%). After excluding postoperative early mortal cases (6 patients), longer OS was achieved in patients treated with adjuvant therapy (p = 0.03). PCI value was higher in patients with morbid course. Morbidity was higher in patients with obesity, diabetes mellitus (DM) and CA125 levels above 1000 U / ml.
DISCUSSION AND CONCLUSION: It has shown that adjuvant chemotherapy can improve OS in PM patients receiving SRC + HIPEC. However, multimodal treatments should be carefully evaluated in patients with DM, high PCI, and preoperative CA125 levels above 1000 IU / ml.

GÝRÝÞ ve AMAÇ: Çalýþmamýz, prostat kanseri nedeniyle, robot yardýmlý laparoskopik radikal prostatektomi (RYLRP) ameliyatý uygulanan hastalarý, vezikoüretral anostomozda (VÜA), çift yönlü dikenli sütür ile monofilament poliglekapron sütürün sistografideki anastomoz ve ameliyat süresi, anostomoz kaçaðý, üriner inkontinans, hastanede yatýþ ve kateterizasyon süreleri açýsýndan deðerlendirmeyi amaçlamýþtýr.
YÖNTEM ve GEREÇLER: 2017-2020 yýllarý arasýnda RYLRP ameliyatý yapýlan 118 hastanýn (40 çift yönlü dikenli sütür, 78 monofilament poliglekapron sütür) verileri restrospektif olarak analiz edildi. Hastalarýn demografik bilgileri, kateterizasyon süreleri, sistografi çekilme zamanlarý ve üriner inkontinans durumlarý hastane veritabaný kullanýlarak elde edildi. Tüm cerrahi iþlemler Da-Vinci Xi robotik cerrahi sistemleri (Intuitive surgical, Sunnyvale, CA) kullanýlarak tek cerrah tarafýndan gerçekleþtirildi. Hastalar kullanýlan sütür tipine göre iki gruba ayrýldý.
BULGULAR: Grup 1 deki 48 hastada (% 40,6) dikenli sütür ve Grup 2 deki 70 hastada (%59,4) ise monofilament poliglekapron sütür kullanýlmýþtýr. Gruplardaki ortanca yaþ daðýlýmý, Psa seviyesi, ameliyat öncesi Uluslararasý erektil fonksiyon indexi (international index of erectile function-IIEF) skorlarý, ortanca tahmini kan kaybý miktarý benzerdi. Grup 1 ve Grup 2 de ortalama anostomoz süresi 13(8-25) ve 21(12-31) (p<0.001), ortanca konsol süreleri sýrasýyla 21(12-31), 110(73-205) (p<0.001) olarak gözlendi. Grup 1 ve Grup 2 deki hastalarda; ortanca sondalý olma süresi sýrasýyla 7(7-14) güne 8(7-30) gün (p<0.001), ortanca hastanede kalma benzerdi (p=0,249), ameliyat sonrasý 7. günde çekilen sistogramdaki kaçak oranlarý sýrasýyla 3 (%6.3)’a 15(%21.4) olarak gözlendi. Grup 1 ve Grup 2 deki hastalarda kontinans oranlarý sýrasýyla; 1.ayda %77.1 (n=37), %75.7 (n=53); 3.ayda % 87.5 (n=42), %82.9 (n=58). Geç dönem postoperatif kontinans oranlarý dikenli sütür lehine anlamlý olacak þekilde yüksek iken (p=0,047), erken dönem kontinans oranlarý benzer bulunmuþtur (p<0.001). Gruplarda bulunan hiçbir hastada mesane boynu kontraktürü izlenmedi.
TARTIÞMA ve SONUÇ: Robotik cerrahi erken kontinans saðlanmasýný hýzlandýrsa da, en uygun sütür tipinin seçilmesi, kontinansýn erken edinilmesi için halen klinik açýdan önemlidir. Mevcut çalýþma, dikenli sütürün monofilament sütüre kýyasla daha kýsa anostomoz süreleri ve erken sonda çýkartýlmasýný saðladýðýný kanýtlamaktadýr.

INTRODUCTION: We aimed to evaluate anostomosis time, anostomosis leakage status, length of catheterization, urinary continence recovery following robot-assisted radical prostatectomy (RARP) using monofilament polyglecaprone suture vs. barbed suture during vesicourethral anastomosis.
METHODS: The data of 118 patients (40 bidirectional barbed sutures, 78 monofilament polyglycapron sutures) who underwent RARP between 2017-2020 were analyzed retrospectively. Demographic information, length of catheterization, cystography times and urinary incontinence status of the patients were obtained using the hospital database. All of the surgical procedures were performed by a single surgeon using Da-Vinci Xi robotic surgical systems (Intuitive surgery, Sunnyvale, CA). The patients were divided into two groups according to the type of sutures used.
RESULTS: Median age, Psa level, preoperative International index of erectile function (IIEF) scores, prostate biopsy gleason scores, length of hospital stay and median blood loss were similar in the groups. Median anastomosis time 13 (8-25) and 21 (12-31) (p <0.001), median console times 21 (12-31), 110 (73-205) (p <0.001) were observed in group 1 and group 2, respectively. In Group 1 and 2; median catheterization time was 7 (7-14) days to 8 (7-30) days (p <0.001), and median hospitalization was similar (p = 0.259). Leakage rates on the 7th postoperative day were observed as 15 (21.4%) to 3 (6.3%), respectively. The continence rates of the patients in Group 1 and Group 2; 77.1% (n = 37), 75.7% (n = 53) at 1st month; In the 3rd month, 87.5% (n = 42), 82.9% (n = 58), respectively. While late postoperative continence rates were significantly higher in favor of barbed suture (p = 0.047), early continence rates were similar (p <0.001). None of the patients showed bladder neck contracture in two groups.
DISCUSSION AND CONCLUSION: The current study proves that the barbed suture provides shorter anostomosis times and early catheter removal compared to the monofilament suture.

GÝRÝÞ ve AMAÇ: Bu çalýþmanýn amacý, otolog hematopoietik kök hücre nakli (HSCT) olan hastalarda HBV reaktivasyonunu etkileyen faktörleri araþtýrmak ve HBs Ag negatif/AntiHbc IgG pozitif hastalarda hepatit profilaksisinin gerekliliðini deðerlendirmektir.
YÖNTEM ve GEREÇLER: Çalýþma, 500 yataklý bir eðitim hastanesinde yapýlan retrospektif gözlemsel kohort çalýþmasýdýr. HSCT için immünosüpresif tedavi almasý planlanan hastalar Hbs Ag, Anti HBs ve Anti Hbc IgG bakýlarak HBV açýsýndan tarandý. Çalýþma popülasyonu Mayýs 2012 - Aralýk 2018 tarihleri arasýnda hastanemizde otolog HSCT olan ve Anti Hbc IgG için pozitif olan hastalardan oluþmaktaydý.
BULGULAR: HSCT uygulanan 328 hastanýn HBs Ag, Anti Hbs ve Anti Hbc IgG test sonuçlarý incelendi. Ortanca yaþ 59'du (Aralýk: 23-66 yaþ) ve hastalarýn 63'ü (% 65,6) erkekti. HBs-Ag negatif / Anti Hbc IgG pozitif hastalarýn beþinde (gizli hepatit) HBV-DNA pozitifliði saptandý. Bu hastalara nükleoz(t)id (NA) profilaksisi uygulandý. Hbs Ag negatif hastalarýn toplam 52'si (% 61.9) NA profilaksisi aldý. Herhangi bir antiviral profilaksi almayan 32 hastanýn dördünde (% 12.5), nakilden sonraki ortanca 9. ayda (6-13 ay) HBV reaktivasyonu görüldü.
TARTIÞMA ve SONUÇ: HBs Ag negatif/anti-HBc IgG pozitif olan otolog HSCT alýcýlarýna, HBV reaktivasyonu riski göz önüne alýnarak, antiviral profilaksi uygulanmalýdýr. Lammivudin (LAM) bu hastalar için profilaksideki potent NA'lar kadar etkilidir ve 12 aylýk süre profilaksi için yeterlidir

INTRODUCTION: The aim of the study is to investigate the factors affecting HBV reactivation in patients with autologous hematopoietic stem cell transplantation (HSCT) and to evaluate the necessity of hepatitis prophylaxis in HBs Ag negative/AntiHbc IgG positive patients

METHODS: The study is a retrospective observational cohort study conducted in a 500-bed teaching hospital. Patients who were planned to get immunosuppressive therapy for malignancy were screened for HBV by Hbs Ag, Anti HBs, and Anti Hbc IgG levels. The study population was consisted of patients, who had autologous HSCT in our hospital between May 2012 and December 2018, and were positive for Anti Hbc IgG.

RESULTS: HBs Ag, Anti Hbs, and Anti Hbc IgG test results of 328 patients who underwent HSCT were examined. The median age was 59 years (Range: 23-66 years) and 63 (65.6%) of them were male. HBV-DNA was detected in low values in five (5.9%) of HBs Ag negative/Anti Hbc IgG positive patients (occult hepatitis). Nucleot(s)ide analogue (NA) prophylaxis was administered to those patients. Totally 52 (61.9%) of the Hbs Ag negative patients received NA prophylaxis. HBV reactivation occurred in four (12.5 %) of 32 patients who did not receive any antiviral prophylaxis, in a median of 9 months (6-13 months) after transplantation
DISCUSSION AND CONCLUSION: Antiviral prophylaxis should be administered to autologous HSCT patients, who are HBs Ag negative/anti-HBc IgG positive, taking into consideration the risk of HBV reactivation. Lamivudine (LAM) is as effective as the potent NAs in the prophylaxis for those patients, and 12 months is enough for prophylaxis.

GÝRÝÞ ve AMAÇ: Covid 19 pandemi þartlarýnda, pandemi merkezinde sorunsuz bir þekilde kemoterapi alan hastalarýn özelliklerinin belirlenmesi ve onkoloji pratiðinde ki deðiþikliklerin araþtýrýlmasý amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: 01.04.2020 ile 20.05.2020 tarihleri arasýnda merkezimizde aktif olarak kemoterapi alan ve birbirini takip eden en az iki vizitte nötropenik ateþ yada Covid 19 tanýsý almayan hastalarýn verileri retrospektif olarak incelenmiþtir. Numerik ve kategorik deðiþkenlerin kýyaslanmasý için sýrasýyla Wilcoxon testi ve Mc-Nemar analizi kullanýldý. Analizler sonucunda çift yönlü p deðeri raporlandý ve 0.05'in altýnda ki deðerler istatistiksel olarak anlamlý kabul edildi.
BULGULAR: Çalýþmaya toplam 98 hasta dahil edilmiþtir. Tüm grupta median takip süresi 20 gün idi (6-48). Hastalarýn ortanca yaþý 59 (28-82) olup, tüm grupta 52 (53%) erkek hasta ve 46 (%47) kadýn hasta yer almaktaydý. Birinci vizitte granulocyte-colony-stimulating factor (G-CSF) verilen hasta sayýsý 50 (%51) iken, ikinci vizitte G-CSF verilen hasta sayýsý 37 (%38) idi (p=0.035). Ýkinci vizitte öksürük (%8 vs %1, p=0.039), balgam (%8 vs %0, p=0.016) ve halsizlik (%18 vs %8, p=0.004) þikayetlerinin birinci vizite kýyasla daha az olduðu saptanmýþtýr.
TARTIÞMA ve SONUÇ: Çalýþmamýzda hastalarýn Covid 19 semptomlarý açýsýndan sorgulanmasý ve laboratuar olarak normal limitler içerisinde kalýnarak kemoterapilerinin sorunsuz bir þekilde alabildikleri saptanmýþtýr. Ayrýca, G-CSF kullaným oranlarýnýn ise pandemi öncesine göre literatürde belirtilen oranlardan daha fazla olduðu saptanmýþtýr.

INTRODUCTION: To determine the characteristics of patients who received chemotherapy in the pandemic center under Covid 19 pandemic conditions and to investigate the changes in oncology practice.
METHODS: The data of patients receiving chemotherapy in our center between 01.04.2020 and 20.05.2020 and who were not diagnosed with neutropenic fever or Covid 19 in at least two consecutive visits were retrospectively analyzed. Wilcoxon and Mc-Nemar tests were used for comparison of numerical and categorical variables, respectively. We reported two-sided p value and <0.05 were considered statistically significant
RESULTS: A total of 98 patients were included in the study. Median follow-up time was 20 days in the whole group (6-48). The median age of the patients was 59 (28-82), and there were 52 (53%) male patients and 46 (47%) female patients. While number of patients who received granulocyte-colony-stimulating factor (G-CSF) at the first visit was 50 (51%), number of patients who received G-CSF at the second visit was 37 (38%) (p = 0.035). Cough (8% vs 1%, p = 0.039), sputum (8% vs 0%, p = 0.016) and fatigue (18% vs 8%, p = 0.004) were found to be more common in the second visit compared to the first visit.
DISCUSSION AND CONCLUSION: It was shown that patients could receive chemotherapy without any problems by examining for Covid 19 symptoms and with normal limits of laboratory. In addition, the rates of G-CSF use were found to be higher than the rates in the literature compared to the pre-pandemic.

Anaplastik tiroid karsinomu (ATC), etkili sistemik tedavileri olmayan nadir görülen, ölümcül bir hastalýktýr. ATC genellikle hýzlý büyüyen tiroid kitlesi ile birlikte özofagus ve trakeadaki kitle etkisine baðlý olarak disfaji, disfoni veya ses kýsýklýðý, stridor ve dispne semptomlarýna neden olan lokal semptomlarla gösterir.
Boyunda þiþlik nedeniyle hastanemize sevk edilen 56 yaþýndaki kadýn hasta olgusunu sunuyoruz. Tiroidde boynunun sol tarafýnda palpe edilebilen, sert, hareketsiz bir tümör ve palpe edilebilen, hareketsiz bir lenf nodu saptandý. Hastaya birinci basamak tedavi olarak 75 mg / m2 / gün cisplatin, 21 günde bir doksorubisin 60 mg / m2 / gün 21 günde bir 6 kür kemoterapi rejimi uygulandý. 6 kür kemoterapi sonrasý F18-FDG-PET’ de kitle saptanmadý. Radyolojik olarak tam remisyon saðlandý. Hasta 2 hafta sonra opere edildi. Total tiroidektomi, bilateral santral ve sol modifiye radikal servikal lenf nodu diseksiyonu yapýldý. Cerrahi olarak tam R0 rezeksiyonu saðlandý.
Saðkalým açýsýndan en iyi sonuçlar, cerrahi, eksternal radyoterapi ve kemoterapiyi birleþtiren multidisipliner bir tedavi ile elde edilir. Fakat multidisipliner tedaviye raðmen, tedaviye yanýtlar umut verici deðildir. Birinci basamak neadjuvan kemoterapi rejimleri, özellikle cerrahi tam R0 rezeksiyon þansý az olan hastalarda tercih edilebilir bir seçenek olabilir.

Anaplastic thyroid carcinoma(ATC) is a rare, lethal disease with no effective systemic therapies. ATC usually manifests itself with the local symptoms due to a rapidly enlarging thyroid mass, that causing dysphagia, dysphonia or hoarseness, stridor, and dyspnea symptoms due to mass effect on the esophagus and trachea.
We report the case of a 56 year-old woman who was referred to our hospital due to swelling in the neck. A palpable, hard, immobile tumor was observed in the left side of his neck in thyroid, along with a swollen, palpable, immobile lymph node. The patient underwent chemotherapy regimen as cisplatin 75 mg/m2/day at D1, doxorubicin 60 mg/m2/day D1, every 21 days) regimen as first-line therapy for six cycles. No mass was detected in F18- FDG-PET after six cycled of chemotherapy. Complete remission was achieved radiologically. The patient underwent surgery after two weeks. Total thyroidectomy, bilateral central and left modified radical cervical lymph node dissection were performed. A surgical complete R0 resection was achieved.
The best results in terms of survival are obtained with a multidisciplinary treatment combining surgery, external beam radiotherapy and chemotherapy. Despite multidisciplinary treatment, responses to treatment are not promising. Neoadjuvant chemotherapy can be a preferable choice especially for the one who have a little chance for surgical complete R0 resection.

Spermatik kord hidrosel (SCH), testisler fetal geliþim sýrasýnda skrotuma inerken, processus vaginalis'in (PV) kapanmasý esnasýnda bir anormallikten kaynaklanýr. Testis üzerindeki spermatik kord boyunca kapalý bir sývý toplanmasýdýr. Ýki tür SCH vardýr. “Encysted” tipi hem proksimal hem de distal uçlarda kapalýdýr ve periton boþluðu ile iletiþim kurmaz. Füniküler tip iç inguinal halkada proksimal kaynaklýdýr ve distal olarak kapalýdýr, bu nedenle periton boþluðu ile iletiþim kurar. Literatürde olgularýn çoðu pediyatrik hastalarda bildirilmiþtir ve eriþkinlerde SCH oldukça nadirdir. Burada inguinal þiþlik ve aralýklý kasýk aðrýsý ile baþvuran 51 yaþýnda bir erkekte encysted tipte bir SCH olan bir olguyu sunuyoruz.

Spermatic cord hydrocele (SCH) is caused by an aberration in the closure of the processus vaginalis (PV) as the testicles descend into scrotum during fetal development. It is an enclosed fluid collection along the spermatic cord above the testicle. There are two types of SCH. The “encysted” type is closed at both proximal and distal ends and does not communicate with the peritoneal cavity. Funicular type is patent proximally at the internal inguinal ring and closed distally, thus communicates with the peritoneal cavity. In the literature, most of the cases were reported in pediatric patients and SCH in adults is extremely rare. Herein we present a case with an encysted type of SCH in a 51-year-old male presenting with inguinal swelling and intermittent groin pain.

Meme kanseri taramasýnýn en önemli amacý, kanserin erken evrede yakalanarak meme kanserine baðlý ölümlerin azaltýlmasýdýr. COVID-19 salgýný, hastalarýn ve saðlýk çalýþanlarýnýn saðlýk durumu ile ilgili acil bir sorun olarak kýsa bir süre önce dünya gündemini ve genel kaygýlarý deðiþtirmiþtir. Hala meme taramanýn amacý mortaliteyi azaltmaktýr; ancak bunun COVID-19 (SARS-COV-2) kaynaklý ölümlere neden olmamasý için ayrýntýlý rehberler oluþturulmalýdýr.

The most important goal of breast cancer screening is to detect cancer at an early stage and reduce deaths due to breast cancer. The COVID-19 pandemic has recently changed the world agenda and general concerns as an urgent issue regarding the health status of patients and healthcare workers. Still, the goal of breast screening is to reduce mortality; However, detailed guidelines should be created so that this does not cause deaths from COVID-19 (SARS-COV-2).