Browsing by Author "Inanc, M"
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Item Seasonal distribution of ocular conditions treated at the emergency room: a 1-year prospective studySen, E; Celik, S; Inanc, M; Elgin, U; Ozyurt, B; Yilmazbas, PPurpose: To determine the clinical characteristics and seasonal distribution of patients admitted to the ocular emergency department of a tertiary ophthalmology care center. Methods: The study cohort includes 27,120 patients who were admitted to ocular emergency room between November 2013 and November 2014. The age, sex, reason for admission, diagnosis, and complete ocular examination reports were recorded for each patient. X-ray and ultrasonographic examinations were performed if necessary. Results: The mean patient age was 32.83 +/- 17.62 years (range, 0-95). The number of males was nearly two times the number of females, with 18,808 (69.4%) males and 8312 (30.6%) females. The diagnoses included viral conjunctivitis (7,859 patients; 29.0%), corneal foreign body (5,286 patients; 19.5%), bacterial conjunctivitis (3,892 patients; 14.4%), corneal abrasions (2,306 patients; 8.5%), and allergic conjunctivitis (1,433 patients; 5.3%) (Table 1). Other frequent diagnoses included subconjunctival hemorrhage, photo keratopathy, chemical eye injury, and penetrating and blunt eye injuries. Allergic conjunctivitis, ocular trauma, and corneal foreign body were more frequent in spring, whereas keratitis and chemical eye injury were more common in winter (chi-square test). The most common reasons for emergency room admission, in order of frequency, were viral conjunctivitis, corneal foreign body, bacterial conjunctivitis, and corneal abrasions. Conclusion: This study is the first long-term prospective study to evaluate the seasonal distribution and diagnosis of all adult and pediatric patients admitted to the emergency room for ocular conditions. The frequency of ophthalmological conditions seen in the emergency room may vary according to the season.Item Identification of susceptibility loci for Takayasu arteritis through a large multi-ancestral genome-wide association studyOrtiz-Fernández, L; Saruhan-Direskeneli, G; Alibaz-Oner, F; Kaymaz-Tahra, S; Coit, P; Kong, XF; Kiprianos, AP; Maughan, RT; Aydin, SZ; Aksu, K; Keser, G; Kamali, S; Inanc, M; Springer, J; Akar, S; Onen, F; Akkoc, N; Khalidi, NA; Koening, C; Karadag, O; Kiraz, S; Forbess, L; Langford, CA; McAlear, CA; Ozbalkan, Z; Yavuz, S; Çetin, GY; Alpay-Kanitez, N; Chung, S; Ates, A; Karaaslan, Y; McKinnon-Maksimowicz, K; Monach, PA; Ozer, HTE; Seyahi, E; Fresko, I; Cefle, A; Seo, P; Warrington, KJ; Ozturk, MA; Ytterberg, SR; Cobankara, V; Onat, AM; Duzgun, N; Bicakcigil, M; Yentür, SP; Lally, L; Manfredi, AA; Baldissera, E; Erken, E; Yazici, A; Kisacik, B; Kasifoglu, T; Dalkilic, E; Cuthbertson, D; Pagnoux, C; Sreih, A; Reales, G; Wallace, C; Wren, JD; Cunninghame-Graham, DS; Vyse, TJ; Sun, Y; Chen, HY; Grayson, PC; Tombetti, E; Jiang, LD; Mason, JC; Merkel, PA; Direskeneli, H; Sawalha, AHTakayasu arteritis is a rare inflammatory disease of large arteries. We performed a genetic study in Takayasu arteritis comprising 6,670 individuals (1,226 affected individuals) from five different populations. We discovered HLA risk factors and four non-HLA susceptibility loci in VPS8, SVEP1, CFL2, and chr13q21 and reinforced IL12B, PTK2B, and chr21q22 as robust susceptibility loci shared across ancestries. Functional analysis proposed plausible underlying disease mechanisms and pinpointed ETS2 as a potential causal gene for chr21q22 association. We also identified >60 candidate loci with suggestive association (p < 5 x 10(-s)) and devised a genetic risk score for Takayasu arteritis. Takayasu arteritis was compared to hundreds of other traits, revealing the closest genetic relatedness to inflammatory bowel disease. Epigenetic patterns within risk loci suggest roles for monocytes and B cells in Takayasu arteritis. This work enhances understanding of the genetic basis and pathophysiology of Takayasu arteritis and provides clues for potential new therapeutic targets.Item EGFR Mutation in Patients with NSCLC and Its Relationship Between Survival and Clinicopathological Features: An Update AnalysisOzturk, A; Celik, S; Kodaz, H; Yildiz, I; Ocak, A; Hacibekiroglu, I; Bayoglu, IV; Ercelep, O; Ekinci, AS; Menekse, S; Gumusay, O; Oven, B; Aldemir, MN; Geredeli, C; Baykara, M; Uysal, M; Sevinc, A; Aksoy, A; Ulas, A; Inanc, M; Tanriverdi, O; Avci, N; Turan, N; Gumus, MItem Frequency of EGFR Mutation in Nsclc and Its Relationship with Clinicopathological Features: A Multicenter Asmo TrialYuksel, S; Kodaz, H; Yildiz, I; Odabasi, H; Ocak, A; Bayoglu, IV; Hacibekiroglu, I; Ercelep, O; Ekinci, AS; Erdogan, B; Mert, AG; Karaca, H; Salman, T; Menekse, S; Gumusay, O; Ustaalioglu, BO; Aldemir, MN; Geredeli, C; Baykara, M; Uysal, M; Sevinc, A; Aksoy, A; Ulas, A; Inanc, M; Tanriverdi, O; Avci, N; Turan, N; Aliustaoglu, M; Gumus, MItem Endocrine therapy alone vs chemotherapy plus endocrine therapies for the treatment of elderly patients with endocrine-responsive and node positive breast cancer: A retrospective analysis of a multicenter study (Anatolian Society of Medical Oncology)Inal, A; Akman, T; Yaman, S; Ozturk, SD; Geredeli, C; Bilici, M; Inanc, M; Harputoglu, H; Demirci, U; Balakan, O; Cinkir, HY; Alici, S; Sonmez, OU; Goksel, G; Dogu, GG; Unal, OU; Tamozlu, T; Buyukberber, S; Boruban, CM; Isikdogan, APurpose: The extra benefit of adding chemotherapy to effective endocrine therapy (ET) has not been clearly or consistently identified in patients older than 70 years with estrogen receptor (ER) positive and node positive breast cancer. The aim of this study was to evaluate the efficacy of adjuvant ET vs chemotherapy plus endocrine therapies (Chemo/ET) in such patients. Methods: In this retrospective multicenter study 191 patients >= 70 years with operated hormone receptor positive breast cancer, who were administered adjuvant ET or Chemo/ET were assessed. Results: The median patient follow-up time was 29.0 months (range 1-252). Therefore disease free survival (DFS) and overall survival (OS) analysis was limited, due to the rather short median follow-up, and only 30-month cumulative percentages are reported herein. The 30-month DFS rates were 50.0% in the ET arm and 49.0% in the Chemo/ET arm (p=0.79). The 30-month OS rates were 86% in the ET arm and 96.0% in the Chemo/ET arm (p=0.08). Cox proportional hazard model showed that only surgery was independent prognostic factor for survival (p=0.047), while tumor size showed a strong trend for statistical significance (p=0.051). Conclusion: The addition of chemotherapy to endocrine therapy in older patients has no significant impact on DFS and OS.Item Pathologic and Clinical Characteristics of Elderly Patients With Breast Cancer: A Retrospective Analysis of a Multicenter Study (Anatolian Society of Medical Oncology)Inal, A; Akman, T; Yaman, S; Ozturk, SC; Geredeli, C; Bilici, M; Inanc, M; Harputoglu, H; Demirci, U; Balakan, O; Cinkir, HY; Alici, S; Colak, D; Sonmez, OU; Goksel, G; Dogu, GG; Engin, H; Unal, OU; Tamozlu, T; Buyukberber, S; Boruban, CM; Isikdogan, AThere is very little information about breast cancer characteristics, treatment choices, and survival among elderly patients. The purpose of this multicenter retrospective study was to examine the clinical, pathologic, and biologic characteristics of 620 breast cancer patients age 70 years or older. Between June 1991 and May 2012, 620 patients with breast cancer, recruited from 16 institutions, were enrolled in the retrospective study. Patients had smaller tumors at diagnosis; only 15% of patients had tumors larger than 5 cm. The number of patients who had no axillary lymph node involvement was 203 (32.7%). Ninety-three patients (15.0%) had metastatic disease at diagnosis. Patients were characterized by a higher fraction of pure lobular carcinomas (75.3%). The tumors of the elderly patients were also more frequently estrogen receptor (ER) positive (75.2%) and progesterone receptor (PR) positive (67.3%). The local and systemic therapies for breast cancer differed according to age. An association between age and overall survival has not been demonstrated in elderly patients with breast cancer. In conclusion, the biologic behavior of older patients with breast cancer differs from younger patients, and older patients receive different treatments.Item Is lymph node ratio prognostic factor for survival in elderly patients with node positive breast cancer? The Anatolian Society of Medical OncologyInal, A; Akman, T; Yaman, S; Ozturk, SC; Geredeli, C; Bilici, M; Inanc, M; Harputoglu, H; Demirci, U; Suner, A; Cinkir, HY; Alici, S; Colak, D; Sonmez, OU; Goksel, G; Dogu, GG; Engin, H; Unal, OU; Tamozlu, T; Buyukberber, S; Boruban, CM; Isikdogan, ASeveral studies have now demonstrated that the lymph node ratio (LNR), as a superior indicator of axillary tumor burden to the number of excised nodes. While, about the prognostic value of LNR on the the survival of elderly patients is limited. The aim of this retrospective multicenter study is to evaluate the prognostic value of lymph node ratio in elderly patients with node positive breast cancer. METHODS: Onehundredeightyfour patient with operable breast cancer, recruited from 17 institutions, were enrolled into the retrospectively study. Eleven potential prognostic variables were chosen for analysis in this study. Univariate and multivariate analyses were conducted to identify prognostic factors associated with survival. RESULT: Among the eleven variables of univariate analysis, four variables were identified to have prognostic significance for Overall survival (OS): pathologic tumor size (T), No. of positive nodes (N), LNR and estrogen receptor-positive (ER). Among the eleven variables of univariate analysis, two variables were identified to have prognostic significance for Disease-free survival (DFS): N and LNR. Multivariate analysis by Cox proportional hazard model showed that 7; LNR and ER were considered independent prognostic factors for OS. Furthermore, LNR was considered independent prognostic factors for DFS. CONCLUSION: In conclusion, the LNR was associated with the prognostic importance for DFS and OS in elderly patients who were administered adjuvant treatments.Item XELOX Plus Bevacizumab vs. FOLFIRI Plus Bevacizumab Treatment for First-line Chemotherapy in Metastatic Colon Cancer: a Retrospective Study of the Anatolian Society of Medical OncologyDuran, AO; Karaca, H; Besiroglu, M; Bayoglu, IV; Menekse, S; Yapici, HS; Yazilitas, D; Bahceci, A; Uysal, M; Sevinc, A; Hacibekiroglu, I; Aksoy, A; Tanriverdi, O; Arpaci, E; Inanc, M; Dane, F; Ozkan, MBackground: XELOX plus bevacizumab (XELOX-Bev) and FOLFIRI plus Bevacizumab (FOLFIRI - Bev) treatments are an effective strategies patients with metastatic colorectal cancer (mCRC). The aim of this study was to compare efficacy of first-line XELOX-Bev treatment vs FOLFIRI-Bev treatment for mCRC. Materials and Methods: A total of 409 patients with mCRC who received chemotherapy were included and divided into 2 groups. Group 1 (n=298) received XELOX-Bev and Group 2 (n=111) FOLFIRI-Bev. Comparisons were made in terms of overall (OS) and progression-free (PFS) survival, response rate (RR), and grade 3-4 toxicity. Results: Median follow-up was 11 months in Group 1 and 15 months for Group 2. Complete remission was observed in 29 (9.7%) and 2 (1.8%) patients, partial remission in 139 (46.6%) and 27 (24.5%), stable disease in 88 (29.5%) and 49 (44.1%) and progressive disease in 42 (14.1%) and 33 (30.0%) patients in Group 1 and 2, respectively. Median OS was 25 months (range 2-57 months, 95% CI; 22.2-27.7) for Group 1 and 20 months (range 1-67 months, 95% CI; 16.8-23.1) for Group 2 (p=0.036). Median PFS was 9.6 months (range 2-36 months, 95% CI; 8.8-10.4) for Group 1 and 9 months (range 1-44 months, 95% CI; 7.4-10.5) for Group 2 (p=0.019). Objective RR was 56.4% in Group 1 and 26.1% in Group 2 (p<0.001). Conclusions: First-line XELOX-Bev is more effective with a better response rate, prolongation of median PFS/OS, and a superior safety profile compared with FOLFIRI-Bev.Item Prognostic factors of patients who received chemotherapy after cranial irradiation for non-small cell lung cancer with brain metastases: A retrospective analysis of multicenter study (Anatolian Society of Medical Oncology)Inal, A; Kodaz, H; Odabas, H; Duran, AO; Seker, MM; Inanc, M; Elkiran, ET; Gunaydin, Y; Menekse, S; Topcu, TO; Urakci, Z; Tastekin, D; Bilici, M; Cihan, S; Geredeli, C; Sezer, E; Uncu, D; Arpaci, E; Ozturk, B; Bal, O; Uysal, M; Tanriverdi, O; Gumus, M; Ustaalioglu, BBO; Suner, A; Cokmert, S; Hacibekiroglu, I; Aydin, K; Isikdogan, APurpose: Almost half of all patients diagnosed with non-small cell lung cancer (NSCLC) have distant metastases at presentation. One-third of patients with NSCLC will have brain metastases. Without effective treatment, the median survival is only 1 month. However, it is difficult to treat brain metastases with systemic chemotherapy since the agents have difficulty crossing the blood-brain barrier. Therefore, it is important to estimate the patient's survival prognosis. The aim of this study was to analyze prognostic factors for survival in Turkish patients who received chemotherapy after cranial irradiation for NSCLC with brain metastases. Methods: We retrospectively reviewed 698 patients with brain metastases resulting from NSCLC. Ten potential prognostic variables were chosen for analysis. Univariate and multivariate analyses were conducted to identify prognostic factors associated with overall survival (OS). Results: Among the 10 variables for univariate analysis, six were identified to have prognostic significance; these included sex, smoking history, histology, number of brain metastases, extracranial metastases, and neurosurgical resection. Multivariate analysis by the Cox proportional hazard model showed that a smoking history, extracranial metastases, and neurosurgical resection were independent negative prognostic factors for OS. Conclusion: Smoking history, extracranial metastases, and neurosurgical resection were considered independent negative prognostic factors for OS. These findings may facilitate pretreatment prediction of survival and can be used for selecting patients for more appropriate treatment options.Item THE COST OF CARE OF RHEUMATOID ARTHRITIS AND ANKYLOSING SPONDYLITIS PATIENTS IN TERTIARY CARE RHEUMATOLOGY UNITS IN TURKEYMalhan, S; Pay, S; Ataman, S; Dalkilic, E; Dinc, A; Erken, E; Ertenli, I; Ertugrul, E; Gogus, F; Hamuryudan, V; Inanc, M; Karaaslan, Y; Karadag, O; Karakoc, Y; Keskin, G; Kisacik, B; Kiraz, S; Oksel, F; Oksuz, E; Parildar, T; Sari, I; Soy, M; Senturk, T; Taylan, AItem The cost of care of rheumatoid arthritis and ankylosing spondylitis patients in tertiary care rheumatology units in TurkeyMalhan, S; Pay, S; Ataman, S; Dalkilic, E; Dinc, A; Erken, E; Ertenli, I; Ertugrul, E; Gogus, F; Hamuryudan, V; Inanc, M; Karaaslan, Y; Karadag, O; Karakoc, Y; Keskin, G; Kisacik, B; Kiraz, S; Oksel, F; Oksuz, E; Pirildar, T; Sari, I; Soy, M; Senturk, T; Taylan, AObjectives To determine the direct and indirect costs due to rheumatoid arthritis (RA) and ankylosing spondylitis (AS) patients in Turkey. Methods An expert panel was convened to estimate the direct and indirect costs of care of patients with RA and AS in Turkey. The panel was composed of 22 experts chosen from all national tertiary care rheumatology units (n=53). To calculate direct costs, the medical management of RA and AS patients was estimated using cost-of-illness methodology. To measure indirect costs, the number of days of sick leave, the extent of disability, and the levels of early retirement and early death were also evaluated. Lost productivity costs were calculated using the human capital approach, based on the minimum wage. Results The total annual direct costs were 2,917.03 Euros per RA patient and 3,565.9 Euros for each AS patient. The direct costs were thus substantial, but the indirect costs were much higher because of extensive morbidity and mortality rates. The total annual indirect costs were 7,058.99 Euros per RA patient and 6,989.81 for each AS patient. Thus, the total cost for each RA patient was 9,976.01 Euros and that for an AS patient 10,555.72 Euros, in Turkey. Conclusion From the societal perspective, both RA and AS have become burden in Turkey. The cost of lost productivity is higher than the medical cost. Another important conclusion is that indirect costs constitute 70% and 66% of total costs in patients with RA and AS, respectively.