Browsing by Author "Serkan YILDIRIM"

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    HEKİMLERİN BİLİRKİŞİLİK DENEYİMLERİ VE KARŞILAŞTIKLARI SORUNLARIN ÇÖZÜMÜ ÜZERİNE BİR ANKET ÇALIŞMASI
    (2020) Orhan MERAL; Serkan YILDIRIM; Mahmut ATEŞ; Hakan ÖZSEL; Ekin Özgür AKTAŞ; Emin KURT
    Çalışmamız bir anket çalışmasıdır. Manisa Celal Bayar Üniversitesi Tıp Fakültesi Hafsa Sultan Hastanesi ile Sağlık Bilimleri Üniversitesiİzmir Bozyaka Eğitim ve Araştırma Hastanesinde görevli olup çalışmayakatılmayı kabul eden 204 hekime uygulanmıştır. Hekimlere yaş, cinsiyet, uzmanlık alanı ve ünvanı ile hekimlik sürelerini içeren sosyodemografik veriler, ayrıca bilirkişilik uygulamaları ve karşılaşılan sorunların çözümlerine ilişkin görüşler sorgulanan toplam 17 soru yöneltilmiştir.Çalışmaya katılmayı kabul edip yazılı onam veren 204 hekimden157’si (%77) erkek 47’si (%23) kadındır. Hekimlerin yaşları 25-70 arasında değişmekte olup ortalama yaş 39, 73±9, 973 olarak, ayrıca meslektecrübeleri 1-47 yıl arasında değişmekte olup ortalama yıl 15, 24 ± 10,329 olarak bulunmuştur. Katılımcıların 90’ı (%44, 1) Uzman Hekim,43’ü (%21, 1) Araştırma Görevlisi, 39’u (%19, 1) Öğretim Üyesi, 30’u(%14, 7) Pratisyen Hekim, 2’si (%1) Doktoralı Hekim olarak görevyapmaktadır.Katılımcıların %63, 7’si bilirkişilik yaptığını, %67, 6’sı bilirkişilikeğitimi almadığını ifade etmiştir. Alınan görüşler incelendiğinde ise;%78, 4’ü ücretlerin yetersiz olduğunu, %42, 2’si sürekli aynı kurum veya hekimlerden rapor istendiğini, %53, 4’ü ise bilirkişilik alanında verilen eğitimlerin yetersiz olduğunu ifade etmiştir.Bu çalışmada; hekimlerin bilirkişilik uygulamaları ve karşılaştıkları sorunlar ile mevcut sorunlara ilişkin çözüm yollarının tartışılmasıamaçlanmıştır.
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    Are Hormonal Agents Better Than Chemo in Metastatic Castration-resistant Prostate Cancer?
    (2021) Serkan YILDIRIM; Atike Pınar ERDOĞAN
    OBJECTIVE In this study, we aim to determine which treatment is more appropriate in castration-resistant chemotherapy- naive patients. Therefore, docetaxel and agents active in the androgen pathway (abiraterone and enzalutamide) were compared retrospectively in patients progressing on androgen deprivation therapy. METHODS The study was designed as a retrospective and multicenter study. Patients from five centers in Turkey were included in the study. The primary endpoint of the study was overall survival (OS) and the secondary endpoint was progression-free survival. RESULTS Median OS of the docetaxel group was 18.66 months, it was 16.26 months in the hormonal treatment group. There was no statistically significant difference between the groups (p=0.311). Median progressionfree survival of the chemotherapy group was 5.6 months, while it was 9 months in the hormonal therapy group. There was statistically significant difference between the groups (p=0.024). CONCLUSION There was statistical difference in progression-free survival in favor of hormonal therapies in our study. The difference did not reflect on OS and there was no difference between hormonal therapies and docetaxel. Heterogeneity in the selection of patients is considered to lead to this result; however, larger randomized controlled studies are needed to determine the most appropriate treatment in these patients.
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    Evaluation of Castration-Resistant Elderly Patients
    (2021) Serkan YILDIRIM; Atike Pınar ERDOĞAN; Ahmet ÖZVEREN; Ferhat EKİNCİ; Gülcan BULUT
    Objectives: In the present time suggesting an extended human lifespan and expectancy, elderly patients receive asignificant portion of daily healthcare practice whereas they have not been sufficiently addressed in the extensiveand comprehensive clinical studies. We have desgined our study to evaluate the treatment options in this metastaticcastration-resistant prostate cancer patients older than 70 years. Methods: Our study is retrospective. The data of the patients from 5 centers of Turkey were obtained. The patients aged70 years and over were assigned to a group (geriatric group) while the rest of the patients were evaluated in anothergroup (normal group). The primary endpoint of the study was determined as overall survival time. Results: Totally 113 patients were included in our study. The geriatric and normal groups included 58 and 55 patients,respectively. Overall survival as the primary endpoint of our study demonstrated no statistically significant differencebetween survival of the patients aged over 70 years and other patients (geriatric group versus normal group, respectively 18.86 versus 23.93 months, respectively, p=0,542). Progresion-free survival as the secondary endpoint; no statistically significant difference was detected between two groups (geriatric group vs normal group, median 7.83 vs 8.5months, respectively, p=0.73). Conclusion: It was detected that the age variable has a negative impact on overall survival of prostate cancer cases.The overall survival was found numerically shorter in the patients aged 70 years and over set as age limit, however, thisdifference was not found statistically significant.
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    Predictive Value of Lymphocyte-Related Blood Parameters of before Ado-Trastuzumab Emtansin Treatment in Breast Cancer
    (2022) Gülcan BULUT; Ahmet ÖZVEREN; Ferhat EKİNCİ; Cengiz YILMAZ; Serkan YILDIRIM; Atike Pınar ERDOĞAN
    Objective: Ado-Trastuzumab Emtansine ( TDM1) has been used in the treatment of HER2 metastatic breast cancer after FDA approval as an antibody-drug conjugate. Some markers may be predictive for clinician in the management of this TDM1 therapy. There is a need for simple and cost-effective markers to show the treatment response. The primary aim of this study is to establish a correlation between progression free survival and pre-treatment hematological inflammatory parameters [absolute lymphocyte count (ALC), neutrophil-to-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR)] in advance breast cancer. Methods: Forty-one female patients with metastatic HER-2 positive breast cancer who received TDM-1 between 2016 and 2021 were evaluated retrospectively. NLR and PLR were calculated with the values of neutrophils, lymphocytes, and trombocytes in complete blood count at the time of diagnosis. The cut off values of NLR and PLR were determined using receiver operating characteristic (ROC) curve analysis. Overall survival (OS) and progression free survival (PFS) associated with prior treatment NLR, PLR, ALC were performed by Kaplan-Meier method. Results: Median age was 49.5 years years (26-76).Patients divided into 2 groups according to NLR cut-off and TLR cutoff values as NLR/TLR high and low groups. The cut-off values of NLR and TLR were 144.0, and 2.74, respectively. ALC divided into 2 groups. There was no significant difference in OS between NLR ,PLR,ALC (high/low) groups. (p=0.04, 0.15, 0.53 respectively). There was only significant difference in PFS (high/low) groups.(p=0.81, 0.99, 0.96 respectively). Conclusions: The predictive value of pre-treatment only NLR on the therapeutic potential in patients with metastatic breast cancer treated with TDM1.