Goal: 03 - Sağlık ve Kaliteli Yaşam
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AMAÇ 3: SAĞLIKLI BİREYLER
Çocuk ölüm oranlarının azaltılması, anne sağlığının iyileştirilmesi, HIV/AIDS, sıtma ve diğer hastalıklar ile mücadelede büyük aşama kaydetmiş durumdayız. 1990 yılından bu yana, önlenebilir çocuk ölümlerinde dünya genelinde %50’yi aşan azalma olmuştur. Anne ölümleri de dünya genelinde %45 azalmıştır. 2000 ile 2013 arasında HIV/AIDS bulaşma oranı %30 azalmış, 6,2 milyonu aşkın insan sıtmadan kurtarılmıştır.
Bu ölümler; önleme ve tedavi, eğitim, aşı kampanyaları, cinsel ve üreme sağlığı hizmetleri vasıtasıyla önlenebilir. Sürdürülebilir Kalkınma Amaçları; AIDS, verem, sıtma ve diğer bulaşıcı hastalık salgınlarını 2030 yılına kadar ortadan kaldırmaya yönelik cesur bir taahhüttür. Amaç, herkesin genel sağlık hizmeti, güvenli ve erişilebilir ilaç ve aşıya kavuşmasını sağlamaktır. Aşı araştırma ve geliştirmelerinin desteklenmesi, bu sürecin vazgeçilmez bir parçasıdır.
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Publication Metadata only The Prognostic and Predictive Value of Expression of P-AKT in Patients with FIGO IIB Locally Advanced Cervical Cancer under Chemotherapy(2013-01-01T00:00:00Z) Kocak, Mihriban E.; Barisik, Nagehan O.; Mayadagli, Alpaslan; Gemici, Cengiz; Eren, Makbule; Naki, Murat; Ozseker, Naciye; Aksu, Atinc; MAYADAĞLI, ALPASLANTo evaluate the relation between expression of P-Akt and radiotherapy response, disease-free survival and overall survival in cervical cancer patients. A total of 50 patients with FIGO stage IIB locally advanced squamous cell cervical cancer treated primarily with chemoradiotherapy were included in the present study. All patients received external beam radiotherapy (EBRT; 46-50.4 Gy with 1.8-2 Gy of daily fraction, five times a week) followed by high-dose rate brachytherapy (HDR 26 Gy at point A, with 6.5 Gy per fraction a week for 4 weeks). Chemotherapy consisted of 40 mg/m2 cisplatin i.v. once a week for 5 weeks concomitant with external pelvic radiation. Paraffin-embedded, formalin-fixed primary tumor tissue was collected from each patient to identify P-Akt expression, retrospectively. The median follow up time for the study population was 30 (12-120) months. Expression of P-Akt was identified in 86% (43/50) of patients. Overall 3-years survival and disease free survival were 89.3% and 79%; respectively in the study population. There was no significant association between P-Akt staining and survival (89% vs 85.7%, p= 0.641) and disease-free survival (80% vs 88.2%, p= 0.498). There was no relation between expression of P-Akt and treatment response, size of the tumor, lymph node status, age, local and distant failures. Univariate analysis revealed significantly reduced overall 3-years survival and disease free survival only for patients with poor treatment response (p= 0.001). In multivariate analysis, treatment response was found to be statistically significant parameter only for DFS (p= 0.001). In conclusion, in our study, expression of P-Akt was detected in majority of cervical cancer patients. However no correlation was observed between P-Akt staining degree and treatment responsePublication Open Access Radiation field size and dose determine oncologic outcome in esophageal cancer.(2016-10-13T00:00:00Z) GEMICI, C; YAPRAK, G; BATIREL, HF; ILHAN, MAHMUT MUZAFFER; Mayadagli, ALPASLAN; İLHAN, MAHMUT MUZAFFER; MAYADAĞLI, ALPASLANPublication Open Access Outcome of Daily Cisplatin with Thoracic Chemoradiotherapy in Advanced Non-small Cell Lung Cancer Patients with Comorbid Disorders: a Pilot Study(2014-01-01) Kiziltan, HURİYE ŞENAY; Bayir, Ayse Gunes; TAŞTEKİN, Didem; Coban, GANİME; Eris, ALİ HİKMET; Aydin, TEOMAN; MAYADAGLI, Alparslan; KIZILTAN, HURİYE ŞENAY; GÜNEŞ BAYIR, AYŞE; ÇOBAN, GANİME; ERİŞ, ALİ HİKMET; AYDIN, TEOMAN; MAYADAĞLI, ALPASLANBackground: Lung cancer is the most common cancer in males worldwide. The principal mode of treatment in the early stage of non-small cell lung cancer (NSCLC) is surgery. However, five-year survival is only about 15% for all stages. The aim is to investigate the effect of daily low dose cisplatin concurrently with radiation therapy in advanced NSCLC patients with poor performance status. Materials and Methods: Ten patients diagnosed as inoperable Stage IIIB NSCLC with comorbid disease were assessed retrospectively in Bezmialem Vakif University, Faculty of Medicine, Department of Radiation Oncology, between 2011 to 2013. ECOG performance status was between 3 and 4. Cisplatin was administered at 6mg/m2 daily, for 5 days a week concurrently with radiotherapy using 160-200 cGy daily fractions, 54 Gy being the lowest and 63 Gy being the highest dose. Results: Complete response at the primary tumour site was obtained in 20% patients. Grade I esophagitis was seen 70 percent of patients, and the grade II haematological toxicity rate was 20 %. Median survival time was 7 months. Conclusions: Median survival time was reasonable, despite the patients ECOG performance status of 3-4, which is similar to groups even without comorbid disorders in comparison to other published papers in the literature. Acceptable toxicity, high response rates and quality of life of patients are the other favourable features.Publication Metadata only Is there any role of thrombin activatable fibrinolysis inhibitor in the development of a hypercoagulable state in gastric cancer(2012-08-01T00:00:00Z) Eser, Mehmet; Kement, Metin; Balin, Salim; Coskun, Cihan; KEFELİ, UMUT; Gumus, Mahmut; Altuntas, Yunus Emre; Kurt, Necmi; Mayadagli, Alpaslan; MAYADAĞLI, ALPASLANBackground: The purpose of this study was to investigate plasma levels of thrombin activatable fibrinolysis inhibitor (TAFI) and TAFI-s relationship with coagulation markers (prothrombin fragment 1 + 2) in gastric cancer patients.Publication Metadata only Long Term Benefits of Post-surgical Adjuvant Radiotherapy Among Sub-population of Patients with Stage IB Grade 2 Endometrial Cancer(2011-01-01T00:00:00Z) Kocak, Mihriban; Eren, Makbule; Naki, Murat M.; Aksu, Atinc; Celik, Hasniye; Ozkan, Alper; Mayadagli, Alpaslan; Unal, Orhan; MAYADAĞLI, ALPASLANPresent study was designed to evaluate potential risks and benefits of adjuvant radiotherapy in selected patients with intermediate-risk endometrial cancer. A total of 100 patients with stage IB grade II endometrial cancer followed up in Radiation Oncology Clinic at Dr. Lutfi Kirdar Training and Research Hospital were evaluated retrospectively to determine the influence of postsurgical adjuvant radiotherapy on disease-free survival, local recurrences and locally-relaps free survival. Side effects related to adjuvant radiotherapy were also evaluated. Forty-seven (47%) patients were determined to undergo total abdominal hysterectomy + bilateral salphingo-oopherectomy and 53 (53%) patients, total abdominal hysterectomy + bilateral salphingo-oopherectomy + pelvic lymph node dissection. Postsurgical adjuvant radiotherapy was administered in 77 patients (77%), while the surgery was the sole medical intervention for 23 patients (23%). The median follow-up period was 40.5 months (range: 6-139) Five-year disease-free survival (96.6% vs. 80.5%; p<0.01) and local control (98.6% vs. 80.5%; p<0.05) were better in patients who were administered postoperative radiotherapy compared to patients without postoperative radiotherapy.Publication Open Access Is there any role of intravenous iron for the treatment of anemia in cancer?(2016-08-20T00:00:00Z) GEMICI, C; YETMEN, O; YAPRAK, G; OZDEN, S; TEPETAM, H; OZYURT, H; Mayadagli, ALPASLAN; MAYADAĞLI, ALPASLANBackground: Anemia is a major cause of morbidity in patients with cancer resulting in poor physical performance, prognosis and therapy outcome. The aim of this study is to assess the efficacy of intravenous (iv) iron administration for the correction of anemia, for the prevention of exacerbation of anemia, for decreasing blood transfusion rates, and for the survival of cancer patients. Methods: Patients with different solid tumor diagnosis who received iv iron during their cancer treatment were evaluated retrospectively. Sixty-three patients with hemoglobin (Hgb) levels between >= 9 g/dL, and >= 10 g/dL, and no urgent need for red blood cell transfusion were included in this retrospective analysis. The aim of cancer treatment was palliative for metastatic patients (36 out of 63), or adjuvant or curative for patients with localized disease (27 out of 63). All the patients received 100 mg of iron sucrose which was delivered intravenously in 100 mL of saline solution, infused within 30 min, 5 infusions every other day. Complete blood count, serum iron, and ferritin levels before and at every 1 to 3 months subsequently after iv iron administration were followed regularly. Results: Initial mean serum Hgb, serum ferritin and serum iron levels were 9.33 g/dL, 156 ng/mL, and 35.9 mu g/dL respectively. Mean Hgb, ferritin, and iron levels 1 to 3 months, and 6 to 12 months after iv iron administration were 10. 4 g/dL, 11.2 g/dL, 298.6 ng/mL, 296.7 ng/mL, and 71.6 mu g/dL, 67.7 mu g/dL respectively with a statistically significant increase in the levels (p < 0.001). Nineteen patients (30 %) however had further decrease in Hgb levels despite iv iron administration, and blood transfusion was necessary in 18 of these 19 patients (28.5 %). The 1-year overall survival rates differed in metastatic cancer patients depending on their response to iv iron; 61.1 % in responders versus 35.3 % in non-responders, (p = 0.005), furthermore response to iv iron correlated with tumor response to cancer treatment, and this relation was statistically significant, (p < 0.001). Conclusions: Iv iron administration in cancer patients undergoing active oncologic treatment is an effective and safe measure for correction of anemia, and prevention of worsening of anemia. Amelioration of anemia and increase in Hgb levels with iv iron administration in patients with disseminated cancer is associated with increased tumor response to oncologic treatment and overall survival. Response to iv iron may be both a prognostic and a predictive factor for response to cancer treatment and survival.Publication Metadata only Evaluation of Late Radiation Side Effects in Nasopharyngeal Cancer Patients(2012-01-01T00:00:00Z) Mayadagli, Alpaslan; Yaprak, Gokhan; Tezcan, Yilmaz; MAYADAĞLI, ALPASLANThe prolongation of survival in cases with nasopharynx cancer has made quality of life after treatment more important. The aim of this study is to consider late toxicity developing after treatment in order to maintain a high quality of life. Thirty-two patients receiving radiotherapy (RI) to the neck region 1-10 years ago due to nasopharyngeal carcinoma were included in the study. Neck ultrasonography (USG), thyroid function tests and dynamic brain magnetic resonance imaging (MRI) were carried out for carotid artery stenosis, hypothyroidism, and necrosis of the temporal lobe. Obtained data were analyzed with the SPSS 11.5. Intima-media thickness of below 60 Gy and above 60 Gy doses administered to the neck were similar. Intima-media thickness was greater in patients with a period longer than 5 years after RT than with a period shorter than 5 years (p< 0.001). lntima-media thicknesses of the patients above 40 years, with high cholesterol values, a history of smoking and hypertension were higher than those without them (p< 0.001). There was hypothyroidism in five (15%) of the 32 patients. Necrosis of the temporal lobe was not seen in any of the patients. Carotid artery stenosis after treatment depends more on the duration of the period after treatment and the patient-s being in the age group when atherosclerotic risk factors are present than on the amount of dose administered.Publication Metadata only DETERMINATION OF PARAMETERS AFFECTING THE USE OF COMPLEMENTARY AND ALTERNATIVE MEDICINE IN CANCER PATIENTS AND DETECTION OF PREVALENCE OF USE(2011-01-01T00:00:00Z) Mayadagli, Alpaslan; Aksu, Atinc; Goksel, Fatih; Gocen, Erkan; KARAHACIOĞLU, ERAY; Gumus, Mahmut; Pak, Yucel; MAYADAĞLI, ALPASLANThis study was conducted to find out the frequency of complementary and alternative medicine (CAM) use that could lead to troubles in patient health and in applied standard therapy protocols when used improperly, which method is used, the reasons for use and from which resources the information about this topic were obtained. A questionnaire consisting of 28 questions was applied to 195 patients with cancer diagnosis by a face-to-face interview. The obtained data were assessed with SPSS 11.5 program. Out of 195 cancer patients, 100 (51.3%) were using CAM and 48.7% (n=95) were not. The most commonly used agent was nettle (72%). This was followed by herbal teas (21%), grape molasses (20%) and black seed (20%). The frequency of CAM use was found higher in those under age 50, in literate people, in those working during the diagnosis stage and having disease at the later stage. While CAM was commonly recommended by friends and relatives of the patients (73%), this ratio was only 5% for health professionals. While 51.3% of all patients were gathering information about CAM, 75% of those actually using CAM gathered information about it. Whilst information was gathered mostly from the relatives of patients and tamperers (47%), it can be gathered from physicians only with a ratio of 10%. Cancer patients use CAM and they gather information mainly from unreliable sources rather than physicians. Although the primary information source should be physicians, the ratio for this was very low (10%). We suggest that physicians should spend more time in gathering correct information and sharing them with their patients for a better guidance.Publication Metadata only Retrospective Investigation of 49 Cases of Locally Advanced Nasopharyngeal Cancer Patients who were Given Neoadjuvant Docetaxel/Cisplatin Chemotherapy and Concomitant Chemoradiotherapy(2014-01-01T00:00:00Z) Ekici, Kemal; Aksu, Atmc; TEMELLİ, ÖZTUN; Mayadagli, Alpaslan; Ceylaner, Beyhan; Ozseker, Naciye; Htway, Zarni; MAYADAĞLI, ALPASLANNasopharyngeal cancer (NPC) generally shows higher incidence in China, South-east Asia and some regions of the world. Being radio- and chemo-sensitive, NPCs have higher prevalence in middle ages and occupy a special place among head and neck tumors. The aim of this study is to investigate the results of 49 locally advanced NPC patients who were given Docetaxel/cisplatin as neoadjuvant therapy and concomitant chemoradiotherapy. Our study included 49 locally advanced NPC patients who presented to our clinic between 2004 and 2011 and received two to three cures of neoadjuvant Docetaxel/Cisplatin therapy followed by concomitant chemoradiotherapy. Neoadjuvant chemotherapy scheme was docetaxel 75 mg/m(2)/day and cisplatin 75 mg/m(2)/day in three weeks. Median age of the patients was 50 years, and median follow-up period was 40.4 months. After concomitant chemotherapy of the patients, complete response was obtained in 47 (95.9%) patients and partial response in 2 (4.1%) patients. Average survival was found to be 78.3 months, and 3-year and 5-year survivals were 93% and 89% respectively. 8 of 49 patients developed recurrence. Average disease-free survival (DFS) was 67.4 months and 5-year DFS rate was 84%. Neoadjuvant chemotherapy in NPC increased disease-free survival rates, but failed to increase general survival. In our study, our patients disease-free survival and 5-year overall survival is quite good, these values have been found promising for the treatment of nasopharyngeal cancer. So this treatment regimen became a promising treatment choice due to its tolerable toxicity.