• Tuberculosis and Respiratory Diseases
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• v.79 no.3
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• pp.158-164
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• 2016

Background: One to three percent of cases of acute tuberculosis (TB) require monitoring in the intensive care unit (ICU). The purpose of this study is to establish and determine the mortality rate and discuss the causes of high mortality in these cases, and to evaluate the clinical and laboratory findings of TB patients admitted to the pulmonary ICU. Methods: The data of patients admitted to the ICU of Yedikule Chest Diseases and Chest Surgery Education and Research Hospital due to active TB were retrospectively evaluated. Demographic characteristics, medical history, and clinical and laboratory findings were evaluated. Results: Thirty-five TB patients (27 males) with a median age of 47 years were included, of whom 20 died within 30 days (57%). The Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) scores were significantly higher, and albumin and $PaO_2/FIO_2$ levels were significantly lower, and shock, multiple organ failure, the need for invasive mechanical ventilation and drug resistance were more common in the patients who died. The mortality risk was 7.58 times higher in the patients requiring invasive mechanical ventilation. The SOFA score alone was a significant risk factor affecting survival. Conclusion: The survival rate is low in cases of tuberculosis treated in an ICU. The predictors of mortality include the requirement of invasive mechanical ventilation and multiple organ failure. Another factor specific to TB patients is the presence of drug resistance, which should be taken seriously in countries where there is a high incidence of the disease. Finding new variables that can be established with new prospective studies may help to decrease the high mortality rate.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.8
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• pp.3565-3572
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• 2015

Background: Breast cancer is the most common cancer among women and leading cause of death worldwide, including in Turkey. High perceptions of cancer fatalism are associated with lower rates of participation in screening for breast cancer. This study was conducted to evaluate the effect of breast cancer fatalism and other factors on breast cancer awareness among nursing students in Turkey. Materials and Methods: This cross-sectional descriptive study was conducted at three universities in the Western Black Sea region. The sample was composed of 838 nursing students. Data were collected by Personal Information Form, Powe Fatalism Inventory (PFI) and Champion's Health Belief Model Scale (CHBMS). Results: Breast cancer fatalism perception of the students was at a low level. It was determined that students; seriousness perception was moderate, health motivation, BSE benefits and BSE self-efficacy perceptions were high, and BSE barriers and sensitivity perceptions were low. In addition, it was determined that students awareness of breast cancer was affected by breast cancer fatalism, class level, family history of breast cancer, knowledge on BSE, source of information on BSE, frequency of BSE performing, having breast examination by a healthcare professional within the last year and their health beliefs. Conclusions: In promoting breast cancer early diagnosis behaviour, it is recommended to evaluate fatalism perceptions and health beliefs of the students and to arrange training programs for this purpose.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.4
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• pp.1643-1649
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• 2015

Background: The aim of the present study was to evaluate clinicopathological characteristics of our early stage breast cancer patients who are epidermal growth factor receptor 2 (HER2) overexpressed/amplified (HER2+), the efficacy of trastuzumab treatment and survival results. Materials and Methods: Patients with HER2-positive early stage breast cancer receiving adjuvant trastuzumab were investigated retrospectively. Clinicopathological features of 210 patients and treatment outcome were analysed. To evaluate survival rates, the Kaplan-Meier method was used. Univariate and multivariate analyses were conducted with the Cox regression model. Results: Mean age of the patients was 51.8, 71.9% being postmenopausal. Some 37.6% of patients were node negative, and 31% had T1 tumor size and 52.4% were positive for estrogen receptor. Of 210 patients, 89.5% completed planned 52 weeks adjuvant trastuzumab treatment. The median follow up was 27.5 months (6.0-86.0). Relapse free survival (RFS) was 68.0 months (95% CI: 62.1-74.0) and overall survival (OS) was 74.8 months (95% CI: 69.5-80.1). The 3 year OS for all patients was 92.0% and RFS was 79.6%. During follow up, relapse was detected at the rate of 14.3%. Trastuzumab associated cardiotoxicity was found at the rate of 3.3%. In univariate analyses, larger tumor size and grade III were significantly associated (p<0.05) with RFS. Multivariate analyses of covariates displaying p<0.05 identified grade III as an independent prognostic factor. Conclusions: In the present study, it was established that trastuzumab had a satisfactory safety profile and treatment efficacy as in other clinical studies and that among clinicopathological factors evaluated, only being grade 3 had a significant effect on RFS. The occurrence of relapse with adjuvant trastuzumab makes it necessary to identify molecular predictors, which will define this group better and help explain resistance to anti HER2 based therapies.

• Structural Engineering and Mechanics
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• v.27 no.2
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• pp.117-134
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• 2007

The force (load) reduction factor, R, which is one of the most important parameters in earthquake load calculation, is independent of the dimensions of the structure but is defined on the basis of the load bearing system of the structure as defined in earthquake codes. Significant damages and failures were experienced on prefabricated reinforced concrete structures during the last three major earthquakes in Turkey (Adana 1998, Kocaeli 1999, Duzce 1999) and the experts are still discussing the main reasons of those failures. Most of them agreed that they resulted mainly from the earthquake force reduction factor, R that is incorrectly selected during design processes, in addition to all other detailing errors. Thus this wide spread damages caused by the earthquake to prefabricated structures aroused suspicion about the correctness of the R coefficient recommended in the current Turkish Earthquake Codes (TEC - 98). In this study, an attempt was made for an approximate determination of R coefficient for widely utilized prefabricated structure types (single-floor single-span) with variable dimensions. According to the selecting variable dimensions, 140 sample frames were computed using pushover analysis. The force reduction factor R was calculated by load-displacement curves obtained pushover analysis for each frame. Then, formulated artificial neural network method was trained by using 107 of the 140 sample frames. For the training various algorithms were used. The method was applied and used for the prediction of the R rest 33 frames with about 92% accuracy. The paper also aims at proposing the authorities to change the R coefficient values predicted in TEC - 98 for prefabricated concrete structures.

• Earthquakes and Structures
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• v.2 no.3
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• pp.207-232
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• 2011

The development of reliable earthquake mitigation plans and seismic risk management procedures can only be based on the establishment of comprehensive earthquake hazard and loss scenarios. Two cities, Grevena (Greece) and D$\ddot{u}$zce (Turkey), were used as case studies in order to apply a comprehensive methodology for the vulnerability and loss assessment of lifelines. The methodology has the following distinctive phases: detailed inventory, identification of the typology of each component and system, evaluation of the probabilistic seismic hazard, geotechnical zonation, ground response analysis and estimation of the spatial distribution of seismic motion for different seismic scenarios, vulnerability analysis of the exposed elements at risk. Estimating adequate earthquake scenarios for different mean return periods, and selecting appropriate vulnerability functions, expected damages of the water and waste water systems in D$\ddot{u}$zce and of the roadway network and waste water system of Grevena are estimated and discussed; comparisons with observed earthquake damages are also made in the case of D$\ddot{u}$zce, proving the reliability and the efficiency of the proposed methodology. The results of the present study constitute a sound basis for the development of efficient loss scenarios for lifelines and infrastructure facilities in seismic prone areas. The first part of this paper, concerning the estimation of the seismic ground motions, has been utilized in the companion paper by Kappos et al. (2010) in the same journal.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.16
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• pp.6749-6754
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• 2014

Background: There are limited data in the literature related to concomitant genital or extra-genital organ pathologies in patients with borderline ovarian tumors (BOTs). The aim of this study was to evaluate our experience with 183 patients to draw attention to the accompanying organ pathologies with BOTs. Materials and Methods: One hundred eighty-three patients with BOTs, diagnosed and/or treated in our center between January of 2000 and March of 2013 were evaluated retrospectively. Data related to age, tumor histology, lesion side, disease stage, accompanying incidental ipsilateral and/or contralateral ovarian pathologies, treatment approaches, and follow-up periods were investigated. Incidental gynecologic and non-gynecologic concomitant organ pathologies were also recorded. Results: The mean age at diagnosis was 40.6 years (range: 17-78). Ninety-five patients (51%) were ${\leq}40$ years. A hundred and forty-seven patients (80%) were at stage IA of the disease. The most common type of BOT was serous in histology. Non-invasive tumor implants were diagnosed in 4% and uterine involvement was found 2% among patients who underwent hysterectomies. There were 12 patients with positive peritoneal washings. Only 17 and 84 patients respectively had concomitant ipsilateral and concomitant contralateral incidental ovarian pathologies. The most common type of uterine, appendicular and omental pathologies were chronic cervicitis, lymphoid hyperplasia and chronic inflammatory reaction. Conclusions: According to our findings most of accompanying pathologies for BOT are benign in nature. Nevertheless, there were additional malignant diseases necessitating further therapy. We emphasize the importance of the evaluation of all abdominal organs during surgery.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.2
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• pp.815-822
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• 2015

Purpose: In this study, we aimed to evaluate the effects of sex-based non-small cell lung cancer (NSCLC) varieties on survival rates. Materials and Methods: A retrospective study was performed in patients with NSCLC who were diagnosed by histological methods between the years 2000 and 2010. A chi-square test was used to compare variables. Overall survival (OS) was estimated by the Kaplan-Meier method. Results: Of the 844 patients, 117 (13.9%) were women and 727 (86.1%) were men. Adenocarcinoma was more common in women than in men (p<0.0001). There were more women non-smokers than men (p<0.0001). There was no statistically significant difference in ECOG PS, weight loss>10%, stage, LDH, albumin and treatment between women and men. Women younger than 65 years (17.0 vs 12.0 months; p=0.03), who had adenocarcinoma histology (15.0 vs 10.0 months; p=0.006) and who had a hemoglobin level ${\geq}12g/dL$ (18.0 vs 12.0 months; p=0.01) were found to have a better median OS rate than men. Median OS rates were found to be 13.0 months in females and 12.0 months in males (p=0.14). Among metastatic patients, the median OS was 11.0 months in females and 8.0 months in males (p=0.005). Among stage IIIB and stage IV patients who had first line platinum-based chemotherapy, the median OS was 17.0 months in women and 11.0 months in men (p=0.002). The response rate of chemotherapy was higher in women than in men (p=0.03). Conclusions: In our study, we found that survival duration is longer and chemotherapy response is better in women with NSCLC who do not have anemia or comorbidities and who are mostly non-smokers with adenocarcinomas. Further studies regarding the causes of these differences may provide clarity on this subject.