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    Albumin Infusion is not Beneficial in Hypoalbuminemic End-Stage Cancer Patients: A Matched-Pair Analysis
    (AKAD DOKTORLAR YAYINEVI, 2012-01-01) Buyukcelik, Abdullah; Demirkazik, Ahmet; Yalcin, Bulent; Dogan, Mutlu; Kavgaci, Halil; Coban, Sahin; Icli, Fikri
    In this retrospective study, it was aimed whether albumin infusion is benefical or not in terminally ill hospitalized hypoalbuminemic cancer patients. Between March 2000 and 31 March 2003, the medical records of 27 terminally ill hypoalbuminemic cancer patients who had albumin infusion(Albumin receiving group-ARG), were retrospectively analysed. This grup was matched (1:1) with 27 terminally ill cancer patients who had no albumin infusion (Albumin not receiving group-ANRG), according to age, sex, ECOG PS, diagnosis and the number of metastatic sites. ARG was compared with ANRG, in regard to the changes of pulse rate, blood pressure, in the levels of serum BUN, creatinin, sodium, total protein, and albumin before albumin infusion and 48 hours after albumin infusion, and documented and/or clinical infections after albumin infusion, hospitalization duration, the rate of exitus in hospital and overall survival. There was no difference in patient characteristics between two groups. Likewise, the groups were not different from each other in terms of the changes of pulse rate, blood pressure, in the levels of serum BUN, creatinin, sodium, and documented and/or clinical infections after albumin infusion (p> 0.05). There was a significant increase in the levels of serum total protein and albumin in ARG (p< 0.05). The rate of exitus in hospital is not different between two groups. The median duration of hospitalization was longer in ANRG (p= 0.022). The overall survival was significantly better in ANRG (p= 0.018). Albumin infusion is not benefical in terminally ill hypoalbuminemic cancer patients. Furthermore, it was found that the survival was significantly worse in patients receiving albumin.
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    Clinical and Molecular Characterization of Fanconi Anemia Patients in Turkey
    (KARGER, 2020-01-01) Toksoy, Guven; Uludag Alkaya, Dilek; Bagirova, Gulendam; Avci, Sahin; Aghayev, Agharza; Gunes, Nilay; Altunoglu, Umut; Alanay, Yasemin; Basaran, Seher; Berkay, Ezgi G.; Karaman, Birsen; Celkan, Tiraje T.; Apak, Hilmi; Kayserili, Huelya; Tuysuz, Beyhan; Uyguner, Zehra O.
    Fanconi anemia (FA) is a rare multigenic chromosomal instability syndrome that predisposes patients to life-threatening bone marrow failure, congenital malformations, and cancer. Functional loss of interstrand cross-link (ICL) DNA repair system is held responsible, though the mechanism is not yet fully understood. The clinical and molecular findings of 20 distinct FA cases, ages ranging from perinatal stage to 32 years, are presented here. Pathogenic variants in FANCA were found responsible in 75\%, FANCC, FANCE, FANCJ/BRIP1, FANCL in 5\%, and FANCD1/BRCA2 and FANCN/PALB2 in 2.5\% of the subjects. Altogether, 25 different variants in 7 different FA genes, including 10 novel mutations in FANCA, FANCN/PALB2, FANCE, and FANCJ/BRIP1, were disclosed. Two compound heterozygous germline cases were mosaic for one allele, revealing that the incidence of reverse mutations may not be uncommon in FA. Another case with de novo FANCD1/BRCA2 and paternally inherited FANCN/PALB2 pathogenic alleles at first glance suggested a digenic inheritance, because the presence of a second pathogenic variant in the unexamined regions of FANCD1/BRCA2 and FANCN/PALB2 were exluded by sequencing and deletion/duplication analysis. A better understanding of the complexity of the FA genotype may provide further access to undiscovered ICL components and apparently dispensable cellular pathways where FA proteins may play important roles.
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    Frequency of antibiotic use in the end-of-life cancer patients
    (BAYRAKOL MEDICAL PUBLISHER, 2021-01-01) Urvay, Semiha; Karagoz, Hatice
    Aim: Making decisions about how to maintain general medical care and manage complications for patients in the last stage of advanced cancer is difficult. The benefits and necessity of antibiotic use in the last period of life are controversial. In this study, we aimed to investigate the frequency of antibiotic use in terminal stage cancer patients followed up with palliative care and died during their hospitalization. Material and Methods: One hundred twenty-one patients from January 2015 to June 2020 were included. Results: Among the 121 patients, 104 (86\%) received antibiotics. Eighty-five (81.7\%) patients received antibiotics until death. The mean duration of antibiotic treatment was 8.9 days. Antibiotic treatment was started 1 week before death in 88 (84.6\%) of 104 patients who used antibiotics. The number of patients whose antibiotic treatment was discontinued was 3 (15.7\%) in hospital wards and 16 (84.2\%) in the intensive care unit. Discussion: This is the first study on the frequency of antibiotic use in the end-of-life cancer patients in our country, and we found that the antibiotic prescription rate is high in dying cancer patients. It is questionable whether such care has positive effects on survival or quality of life. Guidelines on antibiotic use and discontinuation in patients with end-stage cancer should be developed.
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    Comparison of Two Different Antibody Clones of Programmed Cell Death Ligand 1 (PD-L1) with Immunohistochemical Method on Various Tumors
    (KARE PUBL, 2020-01-01) Tokat, Fatma
    Objectives: Programmed cell death ligand 1 (PD-L1) is the most important immune checkpoint protein in immune defense against tumors. PD-1/PD-L1 inhibitors are considered an option in cancer treatments. The evaluation of PD-L1 immunohistochemical staining is used as a biomarker to determine the decision and response of the use ofthese inhibitory drugs. There is a wide variety of clones and platforms for the PD-L1 antibody, and each pathology department uses different clones and platforms which causes confusion. Therefore, in this study, we evaluated the immunohistochemical staining of different clones in the same tumor. Methods: Overall, 90 cases comprising 47 lung, 11 breast, 9 colon, 6 stomach, and 7 pancreatic carcinomas and 10 other tumors were included in the study. Of these, 43 specimens were obtained by resection, 40 by tru-cut biopsy, and 7 by endoscopic biopsy. Sections prepared from formalin-fixed paraffin-embedded blocks were evaluated immunohistochemically with SP142 and SP263 clones. Results: In this study, we observed positive staining in 48.8\% (n=44) and negative staining in 51.2\% (n=46) among all cancers with SP263 clone, and positive staining in 33.3\% (n=30) and negative staining in 66.7\% with SP142 clone as well. This study also showed that compared to SP263, SP142 clone stained tumor cells less in lung, colon, stomach, pancreatic, and other carcinomas. Conclusion: In this study, we found different staining percentages for SP263 and SP142 in the same tumor. Pathologists conducting immunohistochemical studies for PD-L1 should indicate the staining percentages of tumors and the antibody clone they used in the reports. Meanwhile, oncologists should keep in mind which clone was stained, and that selecting SP142 is less positive to correct patients who can receive appropriate immunotherapy.