Gaziantep Onkoloji Hastanesi

Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are significant causes of morbidity and mortality in hemodialysis patients, since those patients are highly susceptible to infections due to immune suppression. The aims of this study were to investigate the presence of HBV and HCV infections in chronic hemodialysis patients by serological and molecular methods, and to determine the rate of occult HBV infection and the viral genotypes. A total of 201 patients who were under hemodialysis due to end-stage renal disease, were retrospectively evaluated. The study involved the patients at three different centers in Antalya, Turkey during 2006. HBV and HCV markers in the patients' sera were screened by ELISA method, viral nucleic acids were investigated by real-time polymerase chain reaction (PCR) in patients' plasma and viral genotypes were determined by DNA sequence analysis. Detection of at least one of the HBV markers HBsAg, anti-HBc total, and HBV DNA, was accepted as HBV infection, and detection of anti-HCV and/or HCV RNA was accepted as HCV infection. HBsAg positive patients with negative HBV DNA were considered as occult HBV infection. Of the patients 80 (40%) were female, 121 (60%) were male and the mean age was 51.16 ± 16.28 (range 17-93) years. In our study, sole anti-HBs positivity due to HBV vaccination, was detected in 89 (44.3%) patients. One hundred (50%) patients were found positive in terms of HBV infection and 40 (20%) were positive for HCV infection, while 24 (12%) patients had HBV and HCV co-infections. Eighty-five (42.3%) patients had no HBV and HCV infection. Among the 5 (2.5%) patients who were HBsAg positive, four were also HBV DNA positive. Occult HBV infection was detected in 1 (0.5%) patient. Anti-HCV and HCV RNA were found positive in 37 (18.4%) and in 24 (12%) patients, respectively. Among the HCV-RNA positive patients, 3 (12.5%) were anti-HCV negative. ALT and AST levels were found normal in all of the HBV DNA positive patients, and 62.5% (15/24) of HCV RNA positive patients. All of the HBV isolates were identified as genotype D and HCV isolates as genotype 1b. No statistically significant correlation was detected between the HBV infection and patients' age, duration of hemodialysis and elevation of serum transaminase levels (p> 0.05). On the other hand, HCV infection was seen to increase with age (p= 0.047). HCV infection showed a statistically significant increase with the duration of hemodialysis. HCV infection risk was increased in patients who were under hemodialysis for ≥ 25 months (p< 0.001, OR: 0224, 95% CI= 0089-0562). There was also a statistically significant correlation between the presence of HCV infection (anti-HCV and/or HCV RNA positive) and high levels of serum transaminases (p< 0.001). However, in two of the three cases who were anti-HCV negative and HCV RNA positive, serum transaminase levels were normal while the viral loads were high. Therefore to follow-up HCV infection in the hemodialysis patients, anti-HCV and serum transaminase levels may not be sufficient alone and these patients should be evaluated periodically for HCV RNA. In addition, the detection of occult HBV infection in one of the study patients, indicated that HBV DNA should also be investigated at regular intervals in the hemodialysis patients.

Cutaneous leishmaniasis (CL), seen endemically in many countries, is a widespread protozoon disease all around the world. The neighboring countries of Turkey namely Iran, Iraq and Syria are highly endemic regions for CL, and more than 98% of the cases in Turkey are reported from South and Southeastern Anatolian regions. The aim of this study was to detect the prevalence of CL in Nizip, a district of Gaziantep province of southeastern Turkey, for three and half year period and to call attention to the dramatic increase of CL cases observed after the Syrian civil war. A total of 416 samples obtained from clinically suspected CL patients (of them 341 were Syrian refugees) who were admitted to Nizip State Hospital between January 1st 2010 and March 19th 2013 were included in the study. Lesion samples were collected according to the notice issued by Turkish Ministry of Health and Giemsa-stained smears were examined under the microscope (x1000). Samples from 77 patients (18.5%) yielded positive results with the observation of Leishmania amastigote forms. Fourty-seven (61%) of patients were female and 30 (39%) were male. Of the positive patients 52 (67.5%) belonged to 0-19 age group, 13 (16.9%) 20-39 and 12 (15.6%) 40-60 age groups. In the evaluation of the lesion characteristics, 33 (43%) patients had single and 44 (57%) had multiple lesions with a distribution mainly on face, arm and lower extremities, in a decreasing order. The period of time for the development of the lesions varied from 1.5 month to one year with the mean value of 3.4 months. There was no statistically significant relationship between the age and gender of patients, and the characteristics (quantity, distribution and time of occurence) of lesions (p> 0.05). The number of domestic and Syrian CL cases detected in Nizip in the years of 2010, 2011, 2012 and 2013 (the first three months) were as follows; 1 and 0, 2 and 0, 7 and 0, 5 and 62, respectively. So a total of 62 (80.5%) and 15 (19.5%) of CL patients were found to be Syrian refugees and Turkish citizens, respectively. Since the number of the cases admitted to the hospital was significantly low in comparison to the total population of refugees living in the camps, it was assumed that the real incidence of CL was much higher than determined. The data obtained in this study revealed that Nizip and the surroundings which have already had favourable climate and vector potential for CL, exhibited a higher threat for the spread of the disease following the hosting of the refugees. Thus implementation of effective prevention and control measures should be taken into consideration implemented in that specific area.

Duplication of the vermiform appendix is a rare congenital abnormality and usually found incidentally during laparotomy. The Modified Cave-Wallbridge classification is used to describe the location of the appendixes in relation to each other and to the cecum as well as the extent of the duplication. We report a 45-year-old patient who underwent laparotomy for acute abdominal pain. The operative finding was double acute appendicitis in appendical duplication. The appendixes were removed separately, as it was type B duplication. Since appendectomy is the most common abdominal operation, all surgeons should keep this rare clinical entity in mind.

Hyperalgesia is normally an increase in the response to a painful stimulant. Opioid-induced hyperalgesia (OIH) is a situation frequently encountered in algology clinics. Its treatment is complicated and problematic and often requires alternative methods. A 40-year-old male patient 45 kg weighing had been diagnosed with stage IV colon cancer 2.5 years ago. He had used non-steroid antiinflammatory drugs, opioid analgesics and steroid preparations casually for his increased pain without any monitoring for one year. He was admitted five times for pain control. In the last visit, he complained of severe abdominal, pubic and rectal pain (visual analogue scale [VAS] 8), which was unresponsive to epidural analgesic, and later presented to the algology clinic; he was sleep-deprived, restless and in a panic state. Intrathecal morphine (1 mg) was applied considering his opioid tolerance. Because of increased pain (VAS 8-9) one hour after surgery for abscess in the liver and peritonea, the patient was given intravenous dexketoprofen trometamol and diazem considering his OIH. Then, bolus dexmedetomidine (1 µg/kg) followed by dexmedetomidine infusion (0.2 µg/kg/h) was started. Three days later, diagnostic intrathecal clonidine (30 µg) was applied, and the patient's complaints regressed. With the patient reporting relaxed pain (VAS 1-2) after 30 minutes, an intrathecal port was placed. Both cancer pain and OIH were controlled with clonidine 90 µg/day. He was more relaxed, and his pain was tolerable until his death. Intrathecal clonidine administration may be an effective method for the treatment of OIH.

OBJECTIVE: Lu-DOTATATE) after the failure of somatostatin analogues. METHODS: Lu-DOTATATE treatment to assess the progression-free survival (PFS). RESULTS: The responses of the patients were evaluated as partial response in 8 (32%) patients, stable disease in 12 (48%), and progressive disease in 5 (20%). The median PFS was 18 months; longer than this threshold in 14 patients (26.0 months) and shorter in 11 (8.4 months). The mean SUVmax of metastases in the liver (34.15±17.89 vs. 14.69±9.17, P=0.004) and mean SUVmax of all body metastatic lesions (33.05±14.32 vs. 15.26±4.84, P=0.001) were higher in patientswith longer PFS. The tumor grade, the origin of the tumor, Ki67 status, and previous somatostatin treatment history were not significantly different between the two PFS groups. CONCLUSION: Lu-DOTATATE treatment, and could be a useful parameter for the treatment selection.

Objective: We aimed to evaluate the epidemiological data of malaria cases by using the data of Gaziantep Public Health Directorate between January 2005 and December 2015. Methods: Blood samples were taken from suspicious cases and temporary agricultural workers living in the Fırat Watershed and in areas in where malaria was seen before and in the tent cities of Islahiye, Nizip and Karkamış by request of the ministry. The cases were evaluated in terms of age, gender, detected malaria species, months when malaria was detected, and whether they were imported cases. Results: Thirty-one malaria cases were detected in blood samples taken from 184.305 patients. The malaria positivity rate was determined as 0.017%. Five of the patients (16.3%) were indigenous; 2 (6.5%) were cases with relapse and 24 cases (77.2%) were imported. Conclusion: In our study, we last saw a new indigenous case in 2005. In the following years , cases with relapses and cases originating from abroad were seen, which was linked to the ease of transportation and the increase in touristic and commercial relations. Although lack of malaria in the samples taken from people living in tent cities in our region is favorable, necessary measures should be taken against new epidemics.

Amaç: Bu çalışmanın amacı, meme kanseri tedavisi ile ilişkili hafif, orta ve şiddetli lenfödemi olan hasta grupları arasında yaşam kalitesi, üst ekstremitenin fonksiyonel durumu ve fiziksel aktivite düzeyindeki karşılaştırmaktı. Gereç ve Yöntemler: Bu çalışmaya, meme kanseri tedavisi ile ilişkili lenfödem tanısı olan 83 kadın (% 24 hafif, % 41 orta, % 35 şiddetli) katıldı. Lenfödemin varlığı ve şiddeti çevre ölçümü ile belirlendi. Lenfödem Yaşam Kalite Ölçeği (LYKÖ), Kol, Omuz ve El Sorunları Anketi’nin kısa versiyonu (DASH) ve Uluslararası Fiziksel Aktivite Anketi’nin kısa formu (UFAA-KF), sırasıyla yaşam kalitesi, üst ekstremitenin fonksiyonel durumu ve fiziksel aktivite düzeyinin değerlendirilmesi için kullanıldı. Bulgular: Hafif, orta ve şiddetli lenfödemi olan hastalar arasında yaşam kalitesi ve üst ekstremitenin fonksiyonel durumu açısından istatistiksel olarak anlamlı fark vardı (p&amp;lt;0.05). Ancak, fiziksel aktivite düzeyinden üç grup arasında anlamlı fark yoktu (p&amp;gt;0.05). İkili analizlerin sonuçlarına göre, şiddetli lenfödemi olan hastalarda, yaşam kalitesinin fonksiyon, görünüm ve semptom alt alanlarının ve üst ekstremitenin fonksiyonel durumunun hafif derecede lenfödemi olan hastalara göre daha fazla etkilendiği bulundu (p&amp;lt;0.016). Lenfödem şiddeti ile LYKÖ fonksiyon, görünüm ve semptom alt alanları ve DASH arasında istatistiksel olarak anlamlı ancak zayıf bir ilişki bulundu (p≤0.01). Tartışma ve Sonuç: Şiddetli lenfödemi olan hastalarda yaşam kalitesinin ve üst ekstremitenin fonksiyonel durumunun hafif lenfödemi olan hastalara göre daha fazla etkilendiği bulundu. Bu sonuçlar, meme kanseri cerrahisi geçiren bireylerde lenfödem hafif düzeyden ileri düzeye geçtiğinde yaşam kalitesi ve üst ekstremite fonksiyonelliğinin etkilenebileceğini göstermektedir. Dolayısıyla bu etkilenimi önlemek veya azaltmak için lenfödemin erken dönemde belirlenmesi ve tedavi edilmesi önemlidir.

Organizing pneumonia (OP) is an inflammatory process of the bronchioles that can lead to destruction of small airways and surrounding lung tissue. Secondary OP, caused by anti-cancer drugs and radiotherapy, has previously been reported. In this study, we report the case of a 60-year-old female patient presented with OP, while using low dose capecitabine maintenance for stage IV gastric cancer under remission. After 18 months of routine follow-up with computed tomography (CT), a 9 mm subpleural nodule was presented at the right lung upper lobe posterior segment. Wedge resection was performed. Based on histopathologic examination, a diagnosis of OP was confirmed. In this instance, capecitabine was implicated as the likely cause of this drug-induced lung toxicity. This patient is the first case associated with development of OP during capecitabine monotherapy.

ZET GR ve AMA: Osteosarkom genelde ocukluk ve gen erikin yalarda grlmekte ve ok agresif seyretmektedir. Tedavide ekstremite koruyucu cerrahi ve kemoterapi yntemleri ile byk baarlar salanmtr, ancak mikroskobik dzeyde kalabilen rezid tmrler rekrrens olasln arttrmaktadr. Bu almada kadmiyumun kemik inetosu ile birlikte in vitro uygulanabilirliini deerlendirilmesi ve cerrahi sonras lokal uygulanarak rezid tmr ve rekrrens olasln nlemedeki etkinlii iin n bulgularn deerlendirilmesi amalanmtr

Ama: Nroblastom ocukluk anda en sk grlen ekstrakraniyal solid tmrdr

Amaç: Bu çalışmada amaç; rutin üst abdominal çok kesitli bilgisayarlı tomografi (ÇKBT) görüntülerinde portal ven (PV) varyasyon dağılımını ve sıklığını belirlemektir. Gereç ve Yöntem: Rutin abdominal tomografileri 64 kesit ÇKBT ile çekilen 363’ükadın,387’sierkektoplam 750hastanın görüntüleri retrospektif olarak değerlendirildi.Portal fazda elde edilen görüntüler multiplanar reformat ve üç boyutlu postprosesing sonrası değerlendirildi. Bulgular: Toplam 750 hastanın 134’ünde (%17.9) ana PV varyasyonları saptandı. Sekiz hastada (% 1.2) sağ posterior portal ven varyasyonu tespit edildi. Tip 1 varyasyon 616 hastada (% 82.1), tip 2 varyasyon 72 hastada (%9.6),tip 3 varyasyon 53 hastada (% 7.4),sağ portal ven trifurkasyonu 8 hastada (%0.9), quadrifikasyon 1 hastada (%0.1),total ramifikasyon 1 hastada (% 0.1) bulundu. Toplamda PV varyason ve anomalisi 142 hastada (%19.1) tespit edildi. Sonuç: Portal ven varyasyon varlığının saptanmasında ÇKBT etkin bir yöntemdir. Abdominal tomografi incelemelerinin raporlanması sırasında portal ven varyasyonlarına dikkat edilmesi ve belirtilmesi klinik açıdan önemli varyasyonların cerrahi planı değiştirebilmesi ve komplikasyonları azaltması açısından önemlidir.

Geçici miyeloproliferatif hastalık (GMPH), Down sendromu tanısı ile izlenen infantların yaklaşık %10'unda ortaya çıkan ve periferik kanda miyeloid blastların artışı ile karakterize bir durumdur. GMPH tanılı Down sendromlu olguların yaklaşık %30'unda ilerleyen yıllarda akut lösemi gelişir. Genellikle spontan remisyona girdiği için kemoterapötik ajanlarla tedavi gerektirmez. Sitotoksik tedaviye hastanın klinik durumu, sitopeninin ilerlemesi veya organ disfonksiyonu gibi kriterlerle karar verilir. Sitotoksik tedavi için sitarabin (ARA-C) veya daunorubisin kullanılır. Bu çalışmada, GMPH gelişen ve düşük doz ARA-C ile tedavi edilen bir Down sendromu olgusu sunulmuştur.

Amaç: Bu çalışmada, immünoterapi hakkında bilgi veren Türkçe YouTube videolarının kalite ve güvenilirlik açısından değerlendirilmesi amaçlanmıştır. Yöntem: 1 Kasım 2025 tarihinde kesitsel olarak gerçekleştirilen çalışmada, Google Trends ile belirlenen beş anahtar kelime ("immünoterapi", "immünoterapi nedir", "immünoterapi tedavisi", "immünoterapi yan etkileri", "immünoterapi ilaçları") kullanılarak YouTube'da arama yapıldı. Dahil edilme kriterlerini karşılayan 95 video, iki onkoloji uzmanı tarafından bağımsız olarak değerlendirildi. Videoların kalitesi ve güvenilirliği; modifiye DISCERN (mDISCERN), Journal of the American Medical Association (JAMA), Global Kalite Skoru (GQS) ve Video Bilgi Kalite Endeksi (VIQI) kullanılarak ölçüldü. Video etkileşimi Video Güç İndeksi (VPİ) ile hesaplandı. Bulgular: Videoların ortalama süresi 423±688 saniye, ortalama toplam izlenme sayısı ise 1245±737 olarak hesaplanmıştır. Videoların %87'si faydalı, %13'ü yanlış veya eksik bilgi içermekteydi. Medikal onkoloji uzmanları tarafından anlatılan videolar yüksek kalite skorlarına sahipti (mDISCERN: 4,22±0,73, JAMA: 3,15±0,77, GQS: 4,14±0,65, VIQI: 16,66±2,52). Onkoloji dışı uzmanların videoları düşük kalite skorlarına rağmen yüksek VPİ puanlarına sahipti (VPİ: 11,59±15,66). mDISCERN, JAMA, GQS ve VIQI puanları arasında güçlü pozitif korelasyon saptandı (her biri için p&amp;lt;0,001). İzlenme oranı ile GQS ve VIQI arasında zayıf korelasyon saptandı (sırasıyla p=0,039, p=0,038). Sonuç: Türkçe YouTube videolarında immünoterapi içeriklerinin kalitesi büyük ölçüde içerik sağlayıcısının uzmanlığına bağlıdır. Medikal onkoloji uzmanları tarafından hazırlanan videolar yüksek kaliteli bilgi sunmaktadır. Ancak yüksek kaliteli içeriklerin görünürlüğünün artırılması ve hastaların güvenilir kaynakları tanımaları konusunda sağlık profesyonellerinin eğitilmeleri gerekmektedir.

Abstract Aim: Although the irinotecan–bevacizumab (IB) combination is a frequently used treatment option in recurrent brain tumors, clinical benefit shows heterogeneity among patient subgroups. This study aimed to evaluate clinical and prognostic factors associated with early-stage mortality and overall survival (OS) in patients receiving IB treatment. Material and Methods: Seventy-eight brain tumor patients who received IB treatment between 2015 and 2023 were retrospectively evaluated. Patients with complete clinical and radiological data were included in the study. The demographic, clinical, and pathological characteristics of the patients were recorded. The timing of the initiation of IB therapy was categorized according to whether it was started at the first recurrence or at the second and subsequent recurrences. Factors associated with early-stage mortality (≤6 months) were determined using log-linear regression analysis, while independent prognostic factors affecting GSK were determined using the Cox proportional hazards regression model. Results: The mean age of patients was 53.01±12.78 years, and the mean follow-up period was 9.47 months. The mortality rate within the first 6 months was determined to be 44.9%. Early-stage mortality was found to be significantly associated with multilobular tumor localization (p=0.037) and initiation of IB therapy at ≥2nd stage (p=0.036). In the log-linear regression analysis, the probability of survival beyond 6 months was 5.05 times lower (RR=0.198, 95% CI: 0.054-0.735) in multilobular localization, while in those who started IB at ≥2nd node, it was 4.40 times lower (RR=0.227, 95% CI: 0.069-0.748). In the multivariate Cox regression analysis, starting IB at ≥2nd line (HR: 2.35, 95% CI: 1.09-5.07, p=0.029), the presence of IDH mutation (HR: 1.98, 95% CI: 1.09-3.58, p=0.025), and age (HR: 1.03, 95% CI: 1.01-1.05, p=0.015) were identified as independent prognostic factors for GSK. Conclusion: This retrospective cohort study based on real-world data demonstrates that the clinical benefit of the IB combination shows significant heterogeneity across patient subgroups. Multilobar tumor location and initiation of IB therapy in the late stages of recurrence are associated with early mortality and poorer survival. Our findings emphasize that IB therapy in recurrent brain tumors should be administered in a personalized manner, considering patient selection and treatment sequence, rather than as a routine approach.

The three step human immunodeficiency virus (HIV) testing algorithm used in Türkiye was updated and implemented in 2019 in accordance with the current HIV testing algorithm of the Centers for Disease Control and Prevention. In this study, it was aimed to obtain HIV test data with a multicenter and multidisciplinary approach in order to reveal the current situation in the diagnosis of HIV/acquired immunodeficiency syndrome in our country and to identify new algorithm applications and problems encountered in HIV diagnosis. For this purpose, 12 HIV testing centers were asked about the HIV testing algorithms they use, the problems they encountered in practice and their suggestions for solution with a 57-question survey. The performance of the current algorithm and the current HIV status of the centers were evaluated with the total number of three-year fourth generation HIV enzyme linked immunsorbent assay (ELISA) tests , the number of repeated reactive tests, the distribution of confirmatory test results and the number of HIV nucleic acid amplification tests (NAT) between 2018 and 2020. Between 2018 and 2020, the total number of anti-HIV ELISA tests were 788261, 871299 and 835498, the repeating reactivity rates were 0.48, 0.51 and 0.70, respectively, while the confirmed HIV test rates were 0.24, 0.25 and 0.21 respectively. During this period the rates of Western Blot (WB) confirmatory test utilization were 25.77%, 12.29% and 9.86%, respectively and are gradually decreasing. The utilization rates of HIV-1/2 antibody differential rapid confirmatory tests recommended in the current algorithm were found to be 25.72%, 38.76% and 45.78%, respectively and it is seen to replace WB. The rates of HIV-1 RNA studied by year were 48.77%, 97.98% and 46.31% respectively. In our study, it has been observed that the use of the rapid HIV-1/2 antibody differential test, which is included in the new algorithm, is gradually increasing and is used more effectively in HIV diagnosis, while the use of HIV-1 NAT has decreased. This situation, which is associated with the shift of NAT opportunities to coronavirus diseases-2019 (COVID-19) polymerase chain reaction studies in the shadow of the COVID-19 pandemic, requires more detailed monitoring in terms of possible changes in the HIV epidemic in our country.

Abstract Background Hip disorders are highly common among pediatric patients. The diagnosis is based primarily on the clinical findings, the context and the personal and family history of the child. It is in most cases steered by the biological and imaging findings. The latter are usually derived from radiographs, ultrasound imaging and, in some cases, MRI. The main purpose of this study is to evaluate assess the diagnostic delay for hip disorders in the pediatric population. Methods We conducted a retrospective study including pediatric patients from the rheumatology and the orthopedics department, who consulted or were referred to orthopeadics for a suspected hip disorder. For all patients, we collected the following data: age, clinical findings, imaging findings, the number of consultations in general medicine or emergency medicine and the number of consultations in orthopedics department before the diagnosis is made, the final retained diagnosis and, ultimately, the diagnostic delay since onset of symptoms and first consultation. Results We included 81 children (48 boys and 33 girls) with a mean age of 9.9 years old [1.5–16]. Sixty-two patients were symptomatic at admission. The pain was located in the hip in 55.5% of patients (n = 45), in the groin in 7.4% of patients (n = 6) and in the knee in 12.34% of patients (n = 10). One child reported unilateral buttock pain. The other reasons for consultation were limping in 3.7% of cases (n = 3), deformity of the lower limb in 1.23% of cases (n = 1), a crying baby in 1.23% of cases (n = 1) and swelling of the knee in 1.23% of cases (n = 1). On clinical examination, 58 patients had a limitation of the hip motion. Twenty-nine percent of the children had a biological inflammatory syndrome at admission. In total, over one hundred and seventy-one imaging examinations were performed in order to adjust the diagnosis; among them, 7 CT pelvic scan and 23 MRI. The different retained diagnoses of hip involvement are summarized in Table 1. The mean number of consultations in general medicine or emergency medicine before the diagnosis is made was 0,58 ranging from 0 to 2. The mean diagnostic delay since the onset of symptoms was 9,12 months ranging from 3 days to 13 years. The mean diagnostic delay since the first medical check -up was 3,5 months ranging from 0 to 10 years. Conclusion Our study showed that the patient lost an average of 9 months from symptom onset to retaining the final diagnosis. The hip being a prognosis joint, this delay could alter the child's future functional abilities.

Abstract Aim: Although the irinotecan–bevacizumab (IB) combination is a frequently used treatment option in recurrent brain tumors, clinical benefit shows heterogeneity among patient subgroups. This study aimed to evaluate clinical and prognostic factors associated with early-stage mortality and overall survival (OS) in patients receiving IB treatment. Material and Methods: Seventy-eight brain tumor patients who received IB treatment between 2015 and 2023 were retrospectively evaluated. Patients with complete clinical and radiological data were included in the study. The demographic, clinical, and pathological characteristics of the patients were recorded. The timing of the initiation of IB therapy was categorized according to whether it was started at the first recurrence or at the second and subsequent recurrences. Factors associated with early-stage mortality (≤6 months) were determined using log-linear regression analysis, while independent prognostic factors affecting GSK were determined using the Cox proportional hazards regression model. Results: The mean age of patients was 53.01±12.78 years, and the mean follow-up period was 9.47 months. The mortality rate within the first 6 months was determined to be 44.9%. Early-stage mortality was found to be significantly associated with multilobular tumor localization (p=0.037) and initiation of IB therapy at ≥2nd stage (p=0.036). In the log-linear regression analysis, the probability of survival beyond 6 months was 5.05 times lower (RR=0.198, 95% CI: 0.054-0.735) in multilobular localization, while in those who started IB at ≥2nd node, it was 4.40 times lower (RR=0.227, 95% CI: 0.069-0.748). In the multivariate Cox regression analysis, starting IB at ≥2nd line (HR: 2.35, 95% CI: 1.09-5.07, p=0.029), the presence of IDH mutation (HR: 1.98, 95% CI: 1.09-3.58, p=0.025), and age (HR: 1.03, 95% CI: 1.01-1.05, p=0.015) were identified as independent prognostic factors for GSK. Conclusion: This retrospective cohort study based on real-world data demonstrates that the clinical benefit of the IB combination shows significant heterogeneity across patient subgroups. Multilobar tumor location and initiation of IB therapy in the late stages of recurrence are associated with early mortality and poorer survival. Our findings emphasize that IB therapy in recurrent brain tumors should be administered in a personalized manner, considering patient selection and treatment sequence, rather than as a routine approach.

Amaç: Radyolojik görüntülemelerde saptanan şüpheli lenf nodu tutulumu, kanser taramalarında açıklığa kavuşturulması gereken bir durumdur. Sarkoid benzeri reaksiyon (SBR) bir kanser taklitçisi olup, sıklıkla malign lenf nodu tutulumu olarak yanlış yorumlanmakla kalmaz, aynı zamanda sarkoidozis ile de karışır. Bu çalışmada sarkoidozis ve SBR granülomlarında immünohistokimyasal boyama yöntemleri ile CD4, CD8 ve CD20 ekspresyonlarının olası farklılıkları araştırıldı. Yöntem: Olgular retrospektif olarak Gaziantep Üniversitesi Tıp Fakültesi Patoloji Anabilim Dalı arşivinden 39 sarkoidozis ve 27 SBR hastası dahil olmak üzere toplandı. Sarkoidozis ve SBR granülomlarını içeren kesitlere immünohistokimyasal CD4, CD8 ve CD20 antikorları uygulandı. Tüm olguların klinik verileri kaydedildi ve ekspresyonlar iki patolog tarafından, granülomların içinde ve dışında olmak üzere iki kademeli bir skorlama sistemine göre değerlendirildi. Bulgular: Sarkoidozis ve SBR granülomlarının hem iç hemde dış kısmında CD4, CD8 ve CD20 ile oldukça benzer ekspresyon sonuçları gözlemledik, bu nedenle istatistiksel karşılaştırmada anlamlı sonuç saptanmadı. Sonuç: Çalışmamızda sarkoidozis ve SBR arasında immün profilleri bakımından farklılık gözlenmedi. Bilakis çalışmamız, her iki antitede görülen granülomların oldukça benzer morfolojik görüntüleri yanı sıra immün profilleri bakımından da oldukça benzer olduklarını gösterdi.

Ama: On farkl ekmeklik undan izole edilen, 20 Bacillus spp. izolatnn snme etkeni olup, olmadklar ve bu izolatlar zerine probiyotik zellikte olan Lactobacillus rhamnosus'un, inhibisyon etkisinin aratrlmas ama-

Koroner arter perforasyonu, perktan koroner ilem esnasnda ok nadir grlen fakat hayat tehdit