Hopelessness, Depression and Social Support with End of Life Turkish Cancer Patients

Sahin, Zumrut Akgun,Tan, Mehtap,Polat, Hatice Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.5

Background: This study was performed to evaluate relationships between different demographic variables and hopelessness and depression in end of life Turkish cancer patients. This study was a descriptive survey with repeated measures conducted a university hospital in the city of Erzurum, in the eastern part of Turkey. The study enrolled 216 patients undergoing palliative treatment at the hospital. Materials and Methods: Data were collected using questionnaires (demographic questionnaire, Beck Hopelessness Scale (BHS), Beck Depression Scale (BDS) and analyzed for demographic and disease-related variable effects on hopelessness and depression. Results: Th hopelessness score was significantly high in female, illiterate, married, and living in rural areas cancer patients. Both hopelessness and depression scores were significantly higher with longer disease duration, receiving radiotherapy treatment, and having metastatic disease. Conclusions: These findings demonstrate the coexistence of the physical, psychological, and cognitive problems faced by patients with cancer. Nurses can conduct brief screening assessments to identify patients with probable distress and and psychosocial support, as well as referrals to support services.

Mechanisms of Alzheimer’s Disease Pathogenesis and Prevention: The Brain, Neural Pathology, N-methyl-D-aspartate Receptors, Tau Protein and Other Risk Factors

Sayad Kocahan,Zumrut Doğan 대한정신약물학회 2017 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.15 No.1

The characteristic features of Alzheimer’s disease (AD) are the appearance of extracellular amyloid-beta (Aβ) plaques and neurofibrillary tangles in the intracellular environment, neuronal death and the loss of synapses, all of which contribute to cognitive decline in a progressive manner. A number of hypotheses have been advanced to explain AD. Abnormal tau phosphorylation may contribute to the formation of abnormal neurofibrillary structures. Many different structures are susceptible to AD, including the reticular formation, the nuclei in the brain stem (e.g., raphe nucleus), thalamus, hypothalamus, locus ceruleus, amygdala, substantia nigra, striatum, and claustrum. Excitotoxicity results from continuous, low-level activation of N-methyl-D-aspartate (NMDA) receptors. Premature synaptotoxicity, changes in neurotransmitter expression, neurophils loss, accumulation of amyloid β-protein deposits (amyloid/senile plaques), and neuronal loss and brain atrophy are all associated with stages of AD progression. Several recent studies have examined the relationship between Aβ and NMDA receptors. Aβ-induced spine loss is associated with a decrease in glutamate receptors and is dependent upon the calcium-dependent phosphatase calcineurin, which has also been linked to long-term depression.

Quality of Life and Chemotherapy-related Symptoms of Turkish Cancer Children Undergoing Chemotherapy

Arslan, Fatma Tas,Basbakkal, Zumrut,Kantar, Mehmet Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.3

This cross-sectional and descriptive study was designed to determine symptoms emerging due to chemotherapy treatment and their effects on children's quality of life. The research was carried out between February 2008 and February 2009 at the pediatric oncology clinics in four hospitals, focusing on 93 patients receiving chemotherapy. A survey form, the Pediatric Quality of Life Inventory (PedsQL 4.0) and the Memorial Symptom Assessment Scale (MSAS) were used as data collection tools. Chi-square and Student t tests were performed for data analysis. Some 51.6% of the children were aged 13-15 years old, and 51.8% were boys and 50.5% were diagnosed as having solid tumors. There were significant relations between: antimetabolite chemotherapeutics and feeling irritable and worrying (p=0.001, p=0.030); vinkoalkaloid and numbness/tingling in hands/feet (p=0.043); antracyclines and lack of energy and skin changes (p=0.021, p=0.004); and corticosteroids and lack of appetite, nausea and sadness (p=0.008, p=0.009, p=0.009). Several symptoms such as feeling sad, worrying and feeling irritable caused a significant decrease in the total domain of quality of life scores (p=0.034, p=0.012, p=0.010, respectively). Chemotherapeutic drugs can cause symptoms that can seriously affect quality of life in children.

South-East Asian Integration in the Context of OIC: Implications of Free Trade among Malaysia, Indonesia and Bangladesh

( Mustafa Acar ),( Savas Alpay ),( Esat Bakimli ),( Zehra Zumrut Koc ) 세종대학교 경제통합연구소 2009 Journal of Economic Integration Vol.24 No.1

Organization of the Islamic Conference (OIC) is the second largest intergovernmental organization after UN with its 57 members. OIC accounts for 22.48 percent of world population, 6.64 percent of world GDP, and 9.1 percent of world trade as of 2007. When it comes to having world valuable resources, OIC`s potential is even more striking with more than 70% of oil and nearly 50% of natural gas reserves of the world. However, the level of economic integration and volume of trade among OIC members over the last 4 decades has been less than satisfactory. But recently there have been some efforts towards increased economic cooperation among the member countries as a key strategy for higher economic growth and welfare. Protocol on Preferential Tariff Scheme (PRETAS) signed by nearly a dozen countries proposes a preferential trade regime among the member states. Further steps in the coming years, including possible free trade areas and customs union are also on the agenda. In this context, this paper looks into the likely consequences of an economic integration among three OIC member countries: Malaysia, Indonesia, and Bangladesh. This could be seen as a first step to investigate the possible gains from more comprehensive economic integration initiative including all members of the OIC. Using a multi-sector, multi-country computable general equilibrium framework, we investigate the impact of full trade liberalization among Malaysia, Indonesia and Bangladesh. One should stress that there is not a simple and clear-cut conclusion one can derive: depending on the nature and the degree of integration, the results vary. The simulation results indicate that free trade among these three countries will likely benefit Indonesia and Malaysia while leading to some welfare loss for Bangladesh. Based on the results, it can be suggested that mechanisms be developed in order to strengthen the adjustment capacity of the less developed trade partners. Correspondingly, instead of FTAs, preferential trade arrangements can be considered in the beginning in accordance with the priorities of countries focusing on certain sectors in which they have comparative advantage. Larger integrations may be achieved in the long term gradually through such small-scale integrations.

Prognostic Factors and Clinical Outcome in Parotid Gland Tumors: a Single Institution Experience from the Eastern Black Sea Region of Turkey

Kandaz, Mustafa,Soydemir, Gulsen,Bahat, Zumrut,Canyilmaz, Emine,Yoney, Adnan Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.3

Purpose: To review clinical characteristics, treatment outcomes and prognostic factors in patients with parotid gland tumors treated with surgery and postoperative radiotherapy. Materials and Methods: We retrospectively reviewed 69 patients with parotid gland tumors, with a median follow-up of 52 months (range, 2-228 months). and a median radiotherapy dose of 60Gy (range, 30-69 Gy). Results: There were 24 (35%) females and 45 (65%) males, at a ratio of 1/1.9. Median age at presentation was $58.9{\pm}17.2$ (range 13-88) years. The most common histology was adenoid cystic carcinoma (33%) and mucoepidermoid carcinoma (28%). The mean overall survival (OS) was $65.3{\pm}8$ (95% confidence interval [CI], 49.6-81.1) months and the median overall survival was $40.0{\pm}7$ (95% CI, 26.2-53.7) months. The -1, -3, -5 and -10 year OS rates were 78%, 52.4%, 35.3% and 19.6% respectively. The mean disease free survival (DFS) was $79.2{\pm}10$ (95% CI, 59.3-97.1) months and the median disease free survival was $38{\pm}13$ (95% CI, 7.05-88.7) months. The -1,-3,-5 and -10 year DFS rates were 71.9%, 50.1%, 43.7% and 30.1% respectively. On univariate analysis, the OS was significantly better with female sex (p<0.005), < 50 age (p<0.021), T stage (p<0.0001), absence of lymph node involvement (p<0.0001), lower tumor grade (p<0.0001), absence of lymphovascular invasion (p<0.002), absence of perineural invasion (p<0.0001), absence of extracapsuler extension (p<0.0001), surgical margin negativity (p<0.006), ${\leq}60Gy$ radiotherapy dose (p<0.0001) and absence of distant metastasis (p<0.027). Conclusions: Employing existing standards of postoperative radiotherapy is a possible treatment that was found to be mainly effective in patients with parotid gland carcinomas.

Evaluation of Prognostic Factors and Survival Results in Pancreatic Carcinomas in Turkey

Canyilmaz, Emine,Serdar, Lasif,Uslu, Gonca Hanedan,Soydemir, Gulsen,Bahat, Zumrut,Yoney, Adnan Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.11

Background: The goal of this retrospective study was to evaluate patient characteristics, treatment modalities and prognostic factors in Turkish patients with pancreatic cancer. Materials and Methods: Between January 1997 and December 2012, 64 patients who presented to the Department of Radiation Oncology, Karadeniz Technical University, Faculty of Medicine with a diagnosis of pancreatic cancer were evaluated. The E/K ratio of the cases was 2.4/1 and the median age was 59.6 (32-80) years, respectively. Some 11 cases (18%) were stage 1, 21 (34.4%) were stage 2, 10 (16.4%) were stage 3, and 19 (31.1%) were metastatic. Results: The mean follow-up time was 15.7 months (0.7-117.5) and loco-regional recurrence was noted in 11 (40.7%) who underwent surgery while metastases were observed in 41 patients (66.1%). The median overall survival (OS) was 11.2 months and the 1, 3 and 5-year OS rates were 41.7%, 9.9% and 7.9% respectively. The median disease-free survival (DFS) was 5.2 month and the1, 2 and 5 year DFS were 22.6%, 7.6% and 3.8% respectively. On univariate analysis, prognostic factors affecting OS included status of the operation (p<0.001), tumor stage (p=0.008), ECOG performance status (p=0.005) and CEA level (p=0.017).On multivariate analysis, prognostic factors affecting survival included status of the operation (p=0.033) and age (p= 0.023). Conclusions: In the current study, age and operation status were independent prognostic factors for overall survival with pancreatic patients. Thus, the patients early diagnosis and treatment ars essential. However, prospective studies with more patients are needed for confirmation.