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    Clinical Characteristics and Outcomes of Cancer Cases Among Syrian Refugees From Southern Turkey
    (Amer Medical Assoc, 2023) Kutluk, Tezer; Sahin, Berksoy; Kirazli, Meral; Ahmed, Fahad; Aydin, Sinem; Cinkir, Havva Yesil; Sezgin, Guelay
    Importance Cancer was a common noncommunicable disease in Syria before the present conflict and is now a major disease burden among 3.6 million Syrian refugees in Turkey. Data to inform health care practice are needed. Objective To explore sociodemographic characteristics, clinical characteristics, and treatment outcomes of Syrian patients with cancer residing in the southern border provinces of Turkey hosting more than 50% of refugees. Design, Setting, and ParticipantsThis was a retrospective hospital-based cross-sectional study. The study sample consisted of all adult and children Syrian refugees diagnosed and/or treated for cancer between January 1, 2011, and December 31, 2020, in hematology-oncology departments of 8 university hospitals in the Southern province of Turkey. Data were analyzed from May 1, 2022, to September 30, 2022. Main Outcomes and Measures Demographic characteristics (date of birth, sex, and residence), date of first cancer-related symptom, date and place of diagnosis, disease status at first presentation, treatment modalities, date and status at last hospital visit, and date of death. The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision and International Classification of Childhood Cancers, Third Edition, were used for the classification of cancer. The Surveillance, Epidemiology, and End Results system was applied for staging. The diagnostic interval was defined as the number of days from first symptoms until the diagnosis. Treatment abandonment was documented if the patient did not attend the clinic within 4 weeks of a prescribed appointment throughout the treatment. Results A total of 1114 Syrian adult and 421 Syrian children with cancer were included. The median age at diagnosis was 48.2 (IQR, 34.2-59.4) years for adults and 5.7 (IQR, 3.1-10.7) years for children. The median diagnostic interval was 66 (IQR, 26.5-114.3) days for adults and 28 (IQR, 14.0-69.0) days for children. Breast cancer (154 [13.8%]), leukemia and multiple myeloma (147 [13.2%]), and lymphoma (141 [12.7%]) were common among adults, and leukemias (180 [42.8%]), lymphomas (66 [15.7%]), and central nervous system neoplasms (40 [9.5%]) were common among children. The median follow-up time was 37.5 (IQR, 32.6-42.3) months for adults and 25.4 (IQR, 20.9-29.9) months for children. The 5-year survival rate was 17.5% in adults and 29.7% in children. Conclusions and Relevance Despite universal health coverage and investment in the health care system, low survival rates were reported in this study for both adults and children with cancer. These findings suggest that cancer care in refugees requires novel planning within national cancer control programs with global cooperation.
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    Vildagliptin Treatment on the Portal Venous Pressure and Hepatosteatosis in Patients with Type 2 Diabetes Mellitus
    (Aves, 2018) Karatoprak, Cumali; Kilicarslan, Rukiye; Cakirca, Mustafa; Aydin, Sinem; Ozkan, Tuba; Kocaman, Orhan; Yolbas, Servet
    Objective: This study investigated how vildagliptin (a di-peptidyl peptidase 4 inhibitor) affects portal vein pressure and hepatosteatosis in patients with type 2 diabetes mellitus. Methods: This cross-sectional study evaluated the use of specific drugs for at least 3 months on two groups of type 2 diabetes mellitus cases. Group 1 used metformin and gliclazide, Group 2 used the same amounts of metformin and gliclazide, with the addition of vildagliptin. Using Doppler ultrasound, all cases were measured for portal vein flow velocity, portal vein flow and portal vein diameter. Degree of hepatosteatosis was also recorded. Results: A total of 97 patients completed the study. The study finished with 49 type 2 DM patients in Group1 (20 men, 29 women) and 48 patients in Group2 (20 men, 28 women. No significant difference was found in term of age, gender, BMI, HbA1c, mean arterial pressure, LDL-C, HDL-C or triglyceride levels in two groups. Portal vein flow velocity, portal vein flow volume, and portal vein diameter of all cases were measured by Doppler ultrasound in both groups. No significant difference was found between the groups (respectively p=0.92,p=0.60, p=0.92). There was no significant difference between groups regarding to ultrasonographic grading of hepatosteatosis Conclusion: Treating type 2 diabetes mellitus patients with vildagliptin for had no effect on portal vein hemodynamics and hepatosteatosis as assessed with Doppler ultrasound. Further long-term studies with better evaluation methods are needed to demonstrate any expected beneficial effect of vildagliptin on portal hemodynamics and hepatosteatosis.