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Firlatan B, Karakulak UN, Hekimsoy V, Iremli BG, Lay I, Yuce D, Dagdelen S, Kabakci G, Erbas T. Evaluation of the relation between subclinical systolic dysfunction defined by four-dimensional speckle-tracking echocardiography and growth differentiation factor-15 levels in patients with acromegaly. Hormones (Athens) 2024:10.1007/s42000-024-00558-7. [PMID: 38632216 DOI: 10.1007/s42000-024-00558-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Accepted: 04/01/2024] [Indexed: 04/19/2024]
Abstract
PURPOSE In patients with acromegaly, the long-term presence of elevated GH and IGF-1 levels is associated with an unfavorable cardiovascular risk profile. We aimed to assess the relationship of four-dimensional speckle tracking echocardiographic (4DSTE) measurements with growth differentiation factor-15 (GDF-15) levels and the Framingham Cardiovascular Risk Score (FRS) in patients with acromegaly. METHODS A single-center, cross-sectional study was conducted. The study included 40 acromegaly and 32 age- and gender-matched controls. Anthropometric, biochemical, and echocardiographic assessments were performed. GDF-15 levels were measured using ELISA. RESULTS In the controlled acromegaly group, global longitudinal (GLS), circumferential (GCS), area (GAS), and radial (GRS) strain measurements identified by 4DSTE were lower than those of the controls (p < 0.05). Moreover, strain parameters were lower in active acromegaly patients than in controls, but the difference was not statistically significant. The GLS was negatively correlated with age, the estimated disease duration, and FRS. Serum GDF-15 levels showed no significant difference between the acromegaly and control groups. In patients with acromegaly, serum GDF-15 levels were positively correlated with age, waist-to-hip ratio, systolic and diastolic blood pressure, FRS, fasting plasma glucose, and HbA1c, but not with strain parameters. The multiple regression analysis revealed that FRS was an independent factor associated with serum GDF-15 levels in patients with acromegaly and the overall cohort (p < 0.001). CONCLUSION Our study demonstrates that while LVEF was within normal limits, global strain parameters (GLS, GCS, GAS, and GRS) measured by using a novel imaging technique, 4DSTE, were lower in patients with acromegaly, suggesting the presence of subclinical systolic dysfunction in patients with acromegaly. GDF-15 can be a potential predictor of cardiovascular risk in patients with acromegaly.
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Affiliation(s)
- Busra Firlatan
- Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey.
| | - Ugur Nadir Karakulak
- Department of Cardiology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Vedat Hekimsoy
- Department of Cardiology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Burcin Gonul Iremli
- Department of Endocrinology and Metabolism, Hacettepe University School of Medicine, Ankara, Turkey
| | - Incilay Lay
- Department of Medical Biochemistry, Hacettepe University School of Medicine, Ankara, Turkey
| | - Deniz Yuce
- Department of Preventive Oncology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Selcuk Dagdelen
- Department of Endocrinology and Metabolism, Hacettepe University School of Medicine, Ankara, Turkey
| | - Giray Kabakci
- Department of Cardiology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Tomris Erbas
- Department of Endocrinology and Metabolism, Hacettepe University School of Medicine, Ankara, Turkey
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Turan-Demirci B, Isgin-Atici K, Sendur SN, Yuce D, Erbas T, Buyuktuncer Z. Dietary Total Polyphenol, Flavonoid, and Lignan Intakes Are Associated with Obesity and Diabetes-Related Traits: A Case-Control Study. Metab Syndr Relat Disord 2024. [PMID: 38588574 DOI: 10.1089/met.2023.0248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024] Open
Abstract
Purpose: Dietary phytochemicals have been under examination as adjuvants for the prevention and treatment of obesity and diabetes. This study aimed at examining the potential associations of dietary "Phytochemical Index" (PI) and polyphenol intake with obesity and diabetes-related parameters. Materials and Methods: The case-control study involved 331 participants (156 overweight/obese and 175 normal weight), aged 18-50 years. Dietary intake was assessed using the 24-hr dietary recall method, and the PI score was calculated as the percentage of energy intake provided by phytochemical-rich foods. Polyphenol intakes were calculated using Phenol-Explorer and U.S. Department of Agriculture databases. Anthropometrical measurements were taken, serum glucose, insulin, and lipid profiles were analyzed, homeostatic model assessment for insulin resistance (HOMA-IR) was calculated, and blood pressure was measured. Linear regression analyses were used to examine the potential associations. Results: Participants with higher PI scores had higher total and some sub-classes polyphenol intakes compared with lower ones (P < 0.05, for each). Dietary PI score was not associated with any of the anthropometrical measurements; however, total polyphenol and flavonoids intakes were inversely associated with body mass index (β = -0.269, P = 0.049; β = -0.262, P = 0.048; respectively), waist circumference (β = -0.127, P = 0.021; β = -0.130, P = 0.016; respectively), and waist-to-hip ratio (β = -20.724, P = 0.032; β = -22.199, P = 0.018; respectively) after adjusting for potential confounders. Either dietary PI score or total and sub-class polyphenol intakes were not associated with a better metabolic profile, except for the lignan intake, which was inversely associated with HOMA-IR (β = -0.048, P = 0.011). Conclusions: Higher dietary polyphenol intake may have potential in the prevention of obesity and diabetes, and validated practical tools are essential for the assessment of polyphenol intake in clinical practice.
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Affiliation(s)
- Busra Turan-Demirci
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Cankiri Karatekin University, Cankiri, Turkey
| | - Kubra Isgin-Atici
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Amasya University, Amasya, Turkey
| | - Suleyman Nahit Sendur
- Department of Endocrinology and Metabolism, School of Medicine, Hacettepe University, Ankara, Turkey
| | - Deniz Yuce
- Department of Preventive Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Tomris Erbas
- Department of Endocrinology and Metabolism, School of Medicine, Hacettepe University, Ankara, Turkey
| | - Zehra Buyuktuncer
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
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Eroğlu İ, Iremli BG, Erkoc A, Idilman IS, Yuce D, Kutukcu EC, Akata D, Erbas T. Nonalcoholic Fatty Liver Disease, Bone and Muscle Quality in Prolactinoma: A Pilot Study. J Clin Densitom 2024; 27:101479. [PMID: 38447349 DOI: 10.1016/j.jocd.2024.101479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 01/26/2024] [Accepted: 02/15/2024] [Indexed: 03/08/2024]
Abstract
OBJECTIVE Hyperprolactinemia has negative impacts on metabolism and musculoskeletal health. In this study, individuals with active prolactinoma were evaluated for nonalcoholic fatty liver disease (NAFLD) and musculoskeletal health, which are underemphasized in the literature. METHODS Twelve active prolactinoma patients and twelve healthy controls matched by age, gender, and BMI were included. Magnetic resonance imaging-proton density fat fraction (MRI-PDFF) was used to evaluate hepatic steatosis and magnetic resonance elastography (MRE) to evaluate liver stiffness measurement (LSM). Abdominal muscle mass, and vertebral MRI-PDFF was also evaluated with MRI. Body compositions were evaluated by dual energy X-ray absorptiometry (DXA). The skeletal muscle quality (SMQ) was classified as normal, low and weak by using "handgrip strength/appendicular skeletal muscle mass (HGS/ASM)" ratio based on the cut-off values previously stated in the literature. RESULTS Prolactin, HbA1c and CRP levels were higher in prolactinoma patients (p<0.001, p=0.033 and p=0.035, respectively). The median MRI-PDFF and MRE-LSM were 3.0% (2.01-15.20) and 2.22 kPa (2.0-2.5) in the prolactinoma group and 2.5% (1.65-10.00) and 2.19 kPa (1.92-2.54) in the control group, respectively and similiar between groups. In prolactinoma patients, liver MRI-PDFF showed a positive and strong correlation with the duration of disease and traditional risk factors for NAFLD. Total, vertebral and pelvic bone mineral density was similar between groups, while vertebral MRI-PDFF tended to be higher in prolactinoma patients (p=0.075). Muscle mass and strength parameters were similar between groups, but HGS/ASM tended to be higher in prolactinoma patients (p=0.057). Muscle mass was low in 33.3% of prolactinoma patients and 66.6 of controls. According to SMQ, all prolactinoma patients had normal SMQ, whereas 66.6% of the controls had normal SMQ. CONCLUSION Prolactinoma patients demonstrated similar liver MRI-PDFF and MRE-LSM to controls despite their impaired metabolic profile and lower gonadal hormone levels. Hyperprolactinemia may improve muscle quality in prolactinoma patients despite hypogonadism.
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Affiliation(s)
- İmdat Eroğlu
- Hacettepe University, School of Medicine, Department of Internal Medicine.
| | - Burcin Gonul Iremli
- Hacettepe University, School of Medicine, Department of Internal Medicine; Hacettepe University, School of Medicine, Department of Endocrinology & Metabolism
| | - Aysegul Erkoc
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Department of Cardiorespiratory Physiotherapy and Rehabilitation
| | - Ilkay S Idilman
- Hacettepe University, School of Medicine, Department of Radiology
| | - Deniz Yuce
- Hacettepe University, School of Medicine, Department of Preventive Oncology, Ankara, Turkey
| | - Ebru Calik Kutukcu
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Department of Cardiorespiratory Physiotherapy and Rehabilitation
| | - Deniz Akata
- Hacettepe University, School of Medicine, Department of Radiology
| | - Tomris Erbas
- Hacettepe University, School of Medicine, Department of Internal Medicine; Hacettepe University, School of Medicine, Department of Endocrinology & Metabolism
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Faherty EAG, Yuce D, Korban C, Bemis K, Kowalski R, Gretsch S, Ramirez E, Poretsky R, Packman A, Leisman KP, Pierce M, Kittner A, Teran R, Pacilli M. Correlation of wastewater surveillance data with traditional influenza surveillance measures in Cook County, Illinois, October 2022-April 2023. Sci Total Environ 2024; 912:169551. [PMID: 38135071 PMCID: PMC10913165 DOI: 10.1016/j.scitotenv.2023.169551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 12/18/2023] [Accepted: 12/18/2023] [Indexed: 12/24/2023]
Abstract
Influenza is a respiratory illness that can result in serious outcomes, particularly among persons who are immunocompromised, aged <5 years or aged >65 years. Traditional influenza surveillance approaches rely upon syndromic surveillance of emergency departments and public health reporting from clinicians and laboratories. Wastewater surveillance infrastructure developed to monitor SARS-CoV-2 is being used for influenza surveillance in the Chicago area. The goal was to evaluate timeliness and correlations between influenza virus detected through wastewater surveillance and traditional influenza surveillance measures to assess utility of wastewater surveillance for influenza at the county level. Specifically, we measured correlations between influenza virus gene copies in wastewater samples and 1) the number of intensive care unit admissions associated with a diagnosis of influenza, 2) the percentage emergency department (ED) visits for influenza-like-illness, and 3) the percentage of ED visits with influenza diagnosis at discharge2 in Cook County. Influenza concentrations in wastewater were strongly correlated with traditional influenza surveillance measures, particularly for catchment areas serving >100,000 residents. Wastewater indicators lagged traditional influenza surveillance measures by approximately one week when analyzed in cross-correlations. Although wastewater data lagged traditional influenza surveillance measures in this analysis, it can serve as a useful surveillance tool as a complement to syndromic surveillance; it is a form of influenza surveillance that does not rely on healthcare-seeking behavior or reporting by healthcare providers.
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Affiliation(s)
- Emily A G Faherty
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, United States of America; Chicago Department of Public Health, United States of America.
| | - Deniz Yuce
- Chicago Department of Public Health, United States of America
| | - Colin Korban
- Chicago Department of Public Health, United States of America
| | - Kelley Bemis
- Cook County Department of Public Health, United States of America
| | - Rishi Kowalski
- Cook County Department of Public Health, United States of America
| | | | - Enrique Ramirez
- Chicago Department of Public Health, United States of America
| | | | | | | | - Melissa Pierce
- University of Illinois System, Discovery Partners Institute, United States of America
| | - Alyse Kittner
- Chicago Department of Public Health, United States of America
| | - Richard Teran
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, United States of America; Chicago Department of Public Health, United States of America
| | - Massimo Pacilli
- Chicago Department of Public Health, United States of America
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Eroğlu İ, Iremli BG, Idilman IS, Yuce D, Lay I, Akata D, Erbas T. Nonalcoholic Fatty Liver Disease, Liver Fibrosis, and Utility of Noninvasive Scores in Patients With Acromegaly. J Clin Endocrinol Metab 2023; 109:e119-e129. [PMID: 37590020 PMCID: PMC10735300 DOI: 10.1210/clinem/dgad490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 05/19/2023] [Accepted: 08/16/2023] [Indexed: 08/18/2023]
Abstract
CONTEXT Nonalcoholic fatty liver disease (NAFLD) is a metabolical disorder and can lead to liver fibrosis. Because it is commonly seen, several noninvasive scores (NS) have been validated to identify high-risk patients. Patients with NAFLD have been shown to have higher serum angiopoietin-like protein-8 (ANGPTL-8) levels. OBJECTIVE The risk of NAFLD is known insufficiently in acromegaly. Moreover, the utility of the NS and the link between NAFLD and ANGPTL-8 in acromegaly is unknown. METHODS Thirty-two patients with acromegaly (n = 15, active [AA] and n = 17, controlled acromegaly [CA]) and 19 healthy controls were included. Magnetic resonance imaging (MRI)-proton density fat fraction (PDFF) was used to evaluate hepatic steatosis, and magnetic resonance elastography to evaluate liver stiffness measurement. ANGPTL-8 levels were measured with ELISA. RESULTS Median liver MRI-PDFF and NAFLD prevalence in AA were lower than in CA (P = .026 and P < .001, respectively). Median magnetic resonance elastography-liver stiffness measurement were similar across groups. Of the NS, visceral adiposity index, fatty liver index, hepatic steatosis index, and triglyceride-glucose index (TyG) all showed positive correlation with the liver MRI-PDFF in the control group. However, only TyG significantly correlated with liver fat in the AA and CA groups. There was no correlation between traditional NAFLD risk factors (body mass index, waist circumference, C-reactive protein, homeostasis model assessment for insulin resistance, visceral adipose tissue) and liver MRI-PDFF in the AA and CA. Patients with acromegaly with NAFLD had lower GH, IGF-1, and ANGPTL-8 levels than in those without NAFLD (P = .025, P = .011, and P = .036, respectively). CONCLUSION Active acromegaly may protect from NAFLD because of high GH. In patients with acromegaly, NAFLD risk cannot be explained with classical risk factors; hence, additional risk factors must be identified. TyG is the best score to evaluate NAFLD risk. Lower ANGPTL-8 in patients with acromegaly and NAFLD implies this hormone may be raised because of insulin resistance rather than being a cause for NAFLD.
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Affiliation(s)
- İmdat Eroğlu
- Department of Internal Medicine, Hacettepe University, School of Medicine, 06230, Ankara, Turkey
| | - Burcin Gonul Iremli
- Department of Internal Medicine, Hacettepe University, School of Medicine, 06230, Ankara, Turkey
- Department of Endocrinology and Metabolism, Hacettepe University, School of Medicine, 06230, Ankara, Turkey
| | - Ilkay S Idilman
- Department of Radiology, Hacettepe University, School of Medicine, 06230, Ankara, Turkey
| | - Deniz Yuce
- Department of Preventive Oncology, Hacettepe University, School of Medicine, 06230, Ankara, Turkey
| | - Incilay Lay
- Department of Biochemistry, Hacettepe University, School of Medicine, 06230, Ankara, Turkey
| | - Deniz Akata
- Department of Radiology, Hacettepe University, School of Medicine, 06230, Ankara, Turkey
| | - Tomris Erbas
- Department of Internal Medicine, Hacettepe University, School of Medicine, 06230, Ankara, Turkey
- Department of Endocrinology and Metabolism, Hacettepe University, School of Medicine, 06230, Ankara, Turkey
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Eroğlu I, İremli BG, Erkoç A, Idilman IS, Yuce D, Calik-Kutukcu E, Akata D, Erbas T. Osteosarcopenia in acromegaly: reduced muscle quality and increased vertebral fat deposition. J Endocrinol Invest 2023; 46:2573-2582. [PMID: 37212954 DOI: 10.1007/s40618-023-02114-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 05/15/2023] [Indexed: 05/23/2023]
Abstract
PURPOSE Musculoskeletal disorders are among the most disabling comorbidities in patients with acromegaly. This study examined muscle and bone quality in patients with acromegaly. METHODS Thirty-three patients with acromegaly and nineteen age- and body mass index-matched healthy controls were included in the study. Body composition was determined using dual-energy X-ray absorptiometry. The participants underwent abdominal magnetic resonance imaging (MRI) for cross-sectional evaluation of muscle area and vertebral MRI proton density fat fraction (MRI-PDFF). Muscular strength was measured using hand grip strength (HGS). Skeletal muscle quality (SMQ) was classified as weak, low, or normal, according to HGS/ASM (appendicular skeletal muscle mass) ratio. RESULTS Groups had similar lean tissues, total body fat ratios, and total abdominal muscle areas. Acromegalic patients had lower pelvic BMD (p = 0.012) and higher vertebral MRI-PDFF (p = 0.014), while total and spine bone mineral densities (BMD) were similar between the groups. The SMQ score rate was normal only 57.5% in the acromegaly group, and 94.7% of the controls had a normal SMQ score (p = 0.01). Subgroup analysis showed that patients with active acromegaly (AA) had higher lean tissue and lower body fat ratios than controlled acromegaly (CA) and control groups. Vertebral MRI-PDFF was higher in the CA group than that in the AA and control groups (p = 0.022 and p = 0.001, respectively). The proportion of participants with normal SMQ was lower in the AA and CA groups than that in the control group (p = 0.012 and p = 0.013, respectively). CONCLUSION Acromegalic patients had reduced SMQ and pelvic BMD, but greater vertebral MRI-PDFF. Although lean tissue increases in AA, this does not affect SMQ. Therefore, increased vertebral MRI-PDFF in controlled acromegalic patients may be due to ectopic adiposity.
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Affiliation(s)
- I Eroğlu
- Department of Internal Medicine, School of Medicine, Hacettepe University, Sıhhıye, 06100, Ankara, Turkey.
| | - B G İremli
- Department of Internal Medicine, School of Medicine, Hacettepe University, Sıhhıye, 06100, Ankara, Turkey
- Department of Endocrinology and Metabolism, School of Medicine, Hacettepe University, Ankara, Turkey
| | - A Erkoç
- Department of Cardiorespiratory Physiotherapy and Rehabilitation, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - I S Idilman
- Department of Radiology, School of Medicine, Hacettepe University, Ankara, Turkey
| | - D Yuce
- Department of Preventive Oncology, School of Medicine, Hacettepe University, Ankara, Turkey
| | - E Calik-Kutukcu
- Department of Cardiorespiratory Physiotherapy and Rehabilitation, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - D Akata
- Department of Radiology, School of Medicine, Hacettepe University, Ankara, Turkey
| | - T Erbas
- Department of Internal Medicine, School of Medicine, Hacettepe University, Sıhhıye, 06100, Ankara, Turkey
- Department of Endocrinology and Metabolism, School of Medicine, Hacettepe University, Ankara, Turkey
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Cunha ARD, Compton K, Xu R, Mishra R, Drangsholt MT, Antunes JLF, Kerr AR, Acheson AR, Lu D, Wallace LE, Kocarnik JM, Fu W, Dean FE, Pennini A, Henrikson HJ, Alam T, Ababneh E, Abd-Elsalam S, Abdoun M, Abidi H, Abubaker Ali H, Abu-Gharbieh E, Adane TD, Addo IY, Ahmad A, Ahmad S, Ahmed Rashid T, Akonde M, Al Hamad H, Alahdab F, Alimohamadi Y, Alipour V, Al-Maweri SA, Alsharif U, Ansari-Moghaddam A, Anwar SL, Anyasodor AE, Arabloo J, Aravkin AY, Aruleba RT, Asaad M, Ashraf T, Athari SS, Attia S, Azadnajafabad S, Azangou-Khyavy M, Badar M, Baghcheghi N, Banach M, Bardhan M, Barqawi HJ, Bashir NZ, Bashiri A, Benzian H, Bernabe E, Bhagat DS, Bhojaraja VS, Bjørge T, Bouaoud S, Braithwaite D, Briko NI, Calina D, Carreras G, Chakraborty PA, Chattu VK, Chaurasia A, Chen MX, Cho WCS, Chu DT, Chukwu IS, Chung E, Cruz-Martins N, Dadras O, Dai X, Dandona L, Dandona R, Daneshpajouhnejad P, Darvishi Cheshmeh Soltani R, Darwesh AM, Debela SA, Derbew Molla M, Dessalegn FN, Dianati-Nasab M, Digesa LE, Dixit SG, Dixit A, Djalalinia S, El Sayed I, El Tantawi M, Enyew DB, Erku DA, Ezzeddini R, Fagbamigbe AF, Falzone L, Fetensa G, Fukumoto T, Gaewkhiew P, Gallus S, Gebrehiwot M, Ghashghaee A, Gill PS, Golechha M, Goleij P, Gomez RS, Gorini G, Guimaraes ALS, Gupta B, Gupta S, Gupta VB, Gupta VK, Haj-Mirzaian A, Halboub ES, Halwani R, Hanif A, Hariyani N, Harorani M, Hasani H, Hassan AM, Hassanipour S, Hassen MB, Hay SI, Hayat K, Herrera-Serna BY, Holla R, Horita N, Hosseinzadeh M, Hussain S, Ilesanmi OS, Ilic IM, Ilic MD, Isola G, Jaiswal A, Jani CT, Javaheri T, Jayarajah U, Jayaram S, Joseph N, Kadashetti V, Kandaswamy E, Karanth SD, Karaye IM, Kauppila JH, Kaur H, Keykhaei M, Khader YS, Khajuria H, Khanali J, Khatib MN, Khayat Kashani HR, Khazeei Tabari MA, Kim MS, Kompani F, Koohestani HR, Kumar GA, Kurmi OP, La Vecchia C, Lal DK, Landires I, Lasrado S, Ledda C, Lee YH, Libra M, Lim SS, Listl S, Lopukhov PD, Mafi AR, Mahumud RA, Malik AA, Mathur MR, Maulud SQ, Meena JK, Mehrabi Nasab E, Mestrovic T, Mirfakhraie R, Misganaw A, Misra S, Mithra P, Mohammad Y, Mohammadi M, Mohammadi E, Mokdad AH, Moni MA, Moraga P, Morrison SD, Mozaffari HR, Mubarik S, Murray CJL, Nair TS, Narasimha Swamy S, Narayana AI, Nassereldine H, Natto ZS, Nayak BP, Negru SM, Nggada HA, Nouraei H, Nuñez-Samudio V, Oancea B, Olagunju AT, Omar Bali A, Padron-Monedero A, Padubidri JR, Pandey A, Pardhan S, Patel J, Pezzani R, Piracha ZZ, Rabiee N, Radhakrishnan V, Radhakrishnan RA, Rahmani AM, Rahmanian V, Rao CR, Rao SJ, Rath GK, Rawaf DL, Rawaf S, Rawassizadeh R, Razeghinia MS, Rezaei N, Rezaei N, Rezaei N, Rezapour A, Riad A, Roberts TJ, Romero-Rodríguez E, Roshandel G, S M, S N C, Saddik B, Saeb MR, Saeed U, Safaei M, Sahebazzamani M, Sahebkar A, Salek Farrokhi A, Samy AM, Santric-Milicevic MM, Sathian B, Satpathy M, Šekerija M, Senthilkumaran S, Seylani A, Shafaat O, Shahsavari HR, Shamsoddin E, Sharew MM, Sharifi-Rad J, Shetty JK, Shivakumar KM, Shobeiri P, Shorofi SA, Shrestha S, Siddappa Malleshappa SK, Singh P, Singh JA, Singh G, Sinha DN, Solomon Y, Suleman M, Suliankatchi Abdulkader R, Taheri Abkenar Y, Talaat IM, Tan KK, Tbakhi A, Thiyagarajan A, Tiyuri A, Tovani-Palone MR, Unnikrishnan B, Vo B, Volovat SR, Wang C, Westerman R, Wickramasinghe ND, Xiao H, Yu C, Yuce D, Yunusa I, Zadnik V, Zare I, Zhang ZJ, Zoladl M, Force LM, Hugo FN. The Global, Regional, and National Burden of Adult Lip, Oral, and Pharyngeal Cancer in 204 Countries and Territories: A Systematic Analysis for the Global Burden of Disease Study 2019. JAMA Oncol 2023; 9:1401-1416. [PMID: 37676656 PMCID: PMC10485745 DOI: 10.1001/jamaoncol.2023.2960] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 05/04/2023] [Indexed: 09/08/2023]
Abstract
Importance Lip, oral, and pharyngeal cancers are important contributors to cancer burden worldwide, and a comprehensive evaluation of their burden globally, regionally, and nationally is crucial for effective policy planning. Objective To analyze the total and risk-attributable burden of lip and oral cavity cancer (LOC) and other pharyngeal cancer (OPC) for 204 countries and territories and by Socio-demographic Index (SDI) using 2019 Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study estimates. Evidence Review The incidence, mortality, and disability-adjusted life years (DALYs) due to LOC and OPC from 1990 to 2019 were estimated using GBD 2019 methods. The GBD 2019 comparative risk assessment framework was used to estimate the proportion of deaths and DALYs for LOC and OPC attributable to smoking, tobacco, and alcohol consumption in 2019. Findings In 2019, 370 000 (95% uncertainty interval [UI], 338 000-401 000) cases and 199 000 (95% UI, 181 000-217 000) deaths for LOC and 167 000 (95% UI, 153 000-180 000) cases and 114 000 (95% UI, 103 000-126 000) deaths for OPC were estimated to occur globally, contributing 5.5 million (95% UI, 5.0-6.0 million) and 3.2 million (95% UI, 2.9-3.6 million) DALYs, respectively. From 1990 to 2019, low-middle and low SDI regions consistently showed the highest age-standardized mortality rates due to LOC and OPC, while the high SDI strata exhibited age-standardized incidence rates decreasing for LOC and increasing for OPC. Globally in 2019, smoking had the greatest contribution to risk-attributable OPC deaths for both sexes (55.8% [95% UI, 49.2%-62.0%] of all OPC deaths in male individuals and 17.4% [95% UI, 13.8%-21.2%] of all OPC deaths in female individuals). Smoking and alcohol both contributed to substantial LOC deaths globally among male individuals (42.3% [95% UI, 35.2%-48.6%] and 40.2% [95% UI, 33.3%-46.8%] of all risk-attributable cancer deaths, respectively), while chewing tobacco contributed to the greatest attributable LOC deaths among female individuals (27.6% [95% UI, 21.5%-33.8%]), driven by high risk-attributable burden in South and Southeast Asia. Conclusions and Relevance In this systematic analysis, disparities in LOC and OPC burden existed across the SDI spectrum, and a considerable percentage of burden was attributable to tobacco and alcohol use. These estimates can contribute to an understanding of the distribution and disparities in LOC and OPC burden globally and support cancer control planning efforts.
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Affiliation(s)
| | - Kelly Compton
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Rixing Xu
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Data and Tooling, Sage Bionetworks, Seattle, Washington
| | - Rashmi Mishra
- Department of Oral Medicine, School of Dentistry, University of Washington, Seattle
| | - Mark Thomas Drangsholt
- Department of Oral Medicine, School of Dentistry, University of Washington, Seattle
- Oral Medicine Clinic, School of Dentistry, University of Washington, Seattle
| | | | - Alexander R Kerr
- Department of Oral and Maxillofacial Pathology, Radiology, and Medicine, College of Dentistry, New York University, New York, New York
| | - Alistair R Acheson
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Dan Lu
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Lindsey E Wallace
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Jonathan M Kocarnik
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Weijia Fu
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Frances E Dean
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Mathematics, University of California, Berkeley
| | - Alyssa Pennini
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Hannah Jacqueline Henrikson
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Global Health, School of Public Health, Boston University, Boston, Massachusetts
| | - Tahiya Alam
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Emad Ababneh
- Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio
| | - Sherief Abd-Elsalam
- Tropical Medicine Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Meriem Abdoun
- Department of Medicine, University of Setif Algeria, Setif, Algeria
| | - Hassan Abidi
- Laboratory Technology Sciences Department, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Hiwa Abubaker Ali
- Department of Banking and Finance, University of Human Development, Sulaymaniyah, Iraq
| | - Eman Abu-Gharbieh
- Clinical Sciences Department, University of Sharjah, Sharjah, United Arab Emirates
| | - Tigist Demssew Adane
- Department of Clinical and Psychosocial Epidemiology, University of Groningen, Groningen, the Netherlands
| | - Isaac Yeboah Addo
- Centre for Social Research in Health, University of New South Wales, Sydney, New South Wales, Australia
- Quality and Systems Performance Unit, Cancer Institute NSW, Sydney, New South Wales, Australia
| | - Aqeel Ahmad
- Department of Medical Biochemistry, Shaqra University, Shaqra, Saudi Arabia
| | - Sajjad Ahmad
- Department of Health and Biological Sciences, Abasyn University, Peshawar, Pakistan
| | - Tarik Ahmed Rashid
- Department of Computer Science and Engineering, University of Kurdistan Hewler, Erbil, Iraq
| | - Maxwell Akonde
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia
| | - Hanadi Al Hamad
- Geriatric and Long Term Care Department, Hamad Medical Corporation, Doha, Qatar
- Rumailah Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Fares Alahdab
- Evidence-Based Practice Center Program, Mayo Clinic Foundation for Medical Education and Research, Rochester, Minnesota
| | - Yousef Alimohamadi
- Health Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Vahid Alipour
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Health Economics, Iran University of Medical Sciences, Tehran, Iran
| | | | | | - Alireza Ansari-Moghaddam
- Department of Epidemiology and Biostatistics, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Sumadi Lukman Anwar
- Department of Surgery, Faculty of Medicine, Gadjah Mada University, Yogyakarta, Indonesia
| | | | - Jalal Arabloo
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Aleksandr Y Aravkin
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Applied Mathematics, College of Arts & Sciences, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Raphael Taiwo Aruleba
- Department of Molecular and Cell Biology, University of Cape Town, Cape Town, South Africa
| | - Malke Asaad
- Department of Plastic Surgery, University of Texas, Houston
| | - Tahira Ashraf
- University Institute of Radiological Sciences and Medical Imaging Technology, The University of Lahore, Lahore, Pakistan
| | | | - Sameh Attia
- Department of Oral and Maxillofacial Surgery, Justus Liebig University of Giessen, Giessen, Germany
| | - Sina Azadnajafabad
- Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Azangou-Khyavy
- Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Muhammad Badar
- Gomal Center of Biochemistry and Biotechnology, Gomal University, Dera Ismail Khan, Pakistan
| | - Nayereh Baghcheghi
- Department of Nursing, Saveh University of Medical Sciences, Saveh, Iran
| | - Maciej Banach
- Department of Hypertension, Medical University of Lodz, Lodz, Poland
- Polish Mothers' Memorial Hospital Research Institute, Lodz, Poland
| | - Mainak Bardhan
- Department of Molecular Microbiology and Bacteriology, National Institute of Cholera and Enteric Diseases, Kolkata, India
- Department of Molecular Microbiology, Indian Council of Medical Research, New Delhi, India
| | - Hiba Jawdat Barqawi
- Clinical Sciences Department, University of Sharjah, Sharjah, United Arab Emirates
| | - Nasir Z Bashir
- School of Oral and Dental Sciences, University of Bristol, Bristol, England, United Kingdom
| | - Azadeh Bashiri
- Health Information Management, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Habib Benzian
- Department of Epidemiology and Health Promotion, College of Dentistry, New York University, New York, New York
| | - Eduardo Bernabe
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, England, United Kingdom
| | - Devidas S Bhagat
- Department of Forensic Chemistry, Government Institute of Forensic Science, Aurangabad, India
| | - Vijayalakshmi S Bhojaraja
- Department of Anatomy, Royal College of Surgeons in Ireland Medical, University of Bahrain, Busaiteen, Bahrain
| | - Tone Bjørge
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Cancer Registry of Norway, Oslo, Norway
| | - Souad Bouaoud
- Department of Medicine, University Ferhat Abbas of Setif, Setif, Algeria
- Department of Epidemiology and Preventive Medicine, University Hospital Saadna Abdenour, Setif, Algeria
| | - Dejana Braithwaite
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville
- Cancer Control and Population Sciences Program, University of Florida Health Cancer Center, Gainesville
| | - Nikolay Ivanovich Briko
- Department of Epidemiology and Evidence-Based Medicine, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Daniela Calina
- Department of Clinical Pharmacy, Faculty of Pharmacy, University of Medicine and Pharmacy of Craiova, Craiova, Romania
| | - Giulia Carreras
- Institute for Cancer Research, Prevention and Clinical Network, Florence, Italy
| | - Promit Ananyo Chakraborty
- School of Population and Public Health, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Vijay Kumar Chattu
- Department of Community Medicine, Datta Meghe Institute of Medical Sciences, Sawangi, India
- Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Chennai, India
| | - Akhilanand Chaurasia
- Department of Oral Medicine and Radiology, King George's Medical University, Lucknow, India
| | - Meng Xuan Chen
- Department of Oral Biological and Medical Sciences, The University of British Columbia, Vancouver, British Columbia, Canada
| | - William C S Cho
- Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong, China
| | - Dinh-Toi Chu
- Center for Biomedicine and Community Health, International School, Vietnam National University, Hanoi, Vietnam
| | | | - Eunice Chung
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Natália Cruz-Martins
- Department of Therapeutic and Diagnostic Technologies, Polytechnic and University Higher Education Cooperative, Gandra, Portugal
- Institute for Research and Innovation in Health, University of Porto, Porto, Portugal
| | - Omid Dadras
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Section Global Health and Rehabilitation, Western Norway University of Applied Sciences, Bergen, Norway
| | - Xiaochen Dai
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Lalit Dandona
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Public Health Foundation of India, Gurugram, India
- Indian Council of Medical Research, New Delhi, India
| | - Rakhi Dandona
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
- Public Health Foundation of India, Gurugram, India
| | - Parnaz Daneshpajouhnejad
- Department of Pathology, Johns Hopkins Medicine, Baltimore, Maryland
- Department of Pathology, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Aso Mohammad Darwesh
- Department of Information Technology, University of Human Development, Sulaymaniyah, Iraq
| | | | | | - Fikadu Nugusu Dessalegn
- Department of Public Health, College of Medicine, Madda Walabu University, Bale Goba, Ethiopia
| | - Mostafa Dianati-Nasab
- Department of Epidemiology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
- Department of Epidemiology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Lankamo Ena Digesa
- Department of Comprehensive Nursing, Arba Minch University, Arba Minch, Ethiopia
| | - Shilpi Gupta Dixit
- Department of Anatomy, All India Institute of Medical Sciences, Jodhpur, India
| | - Abhinav Dixit
- Department of Physiology, All India Institute of Medical Sciences, Jodhpur, India
| | - Shirin Djalalinia
- Development of Research and Technology Center, Ministry of Health and Medical Education, Tehran, Iran
| | - Iman El Sayed
- Department of Biomedical Informatics and Medical Statistics, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Maha El Tantawi
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | | | - Daniel Asfaw Erku
- Centre for Applied Health Economics, Griffith University, Gold Coast, Queensland, Australia
| | - Rana Ezzeddini
- Department of Clinical Biochemistry, Tarbiat Modares University, Tehran, Iran
| | - Adeniyi Francis Fagbamigbe
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
- The Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, Scotland, United Kingdom
| | - Luca Falzone
- Epidemiology and Biostatistics Unit, National Cancer Institute IRCCS Fondazione G. Pascale, Naples, Italy
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Getahun Fetensa
- Department of Nursing, College of Medical and Health Sciences, Wollega University, Nekemte, Ethiopia
| | | | - Piyada Gaewkhiew
- Department of Community Dentistry, Faculty of Dentistry, Mahidol University, Ratchathewi, Thailand
- Population and Patient Health Group, King's College London, London, England, United Kingdom
| | - Silvano Gallus
- Department of Environmental Health Sciences, Mario Negri Institute for Pharmacological Research, Milan, Italy
| | - Mesfin Gebrehiwot
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Ahmad Ghashghaee
- School of Public Health, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Paramjit Singh Gill
- Warwick Medical School, University of Warwick, Coventry, England, United Kingdom
| | - Mahaveer Golechha
- Department of Health Systems and Policy Research, Indian Institute of Public Health, Gandhinagar, India
| | - Pouya Goleij
- Department of Genetics, Sana Institute of Higher Education, Sari, Iran
| | - Ricardo Santiago Gomez
- Department of Oral Surgery and Pathology, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Giuseppe Gorini
- Oncological Network, Institute for Cancer Research, Prevention and Clinical Network, Florence, Italy
| | | | - Bhawna Gupta
- Department of Public Health, Torrens University Australia, Melbourne, Victoria, Australia
| | - Sapna Gupta
- Toxicology Department, Shriram Institute for Industrial Research, Delhi, India
| | - Veer Bala Gupta
- School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Vivek Kumar Gupta
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Arvin Haj-Mirzaian
- Department of Pharmacology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Obesity Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Esam S Halboub
- College of Dentistry, Jazan University, Jazan, Saudi Arabia
- School of Dentistry, Sana'a University, Sana'a, Yemen
| | - Rabih Halwani
- Clinical Sciences Department, University of Sharjah, Sharjah, United Arab Emirates
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Asif Hanif
- University Institute of Public Health, The University of Lahore, Lahore, Pakistan
| | - Ninuk Hariyani
- Department of Dental Public Health, Airlangga University, Surabaya, Indonesia
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, South Australia, Australia
| | - Mehdi Harorani
- Department of Nursing, School of Nursing, Arak University of Medical Sciences, Arak, Iran
| | - Hamidreza Hasani
- Department of Ophthalmology, Iran University of Medical Sciences, Karaj, Iran
| | - Abbas M Hassan
- Department of Plastic Surgery, University of Texas, Houston
| | - Soheil Hassanipour
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
- Caspian Digestive Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Mohammed Bheser Hassen
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- National Data Management Center for Health (NDMC), Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Khezar Hayat
- Institute of Pharmaceutical Sciences, University of Veterinary and Animal Sciences, Lahore, Pakistan
- Department of Pharmacy Administration and Clinical Pharmacy, Xi'an Jiaotong University, Xi'an, China
| | | | - Ramesh Holla
- Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Nobuyuki Horita
- Department of Pulmonology, Yokohama City University, Yokohama, Japan
- National Human Genome Research Institute (NHGRI), National Institutes of Health, Bethesda, Maryland
| | - Mehdi Hosseinzadeh
- Institute of Research and Development, Duy Tan University, Da Nang, Vietnam
- Department of Computer Science, University of Human Development, Sulaymaniyah, Iraq
| | - Salman Hussain
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation, Masaryk University, Brno, Czech Republic
- Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Olayinka Stephen Ilesanmi
- Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Community Medicine, University College Hospital, Ibadan, Ibadan, Nigeria
| | - Irena M Ilic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Milena D Ilic
- Department of Epidemiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, University of Catania, Catania, Italy
| | - Abhishek Jaiswal
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Chinmay T Jani
- Department of Internal Medicine, Mount Auburn Hospital, Harvard University, Cambridge, Massachusetts
| | - Tahereh Javaheri
- Health Informatics Lab, Boston University, Boston, Massachusetts
| | - Umesh Jayarajah
- Postgraduate Institute of Medicine, University of Colombo, Colombo, Sri Lanka
- Department of Surgery, National Hospital of Sri Lanka, Colombo, Sri Lanka
| | - Shubha Jayaram
- Department of Biochemistry, Government Medical College, Mysuru, India
| | - Nitin Joseph
- Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Mangalore, India
| | - Vidya Kadashetti
- Department of Oral and Maxillofacial Pathology, Krishna Vishwa Vidyapeeth (Deemed to be University), Karad, India
| | - Eswar Kandaswamy
- Department of Periodontics, School of Dentistry, Louisiana State University Health Sciences Center, New Orleans
| | | | - Ibraheem M Karaye
- School of Health Professions and Human Services, Hofstra University, Hempstead, New York
| | - Joonas H Kauppila
- Surgery Research Unit, University of Oulu, Oulu, Finland
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
| | | | - Mohammad Keykhaei
- Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Yousef Saleh Khader
- Department of Public Health and Community Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Himanshu Khajuria
- Amity Institute of Forensic Sciences, Amity University, Noida, India
| | - Javad Khanali
- Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahalaqua Nazli Khatib
- Global Consortium for Public Health Research, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, India
| | | | - Mohammad Amin Khazeei Tabari
- Department of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
- MAZUMS Office, Universal Scientific Education and Research Network, Tehran, Iran
| | - Min Seo Kim
- Department of Genomics and Digital Health, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Seoul, South Korea
- Public Health Center, Ministry of Health and Welfare, Wando, South Korea
| | - Farzad Kompani
- Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Reza Koohestani
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - G Anil Kumar
- Public Health Foundation of India, Gurugram, India
| | - Om P Kurmi
- Faculty of Health and Life Sciences, Coventry University, Coventry, England, United Kingdom
- Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | | | - Iván Landires
- Unit of Genetics and Public Health, Institute of Medical Sciences, Las Tablas, Panama
- Ministry of Health, Herrera, Panama
| | - Savita Lasrado
- Department of Otorhinolaryngology, Father Muller Medical College, Mangalore, India
| | - Caterina Ledda
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Yo Han Lee
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, South Korea
| | - Massimo Libra
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Stephen S Lim
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Stefan Listl
- Department of Dentistry, Radboud University, Nijmegen, the Netherlands
- Department of Translational Health Economics, Heidelberg University Hospital, Heidelberg, Germany
| | - Platon D Lopukhov
- Department of Epidemiology and Evidence-Based Medicine, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Ahmad R Mafi
- Department of Clinical Oncology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Rashidul Alam Mahumud
- NHMRC Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Ahmad Azam Malik
- University Institute of Public Health, The University of Lahore, Lahore, Pakistan
- Rabigh Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Manu Raj Mathur
- Department of Health Policy Research, Public Health Foundation of India, Gurugram, India
- Institute of Population Health Sciences, University of Liverpool, Liverpool, England, United Kingdom
| | - Sazan Qadir Maulud
- Department of Biology, College of Science, Salahaddin University, Erbil, Iraq
| | - Jitendra Kumar Meena
- Department of Preventive Oncology, All India Institute of Medical Sciences, New Delhi, India
| | | | - Tomislav Mestrovic
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- University Centre Varazdin, University North, Varazdin, Croatia
| | - Reza Mirfakhraie
- Department of Genetics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Awoke Misganaw
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
- National Data Management Center for Health, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Sanjeev Misra
- Department of Surgical Oncology, All India Institute of Medical Sciences, Jodhpur, India
| | - Prasanna Mithra
- Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Mangalore, India
| | - Yousef Mohammad
- Internal Medicine Department, King Saud University, Riyadh, Saudi Arabia
| | - Mokhtar Mohammadi
- Department of Information Technology, Lebanese French University, Erbil, Iraq
| | - Esmaeil Mohammadi
- Tehran University of Medical Sciences, Tehran, Iran
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Mohammad Ali Moni
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Paula Moraga
- Computer, Electrical and Mathematical Sciences and Engineering Division, King Abdullah University of Science and Technology, Thuwal, Saudi Arabia
| | - Shane Douglas Morrison
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle
| | - Hamid Reza Mozaffari
- Department of Oral and Maxillofacial Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sumaira Mubarik
- Department of Epidemiology and Biostatistics, School of Medicine, Wuhan University, Wuhan, China
| | - Christopher J L Murray
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | | | | | | | - Hasan Nassereldine
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Zuhair S Natto
- Department of Dental Public Health, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Oral Health Policy and Epidemiology, School of Dental Medicine, Harvard University, Boston, Massachusetts
| | | | - Serban Mircea Negru
- Department of Oncology, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - Haruna Asura Nggada
- Department of Histopathology, University of Maiduguri Teaching Hospital, Maiduguri, Nigeria
- Department of Human Pathology, University of Maiduguri, Maiduguri, Nigeria
| | - Hasti Nouraei
- Department of Medical Mycology and Parasitology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Virginia Nuñez-Samudio
- Unit of Microbiology and Public Health, Institute of Medical Sciences, Las Tablas, Panama
- Department of Public Health, Ministry of Health, Herrera, Panama
| | - Bogdan Oancea
- Department of Applied Economics and Quantitative Analysis, University of Bucharest, Bucharest, Romania
| | - Andrew T Olagunju
- Department of Psychiatry and Behavioural Neurosciences, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Department of Psychiatry, Faculty of Clinical Science, University of Lagos, Lagos, Nigeria
| | - Ahmed Omar Bali
- Diplomacy and Public Relations Department, University of Human Development, Sulaymaniyah, Iraq
| | | | - Jagadish Rao Padubidri
- Department of Forensic Medicine and Toxicology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Mangalore, India
| | | | - Shahina Pardhan
- Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, England, United Kingdom
| | - Jay Patel
- Global Health Governance Programme, University of Edinburgh, Edinburgh, Scotland, United Kingdom
- School of Dentistry, University of Leeds, Leeds, England, United Kingdom
| | - Raffaele Pezzani
- Endocrinology Unit, Department of Medicine, University of Padova, Padova, Italy
- Associazione Italiana Ricerca Oncologica di Base (AIROB), Padova, Italy
| | | | - Navid Rabiee
- School of Engineering, Macquarie University, Sydney, New South Wales, Australia
- Pohang University of Science and Technology, Pohang, South Korea
| | | | | | - Amir Masoud Rahmani
- Future Technology Research Center, National Yunlin University of Science and Technology, Yunlin, Taiwan
| | - Vahid Rahmanian
- Department of Public Health, Torbat Jam Faculty of Medical Sciences, Torbat Jam, Iran
| | - Chythra R Rao
- Department of Community Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Sowmya J Rao
- Department of Oral Pathology and Microbiology, Sharavathi Dental College and Hospital, Shimogga, India
| | - Goura Kishor Rath
- Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - David Laith Rawaf
- WHO Collaborating Centre for Public Health Education and Training, Imperial College London, London, England, United Kingdom
- Inovus Medical, St Helens, England, United Kingdom
| | - Salman Rawaf
- Department of Primary Care and Public Health, Faculty of Medicine, Imperial College London, London, England, United Kingdom
- Academic Public Health England, Public Health England, London, England, United Kingdom
| | - Reza Rawassizadeh
- Department of Computer Science, College of Arts & Sciences, Boston University, Boston, Massachusetts
| | - Mohammad Sadegh Razeghinia
- Department of Immunology and Laboratory Sciences, Sirjan School of Medical Sciences, Sirjan, Iran
- Department of Immunology, Kerman University of Medical Sciences, Kerman, Iran
| | - Nazila Rezaei
- Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Negar Rezaei
- Non-Communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Tehran University of Medical Sciences, Tehran, Iran
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Aziz Rezapour
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Abanoub Riad
- Department of Public Health, Masaryk University, Brno, Czech Republic
- Czech National Centre for Evidence-based Healthcare and Knowledge Translation, Masaryk University, Brno, Czech Republic
| | - Thomas J Roberts
- Department of Medicine, Massachusetts General Hospital, Boston
- Harvard Medical School, Harvard University, Boston, Massachusetts
| | - Esperanza Romero-Rodríguez
- Clinical and Epidemiological Research in Primary Care (GICEAP), Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain
| | - Gholamreza Roshandel
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Manjula S
- Department of Oral and Maxillofacial Surgery, JSS Academy of Higher Education and Research, Mysore, India
| | - Chandan S N
- Department of Oral and Maxillofacial Surgery, JSS Academy of Higher Education and Research, Mysore, India
| | - Basema Saddik
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah, United Arab Emirates
| | - Mohammad Reza Saeb
- Department of Polymer Technology, Faculty of Chemistry, Gdańsk University of Technology, Gdańsk, Poland
| | - Umar Saeed
- International Center of Medical Sciences Research, Islamabad, Pakistan
- Multidisciplinary Laboratory Foundation University School of Health Sciences (FUSH), Foundation University, Islamabad, Pakistan
| | - Mohsen Safaei
- Advanced Dental Sciences Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Maryam Sahebazzamani
- Department of Medical Biochemistry, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Medical Laboratory Sciences, Sirjan School of Medical Sciences, Sirjan, Iran
| | - Amirhossein Sahebkar
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Abdallah M Samy
- Department of Entomology, Faculty of Science, Ain Shams University, Cairo, Egypt
- Medical Ain Shams Research Institute (MARSI), Ain Shams University, Cairo, Egypt
| | - Milena M Santric-Milicevic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- School of Public Health and Health Management, University of Belgrade, Belgrade, Serbia
| | - Brijesh Sathian
- Geriatric and Long Term Care Department, Hamad Medical Corporation, Doha, Qatar
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, England, United Kingdom
| | - Maheswar Satpathy
- UGC Centre of Advanced Study in Psychology, Utkal University, Bhubaneswar, India
- Udyam-Global Association for Sustainable Development, Bhubaneswar, India
| | - Mario Šekerija
- Department of Medical Statistics, University of Zagreb, Zagreb, Croatia
- Department of Epidemiology and Prevention of Chronic Noncommunicable Diseases, Croatian Institute of Public Health, Zagreb, Croatia
| | | | - Allen Seylani
- National Heart, Lung, and Blood Institute, National Institutes of Health, Rockville, Maryland
| | - Omid Shafaat
- Department of Radiology and Radiological Science, Johns Hopkins Medicine, Baltimore, Maryland
- Department of Radiology and Interventional Neuroradiology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamid R Shahsavari
- Department of Chemistry, Institute for Advanced Studies in Basic Sciences (IASBS), Zanjan, Iran
| | - Erfan Shamsoddin
- Department of Oral Health, Non-Communicable Diseases Research Center (NCDRC), Tehran, Iran
- Non-Communicable Diseases Committee, National Institute for Medical Research Development (NIMAD), Tehran, Iran
| | | | | | - Jeevan K Shetty
- Department of Biochemistry, Royal College of Surgeons in Ireland Medical University of Bahrain, Busaiteen, Bahrain
| | - K M Shivakumar
- Department of Public Health Dentistry, Krishna Vishwa Vidyapeeth (Deemed to be University), Karad, India
| | - Parnian Shobeiri
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Department of International Studies, Non-Communicable Diseases Research Center (NCDRC), Tehran, Iran
| | - Seyed Afshin Shorofi
- Department of Medical-Surgical Nursing, Nasibeh School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Sunil Shrestha
- School of Pharmacy, Monash University, Selangor Darul Ehsan, Malaysia
| | | | - Paramdeep Singh
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bathinda, India
| | - Jasvinder A Singh
- Heersink School of Medicine, University of Alabama at Birmingham, Birmingham
- Department of Medicine Service, US Department of Veterans Affairs, Birmingham, Alabama
| | - Garima Singh
- Department of Community Medicine, Lady Hardinge Medical College, New Delhi, India
- Department of Community Medicine, All India Institute of Medical Sciences, Jodhpur, India
| | - Dhirendra Narain Sinha
- Department of Epidemiology, School of Preventive Oncology, Patna, India
- Department of Epidemiology, Healis Sekhsaria Institute for Public Health, Mumbai, India
| | - Yonatan Solomon
- Department of Nursing, Dire Dawa University, Dire Dawa, Ethiopia
| | - Muhammad Suleman
- Center for Biotechnology and Microbiology, University of Swat, Mingora, Pakistan
- School of Life Sciences, Xiamen University, Xiamen, China
| | | | | | - Iman M Talaat
- Clinical Sciences Department, University of Sharjah, Sharjah, United Arab Emirates
- Pathology Department, Alexandria University, Alexandria, Egypt
| | - Ker-Kan Tan
- Department of Surgery, National University of Singapore, Singapore, Singapore
| | - Abdelghani Tbakhi
- Department of Cell Therapy and Applied Genomics, King Hussein Cancer Center, Amman, Jordan
| | - Arulmani Thiyagarajan
- Department of Clinical Epidemiology, Leibniz Institute for Prevention Research and Epidemiology, Bremen, Germany
| | - Amir Tiyuri
- Department of Epidemiology and Biostatistics, Birjand University of Medical Sciences, Birjand, Iran
- Department of Epidemiology and Biostatistics, Iran University of Medical Sciences, Tehran, Iran
| | - Marcos Roberto Tovani-Palone
- Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Chennai, India
- Modestum LTD, Eastbourne, England, United Kingdom
| | - Bhaskaran Unnikrishnan
- Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Mangalore, India
| | - Bay Vo
- Faculty of Information Technology, Ho Chi Minh City University of Technology (HUTECH), Ho Chi Minh City, Vietnam
| | - Simona Ruxandra Volovat
- Department of Medical Oncology, University of Medicine and Pharmacy "Grigore T Popa" Iaşi, Iaşi, Romania
- Department of Medical Oncology, Regional Institute of Oncology, Iaşi, Romania
| | - Cong Wang
- Department of Medicine, Vanderbilt University, Nashville, Tennessee
| | - Ronny Westerman
- Competence Center of Mortality-Follow-Up of the German National Cohort, Federal Institute for Population Research, Wiesbaden, Germany
| | - Nuwan Darshana Wickramasinghe
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka
| | - Hong Xiao
- School of Public Health, Zhejiang University, Zhejiang, China
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, School of Medicine, Wuhan University, Wuhan, China
| | - Deniz Yuce
- Hacettepe University Cancer Institute, Ankara, Turkey
| | - Ismaeel Yunusa
- Department of Clinical Pharmacy and Outcomes Sciences, College of Pharmacy, University of South Carolina, Columbia
| | - Vesna Zadnik
- Epidemiology and Cancer Registry Sector, Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - Iman Zare
- Research and Development Department, Sina Medical Biochemistry Technologies, Shiraz, Iran
| | - Zhi-Jiang Zhang
- School of Medicine, Faculty of Medical Sciences, Wuhan University, Wuhan, China
| | - Mohammad Zoladl
- Department of Nursing, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Lisa M Force
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
- Division of Hematology-Oncology, Department of Pediatrics, University of Washington, Seattle
| | - Fernando N Hugo
- Department of Preventive and Social Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Elmali A, Biltekin F, Sari SY, Gultekin M, Yuce D, Yildiz F. Inter-observer variation of target volume delineation for CT-guided cervical cancer brachytherapy. J Contemp Brachytherapy 2023; 15:253-260. [PMID: 37799120 PMCID: PMC10548424 DOI: 10.5114/jcb.2023.131242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 08/22/2023] [Indexed: 10/07/2023] Open
Abstract
Purpose Delineation is a critical and challenging step in radiotherapy planning. Differences in delineation among observers are common, despite the presence of contouring guidelines. This study aimed to identify the inter-observer variability in the target volume delineation of computed tomography (CT)-guided brachytherapy for cervical cancer. Material and methods Four radiation oncologists (ROs) with different expertise levels delineated high-risk (HR) and intermediate-risk (IR) clinical target volume (CTV) according to GYN GEC-ESTRO recommendations, in a blinded manner on every CT set of ten locally advanced cervical cancer cases. The most experienced RO's contours were determined as the index and used for comparison. Dice similarity coefficient (DSC) and pairwise Hausdorff distance (HD) metrics were applied to compare the overlap and gross deviations of all contours. Results Median DSC for HR-CTV and IR-CTV were 0.73 and 0.76, respectively, and a good concordance was achieved for both in majority of contours. While there was no difference in DSC measurements for HR-CTV among the three ROs, RO-3 provided improved DSC values for IR-CTV (p = 0.01). Median HD95 was 5.02 mm and 6.83 mm, and median HDave was 1.69 mm and 2.21 mm for HR-CTV and IR-CTV, respectively. There was no significant difference among ROs in HR-CTV for HD95 or HDave; however, IR-CTV value was significantly improved according to RO-3 (p = 0.01). Case-by-case HD analysis showed no significant inter-observer variations, except for two cases. Conclusions The inter-observer agreement is generally high for target volumes in CT-guided brachytherapy for cervical cancer. The agreement is lower for IR-CTV than HR-CTV. The individual characteristics of each case and different expertise levels of the ROs may have caused the differences. Despite the good concordance for delineation, dosimetric consequences can still be clinically significant.
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Affiliation(s)
- Aysenur Elmali
- Department of Radiation Oncology, Hacettepe University, Faculty of Medicine, Ankara, Turkey
| | - Fatih Biltekin
- Department of Radiation Oncology, Hacettepe University, Faculty of Medicine, Ankara, Turkey
| | - Sezin Yuce Sari
- Department of Radiation Oncology, Hacettepe University, Faculty of Medicine, Ankara, Turkey
| | - Melis Gultekin
- Department of Radiation Oncology, Hacettepe University, Faculty of Medicine, Ankara, Turkey
| | - Deniz Yuce
- Department of Preventive Oncology, Hacettepe University, Faculty of Medicine, Ankara, Turkey
| | - Ferah Yildiz
- Department of Radiation Oncology, Hacettepe University, Faculty of Medicine, Ankara, Turkey
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Gultekin M, Beduk Esen CS, Ates Ozdemir D, Yildirim S, Yuce D, Usubutun A, Yildiz F. Stromal or intraepithelial tumor-infiltrating lymphocytes: which one has more prognostic significance in cervical cancer? Arch Gynecol Obstet 2023; 307:969-980. [PMID: 35840843 DOI: 10.1007/s00404-022-06687-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 06/21/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE To investigate the effect of tumor-infiltrating lymphocytes (TILs) and tumor associated macrophages (TAMs) on treatment results in patients with cervical squamous cell carcinoma who underwent definitive or adjuvant radiotherapy (RT) or chemoradiotherapy (CRT). METHODS Pathological specimens were evaluated from 96 cervical cancer patients who were treated with definitive or adjuvant RT/CRT between April 2001 and January 2020. The percentage of intraepithelial TILs (iTILs) and stromal TILs (sTILs) were calculated, and immunohistochemistry was used for identifying lymphocyte lineage with CD4, CD8, and CD20 antibodies and macrophages with CD68 antibody. Prognostic values of TILs/TAMs on oncological outcomes were evaluated. RESULTS Thirty patients had early-stage disease and 66 patients had advanced-stage disease. Sixty-three and 33 patients received adjuvant RT and definitive CRT, respectively. Low number of sCD20 positive cells was associated with large tumor size and parametrial invasion. In multivariate analysis, low percentage of sTILs and advanced-stage disease were independent poor prognostic factors for overall survival, disease-free survival (DFS), and distant metastasis-free survival; low number of sCD4 positive cells was also an independent poor prognostic factor for DFS. Low percentage of sTILs and low number of sCD8 positive cells was correlated with high rates of distant metastasis (p = 0.038 and p = 0.025, respectively). CONCLUSION sTILs have superior predictive value than iTILs in terms of prognosis. Stromal compartment should be investigated as a routine practice in TIL studies in cervical cancer. Intensifying the treatment in cervical cancer patients with low number of sTILs should be studied in further investigations.
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Affiliation(s)
- Melis Gultekin
- Department of Radiation Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | | | - Deniz Ates Ozdemir
- Department of Pathology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Selma Yildirim
- Department of Pathology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Deniz Yuce
- Department of Preventive Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Alp Usubutun
- Department of Pathology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Ferah Yildiz
- Department of Radiation Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Yildirim M, Halacli B, Yuce D, Gunegul Y, Ersoy EO, Topeli A. Assessment of Admission COVID-19 Associated Hyperinflammation Syndrome Score in Critically-Ill COVID-19 Patients. J Intensive Care Med 2023; 38:70-77. [PMID: 36213939 PMCID: PMC9549159 DOI: 10.1177/08850666221131265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
PURPOSE We aimed to evaluate the relation between admission COVID-19 associated hyperinflammatory syndrome (cHIS) score and intensive care unit (ICU) outcomes. MATERIALS AND METHODS Patients with laboratory confirmed COVID-19 admitted to our ICU between 20th March 2020-15th June 2021 were included. Patients who received immunomodulatory treatment except corticosteroids were excluded. Main outcomes were ICU mortality and invasive mechanical ventilation (IMV) requirement after ICU admission. RESULTS Three hundred and seventy patients with a median (IQR) age of 66 (56-77) were analyzed. Median admission cHIS score was 3 (2-4). A cHIS score ≥3 was found to be associated with ICU mortality (sensitivity = 0.63, specificity = 0.50; p < 0.01) and IMV requirement after ICU admission (sensitivity = 0.61, specificity = 0.51; p < 0.01). Patients with an admission cHIS score ≥3 (n = 199) had worse median admission APACHEII, SOFA scores and PaO2/FiO2 ratio than others (n = 171) (p < 0.01). IMV requirement after ICU admission (38.5% vs 26.1%;p = 0.03), ICU (36.2% vs 25.1%;p = 0.02), hospital (39.1% vs 26.9%;p = 0.01) and 28th day (28.1% vs 19.1%;p = 0.04) mortality were higher in patients with admission cHIS score ≥3 than others (p < 0.01). Age <65 years, malignancy and higher admission SOFA score were independent variables associated with admission cHIS score ≥3. CONCLUSION Critically-ill COVID-19 patients with admission cHIS score ≥3 have worse disease severity and outcomes than other patients.
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Affiliation(s)
- Mehmet Yildirim
- Faculty of Medicine, Department of Internal Medicine, Division of Intensive Care, Hacettepe University, Ankara, Turkey,Mehmet Yildirim, Faculty of Medicine, Department of Internal Medicine, Division of Intensive Care, Hacettepe University, Ankara, Turkey.
| | - Burcin Halacli
- Faculty of Medicine, Department of Internal Medicine, Division of Intensive Care, Hacettepe University, Ankara, Turkey
| | - Deniz Yuce
- Faculty of Medicine, Department of Preventive Oncology, Hacettepe University, Ankara, Turkey
| | - Yunus Gunegul
- Faculty of Medicine, Department of Internal Medicine, Hacettepe University, Ankara, Turkey
| | - Ebru Ortac Ersoy
- Faculty of Medicine, Department of Internal Medicine, Division of Intensive Care, Hacettepe University, Ankara, Turkey
| | - Arzu Topeli
- Faculty of Medicine, Department of Internal Medicine, Division of Intensive Care, Hacettepe University, Ankara, Turkey
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Guven DC, Incesu FGG, Yildirim HC, Erul E, Chalabiyev E, Aktas BY, Yuce D, Arik Z, Kilickap S, Aksoy S, Erman M, Hayran KM, Unal S, Alp A, Dizdar O. Immunogenicity of two doses of inactive COVID-19 vaccine and third booster dose mRNA vaccine in patients with cancer receiving active systemic therapy. Int J Cancer 2022; 152:679-685. [PMID: 36082448 PMCID: PMC9538436 DOI: 10.1002/ijc.34280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 08/28/2022] [Accepted: 08/31/2022] [Indexed: 02/01/2023]
Abstract
We aimed to evaluate the seroconversion rates after two doses of inactive COVID-19 vaccine (CoronaVac) and the benefit of a third dose mRNA vaccine booster in patients with cancer receiving active treatment. Patients with solid tumors receiving active treatment (n = 101) and patients with no-cancer (n = 48) as the control group were included in the study. All the patients and controls had received two doses of CoronaVac and a third booster dose of the mRNA vaccine (Bnt162b2). Anti-SARS-CoV-2 Spike Receptor Binding Domain IgG antibody levels after the second and third dose were measured with quantitative ELISA. The median age of the patients was 66 (IQR 60-71). 79% of the patients were receiving chemotherapy, and 21% were receiving immunotherapy at the time of vaccination. Antibody levels measured after two doses of CoronaVac were significantly lower in patients with cancer than in the control group (median 0 μg/ml [IQR 0-1.17 μg/ml] vs median 0.91 μg/ml [IQR 0-2.24 μg/ml], respectively, P = .002). Seropositivity rates were 46.5% in patients with cancer and 72.9% in the control group (P = .002). Antibody measurement was performed in 26 patients after the third dose. Seroconversion rate increased from 46.5% to 88.5% (P < .001), and the antibody titers significantly increased with the third-dose booster (median 0 μg/ml [IQR 0-1.17 μg/ml] after two doses vs 12.6 μg/ml [IQR 1.8-69.1 μg/ml] after third booster dose, P < .001). Immunogenicity of CoronaVac is low in patients with cancer receiving active treatment, and administering a third dose of an mRNA vaccine is effective in terms of improving seroconversion rates.
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Affiliation(s)
| | | | | | - Enes Erul
- Hacettepe University Cancer InstituteAnkaraTurkey
| | | | | | - Deniz Yuce
- Hacettepe University Cancer InstituteAnkaraTurkey
| | - Zafer Arik
- Hacettepe University Cancer InstituteAnkaraTurkey
| | | | - Sercan Aksoy
- Hacettepe University Cancer InstituteAnkaraTurkey
| | | | | | - Serhat Unal
- Faculty of Medicine, Department of Infectious DiseaseHacettepe UniversityAnkaraTurkey
| | - Alpaslan Alp
- Department of MicrobiologyHacettepe University Faculty of MedicineAnkaraTurkey
| | - Omer Dizdar
- Hacettepe University Cancer InstituteAnkaraTurkey
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Guven D, Gulbahce Incesu F, Yildirim H, Erul E, Chalabiyev E, Aktas B, Yuce D, Arik Z, Kilickap S, Aksoy S, Erman M, Hayran K, Unal S, Alp A, Dizdar O. 1612P Immunogenicity of two doses of inactive COVID-19 vaccine and third booster dose mRNA vaccine in patients with cancer receiving active systemic therapy. Ann Oncol 2022. [PMCID: PMC9472463 DOI: 10.1016/j.annonc.2022.07.1705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Sharma R, Abbasi-Kangevari M, Abd-Rabu R, Abidi H, Abu-Gharbieh E, Acuna JM, Adhikari S, Advani SM, Afzal MS, Aghaie Meybodi M, Ahinkorah BO, Ahmad S, Ahmadi A, Ahmadi S, Ahmed H, Ahmed LA, Ahmed MB, Al Hamad H, Alahdab F, Alanezi FM, Alanzi TM, Alhalaiqa FAN, Alimohamadi Y, Alipour V, Aljunid SM, Alkhayyat M, Almustanyir S, Al-Raddadi RM, Alvand S, Alvis-Guzman N, Amini S, Ancuceanu R, Anoushiravani A, Anoushirvani AA, Ansari-Moghaddam A, Arabloo J, Aryannejad A, Asghari Jafarabadi M, Athari SS, Ausloos F, Ausloos M, Awedew AF, Awoke MA, Ayana TM, Azadnajafabad S, Azami H, Azangou-Khyavy M, Azari Jafari A, Badiye AD, Bagherieh S, Bahadory S, Baig AA, Baker JL, Banach M, Barrow A, Berhie AY, Besharat S, Bhagat DS, Bhagavathula AS, Bhala N, Bhattacharyya K, Bhojaraja VS, Bibi S, Bijani A, Biondi A, Bjørge T, Bodicha BBA, Braithwaite D, Brenner H, Calina D, Cao C, Cao Y, Carreras G, Carvalho F, Cerin E, Chakinala RC, Cho WCS, Chu DT, Conde J, Costa VM, Cruz-Martins N, Dadras O, Dai X, Dandona L, Dandona R, Danielewicz A, Demeke FM, Demissie GD, Desai R, Dhamnetiya D, Dianatinasab M, Diaz D, Didehdar M, Doaei S, Doan LP, Dodangeh M, Eghbalian F, Ejeta DD, Ekholuenetale M, Ekundayo TC, El Sayed I, Elhadi M, Enyew DB, Eyayu T, Ezzeddini R, Fakhradiyev IR, Farooque U, Farrokhpour H, Farzadfar F, Fatehizadeh A, Fattahi H, Fattahi N, Fereidoonnezhad M, Fernandes E, Fetensa G, Filip I, Fischer F, Foroutan M, Gaal PA, Gad MM, Gallus S, Garg T, Getachew T, Ghamari SH, Ghashghaee A, Ghith N, Gholamalizadeh M, Gholizadeh Navashenaq J, Gizaw AT, Glasbey JC, Golechha M, Goleij P, Gonfa KB, Gorini G, Guha A, Gupta S, Gupta VB, Gupta VK, Haddadi R, Hafezi-Nejad N, Haj-Mirzaian A, Halwani R, Haque S, Hariri S, Hasaballah AI, Hassanipour S, Hay SI, Herteliu C, Holla R, Hosseini MS, Hosseinzadeh M, Hostiuc M, Househ M, Huang J, Humayun A, Iavicoli I, Ilesanmi OS, Ilic IM, Ilic MD, Islami F, Iwagami M, Jahani MA, Jakovljevic M, Javaheri T, Jayawardena R, Jebai R, Jha RP, Joo T, Joseph N, Joukar F, Jozwiak JJ, Kabir A, Kalhor R, Kamath A, Kapoor N, Karaye IM, Karimi A, Kauppila JH, Kazemi A, Keykhaei M, Khader YS, Khajuria H, Khalilov R, Khanali J, Khayamzadeh M, Khodadost M, Kim H, Kim MS, Kisa A, Kisa S, Kolahi AA, Koohestani HR, Kopec JA, Koteeswaran R, Koyanagi A, Krishnamoorthy Y, Kumar GA, Kumar M, Kumar V, La Vecchia C, Lami FH, Landires I, Ledda C, Lee SW, Lee WC, Lee YY, Leong E, Li B, Lim SS, Lobo SW, Loureiro JA, Lunevicius R, Madadizadeh F, Mahmoodpoor A, Majeed A, Malekpour MR, Malekzadeh R, Malik AA, Mansour-Ghanaei F, Mantovani LG, Martorell M, Masoudi S, Mathur P, Meena JK, Mehrabi Nasab E, Mendoza W, Mentis AFA, Mestrovic T, Miao Jonasson J, Miazgowski B, Miazgowski T, Mijena GFW, Mirmoeeni S, Mirza-Aghazadeh-Attari M, Mirzaei H, Misra S, Mohammad KA, Mohammadi E, Mohammadi S, Mohammadi SM, Mohammadian-Hafshejani A, Mohammed S, Mohammed TA, Moka N, Mokdad AH, Mokhtari Z, Molokhia M, Momtazmanesh S, Monasta L, Moradi G, Moradzadeh R, Moraga P, Morgado-da-Costa J, Mubarik S, Mulita F, Naghavi M, Naimzada MD, Nam HS, Natto ZS, Nayak BP, Nazari J, Nazemalhosseini-Mojarad E, Negoi I, Nguyen CT, Nguyen SH, Noor NM, Noori M, Noori SMA, Nuñez-Samudio V, Nzoputam CI, Oancea B, Odukoya OO, Oguntade AS, Okati-Aliabad H, Olagunju AT, Olagunju TO, Ong S, Ostroff SM, Padron-Monedero A, Pakzad R, Pana A, Pandey A, Pashazadeh Kan F, Patel UK, Paudel U, Pereira RB, Perumalsamy N, Pestell RG, Piracha ZZ, Pollok RCG, Pourshams A, Pourtaheri N, Prashant A, Rabiee M, Rabiee N, Radfar A, Rafiei S, Rahman M, Rahmani AM, Rahmanian V, Rajai N, Rajesh A, Ramezani-Doroh V, Ramezanzadeh K, Ranabhat K, Rashedi S, Rashidi A, Rashidi M, Rashidi MM, Rastegar M, Rawaf DL, Rawaf S, Rawassizadeh R, Razeghinia MS, Renzaho AMN, Rezaei N, Rezaei N, Rezaei S, Rezaeian M, Rezazadeh-Khadem S, Roshandel G, Saber-Ayad MM, Saberzadeh-Ardestani B, Saddik B, Sadeghi H, Saeed U, Sahebazzamani M, Sahebkar A, Salek Farrokhi A, Salimi A, Salimzadeh H, Samadi P, Samaei M, Samy AM, Sanabria J, Santric-Milicevic MM, Saqib MAN, Sarveazad A, Sathian B, Satpathy M, Schneider IJC, Šekerija M, Sepanlou SG, Seylani A, Sha F, Shafiee SM, Shaghaghi Z, Shahabi S, Shaker E, Sharifian M, Sharifi-Rad J, Sheikhbahaei S, Shetty JK, Shirkoohi R, Shobeiri P, Siddappa Malleshappa SK, Silva DAS, Silva Julian G, Singh AD, Singh JA, Siraj MS, Sivandzadeh GR, Skryabin VY, Skryabina AA, Socea B, Solmi M, Soltani-Zangbar MS, Song S, Szerencsés V, Szócska M, Tabarés-Seisdedos R, Tabibian E, Taheri M, TaheriAbkenar Y, Taherkhani A, Talaat IM, Tan KK, Tbakhi A, Tesfaye B, Tiyuri A, Tollosa DN, Touvier M, Tran BX, Tusa BS, Ullah I, Ullah S, Vacante M, Valadan Tahbaz S, Veroux M, Vo B, Vos T, Wang C, Westerman R, Woldemariam M, Yahyazadeh Jabbari SH, Yang L, Yazdanpanah F, Yu C, Yuce D, Yunusa I, Zadnik V, Zahir M, Zare I, Zhang ZJ, Zoladl M. Global, regional, and national burden of colorectal cancer and its risk factors, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Gastroenterol Hepatol 2022; 7:627-647. [PMID: 35397795 PMCID: PMC9192760 DOI: 10.1016/s2468-1253(22)00044-9] [Citation(s) in RCA: 157] [Impact Index Per Article: 78.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 01/30/2022] [Accepted: 02/04/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Colorectal cancer is the third leading cause of cancer deaths worldwide. Given the recent increasing trends in colorectal cancer incidence globally, up-to-date information on the colorectal cancer burden could guide screening, early detection, and treatment strategies, and help effectively allocate resources. We examined the temporal patterns of the global, regional, and national burden of colorectal cancer and its risk factors in 204 countries and territories across the past three decades. METHODS Estimates of incidence, mortality, and disability-adjusted life years (DALYs) for colorectal cancer were generated as a part of the Global Burden of Diseases, Injuries and Risk Factors Study (GBD) 2019 by age, sex, and geographical location for the period 1990-2019. Mortality estimates were produced using the cause of death ensemble model. We also calculated DALYs attributable to risk factors that had evidence of causation with colorectal cancer. FINDINGS Globally, between 1990 and 2019, colorectal cancer incident cases more than doubled, from 842 098 (95% uncertainty interval [UI] 810 408-868 574) to 2·17 million (2·00-2·34), and deaths increased from 518 126 (493 682-537 877) to 1·09 million (1·02-1·15). The global age-standardised incidence rate increased from 22·2 (95% UI 21·3-23·0) per 100 000 to 26·7 (24·6-28·9) per 100 000, whereas the age-standardised mortality rate decreased from 14·3 (13·5-14·9) per 100 000 to 13·7 (12·6-14·5) per 100 000 and the age-standardised DALY rate decreased from 308·5 (294·7-320·7) per 100 000 to 295·5 (275·2-313·0) per 100 000 from 1990 through 2019. Taiwan (province of China; 62·0 [48·9-80·0] per 100 000), Monaco (60·7 [48·5-73·6] per 100 000), and Andorra (56·6 [42·8-71·9] per 100 000) had the highest age-standardised incidence rates, while Greenland (31·4 [26·0-37·1] per 100 000), Brunei (30·3 [26·6-34·1] per 100 000), and Hungary (28·6 [23·6-34·0] per 100 000) had the highest age-standardised mortality rates. From 1990 through 2019, a substantial rise in incidence rates was observed in younger adults (age <50 years), particularly in high Socio-demographic Index (SDI) countries. Globally, a diet low in milk (15·6%), smoking (13·3%), a diet low in calcium (12·9%), and alcohol use (9·9%) were the main contributors to colorectal cancer DALYs in 2019. INTERPRETATION The increase in incidence rates in people younger than 50 years requires vigilance from researchers, clinicians, and policy makers and a possible reconsideration of screening guidelines. The fast-rising burden in low SDI and middle SDI countries in Asia and Africa calls for colorectal cancer prevention approaches, greater awareness, and cost-effective screening and therapeutic options in these regions. FUNDING Bill & Melinda Gates Foundation.
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Kocarnik JM, Compton K, Dean FE, Fu W, Gaw BL, Harvey JD, Henrikson HJ, Lu D, Pennini A, Xu R, Ababneh E, Abbasi-Kangevari M, Abbastabar H, Abd-Elsalam SM, Abdoli A, Abedi A, Abidi H, Abolhassani H, Adedeji IA, Adnani QES, Advani SM, Afzal MS, Aghaali M, Ahinkorah BO, Ahmad S, Ahmad T, Ahmadi A, Ahmadi S, Ahmed Rashid T, Ahmed Salih Y, Akalu GT, Aklilu A, Akram T, Akunna CJ, Al Hamad H, Alahdab F, Al-Aly Z, Ali S, Alimohamadi Y, Alipour V, Aljunid SM, Alkhayyat M, Almasi-Hashiani A, Almasri NA, Al-Maweri SAA, Almustanyir S, Alonso N, Alvis-Guzman N, Amu H, Anbesu EW, Ancuceanu R, Ansari F, Ansari-Moghaddam A, Antwi MH, Anvari D, Anyasodor AE, Aqeel M, Arabloo J, Arab-Zozani M, Aremu O, Ariffin H, Aripov T, Arshad M, Artaman A, Arulappan J, Asemi Z, Asghari Jafarabadi M, Ashraf T, Atorkey P, Aujayeb A, Ausloos M, Awedew AF, Ayala Quintanilla BP, Ayenew T, Azab MA, Azadnajafabad S, Azari Jafari A, Azarian G, Azzam AY, Badiye AD, Bahadory S, Baig AA, Baker JL, Balakrishnan S, Banach M, Bärnighausen TW, Barone-Adesi F, Barra F, Barrow A, Behzadifar M, Belgaumi UI, Bezabhe WMM, Bezabih YM, Bhagat DS, Bhagavathula AS, Bhardwaj N, Bhardwaj P, Bhaskar S, Bhattacharyya K, Bhojaraja VS, Bibi S, Bijani A, Biondi A, Bisignano C, Bjørge T, Bleyer A, Blyuss O, Bolarinwa OA, Bolla SR, Braithwaite D, Brar A, Brenner H, Bustamante-Teixeira MT, Butt NS, Butt ZA, Caetano dos Santos FL, Cao Y, Carreras G, Catalá-López F, Cembranel F, Cerin E, Cernigliaro A, Chakinala RC, Chattu SK, Chattu VK, Chaturvedi P, Chimed-Ochir O, Cho DY, Christopher DJ, Chu DT, Chung MT, Conde J, Cortés S, Cortesi PA, Costa VM, Cunha AR, Dadras O, Dagnew AB, Dahlawi SMA, Dai X, Dandona L, Dandona R, Darwesh AM, das Neves J, De la Hoz FP, Demis AB, Denova-Gutiérrez E, Dhamnetiya D, Dhimal ML, Dhimal M, Dianatinasab M, Diaz D, Djalalinia S, Do HP, Doaei S, Dorostkar F, dos Santos Figueiredo FW, Driscoll TR, Ebrahimi H, Eftekharzadeh S, El Tantawi M, El-Abid H, Elbarazi I, Elhabashy HR, Elhadi M, El-Jaafary SI, Eshrati B, Eskandarieh S, Esmaeilzadeh F, Etemadi A, Ezzikouri S, Faisaluddin M, Faraon EJA, Fares J, Farzadfar F, Feroze AH, Ferrero S, Ferro Desideri L, Filip I, Fischer F, Fisher JL, Foroutan M, Fukumoto T, Gaal PA, Gad MM, Gadanya MA, Gallus S, Gaspar Fonseca M, Getachew Obsa A, Ghafourifard M, Ghashghaee A, Ghith N, Gholamalizadeh M, Gilani SA, Ginindza TG, Gizaw ATT, Glasbey JC, Golechha M, Goleij P, Gomez RS, Gopalani SV, Gorini G, Goudarzi H, Grosso G, Gubari MIM, Guerra MR, Guha A, Gunasekera DS, Gupta B, Gupta VB, Gupta VK, Gutiérrez RA, Hafezi-Nejad N, Haider MR, Haj-Mirzaian A, Halwani R, Hamadeh RR, Hameed S, Hamidi S, Hanif A, Haque S, Harlianto NI, Haro JM, Hasaballah AI, Hassanipour S, Hay RJ, Hay SI, Hayat K, Heidari G, Heidari M, Herrera-Serna BY, Herteliu C, Hezam K, Holla R, Hossain MM, Hossain MBH, Hosseini MS, Hosseini M, Hosseinzadeh M, Hostiuc M, Hostiuc S, Househ M, Hsairi M, Huang J, Hugo FN, Hussain R, Hussein NR, Hwang BF, Iavicoli I, Ibitoye SE, Ida F, Ikuta KS, Ilesanmi OS, Ilic IM, Ilic MD, Irham LM, Islam JY, Islam RM, Islam SMS, Ismail NE, Isola G, Iwagami M, Jacob L, Jain V, Jakovljevic MB, Javaheri T, Jayaram S, Jazayeri SB, Jha RP, Jonas JB, Joo T, Joseph N, Joukar F, Jürisson M, Kabir A, Kahrizi D, Kalankesh LR, Kalhor R, Kaliyadan F, Kalkonde Y, Kamath A, Kameran Al-Salihi N, Kandel H, Kapoor N, Karch A, Kasa AS, Katikireddi SV, Kauppila JH, Kavetskyy T, Kebede SA, Keshavarz P, Keykhaei M, Khader YS, Khalilov R, Khan G, Khan M, Khan MN, Khan MAB, Khang YH, Khater AM, Khayamzadeh M, Kim GR, Kim YJ, Kisa A, Kisa S, Kissimova-Skarbek K, Kopec JA, Koteeswaran R, Koul PA, Koulmane Laxminarayana SL, Koyanagi A, Kucuk Bicer B, Kugbey N, Kumar GA, Kumar N, Kumar N, Kurmi OP, Kutluk T, La Vecchia C, Lami FH, Landires I, Lauriola P, Lee SW, Lee SWH, Lee WC, Lee YH, Leigh J, Leong E, Li J, Li MC, Liu X, Loureiro JA, Lunevicius R, Magdy Abd El Razek M, Majeed A, Makki A, Male S, Malik AA, Mansournia MA, Martini S, Masoumi SZ, Mathur P, McKee M, Mehrotra R, Mendoza W, Menezes RG, Mengesha EW, Mesregah MK, Mestrovic T, Miao Jonasson J, Miazgowski B, Miazgowski T, Michalek IM, Miller TR, Mirzaei H, Mirzaei HR, Misra S, Mithra P, Moghadaszadeh M, Mohammad KA, Mohammad Y, Mohammadi M, Mohammadi SM, Mohammadian-Hafshejani A, Mohammed S, Moka N, Mokdad AH, Molokhia M, Monasta L, Moni MA, Moosavi MA, Moradi Y, Moraga P, Morgado-da-Costa J, Morrison SD, Mosapour A, Mubarik S, Mwanri L, Nagarajan AJ, Nagaraju SP, Nagata C, Naimzada MD, Nangia V, Naqvi AA, Narasimha Swamy S, Ndejjo R, Nduaguba SO, Negoi I, Negru SM, Neupane Kandel S, Nguyen CT, Nguyen HLT, Niazi RK, Nnaji CA, Noor NM, Nuñez-Samudio V, Nzoputam CI, Oancea B, Ochir C, Odukoya OO, Ogbo FA, Olagunju AT, Olakunde BO, Omar E, Omar Bali A, Omonisi AEE, Ong S, Onwujekwe OE, Orru H, Ortega-Altamirano DV, Otstavnov N, Otstavnov SS, Owolabi MO, P A M, Padubidri JR, Pakshir K, Pana A, Panagiotakos D, Panda-Jonas S, Pardhan S, Park EC, Park EK, Pashazadeh Kan F, Patel HK, Patel JR, Pati S, Pattanshetty SM, Paudel U, Pereira DM, Pereira RB, Perianayagam A, Pillay JD, Pirouzpanah S, Pishgar F, Podder I, Postma MJ, Pourjafar H, Prashant A, Preotescu L, Rabiee M, Rabiee N, Radfar A, Radhakrishnan RA, Radhakrishnan V, Rafiee A, Rahim F, Rahimzadeh S, Rahman M, Rahman MA, Rahmani AM, Rajai N, Rajesh A, Rakovac I, Ram P, Ramezanzadeh K, Ranabhat K, Ranasinghe P, Rao CR, Rao SJ, Rawassizadeh R, Razeghinia MS, Renzaho AMN, Rezaei N, Rezaei N, Rezapour A, Roberts TJ, Rodriguez JAB, Rohloff P, Romoli M, Ronfani L, Roshandel G, Rwegerera GM, S M, Sabour S, Saddik B, Saeed U, Sahebkar A, Sahoo H, Salehi S, Salem MR, Salimzadeh H, Samaei M, Samy AM, Sanabria J, Sankararaman S, Santric-Milicevic MM, Sardiwalla Y, Sarveazad A, Sathian B, Sawhney M, Saylan M, Schneider IJC, Sekerija M, Seylani A, Shafaat O, Shaghaghi Z, Shaikh MA, Shamsoddin E, Shannawaz M, Sharma R, Sheikh A, Sheikhbahaei S, Shetty A, Shetty JK, Shetty PH, Shibuya K, Shirkoohi R, Shivakumar KM, Shivarov V, Siabani S, Siddappa Malleshappa SK, Silva DAS, Singh JA, Sintayehu Y, Skryabin VY, Skryabina AA, Soeberg MJ, Sofi-Mahmudi A, Sotoudeh H, Steiropoulos P, Straif K, Subedi R, Sufiyan MB, Sultan I, Sultana S, Sur D, Szerencsés V, Szócska M, Tabarés-Seisdedos R, Tabuchi T, Tadbiri H, Taherkhani A, Takahashi K, Talaat IM, Tan KK, Tat VY, Tedla BAA, Tefera YG, Tehrani-Banihashemi A, Temsah MH, Tesfay FH, Tessema GA, Thapar R, Thavamani A, Thoguluva Chandrasekar V, Thomas N, Tohidinik HR, Touvier M, Tovani-Palone MR, Traini E, Tran BX, Tran KB, Tran MTN, Tripathy JP, Tusa BS, Ullah I, Ullah S, Umapathi KK, Unnikrishnan B, Upadhyay E, Vacante M, Vaezi M, Valadan Tahbaz S, Velazquez DZ, Veroux M, Violante FS, Vlassov V, Vo B, Volovici V, Vu GT, Waheed Y, Wamai RG, Ward P, Wen YF, Westerman R, Winkler AS, Yadav L, Yahyazadeh Jabbari SH, Yang L, Yaya S, Yazie TSY, Yeshaw Y, Yonemoto N, Younis MZ, Yousefi Z, Yu C, Yuce D, Yunusa I, Zadnik V, Zare F, Zastrozhin MS, Zastrozhina A, Zhang J, Zhong C, Zhou L, Zhu C, Ziapour A, Zimmermann IR, Fitzmaurice C, Murray CJL, Force LM. Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life Years for 29 Cancer Groups From 2010 to 2019: A Systematic Analysis for the Global Burden of Disease Study 2019. JAMA Oncol 2022; 8:420-444. [PMID: 34967848 PMCID: PMC8719276 DOI: 10.1001/jamaoncol.2021.6987] [Citation(s) in RCA: 616] [Impact Index Per Article: 308.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
IMPORTANCE The Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019) provided systematic estimates of incidence, morbidity, and mortality to inform local and international efforts toward reducing cancer burden. OBJECTIVE To estimate cancer burden and trends globally for 204 countries and territories and by Sociodemographic Index (SDI) quintiles from 2010 to 2019. EVIDENCE REVIEW The GBD 2019 estimation methods were used to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life years (DALYs) in 2019 and over the past decade. Estimates are also provided by quintiles of the SDI, a composite measure of educational attainment, income per capita, and total fertility rate for those younger than 25 years. Estimates include 95% uncertainty intervals (UIs). FINDINGS In 2019, there were an estimated 23.6 million (95% UI, 22.2-24.9 million) new cancer cases (17.2 million when excluding nonmelanoma skin cancer) and 10.0 million (95% UI, 9.36-10.6 million) cancer deaths globally, with an estimated 250 million (235-264 million) DALYs due to cancer. Since 2010, these represented a 26.3% (95% UI, 20.3%-32.3%) increase in new cases, a 20.9% (95% UI, 14.2%-27.6%) increase in deaths, and a 16.0% (95% UI, 9.3%-22.8%) increase in DALYs. Among 22 groups of diseases and injuries in the GBD 2019 study, cancer was second only to cardiovascular diseases for the number of deaths, years of life lost, and DALYs globally in 2019. Cancer burden differed across SDI quintiles. The proportion of years lived with disability that contributed to DALYs increased with SDI, ranging from 1.4% (1.1%-1.8%) in the low SDI quintile to 5.7% (4.2%-7.1%) in the high SDI quintile. While the high SDI quintile had the highest number of new cases in 2019, the middle SDI quintile had the highest number of cancer deaths and DALYs. From 2010 to 2019, the largest percentage increase in the numbers of cases and deaths occurred in the low and low-middle SDI quintiles. CONCLUSIONS AND RELEVANCE The results of this systematic analysis suggest that the global burden of cancer is substantial and growing, with burden differing by SDI. These results provide comprehensive and comparable estimates that can potentially inform efforts toward equitable cancer control around the world.
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Affiliation(s)
| | | | - Kelly Compton
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Frances E. Dean
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Weijia Fu
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Brian L. Gaw
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - James D. Harvey
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Hannah Jacqueline Henrikson
- Department of Global Health, Boston University, Boston, Massachusetts
- Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Dan Lu
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Alyssa Pennini
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Rixing Xu
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Emad Ababneh
- Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio
| | - Mohsen Abbasi-Kangevari
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hedayat Abbastabar
- Advanced Diagnostic and Interventional Radiology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Amir Abdoli
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Aidin Abedi
- Department of Orthopaedic Surgery, University of Southern California, Los Angeles
| | - Hassan Abidi
- Laboratory Technology Sciences Department, Yasouj University, Yasuj, Iran
| | - Hassan Abolhassani
- Department of Laboratory Medicine, Karolinska University Hospital, Huddinge, Sweden
- Research Center for Immunodeficiencies, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Qorinah Estiningtyas Sakilah Adnani
- Department of Midwifery, Karya Husada Institute of Health Sciences, Kediri, Indonesia
- Department of Midwifery, Auckland University of Technology, Auckland, New Zealand
| | - Shailesh M. Advani
- Terasaki Institute for Biomedical Innovation, Los Angeles, California
- School of Medicine, Georgetown University, Washington, DC
| | - Muhammad Sohail Afzal
- Department of Life Sciences, University of Management and Technology, Lahore, Pakistan
| | - Mohammad Aghaali
- Department of Epidemiology and Biostatistics, Qom University of Medical Sciences, Qom, Iran
| | - Bright Opoku Ahinkorah
- The Australian Centre for Public and Population Health Research, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Sajjad Ahmad
- Foundation University Medical College, Foundation University Islamabad, Islamabad, Pakistan
| | - Tauseef Ahmad
- Department of Epidemiology and Health Statistics, Southeast University, Nanjing, China
| | - Ali Ahmadi
- Department of Epidemiology and Biostatistics, Shahrekord University of Medical Sciences, Shahrekord, Iran
- Department of Epidemiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sepideh Ahmadi
- School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Tarik Ahmed Rashid
- Department of Computer Science and Engineering, University of Kurdistan Hewler, Erbil, Iraq
| | - Yusra Ahmed Salih
- Database Technology Department, Sulaimani Polytechnic University, Sulaymaniyah, Iraq
- College of Informatics, Sulaimani Polytechnic University, Sulaymaniyah, Iraq
| | - Gizachew Taddesse Akalu
- Microbiology, Immunology and Parasitology Department, St Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
- Microbial, Cellular and Molecular Biology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Addis Aklilu
- Department of Medical Laboratory Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Tayyaba Akram
- School of Mathematical Sciences, University of Science Malaysia, Penang, Malaysia
| | - Chisom Joyqueenet Akunna
- Department of Public Health, Intercountry Centre for Oral Health for Africa, Jos, Nigeria
- Department of Public Health, Federal Ministry of Health, Garki, Nigeria
| | - Hanadi Al Hamad
- Geriatric and Long-Term Care Department, Hamad Medical Corporation, Doha, Qatar
- Rumailah Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Fares Alahdab
- Mayo Evidence-Based Practice Center, Mayo Clinic Foundation for Medical Education and Research, Rochester, Minnesota
| | - Ziyad Al-Aly
- John T. Milliken Department of Internal Medicine, Washington University in St Louis, St Louis, Missouri
- Clinical Epidemiology Center, Department of Veterans Affairs, St Louis, Missouri
| | - Saqib Ali
- Department of Information Systems, Sultan Qaboos University, Muscat, Oman
| | - Yousef Alimohamadi
- Pars Hospital, Iran University of Medical Sciences, Tehran, Iran
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
| | - Vahid Alipour
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Health Economics, Iran University of Medical Sciences, Tehran, Iran
| | - Syed Mohamed Aljunid
- Department of Health Policy and Management, Kuwait University, Safat, Kuwait
- International Centre for Casemix and Clinical Coding, National University of Malaysia, Bandar Tun Razak, Malaysia
| | | | | | | | - Sadeq Ali Ali Al-Maweri
- College of Dental Medicine, Qatar University, Doha, Qatar
- Faculty of Dentistry, Sana'a University, Sana’a, Yemen
| | - Sami Almustanyir
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
- Ministry of Health, Riyadh, Saudi Arabia
| | - Nivaldo Alonso
- Department of Surgery, University of São Paulo, São Paulo, Brazil
| | - Nelson Alvis-Guzman
- Research Group in Hospital Management and Health Policies, Universidad de la Costa, Barranquilla, Colombia
- Research Group in Health Economics, University of Cartagena, Cartagena, Colombia
| | - Hubert Amu
- Department of Population and Behavioural Sciences, University of Health and Allied Sciences, Ho, Ghana
| | | | - Robert Ancuceanu
- Pharmacy Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Fereshteh Ansari
- Research Center for Evidence Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
- Razi Vaccine and Serum Research Institute, Agricultural Research, Education, and Extension Organization, Tehran, Iran
| | - Alireza Ansari-Moghaddam
- Department of Epidemiology and Biostatistics, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Maxwell Hubert Antwi
- Clinical Laboratory Department, Ghana Health Service, Kumasi, Ghana
- Department of Molecular Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Davood Anvari
- Department of Parasitology, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Parasitology, Iranshahr University of Medical Sciences, Iranshahr, Iran
| | | | - Muhammad Aqeel
- Department of Psychology, Foundation University Islamabad, Rawalpandi, Pakistan
| | - Jalal Arabloo
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Morteza Arab-Zozani
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Olatunde Aremu
- Department of Public Health, Birmingham City University, Birmingham, England
| | - Hany Ariffin
- Department of Paediatrics, University of Malaya, Kuala Lumpur, Malaysia
- University of Malaya Medical Centre, University of Malaya, Kuala Lumpur, Malaysia
| | - Timur Aripov
- Public Health and Healthcare Management, Tashkent Institute of Postgraduate Medical Education, Tashkent, Uzbekistan
- Boston Children's Hospital, Boston, Massachusetts
| | - Muhammad Arshad
- Allied Health Sciences, Khyber Medical University, Timergara, Lower Dir, Pakistan
| | - Al Artaman
- Zayed University, Abu Dhabi, United Arab Emirates
| | - Judie Arulappan
- Department of Maternal and Child Health, Sultan Qaboos University, Muscat, Oman
| | - Zatollah Asemi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Mohammad Asghari Jafarabadi
- Department of Biostatistics and Epidemiology, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Biostatistics and Epidemiology, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Tahira Ashraf
- Institute of Radiological Sciences and Medical Imaging Technology, University of Lahore, Lahore, Pakistan
| | - Prince Atorkey
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter New England Population Health, Wallsend, New South Wales, Australia
| | - Avinash Aujayeb
- Northumbria HealthCare National Health Service (NHS) Foundation Trust, NHS England, Newcastle upon Tyne, England
| | - Marcel Ausloos
- School of Business, University of Leicester, Leicester, England
- Department of Statistics and Econometrics, Bucharest University of Economic Studies, Bucharest, Romania
| | | | | | - Temesgen Ayenew
- Department of Nursing, Debre Markos University, Debre Markos, Ethiopia
| | | | | | | | - Ghasem Azarian
- Department of Environmental Health Engineering, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ahmed Y. Azzam
- Faculty of Medicine, October 6 University, 6th of October City, Egypt
| | - Ashish D. Badiye
- Department of Forensic Science, Government Institute of Forensic Science, Nagpur, India
| | - Saeed Bahadory
- Department of Parasitology, Tarbiat Modares University, Tehran, Iran
- Department of Parasitology, Alborz University of Medical Sciences, Karaj, Iran
| | - Atif Amin Baig
- Unit of Biochemistry, Universiti Sultan Zainal Abidin, Kuala Terengganu, Malaysia
| | - Jennifer L. Baker
- Center for Clinical Research and Prevention, Bispebjerg University Hospital, Frederiksberg, Denmark
| | | | - Maciej Banach
- Department of Hypertension, Medical University of Lodz, Lodz, Poland
- Polish Mothers' Memorial Hospital Research Institute, Lodz, Poland
| | - Till Winfried Bärnighausen
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany
- T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | | | - Fabio Barra
- Academic Unit of Obstetrics and Gynecology, University of Genoa, Genoa, Italy
| | - Amadou Barrow
- Department of Public and Environmental Health, University of the Gambia, Brikama, The Gambia
- Epidemiology and Disease Control Unit, Ministry of Health, Kotu, The Gambia
| | - Masoud Behzadifar
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Uzma Iqbal Belgaumi
- Department of Oral Pathology and Microbiology, Krishna Institute of Medical Sciences, Karad, India
| | | | - Yihienew Mequanint Bezabih
- Department of Internal Medicine, Bahir Dar University, Bahir Dar, Ethiopia
- One Health, University of Nantes, Nantes, France
| | - Devidas S. Bhagat
- Department of Forensic Chemistry, Government Institute of Forensic Science, Aurangabad, India
| | - Akshaya Srikanth Bhagavathula
- Department of Social and Clinical Pharmacy, Charles University, Hradec Kralova, Czech Republic
- Institute of Public Health, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Nikha Bhardwaj
- Department of Anatomy, Government Medical College Pali, Pali, India
| | - Pankaj Bhardwaj
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Jodhpur, India
- School of Public Health, All India Institute of Medical Sciences, Jodhpur, India
| | - Sonu Bhaskar
- Neurovascular Imaging Laboratory, New South Wales Brain Clot Bank, Sydney, New South Wales, Australia
- Department of Neurology and Neurophysiology, South West Sydney Local Heath District and Liverpool Hospital, Sydney, New South Wales, Australia
| | - Krittika Bhattacharyya
- Department of Statistical and Computational Genomics, National Institute of Biomedical Genomics, Kalyani, India
- Department of Statistics, University of Calcutta, Kolkata, India
| | | | - Sadia Bibi
- Institute of Soil and Environmental Sciences, University of Agriculture, Faisalabad, Faisalabad, Pakistan
| | - Ali Bijani
- Social Determinants of Health Research Center, Babol University of Medical Sciences, Babol, Iran
| | - Antonio Biondi
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Catherine Bisignano
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
| | - Tone Bjørge
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Cancer Registry of Norway, Oslo, Norway
| | - Archie Bleyer
- Department of Radiation Medicine, Oregon Health and Science University, Portland
- McGovern Medical School, University of Texas, Houston
| | - Oleg Blyuss
- School of Physics, Engineering and Computer Science, University of Hertfordshire, Hatfield, England
- Institute for Women's Health, University College London, London, England
| | | | - Srinivasa Rao Bolla
- Department of Biomedical Sciences, Nazarbayev University, Nur-Sultan City, Kazakhstan
| | - Dejana Braithwaite
- Department of Epidemiology, University of Florida, Gainesville
- Cancer Population Sciences Program, University of Florida Health Cancer Center, Gainesville
| | - Amanpreet Brar
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
| | | | - Nadeem Shafique Butt
- Department of Family and Community Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Zahid A. Butt
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
- Al Shifa School of Public Health, Al Shifa Trust Eye Hospital, Rawalpindi, Pakistan
| | | | - Yin Cao
- Department of Surgery, Washington University in St Louis, St Louis, Missouri
| | - Giulia Carreras
- Institute for Cancer Research, Prevention and Clinical Network, Florence, Italy
| | - Ferrán Catalá-López
- National School of Public Health, Institute of Health Carlos III, Madrid, Spain
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Francieli Cembranel
- Department of Nutrition, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Ester Cerin
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
- School of Public Health, University of Hong Kong, Hong Kong, China
| | - Achille Cernigliaro
- Regional Epidemiological Observatory Department, Sicilian Regional Health Authority, Palermo, Italy
| | | | | | - Vijay Kumar Chattu
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Saveetha Medical College, Saveetha University, Chennai, India
| | - Pankaj Chaturvedi
- Center for Cancer Epidemiology, Tata Memorial Hospital, Navi Mumbai, India
- Department of Head Neck Surgery, Tata Memorial Hospital, Mumbai, India
| | - Odgerel Chimed-Ochir
- Department of Public Health and Health Policy, Hiroshima University, Hiroshima, Japan
| | | | | | - Dinh-Toi Chu
- Center for Biomedicine and Community Health, VNU International School, Hanoi, Vietnam
| | - Michael T. Chung
- Department of Otolaryngology, Wayne State University, Detroit, Michigan
| | - Joao Conde
- Nova Medical School, Nova University of Lisbon, Lisbon, Portugal
| | - Sanda Cortés
- Department of Public Health, Pontifical Catholic University of Chile, Santiago, Chile
- Research Line in Environmental Exposures and Health Effects at Population Level, Centro de Desarrollo Urbano Sustentable, Santiago, Chile
| | | | - Vera Marisa Costa
- Research Unit on Applied Molecular Biosciences, University of Porto, Porto, Portugal
| | - Amanda Ramos Cunha
- Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Omid Dadras
- School of Public Health, Walailak University, Nakhon Si Thammarat, Thailand
- Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | | | - Saad M. A. Dahlawi
- Environmental Health Department, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Xiaochen Dai
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Lalit Dandona
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Public Health Foundation of India, Gurugram, India
- Indian Council of Medical Research, New Delhi, India
| | - Rakhi Dandona
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
- Public Health Foundation of India, Gurugram, India
| | - Aso Mohammad Darwesh
- Department of Information Technology, University of Human Development, Sulaymaniyah, Iraq
| | - José das Neves
- Institute for Research and Innovation in Health, University of Porto, Porto, Portugal
- Institute of Biomedical Engineering, University of Porto, Porto, Portugal
| | | | - Asmamaw Bizuneh Demis
- Department of Nursing, Woldia University, Woldia, Ethiopia
- School of Nursing, Jimma University, Jimma, Ethiopia
| | - Edgar Denova-Gutiérrez
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Deepak Dhamnetiya
- Department of Community Medicine, Dr Baba Saheb Ambedkar Medical College and Hospital, Delhi, India
| | - Mandira Lamichhane Dhimal
- Policy Research Institute, Kathmandu, Nepal
- Global Institute for Interdisciplinary Studies, Kathmandu, Nepal
| | - Meghnath Dhimal
- Health Research Section, Nepal Health Research Council, Kathmandu, Nepal
| | - Mostafa Dianatinasab
- Department of Epidemiology and Biostatistics, Shahroud University of Medical Sciences, Shahroud, Iran
- Department of Epidemiology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Daniel Diaz
- Center of Complexity Sciences, National Autonomous University of Mexico, Mexico City, Mexico
- Faculty of Veterinary Medicine and Zootechnics, Autonomous University of Sinaloa, Culiacán Rosales, Mexico
| | - Shirin Djalalinia
- Development of Research and Technology Center, Ministry of Health and Medical Education, Tehran, Iran
| | - Huyen Phuc Do
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Saeid Doaei
- School of Health, Guilan University of Medical Sciences, Rasht, Iran
- Department of Community Nutrition, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fariba Dorostkar
- Department of Medical Laboratory Sciences, Iran University of Medical Sciences, Tehran, Iran
| | | | - Tim Robert Driscoll
- Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Hedyeh Ebrahimi
- Noncommunicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Liver and Pancreaticobilliary Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Eftekharzadeh
- Division of Urology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Maha El Tantawi
- Pediatric Dentistry and Dental Public Health Department, Alexandria University, Alexandria, Egypt
| | - Hassan El-Abid
- Direction de L'épidémiologie et la Lutte Contre les Maladies, Ministry of Health, Rabat, Morocco
| | - Iffat Elbarazi
- Institute of Public Health, United Arab Emirates University, Al Ain, United Arab Emirates
| | | | | | | | - Babak Eshrati
- Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Sharareh Eskandarieh
- Multiple Sclerosis Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Firooz Esmaeilzadeh
- Department of Public Health, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Arash Etemadi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Sayeh Ezzikouri
- Department of Virology, Pasteur Institute of Morocco, Casablanca, Morocco
| | - Mohammed Faisaluddin
- Department of Internal Medicine, Rochester General Hospital, Rochester, New York
| | - Emerito Jose A. Faraon
- Department of Health Policy and Administration, University of the Philippines Manila, Manila, Philippines
| | - Jawad Fares
- Department of Neurological Surgery, Northwestern University, Chicago, Illinois
| | - Farshad Farzadfar
- Noncommunicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Abdullah Hamid Feroze
- Department of Neurological Surgery, University of Washington, Seattle
- Human Biology Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Simone Ferrero
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | | | - Irina Filip
- Psychiatry Department, Kaiser Permanente, Fontana, California
- School of Health Sciences, A.T. Still University, Mesa, Arizona
| | - Florian Fischer
- Institute of Gerontological Health Services and Nursing Research, Ravensburg-Weingarten University of Applied Sciences, Weingarten, Germany
| | | | - Masoud Foroutan
- Department of Medical Parasitology, Abadan University of Medical Sciences, Abadan, Iran
- Faculty of Medicine, Abadan University of Medical Sciences, Abadan, Iran
| | | | - Peter Andras Gaal
- Health Services Management Training Centre, Semmelweis University, Budapest, Hungary
- Department of Applied Social Sciences, Sapientia Hungarian University of Transylvania, Târgu-Mureş, Romania
| | - Mohamed M. Gad
- Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio
- Gillings School of Global Public Health, University of North Carolina Chapel Hill, Chapel Hill
| | - Muktar A. Gadanya
- Community Medicine Department, Bayero University, Kano, Kano, Nigeria
- Department of Community Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Silvano Gallus
- Department of Environmental Health Sciences, Mario Negri Institute for Pharmacological Research, Milan, Italy
| | | | | | - Mansour Ghafourifard
- Department of Medical Surgical Nursing, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ahmad Ghashghaee
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
- Student Research Committee, Iran University of Medical Sciences, Tehran, Iran
| | - Nermin Ghith
- Research Group for Genomic Epidemiology, Technical University of Denmark, Copenhagen, Denmark
| | - Maryam Gholamalizadeh
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Syed Amir Gilani
- Faculty of Allied Health Sciences, University of Lahore, Lahore, Pakistan
- Afro-Asian Institute, Lahore, Pakistan
| | - Themba G. Ginindza
- Discipline of Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa
| | | | - James C. Glasbey
- National Institute for Health Research Global Health Research Unit on Global Surgery, University of Birmingham, Birmingham, England
| | - Mahaveer Golechha
- Health Systems and Policy Research, Indian Institute of Public Health, Gandhinagar, India
| | - Pouya Goleij
- Department of Genetics, Sana Institute of Higher Education, Sari, Iran
| | - Ricardo Santiago Gomez
- Department of Oral Surgery and Pathology, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Sameer Vali Gopalani
- Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City
- Department of Health and Social Affairs, Government of the Federated States of Micronesia, Palikir, Federated States of Micronesia
| | - Giuseppe Gorini
- Oncological Network, Prevention and Research Institute, Institute for Cancer Research, Prevention and Clinical Network, Florence, Italy
| | - Houman Goudarzi
- Department of Respiratory Medicine, Hokkaido University, Sapporo, Japan
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Giuseppe Grosso
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | | | | | - Avirup Guha
- Harrington Heart and Vascular Institute, Case Western Reserve University, Cleveland, Ohio
- Division of Cardiovascular Medicine, Ohio State University, Columbus
| | | | - Bhawna Gupta
- Department of Public Health, Torrens University, Melbourne, Victoria, Australia
| | - Veer Bala Gupta
- School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Vivek Kumar Gupta
- Department of Clinical Medicine, Macquarie University, Sydney, New South Wales, Australia
| | - Reyna Alma Gutiérrez
- Department of Epidemiology and Psychosocial Research, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Nima Hafezi-Nejad
- Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Maryland
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Arvin Haj-Mirzaian
- Department of Pharmacology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Obesity Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Rabih Halwani
- Clinical Sciences Department, University of Sharjah, Sharjah, United Arab Emirates
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Randah R. Hamadeh
- Department of Family and Community Medicine, Arabian Gulf University, Manama, Bahrain
| | - Sajid Hameed
- University Institute of Public Health, University of Lahore, Lahore, Pakistan
| | - Samer Hamidi
- School of Health and Environmental Studies, Hamdan Bin Mohammed Smart University, Dubai, United Arab Emirates
| | - Asif Hanif
- University Institute of Public Health, University of Lahore, Lahore, Pakistan
| | - Shafiul Haque
- Research & Scientific Studies Unit, Jazan University, Jazan, Saudi Arabia
| | - Netanja I. Harlianto
- Faculty of Medicine, Utrecht University, Utrecht, Netherlands
- Department of Radiology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Josep Maria Haro
- Research Unit, University of Barcelona, Barcelona, Spain
- Biomedical Research Networking Center for Mental Health Network, Barcelona, Spain
| | | | - Soheil Hassanipour
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
- Caspian Digestive Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Roderick J. Hay
- International Foundation for Dermatology, London, England
- St John's Institute of Dermatology, King's College London, London, England
| | - Simon I. Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Khezar Hayat
- Institute of Pharmaceutical Sciences, University of Veterinary and Animal Sciences, Lahore, Pakistan
- Department of Pharmacy Administration and Clinical Pharmacy, Xian Jiaotong University, Xian, China
| | | | - Mohammad Heidari
- Community-Oriented Nursing Midwifery Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | | | - Claudiu Herteliu
- Department of Statistics and Econometrics, Bucharest University of Economic Studies, Bucharest, Romania
- School of Business, London South Bank University, London, England
| | - Kamal Hezam
- Department of Applied Microbiology, Taiz University, Taiz, Yemen
- Department of Microbiology, Nankai University, Tianjin, China
| | - Ramesh Holla
- Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Md Mahbub Hossain
- Social and Environmental Health Research, Nature Study Society of Bangladesh, Khulna, Bangladesh
- Department of Health Promotion and Community Health Sciences, Texas A&M University, College Station
| | | | | | - Mostafa Hosseini
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
- Pediatric Chronic Kidney Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Hosseinzadeh
- Institute of Research and Development, Duy Tan University, Da Nang, Vietnam
- Department of Computer Science, University of Human Development, Sulaymaniyah, Iraq
| | - Mihaela Hostiuc
- Internal Medicine Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Sorin Hostiuc
- Department of Legal Medicine and Bioethics, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Clinical Legal Medicine Department, National Institute of Legal Medicine Mina Minovici, Bucharest, Romania
| | - Mowafa Househ
- College of Science and Engineering, Hamad Bin Khalifa University, Doha, Qatar
| | - Mohamed Hsairi
- Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Junjie Huang
- Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China
| | - Fernando N. Hugo
- Department of Preventive and Social Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Rabia Hussain
- School of Pharmaceutical Sciences, University of Science Malaysia, Penang, Malaysia
| | - Nawfal R. Hussein
- Department of Biomolecular Sciences, University of Zakho, Zakho, Iraq
| | - Bing-Fang Hwang
- Department of Occupational Safety and Health, China Medical University, Taichung, Taiwan
| | - Ivo Iavicoli
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | | | - Fidelia Ida
- Pharmacoepidemiology Department, Sanofi, Cambridge, Massachusetts
| | - Kevin S. Ikuta
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Division of Allergy and Infectious Diseases, University of Washington, Seattle
| | - Olayinka Stephen Ilesanmi
- Department of Community Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Community Medicine, University College Hospital, Ibadan, Ibadan, Nigeria
| | - Irena M. Ilic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Milena D. Ilic
- Department of Epidemiology, University of Kragujevac, Kragujevac, Serbia
| | - Lalu Muhammad Irham
- School of Pharmacy, Taipei Medical University, Taipei, Taiwan
- Faculty of Pharmacy, Ahmad Dahlan University, Yogyakarta, Indonesia
| | - Jessica Y. Islam
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Rakibul M. Islam
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Sheikh Mohammed Shariful Islam
- Institute for Physical Activity and Nutrition, Deakin University, Burwood, Victoria, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | | | - Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, University of Catania, Catania, Italy
| | - Masao Iwagami
- Department of Health Services Research, University of Tsukuba, Tsukuba, Japan
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, England
| | - Louis Jacob
- Research and Development Unit, Biomedical Research Networking Center for Mental Health Network, Sant Boi de Llobregat, Spain
- Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
| | - Vardhmaan Jain
- Department of Internal Medicine, Cleveland Clinic, Cleveland, Ohio
| | - Mihajlo B. Jakovljevic
- Institute of Comparative Economic Studies, Hosei University, Tokyo, Japan
- Department of Global Health, Economics and Policy, University of Kragujevac, Kragujevac, Serbia
| | | | - Shubha Jayaram
- Department of Biochemistry, Government Medical College, Mysuru, India
| | | | - Ravi Prakash Jha
- Department of Community Medicine, Dr Baba Saheb Ambedkar Medical College and Hospital, Delhi, India
- Department of Community Medicine, Banaras Hindu University, Varanasi, India
| | - Jost B. Jonas
- Department of Ophthalmology, Heidelberg University, Heidelberg, Germany
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Beijing, China
| | - Tamas Joo
- Health Services Management Training Centre, Semmelweis University, Budapest, Hungary
| | - Nitin Joseph
- Department of Community Medicine, Manipal Academy of Higher Education, Mangalore, India
| | - Farahnaz Joukar
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
- Caspian Digestive Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Mikk Jürisson
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Ali Kabir
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Danial Kahrizi
- Department of Genetics, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Leila R. Kalankesh
- School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Rohollah Kalhor
- Institute for Prevention of Non-communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
- Health Services Management Department, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Feroze Kaliyadan
- Dermatology Department, King Faisal University, Hofuf, Saudi Arabia
| | - Yogeshwar Kalkonde
- Public Health Division, Society for Education, Action and Research in Community Health, Gadchiroli, India
| | - Ashwin Kamath
- Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
- Manipal Academy of Higher Education, Manipal, India
| | | | - Himal Kandel
- Save Sight Institute, University of Sydney, Sydney, New South Wales, Australia
- Sydney Eye Hospital, South Eastern Sydney Local Health District, Sydney, New South Wales, Australia
| | - Neeti Kapoor
- Department of Forensic Science, Government Institute of Forensic Science, Nagpur, India
| | - André Karch
- Institute for Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Ayele Semachew Kasa
- Department of Adult Health Nursing, Bahir Dar University, Bahir Dar, Ethiopia
| | - Srinivasa Vittal Katikireddi
- Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, Scotland
| | - Joonas H. Kauppila
- Surgery Research Unit, University of Oulu, Oulu, Finland
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
| | - Taras Kavetskyy
- Department of Surface Engineering, John Paul II Catholic University of Lublin, Lublin, Poland
- Drohobych Ivan Franko State Pedagogical University, Drohobych, Ukraine
| | - Sewnet Adem Kebede
- Department of Epidemiology and Biostatistics, University of Gondar, Gondar, Faroe Islands
| | - Pedram Keshavarz
- School of Science and Technology, University of Georgia, Tbilisi, Georgia
- Department of Diagnostic and Interventional Radiology, New Hospitals LTD, Tbilisi, Georgia
| | - Mohammad Keykhaei
- Noncommunicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Students Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Yousef Saleh Khader
- Department of Public Health, Jordan University of Science and Technology, Irbid, Jordan
| | - Rovshan Khalilov
- Department of Biophysics and Biochemistry, Baku State University, Baku, Azerbaijan
- Russian Institute for Advanced Study, Moscow State Pedagogical University, Moscow, Russia
| | - Gulfaraz Khan
- Department of Medical Microbiology and Immunology, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Maseer Khan
- Epidemiology Department, Jazan University, Jazan, Saudi Arabia
| | - Md Nuruzzaman Khan
- Department of Population Science, Jatiya Kabi Kazi Nazrul Islam University, Mymensingh, Bangladesh
| | - Moien A. B. Khan
- Family Medicine Department, United Arab Emirates University, Al Ain, United Arab Emirates
- Primary Care Department, NHS North West London, London, England
| | - Young-Ho Khang
- Department of Health Policy and Management, Seoul National University, Seoul, South Korea
- Institute of Health Policy and Management, Seoul National University, Seoul, South Korea
| | - Amir M. Khater
- National Hepatology and Tropical Medicine Research Institute, Cairo University, Cairo, Egypt
| | - Maryam Khayamzadeh
- Shahid Beheshti University of Medical Sciences, Tehran, Iran
- The Iranian Academy of Medical Sciences, Tehran, Iran
| | - Gyu Ri Kim
- Department of Preventive Medicine, Yonsei University, Seoul, South Korea
| | - Yun Jin Kim
- School of Traditional Chinese Medicine, Xiamen University Malaysia, Sepang, Malaysia
| | - Adnan Kisa
- School of Health Sciences, Kristiania University College, Oslo, Norway
- Department of Global Community Health and Behavioral Sciences, Tulane University, New Orleans, Louisiana
| | - Sezer Kisa
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | | | - Jacek A. Kopec
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
- Arthritis Research Canada, Richmond, British Columbia, Canada
| | | | - Parvaiz A. Koul
- Department of Internal and Pulmonary Medicine, Sheri Kashmir Institute of Medical Sciences, Srinagar, India
| | | | - Ai Koyanagi
- Biomedical Research Networking Center for Mental Health Network, San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain
- Catalan Institution for Research and Advanced Studies, Barcelona, Spain
| | | | - Nuworza Kugbey
- University of Environment and Sustainable Development, Somanya, Ghana
| | | | - Narinder Kumar
- Department of Orthopaedics, Medanta Hospital, Lucknow, India
| | - Nithin Kumar
- Department of Community Medicine, Manipal Academy of Higher Education, Mangalore, India
| | - Om P. Kurmi
- Faculty of Health and Life Sciences, Coventry University, Coventry, England
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Tezer Kutluk
- Department of Pediatric Oncology, Hacettepe University, Ankara, Turkey
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Faris Hasan Lami
- Department of Community and Family Medicine, University of Baghdad, Baghdad, Iraq
| | - Iván Landires
- Unit of Genetics and Public Health, Institute of Medical Sciences, Las Tablas, Panama
- Ministry of Health, Herrera, Panama
| | - Paolo Lauriola
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Sang-woong Lee
- Pattern Recognition and Machine Learning Lab, Gachon University, Seongnam, South Korea
| | - Shaun Wen Huey Lee
- School of Pharmacy, Monash University, Bandar Sunway, Malaysia
- School of Pharmacy, Taylor's University Lakeside Campus, Subang Jaya, Malaysia
| | - Wei-Chen Lee
- Office of Health Policy & Legislative Affairs, University of Texas, Galveston
| | - Yo Han Lee
- Graduate School of Public Health, Ajou University, Suwon-si, South Korea
| | - James Leigh
- Asbestos Diseases Research Institute, University of Sydney, Sydney, New South Wales, Australia
| | - Elvynna Leong
- Faculty of Science, Universiti Brunei Darussalam, Bandar Seri Begawan, Brunei
| | - Jiarui Li
- Department of Medical Oncology, Peking Union Medical College, Beijing, China
| | - Ming-Chieh Li
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan
| | - Xuefeng Liu
- Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
- Department of Quantitative Health Science, Case Western Reserve University, Cleveland, Ohio
| | - Joana A. Loureiro
- Laboratory for Process Engineering, Environment, Biotechnology and Energy, University of Porto, Porto, Portugal
- School of Health, Polytechnic Institute of Porto, Portugal
| | - Raimundas Lunevicius
- Department of General Surgery, Liverpool University Hospitals NHS Foundation Trust, Liverpool, England
- Department of Surgery, University of Liverpool, Liverpool, England
| | | | - Azeem Majeed
- Department of Primary Care and Public Health, Imperial College London, London, England
| | - Alaa Makki
- Mass Communication Department, University of Sharjah, Sharjah, United Arab Emirates
| | - Shilpa Male
- Department of Ophthalmology, M M Joshi Eye Institute, Hubli, India
| | - Ahmad Azam Malik
- University Institute of Public Health, University of Lahore, Lahore, Pakistan
- Rabigh Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
| | - Santi Martini
- Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia
- Indonesian Public Health Association, Surabaya, Indonesia
| | | | - Prashant Mathur
- National Centre for Disease Informatics and Research, Indian Council of Medical Research, Bengaluru, India
| | - Martin McKee
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, England
| | - Ravi Mehrotra
- India Cancer Research Consortium, Indian Council of Medical Research, New Delhi, India
| | - Walter Mendoza
- Peru Country Office, United Nations Population Fund, Lima, Peru
| | - Ritesh G. Menezes
- Forensic Medicine Division, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | | | - Mohamed Kamal Mesregah
- Department of Orthopaedic Surgery, Menoufia University Faculty of Medicine, Shebin El-Kom, Egypt
| | - Tomislav Mestrovic
- Clinical Microbiology and Parasitology Unit, Polyclinic “Dr. Zora Profozic”, Zagreb, Croatia
- University Centre Varazdin, University North, Varazdin, Croatia
| | - Junmei Miao Jonasson
- School of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Bartosz Miazgowski
- Center for Innovation in Medical Education, Pomeranian Medical University, Szczecin, Poland
- Pomeranian Medical University, Szczecin, Poland
| | - Tomasz Miazgowski
- Department of Propedeutics of Internal Diseases and Arterial Hypertension, Pomeranian Medical University, Szczecin, Poland
| | | | - Ted R. Miller
- Pacific Institute for Research and Evaluation, Calverton, Maryland
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Hamed Mirzaei
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Hamid Reza Mirzaei
- Department of Medical Immunology, Tehran University of Medical Sciences, Tehran, Iran
| | - Sanjeev Misra
- Department of Surgical Oncology, All India Institute of Medical Sciences, Jodhpur, India
| | - Prasanna Mithra
- Department of Community Medicine, Manipal Academy of Higher Education, Mangalore, India
| | - Masoud Moghadaszadeh
- Biotechnology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Molecular Medicine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Yousef Mohammad
- Internal Medicine Department, King Saud University, Riyadh, Saudi Arabia
| | - Mokhtar Mohammadi
- Department of Information Technology, Lebanese French University, Erbil, Iraq
| | | | | | - Shafiu Mohammed
- Health Systems and Policy Research Unit, Ahmadu Bello University, Zaria, Nigeria
- Department of Health Care Management, Technical University of Berlin, Berlin, Germany
| | - Nagabhishek Moka
- Oncology Department, Appalachian Regional Healthcare, Hazard, Kentucky
- Internal Medicine, University of Kentucky, Lexington
| | - Ali H. Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Mariam Molokhia
- Faculty of Life Sciences and Medicine, King's College London, London, England
| | - Lorenzo Monasta
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
| | - Mohammad Ali Moni
- Department of Computer Science and Engineering, Pabna University of Science and Technology, Pabna, Bangladesh
| | - Mohammad Amin Moosavi
- Department of Molecular Medicine, National Institute of Genetic Engineering and Biotechnology, Tehran, Iran
| | - Yousef Moradi
- Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Paula Moraga
- Computer, Electrical, and Mathematical Sciences and Engineering Division, King Abdullah University of Science and Technology, Thuwal, Saudi Arabia
| | | | | | - Abbas Mosapour
- Department of Clinical Biochemistry, Babol University of Medical Sciences, Babol, Iran
- Department of Clinical Biochemistry, Tarbiat Modares University, Tehran, Iran
| | - Sumaira Mubarik
- Department of Epidemiology and Biostatistics, Wuhan University, Wuhan, China
| | - Lillian Mwanri
- College of Medicine and Public Health, Flinders University, Adeaide, South Australia, Australia
| | - Ahamarshan Jayaraman Nagarajan
- Research and Analytics Department, Initiative for Financing Health and Human Development, Chennai, India
- Department of Research and Analytics, Bioinsilico Technologies, Chennai, India
| | | | - Chie Nagata
- Department of Education for Clinical Research, National Center for Child Health and Development, Tokyo, Japan
| | - Mukhammad David Naimzada
- Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia
- Experimental Surgery and Oncology Laboratory, Kursk State Medical University, Kursk, Russia
| | | | - Atta Abbas Naqvi
- Department of Pharmacy Practice, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
- Discipline of Social and Administrative Pharmacy, University of Science, Malaysia, Penang, Malaysia
| | | | - Rawlance Ndejjo
- Department of Disease Control and Environmental Health, Makerere University, Kampala, Uganda
| | - Sabina O. Nduaguba
- Pharmaceutical Outcomes and Policy Department, University of Florida, Gainesville
| | - Ionut Negoi
- Department of General Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Department of General Surgery, Emergency Hospital of Bucharest, Bucharest, Romania
| | - Serban Mircea Negru
- Department of Oncology, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | | | - Cuong Tat Nguyen
- Institute for Global Health Innovations, Duy Tan University, Hanoi, Vietnam
| | | | | | - Chukwudi A. Nnaji
- South African Medical Research Council, Cape Town, South Africa
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Nurulamin M. Noor
- Medical Research Council Clinical Trials Unit, University College London, London, England
- Department of Gastroenterology, Cambridge University Hospitals, Cambridge, England
| | - Virginia Nuñez-Samudio
- Unit of Microbiology and Public Health, Institute of Medical Sciences, Las Tablas, Panama
- Department of Public Health, Ministry of Health, Herrera, Panama
| | | | - Bogdan Oancea
- Administrative and Economic Sciences Department, University of Bucharest, Bucharest, Romania
| | - Chimedsuren Ochir
- Department of International Cyber Education, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
- Advisory Board, Ministry of Health, Ulaanbaatar, Mongolia
| | - Oluwakemi Ololade Odukoya
- Department of Community Health and Primary Care, University of Lagos, Idi Araba, Nigeria
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City
| | - Felix Akpojene Ogbo
- Translational Health Research Institute, Western Sydney University, Sydney, New South Wales, Australia
| | - Andrew T. Olagunju
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Department of Psychiatry, University of Lagos, Lagos, Nigeria
| | | | - Emad Omar
- Mass Communication Department, Ajman University, Dubai, United Arab Emirates
| | - Ahmed Omar Bali
- Diplomacy and Public Relations Department, University of Human Development, Sulaymaniyah, Iraq
| | - Abidemi E. Emmanuel Omonisi
- Department of Anatomic Pathology, Ekiti State University, Ado-Ekiti, Nigeria
- Department of Anatomic Pathology, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
| | - Sokking Ong
- Noncommunicable Disease Prevention Unit, Ministry of Health, Bandar Seri Begawan, Brunei
- Early Detection and Cancer Prevention Services, Pantai Jerudong Specialist Centre, Bandar Seri Begawan, Brunei
| | - Obinna E. Onwujekwe
- Department of Pharmacology and Therapeutics, University of Nigeria Nsukka, Enugu, Nigeria
| | - Hans Orru
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
- Section of Sustainable Health, Umeå University, Umea, Sweden
| | | | - Nikita Otstavnov
- Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia
| | - Stanislav S. Otstavnov
- Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia
- Department of Project Management, National Research University Higher School of Economics, Moscow, Russia
| | - Mayowa O. Owolabi
- Department of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Medicine, University College Hospital, Ibadan, Ibadan, Nigeria
| | - Mahesh P A
- Department of Respiratory Medicine, Jagadguru Sri Shivarathreeswara Academy of Health Education and Research, Mysore, India
| | - Jagadish Rao Padubidri
- Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Keyvan Pakshir
- Department of Medical Mycology and Parasitology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Adrian Pana
- Department of Statistics and Econometrics, Bucharest University of Economic Studies, Bucharest, Romania
- Department of Health Metrics, Center for Health Outcomes and Evaluation, Bucharest, Romania
| | | | | | - Shahina Pardhan
- Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, England
| | - Eun-Cheol Park
- Department of Preventive Medicine, Yonsei University, Seoul, South Korea
- Institute of Health Services Research, Yonsei University, Seoul, South Korea
| | - Eun-Kee Park
- Department of Medical Humanities and Social Medicine, Kosin University, Busan, South Korea
| | | | - Harsh K. Patel
- Department of Internal Medicine, Ochsner Medical Center, New Orleans, Louisiana
| | - Jenil R. Patel
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston School of Public Health, Dallas
- Department of Epidemiology, University of Arkansas for Medical Sciences, Little Rock
| | - Siddhartha Pati
- Centre of Excellence, Khallikote University, Berhampur, India
- Research Division, Association for Biodiversity Conservation and Research, Balasore, India
| | | | - Uttam Paudel
- Research Section, Nepal Health Research Council, Kathmandu, Nepal
- Faculty of Humanities and Social Sciences, Tribhuvan University, Kathmandu, Nepal
| | - David M. Pereira
- Associated Laboratory for Green Chemistry, University of Porto, Porto, Portugal
| | | | - Arokiasamy Perianayagam
- Department of Development Studies, International Institute for Population Sciences, Mumbai, India
| | - Julian David Pillay
- Basic Medical Sciences Department, Durban University of Technology, Durban, South Africa
| | - Saeed Pirouzpanah
- Department of Biochemistry and Dietetics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Farhad Pishgar
- Noncommunicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Urooncology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Indrashis Podder
- Department of Dermatology, College of Medicine and Sagore Dutta Hospital, Kolkata, India
| | - Maarten J. Postma
- University Medical Center Groningen, University of Groningen, Groningen, Netherlands
- School of Economics and Business, University of Groningen, Groningen, Netherlands
| | - Hadi Pourjafar
- Department of Nutrition and Food Sciences, Maragheh University of Medical Sciences, Maragheh, Iran
- Dietary Supplements and Probiotic Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Akila Prashant
- Department of Biochemistry, Jagadguru Sri Shivarathreeswara University, Mysuru, India
| | - Liliana Preotescu
- National Institute of Infectious Diseases, Bucuresti, Romania
- Department of Infectious Diseases, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Mohammad Rabiee
- Biomedical Engineering Department, Amirkabir University of Technology, Tehran, Iran
| | - Navid Rabiee
- Department of Physics, Sharif University of Technology, Tehran, Iran
| | - Amir Radfar
- College of Medicine, University of Central Florida, Orlando
| | | | | | - Ata Rafiee
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Fakher Rahim
- Metabolomics and Genomics Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Shadi Rahimzadeh
- Department of Natural Science, Middlesex University, London, England
| | - Mosiur Rahman
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, Bangladesh
| | - Muhammad Aziz Rahman
- School of Nursing and Healthcare Professions, Federation University Australia, Berwick, Victoria, Australia
- School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
| | - Amir Masoud Rahmani
- Future Technology Research Center, National Yunlin University of Science and Technology, Yunlin, Taiwan
| | - Nazanin Rajai
- Department of Internal Medicine, Harvard University, Boston, Massachusetts
| | - Aashish Rajesh
- Department of Surgery, University of Texas Health Science Center at San Antonio, San Antonio
| | - Ivo Rakovac
- European Office for the Prevention and Control of Noncommunicable Diseases, World Health Organization, Moscow, Russia
| | - Pradhum Ram
- Department of Cardiology, Emory University, Atlanta, Georgia
| | - Kiana Ramezanzadeh
- Department of Pharmacology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kamal Ranabhat
- Health Emergency Operation Center, Ministry of Health and Population, Kathmandu, Nepal
- Central Department of Public Health, Institute of Medicine, Kathmandu, Nepal
| | | | - Chythra R. Rao
- Department of Community Medicine, Manipal Academy of Higher Education, Manipal, India
| | - Sowmya J. Rao
- Department of Oral Pathology, Srinivas Institute of Dental Sciences, Mangalore, India
| | - Reza Rawassizadeh
- Department of Computer Science, Boston University, Boston, Massachusetts
| | - Mohammad Sadegh Razeghinia
- Department of Immunology and Laboratory Sciences, Sirjan School of Medical Sciences, Sirjan, Iran
- Department of Immunology, Kerman University of Medical Sciences, Kerman, Iran
| | - Andre M. N. Renzaho
- School of Medicine, Western Sydney University, Campbelltown, New South Wales, Australia
- Translational Health Research Institute, Western Sydney University, Campbelltown, New South Wales, Australia
| | - Negar Rezaei
- Noncommunicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Nima Rezaei
- Research Center for Immunodeficiencies, Tehran University of Medical Sciences, Tehran, Iran
- Network of Immunity in Infection, Malignancy and Autoimmunity, Universal Scientific Education and Research Network, Tehran, Iran
| | - Aziz Rezapour
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | | | | | - Peter Rohloff
- Department of Global Health and Population, Harvard University, Boston, Massachusetts
- Center for Indigenous Health Research, Wuqu' Kawoq Maya Health Alliance, Tecpan, Guatemala
| | | | - Luca Ronfani
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
| | - Gholamreza Roshandel
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | | | - Manjula S
- Oral and Maxillofacial Surgery, Jagadguru Sri Shivarathreeswara University, Mysore, India
| | - Siamak Sabour
- Department of Epidemiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Basema Saddik
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah, United Arab Emirates
| | - Umar Saeed
- Research and Development, Islamabad Diagnostic Center Pakistan, Islamabad, Pakistan
- Biological Production Development, National Institute of Health, Islamabad, Pakistan
| | - Amirhossein Sahebkar
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Harihar Sahoo
- Department of Development Studies, International Institute for Population Sciences, Mumbai, India
| | - Sana Salehi
- Department of Radiology, University of Southern California, Los Angeles
| | - Marwa Rashad Salem
- Public Health and Community Medicine Department, Cairo University, Giza, Egypt
| | - Hamideh Salimzadeh
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrnoosh Samaei
- Emergency Department, Brown University, Providence, Rhode Island
| | | | - Juan Sanabria
- Department of Surgery, Marshall University, Huntington, West Virginia
- Department of Nutrition and Preventive Medicine, Case Western Reserve University, Cleveland, Ohio
| | - Senthilkumar Sankararaman
- Department of Pediatrics, University Hospitals Rainbow Babies & Children's Hospital, Cleveland, Ohio
- Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio
| | - Milena M. Santric-Milicevic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- School of Public Health and Health Management, University of Belgrade, Belgrade, Serbia
| | - Yaeesh Sardiwalla
- Division of Plastic and Reconstructive Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Arash Sarveazad
- Colorectal Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Brijesh Sathian
- Geriatric and Long-Term Care Department, Hamad Medical Corporation, Doha, Qatar
- Faculty of Health & Social Sciences, Bournemouth University, Bournemouth, England
| | - Monika Sawhney
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte
| | | | | | - Mario Sekerija
- Department of Medical Statistics, Epidemiology and Medical Informatics, University of Zagreb, Zagreb, Croatia
- Department of Epidemiology and Prevention of Chronic Noncommunicable Diseases, Croatian Institute of Public Health, Zagreb, Croatia
| | - Allen Seylani
- National Heart, Lung, and Blood Institute, National Institutes of Health, Rockville, Maryland
| | - Omid Shafaat
- Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Maryland
- Department of Radiology and Interventional Neuroradiology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Shaghaghi
- Clinical Research Development Unit of Farshchian Heart Center, Hamedan University of Medical Sciences, Hamadan, Iran
| | | | - Erfan Shamsoddin
- Department of Oral Health, Non-Communicable Diseases Research Center, Tehran, Iran
- Noncommunicable Diseases Committee, National Institute for Medical Research Developmen, Tehran, Iran
| | - Mohammed Shannawaz
- Symbiosis Medical College for Women, Symbiosis International University, Pune, India
| | - Rajesh Sharma
- University School of Management and Entrepreneurship, Delhi Technological University, Delhi, India
| | - Aziz Sheikh
- Centre for Medical Informatics, University of Edinburgh, Edinburgh, Scotland
- Division of General Internal Medicine, Harvard University, Boston, Massachusetts
| | - Sara Sheikhbahaei
- Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Maryland
| | - Adithi Shetty
- Department of Obstetrics and Gynaecology, Manipal Academy of Higher Education, Mangalore, India
| | - Jeevan K. Shetty
- Department of Biochemistry, Manipal University College Melaka, Melaka, Malaysia
| | - Pavanchand H. Shetty
- Department of Forensic Medicine, Manipal Academy of Higher Education, Mangalore, India
| | | | - Reza Shirkoohi
- Cancer Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Cancer Biology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - K. M. Shivakumar
- Public Health Dentistry Department, Krishna Institute of Medical Sciences, Karad, India
| | - Velizar Shivarov
- Clinical Immunology and Hematology, Sofiamed University Hospital, Sofia, Bulgaria
- Department of Genetics, Sofia University St. Kliment Ohridiski, Sofia, Bulgaria
| | - Soraya Siabani
- Department of Health Education and Health Promotion, Kermanshah University of Medical Sciences, Kermanshah, Iran
- School of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | | | | | - Jasvinder A. Singh
- School of Medicine, University of Alabama at Birmingham, Birmingham
- Medicine Service Department of Veterans Affairs, Birmingham, Alabama
| | | | | | | | - Matthew J. Soeberg
- Asbestos Diseases Research Institute, Sydney, New South Wales, Australia
| | - Ahmad Sofi-Mahmudi
- Department of Oral Health, Non-Communicable Diseases Research Center, Tehran, Iran
- Cochrane Iran Associate Centre, National Institute for Medical Research Development, Iranian Ministry of Health and Medical Education, Tehran, Iran
| | - Houman Sotoudeh
- Department of Radiology, University of Alabama at Birmingham, Birmingham
| | | | - Kurt Straif
- Schiller Institute, Boston College, Boston, Massachusetts
- Barcelona Institute for Global Health, Barcelona, Spain
| | | | | | - Iyad Sultan
- Pediatric Services, King Hussein Cancer Center, Amman, Jordan
- Pediatrics, University of Jordan, Amman, Jordan
| | - Saima Sultana
- Maternal and Child Health, Projahnmo Research Foundation, Dhaka, Bangladesh
| | - Daniel Sur
- Department of Medical Oncology, The Oncology Institute “Prof Dr Ion Chiricuţă” Cluj-Napoca, Cluj-Napoca, Romania
- Department of Medical Oncology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Viktória Szerencsés
- Health Services Management Training Centre, Semmelweis University, Budapest, Hungary
| | - Miklós Szócska
- Faculty of Health and Public Administration, Semmelweis University, Budapest, Hungary
| | - Rafael Tabarés-Seisdedos
- Department of Medicine, University of Valencia, Valencia, Spain
- Carlos III Health Institute, Biomedical Research Networking Center for Mental Health Network, Madrid, Spain
| | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | | | - Amir Taherkhani
- Research Center for Molecular Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ken Takahashi
- Asbestos Diseases Research Institute, Sydney, New South Wales, Australia
| | - Iman M. Talaat
- Clinical Sciences Department, University of Sharjah, Sharjah, United Arab Emirates
- Pathology Department, Alexandria University, Alexandria, Egypt
| | - Ker-Kan Tan
- Department of Surgery, National University of Singapore, Singapore, Singapore
| | - Vivian Y. Tat
- Department of Pathology, University of Texas, Galveston
| | - Bemnet Amare A. Tedla
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, Queensland, Australia
- University of Gondar, Gondar, Ethiopia
| | | | - Arash Tehrani-Banihashemi
- Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Community and Family Medicine, Iran University of Medical Sciences, Tehran, Iran
| | | | - Fisaha Haile Tesfay
- School of Public Health, Mekelle University, Mekelle, Ethiopia
- Southgate Institute for Health and Society, Flinders University, Adelaide, South Australia, Australia
| | - Gizachew Assefa Tessema
- School of Public Health, Curtin University, Perth, Western Australia, Australia
- School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
| | - Rekha Thapar
- Department of Community Medicine, Manipal Academy of Higher Education, Mangalore, India
| | - Aravind Thavamani
- Department of Pediatrics, University Hospitals Rainbow Babies & Children's Hospital, Cleveland, Ohio
- Division of Pediatric Gastroenterology, Case Western Reserve University, Cleveland, Ohio
| | | | - Nihal Thomas
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College and Hospital, Vellore, India
| | - Hamid Reza Tohidinik
- HIV/STI Surveillance Research Center and World Health Organization Collaborating Center for HIV Surveillance, Kerman University of Medical Sciences, Kerman, Iran
| | - Mathilde Touvier
- Nutritional Epidemiology Research Team, National Institute for Health and Medical Research Institut national de la santé et de la recherche médicale, Paris, France
- Department of Health, Medicine and Human Biology, Sorbonne Paris Nord University, Bobigny, France
| | - Marcos Roberto Tovani-Palone
- Department of Pathology and Legal Medicine, University of São Paulo, Ribeirão Preto, Brazil
- Modestum LTD, London, England
| | - Eugenio Traini
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
| | - Bach Xuan Tran
- Department of Health Economics, Hanoi Medical University, Hanoi, Vietnam
| | - Khanh Bao Tran
- Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand
- Clinical Hematology and Toxicology, Maurice Wilkins Centre, Auckland, New Zealand
| | - Mai Thi Ngoc Tran
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
- Health Informatics Department, Nursing and Midwifery Faculty, Hanoi Medical University, Ha Noi, Vietnam
| | - Jaya Prasad Tripathy
- Department of Community Medicine, All India Institute of Medical Sciences, Nagpur, India
| | - Biruk Shalmeno Tusa
- Department of Epidemiology and Biostatistics, Haramaya University, Haramaya, Ethiopia
| | - Irfan Ullah
- Department of Allied Health Sciences, Iqra National University, Peshawar, Pakistan
- Pakistan Council for Science and Technology, Ministry of Science and Technology, Islamabad, Pakistan
| | - Saif Ullah
- Institute of Soil and Environmental Sciences, University of Agriculture, Faisalabad, Faisalabad, Pakistan
| | | | | | - Era Upadhyay
- Amity Institute of Biotechnology, Amity University Rajasthan, Jaipur, India
| | - Marco Vacante
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Maryam Vaezi
- Alzahra Teaching Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
- Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sahel Valadan Tahbaz
- Clinical Cancer Research Center, Milad General Hospital, Tehran, Iran
- Department of Microbiology, Islamic Azad University, Tehran, Iran
| | - Diana Zuleika Velazquez
- Faculty of Veterinary Medicine and Zootechnics, Autonomous University of Sinaloa, Culiacán Rosales, Mexico
| | - Massimiliano Veroux
- Department of Medical and Surgical Sciences and Advanced Technologies, University of Catania, Catania, Italy
| | - Francesco S. Violante
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
- Occupational Health Unit, Sant'Orsola Malpighi Hospital, Bologna, Italy
| | - Vasily Vlassov
- Department of Health Care Administration and Economics, National Research University Higher School of Economics, Moscow, Russia
| | - Bay Vo
- Faculty of Information Technology, Ho Chi Minh City University of Technology, Ho Chi Minh City, Vietnam
| | - Victor Volovici
- Department of Neurosurgery, Erasmus University Medical Center, Rotterdam, Netherlands
- Center for Experimental Microsurgery, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Giang Thu Vu
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Yasir Waheed
- Foundation University Medical College, Foundation University Islamabad, Islamabad, Pakistan
| | - Richard G. Wamai
- Cultures, Societies and Global Studies, Integrated Initiative for Global Health, Northeastern University, Boston, Massachusetts
- School of Public Health, University of Nairobi, Nairobi, Kenya
| | - Paul Ward
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Yi Feng Wen
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, Stomatological Hospital (College) of Xi'an Jiaotong University, Xi'an, China
| | - Ronny Westerman
- Competence Center of Mortality-Follow-Up of the German National Cohort, Federal Institute for Population Research, Wiesbaden, Germany
| | - Andrea Sylvia Winkler
- Institute of Health and Society, University of Oslo, Oslo, Norway
- Department of Neurology, Technical University of Munich, Munich, Germany
| | - Lalit Yadav
- Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
- Research and Development Division, The George Institute for Global Health, New Delhi, India
| | | | - Lin Yang
- Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, British Columbia, Canada
- Department of Oncology, University of Calgary, Calgary, Alberta, Canada
| | - Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Ottawa, Ontario, Canada
- George Institute for Global Health, University of Oxford, Oxford, England
| | | | - Yigizie Yeshaw
- Department of Epidemiology and Biostatistics, University of Gondar, Gondar, Ethiopia
| | - Naohiro Yonemoto
- Department of Neuropsychopharmacology, National Center of Neurology and Psychiatry, Kodaira, Japan
- Department of Public Health, Juntendo University, Tokyo, Japan
| | - Mustafa Z. Younis
- Department of Health Policy and Management, Jackson State University, Jackson, Mississippi
- School of Medicine, Tsinghua University, Beijing, China
| | - Zabihollah Yousefi
- Department of Environmental Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, Wuhan University, Wuhan, China
| | - Deniz Yuce
- Cancer Institute, Hacettepe University, Ankara, Turkey
| | - Ismaeel Yunusa
- Department of Clinical Pharmacy and Outcomes Sciences, University of South Carolina, Columbia
| | - Vesna Zadnik
- Epidemiology and Cancer Registry Sector, Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - Fariba Zare
- Shahroud University of Medical Sciences, Shahroud, Iran
| | - Mikhail Sergeevich Zastrozhin
- Laboratory of Genetics and Genomics, Moscow Research and Practical Centre on Addictions, Moscow, Russia
- Addictology Department, Russian Medical Academy of Continuous Professional Education, Moscow, Russia
| | - Anasthasia Zastrozhina
- Pediatrics Department, Russian Medical Academy of Continuous Professional Education, Moscow, Russia
| | - Jianrong Zhang
- Department of General Practice, University of Melbourne, Melbourne, Victoria, Australia
- Victorian Comprehensive Cancer Centre, Melbourne, Victoria, Australia
| | - Chenwen Zhong
- Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China
| | - Linghui Zhou
- Bone Marrow Transplantation Center, Zhejiang University, Hangzhou, China
| | - Cong Zhu
- Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center at Houston, Houston
| | - Arash Ziapour
- Department of Health Education and Health Promotion, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Christina Fitzmaurice
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Division of Hematology, University of Washington, Seattle
| | - Christopher J. L. Murray
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
| | - Lisa M. Force
- Institute for Health Metrics and Evaluation, University of Washington, Seattle
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle
- Division of Pediatric Hematology-Oncology, University of Washington, Seattle
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Ward JL, Azzopardi PS, Francis KL, Santelli JS, Skirbekk V, Sawyer SM, Kassebaum NJ, Mokdad AH, Hay SI, Abd-Allah F, Abdoli A, Abdollahi M, Abedi A, Abolhassani H, Abreu LG, Abrigo MRM, Abu-Gharbieh E, Abushouk AI, Adebayo OM, Adekanmbi V, Adham D, Advani SM, Afshari K, Agrawal A, Ahmad T, Ahmadi K, Ahmed AE, Aji B, Akombi-Inyang B, Alahdab F, Al-Aly Z, Alam K, Alanezi FM, Alanzi TM, Alcalde-Rabanal JE, Alemu BW, Al-Hajj S, Alhassan RK, Ali S, Alicandro G, Alijanzadeh M, Aljunid SM, Almasi-Hashiani A, Almasri NA, Al-Mekhlafi HM, Alonso J, Al-Raddadi RM, Altirkawi KA, Alvis-Guzman N, Amare AT, Amini S, Aminorroaya A, Amit AML, Amugsi DA, Ancuceanu R, Anderlini D, Andrei CL, Androudi S, Ansari F, Ansari I, Antonio CAT, Anvari D, Anwer R, Appiah SCY, Arabloo J, Arab-Zozani M, Ärnlöv J, Asaad M, Asadi-Aliabadi M, Asadi-Pooya AA, Atout MMW, Ausloos M, Avenyo EK, Avila-Burgos L, Ayala Quintanilla BP, Ayano G, Aynalem YA, Azari S, Azene ZN, Bakhshaei MH, Bakkannavar SM, Banach M, Banik PC, Barboza MA, Barker-Collo SL, Bärnighausen TW, Basu S, Baune BT, Bayati M, Bedi N, Beghi E, Bekuma TT, Bell AW, Bell ML, Benjet C, Bensenor IM, Berhe AK, Berhe K, Berman AE, Bhagavathula AS, Bhardwaj N, Bhardwaj P, Bhattacharyya K, Bhattarai S, Bhutta ZA, Bijani A, Bikbov B, Biondi A, Birhanu TTM, Biswas RK, Bohlouli S, Bolla SR, Boloor A, Borschmann R, Boufous S, Bragazzi NL, Braithwaite D, Breitborde NJK, Brenner H, Britton GB, Burns RA, Burugina Nagaraja S, Butt ZA, Caetano dos Santos FL, Cámera LA, Campos-Nonato IR, Campuzano Rincon JC, Cárdenas R, Carreras G, Carrero JJ, Carvalho F, Castaldelli-Maia JM, Castañeda-Orjuela CA, Castelpietra G, Catalá-López F, Cerin E, Chandan JS, Chang HY, Chang JC, Charan J, Chattu VK, Chaturvedi S, Choi JYJ, Chowdhury MAK, Christopher DJ, Chu DT, Chung MT, Chung SC, Cicuttini FM, Constantin TV, Costa VM, Dahlawi SMA, Dai H, Dai X, Damiani G, Dandona L, Dandona R, Daneshpajouhnejad P, Darwesh AM, Dávila-Cervantes CA, Davletov K, De la Hoz FP, De Leo D, Dervenis N, Desai R, Desalew A, Deuba K, Dharmaratne SD, Dhungana GP, Dianatinasab M, Dias da Silva D, Diaz D, Didarloo A, Djalalinia S, Dorostkar F, Doshi CP, Doshmangir L, Doyle KE, Duraes AR, Ebrahimi Kalan M, Ebtehaj S, Edvardsson D, El Tantawi M, Elgendy IY, El-Jaafary SI, Elsharkawy A, Eshrati B, Eskandarieh S, Esmaeilnejad S, Esmaeilzadeh F, Esteghamati S, Faro A, Farzadfar F, Fattahi N, Feigin VL, Ferede TY, Fereshtehnejad SM, Fernandes E, Ferrara P, Filip I, Fischer F, Fisher JL, Foigt NA, Folayan MO, Fomenkov AA, Foroutan M, Fukumoto T, Gad MM, Gaidhane AM, Gallus S, Gebre T, Gebremedhin KB, Gebremeskel GG, Gebremeskel L, Gebreslassie AA, Gesesew HA, Ghadiri K, Ghafourifard M, Ghamari F, Ghashghaee A, Gilani SA, Gnedovskaya EV, Godinho MA, Golechha M, Goli S, Gona PN, Gopalani SV, Gorini G, Grivna M, Gubari MIM, Gugnani HC, Guimarães RA, Guo Y, Gupta R, Haagsma JA, Hafezi-Nejad N, Haile TG, Haj-Mirzaian A, Haj-Mirzaian A, Hall BJ, Hamadeh RR, Hamagharib Abdullah K, Hamidi S, Handiso DW, Hanif A, Hankey GJ, Haririan H, Haro JM, Hasaballah AI, Hashi A, Hassan A, Hassanipour S, Hassankhani H, Hayat K, Heidari-Soureshjani R, Herteliu C, Heydarpour F, Ho HC, Hole MK, Holla R, Hoogar P, Hosseini M, Hosseinzadeh M, Hostiuc M, Hostiuc S, Househ M, Hsairi M, Huda TM, Humayun A, Hussain R, Hwang BF, Iavicoli I, Ibitoye SE, Ilesanmi OS, Ilic IM, Ilic MD, Inbaraj LR, Intarut N, Iqbal U, Irvani SSN, Islam MM, Islam SMS, Iso H, Ivers RQ, Jahani MA, Jakovljevic M, Jalali A, Janodia MD, Javaheri T, Jeemon P, Jenabi E, Jha RP, Jha V, Ji JS, Jonas JB, Jones KM, Joukar F, Jozwiak JJ, Juliusson PB, Jürisson M, Kabir A, Kabir Z, Kalankesh LR, Kalhor R, Kamyari N, Kanchan T, Karch A, Karimi SE, Kaur S, Kayode GA, Keiyoro PN, Khalid N, Khammarnia M, Khan M, Khan MN, Khatab K, Khater MM, Khatib MN, Khayamzadeh M, Khazaie H, Khoja AT, Kieling C, Kim YE, Kim YJ, Kimokoti RW, Kisa A, Kisa S, Kivimäki M, Koolivand A, Kosen S, Koyanagi A, Krishan K, Kugbey N, Kumar GA, Kumar M, Kumar N, Kurmi OP, Kusuma D, La Vecchia C, Lacey B, Lal DK, Lalloo R, Lan Q, Landires I, Lansingh VC, Larsson AO, Lasrado S, Lassi ZS, Lauriola P, Lee PH, Lee SWH, Leigh J, Leonardi M, Leung J, Levi M, Lewycka S, Li B, Li MC, Li S, Lim LL, Lim SS, Liu X, Lorkowski S, Lotufo PA, Lunevicius R, Maddison R, Mahasha PW, Mahdavi MM, Mahmoudi M, Majeed A, Maleki A, Malekzadeh R, Malta DC, Mamun AA, Mansouri B, Mansournia MA, Martinez G, Martinez-Raga J, Martins-Melo FR, Mason-Jones AJ, Masoumi SZ, Mathur MR, Maulik PK, McGrath JJ, Mehndiratta MM, Mehri F, Memiah PTN, Mendoza W, Menezes RG, Mengesha EW, Meretoja A, Meretoja TJ, Mestrovic T, Miazgowski B, Miazgowski T, Michalek IM, Miller TR, Mini GK, Mirica A, Mirrakhimov EM, Mirzaei H, Mirzaei M, Moazen B, Mohammad DK, Mohammadi S, Mohammadian-Hafshejani A, Mohammadifard N, Mohammadpourhodki R, Mohammed S, Monasta L, Moradi G, Moradi-Lakeh M, Moradzadeh R, Moraga P, Morrison SD, Mosapour A, Mousavi Khaneghah A, Mueller UO, Muriithi MK, Murray CJL, Muthupandian S, Naderi M, Nagarajan AJ, Naghavi M, Naimzada MD, Nangia V, Nayak VC, Nazari J, Ndejjo R, Negoi I, Negoi RI, Netsere HB, Nguefack-Tsague G, Nguyen DN, Nguyen HLT, Nie J, Ningrum DNA, Nnaji CA, Nomura S, Noubiap JJ, Nowak C, Nuñez-Samudio V, Ogbo FA, Oghenetega OB, Oh IH, Oladnabi M, Olagunju AT, Olusanya BO, Olusanya JO, Omar Bali A, Omer MO, Onwujekwe OE, Ortiz A, Otoiu A, Otstavnov N, Otstavnov SS, Øverland S, Owolabi MO, P A M, Padubidri JR, Pakshir K, Palladino R, Pana A, Panda-Jonas S, Pandey A, Panelo CIA, Park EK, Patten SB, Peden AE, Pepito VCF, Peprah EK, Pereira J, Pesudovs K, Pham HQ, Phillips MR, Piradov MA, Pirsaheb M, Postma MJ, Pottoo FH, Pourjafar H, Pourshams A, Prada SI, Pupillo E, Quazi Syed Z, Rabiee MH, Rabiee N, Radfar A, Rafiee A, Raggi A, Rahim F, Rahimi-Movaghar V, Rahman MHU, Rahman MA, Ramezanzadeh K, Ranabhat CL, Rao SJ, Rashedi V, Rastogi P, Rathi P, Rawaf DL, Rawaf S, Rawal L, Rawassizadeh R, Renzaho AMN, Rezaei N, Rezaei N, Rezai MS, Riahi SM, Rickard J, Roever L, Ronfani L, Roth GA, Rubagotti E, Rumisha SF, Rwegerera GM, Sabour S, Sachdev PS, Saddik B, Sadeghi E, Saeedi Moghaddam S, Sagar R, Sahebkar A, Sahraian MA, Sajadi SM, Salem MR, Salimzadeh H, Samy AM, Sanabria J, Santric-Milicevic MM, Saraswathy SYI, Sarrafzadegan N, Sarveazad A, Sathish T, Sattin D, Saxena D, Saxena S, Schiavolin S, Schwebel DC, Schwendicke F, Senthilkumaran S, Sepanlou SG, Sha F, Shafaat O, Shahabi S, Shaheen AA, Shaikh MA, Shakiba S, Shamsi M, Shannawaz M, Sharafi K, Sheikh A, Sheikhbahaei S, Shetty BSK, Shi P, Shigematsu M, Shin JI, Shiri R, Shuval K, Siabani S, Sigfusdottir ID, Sigurvinsdottir R, Silva DAS, Silva JP, Simonetti B, Singh JA, Singh V, Sinke AH, Skryabin VY, Slater H, Smith EUR, Sobhiyeh MR, Sobngwi E, Soheili A, Somefun OD, Sorrie MB, Soyiri IN, Sreeramareddy CT, Stein DJ, Stokes MA, Sudaryanto A, Sultan I, Tabarés-Seisdedos R, Tabuchi T, Tadakamadla SK, Taherkhani A, Tamiru AT, Tareque MI, Thankappan KR, Thapar R, Thomas N, Titova MV, Tonelli M, Tovani-Palone MR, Tran BX, Travillian RS, Tsai AC, Tsatsakis A, Tudor Car L, Uddin R, Unim B, Unnikrishnan B, Upadhyay E, Vacante M, Valadan Tahbaz S, Valdez PR, Varughese S, Vasankari TJ, Venketasubramanian N, Villeneuve PJ, Violante FS, Vlassov V, Vos T, Vu GT, Waheed Y, Wamai RG, Wang Y, Wang Y, Wang YP, Westerman R, Wickramasinghe ND, Wu AM, Wu C, Yahyazadeh Jabbari SH, Yamagishi K, Yano Y, Yaya S, Yazdi-Feyzabadi V, Yeshitila YG, Yip P, Yonemoto N, Yoon SJ, Younis MZ, Yousefinezhadi T, Yu C, Yu Y, Yuce D, Zaidi SS, Zaman SB, Zamani M, Zamanian M, Zarafshan H, Zarei A, Zastrozhin MS, Zhang Y, Zhang ZJ, Zhao XJG, Zhu C, Patton GC, Viner RM. Global, regional, and national mortality among young people aged 10-24 years, 1950-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2021; 398:1593-1618. [PMID: 34755628 PMCID: PMC8576274 DOI: 10.1016/s0140-6736(21)01546-4] [Citation(s) in RCA: 72] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 05/07/2021] [Accepted: 06/30/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Documentation of patterns and long-term trends in mortality in young people, which reflect huge changes in demographic and social determinants of adolescent health, enables identification of global investment priorities for this age group. We aimed to analyse data on the number of deaths, years of life lost, and mortality rates by sex and age group in people aged 10-24 years in 204 countries and territories from 1950 to 2019 by use of estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. METHODS We report trends in estimated total numbers of deaths and mortality rate per 100 000 population in young people aged 10-24 years by age group (10-14 years, 15-19 years, and 20-24 years) and sex in 204 countries and territories between 1950 and 2019 for all causes, and between 1980 and 2019 by cause of death. We analyse variation in outcomes by region, age group, and sex, and compare annual rate of change in mortality in young people aged 10-24 years with that in children aged 0-9 years from 1990 to 2019. We then analyse the association between mortality in people aged 10-24 years and socioeconomic development using the GBD Socio-demographic Index (SDI), a composite measure based on average national educational attainment in people older than 15 years, total fertility rate in people younger than 25 years, and income per capita. We assess the association between SDI and all-cause mortality in 2019, and analyse the ratio of observed to expected mortality by SDI using the most recent available data release (2017). FINDINGS In 2019 there were 1·49 million deaths (95% uncertainty interval 1·39-1·59) worldwide in people aged 10-24 years, of which 61% occurred in males. 32·7% of all adolescent deaths were due to transport injuries, unintentional injuries, or interpersonal violence and conflict; 32·1% were due to communicable, nutritional, or maternal causes; 27·0% were due to non-communicable diseases; and 8·2% were due to self-harm. Since 1950, deaths in this age group decreased by 30·0% in females and 15·3% in males, and sex-based differences in mortality rate have widened in most regions of the world. Geographical variation has also increased, particularly in people aged 10-14 years. Since 1980, communicable and maternal causes of death have decreased sharply as a proportion of total deaths in most GBD super-regions, but remain some of the most common causes in sub-Saharan Africa and south Asia, where more than half of all adolescent deaths occur. Annual percentage decrease in all-cause mortality rate since 1990 in adolescents aged 15-19 years was 1·3% in males and 1·6% in females, almost half that of males aged 1-4 years (2·4%), and around a third less than in females aged 1-4 years (2·5%). The proportion of global deaths in people aged 0-24 years that occurred in people aged 10-24 years more than doubled between 1950 and 2019, from 9·5% to 21·6%. INTERPRETATION Variation in adolescent mortality between countries and by sex is widening, driven by poor progress in reducing deaths in males and older adolescents. Improving global adolescent mortality will require action to address the specific vulnerabilities of this age group, which are being overlooked. Furthermore, indirect effects of the COVID-19 pandemic are likely to jeopardise efforts to improve health outcomes including mortality in young people aged 10-24 years. There is an urgent need to respond to the changing global burden of adolescent mortality, address inequities where they occur, and improve the availability and quality of primary mortality data in this age group. FUNDING Bill & Melinda Gates Foundation.
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Elmali A, Koc I, Ciftci SY, Nemutlu E, Surucu S, Kiratli H, Yuce D, Cengiz M, Zorlu F, Ozyigit G, Yazici G. Radiotherapy-induced alterations in vitreous humor: A new potential critical structure. Exp Eye Res 2021; 212:108802. [PMID: 34688623 DOI: 10.1016/j.exer.2021.108802] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 10/06/2021] [Accepted: 10/19/2021] [Indexed: 12/28/2022]
Abstract
Vitreous humor (VH) is not considered as a critical structure in the radiotherapy planning process. In the present study, an experimental animal model was performed to examine the effects of radiotherapy on VH. The right eyes of twelve New Zealand rabbits were irradiated to 60 Gy in 3 fractions in accordance with the scheme used in the treatment of uveal melanoma in our clinic, and contralateral (left) eyes were considered as control. Weekly ophthalmologic examination was performed after irradiation, for three months. At the end of the third month, enucleation and vitreous collection were conducted. The vitreous samples were subjected to metabolomic analyses, ELISA analyses, viscosity measurements, and electron microscopic examination. In control and experimental vitreous samples, 275 different metabolites were identified, and 34 were found to differ significantly between groups. In multivariate analyzes, a clear distinction was observed between control and irradiated vitreous samples. Pathway analysis revealed that nine pathways were affected, and these pathways were mainly related to amino acid metabolism. A significant decrease was observed in the expressions of type II, V, and XI collagens in protein level in the ELISA. There was a non-significant decrease in type IX collagen and viscosity. Electron microscopic examination revealed disrupted collagen fibrillar ultra-structure and dispersed collagen fragments in the experimental vitreous. An intact vitreous is essential for a healthy eye. In this study, we observed that radiation causes changes in the vitreous that may have long-term consequences.
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Affiliation(s)
- Aysenur Elmali
- Department of Radiation Oncology, Hacettepe University, Faculty of Medicine, Ankara, Turkey.
| | - Irem Koc
- Department of Ophthalmology, Hacettepe University, Faculty of Medicine, Ankara, Turkey.
| | | | - Emirhan Nemutlu
- Department of Analytical Chemistry, Hacettepe University, Faculty of Pharmacy, Ankara, Turkey.
| | - Selcuk Surucu
- Department of Anatomy, Koc University, Faculty of Medicine, Istanbul, Turkey.
| | - Hayyam Kiratli
- Department of Ophthalmology, Hacettepe University, Faculty of Medicine, Ankara, Turkey.
| | - Deniz Yuce
- Department of Preventive Oncology, Hacettepe University, Faculty of Medicine, Ankara, Turkey.
| | - Mustafa Cengiz
- Department of Radiation Oncology, Hacettepe University, Faculty of Medicine, Ankara, Turkey.
| | - Faruk Zorlu
- Department of Radiation Oncology, Hacettepe University, Faculty of Medicine, Ankara, Turkey.
| | - Gokhan Ozyigit
- Department of Radiation Oncology, Hacettepe University, Faculty of Medicine, Ankara, Turkey.
| | - Gozde Yazici
- Department of Radiation Oncology, Hacettepe University, Faculty of Medicine, Ankara, Turkey.
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Halit Aktepe O, Sinem Ardic F, Yuce D, Can Guven D, Guner G, Cagri Yildirim H, Kilickap S, Turker A, Kertmen N, Akin S, Aksoy S, Dizdar O, Yalcin S, Erman M. Efficacy analyses of axitinib and nivolumab in metastatic renal cell carcinoma after failure of targeted therapy: which is better? J BUON 2021; 26:2067-2073. [PMID: 34761618 DOI: pmid/34761618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE The objective of the present study was to compare the efficacy of axitinib and nivolumab in metastatic renal cell carcinoma (mRCC) previously treated with targeted therapy. METHODS A total of 79 patients were enrolled (39 patients in axitinib group, 40 patients in nivolumab group). Survival outcomes of patients, progression-free survival (PFS), and overall survival (OS) were estimated using the Kaplan-Meier method and compared with the log-rank test. The associations between potential prognostic variables and OS were evaluated in univariate and multivariate Cox regression analyses. RESULTS The median PFS and OS of all cohort were 8.1 and 36.6 months, respectively. Higher PFS and OS were evaluated in axitinib group than nivolumab group (PFS: 9.4 months vs 6.3 months, p=0.386; OS: 38.2 months vs 36.6 months, p=0.671, respectively). Patients treated with axitinib had numerically higher objective response rate (ORR) and disease control rate (DCR) than those treated with nivolumab (ORR: 43.6% vs 27.6%, p=0.157, DCR: 74.4% vs 62.5%, p=0.157, respectively). Multivariate analysis revealed that the independent predictors of OS were higher tumor grade (hazard ratio [HR]: 6.178, p=0.004), worse response to axitinib and nivolumab (HR:4.902, p=0.011), the presence of lung metastasis (HR:15.637, p=0.002) and the presence of liver metastasis (HR:12.010, p=0.001). CONCLUSION Comparable survival outcomes were detected in the axitinib and nivolumab groups. However, head to head comparisons are needed to highlight the relative efficacy of these therapies in mRCC.
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Affiliation(s)
- Oktay Halit Aktepe
- Department of Medical Oncology, Bolu Abant Izzet Baysal University, 14030, Bolu, Turkey
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Galles NC, Liu PY, Updike RL, Fullman N, Nguyen J, Rolfe S, Sbarra AN, Schipp MF, Marks A, Abady GG, Abbas KM, Abbasi SW, Abbastabar H, Abd-Allah F, Abdoli A, Abolhassani H, Abosetugn AE, Adabi M, Adamu AA, Adetokunboh OO, Adnani QES, Advani SM, Afzal S, Aghamir SMK, Ahinkorah BO, Ahmad S, Ahmad T, Ahmadi S, Ahmed H, Ahmed MB, Ahmed Rashid T, Ahmed Salih Y, Akalu Y, Aklilu A, Akunna CJ, Al Hamad H, Alahdab F, Albano L, Alemayehu Y, Alene KA, Al-Eyadhy A, Alhassan RK, Ali L, Aljunid SM, Almustanyir S, Altirkawi KA, Alvis-Guzman N, Amu H, Andrei CL, Andrei T, Ansar A, Ansari-Moghaddam A, Antonazzo IC, Antony B, Arabloo J, Arab-Zozani M, Artanti KD, Arulappan J, Awan AT, Awoke MA, Ayza MA, Azarian G, Azzam AY, B DB, Babar ZUD, Balakrishnan S, Banach M, Bante SA, Bärnighausen TW, Barqawi HJ, Barrow A, Bassat Q, Bayarmagnai N, Bejarano Ramirez DF, Bekuma TT, Belay HG, Belgaumi UI, Bhagavathula AS, Bhandari D, Bhardwaj N, Bhardwaj P, Bhaskar S, Bhattacharyya K, Bibi S, Bijani A, Biondi A, Boloor A, Braithwaite D, Buonsenso D, Butt ZA, Camargos P, Carreras G, Carvalho F, Castañeda-Orjuela CA, Chakinala RC, Charan J, Chatterjee S, Chattu SK, Chattu VK, Chowdhury FR, Christopher DJ, Chu DT, Chung SC, Cortesi PA, Costa VM, Couto RAS, Dadras O, Dagnew AB, Dagnew B, Dai X, Dandona L, Dandona R, De Neve JW, Derbew Molla M, Derseh BT, Desai R, Desta AA, Dhamnetiya D, Dhimal ML, Dhimal M, Dianatinasab M, Diaz D, Djalalinia S, Dorostkar F, Edem B, Edinur HA, Eftekharzadeh S, El Sayed I, El Sayed Zaki M, Elhadi M, El-Jaafary SI, Elsharkawy A, Enany S, Erkhembayar R, Esezobor CI, Eskandarieh S, Ezeonwumelu IJ, Ezzikouri S, Fares J, Faris PS, Feleke BE, Ferede TY, Fernandes E, Fernandes JC, Ferrara P, Filip I, Fischer F, Francis MR, Fukumoto T, Gad MM, Gaidhane S, Gallus S, Garg T, Geberemariyam BS, Gebre T, Gebregiorgis BG, Gebremedhin KB, Gebremichael B, Gessner BD, Ghadiri K, Ghafourifard M, Ghashghaee A, Gilani SA, Glăvan IR, Glushkova EV, Golechha M, Gonfa KB, Gopalani SV, Goudarzi H, Gubari MIM, Guo Y, Gupta VB, Gupta VK, Gutiérrez RA, Haeuser E, Halwani R, Hamidi S, Hanif A, Haque S, Harapan H, Hargono A, Hashi A, Hassan S, Hassanein MH, Hassanipour S, Hassankhani H, Hay SI, Hayat K, Hegazy MI, Heidari G, Hezam K, Holla R, Hoque ME, Hosseini M, Hosseinzadeh M, Hostiuc M, Househ M, Hsieh VCR, Huang J, Humayun A, Hussain R, Hussein NR, Ibitoye SE, Ilesanmi OS, Ilic IM, Ilic MD, Inamdar S, Iqbal U, Irham LM, Irvani SSN, Islam SMS, Ismail NE, Itumalla R, Jha RP, Joukar F, Kabir A, Kabir Z, Kalhor R, Kamal Z, Kamande SM, Kandel H, Karch A, Kassahun G, Kassebaum NJ, Katoto PDMC, Kelkay B, Kengne AP, Khader YS, Khajuria H, Khalil IA, Khan EA, Khan G, Khan J, Khan M, Khan MAB, Khang YH, Khoja AT, Khubchandani J, Kim GR, Kim MS, Kim YJ, Kimokoti RW, Kisa A, Kisa S, Korshunov VA, Kosen S, Kuate Defo B, Kulkarni V, Kumar A, Kumar GA, Kumar N, Kwarteng A, La Vecchia C, Lami FH, Landires I, Lasrado S, Lassi ZS, Lee H, Lee YY, Levi M, Lewycka S, Li S, Liu X, Lobo SW, Lopukhov PD, Lozano R, Lutzky Saute R, Magdy Abd El Razek M, Makki A, Malik AA, Mansour-Ghanaei F, Mansournia MA, Mantovani LG, Martins-Melo FR, Matthews PC, Medina JRC, Mendoza W, Menezes RG, Mengesha EW, Meretoja TJ, Mersha AG, Mesregah MK, Mestrovic T, Miazgowski B, Milne GJ, Mirica A, Mirrakhimov EM, Mirzaei HR, Misra S, Mithra P, Moghadaszadeh M, Mohamed TA, Mohammad KA, Mohammad Y, Mohammadi M, Mohammadian-Hafshejani A, Mohammed A, Mohammed S, Mohapatra A, Mokdad AH, Molokhia M, Monasta L, Moni MA, Montasir AA, Moore CE, Moradi G, Moradzadeh R, Moraga P, Mueller UO, Munro SB, Naghavi M, Naimzada MD, Naveed M, Nayak BP, Negoi I, Neupane Kandel S, Nguyen TH, Nikbakhsh R, Ningrum DNA, Nixon MR, Nnaji CA, Noubiap JJ, Nuñez-Samudio V, Nwatah VE, Oancea B, Ochir C, Ogbo FA, Olagunju AT, Olakunde BO, Onwujekwe OE, Otstavnov N, Otstavnov SS, Owolabi MO, Padubidri JR, Pakshir K, Park EC, Pashazadeh Kan F, Pathak M, Paudel R, Pawar S, Pereira J, Peres MFP, Perianayagam A, Pinheiro M, Pirestani M, Podder V, Polibin RV, Pollok RCG, Postma MJ, Pottoo FH, Rabiee M, Rabiee N, Radfar A, Rafiei A, Rahimi-Movaghar V, Rahman M, Rahmani AM, Rahmawaty S, Rajesh A, Ramshaw RE, Ranasinghe P, Rao CR, Rao SJ, Rathi P, Rawaf DL, Rawaf S, Renzaho AMN, Rezaei N, Rezai MS, Rios-Blancas M, Rogowski ELB, Ronfani L, Rwegerera GM, Saad AM, Sabour S, Saddik B, Saeb MR, Saeed U, Sahebkar A, Sahraian MA, Salam N, Salimzadeh H, Samaei M, Samy AM, Sanabria J, Sanmarchi F, Santric-Milicevic MM, Sartorius B, Sarveazad A, Sathian B, Sawhney M, Saxena D, Saxena S, Seidu AA, Seylani A, Shaikh MA, Shamsizadeh M, Shetty PH, Shigematsu M, Shin JI, Sidemo NB, Singh A, Singh JA, Sinha S, Skryabin VY, Skryabina AA, Soheili A, Tadesse EG, Tamiru AT, Tan KK, Tekalegn Y, Temsah MH, Thakur B, Thapar R, Thavamani A, Tobe-Gai R, Tohidinik HR, Tovani-Palone MR, Traini E, Tran BX, Tripathi M, Tsegaye B, Tsegaye GW, Ullah A, Ullah S, Ullah S, Unim B, Vacante M, Velazquez DZ, Vo B, Vollmer S, Vu GT, Vu LG, Waheed Y, Winkler AS, Wiysonge CS, Yiğit V, Yirdaw BW, Yon DK, Yonemoto N, Yu C, Yuce D, Yunusa I, Zamani M, Zamanian M, Zewdie DT, Zhang ZJ, Zhong C, Zumla A, Murray CJL, Lim SS, Mosser JF. Measuring routine childhood vaccination coverage in 204 countries and territories, 1980-2019: a systematic analysis for the Global Burden of Disease Study 2020, Release 1. Lancet 2021; 398:503-521. [PMID: 34273291 PMCID: PMC8358924 DOI: 10.1016/s0140-6736(21)00984-3] [Citation(s) in RCA: 73] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/16/2021] [Accepted: 04/22/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Measuring routine childhood vaccination is crucial to inform global vaccine policies and programme implementation, and to track progress towards targets set by the Global Vaccine Action Plan (GVAP) and Immunization Agenda 2030. Robust estimates of routine vaccine coverage are needed to identify past successes and persistent vulnerabilities. Drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020, Release 1, we did a systematic analysis of global, regional, and national vaccine coverage trends using a statistical framework, by vaccine and over time. METHODS For this analysis we collated 55 326 country-specific, cohort-specific, year-specific, vaccine-specific, and dose-specific observations of routine childhood vaccination coverage between 1980 and 2019. Using spatiotemporal Gaussian process regression, we produced location-specific and year-specific estimates of 11 routine childhood vaccine coverage indicators for 204 countries and territories from 1980 to 2019, adjusting for biases in country-reported data and reflecting reported stockouts and supply disruptions. We analysed global and regional trends in coverage and numbers of zero-dose children (defined as those who never received a diphtheria-tetanus-pertussis [DTP] vaccine dose), progress towards GVAP targets, and the relationship between vaccine coverage and sociodemographic development. FINDINGS By 2019, global coverage of third-dose DTP (DTP3; 81·6% [95% uncertainty interval 80·4-82·7]) more than doubled from levels estimated in 1980 (39·9% [37·5-42·1]), as did global coverage of the first-dose measles-containing vaccine (MCV1; from 38·5% [35·4-41·3] in 1980 to 83·6% [82·3-84·8] in 2019). Third-dose polio vaccine (Pol3) coverage also increased, from 42·6% (41·4-44·1) in 1980 to 79·8% (78·4-81·1) in 2019, and global coverage of newer vaccines increased rapidly between 2000 and 2019. The global number of zero-dose children fell by nearly 75% between 1980 and 2019, from 56·8 million (52·6-60·9) to 14·5 million (13·4-15·9). However, over the past decade, global vaccine coverage broadly plateaued; 94 countries and territories recorded decreasing DTP3 coverage since 2010. Only 11 countries and territories were estimated to have reached the national GVAP target of at least 90% coverage for all assessed vaccines in 2019. INTERPRETATION After achieving large gains in childhood vaccine coverage worldwide, in much of the world this progress was stalled or reversed from 2010 to 2019. These findings underscore the importance of revisiting routine immunisation strategies and programmatic approaches, recentring service delivery around equity and underserved populations. Strengthening vaccine data and monitoring systems is crucial to these pursuits, now and through to 2030, to ensure that all children have access to, and can benefit from, lifesaving vaccines. FUNDING Bill & Melinda Gates Foundation.
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Firlatan B, Karakulak UN, Hekimsoy V, Iremli BG, Lay I, Yuce D, Dagdelen S, Kabakci G, Erbas TA. The Value of 4D Speckle-Tracking Strain Echocardiography in Evaluating the Relationship Between Asprosin and Growth Differentiation Factor-15 Levels and Subclinical Systolic Dysfunction in Patients With Acromegaly and Prolactinoma. J Endocr Soc 2021. [PMCID: PMC8090685 DOI: 10.1210/jendso/bvab048.1326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Abstract
Introduction: In patients with acromegaly and prolactinoma, the long-term presence of elevated GH and PRL levels is associated with an unfavorable cardiovascular risk profile. Early recognition of dysfunctions related to cardiovascular complications, which can be a significant contributor to mortality, is important. The aim of this study was to assess the relationship of four-dimensional speckle-tracking strain echocardiographic (4DSTE) measurements with asprosin, GDF-15 levels, and the Framingham cardiovascular risk score (FRS) in patients with acromegaly and prolactinoma. Methods: The study included 41 acromegaly [20F/21M, age: 49 (41-57)], 29 prolactinoma patients [18F/11M, age: 40 (28-48)] and 33 healthy control subjects [15F/18M, age: 48 (37-54)]. Data are presented as median with interquartile ranges (IQR). Anthropometric, biochemical and echocardiographic measurements were performed. Asprosin and GDF-15 levels were measured by ELISA. Results: Plasma asprosin concentration in the prolactinoma group [2.4 ng/mL (0.0-9.7)] was significantly lower than the concentration in both the acromegaly group [6.8 ng/mL (2.6-9.9)] and the control group [10.2 ng/mL (2.3-18.0)] (p=0.022 and p=0.006, respectively). In the study population, asprosin levels were positively correlated with age, FRS, and GDF-15 levels (r=0.361, p<0.001; r=0.275, p=0.005 and r=0.240, p=0.015; respectively). Plasma GDF-15 concentration was lower in prolactinoma group [262.2 pg/mL (169.3-336.1)] than in the acromegaly [332.5 pg/mL (257.4-438.8)] and control groups [331.3 pg/mL (233.6-428.9)] (p=0.008 and p=0.047, respectively). In multiple linear regression analysis, GDF-15 level was independently positively related to the FRS in both patient groups (p<0.001). FRS was highest in patients with acromegaly (p=0.004). In 2DE; the left ventricular ejection fraction although within normal limits, was lower in acromegaly [63% (63-65)] and prolactinoma [63% (60-65)] patients compared to the healthy controls [66% (63-68)] (p=0.003). In both acromegaly and prolactinoma groups; global longitudinal, circumferential, areal and radial strain measurements identified by 4DSTE were lower than the control group (acromegaly: p=0.007, p=0.008, p=0.015, p=0.008; prolactinoma: p=0.033, p=0.019, p=0.030, p=0.025, respectively). In contrast, diastolic functions were evaluated as normal in 85% of acromegaly patients, 86% of prolactinoma patients, and 93% of the control group (p=0.365). Conclusion: This is the first study to demonstrate the isolated subclinical systolic dysfunction identified by four-dimensional echocardiography in patients with acromegaly and prolactinoma. Asprosin may be associated with cardiovascular diseases in addition to its role in the pathogenesis of type 2 diabetes mellitus, and GDF-15 can be used as a biomarker to predict cardiovascular risk in these patient groups.
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Affiliation(s)
| | | | | | | | - Incilay Lay
- Hacettepe University Medical School, Ankara, Turkey
| | - Deniz Yuce
- Hacettepe University Medical School, Ankara, Turkey
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Gursoy ID, Barun S, Erdem SR, Keskin U, Kiziltas M, Atilla P, Muftuoglu S, Yuce D, Narin F, Ertunc M, Sara Y, Canpinar H. Investigation of the Possible Protective Effects of Ketamine and Dantrolene on the Hippocampal Apoptosis and Spatial Learning in Rats Exposed to Repeated Electroconvulsive Seizures as a Model of Status Epilepticus. Turk Neurosurg 2021; 30:871-884. [PMID: 32705669 DOI: 10.5137/1019-5149.jtn.27023-19.3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
AIM To evaluate the possible neuroprotective effects of ketamine and dantrolene on the hippocampal apoptosis and spatial learning in rats exposed to repeated electroconvulsive seizures (ECS) as a model of status epilepticus (SE). MATERIAL AND METHODS Twenty-four rats were assigned to 4 groups. 1st Group was Sham. 2nd Group was ECS: ECS was induced by ear electrodes via electrical stimulation. The same ECS protocol was applied to the 3th and 4th Groups which received ketamine (40 mg/kg s.c.) or dantrolene (5 mg/kg i.p.) 1 h before each ECS, respectively. Following 30 days of recovery, the cognitive status of the animals was evaluated via Morris Water Maze (MWM). The same experimental protocol was repeated 14 days afterward to evaluate the retention of the memory. Hippocampal apoptosis was examined in corresponding experimental groups. RESULTS All the animals in four groups learned the task with no significant difference between groups in MWM. The ECS+ketamine group showed memory impairment 14 days afterward. ECS+dantrolene group was not different from controls. ECS caused long term apoptotic processes in dentate gyrus (DG) and non-apoptotic neuronal injury in CA1 and CA2. CONCLUSION Dantrolene and ketamine inhibited apoptosis and showed neuroprotective effects. Although ketamine and dantrolene inhibited ECS-induced apoptosis and non-apoptotic injury, they did not produce similar effects on memory retention. It will be warranted to evaluate cognitive dysfunction by taking into consideration the other factors in addition to apoptosis and neurodegenerative changes.
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Eraslan L, Yuce D, Erbilici A, Baltaci G. Response to the letter to the editor: Comment on "Does Kinesiotaping improve pain and functionality in patients with newly diagnosed lateral epicondylitis?". Knee Surg Sports Traumatol Arthrosc 2021; 29:1008-1010. [PMID: 30900031 DOI: 10.1007/s00167-019-05454-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 02/27/2019] [Indexed: 10/27/2022]
Affiliation(s)
- Leyla Eraslan
- Department of Physiotherapy and Rehabilitation, Hacettepe University Faculty of Health Sciences, 06100, Ankara, Turkey.
| | - Deniz Yuce
- Department of Preventive Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | | | - Gul Baltaci
- Department of Physiotherapy and Rehabilitation, Hacettepe University Faculty of Health Sciences, 06100, Ankara, Turkey
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Aktepe OH, Guven DC, Sahin TK, Yildirim HC, Celikten B, Yeter HH, Yuce D, Dizdar O, Erman M. The Predictive Value of Red Blood Cell Distribution Width for Survival Outcomes of Metastatic Renal Cell Carcinoma Patients Treated with Targeted Therapy. Nutr Cancer 2021; 73:1957-1963. [PMID: 33491495 DOI: 10.1080/01635581.2021.1871925] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND We aimed to investigate the prognostic value of red cell distribution width (RDW) in metastatic renal cell carcinoma (mRCC) patients treated with targeted therapy, including sunitinib and pazopanib. METHODS A total of 104 mRCC patients were included. The Kaplan-Meier method was used to estimate overall survival (OS) and progression-free survival (PFS), and the long-rank test was used for comparison. Univariate and multivariate Cox proportional hazards models were used to determine the association between RDW and PFS and OS. RESULTS The PFS and OS of all cohorts were 11.8 mo and 25.9 mo, respectively. Receiver operating characteristic analysis revealed that RDW level ≥15.4 was the optimal cutoff value for OS prediction with 73.53% sensitivity and 61.11% specificity (area under curve: 0.64, P = 0.012). RDW level ≥15.4 was found as an independent prognostic parameter for OS when adjusted for the number of covariates, including the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) scoring system (hazard ratio: 1.125, 95% confidence interval: 1.024-2.235, P = 0.014). CONCLUSIONS Our study revealed that high RDW level, a routinely and easily assessed marker, was significantly associated with worse survival outcomes in mRCC patients treated with targeted therapy.
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Affiliation(s)
- Oktay Halit Aktepe
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Deniz Can Guven
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Taha Koray Sahin
- Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Hasan Cagri Yildirim
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Burcu Celikten
- Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Haci Hasan Yeter
- Department of Nephrology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Deniz Yuce
- Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Omer Dizdar
- Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Mustafa Erman
- Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
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Sari SY, Yilmaz MT, Elmali A, Yedekci FY, Yuce D, Ozyigit G, Cengiz M, Yazici G. Parotid gland stem cells: Mini yet mighty. Head Neck 2020; 43:1122-1127. [PMID: 33244802 DOI: 10.1002/hed.26556] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/24/2020] [Accepted: 11/20/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Our aim was to evaluate the correlation between the radiation doses to parotid gland (PG) stem cells and xerostomia. METHODS Patients diagnosed with head and neck cancer (HNC) were retrospectively evaluated, and xerostomia inventory (XI) was applied to these patients. PG stem cells were delineated on the treatment planning CT, and the mean doses to the PG stem cells calculated. RESULTS The total test score and mean doses to bilateral PGs were significantly correlated (r = .34, P = .001), and the mean doses to bilateral PG stem cell niches were significantly correlated with the total test score (r = .32, P = .002). CONCLUSIONS In this study, we found that the mean dose to PG stem cells can predict dry mouth as much as the mean dose to the PG.
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Affiliation(s)
- Sezin Yuce Sari
- Department of Radiation Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Melek Tugce Yilmaz
- Department of Radiation Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Aysenur Elmali
- Department of Radiation Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Fazli Yagiz Yedekci
- Department of Radiation Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Deniz Yuce
- Department of Preventive Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Gokhan Ozyigit
- Department of Radiation Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Mustafa Cengiz
- Department of Radiation Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Gozde Yazici
- Department of Radiation Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Hurmuz P, Cengiz M, Ozyigit G, Akkas EA, Yuce D, Yilmaz MT, Yildiz D, Zorlu F, Akyol F. Stereotactic body radiotherapy in patients with early-stage non-small cell lung cancer: Does beam-on time matter? Jpn J Clin Oncol 2020; 50:1182-1187. [PMID: 32542318 DOI: 10.1093/jjco/hyaa093] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 05/25/2020] [Indexed: 12/25/2022] Open
Abstract
PURPOSE Stereotactic body radiotherapy (SBRT) is an effective treatment option for patients with early-stage non-small cell lung cancer (NSCLC). In this study, we evaluated the treatment results using two different SBRT techniques and the effect of beam-on time (BOT) on treatment outcomes. METHODS Between July 2007 and January 2018, 142 patients underwent SBRT for primary NSCLC. We have delivered SBRT using either respiratory tracking system (RTS) or internal-target-volume (ITV)-based motion management techniques. The effect of age, tumor size, pretreatment tumor SUVmax value, presence of tissue diagnosis, histopathological subtype, operability status, tumor location, motion management technique, BED10 value, BOT on overall survival (OS), loco-regional control (LRC), event-free survival (EFS) and primary tumor control (PTC) were evaluated. RESULTS Median age of the patients was 70 years (range, 39-91 years). Most of the patients were inoperable (90%) at the time of SBRT. Median BED10 value was 112.5 Gy. With a median follow-up of 25 months, PTC was achieved in 91.5% of the patients. Two-year estimated OS, LRC, PTC and EFS rates were 68, 63, 63 and 53%, respectively. For the entire group, OS was associated with BOT (P = 0.027), and EFS was associated with BOT (P = 0.027) and tumor size (P = 0.015). For RTS group, OS was associated with age (P = 0.016), EFS with BOT (P = 0.05) and tumor size (P = 0.024), LRC with BOT (P = 0.008) and PTC with BOT (P = 0.028). The treatment was well tolerated in general. CONCLUSION SBRT is an effective and safe treatment with high OS, LRC, EFS and PTC rates in patients with primary NSCLC. Protracted BOT might deteriorate SBRT outcomes.
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Affiliation(s)
- Pervin Hurmuz
- Radiation Oncology, Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Mustafa Cengiz
- Radiation Oncology, Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Gokhan Ozyigit
- Radiation Oncology, Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ebru Atasever Akkas
- Department of Radiation Oncology, Abdurrahman Yurtaslan Oncology Education and Research Hospital, Ankara
| | - Deniz Yuce
- Department of Preventive Oncology, Hacettepe University Faculty of Medicine, Ankara
| | - Melek Tugce Yilmaz
- Radiation Oncology, Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Demet Yildiz
- Radiation Oncology, Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Faruk Zorlu
- Radiation Oncology, Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Fadil Akyol
- Radiation Oncology, Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Yalcin S, Dane F, Oksuzoglu B, Ozdemir NY, Isikdogan A, Ozkan M, Demirag GG, Coskun HS, Karabulut B, Evrensel T, Ustaoglu MA, Ozdemir F, Turna H, Yavuzsen T, Aykan F, Sevinc A, Akbulut H, Yuce D, Hayran M, Kilickap S. Quality of life study of patients with unresectable locally advanced or metastatic pancreatic adenocarcinoma treated with gemcitabine+nab-paclitaxel versus gemcitabine alone: AX-PANC-SY001, a randomized phase-2 study. BMC Cancer 2020; 20:259. [PMID: 32228512 PMCID: PMC7106641 DOI: 10.1186/s12885-020-06758-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Accepted: 03/17/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Combination of gemcitabine and nab-paclitaxel has superior clinical efficacy than gemcitabine alone. Nevertheless, health-related quality of life. (QoL) associated with this combination therapy when administered at first-line in advanced pancreatic adenocarcinoma is unknown. METHODS A total of 125 patients were randomized to combination therapy (1000 mg/m2 gemcitabine + 125 mg/m2 nab-paclitaxel) and single-agent gemcitabine (1000 mg/m2) arms to take treatment weekly for 7 of 8 weeks, and following 3 of 4 weeks, until progression or severe toxicity. Primary endpoints were three-months of definitive deterioration free percent of patients, and QoL. RESULTS Overall QoL analyses showed that 34 and 58.3% of cases in gemcitabine and gemcitabine+nab-P arms had no deterioration in 3rd month QoL scores (p = 0.018). These proportions were 27.3 and 36.6% in 6th month assessments, respectively (p = 0.357). Median overall survivals in combination and single-agent arms were 9.92 months and 5.95 months, respectively (HR: 0.64, 95% CI: 0.42-0.86, p = 0.038). Median progression free survivals in these treatment arms were 6.28 and 3.22 months, respectively (HR: 0.58, 95% CI: 0.39-0.87, p = 0.008). Median time-to-deterioration were 5.36 vs 3.68 months, and objective response rates were 37.1% vs 23.7% (p = 0.009), respectively in combination and single-agent arms. CONCLUSIONS Combination therapy with gemcitabine + nab-paclitaxel had better overall and progression-free survival than gemcitabine alone. Also, combination therapy showed increased response rate without toxicity or deteriorated QoL. Combination treatment with gemcitabine and nab-paclitaxel may provide significant benefit for advanced pancreatic cancer. TRIAL REGISTRATION This study has been registered in ClinicalTrials.gov as NCT03807999 on January 8, 2019 (retrospectively registered).
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Affiliation(s)
- Suayib Yalcin
- grid.14442.370000 0001 2342 7339Hacettepe University Faculty of Medicine, Ankara, Turkey
- grid.14442.370000 0001 2342 7339Hacettepe University Cancer Institute, Ankara, Turkey
| | - Faysal Dane
- grid.16477.330000 0001 0668 8422Marmara University Faculty of Medicine, İstanbul, Turkey
| | - Berna Oksuzoglu
- grid.413794.cDr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Nuriye Yildirim Ozdemir
- grid.413791.90000 0004 0642 7670Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Abdurrahman Isikdogan
- grid.411690.b0000 0001 1456 5625Dicle University Faculty of Medicine, Dyarbakir, Turkey
| | - Metin Ozkan
- grid.411739.90000 0001 2331 2603Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Guzin Gonullu Demirag
- grid.411049.90000 0004 0574 2310Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey
| | - Hasan Senol Coskun
- grid.29906.340000 0001 0428 6825Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Bulent Karabulut
- grid.8302.90000 0001 1092 2592Ege University Faculty of Medicine, İzmir, Turkey
| | - Turkkan Evrensel
- grid.34538.390000 0001 2182 4517Uludag University Faculty of Medicine, Bursa, Turkey
| | - Mehmet Ali Ustaoglu
- grid.414116.70000 0004 0419 1537Lütfi Kirdar Kartal Training and Research Hospital, İstanbul, Turkey
| | - Feyyaz Ozdemir
- grid.31564.350000 0001 2186 0630Karadeniz Teknik University Faculty of Medicine, Trabzon, Turkey
| | - Hande Turna
- grid.506076.20000 0004 1797 5496İstanbul University Cerrahpasa Faculty of Medicine, Bursa, Turkey
| | - Tugba Yavuzsen
- grid.21200.310000 0001 2183 9022Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Faruk Aykan
- grid.9601.e0000 0001 2166 6619İstanbul University Cancer Institute, İstanbul, Turkey
| | - Alper Sevinc
- grid.411549.c0000000107049315Gaziantep University Faculty of Medicine, Gaziantep, Turkey
| | - Hakan Akbulut
- grid.7256.60000000109409118Ankara University Faculty of Medicine, Ankara, Turkey
| | - Deniz Yuce
- grid.14442.370000 0001 2342 7339Hacettepe University Cancer Institute, Ankara, Turkey
| | - Mutlu Hayran
- grid.14442.370000 0001 2342 7339Hacettepe University Cancer Institute, Ankara, Turkey
| | - Saadettin Kilickap
- grid.14442.370000 0001 2342 7339Hacettepe University Cancer Institute, Ankara, Turkey
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Sade LE, Keskin S, Colak A, Ciftci O, Can U, Kibaroglu S, Yuce D, Ozin B, Muderrisoglu H. P1797 Left atrial mechanics in patients with stoke: Implications for emprical anticoagulation. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.1152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Purpose
Detection of atrial fibrillation (AF) after stroke impacts patient management. However, detection of AF is difficult due to its paroxsysmal nature. We sought to test the hypothesis that echocardiographic quantification left atrial (LA) mechanics in patients with stoke can be an imaging biomarker to predict AF.
Methods
We enrolled prospectively and consecutively 131 patients in normal sinus rhythm with a new diagnosis of ischemic stroke. All patients underwent 48-hour Holter monitorization, transthoracic echocardiography with saline injection in addition to routine work-up of stroke evaluation. Two-dimensional and Doppler studies, together with most up-to-date LA quantification tools were performed including 3-dimensional LA phasic volumes (maxiumum and minimum LA Volume index - LAVImax, LAVImin) and LA strain quantification (average strain from apical 4- and 2-chamber during reservoir (Ss) and contraction (Sa) phases). Patients were followed-up and underwent second 48-hour Holter monitorization 6-12 months later if no etiologic cause was found. Any AF episode lasting >30 seconds was considered significant parosysmal AF.
Results
In 49 patients, causes other than AF were identified (Noncryptogenic). In 43 patients no discernable cause was found (NoAF Cryptogenic). Paroxysmal AF episodes lasting longer than 30 sec were documented in 27 patients at first 48-hour Holter and in 12 patients during follow-up (9.2 ± 3.1 months) either by second 48-hour Holter monitorization or clinically (AF cryptogenic). LAVImax and LAVImin were significantly increased, Ss and Sa were significantly reduced in patients with AF as compared to No AF and Noncryptogenic groups (Table). LA volumes and strain measures predicted AF development independently of CHA2DS2-VASc score. Better discrimination between No AF and AF groups was obtained after second Holter monitorization that enabled detection of more cases with paroxysmal AF (Figure).
Conclusions
Our findings underscore the value of echocardiographic assessment of LA function as a marker of AF development and for selection of patients who could benefit from empiric anticoagulation.
Noncryptogenic AF cryptogenic No AF cryptogenic 3D LAVI max (ml/m²) 30.1 ± 9,4 38.1 ± 12.7 28.9 ± 9.2 3D LAVI min (ml/m²) 13.9 ± 7.5 20.7 ± 10.7 13.4 ± 5.3 3D LA EF (%) 55.5 ± 9.4 50.0 ± 10.5 53.8 ± 10.0 Ss (%) 17.4 ± 8.5 12.7 ± 5.3 17.5 ± 8.5 Sa (%) 12.7 ± 6.3 9.0 ± 5.0 12.8 ± 6.3 CHA2DS2-VASc 4.0 ± 1.6 5.0 ± 1.6 3.9 ± 1.5
Abstract P1797 Figure.
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Affiliation(s)
- L E Sade
- Baskent University, Faculty of Medicine, Ankara, Turkey
| | - S Keskin
- Baskent University, Faculty of Medicine, Ankara, Turkey
| | - A Colak
- Baskent University, Faculty of Medicine, Ankara, Turkey
| | - O Ciftci
- Baskent University, Faculty of Medicine, Ankara, Turkey
| | - U Can
- Baskent University, Neurology, Ankara, Turkey
| | - S Kibaroglu
- Baskent University, Neurology, Ankara, Turkey
| | - D Yuce
- Hacettepe University, Ankara, Turkey
| | - B Ozin
- Hacettepe University, Ankara, Turkey
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Ozyigit G, Hurmuz P, Yuce D, Akyol F. Prognostic significance of castrate testosterone levels for patients with intermediate and high risk prostate cancer. World J Clin Oncol 2019; 10:283-292. [PMID: 31528544 PMCID: PMC6717705 DOI: 10.5306/wjco.v10.i8.283] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 05/05/2019] [Accepted: 07/30/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Testosterone level of < 50 ng/dL has been used to define castrate level after surgery or after androgen deprivation treatment (ADT) in metastatic prostate cancer (PC).
AIM To evaluate the effect of two different castrate testosterone levels, < 50 and < 20 ng/dL, on biochemical relapse free survival (BRFS) in patients with non-metastatic intermediate and high risk PC receiving definitive radiotherapy (RT) and ADT.
METHODS Between April 1998 and February 2011; 173 patients with intermediate and high risk disease were treated. Radiotherapy was delivered by either three-dimensional-conformal technique to a total dose of 73.4 Gy at the ICRU reference point or intensity modulated radiotherapy technique to a total dose of 76 Gy. All the patients received 3 mo of neoadjuvant ADT followed by RT and additional 6 mo of ADT. ASTRO Phoenix definition was used to define biochemical relapse.
RESULTS Median follow up duration was 125 months. Ninety-six patients (56%) had castrate testosterone level < 20 ng/dL and 139 patients (80%) had castrate testosterone level < 50 ng/dL. Both values are valid at predicting BRFS. However, patients with testosterone < 20 ng/dL have significantly better BRFS compared to other groups (P = 0.003). When we compare two values, it was found that using 20 ng/dL is better than 50 ng/dL in predicting the BRFS (AUC = 0.63 vs 0.58, respectively).
CONCLUSION Castrate testosterone level of less than 20 ng/dL is associated with better BRFS and is better in predicting the BRFS. Further studies using current standard of care of high dose IMRT and longer ADT duration might support these findings.
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Affiliation(s)
- Gokhan Ozyigit
- Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara 06100, Turkey M.D
| | - Pervin Hurmuz
- Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara 06100, Turkey M.D
| | - Deniz Yuce
- Department of Preventive Oncology, Hacettepe University Faculty of Medicine, Ankara 06100, Turkey
| | - Fadil Akyol
- Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara 06100, Turkey M.D
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Ozyigit G, Onal C, Igdem S, Alicikus ZA, Iribas A, Akin M, Yalman D, Cetin I, Aksu MG, Atalar B, Dincbas F, Hurmuz P, Guler OC, Aydin B, Sert F, Yildirim C, Gorken IB, Agaoglu FY, Korcum AF, Yuce D, Ozkok S, Darendeliler E, Akyol F. Treatment outcomes of prostate cancer patients with Gleason score 8-10 treated with definitive radiotherapy : TROD 09-001 multi-institutional study. Strahlenther Onkol 2019; 195:882-893. [PMID: 31143994 DOI: 10.1007/s00066-019-01476-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 05/10/2019] [Indexed: 12/14/2022]
Abstract
PURPOSE To validate the clinical outcomes and prognostic factors in prostate cancer (PCa) patients with Gleason score (GS) 8-10 disease treated with external beam radiotherapy (EBRT) + androgen deprivation therapy (ADT) in the modern era. METHODS Institutional databases of biopsy proven 641 patients with GS 8-10 PCa treated between 2000 and 2015 were collected from 11 institutions. In this multi-institutional Turkish Radiation Oncology Group study, a standard database sheet was sent to each institution for patient enrollment. The inclusion criteria were, T1-T3N0M0 disease according to AJCC (American Joint Committee on Cancer) 2010 Staging System, no prior diagnosis of malignancy, at least 70 Gy total irradiation dose to prostate ± seminal vesicles delivered with either three-dimensional conformal RT or intensity-modulated RT and patients receiving ADT. RESULTS The median follow-up time was 5.9 years (range 0.4-18.2 years); 5‑year overall survival (OS), biochemical relapse-free survival (BRFS) and distant metastases-free survival (DMFS) rates were 88%, 78%, and 79%, respectively. Higher RT doses (≥78 Gy) and longer ADT duration (≥2 years) were significant predictors for improved DMFS, whereas advanced stage was a negative prognosticator for DMFS in patients with GS 9-10. CONCLUSIONS Our results validated the fact that oncologic outcomes after radical EBRT significantly differ in men with GS 8 versus those with GS 9-10 prostate cancer. We found that EBRT dose was important predictive factor regardless of ADT period. Patients receiving 'non-optimal treatment' (RT doses <78 Gy and ADT period <2 years) had the worst treatment outcomes.
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Affiliation(s)
- Gokhan Ozyigit
- Department of Radiation Oncology, Hacettepe University, Faculty of Medicine, 06100, Ankara, Turkey.
| | - Cem Onal
- Adana Dr Turgut Noyan Research and Treatment Center, Department of Radiation Oncology, Baskent University, Adana, Turkey
| | - Sefik Igdem
- Department of Radiation Oncology, İstanbul Bilim University, Faculty of Medicine, Istanbul, Turkey
| | - Zumre Arican Alicikus
- Department of Radiation Oncology, Dokuz Eylul University, Faculty of Medicine, Izmir, Turkey
| | - Ayca Iribas
- Istanbul Oncology Institute, Department of Radiation Oncology, İstanbul University, Istanbul, Turkey
| | | | - Deniz Yalman
- Department of Radiation Oncology, Ege University, Faculty of Medicine, Izmir, Turkey
| | - Ilknur Cetin
- Department of Radiation Oncology, Marmara University, Faculty of Medicine, Istanbul, Turkey
| | - Melek Gamze Aksu
- Department of Radiation Oncology, Akdeniz University, Faculty of Medicine, Antalya, Turkey
| | - Banu Atalar
- Department of Radiation Oncology, Acibadem University, Faculty of Medicine, Istanbul, Turkey
| | - Fazilet Dincbas
- Cerrahpasa Faculty of Medicine, Department of Radiation Oncology, İstanbul University-Cerrahpasa, Istanbul, Turkey
| | - Pervin Hurmuz
- Department of Radiation Oncology, Hacettepe University, Faculty of Medicine, 06100, Ankara, Turkey
| | - Ozan Cem Guler
- Adana Dr Turgut Noyan Research and Treatment Center, Department of Radiation Oncology, Baskent University, Adana, Turkey
| | - Barbaros Aydin
- Department of Radiation Oncology, Dokuz Eylul University, Faculty of Medicine, Izmir, Turkey
| | - Fatma Sert
- Department of Radiation Oncology, Ege University, Faculty of Medicine, Izmir, Turkey
| | - Cumhur Yildirim
- Cerrahpasa Faculty of Medicine, Department of Radiation Oncology, İstanbul University-Cerrahpasa, Istanbul, Turkey
| | - Ilknur Birkay Gorken
- Department of Radiation Oncology, Dokuz Eylul University, Faculty of Medicine, Izmir, Turkey
| | - Fulya Yaman Agaoglu
- Istanbul Oncology Institute, Department of Radiation Oncology, İstanbul University, Istanbul, Turkey
| | - Aylin Fidan Korcum
- Department of Radiation Oncology, Akdeniz University, Faculty of Medicine, Antalya, Turkey
| | - Deniz Yuce
- Department of Prevantive Oncology, Hacettepe University, Hacettepe Cancer Institute, Ankara, Turkey
| | - Serdar Ozkok
- Department of Radiation Oncology, Ege University, Faculty of Medicine, Izmir, Turkey
| | - Emin Darendeliler
- Istanbul Oncology Institute, Department of Radiation Oncology, İstanbul University, Istanbul, Turkey
| | - Fadil Akyol
- Department of Radiation Oncology, Hacettepe University, Faculty of Medicine, 06100, Ankara, Turkey
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Lacin S, Tasar GE, Usubutun A, Arik Z, Karakas Y, Yuce D, Salman MC, Kars A. Is microsatellite instability a negative prognostic factor in early stage endometrial cancer patients? J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e17107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e17107 Background: Endometrial cancer(EC) is a heterogeneous disease with diverse histological features and biological behaviour. Microsatellite instability (MSI) which occurs in cancerous tissue secondary to mismatch repair (MMR) defect of hereditary or somatic origin is a well-known feature further diversifying genetic tumor landscape. In this study, we aim to investigate the relationship between MSI and prognosis in patients with early stage EC. Methods: The patients diagnosed with EC between 2004 and 2017 were retrospectively analysed in the study. The demographic characteristics, disease stage, menopausal status, and clinical and laboratory values were noted. MLH1, MSH2, MSH6 and PMS2 antibodies were used to detect microsatellite status within the tumor tissue samples. Results: The mean age of the 93 patients and menopause was 60.6 ± 9.8 and 49.68 ± 4.5 years , respectively. The median follow-up period was 28 (1-110) months. At the time of diagnosis, number of the patients with stage IA, IB, II, III, and IV were 5, 64, 8, 14, and 2, respectively. Forty three patients were grad 1, 23 patients grad 2, and 27 patients were grade 3. In terms of microsatellite status, 59 patients (63.4%) were microsatellite stable (MSS) and 34 patients (36.6%) were microsatellite instable(MSI). There was no significant association between MSI and tumor stage or grade (X2 = 1.97 p = 0.74 and X2= 3.2, p = 0.19, respectively). There was a significant relationship between peritumoral lymphocyte infiltration rate (pTIL) and MSI. PTIL ratio was higher in tumoral tissues with MSI, whereas pTIL was low in MSS tumor tissues (X2= 28.6, p < 0.0001). Patients with MSI tended to have poorer survival than patients with MSS irrespective of disease stage; mOS rates were 76 and 91 months, respectively (p = 0.086). However, patients with early stage disease and MSI had significantly poorer survial in comparison to patients with similar disease stage and MSS: Overall survival rates for patients with MSI and MSS were 75.8 and 94.7 months, respectively (Log-rank p = 0.048). Conclusions: There is a limited number of studies assessing the association between MSI and clinical outcomes in EC. Our study hints at the presence of potential relationship between MSI and pognosis in patients with MSI. Similar to previous studies performed with various types of tumors we found that EC with MSI attract more immune cells to tumor microenvironments. Interestingly, patients with MSI tended to have poorer prognosis despite augmented immune-cell inftration.
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Affiliation(s)
- Sahin Lacin
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Gozde Elif Tasar
- Department of Medical Pathology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Alp Usubutun
- Department of Medical Pathology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Zafer Arik
- Hacettepe University Institute of Oncology, Department of Medical Oncology, Ankara, Turkey
| | - Yusuf Karakas
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Deniz Yuce
- Hacettepe University Cancer Institute, Department of Preventive Oncology, Ankara, Turkey
| | - Mehmet Coskun Salman
- Department of Obstetrics and Gynecology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ayse Kars
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
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Ozyigit G, Hurmuz P, Yuce D, Akyol F. PO-0838 Castrate testosterone predicts biochemical relapse free survival in non-metastatic prostate cancer. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31258-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
BACKGROUND Repeated exposure to a given perturbation of the postural control system has been shown to cause learning of more efficient postural strategies for maintaining balance both within a session and over time. It is important to show whether outcomes from treatment strategies are related to the effectiveness of training or are the result of the learning of the test process. OBJECTIVE To investigate the learning effect of the dynamic postural stability evaluation system. METHODS We studied 20 healthy young subjects (13 females and 7 males), with a mean age of 22.3 ± 1.9 years. Limits of stability and postural sway were assessed. All participants completed the standardized dynamic postural stability evaluation test (Bertec, Bertec Corporation, Columbus, OH, USA) seven times. The test was performed in both eyes open and eyes closed conditions. RESULTS There were differences in the limits of stability scores for backward (p= 0.042), left side (p= 0.05), and the total score (p= 0.04). There were significant differences in postural sway anteroposterior direction in perturbed surface with eyes closed condition (p= 0.004) and total limits of stability scores of perturbed surface with eyes closed condition (p= 0.046). CONCLUSIONS The study showed that balance test scores stabilized at different sessions from 1st to 3rd assessment period. Maximum normalized scores were reached at the third trial.
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Affiliation(s)
- Hilal Keklicek
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Trakya University, Edirne, Turkey
| | - Elif Kırdı
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Ali Yalcin
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Deniz Yuce
- Department of Preventive Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Semra Topuz
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
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Atta N, Kilickap S, Yuce D, Hayran M. Reproductive cancer risk factors among relatives of cancer patients in a tertiary oncology center. BMC Cancer 2019; 19:154. [PMID: 30770749 PMCID: PMC6377741 DOI: 10.1186/s12885-019-5350-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 02/04/2019] [Indexed: 12/02/2022] Open
Abstract
Background The aim of this study was to evaluate the prevalence of some gynecological cancer risk factors in a population of female relatives of cancer patients in Hacettepe University Oncology Hospital. Additionally, what are the levels of the women’s awareness /behavior toward available screening tools? Methods An individual cancer risk assessment questionnaire has been developed in the Department of Preventive Oncology, which questions the medical history, health behaviors and cancer awareness, as well as their behavior toward available cancer screening tools. Results The mean age of the study population was 45.7 ± 12.2 years. Median age at menarche was 13 years (IQR, 12–14), 6.9% of the women reported their menarche was before age of 12. About 11.1% of the women had intercourse before age of 18. The median age at first delivery was 22 years. Median BMI was 24.9, with 18.3% of population having obesity. Of the women 65% were current/past smokers. Sixty-two percent of the women had never used condom. About 8% of the women were unaware about mammography and 17.7% about the Pap test. Conclusions This study has documented high tobacco use, low protective condom use and low rates of physical activity. Percentage of some risk factors like early menarche was lower than what was suggested for general Turkish population. Awareness and behavior of the women were better about mammography when compared to the Pap test. Considering our results, some measures should be put in place to increase people’s awareness, and to modify their behavior toward cancer prevention.
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Affiliation(s)
- Nooria Atta
- Department of Obstetrics and Gynecology, Kabul Medical University, Kabul, Afghanistan. .,Department of preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey.
| | - Saadettin Kilickap
- Department of preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Deniz Yuce
- Department of preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Mutlu Hayran
- Department of preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
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Ercan ES, Polanczyk G, Akyol Ardıc U, Yuce D, Karacetın G, Tufan AE, Tural U, Aksu H, Aktepe E, Rodopman Arman A, Başgül S, Bılac O, Coşkun M, Celık GG, Karakoc Demırkaya S, Dursun BO, Durukan İ, Fidan T, Perdahlı Fiş N, Gençoğlan S, Gökçen C, Görker I, Görmez V, Gündoğdu ÖY, Gürkan CK, Hergüner S, Tural Hesapçıoğlu S, Kandemir H, Kılıç BG, Kılınçaslan A, Mutluer T, Nasiroğlu S, Özel Özcan Ö, Öztürk M, Öztop D, Yalın Sapmaz S, Süren S, Şahin N, Yolga Tahıroglu A, Toros F, Ünal F, Vural P, Perçinel Yazıcı İ, Yazıcı KU, Yıldırım V, Yulaf Y, Yüce M, Yüksel T, Akdemir D, Altun H, Ayık B, Bilgic A, Hekim Bozkurt Ö, Demirbaş Çakır E, Çeri V, Üçok Demir N, Dinç G, Irmak MY, Karaman D, Kınık MF, Mazlum B, Memik NÇ, Foto Özdemir D, Sınır H, Ince Taşdelen B, Taşkın B, Uğur Ç, Uran P, Uysal T, Üneri Ö, Yilmaz S, Seval Yılmaz S, Açıkel B, Aktaş H, Alaca R, Alıç BG, Almaidan M, Arı FP, Aslan C, Atabay E, Ay MG, Aydemir H, Ayrancı G, Babadagı Z, Bayar H, Çon Bayhan P, Bayram Ö, Dikmeer Bektaş N, Berberoğlu KK, Bostan R, Arıcı Canlı M, Cansız MA, Ceylan C, Coşkun N, Coşkun S, Çakan Y, Demir İ, Demir N, Yıldırım Demirdöğen E, Doğan B, Dönmez YE, Dönder F, Efe A, Eray Ş, Erbilgin S, Erden S, Ersoy EG, Eseroğlu T, Kına Fırat S, Eynallı Gök E, Güler G, Güles Z, Güneş S, Güneş A, Günay G, Gürbüz Özgür B, Güven G, Çelik Göksoy Ş, Horozcu H, Irmak A, Işık Ü, Kahraman Ö, Kalaycı BM, Karaaslan U, Karadağ M, Kılıc HT, Kılıçaslan F, Kınay D, Kocael Ö, Bulanık Koç E, Kadir Mutlu R, Lushi-Şan Z, Nalbant K, Okumus N, Özbek F, Akkuş Özdemir F, Özdemir H, Özkan S, Yıldırım Özyurt E, Polat B, Polat H, Sekmen E, Sertçelik M, Sevgen FH, Sevince O, Süleyman F, Shamkhalova Ü, Eren Şimşek N, Tanır Y, Tekden M, Temtek S, Topal M, Topal Z, Türk T, Uçar HN, Uçar F, Uygun D, Uzun N, Vatansever Z, Yazgılı NG, Miniksar Yıldız D, Yıldız N. The prevalence of childhood psychopathology in Turkey: a cross-sectional multicenter nationwide study (EPICPAT-T). Nord J Psychiatry 2019; 73:132-140. [PMID: 30964388 DOI: 10.1080/08039488.2019.1574892] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
AIM The aim of this study was to determine the prevalence of childhood psychopathologies in Turkey. METHOD A nation-wide, randomly selected, representative population of 5830 children (6-13 years-old) enrolled as a 2nd,3rd or 4th grade student in 30 cities were evaluated for presence of a psychiatric or mental disorder by a Sociodemographic Form, Kiddie Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version (K-SADS-PL), and DSM-IV-Based Screening Scale for Disruptive Behavior Disorders in Children and Adolescents scales. Impairment criterion was assessed via a 3 point-Likert scale by the parent and the teacher independently. RESULTS Overall prevalence of any psychopathology was 37.6% without impairment criterion, and 17.1% with impairment criterion. Attention-deficit hyperactivity disorder was the most frequent diagnosis, followed by anxiety (19.5% and 16.7% without impairment, 12.4% and 5.3% with impairment, respectively). Lower education level and presence of a physical or psychiatric problem of the parents were independent predictors of any psychopathology of the offspring. CONCLUSION This is the largest and most comprehensive epidemiological study to determine the prevalence of psychopathologies in children and adolescents in Turkey. Our results partly higher than, and partly comparable to previous national and international studies. It also contributes to the literature by determining the independent predictors of psychopathologies in this age group.
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Affiliation(s)
- Eyup Sabri Ercan
- a Child and Adolescent Psychiatry Department, Medical Faculty , Ege University , Izmir , Turkey
| | - Guilherme Polanczyk
- b Department of Psychiatry , University of Sao Paulo Medical School , São Paulo , BR
| | - Ulku Akyol Ardıc
- c Child and Adolescent Psychiatry Department , Denizli State Hospital , Denizli , Turkey
| | - Deniz Yuce
- d Department of Preventive Oncology and Epidemiology , Cancer Institute, Hacettepe University , Ankara , Turkey
| | - Gul Karacetın
- e Child and Adolescent Psychiatry Department, Medical Faculty , Bakirkoy Prof. Dr. Mazhar OSMAN Training and Research Hospital for Mental Health and Nervous Disorders , Istanbul , Turkey
| | - Ali Evren Tufan
- f Child and Adolescent Psychiatry Department, Medical Faculty , Acıbadem University , Istanbul , Turkey
| | - Umit Tural
- g Psychiatry Department, Medical Faculty , Kocaeli University , Izmit , Turkey
| | - Hatice Aksu
- h Child and Adolescent Psychiatry Department, Medical Faculty , Adnan Menderes University , Aydın , Turkey
| | - Evrim Aktepe
- i Child and Adolescent Psychiatry Department, Medical Faculty , Suleyman Demirel University , Isparta , Turkey
| | - Ayşe Rodopman Arman
- j Child and Adolescent Psychiatry Department, Medical Faculty , Marmara University , Istanbul , Turkey
| | - Senem Başgül
- k Child and Adolescent Psychiatry Department, Medical Faculty , Private Clinic , Istanbul , Turkey
| | - Oznur Bılac
- l Child and Adolescent Psychiatry Department, Medical Faculty , Manisa Hospital for Mental Health and Nervous Disorders , Manisa , Turkey
| | - Murat Coşkun
- m Child and Adolescent Psychiatry Department, Medical Faculty , Istanbul University , Istanbul , Turkey
| | - Gonca Gul Celık
- n Child and Adolescent Psychiatry Department, Medical Faculty , Çukurova University , Adana , Turkey
| | - Sevcan Karakoc Demırkaya
- h Child and Adolescent Psychiatry Department, Medical Faculty , Adnan Menderes University , Aydın , Turkey
| | - Burak Onur Dursun
- o Child and Adolescent Psychiatry Department, Medical Faculty , Ataturk University , Erzurum , Turkey
| | - İbrahim Durukan
- p Child and Adolescent Psychiatry Department, Medical Faculty , Gülhane Training and Research Hospital , Ankara , Turkey
| | - Tülin Fidan
- q Child and Adolescent Psychiatry Department, Medical Faculty , Osmangazi University , Eskişehir , Turkey
| | - Neşe Perdahlı Fiş
- j Child and Adolescent Psychiatry Department, Medical Faculty , Marmara University , Istanbul , Turkey
| | - Salih Gençoğlan
- r Child and Adolescent Psychiatry Department, Medical Faculty , Private Clinic , Van , Turkey
| | - Cem Gökçen
- s Child and Adolescent Psychiatry Department, Medical Faculty , Gaziantep University , Gaziantep , Turkey
| | - Işık Görker
- t Child and Adolescent Psychiatry Department, Medical Faculty , Trakya University , Edirne , Turkey
| | - Vahdet Görmez
- u Child and Adolescent Psychiatry Department, Medical Faculty , Bezmi-alem University , Istanbul , Turkey
| | - Özlem Yıldız Gündoğdu
- v Child and Adolescent Psychiatry Department, Medical Faculty , Kocaeli University , Kocaeli , Turkey
| | - Cihat Kaan Gürkan
- w Child and Adolescent Psychiatry Department, Medical Faculty , Ankara University , Ankara , Turkey
| | - Sabri Hergüner
- x Child and Adolescent Psychiatry Department, Medical Faculty , Necmettin Erbakan University , Konya , Turkey
| | - Selma Tural Hesapçıoğlu
- y Child and Adolescent Psychiatry Department, Medical Faculty , Karadeniz Technical University , Trabzon , Turkey
| | - Hasan Kandemir
- z Child and Adolescent Psychiatry Department, Medical Faculty , Harran University , Sanlıurfa , Turkey
| | - Birim Günay Kılıç
- w Child and Adolescent Psychiatry Department, Medical Faculty , Ankara University , Ankara , Turkey
| | - Ayse Kılınçaslan
- m Child and Adolescent Psychiatry Department, Medical Faculty , Istanbul University , Istanbul , Turkey
| | - Tuba Mutluer
- r Child and Adolescent Psychiatry Department, Medical Faculty , Private Clinic , Van , Turkey
| | - Serhat Nasiroğlu
- aa Child and Adolescent Psychiatry Department, Medical Faculty , Sakarya University , Sakarya , Turkey
| | - Özlem Özel Özcan
- ab Child and Adolescent Psychiatry Department, Medical Faculty , Inonu University , Malatya , Turkey
| | - Mücahit Öztürk
- k Child and Adolescent Psychiatry Department, Medical Faculty , Private Clinic , Istanbul , Turkey
| | - Didem Öztop
- ac Child and Adolescent Psychiatry Department, Medical Faculty , Erciyes University , Kayseri , Turkey
| | - Sermin Yalın Sapmaz
- ad Child and Adolescent Psychiatry Department, Medical Faculty , Celal Bayar University , Manisa , Turkey
| | - Serkan Süren
- ae Child and Adolescent Psychiatry Department, Medical Faculty , 19 May University, Samsun , Turkey
| | - Nilfer Şahin
- af Child and Adolescent Psychiatry Department, Medical Faculty , Muğla Sıtkı Koçman University , Muğla , Turkey
| | - Aysegul Yolga Tahıroglu
- n Child and Adolescent Psychiatry Department, Medical Faculty , Çukurova University , Adana , Turkey
| | - Fevziye Toros
- ag Child and Adolescent Psychiatry Department, Medical Faculty , Mersin University , Mersin , Turkey
| | - Fatih Ünal
- ah Child and Adolescent Psychiatry Department, Medical Faculty , Hacettepe University , Ankara , Turkey
| | - Pınar Vural
- ai Child and Adolescent Psychiatry Department, Medical Faculty , Uludağ University , Bursa , Turkey
| | - İpek Perçinel Yazıcı
- aj Child and Adolescent Psychiatry Department, Medical Faculty , Fırat University , Elazığ , Turkey
| | - Kemal Utku Yazıcı
- aj Child and Adolescent Psychiatry Department, Medical Faculty , Fırat University , Elazığ , Turkey
| | - Veli Yıldırım
- ag Child and Adolescent Psychiatry Department, Medical Faculty , Mersin University , Mersin , Turkey
| | - Yasemin Yulaf
- ak Child and Adolescent Psychiatry Department, Medical Faculty , Private Clinic , Tekirdağ , Turkey
| | - Murat Yüce
- ae Child and Adolescent Psychiatry Department, Medical Faculty , 19 May University, Samsun , Turkey
| | - Tuğba Yüksel
- al Child and Adolescent Psychiatry Department, Medical Faculty , Dıcle University , Diyarbakır , Turkey
| | - Devrim Akdemir
- ah Child and Adolescent Psychiatry Department, Medical Faculty , Hacettepe University , Ankara , Turkey
| | - Hatice Altun
- am Child and Adolescent Psychiatry Department, Medical Faculty , Kahramanmaras Sutcu Imam University , Kahramanmaraş , Turkey
| | - Başak Ayık
- an Child and Adolescent Psychiatry Department, Medical Faculty , Usküdar University , İstanbul , Turkey
| | - Ayhan Bilgic
- x Child and Adolescent Psychiatry Department, Medical Faculty , Necmettin Erbakan University , Konya , Turkey
| | - Özlem Hekim Bozkurt
- ao Child and Adolescent Psychiatry Department, Medical Faculty , Ankara Hematology and Oncology Child Health and Diseases Training and Research Hospital , Ankara , Turkey
| | - Emine Demirbaş Çakır
- ap Child and Adolescent Psychiatry Department, Medical Faculty , Abant Izzet Baysal University , Bolu , Turkey
| | - Veysi Çeri
- j Child and Adolescent Psychiatry Department, Medical Faculty , Marmara University , Istanbul , Turkey
| | - Nagehan Üçok Demir
- j Child and Adolescent Psychiatry Department, Medical Faculty , Marmara University , Istanbul , Turkey
| | - Gülser Dinç
- ao Child and Adolescent Psychiatry Department, Medical Faculty , Ankara Hematology and Oncology Child Health and Diseases Training and Research Hospital , Ankara , Turkey
| | - Mustafa Yasin Irmak
- j Child and Adolescent Psychiatry Department, Medical Faculty , Marmara University , Istanbul , Turkey
| | - Dursun Karaman
- p Child and Adolescent Psychiatry Department, Medical Faculty , Gülhane Training and Research Hospital , Ankara , Turkey
| | - Mehmet Fatih Kınık
- v Child and Adolescent Psychiatry Department, Medical Faculty , Kocaeli University , Kocaeli , Turkey
| | - Betül Mazlum
- k Child and Adolescent Psychiatry Department, Medical Faculty , Private Clinic , Istanbul , Turkey
| | - Nursu Çakın Memik
- v Child and Adolescent Psychiatry Department, Medical Faculty , Kocaeli University , Kocaeli , Turkey
| | - Dilşad Foto Özdemir
- ah Child and Adolescent Psychiatry Department, Medical Faculty , Hacettepe University , Ankara , Turkey
| | - Hayati Sınır
- am Child and Adolescent Psychiatry Department, Medical Faculty , Kahramanmaras Sutcu Imam University , Kahramanmaraş , Turkey
| | - Bedia Ince Taşdelen
- aq Child and Adolescent Psychiatry Department, Medical Faculty , Kayseri Education and Research Hospital , Kayseri , Turkey
| | - Beril Taşkın
- k Child and Adolescent Psychiatry Department, Medical Faculty , Private Clinic , Istanbul , Turkey
| | - Çağatay Uğur
- ao Child and Adolescent Psychiatry Department, Medical Faculty , Ankara Hematology and Oncology Child Health and Diseases Training and Research Hospital , Ankara , Turkey
| | - Pınar Uran
- ar Child and Adolescent Psychiatry Department, Medical Faculty , Ankara Hospital , Ankara , Turkey
| | - Taciser Uysal
- as Child and Adolescent Psychiatry Department, Medical Faculty , Maternity and Child Health Hospital , Isparta , Turkey
| | - Özden Üneri
- ao Child and Adolescent Psychiatry Department, Medical Faculty , Ankara Hematology and Oncology Child Health and Diseases Training and Research Hospital , Ankara , Turkey
| | - Savas Yilmaz
- x Child and Adolescent Psychiatry Department, Medical Faculty , Necmettin Erbakan University , Konya , Turkey
| | - Sultan Seval Yılmaz
- j Child and Adolescent Psychiatry Department, Medical Faculty , Marmara University , Istanbul , Turkey
| | - Burak Açıkel
- x Child and Adolescent Psychiatry Department, Medical Faculty , Necmettin Erbakan University , Konya , Turkey
| | - Hüseyin Aktaş
- al Child and Adolescent Psychiatry Department, Medical Faculty , Dıcle University , Diyarbakır , Turkey
| | - Rümeysa Alaca
- al Child and Adolescent Psychiatry Department, Medical Faculty , Dıcle University , Diyarbakır , Turkey
| | - Betül Gül Alıç
- w Child and Adolescent Psychiatry Department, Medical Faculty , Ankara University , Ankara , Turkey
| | - Mahmut Almaidan
- p Child and Adolescent Psychiatry Department, Medical Faculty , Gülhane Training and Research Hospital , Ankara , Turkey
| | - Fatma Pınar Arı
- q Child and Adolescent Psychiatry Department, Medical Faculty , Osmangazi University , Eskişehir , Turkey
| | - Cihan Aslan
- ah Child and Adolescent Psychiatry Department, Medical Faculty , Hacettepe University , Ankara , Turkey
| | - Ender Atabay
- j Child and Adolescent Psychiatry Department, Medical Faculty , Marmara University , Istanbul , Turkey
| | - Merve Günay Ay
- w Child and Adolescent Psychiatry Department, Medical Faculty , Ankara University , Ankara , Turkey
| | - Hilal Aydemir
- ao Child and Adolescent Psychiatry Department, Medical Faculty , Ankara Hematology and Oncology Child Health and Diseases Training and Research Hospital , Ankara , Turkey
| | - Gülseda Ayrancı
- j Child and Adolescent Psychiatry Department, Medical Faculty , Marmara University , Istanbul , Turkey
| | - Zehra Babadagı
- ae Child and Adolescent Psychiatry Department, Medical Faculty , 19 May University, Samsun , Turkey
| | - Hasan Bayar
- s Child and Adolescent Psychiatry Department, Medical Faculty , Gaziantep University , Gaziantep , Turkey
| | - Pelin Çon Bayhan
- ab Child and Adolescent Psychiatry Department, Medical Faculty , Inonu University , Malatya , Turkey
| | - Özlem Bayram
- x Child and Adolescent Psychiatry Department, Medical Faculty , Necmettin Erbakan University , Konya , Turkey
| | - Neşe Dikmeer Bektaş
- ah Child and Adolescent Psychiatry Department, Medical Faculty , Hacettepe University , Ankara , Turkey
| | - Kıvanç Kudret Berberoğlu
- t Child and Adolescent Psychiatry Department, Medical Faculty , Trakya University , Edirne , Turkey
| | - Recep Bostan
- ag Child and Adolescent Psychiatry Department, Medical Faculty , Mersin University , Mersin , Turkey
| | - Merve Arıcı Canlı
- w Child and Adolescent Psychiatry Department, Medical Faculty , Ankara University , Ankara , Turkey
| | - Mehmet Akif Cansız
- ap Child and Adolescent Psychiatry Department, Medical Faculty , Abant Izzet Baysal University , Bolu , Turkey
| | - Cansın Ceylan
- t Child and Adolescent Psychiatry Department, Medical Faculty , Trakya University , Edirne , Turkey
| | - Neşe Coşkun
- k Child and Adolescent Psychiatry Department, Medical Faculty , Private Clinic , Istanbul , Turkey
| | - Seyma Coşkun
- s Child and Adolescent Psychiatry Department, Medical Faculty , Gaziantep University , Gaziantep , Turkey
| | - Yasemin Çakan
- m Child and Adolescent Psychiatry Department, Medical Faculty , Istanbul University , Istanbul , Turkey
| | - İbrahim Demir
- ao Child and Adolescent Psychiatry Department, Medical Faculty , Ankara Hematology and Oncology Child Health and Diseases Training and Research Hospital , Ankara , Turkey
| | - Nuran Demir
- ap Child and Adolescent Psychiatry Department, Medical Faculty , Abant Izzet Baysal University , Bolu , Turkey
| | - Esen Yıldırım Demirdöğen
- o Child and Adolescent Psychiatry Department, Medical Faculty , Ataturk University , Erzurum , Turkey
| | - Büşra Doğan
- ah Child and Adolescent Psychiatry Department, Medical Faculty , Hacettepe University , Ankara , Turkey
| | - Yunus Emre Dönmez
- ab Child and Adolescent Psychiatry Department, Medical Faculty , Inonu University , Malatya , Turkey
| | - Funda Dönder
- v Child and Adolescent Psychiatry Department, Medical Faculty , Kocaeli University , Kocaeli , Turkey
| | - Ayşegül Efe
- w Child and Adolescent Psychiatry Department, Medical Faculty , Ankara University , Ankara , Turkey
| | - Şafak Eray
- ai Child and Adolescent Psychiatry Department, Medical Faculty , Uludağ University , Bursa , Turkey
| | - Seda Erbilgin
- m Child and Adolescent Psychiatry Department, Medical Faculty , Istanbul University , Istanbul , Turkey
| | - Semih Erden
- ah Child and Adolescent Psychiatry Department, Medical Faculty , Hacettepe University , Ankara , Turkey
| | - Elif Gökçe Ersoy
- q Child and Adolescent Psychiatry Department, Medical Faculty , Osmangazi University , Eskişehir , Turkey
| | - Tuğba Eseroğlu
- e Child and Adolescent Psychiatry Department, Medical Faculty , Bakirkoy Prof. Dr. Mazhar OSMAN Training and Research Hospital for Mental Health and Nervous Disorders , Istanbul , Turkey
| | - Sümeyra Kına Fırat
- w Child and Adolescent Psychiatry Department, Medical Faculty , Ankara University , Ankara , Turkey
| | - Ezgi Eynallı Gök
- n Child and Adolescent Psychiatry Department, Medical Faculty , Çukurova University , Adana , Turkey
| | - Gülen Güler
- ag Child and Adolescent Psychiatry Department, Medical Faculty , Mersin University , Mersin , Turkey
| | - Zafer Güles
- h Child and Adolescent Psychiatry Department, Medical Faculty , Adnan Menderes University , Aydın , Turkey
| | - Serkan Güneş
- ag Child and Adolescent Psychiatry Department, Medical Faculty , Mersin University , Mersin , Turkey
| | - Adem Güneş
- at Child and Adolescent Psychiatry Department , Private clinic , Istanbul , Turkey
| | - Gülay Günay
- at Child and Adolescent Psychiatry Department , Private clinic , Istanbul , Turkey
| | - Börte Gürbüz Özgür
- h Child and Adolescent Psychiatry Department, Medical Faculty , Adnan Menderes University , Aydın , Turkey
| | - Gökçen Güven
- at Child and Adolescent Psychiatry Department , Private clinic , Istanbul , Turkey
| | - Şeyda Çelik Göksoy
- at Child and Adolescent Psychiatry Department , Private clinic , Istanbul , Turkey
| | - Havvana Horozcu
- ah Child and Adolescent Psychiatry Department, Medical Faculty , Hacettepe University , Ankara , Turkey
| | - Ayşe Irmak
- ac Child and Adolescent Psychiatry Department, Medical Faculty , Erciyes University , Kayseri , Turkey
| | - Ümit Işık
- x Child and Adolescent Psychiatry Department, Medical Faculty , Necmettin Erbakan University , Konya , Turkey
| | - Özlem Kahraman
- ac Child and Adolescent Psychiatry Department, Medical Faculty , Erciyes University , Kayseri , Turkey
| | - Bilge Merve Kalaycı
- ah Child and Adolescent Psychiatry Department, Medical Faculty , Hacettepe University , Ankara , Turkey
| | - Umut Karaaslan
- am Child and Adolescent Psychiatry Department, Medical Faculty , Kahramanmaras Sutcu Imam University , Kahramanmaraş , Turkey
| | - Mehmet Karadağ
- s Child and Adolescent Psychiatry Department, Medical Faculty , Gaziantep University , Gaziantep , Turkey
| | - Hilal Tuğba Kılıc
- w Child and Adolescent Psychiatry Department, Medical Faculty , Ankara University , Ankara , Turkey
| | - Fethiye Kılıçaslan
- z Child and Adolescent Psychiatry Department, Medical Faculty , Harran University , Sanlıurfa , Turkey
| | - Duygu Kınay
- at Child and Adolescent Psychiatry Department , Private clinic , Istanbul , Turkey
| | - Ömer Kocael
- ai Child and Adolescent Psychiatry Department, Medical Faculty , Uludağ University , Bursa , Turkey
| | - Esra Bulanık Koç
- at Child and Adolescent Psychiatry Department , Private clinic , Istanbul , Turkey
| | - Rahime Kadir Mutlu
- ah Child and Adolescent Psychiatry Department, Medical Faculty , Hacettepe University , Ankara , Turkey
| | - Zejnep Lushi-Şan
- ac Child and Adolescent Psychiatry Department, Medical Faculty , Erciyes University , Kayseri , Turkey
| | - Kevser Nalbant
- ah Child and Adolescent Psychiatry Department, Medical Faculty , Hacettepe University , Ankara , Turkey
| | - Nilüfer Okumus
- v Child and Adolescent Psychiatry Department, Medical Faculty , Kocaeli University , Kocaeli , Turkey
| | - Fatih Özbek
- at Child and Adolescent Psychiatry Department , Private clinic , Istanbul , Turkey
| | - Fatma Akkuş Özdemir
- w Child and Adolescent Psychiatry Department, Medical Faculty , Ankara University , Ankara , Turkey
| | - Hanife Özdemir
- j Child and Adolescent Psychiatry Department, Medical Faculty , Marmara University , Istanbul , Turkey
| | - Selçuk Özkan
- p Child and Adolescent Psychiatry Department, Medical Faculty , Gülhane Training and Research Hospital , Ankara , Turkey
| | - Esra Yıldırım Özyurt
- v Child and Adolescent Psychiatry Department, Medical Faculty , Kocaeli University , Kocaeli , Turkey
| | - Berna Polat
- ag Child and Adolescent Psychiatry Department, Medical Faculty , Mersin University , Mersin , Turkey
| | - Hatice Polat
- aq Child and Adolescent Psychiatry Department, Medical Faculty , Kayseri Education and Research Hospital , Kayseri , Turkey
| | - Ebru Sekmen
- ao Child and Adolescent Psychiatry Department, Medical Faculty , Ankara Hematology and Oncology Child Health and Diseases Training and Research Hospital , Ankara , Turkey
| | - Mehmet Sertçelik
- w Child and Adolescent Psychiatry Department, Medical Faculty , Ankara University , Ankara , Turkey
| | - Feyza Hatice Sevgen
- am Child and Adolescent Psychiatry Department, Medical Faculty , Kahramanmaras Sutcu Imam University , Kahramanmaraş , Turkey
| | - Oğuz Sevince
- n Child and Adolescent Psychiatry Department, Medical Faculty , Çukurova University , Adana , Turkey
| | - Funda Süleyman
- at Child and Adolescent Psychiatry Department , Private clinic , Istanbul , Turkey
| | - Ülker Shamkhalova
- n Child and Adolescent Psychiatry Department, Medical Faculty , Çukurova University , Adana , Turkey
| | - Nurcan Eren Şimşek
- v Child and Adolescent Psychiatry Department, Medical Faculty , Kocaeli University , Kocaeli , Turkey
| | - Yaşar Tanır
- w Child and Adolescent Psychiatry Department, Medical Faculty , Ankara University , Ankara , Turkey
| | - Mehmet Tekden
- at Child and Adolescent Psychiatry Department , Private clinic , Istanbul , Turkey
| | - Seyhan Temtek
- ao Child and Adolescent Psychiatry Department, Medical Faculty , Ankara Hematology and Oncology Child Health and Diseases Training and Research Hospital , Ankara , Turkey
| | - Melike Topal
- at Child and Adolescent Psychiatry Department , Private clinic , Istanbul , Turkey
| | - Zehra Topal
- ap Child and Adolescent Psychiatry Department, Medical Faculty , Abant Izzet Baysal University , Bolu , Turkey
| | - Tuğba Türk
- at Child and Adolescent Psychiatry Department , Private clinic , Istanbul , Turkey
| | - Halit Necmi Uçar
- ai Child and Adolescent Psychiatry Department, Medical Faculty , Uludağ University , Bursa , Turkey
| | - Filiz Uçar
- ae Child and Adolescent Psychiatry Department, Medical Faculty , 19 May University, Samsun , Turkey
| | - Duygu Uygun
- ao Child and Adolescent Psychiatry Department, Medical Faculty , Ankara Hematology and Oncology Child Health and Diseases Training and Research Hospital , Ankara , Turkey
| | - Necati Uzun
- x Child and Adolescent Psychiatry Department, Medical Faculty , Necmettin Erbakan University , Konya , Turkey
| | - Zeynep Vatansever
- v Child and Adolescent Psychiatry Department, Medical Faculty , Kocaeli University , Kocaeli , Turkey
| | - Neslihan Gökçe Yazgılı
- ah Child and Adolescent Psychiatry Department, Medical Faculty , Hacettepe University , Ankara , Turkey
| | - Dilşat Miniksar Yıldız
- ab Child and Adolescent Psychiatry Department, Medical Faculty , Inonu University , Malatya , Turkey
| | - Nazike Yıldız
- t Child and Adolescent Psychiatry Department, Medical Faculty , Trakya University , Edirne , Turkey
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Korucu B, Helvaci O, Ozbas B, Yeter H, Yuce D, Elbeg S, Derici U. Low Copeptin Levels in Patients With Intradialytic Hypotension. Ther Apher Dial 2018; 23:460-466. [PMID: 30549206 DOI: 10.1111/1744-9987.12784] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 12/06/2018] [Accepted: 12/11/2018] [Indexed: 12/25/2022]
Abstract
Intradialytic hypotension (IDH) is related to high morbidity and mortality. There is evidence that arginine-vasopressin (AVP) responses could play a role. Copeptin is a reliable biomarker of AVP. In this study, copeptin, aldosterone, epinephrine, and norepinephrine levels in patients with IDH were evaluated throughout a hemodialysis (HD) session and compared with the control group. The study includes 15 patients who were normotensive during HD and 15 patients with IDH with a minimum HD vintage of 1 year. Blood samples were collected before the initiation of an HD session (T0 ), in the mid-session for control group, 30 min after mean arterial pressure drop for IDH patients (T1 ), and at the end of the session (T2 ). Groups had similar demographic features and health parameters, interdialytic weight gains, and ultrafiltration amounts. The IDH group had a mean arterial pressure decline of 39.9 (±6.4) mm Hg. Copeptin levels of the control group increased an average of 79.9 (±97.5) pmol/L at T1 and an additional 24.8 (±33.9) pmol/L at T2 . In the IDH group, copeptin level increases at T1 and T2 were 3.2 (±5.5) pmol/L and 34 (±44.6) pmol/L, respectively. Copeptin levels of the IDH group were significantly lower at T1 (P < 0.001) and at the T0 -T2 interval than control group (P = 0.05). In the control group, aldosterone levels distinctly decreased, and in the IDH group, aldosterone levels were elevated (P < 0.001). Small changes were detected in epinephrine and norepinephrine levels for both groups but did not reach significance (P = 0.6 and P = 0.3, respectively). Lower copeptin level alterations suggest inadequate AVP responses in patients with IDH.
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Affiliation(s)
- Berfu Korucu
- Department of Nephrology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Ozant Helvaci
- Department of Nephrology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Burak Ozbas
- Department of Nephrology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Hasan Yeter
- Department of Nephrology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Deniz Yuce
- Department of Preventive Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Sehri Elbeg
- Department of Biochemistry, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Ulver Derici
- Department of Nephrology, Gazi University Faculty of Medicine, Ankara, Turkey
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Yavas G, Yavas C, Celik E, Sen E, Ata O, Yuce D, Elsurer-Afsar R. P1.16-28 The Impact of Spironolactone on the Lung Injury Induced by Concomitant Trastuzumab and Thoracic Radiotherapy. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Yavas C, Yavas G, Celik E, Buyukyoruk A, Buyukyoruk C, Yuce D, Ata O. Beta-Hydroxy-Beta-Methyl-Butyrate, L-glutamine, and L-arginine Supplementation Improves Radiation-Induce Acute Intestinal Toxicity. J Diet Suppl 2018; 16:576-591. [PMID: 29969326 DOI: 10.1080/19390211.2018.1472709] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
We aimed to evaluate effects of β-hydroxy-β-methylbutyrate, L-glutamine, and L-arginine (HMB/GLN/ARG) on radiation-induced acute intestinal toxicity. Forty rats were divided into four groups: group (G) 1 was defined as control group, and G2 was radiation therapy (RT) control group. G3 and G4 were HMB/GLN/ARG control and RT plus HMB/GLN/ARG groups, respectively. HMB/GLN/ARG started from day of RT and continued until the animals were sacrificed 10 days after RT. The extent of surface epithelium smoothing, villous atrophy, lamina propria inflammation, cryptitis, crypt distortion, regenerative atypia, vascular dilatation and congestion, and fibrosis were quantified on histological sections of intestinal mucosa. Statistical analyses were performed using the analysis of variance (ANOVA) test. There were significant differences between study groups regarding extent of surface epithelium smoothing, villous atrophy, lamina propria inflammation, cryptitis and crypt distortion, regenerative atypia, vascular dilatation and congestion, and fibrosis (p values were 0.019 for fibrosis, <.001 for the others). Pair-wise comparisons revealed significant differences regarding surface epithelium smoothing, villous atrophy, lamina propria inflammation, cryptitis, vascular dilatation, and congestion between G2 and G4 (p values were <.001, .033, <.001, .007, and <.001, respectively). Fibrosis score was significantly different only between G1 and G2 (p = .015). Immunohistochemical TGF-β score of G2 was significantly higher than G1 and G3 (p values were .006 and .017, respectively). There was no difference between TGF-β staining scores of G2 and G4. Concomitant use of HMB/GLN/ARG appears to ameliorate radiation-induced acute intestinal toxicity; however, this finding should be clarified with further studies.
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Affiliation(s)
- Cagdas Yavas
- Selcuk University, Department of Radiation Oncology , Konya , Turkey
| | - Guler Yavas
- Selcuk University, Department of Radiation Oncology , Konya , Turkey
| | - Esin Celik
- Selcuk University, Department of Pathology , Konya , Turkey
| | - Ahmet Buyukyoruk
- Konya Training and Research Hospital, Department of Radiation Oncology , Konya , Turkey
| | - Cennet Buyukyoruk
- Necmettin Erbakan University, Department of Family Medicine , Konya , Turkey
| | - Deniz Yuce
- Hacettepe University, Department of Preventive Oncology , Ankara , Turkey
| | - Ozlem Ata
- Selcuk University, Department of Medical Oncology , Konya , Turkey
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Guven DC, Dizdar O, Akman AC, Berker E, Yekeduz E, Ceylan F, Baspinar B, Akbiyik I, Aktas BY, Yuce D, Erman M, Hayran M. Evaluation of cancer risk in patients with periodontal diseases. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e13571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Deniz Can Guven
- Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Omer Dizdar
- Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Abdullah Cevdet Akman
- Department of Periodontology, Hacettepe University Faculty of Dentistry, Ankara, Turkey
| | - Ezel Berker
- Department of Periodontology, Hacettepe University Faculty of Dentistry, Ankara, Turkey
| | - Emre Yekeduz
- Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Furkan Ceylan
- Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Batuhan Baspinar
- Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ilgın Akbiyik
- Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Burak Yasin Aktas
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Deniz Yuce
- Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Mustafa Erman
- Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Mutlu Hayran
- Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
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Affiliation(s)
- Özge Keskin
- Selcuk University Faculty of Medicine, Department of Medical Oncology, KONYA, Turkey
| | - Esin Oktay
- Aydin Ataturk State Hospital, Aydin, Turkey
| | - Merve Turan
- Aydın Adnan Menderes University, Department of Medical Oncology, Aydin, Turkey
| | - Neyran Kertmen
- Hacettepe University Cancer Institute, Department of Medical Oncology, Ankara, Turkey
| | - Ozgur Tanriverdi
- Mugla Sitki Kocman University, Department of Medical Oncology, Mugla, Turkey
| | | | - Deniz Yuce
- Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Banu Ozturk
- Health Sciences University/ Antalya Education and Research Hospital, Antalya, Turkey
| | - Ozlem Ata
- Selcuk University, Selcuklu Medical Faculty, Konya, Turkey
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Hayran KM, Yuce D, Erman M, Dizdar O, Kilickap S, Huseyin B, Celik I. Factors associated with quitting action following smoking cessation counseling. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e18750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Deniz Yuce
- Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Mustafa Erman
- Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Omer Dizdar
- Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Saadettin Kilickap
- Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Beril Huseyin
- Hacettepe University Cancer Institute, Department of Preventive Oncology, Ankara, Turkey
| | - Ismail Celik
- Hacettepe University Cancer Institute, Department of Preventive Oncology, Ankara, Turkey
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Kamisli S, Yuce D, Karakilic B, Kilickap S, Hayran M. Cancer patients and oncology nursing: Perspectives of oncology nurses in Turkey. Niger J Clin Pract 2018; 20:1065-1073. [PMID: 29072227 DOI: 10.4103/njcp.njcp_108_16] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND AND AIM Burnout and exhaustion is a frequent problem in oncology nursing. The aim of this study is to evaluate the aspects of oncology nurses about their profession in order to enhance the standards of oncology nursing. MATERIALS AND METHODS This survey was conducted with 70 oncology nurses working at Hacettepe University Oncology Hospital. Data were collected between January-April 2012. Each participant provided a study form comprising questions about sociodemographic information; about difficulties, positive aspects and required skills for oncology nursing; and questions evaluating level of participation and clinical perception of oncology nursing. RESULTS Mean age of nurses was 29.9 ± 5.7 years. More than half of the participants were married (51.4%) and 30% had at least one child. Percent of nurses working in oncology for their entire work life was 75.8%. Most frequently expressed difficulties were exhaustion (58.6%), coping with the psychological problems of the patients (25.7%), and frequent deaths (24.3%); positive aspects were satisfaction (37.1%), changing the perceptions about life (30%), and empathy (14.3%); and required skills were patience (60%), empathy (57.1%), and experience (50%). For difficulties of oncology nursing, 28.3% of difficulties could be attributed to job-related factors, 30.3% to patient-related factors, and 77% of difficulties to individual factors. The independent predictors of participation level of the nurses were self-thoughts of skills and positive aspects of oncology nursing. CONCLUSION According to the findings of this study, nurses declared that working with cancer patients increase burnout, they are insufficient in managing work stress and giving psychological care to patients, but their job satisfaction, clinical skills and awareness regarding priorities of life has increased.
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Affiliation(s)
- S Kamisli
- Department of Preventive Oncology, Hacettepe University Oncology Hospital, Ankara, Turkey
| | - D Yuce
- Department of Preventive Oncology, Hacettepe University Oncology Hospital, Ankara, Turkey
| | - B Karakilic
- Clinical Oncology Unit, Hacettepe University Oncology Hospital, Ankara, Turkey
| | - S Kilickap
- Department of Preventive Oncology, Hacettepe University Oncology Hospital, Ankara, Turkey
| | - M Hayran
- Department of Preventive Oncology, Hacettepe University Oncology Hospital, Ankara, Turkey
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Taskiran-Sag A, Yemisci M, Gursoy-Ozdemir Y, Erdener SE, Karatas H, Yuce D, Dalkara T. Improving Microcirculatory Reperfusion Reduces Parenchymal Oxygen Radical Formation and Provides Neuroprotection. Stroke 2018; 49:1267-1275. [PMID: 29669868 DOI: 10.1161/strokeaha.118.020711] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 03/17/2018] [Accepted: 03/20/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND PURPOSE Reperfusion is the most significant determinant of good outcome after ischemic stroke. However, complete reperfusion often cannot be achieved, despite satisfactory recanalization. We hypothesized that microvascular protection was essential for achieving effective reperfusion and, hence, neuroprotection. To test this hypothesis, we have developed an in vivo model to differentially monitor parenchymal and vascular reactive oxygen species (ROS) formation. By comparing the ROS-suppressing effect of N-tert-butyl-α-phenylnitrone (PBN) with its blood-brain barrier impermeable analog 2-sulfo-phenyl-N-tert-butylnitrone (S-PBN), we assessed the impact of vascular ROS suppression alone on reperfusion and stroke outcome after recanalization. METHODS The distal middle cerebral artery was occluded for 1 hour by compressing with a micropipette and then recanalized (n=60 Swiss mice). ROS formation was monitored for 1 hour after recanalization by intravital fluorescence microscopy in pial vasculature and cortical parenchyma with topically applied hydroethidine through a cranial window. PBN (100 mg/kg) or S-PBN (156 mg/kg) was administered shortly before recanalization, and suppression of the vascular and parenchymal hydroethidine fluorescence was examined (n=22). Microcirculatory patency, reperfusion, ischemic tissue size, and neurological outcome were also assessed in a separate group of mice 1 to 72 hours after recanalization (n=30). RESULTS PBN and S-PBN completely suppressed the reperfusion-induced increase in ROS signal within vasculature. PBN readily suppressed ROS produced in parenchyma by 88%. S-PBN also suppressed the parenchymal ROS by 64% but starting 40 minutes later. Intriguingly, PBN and S-PBN comparably reduced the size of ischemic area by 65% and 48% (P>0.05), respectively. S-PBN restored the microvascular patency and perfusion after recanalization, suggesting that its delayed parenchymal antioxidant effect could be secondary to improved microcirculatory reperfusion. CONCLUSIONS Promoting microvascular reperfusion by protecting vasculature can secondarily reduce parenchymal ROS formation and provide neuroprotection. The model presented can be used to directly assess pharmacological end points postulated in brain parenchyma and vasculature in vivo.
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Affiliation(s)
- Aslihan Taskiran-Sag
- From the Institute of Neurological Sciences and Psychiatry (A.T.-S., M.Y., Y.G.-O., S.E.E., H.K., T.D.)
| | - Muge Yemisci
- From the Institute of Neurological Sciences and Psychiatry (A.T.-S., M.Y., Y.G.-O., S.E.E., H.K., T.D.).,Department of Neurology (M.Y., Y.G.-O., T.D.)
| | - Yasemin Gursoy-Ozdemir
- From the Institute of Neurological Sciences and Psychiatry (A.T.-S., M.Y., Y.G.-O., S.E.E., H.K., T.D.).,Department of Neurology (M.Y., Y.G.-O., T.D.)
| | - Sefik Evren Erdener
- From the Institute of Neurological Sciences and Psychiatry (A.T.-S., M.Y., Y.G.-O., S.E.E., H.K., T.D.)
| | - Hulya Karatas
- From the Institute of Neurological Sciences and Psychiatry (A.T.-S., M.Y., Y.G.-O., S.E.E., H.K., T.D.)
| | - Deniz Yuce
- Institute of Cancer (D.Y.), Hacettepe University, Ankara, Turkey
| | - Turgay Dalkara
- From the Institute of Neurological Sciences and Psychiatry (A.T.-S., M.Y., Y.G.-O., S.E.E., H.K., T.D.) .,Department of Neurology (M.Y., Y.G.-O., T.D.)
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Esin S, Yuce D. Re: Impaired maternal hemodynamics in morbidly obese women: a case-control study. Ultrasound Obstet Gynecol 2018; 51:420. [PMID: 29512276 DOI: 10.1002/uog.19006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 01/14/2018] [Indexed: 06/08/2023]
Affiliation(s)
- S Esin
- Baskent University Medical Faculty, Department of Perinatology, Ankara, Turkey
| | - D Yuce
- Hacettepe University, Department of Preventive Oncology, Ankara, Turkey
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Yalcin S, Dane F, Oksuzoglu B, Yildirim N, Isikdogan A, Ozkan M, Demirag G, Coskun HS, Karabulut B, Evrensel T, Ustaoglu MA, Ozdemir F, Turna H, Yavuzsen T, Aykan F, Sevinc A, Akbulut H, Yuce D, Hayran M, Kilickap S. Quality of life study in patients with unresectable locally advanced or metastatic pancreatic cancer treated with gemcitabine in combination with nab-paclitaxel versus gemcitabine alone:ax-panc-sy001: A phase II randomized study. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.4_suppl.346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
346 Background: Although clinical efficacy of gemcitabine in combination with nabpaclitaxel has been shown to be superior to single agent gemcitabine in a randomize phase 3 trial, data are lacking on the quality of life of this combination regimen as first-line therapy in patients with unresectable locally advanced or metastatic pancreatic adenocarcinoma. Methods: We randomly assigned 125 patients with an Eastern Cooperative Oncology Group performance status score of 0 or 1 to receive gemcitabine, 1000 mg/m2 plus nabpaclitaxel 125 mg/m2 or gemcitabine at a dose of 1000 mg per square meter weekly for 7 of 8 weeks and then weekly for 3 of 4 weeks. Treatment continued until disease progression or unacceptable toxicity. The primary end point was 3-months deterioration-free rate (percentage of patients free from definitive deterioration) and quality of life of patients. Results: The median overall survival was 9.92 months in the gemcitabine plus nabpaclitaxel group as compared with 5.95 months in the gemcitabine group (hazard ratio for death, 0.642, 95% confidence interval, 0.422 to 0.866; p < 0.038). Median progression-free survival was 6.28 months in the combination group and 3.22 months in the gemcitabine group (hazard ratio for disease progression, 0.582; 95% CI, 0.391 to 0.866; p < 0.008). The objective response rate was 37.1% in the combination group versus 23.7% in the gemcitabine group (p < 0.009). Median time to deterioration was 3.68 months in the gemcitabine arm versus 5.36 months in the combination arm. More data on quality of life will be presented. Conclusions: As compared with gemcitabine, gemcitabine plus nabpaclitaxel was associated with an overall and progressive free survival advantage, with increased response rate, without increasing toxicity and deterioration of quality of life. Gemcitabine and nabpaclitaxel combination regimen with this form is a preferable option for the treatment of patients with advanced pancreatic cancer Clinical trial information: EudraCT: 2013-004180-32.
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Affiliation(s)
| | | | - Berna Oksuzoglu
- Dr. A.Y. Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Nuriye Yildirim
- Ankara Numune Education and Research Hospital, Ankara, Turkey
| | | | | | - Guzin Demirag
- Ondokuzmayis University Medical Oncology, samsun, Turkey
| | | | | | | | | | - Feyyaz Ozdemir
- Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
| | - Hande Turna
- Istanbul University Cerrahpasa School of Medicine, Istanbul, Turkey
| | - Tugba Yavuzsen
- Dokuz Eylul University Oncology Institute, Izmir, Turkey
| | - Faruk Aykan
- University of Istanbul, Institute of Oncology, Istanbul, Turkey
| | | | - Hakan Akbulut
- Ankara Numune Education and Research Hospital, Ankara, Turkey
| | - Deniz Yuce
- Hacettepe University Cancer Institute, Ankara, Turkey
| | - Mutlu Hayran
- Hacettepe University Cancer Institute, Ankara, Turkey
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Karakas Y, Yuce D, Kılıckap S. Immune Thrombocytopenia Induced by Nivolumab in a Metastatic Non-Small Cell Lung Cancer Patient. Oncol Res Treat 2017; 40:621-622. [PMID: 28950270 DOI: 10.1159/000477968] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 06/02/2017] [Indexed: 11/19/2022]
Affiliation(s)
- Yusuf Karakas
- Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
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Esin E, Akin Telli T, Yuce D, Yalcin S. Eliminating fluorouracil toxicity without sacrificing efficacy in colorectal cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx261.282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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46
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Yuce Sari S, Yazici G, Yuce D, Karabulut E, Cengiz M, Ozyigit G. The effect of glutamine and arginine-enriched nutritional support on quality of life in head and neck cancer patients treated with IMRT. Clin Nutr ESPEN 2016; 16:30-35. [DOI: 10.1016/j.clnesp.2016.08.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 06/24/2016] [Accepted: 08/16/2016] [Indexed: 10/21/2022]
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Ardic UA, Ercan ES, Ercan E, Yuce D, Basay BK. Osmotic Release Oral System Methylphenidate is More Effective Than Immediate Release Methylphenidate: A Retrospective Chart Review in Turkish Children with Attention Deficit Hyperactivity Disorder. ACTA ACUST UNITED AC 2016. [DOI: 10.5455/bcp.20141009112739] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Ulku Akyol Ardic
- Ege University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Izmir - Turkey
| | - Eyup Sabri Ercan
- Ege University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Izmir - Turkey
| | - Elif Ercan
- Ege University Faculty of Education, Department of Psychological Counseling and Guidance, Izmir - Turkey
| | - Deniz Yuce
- Hacettepe University Cancer Institute, Department of Preventive Oncology, Ankara - Turkey
| | - Burge Kabukcu Basay
- Ege University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Izmir - Turkey
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Isli F, Caglar O, Helvaci CS, Aksoy M, Kadi E, Yuce D, Hayran M. Assessment of antibiotic including prescriptions prescribed by family physicians in Turkey in 2015. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw175.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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49
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Yavas C, Yavas G, Celik E, Buyukyoruk A, Buyukyoruk C, Yuce D, Ata O. Amelioration of Radiation-Induced Intestinal Toxicity by Beta-Hydroxy-Beta-Methyl-Butyrate, L-Glutamine, and L-Arginie: Results of an Experimental Study. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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50
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Yuce D, Hayran M, Eser S, Uner S. Geographical differences in preventable cancers in Turkey. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw387.28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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