Saturday, September 18, 2021
Friday, September 17, 2021
Milliyet, 10 Eylül 2021
Hafta başında Ankara Şehir Hastanesi yoğun bakım doktorlarının uyarılarını yazmıştım. Özellikle gebe olup da kovide yakalanan hastaların sayısının arttığı ve kayıpların olduğu vurgulanmıştı. Bir kaç gündür bazı illerden de benzer haberler geliyor.
Yoğun bakım doktoru Mehmet Eren Yüksel’in şu uyarıları çok önemli:
“Son günlerde gebe olup da kovide yakalanan çok hastamız var.
Özellikle hamile olan hastalarımızda aşı olma yüzdesinin çok düşük olduğunu görüyoruz.
Sezeryanla bebekleri almak gerekiyor. Birçoğu erken doğum olduğu için yaşamıyor.
Bu süreçte genç anne ve bebeklerinin ölümlerinin önüne geçmek için gebeler mutlaka aşı olmalı."
Abdullah Karakuş, Milliyet, 10 Eylül 2021
Prolonged SARS-CoV-2 RNA detection in nasopharyngeal RT-PCR test in COVID-19 patients with Myelodysplastic Syndrome: A case report
Prolonged SARS-CoV-2 RNA detection in nasopharyngeal RT-PCR test in COVID-19 patients with Myelodysplastic Syndrome: A case report
Dr. Hasan Dirik
Ankara City Hospital, Intensive
Care Unit, Ankara, Turkey. e-mail: hsndrk_38@hotmail.com
Dr. Şerife Bektaş
Ankara City Hospital, Intensive
Care Unit, Ankara, Turkey. e-mail: serifegbektas@gmail.com
Dr. Mehmet Eren Yüksel
Ankara Yıldırım Beyazıt
University School of Medicine, Intensive Care Unit, Ankara, Turkey. e-mail:
doctormehmeteren@yahoo.com
Prof. Dr. Seval İzdeş
Ankara Yıldırım Beyazıt
University School of Medicine, Intensive Care Unit, Ankara, Turkey. E-mail:
sevalizdes@yahoo.com
Introduction:The detection of
viral ribonucleic acid using reverse transcription polymerase chain reaction
(RT-PCR) within nasopharyngeal swabs is essential for the diagnosis of
SARS-CoV-2 infection. Myelodysplastic syndrome (MDS) represents a heterogeneous
group of myeloid neoplasms which are characterized by ineffective
hematopoiesis, cytopenia, and risk of progression to acute myeloid leukemia.
Hereby, we present a 62-year-old female patient with both MDS and Covid-19, who
continued to have a positive nasopharyngeal RT-PCR test for 46 days until she
passed away.
Case Report: The patient, who was
diagnosed with MDS in August 2020, was complaining of high fever. She had had
two doses of Sinovac vaccine. Past medical history was remarkable for
chemotherapy which was ended 1 month before. Bone marrow transplantation was
planned within a week. Despite the i.v. ertapenem treatment, high fever
persisted, and neutropenia occurred. White blood cell count (Wbc) was 0.43
x109/L. Blood and urinary cultures revealed extended spectrum beta-lactamase
(ESBL) producing Escherichia coli. In addition, SARS-CoV-2 RT-PCR test on
nasopharyngeal swab was performed, which was revealed to be positive.
Antibiotic treatment was initiated. The patient was admitted to the intensive
care unit. Afterwards, serial nasopharyngeal swabs were collected from the
patient for 46 days until she passed away, and all were positive for Covid-19.
Discussion: In the medical
literature, long-term (longer than 3 weeks) SARS-CoV-2 RT-PCR positivity has
been reported in mild or asymptomatic patients. There are a few number of
publications dealing with MDS and Covid-19 in the English medical literature.
Qing et al. reported MDS in a 30-year-old man with Covid-19, however, RT-PCR
positive period was not mentioned. SARS-CoV-2 clearance period depends on
immunity of the patients and Covid-19 infection may have a prolonged course in patients with
hematological disorders such as MDS.
References
1. Platzbecker U, Kubasch AS, Hom:er-Bouthiette
C, Prebet T. Current challenges and unmet medical needs in myelodysplastic
syndromes. Leukemia. 2021;35(8):2182-98.
2. Kim SM, Hwang YJ, Kwak Y.
Prolonged SARS-CoV-2 detection and reversed RT-PCR results in mild or
asymptomatic patients. Infect Dis (Lond). 2021;53(1):31-7.
3. Bhattacharya B, Kumar R, Meena
VP, Soneja M, Singh A, Das R, et al. SARS-CoV-2 RT-PCR profile in 298 Indian
COVID-19 patients: a retrospective observational study. Pathog Dis. 2021;79(1).
4. Xu W, Piper-Vallillo AJ,
Bindal P, Wischhusen J, Patel JM, Costa DB, et al. Time to SARS-CoV-2 clearance
among patients with cancer and COVID-19. Cancer Med. 2021;10(5):1545-9.
5. Qing X, Cai J, Rock A.
Myelodysplastic syndrome in a 30-year-old man with coronavirus disease 2019
(COVID-19): a diagnostic challenge. Autops Case Rep. 2021;11:e2021274.
Conference: 2. International Cancer Days, Sivas Cumhuriyet University, 16-18 September 2021
https://kansergunleri.cumhuriyet.edu.tr/?page_id=589&lang=tr
Comparison Of Colorectal Cancer Screening Programmes Of Turkey and The European Union
Comparison Of Colorectal Cancer Screening Programmes Of Turkey and The European Union
Dr.
Mehmet Eren Yuksel
Ankara Yıldırım Beyazıt
University School of Medicine, Intensive Care Unit, Ankara, Turkey. e-mail:
doctormehmeteren@yahoo.com
Dr.
Hasan Dirik
Ankara City Hospital,
Intensive Care Unit, Ankara, Turkey. e-mail: hsndrk_38@hotmail.com
Introduction:
Faecal
immunochemical test (FIT), faecal occult blood test (FOBT), flexible
sigmoidoscopy (FS), Guaiac faecal occult blood test (gFOBT) and total colonoscopy
(TC) can be used for colorectal cancer screening. However, Turkey and other European
countries have different practices for colorectal screening tests, beginning-stopping
ages and screening intervals.
Method:
World
Cancer Report, which was published by World Health Organization (WHO) International
Agency For Research on Cancer in 2020, has been throughly examined (1).
Results:
Colorectal
cancer screening starting age is 40 in Bulgaria and Austria, whereas it is 50
in Belgium, Croatia, Denmark, France, Germany, Greece, Italy, Latvia,
Lithuania, Portugal, Slovenia, Spain, Scotland, Serbia, Switzerland and Turkey,
and it is 55 in Netherlands, Poland and
Norway, whereas it is 60 in Estonia, Finland, Ireland, Sweden and United
Kingdom. The stopping age for colorectal cancer screening is 60 in Bulgaria, 69
in Turkey, 80 in Austria and Switzerland. Interval period is 1 year in Bulgaria
and Latvia, whereas it is 2 years in most of the European countries. Attendance
to the colorectal screening programme is 1% in Hungary and Portugal, 2% in
Poland, 8% in Greece and Spain,13% in Sweden, 30% in Turkey, 56% in United
Kingdom and 61% in Austria.
Conclusion:
WHO
reported no definitive colorectal cancer screening interval period for Turkey, however,
Turkish Ministry of Health recommends FOBT every 2 years and TC in every 10
years (2). For gFOBT, dietary
restrictions are required before
testing (1). However, FIT is based on human haemoglobin antibodies, and thus it
does not require a special diet before testing. This might explain why FIT is the
preferred colorectal cancer screening test in most of the European countries.
Keywords:
cancer,
colorectal, Europe, screening, Turkey
References:
1- Wild CP, Weiderpass E,
Stewart BW, editors (2020). World Cancer Report: Cancer Research for Cancer
Prevention. Lyon, France: International Agency for Research on Cancer.
Available from: http://publications.iarc.fr/586. Licence: CC BY-NC-ND 3.0 IGO.
2- Turkish Ministry of Health.
Colorectal Cancer Screening Programme National Standards. Available from: https://hsgm.saglik.gov.tr/tr/kanser-tarama-standartlari/listesi/kolorektal-kanser-tarama-program%C4%B1-ulusal-standartlar%C4%B1.html
Conference: 2. International Cancer Days, Sivas Cumhuriyet University, 16-18 September 2021
https://kansergunleri.cumhuriyet.edu.tr/?page_id=589&lang=tr
Thursday, September 16, 2021
Should Physicians Recommend Vitamins, Minerals and Micronutrients To Patients With Cancer?: An Analysis From The Perspective of ESPEN Guideline
Should Physicians Recommend Vitamins, Minerals and Micronutrients To Patients With Cancer?: An Analysis From The Perspective of ESPEN Guideline
Dr.
Mehmet Eren Yuksel
Ankara Yıldırım Beyazıt
University School of Medicine, Intensive Care Unit, Ankara, Turkey. e-mail: doctormehmeteren@yahoo.com
Dr. Hasan Dirik
Ankara City Hospital, Intensive Care Unit, Ankara, Turkey. e-mail: hsndrk_38@hotmail.com
Abstract
Background: The
number of cancer patients using complementary and alternative medicine (CAM) is
rapidly increasing in Turkey. However, it is a matter of debate if physicians
should prescribe vitamins, minerals and micronutrients to patients with cancer.
Method: A
Pubmed search, between the years 1990 and 2021, was performed to identify the prevalence
of patients using CAM. Moreover, studies about vitamin C-D-E supplementation
were examined according to the recommendations of European Society for Clinical
Nutrition and Metabolism (ESPEN) guideline (1).
Results:
Ernst
et al. published the first systemic review regarding the prevalence of CAM use
in cancer patients, which was 31.4%, in 1998 (2). Horneber et. al reported in
2012 that their meta-analysis included 152 studies from 18 countries with
65.000 cancer patients and the prevalance of CAM usage was 40% (3). The CAM use was the
highest in the United States (50%) and the lowest both in Italy and the Netherlands
(22%). Turkey had the highest prevalence of CAM use with 48% in Europe (3). ESPEN guideline on
clinical nutrition in cancer published in 2021 pointed out a few studies (1). Wang
et al. reported that a total of 14,641 male physicians received 400 IU of
vitamin E and 500 mg of vitamin C daily for 10 years. However, vitamin E and C
supplementation had no immediate or long-term effects on the risk of total
cancer and prostate cancer (4). Bolland
et al. stated that vitamin D supplementation did not reduce skeletal or
non-skeletal outcomes in individuals by more than 15% (5).
Klein et al. revealed that dietary supplementation with vitamin E significantly
increased the risk of prostate cancer (6).
Conclusion: Despite
the fact that approximately 50% of all cancer patients consume CAM, ESPEN recommends
that vitamins and minerals should be supplied in amounts equal to the
recommended daily allowance, whereas high-dose micronutrients should be
discouraged in the absence of specific deficiencies (1).
Keywords: Alternative, cancer, complementary, medicine, vitamin
References:
1. Muscaritoli M, Arends J, Bachmann P,
Baracos V, Barthelemy N, Bertz H, et al. ESPEN practical guideline: Clinical
Nutrition in cancer. Clin Nutr. 2021;40(5):2898-913.
2. Ernst E, Cassileth BR. The prevalence
of complementary/alternative medicine in cancer: a systematic review. Cancer.
1998;83(4):777-82.
3. Horneber M, Bueschel G, Dennert G, Less
D, Ritter E, Zwahlen M. How many cancer patients use complementary and
alternative medicine: a systematic review and metaanalysis. Integr Cancer Ther.
2012;11(3):187-203.
4. Wang L, Sesso HD, Glynn RJ, Christen
WG, Bubes V, Manson JE, et al. Vitamin E and C supplementation and risk of
cancer in men: posttrial follow-up in the Physicians' Health Study II randomized
trial. Am J Clin Nutr. 2014;100(3):915-23.
5. Bolland MJ, Grey A, Gamble GD, Reid IR.
The effect of vitamin D supplementation on skeletal, vascular, or cancer
outcomes: a trial sequential meta-analysis. Lancet Diabetes Endocrinol.
2014;2(4):307-20.
6. Klein EA, Thompson IM, Jr., Tangen CM, Crowley JJ, Lucia MS, Goodman PJ, et al. Vitamin E and the risk of prostate cancer: the Selenium and Vitamin E Cancer Prevention Trial (SELECT). Jama. 2011;306(14):1549-56.
Conference: 2. International Cancer Days, Sivas Cumhuriyet University, 16-18 September 2021
https://kansergunleri.cumhuriyet.edu.tr/?page_id=589&lang=tr
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