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Biomedical subjects

U Derman

Publications and source records attributed to U Derman.

At least 19 recordsLinked to original sources
PubMed1995

Is awareness of its risk enough to stop people from smoking?

A questionnaire to elicit information about smoking habits and knowledge of the risks of smoking was administered to 100 students (53 men and 47 women) in the graduating class of 1993 at the Cerrahpaşa Medical School of Istanbul. Forty-three percent of the men and 27% of the women students were smokers. All but one of the 100 students were aware that smoking is a risk factor for both lung and laryngeal cancers, and 44% of the smokers believed that cessation of smoking by the smoking population could decrease the incidence of lung cancers to less than half of its present level. These data suggest that awareness of the risks of smoking is not enough to motivate smokers to quit, even when they are young physicians. Of the nonsmokers, 87.5% indicated that they would attempt to restrain their younger siblings from smoking, whereas the corresponding figure for smokers was 58.3%. The smokers and the nonsmokers answered two of the questions on the questionnaire significantly differently. Thirty-six percent of the mothers of the nonsmokers and 31% of their siblings were also smokers, whereas the corresponding figures for the nonsmokers were 18% and 13% (half of the fathers in both groups smoked). Thus, family and the environment appear to influence smoking behavior. Successful modification of smoking habits will necessitate more education of the general public.

Female↗
PubMed1994

Adapting undergraduate preclinical courses to changes in clinical applications.

The availability of new technologic tools has greatly changed differential diagnosis. To assess the importance of these tools in current clinical practice, the authors determined the frequencies of use of new imaging methods in diagnosis, staging, and follow-up in 71 oncology cases. The new methods were found to have replaced traditional diagnostic procedures to a substantial extent. To familiarize medical students with the new techniques, lectures on sectional anatomy given by radiologists were integrated into traditional anatomy courses for a group of 50 students. Two years later, after their initial exposure to clinical practice, the 42 students remaining in the group answered a questionnaire regarding the usefulness of the sectional anatomy segment of their anatomy training. Of these 42 students, 14 rated the sectional anatomy exposure "very helpful" to comprehension in the clinical internship and 21 rated it "helpful." The students suggested that the program be reinforced by an integrated textbook. This preliminary study suggests that basic preclinical courses should be modulated to reflect new methods that come into routine use in clinical practice.

Anatomy↗
PubMed1994

Haematological effects of pulse steroid therapy.

The aim of this study was to determine the haematological effects of 1 g methylprednisolone given intravenously as pulse steroid therapy (PST) to 10 cancer patients who had not received any chemotherapy or immunoactive drugs in the previous 3 weeks. Haematological values as determined with flow cytometry were evaluated before, and 1 and 24 h after, the pulse therapy. Total leucocyte count was found to be decreased at the first hour and significantly increased at the 24th hour, whereas total lymphocyte count decreased at the first hour and remained low at 24 h. CD4 lymphocytes were found decreased at the first hour whereas CD8 lymphocytes were significantly decreased at the 24th hour. The CD4/CD8 lymphocyte ratio and the values of haematocrit and platelets did not change significantly. The decrease in the total leucocyte count after 1 hour of steroid administration was notable, in addition to the results which were in accordance with previously reported data about steroid effects on haematological values.

Adult↗
PubMed1993

Cancer patients' awareness of disease and satisfaction with services: the influence of their general education level.

Forty-five cancer patients, 22 with a low and 23 with a high general educational level, receiving chemotherapy in the chemotherapy day clinic of the Cerrahpaşa Medical Faculty, were interviewed individually by a clinical psychology Master's Program student. The interview covered 45 questions about the level of their awareness of disease and treatment, prognosis, and the sources of information and whether these affected their satisfaction with the services given. The answers of the two groups with different educational levels were compared. There was no significant difference between the two groups in awareness of disease or in satisfaction with the services. However, there was significant difference between the two groups in patient-physician dialogue as to asking more and direct questions and thus in the source of information. Six attending physicians in charge of the clinic were also interviewed about their guesses on the patients' answers, and their reasons for giving different levels of information to their patients. It was suggested that general public education on the communities' concept of cancer was the most important single factor in the formation of demand and therefore revealing correct information during patient-physician communication.

Antineoplastic Agents↗
PubMed1992

Mitochondria-lytic action of warfarin in lymphocytes.

Warfarin given as a single dose of 20 mg induces lysis of mitochondria in lymphocytes from chronic and acute lymphocytic leukemias studied under the electron microscope. Normal lymphocytes remain unchanged. This cytotoxic actin may be due to superoxide radicals produced in the malignant cells by warfarin, which is a potent electron-transferring substance.

Humans↗
PubMed1991

The "EMIO" way--a different approach to listing etiologies in differential diagnosis.

To introduce the early diagnosis concept in oncology to medical students as early as possible in their curriculum, in the Cerrahpaşa Medical School, University of Istanbul, English-speaking section, weekly workshops were added to their regular courses in Record Taking and Differential Diagnosis in the third year (six-year curriculum). A different method was selected in listing possible etiologies of signs and symptoms, to emphasize early diagnosis of malignancies. This approach aimed to arouse more interest in students who were actively participating in the formation of these lists, which finally were compiled as a syllabus.

Curriculum↗
PubMed1988

Survival analysis of patients with small cell lung cancer.

The effects of different chemotherapy protocols on survival were evaluated in 197 small cell lung cancer patients followed-up between 1974 and 1987 in our unit. Of these, 170 patients had Stage IV disease and 24 had Stage III disease. Thoracic radiotherapy was given to 73 patients of whom 63 had Stage IV disease. Cytotoxic chemotherapy was given in four main protocols consisting of cyclophosphamide (CYC): CYC + vincristine (VCR); CYC + VCR + adriamycin (ADM) and CYC + VCR + ADM + lomustine (CCNU). The latter protocol was associated with the highest survival rates and differed significantly (p less than 0.05) from the others. In patients with extensive disease, both radiotherapy to the primary site and adjuvant immunomodulation in conjunction with the above chemotherapy regimens lacked any beneficial effect on survival.

Adult↗
PubMed1988

Overall survival results of non-small cell lung cancer patients: chemotherapy alone versus chemotherapy with combined immunomodulation.

The effect on long-term survival of immunomodulation adjuvant to various cytotoxic chemotherapy regimens in non-small cell lung cancer (NSCLC) was evaluated in 669 patients followed up between 1974 and 1987. Four hundred seventeen patients were treated only by cytotoxic chemotherapy and served as controls. Two hundred fifty-two patients received warfarin (W), levamisole (L) and tranexamic acid (T) for adjuvant immunomodulation. These drugs, especially when given in combination (W + L + T), led to a significant (p less than 0.05) enhancement of survival in patients with advanced NSCLC, independent of the cytotoxic regimen used.

Adjuvants, Immunologic↗
PubMed1987

A clinical trial of mitoxantrone (novantrone) versus doxorubicin (adriamycin) in combination chemotherapy for metastatic breast cancer.

Mitoxantrone (Novantrone, N) is a new anthracenedione derivative with structural similarities to doxorubicin (Adriamycin, A). It has shown significant activity during phase I and II clinical trials in the treatment of advanced breast cancer. The present trial compares the CNF regimen to CAF. All patients received cyclophosphamide (500 mg/m2) and 5-fluorouracil (500 mg/m2), with either N (10 mg/m2) or A (50-60 mg), repeated every three weeks. There were 30 patients in the mitoxantrone group and 30 patients in the doxorubicin group. The results presented are based on 60 patients: 70% were postmenopausal; 25% had received adjuvant chemotherapy; 29% had prior hormonal therapy in an adjuvant setting or for relapse. There were no significant differences between the pretreatment characteristics of each group. The response rate (complete + partial) for CNF was 57% and for CAF was 40%. The dose limiting toxicity was granulocytopenia seen after the 3rd cycle in the CNF group. Thrombocytopenia was not seen. There was less nausea and vomiting in the CNF group. No cardiotoxicity was seen in CNF; only 2 patients suffered from congestive heart failure in CAF. These preliminary data indicate that CNF seems to be an effective regimen for patients with advanced breast cancer and has fewer adverse effects than CAF.

Adult↗
PubMed1986

Salmon calcitonin in the treatment of bone metastases.

The effects of salmon calcitonin administered 100 IU i.m. daily for 30 consecutive days were evaluated in patients with painful bone metastasis secondary to different types of solid cancer. The results were compared with placebo-receiving patients. In the 22 patients treated with calcitonin a significant reduction ( p less than 0.001) was observed in the severity of bone pain. Significant reductions were also encountered in the serum alkaline phosphatase (p less than 0.02) and urinary hydroxyproline excretion values (p less than 0.05) in calcitonin-treated patients, indicating an inhibition of bone destruction. It is concluded that salmon calcitonin has an important place in the treatment of patients with metastatic bone lesions both as a potent analgesic and as an effective inhibitor of bone destruction.

Adult↗
PubMed1986

Chemotherapy in colorectal cancer.

198 patients with colorectal carcinoma were given chemotherapy. Adjuvant chemotherapy was applied to 73 patients, postoperatively, with Dukes A, B, C disease. 125 patients were Dukes D. The four different chemotherapy regimens comprised fluorouracil (5-FU) alone, 5-FU plus levamisole, 5-FU plus mitomycin-C and 5-FU plus adriamycin. Median survival was 18 months in the adjuvant group, with 67%, 30% and 19% of patients alive at the end of 1st, 2nd and 3rd years. 5-FU plus adriamycin and 5-FU plus levamisole give better survival rates. Median survival was 7 months in the metastatic group and only 23% are alive at the end of the first year. Favorable results were observed only with 5-FU plus adriamycin. Even though chemotherapy seems to be of limited value in advanced colorectal cancer, survival and life quality improve when it is given on an adjuvant basis.

Adenocarcinoma↗
PubMed1983

The effect of coumarin derivatives on the immunological system of man.

Peripheral blood lymphocyte mitogen responsiveness was studied in 12 normal and 51 cancer patients. One group of patients was treated with warfarin, the second group with coumarin. There was a significant increase in lymphocyte response to phytohaemagglutinin (PHA) following both drugs. This increase indicates that both agents are capable of activating lymphocytes and thus stimulating some immunological functions.

Coumarins↗