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Öğe Application of Omics and Systems Medicine in Bladder Cancer(wiley, 2017) Frantzi M.; Latosinska A.; Akand M.; Merseburger A.S.Bladder cancer (BC) is the ninth most common cancer in the world. Smoking remains the main disease risk factor which is responsible for about half of the diagnosed BC cases. Although the vast majority (~75%) of BC cases are diagnosed at an early stage, the recurrence rate is reaching up to 78%. Thus, frequent monitoring is required. Since cystoscopy, the current diagnostic procedure, is highly invasive, disease monitoring is associated with increased patient incompliance and high disease-related costs. However, the limitations of the alternative diagnostic means (suboptimal accuracy of cytology and/or noninvasive markers) underscore the need for the development of novel diagnostic approaches. Apart from the diagnostic complications, the current therapeutic options for BC are also limited. The high disease heterogeneity at the molecular level presents significant challenges for biomarker translational research, as well as for drug development trials. In order to overcome the difficulties associated with the inter- and intratumor variability, the application of -omics approaches and systems medicine will greatly help to address the disease heterogeneity. The application of high-resolution -omics datasets has recently gained more popularity in several applications, such as: (i) BC disease characterization, (ii) patient stratification for therapy decision-making, and (iii) diagnostic and prognostic biomarker development. The concept of applying systems medicine to answer the above clinical questions paves a new avenue toward precision and personalized medicine. This chapter aims at providing an overview of the BC pathophysiology and main clinical needs that remain to be addressed. Along these lines, research efforts to address these clinical demands will be summarized, mainly focused on the use of state-of-the-art "OMICS" methodologies. © 2018 John Wiley & Sons, Inc.Öğe Fluorodeoxyglucose positron emission tomography/computed tomography imaging of a patient with squamous cell carcinoma of prostate(Hindawi Limited, 2014) Kara Gedik G.; Yavas G.; Akand M.; Celik E.; Sari O.Primary squamous cell carcinoma is an uncommon tumor of the prostate gland. We report a 77-year-old male patient with urinary frequency and constipation. Fine needle biopsy from prostate was suspicious of squamous cell carcinoma of the prostate. Whole body positron emission tomography/computed tomography scan revealed high fluorodeoxyglucose uptake in prostate gland. Transurethral resection confirmed the diagnosis. In contrast to prostatic adenocarcinoma, high fluorodeoxyglucose accumulation was observed in the primary tumor of the prostate gland. © 2014 Gonca Kara Gedik et al.Öğe Predictive effect of preoperative anemia on long-term survival outcomes with non-muscle invasive bladder cancer(Asian Pacific Organization for Cancer Prevention, 2016) Celik O.; Akand M.; Keskin M.Z.; Ekin R.G.; Yoldas M.; Ilbey Y.O.Background: Anemia is the most common hematologic abnormality in bladder cancer (BC) patients. We evaluated the impact of preoperative anemia on oncologic outcomes in BC undergoing transurethral resection of a bladder tumor (TURBT) for the first time diagnosis. Materials and Methods: We retrospectively evaluated the data collected from 639 patients who underwent TURBT between January 2006 and September 2014 in our department. Of these patients, 320 qualified for inclusion in the study. The primary efficacy endpoint was the effect of preoperative anemia status on cancer-specific and overall survival. Independent t-test and chi-square analyses were performed to assess the effects of anemia on oncologic outcomes. Survival was estimated by using the Kaplan-Meier test. Results: There were 118 (36.9%) and 202 (63.1%) patients in the anemia (Group-1) and non-anemia groups (Group-2), respectively. The median follow-up duration was 68 months. Anemia was associated with decreased overall survival (p < 0.001). Comparison between cancer-specific survival of two groups did not show any statistically significant difference (p=0.17). Conclusions: Preoperative anemia status of BC patients according to World Health Organization classification is associated with decreased overall survival, but not with cancer-specific survival. We think that preoperative hemoglobin levels should be considered in patient counseling and decision-making for additional therapy.Öğe Prostate myths: What is the prostate awareness in the general male population in Turkey? [Prostat mitleri: Türkiye'deki genel erkek popülasyonundaki prostat farkındalığı nedir?](AVES İbrahim KARA, 2014) Kulaksızoğlu H.; Akand M.; Kılıç Ö.; Gül M.; Kucur M.; Göktaş S.Results: A total of 1004 men between the ages of 18-70 were included in the study (mean age 38.0±12.9 years). Of those included, 20.2% were primary school graduates, 8.6% were secondary school graduates, 25.5% were high school graduates, 39.8% were university graduates, and 5.8% had a doctorate or higher education. Of all 1004 men, 31.5% had seen a urologist or attended an interview with a close relative for a PDs-related visit in a urologist’s office; 56.2% reported “prostate” as a disease and only 16.5% as an organ. In terms of beliefs, 50.2% believed that all men had a “prostate,” 5.4% said that sexual activity would cause PDs, 13% thought that sexual activity would prevent PD, 24.9% reported that a rectal exam would affect sexual activity, and 63.5% believed that urinating when squatting would prevent prostate hyperplasia. Prostate cancer transmission to sexual partners was marked as true by 5% of the men. As many as 41.3% of the participants believed that early prostate surgery for BPH would prevent prostate cancer, and 13% reported that sexual activity ceases with prostate surgery and that retrograde ejaculation or anejaculation is the end of sexual activity in men.Conclusion: The survey clearly showed that prostate awareness is still very unsatisfactory in the Turkish male population and that urologists need to better inform the general population. PD knowledge is still lacking throughout all education levels. This is a unique study showing a cross-sectional analysis of the Turkish community; however, the applicability of these results to other communities should be evaluated.Material and methods: A cross-sectional population sampling was performed in the general population for men between the ages of 18-70 with a survey conducted by medical students. The survey consisted of 15 questions addressing different aspects of PDs and common misinformation in the general population. All participants were stratified according to age, degree of education, occupation and whether the person himself or a close relative had visited a urologist for PDs. All questionnaires were anonymous, and patients were informed about the confidentiality of the results.Objective: The aim of the study was to evaluate prostate awareness in the general male population and discover the common misinformation about prostate diseases (PDs). © 2014 by Turkish Association of Urology.Öğe An unusual complication of a double-J ureteral stent: Renal parenchymal perforation in a solitary kidney(AVES Ibrahim Kara, 2014) Gönülalan U.; Akand M.; Hasırcı E.; Koşan M.Double-J ureteral stenting is commonly used in urological practice and has various complications. We report a patient with a renal parenchymal perforation and perirenal hematoma due to a double-J ureteral stent in a solitary kidney. This complication of ureteral stents is rarely observed and is life-threatening. © 2014 by Turkish Association of Urology.
