Author Correction: The clinical significance and diagnostic value of serum Dickkopf1 and CKAP4 levels in patients with gastric cancer: a prospective study

Correction to: Eur Rev Med Pharmacol Sci 2023; 27 (20): 10031-10040-DOI: 10.26355/eurrev_202310_34183-PMID: 37916373-published online on October 27, 2023. After publication, the authors found a mistake in Table I. Under Table I, the following sentence "HR: hazard ratio. CI: confidence interval. SCC: squamous cell carcinoma. FIGO: International Federation of Gynecology and Obstetrics. DFS: disease-free survival. OS: overall survival. p<0.05 and p<0.01 values were accepted for the significance level of the test" has been mistakenly inserted and must be removed. There are amendments to this paper. The Publisher apologizes for any inconvenience this may cause. https://www.europeanreview.org/article/34183.

Predictors of Significant Histological Hepatic Abnormality in Treatment-Naive Patients Infected with HBeAg-Negative Chronic Hepatitis B

Objective

This study aimed to determine the predictors for significant hepatic abnormality (SHA), a treatment indication, by assessing demographic, laboratory, and radiological results of chronic hepatitis B (CHB) patients who underwent liver biopsy.

Materials and Methods

In this retrospective study, individuals with untreated hepatitis B e-antigen (HBeAg)-negative CHB infection were enrolled. Multivariate analysis modeling was conducted with parameters identified as predictors for SHA in univariate analysis. Optimal threshold levels for variables to predict SHA in patients with chronic hepatitis B were determined based on receiver operating characteristic (ROC) curve analysis.

Results

A total of 566 patients with untreated chronic hepatitis B were included in the cohort; 61% (345/566) were male, and the median age was 41 years (interquartile range [IQR]=34-50). Notably, 36.9% (209/566) had SHA. In the multivariate analysis, utilizing different models, age, gender, HBV-DNA, LDL, ALT, and platelet count were identified as the most reliable predictors for SHA in CHB patients. For predicting SHA, the area under the ROC curve values of HBV-DNA, AST, and ALT were 0.704 (sensitivity=62.8%, specificity=76.2%; p<0.0001), 0.747 (sensitivity=51.9%, specificity=88.9%; p<0.0001), and 0.737 (sensitivity=68.6%, specificity=68.4%; p<0.0001), respectively.

Conclusion

In our study, age, male gender, ALT, AST, HBV-DNA, LDL cholesterol, platelet count, and FIB-4 score were independent predictors of SHA in HBeAg-negative chronic hepatitis B. The most sensitive parameters for SHA were LDL and ALT. The most specific parameters were age, AST, and APRI score. SHA may occur in patients with high HBV-DNA levels, even if ALT values are normal in HBeAg-negative patients.

Third molar angulation and retromolar space after functional orthodontic treatment : Evaluation of panoramic radiographs after monoblock or Herbst appliance

PURPOSE

The aim of this respectively cohort study was to evaluate the lower second and third molars and canine angulations, retromolar space and occlusal relationships after functional orthodontic treatments with the monoblock or Herbst appliance using panoramic radiographs.

METHODS

Pre- and posttreatment cephalometric and panoramic radiographs of 133 patients (mean age 13.89 ± 1.14 years) treated non-extraction with monoblock (n: 44), Herbst (n: 45) and fixed orthodontic appliances (control group; n: 44) were included to the study. Dental and skeletal measurements were performed on cephalometric radiographs. The angle between the third and second molars, and canines with the lower border of the mandible and the occlusal plane, gonial angle, the angle between the third and second molars and the retromolar space width were assessed on pre- and posttreatment panoramic radiographs. Paired and independent t tests were used for the statistical analysis of the data for intragroup and intergroup comparisons.

RESULTS

Functional treatment with both the monoblock and the Herbst appliances resulted in improvement of skeletal class II relationships. Retromolar space significantly increased in the functional appliance groups compared to the control group (p ≤ 0.001), but improvement of the angulations of posterior teeth was significant only in the monoblock group (p ≤ 0.001).

CONCLUSION

While both the Herbst and monoblock appliances led to an increase in retromolar space, monoblock treatment resulted in more favorable angulation of the third molars compared to the Herbst treatment.

Examining Postoperative Posterior Cruciate Ligament Index: A Structural Paradigm in Anterior Cruciate Ligament (ACL) Reconstructions With Hamstring Tendon Autograft

BACKGROUND

The current study aimed to compare the posterior cruciate ligament (PCL) index values of patients who underwent hamstring tendon (HT) autograft reconstruction due to an anterior cruciate ligament (ACL) tear. The comparison involved assessing these values in a similar cohort and evaluating the association between the alteration in the PCL index and functional results.

METHODS

Patients who were clinically diagnosed with a complete, unilateral ACL tear and underwent ACL reconstruction (ACLR) using HT autograft between January 2018 and January 2021 constituted the operated group (Group 1) of the study. The control group (Group 2) consisted of patients selected from a convenience sample without ACL rupture, meniscal lesion, or cartilage damage who underwent an MRI during an outpatient orthopaedic consultation for knee pain. The operated group was submitted for an MRI of the knee one year after the operation for any reason such as pain, graft healing, the presence of tunnel widening, or suspicion of re-rupture. The International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form and the Lysholm Scoring System were applied to the patients in the operated group in the preoperative and postoperative periods to evaluate their complaints, function, and participation in sports and to assess functional ability and functional capacity. A radiologist with five years of experience measured the PCL index in the sagittal section of an MRI. In the operated group, changes in PCL index, IKDC, and Lysholm values during the postoperative period were assessed, along with their correlation. Additionally, a comparison was made between the values of the operated group and the non-operated group.

RESULTS

No statistically significant correlation was found between the PCL index alteration and the functional score alteration (IKDC and Lysholm) in the operated group (p>0.05). In comparison to the non-operated group, the preoperative PCL index measures of the operated group were significantly lower (p: 0.000; p<0.05). The increase in the postoperative PCL index measurements of the operated group was similarly statistically significant (p: 0.000; p<0.05).

CONCLUSION

Although the PCL index appears to be a strong anatomical structural parameter in ACLR patients performing HT autograft in the postoperative period, its correlation with functional results is weak.

A bioinformatic analysis: Previous allergen exposure may support anti- SARS-CoV-2 immune response

COVID-19, caused by infection with the SARS-CoV-2 has become a global health problem due to significant mortality rates; the exact pathophysiological mechanism remains uncertain. Articles reporting patient data are quite heterogeneous and have several limitations. Surviving patients develop a CD4 and CD8 T-cell response to the virus SARS-CoV-2 during COVID-19. Interestingly, pre-existing virus-reactive T-cells have been found in patients that were not infected before, suggesting some form of cross-reactivity or immunological mimicry. To better understand this phenomenon, we performed a bioinformatic study, which was aimed to identify antigenic structures that may explain the presence of such "reactive" T-cells, which may support or modulate the immune response to SARS-CoV-2 infections. Seven different common environmental allergen epitopes identical to the SARS-CoV-2 S-protein were identified that share affinity to 8 MHCI-specific epitope regions. Pollen showed the greatest similarity with the S protein epitope. In the epitope similarity analysis between the S protein and MHC-II / T helper epitopes, the highest similarity was determined for mites. When S-protein that stimulates B cells and identical epitope antigens are examined, the most common allergens were hornbeam and wheat. The high epitope similarity observed for the allergens examined and S protein epitopes suggest that these allergens may be a reason for pre-existing SARS-CoV-2 - reactive T-cells in previously non-infected subjects and such a previous exposure may affect the course of the disease in COVID-19 infection. It remains to be determined whether such a previous existence of SARS-CoV-2 reactive cells can support the clearance of the virus or if they, in contrast, may even aggravate the disease course. (Table 4, Ref 54).

Evaluation of the Relationship Between Diabetic Retinopathy and the Development of Left Atrial Stiffness in Patients with Diabetes Mellitus

OBJECTIVE

Based on several studies, atrial remodeling results in an increase in left atrial (LA) stiffness, which is indicative of a worsened reservoir function. A typical microvascular consequence of diabetes mellitus (DM) is diabetic retinopathy. Therefore, the objective of this study was to assess the factors that might be related to LA stiffness in DM patients.

MATERIALS AND METHODS

There were 200 DM patients in the study population. The LA stiffness value of 0.33 led to the division of the patients into 2 groups. According to these groups, the parameters to predict the development of the LA stiffness were investigated.

RESULTS

The patient population's median age was 54.7 ± 9.4 years, and of them, 105 (52.5% of the population) were men. Retinopathy was substantially linked with LA stiffness. Interventricular septum thickness (B coefficient: 0.261, 95% CI 0.128; 0.394; P < .001), mitral annular plane systolic excursion (B coefficient: -0.350, 95% CI -0.489; -0.2212; P < 0.001), and retinopathy (B coefficient: 0.644, 95% CI 0.307; 0.983; P < .001) were identified as independent predictors of the progression of LA stiffness by the linear regression model.

CONCLUSION

The results of the current investigation demonstrated a correlation between higher LA stiffness values and the presence of diabetic retinopathy in diabetic patients.

The clinical significance and diagnostic value of serum Dickkopf1 and CKAP4 levels in patients with gastric cancer: a prospective study

OBJECTIVE

Gastric cancer is diagnosed at an advanced stage in most patients, and the prognosis is poor. Novel biochemical markers of high diagnostic value for the detection of the disease are therefore important. Dickkopf1 (DKK1) and cytoskeleton-associated protein 4 (CKAP4) have been extensively studied as biomarkers in cancer patients.

PATIENTS AND METHODS

Serum DKK1 and CKAP4 levels in 58 patients with gastric cancer and 41 healthy controls were examined using an ELISA kit in this prospective study. The patients were subdivided into groups based on pathological TNM staging and histological grades. Serum levels of both proteins in the patients with gastric cancer were measured preoperatively, 10 and 30 days after surgery.

RESULTS

Serum DKK1 and CKAP4 levels were significantly higher in the gastric cancer group compared to the healthy controls (p<0.05). Serum levels of both proteins increased in line with the pathological stage and histological grade of the gastric cancer. Serum CKAP4 and DKK1 levels decreased after surgical resection. Both serum levels also decreased significantly on day 30 after surgery compared to day 10 (p<0.05). Serum carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) positivity rates were below 20% in the gastric cancer group, while the diagnostic value (sensitivity and specificity) of serum CKAP-4 and DKK1 exceeded 80%.

CONCLUSIONS

DKK1 and CKAP4 are biomarkers of high diagnostic value that can be used to diagnose and predict the severity of gastric cancer. These proteins can also be employed for disease monitoring after surgical resection. The diagnostic value of these proteins is higher than that of biomarkers such as CEA and CA19-9, which are routinely used in clinical practice.

Could ischemia-modified albumin levels predict the severity of disease in SARS-CoV-2 infection?

INTRODUCTION

Ischemia-modified albumin (IMA) level increases in inflammatory conditions. We aimed to investigate the association between IMA levels and the severity of coronavirus disease 2019 (COVID-19) infection in adult patients.

METHODOLOGY

We grouped adult patients with COVID-19 infection: Group A - mild symptoms, but normal computed tomography (CT), Group B - mild/moderate illness, and Group C - severe or critical illness. We measured IMA levels at the time of diagnosis of COVID-19 infection.

RESULTS

Mean age of the total number of patients (n = 90) was 54.43 (± 8.11) year, and 46.7% (n = 42) were female. IMA levels were highest in Group C and lowest in A (p < 0.001). The most important factor predicting COVID-19 disease severity was IMA. Type 2 diabetes was more frequent in Group C (n = 31) than in Group B (n = 30) (p = 0.042). Asthma was less frequent, and coronary artery disease was more frequent in Group C than in Group A (n = 29) and B (p = 0.009). Duration of hospitalization was highest in Group C (p < 0.001).

CONCLUSIONS

We analyzed a sample of patients with COVID-19 infection and found that IMA predicted severe COVID-19 disease. Disease severity grouping was based on patients' clinical and radiological features. IMA level measured when SARS-CoV-2 infection is diagnosed may be a useful marker in predicting likely disease severity or intensive care need.

Real-life outcomes for oral disease-modifying treatments of relapsing-remitting multiple sclerosis patients: Adherence and adverse event profiles from Marmara University

BACKGROUND

To have country-wide information about multidrug resistance (MDR) in isolates from community-acquired urinary tract infections (CAUTI) of Turkey, in terms of resistance rates and useful options.

METHODS

We used a geocode standard, nomenclature of territorial units for statistics (NUTS), and a total of 1588 community-acquired isolates of 20 centres from 12 different NUTS regions between March 2019 and March 2020 were analysed.

RESULTS

Of the 1588 culture growths, 1269 (79. 9%) were Escherichia coli and 152 (9.6%) were Klebsiella spp. Male sex, advancedage, and having two or more risk factors showed a statistically significant relation with MDR existence (p < 0.001, p: 0.014, p < 0.001, respectively) that increasing number of risk factors or degree of advancing in age directly affects the number of antibiotic groups detected to have resistance by pathogens. In total, MDR isolates corresponded to 36.1% of our CAUTI samples; MDR existence was 35.7% in E. coli isolates and 57.2% in Klebsiella spp. isolates. Our results did not show an association between resistance or MDR occurrence rates and NUTS regions.

DISCUSSION

The necessity of urine culture in outpatient clinics should be taken into consideration, at least after evaluating risk factorsfor antibacterial resistance individually. Community-acquired UTIs should be followed up time- and region-dependently. Antibiotic stewardship programmes should be more widely and effectively administrated.

Clinical Features and Risk Factors for Mortality in Patients with Stenotrophomonas maltophilia Infection

Introduction: It is important to know the risk factors for death in reducing mortality in patients with Stenotrophomonas maltophilia infections. The purpose of this study was to examine the risk factors associated with mortality in hospitalized patients with S. maltophilia infections. Materials and Methods: Patients with S. maltophilia infections aged 18 years and older who were hospitalized in Haseki Research and Training between January 1, 2017, and April 30, 2022, were included in the study. The patients were divided into two groups, non-survivors and survivors, and the clinical features and laboratory parameters of the groups were compared. Mortality risk factors were analyzed by logistic and Cox regression analyses. Results: A total of 75 patients with S. maltophilia infections were included. The mortality rate was 38.6% (n= 29). Advanced age (OR= 1.05, 95% CI= 1.012-1.085, p= 0.009), COVID-19 pneumonia (OR= 9.52, 95% CI= 1.255-72.223, p= 0.029), and presence of central venous catheter (CVC) (OR= 18.25, 95% CI= 2.187-152.323, p= 0.007) were risk factors for death. Conclusion: Physicians should be aware of the potential risk of S. maltophilia infections for mortality, particularly in patients with predefined risk factors such as advanced age, the presence of CVC, and COVID-19. Performing CVC care in accordance with infection prevention and control measures and timely removal of CVC may be beneficial in reducing deaths due to S. maltophilia infection.

Pseudomonas aeruginosa Keratitis in Rats: Study of the Effect of Topical 5% Hesperidin Practice on Healing

OBJECTIVE

The aim of this study is to investigate the effect of topical 5% hesperidin application on healing.

MATERIALS AND METHODS

After 48 rats were randomized and divided into 7 groups, on the first day, an epithelial defect was created in the center of the cornea with the help of microkeratome under intraperitoneal ketamine+xylazine and topical 5% proparacaine anesthesia for the groups to be infected with keratitis according to the groups mentioned below. An amount of 0.05 mL of the solution containing 108 colony-forming units/ mL Pseudomonas aeruginosa (PA-ATC27853) will be taken and inoculated per rat. At the end of the 3 days incubation period, rats with keratitis will be added to the groups, and active substances and antibiotics will be given topically together with other groups for 10 days. At the end of the study, the ocular tissues of the rats will be removed and examined histopathologically.

RESULTS

A clinically significant reduction in inflammation was detected in the groups using hesperidin. No transforming growth factor-β1 staining was detected in the group in which keratitis+hesperidin was treated topically. In the group in which hesperidin toxicity was examined, mild inflammation and thickening of the corneal stroma layer were observed, and it was evaluated as a negative transforming growth factor-β1 expression in the lacrimal gland tissue. Corneal epithelial damage was minimal in the keratitis group, and the toxicity group was treated with only hesperidin when compared to the other groups.

CONCLUSION

Topical hesperidin drops may be an important therapeutic factor in tissue healing and in the fight against inflammation in the treatment of keratitis.

Role of serum cathelicidin in diagnosis of patient with prostatitis and prostate carcinoma

Background

This study investigated the diagnostic role of 75 levels measured in serum prostatitis and prostate carcinoma and in the differentiation of these two conditions.

Methods

The study was conducted with 75 patients histopathologically diagnosed with prostate carcinoma or prostatitis and followed up at the Departments of Urology and Medical Oncology and 21 healthy male subjects. Serum cathelicidin levels were investigated using the ELISA method. Statistical analyses were performed using the SPSS for Windows 22.0 package software. Compliance of the variables to normal distribution was examined using visual and analytic methods. In the Kolmogorov–Smirnov test, cases with a p value of greater than 0.05 were accepted as normal distribution.

Results

A total of 75 patients including 45 diagnosed with prostate carcinoma and 30 diagnosed with prostatitis, as well as 21 healthy control subjects were included in the study. Prostate-specific antigen (PSA) was detected as 23 (4–1200) ng/mL in the patients with prostate carcinoma and as 9.85 (3.9–405 ng/mL) in the patients with prostatitis. The cathelicidin levels were diagnostically significant when assessed by ROC analysis in the prostate cancer, prostatitis and control groups (p = 0.005). The cutoff values derived from the ROC curve analysis were 3.5151 ng/mL for distinguishing prostate cancer from prostatitis, 2.2620 ng/mL for prostate cancer versus control group and 1.2340 ng/mL for prostatitis versus control group.

Conclusions

In this study we showed that the serum cathelicidin levels were significantly higher in the patients diagnosed with prostate carcinoma. Measurement of serum cathelicidin levels could be used as a diagnostic marker in prostate carcinoma as well as facilitating differential diagnosis to strengthen the diagnostic suspicion before prostate biopsy and distinguish the diagnosis from prostatitis cases.

A Case of İntrapancreatic Accessory Spleen Mimicking a Pancreatic Metastasis on the 18F-FDG PET/CT Scan: A Case with Breast Cancer

The accessory spleen is a focus of splenic tissue which is separated from the main of the spleen. Although accessory spleens are generally recognized on computed tomography (CT), intrapancreatic accessory spleen (IPAS) may be mistaken for other pancreatic tail lesions. We report a case of IPAS mimicking a pancreatic metastasis on the ¹⁸ F-fluorodeoxyglucose positron emission tomography/computed tomography ( ¹⁸ F-FDG PET/CT). A 41-year-old with diagnosed breast cancer (invasive ductal carcinoma) woman patient underwent an ¹⁸ F-FDG PET/CT for metastasis screening and staging. ¹⁸ F-FDG PET/CT showed a focal uptake in the pancreatic tail. The patient underwent a contrast-enhanced CT and magnetic resonance imaging (MRI) for lesion characterization. The density and intensity of lesion were similar to spleen on all phases and all sequences. The lesion was evaluated as IPAS. The diagnosis was confirmed by endoscopic ultrasound (EUS) biopsy. A case of IPAS positive at ¹⁸ F-FDG PET/CT could not found in the literature. We present a case of IPAS mimicking a pancreatic metastasis positive at ¹⁸ F-FDG PET/CT.

Prospective external validation of an updated algorithm to quantify risk of febrile neutropenia in cancer patients after a cycle of chemotherapy

PURPOSE

Febrile neutropenia resulting from chemotherapy is a significant cause of morbidity and mortality in cancer patients. We had previously published the associates of the risk of febrile neutropenia, and this study now extends and modifies the previous model as well as tests its external validity.

METHODS

We have recruited documented febrile neutropenia cases with solid tumors, in addition to a selected control group of cancer patients from one institution treated between 2015 and 2019. We then united our sample with our previously published original derivation group, to modify and update our previous model by logistic regression analysis. Additionally, consecutive cancer patients from 5 institutions were recruited in 2020 to test external validity of the resultant algorithm.

RESULTS

A total of 4075 cycles of chemotherapy in 1282 cases were recruited in the updated, new model derivation group, and a total of 8 variables were selected for the updated algorithm. In the new external validation group, 653 cycles of chemotherapy in 624 patients were analyzed, to indicate that after cycles without prophylactic granulocyte colony-stimulating factor (GCSF) usage, the algorithm yielded a sensitivity value of 91%, specificity of 40%, and an area under curve (AUC) figure of 0.78, when a risk cutoff threshold value of ≥ 0.20 is chosen. This algorithm is now embedded in a web application for free clinical use.

CONCLUSION

Our algorithm identifies and quantifies the risk of febrile neutropenia in cancer patients. Further studies are required to improve this model with additional predictors.

Predictors for tuberculosis co-infection in people living with HIV/AIDs

Background/aim

Tuberculosis (TB) is one of the most common chronic infectious conditions causing mortality and severe outcomes, particularly in people living with HIV/AIDS (PLWHA). In this study, we aimed to determine the prevalence and predictors of TB among PLWHA.

Materials and Methods

We conducted a retrospective and single-center study of adults (≥18 years) PLWHA registered at our tertiary teaching and research hospital between 2000 and 2016.

Results

A total of 711 PLWHA were included. Of whom, 633 (89.0%) were male. Mean age was 36.53 ±11.55 years (range, 17–79). Thirty-eight (5.3%) patients were diagnosed with active TB. TB development was associated with low CD4+ lymphocyte count (p<0.001), high viral load (p=0.040) and alcohol consumption (p=0.004) but no association with age (p=0.392), gender (p=0.928) and duration since anti-retroviral therapy initiation (p=0.788) was found. Also, a receiver operating characteristic analysis showed that the area under the curves of CD4+ lymphocyte count as a predictor for TB development in PLWHA was 0.717 (p<0.001).

Conclusion

There are still clinical challenges to predict TB diagnosis. However, CD4+ lymphocyte count and viral load may be considered as valuable predictors for TB development. Also, community strategies to reduce harmful effect of alcohol use should be developed.

Scalable optical learning operator

Today's heavy machine learning tasks are fueled by large datasets. Computing is performed with power-hungry processors whose performance is ultimately limited by the data transfer to and from memory. Optics is a powerful means of communicating and processing information, and there is currently intense interest in optical information processing for realizing high-speed computations. Here we present and experimentally demonstrate an optical computing framework called scalable optical learning operator, which is based on spatiotemporal effects in multimode fibers for a range of learning tasks including classifying COVID-19 X-ray lung images, speech recognition and predicting age from images of faces. The presented framework addresses the energy scaling problem of existing systems without compromising speed. We leverage simultaneous, linear and nonlinear interaction of spatial modes as a computation engine. We numerically and experimentally show the ability of the method to execute several different tasks with accuracy comparable with a digital implementation.

Factors affectıng recurrence after trımodal treatment ın ınvasıve bladder cancer

Background

In this study, we aimed to determine which patients will benefit most from TMT treatment, and to evaluate the factors affecting relapse, survival and response to treatment separately.

Methods

For the study, patients who presented to our hospital’s outpatient clinic between 2010 and 2020 and were diagnosed with locally advanced (T2-G3) invasive urothelial bladder cancer and treated with gemcitabine concomitantly with radiotherapy following complete TUR were identified. A total of 112 patients with transitional cell bladder cancer invading the muscle were enrolled in the study including 88 (78.6%) males and 24 (21.4%) females.

Results

Tumor location was significantly associated with tumor recurrence (p = 0.003). Recurrence at follow-up was significantly associated with the number of tumor foci (p = 0.008). Median duration of follow-up and median progression-free survival were 41.50 months and 65 ± 4.21 (95% CI, 56.74-73.25) months, respectively. Progression-free survival was not statistically significantly associated with neutrophil/lymphocyte ratio (NLR), platelet/ lymphocyte ratio (PLR) or BMI (p = 0.32, p = 0.47, p = 0.39, respectively), but muscle invasion during follow-up was significantly associated with progression-free survival (p = 0.009).

Conclusions

Tumor location, the number of tumor foci, history of multiple transurethral resection surgeries and a NLR ≥ 2.56 were significantly associated with recurrence following Trimodal therapy (TMT). A lower rate of recurrence was observed among patients undergoing early TMT after initial diagnosis. None of the patients treated with trimodal therapy experienced severe adverse effects. Therefore, trimodal therapy is a safe, effective and tolerable therapeutic option with a low rate of recurrence in selected eligible patients.

Checkpoint inhibitors in advanced nonsmall-cell lung cancer; a Bayesian network meta-analysis

Background

Checkpoint inhibitors (CPIs) have improved survival compared to chemotherapy alone in advanced nonsmall-cell lung cancer (NSCLC). This article aims to compare indirect evidence and rank the effect of different CPIs in this setting.

Materials and Methods

In this network meta-analysis, we searched for trials comparing CPIs in advanced NSCLC. Figures for survival endpoints were extracted. In addition, a network meta-regression analysis was carried out.

Results

A total of 9220 patients from 16 trials were included in the analysis. In the first-line setting, for the overall survival endpoint, the chemotherapy + Pembrolizumab combination had the highest effectivity rank probability as compared to chemotherapy (hazard ratio = 0.788, 95% credential interval = 0.728-0.855). For the second-line setting, and also for the efficacy in terms of progression-free survival, various CPIs and their combinations were ranked.

Conclusion

Some degree of differences in terms of efficacy exists between different types, dosages, settings, and combinations of CPI. We quantify these differences to guide clinical practice.

Programmed death-1 or programmed death ligand-1 inhibitors? A meta-analysis of differential efficacy as compared to chemotherapy in advanced non-small cell lung cancer

BACKGROUND

Programmed Death-1 (PD-1) and Programmed Death Ligand-1 (PDL-1) inhibitors have improved survival over chemotherapy in advanced Non- Small Cell Lung Cancer (NSCLC). However, it is unclear if there are class specific differences in the efficacy of Checkpoint Inhibitors (CPIs) in NSCLC, and this paper is designed to answer these clinical questions.

METHODS

For this Meta-analysis, we searched PubMed, Science of Web, "Clinicaltrials.gov" and online sources for trials comparing PD-1 and PDL-1 CPIs in advanced NSCLC. The data for Hazard Ratio (HR) and their Confidence Intervals (CI) for Overall Survival (OS) was extracted.

RESULTS

A sum of 9739 patients from 16 trials were included in the efficacy evaluation. For the OS endpoint, both PD-1 inhibitors (HR = 0.76, 95%CI = 0.69-0.83, P < 0.001) and PDL-1 inhibitors (HR = 0.84, 95%CI = 0.74-0.95, P < 0.001) were superior to chemotherapy in treatment naïve (upfront) patients, the results were similar in treatment refractory patients (PD-1 inhibitors (HR = 0.67, 95%CI = 0.60-0.75, P < 0.001) and PDL-1 inhibitors (HR = 0.78, 95%CI = 0.69-0.88, P < 0.001) were superior to chemotherapy). There was no difference in the effect of PD-1 and PDL-1 classes of CPIs over chemotherapy in treatment naïve and treatment refractory settings (Q = 1.88, df = 1, P = 0.017, and, Q = 3.27, df = 1, P = 0.070, respectively).

CONCLUSION

Efficacy of PD-1 and PDL-1 class of CPIs was not different, although differences among individual CPIs or their combinations cannot be excluded. We were also able to compute pooled efficacy data, as compared to chemotherapy alone, for trials where these groups of CPIs were utilized.

How the Process of the CSR Activities Works on Private Hospitals and Pharmaceutical Firms: Multiple Case Study from Strategic Perspective

The phenomenon of corporate social responsibility "CSR" has stimulated lots of debates and disagreement among the business scholars. One of the most howling sounds comes from strategy and CSR thinkers. Strategic thinkers of this debate believe that CSR is not only an accountability action but also it is countability action. Due to this countability action heavily based on profit, the scholar of strategy field stated that strategic thinking lens should revise the phenomenon of CSR and the result of its activities. To this end in this study, we examine the CSR activities, especially philanthropy activities (sports, art sponsorships, etc.) from strategy perspectives. And the question of this study is "How the process of the CSR activities work on private hospitals and pharmaceutical firms?" In this framework, private hospitals, pharmaceutical firms in Turkey, and their CSR activity and global compact reports are used as the cases of the study. We make qualitative content analysis, and the documents in this study are analyzed with qualitative analysis software (MAXQDA). The results which were obtained from the analysis are considered important by the researchers since it is shown in this multiple case study that private hospitals and pharmaceutical firms have to focus on some specific points in their social responsibility activities to get competitive superiority for themselves and gain profit in the long term. While the CSR orientation of the private hospitals concentrates on sports dimension, the direction of pharmaceutical firms is on education dimension. In both fields, the cases construct their CSR activities on these two dimensions or relate their other CSR activities with these dimensions.

Evaluation of oxidative stress in patients with recalcitrant warts

BACKGROUND

Warts are benign conditions of the skin and mucosa caused by human papilloma viruses (HPV) that affect many people worldwide.

OBJECTIVE

The aim of this study was to evaluate OS by TOS/TAS, levels of 8-hydroxy-2-deoxyguanosine (8-OHdG) an indicator of DNA damage, and also protein oxidation levels by determining the dynamic serum thiol/disulphide homeostasis in patients with warts. We also aimed to investigate whether there is a relationship between thiol/disulphide homeostasis, recalcitrance of warts and DNA damage.

METHODS

Forty patients of age ≥18 years, having recalcitrant genital and/or non-genital warts that persisted for more than 2 years, 40 patients with warts that persisted for <2 years and 40 healthy controls were enrolled in the study. Blood TAS, TOS, OSI, 8-OHdG and dynamic thiol/disulphide homeostasis were evaluated.

RESULTS

Significant differences were detected between the groups in the levels of 8-OHdG, TOS, OSI, total thiol, native thiol, reduced thiol, as well as native thiol/total thiol ratio, disulphide/total thiol ratio and disulphide/native thiol ratio. Compared with the controls, patients with recalcitrant warts had significantly higher levels of 8-OHdG, TOS and OSI levels. Total thiol and native thiol levels were significantly lower in patients with recalcitrant warts compared with patients with warts that persisted for <2 years. Disulphide levels were significantly higher in the latter group of patients compared with patients with recalcitrant warts and controls. Native thiol/total thiol ratio was significantly higher in both patient groups compared with controls whereas disulphide/total thiol and disulphide/native thiol ratios were significantly lower in both patient groups than in controls.

CONCLUSION

Our findings suggest that impairment of thiol disulphide homeostasis in patients with recalcitrant warts may lead to increased OS and DNA damage. Thus, antioxidant administration with thiol containing proteins may help in the regression of warts and thereby prevent carcinogenesis.

[Cases of Zika virus infection in Turkey: newly married couple returning from Cuba]

Zika virus is a Flavivirus in the family Flaviviridae, and transmitted to humans by Aedes species mosquitoes. Zika virus infection is asymptomatic in 80% of cases and has a mild course when symptoms occur. These symptoms include headache, myalgia, mild fever, maculopapular rash and conjunctivitis. Zika virus has been associated with serious neurological complications such as Guillain-Barre syndrome in adults and microcephaly development in neonates. It has recently become a global public health problem as a result of increasing cases. As it is known that the vector of this disease is present in our country; entry of Zika virus infection in our country has a great importance. In this report the clinical and laboratory findings of two cases of Zika virus infection imported to Turkey by a couple returning from Cuba in October 2017 were presented. Newly married couple, both 29 years old, without a known chronic disease history, went on honeymoon to Cuba between 17-29 September and they visited Havana and Varadero. They reported that they were bitten repeatedly by the mosquitoes and did not use insect repellents during this time. Four days after returning to Turkey, they had headaches, back pain and myalgia followed by rash and joint pain. They reported having their symptoms started in the same day in a few hours difference. The symptoms for both patients disappeared in 10 days. Serum samples from the patients were sent to the Public Health General Directorate National Arboviruses and Viral Zoonoses Laboratory to be tested for Dengue, Chikungunya and Zika viruses. Nucleic acid testing yielded negative results. The Arbovirus Indirect Immunofluorescence test were positive both for IgM and IgG for Zika virus. No cross reactivity with Dengue virus was detected. Chikungunya antibodies were found as negative. At two months of the diagnosis, urine and semen samples of the male patient were tested by real-time reverse transcriptase polymerase chain reaction (rRT-PCR). The result was negative for urine but positive for semen sample. This report is important to present the first cases of Zika virus infection published in Turkey. Zika virus infection should be suspected in patients with fever, headache, rash, myalgia and joint pain returning from an endemic areas. All travelers, especially pregnant women, have to take precautions for mosquitos during the trip.

Prognostic Significance of Indicators of Systemic Inflammatory Responses in Glioblastoma Patients

Background: High-grade gliomas, with glioblastomas as the most frequently observed histologic subtype, are the most common primary brain tumours in adults. It is considered that inflammatory responses play a major role in malignancies, including tumour progression. This study aimed to determine the prognostic significance of the neutrophil to lymphocyte ratio (NLR) and the thrombocyte to lymphocyte ratio (PLR) as indicators of systemic inflammatory response (SIR) in glioblastoma patients. Methods: A total of 90 patients treated for glioblastoma were retrospectively evaluated. Absolute counts were used to generate NLR and PLR. A SIR was considered to be present with an NLR ≥5 and/or PLR ≥150. Results: Median follow-up time was 11.3 months (range: 1-70 months). The 1-year and 2-year overall survival rates were 55.2% and 19.5%, respectively. Univariate analysis showed that there was no correlation between overall survival and gender (p=0.184), comorbid disease (p = 0.30), clinical presentation (p = 0.884), or tumour lateralization (p = 0.159). Multivariate analysis showed that overall survival was significantly correlated with SIR based on NLR (HR: 2.41), and ECOG performance status (HR: 1.53). The prognostic factors that affected survival, other than SIR, were Eastern Cooperative Oncology Group (ECOG) performance status (p = 0.003), and tumour localization (p = 0.006). Conclusion: The present findings confirm that NLR based on peripheral blood counts prior to treatment can be used as a prognostic factor in patients with glioblastoma. Since tumour aggression increases and survival decreases as the NLR value rises, choice of treatment modality is facilitated for glioblastoma patients.

The spectrum and some subdivisions of the spectrum of discrete generalized Cesàro operators on [Formula: see text] ([Formula: see text])

The discrete generalized Cesàro matrix [Formula: see text] is the triangular matrix with nonzero entries [Formula: see text], where [Formula: see text]. In this paper, boundedness, compactness, spectra, the fine spectra and subdivisions of the spectra of discrete generalized Cesàro operator on [Formula: see text] ([Formula: see text]) have been determined.

Serum levels of HMGB1 have a diagnostic role in metastatic renal cell cancer

RCC constitutes approximately 90% of all renal malignancies and 2-3% of all malignant tumours in adults. In spite of the improvement in radiologic methods, nearly 30% of the early metastatic RCC patients are incidentally diagnosed. HMGB1 is an extracellular signalling molecule that plays a role both in inflammation and carcinogenesis. Patients who were followed in Medical Oncology Departments of Denizli Government Hospital and Antalya Education and Research Hospital with a histopathological diagnosis of RCC between years 2010-2012 were enrolled in this study. HMGB1 levels were also assessed in a manually performed quantitative sandwich-enzyme-linked immunosorbent assay (ELISA) assay kit. In our study, we showed that the serum level of HMGB1, whether 149.9 pg/ml or not is important in differential diagnosis between patient and control group.

Role of ultrasonographic chronic kidney disease score in the assessment of chronic kidney disease

PURPOSE

Ultrasonography (US) is an inexpensive, noninvasive and easy imaging procedure to comment on the kidney disease. Data are limited about the relation between estimated glomerular filtration rate (e-GFR) and all 3 renal US parameters, including kidney length, parenchymal thickness and parenchymal echogenicity, in chronic kidney disease (CKD). In this study, we aimed to investigate the association between e-GFR and ultrasonographic CKD score calculated via these ultrasonographic parameters.

METHODS

One hundred and twenty patients with stage 1-5 CKD were enrolled in this study. The glomerular filtration rate was estimated by the Chronic Kidney Disease Epidemiology Collaboration equation. US was performed by the same radiologist who was blinded to patients' histories and laboratory results. US parameters including kidney length, parenchymal thickness and parenchymal echogenicity were obtained from both kidneys. All 3 parameters were scored for each kidney, separately. The sum of the average scores of these parameters was used to calculate ultrasonographic CKD score.

RESULTS

The mean age of patients was 63.34 ± 14.19 years. Mean kidney length, parenchymal thickness, ultrasonographic CKD score and median parenchymal echogenicity were found as 96.2 ± 12.3, 10.97 ± 2.59 mm, 6.28 ± 2.52 and 1.0 (0-3.5), respectively. e-GFR was positively correlated with kidney length (r = 0.343, p < 0.001), parenchymal thickness (r = 0.37, p < 0.001) and negatively correlated with CKD score (r = -0.587, p < 0.001) and parenchymal echogenicity (r = -0.683, p < 0.001). Receiver operating characteristic curve analysis for distinction of e-GFR lower than 60 mL/min showed that the ultrasonographic CKD score higher than 4.75 was the best parameter with the sensitivity of 81% and positive predictivity of 92% (AUC, 0.829; 95% CI, 0.74-0.92; p < 0.001).

CONCLUSION

We found correlation between e-GFR and ultrasonographic CKD score via using all ultrasonographic parameters. Also, our study showed that ultrasonographic CKD score can be useful for distinction of CKD stage 3-5 from stage 1 and 2. We suggested that the ultrasonographic CKD score provided more objective data in the assessment of CKD.

The role of gender in patients with diffuse large B cell lymphoma treated with rituximab-containing regimens: a meta-analysis

INTRODUCTION

Diffuse large B cell lymphoma (DLBCL) is the most common subtype of non-Hodgkin lymphoma (NHL). Although gender has not been included in prognostic systems, male gender has been found as a bad prognostic indicator in Hodgkin lymphoma, follicular lymphoma and chronic lymphocytic leukemia. The relationship between gender and prognosis is not clear in patients with DLBCL treated with rituximab-containing regimens. The aim of this meta-analysis is to determine the prognostic/predictive role of gender in patients with DLBCL treated with rituximab-containing regimens.

MATERIAL AND METHODS

We systematically searched for studies investigating the relationships between gender and prognosis in DLBCL treated with rituximab-containing regimens. After careful review, survival data were extracted from eligible studies. A meta-analysis was performed to generate combined hazard ratios for overall survival, disease-free survival (DFS) and event-free survival (EFS).

RESULTS

A total of 5635 patients from 20 studies were included in the analysis. Our results showed that male gender was associated with poor prognosis in terms of overall survival (OS) (hazard ratio (HR) = 1.155; 95% confidence interval (CI): 1.037-1.286; p < 0.009). The pooled hazard ratio for DFS and EFS showed that male gender was not statistically significant (HR = 1.219; 95% CI: 0.782-1.899; p = 0.382, HR = 0.809; 95% CI: 0.577-1.133; p = 0.217).

CONCLUSIONS

The present meta-analysis indicated male gender to be associated with a poor prognosis in patients with DLBCL treated with rituximab-containing regimens.

Loss of tight junction proteins (Claudin 1, 4, and 7) correlates with aggressive behavior in colorectal carcinoma

BACKGROUND

Tight junction proteins in the cell organize paracellular permeability and they play a critical role in apical cell-to-cell adhesion and epithelial polarity. Claudins are major integral membrane proteins of tight junctions, especially Claudin 1, 4, and 7, which are known as the impermeability Claudins. In this study, we investigated the importance of loss of Claudin 1, 4, and 7 expression, and their relation to tumor progression in colorectal cancer patients.

MATERIAL/METHODS

Loss of Claudin 1, 4, and 7 expression was examined by immunohistochemical method in 70 patients diagnosed with colorectal cancer. Cases with loss of Claudin expression in <1/3 of tumor cells were classified as mild loss, whereas cases with loss of Claudin expression ³1/3 of tumor cells were classified as moderate-to-marked loss in order to evaluate the relation between loss of Claudin 1, 4, and 7 expression and clinicopathologic data.

RESULTS

The severe suppression of Claudin 1, 4, and 7 expression was found to be significantly related to the depth of tumor invasion, positive regional lymph nodes, histological grade, lymphovascular invasion, perineural invasion, and lymphocytic response. Additionally, severity of loss in Claudin 4 expression was found to have a relation with distant metastasis.

CONCLUSIONS

Claudin 1, 4, and 7 are important building blocks of paracellular adhesion molecules. Their decreased expression in colorectal cancer seems to have critical effects on cell proliferation, motility, invasion, and immune response against the tumor.

Pilomatrixoma-like testicular tumour without teratomatous elements

A 40-year-old man presented to us with infertility. During scrotal ultrasonography, a heterogeneous nodular mass was seen in the right testicle. Surprisingly, histopathological examination revealed shadow cells, which are the characteristic feature of pilomatrixomas.

Serum paraoxonase, TAS, TOS and ceruloplasmin in brucellosis

It is possible that brucellosis may be related to increase free radical production and antioxidant depletion. Thus, in the present study we aimed to evaluate the oxidative status in patient with brucellosis and healthy controls.

METHODS

This study includes the patients with brucellosis diagnosed by clinical findings and positive agglutination titer. The paraoxonase, ceruloplasmin, total antioxidant capacity and total oxidant status values were measured from the samples taken. The oxidative stress index value was calculated through the total antioxidant capacity and total oxidant status values.

RESULTS

A total number of 93 people, 40 women (43%) and 53 men (57%) were included to the study. The levels of ceruloplasmin were found higher in patients when compared to the control group (p < 0.001). The total antioxidant capacity level was found significantly higher in the patients group when compared to the control group (p < 0.001). The oxidative stress index value was significantly lower in the patients group when compared to the control group (p < 0.001). The paraoxonase-1 level was not different in control and patient groups (p = 0.077).

CONCLUSIONS

Brucellosis is an infection that is frequently seen in Mediterranean countries. This infection breaks the oxidant and antioxidant balance. In this disease, oxidant-antioxidant system indicators such as ceruloplasmin, total antioxidant capacity, total oxidant status and oxidative stress index can be used for showing the role of the brucella infection and for the monitoring of the treatment results.

The role of high mobility group box 1 (HMGB1) in colorectal cancer

Background

HMGB1, the most important member of the high mobility group box protein family, is a nuclear protein with different functions in the cell; it has a role in cancer progression, angiogenesis, invasion, and metastasis development. We studied the expression of HMGB1 and whether it is a prognostic factor in colorectal carcinoma.

Material/Methods

The study included 110 cases that were histopathologically diagnosed with colorectal carcinoma from the tissue samples acquired by surgical resection and biopsy in Antalya Education and Research Hospital between 2008 and 2012. HMGB1 expression was examined via immunohistochemical method.

Results

HMGB1 expression was evaluated as negative in 32 (44.4%) of the patients and as positive in 40 (55.6%) patients. There was no relation between the HMGB1 expression and sex, age, tumor invasion depth, and histological type. However, a significant relation was detected between the HMGB1 expression and lymph node status, metastasis status, and stage (p:<0.001, p:<0.001, p:<0.001, respectively). Similar results were obtained for the relations between the HMGB1 and histological grade, perineural invasion, lymphovascular invasion, and lymphocytic response (p<0.001, p<0.001, p<0.001, and p<0.001, respectively).

Conclusions

The results of our study demonstrate that HMGB1 overexpression has a significant role in tumor progression (especially migration of tumor cells) and tumor ability to metastasize in colorectal cancers; thus, it corroborates the idea that it might be an important prognostic factor.

The relation of radiation-induced pulmonary fibrosis with stress and the efficiency of antioxidant treatment: an experimental study

BACKGROUND

Radiation-Induced Lung Injury has 2 components: radiation pneumonitis and radiation fibrosis. The pulmonary fibrosis has no known efficient treatment. The purpose of this study was to study the relationship between the oxidant/antioxidant status and pulmonary fibrosis in rats having radiation induced pulmonary fibrosis and to study the antioxidant effects of pentoxifylline, vitamin E, and vitamin C in the treatment of pulmonary fibrosis.

MATERIAL AND METHODS

The study rats were divided into 5 groups: Thoracic RT + vitamin E+ Pentoxifylline for group 1, Thoracic RT + vitamin C + Pentoxifylline for group 2, Thoracic RT + vitamin C + vitamin E + Pentoxifylline for group 3, and Thoracic RT + Pentoxifylline for group 4, and group 5 was the control group.

RESULTS

When groups are evaluated in pairs, significant differences between group 1 and 2, group 1 and 4, and group 1 and 5 were determined (p: 0.002, p: 0.002, p<0.001, respectively). No significant difference was determined between group 1 and 3 (p: 0.161). No significant difference was determined between group 2 and group 3, 4, and 5 (p: 0.105, p: 0.645, p: 0.234, respectively). There was no significant difference between group 4 and 5 (p: 0.645).

CONCLUSIONS

The combination of vitamin E and pentoxifylline is efficient in preventing radiation-induced lung fibrosis. The additional benefit of vitamin C, which is added to this combination to increase the antioxidant activity, cannot be shown. It would be useful to investigate the combination of vitamin E, pentoxifylline, and other non-enzymatic antioxidants.

Multiple myeloma: relationship to antioxidant esterases

OBJECTIVE

To investigate the status of the oxidant/antioxidant balance in patients with multiple myeloma compared to healthy controls.

MATERIALS AND METHODS

This study was conducted on 40 multiple myeloma patients and 40 healthy controls of matched age and sex. Serum total thiol, oxidative stress index (OSI), total oxidant status (TOS), and total antioxidant status (TAS) were measured using colourimetric methods; paraoxonase-1 and arylesterase enzyme activities were also quantified.

RESULTS

Serum paraoxonase-1 and arylesterase activities and total thiol levels were significantly lower (p = 0.0001, p = 0.036 and p < 0.0001, respectively), whereas TOS and OSI levels were significantly higher (p < 0.0001 for both parameters) in multiple myeloma patients compared to controls. However, no significant differences in TAS were identified when the two groups were compared.

CONCLUSIONS

Our findings indicate an impaired oxidative/antioxidative balance in multiple myeloma. We recommend further studies with larger groups to investigate the possible relationship between oxidative stress and the aetiopathogenesis of multiple myeloma.

Diagnostics of peripherally located intrathoracic lipoma

In the differential diagnosis of lipomas, fibromatous hamartoma, liposarcoma, fibrolipoma and teratoma may be mentioned as fat-containing lesions of peripheral localization. However, these lesions are different from lipomas in that they contain soft tissue components and are not homogeneous. Furthermore, they are much larger than lipomas, are infiltrative and their CT density is greater than -50 HU. Though it is emphsized that up to the present time surgery has been the gold standard method in the recognition and treatment, considering the risks of surgical procedures, we are of the opinion that diagnosis can be established and the follow-up can be managed with advanced radiological methods and that there is no necessity for invasive interventions especially in asymptomatic patients.

Tumour markers in peritoneal washing fluid - contribution to cytology

BACKGROUND

Peritoneal washing cytology (PWC) that shows the microscopic intra-peritoneal spread of gynaecologic cancers is not used in staging but is known as prognostic factor and effective in planning the intensity of the therapy. False negative or false positive results clearly affect the ability to make the best decision for therapy. In this study we assessed levels of tumour markers, carcinoembryonic antigen (CEA), cancer antigen 125 (CA-125) and carbohydrate antigen (CA19-9), in peritoneal washing fluid to establish any possible contribution to the peritoneal washing cytology in patients operated for gynaecologic cancer.

MATERIALS AND METHODS

Preoperative tumour markers were studied in serum of blood samples obtained from the patients for preoperative evaluation of a gynaecologic operation. In the same group peritoneal tumour markers were studied in the washing fluid obtained for intraoperative cytological evaluation.

RESULTS

This study included a total of 94 patients, 62 with malignant and 32 with benign histopathology. The sensitivity of the cytological examination was found to be 21% with a specificity of 100%. When evaluated with CEA the sensitivity of the cytological examination has increased to 37%.

CONCLUSIONS

In addition to examination of PWC, the level of CEA, a tumour marker, in peritoneal washing fluid can make a diagnostic contribution. Determining the level of CEA in peritoneal washing fluid will be useful in the management of gynaecologic cancers.

[Major urologic surgical procedures in locally advanced colorectal cancers]

OBJECTIVE

To evaluate the outcomes of major urological procedures performed in patients with locally advanced colorectal cancer.

MATERIAL AND METHODS

Data of 37 patients with locally advanced colorectal cancer who underwent major urological surgical procedures along with simultaneous cancer surgery between the years of 2005 and 2010 were retrospectively evaluated.

RESULTS

The mean age was 58.3 years. Male/Female ratio was 2.7. 59% of the patients were primary, and 41% were recurrent cases of colorectal cancer. Bladder, ureters, urethra, kidneys and prostate were found as invaded in 19, 9, 5, 2 and 2 cases, respectively. The following single or combined procedures were performed; partial (n=11) or total (n=8; 2 combined with urethrocutaneostomy, 6 with ileal-conduit) cystectomy, urethroplasty (n=5), nephroureterectomy (n=2), radical nephrectomy (n=1), partial nephrectomy (n=1), ureteroneocystostomy (n=7), Boari's flap (n=4), transureteroureterostomy (n=3). Prolonged drainage was the most common surgical complication (27%). Urethrocutaneous fistula and total urinary incontinence were encountered in 1 and 1 patient, respectively. The incidence of hydronephrosis and elevated creatinine were 38% (preoperative 27%; postoperative 11%) and 24% (11% preoperative; 13% postoperative), respectively. Two deaths occurred in the first month of operations. Mean duration of follow up was 18(6-28) months for surviving 13 patients. Overall survival in 24 cases resulting in death was 21(1-42) months.

CONCLUSIONS

Since the most important eventual effects of locally advanced colorectal cancer are on the kidneys from the urological point of view; the aim of an urologist, as a member of surgical team, should be preserving renal function in addition to helping complete removal of the tumor.

Aortic flow propagation velocity as an early predictor of high coronary risk in hypertensive patients

AIM

To assess the value of aortic flow propagation velocity (Vp) in detecting hypertensive patients with coronary risk.

METHODS

The study included 120 patients with hypertension. According to the 10-year risk of coronary heart disease the patients were categorized in the three groups: 10-year risk < 10% (I),10 - year risk=%10 - 20 (II), and 10-year risk > 20% (III). The aortic flow propagation velocity (Vp) was measured from descending aorta with color M-mode echoardiography. The slope of the first aliasing contour was accepted as Vp. It was compared with Framingham coronary risk score, carotid intima media thickness and high sensitive C-reactive protein. Twelve patients were excluded from the study due to poor acoustic window.

RESULTS

The Vp was significantly lower (p<0.001), carotid intima media thickness and high sensitive C-reactive protein was significantly higher in group III (p=0.002 and p=0.014). The area under ROC curve of Vp, carotid intima media thickness and high sensitive C-reactive protein were 0.890, 0,700 and 0.664, respectively. There was a significant inverse relation between Vp and carotid intima media thickness (r=-0.37; p<0.001).

CONCLUSIONS

The aortic flow propagation velocity is a simple, feasible and reproducible marker of atherosoclerosis with an acceptable sensitivity and specificity. There is a need for longitudinal prospective studies to use it routinely.