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Metastatic castration‐resistant prostate cancer (mCRPC) remains a challenging condition to treat despite recent advancements. This retrospective study aimed to assess the activity and tolerability of Lutetium‐177 (Lu‐177) PSMA‐617 radioligand therapy (RLT) in mCRPC patients across multiple cancer centers in Turkey. The study included 165 patients who received at least one cycle of Lu‐177 PSMA‐617 RLT, with the majority having bone metastases and undergone prior treatments. Prostate‐specific antigen (PSA) levels were assessed before each treatment cycle, and the biochemical response was evaluated in accordance with the Prostate Cancer Work Group 3 Criteria. The PSA decline of ≥50% was classified as a response, while an increase of ≥25% in PSA levels was indicative of progressive disease. Neither response nor progression was considered as stable disease. The Lu‐177 PSMA‐617 RLT led to a significant PSA response, with 50.6% of patients achieving a >50% decrease in PSA levels. Median overall survival (OS) and progression‐free survival were 13.5 and 8.2 months, respectively. Patients receiving Lu‐177 PSMA‐617 RLT in combination with androgen receptor pathway inhibitors (ARPIs) had a higher OS compared to those receiving Lu‐177 PSMA‐617 RLT alone (18.2 vs 12.3 months, P =.265). The treatment was generally well‐tolerated, with manageable side effects such as anemia and thrombocytopenia. This study provides real‐world evidence supporting the effectiveness and safety of Lu‐177 PSMA‐617 RLT in mCRPC patients, particularly when used in combination with ARPIs. These findings contribute to the growing body of evidence on the potential benefits of PSMA‐targeted therapies in advanced prostate cancer. [ABSTRACT FROM AUTHOR]

Aim: To investigate the efficacy and safety of bevacizumab in patients with recurrent low-grade serous ovarian carcinoma. Materials & methods: The data of patients who received at least two cycles of bevacizumab in combination with chemotherapy were retrospectively recorded. Results: The median age of 51 patients was 56 (range: 33–75) years. The complete response rate was 10.4% and the partial response rate was 43.7%. The objective response rate was 54.1%. Median progression-free survival was 15.9 months (95% CI: 9.1–22.6) and median overall survival was 42.5 months (95% CI: 37.2–47.8). Conclusion: Bevacizumab with chemotherapy is an effective option for treating recurrent ovarian low-grade serous carcinoma. [ABSTRACT FROM AUTHOR]

Objectives: To compare the second-line treatments on survival after trastuzumab failure in HER2-positive metastatic gastric cancer. Methods: We retrospectively included 57 patients. Of whom, 32 (56%) received paclitaxel, whereas 25 (44%) received 5-fluorouracil, leucovorin, and irinotecan (FOLFIRI). We analyzed the patient characteristics, and survival outcomes of the second-line treatment. Results: The median PFS was 3.5 months in the paclitaxel-group and 4.8 months in the FOLFIRI-group (p=0.569). The median overall survival (OS) was 6.0 months in paclitaxel-group and 11.0 months in FOLFIRI-group (p=0.410). FOLFIRI provided a significant OS advantage over paclitaxel in patients with grade 3 tumors or who did not have an objective first-line treatment response. Conclusion: FOLFIRI may be recommended as a preferred option over paclitaxel in patients with these identified risk factors. [ABSTRACT FROM AUTHOR]

It is highly probable to encounter disputes in construction projects and construction disputes are detrimental as they may lead to cost overruns and delays. Knowing the compensation with some certainty can avoid parties from extending inconclusive claims. Decision support systems can be helpful to understand the aspect of the compensation, if any compensation can be acquired. Within this context, the primary objective of this research is to predict the associated compensations in construction disputes by using machine learning (ML) techniques on past project data so that in new projects, decision support can be provided with some certainty via forecasts on the aspect of the compensation. To do this, a conceptual model identifying the attributes affecting compensations was established based on an extensive literature review. Using these attributes, data from real-world dispute cases were collected. Insignificant attributes were eliminated via Chi-square tests to establish a simpler classification model, which was experimented via alternative single and ensemble ML techniques. The Naïve Bayes (NB) classifier generated the highest average classification accuracy as 80.61% when One-vs-All (OvA) decomposition technique was utilized. The conceptual model can guide construction professionals during dispute management decisionmaking and the promising results indicate that the classification model has the potential to identify compensations. This study can be used to mitigate disputes by preventing parties from resorting to unpleasant and inconclusive resolution processes. [ABSTRACT FROM AUTHOR]

Aims: In this multicenter study, the authors aimed to determine the real-life efficacy and safety of first-line alectinib. Materials & methods: This retrospective trial included advanced-stage, ALK-positive non-small-cell lung cancer patients who were treated with first-line alectinib in terms of ALK-tyrosine kinase inhibitors, regardless of previous chemotherapy. The co-primary end points were progression-free survival both for all patients and for the treatment-naive population. The secondary end points were overall response rate, overall survival, rate of CNS progression and safety. Results & conclusion: A total of 274 patients (n = 177 for treatment-naive patients) were enrolled in the study. The median progression-free survival was 26 and 28.8 months for all patients and the treatment-naive group, respectively. The overall response rate, CNS progression rate and 1-year overall survival ratio were 77.9, 12.4 and 77%. Alectinib is a highly effective therapy with a favorable safety profile. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Health Sciences / Sağlık Bilimleri Dergisi is the property of Erciyes Universitesi Saglik Bilimleri Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: We aimed to investigate the role of skin tests (ST) in the diagnosis of hypersensitivity reactions (HSRs) with platinum salts (PS) and taxane (TX) groups drugs and their reliability in patient management. Materials and Method: Patients' data who developed immediate HSR with PS and TX were recorded and ST was performed. The gradual challenge was applied to all patients with ST negative and grade 1–2 with the suspect drug. Results: In total, the data of 104 patients (74 with PS, 30 with TX) who developed HSR against PS and TX were shared. The gradual challenge was applied to 72 ST negative and grade 1–2 patients (46 PS group, 26 TX group). The gradual challenge was negative in 39 patients in the PS group and 23 patients in the Tx group. The negative predictive value (NPV) for PS was 83% and NPV for TX was 88%. We found significantly higher skin test positivity in patients with PS and TX and grade 3 HSR (p = 0.007, p = 0.001). A significant correlation was found between skin test positivity and early onset of symptoms (p = 0.001 for PS, p = 0.015 for TX). In terms of symptoms witnessed in HSR, we observed the itching, urticaria, hypotension, syncope, and abdominal pain symptoms significantly more in the group with a positive skin test (p < 0.024, p < 0.001, p < 0.001, p < 0.002, and p < 0.025, respectively). Conclusions: We found very high NPV values for PS and TX. We found that the gradual challenge applied to patients with negative skin tests is reliable if Grade 3 HSR is not observed and with this approach, unnecessary desensitization processes and/or drug alterations can be avoided. [ABSTRACT FROM AUTHOR]

Triple-negative-breast-cancer (TNBC) has a poor prognosis if pathologic complete response (pCR) cannot be achieved following neoadjuvant chemotherapy (NAC). The group of patients that benefit most from adjuvant capecitabine remains unclear. We analyzed data of 160 consecutive patients with residual TNBC from eight cancer-center. Pathologic response was defined into two groups as having good-pathologic-response (MillerPayneGrading (MPG) IV–III) or poor-pathologic-response (MPG I–II). The characteristics of patients were compared regarding adjuvant capecitabine usage. Univariate-analysis revealed that age, histology, clinical-stage, tumor-size, lymph-nodes number, menopausal status, and pathological-stage were significantly different between two groups. In multivariate-analysis, menopausal status (p = 0.043) and residual tumor-size (p < 0.001) were found to be independent prognostic factors for pathological response. The hazard-ratio for disease recurrence and death in the poor-response group with adjuvant capecitabine was 2.94 (95% confidence-interval (CI), 1.21 to 7.10; p = 0.016) and 4.080 (95% CI, 1.22 to 13.64; p = 0.022), respectively. DFS (p = 0.58) and OS (p = 0.89) improvements with adjuvant capecitabine were not demonstrated in good-response groups. This multicenter-study suggested that only the poor-response group to NAC achieved benefit from adjuvant capecitabine. Postmenopausal status and residual tumor-size were related to poor prognosis. [ABSTRACT FROM AUTHOR]

Aim: Allergic contact dermatitis (ACD) is a delayed hypersensitivity reaction to specific allergens that come in contact with the skin. Detection of the culprit allergen plays a central role in the effective treatment and management of this chronic disease. The present study aims to report distribution of allergens that cause ACD by analyzing patch test results, and investigate atopic background of these patients. Materials and Methods: Results from patch tests performed on patients with ACD in the Department of Adult Allergy and Clinical Immunology at a tertiary hospital in Anatolian side of Istanbul were retrospectively assessed. Data regarding age, gender, occupation, lesion localization, history of suspected exposure, total Immunoglobulin E levels, concomitant allergic rhinitis and skin prick test results were inspected. Results: Of the 131 patients, female/male ratio was 91 (69.5%)/40 (30.5%). Patch test results were negative in 56 (42.7%) patients, and positive for at least one allergen in 75 (57.3%) patients. Five most common allergens with a positive result were nickel sulphate (25.2%), gold sodium thiosulfate (13%), cobalt (9.9%), thiomersal (9.9%), and colophony (5.3%), respectively. A comparison between patch test results and genderdid not demonstrate any statistical significance. Young patients had a significantly higher positive reaction to thiomersal (p = 0.008). No correlation was found between atopic background and ACD. Conclusion: Patch test results significantly contribute in the differential diagnosis and management of patients with dermatitis. Metals and thiomersal were the most common allergens detected by patch tests in our study. This is in correlation with previous research. We believe that types of allergens may go through an alteration as the environment and lifestyle changes over time, and that our findings contribute to determine which allergens to be used in patch tests in the future. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the importance of FDG PET/CT in predicting pathologic complete response (pCR) in primary breast lesions and axillary lymph nodes of patients with local, advanced breast cancer who were given neoadjuvant chemotherapy (NAC). Methods: One hundred twenty-one patients who had FDG PET/CT and underwent surgery due to local, advanced breast cancer before and after NAC were involved in the study. SUVmax and SULpeak values before and after NAC were evaluated using FDG PET/CT and post-surgical responses were re-evaluated. Results: Our study included 121 patients in total and 34 patients (28.1%) had a complete response in the breast, and 53 patients (43.8%) had a complete response in axillary lymph nodes. PostSUVmax and PostSULpeak values ≤1.15 and the activity presenting the pCR were controlled and the sensitivity and specificity were found as 61.8% and 61.8%, and 73.3% and 77.0%, respectively, for the breast (p<0.001 and p<0.001). The reduction rate (RR) of SUVmax >88% and the SULpeak (RR) >81% values and the activity presenting the pCR were controlled and the sensitivity and specificity were found as 80.0% and 81.8%, and 80.0% and 60.7%, respectively, for the breast (p<0.001 and p<0.001). Conclusion: The decrease of SUVmax and SULpeak values detected between PET/CT studies before and after NAC were well correlated with the pathologic response. FDG-PET/CT has high sensitivity and specificity in the evaluation of treatment response rates in breast lesions of patients with breast cancer receiving NAC. [ABSTRACT FROM AUTHOR]

Introduction: Nivolumab is a human immunoglobulin G4 monoclonal antibody that inhibits programmed cell death-1 activity by binding to the programmed cell death-1 receptors. Cancer cells express increased number of programmed cell death-1 ligands and this allows them to escape the cytotoxic effects of the T cells. Therefore, the negative programmed cell death-1 receptor signal regulates T-cell proliferation and activation is disrupted. However, this change in the activity of the T cells can cause them to lose their ability to recognize host cells. The immune response enabled by these agents has led to side effects, commonly known as "immune-related adverse events." Case report: We report a case of a 66-year-old male patient who was treated with nivolumab for recurrent renal cell carcinoma presented with hepatitis and adrenalitis. Three weeks after starting nivolumab, the patient had abdominal pain and weakness, and then aspartate and alanine transaminase levels were found to be elevated. Management and outcome: Hepatitis was predicted to be due to nivolumab, because other causes were excluded. He started using oral methylprednisolone and then, hepatitis improved. However, while receiving methylprednisolone treatment, fludrocortisone was started with the pre-diagnosis of adrenalitis due to the persistence of fatigue, weakness, and hyponatremia and hyperkalemia. With both treatments, the patient's symptoms and sodium and potassium level returned to normal. Discussion: This case emphasizes the need for patient's education and awareness of immune-related adverse events, and the importance of understanding the management of life-threatening complications of the checkpoint inhibitors, because these side effects require prompt recognition and treatment. [ABSTRACT FROM AUTHOR]

Narco-submarines which have been used by drug smugglers since the early 1990s, are a security threat that causes concerns especially in South and Central America. The seizure of a cocaine-laden narco-submarine in Spain in 2019 shows that this threat has spread from South and Central America to other continents. Drug smugglers are groups that follow technological developments closely, are innovative and can keep up with the conditions. It is predicted that because of the strictness of the measures taken at security points due to Covid-19 nowadays and the uncertainty of the post-epidemic global period, drug smugglers will change their methods and one of these methods will be narcosubmarines. In this study, which aims to examine the narco-submarine threat in order to be more effective for fighting against drug smuggling and to contribute to the scientific security literature with the results achieved, the possibility of narco-submarines to become a bigger threat by spreading globally in the future with the effect of the Covid-19 period has been evaluated. In this study, in which the qualitative research method was used, the data were collected from written documents related to the subject, and with the findings obtained, it is concluded that narco-submarines are a growing threat in the changing world, and that a close examination of this threat by law enforcement agencies is important for fighting against drug smuggling in the future. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the efficacy of trastuzumab and potential risk factors on survival in patients with HER2-positive metastatic gastric cancer. Methods: We retrospectively included 138 patients who were given trastuzumab-based chemotherapy as first-line treatment and analyzed the relationship between clinical response rates and maintenance treatment status and survival outcomes. Results: In the whole group, the median progression-free survival and overall survival were 10.2 and 16 months, respectively. Clinical response was obtained in 79% of patients. The median overall survival was 16.9 months in follow-up group and 19.0 months in the maintenance group in patients with clinical response. Continuation of maintenance trastuzumab created a significant survival advantage (p = 0.021). Eastern Cooperative Oncology Group performance status 2 (hazard ratio [HR]: 2.02), grade 3 (HR: 1.78) and more than four metastatic lesions (HR: 1.67) were determined as risk factors for death. Conclusion: We recommend the continuation of maintenance trastuzumab in patients with clinical response, but those with identified risk factors may not benefit from treatment because life expectancy may be low. [ABSTRACT FROM AUTHOR]

Purpose: We aimed to determine the COVID-19 infection rate and determine the factors that affect hospitalization and prognosis in patients receiving systemic chemotherapy (CT), immunotherapy (IT) and molecular-targeted therapies at our hospital within three months after the onset of COVID-19 pandemic. Materials and methods: The patients who received systemic treatment at chemotherapy unit with diagnosis of cancer between 11 March 2020 and 11 June 2020 were included. The clinical and demographic characteristics of patients, the systemic treatments that they received (CT, IT, targeted therapies), and the stage of disease were determined. For the parameters that affect the hospitalization of COVID-19 infected patients were also determined. Results: Among 1149 patients with cancer, 84 of them were infected with COVID-19, and the median age of infected patients was 61.0 (IQR: 21–84) and 60.7% of them were male. As a subtype of cancers lung cancer was more frequent in the patients who infected with COVID compared with non-infected ones and the difference was statistically significant when the underlying malignities were compared (32.1% vs 19.0%, p = 0.031). The hospitalization rate and receiving COVID-19 treatment were more frequent in metastatic patients who were receiving palliative therapy, and the difference was statistically significant (p = 0.01, p = 0.03). In our study, infection rate was similar among patients treated with CT, IT and CT plus targeted therapy; however, fewer COVID-19 infections were seen at patients who received only targeted therapy. Conclusion: COVID-19 infection is more frequent in cancer patients and tends to be more severe in metastatic cancer patients receiving anticancer treatment, and the continuation of palliative cancer treatments in these patients may cause increased cancer and infection-related morbidity and mortality. [ABSTRACT FROM AUTHOR]

The construction industry is overwhelmed by an increasing number and severity of disputes. The primary objective of this research is to predict the occurrence of disputes by utilizing machine learning (ML) techniques on empirical data. For this reason, variables affecting dispute occurrence were identified from the literature, and a conceptual model was developed to depict the common factors. Based on the conceptual model, a questionnaire was designed to collect empirical data from experts. Chi-square tests were conducted to reveal the associations between input variables and dispute occurrence. Alternative classification techniques were tested, and support vector machine (SVM) classifiers achieved the best average accuracy (90.46%). Ensemble classifiers combining the tested classification techniques were developed for enhanced prediction performance. Experimental results showed that the best ensemble classifier, obtained from the majority voting technique, can achieve 91.11% average accuracy. Based on Chi-square tests, the most influential factors on dispute occurrence were found as variations and unexpected events in projects. Other important predictors were all related to the skills of the parties involved. This study contributes to the construction dispute domain in three ways: (1) by proposing a conceptual model that combined the diverse efforts in the literature for identifying variables affecting dispute occurrence; (2) by highlighting the influential factors, such as response rate and communication skills, as indicators for potential disputes; and (3) by providing an empirical ML-based model with enhanced prediction capabilities that can function as an early-warning mechanism for decision-makers. [ABSTRACT FROM AUTHOR]

Author(s): Philipp Berens, Murat Seckin AyhanAuthor Affiliations:Proprietary data formats block health research In ophthalmology, for example, the Eye and Vision consortium has collected data for more than 100,000 individuals from [...]

Copyright of Der Ophthalmologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Mucinous colorectal adenocarcinoma (MCAC) is a distinct subtype of colorectal carcinoma (CRC). The prognostic and predictive significance of mucinous histology remains controversial. It was aimed to investigate the prognostic and/or predictive role of mucinous histology in left-sided metastatic CRC (mCRC) with wild-type RAS. This is a retrospective multicenter study of mCRC treated with first line anti-EGFR combined 5-fluorouracil based chemotherapy (CT). Patients were stratified according to presence (>50% extracellular mucin) or absence of mucinous histology. Survival analyses were performed firstly regardless of treatment options and then performed as separating according to CT regimens. Additional analyses were performed for MCAC patients considering backbone CT regimens. A total of 125 patients were included, consisting of 40 (32.0%) patients with MCAC and 85 (68.0%) patients with non-MCAC. Median follow-up time was 19.7 months. Median progression-free survival (PFS) was 10.7 months in all patients, and PFS was lower in MCAC than non-MCAC (9.9 vs. 12.0 months, respectively, P=0.005). Median overall survival (OS) was 25.7 months in all patients. OS was lower in MCAC than non-MCAC (22.8 vs. 29.7 months, respectively, P=0.005). When considering backbone CT regimens, in multivariate analyses, mucinous histology was an independent prognostic factor for OS in both for mFOLFOX6 (HR: 1.92, P=0.04) and FOLFIRI (HR: 2.04, P=0.04) groups and was associated with poor PFS in only mFOLFOX6 (HR: 3.86, P<0.001) group. When outcomes were analyzed for the MCAC group, median OS of MCAC patients receiving mFOLFOX6 and FOLFIRI was 22.47 and 14.22 months, respectively (P=0.41). Median PFS of MCAC patients receiving mFOLFOX6 and FOLFIRI was 10.15 and 8.11 months, respectively (P=0.73). The study revealed poor prognosis of mucinous histology, both in whole study population and in backbone CT groups. Moreover, lower PFS of MCAC patients was revealed in only mFOLFOX6 group and this finding may be a valuable issue for the future research. However, considering all analyses, the present results did not indicate a special benefit of any backbone CT regimen for MCAC patients. [ABSTRACT FROM AUTHOR]

Retroperitoneal sarcomas (RPS) account for approximately 15% of all soft tissue sarcomas (STS) and encompass a heterogeneous group of tumors with limited multimodality treatment options. Surgical resection with negative margins remains the standard primary treatment for patients with localized RPS. In this multicenter study, we aimed to demonstrate the real-world data on factors affecting survival in RPS treated with upfront surgery. We included a total of 197 patients who underwent curative-intent resection of a primary non-metastatic RPS between 2000-2020 at ten experienced medical oncology departments in Turkey. The median follow-up was 33 months. The median age of patients was 53 years, 57.4% of patients were female. Univariate analysis revealed that; tumor size, grade, necrosis, resection margin status, were factors affecting recurrence-free survival (RFS) (p= 0.002, p= 0.044, p= 0,024, p= 0.003 respectively). Age, tumor size, stage, resection margin status were factors affecting overall survival (OS) (p= 0.038, p= 0.001, p= 0.032, p< 0.001, respectively). In multivariate analysis, tumor size and resection margin status were independent factors affecting RFS and OS (all p-values < 0.05). Our study demonstrated that tumor size, and resection margin status were the main factors affecting survival in resected RFS. In comparison, adjuvant chemotherapy (CT), radiotherapy (RT), or multimodality treatment did not show OS and RFS advantages. We believe that advances in the molecular characterization of these tumors might help clinicians to detect the best candidates for adjuvant therapies in RPS. [ABSTRACT FROM AUTHOR]