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Introduction: We sought to evaluate secondary infections (SIs) in patients admitted to the intensive care unit (ICU) for COVID-19 with respect to incidence, causative pathogens, and clinical outcomes. Methodology: In this two-centre retrospective study, we analysed 146 patients (96 males, 50 females; median age, 64 years) admitted to the ICU with COVID-19 between March 26 and December 31, 2020. Inclusion criteria were an ICU admission for at least 48 hours and age beyond 18 years. Patients with and without SIs were compared and the impacts of SIs and carbapenem resistance on mortality were analysed. Results: During ICU admission, 84 episodes of SIs developed in 58 patients (39.7%). A total of 104 isolates were recovered, with Gram-negative bacteria most frequent accounting for 74%. At least one carbapenem-resistant pathogen (n = 61) was recovered in 41 patients (70.1%). In multivariate analysis, the use of ECMO and an elevated procalcitonin level were significantly associated with the development of SIs. The mortality rate and the incidence of carbapenem resistance did not differ significantly in COVID-19 patients with and without SIs (p = 0.059 and p = 0.083, respectively). Conclusions: The incidences of SIs and carbapenem resistance among COVID-19 patients were alarming, emphasizing stricter infection control measures in the ICU setting. © 2022 Journal of Infection in Developing Countries. All rights reserved.

Objective: Peripheral T-cell lymphomas (PTCLs) are an uncommon and quite heterogeneous group of disorders, representing only 10%-15% of all non-Hodgkin lymphomas. Although both molecular and clinical studies have increased in recent years, we still have little knowledge regarding real-life practice with PTCLs. In this study, we aimed to investigate the clinical characteristics and treatment outcomes of a large population-based cohort of patients presenting with systemic non-cutaneous PTCL. Materials and Methods: We conducted a multicenter retrospective analysis of 190 patients consecutively diagnosed and treated with non-cutaneous PTCLs between 2008 and 2016. Results: Considering all first-line treatment combinations, the overall response rate was 65.9% with 49.4% complete remission (n=81) and 16.5% partial response (n=27). The 5-year overall survival and eventfree survival rates were significantly different between the transplant and non-transplant groups (p, Amaç: Periferik T-hücreli lenfomalar (PTHL) nadir görülen, oldukça heterojen bir grup hastalıktır ve tüm non-Hodgkin lenfomaların sadece %10-15’ini oluşturur. Son yıllarda hem moleküler hem de klinik çalışmalar artmış olsa da PTHL’ler üzerindeki gerçek yaşam verileri hakkında hala çok az bilgiye sahibiz. Bu çalışmada, sistemik, kutanöz olmayan PTHL hastaları içeren geniş popülasyon tabanlı hasta grubunun klinik özellikleri ve tedavi sonuçlarını araştırmayı amaçladık. Gereç ve Yöntemler: 2008 ve 2016 yılları arasında kutanöz olmayan PTHL tanısı ile tedavi edilen 190 ardışık hastanın geriye dönük analizini gerçekleştirdik. Bulgular: Tüm birinci basamak tedavi kombinasyonları dikkate alındığında, genel yanıt oranı; tam remisyon (n=81) %49,4 ve kısmi yanıt (n=27) %16,5 olmak üzere %65,9 saptandı. Beş yıllık genel ve olaysız sağkalım oranları, transplant ve transplant olmayan gruplar arasında önemli ölçüde farklıydı (sırasıyla, p

Objective To compare the sexual violence suffered by women in early and late adolescence, the reactions triggered after the aggression, and the care provided. Methods A retrospective study in which we reviewed the medical records of 521 female adolescents treated by a multidisciplinary team at a reference hospital in the city of Campinas, state of São Paulo, Brazil. We analyzed sociodemographic variables, and those pertainin to the characteristics of the episodes of violence, the emergency care, and the physical and psychological reactions observed during the follow-up. For the analysis, the sample was divided into groups of early (10 to 14 years) and late (15 to 18 years) adolescence. We used the Chi-squared/Fisher Exact, Mann-Whitney, and Kruskal-Wallis tests to compare the groups; the level of significance adopted was 5%. Results The early group (n = 242) contained more adolescents who were enrolled in school (p Conclusion The age groups showed differences in the characteristics of the episodes of violence; early adolescents took longer to seek help, and the late group presented more intense symptoms and psychological worsening during the follow-up. Measures of prevention and specific care aimed at this population are needed.

Background There have been several reports about the prognosis of teeth adjacent to edentulous spaces for implant-supported fixed prostheses (ISFPs) and removable partial dentures (RPDs). However, there are few reports about the prognosis of the other remaining teeth comparing ISFPs with RPDs. Purpose The aim of this study was to evaluate and compare the prognosis of the remaining teeth for ISFPs and RPDs in terms of survival and complication-free rates. Methods Subjects were partially edentulous patients with ISFPs or RPDs inserted in 2003-2016. Teeth adjacent to edentulous spaces (A-teeth), teeth not adjacent to edentulous spaces (R-teeth), and teeth opposing edentulous spaces (O-teeth) were investigated. The endpoints were tooth extraction and complications. A multivariate cox regression model was used to estimate the risk factors for survival of the investigated teeth. Results A total of 233 (ISFP: 89, RPD: 144) patients were included in the statistical analyses. An IFSP prosthesis, when compared to an RPD prosthesis did not significantly decrease the tooth loss rate for A-teeth (hazard ratio [HR]: 0.76; 95% confidence interval [CI]: 0.30-1.92), for R-teeth (HR: 0.54; 95% CI: 0.28-1.05), or for O-teeth (HR: 0.45; 95% CI: 0.10-2.09). Conclusions In partially edentulous spaces, the difference between ISFPs and RPDs does not affect the prognosis of teeth adjacent to edentulous spaces, teeth not adjacent to edentulous spaces, and teeth opposing edentulous spaces. Namely, our findings suggest that it depends largely on the tooth type, jaw, endodontic therapy performed, not on the type of prostheses.

BACKGROUND: Coronary slow fl ow (CSF) is determined by delayed opacifi cation of the epicardial coronary arteries without obstructive disease. The triglyceride glucose index (TGI) has been suggested as a useful marker of insulin resistance. Previous studies have shown that TGI is associated with cardiovascular disease, but no study has examined the relationship between TGI and CSF. OBJECTIVES: Therefore, the primary objective of the present study was to investigate the relationship between TGI and CSF. METHODS: This study retrospectively evaluated patients who were admitted to our clinic with complaints of chest pain and underwent coronary angiography between January and December 2018. A total of 1100 coronary angiography images were assessed, and 72 patients with CSF were detected. Coronary fl ow was quantifi ed objectively using the TIMI (thrombolysis in myocardial infarction) frame count (TFC) method as described by Gibson et al. TGI was calculated as follows: ln [fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2]. RESULTS: The CSF group had signifi cantly higher glucose levels (mg/dl) [ (114.92±30.92), (125.61±33.22), than the control and CSF groups, respectively, p=0.0001], TGI [ (9.02±0.56), (9.26±0.54), p=0.0001], and triglyceride levels (mg/dl) [ (170.67±110.81), (201.19±136.93), p=0.002]. There was no statistically signifi cant correlation between TGI and left anterior descending artery TFC, circumfl ex artery TFC, right coronary artery TFC (r/p values; 0.24/0.06; 0.32/0.08; 0.18/0.36, respectively). TGI, HDL, HT, age, and sex were examined with a multiple logistic model, and TGI was found to be statistically signifi cant for the risk of CSF (p=0.0001; O.R:7.459). CONCLUSION: TGI was statistically signifi cantly higher in the CSF group than the control group. According to the multivariate logistic regression analysis, only TGI was independently associated with the risk of CSF, but higher TGI did not predict more slow coronary fl ow. Prospective studies are needed to clarify the prognostic relationship of TGI and CSF in terms of future cardiovascular events (Tab. 2, Fig. 1, Ref. 19). Text in PDF www.elis.sk © 2022. Bratislava Medical Journal.All Rights Reserved

OBJECTIVE Despite the relatively high success of surgical clipping of supraclinoid segment aneurysms of the internal carotid artery (ICA), flow diverter (FD) stent therapy is becoming increasingly used for these aneurysms. This study aims to evaluate the characteristics of FD placement for unruptured ICA supraclinoid segment aneurysms at 6 different centers with different experience levels in Türkiye. METHODS In this retrospective, multicenter study, the authors reviewed the demographic information, aneurysm shape/dimensions (neck, aspect ratio, dome/neck ratio, and maximum diameter), preoperative antiplatelet regimen, FD stent brand, perioperative complications, intervention time, clinical (modified Rankin Scale) and radiological (O’Kelly-Marotta [OKM] grading scale) outcomes, and follow-up time of 54 patients. RESULTS A total of 55 interventions for 61 aneurysms (58 supraclinoid ICA aneurysms) were performed in the 54 patients included in the study. The female/male ratio in this population was 44/10, and the mean age was 53.5 ± 13.6 (range 21–82) years. The most common form and location of the aneurysms were saccular 91.4% (53/58) and ophthalmic segment 69% (40/58), respectively. The preferred antiplatelet regimen was acetylsalicylic acid plus ticagrelor 50% (27/54). The overall complication rate was 25.5% (14/55), and the mean follow-up time was 25.76 ± 17.88 months. The successful radiological outcome (OKM grade C or D) rate at the 6-month follow-up was 92.6%. No perioperative complications led to any permanent or transient neurological deficit. CONCLUSIONS The results of this first multicenter study evaluating FD stent use for unruptured ICA supraclinoid segment aneurysms showed that FD stent treatment is a feasible method for replacing clipping and coil embolization with manageable complications and a high success rate.

OBJECTIVE: We designed a retrospective study to evaluate the performance and outcomes of a novel iopromide-based paclitaxel-coated balloon for the treatment of chronic total occlusion of femoropopliteal arteries. METHODS: Patients with femoropopliteal chronic total occlusion (

Aim Hypertrophic cardiomyopathy (HCM) is a relatively common, heritable cardiomyopathy, and cardiac magnetic resonance (CMR) studies have been performed previously to evaluate different aspects of the disease. However, a comprehensive study, including all four cardiac chambers and analysis of left atrial (LA) function, is missing in the literature. The aim of this retrospective study was to analyze CMR-feature tracking (CMR-FT) strain parameters and atrial function of HCM patients and to investigate the association of these parameters with the amount of myocardial late gadolinium enhancement (LGE).Material and Methods In this retrospective, cross-sectional study, we analyzed the CMR images (CMRI) of 58 consecutive patients, who from February 2020 to September 2022 were diagnosed with HCM at our tertiary cardiovascular center. Patients who were younger than 18 yrs or who had moderate or severe valvular heart disease, significant coronary artery disease, previous myocardial infarction, suboptimal image quality, or with contraindication to CMR were excluded. CMRI was performed at 1.5 T with a scanner, and all scans were assessed by an experienced cardiologist and then re-assessed by an experienced radiologist. SSFP 2-, 3- and 4‑chamber, short axis views were obtained and left ventricular (LV) end-diastolic volume (EDV), end-systolic volume (ESV), ejection fraction (EF), and mass were measured. LGE images were obtained using a PSIR sequence. Native T1 and T2 mapping and post-contrast T1 map sequences were performed and each patient’s myocardial extracellular volume (ECV) was calculated. LA volume index (LAVI), LA ejection fraction (LAEF), LA coupling index (LACI) were calculated. The complete CMR analysis of each patient was performed with CVI 42 software (Circle CVi, Calgary, Canada), off-line.Results The patients were divided into two groups, HCM with LGE (n=37, 64 %) and HCM without LGE (n=21, 36 %). The average patient age in the HCM patients with LGE was 50.8±14 yrs and 47±12.9 yrs in the HCM patients without LGE. Maximum LV wall thickness and basal antero-septum thickness were significantly higher in the HCM with LGE group compared to the HCM without LGE group (14.8±3.5 mm vs 20.3±6.5 mm (pConclusion This study sheds light on the CMR-FT differences between HCM with and without LGE. We found a greater burden of LA volume but significantly lower LA and LV strain in the LGE patients. These findings highlight further the LA and LV remodeling in HCM. Impaired LA function appears to have physiological significance, being associated with greater LGE. While our CMR-FT findings support the progressive nature of HCM, beginning with sarcomere dysfunction to eventual fibrosis, further studies are needed to validate these results in larger cohorts and to evaluate their clinical relevance.

Sarcomatoid renal cell carcinoma (sRCC) is a rare variant of renal cell carcinoma (RCC) and is associated with a poor prognosis. We reviewed the outcomes of patients from oncology centers in Turkey. Our aim is to share our real-life experience and to contribute to the literature. The demographic and clinical features, treatment, and survival outcomes of 148 patients with sRCC were analyzed. The median age at the time of diagnosis was 58 years (range: 19-83 years). Most patients (62.8%) had clear-cell histology. Most patients were in the intermediate Memorial Sloan-Kettering Cancer Center (MSKCC) risk group (67.6%) and were stage 4 at the time of diagnosis (63.5%). The most common sites of metastasis were the lung (60.1%), lymph nodes (47.3%), and bone (35.8%). The patients received a median of two lines (range: 0-6) of treatment. The most common side effects were fatigue, hematological side effects, hypertension, and hypothyroidism. The median follow-up was 20.9 months (range: 1-162 months). The median overall survival (OS) was 30.8 months (95% confidence interval: 24.9-36.7 months). In multivariate analysis, high MSKCC scores, sarcomatoid differentiation rates >50%, having stage 4 disease, and having lung metastasis at the time of diagnosis were independent factors for poor prognosis affecting OS. No difference was observed between patients who received tyrosine kinase inhibitor (TKI) as the first or second-line treatments. Similarly, no difference between TKI and immunotherapy as the second-line treatment. In conclusion, sRCC is a rare variant of RCC with a poor prognosis and response to treatment. Larger-scale prospective studies are needed to define an optimal treatment approach for longer survival in this aggressive variant.

OBJECTIVE: Long-term bene-fits of percutaneous endoscopic gastrostomy and satisfaction of patients' caregivers have not been investigated in the literature in detail. Hence, this study was carried out to investigate the long-term nutritional benefits of percutane-ous endoscopic gastrostomy in critically ill pa-tients and their caregivers' acceptance and sat-isfaction rates.PATIENTS AND METHODS: The population of this retrospective study consisted of critical-ly ill patients who underwent percutaneous en-doscopic gastrostomy between 2004 and 2020. Data about the clinical outcomes were obtained via telephone interviews using a structured questionnaire. The long-term benefits of the procedure in terms of weight change and the current thoughts of the caregivers about per -cutaneous endoscopic gastrostomy were ad-dressed. RESULTS: The study sample consisted of 797 patients with a mean age of 66.4 +/- 17.1 years. Pa-tients' Glasgow Coma Scale scores ranged from 4.0 to 15.0, with a median score of 8. Hypoxic en-cephalopathy (36.9%) and aspiration pneumoni-tis (24.6%) were the most common indications. There was neither change in body weight nor weight gain in 43.7% and 23.3% of the patients, respectively. Oral nutrition could be recovered in 16.8% of the patients. Of the caregivers, 37.8% stated that percutaneous endoscopic gastrosto-my was beneficial. CONCLUSIONS: Percutaneous endoscopic gastrostomy may be a feasible and effective method for long-term enteral nutrition in criti-cally ill patients treated in intensive care units.

This study aimed to investigate the relationship between body mass index (BMI), age, and sex and morphological risk factors that may cause internal knee injuries. The magnetic resonance images of 728 participants who met the inclusion criteria and had a mean age of 34.4?±?6.8 years were analyzed retrospectively. Demographic differences were analyzed by measuring 17 morphological parameters known to be associated with internal knee injuries. Men had a higher anterior cruciate ligament length (ACLL), anterior cruciate ligament width, (ACLW) lateral femoral condylar width (LFCW), medial femoral condylar width (MFCW), lateral femoral condylar depth (LFCD), distal femoral width (DFW), and intercondylar femoral width (IFW) than women (P?.05). By contrast, the medial meniscus bone angle (MMBA) was lower in men than in women (P?

Background There is no standard treatment recommended at category 1 level in international guidelines for subsequent therapy after cyclin-dependent kinase 4/6 inhibitor (CDK4/6) based therapy. We aimed to evaluate which subsequent treatment oncologists prefer in patients with disease progression under CDKi. In addition, we aimed to show the effectiveness of systemic treatments after CDKi and whether there is a survival difference between hormonal treatments (monotherapy vs. mTOR-based). Methods A total of 609 patients from 53 centers were included in the study. Progression-free-survivals (PFS) of subsequent treatments (chemotherapy (CT, n:434) or endocrine therapy (ET, n:175)) after CDKi were calculated. Patients were evaluated in three groups as those who received CDKi in first-line (group A, n:202), second-line (group B, n: 153) and ≥ 3rd-line (group C, n: 254). PFS was compared according to the use of ET and CT. In addition, ET was compared as monotherapy versus everolimus-based combination therapy. Results The median duration of CDKi in the ET arms of Group A, B, and C was 17.0, 11.0, and 8.5 months in respectively; it was 9.0, 7.0, and 5.0 months in the CT arm. Median PFS after CDKi was 9.5 (5.0–14.0) months in the ET arm of group A, and 5.3 (3.9–6.8) months in the CT arm (p = 0.073). It was 6.7 (5.8–7.7) months in the ET arm of group B, and 5.7 (4.6–6.7) months in the CT arm (p = 0.311). It was 5.3 (2.5–8.0) months in the ET arm of group C and 4.0 (3.5–4.6) months in the CT arm (p = 0.434). Patients who received ET after CDKi were compared as those who received everolimus-based combination therapy versus those who received monotherapy ET: the median PFS in group A, B, and C was 11.0 vs. 5.9 (p = 0.047), 6.7 vs. 5.0 (p = 0.164), 6.7 vs. 3.9 (p = 0.763) months. Conclusion Physicians preferred CT rather than ET in patients with early progression under CDKi. It has been shown that subsequent ET after CDKi can be as effective as CT. It was also observed that better PFS could be achieved with the subsequent everolimus-based treatments after first-line CDKi compared to monotherapy ET.

Background/Aim: Endometriosis is a gynecological estrogen-dependent inflammatory disease due to ectopic endometrial tissue and often associated with pelvic pain. Despite its high prevalence, there are still uncertainties about its pathogenesis, diagnosis, and therapy. Patients and Methods: This study presents a retrospective study conducted on 4,401 endometriosis patients, 584 of which underwent laparoscopic procedures. The archived data about clinical signs, magnetic resonance imaging (MRI) results, topography of the endometriosis lesions (obtained via laparoscopy) associated diseases, sample analysis and histological findings were analyzed. Next, the statistical associations between the information for each case, provided by these diagnostic tools were determined. Results: MRI is the most sensitive and specific diagnostic system for ovarian lesions, but poor in sensitivity and specificity for deep endometriosis lesions and not indicated for peritoneal lesions which remain the exclusive prerogative of laparoscopy. Clinical signs are essential for diagnosing deep lesions. The Ca125 and Ca19.9 markers have a poor reliability and their negativity in symptomatic patients has no clinical value, while in positive cases it could probably be used as a monitoring parameter. Conclusion: The results generated will help provide an accurate picture of the topography and distribution of endometriotic lesions. Correlation analyses between the data generated by the clinical-instrumental examinations and those on the site of the disease identified by laparoscopy, allow to define the predictive value of the clinical-instrumental signs in the diagnosis and localization of endometriotic disease.

Introduction This study, for the first time to our knowledge, evaluated the efficacy of ropeginterferon alfa-2b, a long-acting pegylated interferon (IFN)-alfa, in the treatment of COVID-19. Methods We retrospectively evaluated ropeginterferon alfa-2b administered subcutaneously at a single dose of 250 µg for the treatment of mild and moderate COVID-19. Primary outcome was to compare the overall negative conversion time from the confirmed, last positive SARS-CoV-2 RT-PCR to the first RT-PCR negative conversion between patients receiving ropeginterferon alfa-2b plus standard of care (SOC) and those receiving SOC alone. Results Thirty-five patients with mild COVID-19 and 37 patients with moderate disease were included. Of them, 19 patients received SOC plus ropeginterferon alfa-2b and 53 patients received SOC alone. All patients with moderate disease in the ropeginterferon alfa-2b group showed RT-PCR negative conversion within 8 days, while a significant portion of patients in the SOC alone group failed to do so. For patients with moderate disease and age ≤ 65 years old, the ropeginterferon alfa-2b group had statistically significant shorter median RT-PCR conversion time than the SOC alone group (7 vs. 11.5 days, p

BACKGROUND New prognostic factors have been reported in patients with metastatic or recurrent gastric cancer (MRGC), necessitating modifications to the previous prognostic model. AIM To develop a new model, MRGC patients who received fluoropyrimidines/ platinum doublet chemotherapy between 2008 and 2015 were analyzed. METHODS A total of 1883 patients was divided into a training set (n = 937) and an independent validation set (n = 946). RESULTS Multivariate analysis showed that the following six factors were associated with poor overall survival (OS) in the training set: Eastern Cooperative Oncology Group performance score ≥ 2 and bone metastasis (2 points each), peritoneal metastasis, high alkaline phosphatase level, low albumin level, and high neutrophil-lymphocyte ratio (1 point each). A prognostic model was developed by stratifying patients into good (0-1 point), moderate (2-3 points), and poor (≥ 4 points) risk groups. In the validation set, the median OS of the three risk groups was 15.8, 10.1, and 5.7 mo, respectively, and those differences were significant (P < 0.001). CONCLUSION We identified six factors readily measured in clinical practice that are predictive of poor prognosis in patients with MRGC. The new model is simpler than the old and more easily predicts OS.

Background Erenumab is a calcitonin gene-related peptide (CGRP)-receptor antibody inhibiting CGRP function. CGRP is prominently involved in the pathophysiology of migraine through nociceptive modulation in the trigeminovascular system. This study aims to explore the treatment effect of erenumab in a real-life setting. Methods In this retrospective observational study, we analyzed the data of 91 patients with migraine receiving at least three consecutive monthly injections of erenumab and followed up for 3–12 months. The primary objective was to describe the reduction in monthly migraine days throughout the follow-up period. To identify patients who responded to treatment, we analyzed the association between different patient characteristics and their treatment outcomes. Results Seventy-three patients (80.2%) responded to erenumab treatment, defined as ≥50% reduction of migraine days per month, across all migraine types. It was noted that ethnicity (p-value = 0.015) and older age (p-value = 0.035) were associated with clinically relevant improvement of symptoms. Middle Eastern ethnicity was related to less improvement of symptoms while Europeans were more likely to benefit from erenumab therapy (odds ratio: 12.788, p = 0.037). Patients aged from 31 to 40 and 41–65 years benefited most from erenumab treatment with a response rate of 77.8 and 89.9%, respectively, also confirmed by logistic regression (p = 0.047). Neither gender nor dose increase of erenumab showed association with the reported clinically relevant improvement of the symptoms. An association between clinically relevant improvement of headaches and the type of migraine was also noted. Around 87.9% of patients with episodic migraine responded to treatment, followed by 84.1% of chronic migraine patients and 50% of medication overuse headache patients. Medication overuse headache showed a lower probability of therapy success with erenumab (odds ratio: 0.126, p = 0.039). An improvement of headaches was eminent in patients who received 140 mg erenumab monthly (2 × 70 mg injections) and patients who had one injection every two weeks. Conclusions Erenumab is a novel preventive treatment for all migraine types. Clinically relevant improvement of headaches and reduction of monthly migraine days were demonstrated in patients that continued the treatment course. In real-life, a substantial number of patients suspended therapy early, reasons for which need further investigation.

BACKGROUND: A significant number of children are injured by or die from firearm-related incidents every year, although there is a lack of global data on the number of children admitted to pediatric emergency departments (PEDs) and pediatric intensive care units (PICU) with firearm injuries. This study is the most comprehensive analysis of firearm injuries sustained by children in Turkey to date. METHODS: This multicenter, retrospective, cohort study was conducted between 2010 and 2020 with the contributions of the PEDs, PICUs, intensive care units, and surgery departments of university hospitals and research hospitals. RESULTS: A total of 508 children were admitted to hospital with firearm-related injuries in the research period, although the medical records of only 489 could be obtained. Of the total admissions to hospitals, 55.0% were identified as unintentional, 8.2% as homicide, 4.5% as self-harm, and 32.3% as undetermined. The Glasgow Coma Scale (GCS) and ventilation support were found to be the most significant predictors of mortality, while head/neck injury, length of stay (LOS) in the hospital and surgical interventions were found to be the most significant predictors of disability. The overall mortality of firearm-related injuries was 6.3%, and the mortality for children admitted to the PICU was 19.8%. The probability of disability was calculated as 96.0% for children hospitalized with firearm injuries for longer than 75 days. CONCLUSIONS: Head/neck injury, LOS in the hospital, and surgical interventions were found to be the most significant parameters for the prediction of disability. Hospitalization exceeding 6 days was found to be related to disability.

Crizotinib is a multikinase inhibitor, effective in non-small cell lung cancer (NSCLC) harboring mesenchymal-epidermal transition (MET) alterations. Although small prospective studies showed efficacy and safety of crizotinib in NSCLC with MET alterations, there is limited real-life data. Aim of this study is to investigate real-life efficacy and safety of crizotinib in patients with advanced NSCLC harboring MET alterations. This was a retrospective, multicenter (17 centers) study of Turkish Oncology Group. Patients' demographic, histological data, treatment, response rates, survival outcomes, and toxicity data were collected. Outcomes were presented for the study population and compared between MET alteration types. Total of 62 patients were included with a median age of 58.5 (range, 26-78). Major histological type was adenocarcinoma, and 3 patients (4.8%) had sarcomatoid component. The most common MET analyzing method was next generation sequencing (90.3%). MET amplification and mutation frequencies were 53.2% (n?=?33) and 46.8% (n?=?29), respectively. Overall response rate and disease control rate were 56.5% and 74.2% in whole study population, respectively. Median progression free survival (PFS) was 7.2 months (95% confidence interval [CI]: 3.8-10.5), and median overall survival (OS) was 18.7 months (95% CI: 13.7-23.7), regardless of treatment line. Median PFS was 6.1 months (95% CI: 5.6-6.4) for patients with MET amplification, whereas 14.3 months (95% CI: 6.7-21.7) for patients with MET mutation (P?=?.217). Median PFS was significantly longer in patients who have never smoked (P?=?.040), have good performance score (P?.001), and responded to the treatment (P?

The study aims to investigate the morphological integrity of the outer retinal layers (ORLs) (an ellipsoid layer (EL) + external limiting membrane) and visual prognosis in chronic central serous chorioretinopathy (CSCR) with subretinal fluid (SRF) completely resorbed after half-dose photodynamic therapy (HD PDT) using enhanced-depth imaging (EDI) spectral domain optical coherence tomography (SD-OCT). This retrospective study included 40 eyes of 38 chronic CSCR patients treated with HD PDT between December 2012 and June 2016. However, only 34 eyes (85%) with complete SRF resorption 3 months after HD PDT had their 6th and 12th month data analyzed. Morphological integrity of the ORLs was further analyzed in relation to best-corrected visual acuity (BCVA) and disease duration. Thirty-four eyes of 34 patients (male/female: 82.35/17.65%) with mean age of 49.90 ± 7.80 (32–61) years were studied. The mean logMAR BCVA improved significantly from 0.52 ± 0.31 at baseline to 0.34 ± 0.36 and 0.26 ± 0.26 at the 6th and 12th months after HD PDT, respectively (p < 0.001). The proportion of eyes with completely normal morphological ultrastructural integrity of the ORLs was 44.12% at the 6th month, which increased to 64.71% at the 12th month after HD PDT. However, the EL morphological disruption was associated with significantly lower mean logMAR BCVA 12 months after HD PDT (p = 0.029). The disease duration had no effect on mean logMAR BCVA gain. Even after complete resorption of serous neurosensory retinal detachment after HD PDT in chronic CSCR, the ORLs, especially the EL, may not be anatomically restored. The EL morphological ultrastructural integrity seems to be the most important factor influencing visual prognosis. © 2022, The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.

Background and Objectives: Endoscopic variceal ligation (EVL) is the primary and secondary treatment for acute esophageal variceal bleeding. Post-banding ulcer bleeding (PBUB) may lead to bleeding episodes following EVL, increasing mortality. The aim of this study was to evaluate the risk factors for PBUB and predict the 6-week mortality risk after PBUB. Materials and Methods: We retrospectively analyzed the data collected from cirrhotic patients with EVL from 2015 to 2017. The incidence of PBUB and the 6-week mortality rate were evaluated. Risk factors for PBUB and predictive factors for mortality after PBUB were analyzed. Results: A total of 713 patients were enrolled in this study. Among the studied subjects, the incidence of PBUB was 5.8% (N = 41). The 6-week mortality rate was 63.4% (26/41). In multivariate analysis, MELD score ≥20 (OR: 3.77, 95% CI: 1.94–7.33, p < 0.001), ALBI score of 3 (OR: 2.67, 95% CI: 1.34–5.3, p = 0.005) and the presence of gastric varices (OR: 2.1, 95% CI: 1.06–4.16, p = 0.03) were associated with the development of PBUB. Patients with ALBI grade 3 (OR: 4.8, 95% CI: 1.18–19.6, p = 0.029) and Child-Pugh scores B and C (OR: 16.67, 95% CI: 1.75–158.1, p = 0.014) were associated with 6-week mortality after PBUB. Conclusions: PBUB is a complication with low incidence but increased mortality following EVL. The ALBI grade is a useful score to predict not only the development of PBUB but also the 6-week mortality after PBUB.

Purpose To examine the live birth and other outcomes reported with and without preimplantation genetic testing for aneuploidy (PGT-A) in the United Kingdom (UK) Human Embryology and Fertilization Authority (HFEA) data collection. Methods A retrospective cohort analysis was conducted following freedom of information (FoI) requests to the HFEA for the PGT-A and non-PGT-A cycle outcomes for 2016–2018. Statistical analysis of differences between PGT-A and non-PGT-A cycles was performed. Other than grouping by maternal age, no further confounders were controlled for; fresh and frozen transfers were included. Results Outcomes collected between 2016 and 2018 included total number of cycles, cycles with no embryo transfer, total number of embryos transferred, live birth rate (LBR) per embryo transferred and live birth rate per treatment cycle. Data was available for 2464 PGT-A out of a total 190,010 cycles. LBR per embryo transferred and LBR per treatment cycle (including cycles with no transfer) were significantly higher for all PGT-A vs non-PGT-A age groups (including under 35), with nearly all single embryo transfers (SET) after PGT-A (significantly more in non-PGT-A) and a reduced number of transfers per live birth particularly for cycles with maternal age over 40 years. Conclusion The retrospective study provides strong evidence for the benefits of PGT-A in terms of live births per embryo transferred and per cycle started but is limited in terms of matching PGT-A and non-PGT-A cohorts (e.g. in future studies, other confounders could be controlled for). This data challenges the HFEA “red traffic light” guidance that states there is “no evidence that PGT-A is effective or safe” and hence suggests the statement be revisited in the light of this and other new data.

BACKGROUND Combined hepatocellular carcinoma (HCC) and cholangiocarcinoma (cHCC-CCA) is defined as a single nodule showing differentiation into HCC and intrahepatic cholangiocarcinoma and has a poor prognosis. AIM To develop a radiomics nomogram for predicting post-resection survival of patients with cHCC-CCA. METHODS Patients with pathologically diagnosed cHCC-CCA were randomly divided into training and validation sets. Radiomics features were extracted from portal venous phase computed tomography (CT) images using the least absolute shrinkage and selection operator Cox regression and random forest analysis. A nomogram integrating the radiomics score and clinical factors was developed using univariate analysis and multivariate Cox regression. Nomogram performance was assessed in terms of the C-index as well as calibration, decision, and survival curves. RESULTS CT and clinical data of 118 patients were included in the study. The radiomics score, vascular invasion, anatomical resection, total bilirubin level, and satellite lesions were found to be independent predictors of overall survival (OS) and were therefore included in an integrative nomogram. The nomogram was more strongly associated with OS (hazard ratio: 8.155, 95% confidence interval: 4.498-14.785, P < 0.001) than a model based on the radiomics score or only clinical factors. The area under the curve values for 1-year and 3-year OS in the training set were 0.878 and 0.875, respectively. Patients stratified as being at high risk of poor prognosis showed a significantly shorter median OS than those stratified as being at low risk (6.1 vs 81.6 mo, P < 0.001). CONCLUSION This nomogram may predict survival of cHCC-CCA patients after hepatectomy and therefore help identify those more likely to benefit from surgery.

Hui Yang,1– 3 Shaoxing Sun,1– 3 Zijie Mei,1– 3 Qingming Xiang,1– 3 Chunxu Yang,1– 3 Min Chen,1– 3 Conghua Xie,1– 3 Yunfeng Zhou,1– 3 Hui Qiu1– 3 1Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, People’s Republic of China; 2Hubei Key Laboratory of Tumor Biological Behaviors, Zhongnan Hospital of Wuhan University, Wuhan, People’s Republic of China; 3Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, People’s Republic of ChinaCorrespondence: Hui Yang; Hui QiuDepartment of Radiation and Medical Oncology, Hubei Key Laboratory of Tumor Biological Behaviors, Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuhan, 430071, People’s Republic of ChinaEmail huiyangwhu@whu.edu.cn; qiuhuiznyy@whu.edu.cnBackground: Anlotinib is an oral anti-angiogenesis inhibitor targeting vascular endothelial growth factor receptors (VEGFRs), platelet-derived growth factor receptors, fibroblast growth factor receptors, etc., and its clinical value in cervical cancer is rarely reported. We designed a retrospective study to evaluate the efficacy and safety of anlotinib in patients with persistent, metastatic, or recurrent cervical cancer who have failed first-line therapy, and compare the efficacy of anlotinib with that of apatinib which targets only VEGFR2 and has shown efficacy in recent studies.Methods: Fifty-two patients with persistent, metastatic, or recurrent cervical cancer who failed first-line therapy and administrated anlotinib or apatinib as monotherapy or combination with chemo-, radio- or immunotherapy were included in this study. Among the 52 patients, 20 patients who received anlotinib from January 2019 to August 2020 were defined as anlotinib group, whereas 32 patients who received apatinib from our previous study were selected as apatinib group. The safety, objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), and overall survival (OS) were reviewed and recorded.Results: The ORR and DCR in patients receiving anlotinib were 25% and 80%, respectively. The median PFS and OS in anlotinib group were significantly longer than those in apatinib group, respectively (PFS: 5 months vs 3 months, p=0.015; OS: 10 months vs 5 months, p=0.008). Moreover, the patients treated with anlotinib had better survival with a significantly lower cumulative incidence of cancer-related death than those treated with apatinib (HR=0.31, 95% CI: 0.13– 0.77, p=0.012). The most common adverse effects in the patients treated with anlotinib were hypertension (20%), fatigue (20%), and nausea (15%). No drug-related death occurred.Conclusion: Anlotinib showed beneficial efficacy and safety and can be a treatment option for patients with persistent, metastatic, or recurrent cervical cancer who have failed the first-line therapy.Keywords: angiogenesis, anlotinib, cervical cancer, efficacy, safety, retrospective study

BACKGROUND: In our previous report on Turkish COVID-19 patients requiring intensive care, the 24 patients in a single ICU were elderly and mortality was high. We extended our analysis to include patients admitted to ten ICUs. OBJECTIVES: Report the demographics, clinical features, imaging findings, comorbidities, and outcomes in COVID-19 patients. DESIGN: Retrospective. SETTING: Intensive care unit. PATIENTS AND METHODS: The study includes patients with clinical and radiological confirmed or laboratory-confirmed COVID-19 infection who were admitted to ten ICUs between 15 March and 30 June 2020. MAIN OUTCOME MEASURES: Clinical outcomes, therapies, and death during hospitalization SAMPLE SIZE: 974, including 571 males (58%). RESULTS: The median age (range) was 72 (21–101) years for patients who died (n=632, 64.9%) and 70 (16–99) years for patients who lived (n=342, 35.2%) ( P P P =.013). Most (n=719, 73.8%) underwent invasive mechanical ventilation therapy. CONCLUSIONS: The majority of patients admitted to the ICU with a diagnosis of COVID-19 require respiratory support. LIMITATIONS: Although the Turkish Ministry of Health made recommendations for the treatment of COVID-19 patients, patient management may not have been identical in all ten units. CONFLICT OF INTEREST: None.