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It is well-known that asthma patients show compromised production of antiviral interferons and lower expression of ACE-2, most likely owing to ACE-2 expression is inversely correlated with type 2 (Th2: T helper 2) cytokine levels of asthmatics. However, COVID-19 patients with poor outcomes show early vigorous type I interferon expression. This does not match with the pathophysiology of worse COVID-19 disease development in asthma patients. Actually, why asthma might protect against poor outcomes in COVID-19 is explained in detail in recent reviews. Some new data even show decreased mortality in asthma patients. There were no flawless data that asthma patients are at a greater risk of becoming severely ill with SARS-CoV-2 infection, although current reports from the United States and the United Kingdom indicate that asthma is much more common in children and adults with COVID-19 than was formerly described from Asia as well as from central Europe., (© 2022 The Author(s).)

Purpose: This study aimed to examine the relationship between self-disclosure, empathy, and anxiety in nurses., Design and Methods: The study was conducted with 255 nurses working in hospitals in Turkey. Data were collected using a Sociodemographic Form, the Self-Disclosure Scale (SDS), the Basic Empathy Scale (BES), and the Spielberger State-Trait Anxiety Inventory (STAI)., Findings: A statistically significant positive relationship was found among the SDS, BES, and Spielberger STAI., Practice Implications: Psychiatric nurses should ensure the reduction of nurses' anxiety levels by planning different interventions such as psychotherapy, counseling, and training. They may determine nurses' self-disclosure and empathy skills as well as their needs., (© 2021 Wiley Periodicals LLC.)

Background: The aim of this study was to provide insight into the real-life clinical presentation and outcomes of the elderly presenting with acute myocardial infarction from the Turkish Myocardial Infarction registry database., Methods: TURKMI was a nationwide, multicenter, observational, 15-day snapshot registry conducted to address the management of acute myocardial infarction patients admitted to percutaneous intervention-capable hospitals. The present analysis included the comparison of consecutively enrolled acute myocardial infarction patients aged ≥75 and <75 years., Results: Of the overall 1930 patients, 362 patients were aged ≥75 years. Elderly patients were more likely to have hypertension and renal failure and less likely to have hypercholesterolemia. Elderly patients were admitted to hospitals almost 1 hour later mainly due to a late call to emergency medical service. At discharge, medical therapies were significantly less prescribed to the elderly. The proportion of patients undergoing coronary angiography was significantly lower in elderly (81.8% vs. 96.4%, P < .001). Both in-hospital and 1-year mortality were significantly higher in elderly patients (9.1% vs. 2.7% and 22.7% vs. 5.8%, P < .001 respectively). The adjusted risk of 1-year mortality was 4-fold in elderly (hazard ratio and 95% CI 4.0 [2.9-5.6], P < .001). In multivariate analysis, every 5-beat/min increase in heart rate increased mortality by 7%. Higher heart rate and use of antiplatelet agents on admission were predictors of mortality in elderly., Conclusion: In real-life settings, elderly patients presenting with acute myocardial infarction are prone to prolonged total ischemic time and are subjected to less-intensive medical treatment and interventional approaches. Besides age, the increased heart rate could be the major determinant of mortality.

Background: Studies show that although the presence of women in the medical field has risen, there is a lesser representation of women within editorial boards of journals. Studies on this subject have mostly been carried out related to the medical field of the researcher. It is not known what position the emergency medicine department is in this regard compared to other departments. We aimed to investigate whether gender disparity exists within the editors and editorial board members of medical journals, especially in those related to emergency medicine., Methods: In the present cross-sectional study, we searched medical journals using the Scimago Journal/Country Rank journal system for comparison. The websites of the journals included in the study were searched, and gender data of the editor and editorial board, associate editors, consultant editors, and section editors for each journal were obtained., Results: The total number of journals examined in this study was 276. The median percentage of female editorial board members (20.8%; 50-100) was lower in emergency medicine journals compared to other branches of medicine (31%; 0-100) (p < .001). The median percentage of female editorial board members and editors was also lower in the emergency medicine field (20.6%; 0-50) (p < .001) than in other branches of medicine. The percentage of female editorial board members of emergency medicine journals was 19.5% with the third-lowest ranking among 26 branches. When both the editors and editorial board members were considered, the highest female percentage was found in pediatrics (50.7%) followed by geriatric medicine (43.4%)., Conclusion: There is a significant gender disparity within editors and editorial board members in emergency medicine journals. The proportion of women within the editorial board was found to be lower in emergency medicine journals among all the journals included in the study., Competing Interests: Declaration of Competing Interest Authors report there is no conflict of interest., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Background Predicting the mortality and prognosis of patients with stroke is one of the commonly studied topics. Various scoring systems have been used in this regard. One of them is the Full Outline of UnResponsiveness (FOUR) score. In this study, we aimed to investigate the utility of the FOUR scores in terms of their ability to predict hospital stay duration and mortality in patients who were diagnosed with ischemic stroke upon their admission to the emergency department. Methods Our study is a prospective observational study. Patients who were admitted to the emergency department of a tertiary hospital and diagnosed with ischemic stroke between August 1, 2020, and August 1, 2021, were included in the study. The inclusion criteria were as follows: being over the age of 18, being diagnosed with ischemic stroke, having symptoms that started within the last 48 hours, and patient consent approved by the patients themselves or their relatives. The patients were divided into two groups according to the FOUR scores (FOUR score = 16 and FOUR score < 16). Patients' demographic information, vital parameters, symptoms, time to admission, comorbidities, laboratory parameters, length of hospitalization, mortality, and Glasgow Coma Scale (GCS), FOUR, and National Institutes of Health Stroke Scale (NIHSS) scores were recorded. Results A total of 79 patients were included in the current study, of which 47 (59.5%) were male. The patients included in the present study had a mean age of 66 ± 13 years. When the two groups of patients with a FOUR score of 16 and a FOUR score of below 16 were compared, the mean platelet count was found to be 248 ± 70 × 10 3 /L in the former group and 170 ± 84 × 10 3 /L in the latter (p = 0.004). Sixty-five (91.5%) of the patients in the group with a FOUR score of 16 and three (37.5%) of the patients in the group with a FOUR score of less than 16 stayed for more than six hours in the hospital (p < 0.001). When the patients were evaluated for intensive care unit (ICU) admission rates, five (62.5%) patients with a FOUR score of <16 were admitted to the ICU. This rate was 2.8% (n = 2) in the group of patients with a FOUR score of 16 and was found to be significantly lower (p < 0.001). Conclusion The FOUR score was found to be useful in predicting the ICU admission rate of patients with ischemic stroke. It has also been shown that the admission time was shorter in patients with a lower FOUR score, and platelet counts were also lower in this group., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Atiş et al.)

Thrombocytopenia is often seen as a laboratory finding during childhood. A supposed idiopathic thrombocytopenic purpura patient who was later diagnosed as Wiskott-Aldrich syndrome (WAS) and developed acquired thrombotic thrombocytopenic purpura (aTTP). Although autoimmune manifestations in WAS described, aTTP was reported just once. Five-year-old-boy was initially brought with cough, bloody stool (diarrhea), oral mucosal bleeding at 12th months of age. Following diagnosed with idiopathic thrombocytopenic purpura and receiving intravenous immunoglobulin, platelet count raised from 20,000 to 50,000/µL. One year after WAS diagnosis by mutation analysis, he presented with complaints of resistant fever, epistaxis, and melena. Hemoglobin decreased from 10 to 5.9 g/dL. Schistocytes in peripheral blood smear and high anti-ADAMTS-13 antibody level indicated development of aTTP., Competing Interests: The authors declare no conflict of interest., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Aorta-right atrial tunnel is a rarely seen congenital anomaly with an unknown etiopathology. Due to its life-threatening complications, it must be treated either surgically or by transcatheterization technique as soon as possible. Planning the treatment strategy considering the relation between the aorta-right atrial tunnel and coronary arteries is of utmost importance. Herein, we report a young case of a right coronary artery ostium originating from the proximal part of aorta-right atrial tunnel and her successful treatment with a new surgical technique using a pericardial patch., Competing Interests: Conflict of Interest: The authors declared no conflicts of interest with respect to the authorship and/or publication of this article., (Copyright © 2022, Turkish Society of Cardiovascular Surgery.)

In this narrative review, firstly, we describe the characteristics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the pathogenesis of its infection in humans. Later, the importance of mast cells in SARS-CoV-2 infection and their role in Coronavirus Disease 2019 (COVID-19) will be discussed. SARS-CoV-2 is a transmissible agent frequently detected in some mammalian species and also in humans. Literature data published in PubMed that covered mast cells' role in cytokine release syndrome and related manifestations of COVID-19 disease were reviewed by the authors independently and collectively. Recommendations for the management of cytokine release syndrome and related manifestations were made by the authors. Mast cells are concentrated in environments where they encounter viruses, bacteria, and toxins, especially in the skin, nasal mucosa, lungs, airways, gastrointestinal tract, and meninges, to prevent their entry into the human body. Once SARS-CoV-2 enters the host, it stimulates one of the mast cells, together with pre-existing innate immune cells that form a defensive barrier in the submucosa of the respiratory tract and nasal cavities against pathogenic microorganisms. The roles of mast cells in SARS-CoV-2-induced hyperinflammation and cytokine storms have recently been one of the hot topics in the literature. Physicians should keep in mind the mast cells' role in cytokine release syndrome and related manifestations of COVID-19 disease. Mast cell-targeting therapies (e.g., H1 and H2 receptor antagonists) can reduce the severity and course of the disease when used after complications associated with COVID-19 are suspected or seen., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Background: Granulocytic sarcoma (GS) is an extramedullary solid tumor composed of immature myeloid cells. GS has been associated with acute myeloid leukemia (AML), myelodysplastic syndromes or myeloproliferative diseases. Although GS can affect various tissues of the human body, it has rarely been reported in other soft tissues such as the breast, gastrointestinal, respiratory and genitourinary tracts. We report a pediatric case diagnosed with granulocytic sarcoma of the bladder and concomitant AML., Case: A twelve-year-old previously healthy girl was admitted to the pediatric urology clinic with a ten-day history of hematuria and pollakiuria. Laboratory examinations revealed anemia, thrombocytopenia and neutrophilic leukocytosis. Bone marrow aspiration results were consistent with acute myeloid leukemia -FAB subtype M2-. Abdominal magnetic resonance imaging (MRI) showed an irregularly bounded 12 cm mass on the right side of the bladder. Transurethral resection (TUR) pathology was consistent with granulocytic sarcoma. After a multimodal treatment approach, complete remission was achieved., Conclusions: Malignant bladder masses are rare causes of macroscopic hematuria in childhood. The diagnostic spectrum is wide, ranging from rhabdomyosarcoma to leukemia involvement. The bladder is a rare site of extramedullary involvement in pediatric patients with AML. Multimodal treatment should be considered on a per-patient basis.

Tens of thousands of people worldwide became infected with severe acute respiratory syndrome coronavirus-2. Death rate in the general population is about 1%-6%, but this rate rises up to 15% in those with comorbidities. Recent publications showed that the clinical progression of this disease in organ recipients is more destructive, with a fatality rate of up to 14%-25%. We aimed to review the effect of the pandemic on various transplantation patients. Coronavirus disease 2019 (COVID-19) has not only interrupted the lives of waiting list patients'; it has also impacted transplantation strategies, transplant surgeries and broken donation chains. COVID-19 was directly and indirectly accountable for a 73% surplus in mortality of this population as compared to wait listed patients in earlier years. The impact of chronic immunosuppression on outcomes of COVID-19 remains unclear but understanding the immunological mechanisms related to the virus is critically important for the lifetime of transplantation and immune suppressed patients. It is hard to endorse changing anti-rejection therapy, as the existing data evaluation is not adequate to advise substituting tacrolimus with cyclosporine during severe COVID-19 disease., (©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.)

Objective: To assess the effects of transvalvular aortic valve implantation (TAVI) on the outcomes of the patients with symptomatic severe aortic stenosis (AS), and predict the effect of left ventricular ejection fraction (LVEF) and cardiac structural recovery on mortality after the TAVI in patients with different stage of LV function., Methods: Out of 191 patients, 151 consecutive patients in 3 centers were evaluated for outcome analysis. Patients were classified into 3 subgroups as AS with reduced ejection fraction (ASrEF) (LVEF <40%), AS with mildly reduced EF (ASmrEF) (LVEF 40-49%) and AS with preserved EF (ASpEF) (LVEF ≥50%)., Results: The mean follow-up period was 19.4±12.4 (up to 54) months. All-cause mortality was not different among all 3 groups. (p=0.901). In multivariate analysis, stroke volume index (SVI) (Exp(B): 0.039, 95% confidence interval [CI]: 0.011-0.013, p<0.001), baseline blood urea nitrogen (Exp(B): 1.022, 95% CI: 1.006-1.038, p=0.006), and percent LVEF change after TAVI (d-LVEF) (Exp(B): 0.046, 95% CI: 0.004-0.610, p=0.046) were the independent predictors for mortality after TAVI. The receiver operating characteristic curve analysis showed that the cutoff value of "≤10%" for d-LVEF had sensitivity of 50%, specificity of 75%, and an area under the curve of 0.72 in predicting mortality in patients with SVI <35 mL/m2., Conclusion: Improvement of LVEF after TAVI, which reflected the marked LV reverse remodeling, has an impact on the prediction of the survival in patients with AS, and this is more prominent in patients with low SVI.

Objectives: This study aims to investigate the prevalence, etiology, and risk factors of cervicogenic dizziness in patients with neck pain., Patients and Methods: Between June 2016 and April 2018, a total of 2,361 patients (526 males, 1,835 females; mean age: 45.0±13.3 years; range, 18 to 75 years) who presented with the complaint of neck pain lasting for at least one month were included in this prospective, cross-sectional study. Data including concomitant dizziness, severity, and quality of life (QoL) impact of vertigo (via Numeric Dizziness Scale [NDS]), QoL (via Dizziness Handicap Inventory [DHI]), mobility (via Timed Up-and-Go [TUG] test), balance performance [via Berg Balance Scale [BBS]), and emotional status (via Hospital Anxiety- Depression Scale [HADS]) were recorded., Results: Dizziness was evident in 40.1% of the patients. Myofascial pain syndrome (MPS) was the most common etiology for neck pain (58.5%) and accompanied with cervicogenic dizziness in 59.7% of the patients. Female versus male sex (odds ratio [OR]: 1.641, 95% CI: 1.241 to 2.171, p=0.001), housewifery versus other occupations (OR: 1.285, 95% CI: 1.006 to 1.642, p=0.045), and lower versus higher education (OR: 1.649-2.564, p<0.001) significantly predicted the increased risk of dizziness in neck pain patients. Patient with dizziness due to MPS had lower dizziness severity scores (p=0.034) and milder impact of dizziness on QoL (p=0.005), lower DHI scores (p=0.004), shorter time to complete the TUG test (p=0.001) and higher BBS scores (p=0.001)., Conclusion: Our findings suggest a significant impact of biopsychosocial factors on the likelihood and severity of dizziness and association of dizziness due to MPS with better clinical status., Competing Interests: Conflict of Interest: The authors declared no conflicts of interest with respect to the authorship and/or publication of this article., (Copyright © 2021, Turkish Society of Physical Medicine and Rehabilitation.)

I will have a couple of comments on the issues elaborated in the article titled as 'Impact of COVID-19 in patients with lymphoid malignancies'. First, the author did not emphasize and overlook the prolonged persistence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA in coronavirus disease 2019 (COVID-19) patients with hematological malignancies. Second, the rise of a chronic lymphoid leukemia clone in COVID-19 was not mentioned by the authors. Third, achieving a complete remission in asymptomatic COVID-19 patients with follicular lymphoma in partial remission after bendamustine-based therapy is not specific to this lymphoma subtype. Fourth, follicular lymphoma does not always undergo complete remission with SARS-CoV-2 infection. Our aim is to help the authors to discuss and clarify these issues a little more in COVID-19 patients with hematological malignancies., Competing Interests: Conflict-of-interest statement: None., (©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.)

Due to Turkey's reliance on imported electricity, it has been using hydroelectric power plants (HPPs) to cover some of its electrical energy needs since 2011. However, HPP projects, which do not take landscape sensitivity into account, cause the ecological integrity of the basins and the ecosystem structure to deteriorate. This study presents the Tokat-Niksar HPP project field example in Turkey's Central Black Sea region with its steep slopes, rich forest and creek vegetation, protected endemic plants and wildlife, cultural heritage dating back to 3000 BC agricultural activities, and long-established local culture. The study, in fact, aims to develop a landscape restoration plan that considers the sensitivity of landscapes in the HPP project area. For this purpose, a landscape sensitivity analysis consisting of water, habitat, visibility, erosion functions, and multi-criteria decision analysis (MCDA) determining priority of functions conducted with experts were performed. According to the results, the water function was found to have the highest, and the visibility the lowest priority in the ranking. Consequently, 1st, 2nd, 3rd, and 4th-degree sensitive areas with very high, high, and moderate landscape sensitivity were determined by weighted sum function by considering the priority of each landscape function, and accordingly, a five-stage landscape restoration model was developed including soil protection, areas to be protected, erosion control, vegetation screening, and creek reclamation. This study presents a framework for sustainable landscape restoration solutions in the town by combining landscape sensitivity analysis via MCDA., (© 2021. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Introduction This study aimed to determine the factors that trigger seizures in patients reporting to our emergency department (ED) with seizures and the factors that affect recurrent seizures during the emergency department stay. Materials and methods This study was designed prospectively and was conducted among patients over the age of 18 years who reported to the ED of the Education and Research Hospital with complaints of epileptic seizure between July 01, 2020 and July 01, 2021. In addition to the sociodemographic information of the patients, the time of admission after the seizure, the medications used, comorbidities, the treatment given in the ED, history of trauma, previous epilepsy diagnosis, time of last seizure, alcohol use in the last 24 hours, insomnia, presence of infective symptoms in the past week, vital parameters, blood tests, and presence of recurrent seizure during hospital follow-up were recorded. Results The median age of the 102 patients included in the statistical analysis was 37 (25%-57%), and 61 (59.8%) were men. Patients who came to the ED with the complaint of seizures were divided into two groups, namely, those who had recurrent seizures and those who did not. When the differences between the groups in terms of various variables were examined, no statistically significant difference was found in the univariate analysis, except for WBC, aspartate aminotransferase (AST), and alanine aminotransferase (ALT) values. The diagnostic value of WBC, AST, and ALT levels in predicting recurrent seizures in emergency follow-up was analyzed using a receiver operating characteristic curve. Conclusion In this study, we could not find a parameter that can predict the probability of recurrent seizures in the ED in patients presenting with epileptic seizures., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Bozan et al.)

Introduction: The COVID-19 pandemic not only affected physical health but also caused high levels of mental health problems including sleep disturbances, depression and post-traumatic stress symptoms. The aim of this study was to examine the sleep parameters of healthcare workers before COVID-19 infection and after recovery., Materials and Methods: Healthcare workers who were infected with COVID-19 and whose treatment was completed at least 30 days ago were included in the study. A web-based cross-sectional survey was conducted on the participants., Results: The median PSQI score increased significantly after COVID-19 infection (7.0) compared with the level before COVID-19 infection (5.0). The increases in median scores for subjective sleep quality, sleep latency, sleep duration, sleep efficiency, sleep disturbance, use of sleeping medication and daytime dysfunction were all significant., Conclusion: Sleep quality decreased during the convalescence period from COVID-19 infection as compared with the pre-COVID-19 period., (© 2021 John Wiley & Sons Ltd.)

Purpose: Metastasis-directed radiation therapy (MDRT) may improve oncologic and quality of life outcomes in patients with metastatic cancer, but data on its use in metastatic bladder cancer is severely limited. We sought to review our institutional experience with MDRT in patients with metastatic bladder cancer following radical cystectomy., Materials and Methods: We reviewed records of patients who underwent radical cystectomy and subsequent MDRT at our institution between 2009 and 2020. Baseline demographic and clinical/pathologic factors were collected, as were details of treatment including systemic therapy and MDRT. Cases were categorized by treatment intent as consolidative (intended to prolong survival) and palliative (intended only to relieve symptoms). Response to treatment, survival, and toxicity outcomes were reviewed., Results: A total of 52 patients underwent MDRT following radical cystectomy. MDRT was categorized as consolidative in 40% of cases and palliative in 60%. Toxicity (CTCAE Grade ≥ 2) was reported in 15% of patients, none of which exceeded Grade 3. Most patients undergoing consolidative MDRT were treated with SBRT techniques (76%) and a majority (67%) received concurrent treatment with an immuno-oncology agent. Among patients treated with consolidative intent, 2-year progression-free and overall survival were 19% and 60%, respectively., Conclusion: MDRT is safe and well-tolerated by a majority of patients. A majority of patients treated with consolidative intent survived ≥ 2 years from treatment., Competing Interests: Conflict of interest The authors report no conflicts of interest., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Background: The latest coronavirus infection due to SARS-CoV-2, which started in China in December 2019, was announced as a pandemic by the World Health Organization (WHO) in March 2020. All epidemiological data so far show us that SARS-CoV-2 infection is less serious in children than in adults. Allergic asthma, the most common chronic disease in children, is usually not to be related to greater risk or severity for COVID-19 in pediatric populations. Although reports/research on asthma and COVID-19 in children have thus far been comforting, when coming across an asthma patient with any lower airway infection, attention should be given to evaluate their asthma control level and the possibility of SARS-CoV-2 infection. Case Report . Here, we report a rare adolescent case of COVID-19-related pneumonia development with underlying asthma. A 16-year-old male patient has been followed up by the pediatric allergy outpatient clinic with the diagnosis of asthma for the last 5 years. He was thought to have typical clinical and laboratory findings for SARS-CoV-2 infection combined with underlying pediatric (allergic) asthma. Pulmonary CT showed findings consistent with COVID-19-related pneumonia. He was discharged after 1 week when all his complaints regressed, his examination became normal, and 5-day favipiravir treatment was completed., Conclusion: When a physician comes across an asthma patient with any lower airway infection, attention should be given to evaluate their asthma control level and possibility of SARS-CoV-2 infection., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2021 Öner Özdemir et al.)

Concern has arisen about the role played in coronavirus disease 2019 (COVID-19) infection by angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs). This study was designed to assess the practice behaviors of physicians toward hypertension treatment with ACE-i or ARBs during the COVID-19 pandemic. A self-administered survey questionnaire consisting of 26 questions about current hypertension treatment with ACE-i/ ARBs was applied to cardiologists, internists, and family physicians in central and western Turkey, between 01 and 19 May 2020. A total of 460 physicians were approached, and 220 (47.8%) participated in the study. Of the total respondents, 78.7% reported that they had not changed their antihypertensive medication prescribing pattern, 8.6% of clinicians had changed ACE-i/ ARBs medicine of patients during the COVID-19 pandemic and 12.7% of them were undecided. The median (±interquartile range) score indicating general reliance level of physicians in ACE-i/ARBs therapy was 8 ± 4 (range, 1-10). In multiple comparison analyses, the general reliance level in ACE-i/ARBs, reliance level when starting a new ACEi/ARBs and changing behavior in heart failure patients were significantly different with regard to the specialties (p:0.02, p:0.009, p:0.005 respectively). Although most of the physicians found the publications about ACE-i/ ARBs during the COVID-19 pandemic untrustworthy, there were variable levels of knowledge and reliance among different physicians and specialty groups. In general, the ACE-i/ ARBs prescribing habits were not affected by safety concerns during the COVID-19 pandemic in Turkey., (© 2020. The Author(s), under exclusive licence to Springer Nature Limited part of Springer Nature.)

Competing Interests: Declaration of Competing Interest None.

This paper examines second language (L2) acquisition of stress in Khalkha Mongolian, which is one of the few Default-to-Opposite Edge stress systems of the world, and as such, demonstrates "conflicting directionality" regarding stress assignment, resulting in the leftmost edge of a word being more prominent in certain words and the rightmost edge in certain others. Given the additional fact that the language exhibits Non-finality effects, and that, unlike English, codas are not moraic, its acquisition presents unique difficulties and challenges for English-speaking learners of the language. Many of these challenges potentially lead these learners to make Universal Grammar (UG)-unconstrained (but cognitively reasonable) assumptions about how the phonology of Mongolian works, especially since the learners do not have all the Mongolian data available to them all at once. The learning scenario here, thus, provides unique opportunities to investigate whether L2 phonologies are constrained by the options made available by UG. The findings of a semi-controlled production experiment indicate that although learners do not necessarily converge on the prosodic representations employed by native speakers of the L2 (i.e., footless intonational prominence, at least for the leftmost/default edge 'stress'), and although certain changes to the grammar are very difficult to implement, such as switching from moraic codas to non-moraic codas, the learners nevertheless demonstrate a stage-like behavior where each step exhibits the parameter settings employed by a natural language, one that is neither like the L2 nor the L1. Conversely, despite the input leading them to do so, learners do not entertain UG-unconstrained prosodic representations, such as End-Rule- Middle or End-Rule- Variable ; End-Rule is set either to Right or Left , as is expected in a system constrained by the options made available by UG. We conclude that the hypothesis space for interlanguage phonologies is determined by UG., Competing Interests: The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Özçelik.)

The recently emergent disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), transmitted by droplets and aerosols, was named coronavirus disease 2019 (COVID-19) by World Health Organization. Predominantly, the disease progress is asymptomatic or mild, but one-fifth of the patients advance to severe or critical illness. In severe COVID-19 patients, type-2 T helper cells release numerous cytokines; this excessive immune response is named as cytokine storm. The cytokine storm, which is the hallmark of the COVID-19 induced by the disease and aggravates due to lack of proper immune response, similar to SARS and Middle East respiratory syndrome (MERS), and the disease status may progress forward to acute respiratory distress syndrome (ARDS), systemic inflammatory response syndrome, multi-organ dysfunction syndrome, and death. Mesenchymal stromal cell transplantation is up-and-coming in treating many diseases such as HIV, hepatitis B, influenza, coronavirus diseases (SARS, MERS), lung injuries, and ARDS. Upon closer inspection on respiratory diseases, COVID-19, influenza, SARS, and MERS have similarities in pathogenesis, especially cytokine and immune response profiles. These comparable features in terms of the cytokine storm will provide hints for the treatment of COVID-19., Competing Interests: Conflict-of-interest statement: The authors declare no conflict of interest regarding the publication of this paper., (©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.)

Aim : This study aims to determine the prognostic value of the Glasgow Prognostic Score (GPS) and fibrinogen to albumin ratio (FAR) in patients with COVID-19. Methods : Electronic database records of 400 patients with COVID-19 were retrospectively analyzed and the initial levels of CRP, albumin, fibrinogen values were recorded. The ground-glass opacities (GGO) and consolidations were evaluated on thorax CT. Hospital mortality and the need for intensive care unit (ICU) transfer were determined as adverse outcomes. Results : It was determined that 345 patients (86.25%) were discharged while 31 patients (7.75%) were transferred to ICU in addition to 24 patients who died (6%). The rates of deaths and transfers to ICU were significantly increased in GPS 2 group compared to both GPS 0 and 1 groups. Additionally, increased FAR was observed in patients who died and transferred to ICU compared to the discharged patients. The FAR was significantly increased in patients with diffuse GGO. Logistic regression analysis indicated that FAR ≥144.59 and the presence of GPS 2 were independent predictors of the adverse outcomes in COVID-19 patients. Conclusion : Our results demonstrated that the GPS and FAR could possess a predictive value for adverse outcomes in patients with COVID-19.

Dyscalculia is a learning disability affecting the acquisition of arithmetical skills in children with normal intelligence and age-appropriate education. Two hypotheses attempt to explain the main cause of dyscalculia. The first hypothesis suggests that a problem with the core mechanisms of perceiving (non-symbolic) quantities is the cause of dyscalculia (core deficit hypothesis), while the alternative hypothesis suggests that dyscalculics have problems only with the processing of numerical symbols (access deficit hypothesis). In the present study, the symbolic and non-symbolic numerosity processing of typically developing children and children with dyscalculia were examined with functional magnetic resonance imaging (fMRI). Control ( n = 15, mean age: 11.26) and dyscalculia ( n = 12, mean age: 11.25) groups were determined using a wide-scale screening process. Participants performed a quantity comparison paradigm in the fMRI with two number conditions (dot and symbol comparison) and two difficulty levels (0.5 and 0.7 ratio). The results showed that the bilateral intraparietal sulcus (IPS), left dorsolateral prefrontal cortex (DLPFC) and left fusiform gyrus (so-called "number form area") were activated for number perception as well as bilateral occipital and supplementary motor areas. The task difficulty engaged bilateral insular cortex, anterior cingulate cortex, IPS, and DLPFC activation. The dyscalculia group showed more activation in the left orbitofrontal cortex, left medial prefrontal cortex, and right anterior cingulate cortex than the control group. The dyscalculia group showed left hippocampus activation specifically for the symbolic condition. Increased left hippocampal and left-lateralized frontal network activation suggest increased executive and memory-based compensation mechanisms during symbolic processing for dyscalculics. Overall, our findings support the access deficit hypothesis as a neural basis for dyscalculia., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Üstün, Ayyıldız, Kale, Mançe Çalışır, Uran, Öner, Olkun and Çiçek.)

Competing Interests: Conflict of Interest: The authors have no conflicts of interest to declare.

Aim: This study was conducted to reveal the feelings, thoughts and opinions of male and female nursing students about gender perception in nursing., Design and Methods: This descriptive study using qualitative methods sought to reveal gender perception among first- and fourth-year nursing students. The focus group interview (FGI) approach was used purposefully to obtain in-depth information about nursing students' gender perceptions and their underlying attitudes, beliefs and behaviours. There were 27 female and 17 male participants, of whom 23 were first-year and 21 were fourth-year nursing students., Results: The analysis revealed four themes: (1) reasons for choosing the nursing profession, (2) gender perception, (3) religion and cultural factors and (4) occupational gender perception. The students reported that in certain units, gender would make a more positive difference for patients and themselves. The responses of male students regarding their professional gender perceptions also differed depending on whether they were first- or fourth-year students., Conclusions: Gender affects the perception of professional gender and to has a positive effect on the adoption of the profession during education by male students., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Objective: In this study, we aimed to analyze the TURKMI registry to identify the factors associated with delays from symptom onset to treatment that would be the focus of improvement efforts in patients with acute myocardial infarction (AMI) in Turkey., Methods: The TURKMI study is a nation-wide registry that was conducted in 50 centers capable of 24/7 primary percutaneous coronary intervention (PCI). All consecutive patients (n=1930) with AMI admitted to coronary care units within 48 hours of symptom onset were prospectively enrolled during a predefined 2-week period between November 1, 2018, and November 16, 2018. All the patients were examined in detail with regard to the time elapsed at each step from symptom onset to initiation of treatment, including door-to-balloon time (D2B) and total ischemic time (TIT)., Results: After excluding patients who suffered an AMI within the hospital (2.6%), the analysis was conducted for 1879 patients. Most of the patients (49.5%) arrived by self-transport, 11.8% by emergency medical service (EMS) ambulance, and 38.6% were transferred from another EMS without PCI capability. The median time delay from symptom-onset to EMS call was 52.5 (15-180) min and from EMS call to EMS arrival 15 (10-20) min. In ST-segment elevation myocardial infarction (STEMI), the median D2B time was 36.5 (25-63) min, and median TIT was 195 (115-330) min. TIT was significantly prolonged from 151 (90-285) min to 250 (165-372) min in patients transferred from non-PCI centers. The major significant factors associated with time delay were patient-related delay and the mode of hospital arrival, both in STEMI and non-STEMI., Conclusion: The baseline evaluation of the TURKMI study revealed that an important proportion of patients presenting with AMI within 48 hours of symptom onset reach the PCI treatment center later than the time proposed in the guidelines, and the use of EMS for admission to hospital is extremely low in Turkey. Patient-related factors and the mode of hospital admission were the major factors associated with the time delay to treatment.

Background: Hypertriglyceridemia (HTG) is an important component of residual risk. The knowledge regarding its treatment might not be at a desired level which might prevent patients from receiving the maximum benefit. We aimed to investigate the knowledge and attitudes of Turkish cardiologists who responded to a survey regarding HTG treatment., Methods: A multiple-choice survey was conducted to analyze Turkish cardiologists' management of HTG. The questionnaire was submitted by the Turkish Society of Cardiology to all its members., Results: A total of 160 cardiologists responded to the survey. The mean age was 37.5±8.5 years, and 35 (21.9%) of the participants were female. Most of the participants (88%) thought HTG was a risk factor, and 75% of them felt confident in diagnosing and treating HTG. Patient compliance (41%), polypharmacy (33%), and lack of treatment options (15%) were the most common problems obstructing treatment of HTG. A proportion of 96% of the participants knew about non-high-density lipoprotein cholesterol, which is a good surrogate marker of atherogenic dyslipidemia; however, only 39% were using it as a treatment goal. In the case of low-density lipoprotein cholesterol at goal but with HTG (residual risk), the first choice for treatment was fibrates (94%). Half of cardiologists had never used omega-3 fatty acids as a treatment option., Conclusions: Although most of the participating cardiologists felt competent treating HTG, there was a knowledge gap in the treatment of atherogenic dyslipidemia and management of residual risk. Evidence of the benefit of lowering triglycerides from cardiovascular outcome trials is eagerly awaited. There is also an unmet need of increasing patient compliance and managing polypharmacy.

The purpose of this study was to determine the feelings, thoughts, perceptions and cultural standpoint of nursing students concerning patient privacy. This study was conducted as a qualitative descriptive design. The homogeneous sampling method, purposive sampling method for qualitative research samples, was used to determine the study group. Data were collected from 17 nursing students at a state university in Turkey. Individual semi-structured interviews were conducted, and content analysis was used to analyze data. Three main themes emerged from the data: perception of privacy, factors affecting patient privacy and suggested solutions. Four sub-categories emerged: religion, gender, culture and reassuring communication. The perceptions of many of the students relating to the concept of privacy coincided with the concepts of confidentiality and all kinds of information concerning the patient. It was seen that the most effective intervention among the students' solution proposals to ensure privacy was the necessity to make physical improvements in hospitals.

Background: Chemotherapy with high dose methotrexate is the mainstay of treatment for Burkitt lymphoma (BL), especially to manage central nervous system (CNS) disease. However, methotrexate administration requires close drug level monitoring for appropriate folinic acid rescue, which might not be readily available in all centers. In this study, we assessed the long-term treatment outcomes of a modified Non-Hodgkin lymphoma (NHL)-Berlin-Frankfurt-Munster (BFM) 90 regimen in pediatric high-risk BL without CNS involvement., Methods: Between 1999 and 2011, 42 patients (median age: 7 years) with advanced-stage BL were treated with modified NHL-BFM 90 regimen (methotrexate at a dose of 1 g/m2). Demographic data, stage, lactate dehydrogenase (LDH) and treatment results were retrospectively evaluated. The patients were assessed for toxicity, survival and CNS recurrence., Results: Thirty-six patients had Stage III and six had Stage IV disease, respectively. The median LDH level was 1,432 IU/L. Four patients died of infectious and metabolic complications. One patient had local recurrence at the 48 < sup > th < /sup > month of the follow-up and he is in the second remission for 72 months. In Kaplan-Meier analysis, the overall survival and event-free survival rates at 10 years were found as 90 % and 88 %, respectively. None of our patients died of treatment failure., Conclusions: The administration of the reduced dose of methotrexate seems to not compromise treatment success nor increase the risk of CNS recurrence in high-risk BL without CNS involvement. The limitation of the study is that it is not randomized. Our treatment scheme might be considered for centers without methotrexate measurement facility.

Objective: The neurobiological correlates of Somatic Symptom Disorder (SSD) introduced in the DSM-5 has been the focus of a limited investigation. We aimed to examine the cortical response to painful stimuli and its relationship to symptom severity as well as cognitive and psychological characteristics in proposed models of somatoform disorders., Methods: We measured hemodynamic responses by 52-channel functional near-infrared spectroscopy. We compared the cortical response to painful stimuli in index patients with SSD (N = 21) versus age, and gender matched healthy control subjects (N = 21). We used brush stimulation as the control condition. We analyzed the relationship of cortical activity with SSD symptom severity as well as somatosensory amplification (SSA), alexithymia, dysfunctional illness behaviour, worry, and neuroticism., Results: Patients with SSD had higher somatic symptom severity, SSA, alexithymia, neuroticism, illness-related worry, and behaviour. Somatic symptom severity was predicted by a model including SSA and subjective feeling of pain in the index patients. Activity in the left-angular and right-middle temporal gyri was higher in the SSD subjects than the controls during pain stimulation. Positive correlations were detected between mean pain threshold levels and left middle occipital gyrus activity, as well as between SSA-scores and right-angular gyrus activity during pain condition in the index patients with SSD., Conclusion: We present the first evidence that representation of pain in terms of cortical activity is different in subjects with SSD than healthy controls. SSA has functional neuroanatomic correlates and predicts symptom severity in SSD and therefore is involved as a valid intermediate phenotype in SSD pathophysiology., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background: Urticaria can be the only sign of a food allergy or can be seen together with other signs and symptoms of a food allergy., Objective: To determine the demographic, etiologic, and clinical features of food-induced acute urticaria in childhood., Methods: Patients suspected of food-induced acute urticaria were included in this prospective cross-sectional multicenter study., Results: Two hundred twenty-nine urticaria cases were included in this study. Seventeen patients who did not meet the inclusion criteria of the study were excluded. Of the 212 included cases, 179 (84.4%) were diagnosed with definitive food-induced acute urticaria. The most common foods causing acute urticaria were cow's milk, hen's eggs, and nuts in 56.4, 35.2, and 19% of cases, respectively. The positive predictive value of a history of milk-induced acute urticaria together with a milk-specific IgE >5 kU/L for cow's milk-induced acute urticaria was 92% (95% CI: 81-96%). A history of cow's milk-induced and/or hen's egg-induced acute urticaria was consistent with a definitive diagnosis of food-induced urticaria (Chen's kappa: 0.664 and 0.627 for milk and eggs, respectively). Urticaria activity scores were higher in patients with food-induced acute urticaria (p = 0.002)., Conclusion: Cow's milk, hen's eggs, and nuts were the most common allergens in the etiology of childhood food-induced acute urticaria. Although the urticaria activity score provides guidance for diagnosis, an oral food challenge is often essential for the definitive diagnosis of a patient with a history of food-induced acute urticaria., (© 2021 S. Karger AG, Basel.)

Introduction: The aim of this study was to present the follow-up results of 110 patients who were given anti-tumor necrosis factor alpha (TNF-α) therapy for rheumatic and dermatologic diseases in a country with a high rates of active and latent tuberculosis bacillus infection., Material and Methods: Between February 2008 and January 2015, 110 cases in the age range of 23-77 who are using anti-TNF-α were included in the study retro-prospectively., Results: 52.7% of them ( n  = 58) were male. The most common diagnoses were rheumatoid arthritis (42.7%) and ankylosing spondylitis (38.2%). Most frequently given treatment were infliximab 37.3% and etanercept 30.9%, respectively. The 65 patients whose first tuberculin skin test (TST) value "5 mm and above" was started daily 300 mg INH prophylaxis for 9 months but 3 patients had not been started because of refusing treatment. In only one case chemoprophylaxis has had to be interrupted because of high liver function test due to the INH prophylaxis. TST conversion was observed in 14 patients. Further follow-up, it was observed that 4 patients had TST's positivity. Isoniazide (INH) prophylaxis was started these 18 patients (42.9%). Although INH prophylaxis has been given in two patients, they developed active tuberculosis in follow-up., Conclusion: Considering the INH resistance in our country, all patients especially the ones with residual lesion and history of previous exposure, should be followed up closely during the anti-TNF-α treatment.

It has been more than 3 months now since the first case of COVID-19 was reported in Turkey. Globally, the number of confirmed cases and deaths reached 9,653,048 and 491,128 respectively, as reported by 216 countries by June 27, 2020. Turkey had 1,396 new cases, 194,511 total cases, and 5,065 deaths by the same date. From the first case until today, the Turkish Thoracic Society (TTS) has been very proactive in educating doctors, increasing public awareness, undertaking academic studies, and assisting with public health policies. In the present report, social, academic, and management perspectives of the pandemic are presented under appropriate subtitles. During this critical public health crisis, TTS has once again demonstrated its readiness and constructive stance by supporting public health, healthcare workers, and the environment. This review summarizes the perspective of TTS on each aspect of the COVID-19 pandemic and casts light on its contributions.

Background: The aim of this study was to determine levels of Mid-regional Pro-adrenomedullin (MR-proADM) and Mid-regional Pro-atrial Natriuretic Peptide (MR-proANP) in patients with acute pulmonary embolism (PE), the relationship between these parameters and the risk classification in addition to determining the relationship between 1and 3month mortality., Methods: 82 PE patients and 50 healthy control subjects were included in the study. Blood samples for Mr-proANP and Mr-proADM were obtained from the subjects prior to the treatment. Risk stratification was determined according to sPESI (Simplified Pulmonary Embolism Severity Index). Following these initial measurements, cases with PE were assessed in terms of all causative and PE related mortalities., Results: The mean serum Mr-proANP and Mr-proADM levels in acute PE patients were found to be statistically higher compared to the control group (p < 0.001, p < 0.01; respectively) and statistically significantly higher in high-risk patients than low-risk patients (p < 0.01, p < 0.05; respectively). No statistical difference was determined in high-risk patients in case of sPESI compared to low-risk patients while hospital mortality rates were higher. It was determined that the hospital mortality rate in cases with Mr-proANP ≥ 123.30 pmol/L and the total 3-month mortality rate in cases with Mr-proADM ≥ 152.2 pg/mL showed a statistically significant increase., Conclusions: This study showed that Mr-proANP and MRproADM may be an important biochemical marker for determining high-risk cases and predicting the mortality in PE patients and we believe that these results should be supported by further and extensive studies., Competing Interests: Conflict of Interest: The authors stated that they have no conflicts of interest regarding the publication of this article., (2020 Önsel Öner, Figen Deveci, Selda Telo, Mutlu Kuluöztürk, Mehmet Balin, published by CEON/CEES.)

Corona Virus disease 2019 (COVID-19), which is one of the biggest outbreaks in the last century and is caused by a kind of coronavirus, spread to many countries in a short time after being first seen in the Wuhan region of China in December 2019. The COVID-19 outbreak, which spread rapidly and caused many deaths, was declared as a pandemic by the World Health Organization on March 11, 2020. The first COVID-19 case in Turkey, coincidentally, was seen on the same day. In this article, the story of the pandemic struggle successfully carried out in a private hospital and the teachings of the process are provided.

Background/aim: The male sling operation and artificial urinary sphincter implantation are common methods for treating urinary incontinence. However, there are some drawbacks to these methods such as infection, urethral erosion, pain, inefficiency, and the technical difficulty of the operations. Here we describe a new device we have named the Turkish Continence Device (TCD) which has advantages over these other methods. The aim of this study was perform experiments with the TCD prototype in vivo and ex vivo to determine efficiency, convenience of implantation, and negative effects., Materials and Methods: We implanted the prototype device in male goats and sheep, compressing the posterior urethra, and then fixed it by sutures on the lateral sides of the cavernosal bodies, bilaterally. Then we recorded urodynamic findings and performed urinary imaging. Additionally we measured urethral closure pressure ex vivo., Results: The balloon volume for efficient urethral closure pressure using the new device was under 1 mL. It compressed the urethra towards the corpus cavernosum perfectly, because the wings of the prototype device are fixed near the tunica of the cavernosal bodies on each side., Conclusion: A smaller device with smaller arms/wings would be efficient for obtaining enough pressure on the urethra. Additionally, the technique for implanting the device is very simple and would likely be learned quickly., Competing Interests: The authors have nothing to disclose., (This work is licensed under a Creative Commons Attribution 4.0 International License.)

Myasthenia gravis (MG) is an autoimmune disease mediated by autoantibodies predominantly against the acetylcholine receptor (AChR). Specific T cell subsets are required for long-term antibody responses, and cytokines secreted mainly from CD4 + T cells regulate B cell antibody production. The aim of this study was to assess the differences in the cytokine expressions of CD4 + T cells in MG patients with AChR antibodies (AChR-MG) and the effect of immunosuppressive (IS) therapy on cytokine activity and to test these findings also in MG patients without detectable antibodies (SN-MG). Clinically diagnosed AChR-MG and SN-MG patients were included. The AChR-MG patients were grouped as IS-positive and -negative and compared with age- and sex-matched healthy controls. Peripheral blood mononuclear cells were used for ex vivo intracellular cytokine production, and subsets of CD4 + T cells and circulating follicular helper T (cTfh) cells were detected phenotypically by the expression of the chemokine and the costimulatory receptors. Thymocytes obtained from patients who had thymectomy were also analyzed. IL-21, IL-4, IL-10, and IL-17A productions in CD4 + T cells were increased in AChR-MG compared to those in healthy controls. IS treatment enhanced IL-10 and reduced IFN-γ production in AChR-MG patients compared to those in IS-negative patients. Increased IL-21 and IL-4 productions were also demonstrated in SN-MG patients. Among CD4 + T cells, Th17 cells were increased in both disease subgroups. Treatment induced higher proportions of Th2 cells in AChR-MG patients. Both CXCR5 + and CXCR5 - CD4 + T cells expressed higher programmed cell death protein 1 (PD-1) and inducible costimulatory (ICOS) in AChR-MG and SN-MG groups, mostly irrespective of the treatment. Based on chemokine receptors on CXCR5 + PD-1 + in CD4 + T (cTfh) cells, in AChR-MG patients without treatment, the proportions of Tfh17 cells were higher than those in the treated group, whereas the Tfh1 cells were decreased compared with those in the controls. The relevance of CXCR5 and PD-1 in the pathogenesis of AChR-MG was also suggested by the increased presence of these molecules on mature CD4 single-positive thymocytes from the thymic samples. The study provides further evidence for the importance of IL-21, IL-17A, IL-4, and IL-10 in AChR-MG. Disease-related CD4 + T cells are identified mainly as PD-1 + or ICOS + with or without CXCR5, resembling cTfh cells in the circulation or probably in the thymus. AChR-MG and SN-MG seem to have some similar characteristics. IS treatment has distinctive effects on cytokine expression., (Copyright © 2020 Çebi, Durmus, Aysal, Özkan, Gül, Çakar, Hocaoglu, Mercan, Yentür, Tütüncü, Yayla, Akan, Dogan, Parman and Saruhan-Direskeneli.)

Purpose: Autosomal recessive (AR) CARD9 deficiency is an inherited immune disorder which results in impaired innate immunity against various fungi. Superficial and invasive fungal infections, mainly caused by Candida or Trichophyton species, are the hallmark of CARD9 deficiency. Together with the increasing number of CARD9-deficient patients reported, different pathogenic fungal species have been described such as Phialophora, Exophiala, Corynespora, Aureobasidium, and Ochroconis. Saprochaete capitata is an opportunistic infectious agent in immunocompromised patients and is a common cause of invasive fungal disease in patients with hematological malignancies. In this study, we investigated the causative genetic defect in a patient with S. capitata fungal infection which disseminated to lymph nodes and common bile duct., Methods: The identification of the isolated yeast strain was made by direct microscopic examination and confirmed by internal transcribed spacer (ITS) sequencing. We applied whole exome sequencing to search for the disease-causing mutation. Sanger sequencing was used to validate the mutation in the patient and his parents., Results: S. capitata was isolated from the biopsy specimen as the causative microorganism responsible for the invasive fungal disease in the patient. Whole exome sequencing revealed a homozygous c.883C > T, (p.Q295*) mutation in CARD9, confirmed by Sanger sequencing., Conclusions: This is the first report of invasive Saprochaete infection associated with autosomal recessive (AR) CARD9 deficiency in the literature and thereby further extends the spectrum of fungal diseases seen in these patients.

Purpose: Precision oncology connects highly complex diagnostic procedures with patient histories to identify individualized treatment options in interdisciplinary molecular tumor boards (MTBs). Detailed data on MTB-guided treatments and outcome with a focus on advanced GI cancers have not been reported yet., Patients and Methods: Next-generation sequencing of tumor and normal tissue pairs was performed between April 2016 and February 2018. After identification of relevant molecular alterations, available clinical studies or in-label, off-label, or matched experimental treatment options were recommended. Follow-up data and a response assessment that was based on radiologic imaging were recorded., Results: Ninety-six patients were presented to the MTB of Tuebingen University Hospital. Sixteen (17%) showed "pathogenic" or "likely pathogenic" germline variants. Recommendations on the basis of molecular alterations or tumor mutational burden were given for 41 patients (43%). Twenty-five received the suggested drug, and 20 were evaluable for best response assessment. Three patients (15%) reached a partial response (PR), and 6 (30%), stable disease (SD), whereas 11 (55%) had tumor progression (progressive disease). Median progression-free survival (PFS) for all treated and evaluable patients was 2.8 months (range, 1.0-9.0 months), and median overall survival (OS) of all treated patients was 5.2 months (range, 0.1 months to not reached). Patients with SD for ≥ 3 months or PR compared with progressive disease showed both a statistically significant longer median PFS (7.8 months [95% CI, 4.2 to 11.4 months] v 2.2 months [95% CI, 1.5 to 2.8 months], P < .0001) and median OS (18.0 months [95% CI, 10.4 to 25.6 months] v 3.8 months [95% CI, 2.3 to 5.4 months], P < .0001)., Conclusion: Next-generation sequencing diagnostics of advanced GI cancers identified a substantial number of pathogenic or likely pathogenic germline variants and unique individual treatment options. Patients with PR or SD in the course of MTB-recommended treatments seemed to benefit with respect to PFS and OS., Competing Interests: The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated unless otherwise noted. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/po/author-center. Open Payments is a public database containing information reported by companies about payments made to US-licensed physicians (Open Payments). Michael BitzerConsulting or Advisory Role: Bristol-Myers Squibb, Bayer Vital GmbH, EISAI, Ipsen, Lilly Travel, Accommodations, Expenses: Ipsen, CelgeneSaskia BiskupEmployment: CeGaT Stock and Other Ownership Interests: CeGaTMartin SchulzeEmployment: Praxis für Humangenetik TuebingenFranz HilkeHonoraria: Agilent Technologies Research Funding: Novartis (Inst) Travel, Accommodations, Expenses: Agilent TechnologiesKonstantin NikolaouHonoraria: Siemens Healthineers, Bayer Schering Pharma Consulting or Advisory Role: Siemens Healthineers Speakers' Bureau: Siemens Healthineers Research Funding: Siemens Healthineers (Inst), Bayer Schering Pharma (Inst) Travel, Accommodations, Expenses: Siemens Healthineers, Bayer Schering PharmaChristopher SchroederResearch Funding: Illumina (Inst), Novartis (Inst)Olaf RiessHonoraria: AstraZeneca, Takeda/Shire Consulting or Advisory Role: Illumina Research Funding: Illumina (Inst)Falko FendConsulting or Advisory Role: Roche, EUSA PharmaDaniel ZipsResearch Funding: Elekta (Inst), Siemens (Inst), Sennewald (Inst) Travel, Accommodations, Expenses: Elekta (Inst)Martina HinterleitnerTravel, Accommodations, Expenses: Novartis/IpsenLars ZenderLeadership: HeparegeniX GmBH Consulting or Advisory Role: Boehringer Ingelheim Research Funding: HeparegeniX GmBH Patents, Royalties, Other Intellectual Property: Patent on MKK4 Inhibition for the treatment of acute and chronic liver diseases Travel, Accommodations, Expenses: IpsenGhazaleh TabatabaiHonoraria: AbbVie, Bayer, Medac, Novocure (Inst) Consulting or Advisory Role: AbbVie, Bayer Travel, Accommodations, Expenses: Novocure (Inst)Nisar P. MalekHonoraria: Spring Bank Travel, Accommodations, Expenses: Falk Foundation No other potential conflicts of interest were reported., (© 2020 by American Society of Clinical Oncology.)