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Objective: Cisplatin-associated acute kidney injury is a common clinical event that causes increased morbidity and mortality in cancer patients even if they are categorized as having normal functioning kidneys. We aimed to determine predictive factors that can predict acute kidney injury associated with cisplatin therapy in patients with normal renal function by comparison of pre-chemotherapy estimated glomerular filtration rates calculated separately by Cockcroft and Gault (CG), the Modification of Diet in Renal Disease (MDRD), and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPİ) equations and accompanying patient-associated factors. Materials and Methods: A total of 200 patients diagnosed with lung cancer and determined to have normal functioning kidneys and considered cisplatin eligible by the attending physician before chemotherapy were included in this retrospective study. Acute kidney injury after cisplatin chemotherapy (c-AKI) was determined according to the National Cancer Institute's Common Terminology Criteria for Adverse Events v4.03. Pre-chemotherapy serum laboratory parameters and clinico-histopathological characteristics of patients were recorded from the hospital electronic system. The optimal cut-off for eGFR methods was determined by the area under the receiver operating characteristic curve (ROC-AUC) analysis. Predictive factor analysis for c-AKI was performed by regression analyses. Results: C-AKI developed in 39 (19.5%) patients. In the univariate analysis, a significant correlation was observed between c-AKI and high body mass index (BMI) before treatment, older age (>62.5), female gender, eGFR by MDRD (=94.5 mL/min) and eGFR by CKD-EPI (=91.5 mL/min). There was no relation between eGFR by CG and c-AKI. Two different multivariate models were established. Model 1 showed that female gender (odds ratio [OR] =4.90, 95% confidence interval [CI]: 1.52-15.79, P = 0.008) and eGFR by MDRD less than or equal to 94.5 mL/min (OR = 3.52, 95% CI: 1.68-7.38, P = 0.001) were predictive markers for c-AKI. In Multivariate Model 2, female gender (OR = 5.51, 95% CI: 1.70-17.83, P = 0.004) and eGFR by CKD-EPI less than or equal to 91.5 mL/min (OR = 3.52, 95% CI: 1.67-7.42, P = 0.001) were found to be predictive markers for c-AKI. Conclusions: This study revealed that eGFR calculated based on MDRD (=94.5 mL/min/m2) or CKD-EPI (=91.5 mL/min/m2) before chemotherapy indicates a strong tendency for c-AKI. In addition, we detected a high risk of c-AKI for females compared to their counterparts. Although eGFR 60 mL/min is considered the threshold level to accept patients as cisplatin-eligible, we recommend close follow-up of high-risk patients for cisplatin nephrotoxicity we detected in our models. [ABSTRACT FROM AUTHOR]

With each passing day, maritime organisations are equipped with more technology, and these systems form a structure that creates international networks. Digitalisation will have implications and effects on value creation, business models, horizontal and vertical integration, services and work organisation. While digital technologies in the maritime sector reduce risks owing to transparency, adaptability, traceability, flexibility and scalability, can also give discernible improvements in terms of operational processes, cost reductions, etc.. In the developing maritime sector, there are a variety of digital technology-related challenges that remain to be overcome, but there is no structured overview of the main types of challenges/barriers encountered by specialists. In this study, we explore the challenges/barriers to digitalisation in the maritime sector and how these are perceived by employees in this sector. The aim of our research is to identify these challenges/barriers and understand the relationships between them. To categorise the challenges/barriers, the DEMATEL approach was used. As a result of the analysis, it is seen that the main hindrances to digitalisation in the maritime sector are the problems of complexity, integration and interoperability. In contrast, the difficulties of performance appraisal and scalability emerge as the least important issues affecting the implementation of digital technologies in this area. Our results indicate that economic problems exert a significant causal influence on the other challenges/barriers.

Background: The present study aimed to evaluate the safety and efficacy of transperitoneal laparoscopic adrenalectomy (LA) for large adrenal tumours by comparing the outcomes of tumours larger than 6 cm with those smaller than 6 cm and also to identify the risk factors associated with prolonged operative time in transperitoneal LA. Patients and Methods: One hundred and sixty-three patients underwent LA at our clinic from January 2014 to December 2020. Bilateral LA was performed in 20 of these 163 patients. A total of 143 patients were included in this study. Data were analysed retrospectively from the patients' medical records collected. Results: Large tumour (LT) group consists of 33 patients and the small tumour (ST) group consists of 110 patients. There was no statistically significant difference between the groups regarding conversion to open surgery and complications. A multiple regression analysis was conducted to identify the independent predictors of prolonged operation time. The tumour size ≥8 cm (odds ratio [OR], 19.132; 95% confidence interval [CI], 3.881–94.303; P < 0.001) and diagnosis of pheochromocytoma (OR, 2.762; 95% CI, (1.123–6.789, P = 0.026) were the significant predictors of prolonged operation time. Conclusion: Our study shows that LA can be considered the treatment of choice for small and large adrenal tumours. The tumour size ≥8 cm and diagnosis of pheochromocytoma are the independent risk factors for the prolonged operative time in transperitoneal LA.

Introduction: This study investigated the relationship between serum interleukin-20 (IL-20) levels and paclitaxel-associated neuropathy in patients with non-metastatic breast cancer. Paclitaxel-induced peripheral neuropathy (PIPN) is a significant side effect of paclitaxel chemotherapy, and the exact mechanism underlying PIPN is not fully understood. Methods: This prospective observational study was conducted with non-metastatic breast cancer patients between January 2022 and November 2022. Neuropathy symptoms were evaluated using the QLQ-CIPN20 questionnaire, and serum IL-20 levels were measured at three time points: before chemotherapy, on the 7th day after the first paclitaxel treatment, and after the last treatment. Univariate and multivariate logistic regression analyses were performed to identify factors predicting PIPN. Results: This study was completed with 59 female patients. During the study, 47 patients (79.6%) reported any degree of neuropathy, whereas 12 patients (20.4%) had no neuropathy. Univariate analysis to predict neuropathy measured on day 7 after first paclitaxel administration demonstrated that age, body mass index, 7th-day serum IL-20 level, and last cycle serum IL-20 level were predictive for PIPN. Conclusion: This study demonstrated the relationship between serum IL-20 levels and paclitaxel-related neuropathy in breast cancer patients. Further research targeting the function of IL-20 is needed to investigate potential strategies to prevent and treat PIPN.