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Objectives: More than half of gastric cancer patients have no chance of resection at the time of diagnosis. In gastric cancer, which has increased frequency with age, chemotherapy efficacy and tolerability in metastatic gastric cancer aged 75 and over have been investigated due to the fact that the elderly patient population is not sufficiently involved in the studies. Methods: In our study, the clinical and demographic characteristics of patients, treatment regimens and responses, prognostic factors, grad 3-4 toxicity, progression-free survival (PFS) and overall survival (OS) were examined. Results: In the study involving 118 patients, PFS was 5.8 months and OS was 8.4 months. A disease control rate of 38.1% was achieved with chemotherapy. Conclusion: Since the OS in this study was 10.5 months in patients with ECOG PS 0-1, 13.8 months in patients who received two lines or more, and the frequency of side effects was acceptable, we believe that this patient population should not be left untreated. Since there are acceptable survival values even with single-agent therapies, monotherapy can be recommended for patients with poor ECOG PS and combination therapies can be recommended for patients with good PS without comorbidities. [ABSTRACT FROM AUTHOR]

Proton pump inhibitors (PPIs) are recommended for the prevention of gastrointestinal bleeding in acute coronary syndrome (ACS) patients who receive dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) but have been associated with an increased risk of major adverse cardiovascular events (MACE) in these patients. We aimed to investigate the relationship between serum asymmetric dimethylarginine (ADMA) and copeptin levels and MACE in those who started on imminent DAPT and PPI therapy after PCI. 90 patients with ACS were included in this prospective observational study and divided into three groups lansoprazole (n=30), rabeprazole (n=31), and pantoprazole (n=29). The serum ADMA and copeptin levels were examined at the time of diagnosis, at the end of 1st and 6th month. MACE was defined as mortality, recurrent AMI (acute myocardial infarction), and CST (coronary stent thrombosis) development after PCI. MACE developed in two patients in the first month and eight patients (8.9%) after six months of follow-up. At six months, CST was seen in only two patients (2.2%). At the first-month evaluation, while a significant increase was observed in serum ADMA levels at the time of admission (p<0.001), the copeptin levels decreased significantly in all patients (p<0.001). In the 6th month, the serum ADMA and copeptin levels significantly increased compared to the time of admission and 1st-month evaluation in all groups (p<0.001). PPIs might significantly influence serum ADMA and copeptin levels in patients undergoing coronary stenting due to ACS. Nevertheless, we did not notice clinical extrapolation of the potential effects. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Squamous cell esophageal cancer (ESCC) is a highly fatal malignancy. This study aims to investigate the factors affecting survival in patients with metastatic and non-metastatic ESCC. METHODS: Between 2008 and 2016, 107 patients with ESCC who were followed up in an oncology clinic were included in the analysis. Patients were grouped based on the stage of disease as clinical-stage II to IV. RESULTS: Of the 107 patients, 55 (55.1%) of them were male and 52 (48.6%) of them were female. The mean age was 60.8 years. Based on the clinical-stage, 28 (26.2%) patients had stage II disease, 33 (30.8%) had stage III disease, and 46 (43.0%) had stage IV disease. Twenty-nine (27.1%) patients with the non-metastatic disease underwent surgery following neoadjuvant chemoradiotherapy (CRT), while 29 (27.1%) patients received definitive CRT. Twenty-six (56.5%) patients with metastatic disease received chemotherapy (CT). While median overall survival (mOS) could not be reached in patients who underwent surgery following neoadjuvant CRT, mOS for patients receiving definitive CRT versus patients treated with surgery alone-was 22.0 months and 24.0 months, respectively (p=0.008). In the metastatic stage, mOS was 8.0 months for the patients treated with a first-line CT and 3.0 months for patients receiving best supportive care (p<0.001). In multivariate analysis, factors predicting survival in patients with the non-metastatic disease were ECOG PS 3-4 (Hazard ratio [HR], 6.13), undergoing surgery (HR, 0.22), clinical-stage III disease (HR, 3.19), and presence of recurrence (HR, 24.12). For patients with metastatic disease, ECOG PS 3-4 (HR, 3.31), grade-III histology (HR, 3.39), liver metastasis (HR, 2.53), and receiving CT (HR, 0.15) were the factors associated with survival in multivariate analysis. CONCLUSION: In our study, surgery and early clinical-stage increased survival, whereas experiencing recurrence adversely affected survival in non-metastatic ESCC. In the metastatic stage, ECOG PS 3-4, grade-3 histology and liver metastasis adversely affected survival, while receiving CT significantly improved survival. [ABSTRACT FROM AUTHOR]

Introduction: Gastrointestinal (GI) symptoms in coronavirus-19 disease (COVID-19) have been reported with great variability and without standardization. In hospitalized patients, we aimed to evaluate the prevalence of GI symptoms, factors associated with their occurrence, and variation at 1 month., Methods: The GI-COVID-19 is a prospective, multicenter, controlled study. Patients with and without COVID-19 diagnosis were recruited at hospital admission and asked for GI symptoms at admission and after 1 month, using the validated Gastrointestinal Symptom Rating Scale questionnaire., Results: The study included 2036 hospitalized patients. A total of 871 patients (575 COVID+ and 296 COVID-) were included for the primary analysis. GI symptoms occurred more frequently in patients with COVID-19 (59.7%; 343/575 patients) than in the control group (43.2%; 128/296 patients) (P < 0.001). Patients with COVID-19 complained of higher presence or intensity of nausea, diarrhea, loose stools, and urgency as compared with controls. At a 1-month follow-up, a reduction in the presence or intensity of GI symptoms was found in COVID-19 patients with GI symptoms at hospital admission. Nausea remained increased over controls. Factors significantly associated with nausea persistence in COVID-19 were female sex, high body mass index, the presence of dyspnea, and increased C-reactive protein levels., Discussion: The prevalence of GI symptoms in hospitalized patients with COVID-19 is higher than previously reported. Systemic and respiratory symptoms are often associated with GI complaints. Nausea may persist after the resolution of COVID-19 infection., (Copyright © 2021 by The American College of Gastroenterology.)

Objective: Squamous cell esophageal cancer (ESCC) is a highly fatal malignancy. This study aims to investigate the factors affecting survival in patients with metastatic and non-metastatic ESCC., Methods: Between 2008 and 2016, 107 patients with ESCC who were followed up in an oncology clinic were included in the analysis. Patients were grouped based on the stage of disease as clinical-stage II to IV., Results: Of the 107 patients, 55 (55.1%) of them were male and 52 (48.6%) of them were female. The mean age was 60.8 years. Based on the clinical-stage, 28 (26.2%) patients had stage II disease, 33 (30.8%) had stage III disease, and 46 (43.0%) had stage IV disease. Twenty-nine (27.1%) patients with the non-metastatic disease underwent surgery following neoadjuvant chemoradiotherapy (CRT), while 29 (27.1%) patients received definitive CRT. Twenty-six (56.5%) patients with metastatic disease received chemotherapy (CT). While median overall survival (mOS) could not be reached in patients who underwent surgery following neoadjuvant CRT, mOS for patients receiving definitive CRT versus patients treated with surgery alone-was 22.0 months and 24.0 months, respectively (p=0.008). In the metastatic stage, mOS was 8.0 months for the patients treated with a first-line CT and 3.0 months for patients receiving best supportive care (p<0.001). In multivariate analysis, factors predicting survival in patients with the non-metastatic disease were ECOG PS 3-4 (Hazard ratio [HR], 6.13), undergoing surgery (HR, 0.22), clinical-stage III disease (HR, 3.19), and presence of recurrence (HR, 24.12). For patients with metastatic disease, ECOG PS 3-4 (HR, 3.31), grade-III histology (HR, 3.39), liver metastasis (HR, 2.53), and receiving CT (HR, 0.15) were the factors associated with survival in multivariate analysis., Conclusion: In our study, surgery and early clinical-stage increased survival, whereas experiencing recurrence adversely affected survival in non-metastatic ESCC. In the metastatic stage, ECOG PS 3-4, grade-3 histology and liver metastasis adversely affected survival, while receiving CT significantly improved survival., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors., (Copyright: © 2020 by Istanbul Northern Anatolian Association of Public Hospitals.)