Nutritional status and severity of coronary artery disease

Objective The aim of this study is to evaluate the association between Nutritional Risk Index (NRI), a simple tool to assess nutritional status, and coronary artery disease severity and complexity in patients undergoing coronary angiography. Methods This study is a retrospective analysis of 822 patients undergoing coronary angiography. Patients with previous revascularization were excluded. Gensini and SYNTAX scores were calculated according to the angiographic images to determine atherosclerosis severity. NRI was calculated as follows: NRI = [15.19 × serum albumin (g/dl)] + [41.7 × (body weight/ideal body weight)]. In patients ≥65 years of age, Geriatric NRI (GNRI) was used instead of NRI. GNRI was calculated as follows: GNRI = [14.89 × serum albumin (g/dl)] + [41.7 × (body weight/ideal body weight)]. Patients were then divided into three groups as previously reported: NRI < 92, NRI 92–98 and NRI > 98. Gensini and SYNTAX scores were compared between three groups. Results The mean age of study population was 61.9 ± 11.1 years. NRI 98 was measured in 212, 321 and 289 patients, respectively. There was no difference regarding to sex, BMI, smoking, hypertension and diabetes mellitus between three groups. Patients with NRI < 92 had the highest mean Gensini score than the patients with NRI 92–98 and NRI > 98 (38.0 ± 40.6 vs. 31.17 ± 42.4 vs. 25.8 ± 38.4, P = 0.005). Also patients with NRI < 92 had the highest mean SYNTAX score than the patients with NRI 92–98 and NRI > 98 (11.8 ± 12.9 vs. 9.3 ± 12.4 vs. 7.7 ± 11.8, P = 0.001). Also, Gensini score of ≥20 and high SYNTAX score of ≥33 were associated with lower NRI (P < 0.001 and P < 0.001, respectively). Conclusion In our study, nutritional status evaluated by the NRI was associated with more extensive and complex coronary atherosclerosis in patients undergoing coronary angiography

Metastatik safra yolu kanseri olan yaşlı hastalarda optimal tedavi yaklaşımları ve prognostik faktörler

Introduction: There is a lack of evidence of the outcomes in elderly patients advanced stage biliary tract cancer due to the patients aged over 65 years are less than 25% in many prospective trials. We designed a retrospective multicenter study to evaluate the factors affecting treatment and survival in elderly patients with advanced-stage biliary tract cancer. Materials and methods: A total of 116 patients with advanced stage biliary tract cancer aged ≥65 years were included, and the treatment responses, survival, and toxicity rates were evaluated with respect to age groups Results: There was no significant difference between age and response to treatment, survival, or toxicity. The median progression-free survival and overall survival were 5.3, and 11.8 months respectively. Multivariate analysis indicated that ECOG PS (p<0.001 CI95% 1.5-3.7) and PNI (p<0.001 CI 95% 0.14-0.41) were significant independent prognostic factors for PFS. The independent prognostic factors for OS were choice of frontline regimen, NLR and PNI (p=0.007 CI 95% 0.71 – 0.94, p=0.006 CI 95% 1.2 – 3.1, p=0.001 CI 95% 0.35 – 0.91, respectively). Discussion: This study confirms the general prognostic relevance of inflammatory parameters and the importance of frontline treatment in elderly patients with advanced-stage biliary tract tumors. Additionally, getting older does not indicate that treatment will be avoided or that they will have a worse prognosis and suffer from more toxicities.Giriş: 65 yaş üzeri hastaların klinik çalışmaların %25’inden daha azını oluşturması nedeniyle biliyer sistem kanseri olan ileri yaş hastaların yönetimi konusunda kanıt eksiği bulunmaktadır. Bu amaçla, metastatik safra yolu kanseri tanılı yaşlı hastalarda tedaviyi ve sağkalımı etkileyen faktörleri değerlendirmek için retrospektif çok merkezli bir çalışma tasarladık. Gereç ve yöntemler: Çalışmaya 65 yaş ve üzeri, ileri evre safra yolu kanseri tanısı almış, 116 hasta dahil edildi ve yaş gruplarına göre tedavi yanıtları, sağkalım ve toksisite oranları değerlendirildi. Bulgular: Median yaşa göre gruplandırılıdğında; yaş ile tedaviye yanıt, sağkalım, toksisite arasında anlamlı bir fark bulunmadı. Tüm populasyonda medyan progresyonsuz sağkalım (PSK) ve genel sağkalım (GSK) sırasıyla 5.3, 11.8 aydı. Multivariate analizde, PSK için bağımsız prognostik faktörler preformans durumu(ECOG PS) (p<0.001 CI95% 1.5-3.7) ve Prognostik nutrisyonel indek (PNI) (p<0.001 CI 95% 0.14-0.41) olarak bulundu. GSK için ise bağımsız prognostik faktörler, birinci sıra tedavi seçimi, Notrofil Lenfosit oranı (p=0,007 CI %95 0,71 – 0,94) ve PNI (p=0,001 CI %95 0,35 – 0,91) olarak bulundu. Tartışma: Metastatik safra yolu kanseri olan yaşlı hastalarda prognozu etkileyen temel faktöreler inflamatuar parametreler ve birinci basamakta seçilen kemoterapi rejimidir. İleri yaş ile sağkalım, toksiste profili ve tedavi toleransı farklılık göstermemektedir

Efecto inhibidor de algunos aceites esenciales sobre el Penicillium digitatum causante de la putrefacción postcosecha de cítricos

In this study to control blue mould caused by Penicillium digitatum, essential oil of cumin was applied with filter paper discs of 6 mm diameter which were soaked in 0,04 ml oil and vapour effect inhibited completely mycelial growth and spore germination of pathogen in vitro. When filter paper discs soaked in essential oils of black thyme, dill, coriander and rosemary were placed on the culture medium (PDA), they had no effect on the mycelial growth. Their vapour effect inhibited mycelial growth of pathogen 85.8%, 82.8%, 80% and 71.4% respectively. Dill and rosemary oils also prevented mycelial colour.En este estudio para controlar las manchas azules causadas por Penicillium digitatum, se aplicó aceite esencial de comino en discos de papel de filtro de 6 mm de diámetro, los cuales fueron empapados en 0,04 ml de aceite y su vapor inhibió completamente el crecimiento micelar y la germinación de esporas del patógeno in vitro. Cuando los discos de papel de filtro empapados en aceites esenciales de tomillo, eneldo, culantro y romero se colocaron sobre el medio de cultivo (PDA), no se observó efecto sobre el crecimiento micelar. Los efectos de sus vapores inhibieron el crecimiento micelar de patógenos en un 85,8%, 82,8%, 80% y 71,4% respectivamente. Los aceites de eneldo y romero también evitaron la aparición del color micelar

The Effect of Adult Attention Deficit/Hyperactivity Symptoms on Quality of Life in People with Epilepsy

Objective:The aim of this study is to investigate the relationship between the diagnosis and symptoms of adult attention defic it/hy perac tivit y disorder and quality of life in people with epilepsy.Methods:In this study, 50 idiop athic /cryp togen ic epilepsy patients aged 18-65 years, followed by University Hospital Neurology outpatient clinic, and 50 healthy controls were included. Adult-Attention Deficit/Hyperactivity Disorder (A-ADD/ADHD), Symptom Checklist 90-Revised, Barratt Impulsivity Scale, and World Health Organization Quality of Life Short Form (WHOQoL-Bref) were completed by the participants. The diagnosis of adult attention defic it/hy perac tivit y disorder was made according to the Diagnostic and Statistical Manual (DSM)-5 diagnostic criteria.Results:The positive screening rate for adult attention defic it/hy perac tivit y disorder was 22% in people with epilepsy. Totally 6 (12%) people in the people with epilepsy and 2 (4%) people in the control group were diagnosed with adult attention defic it/hy perac tivit y disorder (P = .204). Significant differences were found in WHOQoL-Bref General, Physical, and Mental sub-parameters, A-ADD/ADHD-total and attention-deficit and related characteristics scores, Barratt Impulsivity Scale-11 total and all subgroups, and Symptom Checklist general and all subscales between people with epilepsy and control groups. A moderate negative correlation was found between WHOQoL-Bref scores and A-ADD/ADHD-attention deficit, Barratt Impulsivity Scale-11 total, Symptom Checklist General scores. Barratt Impulsivity Scale-11 total, and adult attention defic it/hy perac tivit y disor der-a ttent ion-d efici t scores; there was a moderate positive correlation between each of the number of hospitalization and outpatient treatments. A multivariate linear regression analysis was performed to predict the dependent variable as WHOQoL-Bref General using the independent variables of epilepsy age of onset, Barratt Impulsivity Scale-11 total, A-ADD/ADHD-attention-deficit, and Symptom Checklist general score. Accordingly, from the independent variables, the impulsivity total score predicts the dependent variable as negative and significant.Discussion:Impulsivity predicts general quality of life scores reported by people with epilepsy and reveals the importance of the attention defic it/hy perac tivity disorder clinic for people with epilepsy and its visible impact on daily functioning. It is important to evaluate attention defic it/hy perac tivit y disorder in these patients, as attention defic it/hy perac tivit y disorder comorbidity will create a serious burden for epilepsy

Prognostic factors for regorafenib treatment in patients with refractory metastatic colorectal cancer: A real-life retrospective multi-center study

Regorafenib, an oral multikinase inhibitor, has improved survival in metastatic colorectal cancer (mCRC) patients who have progressed on standard therapies. Our study aimed to evaluate prognostic factors influencing regorafenib treatment and assess the optimal dosing regimen in a real-life setting. We retrospectively analyzed 263 patients with mCRC from multiple medical oncology clinics in Turkey. Treatment responses and prognostic factors for survival were evaluated using univariate and multivariate analysis. Of the patients, 120 were male and 143 were female; 28.9% of tumors were located in the rectum. RAS mutations were present in 3.0% of tumors, while BRAF, K-RAS, and N-RAS mutations were found in 3.0%, 29.7%, and 25.9% of tumor tissues, respectively. Dose escalation was preferred in 105 (39.9%) patients. The median treatment duration was 3.0 months, with an objective response rate (ORR) of 4.9%. Grade ≥ 3 treatment-related toxicity occurred in 133 patients, leading to discontinuation, interruption, and modification rates of 50.6%, 43.7%, and 79.0%, respectively. Median progression-free survival (PFS) and overall survival (OS) were 3.0 and 8.1 months, respectively. RAS/RAF mutation (hazard ratio [HR] 1.5, 95% confidence interval [CI] 1.1–2.3; P = 0.01), pre-treatment carcinoembryonic antigen (CEA) levels (HR 1.6, 95% CI 1.1–2.3; P = 0.008), and toxicity-related treatment interruption or dose adjustment (HR 1.6, 95% CI 1.1–2.4; P = 0.01) were identified as independent prognostic factors for PFS. Dose escalation had no significant effect on PFS but was associated with improved OS (P < 0.001). Independent prognostic factors for OS were the initial TNM stage (HR 1.3, 95% CI 1.0–1.9; P = 0.04) and dose interruption/adjustment (HR 0.4, 95% CI 0.2–0.9; P = 0.03). Our findings demonstrate the efficacy and safety of regorafenib. Treatment line influences the response, with dose escalation being more favorable than adjustment or interruption, thus impacting survival