Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

An EPR Study On Cytosine Irradiated

WOS: 000293594100004In this study, paramagnetic centers over the cytosine were formed by photolysis then these centers were investigated using EPR method. EPR signals were not recorded from non-irradiated the cytosine, but irradiated polycrystalline exhibited complex EPR spectra. For obtaining of cytosine polycrystalline, novel crystallization method was performed on powder cytosine. Effective crystallization conditions were achieved by adjustment of the concentration of the metal ions, chemical solutions, NaCl, KCl, glacial asetic acid, nitric oxide, percloric acid, glutamic acid, and pH of buffer. Cytosine (C4H5N2O) polycrystalline obtained were irradiated with Co-60 - rays at room temperature for 24 and 72 h. At the sample irradiated for 72 h, the paramagnetic centers were determined between 120 and 450 K by X-band EPR spectrometer. The spectra were found to be dependent slightly on temperature. Two cation radicals were determined in the structure and these were called Radicals I and II. The g and hyperfine constants were found to be a(H2a) = 61 G, a(N2) = 9.39 G, a(N1) = 7.15 G, and g(1) = 2.0026 for the Radical I; a(H3) = 10.57 G, a(H1) = 3 G, a(N3) = 6.72 G, a(N1) = 5.36 G for, and g(2) = 2.0034 the Radical II. Copyright (C) 2010 John Wiley & Sons, Ltd.Scientific Research Projects Coordination Center of Selcuk University, Konya/TurkeyThis study was partially supported by the Scientific Research Projects Coordination Center of Selcuk University, Konya/Turkey

Autophagy and nuclear changes in FM3A breast tumor cells after epirubicin, medroxyprogesterone and tamoxifen treatment in vitro

Objective: Autophagy is a form Of physiological programmed cell death Which is, observable after hormonal withdrawal. In this study, the FM3A murine breast tumor cell line was treated with epirubicin alone and with medroxyprogesterone, acetate: (MPA) or tamoxifen, to determine if structural and kinetic signs, of autophagy may also Occur in an enhanced manner during epirubicin sensitization via hormonal, agents. Methods: One-week soft agar colony growth, 96-hour values of plating and pulse thymidine, labeling and electron microscopical examinations were performed following treatment with MPA and tamoxifen alone: or with epirubicin. Results. Tamoxifen. induced signs of autophagy, which was enhanced. when it was combined with M PA. Epirubicin also induced autophagy of secretory granules, which coalesced to form an intracytoplasmic lumen. Combining MPA with epirubicin enhanced the, formation of apoptotic blebs and chromatin fragmentation. When epirubicin was combined with tamoxifen, peculiar nuclear structures were formed. Conclusions: Hormonal agents may modulate anthracycline activity towards specific patterns in eliciting cell death, via autophagy and/or as yet unknown nucleolus-specific interactions. Copyright (C) 2002 S. Karger AG, Basel

Technical Aspects and Difficulties in the Management of Head and Neck Cutaneous Malignancies in Xeroderma Pigmentosum.

Xeroderma pigmentosum (XP) is an autosomal recessive disorder characterized by xerosis, ultraviolet light sensitivity, and cutaneous dyspigmentation. Due to defects in their DNA repair mechanism, genetic mutations and carcinogenesis inevitably occurs in almost all patients. In these patients, reconstruction of cutaneous malignancies in the head and neck area is associated with some challenges such as likelihood of recurrence and an aggressive clinical course. The aim of this study is to discuss the therapeutic options and challenges commonly seen during the course of treatment

Different doses of radiation on agar colony forming development in C6 glioma cells: Assessment by thymidine labeling index, and bromodeoxyuridine labeling index

WOS: 000254582600002Objective: Gliomas are relatively frequent in adults, and are among the most malignant primary brain tumors. Glioblastoma. multiforme, like many other tumors that exhibit radiation sensitivity in vitro, seems to be very resistant to radiation in vivo, thus suggesting that irradiation may not be a rate-limiting factor for malignant glioma tumor growth. In this study, we aimed to determine the optimal dose of radiation in C6 glioma colony forming assay, which is a valuable tool for antitumor treatment screening. Material and Methods: 10(5) cell/lamella colony forming cells were radiated with 200 cGy, 400 cGy, 800 cGy and 1600 cGy for 10 minutes. Radiosensitivity was measured systematically 24, 48, 72 and 96 hours after the radiation by three methods: soft-agar bilayer assay, thymidinE incorporation, and bromodeoxyuridine (BrdU) incorporation. Results: The soft-agar bilayer assay, which assessed the colony-forming units, showed that the number of colonies in the control group (609, 3 +/- 86.8) were decreased after 200 cGy (8.3 +/- 3.6) and 400 cGy (7.2 +/- 4.3). No colony was detected in 800 cGy and 1600 cGy irradiated cells [3H] Thymidine incorporation was more prominent with higher doses of radiation. BrdU incorporation revealed that even at low doses (200 cGy) of radiation there was a significant decrease of cell proliferation. On higher doses like 1600 cGy it was more prominent. Conclusion: Cell survival, doubling time, and cell phases are parameters of growth kinetics, and the results suggest that C6 glioma cells are radiosensitive and are virtually affected by all radiation doses in our experiment even 200 cGy at 24 hours. Besides, colony forming assay with thymidine labeling index, and BrdU labeling index may be used as new methods for determining radiotherapy doses in clinical applications

Water-Filled Vesicles of Choroid Plexus Tumors

ozmen, sevilay/0000-0002-1973-6101;WOS: 000500374200106PubMed: 31574785Objective: Choroid plexus cysts are the most common neuroepithelial cysts. Methods: the authors describe 2 cases. the first case is a 1-year-old child presenting with hydrocephalus and cyst of the choroid plexus. the child was treated with endoscopic fenestration of the cysts. Results: the histological examination of the cyst wall was consistent with choroid epithelium and water-filled vesicles. the second case is a 63 year old male with a highly vascularized tumor extending to choroid plexus. A quaductus Silvius was obstructed by the tumor. the histopathologic examination of choroid plexus showed a low number, water-vesicles. Conclusions: According to our knowledge, there are no previous reports of water-filled vesicles with choroid plexus cyst causing hydrocephalus. the first case is a good example of over secretion of cerebrospinal fluid (CSF) with the water-filled vesicle. the second case with low number of water filled vesicle shows that the cause of hydrocephalus is not over production of CSF, it is blockage of the CSF pathway in Aquaductus Silvius by the tumor itself. These 2 cases are illustrative and more importantly highlight the need to study for water-filled vesicles in these kind of cases

Investigation of Potential Virulence Genes and Antibiotic Resistance Characteristics of Enterococcus Faecalis Isolates from Human Milk and Colostrum Samples

Enterococci may improve the typical taste and flavor of fermented foods through their proteolytic and lipolytic activities. However, some enterococcal strains are recognized as nosocomial pathogens, which have virulence genes and resistance to certain antibiotics. Enteroccocci are also found in human milk microflora. The aim of this study was to investigate the potential virulence genes and antibiotic resistance characteristics of Enterococcus faecalis isolates from human milk and colostrum samples. In total, 23 Enterococcus faecalis strains were identified from human milk and colostrum samples. Antibiotic-resistant E. faecalis isolates were determined using the disk diffusion method. Vancomycin resistance genes (vanA, vanB) and some virulence genes (agg(2), gelE, efaAfm, ccf, cpd, cad, cylM, cylB, etc.) were investigated using polymerase chain reaction (PCR). All strains were sensitive to ampicillin, penicillin G, chloramphenicol, and vancomycin. None of the E. faecalis isolates contained vanA, vanB, or efaAfm genes. The results of this study indicated that there were no harmful enterococci strains in human milk and colostrum samples in terms of tested virulence factors and antibiotic resistance. Therefore, the E. faecalis isolates from human milk may have the potential to be considered as a functional culture for the food industry.WoSScopu