Assessment of serum levels of prognostic and predictive biomarkers patients with lung cancer

İleri evre akciğer kanserinde ortalama sağkalım süresi oldukça kısadır. Kanser tedavisinin etkinliğini erken dönemde saptamak, sağkalım için önemlidir.Sitokeratinler, epiteliyal hücrelerde yüksek düzeylerde bulunmakta, serumda ölçülebilmektedir. Onkojenik transformasyondan sonra bu ekspresyon devam etmekte hatta artmaktadır. Hücre ölümü belirteçleri olan M30 (Apoptoz belirteci) ve M65 (Nekroz belirteci) antijenlerinin birçok kanser türünde prognozda ve kanser tedavisine cevabı değerlendirmede önemli belirteçler olduğu bilinmektedir.Bu çalışmaya, potansiyel rezektabıl akciğer kanseri tanılı 48 hasta, 38 sağlıklı kontrol grubu dahil edilmiştir. Hastaların 43'ünde kemoterapi öncesi ve kemoterapiden 48 saat sonra serum M30, M65 seviyeleri çalışılmıştır. Kanserli hastalarda, sağlıklı kontrol grubuna göre tedavi öncesi serum M30, M65 seviyelerinin istatistiksel olarak anlamlı (p<0.001 ve p<0.05) derecede yüksek olduğu görülmüştür. Kemoterapi sonrası her iki belirteç de tedavi öncesine oranla anlamlı derecede yükselmiştir (p<0.001).Tedaviye yanıt veren hastalarda (n=28) M30 değerinin %34 arttığı, M65 değerinin ise %68 arttığı görüldü. Progrese olan hastalarda (n=12) M30 değerinin % 78 arttığı, M65 değerinin ise %54 arttığı görüldü. Hastaların yüzde değişimi göz önüne alındığında tedaviye cevap veren ve vermeyenlerin M30, M65 düzeyleri karşılaştırıldığında M65 değerlerinde farklılık saptanmazken, progrese olan hastalarda M30 değerinin anlamlı olarak arttığı saptandı (p=0.694, p<0.05).Sonuç olarak, akciğer kanserli hastalar, belirgin yüksek M30, M65 seviyelerine sahiptir. Bu da M30, M65 antijenlerinin prediktif marker olarak kullanılabileceğini düşündürmektedir. Tedaviye yanıt veren hastalarda M65 seviyeleri daha çok artarken, tedaviye yanıt vermeyenlerde M30 seviyeleri daha çok artmıştır. Bu artış istatistiksel olarak anlamlı olmamakla birlikte;yalnızca apoptozun değil, total hücre ölümünün (apoptoz + nekroz) ölçülmesi, taksan-bazlı kemoterapiye yanıt hakkında daha iyi bir fikir sağlayabilir.In advanced lung cancer, the mean survival is extremely short. It is very important to establish effectiveness of cancer therapy in early stages for survival of the patient.Cytokeratins are present at high amounts, in epithelial cells and can be detected at serum. Expressions of these markers still continuous after oncogenic transformation and moreover may be increased. It is known that, among the cell death markers, M30 (marker of apoptosis) and M65 (marker of necrosis) antigens are important in prognosis and assessment of response to cancer therapy.In this study we aimed to compare M30, M65 levels in patients with local advanced lung cancer with healthy controls. Secondly we aimed to investigate the role of these markers in determining the response to therapy. Forty-eight patients, diagnosed with potentially resectable lung cancer and 38 healthy volunteers were included. M30, M65 levels before and 48 hours after chemotherapy are studied in 43 out of 48 patients. M30, M65 levels in patients with lung cancer before treatment were significantly increased when compared to healthy controls (p<0.001 and p<0.05). Both of the markers were significantly increased after chemotherapy when compared prior to the treatment (p<0.001).The mean increase in M30, M65 levels was 34% and 68% respectively among the patients who responded to therapy and the mean increase in M30, M65 levels was 78% and 54% respectively among the patients who did not responded to therapy. While the M65 levels did not vary according to response to therapy the M30 levels were significantly increased in non-responder group (p=0.694, p<0.05 respectively).In conclusion, the patients with local advanced lung cancer have significantly higher levels of M30, M65. Accordingly, M30, M65 antigens may be used as a predictive marker. While much more increase observed in serum levels of M65 in patients with respond; M30 levels were higher in non-responder group. However, this increase was not significant; not only apoptosis, also evaluation of total cell death (apoptosis and necrosis) could provide better opinion on taxan-based chemotherapy

The usefulness and reliability of English-language YouTube videos as a source of knowledge for patients with familial Mediterranean fever

Background/Objectives YouTube is increasingly being used as an educational tool and is a substantial source of information. This study aimed to assess the quality of the most viewed YouTube videos pertaining to familial Mediterranean fever (FMF). Methods A search on YouTube was conducted on January 13, 2022, using the keywords: “familial Mediterranean fever treatment,” “familial Mediterranean fever colchicine,” and “familial Mediterranean fever colchicine opacalcium.” Two rheumatologists independently evaluated the relevance and accuracy of the videos. Redundant or irrelevant videos were excluded. The educational value of YouTube videos was assessed using the Global Quality Scale (GQS). Comparative analyses of video parameters across different cohorts were performed. To assess the reliability and quality of the videos, a modified version of the DISCERN scale and the GQS were employed. Results Out of the 59 videos reviewed, 43 (72.9%) were of high quality, 10 (16.9%) were of medium quality, and 6 (10.2%) were of low quality. Upon comparing parameters among groups, no significant disparities were observed in terms of daily views, daily favorites, daily dislikes, or daily comments (p > 0.05). GQS scores for usefulness and modified DISCERN scores showed significant differences among groups (p < 0.001). Additionally, both GQS and modified DISCERN scores exhibited moderately negative correlations (r =  − .450 and r =  − .474, respectively) and high statistical significance (p < 0.001 for both) with utility assessment. Conclusion YouTube is a valuable repository of high-quality videos for FMF patients. Healthcare providers should guide their patients to high-quality video sources to supplement their educational material

In the era of disease-modifying antirheumatic drugs, how close are we to treating rheumatoid arthritis without the use of glucocorticoids?

We wanted to see how close we could get to our goal of treating rheumatoid arthritis (RA) without the use of glucocorticoids (GCs) in the disease-modifying antirheumatic drugs (DMARDs) era using real-life data. Established in 2017, the TReasure database is a web-based, prospective, observational cohort for Turkey. As of May 2019, there were 2,690 RA patients recorded as receiving biologic and targeted synthetic DMARDs (bDMARDs and tsDMARDs) therapy. At the start of the bDMARDs or tsDMARDs, patients with follow-up visits of at least 3 months were registered. At the time of registration and the last visit, doses of GCs were recorded and it was determined if the target dose of = 7.5 mg/day was found to be crucial in not reaching the GC target dose (p = 7.5 mg/day, female gender, age, RF positivity, high DAS28, and VAS pain level were all highly related for GC continuation. Despite the use of DMARDs, our data revealed that we are still far from achieving our goal of treating RA without using steroids.Hacettepe Rheumatology Association (HRD); Hacettepe Financial EnterprisesHacettepe Rheumatology Association (HRD) and Hacettepe Financial Enterprises

Pan-Immune-Inflammation Value Could Be a New Marker to Predict Amyloidosis and Disease Severity in Familial Mediterranean Fever

Familial Mediterranean fever (FMF) is characterized by recurrent episodes of fever and serositis. Blood-based biomarkers determined in FMF patients during attack-free periods could be used to predict the risk of amyloidosis and the severity of the disease. The recently defined pan-immune-inflammation value (PIV) comprises four distinct subsets of blood cells and serves as an easily accessible and cost-effective marker. The objective of this study was to assess the role of PIV in predicting amyloidosis and moderate-to-severe disease. Clinical characteristics and laboratory values during the attack-free period were retrospectively analyzed in 321 patients over 18 years of age diagnosed with familial Mediterranean fever (FMF). In our tertiary adult rheumatology outpatient clinic, disease severity and laboratory markers were evaluated during the first attack-free interval. At baseline, patients with amyloidosis were excluded. Patients were categorized based on the presence of amyloidosis and the severity of the disease. When focusing on amyloidosis in receiver operating characteristic (ROC) analysis, optimal cut-off values for pan-immune-inflammation value (PIV), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio were determined as ≥518.1, ≥2.3, and ≥127.2, respectively. In multivariate analysis, PIV, C-reactive protein (CRP), and the presence of the M694V homozygous mutation emerged as independent risk factors for both amyloidosis and moderate-to-severe disease. Additionally, NLR was identified as an independent risk factor for amyloidosis, while red blood cell distribution width was associated with moderate-to-severe disease. In patients with FMF, especially in the presence of the M694V homozygous mutation, CRP and PIV may be useful in predicting both amyloidosis and moderate-to-severe disease