Mean Platelet Volume (MPV) For Predicting Prognosis of Rectum Cancer After Neoadjuvant Treatment

Aim:Rectum cancer is a subtype of colorectal cancer. Its etiology and etiopathogenesis is similar to colon cancer. However, it is differentiated from colon tumors because of its anatomic location and treatment approach. In the literature, Mean Platelet Volume (MPV) has been shown to correlate with inflammation in gastrointestinal cancer patients. Based on this fact, we aimed to evaluate the MPV value for predicting prognosis of rectum cancer patients who are treated with neoadjuvant chemoradiotherapy.Materials and Methods:We retrospectively collected the data of 80 operated rectum adenocarcinoma patients who were treated neoadjuvant chemoradiotherapy between 2011 and 2018. MPV value was investigated as prognostic factors for disease free survival.Results:Fifty-five patients were male (69%). Median age was 56 (range 22 to 83 years). The most common histopathologic was adenocarcinoma (94%). The ideal cut-off value of pretreatment MPV that predicted disease-free survival was 7.65 in the ROC analysis [AUC:0.74 (0.63-0.85); p<0.002] with a sensitivity of 81%, and specificity of 69 %. Median DFS was 43 months in patients with MPV <7.65 (95%CI: 35.5-54.6). In multivariate analysis, MPV was found to be an independent prognostic factor for disease free survival (p = 0.02).Conclusion:According to our study, we suggest that high levels of MPV at the time of diagnosis can be used as a predictive biomarker for early relapse in rectum cancer patients

Determination of right ventricular dysfunction using the speckle tracking echocardiography method in patients with obstructive sleep apnea

Background: The speckle tracking echocardiography (STE) method shows the presence of right ventricular (RV) dysfunction before the advent of RV failure and pulmonary hypertension in patients with cardiopulmonary disease. We aimed to assess subclinical RV dysfunction in obstructive sleep apnea (OSA) using the STE method. Method: Twenty-one healthy individuals and 58 OSA patients were included. According to severity as determined by the apnea&#8211;hypopnea index (AHI), OSA patients were examined in three groups: mild, moderate and severe. RV free wall was used in STE examination. Results: Right ventricle strain (ST %) and systolic strain rate (STR-S 1/s) were decreasing along with the disease severity (ST &#8212; healthy: &#8211;34.05 &#177; &#8211;4.29; mild: &#8211;31.4 &#177; &#8211;5.37; moderate: &#8211;22.75 &#177; &#8211;4.89; severe: &#8211;20.89 &#177; &#8211;5.59; p < 0.003; STR-S &#8212; healthy: &#8211;2.93 &#177; &#8211;0.64; mild: &#8211;2.85 &#177; &#8211;0.73; moderate: &#8211;2.06 &#177; &#8211;0.43; severe: &#8211;1.43 &#177; &#8211;0.33; p < 0.03). Correlated with the disease severity, the RV early diastolic strain rate (STR-E) was decreasing and the late diastolic strain rate was increasing (STR-E &#8212; healthy: 2.38 &#177; 0.63; mild: 2.32 &#177; 0.84; moderate: 1.66 &#177; 0.55; severe: 1 &#177; 0.54; p < 0.003; STR-A &#8212; healthy: 2.25 &#177; 0.33; mild: 2.32 &#177; 0.54; moderate: 2.79 &#177; 0.66; severe: 3.29 &#177; 0.54; p < 0.03). The STR-E/A ratio was found to be in a decreasing trend along with the disease severity (healthy: 1.08 &#177; 0.34; mild: 1.06 &#177; 0.46; moderate: 0.62 &#177; 0.22; severe: 0.34 &#177; 0.23; p < 0.03). Conclusions: Subclinical RV dysfunction can be established in OSA patients even in the absence of pulmonary hypertension and pathologies which could have adverse effects on RV functions. In addition to the methods of conventional, Doppler and tissue Doppler echocardiography, using the STE method can determine RV dysfunction in the subclinical phase. (Cardiol J 2012; 19, 2: 130&#8211;139

Mitochondrial carrier homolog 1 (Mtch1) antibodies in neuro-Behçet's disease

Cataloged from PDF version of article.Efforts for the identification of diagnostic autoantibodies for neuro-Behcet's disease (NBD) have failed. Screening of NBD patients' sera with protein macroarray identified mitochondrial carrier homolog 1 (Mtch1), an apoptosis-related protein, as a potential autoantigen. ELISA studies showed serum Mtch1 antibodies in 68 of 144 BD patients with or without neurological involvement and in 4 of 168 controls corresponding to a sensitivity of 47.2% and specificity of 97.6%. Mtch1 antibody positive NBD patients had more attacks, increased disability and lower serum nucleosome levels. Mtch1 antibody might be involved in pathogenic mechanisms of NBD rather than being a coincidental byproduct of autoinflammation. © 2013 Elsevier B.V

A stochastic programming approach for chemotherapy appointment scheduling

Chemotherapy appointment scheduling is a challenging problem due to the uncertainty in pre-medication and infusion durations. In this paper, we formulate a two-stage stochastic mixed integer programming model for the chemotherapy appointment scheduling problem under limited availability and number of nurses and infusion chairs. The objective is to minimize the expected weighted sum of nurse overtime, chair idle time, and patient waiting time. The computational burden to solve real-life instances of this problem to optimality is significantly high, even in the deterministic case. To overcome this burden, we incorporate valid bounds and symmetry breaking constraints. Progressive hedging algorithm is implemented in order to solve the improved formulation heuristically. We enhance the algorithm through a penalty update method, cycle detection and variable fixing mechanisms, and a linear approximation of the objective function. Using numerical experiments based on real data from a major oncology hospital, we compare our solution approach with several scheduling heuristics from the relevant literature, generate managerial insights related to the impact of the number of nurses and chairs on appointment schedules, and estimate the value of stochastic solution to assess the significance of considering uncertainty

Renal complications of lipodystrophy: A closer look at the natural history of kidney disease

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/144612/1/cen13732_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/144612/2/cen13732.pd

The frequency of Duchenne muscular dystrophy/Becker muscular dystrophy and Pompe disease in children with isolated transaminase elevation: results from the observational VICTORIA study

IntroductionElevated transaminases and/or creatine phosphokinase can indicate underlying muscle disease. Therefore, this study aims to determine the frequency of Duchenne muscular dystrophy/Becker muscular dystrophy (DMD/BMD) in male children and Pompe disease (PD) in male and female children with isolated hypertransaminasemia.MethodsThis multi-center, prospective study enrolled patients aged 3–216 months with serum alanine transaminase (ALT) and/or aspartate transaminase (AST) levels &gt;2× the upper limit of normal (ULN) for ≥3 months. Patients with a known history of liver or muscle disease or physical examination findings suggestive of liver disease were excluded. Patients were screened for creatinine phosphokinase (CPK) levels, and molecular genetic tests for DMD/BMD in male patients and enzyme analysis for PD in male and female patients with elevated CPK levels were performed. Genetic analyses confirmed PD. Demographic, clinical, and laboratory characteristics of the patients were analyzed.ResultsOverall, 589 patients [66.8% male, mean age of 63.4 months (standard deviation: 60.5)] were included. In total, 251 patients (188 male and 63 female) had CPK levels above the ULN. Of the patients assessed, 47% (85/182) of male patients were diagnosed with DMD/BMD and 1% (3/228) of male and female patients were diagnosed with PD. The median ALT, AST, and CPK levels were statistically significantly higher, and the questioned neurological symptoms and previously unnoticed examination findings were more common in DMD/BMD patients than those without DMD/BMD or PD (p &lt; 0.001).DiscussionQuestioning neurological symptoms, conducting a complete physical examination, and testing for CPK levels in patients with isolated hypertransaminasemia will prevent costly and time-consuming investigations for liver diseases and will lead to the diagnosis of occult neuromuscular diseases. Trial RegistrationClinicaltrials.gov NCT04120168

The relation between body mass index and end organ damage in white coat hypertension

Objective: White coat hypertension (WCH) is characterized by blood pressure, which is high in the outpatient clinic and normal either on ambulatory blood pressure (BP) monitoring or home BP monitoring. In this study, our objective was to investigate the effects of obesity on end organ damage and the correlation between body mass index (BMI) and end organ damage caused by WCH

The relation between body mass index and end organ damage in white coat hypertension

Objective: White coat hypertension (WCH) is characterized by blood pressure, which is high in the outpatient clinic and normal either on ambulatory blood pressure (BP) monitoring or home BP monitoring. In this study, our objective was to investigate the effects of obesity on end organ damage and the correlation between body mass index (BMI) and end organ damage caused by WCH

Tumor budding for predicting prognosis of resected rectum cancer after neoadjuvant treatment

Abstract Background Rectum cancer is a type of colorectal cancer. Its etiology and etiopathogenesis are similar to other colon diseases. We aimed to evaluate the tumor budding for predicting prognosis of resected rectum cancer patients. Methods We retrospectively collected the data of 75 operated rectum adenocarcinoma patients who were treated neoadjuvant chemoradiotherapy between 2013 and 2018 in Umraniye Research and Training Hospital and Acıbadem University Medical Oncology Outpatient Clinic. Tumor budding was investigated as a prognostic factor for disease-free survival. Results This study included 75 rectum cancer patients and 51 were male (68%). Median age was 56 (range 19 to 77 years). There were 29 (39%) and 46 (61%) patients in tumor budding low-intermediate and high groups respectively. In multivariate analysis, tumor budding was found to be an independent prognostic factor for disease-free survival (p = 0.00). Conclusions According to our study, having high tumor budding suggests a high likelihood of relapse. Therefore, we might need additional follow-up protocol in these patients