Reliability of the Lymph Node Ratio in the Prediction of Gastric Cancer Survival

Background. Lymph node metastasis is the major determinant factor in the prognosis of gastric cancer. There is still no definite consensus on the lymph node number that should be harvested during gastric cancer surgery. Lymph Node Ratio (LNR) is defined as the ratio of metastatic nodes to the total number of pathologically examined lymph nodes. LNR has been proposed to be a sensitive prognostic factor in patients with gastric cancer. In this study the reliability of the LNR is tested for being a prognostic factor in gastric cancer survival. Methods. Medical records of 244 patients, with neither distant metastases nor neoadjuvant treatment underwent curative gastrectomy, were analyzed retrospectively in terms of survival according to the lymph node ratio (LNR). Patients were divided in two groups by using LNR cut-off value. Results. LNR of 0.4 was proved to be the best cut-off value to predict the prognosis of patients with gastric cancer. Univariate and multivariate analysis revealed that age over 65 (p < 0.001), and LNR ≥ 0.4 (p = 0.02) were independent factors in gastric cancer survival. Patients with LNR ≥ 0.4 presented with worse outcomes regarding other prognostic parameters (tumor differentiation, tumor diameter, lymphovascular invasion or perineural invasion), despite similar numbers of lymph nodes being harvested in both groups during surgery. Conclusion. Lymph node ratio is a reliable parameter to predict the survival in gastric cancer

EFFECTIVENESS OF LIDOCAINE/PRILOCAINE CREAM ON PERCEIVED PAIN DURING MAMMOGRAPHY: A PILOT STUDY

Background: Mammography (MG) is an important imaging method in the diagnosis of breast diseases. However, pain during MG is an uncomfortable factor for the majority of women. Aim: The aim of this study is to determine the effectiveness of lidocaine/prilocaine cream on reducing pain during mammography. Methods: This is a prospective clinical study. A total of 60 female patients who had mammographic examination were equally divided into three groups; patients receiving 10 g EMLA cream (EMLA group), patients receiving 10 g Bepanthen cream (placebo group), and patients not receiving any cream (control group). Pain levels were assessed by using visual analogue scale (VAS) before and after MG. RESULTS: Each group was statistically similar in terms of basic patient characteristics. There was also no significant difference between the pre-MG VAS scores of the three groups (p = 0.996). On the other hand, VAS scores during MG was found significantly different between the groups (p = 0.001). When the groups were compared in pairs, the patients in EMLA group had significantly less post-MG VAS score than the Bepanthen and control groups (p = 0.001). There was no significant difference between Bepanthen and control groups (p = 0.678). CONCLUSION: To our knowledge, this is the first study demonstrating that a topical anaesthetic, EMLA, provides an effective analgesia during MG. Reducing the pain can change women’s preconceptions regarding MG

Bronchoscopic findings in children with congenital heart disease

WOS: 000451979401455Introduction: The aim of this study was evaluation of broncoscopic findings in children with congenital heart disease(CHD). Method: Bronchoscopy was performed in 37 patients with CHD who were followed between October 2012–December 2014 in our hospital. The data obtained from these patients were evaluated retrospectively. Results: Twenty-one of the patients were males and 16 were females, median ages 12.5 mo (1-36m). Twenty-seven patients (72.9 %) were operated for congenital heart disease. Twelve of the patients had pulmonary hypertension. Bronchoscopy was performed because of extubation failure, atelectasis, recurrent or persistant pneumonia, stridor and persistant cough; 17,7,7,4 and 2, respectively. Laryngomalacia, tracheomalacia, bronchomalacia, tracheal stenosis, airway branch anomalies, granulation tissue formation and pulsatile airway pressure was determined in flexible bronchoscopy, 13,12,8,4,17,7 and 10, respectively. Twenty-seven of the patients were followed with mechanical ventilation(MV). MV duration before and after bronchoscopy was median 30 and 12 days, respectively. Tracheostomy was performed in 15 cases. After bronchoscopy five of these patients were removed from tracheostomy. Eleven out of the patients had positive culture in bronkoalveolar lavage. Patients were discharged with room air, tracheostomy with room air, only with supplemental oxygen, tracheostomy with supplemental oxygen; 19(51.3%), 6(16.2%), 1(2.7%),1(2.7%), respectively. One patient was following intubated with ventilatory support. Nine patients died. Conclusions: Airway anomalies were more frequently encountered in patients with congenital heart disease

Identification Of Multiple Genetic Susceptibility Loci In Takayasu Arteritis

Takayasu arteritis is a rare inflammatory disease of large arteries. The etiology of Takayasu arteritis remains poorly understood, but genetic contribution to the disease pathogenesis is supported by the genetic association with HLA-B*52. We genotyped similar to 200,000 genetic variants in two ethnically divergent Takayasu arteritis cohorts from Turkey and North America by using a custom-designed genotyping platform (Immunochip). Additional genetic variants and the classical HLA alleles were imputed and analyzed. We identified and confirmed two independent susceptibility loci within the HLA region (r(2) < 0.2): HLA-B/MICA (rs12524487, OR = 3.29, p = 5.57 x 10(-16)) and HLA-DQB1/HLA-DRB1 (rs113452171, OR = 2.34, p = 3.74 x 10(-9); and rs189754752, OR = 2.47, p = 4.22 x 10(-9)). In addition, we identified and confirmed a genetic association between Takayasu arteritis and the FCGR2A/FCGR3A locus on chromosome 1 (rs10919543, OR = 1.81, p = 5.89 x 10(-12)). The risk allele in this locus results in increased mRNA expression of FCGR2A. We also established the genetic association between IL12B and Takayasu arteritis (rs56167332, OR = 1.54, p = 2.18 x 10(-8)).WoSScopu