Damage Control Surgery

Objective: The basis of damage control surgery rests on quick control of life-threatening bleeding, injuries, and septic sources in the appropriate patients before restoring their physiological reserves as a first step followed by ensuring of the physiological reserves and control of acidosis, coagulopathy, and hypothermia prior to complementary surgery

Polatuzumab vedotin, rituximab, and bendamustine combination in relapsed or refractory diffuse large B-cell lymphoma: A real-world data from Turkey

Polatuzumab vedotin (Pola) with bendamustine and rituximab (BR) is a promising option for patients with relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL). We analyzed the data of 71 R/R DLBCL patients who had been treated with Pola-BR in the named patient program from March 2018 to April 2021 from 32 centers in Turkey. All patients received up to six cycles of Pola 1.8 mg/kg, rituximab 375 mg/m2 on day 1, and bendamustine 90 mg/m2 on days 1–2 of each cycle. Median age at Pola-BR initiation was 55 (19–84). The overall response rate was 47.9%, including 32.4% CR rate when a median of 3 cycles was applied. With a median follow-up of 5 months, the median OS was 5 months. Grade 3–4 neutropenia and thrombocytopenia were the most common hematological toxicities. The real-world data from our cohort showed the Pola-BR is an effective option with a manageable toxicity profile

Glofitamab in relapsed/refractory diffuse large B cell lymphoma: Real world data

Abstract INTRODUCT ̇ION Glofitamab is a T-cell-engaging bispecific antibody connecting CD20 on B cells and CD3 on T cells. Although, most of the patients with B-cell non-Hodgkin lymphoma (BNHL) achieve complete response (CR) following firstline treatment with rituximab and chemotherapy, about 40% of patients with diffuse large B-cell lymphoma (DLBCL) is refractory or relapse (R/R). Autologous stem-cell transplantation (ASCT) can cure some of these patients but many patients cannot undergo this procedure. CAR-T therapies are a significant advance but not available in many countries like Turkey. In Phase II expansion study, the overall response rate (ORR) was 51.6% and complete remission (CR) rate was 39.4% in R/R DLBCL patients (Dickinson er al. JCO 2022). In this retrospective study, we aimed to report the outcomes of patients who used glofitamab via compessionate use in Turkey

Açık cerrahi ile tedavi edilen inkarsere inguinal hernide hastane yatışı ile trombosit dağılım genişliği ilişkisi

Purpose: The study aimed to investigate the value of platelet distribution width (PDW) in incarcerated inguinal hernia which was treated with graft to illuminate its inflammatory role in surgery-related disorders. Materials and Methods: We perormed a case-control study by retrospective screening data of the 88 patients with inguinal hernia and 75 healthy. Patients data included demographics, hernia location, hospital stay, and hemogram parameters. Platelet-related parameters were anayzled with automated devices from EDTA samples. Results: The mean defect size was 25.3±17 mm for inguinal hernia, which ranged 6 to 75 mm. The PDW value was higher in group A as compared with that of group B. Also, the platelets were statistically higher in group A than group B. In the Pearson correlation analysis, PDW showed a strong and positive relationship with a hospital stay. Conclusion: We suggest that a strong positive correlation of platelet distribution width with hospital stay can be useful in incarcerated inguinal hernia which we treated with grafted by open surgery.Amaç: Çalışma, greftle tedavi edilen, inkarsere inguinal hernideki trombosit dağılım genişliğinin (PDW) cerrahi ile ilişkili bozukluklardaki inflamatuvar rolünü aydınlatmak için değerini araştırmayı amaçladı. Gereç ve Yöntem: İnguinal hernisi olan ve 75 sağlıklı olan 88 hastanın retrospektif tarama verilerini inceleyerek bir vaka kontrol çalışması yaptık. Hasta verileri demografik özellikleri, herni yerleşimi, hastanede kalış süresi ve hemogram parametrelerini içeriyordu. Trombosit ilişkili parametrelerde ölçüm EDTA'lı numune örneklerinden otomatize cihazlarla yapıldı. Bulgular: Ortalama defekt büyüklüğü 6 ila 75 mm arasında değişen inguinal herni için 25.3±17 mm idi. PDW değeri hasta grubunda sağlıklı gruba göre daha yüksekti. Ayrıca, trombositler hasta grubunda istatistiksel olarak daha yüksekti. Pearson korelasyon analizinde PDW hastanede kalış ile güçlü ve pozitif bir ilişki gösterdi. Sonuç: Trombosit dağılım genişliği ile hastanede kalış arasındaki güçlü pozitif korelasyonun, açık cerrahi ile tedavi ettiğimiz inguinal hernilerde hastane yatış süresi üzerinde yararlı bilgiler vereceğini düşünüyoruz

Evaluation of preoperative anxiety in cancer patients: Experience of a single center

Anxiety disorder is observed in half of the patients in the preoperative period. Psychological disorders are also frequently observed in cancer patients and need to be supported. The aim of the present study is to determine the level of preoperative anxiety in patients with malignant and benign diagnoses who were planned for elective surgery and to reveal its relationship with socio-demographic data. A tertiary hospital-based cross-sectional study was conducted in the general surgery clinic between June 1, 2021- March 31, 2022, on 158 patients who underwent elective surgery. Participants were evaluated in two groups depending on their diagnosis; the cancer group and the benign group. The socio-demographic data were recorded and the level of anxiety was determined by the Beck Anxiety Inventory (BAI). The median age of participants was 55 (19-78) years. There were 72 (45.6%) patients in the cancer group and 86 (54.4%) patients in the benign group. There was no significant difference in age, gender, marital status, job, level of income, and family cancer history between the two groups. There were significant differences between the groups in level of education, and previous surgical history (p=0.035, and p=0.037, respectively). BAI scores of the cancer group and control group were 10.5 (0-35) and 5 (0-49), respectively (p [Med-Science 2022; 11(4.000): 1452-5

The Relationship Between Hepatic Activity Index and Serum Tumor Necrosis Factor Alpha Levels in Patients with Chronic Active Hepatitis-B and Chronic Active Hepatitis-C

In the present study, we investigated the relationship between serum TNF-α levels and hepatic activity in liver biopsies of chronic hepatitis B and C patients.The study was performed on 30 chronic hepatitis B patients, 25 chronic hepatitis C patients and 25 healthy controls. Serum samples of patients who underwent biopsy and healthy controls were collected. Control group was seronegative for hepatitis and had normal liver function tests. TNF- α levels measured by ELISA. Knodells hepatic activity index was used in evaluation of liver biopsies. Serum TNF-α levels were determined higher in chronic hepatitis B and C patients than control group. HAI and TNF- α compared in chronic hepatitis B and C patients. Although we detected a relationship between HAI and TNF-α levels in chronic hepatitis B patients, no true correlation was shown in chronic hepatitis C patients. Cytokines have an important role in progression of chronic hepatitis B and C infections. There is a relationship between hepatic activity index and TNF-α level in chronic hepatitis B infection.But There is not relationship between hepatic activity index and chronic hepatitis C infection.only in two patients and both of them where in the middle of their reproductive age while as symptomatic ovarian cysts was a more common finding in unmarried females in 21-28 years of age group. This study concluded that laparoscopy has a diagnostic as well as a therapeutic implication in management of NSAP. [Med-Science 2015; 4(4.000): 2772-81

Superior vena cava syndrome caused by a benign intrathoracic goiter

Intrathoracic goiters are defined as the extension of the thyroid gland into the mediastinum. Superior Vena Cava (SVC) syndrome due to the compression of major vessels can be seen in these patients. Most cases of SVC syndrome occur as a complication of malignancy. A 75-year-old female, non-smoker, was admitted with complaints of the midline neck swell- ing for the past 45 years, mild puffiness of face, breathlessness on lying down and dry cough for last 5 years. On clinical examination, there was a massive grade IV thyromegaly. Neck computed tomography revealed a heterogeneous, hyper- trophic, nodular thyroid gland with multiple calcification and mediastinal extension with narrowed trachea. Intraoperatively, there was a huge retrosternal thyroid gland compression of the right brachiocephalic vein, the brachiocephalic trunk from behind the vessel and the right carotid artery along with the right internal jugular vein. Pathological examination showed a nodular colloid goitre without signs of malignancy. When SVC syndrome is secondary to benign thyroid disease, total thyroidectomy should be performed. [Arch Clin Exp Surg 2016; 5(4.000): 242-245

Polatuzumab vedotin, rituximab, and bendamustine combination in relapsed or refractory diffuse large B-cell lymphoma: a real-world data from Turkey

Polatuzumab vedotin (Pola) with bendamustine and rituximab (BR) is a promising option for patients with relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL). We analyzed the data of 71 R/R DLBCL patients who had been treated with Pola-BR in the named patient program from March 2018 to April 2021 from 32 centers in Turkey. All patients received up to six cycles of Pola 1.8 mg/kg, rituximab 375 mg/m(2) on day 1, and bendamustine 90 mg/m(2) on days 1-2 of each cycle. Median age at Pola-BR initiation was 55 (19-84). The overall response rate was 47.9%, including 32.4% CR rate when a median of 3 cycles was applied. With a median follow-up of 5 months, the median OS was 5 months. Grade 3-4 neutropenia and thrombocytopenia were the most common hematological toxicities. The real-world data from our cohort showed the Pola-BR is an effective option with a manageable toxicity profile

Glofitamab in relapsed/refractory diffuse large B-cell lymphoma: Real-world data

Glofitamab is a CD3xCD20 bi-specific antibody with two fragments directed to the CD20 antigen and a single CD3-binding fragment. Encouraging response and survival rates were recently reported in a pivotal phase II expansion trial conducted in patients with relapsed/refractory (R/R) B-cell lymphoma. However, the real-world data of patients of all ages with no strict selection criteria are still lacking. Herein, this retrospective study aimed to evaluate the outcomes of diffuse large B-cell lymphoma (DLBCL) patients who received glofitamab via compassionate use in Turkey. Forty-three patients from 20 centers who received at least one dose of the treatment were included in this study. The median age was 54 years. The median number of previous therapies was 4, and 23 patients were refractory to first-line treatment. Twenty patients had previously undergone autologous stem cell transplantation. The median follow-up time was 5.7 months. In efficacy-evaluable patients, 21% and 16% of them achieved complete response and partial response, respectively. The median response duration was 6.3 months. The median progression-free survival (PFS) and overall survival (OS) was 3.3 and 8.8 months, respectively. None of the treatment-responsive patients progressed during the study period, and their estimated 1-year PFS and OS rate was 83%. The most frequently reported toxicity was hematological toxicity. Sixteen patients survived, while 27 died at the time of the analysis. The most common cause of death was disease progression. One patient died of cytokine release syndrome during the first cycle after receiving the first dose of glofitamab. Meanwhile, two patients died due to glofitamab-related febrile neutropenia. This is the largest real-world study on the effectiveness and toxicity of glofitamab treatment in R/R DLBCL patients. The median OS of 9 months seems promising in this heavily pretreated group. The toxicity related mortality rates were the primary concerns in this study