Yttrium-90 radioembolization for the treatment of unresectable liver cancer: Results of a single center

Objective: To determine the effects of yttrium-90 (Y-90) resin microsphere radioembolization therapy on patients with unresectable liver cancer who do not benefit from chemotherapy. Methods: Fifty-five patients underwent radioembolization therapy included in the study whose had unresectable primary or metastatic liver cancer originating from the gastrointestinal tract. Three were excluded from the study after pre-evaluation angiography. Thirteen (23.6%) of the remaining 52 patients had hepatocellular carcinoma and 39 (76.4%) had metastatic liver cancer. Fifty-two patients underwent Y-90 radioembolization treatment. Each patient's response to the administered treatment was evaluated using the Response Evaluation Criteria in Solid Tumors (RECIST) and the overall probability of survival was displayed graphically by the Kaplan-Meier method. Results: After Y-90 therapy, 47 patients were follow-up. While 57% of the patients responded to treatment as clinical benefit, the disease progressed in 43%. The median hepatic progression-free survival time of the patients was 3.4 months (95% confidence interval (ci):1.4-5.3) and the overall survival time was 11.3 months (95%, CI:8.7-14.03). Conclusion: This study emphasizes that Y-90 resin microsphere radioembolization treatment is effective in patients with unresectable liver cancer

The serum amyloid-a, haptoglobin, ceruloplasmin and albumin levels in dogs which are infected with babesia canis

Bu çalışmada Babesia canis ile doğal enfekte köpeklerde serum haptoglobin (Hp), serum amiloid-A (SAA), seruloplazmin (Cp)ve albümin (Alb) seviyelerinin belirlenmesi amaçlanmıştır. Çalışmanın materyalini, Kafkas Üniversitesi Veteriner Fakültesi İç Hastalıkları Anabilim Dalı kliniklerine getirilen, kan frotilerinin giemsa yöntemi ile boyanması sonucunda B. canis tanısı konulan 20 hasta köpek oluşturdu. Kontrol amacı ile 10 sağlıklı köpek kullanıldı. Hasta hayvanların serum Hp, SAA, Cp ve Alb seviyeleri sırasıyla 0.44±0.12 mg/mL, 43.18±13.77 µg/mL, 10.75±2.45 mg/dL, 2.74±0.15 g/dL olarak belirlendi. Sağlıklı hayvanların serum Hp, SAA, Cp ve Alb değerleri ise sırasıyla 1.84±0.29 mg/mL, 1.18±0.40 µg/mL, 4.80±0.53 mg/dL, 3.01±0.34 g/dL olarak ölçüldü. Hasta hayvanların SAA ve Cp değerleri sağlıklı hayvanlara göre daha yüksek bulunurken (P<0.001), Hp (P<0.001) ve Alb (P<0.01) seviyelerinin daha düşük olduğu belirlendi. Sonuç olarak köpeklerde B. canis enfeksiyonunda serum SAA ve Cp değerleri yükselirken, Hp ve Alb seviyelerinin düştüğü belirlendi.In this study, we aimed to determine the serum haptoglobin (Hp), serum amyloid-A (SAA), ceruloplasmin (Cp) and albümin (Alb) levels in the dogs which are naturally infected with Babesia canis. 20 patient dogs which were diagnosed as B. canis by staining of their blood smears with giemsa method, which were brought to Kafkas University Veterinary Faculty Internal Medicine Department clinics formed the material of the study. 10 Healthy dogs were used for control. The serum Hp, SAA, Cp and Alb levels of the sick animals were determined as 0.44±0.12 mg/mL, 43.18±13.77 µg/mL, 10.75±2.45 mg/dL, 2.74±0.15 g/dL, respectively. Whereas, the serum Hp, SAA, Cp and Alb values of the healthy animals were measured as 1.84±0.29 mg/mL, 1.18±0.40 µg/mL, 4.80±0.53 mg/dL, 3.01±0.34 g/dL, respectively. While the SAA and Cp values of the sick animals were determined higher than that of the healthy animals, the (P <0.001), the Hp (P <0.001) and the Alb (P <0.01) levels were found to be lower. As a result, it was determined that the serum SAA and Cp levels increased, and the Hp and Alb levels decreased in the dogs which are infected with B. canis

Current barriers and recommendations on the diagnosis of transthyretin amyloid cardiomyopathy: a Delphi study

ObjectivesThis study has been conducted to investigate the non-invasive diagnostic journey of patients with a transthyretin amyloid cardiomyopathy (aTTR-CM) in Turkey, identify the challenges and uncertainties encountered on the path to diagnosis from the perspectives of expert physicians, and develop recommendations that can be applied in such cases.MethodsThis study employed a three-round modified Delphi method and included 10 cardiologists and five nuclear medicine specialists. Two hematologists also shared their expert opinions on the survey results related to hematological tests during a final face-to-face discussion. A consensus was reached when 80% or more of the panel members marked the “agree/strongly agree” or “disagree/strongly disagree” option.ResultsThe panelists unanimously agreed that the aTTR-CM diagnosis could be established through scintigraphy (using either 99mTc-PYP, 99mTc-DPD, or 99mTc-HMPD) in a patient with suspected cardiac amyloidosis (CA) without a further investigation if AL amyloidosis is ruled out (by sFLC, SPIE and UPIE). In addition, scintigraphy imaging performed by SPECT or SPECT-CT should reveal a myocardial uptake of Grade ≥2 with a heart-to-contralateral (H/CL) ratio of ≥1.5. The cardiology panelists recommended using cardiovascular magnetic resonance (CMR) and a detailed echocardiographic scoring as a last resort before considering an endomyocardial biopsy in patients with suspected CA whose scintigraphy results were discordant/inconclusive or negative but still carried a high clinical suspicion of aTTR-CM.ConclusionThe diagnostic approach for aTTR-CM should be customized based on the availability of diagnostic tools/methods in each expert clinic to achieve a timely and definitive diagnosis

Datasheet1_Current barriers and recommendations on the diagnosis of transthyretin amyloid cardiomyopathy: a Delphi study.docx

ObjectivesThis study has been conducted to investigate the non-invasive diagnostic journey of patients with a transthyretin amyloid cardiomyopathy (aTTR-CM) in Turkey, identify the challenges and uncertainties encountered on the path to diagnosis from the perspectives of expert physicians, and develop recommendations that can be applied in such cases.MethodsThis study employed a three-round modified Delphi method and included 10 cardiologists and five nuclear medicine specialists. Two hematologists also shared their expert opinions on the survey results related to hematological tests during a final face-to-face discussion. A consensus was reached when 80% or more of the panel members marked the “agree/strongly agree” or “disagree/strongly disagree” option.ResultsThe panelists unanimously agreed that the aTTR-CM diagnosis could be established through scintigraphy (using either 99mTc-PYP, 99mTc-DPD, or 99mTc-HMPD) in a patient with suspected cardiac amyloidosis (CA) without a further investigation if AL amyloidosis is ruled out (by sFLC, SPIE and UPIE). In addition, scintigraphy imaging performed by SPECT or SPECT-CT should reveal a myocardial uptake of Grade ≥2 with a heart-to-contralateral (H/CL) ratio of ≥1.5. The cardiology panelists recommended using cardiovascular magnetic resonance (CMR) and a detailed echocardiographic scoring as a last resort before considering an endomyocardial biopsy in patients with suspected CA whose scintigraphy results were discordant/inconclusive or negative but still carried a high clinical suspicion of aTTR-CM.ConclusionThe diagnostic approach for aTTR-CM should be customized based on the availability of diagnostic tools/methods in each expert clinic to achieve a timely and definitive diagnosis.</p