Increased mean platelet volume in patients with infective endocarditis and embolic events

Background: Platelet activation appears to play an important role in thromboembolic com­plications of infective endocarditis (IE). Mean platelet volume (MPV) is a potentially useful marker of platelet activity and a quick and easy determinant of thrombotic risk. Hence the aim of this study was to investigate the baseline platelet volume indices (MPV and platelet distribution width [PDW]) in IE patients who developed embolic events in the follow-up period and who did not. Methods: The study group consisted of 76 consecutive patients (female: 55, male: 21, mean age: 26 years old, ranged: 8–64 years) with definite IE according to Duke Criteria. Thirty four healthy subjects, who were age and gender adjusted, served as the control group. The mean duration of hospital stay was 44 days. Results: Among the IE patients, 13 (13/76, 17.1%) had major embolic events. Significantly larger vegetations were observed in patients with embolic events as compared to non-embolic group (1.4 vs. 1.0 cm, p = 0.03). MPV at hospital admission was higher in patients who had embolic events in the follow-up period compared to both those who did not and the control subjects (10.62 ± 1.13 vs. 9.25 ± 0.97 and 8.93 ± 0.82 fL, p < 0.001, respectively). Similarly, the patients with embolic events had increased PDW compared to the non-embolic ones and the control group (16.31 ± 2.42 vs. 14.35 ± 1.97 and 14.04 ± 1.82%, p < 0.001, respectively). Conclusions: The present study demonstrated that IE patients with embolic events had in­creased MPV and PDW values, compared to non-embolics. Future prospective studies with standardized measurements may clarify the clinical role of platelet volume indices in thrombo­embolic complications of IE

N-(3-Oxo-1-thia-4-aza­spiro­[4.5]dec-4-yl)-6-phenyl­imidazo[2,1-b][1,3]thia­zole-3-acetamide hemihydrate

The title compound, C21H22N4O2S2·0.5H2O, crystallizes with two mol­ecules in the asymmetric unit. The dihedral angles between the phenyl and imidazothiazole ring systems are 19.16 (9) and 21.37 (9)°. In the imidazothiazole ring systems, the cyclohexane rings adopt chair conformations, while the thiazole rings have distorted envelope conformations. The two mol­ecules are stabilized by intra­molecular N—H⋯O, O—H⋯O and C—H⋯S inter­actions and the crystal structure is stabilized by inter­molecular N—H⋯O, O—H⋯O, C—H⋯O and C—H⋯N inter­actions

Crizotinib efficacy and safety in patients with advanced NSCLC harboring MET alterations: A real-life data of Turkish Oncology Group

Crizotinib is a multikinase inhibitor, effective in non-small cell lung cancer (NSCLC) harboring mesenchymal-epidermal transition (MET) alterations. Although small prospective studies showed efficacy and safety of crizotinib in NSCLC with MET alterations, there is limited real-life data. Aim of this study is to investigate real-life efficacy and safety of crizotinib in patients with advanced NSCLC harboring MET alterations. This was a retrospective, multicenter (17 centers) study of Turkish Oncology Group. Patients' demographic, histological data, treatment, response rates, survival outcomes, and toxicity data were collected. Outcomes were presented for the study population and compared between MET alteration types. Total of 62 patients were included with a median age of 58.5 (range, 26-78). Major histological type was adenocarcinoma, and 3 patients (4.8%) had sarcomatoid component. The most common MET analyzing method was next generation sequencing (90.3%). MET amplification and mutation frequencies were 53.2% (n = 33) and 46.8% (n = 29), respectively. Overall response rate and disease control rate were 56.5% and 74.2% in whole study population, respectively. Median progression free survival (PFS) was 7.2 months (95% confidence interval [CI]: 3.8-10.5), and median overall survival (OS) was 18.7 months (95% CI: 13.7-23.7), regardless of treatment line. Median PFS was 6.1 months (95% CI: 5.6-6.4) for patients with MET amplification, whereas 14.3 months (95% CI: 6.7-21.7) for patients with MET mutation (P = .217). Median PFS was significantly longer in patients who have never smoked (P = .040), have good performance score (P < .001), and responded to the treatment (P < .001). OS was significantly longer in patients with MET mutation (25.6 months, 95% CI: 15.9-35.3) compared to the patients with MET amplification (11.0 months; 95% CI: 5.2-16.8) (P = .049). In never-smokers, median OS was longer than smoker patients (25.6 months [95% CI: 11.8-39.3] vs 16.5 months [95% CI: 9.3-23.6]; P = .049). The most common adverse effects were fatigue (50%), peripheral edema (21%), nausea (29%) and diarrhea (19.4%). Grade 3 or 4 adverse effects were observed in 6.5% of the patients. This real-life data confirms efficacy and safety of crizotinib in the treatment of advanced NSCLC harboring MET alteration

Adrenokortikal karsinom: Tek merkez deneyimi

Aim: Adrenocortical cancer is a rare type of disease. Prognosis is poor despite cytotoxic chemotherapies. The primary treatment is surgery however postoperative disease relapse is common. The survival is poorer in patients who develop recurrence. Adjuvan treatment may be performed in patients carrying high risk. Cytotoxic chemotherapy is the only treatment option for inoperable and metastatic patients. In our study, we aimed to evaluate our patient outcome in this rarely seen cancer type. Materials and Methods: We retrospectively reviewed medical records of patients with adrenocortical cancer admitted to Ege University Medical Oncology Clinic between 2010 and 2018. Patient demographics, treatment types for adjuvant and metastatic setting and survival data were collected. Results: We identified 11 adrenocortical cancer patients. Median age was 44 (31-69). Three patients were metastatic at initial diagnosis. Five of 8 patients with nonmetastatic disease received adjuvant chemotherapy . The median overall survival (OS) was 30.2 months (%95 CI 7.9-52.4) in whole patient group. The median OS was found to be better in patients who presented with local disease than de novo metastatic setting (median OS 48.5 and 11.3 months respectively, p=0.02). The OS was 48.5 and 9 months respectively in patients who did and did not receive adjuvant treatment, however this finding was not found to be statistically significant. Conclusion: Nonmetastatic adrenocortical tumor patients who received adjuvant chemotherapy was found to have a slightly favorable OS. However present findings may not enlighten the management of this disease without evaluating treatment efficacy of these patients on multicenter, prospective trial study results.Amaç: Adrenokortikal kanserler nadir görülen bir kanser türüdür. Prognozları sitotoksik kemoterapilere rağmen oldukça kötüdür. Primer tedavi cerrahi olup, cerrahi sonrası nüks sıktır. Nüks eden olgularda daha kısa sağkalım izlenmektedir. Cerrahi sonrası adjuvan tedavi yüksek riskli değerlendirilen vakalarda uygulanmaktadır. İnoperabl ya da metastatik hastalarda sitotoksik kemoterapi yapılabilir. Çalışmamızın amacı, nadir görülen bu hastalık grubunda merkez deneyimlerimizi paylaşmaktır. Gereç ve Yöntem: Ege Üniversitesi Tülay Aktaş Onkoloji Hastanesine 2010-2018 yılları arasında adrenokortikal kanser (AKK) tanısı ile başvuran hastaların dosyaları retrospektif olarak incelendi. Hastaların demografik verileri, adjuvan ve metastatik tedavi seçenekleri ve sağkalım süreleri değerlendirildi. Bulgular: AKK tanısı ile bölümümüze başvuran 11 hasta mevcuttu. Hastalarımızın medyan yaşı 44 (31-69) idi. Tanı esnasında 3 hastada metastaz mevcuttu. Metastazı olmayan 8 hastanın 5’inde adjuvan kemoterapi tedavisi uygulanmıştı. Tüm grupta medyan genel sağkalım (OS) 30,2 ay (%95 CI 7,9-52,4) idi. Lokal hastalıkta metastatik hastalığa göre medyan OS istatistiksel olarak anlamlı yüksek bulundu (sırasıyla lokal hastalık medyan OS 48,5, metastatik hastalık medyan OS 11,3; p=0,02). Adjuvan kemoterapi alan ve almayan hastalarda sırasıyla medyan OS 48,5 ve 9 ay olmakla birlikte, hasta kollarının sayısının çok az olması nedeniyle istatistiksel açıdan anlamlı olarak değerlendirilemedi. Sonuç: AKK tanısı ile izlenen hastalarımızda adjuvan tedavi alan hastalarda almayanlara göre daha iyi OS eğilimi görüldü. Mevcut bulgular prospektif çok merkezli çalışmalar ile doğrulanmadıkça tedavi yaklaşımlarını değiştirmeyecektir

Prognosis-related novel immunostaining pattern for programmed cell death ligand 1 and prognostic value of tumour-infiltrating lymphocytes in triple-negative breast cancer

This study aims to determine the prognostic significance of programmed cell death ligand 1 (PD-L1) expression and tumour-infiltrating lymphocytes (TILs) in triple- negative breast cancer (TNBC). PD-L1 expression and TIL percentage were determined in TNBCs that did not receive neoadjuvant therapy. The relationship between PD-L1 expression and the percentage of TILs with survival was investigated. The presence of intratumoural PD-L1-positive tumour-infiltrating immune cells (TIICs) in tumours with ≥ 1% PD-L1 expression was identified as a new PD-L1 evaluation parameter. The presence of intratumoural PD-L1-positive TIICs as a new parameter in PD-L1-positive cases increased overall survival. The percentage of TILs increased in both overall and distant metastasis-free survival (p = 0.040 and p = 0.006, respectively). As a result, it was found that the risk of death was increased 5.18-fold (p = 0.013) in patients without intratumoural PD-L1-positive TIICs. This risk of death was calculated to be 5.40-fold higher in patients with TIL percentage ≤ 10% than in those with > 40% (p = 0.024), and the risk of distant metastasis was calculated to be 11.95 times higher. In our study, we discovered that the percentage of TILs made a statistically significant difference in TNBC survival. The presence of intratumoural PD-L1-positive TIICs in PD-L1-positive cases significantly increased survival

COVID-19’da biyokimyasal ve hematolojik parametreler

There is extensive research related to the changes in the hematological and biochemical tests in COVID- infection. The complete blood count, especially leucocyte, lymphocyte and thrombocyte counts became prominent among the routine clinical chemistry tests since this is a infectious process and these tests are easy to perform. Besides, interleukins, C-reactive protein, erithrocyte sedimentation rate, procalcitonin, ferritin were used widely to assess the inflamatory process and the “cytokine storm”. Some parameters are used to evaluate the complications related to the liver, kidneys and the heart. Hypercoagulopathy and thrombosis werecommon in this infection and the major reason for many complications seen in COVID-19. Creatine kinase, cardiac troponins, myoglobin were used to assess cardiac status; aspartat aminotransferase, albumin, lactate dehydrogenase were used broadly to assess liver function and fibrin degradation products, activated partial thromboplastin time and D-dimer were used to determine the thrombotic state.In this review article, we aimed to address the parameters that are important in the diagnosis, treatment and prognosis of COVID-19, discuss their diagnostic and prognostic efficiency and their value in risk stratification.Keywords:&nbsp;COVID-19, laboratory tests, biochemistry, hematology, prognosis</p