MELD-sodium score and its prognostic value in malignancy-related ascites of pancreatic and gastric cancer

Background: Malignant ascites is a manifestation of end-stage events in a variety of cancers. There is significant lack of possible survival predictors in patients with malignancy-related ascites. Since the Model for End-Stage Liver Disease (MELD)-Na score has been shown to be a feasible and independent prognostic predictor for both short- and long-term outcome in HCC patients, we decided to test its prognostic role in other cancer types with ascites. Material and methods: This is a retrospective study. The outpatient oncology clinic's records were screened for the period between 2004 and 2011. Eighty-two pancreatic and gastric cancer patients were enrolled into the study. Results: The median age of patients was 59 (±12). Fifty-nine patients had gastric cancer and 23 had pancreatic cancer. Overall survival (OS) was 16.8 (IR, 1-98)?months in gastric cancer and 16.3 (IR, 0.5-81)?months in pancreatic cancer. There was no statistically significant difference between OS of gastric and pancreatic cancer. Progression-free survival (PFS) was statistically significantly longer in gastric cancer than pancreatic cancer with 16.5 (IR, 0.5-90) vs 6.5 (IR, 0.4-34)?months (P?=?0.04). Further analysis of data included stepwise multiple regression analysis with the dependent variable overall survival. The model had two independent predictors and an R 2 of 82 % and a predicted R 2 of 81 %. Predictors for time to remission were PFS and MELD-Na. The regression equation for the model was: $$\mathrm{Overall}\;\mathrm{survival}=17.4-0.522\,\,\ mathrm{MELD}\text{-}\mathrm{Na} + 0.902\;\mathrm{PFS}$$ Conclusion: In this study we showed that progression-free survival and MELD-Na score are significantly related with overall survival. MELD-Na score can be one of the predictors of the survival and PFS in pancreatic and gastric cancer patients with ascites. © 2012 Springer-Verlag Berlin Heidelberg

The efficacy of sequential therapy in eradication of Helicobacter pylori in Turkey

Background and Aim: Most of the studies about sequential therapy that have been reported from Turkey were levofloxacin based. We aimed to compare the Helicobacter pylori (H. pylori) eradication rates of standard triple, sequential and quadruple therapies including claritromycin regimes in this study.Materials and Methods: A total of 160 patients with dyspeptic symptoms were enrolled to the study. The patients were randomized to four groups of treatment protocols. And 40 patients received standard triple therapy for 2 weeks, 40 patients received bismuth containing quadruple therapy for 2 weeks, 40 patients received 5 + 5 clarithromycin-based sequential therapy, and 40 patients received 7 + 7 clarithromycin-based sequential therapy. H. pylori eradication was assessed by C 14 urea breath test 4 weeks after therapy.Results: Out of 160 patients with H. pylori infection, 131 (81.9%) were eradicated successfully and 29 (18.1%) failed to eradicate H. pylori infection. H. pylori eradication was achieved in 28 of 40 patients receiving standard triple therapy (70%), in 33 of 40 patients receiving quadruple therapy (82.5%), in 37 of 40 patients receiving 5 + 5 sequential therapy (92.5%), and in 33 of 40 patients receiving 7 + 7 sequential therapy (82. 5%). Statistics revealed that 5 + 5 sequential therapy led to significantly higher H. pylori eradication rates compared with that of standard triple therapy (P = 0.019). There was no statically difference between 5 + 5 sequential therapy and the other therapy groups’ eradication rates, but it was higher than all of the protocols. H. pylori eradication rate with sequential therapy in our patients with nonulcer dyspepsia was higher than those of patients with standard therapy (93% versus 82%, respectively, P>0.05).Conclusion: 5 + 5 sequential therapy was associated with significantly higher eradication rate of H. pylori compared with standard triple therapy in our study cohort.Keywords: H.pylori, sequential therapy, eradication protocol

Sequential evaluation of pancreato-biliary findings in a case with IgG4-associated cholangiopathy and autoimmune pancreatitis during corticosteroid treatment

Background: Immunoglobulin G4 (IgG4)-associated diseases mostly involve the pancreatico-biliary tree and pancreatic parenchyma. This disease complex is characterized by marked response to corticosteroid therapy and response to steroids is incorporated in the diagnostic algorithm of IgG4 associated diseases. However, there is much unknown about the sequences and duration of healing during the corticosteroid therapy in the literature. Case Report: In this case report, we report a young male patient with IgG4 associated extrahepatic biliary stricture and autoimmune pancreatitis successfully treated with corticosteroids. Recovery in the laboratory and radiological findings seemed to correlate well with the decrease in serum IgG4 levels in this patient. We also discussed sequences and the duration of healing in the pancreaticobiliary tree and pancreatic parenchymal manifestations in this case report. Conclusion: There is a gap in our knowledge about the evaluation of response criteria after steroid trial with regard to the duration and sequences of healing in the pancreaticobiliary involvement in diagnosing IgG4-related biliary and pancreatic diseases. © Trakya University Faculty of Medicine

The effects of hyperbaric oxygen treatment on oxidative stress and SCE frequencies in humans

Objectives: Hyperbaric oxygen (HBO) therapy is a useful method for treatment of various clinical conditions but it can also cause an increased production of free radicals and oxidative DNA damage. In this Study, our aim was to investigate the effects of hyperbaric oxygen on oxidative stress and genetic toxicity

Isolated Gingival Relapse During Complete Hematological Remission in Acute Promyelocytic Leukemia

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Serum leptin levels and their relationship to tumor necrosis factor-? and interleukin-6 in neonatal sepsis

PubMed: 14714752Circulating leptin concentrations are raised in animal models of inflammation and sepsis and leptin production is also increased in rodents by administration of endotoxin or cytokines. The purpose of this study was to investigate the effect of sepsis on serum leptin concentration and whether circulating leptin was related to tumor necrosis factor-? (TNF-?) and interleukin-6 (IL-6) release in newborn infants. Plasma leptin, TNF-? and IL-6 were measured in 20 neonates with culture-proven sepsis as soon as sepsis was diagnosed and after recovery and in 15 healthy control infants. There was no significant difference in plasma leptin levels between septic and control infants (p>0.05); there was also no difference in plasma leptin levels in septic neonates before and after therapy (p >0.05). No relationship between leptin and TNF-? (r = 0.16, p >0.05) or I1-6 (r = 0.12, p >0.05) was identified. These findings suggest that a major role of leptin in acute neonatal sepsis appears unlikely