Identification of Spatial Proteomic Signatures of Colon Tumor Metastasis: A Digital Spatial Profiling Approach.

Over 150,000 Americans are diagnosed with colorectal cancer (CRC) every year, and annually >50,000 individuals are estimated to die of CRC, necessitating improvements in screening, prognostication, disease management, and therapeutic options. CRC tumors are removed en bloc with surrounding vasculature and lymphatics. Examination of regional lymph nodes at the time of surgical resection is essential for prognostication. Developing alternative approaches to indirectly assess recurrence risk would have utility in cases where lymph node yield is incomplete or inadequate. Spatially dependent, immune cell-specific (eg, tumor-infiltrating lymphocytes), proteomic, and transcriptomic expression patterns inside and around the tumor-the tumor immune microenvironment-can predict nodal/distant metastasis and probe the coordinated immune response from the primary tumor site. The comprehensive characterization of tumor-infiltrating lymphocytes and other immune infiltrates is possible using highly multiplexed spatial omics technologies, such as the GeoMX Digital Spatial Profiler. In this study, machine learning and differential co-expression analyses helped identify biomarkers from Digital Spatial Profiler-assayed protein expression patterns inside, at the invasive margin, and away from the tumor, associated with extracellular matrix remodeling (eg, granzyme B and fibronectin), immune suppression (eg, forkhead box P3), exhaustion and cytotoxicity (eg, CD8), Programmed death ligand 1-expressing dendritic cells, and neutrophil proliferation, among other concomitant alterations. Further investigation of these biomarkers may reveal independent risk factors of CRC metastasis that can be formulated into low-cost, widely available assays.

Role of Artificial Intelligence in PET/CT Imaging for Management of Lymphoma.

Our review shows that AI-based analysis of lymphoma whole-body FDG-PET/CT can inform all phases of clinical management including staging, prognostication, treatment planning, and treatment response evaluation. We highlight advancements in the role of neural networks for performing automated image segmentation to calculate PET-based imaging biomarkers such as the total metabolic tumor volume (TMTV). AI-based image segmentation methods are at levels where they can be semi-automatically implemented with minimal human inputs and nearing the level of a second-opinion radiologist. Advances in automated segmentation methods are particularly apparent in the discrimination of lymphomatous vs non-lymphomatous FDG-avid regions, which carries through to automated staging. Automated TMTV calculators, in addition to automated calculation of measures such as Dmax are informing robust models of progression-free survival which can then feed into improved treatment planning.

Multi-Scale Temporal Imaging: From Micro- and Meso- to Macro-scale-time Nuclear Medicine.

Time provides a common frame of reference for understanding different processes of change. Within the context of medical imaging, time has three different time scales to be considered: (i) microtime, (ii) mesotime, and (iii) macrotime, respectively, which span a single imaging session, distinct imaging sessions within a short period, and scans with large time gaps spanning months of even years. There has commonly been greater emphasis on the microtime and mesotime scales in both clinical practice and research, with less focus on questions that are at the macrotime scale.

Do radiation oncologists publish what they present? An observational analysis of abstracts presented at the radiation oncology congresses in Turkey: A young radiation oncologists group study.

Background: The publication rate of abstracts is a measure of the quality of scientific meetings. Aims: The present study aimed to determine the radiation oncologists' publication rates of abstracts presented at the National Radiation Oncology Congresses (UROK) and National Cancer Congresses (UKK) and identify the top journals that published these studies. Materials and Methods: We reviewed the abstracts presented at UROK and UKK, held between 2013 and 2017. To retrieve any publications originating from the presented abstracts, we searched the match terms in the public databases, including PubMed, Web of Science, Google Scholar, The Turkish Academic Network, and Information Center (ULAKBIM). We evaluated the articles' publication dates and peer-review history and noted the journals' impact factors. Results: Three thousand seven hundred six abstracts were accepted for presentation; 1178 papers met the study criteria and were included in the analyses. There were 297 oral and 881 poster presentations. The overall publication rate was 18.9%. The median time to publication was 12 months. The studies were published in 94 scientific journals with a median impact factor of 1.28. Breast cancer and lung cancer studies had the highest publication rates among all subspecialties (15.2%). Retrospective studies had higher publication rates than those with other study designs (P < 0.0001). Conclusion: Almost 20% of abstracts presented at UROK and UKK were converted into full-text publications. Most of the abstracts achieved publication within 2 years from the presentation. Oral presentations had a significantly higher publication rate than poster presentations, reflecting their higher quality. The authors' affiliations and the study designs were among the significant factors that determine publication success.

Comparison of interfragmentary pinning versus the extension block technique for acute Doyle type 4c mallet finger.

The aim of this study was to compare the closed reduction interfragmentary pinning method (IPM) with the extension block technique (EBT) for bony mallet finger. Patients who underwent mallet finger operations were screened retrospectively for the following inclusion criteria: Doyle type 4c, age between 18 and 75 years, less than 4 weeks to surgery, and more than 1 year of follow-up time. Group I underwent a closed reduction IPM, and group II underwent the EBT. Lateral radiographs taken during the preoperative and final examination were used to evaluate the size and amount of displacement from the distal interphalangeal (DIP) joint and the dorsal fragment as well as the articular surface. Operation times were compiled from patient records. During the final examination, pain and DIP joint range of motion (ROM) were assessed and complications were recorded. The Crawford criteria were used for functional results. Fifteen patients in group I (8 men, 7 women) and 17 patients in group II (10 men, 7 women) were evaluated. Age, gender, time to surgery and follow-up time showed no statistically significant differences between the two groups. The differences in fragment size, preoperative and postoperative joint displacement, amount of dorsal displacement and DIP joint ROM were not statistically significant between the two groups. However, the operation time was significantly shorter time in group I than in group II (p=0.000). The average time to fracture union was significantly longer in group I (7.3 weeks) than in group II (6 weeks) (p=0.013). The EBT has faster time to union and is a safer method with lesser risk of arthritis and fragmentation. The IPM can be an alternative with shorter operation time, less pin bed infection and nail bed damage, especially in Doyle type 4c cases with large fragments.

Mixed Effects Machine Learning Models for Colon Cancer Metastasis Prediction using Spatially Localized Immuno-Oncology Markers.

Spatially resolved characterization of the transcriptome and proteome promises to provide further clarity on cancer pathogenesis and etiology, which may inform future clinical practice through classifier development for clinical outcomes. However, batch effects may potentially obscure the ability of machine learning methods to derive complex associations within spatial omics data. Profiling thirty-five stage three colon cancer patients using the GeoMX Digital Spatial Profiler, we found that mixed-effects machine learning (MEML) methods† may provide utility for overcoming significant batch effects to communicate key and complex disease associations from spatial information. These results point to further exploration and application of MEML methods within the spatial omics algorithm development life cycle for clinical deployment.

Risk factors for diabetic foot ulcers in metreleptin naïve patients with lipodystrophy.

AIM: Patients with lipodystrophy are at high risk for chronic complications of diabetes. Recently, we have reported 18 diabetic foot ulcer episodes in 9 subjects with lipodystrophy. This current study aims to determine risk factors associated with foot ulcer development in this rare disease population. METHODS: Ninety metreleptin naïve patients with diabetes registered in our national lipodystrophy database were included in this observational retrospective cohort study (9 with and 81 without foot ulcers). RESULTS: Patients with lipodystrophy developing foot ulcers had longer diabetes duration (p = 0.007), longer time since lipodystrophy diagnosis (p = 0.008), and higher HbA1c levels (p = 0.041). Insulin use was more prevalent (p = 0.003). The time from diagnosis of diabetes to first foot ulcer was shorter for patients with generalized lipodystrophy compared to partial lipodystrophy (p = 0.036). Retinopathy (p < 0.001), neuropathy (p < 0.001), peripheral artery disease (p = 0.001), and kidney failure (p = 0.003) were more commonly detected in patients with foot ulcers. Patients with foot ulcers tended to have lower leptin levels (p = 0.052). Multiple logistic regression estimated significant associations between foot ulcers and generalized lipodystrophy (OR: 40.81, 95% CI: 3.31-503.93, p = 0.004), long-term diabetes (≥ 15 years; OR: 27.07, 95% CI: 2.97-246.39, p = 0.003), and decreased eGFR (OR: 13.35, 95% CI: 1.96-90.67, p = 0.008). CONCLUSIONS: Our study identified several clinical factors associated with foot ulceration among patients with lipodystrophy and diabetes. Preventive measures and effective treatment of metabolic consequences of lipodystrophy are essential to prevent the occurrence of foot ulcers in these high-risk individuals.

Loop-Cluster Coupling and Algorithm for Classical Statistical Models.

Potts spin systems play a fundamental role in statistical mechanics and quantum field theory and can be studied within the spin, the Fortuin-Kasteleyn (FK) bond or the q-flow (loop) representation. We introduce a Loop-Cluster (LC) joint model of bond-occupation variables interacting with q-flow variables and formulate an LC algorithm that is found to be in the same dynamical universality as the celebrated Swendsen-Wang algorithm. This leads to a theoretical unification for all the representations, and numerically, one can apply the most efficient algorithm in one representation and measure physical quantities in others. Moreover, by using the LC scheme, we construct a hierarchy of geometric objects that contain as special cases the q-flow clusters and the backbone of FK clusters, the exact values of whose fractal dimensions in two dimensions remain as an open question. Our work not only provides a unified framework and an efficient algorithm for the Potts model but also brings new insights into the rich geometric structures of the FK clusters.

Characterizing Extracellular Vesicles and Their Diverse RNA Contents.

Cells release nanometer-scale, lipid bilayer-enclosed biomolecular packages (extracellular vesicles; EVs) into their surrounding environment. EVs are hypothesized to be intercellular communication agents that regulate physiological states by transporting biomolecules between near and distant cells. The research community has consistently advocated for the importance of RNA contents in EVs by demonstrating that: (1) EV-related RNA contents can be detected in a liquid biopsy, (2) disease states significantly alter EV-related RNA contents, and (3) sensitive and specific liquid biopsies can be implemented in precision medicine settings by measuring EV-derived RNA contents. Furthermore, EVs have medical potential beyond diagnostics. Both natural and engineered EVs are being investigated for therapeutic applications such as regenerative medicine and as drug delivery agents. This review focuses specifically on EV characterization, analysis of their RNA content, and their functional implications. The NIH extracellular RNA communication (ERC) program has catapulted human EV research from an RNA profiling standpoint by standardizing the pipeline for working with EV transcriptomics data, and creating a centralized database for the scientific community. There are currently thousands of RNA-sequencing profiles hosted on the Extracellular RNA Atlas alone (Murillo et al., 2019), encompassing a variety of human biofluid types and health conditions. While a number of significant discoveries have been made through these studies individually, integrative analyses of these data have thus far been limited. A primary focus of the ERC program over the next five years is to bring higher resolution tools to the EV research community so that investigators can isolate and analyze EV sub-populations, and ultimately single EVs sourced from discrete cell types, tissues, and complex biofluids. Higher resolution techniques will be essential for evaluating the roles of circulating EVs at a level which impacts clinical decision making. We expect that advances in microfluidic technologies will drive near-term innovation and discoveries about the diverse RNA contents of EVs. Long-term translation of EV-based RNA profiling into a mainstay medical diagnostic tool will depend upon identifying robust patterns of circulating genetic material that correlate with a change in health status.

Comparison of 2D vena contracta area with 3D planimetric mitral valve area in rheumatoid mitral valve disease.

Rheumatoid valve disease is a general health problem of developing countries, and it mainly affects after the age of 40. Assessment of the correct mitral valve area (MVA) is important for the treatment of rheumatoid valve disease. However, there are contradictions between the three-dimensional (3D) and two-dimensional (2D) methods. A measurement with 3D echocardiography is a more accurate method to measure the MVA. However, in centers without 3D echocardiography, there are some difficulties in the accurate measurement of the MVA. The aim of this study was to assess the value of 2D transesophageal echocardiography (TEE) mitral valve vena contracta area (VCA) in predicting the severity of rheumatoid mitral stenosis (RMS) by comparing 3D planimetry. A total of 24 patients (10 females and 14 males) who were diagnosed with mild/moderate/severe RMS with using pressure half time, mean transmitral gradient, and planimetry methods were included in this study. 3D images were acquired using the 3D zoom and full volume. 2D TEE VCA was measured at an angle of 140° and 60°, which was perpendicular to the former, with color Doppler and the VCA was measured with an ellipsoid area using mathematical formula. There was statistically significant relationship between the measurements of 2D VCA and 3D zoom mode MVA planimetry and MVA full measurements (MVA full volume) (p < 0.01). Calculation of the valvular area after measuring the mitral valve VCA with 2D TEE is a reliable method that is usable in centers without 3D echocardiography.

Correction to: Comparison of 2D vena contracta area with 3D planimetric mitral valve area in rheumatoid mitral valve disease.

In the original publication of the article one co-author, A. Zencirci, was listed by mistake. Dr. A. Zencirci has not contributed to this article and therefore, the author list has been updated. The author name A. Zencirci has been removed. All authors have agreed to the updated author list.

Effects of different bone marrow stimulation techniques on avascular zone meniscal defects.

OBJECTIVES: In this study, we sought to investigate the effect of different amounts of Bone Marrow-Derived Mesenchymal Stem Cells (BMSCs), obtained by different BMSCs, on the healing of avascular zone meniscal defects. BACKGROUND: Treating avascular zone meniscal injuries has gained popularity. BMSCs contribute to the healing of avascular zone meniscal defects. The amount of BMSCs derived from different bone marrow stimulation techniques (BMSTs) varies, which could affect the therapeutic efficacy of this treatment. METHODS: Fifty-four skeletally mature female New Zealand White rabbits were used after local ethical committee approval. A full thickness, 1.5 mm diameter defect was produced in the inner two-thirds of the anterior portion of the medial meniscus avascular zone using a biopsy punch. Animals were enrolled into three different groups according to BMST (0.8 mm, 1.5 mm, and 4 mm). Medial menisci were harvested and prepared for histomorphometric, histologic and immune-histologic analyses. RESULTS: Larger bridging tissues across the defect were detected in the 1.5-mm and 4-mm groups at 4 weeks (p < 0.05). The best quality score at the 1-,4- and 12-week endpoints was in 0.8 mm, 4 mm and 0.8 mm, 1.5 mm, respectively (p 0.05)CONCLUSION: The largest amount of BMSCs did not correlate with best quality and largest quantity of bridging tissue at the avascular zone in meniscal defects (Tab. 3, Fig. 4, Ref. 30).

Fibroblast-adapted human CMV vaccines elicit predominantly conventional CD8 T cell responses in humans.

Cytomegalovirus (CMV)-based vaccines have shown remarkable efficacy in the rhesus macaque model of acquired immune deficiency syndrome, enabling 50% of vaccinated monkeys to clear a subsequent virulent simian immunodeficiency virus challenge. The protective vaccine elicited unconventional CD8 T cell responses that were entirely restricted by MHC II or the nonclassical MHC I molecule, MHC-E. These unconventional responses were only elicited by a fibroblast-adapted rhesus CMV vector with limited tissue tropism; a repaired vector with normal tropism elicited conventional responses. Testing whether these unusual protective CD8 T responses could be elicited in humans requires vaccinating human subjects with a fibroblast-adapted mutant of human CMV (HCMV). In this study, we describe the CD8 T cell responses of human subjects vaccinated with two fibroblast-adapted HCMV vaccines. Most responses were identified as conventional classically MHC I restricted, and we found no evidence for MHC II or HLA-E restriction. These results indicate that fibroblast adaptation alone is unlikely to explain the unconventional responses observed in macaques.

A nano particle vector comprised of poly lactic-co-glycolic acid and monophosphoryl lipid A and recombinant Mycobacterium avium subsp paratuberculosis peptides stimulate a pro-immune profile in bovine macrophages.

AIMS: We evaluated the potential of a nanoparticle (NP) delivery system to improve methods of delivery of candidate peptide-based vaccines for Paratuberculosis in cattle. METHODS AND RESULTS: Peptides derived from Mycobacterium avium subsp. paratuberculosis (Map), and the pro-inflammatory monophosphoryl lipid A (MPLA) were incorporated in polymeric NPs based on poly (d,l-lactide-co-glycolide) (PLGA). The PLGA/MPLA NPs carriers were incubated with macrophages to examine their effects on survival and function. PLGA/MPLA NPs, with and without Map antigens, are efficiently phagocytized by macrophages with no evidence of toxicity. PLGA/MPLA NP formulations did not alter the level of expression of MHC I or II molecules. Expression of TNFα and IL12p40 was increased in Map-loaded NPs. T-cell proliferation studies using a model peptide from Anaplasma marginale demonstrated that a CD4 T-cell recall response could be elicited with macrophages pulsed with the peptide encapsulated in the PLGA/MPLA NP. CONCLUSIONS: These findings indicate PLGA/MPLA NPs can be used as a vehicle for delivery and testing of candidate peptide-based vaccines. SIGNIFICANCE AND IMPACT OF THE STUDY: These results will assist on more in depth studies on PLGA NP delivery systems that may lead to the development of a peptide-based vaccine for cattle.

Effect of catechins on fattening performance, meat quality, some antioxidant and blood parameters and fattening costs in Japanese quail (Coturnix coturnix japonica).

The aim of this study was to investigate the effect of dietary supplementation of green tea (Camellia sinensis) catechins in quail (Coturnix coturnix japonica). Quail were fed with a basal diet, and the treatment groups were fed on the basal diet with 1.25 or 2.50 g/kg catechin supplementation for 30 d. Fattening performance and meat quality of the quail were estimated. Serum total antioxidant status (TAS), plasma and liver malondialdehyde (MDA) and some serum biochemical parameters were measured. The results showed that catechin supplementation did not affect live weight, feed intake, feed conversion ratio, carcass weight, carcass dressing or the nutrient composition of breast and thigh meats. The water holding capacity (WHC) of breast meat was increased in the 2.50 g/kg catechin treatment. Catechin supplementation increased the serum TAS, but decreased plasma MDA and liver MDA concentration as well as serum glucose and total cholesterol levels. Serum triglyceride and total protein levels were not affected by catechin supplementation. In conclusion, catechins have effective antioxidant hypoglycaemic and hypocholesterolaemic properties, as well as having the potential to increase meat quality in fattening quail. On the other hand, catechin supplementation did not have any negative effect on the fattening performance, meat nutrient composition and fattening costs in fattening quail.

Saccharomyces boulardii CNCM I-745 reduces the duration of diarrhoea, length of emergency care and hospital stay in children with acute diarrhoea.

Evidence from the literature has shown that Saccharomyces boulardii provides a clinically significant benefit in the treatment of acute infectious diarrhoea in children. In this multicentre, randomised, prospective, controlled, single blind clinical trial performed in children with acute watery diarrhoea, we aimed to evaluate the impact of S. boulardii CNCM I-745 in hospitalised children, in children requiring emergency care unit (ECU) stay and in outpatient settings. The primary endpoint was the duration of diarrhoea (in hours). Secondary outcome measures were duration of hospitalisation and diarrhoea at the 3(rd) day of intervention. In the whole study group (363 children), the duration of diarrhoea was approximately 24 h shorter in the S. boulardii group (75.4±33.1 vs 99.8±32.5 h, P<0.001). The effect of S. boulardii (diarrhoea-free children) was observed starting at 48 h. After 72 h, only 27.3% of the children receiving probiotic still had watery diarrhoea, in contrast to 48.5% in the control group (P<0.001). The duration of diarrhoea was significantly reduced in the probiotic group in hospital, ECU and outpatient settings (P<0.001, P<0.01 and P<0.001, respectively). The percentage of diarrhoea-free children was significantly larger after 48 and 72 h in all settings. The mean length of hospital stay was shorter with more than 36 h difference in the S. boulardii group (4.60±1.72 vs 6.12±1.71 days, P<0.001). The mean length of ECU stay was shorter with more than 19 h difference in the probiotic group (1.20±0.4 vs 2.0±0.3 days, P<0.001). No adverse effects related to the probiotic were noted. Because treatment can shorten the duration of diarrhoea and reduce the length of ECU and hospital stay, there is likely a social and economic benefit of S. boulardii CNCM I-745 in adjunction to oral rehydration solution in acute infectious gastroenteritis in children.

Bardet-Biedl syndrome with vulva carcinoma presented with acute renal failure: a case report.

BACKGROUND: Bardet-Biedl syndrome is a rare disorder characterized by retinal dystrophy, obesity, kidney dysfunction, polydactyly, hypogonadism and cognitive impairment. It can be accompanied by systemic findings such as malignancy, hypertension, diabetes mellitus, constitutional and functional disorders of urogenital system and liver fibrosis. CASE REPORT: A 35-year-old woman with Bardet-Biedl syndrome was referred to our outpatient nephrology clinic with dysuria, acute renal failure, and urinary tract infection. A sized 2 x 1 cm mass between labia major and minor was noted, while CT scan showed a lesion that encompassed uterus and extended to the posterior side of the bladder in the left adnexal region and a 3 cm lesion in the liver. Excisional biopsy of the mass revealed a well-differentiated, squamous cell carcinoma. Dysuria resolved with insertion of urinary catheter after bougie dilatation and the patient was referred for radiotherapy. CONCLUSION: It should be kept in the mind that renal failure may develop due to constitutional urogenital anomalies such as vulva carcinoma. This can be an important cause of morbidity and mortality in patients with Bardet-Biedl syndrome.Hippokratia 2015; 19 (2):176-178.

Alteration of serum and cardiac tissue adropin, copeptin, irisin and TRPM2 expressions in DOX treated male rats.

Doxorubicin (DOX) cardiotoxicity is a significant side effect in cancer survivors. DOX and its metabolites alter cardiac gene expression and affect metabolic energy-related peptides. Adropin, copeptin, irisin and TRPM2 are produced locally in the heart and play a role in energy homeostasis. We investigated the fates of adropin, copeptin, irisin and TRPM2 in serum and cardiac tissues of DOX treated rats. Animals were divided into three groups of six: 1) untreated controls, 2) DOX treated and 3) saline treated. The rats were fed a standard diet ad libitum for 14 days then were sacrificed and heart and serum samples were taken. Adropin, copeptin, irisin levels in tissue homogenates and serum were measured using ELISA. Immunoreactivity of heart tissue adropin, copeptin, irisin and TRPM2 also were investigated. The peptides increased in both serum and cardiac tissue homogenates in animals treated with DOX compared to the other groups. DOX increased adropin in endocardial and myocardial cells, but it decreased expression of copeptin. DOX did not affect endocardial irisin and TRPM2 expressions, but myocardial irisin and TRPM2 expressions were increased. Serum adropin, irisin and copeptin were increased in DOX treated rats. Cardiac adropin, copeptin, irisin and TRPM2 are affected by DOX and may play a role in DOX cardiotoxicity.

The Levels of Oxidative Stress Biomarkers in Rats as a Response to Different Techniques of Testicular Biopsy.

Some biopsy techniques may cause oxidative stress. Therefore, we aimed to evaluate the possible role of testicular biopsy-induced damage on production of reactive oxygen species using quantitative and biochemical methods. Adult male Wistar albino rats were randomly divided into five groups. Group 1 (sham) (n = 6) was sham operated. Group 2 (n = 7) underwent fine-needle aspiration testicular biopsy. Group 3 (n = 6) underwent microscopic testicular sperm extraction (micro-TESE). Open testicular biopsy was performed to rats in group 4 (macro-TESE) (n = 8). Group 5 (n = 7) underwent Tru-cut biopsy. Six weeks after the initial operations, orchiectomies were performed. Oxidative stress biomarkers such as superoxide dismutase (SOD) and catalase (CAT) activities, and malondialdehyde (MDA) in biopsy samples were measured as spectrophotometric. Compared with group I, SOD and CAT activities, and MDA levels were elevated significantly in the fine-needle aspiration group, in the macro-TESE group and in the Tru-cut biopsy group (groups II, IV, and V), (p < 0.05). However, there were no significant differences between group I and group III (p > 0.05). These data suggest that micro-TESE biopsy is the best technique among all others. All of the biopsy techniques except micro-TESE may cause the overproduction of reactive oxygen species. We consider that the increased antioxidant enzyme activities (CAT, SOD) may reflect the cellular response against oxidative stress in these groups.

The predictors of poor outcomes in patients with femoral artery injuries.

PURPOSE: This study investigated the predictors of poor outcomes, including limb loss and death, in patients with femoral artery injuries. PATIENTS AND METHODS: The study included 158 patients aged 2-82 (mean age 28.4 ± 16.5) with femoral arterial injury (common, deep, and superficial femoral artery) that were treated surgically between 2000 and 2010. Isolated venous injuries were excluded. Demographic and clinical data of the patients, including age, gender, admission time, pulse rate and blood pressure, hematocrit value, reason of injury, associated injury, and Mangled Extremity Severity Score (MESS) were recorded. RESULTS: Of the 158 patients, the death and amputation rates were 5.7% (9) and 5.1% (8), respectively. In logistic regression analysis, four variables (pulse rate, MESS, hematocrit, and bone trauma) were found to be independent predictors for poor outcomes. The Odd's ratios and confidence interval values of these variables were as follows: 7.24 (1.94-26.92), 21.75 (5.41-87.48), 5.93 (3.04-11.54) and 7.46 (2.09-9.56), respectively. CONCLUSIONS: The MESS value, presence of bone fracture, hematocrit, and pulse rate on admission are predictive risk factors for poor outcomes in patients with femoral artery injury. Therefore, in these patients, prompt intervention by experienced surgeons is crucial for limb salvage and decreased mortality.