Thermochromic nail polish as a novel indicator to predict infraclavicular brachial plexus block success: A prospective cohort study.

BACKGROUND: Skin temperature measurements after peripheral nerve block can be used as an easy and objective method to help predict block success. Thermochromic nail polishes are popular cosmetic products especially among young women. The colour change of nail polish is based on a thermochromic reaction as the temperature changes. OBJECTIVE: The aim of this study was to test the hypothesis that the success of infraclavicular brachial plexus blocks (IBPBs) can be predicted by the colour change in thermochromic nail polish, which depends on skin temperature changes. DESIGN: A prospective cohort study. SETTING: Training and research hospital from December 2018 to March 2019. PATIENTS: A total of 50 patients who received IBPB for forearm, wrist or hand surgery were included. MAIN OUTCOME MEASURES: Thermochromic nail polish was applied to the nails of both hands of all patients before the block. Reaction of the nail polish in both hands was photographed immediately after application of nail polish and at 30 min after performing the block. The digital photographs of each patient were evaluated by observers. To evaluate the validity of the colour change in nail polish in predicting a successful IBPB, sensitivity, specificity, positive and negative predictive values and positive and negative likelihood ratios were estimated. RESULTS: The positive predictive value for colour change in thermochromic nail polish predicting a successful IBPB was 96% [95% confidence interval (CI) 90 to 98] and sensitivity was 94% (95% CI 87 to 97). Fleiss kappa value showed substantial agreement (0.76; 95% CI 0.59 to 0.93) in the assessment of interobserver agreement. CONCLUSION: The current study demonstrates that the colour change in thermochromic nail polish is a valid and reliable indicator for the prediction of block success. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT03767868.

Thiol disulphide homeostasis in patients with acute myocardial infarction (AMI).

OBJECTIVE: To investigate novel oxidative stress marker thiol disulphide homeostasis in patients with acute myocardial infarction.. METHODS: The case-control study was conducted at Yildirim Beyazit University, Ankara, Turkey, between October 26, 2015 and January 26, 2016. It comprised patients of ST elevation myocardial infarction, and healthy individuals. Troponin levels, native thiol, total thiol, and disulphide were compared among the groups. Results: Of the 128 subjects, 98(76.5%) were patients and 30(23.43%) were controls. Disulphide levels were lower in the patients compared to the controls (p<0.001).As troponin levels increased, native thiol, total thiol and disulphide levels in patients decreased (p<0.05). RESULTS: Of the 128 subjects, 98(76.5%) were patients and 30(23.43%) were controls. Disulphide levels were lower in the patients compared to the controls (p<0.001).As troponin levels increased, native thiol, total thiol and disulphide levels in patients decreased (p<0.05). CONCLUSIONS: Native thiol and total thiol levels may be used as a novel oxidative stres marker in patients with acute myocardial infarction.

Clinical outcomes and prognostic factors of adult's Ewing sarcoma family of tumors: single center experience.

AIM OF THE STUDY: Aim of the study was to investigate the demographics of Ewing sarcoma family of tumours (ESTF) patients, treatment alternatives, clinical outcomes, and prognostic factors for survival. MATERIAL AND METHODS: We retrospectively reviewed 39 patients with ESFT who were admitted to our institute between September 2008 and September 2012. RESULTS: The patients included 32 (82.1%) males and seven (17.9%) females of median age 24 (range, 18-66) years. Among the 27 patients with a primary osseous localization, 17 (43.5%) had a central axis localization. Fifteen patients (38.5%) had metastases at the time of diagnosis. Patients were followed up for a median period of 18 (range, 2-134) months. The median event-free survival (EFS) was 23 (range, 1-64) months, and the 1- and 4-year EFS were 60% and 48%, respectively. The median overall survival (OS) was 91 (range, 1-188) months, and the 1- and 4-year OS were 78% and 54%, respectively. Gender, age, primary tumor site, and local treatment modalities, either alone or in combination, did not have a significant effect on OS (p = 0.210, p = 0.617, p = 0.644, and p = 0.417, respectively). In contrast, osseous site of peripheral localization, limited stage, and metastasis to the bone significantly affected OS (p = 0.015, p < 0.001, and p = 0.042, respectively). CONCLUSIONS: ESFTs are aggressive tumors with a high rate of relapse and metastatic potential. Patients with peripheral bone involvement and limited stage had a good prognosis. Appropriate surgical resection, radiotherapy, and aggressive chemotherapy regimens are recommended.

Progesterone receptor status in determining the prognosis of estrogen receptor positive/ HER2 negative breast carcinoma patients.

PURPOSE: To evaluate the impact of progesterone receptor (PR) status on estrogen receptor (ER)-positive and HER2-negative breast cancer. METHODS: A total of 1673 operable breast cancer patients, diagnosed from June 1984 to June 2011 were retrospectively reviewed and 400 patients with ER-positive and HER2-negative tumors were identified and evaluated. ER-positive and HER2-negative patients were classified into two groups: group A: ER+/PR-/HER2- and group B : ER+/PR+/HER2- according to PR status. RESULTS: Median follow-up was 14.2 years (range 10.1-18.2). The ratio of postmenopausal patients was significantly higher in group A (68.2%, p=0.015). Grade 1 tumor and stage I disease were significantly higher in group B (15%, p=0.007 and 15%, p=0.005, respectively). Mean overall survival (OS) and disease free survival (DFS) were significantly better in group B (15.3±1.5 years vs 8.7±0.8 years, p=0.032; 10.5±1.6 years vs 5.7±0.5 years, p=0.022) as compared with group A. Relative risk for recurrence and death were two-fold higher in group A (p=0.05 and p=0.01, respectively). CONCLUSION: PR status exerts a significant impact on prognosis of ER+/HER2- breast cancer.

Treatment decision plans matter in elderly patients with gastrointestinal cancer: suboptimal or optimal?

PURPOSE: Aging is an important risk factor for cancer. Molecular changes and defective immunity associated with aging result in increased susceptibility to many carcinogens of the gastrointestinal system (GIS). Comorbidities and changes in drug metabolism in elderly patients make the treatment of GIS cancers difficult. METHODS: Between January 2009 and December 2012, a total of 790 patients diagnosed with GIS cancers were retrospectively evaluated. Among them, 357 patients aged ≥ 65 years constituted the study population in which the patient characteristics, disease location, TNM stage, ECOG PS, co-morbidities, chemotherapy regimens and overall survival (OS) were assessed. RESULTS: The patient median age was 71 years (range 65-94). Cancer localizations were colorectal cancer (CRC), gastric cancer, and the pancreaticobiliary system (PBS) cancer in 178 (49.9%), 124 (34.7%), and 55 (15.4%) patients, respectively. A total of 260 (69%) patients underwent chemotherapy: 167 (64.3%) patients received optimal chemotherapy, and 93 (35.7%) suboptimal chemotherapy. The median OS was 47, 14, and 11 months in CRC, gastric, and PBS cancers, respectively. OS was better in the optimally-treated group than in the suboptimally-treated group among patients with all types of cancer. OS was 67 vs 19 months (p<0.001), 17 vs 8 months (p=0.004), and 12 vs 10 months (p=0.46) in CRC, gastric, and PBS cancers in the optimal and suboptimal chemotherapy groups, respectively. Multivariate analysis showed that the disease stage in all cancer types and optimal chemotherapy in the CRC group were important predictors of survival (p<0.001 and p=0.021, respectively). CONCLUSION: Cancer is usually in advanced stage at the time of diagnosis in these elderly patients and screening programs might improve outcomes in this age group. Patients with GIS cancers (especially CRC and gastric cancer) should be encouraged to receive optimal chemotherapy regimens.

Outcome of 561 non-metastatic triple negative breast cancer patients: multi-center experience from Turkey.

PURPOSE: Triple-negative breast cancers account for 15% of breast carcinomas and, when present as early-stage disease, they are associated with higher rates of recurrence and early distant metastasis risk when compared to hormone receptor positive and human epidermal growth factor receptor (HER-2) positive breast cancers. In this study we aimed to explore the basic clinicopathological characteristics, prognostic factors and recurrence patterns of non-metastatic triple negative breast cancer patients. METHODS: In this study 561 non-metastatic triple-negative breast cancer female patients admitted to 8 different cancer centers in Turkey between 2000 and 2010 were retrospectively evaluated through their medical records, to identify the basic clinico-pathological characteristics, prognostic factors and recurrence patterns. RESULTS: The ratio of triple-negative breast cancer was 12%. The median age of patients was 48 years, of whom 311 (55.4%) were premenopausal. The majority had early-stage breast cancer at the time of diagnosis (16.8% stage I, 48.1% stage II, 35.1 % stage III) and the most commonly identified variant was invasive ductal carcinoma (84.1%). Grade II and III tumors were 27.1 and 48.5%, respectively. Adjuvant chemotherapy was administered to 90.5% of women and adjuvant radiotherapy to 41.2%. Median patient follow up was 28 months (range 3-290). During the follow up period 134 (23.8%) patients developed metastatic disease. In most of these cases, metastatic sites were bone, soft tissue, and lung. Factors affecting disease free survival (DFS) and overall survival (OS) were age (both p<0.001), lymph node involvement (both p<0.001), lymphovascular invasion (LVI) (p<0.001 and p=0.004, respectively), tumor stage (both p<0.001), adjuvant administration of anthracycline-based chemotherapy (both <0.001) and type of surgery (not significant for DFS but p=0.05 for OS). Three-year DFS and OS were 72.0 and 93.0%, respectively. CONCLUSION: Age, lymph node involvement, LVI, stage, and adjuvant chemotherapy were determined as prognostic factors for DFS and OS. The most common recurrence sites were bone, soft tissue and the lung. Further prospective randomised trials are needed to confirm the prognostic and predictive factors identified in this study.

Effects of comorbidities and functional living activities on survival in geriatric breast cancer patients.

AIM OF THE STUDY: We evaluated the possible effects of comorbid diseases and functional capacity on the survival of elderly female patients with breast cancer. MATERIAL AND METHODS: The study included 159 breast cancer patients aged 65 years or older. Functional status of the patients was evaluated using Katz's index of activities of daily living (ADL) and Lawton and Brody's Instrumental ADL (IADL) scale. RESULTS: ADL-based evaluation revealed 121 patients (76.1%) were independent, 34 (21.4%) semi-dependent and 4 (2.5%) dependent whereas IADL-based evaluation showed 69 patients (43.4%) were independent, 67 patients (42.1%) semi-dependent and 23 patients (14.5%) dependent. Among the patients, 69 (43.4%) had one comorbid disease, 62 (39.0%) had two and 26 (16.4%) had three or more. Of the entire cohort, 60.4% received adjuvant chemotherapy. Based on ADL index, overall survival (OS) was significantly better in semi-dependent and independent patients than in dependent patients (p = 0.001). In the upfront non-metastatic patient subgroup, disease-free survival (DFS) was favourable in the independent patients according to ADL index (p = 0.001). Having more than one comorbid disease had an unfavourable effect on OS. In the multiple regression analysis of non-metastatic patients, stage, triple-negative histology and ADL index remained significant in terms of OS (p = 0.008, HR: 3.17, CI: 1.35-7.44; p = 0.027, HR: 2.78, CI: 1.172-6.91; and p = 0.006, HR: 0.29, CI: 0.12-0.70, respectively). CONCLUSIONS: In elderly patients with breast cancer, evaluation of daily living activities and comorbid diseases are as important as staging and subclassification of breast cancer in the determination of prognosis and survival.

Comparison of the Effects of Anaesthesia Methods Used in Caesarean Delivery on Neonatal Cerebral and Renal Oxygenation: A Randomised Controlled Trial.

Background: During a newborn's adaptation to extrauterine life, many changes take place that are influenced by various factors. The type of delivery and anaesthesia strategy utilised during labour can modify these adaptive modifications. In this regard, this study was designed to compare the effects of general and spinal anaesthesia on cerebral and renal oxygenation after elective caesarean deliveries. Methods: This randomised controlled study comprised sixty parturient women who were over 18 years old and had a gestational age between 37 and 41 weeks. All participants had an ASA (American Society of Anesthesiologists) classification of II. Neonatal cerebral (CrSO2) and renal (RrSO2) regional oxygen saturations were assessed using near-infrared spectroscopy. Additionally, the 1st-5th min Apgar scores, preductal and postductal peripheral oxygen saturation (SpO2), and perfusion index were recorded in both the general anaesthesia and spinal anaesthesia groups. Results: There was no statistically significant difference between the two groups in terms of CrSO2 or RrSO2 values. The values of CrSO2 and RrSO2 in both groups showed a significant rise from the 10th to the 15th min, respectively. Conclusions: General and spinal anaesthesia techniques used for cesarean delivery have similar effects on neonatal cerebral and renal oxygenation.

Childhood, adolescents, and young adults (≤25 y) colorectal cancer: study of Anatolian Society of Medical Oncology.

PURPOSE: To evaluate the clinicopathologic characteristics and treatment outcomes of young patients with colorectal cancer (CRC). METHODS: Between May 2003 and June 2010, 76 patients were found eligible for this retrospective study. Age, sex, presenting symptoms, patients with acute presentation, family history, presence of polyps, histologic features, localization and stage of the tumor, treatment outcomes, time and site of recurrence, sites of metastasis, and survival outcomes were recorded from the patient files. RESULTS: Seventy-six patients (55.3% male) with a median age of 23 years were evaluated. Patients were evaluated in 2 groups as follows: child-adolescent (0 to 19 y, n=20) and young adult (20 to 25 y, n=56). Sex and symptoms (abdominal pain and rectal bleeding) were significantly differed between the groups and acute presentation was close to statistical significance. Overall survival significantly increased in patients undergoing curative surgery (P<0.001). Other parameters affecting the survival was stage of disease (P=0.004). Response to palliative chemotherapy in metastatic patients (P=0.042) and postoperative adjuvant chemotherapy had a statistically significant survival advantage (P=0.028). CONCLUSIONS: Diagnosis of CRC should not be excluded solely on the basis of age. CRC features in young-adult patients are more similar to adults compared with that of child-adolescent patients according to the symptoms and presentation. In patients with CRC in this age group, curative surgery, adjuvant chemotherapy, and palliative chemotherapy provide survival advantage.

Isolated ovarian metastasis of gastric cancer: Krukenberg tumor.

INTRODUCTION: Gastric cancer, one of the most common cancers in the world, rarely metastasizes to the ovaries. Ovarian metastases of gastric signet ring cell cancer (SRCC) are referred to as Krukenberg tumors and account for 1-2% of all ovarian cancers. Here, we analyze the characteristics, treatment, and prognosis of patients with Krukenberg tumors. MATERIAL AND METHODS: We retrospectively analyzed the demographic characteristics, treatment modalities, progression-free survival (PFS), and overall survival (OS) of patients who were diagnosed with Krukenberg tumors of gastric cancer origin and who underwent treatment and follow-up between January 2005 and January 2012 in the Ankara Oncology Education and Research Hospital. RESULTS: Among 1755 patients diagnosed with gastric cancer between January 2005 and January 2012, eight patients (0.45%) with histopathologically identified Krukenberg tumors were enrolled. The median age of the eight patients was 42.2 years (range, 32-69 years). Two (25%) of the patients were stage 3A, two (25%) were stage 3C, and four (50%) were stage 4 at the time of diagnosis. The median PFS was 13.2 months (1-25 months), the median OS after the original diagnosis was 16.7 months (1-41 months), and the median OS after ovarian metastasis was 3.6 months (1-10 months). DISCUSSION: Krukenberg tumors were seen particularly in young patients and more frequently during the premenopausal period. The prognosis was poor. When only the ovaries were affected, metastasectomy prolonged the survival time.

Assessment of general characteristics of patients with primary metastatic breast carcinoma: single center experience.

INTRODUCTION: Breast cancer (BC) is a heterogeneous disease. Several subgroups have been identified, according to the clinical presentation and radiographic, pathological, biological, and molecular characteristics of the tumor. Intrinsic genetic heterogeneity may be responsible for these differences. To date, little is known about the clinical features and outcome of patients with primary metastatic BC (PMBC) defined as those presenting with stage IV disease. MATERIAL AND METHODS: Between September 2007 and May 2011, BC patients who were admitted to a clinic were assessed. Patients with PMBC were included in this retrospective analysis. The patients' demographic characteristics, treatment schedules, and survival data were recorded. RESULTS: Of 2478 BC patients, 102 (4.1%) with PMBC were included in the analysis. The median age of the patients was 50 (26-90) years. Only four patients (3.9%) had previously undergone mammography. The median progression-free survival (PFS) and overall survival (OS) were 30 and 66 months, respectively. The PFS and OS were unaffected by age, menopausal status, ECOG, histology, or tumor grade. Both PFS and OS were affected by HR status (log rank p = 0.006, log rank p = 0.04), HER2 status (p = 0.001, p = 0.005), site of metastasis (p = 0.01, p = 0.04), radiotherapy (p = 0.04, OS p = 0.03), and bisphosphonate treatment (p = 0.02, p = 0.006). PFS was greater in the hormone therapy group (43 months, p = 0.03) while OS was greater in the patients that received chemotherapy (76 months, p = 0.01). CONCLUSIONS: Mammography should be given greater emphasis, considering its importance in the prevention of PMBC. As a treatment option for bone and soft tissue metastatic PMBC patients, hormone therapy should be effective as a first-line treatment.

The Impact of CoronaVac Vaccination on 28-day Mortality Rate of Critically Ill Patients with COVID-19 in Türkiye.

Background: Vaccines against coronavirus disease-19 (COVID-19) have been effective in preventing symptomatic diseases, hospitalizations, and intensive care unit (ICU) admissions. However, data regarding the effectiveness of COVID-19 vaccines in reducing mortality among critically ill patients with COVID-19 remains unclear. Aims: To determine the vaccination status and investigate the impact of the COVID-19 vaccine on the 28-day mortality in critically ill patients with COVID-19. Study Design: Multicenter prospective observational clinical study. Methods: This study was conducted in 60 hospitals with ICUs managing critically ill patients with COVID-19. Patients aged ≥ 18 years with confirmed COVID-19 who were admitted to the ICU were included. The present study had two phases. The first phase was designed as a one-day point prevalence study, and demographic and clinical findings were evaluated. In the second phase, the 28-day mortality was evaluated. Results: As of August 11, 2021, 921 patients were enrolled in the study. The mean age of the patients was 65.42 ± 16.74 years, and 48.6% (n = 448) were female. Among the critically ill patients with COVID-19, 52.6% (n = 484) were unvaccinated, 7.7% (n = 71) were incompletely vaccinated, and 39.8% (n = 366) were fully vaccinated. A subgroup analysis of 817 patients who were unvaccinated (n = 484) or who had received two doses of the CoronaVac vaccine (n = 333) was performed. The 28-day mortality rate was 56.8% (n = 275) and 57.4% (n = 191) in the unvaccinated and two-dose CoronaVac groups, respectively. The 28-day mortality was associated with age, hypertension, the number of comorbidities, type of respiratory support, and APACHE II and sequential organ failure assessment scores (p < 0.05). The odds ratio for the 28-day mortality among those who had received two doses of CoronaVac was 0.591 (95% confidence interval: 0.413-0.848) (p = 0.004). Conclusion: Vaccination with at least two doses of CoronaVac within six months significantly decreased mortality in vaccinated patients than in unvaccinated patients.

Biological subtypes and survival outcomes in breast cancer patients with brain metastases (study of the Anatolian Society of Medical Oncology).

BACKGROUND: The aim of this study is to determine the relationship between the survival outcomes and biological subtype in breast cancer patients with brain metastases. METHODS: We retrospectively evaluated clinical data from 422 breast cancer patients with brain metastases between 2001 and 2011 from referral centers in Turkey. The study population was divided into four biological subtypes according to their hormone receptor status and HER2 expression. RESULTS: Systemic treatment prolonged median overall survival (OS) after brain metastases in the entire group (14 vs. 3.2 months, p < 0.001). It also prolonged median OS after brain metastases in the triple negative (7.5 vs. 1.6 months, p = 0.010) and luminal A (14.3 vs. 7.1 months, p = 0.003) subgroups. The median OS for untreated patients, chemotherapy and/or hormonal therapy receiving patients, and chemotherapy and/or hormonal therapy plus targeted therapy receivers was 2, 5.8, and 17.7 months, respectively (p < 0.001), in the HER2-overexpressing subgroup. In the luminal B subgroup, it was 3.7, 5.3, and 15.4 months, respectively (p = 0.003). CONCLUSIONS: The use of systemic therapy improves OS after brain metastases in all biological subgroups. Targeted therapies also improve OS after brain metastases in HER2-positive patients. The combined use of targeted therapies and lapatinib are superior to single use and trastuzumab, respectively, in these patients.

The awareness levels of women for gynecologic cancer in Turkey: A cross-sectional study.

OBJECTIVE: To investigate the awareness levels of women for gynecologic cancers and the affecting factors. METHODS: This descriptive and cross-sectional study was conducted with 321 women. Data were collected using a Personal Information Form and the Gynecologic Cancer Awareness Scale (GCAS). RESULTS: The women's mean score (± standard deviation) on the GCAS was 151.08 ± 3.84. It was determined that the awareness of gynecologic cancer in the women who had undergone gynecologic examination and cervical smear test was higher than in other women. It was also determined that the level of education and income level, the status of having gynecologic examination and operation, and the wanting to get information about gynecologic cancer were not found to affect awareness of gynecologic cancers. The gynecologic cancer awareness of the women increased with the increase in age. It was found that there was no statistically significant relationship between the years of marriage, gravida, and the number of children, and the total GCAS score. CONCLUSION: Although the gynecologic cancer awareness levels of the participants were high, they were not at the intended level. Education including early diagnosis, risk factors, and symptoms should be provided to women to increase their awareness of gynecologic cancer.

Systemic Immune-inflammation Index (SII) Predicts Pathological Complete Response to Neoadjuvant Chemoradiotherapy in Locally Advanced Rectal Cancer.

OBJECTIVE: To determine the relationship between inflammatory markers and pathological complete response (pCR) in patients with locally advanced rectal cancer (LARC), who received neoadjuvant chemoradiotherapy (NACRT). STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Department of Medical Oncology, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey from January 2014 to June 2020. METHODOLOGY: Patients older than 18 years of age, who underwent NACRT with a diagnosis of LARC, and who had no disease or drug-use that could affect inflammatory parameters, were included in the study. Inflammatory indices (neutrophil-to-lymphocyte ratio-NLR, platelet-to-lymphocyte ratio-PLR, lymphocyte monocyte ratio-LMR, systemic immune-inflammation index-SII, prognostic nutritional index-PNI) and changes in these indices, were calculated from blood samples taken before NACRT and before surgery. The relationship between pCR and calculated inflammatory indices was evaluated by comparing patients with and without pCR. RESULTS: Out of the 932 patients, who received NACRT with a diagnosis of LARC, 188 were eligible for the study. Median values of baseline SII for pCR and non-pCR groups were 729.3 (595.4-894.8) and 869.9(567.2-1145.2, p=0.049). Baseline NLR and PLR levels were lower in the pCR group than the non-pCR group in univariate analysis with a tendency to statistical significance. In the logistic regression analysis, which included NLR, PLR, and SII, only SII <748 was found to be an independent predictive factor of pCR (OR: 0.471, 95% CI; 0.224-0.991, p=0.047). CONCLUSION: Baseline SII might be an independent predictive factor for pCR in patients receiving NACRT with a diagnosis of LARC. Key Words: Locally advanced rectal cancer, Neoadjuvant chemoradiotherapy, Pathological complete response, Inflammatory index, Systemic immune-inflammation index, SII, NLR, PLR, LMR, PNI.

The use of ultrasound guided combined peripheral nerve blocks in a high-risk patient: A case report.

Combined peripheral nerve blocks can be used as an alternative anesthetic technique for lower limb amputations in high-risk patients. The approach may vary according to the clinical condition of the patient. Presently described is the use of a combination of peripheral nerve blocks used for above-the-knee amputation in a high-risk patient: a sciatic nerve block with an anterior approach, a femoral nerve block, and a lateral femoral cutaneous nerve block.

The effect of adjuvant chemotherapy on the survival of patients with high-risk soft tissue sarcomas: Single center experience.

PURPOSE: To evaluate the effect of adding adjuvant ifosfamide/doxorubicin combination chemotherapy (CTX) to adjuvant radiotherapy (RT) on the survival in patients with surgically treated high-risk soft tissue sarcomas (STSs). METHODS: The study included 69 patients (group A) receiving adjuvant RT and 74 patients (group B) receiving adjuvant CTX after adjuvant RT. RESULTS: The median relapse-free survival (RFS) was 18.2 months (95% CI, 11.9-43.4) in group A and 27.2 months (95% CI, 17.6-36.8) in group B (p = 0.004). The median overall survival (OS) was 45.6 months (95% CI, 26.4-64.8) in group A and 110.1 mo (95% CI, 44.3-175.8) in group B (p = 0.007). Receiving adjuvant CTX was an independent predictive factor for both RFS [HR: 0.482, (0.307-0.757), p = 0.002) and OS (HR: 0.549, [0.348-0.867], p = 0.010). CONCLUSION: There are conflicting literature data regarding the survival benefit of adjuvant CTX for surgically treated STSs. However, appropriate patient selection may provide a significant survival benefit in RFS and OS with CTX in the adjuvant treatment of high-risk STSs.

Prediction of Peritoneal Recurrence in Patients with Gastric Cancer: a Multicenter Study.

PURPOSE: The peritoneum is the common recurrence site of gastric cancer (GC) presenting with worse survival. Although some predictive clinicopathological factors have been identified, there is no comprehensive assessment of peritoneal recurrence risk prediction for patients treated with adjuvant chemotherapy (CR) or chemoradiotherapy (CRT) after surgery. We aimed to predict peritoneal recurrence and develop a new scoring model in GC. METHODS: This retrospective study included 274 GC patients who presented with recurrence after curative gastrectomy followed by adjuvant chemotherapy (CT) or chemoradiotherapy (CRT). Risk factors for peritoneal recurrence were analyzed using the following parameters: age, gender, tumor location and characteristics, and differences between treatment modalities. All parameters were assessed by binary logistic regression analysis to compare the patients with and without peritoneal recurrence. Then, a new risk scoring model was developed. RESULTS: Peritoneal recurrence was observed in 115 (44.1%) patients. Peritoneal recurrence was higher in female gender (odds ratio (OR), 1.93; 1.07-3.49, P = 0.030, 1 point), T4a-b stage (OR, 2.47; 1.14-5.36, P = 0.022, 1 point), poor/undifferentiated (OR, 2.04; 1.31-4.06, P = 0.004, 1 point), and signet cell carcinoma (OR, 2.04; 1.04-4.02, P = 0.038, 1 point) after adjusted for resection and dissection types. The risk scoring model was developed using the related parameters: Peritoneal recurrence rates were 24.6%, 42.6%, and 71.4% for group 1 (0 point), group 2 (1-2 points), and group 3 (3-4 points), respectively. CONCLUSION: Female gender, T4 tumor stage, undifferentiated histopathology, and signet cell type had a tendency to peritoneal recurrence after adjusted for treatment modalities. Patients with 3 or 4 risk factors had an 8.8-fold increased risk for the development of peritoneal recurrence.

Characteristics and outcomes of 974 COVID-19 patients in intensive care units in Turkey.

BACKGROUND: In our previous report on Turkish COVID-19 patients requiring intensive care, the 24 patients in a single ICU were elderly and mortality was high. We extended our analysis to include patients admitted to ten ICUs. OBJECTIVES: Report the demographics, clinical features, imaging findings, comorbidities, and outcomes in COVID-19 patients. DESIGN: Retrospective. SETTING: Intensive care unit. PATIENTS AND METHODS: The study includes patients with clinical and radiological confirmed or laboratory-confirmed COVID-19 infection who were admitted to ten ICUs between 15 March and 30 June 2020. MAIN OUTCOME MEASURES: Clinical outcomes, therapies, and death during hospitalization SAMPLE SIZE: 974, including 571 males (58%). RESULTS: The median age (range) was 72 (21-101) years for patients who died (n=632, 64.9%) and 70 (16-99) years for patients who lived (n=432, 35.2%) (P<.001). APACHE scores, and SOFA scores were higher in patients who died than in those who survived (P<.001, both comparisons). Respiratory failure was the most common cause of hospitalization (82.5%), and respiratory failure on admission was associated with death (P=.013). Most (n=719, 73.8%) underwent invasive mechanical ventilation therapy. CONCLUSIONS: The majority of patients admitted to the ICU with a diagnosis of COVID-19 require respiratory support. LIMITATIONS: Although the Turkish Ministry of Health made recommendations for the treatment of COVID-19 patients, patient management may not have been identical in all ten units. CONFLICT OF INTEREST: None.

Developing compassion and emotional intelligence in nursing students: A quasi-experimental study.

PURPOSE: This study examined the effect of the Caring Behavior in Nursing course on the compassion and emotional intelligence levels of nursing students. DESIGN AND METHODS: This quasi-experimental study was carried out using pretest and posttest design. The research sample consisted of the intervention (n = 37) and the control (n = 36) group. Data were collected through "The Emotional Intelligence Evaluation Survey" and "The Compassion Scale." FINDINGS: It was determined that the compassion levels of the students in the intervention group were statistically significantly higher than the compassion levels of the control group of students. PRACTICE IMPLICATIONS: It was found that the Caring Behavior in Nursing course was effective in developing compassion.