Effect of Microsatellite Status and Pan-Immune-Inflammation Score on Pathological Response in Patients with Clinical Stage III Stomach Cancer Treated with Perioperative Chemotherapy.

Background and Objective: This study evaluated the relationship between microsatellite status (MSI) and pan-immune-inflammation score (PIV) in tumor response to neoadjuvant chemotherapy (NAC) in patients with clinical stage III gastric cancer (cStage III GC). Materials and Methods: Microsatellite instability (MSI) status was evaluated based on pathology preparations. Pan-immune-inflammation score (PIV) was obtained from pre-treatment blood tests. The relationship of both parameters with pathological complete response (pCR) was evaluated. Results: A total of 104 patients were included in this study. All the patients were stage III GC patients receiving perioperative treatment. There were 13 patients in total who achieved a pCR response. While CNS was detected in 11 of the patients who achieved a pCR, the MSI status of the other two patients was unknown. No pCR was observed in any patient with MSI-H. According to the cut-off value for PIV, 25 (24%) patients were in the PIV-low (≤53.9) group, while 79 (76%) were in the PIV-high (>53.9) group. Based on univariate analysis, a higher PIV was associated with worse outcomes for pathological response, disease recurrence, and survival (p < 0.05). Conclusions: In patients with clinically stage III GC, the presence of MSI-H may predict no benefit from perioperative treatment. Conversely, a pre-treatment PIV score using specific cut-off values may provide a positive prediction of pathological response and survival.

A New Method for the Prevention of Pre-Analytical Errors due to Hemolysis: Intensive Training.

BACKGROUND: Our aim was to compare the routine training (RT) method with the intensive training (IT) method, described for the first time by our group, for preventing pre-analytical errors in induced hemolysis. METHODS: At two months, either RT or IT methods were introduced, and data collected in the second two months were compared with the initial two months to assess changes in the number of samples rejected. Working groups were formed according to the methods of training, clinics, and services. Group I contained only the emergency clinic and services. Group II included other polyclinics and services. In this study, Group I followed the IT method and Group II followed the RT method. Training and supervision were conducted during regular office hours every weekday. In this study, the percentage of errors in the different groups of the pre-analytical samples that underwent hemolysis was evaluated using the error correction ratio. The effectiveness of training in the groups was compared. RESULTS: The incidence of hemolysis in the samples showed a significant decline when the IT method was followed. The hemolysis frequency using the RT method had decreased compared to previous training. Both results were statistically significant. A further result of the study was a reduction in the incidence of the hemolysis ratio when comparing Groups I and II; the IT method was more effective than the RT method. CONCLUSIONS: The IT method is effective in preventing hemolysis-induced pre-analytical errors.

[Rare Case of Strongyloides stercoralis with Vitamin B12 Deficiency]. / B12 Vitamin Eksikligi Olan Nadir Strongyloides stercoralis Vakasi.

Strongyloidiyasis is endemic in tropical and subtropical regions, and mostly soil transmitted nematode disease that is seen as sporadic cases in Turkey. As may be asymptomatic in healthy individuals, it may even cause death in immunosuppressive people. We report a case of Strongyloides stercoralis infection in a patient, 29 years old young male was admitted to our institution with diarrhea who has got vitamin B12 deficiency and eosinophilia. The case represents an extremely rare and in our knowledge, it is the first case in Sakarya.

Immune thrombocytopenic purpura associated with Brucella and Toxoplasma infections.

Bacterial and protozoal infections can cause thrombocytopenia and may mimic idiopathic thrombocytopenic purpura (ITP). Brucella species and Toxoplasma are among the infectious agents with protean clinical manifestations which may induce immune thrombocytopenia. In rare cases, thrombocytopenia can be severe and may result bleeding into the skin and from mucosal sites. Prompt recognition of this complication and aggressive therapy are essential, since the mortality associated with bleeding into the central nervous system is high. We report two patients with complaints of severe epistaxis and thrombocytopenia associated with brucellosis and toxoplasmosis. Thrombocytopenic purpura in these cases responded well to the high-dose corticosteroid treatment with platelet recovery within 2-3 days. For cases with infection-induced immune thrombocytopenic purpura, short-term high-dose corticosteroids may be applied as an urgent therapy without worsening of the clinical condition.