Factors associated with thirty-day mortality and intensive care unit admission in patients undergoing hip fracture surgery.

BACKGROUND: Various factors contribute to the development of mortality and morbidity in hip fracture surgeries. This study aims to investigate the effects of modifiable factors such as the type of anesthesia, anesthesia management, surgical method, and timing of surgery on 30-day mortality rates, intensive care unit admissions, and complications. METHODS: A total of 400 patients who underwent hip fracture surgery between January 2021 and December 2023 at a Training and Research Hospital were retrospectively analyzed. Patients were divided into two groups: those followed in the ward, named Group 1 (n=304), and those in the intensive care unit, named Group 2 (n=96). Recorded data included demographic characteristics, American Society of Anesthesiologists (ASA) physical status scores, types of comorbidities, anesthesia type, surgical method, surgical delay time, duration of surgery, blood transfusion requirements, and complications. RESULTS: Patients in Group 2 had higher mean age, comorbidity, and mortality rates compared to Group 1 (p<0.001). In terms of types of comorbidities, the rate of intensive care unit admission was higher in patients with coronary artery disease and chronic renal failure (p<0.001). Mean surgical delay and length of hospital stay were also higher in Group 2 (p<0.001). In multivariate logistic regression analysis, age (p<0.001, Odds Ratio [OR]=1.91, Confidence Interval [CI]=1.046-1.137), ASA score (p<0.001, OR=3.872, CI=1.913-7.838), duration of surgical delay (p<0.001, OR=2.029, CI=1.365-3.017), surgical method (p=0.003, OR=2.003, C=1.258-3.188), and length of hospital stay (p=0.006, OR=1.147, CI=1.04-1.266) were determined as predictive factors for 30-day mortality. CONCLUSION: This study found that age, ASA classification, length of hospital stay, surgical method, and surgical delay were predictive factors for both morbidity and mortality. Among these, surgical delay time appears to be a modifiable parameter when all factors are considered.

Quality matters: Response of bacteria and ciliates to different allochthonous dissolved organic matter sources as a pulsed disturbance in shallow lakes.

Shallow lake ecosystems are particularly prone to disturbances such as pulsed dissolved organic matter (allochthonous-DOM; hereafter allo-DOM) loadings from catchments. However, the effects of allo-DOM with contrasting quality (in addition to quantity) on the planktonic communities of microbial loop are poorly understood. To determine the impact of different qualities of pulsed allo-DOM disturbance on the coupling between bacteria and ciliates, we conducted a mesocosm experiment with two different allo-DOM sources added to mesocosms in a single-pulse disturbance event: Alder tree leaf extract, a more labile (L) source and HuminFeed® (HF), a more recalcitrant source. Allo-DOM sources were used as separate treatments and in combination (HFL) relative to the control without allo-DOM additions (C). Our results indicate that the quality of allo-DOM was a major regulator of planktonic microbial community biomass and/or composition through which both bottom-up and top-down forces were involved. Bacteria biomass showed significant nonlinear responses in L and HFL with initial increases followed by decreases to pre-pulse conditions. Ciliate biomass was significantly higher in L compared to all other treatments. In terms of composition, bacterivore ciliate abundance was significantly higher in both L and HFL treatments, mainly driven by the bacterial biomass increase in the same treatments. GAMM models showed negative interaction between metazoan zooplankton biomass and ciliates, but only in the L treatment, indicating top-down control on ciliates. Ecosystem stability analyses revealed overperformance, high resilience and full recovery of bacteria in the HFL and L treatments, while ciliates showed significant shift in compositional stability in HFL and L with incomplete taxonomic recovery. Our study highlights the importance of allo-DOM quality shaping the response within the microbial loop not only through triggering different scenarios in biomass, but also the community composition, stability, and species interactions (top-down and bottom-up) in bacteria and plankton.

KELIM score predicts outcome in patients with platinum-resistant/refractory recurrent ovarian cancer.

Aim: To assess the prognostic role of the CA-125 elimination rate constant K (KELIM) score in platinum-resistant/refractory ovarian cancer patients receiving second-line treatment. Methods: A retrospective study was carried out including 117 patients with advanced-stage platinum-resistant/refractory ovarian cancer treated with liposomal doxorubicin ± bevacizumab. The KELIM score, calculated using CA-125 measurements within the first 100 days of chemotherapy, was used. Survival analyses were performed for overall survival (OS) and progression-free survival (PFS). Results: Higher KELIM scores were associated with a superior PFS and OS. Multivariate analysis confirmed the independent prognostic value of the KELIM score for OS. Validation cohorts showed consistent results. Conclusion: KELIM score may serve as a valuable prognostic marker for predicting OS and PFS in platinum-resistant/refractory ovarian cancer patients receiving second-line treatment. Prospective studies are needed for validation.

This study aimed to investigate the usefulness of a scoring system called CA-125 elimination rate constant K (KELIM) in predicting the outcomes of ovarian cancer patients who are resistant to or have not responded to platinum-based treatments and are receiving a second-line treatment. The researchers conducted a retrospective (backwards looking) study involving 117 patients with advanced-stage ovarian cancer. They analyzed the patients' CA-125 levels within the first 100 days of chemotherapy to calculate the KELIM score. The results showed that higher KELIM scores were associated with better progression-free survival (the length of time during and after the treatment of a disease, that a patient lives with the disease but it does not get worse) and overall survival (the length of time from either the date of diagnosis or the start of treatment for a disease that patients diagnosed with the disease are still alive). Further analysis confirmed that the KELIM score was an independent predictor of overall survival. The findings were consistent when validated with additional patient groups. In conclusion, the KELIM score has the potential to be a useful tool for predicting the outcomes of ovarian cancer patients undergoing second-line treatment. However, further prospective studies are necessary to validate these findings.

Design and evaluation of erucic acid-phytosphingosine structured cationic nanoemulsions as a plasmid DNA delivery system against breast cancer cells.

This study is focused on the preparation and characterization of erucic acid (EA) and phytosphingosine (PS) containing cationic nanoemulsions (NEs) for plasmid DNA (pDNA) delivery. Repurposing of cationic agents guided us to PS, previously used for enhanced interaction with negatively charged surfaces. It was reported that EA might act anti-tumoral on C6 glioma, melanoma, neuroblastoma, and glioblastoma. However, there is only one study about mixed oleic acid-EA liposomes. This gap attracted our interest in the possible synergistic effects of PS and EA on MDA-MB-231 and MCF-7 breast cancer cells. Three cationic NEs (NE 1, NE 2, and NE 3) were prepared and characterized in terms of droplet size (DS), polydispersity index (PDI), and zeta potential (ZP) before and after complexation with pDNA, long-term stability, SDS release, cytotoxicity, and transfection studies. The cationic NEs had DSs of <200 nm, PDIs <0.3, and ZPs > +30 mV. Long-term stability studies revealed that NE 2 and NE 3 were stable. NE 1-pDNA had appropriate particle properties. NE 2 reduced the viability of MDA-MB-231 cells to 11% and of MCF-7 cells to 13% and resulted in the highest number of transfected cells. To sum up, NE 2 containing PS and EA is appropriate for delivering pDNA.