Evaluation of PD-L1 Expression in Colorectal Carcinomas by Comparing Scoring Methods and Their Significance in Relation to Clinicopathologic Parameters.

BACKGROUND: This study aims to evaluate PD-L1 expression in colorectal carcinomas (CRCs) by using the tumor proportion score (TPS) and the combined positive score (CPS), and to investigate whether there is a correlation with clinicopathologic features. METHODS: A cross-sectional study was conducted that included samples from patients with colorectal adenocarcinoma treated with colon resection and rectal resection after neoadjuvant radio- and chemotherapy at the Department of Abdominal Surgery at Pozega Hospital in the period from 2017 to 2022. The study included 102 tumor tissue samples from patients after resection and the pathohistological diagnosis of adenocarcinoma. RESULTS: In our study, the PD-L1 positivity rate after the TPS was 42 (41%) samples, and after the CPS, 97 (95%) of them (p < 0.001). The positive expression of PD-L1 in tumor cells using the TPS method showed a statistically significant association with adenocarcinoma (TPS ≥ 10-50% and ≥50%). There were significantly more that were moderately differentiated, with TPS ≥ 50%, and those poorly differentiated had values ≥ 10-50%. There were significantly more patients with a status of more than one positive lymph node with TPS values ≥ 10-50%. Patients without metastases in the lymph nodes are significantly more likely to have CPS values > 50%, compared with other lymph node statuses. CONCLUSIONS: These results suggest that the total number of PD-L1-expressing cells, including tumor and immune cells, is a more sensitive biomarker than the number of PD-L1-expressing tumor cells alone in CRC.

Croatian Translation and Validation of the Patient Satisfaction with Nursing Care Quality Questionnaire (PSNCQQ).

Patient satisfaction is a crucial measure of the quality of healthcare, especially with regard to nursing services in hospital settings. Understanding and increasing patient satisfaction with nursing care is critical to improving overall healthcare and ensuring positive patient experiences during their hospital stay. The aim of this research was to evaluate the psychometric properties of the Croatian version of the Satisfaction with Nursing Care Quality Questionnaire (PSNCQQ), test the reliability and validity of the tool after translation, and investigate differences in patient satisfaction based on demographic variables, as well as their contribution to satisfaction with the quality of nursing care. After translation and adaptation, the Croatian version of the PSNCQQ was applied to 350 hospitalized patients (average age 51.19 years (range: 18-87)), of whom 194 (55.4%) were men and 156 (44.6%) were women. The results showed high internal consistency (Cronbach's α = 0.977) and confirmed the one-factor structure of the questionnaire, explaining 70.64% of the total variance. Confirmatory factor analysis supported the unidimensional model, showing strong fit indices (χ2 = 583.047, df = 149, p < 0.001, GFI = 0.861, AGFI = 0.818, NFI = 0.936, TLI = 0.946, CFI = 0.955, RMSEA = 0.080, PCLOSE < 0.001). In conclusion, the validation of the PSNCQQ in the Croatian language increases resources for evaluating and improving the quality of nursing care. This research lays the foundation for future studies and practical applications aimed at improving patient satisfaction and nursing care outcomes in Croatia, but there are also limitations to this study, including its one-institution scope, the possible influence of factors outside the current treatment on satisfaction, and the lack of comparison with objective clinical indicators.

Influence of Personality Traits and Organizational Justice on Job Satisfaction among Nurses.

The purpose of this research was to examine whether demographic variables, personality traits, and workplace variables (working in shifts, job tenure, and perceived organizational justice) contribute the most to the prediction of job satisfaction in nurses. The survey included 161 nurses. The instruments used in this research were as follows: the Demographic Data Questionnaire, the Perceived Organizational Justice Scale, the Job Satisfaction Scale, and the NEO five-factor inventory. The study findings indicated that age, health status, distributive justice, and procedural justice positively contribute to job satisfaction among nurses, while neuroticism contributes negatively. Older nurses, those in better health, those who are satisfied with the organization's decision-making process, and those who feel adequately rewarded for their contributions tend to be more satisfied with their jobs. Conversely, nurses with a higher level of the neuroticism personality trait tend to be less satisfied with their job. The strongest predictors of job satisfaction among nurses were found to be health status, the personality trait of neuroticism, and distributive and procedural justice, with the age of nurses being slightly less powerful but still significant.

A low grade osteosarcoma of the colon.

BACKGROUND: Soft-tissue osteosarcomas are very rare. Only three cases of extraskeletal osteosarcoma have been reported arising in colon and we report the first well differentiated one. PATIENTS AND METHODS: A 58-year-old woman was admitted to our hospital with a history of pain and swelling in lower right abdomen for the last 3 months. Routine laboratory tests and tumor markers (CEA, CA19-9, AFP) were all normal, as well as colonoscopy. CT-scan revealed large partly calcificated mass connected to the ascending colon without significant imbibition of contrast. Because of the size of the tumor, open surgery was indicated. An exploratory laparotomy followed by right hemicolectomy with anastomosis was performed according to oncological principles. RESULTS: Surgery and pathology confirmed the presence of 13 cm large soft tissue tumor connected to the colon by vascular pedicle. Histopathology showed spindle cells with minimal cellular atypia and focal osteoid production which lead to diagnosis of low grade osteosarcoma. Immunohistochemicaly, neoplastic cells were positive for alpha smooth muscle actin, caldesmon and desmin, but are negative for S100, CD34, CD117, DOG1, BCL-2, epithelial membrane antigen, and beta-catenin. CONCLUSION: Postoperative course went uneventful and adjuvant chemotherapy was not recommended. At 6-months follow-up there was no sign of recurrent tumor.

Angiomyolipomatous hamartoma of the inguinal lymph node--report of two cases and literature review.

Angiomyolipomatous hamartoma is a variant of angiomyomatous hamartoma (AMH), a rare nodal smooth muscle proliferation, first identified as a distinct entity by Chan et al. in 1992. To date, several cases have been described, mostly involving inguinal lymph nodes. We present two cases of angiomyolipomatous hamartoma, in a 52-year-old male and 67-year-old female patient. Both patients were surgically treated. Microscopically, in the affected nodes, the parenchyma was mostly replaced with bundles of smooth muscle cells, fibrous tissue and lobules of mature adipocytes. Only a few atrophic lymphatic follicles were maintained in the subcapsular area. The presence of smooth muscle cells and endothelial cells was confirmed immunohistochemically by staining for smooth muscle actin, desmin and CD31. The hilus contained numerous thick-walled vessels extending to the medulla. Pleomorphism, mitoses and necrosis were absent. Considering there are no reported recurrences of AMH, it probably has benign behaviour; thus extensive resection may not be needed. Nevertheless, we believe that recognition of AMH is important in the differential diagnosis of other pathological conditions that may affect lymph nodes.