The relationship of proximal lateral collateral ligament hyperintensity with knee joint ligament and meniscus pathologies.

BACKGROUND: Hyperintensity in the proximal lateral collateral ligament (LCL) is often confusing. This appearance may be alone or accompany other pathologies. PURPOSE: To investigate the relationship between the signal intensity (SI) change in the proximal LCL and the knee joint pathologies. MATERIAL AND METHODS: The knee MRI scans taken between 2020 and 2022 were queried retrospectively. Patients with acute trauma, instability, knee surgery, or high-grade osteoarthritis were excluded. Included patients were divided into two groups as normal SI and increased SI according to proximal LCL. The difference in ligamentous and meniscal pathologies between the two groups was analyzed using a chi-square test. Inter-observer agreement analysis was performed on 50 randomly selected patients. RESULTS: A total of 351 patients (139 men [39.6%], 212 women [60.4%]; median age = 37 years; interquartile range = 67 years) were included. There were 114 (32.5%) LCLs with normal SI and 237 (67.5%) LCLs with increased SI. Normal SI and increased SI groups had a significant difference in terms of joint side, median age, patellar tendon SI, anterior cruciate ligament SI, and medial collateral ligament SI (P = 0.004, P = 0.004, P = 0.001, P = 0.011, P = 0.004, respectively). A significant difference between the results of two separate LCL examinations in coronal + axial and coronal-only planes (P <0.001). Inter-observer agreement was found to be good to excellent. CONCLUSION: Hyperintensity in the proximal LCL was more common on the right joint side, in older patients, and patients with hyperintensity in the proximal patellar tendon, anterior cruciate ligament, and medial collateral ligament. Evaluating the LCL only in the coronal plane overestimates the hyperintensity.

Regorafenib therapy as a third-line treatment for metastatic colorectal cancer: A single center long term experience.

This study examined the effects of regorafenib (Reg) on progression-free survival (PFS), overall survival (OS), and adverse events (AEs) in metastatic colorectal cancer (mCRC) patients who underwent targeted treatment and chemotherapy. Reg was administered as a third-line treatment to 84 patients who had undergone 2 rounds of chemotherapy and targeted therapy and subsequently experienced progression. Treatment was initiated with a daily dose of 80 or 120 mg, based on the patient's ability to tolerate the medication, which was increased to 160 mg/day. The median PFS with Reg was 4 ±â€…0.2 months, while the median OS was 9 ±â€…1.2 months. When compared to patients who started Reg treatment at 80 mg, patients starting at 160 mg had longer median PFS and OS (PFS:6 ±â€…2.1 months vs 4 ±â€…0.2 months; P = .05; OS:13 ±â€…0.7 months vs 6 ±â€…1.3 months; P = .069). Patients with right-sided colon cancer who received Reg as third-line therapy had a significantly longer mPFS than those with left-sided colon cancer (8 months ±â€…4 vs 4 months ±â€…0.3, P = .039). Patients with KRAS mutations had a prolonged mPFS than those with panRAS-wild type (6 ±â€…1.6 months vs 4 ±â€…0.3 months, P = .06). The mPFS contribution in the BRAF mutant subgroup with poor prognosis is promising, as it is similar to that of patients without BRAF mutations (4 months ±â€…0.8 × 4 months ±â€…0.5, P = .74). The most common AEs reported were elevated liver enzyme levels and dermatological toxicities.

HALP score and GNRI: Simple and easily accessible indexes for predicting prognosis in advanced stage NSCLC patients. The Izmir oncology group (IZOG) study.

Objective: The Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) Score and the Geriatric Nutrition Risk Index (GNRI) are used as prognostic factors in different types of cancers. In this study we analyzed the prognostic value of the HALP Score and the GNRI calculated prior to first-line treatment in patients diagnosed with de novo metastatic non-small cell lung cancer (mNSCLC). Materials and methods: De novo mNSCLC patients were retrospectively evaluated from January 2016 to December 2019. Patients with Driver's mutation, severe comorbidities, active infection, or insufficient organ function, and those receiving anti-inflammatory treatment were excluded from the study. Optimal cut-off points for the HALP score and the GNRI were calculated with the receiver operating characteristic (ROC) curve analysis. Predictive factors for overall survival (OS) were assessed with univariate and multivariate Cox proportional hazard analyses, and OS was studied with the Kaplan-Meier analysis. Results: The study included 401 patients in total. In the ROC curve analysis, the cut-off points were found 23.24 (AUC = 0.928; 95% CI: 0.901-0.955, p < 0.001) for HALP, and 53.60 (AUC = 0.932; 95% CI: 0.908-0.955, p < 0.001) for GNRI. Groups with lower HALP scores and lower GNRI had significantly shorter OS compared to those with higher HALP scores and GNRIs. Univariate analysis showed that male gender, smoking, high ECOG score, low HALP score and low GNRI were associated with worse survival rates. Multivariate analysis showed that low HALP score (HR = 2.988, 95% CI: 2.065-4.324, p < 0.001); low GNRI score (HR = 2.901, 95% CI: 2.045-4.114, p < 0.001) and smoking history (HR = 1.447, 95% CI: 1.046-2.001, p = 0.025) were independent factors associated with worse OS rates. Conclusion: Our study showed the HALP score and the GNRI to be of prognostic value as simple, cost-effective, and useful markers that predict OS in de novo mNSCLC patients.

The relationship between sarcopenia detected in newly diagnosed colorectal cancer patients and FGF21, irisin and CRP levels.

AIM: Sarcopenia is a progressive and generalized syndrome that can be linked to many causes such as cancers, and is caused by a quantitative and qualitative disorder (loss of muscle strength and/or physical performance) of skeletal muscle mass. Although sarcopenia has some hypothetical explanation in clinical practice, the mechanisms underlying this condition have not been clearly differentiated in patients with cancer. We aimed to investigate the relationship between irisin, FGF21 and CRP in detecting sarcopenia in colorectal cancer patients. MATERIAL AND METHODS: Current prospectively study included non-metastatic newly diagnosed colorectal cancer patients. Patients were divided into 2 groups of 25 people, those with and without sarcopenia. Body composition measurements by examined by BIA. To measure the level of iris and FGF21 from patients, blood samples were taken into the biochemistry tube and their levels were measured. RESULTS: The median age of the patients included in the study was 60 years (range: 21-81), 68% were men. It was found that there was a significant relationship between sarcopenia and gender and BMI measurement. When Spearman correlation analysis was performed between skeletal muscle mass index and FGF21, irisin and CRP, there was a positive correlation between skeletal muscle mass index and irisin and FGF21, while there was a negative correlation between skeletal muscle mass index and CRP. [respectively: (r: 0.282, p: 0.048), (r: 0.564, p: < 0.001) and (r: - 0.360, p: 0.010)]. Similar results were found between hand-grip strength and FGF21, irisin and CRP. [respectively: (r: 0.342, p: 0.015), (r: 0.290, p: 0.041) and (r: - 0.476, p < 0.001)]. When sarcopenia was treated as the dependent variable in the logistic regression analysis, and FGF21, irisin, CRP, gender and BMI were treated as the independent variables, irisin and CRP levels were determined as independent predictors. CONCLUSION: This study was revealed that there is a negative relationship between sarcopenia and irisin and FGF-21 in operated non-metastatic colorectal cancer patients and there may be a relationship between sarcopenia and inflammation. It suggests that these biomarkers may play a role in the pathophysiology of sarcopenia. However, our results need to be validated in different types of cancer and with more patients.

Immature Teratoma with Growing Teratoma Syndrome and Gliomatosis Peritonei Coexistence.

Ovarian germ cell tumours constitute 5% of all ovarian cancers. During the natural course and treatment of these tumours , there may be more unusual cases. One of them is gliomatosis peritonei, which is characterised by the spread of glial cells on the peritoneal surfaces, while the other one is growing teratoma syndrome characterised by the rapid growth of benign component and loss or shrinkage of the malignant component in response to systemic chemotherapy during the treatment of germ cell tumours. Herein, we present a case of coexistence of gliomatosis peritonei and growing teratoma syndrome during the treatment of a 29-year female with immature ovarian teratoma. Key Words: Germ cell tumours , Growing teratoma syndrome, Gliomatosis peritonei, Ovaries.

SARS-CoV-2 Mutations and their Viral Variants.

Mutations in the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) occur spontaneously during replication. Thousands of mutations have accumulated and continue to since the emergence of the virus. As novel mutations continue appearing at the scene, naturally, new variants are increasingly observed. Since the first occurrence of the SARS-CoV-2 infection, a wide variety of drug compounds affecting the binding sites of the virus have begun to be studied. As the drug and vaccine trials are continuing, it is of utmost importance to take into consideration the SARS-CoV-2 mutations and their respective frequencies since these data could lead the way to multi-drug combinations. The lack of effective therapeutic and preventive strategies against human coronaviruses (hCoVs) necessitates research that is of interest to the clinical applications. The reason why the mutations in glycoprotein S lead to vaccine escape is related to the location of the mutation and the affinity of the protein. At the same time, it can be said that variations should occur in areas such as the receptor-binding domain (RBD), and vaccines and antiviral drugs should be formulated by targeting more than one viral protein. In this review, a literature survey in the scope of the increasing SARS-CoV-2 mutations and the viral variations is conducted. In the light of current knowledge, the various disguises of the mutant SARS-CoV-2 forms and their apparent differences from the original strain are examined as they could possibly aid in finding the most appropriate therapeutic approaches.

Being a Cancer Patient during the Time of COVID-19: Impact of the Pandemic on the Anxiety and the Sleeping Quality of Oncology Patients.

OBJECTIVE: In this study, we aimed to assess anxiety and sleep quality in cancer patients treated or followed up at our clinic at the time of the outbreak of the COVID-19 pandemic. METHODS: Seven hundred and sixty-one patients who were either treated or followed up at our oncology clinic between April 2020 and May 2020 were included. Patients were assessed with the State-Trait Anxiety Inventory (STAI) and the Pittsburgh Sleep Quality Index (PSQI). RESULTS: Mean scores of the 761 participants were STAI, 43.45 ± 9.34 (range, 23-75), and PSQI, 5.67 ± 4.24 (range, 0-19). Quality of sleep was found bad in 447 (58.7%) (global score ≥5). Univariate analyses demonstrated statistical differences by stage of cancer, status of treatment, subgroup of treatment, monthly income, and levels of education in anxiety and sleep quality levels. Multivariate analyses showed active treatment (OR: 21.4; 95% CI: 9.08-50.4; p < 0.001) as the major independent variable that affected sleep quality; the major independent variable associated with anxiety was low income (OR: 4.43; 95% CI: 1.69-11.5; p = 0.002). CONCLUSION: Anxiety and sleep quality levels were found comparable to pre-pandemic reports, and the pandemic was not observed to have additional negative impact on cancer patients. Also, universal basal anxiety and sleep disorder that accompany cancer or active treatment were observed in our study. The accurate effects of the pandemic can be analyzed in further studies using repeated data obtained from the same patient group.

Host variations in SARS-CoV-2 infection.

The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the zoonotic pathogen that causes the "Coronavirus Disease of 2019 (COVID-19)", and COVID-19 itself is yet to be thoroughly understood. Both the disease as well as the mechanisms by which the host interacts with the SARS-CoV-2 have not been fully enlightened. The epidemiological factors -e.g. age, sex, race-, the polymorphisms of the host proteins, the blood types and individual differences have all been in discussions about affecting the progression and the course of COVID-19 both individually and collectively, as their effects are mostly interwoven. We focused mainly on the effect of polymorphic variants of the host proteins that have been shown to take part in and/or affect the pathogenesis of COVID-19. Additionally, how the procedures of diagnosing and treating COVID-19 are affected by these variants and what possible changes can be implemented are the other questions, which are sought to be answered.

Virus-associated ribozymes and nano carriers against COVID-19.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a zoo tonic, highly pathogenic virus. The new type of coronavirus with contagious nature spread from Wuhan (China) to the whole world in a very short time and caused the new coronavirus disease (COVID-19). COVID-19 has turned into a global public health crisis due to spreading by close person-to-person contact with high transmission capacity. Thus, research about the treatment of the damages caused by the virus or prevention from infection increases everyday. Besides, there is still no approved and definitive, standardized treatment for COVID-19. However, this disaster experienced by human beings has made us realize the significance of having a system ready for use to prevent humanity from viral attacks without wasting time. As is known, nanocarriers can be targeted to the desired cells in vitro and in vivo. The nano-carrier system targeting a specific protein, containing the enzyme inhibiting the action of the virus can be developed. The system can be used by simple modifications when we encounter another virus epidemic in the future. In this review, we present a potential treatment method consisting of a nanoparticle-ribozyme conjugate, targeting ACE-2 receptors by reviewing the virus-associated ribozymes, their structures, types and working mechanisms.

Association of illness perception with chemotherapy-induced nausea and vomiting: a Turkish Oncology Group (TOG) study.

Chemotherapy-induced nausea and vomiting (CINV) may be linked to the psychological status of cancer patients. Therefore, the authors aimed to better understand the underlying risk factors for CINV using the Brief Illness Perception Questionnaire. A total of 238 patients were recruited during three cycles of chemotherapy. Patient, disease and treatment characteristics were noted at the onset of chemotherapy. The Brief Illness Perception Questionnaire was administered face-to-face prior to chemotherapy. The relationship between illness perceptions and CINV was analyzed using Spearman's rank correlation. Positive illness perception parameters, including personal and treatment control, were negatively correlated, whereas negative illness perception parameters, including consequences, timeline, identity, concern and emotions, were positively correlated with CINV after adjusting for age, sex and emetogenic potential of chemotherapy (p < 0.001). Illness perception may be an underlying risk factor for CINV.