C-reactive protein-to-serum albumin ratio as a marker of prognosis in adult intensive care population.

BACKGROUND: Patients in intensive care unit (ICU) require close follow up and clinical attention due to variability in the course of their underlying morbidities. The estimation of prognosis in these subjects has an utmost importance. Recent studies showed that C-reactive protein-to-serum albumin ratio (CAR) could be a reliable marker of inflammation in certain conditions. We aimed to compare CAR levels of deceased patients to those in survived subjects treated in ICU. PATIENTS AND METHODS: We retrospectively analyzed the data of adult patients. CAR was simply calculated by dividing the levels of CRP by those of serum albumin. Patients were grouped either as deceased or survived according to the prognosis. The data of the survived and deceased ICU subjects were compared. RESULTS: A total of 208 subjects, 101 deceased and 107 survived, were enrolled in the study. Median CAR levels of the deceased and survived subjects were 49.5 (3-153 %) and 11 (0.2-119 %), respectively (p < 0.001). CAR was significantly correlated with PDW (r = 0.24; p < 0.001) and serum creatinine (r = 0.27; p < 0.001) levels. In ROC analysis, CAR values higher than 30.2 % have 72 % sensitivity and 70 % specificity in predicting mortality in ICU population (AUC: 0.74; p < 0.001; 95% CI: 0.67-0.81). CONCLUSIONS: We suggest that CAR levels of the subjects in ICU should be evaluated during medical care. Increased CAR levels should alert physicians for a worse outcome in those subjects (Tab. 1, Fig. 1, Ref. 21). Text in PDF www.elis.sk Keywords: C-reactive protein-to-serum albumin ratio, intensive care, mortality.

Effect of physical exercise on inactivated COVID-19 vaccine antibody response in the elderly.

BACKGROUND: Physical exercise has been proposed as a new alternative to chemical adjuvants. OBJECTIVE: To investigate the relationship between regular exercise and post-vaccination antibody response in the elderly. METHODS: The study was conducted with the elderly over the age of 65. 30 participants we randomized into 2 groups and divided into exercise and control groups. The experimental group received a 12-week exercise program. The control group was followed up without any exercise. The day on which the second dose of the vaccine was administered to all participants was considered day 0. The antibody level in the serum samples was taken 15 days and 12 weeks after the vaccination. The antibody concentration was measured after the second dose of vaccination. RESULTS: The mean antibody level in the control group was 69.4 U/ml and 56.4 U/ml 15 days and 12 weeks after the second vaccination. The mean antibody level in the exercise group was 74 U/ml and 71.6 U/ml 15 days and 12 weeks after the second vaccination. CONCLUSIONS: Regular exercise of light to moderate intensity may increase post-vaccination antibody response in the elderly. Therefore, exercise can be used as a behavioral adjuvant to improve the vaccine efficacy in the elderly.

Tumor budding in invasive breast carcinoma: correlation with clinicopathological parameters, hormone receptor status, and survival: an observational study.

OBJECTIVE: Tumor budding is currently thought to be associated with worse prognosis. This study aims to examine tumor budding in invasive ductal-type breast carcinoma and its relationship with other clinicopathological parameters and overall survival. METHODS: All the H&E slides of 198 patients were re-evaluated for the histological grade, angiolymphatic invasion, perineural invasion, lymph node status, extranodal extension, multicentricity, pT, presence of the tumor budding, tumor budding score (i.e., low, intermediate, or high). Overall survival was considered the period after surgery until death. SPSS was used for statistical analysis. RESULTS: Tumor budding was identified in 98 (49.5%) patients. Tumor budding score was low in 41 (41.8%) of 98 cases, intermediate in 25 (25.5%), and high in 32 (32.7%). We determined a strong correlation between tumor budding and poor prognostic variables such as tumor size, pT stage, angiolymphatic invasion, perineural invasion, number of metastatic axillary lymph nodes, overall survival, and extranodal tumor extension in metastatic lymph nodes. This strong correlation was also present for the tumor budding score. CONCLUSION: Tumor budding may be a prognostic indicator for breast cancer.

The impact of CYP2C9 and VKORC1 genetic polymorphism and patient characteristics upon warfarin dose requirements in an adult Turkish population.

In this study, we investigated the contribution of vitamin K epoxide reductase (VKORC1) and cytochrome P450 2C9 (CYP2C9) genotypes, age, and body surface area (BSA) on warfarin dose requirements and in an adult Turkish population. Blood samples were collected from 100 Turkish patients with stable warfarin dose requirements and an international normalized ratio (INR) of the prothrombin time within the therapeutic range. Genetic analyses for CYP2C9 genotypes (*2 and *3 alleles) and VKORC1 -1639 G>A polymorphism were performed and venous INR determined. The mean warfarin daily dose requirement was higher in CYP2C9 homozygous wild-type patients, compared to those with the variant *3 allele (P < 0.05), similar to those with the variant *2 allele (P > 0.05) and highest in patients with the VKORC1 -1639 GG genotype compared to those with the GA genotype and the AA genotype (P < 0.01). The time to therapeutic INR was longer in CYP2C9 homozygous wild-type patients compared with those with the variant *2 and *3 alleles (P < 0.01), and longer in patients with the VKORC1 (position -1639) GG genotype compared with those with the GA genotype and the AA genotype (P < 0.01). The multivariate regression model including the variables of age (R (2) = 4.4%), BSA (R (2) = 27.4%), CYP2C9 (R (2) = 8.1%), and VKORC1 genotype (R (2) = 34.1%) produced the best model for estimating warfarin dose (R (2) = 60.4%). VKORC1 genotype and CYP2C9 polymorphism affect daily dose requirements and time to therapeutic INR in Turkish patients receiving warfarin for anticoagulation.

The relationship between tumor budding and survival in colorectal carcinomas.

OBJECTIVE: Tumor budding is a parameter that is increasingly understood in colorectal carcinomas. We aimed to investigate the relationship between tumor budding, prognostic factors, and survival. METHODS: A total of 185 patients who had undergone colorectal surgery were observed. Tumor budding, the tumor budding score, and the relationship between these and prognostic factors, and survival investigated. RESULTS: Tumor budding was found in 91 (49.2%) cases. The relationship between the tumor budding score and histological grade, lymphovascular invasion, perineural invasion, pathological lymph node stage, and mortality rates were significant. CONCLUSION: In our study, the relationship between tumor budding and survival is very strong. Considering these findings and the literature, the prognostic significance of tumor budding becomes clear and should be stated in pathology reports.

Effects of alpha-tocopherol on acute pancreatitis in rat.

BACKGROUND: Acute pancreatitis is a disease with high morbidity and mortality, despite all the advances in technology. The overall mortality rate of acute pancreatitis is 10%, whereas the mortality rate in infected necrotizing pancreatitis is approximately 35%. In this study, we aimed to establish acute pancreatitis in rats in order to try out the alpha-tocopherol treatment protocol and to reveal the results biochemically and histopathologically. METHODS: Twenty-four male male Sprague-Dawley rats weighing between 300 and 350 g were used in the study. In Group 1, 80 µg/kg of normal saline was subcutaneously injected into eight rats; in Group 2, 80 µg/kg of cerulein was subcutaneously injected into eight rats; and in Group 3, 80 µg/kg of cerulein was subcutaneously injected into eight rats. In addition, 30 mg/kg of alpha-tocopherol was intraperitoneally injected into eight rats. RESULTS: The mean Schoenberg score, serum amylase, and lipase and Neutrophil Gelatinase-Associated Lipocalin (NGAL) levels were statistically significantly higher in Group 2 than in Group 1. The mean Schoenberg score and serum amylase and lipase levels were statistically significantly lower in Group 3 than in Group 2. CONCLUSION: In this experimental study rat model of cerulein-induced acute pancreatitis, 30 mg/kg of alpha-tocopherol was injected intraperitoneally to examine its effect on pancreatitis. The improvement was observed in the histopathological examination of pancreatic tissues. We think that alpha-tocopherol may have a therapeutic effect on pancreatic tissue.

Tumor budding in invasive breast carcinoma: correlation with clinicopathological parameters, hormone receptor status, and survival: an observational study

SUMMARY OBJECTIVE: Tumor budding is currently thought to be associated with worse prognosis. This study aims to examine tumor budding in invasive ductal-type breast carcinoma and its relationship with other clinicopathological parameters and overall survival. METHODS: All the H&E slides of 198 patients were re-evaluated for the histological grade, angiolymphatic invasion, perineural invasion, lymph node status, extranodal extension, multicentricity, pT, presence of the tumor budding, tumor budding score (i.e., low, intermediate, or high). Overall survival was considered the period after surgery until death. SPSS was used for statistical analysis. RESULTS: Tumor budding was identified in 98 (49.5%) patients. Tumor budding score was low in 41 (41.8%) of 98 cases, intermediate in 25 (25.5%), and high in 32 (32.7%). We determined a strong correlation between tumor budding and poor prognostic variables such as tumor size, pT stage, angiolymphatic invasion, perineural invasion, number of metastatic axillary lymph nodes, overall survival, and extranodal tumor extension in metastatic lymph nodes. This strong correlation was also present for the tumor budding score. CONCLUSION: Tumor budding may be a prognostic indicator for breast cancer.

Protective effect of lycopene on adriamycin-induced cardiotoxicity and nephrotoxicity.

The aim of this study was to investigate the possible protective role of lycopene on adriamycin (ADR)-induced heart and kidney toxicity using biochemical and histopathological approaches. Rats were randomly divided into four groups. The first group received no medication and was regarded as the control group; the second group was injected with a single dose of ADR; the third group was treated with lycopene for 10 days before ADR injection and the last group was treated with lycopene for 2 days before and for 3 days after the administration of a single dose of ADR. ADR (10mg/kg) was intraperitoneally (i.p.) injected as a single dose and lycopene (4 mg/kg) was administered in corn oil by gavage. The levels of malondialdehyde (MDA) and reduced glutathione (GSH) in both the heart and kidneys were higher in the group treated with ADR alone than in the control group, and were lower in the groups administered with lycopene than in the ADR alone group. Although the activity of catalase (CAT) in the heart was higher in the ADR alone group than in the control group, it was lower in the kidneys. In particular, treatment with lycopene post-injection normalized both cardiac and kidney CAT activities. In heart and kidney tissues, glutathione peroxidase (GSH-Px) activities were not significantly different between all groups. Significant increases in the levels of plasma creatinine and urea were observed in the ADR group when compared to the control group, and these increases were normalized by lycopene treatment. Cardiac and renal histopathological changes were observed in the ADR group as compared to the control group. In contrast, these histopathological changes appeared nearly normal in the groups treated with lycopene pre- and post-injection. In conclusion, this study clearly indicated that ADR treatment markedly impaired cardiac and renal function and that treatment with lycopene might prevent this toxicity in rats.

The relationship between tumor budding and survival in colorectal carcinomas

SUMMARY OBJECTIVE Tumor budding is a parameter that is increasingly understood in colorectal carcinomas. We aimed to investigate the relationship between tumor budding, prognostic factors, and survival METHODS A total of 185 patients who had undergone colorectal surgery were observed. Tumor budding, the tumor budding score, and the relationship between these and prognostic factors, and survival investigated. RESULTS Tumor budding was found in 91 (49.2%) cases. The relationship between the tumor budding score and histological grade, lymphovascular invasion, perineural invasion, pathological lymph node stage, and mortality rates were significant. CONCLUSION In our study, the relationship between tumor budding and survival is very strong. Considering these findings and the literature, the prognostic significance of tumor budding becomes clear and should be stated in pathology reports.

RESUMO OBJETIVO Brotamento de tumor é um parâmetro que é cada vez mais conhecido em carcinomas colorretais. Nosso objetivo foi investigar a relação entre brotamento tumoral e fatores prognósticos e sobrevida. MÉTODOS Um total de 240 pacientes observados, submetidos à cirurgia colorretal. Brotamento de tumor, escore de brotamento tumoral e a relação entre estes e fatores prognósticos, sobrevida investigada. RESULTADOS Brotamento de tumores foi encontrado em 91 (49,2%) casos. A relação entre o escore de brotamento tumoral e o grau histológico, invasão linfovascular, invasão perineural, estadiamento linfonodal patológico e taxas de mortalidade foram significativas. CONCLUSÃO Em nosso estudo, a relação entre brotamento tumoral e sobrevida é muito forte. Em conjunto, todos esses achados e literatura são avaliados simultaneamente, o significado prognóstico da brotação do tumor é claramente visto e deve ser indicado nos relatórios de patologia.

Effects of drug-eluting stents on systemic inflammatory response in patients with unstable angina pectoris undergoing percutaneous coronary intervention.

Inflammatory markers are elevated in acute coronary syndromes, and are also known to play a crucial role in the pathogenesis of neointimal proliferation and stent restenosis. Drug-eluting stents (DESs) have been shown to decrease stent restenosis in different studies. In this study, we aimed to investigate the effect of treatment with DESs on systemic inflammatory response in patients with unstable angina pectoris who underwent percutaneous coronary intervention (PCI). We compared plasma high-sensitivity C-reactive protein (hsCRP), human tumor necrosis factor alpha (Hu TNF-alpha), and interleukin 6 (IL-6) levels after DES (dexamethasone-eluting stent [DEXES], and sirolimuseluting stent [SES]) implantation with levels after bare metal stent (BMS) implantation. We performed PCI with a single stent in 90 patients (62 men; 59 +/- 9 years of age; n = 30 in the BMS group, n = 30 in the DEXES group, n = 30 in the SES group) who had acute coronary syndrome. Plasma hsCRP, Hu TNF-alpha, and IL-6 levels were determined before intervention and at 24 h, 48 h, and 1 week after PCI. The results were as follows. Plasma hsCRP levels at 48 h (11.19 +/- 4.54, 6.43 +/- 1.63 vs 6.23 +/- 2.69 mg/l, P = 0.001) after stent implantation were significantly higher in the BMS group than in the DES group; this effect persisted for 7 days (P = 0.001). Plasma Hu TNF-alpha levels at each time point were higher in the SES group than in the BMS and DEXES groups (P < 0.05). The time course of Hu TNF-alpha values was similar in all groups. Although IL-6 levels at baseline and at 24 and 48 h showed no statistically significant difference between the study groups, postprocedural values at 7 days were slightly statistically significant in the SES group (P = 0.045). Drug-eluting stents showed significantly lower plasma hsCRP levels after PCI compared with BMSs. This may reflect the potent effects of DESs on acute inflammatory reactions induced by PCI.