Comparison of post-mortem vitreous fluid and blood glucose levels in diabetes-induced rabbit models.

Background: Diabetes is a common systemic disease in the world. Acute complications of diabetes may cause sudden unexpected deaths. Analysis done in vitreous fluid which is more protected and less contaminated by bacteria comparing to blood will produce more accurate results. Aim: Thus, we aimed to diagnose diabetes by comparing glucose levels of post mortem blood and vitreous fluid in death cases. Materials and Methods: A total of 17 New Zealand-type rabbits were divided into hyperglycemia (8), hypoglycemia (8), and control group (1). Rabbits were monitored for 5 days after experimental diabetes induction, and samples were taken at the point of death. Later rabbits were left in their environment, and samples were taken again at the post mortem first day. Mean blood glucose levels of hyperglycemia and hypoglycemia group were in diabetic range. Results: Blood glucose levels of hyperglycemic rabbits were measured as 512 ± 52,1 mg/dl, while vitreous glucose levels were 518,3 ± 76,8 mg/dl at the point of death. After one day, levels were measured as 433,9 ± 59,3 mg/dl and 329,8 ± 86,6 mg/dl. Blood glucose levels of hypoglycemic rabbits were measured as 39 ± 3,8 mg/dl, while vitreous glucose levels were 53,4 ± 13,9 mg/dl at the point of death. After one day, levels were measured as 36 ± 4,2 mg/dl and 1,6 ± 0,6 mg/dl. After analysis, there was a statistically significant difference between day 0 and 1 vitreous levels of hypoglycemia group. Conclusion: It can be clearly seen that vitreous fluid samples should be taken in judicial cases with sudden unexpected deaths like diabetes. This will contribute to identification cause of death.

Mask-Associated Dry Eye (MADE) in healthcare professionals working at COVID-19 pandemic clinics.

Background: Healthcare professionals working at COVID-19 pandemic clinics have to work with masks during long hours. After the widespread use of masks in the community, many mask-related side effects were reported to clinics. The increase in the number of applicants with dry eye symptoms due to mask use in ophthalmology clinics has led to the emergence of the concept of mask-associated dry eye (MADE). We think that it would be valuable to evaluate ocular surface tests with a comparative study using healthcare professionals working in pandemic clinics, which we think is the right study group to examine the effects of long-term mask use. Aims: We aimed to evaluate the mask-associated dry eye (MADE) symptoms and findings in healthcare professionals who have to work prolonged time with face masks in coronavirus disease 2019 (COVID-19) pandemic clinics. Patients and Methods: In this prospective, observational comparative clinical study, healthcare professionals who use the mask for a long time and work in COVID-19 pandemic clinics were compared with an age and sex-matched control group consisting of short-term masks users, from April 2021 to November 2021. All participants underwent the Ocular Surface Disease Index (OSDI) questionnaire, tear film break-up time (T-BUT), Oxford staining score, Schirmer's test I, and meibography with infrared transillumination. Results: The long-term mask user group consisted of 64 people, while the short-term mask user group consisted of 66 people (260 eyes, total). The OSDI score and Schirmer I measurement were not statistically different between the two groups. T-BUT was statistically significantly shorter in the long-term group (P: 0.008); lid parallel-conjunctival fold, Oxford staining score, and upper and lower lid meibography score were found to be significantly higher in the long-term group (P < 0.001, P: 0.004, P: 0.049, P: 0.044, respectively). Conclusion: Healthcare professionals with longer mask-wearing times are at greater risk of ocular surface damage. It may be considered to prevent this damage by blocking airflow to the ocular surface, such as by wearing a face mask properly or fitting it over the nose with surgical tape. Those who have to work with a mask for a long time during the COVID-19 pandemic should keep in mind the ophthalmology follow-up for eye comfort and ocular surface health.

The impact of propranolol on apoptosis in cutaneous squamous cell carcinomas.

OBJECTIVES: Cutaneous squamous cell carcinoma (cSCC) is a common cancer in Caucasian populations. Treatments registered for high-risk cSCC are still undetermined. Experimental data have demonstrated possibly useful effects of a combined application of beta­blockers in cancer therapy. The goal of this study was to examine the efficacy of propranolol in the treatment of cSCC and its impact on apoptosis. Thus, we aimed to investigate the apoptotic pathway protein levels and activity in beta­blocker­treated cSCC cells. MATERIALS AND METHODS: The study was performed on human cSCC cancer cell line culture. One of the cSCC cell lines was treated with propranolol, whereas no treatment was given to the other group. Then, the levels of apoptotic pathway proteins were determined by ELISA test in both groups. RESULTS: The propranolol treatment group exhibited a remarkable difference as compared with the other group. It was found that propranolol treatment enhanced the activity of caspase-3 while the expression of bax, wee1, gadd153, grp78 and AIF decreased bcl-2 which is antiapoptotic protein in cSCC cell lines. CONCLUSION: Our results suggest that propranolol treatment has anti-cancer properties with an effect on various apoptotic pathways in cSCC. These data are important because propronalol may be involved in future cSCC treatment (Tab. 1, Fig. 3, Ref. 22).

Subclinical atherosclerosis and impaired cardiac autonomic control in pediatric patients with Vitamin B12 deficiency.

OBJECTIVE: Homocysteine (Hcy) is an independent risk factor for predisposing to atherosclerosis and endothelial dysfunction. Hcy levels increase with Vitamin B12 deficiency. The aim of this study was to investigate the association between carotid intima-media thickness (CIMT) and the autonomic modulation of heart rate variability (HRV) in early detection of atherosclerosis and impaired cardiac autonomic control in pediatric patients with Vitamin B12 deficiency. MATERIALS AND METHODS: Sixty patients with Vitamin B12 deficiency (14.4 ± 1.72 years, 36 female) and 40, age, sex, and body mass index-matched healthy controls (13.4 ± 1.86 years, 24 female) had performed 24-h Holter monitoring, carotid ultrasonography, and echocardiography. Linear regression models assessed associations between to HRV parameters and CIMT and the blood markers. RESULTS: We defined Vitamin B12 deficiency as a serum level, 200 pg/mL. Hcy (P < 0.001) and CIMT (P < 0.001) levels were significantly higher in the patient group compared with the control group. Hcy level was found to be the most important independent variable affecting CIMT. Each 1 degree increase in Hcy, it was observed that the CIMT value increased by 0.01 mm (B = 0.01; t = -2.39; P < 0.05). Low-frequency power (LF), high-frequency power (HF) (P < 0.001), and the square root of the mean of the squared differences of two consecutive RR intervals (rMSSd) (P = 0.04) were significantly lower in the B12 deficient patients. Furthermore, Hcy level was found to be the most important independent variable affecting LF, HF, and rMSSd. CONCLUSIONS: Subclinical atherosclerosis was associated with cardiovascular autonomic imbalance in pediatric patients with Vitamin B12 deficiency. Homocysteinemia may be an important marker for the prediction of future cardiovascular disease.

Influence of visual information on consent for invasive procedures in intensive care unit.

OBJECTIVE: Patients hospitalized in Intensive Care Units (ICU) are critically ill. Sometimes informed consent for invasive procedures cannot be obtained from patients or relatives due to insufficient information. METHODOLOGY: Relatives of the patients who were being hospitalized in ICUs of state hospitals in 3 provinces in Eastern part of Turkey during year 2015, who were planned to undergo central venous catheter insertion, tracheostomy, and percutaneous gastroenterostomy (PGE) were asked to sign consent forms and these relatives were included in the study. The study groups were allocated as verbal (VeIG) and verbal-visual information groups (ViIG). The next of kin who had the right for signing was included in the study. RESULTS: Relatives of patients were interviewed for 512 invasive procedures. For the central venous catheterization, 91.6% of the VeIG (n = 166) and 97.6% of the ViIG (n = 166) accepted the central venous catheterization interventions (n = 332), for the tracheostomy, 65.3% of the VeIG (n = 49), 85.4% of the ViIG (n = 48) accepted the tracheostomy interventions (n = 97), and for the PGE, 23.8% of the VeIG (n = 42) and 48.8% of the ViIG (n = 41) accepted the PGE interventions (n = 83). A statistically significant difference was detected between VeIG and ViIG with regard to approval and refusal rates for different interventions. When approval-refusal rates were compared with regard to education level, statistically significant difference was not detected between VeIG and ViIG with regard to approval and refusal rates. CONCLUSIONS: Using visual materials such as video in addition to verbal information provided an improvement in consent ratios regardless of education levels.

Clinical performance of a combined approach for the esthetic management of fluorosed teeth: Three-year results.

OBJECTIVE: The long-term clinical performance of combined therapy including enamel microabrasion and vital bleaching is debatable due to the abrasion of outer enamel surface. The aim of this longitudinal cohort study was to evaluate the 3-year clinical performance of enamel microabrasion in combination with vital tooth bleaching for the esthetic management of fluorosed teeth. MATERIALS AND METHODS: Fifteen patients with 176 fluorosed incisors and canines were included in this study. All the teeth were treated with enamel microabrasion (Opalustre, Ultradent), and at-home bleaching technique (10% Opalescence PF, Ultradent). Fluorosed teeth were evaluated at baseline, after microabrasion, after combined therapy, and at 3-year follow-up in terms of esthetic criteria (esthetic appearance, brown stains, and opaque white areas), side effects, and patient satisfaction using visual analog scales. The data were statistically analyzed (α = 0.05). RESULTS: Fluorosed teeth revealed significantly better esthetic appearance after microabrasion and combined therapy and at 3-year follow-up compared to those at baseline (P P Conclusions: The combined therapy was effective in the esthetic management of fluorosed teeth. However, a significant relapse was observed in the esthetic appearance and brown stains of these patients after 3 years, which also reduced patient satisfaction.

Influence of blood contamination during multimode adhesive application on the microtensile bond strength to dentin.

OBJECTIVES: The present study evaluated the effects of blood contamination performed at different steps of bonding on the microtensile bond strength (µTBS) of multimode adhesives to dentin when using the self-etch approach. MATERIALS AND METHODS: Seventy-five molars were randomly assigned to three adhesive groups comprising 25 specimens each: two multimode adhesives [Single Bond Universal (SBU) and All-Bond Universal (ABU)] and a conventional one-step self-etch adhesive [Clearfil S3 Bond Plus (CSBP)]. Each group was subdivided as follows: (1) uncontaminated (control): bonding application/light curing as a positive control; (2) contamination-1 (cont-1): bonding application/light curing/blood contamination/dry as a negative control; (3) contamination-2 (cont-2): bonding application/light curing/blood contamination/rinse/dry; (4) contamination-3 (cont-3): bonding application/blood contamination/dry/bonding re-application/light curing; and (5) contamination-4 (cont-4): bonding application/blood contamination/rinse/dry/bonding re-application/light curing. Dentin specimens were prepared for µTBS testing after the composite resin application. Data were analyzed with two-way ANOVA and post-hoc tests (α = 0.05). RESULTS: µTBS values were similar in cont-3 groups, and ABU/cont-4 and corresponding control groups, but were significantly lower in the other groups than in their control groups (P < 0.05). Cont-1 groups showed the lowest µTBS values (P < 0.05). CONCLUSIONS: Neither decontamination method prevented the decrease in µTBS when contamination occurred after light curing. Drying the blood contaminants and reapplying the adhesive may regain the dentin adhesion when contamination occurs before light curing. Alternatively, rinsing and drying contaminants followed by adhesive re-application may be effective depending on adhesive type.

The relationship between uterine prolapse and premalignant endometrial pathology.

OBJECTIVE: The aim of this study was to stress the importance of performing a thorough uterine assessment before selecting an organ- sparing surgery in patients presenting with uterine prolapse and no other complaints. MATERIALS AND METHODS: This study included a total of 111 participants who presented with pelvic organ prolapse and underwent hysterectomy for grades 3-4 uterine prolapse. The posthysterectomy histopathology results were classified as benign (atrophic endometrium, proliferative or secretory endometrium) or pathologic (endometrial hyperplasia, endometrial polyp, adenomyosis, myoma uteri, and endometrium carcinoma). RESULTS: Of the 111 patients enrolled in this study, 23 (20.2%) had endometrial hyperplasia, eight (7.2%) had endometrial polyps, 30 (27%) had uterine fibroids, and 20 (18%) had adenomyosis. CONCLUSION: There may be premalignant lesions of the endometrium in both premenopausal and postmenopausal women presenting with uterine prolapse and no other symptoms. A chronic inflammatory process resulting from the extra-vaginal location of the uterus may play a role in the development of these lesions. Further studies are needed on this subject.

Efficacy of a casein phosphopeptide amorphous calcium phosphate (CPP-ACP) paste in preventing white spot lesions in patients with fixed orthodontic appliances: A prospective clinical trial.

AIM: The aim of this prospective study was to test the efficacy of casein phosphopeptide amorphous calcium phosphate (CPP-ACP) paste applied in-office to prevent white spot lesions (WSL) in patients undergoing fixed orthodontic treatment. MATERIALS AND METHODS: Study design: this study was designed as a randomised controlled clinical trial. Fifty-seven patients undergoing nonextraction fixed orthodontic treatment were enrolled and divided randomly into two groups (control n = 28, experimental n = 29). The pretreatment plaque, gingival and bleeding indices, and oral hygiene habits were recorded. One group received CPP-ACP paste (GC Tooth Mousse) at each monthly orthodontic follow-up examination; the control group received routine orthodontic treatment. The mean patient age was 16.9 years in the experimental group and 17.1 years in the control group. The periodontal indices, decayed, missing, and filled teeth (DMFT), decayed, missing, and filled surfaces (DMFS), and the WSL prevalence pre- and post-treatment were measured and compared between the groups. STATISTICS: differences between groups in normally distributed data between groups were assessed by the paired-t test, and the Wilcoxon Signed Rank test was used to compare variables that were not normally distributed. RESULTS: There was a lower incidence of WSL in the experimental group compared to the control group. Most of the WSL occurred at the maxillary incisors, mandibular canines and premolars. CONCLUSION: The in-office application of CPP-ACP paste did not prevent WSL development completely; however, it did significantly decrease the number of WSL compared to the control patients.

A case of a sinonasal adenocarcinoma with metaplastic ossification.

Sinonasal adenocarcinomas are rare tumours, with three subtypes. They are mostly low-grade tumours, although they can also be aggressive. In this case report, we describe a 34-year-old patient with sinonasal adenocarcinomas. Within his nasal cavity was found an irregular mass. Given the intratumoral calcification and bone, the mass was thought to be a bone-producing tumour, such as an osteosarcoma. The pathological diagnosis was a sinonasal adenocarcinoma with extensive metaplastic bone. To the best of our knowledge, this is the first case of a sinonasal adenocarcinoma with metaplastic ossification.

Can N-terminal pro B-type natriuretic peptide, neutrophil-to-lymphocyte ratio, C-reactive protein help to predict short and long term mortality?

BACKGROUND: There is limited data about ICU, short and long-term mortality prediction of severe CAP with neutrophil-to-lymphocyte ratio (NLR): N-terminal proB- type natriuretic peptide (NT-proBNP): C-reactive protein (CRP). AIM: Besides the known severity indexes of ICU, can NLR, NT-proBNP, CRP predict ICU, short and long term mortality? METHODS: A retrospective cohort study was carried out in a level III ICU of a tertiary training hospital for chest diseases and thoracic surgery. RESULTS: Over the study period, a total of 143 patients were enrolled in the study. The APACHE II scoring showed a significantly higher predicting performance for ICU mortality (p = 0.002). The performance for predicting short term mortality NLR (p = 0.039) and long term mortality NTproBNP (p = 0.002) had a significantly higher performance. The survival analysis revealed that mortality was significantly higher in patients with CURB65 score ≥ 4 (p = 0.047). CONCLUSION: NLR, NTproBNP > 2000pg/mL can be used to predict pneumonia severity in ICU alike CURB65 and PSI. Higher NLR, APACHE II and atrial fibrillation can cause an important mortality factor in long term. Consequently, clinicians should take an attention for good cardiac evaluation and cardiac follow-up of patients with CAP (Tab. 4, Fig. 3, Ref. 36).

Endometrial pathology in postmenopausal women with no bleeding.

OBJECTIVE: The aim of this study was to determine the rate of unexpected uterine pathology in postmenopausal women admitted to a gynecology clinic with symptoms other than vaginal bleeding and who were scheduled to undergo hysterectomy. MATERIALS AND METHODS: We reviewed retrospectively the medical records of 283 postmenopausal patients who had gynecological surgery between September 2007 and January 2014. We reviewed their presenting symptoms on admission, the indications for surgery, and their transvaginal ultrasonographic findings. Postoperative histopathological results based on uterine specimens were also recorded. The results were analyzed statistically. RESULTS: Of 283 patients who had surgery, 209 had no vaginal bleeding at the time of admission. From this group, 75.6% were found to have unsuspected pathology, including endometrial hyperplasia, endometrial polyps, uterine fibroids, adenomyosis, and one case of endometrial carcinoma (0.5%). The remaining 74 patients had experienced postmenopausal bleeding and in 87.8% there were pathological findings including 13 cases (17.6%) of endometrial cancer (p = 0.0001). CONCLUSION: Vaginal bleeding in postmenopausal women is indicative of a wide array of gynecological pathologies, including endometrial carcinoma. However, uterine fibroids, pelvic masses, or even endometrial cancer may develop without co-morbid vaginal bleeding. Therefore we advocate that postmenopausal women should undergo yearly screening and consultation, without waiting for an episode of vaginal bleeding.

Does bupivacaine and fentanyl combination for epidural analgesia shorten the duration of labour?

In this study we aimed to explore the effects of epidural analgesia achieved by a combination of low-dose bupivacaine and fentanyl infused through an epidural catheter on mother, foetus and labour process in nulliparous at-term pregnant women during vaginal delivery. This study was designed in a prospective, randomised controlled manner. Epidural analgesia was achieved in 50 nulliparous women. Fifty nulliparous women did not undergo epidural analgesia procedure. The duration of the first stage of labour was significantly shortened, while the second stage was significantly lengthened in pregnant women who underwent epidural analgesia (p < 0.05). In conclusion, starting epidural analgesia application during the active phase of the first stage of labour may shorten the duration of the first stage compared with the group of nulliparous women not undergoing epidural analgesia. The factor that has an impact on this may be the addition of fentanyl to bupivacaine used for epidural analgesia.

Effect of different surface pre-treatment methods on the microleakage of two different self-adhesive composites in Class V cavities.

AIM: To evaluate the effect of different surface pre-treatment methods on the microleakage of self-adhesive flowable composites (SAFCs) in comparison with a conventional flowable composite applied with an etch-and-rinse adhesive system. MATERIALS AND METHODS: One hundred and thirty-five standardised Class V cavities were randomly divided into nine groups: (1) three-step etch-and-rinse adhesive (Optibond FL - Kerr, Orange, USA)/flowable composite (Clearfil Majesty Flow - Kuraray, Tokyo, Japan) (E&Ra/flowC); (2) Fusio Liquid Dentin (Pentron Clinical, Orange, USA); (3) Er:YAG Laser/Fusio Liquid Dentin (Er&Las/Fusio Liquid Dentin); (4) Phosphoric Acid/Fusio Liquid Dentin (PhosA/Fusio Liquid Dentin); (5) Polyacrylic Acid/Fusio Liquid Dentin (PolyA/Fusio Liquid Dentin); (6) Vertise Flow (Kerr, Orange, USA); (7) Er:YAG Laser/Vertise Flow (Er&Las/Vertise Flow); (8) Phosphoric Acid/Vertise Flow (PhosA/Vertise Flow); (9) Polyacrylic Acid/Vertise Flow (PolyA/Vertise Flow). After thermocycling and immersion in a 0.5% basic fuchsin, the restorations were evaluated under a stereomicroscope (n = 30). The data were statistically analysed (α = 0.05). RESULTS: Both SAFCs showed higher leakage scores than E&Ra/flowC in enamel and dentin (p < 0.05). Vertise Flow showed lower leakage than Fusio Liquid Dentin in dentin (p < 0.05). Pre-phosphoric acid etching reduced the microleakage scores of Fusio Liquid Dentin in both enamel and dentin (p < 0.05), while all surface pre-treatment methods led to a significant reduction in the microleakage scores of Vertise Flow at the enamel margin (p < 0.05). CONCLUSION: Pre-etching of enamel and dentin by phosphoric acid may be satisfactory in improving the sealing ability of Fusio Liquid Dentin, while phosphoric acid or polyacrylic acid etching or laser irradiation may be used to improve the adhesion of Vertise Flow to enamel.

Patients with psoriasis have an increased amount of epicardial fat tissue.

BACKGROUND: Psoriasis is associated with coronary artery disease, and ischemic heart disease is associated with increased amounts of epicardial fat tissue (EFT). There has as yet been no study published on the accumulation of EFT in patients with psoriasis. AIM: To compare epicardial fat accumulation and coronary artery calcium score (CACS) in patients with psoriasis and controls. METHODS: We enrolled 38 patients with psoriasis and 38 controls matched for age and gender. Epicardial fat area (EFA) and CACS were evaluated by multidetector computed tomography. RESULTS: Mean EFA in patients with psoriasis was significantly higher than in controls (13.8 ± 8.4 vs. 9.7 ± 6.4 cm(2) , respectively, P = 0.02), but mean CACS did not differ significantly between the two groups (55.2 ± 65.4 vs. 27.8 ± 29.3; P > 0.05). Multiple linear regression analyses indicated that EFA was significantly associated with waist circumference and presence of coronary artery calcification in both patients and controls, whereas EFA was significantly associated waist circumference and age in patients only (P < 0.05). CONCLUSIONS: Patients with psoriasis had a higher level of EFA compared with controls, and EFA was independently associated with the presence of CAC in all study subjects.

The effects of using the Internet on the health-related quality of life in people with spinal cord injury: a controlled study.

STUDY DESIGN: Prospective cohort study. OBJECTIVES: To compare the health-related quality of life (HRQoL) in people with spinal cord injury (SCI) who use the Internet versus those who don't and with a control group of able-bodied individuals. To investigate the frequency of Internet usage before and after injury. To evaluate the differences in terms of demographic features of both groups, analyze the variation in the Internet usage pattern of people with SCI before and after the injury. SETTING: Istanbul, Turkey. METHODS: A total of 60 people with SCI (38 Internet users, 22 nonusers) were included in the study. The control group consisted of 33 healthy persons of similar age and sex. The HRQoL was evaluated with the SF-36 Health Survey. RESULTS: The scores of all the subscales of the SF-36, except vitality, were significantly lower in people with SCI than those of the controls'. The bodily pain subscale and physical component scores were found to be significantly higher in people with SCI using the Internet than the nonuser group with SCI (P<0.05). The Internet usage frequency increased significantly in people with SCI after injury (P<0.05). A significant correlation was found between time since injury and Internet use (r=0.365, P=0.007). CONCLUSION: Although HRQoL scores were lower in people with an SCI, the physical status component score was better in the Internet user SCI group. As there is a significant increase in the time spent online after injury, the Internet could be an effective modality to contact and educate people with an SCI.

Sexual problems of women with spinal cord injury in Turkey.

OBJECTIVES: Spinal cord injury (SCI) is a traumatic event that affects many facets of the injured people's lives. One aspect is sexual functioning. The purpose of this study is to identify the sexual problems of women with SCI and determine their level of knowledge about sexuality. METHODS: Twenty-six women with SCI for longer than 6 months were evaluated. Demographic information, sexual experiences were surveyed. Patients were also asked if and how they received sexual health consultation after SCI. Female Sexual Function Index (FSFI) and Beck Depression Inventory were evaluated. RESULTS: In this study, average age of the women with SCI was 32.96±8.23 years (22-50 years). Eight patients had regular sexual intercourse while one married woman did not have any sexual relationship after SCI. Twenty-four of the patients in the study received no information about pregnancy or sexual health after SCI. All women were willing to receive information about sexuality after SCI. These patients expected the doctors to start the conversation about sexuality rather than asking about it. FSFI survey revealed that all the patients had sexual dysfunction. CONCLUSION: Sexual rehabilitation should thus be fully addressed in all spinal units and rehabilitation centers, along with other aspects of rehabilitation.

Safety and efficacy of nivolumab therapy in patients with metastatic renal cell carcinoma and impaired kidney function.

INTRODUCTION: Patients with renal insufficiency, usually defined as those with creatinine clearance < 40 mL/min, were excluded from pivotal clinical trials, especially in studies involving nivolumab therapy in patients with renal cell carcinoma (RCC). The aim of the study is to evaluate the efficacy and safety of nivolumab in patients with metastatic RCC (mRCC) stratified according to creatinine clearance. MATERIAL AND METHODS: Data from mRCC patients treated with nivolumab were retrospectively analyzed. Patients were classified into two categories according to their estimated glomerular filtration rate (eGFR); the first category (C1) included patients with eGFR < 40 mL/min/1.73 m2 and the second category (C2) included those with eGFR ≥ 40 mL/min/1.73 m2. RESULTS: Of the 95 patients enrolled, 1. group included 26 patients (27.4%) and 2. group included 69 patients (72.6%). None of the pts in category 1 were on hemodialysis. Overall incidence of adverse events was not statistically different between the two groups (P = .469). The overall response rate ORR was 50% in the first group and 42.0% in the second group (P = .486). Median overall survival (OS) was longer with 23.3 months in the 2. group versus 11 months in the 1. group (P = .415). CONCLUSION: Renal insufficiency is a common problem in patients with advanced renal cancer since they often undergo nephrectomy and their renal function may also worsen while receiving tyrosine kinase inhibitor therapy. We found that there is no significant difference in the safety and efficacy of nivolumab treatment between two groups. Nivolumab appears to be a safe and effective agent in patients with renal impairment.