Background:HMGB1, the most important member of the high mobility group box protein family, is a nuclear protein with different functions in the cell; it has a role in cancer progression, angiogenesis, invasion, and metastasis development. We studied ...

Background: High-grade gliomas, with glioblastomas as the most frequently observed histologic subtype, are the most common primary brain tumours in adults. It is considered that inflammatory responses play a major role in malignancies, including tumour progression. This study aimed to determine the prognostic significance of the neutrophil to lymphocyte ratio (NLR) and the thrombocyte to lymphocyte ratio (PLR) as indicators of systemic inflammatory response (SIR) in glioblastoma patients. Methods: A total of 90 patients treated for glioblastoma were retrospectively evaluated. Absolute counts were used to generate NLR and PLR. A SIR was considered to be present with an NLR ≥5 and/or PLR ≥150. Results: Median follow-up time was 11.3 months (range: 1-70 months). The 1-year and 2-year overall survival rates were 55.2% and 19.5%, respectively. Univariate analysis showed that there was no correlation between overall survival and gender (p=0.184), comorbid disease (p = 0.30), clinical presentation (p = 0.884), or tumour lateralization (p = 0.159). Multivariate analysis showed that overall survival was significantly correlated with SIR based on NLR (HR: 2.41), and ECOG performance status (HR: 1.53). The prognostic factors that affected survival, other than SIR, were Eastern Cooperative Oncology Group (ECOG) performance status (p = 0.003), and tumour localization (p = 0.006). Conclusion: The present findings confirm that NLR based on peripheral blood counts prior to treatment can be used as a prognostic factor in patients with glioblastoma. Since tumour aggression increases and survival decreases as the NLR value rises, choice of treatment modality is facilitated for glioblastoma patients.

Nutritional deficiency is common in critically ill hospitalized patients. This condition may be aggravated by increased dietary requirements and deficiencies in nutrient absorption. This study aimed to evaluate the associations between the modified Nutritional Risk in Critically ill (mNUTRIC) score and mortality and morbidity in patients with sepsis. In this prospective observational study, 78 patients with sepsis were enrolled in the general intensive care unit over a 3-month period. Demographic and clinical data and laboratory results were recorded and followed up. The nutrition of each patient was started by the nutrition team, and a modified score (mNUTRIC) was calculated. This score was used to assess the patients’ nutritional status and mortality risk. The mean age of the patients was 77.2 ± 9.9 years, and the majority were men. The median mNUTRIC score was 6. The cohort was divided into two groups: 31 patients (39.7%) with low scores and 47 patients (60.3%) with high mNUTRIC scores. A high mNUTRIC score was associated with an increased need for vasoactive drugs (p < 0.001) and mechanical ventilation (p < 0.001), as well as increased acute kidney injury (p = 0.014) and prolonged hospital stay (p < 0.001) during ICU follow-up. The mNUTRIC score showed high accuracy in predicting mortality (p < 0.001). In this study, to predict the prognosis of patients with sepsis in the ICU, the mNUTRIC score was associated with mortality. The inclusion of nutritional assessment scoring tools in the routine clinical evaluation of ICU patients is important.

Non-Hodgkin Lymphoma and Pesticide Exposure in Turkey Non-Hodgkin lymphoma;pesticides;agriculture;cancer; Background: Non-Hodgkin lymphoma (NHL) is a solid tumour of lymphocytes, important elements in the immune system. According to 2006 data, in Turkey the incidence was 6.5 per 100,000 in males, and 4.4 in females. The relationship between the use of pesticides and development of NHL has been extensively investigated in many studies, and it has been demonstrated that the risk of NHL is increased by exposure to such compounds. Antalya is a region of intensive agricultural activity. In this study, the relationship between the incidence of lymphoma in Antalya and the amount of pesticides employed was investigated. Materials and Methods: The study used data from 1995 to 2010 on the patients from the databank of TR Ministry of Health, Antalya Provincial Health Directorate, Cancer Registration Center and the patients who were histopathologically diagnosed with NHL during these years. Results: The relationship between the amount of pesticide used and the incidence was studied with the Spearman correlation analysis and the p value was found as 0.05. The correlation coefficient was 0.497. An increase in the NHL incidence over the years was identified, with a 2.42-fold increment found from 1995 to 2005 and a 2.77 fold elevation from 1995 to 2010. The use of pesticides increased 1.89 fold over the same period. Conclusions: Our study investigated the relationship of the pesticides used with NHL patients diagnosed during the same year. Since the time elapsing after exposure to pesticides until the development of cancer is not clear, no comparison can be made at present. We believe that the increase in use of pesticides since 1995 may be associated with the increase in the incidence of NHLand therefore that further studies on the issue including measurements of serum pesticide levels, are required.

Although rare, 5-fluorouracil (5-FU) may lead to cardiotoxicity that presents with angina, elevated cardiac enzymes and electrocardiogram (ECG) changes. Coronary vasospasm related to 5-FU is a rare clinical entity in oncological practice and may be seen during both bolus and protracted infusional administration. This toxicity is generally reversible and responds well to conventional anti-angina treatment following discontinuation of infusion. We propose that parenteral diltiazem is an effective and safe approach for the treatment of coronary vasospasm secondary to 5-FU infusion. We present clinical findings and management of a case in which coronary vasospasm occurred during the infusion of the 5-FU component of FOLFIRI-bevacizumab chemotherapy (CT) regimen given for treatment of metastatic rectal cancer.