Objectives Studies have shown that severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) is primarily transmitted from person to person via airborne droplets.It is unclear whether it can be shed into human milk and transmitted to a child via breastfeeding.We investigated the presence of SARS‐CoV‐2 RNA in human milk samples of 15 mothers with coronavirus disease 19(COVID‐19) and in the throat swab samples of their infants. Methods This is a prospective observational study in which breast milk samples were collected from 15 mothers with COVID‐19.The presence of SARS‐CoV‐2 RNA in the whole human milk samples of the patients was investigated using RT‐qPCR. All of the infants underwent a clinical follow‐up during their 14‐day isolation and their throat swab samples were tested for SARS‐CoV‐2 RNA. Results Of 15 mothers with COVID‐19,SARS‐CoV‐2 RNA was detected in milk samples from 4 mothers. The throat swab samples from these mothers’infants were found to be positive for SARS‐CoV‐2 RNA.Three of the four mothers were breastfeeding. In addition, during the 14‐day isolation,all but three of the mothers breastfed their infants. Of the 12 breastfed infants,while the test for SARS‐CoV‐2 RNA in throat swab samples was negative in six of the infants, the other six infants,who had mild COVID‐19 symptoms,tested positive for SARS‐CoV‐2 RNA.Clinical outcomes of all mothers and infants were uneventful. Conclusion To our knowledge, this is the first case series with the largest number of cases with SARS‐CoV‐2 RNA positivity in human milk samples of mothers with COVID‐19. However, we believe that the benefits of breastfeeding may outweigh the risk of SARS‐CoV‐2 infection in infants

Objectives: Hemodynamic status, cardiac enzymes, and imaging-based risk stratification are frequently used to evaluate a pulmonary embolism (PE). This study investigated the prognostic role of a simplified Pulmonary Embolism Severity Index (sPESI) score and the European Society of Cardiology (ESC) model.Methods: The study included 50 patients from the emergency and pulmonology department of one medical center between October 2005 and June 2006. The ability of the sPESI and ESC model to predict short-term (in-hospital) and long-term (6-month and 6-year) overall mortality was assessed, in addition to the accurancy of the sPESI and ESC model in predicting short-term adverse events, such as cardiopulmonary resuscitation, or major bleeding.Results: Of the 50 patients, the in-hospital and 6-year mortality rates were 14% and 46%, respectively. Fifteen (30%) of these experienced adverse events during hospitalization. Importantly, patients classified as low-risk according to the sPESI had no short-term adverse events as opposed to 4.8% in the ESC low-risk group. They also had no in-hospital, 6-month, or 6-year mortality compared to 4.8%, %14.3, and %23.8, respectively, in the ESC low-risk group.Conclusions: The sPESI predicted short-term and long-term survival. The exclusion of short-term adverse events does not appear to require imaging and laboratory testing.doi: http://dx.doi.org/10.12669/pjms.306.5737How to cite this:Kilic T, Gunen H, Gulbas G, Hacievliyagil SS, Ozer A. Prognostic role of simplified Pulmonary Embolism Severity Index and the European Society of Cardiology Prognostic Model in short- and long-term risk stratification in pulmonary embolism. Pak J Med Sci 2014;30(6):1259-1264.

The results of standard chemotherapy in lung cancer are not very satisfactory, so it is important to identify genetic mutations that provide targeted therapies. Recent reports have suggested influences of racial difference on the frequency of mutation in lung cancer. We aimed to determine the frequency and regional distribution of genetic mutations of non-small cell lung cancer (NSCLC) in Turkey. Regional distribution of genetic mutations in lung cancer in Turkey (REDIGMA) study was carried out as a prospective, cross-sectional, observational study in a large number of centers in which lung cancer patients were followed and could perform genetic mutation analysis on patients' biopsy materials. The 703 patients (77.7% male, mean age 63.3 ± 12.5 years) who were diagnosed as NSCLC from 25 different centers were included in the study. Tumor samples from patients were reported as 87.1% adenocarcinoma, 6.4% squamous cell carcinoma and 6.5% other. Mutation tests were found to be positive in 18.9% of these patients. The mutations were 69.9% EGFR, 26.3% ALK, 1.6% ROS and 2.2% PDL. Mutations were higher in women and non-smokers (p<0.000, p<0.001). Again, the frequency of mutations in adenocarcinoma was higher in metastatic disease. There was no difference between the patient's age, area of residence, comorbidity and clinical stage and mutation frequency. Our study revealed that the EGFR mutation rate in Turkey with NSCLC was similar to East European, African-American and Caucasian patients, and was lower than in East Asia.