Background: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumor originating from the gastrointestinal tract and have a broad spectrum of clinicopathological features affecting disease management regarding the treatment modalities. Methods: A retrospective study of 49 patients who underwent surgery for gastrointestinal tumors between 2008 and 2016 was conducted. Clinical, pathological, and immunohistochemical features of patients with and without recurrence were statistically analyzed.Results: Twenty-nine (59.1%) patients had gastric; 16 (32.6%) had small intestinal; 3 (6.1%) had mesenteric; and 1 (2.2%) had rectal GISTs. Microscopic tumor necrosis and tumor ulceration were also significant for disease recurrence (P = 0.005, P = 0.049). High-risk patients according to Miettinen’s risk classification were more likely to develop a recurrence (P < 0.001). Additionally, high-grade tumors were also a risk factor for recurrence (P < 0.001). Ki-67 levels were available in 40 patients and the mean Ki-67 level was 16.8 in patients with recurrence, which was a significant risk factor in regression analysis (HR: 1.24, 95%, CI: 1.08-1-43). Five-year disease-free survival rates of non-gastric and gastric GISTs were 62.3% and 90%, respectively (P = 0.044).Conclusion: Larger tumors and higher mitotic rates are more likely to develop recurrence. High Ki-67 levels were also associated with recurrence.

BACKGROUND: Breast cancer is one of the most common cancers in women globally. Axillary lymph node metastasis remains one of the most independent prognostic factors in breast cancer. OBJECTIVE: Evaluate the diagnostic accuracy of 18F-FDG-PET/CT in detecting axillary lymph node metastasis based on immunohistochemical subtypes and its correlation with sentinel lymph node biopsy (SLNB) results. DESIGN: A retrospective cohort SETTING: Tertiary oncology center in Turkiye PATIENTS AND METHODS: Patients diagnosed with early-stage invasive ductal breast cancer and who underwent preoperative F-18 fluorodeoxyglucose positron emission computed tomography (18F-FDG PET/CT) evaluation were included in the study. Patients were divided into five immunohistochemical subtypes: Luminal A, Luminal B HER2 (−) (human epidermal growth factor receptor 2), Luminal B HER2 (+), HER2 (+), and triple negative. SLNB and SUVmax (Maximum Standard Unit Value) results were compared. MAIN OUTCOME MEASURES: Diagnostic accuracy of 18F-FDG PET/CT for detecting axillary metastasis was the primary outcome. Interrater reliability testing in determining the agreement between 18F-FDG PET/CT and SLNB was the secondary outcome. SAMPLE SIZE: 248 RESULTS: The sensitivity, specificity, PPV, NPV and accuracy of 18F-FDG-PET/CT for detecting axillary metastasis were 62%, 92%, 88%, 71% and 77%, respectively. Cohen's Kappa coefficient (0.54) showed moderate agreement with SLNB ( P <.001). Tumors with positive HER2 gene amplification [HER2 (+) and Luminal B HER2 (+) have higher sensitivity than other subtypes (Luminal A, Luminal B HER2 (−) and triple negative). HER2 gene amplification also increases the agreement between 18F-FDG-PET/CT and SLNB results. CONCLUSION: 18F-FDG-PET/CT has a high specificity but low sensitivity for ipsilateral axillary metastasis in invasive ductal carcinoma. The presence of HER2 gene amplification can increase sensitivity and concordance with SLNB. LIMITATIONS: Retrospective design and limited number of patients for each subtype.

Aralık 2019’da Çin’in Wuhan bölgesinde başlayan Covid-19 (koronavirus hastalığı 2019) pandemisi, Afrika kıtasında da etkisini göstermektedir. Sağlık personeli sayısı, yoğun bakım yatağı sayısı, laboratuvar kapasitesi, temiz su ve altyapı imkanları, Covid-19 test ve tedavi imkanlarının yetersiz olduğu kıta ülkelerinde salgının daha büyük halk kitlelerini etkisi altına alarak vaka ve ölüm sayılarını artırmasından endişe edilmektedir. Bunların yanı sıra, kıtadaki sıtma, HIV, tüberküloz gibi hastalıklardaki prevalansın hali hazırda yüksek olmasının da mortaliteye katkıda bulunabileceği düşünülmektedir. Afrika Birliği (African Union) çatısı altındaki Afrika Hastalık Kontrolü ve Önleme Merkezleri (Africa Centres for Disease Control and Prevention - Africa CDC), koordineli bir şekilde önlemler alsa da yüksek gelirli ülkelerin dahi tedarik zincirinde ve medikal ekipman stoklarında sorun yaşadığı bu pandemi sürecinde kıta ülkelerinin ekonomik yönden de yardıma ihtiyaç duyduğu açıktır. Dünya Sağlık Örgütü, Afrika Birliği ile Afrika CDC gibi kuruluşların verimli iş birlikleri ve örgütlenmeleri, hükümetlerin sağlık otoriteleriyle ortak ve hızlı bir şekilde karar almaları, medyanın halkı bilinçlendirme noktasında doğru kullanımı, halkın fiziksel mesafe ve sık el yıkama kurallarına uyması, koronavirüs test kitleri, kişisel koruyucu ekipman, maske, ventilatör ve diğer yaşam destek ekipmanlarının sağlanması ve/veya bağışlanması Afrika’da Covid-19’dan mümkün olduğunca az sayıda insanın etkilenmesinin sağlanmasında kritik öneme sahiptir.

Nuray Colapkulu-Akgul, Ibrahim Ali Ozemir, Damla Beyazadam, and Orhan Alimoglu. Vasc Specialist Int 2021;37:. https://doi.org/10.5758/vsi.210065

OBJECTIVE: Trauma care systems are life-saving significant implementations of a country's healthcare systems. Trauma care requires well -established trauma settings and organizations with experienced trauma teams including experienced emergency medicine, surgery and anesthesiology staff. This study aimed to investigate the outcomes of penetrating abdominal injuries treated by solo surgeons in a suburban area. METHODS: Medical records of the patients who were admitted to the emergency department with penetrating abdominal injuries between January 2012 and December 2021 were retrospectively analyzed. Patients were evaluated based on their injury sites and treatment approaches. RESULTS: In total, 110 patients with anterior abdominal penetrating injuries were enrolled in the study; 83 (75.4%) were stabbed and 27 (24.6%) had gunshot wounds. According to the injury site, there were 90 (81.8%) anterior; 11 (11%) right thoracoabdominal and 9 (7.2%) left thoracoabdominal injuries. Fifty-one (61.4%) stab wounds were treated with immediate laparotomy and 21 (41.1%) of these operations resulted in negative or nontherapeutic laparotomy. Also, 32 (38.6%) stab wounds were managed nonoperatively; three (9.3%) failed conservative management and received delayed laparotomy. All gunshot wounds were treated with immediate laparotomy and 14.8% resulted in either negative or nontherapeutic laparotomy. On -call surgeons were found to be more prone to perform immediate laparotomy on weekends when they were on call for 48 or 72 hours. CONCLUSION: Being a solo surgeon may increase negative laparotomy rates of penetrating abdominal injuries. This high percentage (41.1%) of negative laparotomy rates can be reduced by establishing well -organized trauma teams.

AIM: Cancer-related systemic inflammation causes the increase of proinflammatory markers and acute phase proteins. Activation of systemic inflammatory response has been linked to poorer prognosis in colorectal cancer. This study aims to evaluate the prognostic value of preoperative systemic inflammatory markers and inflammation/nutrition scoring systems in predicting the postoperative early period (first 30 days) complications and mortality outcomes of patients who underwent curative surgery for colorectal cancer in our clinic. METHODS: This study was designed as a retrospective single-arm cross-sectional study. In this study, 300 patients older than 18 years of age who underwent open and laparoscopic surgery for colorectal cancer were included. Demographic characteristics of the patients, preoperative hemogram and biochemical values, operation characteristics, postoperative tumor pathologies and disease stages were recorded. RESULTS: Neoadjuvant chemoradiotherapy, Systemic Inflammation Score, Modified Glasgow Prognostic Score, Naples Prognostic Score and Prognostic Nutritional Index had a significant effect on the first 30-day mortality (p-values: <0.001, 0.007, <0.001, <0.001, <0.001, respectively). CONCLUSIONS: The results suggest that certain preoperative inflammation and nutrition scores might serve as indicators for potential early postoperative adverse outcomes in colorectal cancer surgery.