The Nottingham Prognostic Index, Ki-67 Prognostic Index, and combination of platelet count and lymphocyte-to-monocyte ratio have shown prognostic significance in breast cancer. This aim of the study was to compare combination of platelet count and lymphocyte-to-monocyte ratio with Nottingham Prognostic Index and Ki-67 Prognostic Index in early-stage breast cancer. A retrospective cohort study included 321 women aged ≥18 years diagnosed with early-stage breast cancer (2010-2020) who did not receive neoadjuvant chemotherapy. Data were extracted from records, with laboratory values collected preoperatively, postoperatively, and at 6-month and 1-year intervals. Regression and survival analyses evaluated the predictive value of combination of platelet count and lymphocyte-to-monocyte ratio, Nottingham Prognostic Index, and Ki-67 Prognostic Index for disease-free survival and overall survival. The mean age at diagnosis was 53.3 years. The mortality rate was 6.2%, and recurrence occurred in 9.3% of patients. Univariate regression showed age as the sole factor influencing overall survival (HR 1.063, p<0.001). Factors associated with disease-free survival included Luminal-B subtype (HR 3.790, p=0.029), estrogen receptor negativity (HR 15.710, p=0.007), human epidermal growth factor receptor 2 positivity (HR 4.833, p<0.001), Nottingham Prognostic Index (HR 1.967, p=0.009), and Ki-67 Prognostic Index stage (HR 1.908, p=0.008). Multivariate analysis identified age as the only significant predictor for overall survival, while human epidermal growth factor receptor 2-negativity was the sole independent factor for disease-free survival. Combination of platelet count and lymphocyte-to-monocyte ratio did not show significant prognostic value in early-stage hormone receptor-positive breast cancer. However, Nottingham Prognostic Index and Ki-67 Prognostic Index were strong predictors, particularly for disease-free survival.

Background: This study aimed to analyze the association between monocyte-to-lymphocyte ratio (MLR) and nutritional indicators in peritoneal dialysis (PD) patients Methods: Among the 228 maintenance PD patients 44 of those were included in this retrospective analysis. The geriatric nutrition risk index (GNRI) was calculated by using serum albumin and body weight, and the prognostic nutrition index (PNI) was by serum albumin and lymphocyte count. Monocyte-to-lymphocyte ratio (MLR) and nutritional indicators were analyzed by Spearman correlation and linear regression analysis. Results: During the follow-up of 25 months, median GNRI and PNI values showed an increase from a median baseline GNRI of 86.7 (IQR, 92.9, 104.9) to 100.5 (IQR, 92.7, 109.0) (p=0.03) and PNI values of baseline 43.1 (IQR, 41.0, 46.3) to 46.1 (IQR, 39.1, 50.5) (p=0.02). MLR showed a decrease from the baseline median value of 0.38 (IQR, 0.28, 0.58) to 0.36 (IQR, 0.29, 0.47) p=0.03. There were no changes in leukocyte and hs-CRP levels. There were statistically significant negative correlations between MLR and PNI (rs -0.452; p=0.002), GNRI (rs -0.400 p=0.008), and BMI (rs -0.308; p=0.04). No significant correlation was observed with albumin levels (rs =0.221; p=0.154). MLR was statistically significantly associated with GNRI, PNI, and body mass index (BMI) except albumin, however, hs-CRP level was only associated with serum albumin in both univariate and multivariate regression analysis. Conclusion: This study indicates that the higher MLR values were associated with lower GNRI and PNI values in PD patients. MLR may help clinicians to identify the nutritional status of this population.

Background/Objectives: Real-world data are limited for short-term renal and metabolic changes after the initiation of sodium–glucose co-transporter 2 (SGLT2) inhibitors in Turkish clinical practice. We described 1-year changes in these parameters in adults with type 2 diabetes who started treatment with empagliflozin or dapagliflozin. Methods: In this single-centre retrospective cohort (2016–2021; n = 780), paired baseline and 12-month values were compared in patients with available measurements. The urinary albumin-to-creatinine ratio (UACR) was compared with the Wilcoxon signed-rank test. Factors associated with albuminuria response (≥30% UACR reduction) were examined using multivariable logistic regression. Results: HbA1c decreased by 1.0% (95% CI 0.8–1.1; n = 398), haematocrit increased by 1.3 percentage points (n = 418), uric acid decreased by 0.5 mg/dL (n = 221) and eGFR declined by 3.2 mL/min/1.73 m² (95% CI 2.1–4.2; n = 426). In 109 patients with paired UACR, the median UACR fell from 20.9 [9.0–49.0] to 11.0 [6.0–30.0] mg/g (p < 0.001). A ≥30% reduction occurred in 81.1% of patients with a baseline UACR ≥30 mg/g and 41.7% of patients with a baseline UACR <30 mg/g (adjusted odds ratio: 6.10; 95% CI: 2.24–16.57). Genitourinary infections were more frequent in women as the most common documented reason for discontinuation. Conclusions: In routine care, SGLT2 inhibitor initiation was followed by changes in glycaemic, haematological, uric acid and albuminuria parameters that were similar in direction to those reported in randomised trials; the uncontrolled design and incomplete UACR data preclude causal inference.

Introduction: 5-Fluorouracil (5-FU) is an antimetabolite widely used in colorectal, gastric, breast, and other solid tumors. Hypersensitivity reactions are uncommon but may be severe. Case Report: We report a 63-year-old woman with metastatic sigmoid colon cancer who developed an anaphylactic reaction during the second course of a 5-FU—containing regimen, specifically following the bolus infusion. Skin prick and intradermal tests performed four weeks later were negative. Management & Outcome: As no equally efficacious alternative existed within the planned regimen, rapid intravenous desensitization was performed using a 16-step protocol with four dilution solutions. Desensitization was completed without adverse events, and the subsequent 48-h continuous 5-FU infusion was also well tolerated. Discussion: This case adds to the limited literature on 5-FU desensitization and underscores its feasibility and safety in agent-dependent patients.

Amaç: Taksanlar (paklitaksel, dosetaksel), solid tümörlerin tedavisinde standart kemoterapi protokollerinin temel bileşenlerini oluşturan ajanlardır. Bu ajanlarla gelişen aşırı duyarlılık reaksiyonları (ADR), tedavinin kesilmesine veya hayatı tehdit eden klinik tablolara yol açabilmektedir. Bu çalışmada; taksan grubu ilaçlarla reaksiyon geliştiren hastaların demografik ve klinik özelliklerini, reaksiyon şiddetini Brown sınıflamasına göre ve reaksiyon sonrası yönetim yaklaşımlarını kapsamlı biçimde değerlendirmek amaçlanmıştır.Gereç ve Yöntemler: Taksan grubu kemoterapi (paklitaksel veya dosetaksel) infüzyonu sırasında ADR gelişen 30 hasta retrospektif olarak değerlendirildi. Demografik veriler, primer tanılar, komorbiditeler, reaksiyonun kür numarası ve klinik bulgular kayıt altına alındı. Reaksiyon şiddeti Brown sınıflamasına göre Grade 1 (hafif), Grade 2 (orta) ve Grade 3 (ağır) olarak kategorize edildi. İstatistiksel analizler SPSS 25.0 yazılımı ile gerçekleştirildi.Bulgular: Hastaların ortalama yaşı 50,87 ± 10,52 yıl (aralık: 32–71) olup %73,3'ü (n=22) kadındı. En sık primer tanı meme kanseri (%50) idi. Reaksiyonların %80'i (n=24) ilk iki maruziyet küründe gelişti. Kutanöz bulgular (%70) ve respiratuar semptomlar (%56,7) en sık gözlenen fenotiplerdi. Hastaların %36,7'si (n=11) Brown Grade 3 reaksiyon geçirdi; bu hastaların %81,8'i ilk kez taksan alan bireylerdi. İntradermal deri testi pozitifliği %12,5 olarak saptandı. Hastaların %30'una (n=9) desensitizasyon protokolü uygulandı.Tartışma ve Sonuç: Taksan ADR'leri, yaygın premedikasyon kullanımına karşın ilk iki kürde yoğunlaşmaya ve ciddi klinik tablolarla seyretmeye devam etmektedir. Düşük deri testi pozitifliği, reaksiyonların büyük oranda non-IgE mekanizmalarla geliştiğini desteklemektedir. Reaksiyon sonrası yönetim, reaksiyonun fenotipi ve şiddetine göre multidisipliner yaklaşımla kişiselleştirilmelidir.Anahtar Kelimeler: Taksanlar; Kemoterapi; İlaç Aşırı Duyarlılık Reaksiyonları; Brown Sınıflaması; Desensitizasyon.

Management of chronic spontaneous urticaria (CSU) remains challenging due to frequent patient refractoriness to high-dose H1-antihistamines, necessitating omalizumab therapy. At diagnosis, reliable and accessible biomarkers are critical to predict which patients will require treatment escalation. This study aimed to evaluate baseline hematological parameters and derive inflammatory indices for their capacity to predict maximum H1-antihistamine dose and subsequent need for omalizumab in a homogenous CSU cohort without major comorbidities. This single-center, retrospective cohort study included 185 adult CSU patients. Baseline inflammatory markers were analyzed relative to the primary outcome of omalizumab requirement and secondary outcome of intensity of antihistamine dose. Multivariate logistic regression and receiver operating characteristic analyses identified independent predictors and optimized cut-off values. Higher baseline levels of inflammatory markers, such as white blood cell count, neutrophils, neutrophil-to-lymphocyte ratio, systemic immune-inflammation index, and aggregate index of systemic inflammation (AISI), were significantly associated with the need for fourfold antihistamine dosing. Adjusted multivariate analysis identified AISI ≥ 346.8 (adjusted odds ratio [aOR] = 7.45) as an independent predictor of omalizumab requirement, while erythrocyte sedimentation rate (ESR) > 7.5 (aOR = 0.24) was identified as an independent protective factor against omalizumab requirement. As a standalone biomarker, AISI demonstrated an area under the curve (AUC) of 0.733 and a negative predictive value (NPV) of 96.4% at this threshold. In this cohort, baseline AISI was independently associated with omalizumab requirement and appears to be a promising marker that warrants external validation, whereas elevated ESR appears protective. Given the retrospective single-center design, these findings should be interpreted cautiously. A high NPV of the AISI cut-off suggests potential clinical utility for ruling out patients unlikely to require treatment escalation.