Prospective evaluation of hematological parameters in preoperative renal cell cancer patients.

BACKGROUND: Of all the genitourinary cancers, renal cell carcinoma (RCC) is still the most common malignancy with high mortality rates. There are still insufficient biomarkers to predict disease prognosis. Systemic inflammation markers play an important role in tumor development and growth. There are studies which show the relationship of fibrinogen and albumin individually with cancer prognosis in many cancers. Fibrinogen/albumin ratio(FAR), on the other hand, has prognostic importance like other inflammation indicators in cancer. Therefore, we investigated whether FAR had a potential value in evaluating the prognosis of patients with nonmetastatic kidney cancer or not. METHODS: A total of 72 patients who had nephrectomy operation at 19 Mayis University, Faculty of Medicine between January 2019 and January 2021 and who did not have distant metastasis were included in the study. FAR was calculated from the blood taken from the patients before the nephrectomy operation. The cut-off value was found for this FAR by receiver operating characteristic(ROC) curve analysis. The patients were divided into 2 groups as high- and low-FAR according to this cut-off value. Kaplan Meier test was used to evaluate the predictive value of clinicopathological parameters for overall survival (OS). The Log-rank test was used to determine whether there was a relationship between the preoperative FAR and the clinico-pathological data of the patients. RESULTS: The best cutoff value for the FAR was 0.114. A FAR > 0.114 was associated with higher Fuhrman Grade (FG) (P < 0.0001) and later pathological T stage (P < 0.0001). Patients with a high FAR (> 0.114) had worse OS [Std. Error 2.932, 95% confidence interval (CI): 73.659-85.154, P < 0.0001]. In addition, a positive significant correlation was found between high grade and platelet lymphocyte ratio (p < 0,020). Furthermore, a significant correlation was found between the pathology t stage of the patients and the platelet lymphocyte ratio (p: 0.020). CONCLUSIONS: The preoperative FAR is an independent prognostic factor of OS in renal cancer patients. A FAR > 0.114 was significantly related to decreased survival in renal cancer patients. In addition, the platelet-lymphocyte ratio seems to be related to OS, as well as FAR. Further studies are required on this subject.

Transient motion of the largest landslide on earth, modulated by hydrological forces.

Sea-level rise of the Caspian Sea (CS) during the early Khvalynian (approximately 40-25 ka BP) generated hundreds of giant landslides along the sea's ancient coastlines in western Kazakhstan, which extended hundreds of kilometers. Although similar landslides have been observed along the present-day coastlines of the CS in the area of a prominent high escarpment, it remains unclear whether some of these ancient landslides are still active and whether the movement is slow or catastrophic, as previously suggested. The present study is the first to show evidence proving that the geomorphic responses to sea-level changes of the CS that were triggered in the Pleistocene are currently active. Using interferometric synthetic aperture radar (InSAR) data, we show that one of these giant landslides occurring along the western shore of the Kara-Bogaz-Gol (KBG) lagoon of the CS presents active transient motion, which makes it the world's largest active landslide reported thus far. Extending more than 25 km along the eastern coast of the inundated KBG depression in a N-S direction with maximum landward expansion of 5 km from the shoreline to the flat Ustyurt Plateau, this landslide conveys ~ 10 × 109 m3 rocks toward the lagoon at a rate of ~ 2.5 cm/year. This event releases a nearly episodic aseismic moment of 6.0 × 1010 Nm annually, which is equivalent to the response of an Mw 5.1 earthquake. We analyze the present-day evolution of this giant coastal landslide at high temporal and spatial resolutions using Sentinel-1 radar images acquired on descending and ascending modes every 12 days between 2014 and 2020. Modelling with elastic dislocations suggests that the KBG landslide was accommodated mostly by a shallow basal décollement with a nearly horizontal listric slip plane. Moreover, our analysis reveals week-long accelerating slip events at changing amplitudes that occur seasonally with slow, lateral spreading rather than sudden catastrophic motion. A strong correlation between the episodic slip events and seasonal water-level changes in the KBG lagoon suggests a causative mechanism for the transient accelerating slip events. Although water-level changes are widely acknowledged to trigger transient motion on a land mass, such movement, which is similar to a silent earthquake, has not been observed thus far at this mega scale; on an extremely low-angle detachment planes at < 5° with modulation by sea-level changes. This study suggests that present-day sea-level changes can reactivate giant landslides that originated 40-25 ka.

The effect of postoperative serratus anterior plane block on postoperative analgesia in patients undergoing breast surgery.

OBJECTIVES: This study aimed to evaluate the effect of serratus anterior plane block (SAP) on postoperative morphine consumption. We aimed to determine the differences between both similar blocks and evaluate the effect of the methods of application of this block on patients' postoperative pain scores and morphine consumption. MATERIAL AND METHODS: This study is a single-center, prospective and observational study performed with 40 volunteer patients with American Society of Anesthesiologists (ASA) I-III, who were 18-70 years of age, scheduled for breast surgery. A total of 40 patients who underwent general anesthesia were divided into two groups each with 20 patients. While SAP block was applied to the study group, no block was applied to the control group. SAP block was made by injecting a total of 40 ml of 0.25% bupivacaine between 2 muscles after the test dose was injected with saline. All patients were followed up for 12 hours postoperatively with patient-controlled analgesia (PCA) pump. Morphine consumption, visual analogue score (VAS) values and side effects were recorded at the postoperative 1st, 6th and 12th hours. RESULTS: There was no significant difference between the two groups in terms of hemodynamic parameters and demographic data. Postoperative morphine consumption and postoperative analgesic requirement were significantly lower in the SAP block group (p <0.001). Postoperative VAS values were significantly lower in the SAP block group (p <0.001). No complication was observed related to the block. CONCLUSION: It was found that the SAP block reduced morphine consumption, significantly decreased VAS values, and reduced side effects due to opioids postoperatively.

Evaluation of retinal nerve fiber layer changes with oral isotretinoin treatment.

INTRODUCTION: Central nervous system toxicity is a well-known side effect of isotretinoin treatment. The aim of this study was to establish the effects of isotretinoin on retinal nerve fiber layer (RNFL) thickness. MATERIALS AND METHODS: Study subjects received oral isotretinoin treatment for nodulocystic acne. All patients underwent a detailed ophthalmologic examination including best-corrected visual acuity, slit-lamp examination, tonometry, color vision assessment, fundoscopy, and RNFL measurement. RNFL measurements by optical coherence tomography were done at onset, and were repeated at the 1st and 6th months of therapy. RESULTS: A total of 22 eyes of 11 patients (seven males and four females) were included in this study. The mean age of the patients was 20.18 ± 5.13 (14-26) years. Mean RNFL thickness was 90.72 ± 9.19 (78.2-112.0) µm before treatment, 90.40 ± 9.24 (79.5-112.4) µm after 1 month of treatment, and 90.52 ± 8.92 (78.4-114.8) µm after 6 months. No statistically significant change was detected between RNFL thickness values before and after treatment. CONCLUSION: No adverse effects of systemic isotretinoin treatment on RNFL thickness were observed.