Comparison of daytime and after-hours surgical treatment of femoral neck fractures.

Background: The timing of surgery for femoral neck fractures in young adults remains controversial. Nonetheless, the debate continues about whether orthopedic trauma cases should be operated daytime or after hours. Aim: This study compared the clinical and radiological outcomes of surgery on femoral neck fractures during daytime versus after-hours. Patients and Methods: A total of 124 patients aged 18-60 years who were operated for femoral neck fractures between 2015 and 2020 were included in the study. The patients were separated into two groups. Seventy-two patients operated between 08:00 and 17:00 hours were defined as the daytime group and 52 patients operated between 17:01 and 07:59 hours were defined as the after-hours group. Demographic data, reduction quality, duration of operation, intraoperative estimated blood loss (EBL), postoperative complications, revision rates, and postoperative Harris hip score results of the two groups were recorded for analysis. Results: There was no significant difference between the groups in terms of age, gender, body mass index, smoking, fracture type and follow-up time, reduction quality, postoperative complication rates, revision rates, and Harris hip score results. Waiting times until surgery, operation duration, and intraoperative EBL amounts were, in the daytime group, significantly higher than in the after-hours group. Conclusion: In this study comparing femoral neck fractures operated on daytime and after-hours in adults, the waiting time until surgery was found to be higher in the daytime group. Operation duration and EBL were higher in the after-hours group.

Explosive enantiospecific decomposition of aspartic acid on Cu surfaces.

Aspartic acid adsorbed on Cu surfaces is doubly deprotonated. On chiral Cu(643)R&S its enantiomers undergo enantiospecific decomposition via an autocatalytic explosion. Once initiated, the decomposition mechanism proceeds via sequential cleavage of the C3-C4 and C1-C2 bonds each yielding CO2, followed by conversion of the remaining species into N[triple bond, length as m-dash]CCH3.

Is there any association of glutathione S-transferase T1 (GSTT1) and glutathione S-transferase M1 (GSTM1) gene polymorphism with gastric cancers?

The glutathione S-transferases (GST) are enzymes catalyzing reactions including carcinogens. GSTT1 and GSTM1 genes are polymorphic in humans. The relations between polymorphism of some GST genes and cancer have been reported. In this study, we aimed to investigate the distribution of GSTT1 and GSTM1 polymorphisms in a group of gastric cancer patients. The study group consisted of 50 patients (21 females, 29 males) with gastric adenocarcinoma from the archives of the pathology department of a training hospital. Fifty-seven healthy control subjects were included in the study as a control group. DNA was extracted from peripheral venous blood of control subjects and from the paraffin blocks of cases. Genotyping of GSTT1 and GSTM1 genes was performed with duplex polymerase chain reaction. No differences in the frequencies of GSTM1 or GSTT1 null genotypes were observed between patients and healthy subjects (GSTM1: 52% vs. 43.85%, OR = 1.27, 95% CI: 0.55-2.96; GSTT1: 38.46% vs. 28.07%, OR = 0.72, 95% CI: 0.25-1.96). Moreover, simultaneous carriage of both genotypes was almost identical in both groups. GSTM1 or GSTT1 null genotypes were not different in diffuse or intestinal type gastric cancer. Our data suggest that the GSTM1 and GSTT1 polymorphisms are not associated with gastric cancer in a small group of the Turkish population.

Hyperammonemic encephalopathy in a patient with primary hepatic neuroendocrine carcinoma.

A 53-year-old male patient was admitted to our hospital with abdominal pain in the right upper quadrant. There was no change in laboratory investigations other than a slight increase in serum levels of alkaline phosphatase (ALP), alanine aminotransferase (ALT), and gamma glutamyl transferase (GGT). Computed tomography (CT) of the abdomen showed multiple hepatic nodular lesions in the liver. Tru-cut biopsy of the lesions was reported as well-differentiated neuroendocrine carcinoma. The patient received sandostatin treatment. After a few days, the patient was hospitalized in the intensive care unit with disturbance of consciousness and clinical features suggestive of encephalopathy. Serum ammonia level was found highly elevated. After the treatment with L-ornithine-L-aspartate, a remarkable improvement in the level of patient's sensorium occurred as well as a reduction in serum ammonia level within a few days. Transarterial chemoembolization (TACE) was performed one week later. The patient's condition began to worsen along with increase in serum ammonia level and he died because of hyperammonemic encephalopathy. There are case reports of hyperammonemia with some malignancies such as multiple myeloma, plasma cell leukemia, and leiomyosarcoma, or in some patients who have received chemotherapy. This case may suggest an association between hyperammonemia and neuroendocrine tumors.

Prognostic significance of thrombocytosis in node-negative colon cancer.

Several clinical studies have shown that thrombocytosis is a poor prognostic factor in some types of cancer, but data about the impact of thrombocytosis on prognosis in patients with colon cancer are very limited. We investigated the prevalence and prognostic effect of pre-operative thrombocytosis, defined as a platelet count > 400 x 10(9)/l, retrospectively in patients with node-negative colon cancer. Out of 198 patients, 24 (12.1%) had thrombocytosis, and its presence correlated with tumour depth and lymphatic invasion. Univariate analysis revealed that disease-free survival and overall survival were shorter in patients with pre-operative thrombocytosis than those without thrombocytosis. On multivariate analysis, thrombocytosis alone retained significance as a poor prognostic factor for both disease-free survival and overall survival. In conclusion, this study shows an association between thrombocytosis and poor survival in patients with node-negative colon cancer. The preoperative platelet count may help to identify patients with an unfavourable prognosis in this subgroup.