SUMMARY OBJECTIVE: In coronavirus disease 2019, a rapidly progressive inflammatory process is considered to be the main cause of organ damage and mortality. Therefore, the importance of anti-inflammatory treatments such as tocilizumab is increasing. METHODS: A total of 107 patients who received tocilizumab between March 2020 and March 2021 were included in the study. The primary termination point was mortality. We compared surviving and deceased patients by the stage of the disease and where the drug was given (service or intensive care unit). RESULTS: The mean age was 60.8±14.6 years (minimum 29 years, maximum 96 years). According to the WHO staging system, 16 (15%) patients had moderate, 47 (43.9%) patients had severe, 44 (41.1%) patients had a critical illness. Although all patients were admitted to the service, 26 (24.3%) patients received tocilizumab in the intensive care unit. Of 107 patients, 80 (74.7%) survived and 27 (25.2%) died. Mortality was found to be significantly higher in critical patients (96.3%), severe patients (3.7%), and moderate patients (0%) (p<0.001). Peripheral oxygen saturation measured at admission was found to be significantly lower in patients who died. The initial saturations (p=0.008) were found to have independent effects on mortality. CONCLUSION: The results showed that tocilizumab is an effective treatment option for coronavirus disease 2019 disease and reduces mortality, but the key point is timing.

Abstract Lung cancer is the leading cause of cancer-related death, and NSCLC constitutes nearly 85%–90% of all cases. The IRS proteins function as adaptors and transmit signals from multiple receptors. Upon binding of insulin to the insulin receptor (IR), IRS1 is phosphorylated at several YXXM motifs creating docking sites for the binding of PI3Kp85, which activates AKT kinase. Therefore, we thought that gain of function mutantions of IRS1 could be related to development of lung cancer. In line with this, we wanted determine whether the IRS1 gene was mutated in the coding regions surrounding YXXM motifs. We sequenced the coding regions surrounding YXXM motifs of IRS1 using tumor samples of 42 NSCLC patients and 40 matching controls and found heterozygote p.S668T mutation in nine of 42 samples and four of nine also had the p.D674H mutation. We generated IRS1 expression vectors harboring p.S668T, p.D674H and double mutants. Expression of the mutants differentially affected insulin-induced phosphorylation of IRS1, AKT, ERK, and STAT3. Also, our mutants induced proliferation, glucose uptake, inhibited the migration of 293T cells and affected the responsiveness of the cells to cisplatin and radiation. Our results suggest that these novel mutations play a role in the phenotype of lung cancer.

ABSTRACT Objective To present clinical, chromosomal and hormonal features of ten cases with SRY-positive 46,XX testicular disorder of sex development who were admitted to our infertility clinic. Cases and Methods Records of the cases who were admitted to our infertility clinic between 2004 and 2015 were investigated. Ten 46,XX testicular disorder of sex development cases were detected. Clinical, hormonal and chromosomal assessments were analized. Results Mean age at diagnosis was 30.4, mean body height was 166.9cm. Hormonal data indicated that the patients had a higher FSH, LH levels, lower TT level and normal E2, PRL levels. Karyotype analysis of all patients confirmed 46,XX karyotype, and FISH analysis showed that SRY gene was positive and translocated to Xp. The AZFa, AZFb and AZFc regions were absent in 8 cases. In one case AZFb and AZFc incomplete deletion and normal AZFa region was present. In the other one all AZF regions were present. Conclusion Gonadal development disorders such as SRY-positive 46,XX testicular disorder of sex development can be diagnosed in infertility clinics during infertility work-up. Although these cases had no chance of bearing a child, they should be protected from negative effects of testosterone deficiency by replacement therapies.

OBJECTIVE: We evaluated the efficacy of local nitroglycerin application in preventing and treating flap complications after modified radical mastectomy in a large patient cohort. PATIENTS AND METHODS: Between 1993 and 2008, 6 426 patients undergoing surgery for stage II breast cancer were enrolled in this prospective study. Patients were randomised into treatment and control groups. In the treatment group a nitroglycerin preparation (Nitroderm) was applied to the flap area. Major complications, recovery periods, menopausal status, additional diseases (diabetes mellitus, hypertension, atherosclerotic heart disease) and adverse effects related to nitroglycerin use were recorded. RESULTS: The recovery rate without major complications was statistically significantly higher in the nitroglycerin-treated group than in the controls (p<0.001). CONCLUSION: Our results indicate that topical nitroglycerin reduces flap complications after breast surgery.