Introduction
Hepatotoxicity is observed due to cyclin-dependent kinase (CDK4/6) inhibitors used to treat hormone receptor-positive metastatic breast cancer. However, it should not be ignored that ...denosumab may be hepatotoxic, although it is rare.
Case Report
A 73-year-old female patient with breast cancer with axillary lymph node, adrenal gland and bone metastases was started on ribociclib letrozole and denosumab treatment. Ribociclib treatment was discontinued due to grade 4 hepatotoxicity during treatment, but liver function tests did not decrease. After discontinuation of denosumab treatment, alanine aminotransferase and aspartate aminotransferase values regressed to baseline values.
Management and Outcome
Despite the discontinuation of ribociclib treatment, other causes of liver toxicity were investigated due to persistence of hepatic transaminases and elevation. Autoimmune hepatitis markers were negative. Hepatobiliary USG did not reveal any pathological findings except hepatosteatosis. Liver biopsy was performed to determine the etiology. Pathology result was compatible with acute hepatocellular damage (in favor of toxic hepatitis). A decrease in liver values was detected after discontinuation of denosumab treatment.
Discussion
Although cases with improvement in liver enzymes have been reported after discontinuation of ribociclib, no improvement in hepatotoxicity was observed in our case. Since the liver biopsy was toxic hepatitis, it was thought that other drugs used by the patient might cause this toxicity, and a significant decrease was observed in liver values after discontinuation of denosumab. Denosumab-induced liver toxicity is very rare, and there are only a limited number of cases in the literature.
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NUK, OILJ, SAZU, UKNU, UL, UM, UPUK
The extraction of zinc from a sphalerite concentrate using sodium chlorate as an oxidant in hydrochloric acid solutions was examined. It was determined that stirring speed did not significantly ...affect zinc extraction compared with other experimental parameters. The dissolution rate increased with increasing sodium chlorate and hydrochloric acid concentrations and temperature, but decreased with increasing particle size. The kinetic study showed that the dissolution of zinc could be represented by a shrinking core model with surface chemical reaction. The activation energy (
Ea) for the dissolution reaction was calculated as 41.1 kJ/mol.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
The extraction of lead from a galena concentrate in nitric acid solutions with additional hydrogen peroxide was studied taking stirring speed, temperature, hydrogen peroxide and nitric acid ...concentrations, and particle size as dissolution parameters. The dissolution curves followed the surface chemical reaction controlled shrinking core model over the whole range of parameters, except at high nitric acid concentrations where the reaction was diffusion-controlled. The activation energy of 42 kJ mol
−
1
and a linear relationship between rate and inverse particle size support the reaction controlled dissolution mechanism. Hydrogen peroxide addition accelerated the reaction compared with nitric acid alone. It was concluded that the dissolution process is favourable, since the acid consumed for oxidation of galena can easily be regenerated in the same reactor by means of hydrogen peroxide.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Many patients present for emergency services after electric injuries or require defibrillation during emergency services. Although the defibrillation process is safe, skin burns and myocardial ...injuries are reported after defibrillation procedures. There are limited data about the complications of defibrillation. In the case reported here, a lung injury and a small pneumothorax were observed after defibrillation. To the best of our knowledge, this is the first reported case in which computed tomography is used to demonstrate that a trace of electric current passed through the lung. Computed tomography may be an excellent diagnostic modality to demonstrate the severity and extent of electric injuries to the lung.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Background
Bladder cancer surgery is critical for treatment, and systemic treatment before or after cystectomy may be necessary. We aimed to investigate the efficacy and response to neoadjuvant and ...adjuvant treatments.
Methods
Data on 93 patients with resectable muscle-invasive bladder cancer were analyzed retrospectively. Patients who received neoadjuvant and adjuvant chemotherapies were included. The neoadjuvant treatment group was divided into pathological responders and non-responders. Overall survival and disease-free survival were calculated.
Results
The median age was 61.5 years; there were 6 female and 87 male patients. Baseline characteristics were similar between the groups. While there was no difference in OS between the neoadjuvant and adjuvant treatment groups (20 months vs. not reached), DFS was significantly higher in the adjuvant group (20.6 vs. 25.3 months). While there was no significant difference in DFS between the responders and non-responders to neoadjuvant treatment (20.6 vs. 19.1 months), OS was significantly longer in the responders (Not reached vs. 12.3 months).
Conclusions
Our results concluded that neoadjuvant and adjuvant chemotherapies have similar survival rates, but no response was associated with poor outcomes. Determining the group for patient selection may be helpful for optimal management.
Objectives
Olfactory sensory neurons and the olfactory mucosa are both important for optimal olfactory function. The potential nasal mucosal toxicity of chemotherapy regimens has not been assessed ...yet. The aim of this study was to objectively investigate the effect of chemotherapy on mucociliary clearance and olfactory function and to evaluate whether this effect differs between different chemotherapy regimens and age groups.
Patients and methods
The study included consecutive patients admitted for the treatment of a variety of primary tumors (except head and neck and brain malignancies). Patients were evaluated for olfaction and mucociliary clearance before and immediately after completing the last session of chemotherapy cycles, according to the therapeutic protocol. For objective evaluation, the saccharine test was used for mucociliary clearance and the Sniffin’ Sticks test for olfactory function. Of the 46 initial patients, 30 completed the study. Groups were formed according to the chemotherapy regimen (four groups: CA (doxorubicin + cyclophosphamide), Folfox (oxaliplatin +5-FU + folinic acid), DCF (docetaxel + cisplatin +5-FU), and GC (gemcitabine + cisplatin)) and according to age (two groups: < 55 years and > 55 years).
Results
In the overall analyses, significant deterioration was noted in both mucociliary clearance time and smell scores (olfactory threshold (OT), olfactory discrimination (OD), olfactory identification (OI), and the composite threshold–discrimination–identification (TDI) score). The changes in these scores showed no significant differences between chemotherapy groups. The decrease in OT and global TDI scores was more severe in the younger age group.
Conclusions
Chemotherapy impairs both the mucociliary clearance and olfactory function in cancer patients. This might reflect the collective negative effect of chemotherapy on olfactory function, not only through the neurocytotoxic effect but also the cytotoxic effect on the nasal mucosa. In addition, the reduction in olfactory threshold and total olfactory function scores was seen to be more profound in younger patients, which could have been due to higher initial scores.
The kinetics of leaching lead from galena in acetic (ethanoic) acid solutions with hydrogen peroxide are investigated with regard to stirring speed, temperature and concentration of HAc and H2O2 ...concentration. Oxidation of galena with H2O2 to produce lead sulphate which dissolves by complexing Pb2+ with acetate anion (PbCH3COO+ and Pb(CH3COO)2). Results indicate that the rate of galena dissolution is controlled by a surface chemical reaction with an apparent activation energy is 65.6 kJ mol−1 in the temperature range 30–70 °C. Both HAc and H2O2 affect the rate of extraction of lead as an acetate complex. The order of reaction was 0.79 and 0.31 for H2O2 and HAc concentrations, respectively.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Abstract
This study aims to investigate the prognostic value of the systemic immune-inflammation index (SII)and its impact on survival in patients with metastatic renal cell carcinoma (mRCC). A total ...of 706patients with mRCC treated with tyrosine kinase inhibitors (TKIs)between January 2007 and June 2020 (i.e., sunitinib, pazopanib) were included in this study. SII was calculated in 621 patients with the following formula:neutrophil (cellsx10
9
/L) x platelet (cellsx10
9
/L) / lymphocyte (cellsx10
9
/L).All patients were classified into SII-high and SII-low groups based on the cut-off value of SII at 756, which was the median SII level of our study group. The minimal follow-up duration was 10 months in all cohorts. The median age of patients was 60 (interquartile range (IQR):53–67) years. Three out of four patients were male. The majority of patients (85.7%) had clear cell histology, and sarcomatoid differentiation was observed in 16.9% of all patients. There were 311 and 310 patients in the SII-low and SII-high groups, respectively. In general, baseline characteristics were similar in each group. However, the rate of patients treated with sunitinib (63.3% vs. 49.0%,
p
< 0.001) and those who underwent nephrectomy (83.6% vs. 64.2%,
p
< 0.001) was higher in the SII-low group than in the SII-high group. On the other hand, patients with the IMDC poorrisk (31.6% vs. 8.0%,
p
< 0.001), those with bone (51.8% vs. 32.2%,
p
< 0.001) or central nervous system (12.9% vs. 5.8%,
p
= 0.026) metastasis, and those with Eastern Cooperative Oncology Group(ECOG) 2–4 performance score (28.1% vs.17.7%,
p
= 0.002) were more common in the SII-high group than in the SII-low group. The median overall survival (OS) was longer in the SII-low group than in the SII-high group (34.6 months vs. 14.5 months,
p
< 0.001). Similarly, the median progression-free survival (PFS) was longer in the SII-low group than in the SII-high group (18.0 months vs. 7.7 months,
p
< 0.001).In multivariableanalysis, SII was an independent prognostic factor for OS (hazard ratio (HR):1.39, 95% confidence interval (CI):1.05–1.85,
p
= 0.01) and PFS (HR:1.60, 95% CI:1.24–2.05,
p
< 0.001).Pre-treatment level of high SII might be considered a predictor of poor prognosisin patients with mRCC treated with TKIs.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
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