Purpose
To investigate the clinical outcomes of patients with hyponatremia who received supportive treatment or tolvaptan plus supportive treatment and the effects of treatment and other variables on ...overall survival
Methods
This study included oncology patients who were hospitalized at two oncology centers between January 1, 2016 and December 31, 2019 for hyponatremia (sodium levels < 135 mEq/L) and who received tolvaptan plus supportive treatment (
n
= 22) or supportive treatment only (
n
= 42).
Results
The median age of all the patients was 59 years (range 26–85) and 64.1% of the patients were male. There was no statistically significant difference between patients in the tolvaptan plus supportive treatment (TpST) group and the supportive treatment only (ST) group in terms of gender and age (
p
> 0.05). In the TpST group, recovery days of the hyponatremia after treatment and the length of hospital stay was shorter and hyponatremia symptoms and hospital complications were less frequent compared to the ST group (
p
< 0.05). There was no significant difference between the TpST group and the ST group in terms of overall survival (OS). OS was shorter in men who were non-responders to hyponatremia treatment and had recurrent hyponatremia. Multivariable analysis showed that normal sodium levels after treatment decreased the risk of death.
Conclusion
In the treatment of hyponatremia in cancer patients, TpST was found to have more positive effects on blood sodium levels, length of hospital stay, hospital complications, and hyponatremia symptoms compared to ST. A decreased risk of death was observed in patients with normal sodium levels after treatment.
Introduction and aim
To investigate the effect of the prognostic nutritional index on treatment response and survival in patients with metastatic renal cell cancer.
Methods
We retrospectively ...analyzed the treatment modalities; the demographic, clinical and pathological features of 396 patients with RCC and prognostic nutritional index. Based on the median value, patients were grouped as having low and high prognostic nutritional index values. Kaplan-Meier method was used for survival analysis, and Cox-regression analysis was used for multivariate analysis.
Results
The median overall survival was 39 months (95% CI 26.1–51.8), 28 months (95% CI 17.9–38) and 7 months (95% CI 4.7–9.2) in patients with favorable, intermediate and poor International Metastatic Renal Cell Carcinoma Database Consortium risk group, respectively. The difference between the groups was statistically significant (p < 0001). Overall survival was 11 months (95% CI 7.5–14.5) in the low-prognostic nutritional index (prognostic nutritional index ≤38.5) group, and 41 months (95% CI 30.5–51.4) in the high prognostic nutritional index (prognostic nutritional index >38.5) group (p < 0.001). In Cox regression analysis, Eastern Cooperative Oncology Group performance score (HR: 2.5), time to systemic treatment (HR: 1.7) and prognostic nutritional index (HR: 1.8) were associated with overall survival.
Conclusion
In patients with renal cell cancer, prognostic nutritional index is closely related to survival and has prognostic significance.
Introduction and aim
To demonstrate the real-life data about patients who underwent AHSCT due to GCT.
Methods
Between November 2016 and April 2020, 64 patients who received CE as high-dose ...chemotherapy for AHSCT in the Gulhane Education and Research Hospital were included in the study. Sixty-one patients received one AHSCT with CE chemotherapy regimen. Survival data and clinical characteristics were evaluated retrospectively.
Results
The mean age of the patients were 31.9 ± 9 (min-max:18–55). With a median follow-up of 10.7 ± 8.7 months, the 1-year progression-free survival (PFS) rate was 57.8%, and the 1-year overall survival rate was 77.5%. Median overall survival (OS) and progression-free survival (PFS) times were 21.5 ± 1.8 (95% CI: 14.5–33.4) and 20 ± 2 months, respectively. The response rate was 72%. There were three treatment-related deaths.
Conclusion
This sizeable single-centre study shows that patients with relapsed metastatic GCT are curable by CE as high dose chemotherapy plus AHSCT with reliable toxicity even for a single cycle.
What is the relationship between the financial system and politics? In a democratic system, what kind of control should elected governments have over the financial markets? What policies should be ...implemented to regulate them? What is the role played by different elites - financial, technocratic, and political - in the operation and regulation of the financial system? And what role should citizens, investors, and savers play? These are some of the questions addressed in this challenging analysis of the particular features of the contemporary capitalist economy in Britain, the USA, and Western Europe. The authors argue that the causes of the financial crisis lay in the bricolage and innovation in financial markets, resulting in long chains and circuits of transactions and instruments that enabled bankers to earn fees, but which did not sufficiently take into account system risk, uncertainty, and unintended consequences. In the wake of the crisis, the authors argue that social scientists, governments, and citizens need to re-engage with the political dimensions of financial markets. This book offers a controversial and accessible exploration of the disorders of our financial capitalism and its justifications. With an innovative emphasis on the economically 'undisclosed' and the political 'mystifying', it combines technical understanding of finance, cultural analysis, and al political account of interests and institutions. Available in OSO: http://www.oxfordscholarship.com/oso/public/content/management/9780199589081/toc.html
Objective: To demonstrate treatment responses, survival analysis and treatment-related mortality characteristics of patients with malignant somatic transformation (MST). Materials and Methods: In ...this retrospective cross-sectional study, patients with relapsed and refractory MST who had previously received multiple-line chemotherapy were evaluated. Clinical features and follow-up data of relapsed/refractory MST patients were recorded from the patients’ registration database at the hospital. Age, clinical stage at initial diagnosis, serum tumour marker levels, visceral metastasis status, previous treatment protocols and follow-up times were recorded. This study aims to demonstrate demographic and disease-related characteristics, best response to systemic therapy, and overall survival (OS) results. Results: The study included 14 patients. Mean age at diagnosis was 29.6 years for the whole group. The most-common sarcoma subtype was Ewing sarcoma (44.4% in the sarcoma group). In half the patients, the best response to systemic treatment was determined as a complete response. Median OS for the sarcoma group was 19.72 months interquartile range (IQR) 29.18 months, and in the adenocarcinoma group, it was determined as 136.24 months (IQR 131.92 months) (p=0.006). The median OS for the whole group was 28.12 months (IQR 99 months). No significant difference in survival was found between synchronous and relapsed cases median (IQR) 24.09 (91.23) months vs 43.54 (113.51) months, p=0.606. Conclusions: Germ cell tumour patients with MST should be treated according to the somatic component. Poor responses to cisplatin-based chemotherapy have been found in this cohort. Patients with sarcomatous components were found to have significantly shorter OS.
To investigate the clinical significance of VEGF, sVEGFR-1 in heart failure reduced ejection fraction (HFrEF) and heart failure mid-range ejection fraction (HFmrEF) patients. Methods: A total of 104 ...people consisting of HFrEF and HFmrEF patients (n=54) and healthy (n=50) subjects were included in this comparative cross-sectional study. The study took place in Gulhane Training and Research Hospital, Ankara, Turkey, between 2011 and 2013. Serum VEGF, sVEGFR-1, plasma pro-BNP analysis and transthoracic echocardiography were performed. Results: The average sVEGFR-1 level of the HFrEF and HFmrEF patients was significantly higher than the control group (0.185±0.122; 0.141±0.120; p=0.013). The average sVEGFR-1 level of the HFrEF and HFmrEF patients using beta-blocker was significantly higher than the HFrEF and HFmrEF patients not using it (p=0.015). There was a significant and positive correlation between sVEGFR-1 and N-terminal pro-brain natriuretic peptide (pro-BNP) levels in the group with HF (r=0.211, p=0.044). Conclusion: It increases awareness about the role of sVEGFR-1 in HFrEF anf HFmrEF patients and the need for further studies. Beta-blocker may have a negative effect on angiogenesis in HFrEF and HFmrEF via increasing sVEGFR-1 levels. Additionally, Pro-BNP may contribute to inhibiting angiogenesis by increasing sVEGFR-1 levels and sVEGFR-1 may be an important biomarker in HFrEF and HFmrEF.
After the 2007 financial crisis central bank economists in the US produced a map of shadow banking system, a fragile interconnectedness of regulated and unregulated financial institutions, to explain ...why the crisis had happened. This piece of cartographic work in banking regulation had two aims: (a) to represent the economic reality, including the parts that were not in regulatory sight, with full realism and (b) to develop a regulatory surveillance regime to monitor shadow banking to prevent future crises. This paper problematises the first aim as a peculiar cognitive response to the knowledge crisis of economics which challenges the consensus on modern finance as post-modern Baudrilliardian simulacra. The paper then introduces a cultural economy perspective to explore the regulatory fear in the second aim of the shadow banking analysis with references to the theme of the Doppelgänger (the Double) in the genre of horror stories. Finally the societal consequences of the control oriented epistemological choices of the shadow banking analysis are problematised by using Michel Serres concepts of foedera natura versus foedera fati.
Background
To describe the prognostic value of neutrophil–lymphocyte ratio and its effect on survival in in patients with advanced renal cell carcinoma.
Methods
We retrospectively analyzed 331 ...patients. The cut-off value of neutrophil–lymphocyte ratio was specified as “3” which is mostly close—and also clinically easily applicable—to the median neutrophil–lymphocyte ratio level of our study group. High group is identified as neutrophil–lymphocyte ratio >3 (n = 160) and low group is identified as neutrophil–lymphocyte ratio ≤3 (n = 163).
Results
A total of 331 (with 211 male and 120 female) patients were enrolled to study. The median age of the patients was 58. The International Metastatic RCC Database Consortium risk score is calculated for the 72.8% (n = 241) of the study group and among these patients, favorable, intermediate, and poor risk rates were 22, 45.2, and 32.8%. The total usage of tyrosine kinase inhibitors reached 78% of the patients. The median overall survival was 32 months versus 11 months in the neutrophil–lymphocyte ratio low and high groups, respectively (HR: 0.49 (95% CI 0.37–0.65), p < 0.001).
Conclusion
In conclusion, the pre-treatment value of elevated neutrophil–lymphocyte ratio might be a predictor of poor overall survival in advanced renal cell carcinoma patients.
This article argues that major post-crisis regulatory initiatives like the Dodd-Frank Act, the Vickers Report, the Liikanen Review and Basel III capital adequacy and liquidity rules that are shaping ...the banking industry globally are not likely to be successful in de-risking the banks because they do not explicitly engage with the consequences of shareholder value-driven business models that drive management behaviour in banking. Banks operate in a financialized economy where firms compete in the stock market to deliver unrealistic returns to shareholders. The business models of such financialized banks re-locate risks according to conjunctural market and regulatory arbitrage conditions to achieve the unchallenged return targets and therefore thwart the ideal outcomes aimed at by regulatory initiatives. The section ‘Introduction: Post-crisis regulatory reform initiatives to de-risk and re-capitalise banks’ of this article will describe the de-risking and re-capitalisation measures that were introduced by the post-crisis regulatory initiatives in the United States and Europe. The section ‘Financialized bank business models’ will discuss bank business models in a financialised economy and how the post-crisis regulatory initiatives have failed to address the risks in banking that are associated with maximising shareholder value. The section ‘Post-crisis examples of relocated risks in shareholder value-driven banks’ will examine two post-crisis case studies where JP Morgan Chase and the UK retail banks like Lloyds Group, in pursuit of shareholder value creation, suffered losses from activities that the new regulatory initiatives have failed to identify and regulate.
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