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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.

Introduction: It is called as heart failure with reduced ejection (HFrEF) while ejection fraction (EF) is lower than 40%. Patients with EF=40-50% is called as heart failure with mid-range ejection fraction (HFmrEF) which is considered as a subgroup of heart failure with preserved ejection fraction (HFpEF) rather than HFrEF. Angiostatin inhibits the proliferation of smooth muscles, endothelial cells, and mesenchymal stem cells. In this study, we aimed to investigate the clinical significance of angiostatin in HFrEF and HFmrEF patients without chronic kidney disease (CKD). Body text: A total of 62 people consisting of patients with a diagnosis of HFrEF and HFmrEF without CKD (n = 25) and healthy (n = 37) subjects were included in this study. Blood samples were obtained and serum angiostatin, plasma Nterminal Pro-BNP analysis, and transthoracic echocardiography were performed. Results and Discussion: The angiostatin level of HFrEF and HFmrEF group was significantly higher than the control group (94,32 (58,7-282,1); 47,14 (18,8-100,2); p<0.001; respectively). Average angiostatin level of HFrEF and HFmrEF patients using calcium chanel blocker (CCB) was significantly higher than the HF patients without CCB (200,4 (79,1 -282,1); 83,5 (58,7 -228,7; p = 0.021; respectively). Average angiostatin level of HFrEF and HFmrEF patients using spironolactone was significantly lower than the HF patients without spironolactone use (61,8 (58,7 -64,1); 133,8 (62,3 -282,1); p = 0.027; respectively). Conclusion: Our study is the first study in this area. Angiostatin may be an important marker in HFrEF and HFmrEF patients. Use of spironolactone may induce angiogenesis and apoptosis and CCB may inhibit angiogenesis in HFrEF and HFmrEF patients. Further studies are required on this subject.

Cirrhosis is termed as the late stage of progressive hepatic fibrosis characterized by the disruption of the hepatic parenchymal structure and the formation of regenerative nodules. Many factors play a role in the etiology of cirrhosis. Currently, mortality is still high and causes significant work loss. The prognosis of patients with cirrhosis is largely due to its complications. Treatment of cirrhosis is limited except liver transplantation. An important cause of the morbidity and mortality associated with cirrhosis is the development of variceal bleeding secondary to portal hypertension. The prognosis of patients with variceal bleeding depends on the bleeding or other complications is associated with underlying chronic liver disease and its management. The mortality rate due to active variceal bleeding is around 20 percent during each bleeding and re-bleeding is observed in 70 percent of patients within one year. Upper gastrointestinal bleeding unrelated to portal hypertension is also common in patients with portal hypertension (eg, peptic ulcer disease). In this article, we will talk about variceal bleeding secondary to portal hypertension and its treatment based on current data.