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Primary gastrointestinal lymphoma is a common presentation of non-Hodgkin's lymphoma. The main controversy arises when many aspects of its classification and management are under discussion, particularly regarding roles for surgical resection. The aim of this study was to evaluate clinicopathologic characteristics and the therapeutic outcome of primary gastrointestinal non-Hodgkin's lymphoma. We carried out a retrospective analysis of 74 patients who were presented to our center with histopathological diagnosis of primary gastro-intestinal non-Hodgkin's lymphoma between 1990 and 2001. All patients have been staged according to Lugano Staging System. For histopathological classification, International Working Formulation was applied. The treatment choice concerning the surgical or non-surgical management was decided by the initially acting physician. Treatment modalities were compared using the parameters of age, sex, histopathological results, stage, and the site of disease. Of the 74 patients, 31 were female and 43 were male, with a median age of 49 years (range 15-80). The stomach was the most common primary site and was seen in 51 of 74 patients (68.9%). The intermediate and high grade lymphomas constituted 91.9% of the all cases. In a median follow-up of 29 months (range 2-128), 20 out of 74 patients died. There was a three year overall survival rate in 65.4% of all patients. The three year overall survival rate was better in stage I and II1 patients who were treated with surgery plus chemotherapy (+/-RT) than those treated with chemotherapy alone (93.7% vs. 55.6%, p < 0.05). The stage and presence of B symptoms affected the disease free survival and overall survival significantly, but the histopathologic grade only affected the overall survival. On the basis of these results, we suggest that surgical resection is necessary before chemotherapy in early stage (stage I and II1) patients with gastrointestinal non-Hodgkin's lymphomas because of the significant survival advantage it would bring to the patient.

PurposeCovid-19 is a severe lethal disease characterized with pneumonia and acute respiratory distress syndrome. We aimed to analyze the prevalence of critical illness-related corticosteroid insufficiency (CIRCI) in Covid-19 patients treated in intensive care unit and whether treatment of it would create any survival benefit. MethodsA total of 119 Covid-19 patients in intensive care unit were enrolled into the study. All patients received treatment for Covid-19 according to national guideline including hydroxychloroquine, favipiravir, antibiotics including azithromycin and oseltamivir in some patients. Basal cortisol below 10 µg/dl were accepted as CIRCI and above 34 µg/dl as intact HPA axis. Patients between them were introduced 1 µg cosynthropin stimulation test and delta cortisol below 9 µg/dl were also accepted as CIRCI. All patients who got diagnosis received hydrocortisone 300 mg/day until clinical condition stabilized. Mortality rate was recorded, then. ResultsCIRCI was detected in 50.4% of cases and mean plasma ACTH level was 14.8±6.0 pg/ml. Patients below age 65 had a statistically higher risk (63.4 % vs. 40.2%, p=0.012). Presence of comorbidity did not increase the risk of CIRCI (47.3% vs. 62.5%, p=0.18). Also, severity of pulmonary involvement and intubation did not increase the risk of CIRCI. Total mortality rate was 49.5% and not different in patients with and without CIRCI (45.0% vs. 54.5%, p=0.31) indicating benefit of corticosteroid treatment. ConclusionCIRCI is common in Covid-19 patients treated in intensive care unit and treatment of CIRCI provide survival benefit.

Purpose:The choroid and retina receive most of the blood that enter to the eye, and this uptake may be affected by essential thrombocythemia (ET) in which thrombosis and hemorrhage is common. This study compares choroidal thickness, retinal vascular caliber, and ocular pulse amplitude (OPA) measurements between patients with ET and healthy adults.Materials and Methods:Thirty-seven patients with ET and 37 age-sex-matched healthy adults were recruited in this cross-sectional and comparative study. Spectral-domain optical coherence tomography was used to measure the subfoveal choroidal thickness (SFCT) and retinal vascular caliber measurements. The Pascal dynamic contour tonometer was used for OPA and intraocular pressure (IOP) measurements. The independent samples t-test was used for comparison of measurements between the groups. Pearson's correlation coefficient analysis was used to detect correlations between the variables. A P < 0.05 was statistically significant.Results:SFCT, OPA, and IOP measurements were not statistically significant differences between the study group and the control group (P > 0.05, all comparisons). Blood platelet counts were not associated with choroidal thickness, OPA, and IOP (P > 0.05). Retinal arteriolar and venular calibers were statistically, significantly thicker in healthy controls when compared to the study group (P < 0.05).Conclusions:Our results indicate that choroidal thickness and pulsatile blood flow are not significantly affected in ET and under high blood platelet counts. Retinal arteriolar and venular calibers are thinner in ET when compared to age-sex matched healthy controls.

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