Background: Older surgical patients remain at increased risk of adverse postoperative outcome when undergoing both elective and emergency surgery. The needs of the older surgical patient are often substantially different from those of younger patients. As a surgeons we have dilemmas in appropriately treating elderly patients. Specifically, those with cancer have been shown to receive inappropriate care, being either undertreated or overtreated based on their chronological age rather than their degree of frailty. Aim:To evaluate outcome of patients diagnosed with colorectal cancer in patients aged 80 years and over. Methods:Retrospective study of all patients 80 years and above managed with colorectal cancer at the Luton and Dunstable University Hospital UK from January 2015 through December 2019 Results: In the study period 278 patients were diagnosed with colorectal cancer, Male 143 Female 135 ratio 1:1.05. Age range from 80 to 101years. 54.31% patients underwent surgical intervention. 15.10% had complications after surgery. 36.69% patients deemed unsuitable for resection surgery were treated with best supportive care palliatively. 57.19% patients were in ASAIII, 24.10% ASAII and 12.23% ASAIV. 46.40% patients died during the study period. Conclusion:Age on its own would not be taken as for less aggressive therapy; Careful assessment of the patient taking into consideration comorbidities, functional status and patient wishes are essential in decision making and choosing appropriate management plan. Curative surgery for colorectal carcinoma in the geriatric patients are well tolerated. Management of comorbidities preceding surgery may impact postoperative outcome.

Background: The antiviral agent favipiravir is an RNA-dependent RNA polymerase (RdRp) inhibitor. Materials and Methods: We examined patients with a clinical, laboratory, and radiological diagnosis of severe coronavirus disease 2019 (COVID-19) pneumonia. We investigated the effect of administering enteral favipiravir at a 2 × 1,600 mg loading dose and 2 × 600 mg maintenance dose for 5 days in addition to the standard COVID-19 treatment. Results: In total, 180 patients, who were hospitalized at the Istanbul Tuzla State Hospital and received favipiravir treatment between March 20, 2020 and May 30, 2020, were examined. Of these, 47 patients died. Thirty-three of the patients who died were aged over 65 years (70%), indicating that fatality was higher in elderly patients. Most of those who died had at least one comorbidity. Of the 101 patients who initiated favipiravir within =3 days of hospitalization, 17 died (17%). Of the 79 patients who initiated favipiravir after >3 days of hospitalization, 30 died (38%) (P = 0.002). Conclusion: We found that initiation of favipiravir within the first 72 h after the onset of disease symptoms reduced fatality in patients with COVID-19.

Recent investigation successfully identified a pre leukemic ETV6/RUNX1-positive clone in the healthy twin of a patient diagnosed with ETV6/RUNXI-positive acute lymphoblastic leukemia (ALL) and also some studies with ETV6/RUNX1 knock in mice showed that the expression of the fusion gene is not sufficient for the invivo induction of ALL. Taken together, these data indicate that ETV6/RUNX1-positive leukemia is .generated through a multi-step mechanism, and that accumulation of additional genetic changes is necessary for the development of overt leukemia. Hence, to understand fully the genetic evolution of this disorder, identification of the complete spectrum of genetic changes that accompany the ETV6/RUNX1 fusion gene is necessary. Moreover, critical patho genetic insights may be gained from studying the correlation pattern of the different copy number changes.

We report an original case of carcinoma en cuirasse associated with zosteriform metastasis. A 40-year-old woman presented to our department with painful erythematous lesions. She had a history of invasive ductal carcinoma of the left breast. Numerous erythematous, papules and whitish vesicles were present over the right side of the chest in a dermatomal distribution with indurated coalescent plaques. Biopsy revealed metastatic carcinoma of breast origin. Breast mammography showed suspicious right nodule. Controlateral breast carcinoma with CM was diagnosed. CM show a wide range of clinical manifestations. Carcinoma en cuirasse, is a very rare form of metastatic cutaneous breast cancer. It is characterized by diffuse sclerodermatous induration of the skin. Zosteriform metastasis is also rarely seen. It may be distributed along dermatomeres in a variety of clinical patterns, including nodular, papulovesicular, or vesiculobullous. In our case, the zosteriform metastasis occurred in the contralateral site. It announced the developing of contralateral breast cancer.

Background: Metastatic cancer is associated with an invariably fatal outcome. However, DeltaRex-G, a tumor-targeted retrovector encoding a gene-edited dominant-negative CCNG1 inhibitor gene, has induced long term (>10 years) survival of patients with chemo-resistant metastatic pancreatic adenocarcinoma, malignant peripheral nerve sheath tumor, osteosarcoma, B-cell lymphoma, and breast carcinoma. Objective: To evaluate the level of CCNG1 expression in tumors as a potential biomarker for CCNG1 (Cyclin G1-blocking) inhibitor therapy. Methods: CCNG1 RNA expression levels that were previously measured as part of whole genome molecular profiling of tumors (TCGA, N=9161), adjacent “tissues” (TCGA, N=678) and GTEx normal tissues (N=7187) across 22 organ sites were analyzed. Differential expression of CCNG1 and Ki-67 in primary (N= 9161) vs metastatic (N= 393) tumors were also compared in primary (N=103) vs. metastatic (N=367) skin cancers (i.e., melanoma). Statistical Analysis: To detect systematically differential expression of CCNG1 and Ki-67 expression between populations (e.g. tumor vs. normal), unpaired Students t-tests were performed. Results: Enhanced CCNG1 RNA and Cyclin G1 protein expression were noted in tumors compared to normal analogous counterparts, and CCNG1 expression correlated significantly with that of Ki-67. Moreover, CCNG1 expression tended to be higher than that of Ki-67 in metastatic vs primary tumors. Conclusions: Taken together with the emerging Cyclin G1 / Cdk / Myc / Mdm2 / p53 Axis governing Cancer Stem Cell Competence, this supportive data indicates: (1) CCNG1 expression is frequently enhanced in tumors when compared to their normal analogous counterparts, (2) CCNG1 and Ki-67 expressions are higher in metastatic vs primary tumors, (3) CCNG1 expression is significantly correlated with that of Ki-67, and (4) CCNG1 may actually be a stronger prognostic marker of stem cell competence, chemo-refractoriness, and EMT/metastasis than Ki-67. Phase 2 studies are planned to identify patients most likely to respond favorably to CCNG1 inhibitor therapy.