Treatment of Older Adult Patients with Glioblastoma: Moving towards the Inclusion of a Comprehensive Geriatric Assessment for Guiding Management

Glioblastoma (GBM) is the most common primary malignant brain tumor in adults, and over half of patients with newly diagnosed GBM are over the age of 65. Management of glioblastoma in older patients includes maximal safe resection followed by either radiation, chemotherapy, or combined modality treatment. Despite recent advances in the treatment of older patients with GBM, survival is still only approximately 9 months compared to approximately 15 months for the general adult population, suggesting that further research is required to optimize management in the older population. The Comprehensive Geriatric Assessment (CGA) has been shown to have a prognostic and predictive role in the management of older patients with other cancers, and domains of the CGA have demonstrated an association with outcomes in GBM in retrospective studies. Furthermore, the CGA and other geriatric assessment tools are now starting to be prospectively investigated in older GBM populations. This review aims to outline current treatment strategies for older patients with GBM, explore the rationale for inclusion of geriatric assessment in GBM management, and highlight recent data investigating its implementation into practice.

The Role of Cumulative LDL Cholesterol in Cardiovascular Disease Development in Patients with Familial Hypercholesterolemia

In patients with familial hypercholesterolemia (FH) the exposure of very high LDL-C concentration and cumulative LDL-C level (cum LDL-C) can play a significant role in the prognosis. Objective: to analyze the contribution of “cum LDL-C for all life” and the index “cum LDL-C/age” to the development of coronary heart disease (CHD), myocardial infarction (MI), and a combined end point: MI, stroke, unstable angina in FH patients. Methods: 188 patients (mean age 49.2 years, males 45.7%) with FH were examined (Dutch Lipid Clinic Criteria). We had evaluated cumulative LDL-C and index “cum DL-C/age” along with other classical risk factors. Cum LDL-C was calculated as LDL-Cmax × (age at initiating of hypolipidemic therapy) + LDL-C at inclusion age at initiation/correction therapy). Cumulative LDL-C and “cum LDL-C/age” were calculated as the ratio cum LDL-C to age. The follow-up period was 5.4 (from 3 to 10) years. Results: The index “cum LDL-C/age” was higher in patients with CHD 58.7 ± 10.4 mmol/L/years vs. 40.1 ± 11.7 mmol/L/years in patients without CHD (p < 0.001). According to our data based on the results of the logistic regression analysis in patients with FH, cumulative LDL-C and the cumulative index “cum LDL–C/age” played a strong predictive role in the development of CHD in FH patients; it was greater than the role of TC and LDL-C concentrations. We present ROC curves for CHD, MI and combined end point in FH patients, and a prognostic scale for CHD development, which is based on classical cardiovascular risk factors. Conclusion: cumulative LDL-C level plays an important role in the development of CHD in FH patients.

The Predictive Role of NLR, d-NLR, MLR, and SIRI in COVID-19 Mortality

(1) Background: Since its discovery, COVID-19 has caused more than 256 million cases, with a cumulative death toll of more than 5.1 million, worldwide. Early identification of patients at high risk of mortality is of great importance in saving the lives of COVID-19 patients. The study aims to assess the utility of various inflammatory markers in predicting mortality among hospitalized patients with COVID-19. (2) Methods: A retrospective observational study was conducted among 108 patients with laboratory-confirmed COVID-19 hospitalized between 1 May 2021 and 31 October 2021 at Municipal Emergency Clinical Hospital of Timisoara, Romania. Blood cell counts at admission were used to obtain NLR, dNLR, MLR, PLR, SII, and SIRI. The association of inflammatory index and mortality was assessed via Kaplan–Maier curves univariate Cox regression and binominal logistic regression. (3) Results: The median age was 63.31 ± 14.83, the rate of in-hospital death being 15.7%. The optimal cutoff for NLR, dNLR, MLR, and SIRI was 9.1, 9.6, 0.69, and 2.2. AUC for PLR and SII had no statistically significant discriminatory value. The binary logistic regression identified elevated NLR (aOR = 4.14), dNLR (aOR = 14.09), and MLR (aOR = 3.29), as independent factors for poor clinical outcome of COVID-19. (4) Conclusions: NLR, dNLR, MLR have significant predictive value in COVID-19 mortality.

Examination of the Prediction of Person-Job Fit on Person-Organization Fit from the Perspective of Academics

Educational institutions show their activities in an intense environment and lead the generations that will be the architects of the future. Considering the importance of education, it is important for academics to transfer their knowledge and experience to students by blending them with scientific data in this intense environment. However, in order for educational process to work efficiently, it is thought that the harmony of the person with his job and organization is the main point to be emphasized. In this context, this research aimed to determine the person-organization and Person-Job Fit of academics, to determine the relationship between these two variables, and to determine the predictive role of person-to-job fit on Person-Organization Fit working in the field of education. In this study, which was carried out in the relational screening model, the opinions of 403 academics were taken voluntarily. The “Personal Information Form” created by the researchers as a data collection tool in the research, and the “Person-Organization Fit Scale” developed by Netemeyer et al. (1997) and adapted to Turkish culture by Turunç and Çelik (2012) to measure the Person-Organization Fit and “Perceived Person-Job Fit Scale”, adapted to Turkish culture by Yaşar (2009) by benefiting from the researches of Cable and Judge (1996) and Saks and Ashforth (1997) was used to measure perceived Person-Job Fit. As a result of the analyzes made; It has been seen that there is a positive relationship between Person-Organization Fit and Person-Job Fit, and Person-Job Fit is a predictor of Person-Organization Fit. In addition, it was determined that the person-to-work and Person-Organization Fit of the academics were above the medium level. When the scale of Person-Organization Fit is examined, there is no difference in terms of gender, academic title and department of duty, but a significant relationship has been determined according to marital status. When the Person-Job Fit Scale was examined, it was determined that there was no relationship according to gender and the department, and there was a significant difference according to marital status and academic title.