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Abstract The May Measurement Month (MMM) campaign, conducted in South Africa in 2023 aimed to raise awareness of raised blood pressure (BP). Adults aged ≥18 years were recruited through convenience sampling at university campuses, community centres, schools, sport complexes, public parks, shopping centres, hospitals, and through household visits. Three seated BP readings were taken on each participant, and a questionnaire collected information on demographics, lifestyle factors, and comorbidities. Hypertension was defined as a systolic BP ≥140mmHg and/or diastolic BP ≥90mmHg and/or already receiving BP-lowering medication. Controlled BP was defined as being on BP-lowering medication with a BP <140/90mmHg. Multiple imputation was used to estimate missing BP readings. In total, 6,653 were screened, with a mean age of 38.8 years, the majority of whom were females (56.3%). Of all participants, 1,010 (15.2%) reported never having had a BP measured before, 2,500 (37.6%) had hypertension, of whom 1,170 (46.8%) were aware, and 1,098 (43.9%) were on antihypertensive medication. Of those on antihypertensive medication, only 633 (57.7%) had controlled BP, and of all participants with hypertension, only 25.3% had controlled BP. The MMM campaign in South Africa identified a substantial number of participants with untreated or inadequately treated hypertension. The high prevalence of hypertension, despite the young adult age, together with the high proportions of individuals unaware of their hypertension and with uncontrolled BP highlight the importance of hypertension screening and awareness campaigns, and more rigorous management of hypertension, especially among young adults.
Background Preparing medicolegal reports is one of the duties of a physician. The legal procedure is heavily dependent on those reports, which makes them quite significant. it requires expertise and experience to prepare the reports, which essentially describe the severity of the damage. When evaluating radiologic images, physicians may misdiagnose in the absence of these illnesses. This may result to inaccurate medicolegal reports. In order to resolve these conflicts by conducting an entirely new assessment, legal authorities ask for an expert report from a forensic medicine specialist. The presentation aims to demonstrate three cases of individuals who have assessed radiologic images incorrectly. Another goal is to raise forensic medical experts' awareness of these instances. Methods The first case involved a skipped fracture line in the ulna's processus styloideus, the second case included a missed pneumothorax on the right, mosaic attenuation of the lung, and fracture lines in the vertebrae's processus transversus, and the third case involved a skipped fracture line in the pelvic bone's acetabulum, pneumothorax, and mosaic attenuation of the lung. A forensic medicine specialist revised and edited all reports following an additional assessment of the computed tomography and x-rays. Results The goal of forensic medicine specialists' expert reports is to provide assistance in the conduct of justice. Conclusions Developing the assessment of radiologic imaging skills is vital when preparing the expert report. Acknowledgment This presentation was supported by TÜBİTAK BIDEB under the 2224-A International Research Fellowship Program for Participation in Scientific Events Abroad.
1036 Background: Activating PIK3CA mutations are established oncogenic drivers and predictive biomarkers in MBC. In contrast, PIK3CA amplifications are rare, poorly characterized, and of unclear clinical significance. Tissue-based studies report a prevalence of 1–7%, but their detection and relevance in ctDNA are largely unexplored. Moreover, whether amplifications interact with co-occurring mutations to define a distinct high-risk subset is unknown. We therefore aimed to characterize the impact of PIK3CA amplifications detected in ctDNA through a multi-institutional cohort of patients (pts) with MBC. Methods: This retrospective study analyzed a multi-institutional cohort of 1579 pts with MBC and baseline ctDNA testing with the Guardant360 NGS panel within a large academic consortium (PMAC). Hormone Receptor positivity (HR+) and HER2 status were defined based on the most recent biopsy. Associations between SNVs, CNVs, and clinical characteristics were assessed using multivariable logistic regression. The impact of prognosis, adjusted for the number of prior treatment lines, was evaluated through Cox regression for overall survival (OS), defined from time of baseline ctDNA collection. Results: Among 1,579 pts, 1,121 (71%) were HR+/HER2–, 214 (13.5%) HER2+, and 244 (15.5%) had triple-negative breast cancer (TNBC). PIK3CA CNVs were detected in 7.7% of pts, and 44.7% harbored a concomitant PIK3CA SNVs. PIK3CA CNVs were significantly enriched in TNBC compared with other subtypes (Odds Ratio [OR] 2.02, p=0.011). In the overall population, PIK3CA CNVs were associated with significantly worse OS (HR 2.46, p<0.001), an effect observed across all subtypes, including HR+/HER2– (HR 2.21, p<0.001), HER2+ (HR 5.23, p<0.001), and TNBC (HR 1.81, p=0.018). In multivariable analysis, PIK3CA CNVs remained independently associated with inferior OS in the overall cohort (HR 1.61, p=0.015) and in HR+/HER2– disease (HR 1.38, p=0.048). Notably, the coexistence of a PIK3CA CNV and mutation identified a subset with particularly poor prognosis. Compared with patients harboring PIK3CA SNVs alone, those with concurrent SNVs and CNVs had significantly worse OS in the overall population (HR 1.80, p=0.002), in HR+/HER2– disease (HR 1.51, p=0.037), and in TNBC (HR 5.72, p<0.001). Conclusions: PIK3CA amplifications detected in ctDNA are relatively frequent in MBC and are associated with significantly worse survival across molecular subtypes. The coexistence of PIK3CA amplification and mutation identifies a distinct high-risk subset with particularly poor prognosis, beyond the effect of mutations alone. Further mechanistic understanding and real-world outcome analyses are needed to determine whether PIK3CA amplifications, alone or in combination with mutations, have predictive relevance for response or resistance to PI3K-pathway inhibitors.
Background:Traumatic brain injury (TBI) remains a leading cause of morbidity and mortality, yet pharmacological neuroprotection is still an unmet need. Asprosin, a recently identified fasting-induced adipokine, has been implicated in oxidative stress modulation, apoptosis, and metabolic regulation. This study aimed to investigate the neuroprotective role of asprosin in an experimental rat model of TBI. Methods:Thirty-two male Wistar rats were randomized into four groups: Control, Trauma, Trauma+Asprosin, and Asprosin. Moderate head trauma was induced using a validated closed-head injury model. Asprosin (10 µg/kg, intraperitoneal) was administered immediately and 12 h post-trauma. Brain tissues were examined histopathologically (cresyl violet staining) and biochemically for oxidative stress and apoptotic markers, including Glutathione, total oxidant status, superoxide dismutase, Catalase, Malondialdehyde, glutathione peroxidase, nitric oxide, total antioxidant status, asprosin, and caspase-3. Results:Histopathological evaluation revealed pronounced neuronal degeneration, vacuolization, and darkly stained nuclei in the Trauma and Trauma+Asprosin groups, whereas the control and asprosin-only groups preserved normal cortical and hippocampal architecture. Biochemically, no significant differences were observed among groups for oxidative stress parameters; however, caspase-3 levels were significantly higher in the Asprosin group compared to controls (P = 0.02). These findings suggest that while asprosin modulates apoptosis-related pathways, its direct protective effect against trauma-induced neuronal damage remains inconclusive. Conclusion:This study provides the first experimental evidence linking asprosin to TBI. Although asprosin demonstrated potential interactions with oxidative and apoptotic processes, its role as a neuroprotective agent requires further validation with larger cohorts, varied dosing regimens, and molecular analyses.
