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Aim: Isolated coronary artery ectasia (CAE) is an abnormal dilatation of the coronary artery which cause ischemia. RDW has been investigated in several cardiovascular disorders and has also been recently proposed as a predictive biomarker of adverse outcomes in patients with these conditions. We hypothesized that increased RDW would be associated with isolated CAE because both are associated with inflammation. Material and Methods: We studied 140 subjects, including 69 patients with isolated CAE, 71 patients with angiographically normal controls. Baseline clinical characteristics and laboratory findings, including RDW, were compared among two groups. Results: The level of RDW was significantly higher in isolated CAE than normal controls (14,36±1,61vs 13,59±1.57, p=0.005). In addition, the levels of glomerular filtration rate and creatinin, high density lipoprotein and low density lipoprotein were significantly lower in isolated CAE than normal controls (76,43±19,64 vs 100,36±18,3 and 0,9±0,28 vs 0,74±0,25, 43,39±10,09 vs 48,4±13,67, 121,36±32,05 vs 143,70±55,33 p=0,001, p=0,001, p=0,01, p=0,004 respectively). In a ROC curve analysis, a RDW value of 13,5 was identified as an effective cut off point for the discrimination of the presence or absence of isolated CAE (Area Under curve [AUC]: 0.71, CI 95%, 0.62-0.80, p

Background/Aim: Thyroid hormones play an essential role in retinal development and physiological functions. Although the effects of hyperthyroidism on ocular circulation are well-defined, no studies report the effects of clinical hypothyroidism on retinal and choroidal circulation. We aimed to compare the macular vessel density and flow indexes of patients with treatment-naive hypothyroidism and healthy controls using optical coherence tomography angiography (OCTA).Methods: This case-control study included 104 eyes of 52 participants. Group 1 (n=24) consisted of patients with treatment-naive overt hypothyroidism, while Group 2 (n=28) consisted of age and sex-matched healthy controls. Images were obtained using AngioVue software 2.0 of the OCTA device in a 6 × 6 mm area centered on the macula. Foveal avascular zone (FAZ) area, macular retinal thickness, FAZ perimeter (PERIM), choroidal flow index (CF), outer retinal flow index (ORF) and macular vessel density (VD) in the superficial (SCP) and deep retinal capillary plexus (DCP) were recorded for all patients.Results: The whole [Group 1: 49.9 (7.0)%; Group 2: 54.6 (5.9)%], parafoveal [Group 1: 54.7 (4.8)%; Group 2: 58.6 (3.9)%] and perifoveal [Group 1: 51.5 (7.2)%; Group 2: 55.9 (6.8)% ] VD in DCP were significantly lower in Group 1 compared to Group 2 (P=0.012; P=0.002 and P=0.028 respectively). However, parafoveal VD in SCP was significantly higher in Group 1 [52.4 (2.26)] than in Group 2 [49.9 (6.87)] (P=0.032). The mean VD in DCP was significantly positively correlated with the choroidal (P=0.021) and outer retinal flow indexes (P=0.033). The mean foveal VD in DCP was significantly positively correlated with the mean foveal (P

Objective: Metabolic disorders of lipoprotein commonly accompany diabetes. Several studies with a limited number of patients have shown that glycemic control is related to dyslipidemia. Still, the validity of these results in a larger population and diabetic Turkish patients is not well-established. Therefore, this study aimed to reveal glycemic control's effect on lipid parameters and the relationship between Hba1c and lipid parameters in Turkish patients with non-insulin-dependent diabetes . Methods: Turkish patients with non-insulin-dependent diabetes mellitus aged ≥18 years were included in this cross-sectional study. The patients were divided into two groups as good (HbA1c0.05). There was a significant positive correlation between TG and Hba1c (p, Amaç:Lipoprotein metabolizma bozuklukları sıklıkla diyabete eşlik etmektedir. Sınırlı sayıda hastayla yapılan çalışmalar, glisemik kontrolün dislipidemi ile ilişkili olduğunu göstermiştir.Ancak sonuçların daha geniş popülasyonda ve Türk hastalarda geçerliliği tam olarak belirlenmemiştir. Bu nedenle,çalışmamız,diyabetik Türk hastalarda glisemik kontrolün lipid parametreleri üzerine etkisini ve Hba1c ile lipid parametreleri arasındaki ilişkiyi ortaya koymayı,amaçlamıştır.Yöntem:Bu kesitsel çalışmaya,insüline bağımlı olmayan ,18 yaş ve üzeri hastalar dahil edildi.Hastalar glisemik kontrolü iyi (HbA1c0.05).HbA1c ile trigliserid arasında pozitif korelasyon (p

Gender differences affect the frequency and course of many diseases. This study aimed to determine the gender distribution in HIV-infected patients and investigate the relationship between gender and immune response. The study included HIV-infected patients who followed up in our hospital in 2018. The patients were divided into HIV RNA negative patients (Group 1) and HIV RNA positive patients (Group 2). Patients with diseases that may affect the immune system and those using drugs that affect the immune system were excluded from the study. The evaluation was made of 549 patients, as 305 patients (45 females 14.75%) in Group 1 and 224 patients (23 females, 9.43%) in Group 2. When the CD4/CD8 ratio of male and female patients was compared in both groups, a lower rate was determined in females (0.71-0.58) than males (0.82-0.93). A negative correlation was determined between HIV RNA and the CD4/CD8 ratio in premenopausal females (p=0.045) and males (≤45 years p=0.0001). Clinical studies of HIV infection have demonstrated better initial viremia control in females with primary infection, faster disease progression, and stronger immune activation than males for the same level of viral replication.

Background Coronavirus disease 2019 (COVID-19) has quickly turned into a global pandemic with close to 5 million cases and more than 320,000 deaths. Cancer patients constitute a group that is expected to be at risk and poor prognosis in COVID pandemic. We aimed to investigate how cancer patients are affected by COVID-19 infection, its clinical course and the factors affecting mortality. Methods In our single-center retrospective study, we included cancer patients with laboratory confirmed COVID-19 in our hospital. Demographic, clinical, treatment, and laboratory data were obtained from electronic medical records. Logistic regression methods were used to investigate risk factors associated with in-hospital death. Results In the hospital, 4489 patients were hospitalized with COVID infection and 77 were cancer patients. The mean age of cancer patients was 61.9 ± 10.9 and 44 of them were male (62%). While the mortality rate in non-cancer patients was 1.51% (n = 68), this rate was significantly higher in cancer patients, 23.9% (n = 17). The stage of the disease, receiving chemotherapy in the last 30 days also lymphopenia, elevated troponin I, d-dimer, CRP, and CT findings were associated with severe disease and mortality. Severe lung involvement (OR = 22.9, p = 0.01) and lymphopenia (OR = 0.99, p = 0.04) are the most important factors influencing survival in logistic regression. Conclusions The disease is more severe in cancer patients and mortality is significantly higher than non-cancer patients. These data show that it may be beneficial to develop dynamic prevention, early diagnosis and treatment strategies for this vulnerable group of patients who are affected by the infection so much.

Amaç: Tip II Diabetes Mellitus (T2DM) en sık endokrin hastalıktır. Yüksek glikolize hemoglobin (HbA1c) düzeylerinin kardiyovasküler hastalıklarda (KVH) risk faktörü olduğu ve KVH'ların da diyabetik hastalarda ölüm ve sakatlığa neden olduğu bilinmektedir. HbA1c düzeylerinin doğru ölçülmesi, hastaların tanı ve tedavi süreçlerinin değerlendirilmesinde son derece önemli rol oynamaktadır. Ülkemizde başta talasemi minör olmak üzere hemoglobin varyantları yaygın olarak görülmektedir. Diyabetin kardiyovasküler etkileri nedeniyle de asetilsalisilikasit (ASA) sıklıkla diyabetik hastalar tarafından kullanılmaktadır. Diyabetik nefropati ise son dönemde hemodiyaliz gerektiren böbrek yetmezliğine ve üremiye neden olmaktadır. Bu çalışmada immünoturbidimetri ve yüksek performanslı sıvı kromatografi (HPLC) yöntemlerinin 3 hasta grubunda HbA1c düzeylerini ölçmek üzere karşılaştırılması amaçlanmıştır. Gereç-Yöntem: Bu çalışmaya her biri 20 hastadan oluşan üç grup dahil edilmiştir. Bu çalışmaya 20’şer kişilik 3 hasta grubu dahil edilmiştir. İlk grup hemoglobin elektroforezi kullanılarak “hemoglobinopati” tanısı alan hastalardan, ikinci grup en az 6 aydır günde 100 mg veya üzerinde ASA alan hastalardan ve üçüncü grup kronik hemodiyalize giren hastalardan oluşmaktadır. Hastalardan alınan EDTA içeren tüplere toplanan venöz kan örnekleri, Premier Hb 9210 (Trinity Biotech –USA) ve Cobas c501 (Roche –Almanya) cihazları kullanılarak analiz edilmiştir. Sonuç: Her 3 grupta immünoturbidimetri ile HPLC yöntemi karşılaştırıldığında grupların içinde HbA1c düzeyleri arasında anlamlı bir istatistiksel fark bulunamamıştır (p=0,462, p=0,065 p=0,062). Tartışma: İmmünoturbidimetri ve HPLC, HbA1c ölçümlerinde yaygın olarak kullanılan yöntemlerdendir. İmmünoturbidimetrik yöntemin HbA1c ölçümlerinde HPLC yöntemi ile arasında güçlü bir korelasyon olduğu gösterilmiştir. HbA1c analizini etkileyebilecek hastalıklar ve ilaçlar göz önünde bulundurulmalıdır.

Aim: In this study, we aimed to investigate the serum magnesium (Mg) levels in diabetic and prediabetic patients and its correlation with age, body-mass index, HOMA-IR, serum fasting glucose, HbA1c, and insulin levels.Methods: In this retrospective study, a total of 130 patients consisted of newly diagnosed prediabetes (Group PD) (n=63) and type 2 diabetes mellitus (Group D) (n=67) were included. Patients' age, body mass index, serum Mg, glucose and insulin, HOMA-IR and HbA1c were recorded. The prediabetes and type 2 diabetes diagnoses had been made according to WHO criteria at the time of diagnosis.Results: In group D, the mean Mg level (1.88 ± 0.17 mg/dl) was significantly lower than group PD (1.96 ± 0.17 mg/dl) (p = 0.007). Correlation analysis showed that there was a significant negative correlation between Mg and glucose (r = -0.390, p = 0.001) and HOMA-IR (r = -0.284; p = 0.022) in the group D. No correlation was found between serum Mg level and serum insulin, HbA1c, age, and body-mass index (p = 0.801, 0.087, 0.611 and 0.691, respectively). In group PD, serum insulin, HbA1c, glucose, HOMA-IR, age, and body-mass index were not corraleted with serum Mg levels (p = 0.801, 0.087, 0.939, 0.998, 0.611 and 0.691, respectively). Conclusıon: We showed that while there was a negative correlation between magnesium levels and HOMA-IR and fasting blood glucose levels in diabetic patients, but this correlation was not present in prediabetic patients. Our results suggest that serum Mg level is associated with metabolic control of type 2 diabetes and thus it can be considered in these patients.

Objective The prevalence of diabetes mellitus is growing worldwide, as well as in the aging population, and its comorbidity and mortality rates are higher in aging people than they are in young people. It has been observed that the number of drugs used increases in aging patients, especially in diabetic patients. This study aimed to investigate the relationship between polypharmacy and modified Charlson Comorbidity Index (CCI) and Katz Index of Independence in Activities of Daily Living (Katz ADL) scores in aging diabetic and non-diabetic patients. Materials and methods This prospective study included 184 diabetic and 62 non-diabetic subjects who were ≥65 years old. Comorbidity was determined with CCI, and dependency on daily basic activities was assessed with Katz ADL. Results CCI and the number of drugs were significantly higher in diabetic groups (P = .001). In all subjects and in the diabetic group, there was a negative correlation between CCI and Katz ADL (r = -0.343, P = .001; r = -0.383, P = .001, respectively); there was a positive correlation between CCI and number of drugs (r = 0.430, P = .001; r = 0.248, P = .001, respectively). Conclusion We found an increase in the number of drugs taken by the aging patients, positively correlated with the CCI score. The increase in the number of drugs used is closely related to the insufficiency in daily life activity and comorbidity, and this predicts 10-year survival. Patients should be directed to special centers or physicians who will be scheduled for multidisciplinary treatment for the prevention of polypharmacy, especially in the aging.

Laboratuvarlarda gerçekleştirilen hızlı testler için ana hususlar hızlı ve doğru bir test sonucu elde etmektir. Hızlı testlerin serum yerine plazma kullanılarak gerçekleştirilmesini mümkün kılmak için artan sayıda cihaz ve yöntem geliştirilmiştir. Bu çalışmanın amacı, serum ve plazma örnek tüplerinin hızlı test sonuçlarını karşılaştırmaktır. 78 hastanın venöz kan örnekleri BD Vacutainer®SST ™ II Advance serum jeli ve Vacutainer®Barricor ™ plazma tüpüne toplandı. Randomizasyonun sağlanması için kan alma ve tüplerin aletlere yüklenmesi sırasında tüplerin örnekleme sıraları değiştirildi. Kan alma anından itibaren tüplerin ters çevrilmesi, tamamen doldurulması ve serum tüplerinin en az 30 dakika süreyle pıhtılaşması sağlandı. Klorür ve sodyum testlerinin iyi bir uyuma sahip olduğu ve kalan testlerin güçlü bir uyum düzeyine sahip olduğu belirlendi. Albümin, ALT, Amilaz, AST, Bilirubin, Direkt Bilirubin, BUN, Kalsiyum, Klorür, Kreatinin, Mg, Na, CK, CRP, Üre, BNP, troponin-T, D-dimer analizi her biri için benzerdi ve anlamlı bir fark yoktu .Plazma elde etmek için pıhtılaşma süresinın gerekmemesi hızlı testin isüresinin kısalmasına yardımcı olurken, plazma tüpünde serum tüp örneklerinde görülebilen fibrin oluşumunun olmaması ise örnek kalitesini ve test sonuçlarının doğruluğunu destekler. Serum elde etmek için gerekli numune transferinin neden olduğu hemoliz olasılığı nedeniyle serum tüpleri yerine plazma tüpleri kullanılabilir., The major considerations for the STAT testing performed in laboratories are to obtain a fast and accurate test result. Increasing number of instruments and methods have been developed for making it possible to perform the STAT testing on plasma rather than serum. The aim of this study is to compare the STAT test results of the serum and plasma sample tubes. Venous blood samples of 78 patients were collected into BD Vacutainer®SST™II Advance serum gel and Vacutainer®Barricor™ plasma tube. The sampling orders of the tubes were switched during blood collection and loading the tubes into the instruments in order to ensure randomization. It was ensured the tubes were inverted, completely filled, and were allowed serum tubes to clot for a minimum of 30 minutes from the time of blood collection. It was determined that the chloride and sodium tests had a good concordance and the remaining tests had a strong level of concordance. Albumin, ALT, Amylase, AST, Bilirubin, Direct Bilirubin, BUN, Calcium, Chloride, Creatinine, Mg, Na, CK, CRP, Urea, BNP, troponin-T, D-dimer analysis was similar for both, with no significant difference.While it helps to improve TAT since no clotting time is required to obtain plasma it also supports sample quality and accurate test results with the absence of fibrin formation at plasma tube which is possible at serum tube samples. Plasma tubes may be used instead of serum tubes due to the possibility of hemolysis caused by sample transfer required to obtain serum.

Background/aim: In this study, we aimed to investigate the relationship between long-term mortality and survival with ABO blood group in patients with acute coronary syndrome. Materials and methods: This observational study was carried out in two tertiary hospitals. 192 patients followed for 72 months due to acute coronary syndrome, showing a balanced distribution for ejection fraction, additional diseases and age, were included in the study. Results: The survival rate was evaluated in 72 months follow-up. In the survival analysis according to individual blood groups; there was no statistically significant difference between the groups. When the patients were divided into two groups, there was 24.39% mortality in those with O blood group and 15.23% mortality in those without O blood group (p>0.05). Although it was not statistically significant, in patients with O blood group, an increasing tendency was observed in 72 month mortality (p>0.05). There was no association between Rh antigen and survival in this study (p=0.79). Conclusion: Although it was not able to reach statistically significance limit, a decreasing tendency in long-term survival was observed in patients with O blood group compared to those without O blood group in patients with acute coronary syndrome. The results should be confirmed by larger prospective studies.

Context: Statins are effective agents on both primary and secondary prevention in patients who are at high risk of cardiovascular disease, and the number of patients taking statins has significantly raised recently. Aims: The aim of this study was to evaluate the association between Vitamin D levels and statin usage, statin type, dose, and duration. Settings and Design: We enrolled 210 control and 174 patients who were taking statins, and whose Vitamin D levels were checked in the past 3 months. 25-hydroxy Vitamin D levels were analyzed by immunoassay. Subgroup analysis was done firstly according to statin types and other lipid-lowering agents, namely fenofibrate. Subjects and Methods: Statin dosage's effect on Vitamin D levels were analyzed in patients taking low-dose (10–20 mg/day) and high-dose (40–80 mg/day) atorvastatin. Patients were divided into three groups according to statin usage duration (short term: >1 month, less than a year, medium-term: 1–5 years, long term: >5 years). Statistical Analysis Used: Kolmogorov–Smirnov, Kruskal–Wallis, Bonferroni Dunn's multiple comparisons, Spearman rank tests were used. Results: About 71.26% of the patient group was using atorvastatin, 13.21% rosuvastatin, 4.59% pitavastatin, and 10.91% were on fenofibrate treatment. Vitamin D levels were statistically different among statin subtypes (P < 0.001); the highest level was observed in patients taking atorvastatin (23.03 ± 9.94). Vitamin D levels were statistically significantly higher in short-term and medium-term statin usage than control group (P < 0.001). Conclusions: Our study demonstrated that even low-dose statin has a positive effect on Vitamin D. Thereby, it encourages patients to continue with statin therapy more willingly.