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OBJECTIVE: Cytokine storm with elevated levels of multiple proinflammatory cytokines and inflammatory system activation underlie the pathogenesis of coronavirus disease 2019 (COVID-19). In this study, we aimed to investigate whether increased interleukin (IL)-6 levels can predict right ventricular (RV) systolic impairment in patients hospitalized with COVID-19. METHODS: This prospective, observational study included 100 consecutive patients hospitalized with mild and moderate COVID-19. All the patients underwent chest computerized tomography, detailed laboratory tests including IL-6, and two dimensional (2D) transthoracic echocardiography (TTE) with assessment of 2D conventional and Doppler echocardiography parameters and RV systolic functions. RESULTS: After the elimination of six patients with exclusion criteria, the remaining patients were classified into two groups, namely normal RV systolic functions (n=60) and impaired RV systolic functions (n=34). IL-6 levels were significantly higher in patients with impaired RV systolic functions than in those with normal RV systolic functions (20.3, 4.6, p

Objectives Post-hypoxia hypoxia-inducible factor (HIF)-1α activation plays a vital role in colorectal cancer (CRC) angiogenesis. Although glucose metabolism is induced in some cancer types via HIF-1α, the prognostic significance of HIF-1α in CRC and its correlation with 18fluorinefluorodeoxyglucose (18F-FDG) uptake in positron emission tomography (PET) remain controversial. This study aims to investigate the association between 18F-FDG/PET parameters and HIF-1α expression in CRC. Methods Thirty-six histopathologically confirmed patients with CRC who had 18F-FDG/PET scans before surgery were enrolled in the study. The correlations between the maximum standardized uptake value (SUVmax), SUVmean, metabolic tumor volume (MTV), total lesion glycolysis, HIF-1α overexpression, and histopathological features were evaluated. Results The tumor location, tumor diameter, perineural invasion, lymphovascular invasion, T and N stage were not significantly correlated with HIF-1α overexpression. In contrast, the tumor differentiation was negatively correlated with HIF-1α expression (r=-0.332, p=0.048). None of the 18F-FDG/PET parameters was significantly correlated with HIF-1α overexpression. A significant relationship was found between tumor differentiation, tumor necrosis percentage, and MTV (p=0.030, p=0.020). Conclusion The expected association between HIF-1α overexpression and 18F-FDG/PET parameters was not found in this study. However, there was a relationship between MTV, tumor differentiation, and tumor necrosis percentage. Hence, further studies are required to predict the pathological and prognostic courses of CRC using a diagnostic 18F-FDG/PET evaluation.

Objective: Although the efficacy of the visual interpretation of 99mTc-MIBI myocardial perfusion imaging has been repeatedly confirmed in the diagnostic and prognostic evaluation of coronary artery disease (CAD), the efficacy of the automated quantitative evaluation dependent on computer programs is controversial. In our study, we compared automated quantitative data, such as the sum stress score (SSS) and the sum difference score (SDS), with coronary angiography results. We investigated the ability of SSS and SDS values to predict coronary artery disease. Method: SSS and SDS are measurements used in the global scoring of myocardial perfusion. While SSS indicates the degree of ischemia, SDS defines the reversibility degree of ischemia. In the global scoring of myocardial perfusion, when the SSS was 4 and above, MPI was evaluated as positive. In the coronary angiography, a stenosis value of >50% was evaluated as positive. We divided the SSS into three groups; mild (4-8), moderate (9-12), and advanced (>13) hypoperfusion. We divided the SDS into two groups as below and above 10%. We compared the subsequent quantitative data with the results of the three groups of coronary angiographies ( 70% stenosis). Results: A total of 104 patients who underwent angiography were included in the study. The accuracy in detecting positivity between the general quantitative MPI and angiography methods of the patients was calculated as 80.8%. The agreement value was found to be significant (Kappa=0.602; p

Aim: To evaluate epidemiologic features and survival outcomes of 8450 patients treated with the diagnosis of thyroid cancer in Ege University Hospital (EUH) between 1992-2017 and compare them with the literature.Materials and Methods: The thyroid cancer patients’ data that was collected by Ege University Cancer Research Center, was recorded to CANREG computer program, and analyses was performed according to WHO and SEER system definitions. Chi-square, General Linear Model and Kaplan-Meier survival analyses was performed for further analyses. Log Rank (Mantel-Cox), Breslow (Generalized Wilcoxon) and Tarone-Ware statistics was used for survival analyses. P, Amaç: Ege Üniversitesi Hastanesinde 1992-2017 yılları arasında tanı alan ve tedavisi yapılan 8.450 tiroit kanserli olgunun epidemiyolojik ve sağ kalım özelliklerini analiz etmek ve sonuçlarını literatürle karşılaştırmak amaçlanmıştır.Gereç ve Yöntem: Ege Üniversitesi Kanserle Savaş Araştırma ve Uygulama Merkezi tarafından toplanan tiroit kanseri verileri CANREG özel bilgisayar programına kayıt edilmiş, DSÖ ve SEER sistemleri temelinde gruplanarak analizler yapılmıştır. İstatistik analizlerde Ki-kare, General Linear Model, Kaplan Meier sağ kalım analizleri uygulanmıştır. Kaplan Meier sağ kalım analizinde Log Rank (Mantel-Cox), Breslow (Generalized Wilcoxon) ve Tarone-Ware istatistikleri kullanılmıştır. İstatistik analizlerde p

Calcific aortic stenosis (AS) is a common valvular disease especially in elderly population. Inflammation plays significant role in the pathophysiological mechanism. Systemic immune-inflammation index (SII) is a novel marker of immune system and inflammation that includes neutrophil, lymphocyte, and platelet cell counts. The aim of this study was to investigate the predictive value of SII in calcific severe AS.Severe calcific AS patients were categorized into two groups: High flow-high gradient (HFHG) AS (n = 289) and low flow-low gradient AS (n = 79). Control group included 273 patients with similar clinical and demographic characteristics but without AS. SII was calculated as absolute platelet count × absolute neutrophil count/absolute lymphocyte count.SII levels were 525 ± 188, 835 ± 402, and 784 ± 348 in control, HFHG AS, and LFLG AS groups, respectively (P .001). Correlation analyses revealed significant and positive correlation between SII and mean aortic transvalvular pressure gradient (r = .342, P .001), and negative and significant correlation between SII and AVA (r = -.461, P .001). Multivariate analysis performed in separate models demonstrated sex, CAD, LDL, and SII levels (Odds ratio [OR]: 1.004, 95 CI%:1.003-1.004) as independent predictors of severe AS in Model 1. According to Model 2, sex, CAD, LDL, and high SII (661) (OR:5.78, 95 CI%:3.93-4.89) remained as independent predictors of severe AS.SII levels can be useful to predict severe calcific AS patients and significantly correlate with AVA and mean aortic transvalvular pressure gradient.

Introduction Role of systemic inflammation response in prognosis of several solid tumors has been evaluated in quite a lot of recent reports. Objectives In this study, we aimed to investigate the effect of a novel immune response marker; systemic immune-inflammation index (SII) on metabolic response to chemoradiotherapy and outcome in patients with non-small cell lung cancer (NSCLC). Other several inflammatory indices such as neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), lymphocyte to monocyte ratio (LMR) and prognostic nutritional index (PNI) were also evaluated in terms of predictive value. Methods Files of 66 newly diagnosed NSCLC patients who underwent curative radiotherapy were retrospectively analyzed. Factors correlated with overall survival was evaluated via univariate and multivariate survival analysis. Results In 20.05 months of median follow-up 22 (33.33%) patients were alive. Median overall survival, 3 and 5 years survival for the entire group were 25.49 (95% CI: 19.07-31.91) months, 54.9% and 20.1%, respectively. Among investigated inflammatory indices, only low PNI (≤45.45), was found significantly correlated with poor response rate (P: .024). None of the prognostic factors and inflammatory indices were found statistically significant in terms of overall survival via univariate and multivariate analysis. Conclusions Immunoinflammatory indices are feasible prognostic indicators for clinical use with easily accessible components. In this study, we demonstrated that pretreatment PNI ≤ 45.45 was statistically significant for predicting poor treatment response. None of the indices were significantly correlated with radiation pneumonitis.

WOS: 000429745000008, Triple-A syndrome is a rare, multi-systemic disease and is characterized by adrenal insufficiency, achalasia, or alacrima. The symptoms may also involve neurologic manifestations, including pyramidal findings and peripheral motor neuropathy. Other findings include autonomic dysfunction and cerebellar ataxia. In the present study, we present the case of two siblings with triple-A syndrome with neurologic manifestations. The neurologic abnormalities can lead to misdiagnosis owing to resemblance to the manifestations of other neurologic disorders. Therefore, the cases with triple-A syndrome should be carefully evaluated and examined for clinical and neurophysiologic signs.

WOS: 000471902200025, PubMed ID: 31203594, Background/aim: High triglyceride (TG) levels are associated with increases in atherosclerotic cardiovascular disease (CVD), hepatic steatosis, and pancreatitis. Acute pancreatitis is a condition with high mortality. Therapeutic plasma exchange (TPE) in the treatment of hypertriglyceridemic pancreatitis (HTGP) is a rapid and effective treatment modality. In this study, the results of TPE were evaluated and the frequency of lipoprotein lipase (LPL) mutation in these patients was determined. Materials and methods: TPE was performed in 31 patients with HTGP at the Adult Therapeutic Apheresis Center. Results: A TG level under 500 mg/dL was achieved by applying apheresis at a median of 2 times (IQR 2-2, min 1, max 6) in the 31 cases. LPL mutation was detected in 8 (25.8%) of the 31 hypertriglyceridemia cases. When TG levels before and after TPE were evaluated, the mean TG level before TPE was significantly higher (3132 +/- 1472 mg/dL) than the mean TG level afterwards (948 +/- 465 mg/dL, P < 0.001). This result represented a decrease of 69.7% TG after TPE. Conclusion: TPE is a safe, fast, and effective treatment modality in experienced centers.

Background and Objectives: Lichen planus (LP) is a mucocutaneous inflammatory disease. Inflammation plays a major role in the progression of atherosclerosis. Epicardial fat tissue (EFT) has been shown to produce and secrete various proatherogenic and proinflammatory hormones and cytokines. The aim of this study was to assess EFT in patients with lichen planus. Methods: Fifty-four patients with LP and 50 controls were enrolled in the study. LP was diagnosed according to the World Health Organization criteria. EFT was measured on the free wall of the right ventricle in parasternal long-axis view, as previously described and validated. Results: There were positive correlations between EFT thickness and platelet/lymphocyte ratio, neutrophil/lymphocyte ratio, duration of LP, and high-sensitivity C-reactive protein (hsCRP) (p

Objectives: The aim of this study was to investigate the elastic properties of the aorta and the myocardial performance index of the left ventricle (LV) in patients with lichen planus (LP). Subjects and Methods: A total of 54 patients with LP and 50 controls were enrolled in the study. The 2 groups were well-matched regarding age, gender, body mass index, any smoking history, diabetes mellitus and systolic and diastolic blood pressure (SBP and DBP). The echocardiographic examination was performed on the study subjects and the controls. Aortic elasticity parameters and the myocardial performance index of the LV were calculated. The Student t test, the χ2 test and multiple linear regression were used for the statistical analysis. Results: Aortic strain (AS, 4.77 ± 1.81 vs. 8.95 ± 2.22; p < 0.001) and aortic distensibility (AD, 0.25 ± 0.009 vs. 0.42 ± 0.120; p < 0.001) were significantly lower, and aortic stiffness index β (ASIβ, 3.65 ± 1.03 vs. 2.70 ± 0.91; p < 0.001) was significantly higher in the LP group than in the controls. The myocardial performance index (Tei index) was significantly higher in the LP group than in the control group (p = 0.001). The duration of the LP was negatively correlated with AS (r = -0.364, p < 0.001) and AD (r = -0.279, p = 0.006), and positively correlated with the Tei index (r = 0.324, p = 0.001) and ASIβ (r = 0.364, p < 0.001). After adjustment for relevant confounders (age, male gender, smoking, SBP, DBP, diabetes mellitus and low- and high-density lipoprotein cholesterol), LP and its duration were still associated with AS, AD and ASIβ. Conclusion: In this study, AS and AD were lower and ASIβ and myocardial performance index higher in LP patients than in controls.

Purpose: The growing prevalence of obesity has become a major concern. The efficacy of medical treatment, diet and behavior therapy in morbidly obese patients is limited. Obesity surgery is a treatment option for selected morbidly obese patients. Material and Method: Data of 47 patients (n=39 women, 8 men) who underwent bariatric surgery were investigated. Results: Out of 47 patients, 20 underwent Roux-en-Y gastric bypass (RYGB) (43%) and 27 had sleeve gastrectomy (SG) (57%). The mean age of the patients was 37±9.5 (19-59) years. 17% of patients were men and 83% were women. In the analysis of data on weight that could be found for 31 out of 47 patients, we detected preoperative and postoperative (1st and 3rd month) mean weight values as 125.4±15.9 kg, 112.7±13.2 kg (p

WOS: 000443340300009, Thyroid hemiagenesis is a rare congenital anomaly in which one thyroid lobe fails to develop. We recently observed a case of thyroid hemiagenesis accompanied by parathyroid adenoma and papillary thyroid microcarcinoma in a 51-years-old woman. The patient's serum calcium level was 10.9 mg/dL and that of intact parathyroid hormone was 218 pg/mL. Although she had a history of thyroid hemiagenesis, the patient was in a euthyroid state without thyroxine replacement. Thyroid ultrasonography detected no right lobe and four nodules of varying sizes in the left thyroid lobe. Tc-99m scintigraphy also demonstrated the absence of the right thyroid lobe. In addition, MIBI-parathyroid scintigraphy showed a parathyroid adenoma at the lower pole of the right cervical region. Based on the diagnosis, parathyroid adenoma excision and thyroidectomy were performed. Postoperative pathological diagnosis revealed parathyroid adenoma and papillary thyroid microcarcinoma in the form of a 0.4 cm sized tumor in the left thyroid lobe. The coexistence of thyroid hemiagenesis, primary hyperparathyroidism, and papillary thyroid microcarcinoma is truly exceptional and has never been reported in the literature before.

The aim of this study was to evaluate the tear nitric oxide (NO) level in patients with Behçet’s disease and to compare it with that in healthy subjects. Material and Methods. The subjects were divided into 3 groups: the active disease, inactive disease, and control groups. NO concentrations were determined by a nitrate/nitrite colorimetric assay kit and measured spectrophotometrically at 540 nm. Results. The tear nitrate/nitrite levels were 0.06 nmol/μL (SD, 0.05) in the active disease group, 0.05 nmol/μL (SD, 0.05) in the inactive disease group, and 0.02 nmol/μL (SD, 0.01) in the control group. The tear nitrate/nitrite levels of both active and inactive groups were higher than those of the control group (P=0.001 and P=0.047, respectively), but there was no significant difference between the active and inactive groups. Conclusion. Our results demonstrated that the tear NO levels were elevated in the patients with Behçet’s disease. We imply that a better understanding of NO function in the pathogenesis of Behçet uveitis is necessary to develop new therapies based on the inhibitors of NO synthases.