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Purpose: Internal medicine services serve the patient population with many chronic diseases. Therefore, it is high mortality rates compared to other departments of the hospital. Estimating the prognostic risk of hospitalized patients may be useful in mortality for patients. İn this study, we evaluated the level of Systemic Immune Inflammation Index (SII) and Systemic Inflammation Response Index (SIRI) and its association with mortality in inpatients.Patients and methods: This study was performed in 2218 patients who were hospitalized between January 1st–December 31th of 2019. Patients were followed up for three years about primary endpoint as all-cause (except for unnatural deaths) mortality. Participants were divided into 4 equal groups according to their increasing levels of SII and SIRI. (Quartile 1– 4) Age, gender, diabetes mellitus, hypertension, coronary artery disease, chronic kidney disease, malignancies (solid), white blood cell, neutrophil, lymphocyte, monocytes, hemoglobin, hematocrit, platelet, CRP, albumin, Systemic Inflammation Response Index (Quartile 1– 4), Systemic Immune Inflammation Index (Quartile 1– 4) were compared between survival and non-survival groups.Results: There were 1153 female and 1065 male participants enrolled. Compared with surviving patients, patients who died were older and had a higher prevalence of diabetes mellitus, hypertension, malignancy, chronic kidney disease and coronary artery disease (p < 0.001). There was a lower proportion of female patients among the patients who died. Compared to the survivor group, group who died exhibited a significant increase in CRP level, neutrophil, white blood cell and monocyte counts, but had a lower lymphocyte count, albumin level and hemoglobin count (P < 0.001). Results of Cox regression analysis showed that age, chronic kidney disease, malignancy, SIRI quartile 3, 4 and SII quartile 3, 4 pointed out a close relationship with mortality risk. (P < 0.001).Conclusion: The SIRI and SII have indicated the clinical importance of as novel markers for predicting mortality in inpatients. [ABSTRACT FROM AUTHOR]

Objective: There are several clinical outcomes associated with coronavirus disease 2019 (COVID-19) infection, including pneumonia, acute respiratory distress syndrome, and death. The aim of this study is to evaluate whether serum cortisol levels affect COVID-19 prognosis. Methods: A retrospective study was conducted with COVID-19 pneumonia patients hospitalized in an internal medicine clinic at the Haseki Training and Research Hospital in Istanbul from March 13 to May 31, 2020. Demographics, laboratory test results, and clinical outcomes of the patients were recorded. The patients were divided into two groups based on whether they were hospitalized for 1-9 days or =10 days. Both groups were classified according to their average age and duration of hospitalization/discharge, and laboratory parameters were analyzed. Results: This study was conducted on 129 COVID-19 pneumonia patients, 13 of whom died during the study period. The mean age was 68.7±10.9 years for nonsurvivors and 55.7±15.9 years for survivors (p=0.001). Serum cortisol levels were significantly elevated in patients with a long hospital stay. While there was no significant difference in the hemogram or biochemical parameters of the two groups, correlation analysis showed a close relationship between serum cortisol levels and length of hospitalization. Conclusion: Cortisol is a reliable predictor of the length of hospital stay and prognosis of COVID-19 patients. [ABSTRACT FROM AUTHOR]

Purpose: Various parameters have been proposed to predict the outcome of patients with coronavirus disease. The aim of this study was to evaluate the utility of the age-adjusted CCI score and biochemical parameters for predicting outcomes for COVID-19 patients on admission. Patients and methods: A total of 511 patients were included in the study. Only swab or serological tests positive patients were included. The clinical characteristics of the patients were compared between survival and non-survival COVID-19 inpatients. Hemoglobin, platelet, sedimentation, creatinine, AST, ALT, LDH, CK, albumin, ferritin, lymphocyte, neutrophil, CRP (1– 5;5– 10;10– 20 × upper limit), procalcitonin (5– 10;10– 20; > 20 × upper limit), D Dimer (> 2 × upper limit), age, gender, chronic diseases and CCI scores were compared between the two groups. Results: 68 patients died and 443 patients survived. Mean age was 74.3± 7.3 years in survival group and 76.7± 8.0 in nonsurvival group. Age, male sex, ischemic heart disease (CHD), chronic kidney disease and active malignancy was statistically higher in non-survivor group. The biochemical parameters was compared in survival and nonsurvival group. CCI score, AST, LDH, CK, Ferritin, CRP are significantly higher and albumin, lymphocyte levels are significantly lower in nonsurvival group. D-dimer and procalcitonin levels are significantly higher in nonsurvival group. CCI score and neutrophil, creatinine, ALT, AST, d-dimer and procalcitonin elevations were correlated. Low albumin and lymphocyte levels were correlated with the CCI score. There was no significant correlation between ferritin, sedimentation, CRP levels and CCI score. A multivariate logistic regression analysis indicated that anaemia, elevated CRP (> 10– 20 × upper limit), procalcitonin (> 5– 10 × upper limit), ALT, AST levels and higher CCI score were independent risk factors for mortality in COVID-19 patients. Conclusion: Anaemia, elevated CRP, procalcitonin levels, ALT, AST levels and higher CCI score were found independent risk factors for mortality in COVID-19 patients. [ABSTRACT FROM AUTHOR]

Objective: Insulin resistance is one of the most important risk factors for nonalcoholic fatty liver disease (NAFLD). Homeostasis Model Assessment-Insulin Resistance (HOMA-IR) is a marker used to show insulin resistance. Triglyceride/Glucose index (TgG index) is a parameter that can be used to predict NAFLD and is as important as HOMA-IR. In this study, we aimed to determine the value of the HOMA-IR score and TgG index in predicting NAFLD. Methods: 986 patients who applied to University of Health Sciences Haseki Training and Research Hospital Internal Medicine Clinic between 2017-2018 and underwent an abdominal ultrasonography scan for any reason were included in the study retrospectively. All medical cases here were investigated in terms of all clinic and laboratory aspects in order to exclude other possible liver-related diseases before they were diagnosed with NAFLD. The patients were categorized and grouped in two different ways. The first is the group with or without NAFLD; the second group was categorized as the control group, prediabetic group and type 2 diabetic group. Results: Our study was conducted with a total of 986 patients, including 470 patients with NAFLD and 516 patients without NAFLD. When the TgG index is calculated; a statistically significant increase was observed in the incidence of NAFLD at levels above 8.4 (p<0.001). The correlation analysis revealed a positive correlation between the TgG index and HOMA-IR (r=0.438). TgG index (p<0.001 OR=3.702), HOMA-IR (p=0.003, OR=1.143), ALT elevation (p=0.001, OR=1.020) were found to be the most effective risk factors when the Backward Stepwise method was used. Conclusion: The TgG index was found to be a remarkable predictor-parameter for NAFLD. While HOMA-IR increases the risk of NAFLD by 1.1 times, the the TgG index increases it 3.7 times. In our study, it was also observed that the TgG index increased the risk of NAFLD, independent of HOMA-IR. [ABSTRACT FROM AUTHOR]

Copyright of Southern Clinics of Istanbul Eurasia is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background/aim: In parallel with increased frequency and higher quality of imaging techniques, the prevalence of adrenal adenoma has gradually increased. However, despite the growing incidence, the metabolic and tumorigenesis processes involved in its etiology are still unclear. Although visfatin has been reported to be associated with inflammation and tumorigenesis, its role in adrenal adenoma has not yet been investigated. Therefore, the present study was performed with an aim to evaluate visfatin levels and cardiometabolic risk factors in patients with adrenal adenoma. Materials and methods: Thirty patients recently diagnosed with adrenal adenoma along with 30 healthy participants were studied in a tertiary healthcare center. Twenty-four-hour ambulatory blood pressure monitoring and carotid artery intima-media thickness (CIMT) measurements were performed. Results: The frequencies of diabetes mellitus and hypertension were found to be statistically higher in the adrenal adenoma group. Although the values of mean fasting glucose, insulin, HOMA-IR levels, and the mean, maximum, minimum, delta systolic, and diastolic blood pressures were established to be higher in the adrenal adenoma group, the differences were not found to be statistically significant. Mean high-sensitive C-reactive protein, visfatin levels, and CIMT were seen to be significantly higher in the adenoma group. Conclusion: Cardiometabolic risk factors as well as the visfatin levels were established to be higher in patients with adrenal adenoma. Elevated visfatin levels might play a role in the development and metabolic process of adrenal adenoma. [ABSTRACT FROM AUTHOR]

Copyright of Medical Bulletin of Haseki / Haseki Tip Bulteni is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Medical Bulletin of Haseki / Haseki Tip Bulteni is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Fat tissue is an active tissue in terms of endocrine functions. It participates in some pathological processes such as inflammation, insulin resistance, obesity and metabolic syndrome. Leptin, adiponectin, resistin, adipsin, plasminogen activator inhibitor-1, apelin, interleukins, tumor necrosis factor, acylation-stimulating protein, lipoprotein lipase, cholesteryl ester transferase, apolipoprotein E, retinol-binding protein, fasting-induced adipose factor, metallothionein, aromatase are secreted by the adipose tissue. Studies regarding the above-mentioned adipokines are important to better understand the development and treatment of obesity and related disorders. [ABSTRACT FROM AUTHOR]

Fat tissue is an active tissue in terms of endocrine functions. It participates in some pathological processes such as inflammation, insulin resistance, obesity and metabolic syndrome. Leptin, adiponectin, resistin, adipsin, plasminogen activator inhibitor-1, apelin, interleukins, tumor necrosis factor, acylation-stimulating protein, lipoprotein lipase, cholesteryl ester transferase, apolipoprotein E, retinol-binding protein, fasting-induced adipose factor, metallothionein, aromatase are secreted by the adipose tissue. Studies regarding the above-mentioned adipokines are important to better understand the development and treatment of obesity and related disorders. [ABSTRACT FROM AUTHOR]

Disseminated intravascular coagulation (DIC) is characterized by the activation of the extrinsic and intrinsic clotting cascade. There is always an underlying condition such as infection, solid tumors and hematologic malignancies. In this case paper, we present a 53-year-old patient who was admitted to the hospital with the complaint of weariness. Thrombocytopenia, prolongation of the prothrombin time, a low fibrinogen level and enhanced plasma fibrin degradation products were determined, thus, the diagnosisof DIC was established. Endoscopy and gastric biopsy were performed, because of high levels of tumor markers and anemia. Pathological investigation showed the findings of signet ring cell mucinous adenocarcinoma. In this case the cause of DIC was gastric adenocarcinoma. Since gastric adenocarcinoma complicated by DIC has a fatal clinical feature, early diagnosis is of great importance. [ABSTRACT FROM AUTHOR]

Background. The aim of this study was to investigate the association between iron deficiency anemia and H. pylori in patients with normal gastrointestinal tract endoscopy results. Materials and Methods. A total of 117 male patients with normal gastrointestinal tract endoscopy results were included in this retrospective study. The study and control groups included 69 and 48 patients with and without iron deficiency anemia, respectively. The prevalence of H. pylori, the number of RBCs, and the levels of HGB, HTC, MCV, iron, and ferritin were calculated and compared. Results. There was no statistically significant difference found between the groups according to the prevalence of H. pylori (65.2% versus 64.6%, P = 0.896). Additionally, the levels of RBCs, HGB, HTC, MCV, iron, and ferritin in the patients in the study group were lower than those in the control group (P < 0.05). Finally, there was no association between iron deficiency anemia and H. pylori (OR 1.02, Cl 95% 0.47-2.22, and P = 0.943). Conclusion. H. pylori is not associated with iron deficiency anemia in male patients with normal gastrointestinal tract endoscopy results.

Background: This study was performed to evaluate neck circumference (NC) and metabolic syndrome (MS) parameters in severe and non-severe (mild-moderate) obstructive sleep apnea syndrome (OSAS) patients according to apnea-hypopnea index (AHI)., Material and Methods: We enrolled 44 patients diagnosed with OSAS based on overnight polysomnography. The diagnosis of OSAS was based on AHI. Apnea is a pause of airflow for more than 10 seconds. and hypopnea is a decrease of airflow for more than 10 seconds and oxygen desaturation of 4% or greater. AHI score. per hour; below 5 normal. 5-29 mild-moderate. 30 and above were grouped as severe OSAS. Height. weight. neck circumference (NC). waist circumference (WC) and body mass index (BMI) of the patients were measured. MS was diagnosed by the Adult Treatment Panel (ATP) III criteria (≥3 of the following abnormalities): 1) WC ≥94 cm for males, ≥80 cm for females; 2) arterial blood pressure ≥130/85 mmHg; 3) fasting blood glucose ≥100 mg/dl; 4) high density lipoprotein (HDL) cholesterol <40 mg/dl in man, <50 mg/dl in women; 5) triglycerides ≥150 mg/dl., Results: Mean BMI and NC were higher in severe OSAS patients compared to non-severe patients (p=0.021. p<0.001). According to ATP III criteria. 64% of severe and 61.1% of non-severe OSAS patients were MS (p=0.847). A logistic regression model displayed an association with NC as a risk factor for severe OSAS (p=0.01). but not with MS., Conclusions: In this study. NC in severe OSAS patients was significantly higher than in non-severe OSAS patients. The prevalence of metabolic syndrome was not correlated with OSAS severity. NC is an independent risk factor for severe OSAS.