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Introductıon: This study was undertaken to investigate the importance of the CRP/albumin ratio (CAR) as an early prognostic marker for determining disease severity in acute cholangitis. Methods: A total of 366 patients aged >18 years diagnosed with acute cholangitis were included in the study. Acute cholangitis severity was determined according to the 2018 Tokyo criteria. Results: The study population consisted of 49.2% patients with mild, 24.6% moderate, and 26.2% severe acute cholangitis. The cut-off CAR value for predicting moderate risk compared to the mild risk group was found to be >1 with 73.3% sensitivity and 76.7% specificity (AUC±SE: 0.785±0.03; +PV: 61.1%, -PV: 85.2%; p<0.001). The CAR cut-off value for predicting severe risk compared to the moderate risk group was found to be >2.9 with 71.9% sensitivity and 71.1% specificity (AUC±SE: 0.788±0.03; +PV: 72.6%, -PV: 70.3%; p<0.001). The CAR cut-off value for predicting admission to the intensive care unit (ICU) was >2.5 with 77.4% sensitivity and 74.6% specificity (AUC±SE: 0.803±0.03; +PV: 43.1%, -PV: 90.1%; p<0.001). The CAR cut-off value for predicting mortality was >2.8 with 100% sensitivity and 74.9% specificity (AUC±SE: 0.890±0.03; +PV: 19.5%, -PV: 100%; p<0.001). Compared to its components, the CAR was found to exhibit superior diagnostic performance in predicting moderate or severe risk, ICU admission, and mortality. Conclusion: We found that the CAR is a good prognostic marker in determining the severity of acute cholangitis in the early period. [ABSTRACT FROM AUTHOR]

Introduction: It is important to determine which patients admitted to the hospital with COVID-19 should be hospitalized and treated. In this study, the aim was to investigate whether serum neutrophil gelatinase-associated lipocalin (NGAL) levels in the early period are related to the need for intensive care follow-up in COVID-19. Methods: A total of 91 patients with a definite diagnosis of COVID-19 were included in the study. Patients hospitalized in the internal medicine clinic were screened cross-sectionally, and eligible patients were included in the study. Patients were divided into groups as mild/moderate pneumonia and severe pneumonia. Serum NGAL levels were measured before pulse steroid therapy. Age, gender, comorbid diseases, and 1-month survival of the patients were recorded. Results: In patients requiring pulse steroid therapy compared to those who did not, there was a significant difference between the median serum NGAL levels. The median NGAL level showed a significant difference in patients requiring intensive care treatment compared to patients hospitalized in the inpatient service. Receiver operating characteristic curve analysis showed the relationship between serum NGAL levels and the need for treatment in the intensive care unit. It was also observed that the need for admittance to the intensive care unit was 10.9 times higher in those with a serum NGAL level below 30.29, according to the multivariate analysis. There was a significant difference between the median NGAL levels of patients who survived and those who died. Discussion and Conclusion: This study found a significant difference between serum NGAL levels of patients who died, who required intensive care follow-up, and who needed pulse steroid therapy. [ABSTRACT FROM AUTHOR]

Introduction. Calcium channel blockers (CCBs) are commonly used agents in the treatment of hypertension as part of monotherapy or combination therapy. Peripheral edema is the most common side effect that requires discontinuation or replacement of treatment. Some studies in the literature have shown that long-acting dihydropyridine type CCBs lead chylous ascites in peritoneal dialysis patients. However, amlodipine-associated serous ascites cases are not available in the literature. Case Report. In this case report, we describe a rare case of amlodipine induced massive ascites in a 30-year-old male with renal transplantation. Conclusion. We aimed to create awareness that pharmacologic causes should be considered in cases of ascites of unknown aetiology. [ABSTRACT FROM AUTHOR]