Lack of Variation in Inflammatory Hematological Parameters between Benign Nodular Goiter and Papillary Thyroid Cancer.

BACKGROUND: Inflammatory hematological parameters like the neutrophil/lymphocyte (N/L) ratio have been investigated in many cancer types and significant relationships found with prognosis, for example. The aim of this present study was to investigate the impact of hematological parameters notably on N/L ratio and mean platelet volume (MPV) in papillary thyroid cancer cases. MATERIALS AND METHODS: A total of 79 patients who underwent a thyroidectomy operation in Findikli, Goiter Research and Treatment Center during 2011- 2015 period were enrolled in the study, 41 with papillary thyroid cancer and 38 with benign goiter confirmed by pathological examination. We collected clinical and laboratory data for the patients from hospital records retrospectively. Blood samples taken at admission were assessed for parameters compared between the groups. RESULTS: No significant differences between papillary thyroid cancer and benign goiter groups were apparent in terms of age, the N/L ratio, MPV, white blood cell count (WBC), red blood cell count (RBC), hemoglobin, hematocrit, platelet, neutrophil, lymphocyte, red blood cell distribution width (RDW) and platelet crit (PCT) levels (>0.05). Only the level of platelet distribution width (PDW) significantly differed, being lower in the papillary cancer group (<0.05). CONCLUSIONS: No significant relationship between papillary thyroid cancer and inflammatory hematological parameters including in particular the N/L ratio and MPV. The relevance of the PDW values remains unclear.

Agreement of serum potassium measured by blood gas and biochemistry analyzer in patients with moderate to severe hyperkalemia.

PURPOSE: Several studies investigated the agreement between central laboratory biochemistry analyzers and blood gas analyzers for potassium measurements. However, data are scarce when the potassium level is moderate to severely high. We aimed to evaluate the agreement between central laboratory biochemistry analyzers and blood gas analyzer in terms of serum potassium level measurement because differences in potassium at this level translate into very different clinical actions. BASIC PROCEDURES: This was a retrospective medical record review study in which patients who presented to the emergency department and had serum potassium levels ≥6mmol/L were included. Patients who did not have simultaneous potassium measurement by blood gas analyzer were excluded. We included all patients meeting potassium criteria irrespective of their underlying disease or comorbidities. We evaluated agreement between the measurement methods with Pearson correlation, Bland-Altman plot, and Sign test. MAIN FINDINGS: A total of 118 blood sample pairs were included. The mean serum potassium level measured by biochemistry analyzer was 6.78±0.79mmol/L, whereas it was 6.16±0.86mmol/L by blood gas analyzer (P<.001, Sign test). There was a strong correlation (P<.001, r=0.864) between the 2 methods, but agreement was relatively poor. Blood gas analyzer tended to measure potassium significantly lower than measured by biochemistry analyzer. The mean difference between the methods was 0.62±0.43mmol/L. PRINCIPAL CONCLUSIONS: In patients with moderate to severe hyperkalemia, blood gas analyzer and biochemistry analyzer gives significantly different serum potassium results which may be clinically important.

Frequency and types of headaches in patients with metabolic syndrome.

BACKGROUND AND PURPOSE: Metabolic Syndrome (MetS) and headaches are common public health problems in whole world. The relationship between headaches and the MetS isn't understood clearly. Purpose - The aim of this study is to determine the prevalence and types of headaches, and evaluate the relationship between headache characteristics and clinical and laboratory parameters analyzed in patients diagnosed with MetS. METHODS: Of the patients diagnosed with MetS in Endocrinology outpatient clinics between July 2011 and July 2012, 202 patients were included in the study. Hemoglobin, fasting blood glucose (FBG), total cholesterol, triglyceride, HDL and LDL cholesterol, thyroid function tests and HbA1c values of all patients were recorded. Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) were applied to all patients. The headache severity was assessed by Visual Analog Scale (VAS). RESULTS: The prevalence of headache in patients with MetS was found to be 61.4%. The incidence of headache was higher in female patients (F: 86.4%, M: 13.6%). The distribution of the subtypes of headaches was as follows: Episodic Tension-Type Headaches (ETTH) 24.8%, Episodic Migraine 14.4%, Chronic Tension-Type Headaches (CTTH) 11.3%, Episodic Tension-Type Headaches (ETTH) and Episodic Migraine 7.9%, and other types of headaches (Cervicogenic Headache and Cluster Headache) 3%. No statistically significant relationship was found between headache and non-headache groups in terms of body mass index, waist circumference, and the laboratory parameters (p>0.05). The mean BDI and BAI scores were higher in the headache group (p<0.001 and p<0.001). No significant difference was found between the mean MIDAS scores in the subtypes of headaches (p=0.35). In the headache group, there was a significant relationship only between triglyceride levels and attack frequency, duration and severity. CONCLUSION: Prevalence of headache in patients with MetS was 61.4%. The incidence of subtypes of headaches was similar to those in the general population. A relationship was found between triglyceride levels and attack frequency and severity. The result may be important to draw attention to the evaluation of triglyceride levels for reducing the frequency and severity of attacks in patients with headaches.