IL-33/sST2 signaling pathway in pulmonary thromboembolism: A clinical observational study.

BACKGROUND: Pulmonary thromboembolism (PTE) is a cardiovascular emergency that can result in mortality. In the interleukin-33 (IL-33) /soluble suppression of tumorigenicity 2 (sST2) signaling pathway, increased sST2 is a cardiovascular risk factor. This study aimed to investigate the effectiveness of biomarkers in the IL-33/sST2 signaling pathway in determining PTE diagnosis, clinical severity, and mortality. METHOD: This study was conducted as a single-center, prospective, observational study. Patients admitted to the emergency department and diagnosed with PTE constituted the patient group (n = 112), and healthy volunteers with similar sociodemographic characteristics constituted the control group (n = 62). Biomarkers in the IL-33/sST2 signaling pathway were evaluated for diagnosis, clinical severity, and prognosis. RESULTS: IL-33 was lower in the patient group than in the control group (275.89 versus 403.35 pg/mL), while sST2 levels were higher in the patient group than in the control group (53.16 versus 11.78 ng/mL) (p < 0.001 and p = 0.001; respectively). The AUC of IL-33 to diagnose PTE was 0.656 (95 % CI: 0.580-0.726). The optimal IL-33 cut-off point to diagnose PTE was ≤304.11 pg/mL (56.2 % sensitivity, 79 % specificity). The AUC of sST2 to diagnose PTE was 0.818 (95 % CI: 0.752-0.872). The optimal sST2 cut-off point to diagnose PTE was >14.48 ng/mL (83 % sensitivity, 71 % specificity). IL-33 levels were lower in patients with mortality (169.85 versus 332.04 pg/mL) compared to patients without mortality, whereas sST2 levels were higher in patients with mortality (118.32 versus 28.07 ng/mL) compared to patients without mortality (p > 0.001 for both). The AUC of IL-33 to predict the mortality of PTE was 0.801 (95 % CI: 0.715-0.870). The optimal IL-33 cut-off point to predict the mortality of PTE was ≤212.05 pg/mL (75 % sensitivity, 79.5 % specificity). The AUC of sST2 to predict the mortality of PTE was 0.824 (95 % CI: 0.740-0.889). The optimal sST2 cut-off point to predict the mortality of PTE was >81 ng/mL (95.8 % sensitivity, 78.4 % specificity). CONCLUSION: In the IL-33/ST2 signaling pathway, decreased IL-33 and increased sST2 are valuable biomarkers for diagnosis and prediction of mortality in patients with PTE.

Diagnostic and Prognostic Value of Serum Endocan Levels in Patients With COVID-19.

We aimed to evaluate whether there was a relationship between endocan (human endothelial cell-specific molecule-1) levels and disease prognosis in patients who presented to the emergency department with coronavirus disease 2019 (COVID-19). A total of 60 patients with COVID-19 who were hospitalized from the emergency department to clinical wards and a control group consisting of healthy adult individuals (n = 28), were included in the study. The majority (93.3%) of the patients were discharged after recovery; 6.7% died. The median endocan value was 243.5 ng/mL in the patient group versus 201.5 ng/mL in the control group (P = .002). The median endocan level was 240.5 ng/mL in those discharged with recovery and 558 ng/mL in those who died (P = .001). There was no significant relationship in hospitalization duration, sex, tomography findings, and clinical outcomes. A 202 ng/mL serum endocan level had 86.7% sensitivity and 50% specificity for COVID-19. Serum endocan levels may be a useful biomarker both for the diagnosis of COVID-19 and to predict mortality.

Anatomic and arthroscopic study of the medial meniscal horns' insertions.

The insertions of the menisci to the tibia are the most important restraints to extrusion from the knee joint, and are vital for the functional integrity of the menisci. The aim of the present study was to determine variations of tibial insertions of the medial menisci (MM) in newborn cadavers macroscopically and in adults by arthroscopy. Neonatal part of this study was performed on 40 knee joints of 20 Caucasian neonatal cadavers. Adult part was performed on 41 Caucasian adults, whose ages were between 17 and 66 unilaterally by arthroscopy. In neonatal cadavers, according to its insertion, anterior horn of MM was classified in five groups and type 4, in which it was inserted to the transverse ligament, was determined the most frequent one (45%) and posterior horn of MM was classified in three groups and type 3, in which it was inserted to both the posterior intercondylar area of tibia and medial tubercle of intercondylar eminence was determined the most frequent one (50%). In adults, anterior end of MM was most frequently inserted to both anterior intercondylar area of tibia and transverse ligament (76%) and posterior horn of MM was inserted to the posterior intercondylar area of tibia in all of them. This study provides comparative information about insertion of the MM for neonatals and adults, not to evaluate the variants of the insertion of the MM as a tear of the anterior cruciate ligament or a meniscal tear and not to complicate arthroscopy.

Localization of pterion in neonatal cadavers: a morphometric study.

PURPOSE: Pterion is defined as a junction of temporal, frontal, parietal, and sphenoid bones. In newborns, pterion may be defined as a region that shows variability in the exact location because of the lack of complete bony structure. The aim of this study is to define the topographic anatomy of this important surgical point, pterion, and the variability of its localization on craniums of newborn cadavers. METHODS: Our study was performed using 35 term neonatal cadaver specimens. We measured the distances between the pterion and other critical points and used a scale diagram for the definition of pterional area. RESULTS: Our scale diagram showed that pterion is mostly localized in regions c, d, e, and f on the length and regions 2, 3, 4, and 5 on the width. Localization was not observed in regions a, b, g, and h, and in areas of squares 1 and 6. The most observed localization of pterion was the e4 (24.28%) area. CONCLUSION: This study provides a detailed knowledge on localization of this important point, pterion, which will be useful for the clinicians at operation planning and treatment stages, serving for the success in surgery in the presence of this variable topographic cranial anatomy.

Bilateral elongated mandibular coronoid process in an Anatolian skull.

Elongation or hyperplasia of coronoid process of mandible is rare condition characterized by abnormal bone development which cause malocclusion and the limited mouth opening. In this study, in an Anatolian skull, a case of bilateral elongation of mandibular coronoid process was presented. Levandoski panographic analysis was performed on the panoramic radiographie to determine the hyperplasia of the coronoid process. The right condylar process was exactly hyperplastic. The measurements of Kr-Go/Cd-Go were 95.10 mm/79.03 mm on right side and 97.53 mm/87.80 mm on left side. The ratio of Kr-Go/Cd-Go on the right side was 1.20. Elongated coronoid process is one of the factors cause mandibular hypomobility, it as reported here might lead to limited mouth opening. The knowledge of this variation or abnormality can be useful for the radiologist and surgeons and prevent misdiagnosis.

Bilateral origin of superior cerebellar arteries from the posterior cerebral arteries, and clues to its embryologic basis.

The superior cerebellar artery is the most consistent branch of the basilar artery and arises near the bifurcation of the basilar artery. A bilateral origin of the superior cerebellar arteries from the posterior cerebral arteries has been rarely reported in the literature. Reporting variations in brain vessels is important for neurosurgeons to safely and confidently treat pathologies in this region. We report on a specimen with a bilateral origin to the superior cerebellar artery from the posterior cerebral artery and discuss the embryogenesis of this rare variation.