Are there any differences at gray matter sites between severe obstructive sleep apnea patients and healthy controls?

OBJECTIVES: Obstructive sleep apnea (OSA) is a disease that may cause many medical conditions. Neurocognitive disorders may be triggered by OSA. In recent studies, selectively decreased gray matter tissue was observed in patients with OSA. We aimed to determine if there was a substantial difference in patients with extreme OSA by comparing the microstructural changes in different gray matter sub-areas with healthy controls using diffusion-weighted imaging methods. METHODS: We studied 15 diagnosed severe OSA subjects before any treatment and 32 healthy control subjects. High resolution Magnetic Resonance Imaging (MRI) T1 and T2-weighted scans were visually examined to assess any major brain lesions. RESULTS: There were no statistically significant differences of age and gender between the groups.The left and right globus pallidus, putamen and thalamus values did not differ significantly between OSA and control subjects. Right putamen values was negatively correlated with Apnea Hypopnea Index (AHI), supine AHI and non-REM AHI in OSA subjects, but no correlations appeared with left putamen values. The other gray matter parameters did not show any correlations with PSG parameters. AHI, Supine AHI, Non-Supine AHI, REM and NON-REM AHI values was not show any correlation with Right and Left Putamen volume sizes. CONCLUSIONS: We made a morphological comparison of various gray matter areas of OSA patients and healthy volunteers in our study. We observed a significant decrease in right putamen gray matter volumes in patients with higher AHI values. Decreased cognitive functions are found in patients with OSA. In order to demonstrate this cognitive loss in patients with morphologically there is a need for further prospective studies with larger sample sizes.

Predictive value of triglyceride/glucose index (TyG) in predicting breast cancer in patients with breast mass.

OBJECTIVE: Since both breast carcinogenesis and the triglyceride glucose index (TyG) are associated with metabolic syndrome, this study aims at focussing on the TyG index in the breast control group to investigate risk factors causing breast cancer. The predictive value of triglyceride glucose score in predicting breast cancer was investigated. PATIENTS AND METHODS: Patients with a pathological diagnosis of cancer and patients with benign breast lesions who were operated on between May 2018 and December 2021 were included in the study. Patients were divided into two groups: those with Breast Cancer (BC) and those with benign breast lesions. The predictive value of the TyG in predicting breast cancer was investigated. The mean standard deviation (SD) or median values with a 25-75 percent interquartile range (IQR) were used to represent the distribution of continuous data. The Student's t-test was used to evaluate parametric values, and the Mann-Whitney U test was used to analyze non-parametric values. The Chi-square test was used to see if categorical variables could be compared. The optimal cut-off points for the TyG value had been determined using receiver operating curve (ROC) analysis. Cut-off points that are optimal for the TyG value were determined using receiver operating curve (ROC) analysis. RESULTS: The patients in the study had a median age of 51 [IQR (25-75) = 44-62]. Of the 510 patients who had been operated for a breast lesion, 13 were male and 499 were female. While the median glucose value of the patients was 97 [IQR (25-75) = 89-109-9], the median triglyceride value was 155 [IQR (25-75): 86-159]. When glucose and triglyceride values were examined, group I seemed to have significantly lower values (p<0.001, p=0.001, respectively). The mass size was larger in group 2 (p<0.001). In addition, ln TyG was statistically higher in the malignant group (p<0.001). Receiver operating characteristic curves were obtained for TyG levels in BC diagnosis. (AUC = 0.606, standard error 0.025, p<0.001; 95% CI = 0.556-0.655). The cut-off value for TyG was 8,628. The sensitivity of this value was 57.5% and the specificity was 42.6%. CONCLUSIONS: In this study, we investigated the predictive effect of the TyG index in distinguishing benign and malignant lesions of the breast and concluded that the TyG index can be used to differentiate BC in patients with BC.

Is laparoscopic surgery risk for surgical teams during the coronavirus disease pandemic? An in vitro study with a laser and high-speed camera.

OBJECTIVE: Laparoscopic surgery has been suggested to pose a risk of infection to the surgical team due to aerosol and gas leakage during the coronavirus (COVID-19) pandemic. However, there have been no studies on the risk of gas and aerosol leakage in laparoscopic surgery. We aimed to answer the question "Is the aerosol and gas leakage in laparoscopy is hazardous in terms of coronavirus infection?" with this study. MATERIALS AND METHODS: In this study, gas and aerosol leaks were documented by simulating the entry and exit maneuvers from a trocar during laparoscopic surgery using a high-speed camera, fog, and laser in a model representing the abdomen. RESULTS: The maximum gas and aerosol leakage were found during wet gauze extraction from the 10 mm trocar, and its velocity reached 7.5 m/s. The fastest aerosol leakage rate was observed when a 5 mm grasper was extracted from the 5 mm trocar. The results of the subsequent trials were consistent with these values. CONCLUSIONS: Higher leakage speeds were observed than the velocity of the exhaled air in a resting person. The surgical crew members, who work very close to the trocars and each other, are at serious risk of infection with COVID-19 which can spread as fast as exhalation speed through trocars. Since there is an evident risk of infection for the surgical crew from laparoscopic surgery of a patient whose intraabdominal fluids are infected with COVID-19, patients must be evaluated elaborately for COVID-19 preoperatively and infected patients should undergo surgery conventionally.

The predictive value of platelet/mean platelet volume ratio in predicting colon diverticulitis relapse.

OBJECTIVE: Diverticulitis is a health problem that has increased in frequency recently. It has a wide spectrum from simple inflammation to fecal peritonitis, sepsis and even mortality. Thus, it is important to predict diverticulitis, especially recurrent diverticulitis, and take measures to prevent it. In this study, we investigated the predictive value of the PLT/MPV ratio, which is an inflammation marker in predicting the recurrence of diverticulitis disease. PATIENTS AND METHODS: In this study, 132 patients diagnosed with diverticulitis were analyzed retrospectively. Patients' gender, age, localization of diverticulitis, number of diverticula in computed tomography (CT), hospitalization status, length of hospitalization, control colonoscopies, polyps' number and localizations in colonoscopies, presence of malignancy, need for surgery, and recurrences were not reported. White blood cell (WBC), Neutrophil (NE), Lymphocyte (LY), Hemoglobin (Hb), PLT, MPV, Albumin, Creatine Kinase (CK) and C-reactive protein (CRP) levels were examined. The patients were divided into two groups as those who did not relapse concerning diverticulitis and those who did, and statistical analysis was performed between the two groups about related parameters. RESULTS: Among all patients, recurrence was seen in 11 (10.1%) patients. The patients were divided into two groups according to their recurrence status and statistical significance was sought between the data. The calculated PLT/MPV ratio of patients who did not relapse was 25.61±8.05 and 34.98±11.37 for those who had a relapse (p=0.006). The sensitivity for MPV was 81.8%, a specificity of 57.1% and a cut-off of 9.85. The cut-off value for PLT was 207.5 with 100% sensitivity and 33.7% specificity. A cut-off value of 25.11 was found for PLT/MPV with 100% sensitivity and 49% specificity. CONCLUSIONS: PLT/MPV ratio was significantly higher in relapsed cases. Since it is easily accessible and inexpensive, it will guide physicians for diagnosis concerning early detection of relapse cases and initiation of appropriate treatment.