Evaluation of the factors affecting mortality after cardiac arrest - do lactate and procalcitonin concentrations have any implications?

OBJECTIVE: Mortality and morbidity rates are very high in patients admitted to the Intensive Care Unit (ICU) after cardiac arrest. In this study, we aimed to determine the mortality rates, risk factors, and predictive factors for mortality in post-cardiac arrest patients admitted to the ICU. PATIENTS AND METHODS: Following approval from the Ethics Committee, we conducted a retrospective review of patient files for individuals over the age of 18 who received treatment for cardiac arrest in the ICU from January 2017 to June 2020. Demographic data of the patients, comorbidities, arrest location, etiology of arrest, duration of hospitalization, CPR duration, APACHE 2 scores, pH and HCO3 measurements in initial blood gases, lactate levels (1st, 6th, 12th, 24th hour), change in lactate levels (24-1), rate of lactate change, procalcitonin (PRC) levels (1st and 24th hour), change in PRC levels (24-1), rate of PRC change, and blood glucose levels were recorded. The patients were divided into two groups (survivors and non-survivors groups). RESULTS: 151 patients were included in the study. pH and HCO3 levels were lower in the non-survivors group than in the survivors group. Initial PRC levels were similar in both groups, but the 24th-hour PRC levels were higher, and the changes in PRC levels in the first 24 hours were greater in the non-survivors group. The lactate changes in the first 24 hours were higher in the non-survivors group. The receiver operating characteristic (ROC) curve showed that the HCO3 levels, 1st-, 6th-, 12th-, and 24th-hour lactate levels, and changes in lactate levels had predictability for mortality. In logistic regression analysis, we found that high 24th-hour lactate levels and changes in lactate levels were independent risk factors for mortality. CONCLUSIONS: Considering PRC and lactate levels, along with clinical examination and laboratory findings, may improve the accuracy of determining the prognosis of patients experiencing cardiac arrest.

TROP2 is a Good Indicator for Infiltrative Nature of Carcinoma Rather than Diagnosing Malignancy in Thyroid.

TROP2 is a glycoprotein which is expressed in carcinomas rather than normal tissues and associated with poor prognosis. Immunohistohemical TROP2 staining was determined to be useful for diagnosing papillary thyroid carcinoma (PTC). In this study, we aimed to find out relationship between TROP-2 expression and the diagnosis of PTC, and clinico pathological parameters. This retrospective study was conducted on 270 cases (145 malignant and 124 benign). All histopathological parameters were re-evaluated blindly. We used 3 different scores for positivity for TROP2 expression (TES: Total estimation score, 5%, IRS:Immunoreactive score). Sensitivity was respectively according to TES, 5%and IRS; 55.5%, 54.1%, 51.4%. Specificity was 98.4% in all different scores. TROP2 positivity was correlated with older age in 5% score and TES. Absence of encapsulation, presence of infiltrating spreading, perineural invasion, extra thyroidal extension, tall cell and/or hobnail differentiation were associated with TROP2 expression in three different scores. Presence of lymphatic invasion was correlated with TROP2 positivity in 5% score and IRS. TROP2 expression was inversely proportional to follicular variant PTC and tumour size in 5% score. TROP-2 is a marker for aggressive behaviour rather than detecting malignancy, but if it stained and not malignant, it may also have potential for determining precursor lesion that demands further studies. Additionally, in 3 different scores, TES was most sensitive, but most variable that had correlation with TROP2 was seen at 5% score.

What is the relationship of varicose vein pathogenesis with collagen fibers?

Aims and Background: In this study, the densities of collagen 1 and collagen 4, which are an effective vascular component in the remodelling of varicose veins, were investigated. Materials and Methods: The study included primary varicose vein samples of 20 patients and vein samples of 20 healthy controls. Immunohistochemical staining was performed using collagen 1 and collagen 4 antibodies. Histochemical staining was performed using Masson Trichrome. Results: In the immunohistochemical analysis of varicose samples, collagen 1 immunostaining was negative in 17 cases (85%) and positive in 3 cases (15%). In healthy venous tissue samples, collagen 1 immunostaining was negative in 12 cases (60%) and positive in 8 cases (40%). There was no statistically significant difference between both groups concerning collagen 1 immunostaining (p > 0.05). In varicose samples, collagen 4 immunostaining was negative in 4 cases (20%) and positive in 16 cases (80%). In healthy venous tissue samples, collagen 4 immunostaining was negative in 13 cases (65%) and positive in 7 cases (35%). Statistical comparison of healthy veins and varicose veins concerning collagen 4 immunostaining showed a significant difference (p = 0.03). In the histochemical analysis of varicose samples, Masson Trichrome staining was negative in 4 cases (20%) and positive in 16 cases (80%). In healthy venous tissue samples, Masson Trichrome staining was negative in 18 cases (90%) and positive in 2 cases (10%). Statistical comparison of healthy veins and varicose veins concerning collagen 4 immunostaining showed a significant difference (p = 0.01). Conclusion: The change in the density of collagen types plays an important role in vein wall remodeling.

Evaluating YouTube as a source of information on COVID-19: analysis with latent Dirichlet allocation method.

OBJECTIVE: The global impact of COVID-19 pandemic has gained momentum rapidly. People have little information about SARS-CoV-2 (Coronavirus). Internet has become a frequently used tool to obtain information in recent years, while YouTube is one of the popular sources of information with many videos on its platform. This study aims to identify the topics regarding Coronavirus that people learned about on YouTube. The videos about Coronavirus were also evaluated in terms of the reliability of their source of information. METHODS: In total, 160 videos on Coronavirus that had 500,000 or more views were analysed. The latent Dirichlet allocation method was used in the process of identifying the topics that were then compared in terms of video parameters. The reliability of the source of information provided by videos was assessed with a modified DISCERN tool. RESULTS: A proportion of 15.6 % of these videos had a scientific content, while 45 % of these videos were about the process entailed by the COVID-19 pandemic. In terms of video reliability, the difference between video types was found to be significant; videos with scientific content had more reliable sources of information (p<0.001). CONCLUSION: It has been determined that the videos about the symptoms, diagnosis and treatment of COVID-19, and those with scientific content have the most reliable source of information on Coronavirus (Tab. 5, Fig. 1, Ref. 35). Text in PDF www.elis.sk Keywords: coronavirus, SARS-CoV-2, COVID-19 pandemic, coronavirus pandemic, latent Dirichlet allocation, information, YouTube.

Nesfatin 1: a promising biomarker predicting successful reperfusion after coronary artery bypass surgery.

OBJECTIVES: Nesfatin-1 is an antiiflammatory, antiapoptotic, and anorexigenic peptide that has many roles in cardiomyocyte metabolism and viability. Inflammation plays an important role in the pathogenesis of atherosclerosis. In this study, we aimed to evaluate the alterations in serum nesfatin-1 levels of the patients undergoing coronary artery bypass operation due to atherosclerotic coronary artery disease. MATERIALS AND METHODS: The study included 49 patients (30 men, 19 women) undergoing coronary artery bypass surgery. Serum nesfatin-1 levels were measured from venous blood samples of the patients collected before and three months after the operation. The relationship of nesfatin-1 levels with accompanying conditions was also analyzed. RESULTS: Nesfatin-1 levels at third month, postoperatively, were significantly higher than preoperative nesfatin-1 levels of the patients (41.94±13.90 pg/ml and 27.06±8.01pg/ml, respectively; p<0.001). Both preoperative and postoperative nesfatin-1 levels were negatively correlated with age (p<0.001). The postoperative increase in nesfatin-1 levels was significantly higher in diabetic patients than in nondiabetic patients (p<0.001). CONCLUSION: This study revealed that serum nesfatin-1 levels increased significantly in patients undergoing coronary artery bypass operation. Nesfatin-1 level may have a role in assessing myocardial perfusion during the follow-up of these patients (Tab. 4, Fig. 4, Ref. 25).

Comparison of type I collagens and MMP-2 proteins in temporomandibular joint of young and old mice.

BACKGROUND: The effects of ageing on the histopathological changes of tem-poromandibular joint (TMJ) and the existence and age related alterations of immunochemical expressions of type I collagen and matrix metalloproteinase-2 (MMP-2) proteins was aimed to be displayed. MATERIALS AND METHODS: In this study, 14 Balb/C type white mice (50- -80 g) were included. Groups were organised as group 1 - 2-month-old young animals (n = 7) and group 2 - 18-month-old old animals (n = 7). Of the paraffin embedded tissues 4-5 µm thick sections were taken and immunohisto-chemical stainings of haematoxylin-eosin, type-1 collagen and MMP-2 were performed. RESULTS: Collagen bundles showed sagittal and oblique localisations in the young mice, which were comprised of compact collagen bundle layers positioned alterna-tely. While collagen bundle fragmentation was observed in the disks of old mice, some disk regions showed ruptures. In the old mice a decrease in blood vessels, structural impairments and dilatation in arterioles and venules were detected. In the TMJ tissues of the young mice type I collagen and MMP-2 expressions were increased, while they were decreased in old mice. In the MMP-2 H-score evaluation young mice showed significant increase compared to the old mice. CONCLUSIONS: Occurrence of degenerations in the collagen structure of TMJ and decimation in the matrix metalloproteases were observed with age. (Folia Morphol 2018; 77, 2: 329-334).