Thyroid dysfunctions in adult patients after allogeneic hematopoietic stem cell transplantation.

INTRODUCTION: Thyroid dysfunction (TD) is one of the major endocrinopathies shown after allogeneic hematopoietic stem cell transplantation over the long term. The incidence and the risk factors for TD have varied widely. PATIENTS AND METHODS: Two hundred and fifty-nine patients with pre-transplant normal thyroid function tests who survived at least 1 year after allo-HSCT between 2006-2016 were included in the study. RESULTS: Sixty-four patients (25%) developed TD at median of 34 months (range, 1-112 months). Hypothyroidism was detected in 32 patients (12%): 5 patients had primary hypothyroidism, and subclinical hypothyroidism occurred in 27 patients. 18 patients (7%) were diagnosed with hyperthyroidism: 2 patients (0.07%) were treated for primary hyperthyroidism, and 16 patients (6%) were followed for subclinical hyperthyroidism. Euthyroid sick syndrome occurred in 14 cases. None of the patients with thyroid dysfunction developed secondary thyroid malignancy. Receiving high-dose TBI (P = .001) was found to be significant risk for hypothyroidism; older age than median (P = .01) and pre-transplant active disease (P < .0001) were related to hyperthyroidism. CONCLUSIONS: Thyroid dysfunction, mostly hypothyroidism, is a long-term complication after allo-HSCT in 25% of patients. Older age, pre-transplant active disease, and receiving TBI are among the risk factors. Sustained long-term monitoring of thyroid function test should be considered post allo-HSCT.

Clinical prognosis evaluation of COVID-19 patients: An interpretable hybrid machine learning approach.

This retrospective cohort study deals with evaluating severity of COVID-19 cases on the first symptoms and blood-test results of infected patients admitted to Emergency Department of Koc University Hospital (Istanbul, Turkey). To figure out remarkable hematological characteristics and risk factors in the prognosis evaluation of COVID-19 cases, the hybrid machine learning (ML) approaches integrated with feature selection procedure based Genetic Algorithms and information complexity were used in addition to the multivariate statistical analysis. Specifically, COVID-19 dataset includes demographic features, symptoms, blood test results and disease histories of total 166 inpatients with different age and gender groups. Analysis results point out that the hybrid ML methods has brought out potential risk factors on the severity of COVID-19 cases and their impacts on the prognosis evaluation, accurately.

Serum Amino Acid Levels and Mortality in Patients Undergoing Percutaneous Endoscopic Gastrostomy.

OBJECTIVE: To evaluate the effect of feeding via percutaneous endoscopic gastrostomy tube (PEG) on serum amino acid levels and mortality. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: University of Health Sciences, Umraniye Training and Research Hospital, Istanbul, Turkey, from January 2016 to February 2019. METHODOLOGY: Patients over 18 years of age, who were indicated for PEG due to loss of swallowing reflex, were included in the study. The follow-up period of the study was one year. The patients were reevaluated on the 3rd, 6th, and 12th months after inclusion. Anthropometric measurements, and nutritional status were evaluated at each visit, and quantitative amino acid levels were analysed. Statistical significance was accepted as p <0.05. RESULTS: The study was carried out with a total of 53 cases (23 men and 30 women) ranging in the age from 18 to 91 years. While 13 patients were still alive, 40 patients died before completing one year. The levels of glutamine, leucine, taurine, and threonine were significantly different between surviving patients and dead. A statistically significant difference was found between the levels of citrulline (p <0.001), ornithine (p = 0.036) and tyrosine (p = 0.011) during the four different visits of patients who survived. In patients who died, a significant difference was found between the levels of threonine, ornithine, and aspartic acid (p <0.043 for all) between visits. Citrulline and tyrosine levels were found to be significantly increased in surviving patients. CONCLUSION: The amino acid profiles of malnourished patients vary considerably. Increase in citrulline, ornithine and tyrosine levels are noted in surviving patients. Key Words: Amino acid, Percutaneous endoscopic gastrostomy, Malnutrition, Mortality.

Burnout and job satisfaction among Turkish oceangoing seafarers.

BACKGROUND: Seafaring includes a great variety of stressors that may let seafarers suffer from burnout syndrome. Job satisfaction is one of the most important factors affecting burnout. This study aims to determine the factors that affect job satisfaction and burnout levels of Turkish oceangoing seafarers who work actively on Turkish flagged ships. MATERIALS AND METHODS: The questionnaire was applied to participants in a face-to-face mode or by e-mail. The first part of the questionnaire consisted of 12-item which included socio-demographic and health-related information. Thus, according to their health status and socio-demographics, seafarers were classified and their impact on job satisfaction and burnout were examined by nonparametric comparison of multivariate samples analysis. Maslach Burnout Inventory (MBI; 22 items) and Minnesota Satisfaction Questionnaire (MSQ; 20 items) were used. Spearman's rho correlation analysis was used to determine the relationship between the sub-factors of the scales. 203 seafarers, 133 of them deck/engine cadets and 186 of them working on deck, aged 18-60 years participated in the study. RESULTS: Negative correlation between job satisfaction and burnout was found by correlation analysis. Department and happiness while working on board were found as common important factors that vary according to both job satisfaction and burnout. According to these parameters, job satisfaction increased while burnout decreased or vice versa in both deck and engine and total. CONCLUSIONS: According to the results, it was determined that deck officers are more prone to high burnout levels and low job satisfaction levels than the engine department. In addition, the results show that as happiness increases, job satisfaction increases and burnout decreases.