Evaluation of the systemic-immune inflammation index (SII) and systemic immune-inflammation response index (SIRI) in children with type 1 diabetes mellitus and its relationship with cumulative glycemic exposure.

OBJECTIVES: In this study, the systemic proinflammatory status was assessed using the systemic immune-inflammation index (SII) and SIRI systemic immune-inflammatory response index (SIRI) in children and adolescents with type 1 diabetes mellitus (T1DM). METHODS: The study involved 159 patients aged between 6 and 16 years. The SII and SIRI values were calculated based on the complete blood count. Basic blood biochemistry evaluated, and carotid intima-media thickness (cIMT) was measured and recorded. The cumulative glycemic exposure was calculated by multiplying the value above the normal reference range of the HbA1c value. The sum of all these values obtained from the time of diagnosis to obtain the cumulative glycemic exposure. All findings were compared statistically. All statistically significant parameters were evaluated in the multivariate logistic regression analysis. RESULTS: The analysis revealed that only cIMT (Exp(B)/OR: 0.769, 95 % CI: 0.694-0.853, p<0.001), high-density lipoprotein (Exp(B)/OR: 3.924, 95 % CI: 2.335-6.596, p<0.001), monocyte count (Exp(B)/OR: 1.650, 95 % CI: 1.257-2.178, p<0.001), hematocrit (Exp(B)/OR: 0.675, 95 % CI: 0.523-0.870, p<0.001), and SIRI (Exp(B)/OR: 1.005, 95 % CI: 1.002-1.008, p<0.001) were significantly associated with T1DM. A statistically significant positive association was found between cumulative glycemic exposure and SIRI only (r=0.213, p=0.032). To our knowledge, this is the first study to evaluate SII and SIRI in children with type 1 diabetes. CONCLUSIONS: These findings indicate that SIRI could serve as a potential biomarker for detecting early-onset proatherosclerotic processes in diabetic children. However, further clinical studies are required to confirm this.

The Relationship of Coronary Thrombus Burden and Anticoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Score in Patients With ST-Segment Elevation Myocardial Infarction.

BACKGROUND: The anticoagulation and risk factors in atrial fibrillation (ATRIA) score is associated with adverse cardiovascular events. However, its relationship with coronary thrombus burden is unclear. Therefore, we aimed to investigate the relationship between the ATRIA score and thrombus burden in patients with ST-segment elevation myocardial infarction (STEMI) who underwent percutaneous coronary intervention (PCI). MATERIALS AND METHODS: The study was designed as a prospective cross-sectional observational study. Our study included 319 patients who were prospectively admitted with STEMI between January 2021 and April 2022. Patients were divided into 2 groups with low thrombus burden (LTB) (grade <3) and high thrombus burden (HTB) (grade ≥3). ATRIA score was calculated and recorded for all patients. ATRIA scores of both groups were compared. RESULTS: In our study, 58.9% (n = 188) of patients in the LTB group and 41% (n = 131) of patients in the HTB group. The ATRIA risk score (p < .001) was significantly higher in the HTB group. In multivariate logistic regression analysis, ATRIA score, glomerular filtration rate, hypertension, abciximab usage, and no-reflow were found to be independent predictors of HTB in STEMI patients undergoing primary PCI. In receiver operating characteristic analysis, ATRIA score >4 had a sensitivity of 66.2% and specificity of 95.2%, and ATRIA score >8 sensitivity of 98% and specificity of 100% predicted HTB. CONCLUSION: In this study, we found that thrombus burden may be associated with ATRIA risk score in patients presenting with STEMI.

The Role of Axillary SUVmax in 18F-FDG PET/CT in Predicting the Number of Axillary Metastases of Breast Cancer.

OBJECTIVE: To investigate the role of positron emission tomography/computed tomography (PET-CT) in determining the maximum number of axillary lymph node metastasis (ALNM) detectable in sentinel lymph node biopsy (SLNB). STUDY DESIGN: Observational study. Place and Duration of the Study: Sivas Cumhuriyet University Faculty of Medicine, Turkiye, from January 2015 to August 2021. METHODOLOGY: A total of 104 breast cancer patients who underwent surgery after a PET-CT scan were examined. A receiver operating characteristic (ROC) analysis was utilised to determine optimal cut-off values for the standardised uptake values of the primary tumour (pSUVmax) and axillary lymph nodes (nSUVmax) in the presence of ALNM and the presence of more than two ALNMs. RESULTS: The presence of more than two ALNMs was associated with pSUVmax, nSUVmax, LVI, and the number of LNs detected on PET-CT. In the ROC analysis, for the ability to predict more than two ALNMs in SLNB/axillary lymph node dissection (ALND), cut-offvalues were calculated as 4.65 for pSUVmax (AUC=0.669, sensitivity=66.7%, specificity=62%, PPV=0.482, NPV=0.800, p=0.006) and 1.75 for nSUVmax (AUC=0.838, sensitivity=81.8%, specificity=88.7%, PPV= 0.676, NPV=0.913, p<0.001). CONCLUSION: Low sensitivity, NPV, and accuracy values that limit the use of PET-CT in preoperative axillary evaluation can be increased by targeting the criterion of more than two ALNMs. Thus, PET-CT can be used more effectively in axilla management. KEY WORDS: Breast cancer, Positron emission tomography, SUVmax values, Axillary lymph node, ACOSOG Z0011.

Evaluation of the Early Effects of Childhood Asthma and Its Treatment on Cardiac Function as Revealed by Two-Dimensional Speckle-Tracking Echocardiography.

There is minimal information available regarding the early effects of bronchial asthma (BA) and its treatment on cardiac function in children. We used two-dimensional speckle-tracking echocardiography (2D-STE) to evaluate cardiac function before and after the treatment of childhood BA. We enrolled 44 children with moderate and severe BA who had not been treated over the preceding 3 months or who were newly diagnosed. All children received the same treatment (that recommended by the Global Initiative for Asthma [GINA] in 2017). All children also underwent transthoracic 2D-STE before treatment and 6 months later. Clinical data were compared before and after treatment. After treatment, significant increases were evident in right ventricular (RV) systolic and diastolic strain, as well as the systolic strain rate. Before and after treatment, the RV global longitudinal systolic strains were - 22.8 ± 3.6 and - 25.1 ± 4.5, respectively (p = 0.036); the RV global longitudinal diastolic strains were - 18.5 ± 6.0 and - 21.5 ± 5.2, respectively (p = 0.038); and the RV systolic strain rates were - 1.26 ± 0.4 and - 1.12 ± 0.3, respectively (p = 0.025). After treatment, significant increases were observed in the right atrial (RA) peak longitudinal strain and strain rate. Before and after treatment, the RA peak atrial longitudinal strains were 32.5 ± 10.8 and 44.7 ± 11.2, respectively (p = 0.042) and the RA longitudinal strain rates were - 1.6 ± 0.3 and - 2.0 ± 0.5, respectively (p = 0.041). RV and RA subclinical dysfunction may develop in children with early-stage BA. However, asthma treatment appears to improve such dysfunction. In children with BA, clinical and subclinical changes in cardiac functions can be easily detected via 2D-STE.

The test-retest reliability and concurrent validity of the five times sit to stand test and step test in older adults with total hip arthroplasty.

PURPOSE: The aim of the study was to determine the test-retest reliability and concurrent validity of the five times sit to stand test (FTST) and step test (ST) in older adults with total hip arthroplasty (THA). METHODS: A cross-sectional and prospective study was carried out with 32 unilateral total hip arthroplasty patients. FTST, ST, and Timed Up & Go Test were evaluated at the first evaluation session. The test-retest reliability was evaluated by performing two repetitions of the FTST and ST. Besides, the functional status of the patients was evaluated with the Harris Hip Score (HHS). The test-retest reliability of the FTST and ST were assessed by the intraclass correlation coefficient (ICC). In the concurrent validity analysis, the Pearson correlation coefficient was analyzed. In addition, the standard error of measurement (SEM95) and minimal detectable change (MDC95) values of the FTST and ST were also calculated. RESULTS: The mean age of the participants was 75.4 ±â€¯10.3 years. The ICC score of FTST, ST (right) and ST (left) were 0.987, 0.908 and 0.846, respectively. SEM95 and MDC95 values of the FTST were 1.05 and 2.91, respectively. FTST was correlated with both the HHS and TUG (r1 = -0.522, r2 = 0.730, p < 0.01). SEM95 and MDC95 values of the ST (right) were 0.37 and 1.02, respectively. SEM95 and MDC95 values of the ST (left) were 0.55 and 1.52, respectively. Also, ST (right) was only correlated with TUG (r = -0.654, p < 0.01). ST (right) were correlated with both the HHS and TUG (r1 = 0.503, r2 = -0.806, p < 0.01). The degree of correlations was strong. CONCLUSION: The FTST and ST are valid and reliable performance tests in older adults with primary unilateral THA.

Value of sentinel lymph node biopsy in breast cancer patients with previous excisional biopsy.

PURPOSE: Sentinel lymph node biopsy (SLNB) in breast cancer patients with clinically negative axilla will ensure axillary dissection only for cases with lymph node metastasis and provide information about pathologic staging as accurate as the axillary dissection. It was shown that SLNB could be successfully performed regardless of the type of biopsy. The aim of this study was to investigate the feasibility of SLNB after excisional biopsy. METHODS: One hundred patients diagnosed with excisional biopsy or guide wire-localization and operated on with SLNB between February 2007 and March 2009 were retrospectively analyzed. SLNB was performed with 10 cc of 1% methylene blue alone or both methylene blue and 1 mCi of Tc-99m nanocolloid combination. Age, tumor localization and size, length of the biopsy incision, size of the biopsy specimen, multifocality, lymphovascular invasion, tumor grade, staining with methylene blue, localization, number and metastatic status of the lymph nodes stained, and success rate with a gamma probe were evaluated. RESULTS: Sentinel lymph node (SLN) could not be identified in 9 (16.9%) of patients in the methylene blue group (n=53). In the combination group (n=47), SLN could not be identified in one patient. Of 32 patients with negative SLNB, metastatic involvement was found to be present in 5 patients after axillary lymph node dissection (false negatives). The average numbers of SLNs found in the methylene blue group and combination group were 1.4 and 1.6, respectively. SLN detection and false negative rates in the methylene blue group were 83% and 15.7%, respectively. The rates for the combination group were 98% and 6.4%, respectively. None of the parameters related to patient, tumor or process were found to affect detection rates of SLN. CONCLUSION: Only SLNB using a combination method is a safe and reliable technique for breast cancer patients diagnosed with excisional biopsy.