The Diagnostic Value of Soluble Triggering Receptor Expressed on Myeloid Cells for Patients with Acute Stone Pyelonephritis.

Soluble triggering receptor expressed on myeloid cells (sTREM-1) is a new biomarker that can be used for the diagnosis and monitoring of urinary system infections. This study aimed to evaluate the diagnostic performance of serum sTREM-1 in patients with a diagnosis of acute stone pyelonephritis (ASP). This prospective study included 46 patients with a diagnosis of ASP and a control group of 23 individuals without urinary system infection. Blood samples were taken from participants upon hospital admission, and basal serum sTREM-1 levels were analyzed using the ELISA method. Serum sTREM-1 concentrations were measured after treatment of ASP patients. Basal leukocyte counts, C-reactive protein (CRP) levels, procalcitonin (PCT), and sTREM-1 (98.6 vs. 68.4 pg/mL, p < 0.001) levels were higher in the ASP group compared to the control group. After treatment, the median leukocyte counts, PCT, and sTREM-1 levels decreased and were similar to those of the control group. The median CRP level also decreased after treatment, but it remained higher than that of the control group. In predicting patients with ASP, the baseline sTREM-1 exhibited a sensitivity of 74.6% and a specificity of 78.2%, while its diagnostic performance was lower than that of leukocyte counts, CRP, and PCT. Despite the findings that levels of sTREM-1 were higher upon hospital admission in patients with ASP and significantly decreased after treatment, the utility of sTREM-1 as a biomarker for predicting patients with ASP remains constrained when compared to established inflammatory markers.

Non-functioning adrenal incidentalomas may increase toxic metabolites.

BACKGROUND: Non-functioning adrenal incidentaloma (NFAI) is a frequent diagnosis with increasing radiological tests. The emerging shreds of evidence showed that they might have negative cardiometabolic effects. The study aimed to investigate whether the toxic metabolites, asymmetric dimethylarginine (ADMA) levels, were altered in NFAI patients. METHODS: We included 43 NFAI patients and 41 controls with similar ages and body mass indices in the study. We compared plasma ADMA levels of both groups and noted the radiological features of NFAIs. RESULTS: The ADMA levels were significantly higher in NFAI patients than in the control group (307.04 ng/ml, range 81.89-577.7 ng/ml vs 192.54 ng/ml, range 70.61-440.26 ng/ml, p = 0.001). Nevertheless, we could not reach a significant correlation between ADMA levels and mass size. CONCLUSION: The ADMA is known as a toxin and is increased in NFAI patients. NFAIs may not be innocent and may be considered a potential risk for the body. Further investigations were needed for more explanations.

Is Thiol-Disulphide Homeostasis an Indicative Marker in Prediction of Metastasis in Lung Cancer Patients.

BACKGROUND: Thiol/disulfide (SH/SS) homeostasis plays an essential and dynamic role in our body and in various cellular activities and pathways such as cell death, regulation of enzyme activities, mechanisms of transcription and cellular signal transduction. Lung cancer is the most commonly seen cancer type in the adult population. Therefore, prediction of metastases gains importance in this population. METHODS: We included 150 patients with lung cancer who attended Kirikkale University Medical Faculty Hospital between June 2017 and June 2018. Our purpose was to evaluate whether metastases can be predicted in lung cancer patients by testing SH/SS homeostasis as a novel and easily applicable biochemical test. RESULTS: The mean age of the patients was 63.8 ± 8.1 (41 - 71) years. Advanced stage lung cancer, adenocarcinoma, squamous-cell and small cell lung cancers, and other types were detected in 54.7%, 42.7%, 41.3%, 13.3%, and 2.7% of the patients, respectively. SS values of the patients with advanced stage lung cancer were higher than in patients with early stage lung cancer (p < 0.001). It was determined that the patients with advanced stage lung cancer had statistically significantly higher mean values of SS, SS/SH (%), and SS/total SH (%) than patients with early stage lung cancer and that a statistically significantly lower mean value of SH/total SH (%) was found in advanced stage compared with early stage lung cancer patients. No statistically significant difference was found between the patient groups with advanced and early stage lung cancer regarding mean values of native SH and total SH levels. CONCLUSIONS: It can be concluded that SH/SS parameters may vary in advanced and early stage lung cancer patients; however, further studies should be conducted with SH/SS parameters in order to use them as indicators of cancer severity in lung cancer patients.

Who Tweets About Diabetic Foot on Twitter and Which Tweets Are More Attractive?

Diabetic foot is a serious problem for health care systems. Twitter can provide communication between people and it might be an informative tool for health care management. The purpose of this study is detecting the people or organizations that tweet about diabetic foot and analyze the interactions of these tweets on Twitter. All tweets containing the keyword "diabetic foot" in April 2019 were collected. The users were separated into 7 groups: patients with diabetes, health care providers, nongovernmental organizations, information sites and communication media, private companies, medical students, and others. Health care professionals and nonprofessionals were evaluated in likes, mentions, and retweets. The major group was health care providers. By 2-group comparisons of professionals and nonprofessionals, all likes, mentions, and retweets were significantly different (P = .02, P = .04, P < .001, respectively). We concluded that the tweets of health care professionals get more interaction than others. Twitter might be a useful tool to distinguish accurate information about diabetic foot. Also, health care professionals should use for making people aware of the diabetic foot and shed light on society.

Are Lipoprotein Levels and Ratios Able to Predict Mortality due to Sepsis?

OBJECTIVE: To compare lipoprotein levels, and non-HDL to high-density lipoprotein (HDL) ratios of survivors and nonsurvivors of sepsis, and to determine the predictivity levels of specified parameters in mortality. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Department of Internal Medicine, Kirikkale University, School of Medicine, Training and Research Hospital, Kirikkale, Turkey, from December 2017 to December 2018. METHODOLOGY: The study subjects included 37 non-survivors and 32 survivors of sepsis with similar ages, comorbidities, and disease activities. The total lipoprotein levels, and non-HDL to HDL ratios of the participants were compared retrospectively. RESULTS: HDL and non-HDL to HDL ratios were found to be different between the two groups. The cut-off levels of these values were determined as 32 and 3.4, respectively. The cut-off levels found in the study suggest that the low HDL levels and high non-HDL to HDL ratios significantly increase the mortality risk for patients (OR=1.8 and 3.45, respectively). CONCLUSION: Non-HDL to HDL ratio may be used as a useful tool for predicting sepsis mortality. These values may also be included as a part of scoring systems. Further investigations are needed to clarify the role of lipoproteins in sepsis.

Tumour budding in preoperative biopsy specimens is a useful prognostic index for identifying high-risk patients in early-stage (pN0) colon cancer

Background/aim: Tumour budding (BD) is considered a valuable prognostic factor in colon cancer (CC), but its use in daily practice is uncertain. We investigated the prognostic effect of BD using preoperativebiopsy specimens in a fairly homogeneous population. Materials and methods: Eighty-two (pN0) CC patients who underwent surgery after preoperativebiopsy between 1997 and 2013 were included in the study. Model A (using the 'deeply invasive blocks & hot-spot area & invasive margin) and method 1 (using the '20× objective & immunohistochemistry staining & quantitive counting') were used as standard methods. Results: High BD was significantly associated with poor prognostic factors (lymphatic invasion [P = 0.008], perineural invasion [P = 0.041], advanced pT [P = 0.015], invasive margin [P = 0.008], and margin involvement [P = 0.019]). Moreover, correlations between different BD estimates (r = 0.613­0.696), reproducibility of study (Κappa = 0.68­0.73), and usefulnessofcut-off value (area of under ROC = 0.746 [0.663­0.829]) were well. In univariate analysis, 5-year survival was poor in patients with high BD (relaps-free survival [RFS]: 71 %, P < 0.001; overall survival [OS]: 73 %, P = 0.004, local recurrence [LR]: 18 %, P = 0.032). Multivariate analyses confirmed that high BD is an independent worse survival parameter for RFS (Hazard ratio [HR]: 1.53 [1.14­2.80], P = 0.015), OS (HR: 1.44 [1.17­2.75], P = 0.032, and LR (HR: 1.59 [1.05­2.76], P = 0.045). Conclusion: Our data show that BD provides valuable prognostic information for early-stage (pN0) CC in preoperativebiopsy specimens and that adding BD to current risk classification may contribute to better patient selection.

Choroidal thickness in obese women.

BACKGROUND: Excessive weight is a well-known risk factor for microvascular diseases. Changes in thickness in a vascular tissue, such as the choroid, can be useful to evaluate the effect of obesity on the microvascular system. The aim of this study was to evaluate the choroidal thickness (CT) changes in obese women, using optical coherence tomography (OCT). METHODS: The prospective clinical study included examination of the right eyes of 72 patients. The right eyes of 68 patients were examined and served as the controls. A complete ophthalmological examination and OCT imaging were performed for each group studied. The CT in each eye was measured using OCT. RESULTS: The obese group consisted of 72 female patients with a mean age of 37.27 ± 1.18 years. The control group included 68 female subjects with a mean age of 37.85 ± 7.98 years (p > 0.05). There was no statistical significant difference for the foveal retinal thickness measurements between the two groups (p > 0.5). Our study revealed significant choroidal tissue thickening subfoveally and at areas 500 µm temporal, 500 µm nasal, and 1500 µm nasal to the fovea in the obese group (all p < 0.05). There was a positive correlation between body mass index (BMI) and CT changes. CONCLUSIONS: CT may increase in obese women and a positive correlation was found between BMI and CT. The trial protocol was approved by the Local Ethical Committee of the Kirikkale University, date of registration: April 27, 2015 (registration number: 10/11).

The comparison of pandemic HIN1 IgG levels between HIN1 influenza-vaccinated healthcare workers and unvaccinated healthcare workers.

BACKGROUND/AIM: To compare pandemic H1N1 (pH1N1) IgG antibody levels between healthcare workers who were vaccinated with the pH1N1 influenza vaccine and the unvaccinated healthcare workers who were selected as the control group. MATERIALS AND METHODS: A total of 68 healthcare workers were included in this study. Of those, 53 were adults vaccinated with the H1N1 influenza vaccine and 15 were unvaccinated. Serum samples were parsed and stored at -40 °C until they were examined. RESULTS: Of the total 53 vaccinated healthcare workers, 16 (30.1%) were positive for IgG antibodies (titer > 11), 17 (32.0%) were negative for IgG antibodies (titer < 9), and 20 (37.7%) were borderline (titer: 9-11). Of the 15 unvaccinated healthcare workers, 1 (6.6%) was positive for IgG antibodies, 11 (73.3%) were negative for IgG antibodies, and the remaining 3 (20.0%) had borderline values (P = 0.014, P < 0.05). In both groups, there was no statistically significant difference between IgG-negative, IgG-positive, and borderline subjects in terms of age or sex. CONCLUSION: The IgG antibody level was higher in the vaccinated healthcare workers than among the unvaccinated healthcare workers.

Clinical importance of serum neopterin level in patients with pulmonary tuberculosis.

OBJECTIVE: Neopterin is a sensitive marker for cell-mediated immune response. Because of this, the neopterin levels of body fluids show cell-mediated immune response in different infectious diseases which involve T cells and macrophages. The aim of this study was to determine the clinical importance of neopterin levels in patients with tuberculosis and compare with those levels of healthy subjects. METHODS: Seventy patients with tuberculosis (46 newly diagnosed cases, 15 relapse cases, and 9 multidrug-resistant tuberculosis cases) and 18 healthy adult individuals were included in the study. Neopterin concentrations were measured by the ELISA method according to the protocol of the manufacturer. Chi-square test was used in statistical analysis; p⩽0.05 was considered statistically significant. RESULTS: Serum mean neopterin levels were 23.74±21.8nmol/L (median: 18.3) in newly diagnosed patients with pulmonary tuberculosis; 28.69±21.2nmol/L (median: 21.2) in relapse patients and 31.28±14nmol/L (median: 25.4) in multidrug-resistant tuberculosis cases, respectively. Serum mean neopterin levels were 4.03±5.12nmol/L (median: 5.1) in healthy subjects. The serum neopterin levels were found to be significantly higher in patients with tuberculosis than the control group. There was a statistically significant correlation between neopterin positivity (neopterin level ⩾10nmol/L was accepted to be positive) and clinical symptoms of hemoptysis and weight loss. Besides statistically significant correlations between neopterin positivity and hemoglobin level, sedimentation rate, mean leukocyte count and radiological involvement (localized or diffuse) were determined. CONCLUSION: Serum neopterin levels can be used as a helper laboratory finding for the diagnosis of patients with tuberculosis. For this aim, further controlled studies are needed.

Asymmetric dimethyl arginine levels in chronic hemodialysis patients.

BACKGROUND/AIM: To investigate serum asymmetric dimethyl arginine (ADMA) levels in maintenance hemodialysis (HD) patients and to assess their potential correlations with C-reactive protein (CRP), albumin, and cholesterol levels as the established cardiovascular and nutritional parameters. MATERIALS AND METHODS: Forty-nine patients on maintenance HD treatment and 22 healthy volunteers with similar age and sex characteristics were recruited into the study. Serum albumin, CRP, creatinine, calcium, phosphate, total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, hemoglobin, white blood cell counts, and serum ADMA levels were measured. RESULTS: HD patients had significantly higher ADMA levels compared with healthy controls (0.51 ± 0.25 vs. 0.35 ± 0.15, P = 0.002). While white blood cell counts and body mass index values were similar between the 2 groups, CRP and LDL cholesterol were significantly higher and albumin and HDL cholesterol were significantly lower in HD patients compared with healthy controls. ADMA concentrations were positively correlated with mean age (P = 0.02, r = 0.360), LDL cholesterol levels (P = 0.006, r = 0.325), and CRP levels (P = 0.02, r = 0.268) and negatively correlated with serum albumin levels (P = 0.005, r = -0.331). CONCLUSION: ADMA levels were found to be higher in HD patients and were shown to be correlated with preestablished inflammatory and nutritional biomarkers.