Association between hyponatremia, inflammation, and mortality in patients undergoing peritoneal dialysis: A nationwide observations.

INTRODUCTION: Hyponatremia is the most common electrolyte disorder often present in peritoneal dialysis (PD) patients. The aim of this retrospective study was to investigate the effect of hyponatremia on mortality in patients undergoing PD. METHODS: The health records of adult individuals with an inserted PD catheter identified via the centralized national e-health database were used. RESULTS: The mean age of the 846 patients included in the study was 52.48 years (±14.6). The mean sodium level was 136.51 mEq/L. Sodium levels <137 mEq/L were associated with higher death risk independent of comorbidities. There was a 0.821 times less reduction in mortality for each mEq /L increase in serum sodium. CONCLUSION: Our study provides evidence that monitoring and adjusting serum sodium levels is crucial in managing PD patients with hyponatremia, as low serum sodium level was found to be a significant and independent predictor of mortality.

MONOCYTE/HDL RATIO IN NON-ALCOHOLIC HEPATIC STEATOSIS.

BACKGROUND: Non-alcoholic hepatic steatosis (NAS) is characterized by excess fat accumulation in hepatocytes, causing portal and lobular inflammation and hepatocyte injury. OBJECTIVE: We aimed to evaluate the alterations in monocyte count to high-density lipoprotein cholesterol ratio (MHR) in patients with grade 2 or 3 fatty liver disease and the association of this marker with liver function tests and insulin resistance. METHODS: In this retrospective analysis; patients diagnosed and followed for the grade 2 or 3 fatty liver disease were included in the patient group and the patients who had undergone abdominal ultrasound for any reason and who were not having any fatty liver disease were included in the control group. RESULTS: Totally 409 cases were included in the study. Among participants, 201 were in the control group, and 208 were in the NAS group (111 were having grade 2 and 97 were having grade 3 steatosis). The monocyte/HDL ratio was significantly higher in the NAS group compared with the healthy controls (P=0.001). There was a significant positive correlation between the monocyte/HDL ratio and age (r=0.109; P=0.028), ALT (r=0.123, P=0.014) and HOMA-IR (r=0.325, P=0.001) values. CONCLUSION: In conclusion, the monocyte to high-density lipoprotein ratio significantly increases in fatty liver disease and correlates with insulin resistance. Since it was suggested as a prognostic marker in atherosclerotic diseases, elevated MHR values in fatty liver disease should be evaluated cautiously.

Relação monócito/HDL em esteatose não hepática / Monocyte/hdl ratio in non-alcoholic hepatic steatosis

ABSTRACT BACKGROUND: Non-alcoholic hepatic steatosis (NAS) is characterized by excess fat accumulation in hepatocytes, causing portal and lobular inflammation and hepatocyte injury. OBJECTIVE: We aimed to evaluate the alterations in monocyte count to high-density lipoprotein cholesterol ratio (MHR) in patients with grade 2 or 3 fatty liver disease and the association of this marker with liver function tests and insulin resistance. METHODS: In this retrospective analysis; patients diagnosed and followed for the grade 2 or 3 fatty liver disease were included in the patient group and the patients who had undergone abdominal ultrasound for any reason and who were not having any fatty liver disease were included in the control group. RESULTS: Totally 409 cases were included in the study. Among participants, 201 were in the control group, and 208 were in the NAS group (111 were having grade 2 and 97 were having grade 3 steatosis). The monocyte/HDL ratio was significantly higher in the NAS group compared with the healthy controls (P=0.001). There was a significant positive correlation between the monocyte/HDL ratio and age (r=0.109; P=0.028), ALT (r=0.123, P=0.014) and HOMA-IR (r=0.325, P=0.001) values. CONCLUSION: In conclusion, the monocyte to high-density lipoprotein ratio significantly increases in fatty liver disease and correlates with insulin resistance. Since it was suggested as a prognostic marker in atherosclerotic diseases, elevated MHR values in fatty liver disease should be evaluated cautiously.

RESUMO CONTEXTO: A esteatose não hepática (ENH) é caracterizada pelo acúmulo de gordura nos hepatócitos, causando inflamação portal e lobular e lesões ao hepatócito. OBJETIVO: Avaliar as alterações na contagem de monócitos em relação à proporção de lipoproteína de colesterol de alta densidade (MHR) em doentes com doença hepática gordurosa de grau 2 ou 3 e a associação deste marcador com testes de função hepática e de resistência à insulina. MÉTODOS: Nesta análise retrospectiva os pacientes diagnosticados e seguidos para a doença hepática gordurosa de grau 2 ou 3, foram incluídos no grupo de doentes e os indivíduos que tinham sido submetidos a ecografia abdominal por qualquer motivo e que não tinham qualquer doença hepática gordurosa foram incluídos no de controle. RESULTADOS: Foram incluídos 409 pacientes no estudo. Entre os participantes, 201 estavam no grupo controle e 208 estavam no grupo ENH (111 caracterizados como grau 2 e 97 com esteatose de grau 3). A relação monócito/HDL foi significativamente maior no grupo ENH em comparação com os controles saudáveis (P=0,001). Verificou-se correlação positiva significativa entre a relação monócitos/HDL e a idade (r=0,109; P=0,028), e valores de ALT (r=0,123; P=0,014) e HOMA-IR (r=0,325; P=0,001). CONCLUSÃO: A razão entre monócitos e a lipoproteína de alta densidade aumenta significativamente na doença hepática gordurosa e correlaciona-se com a resistência à insulina. Uma vez que foi sugerido como um marcador prognóstico em doenças ateroscleróticas, os valores elevados de MHR na doença hepática gordurosa devem ser avaliados com cautela.

Diagnostic and prognostic role of mean platelet volume and mean platelet volume/platelet ratio in patients with primary malignant bone tumor.

OBJECTIVES: This study aims to investigate the diagnostic and prognostic role of mean platelet volume (MPV) and MPV/platelet (PLT) ratio in primary malignant bone tumors. PATIENTS AND METHODS: We retrospectively investigated patients with primary malignant bone tumors between January 2010 and January 2019 and included 109 patients (69 males, 40 females; mean age: 41.9±17.9 years; range 15 to 86 years) in the study. A total of 107 healthy volunteers (61 males, 46 females; mean age: 47 years; range 19 to 61 years) who donated blood to the blood center of our hospital in 2019 formed the control group. Demographic features, MPV, PLT counts, mortality, and recurrence records of the patients were obtained from archives. RESULTS: Of the 109 patients, 11 were diagnosed with Ewing's sarcoma, 52 with chondrosarcoma, and 46 with osteosarcoma. The tumor was located on the right in 56% of patients and on the lower extremity in 59.6% of patients. The recurrence rate was 41.3% in the patient group. Of the 109 patients, 17 (15.6%) resulted in exitus at follow-up. The mean PLT value of the patient group was significantly higher than the control group (289,440 vs. 247,299, p<0.001). The median MPV and MPV/PLT ratios were statistically significantly lower in the patient group than in the control group (8.3 vs. 10.5, p<0.001 and 0.032 vs. 0.043, p<0.001, respectively). The MPV, PLT count, and MPV/PLT ratio were not associated with mortality and recurrence. The cut-off value was determined as >9.25 fL for MPV (sensitivity=74%, specificity=85%, positive likelihood ratio=4.96, positive predictive value=83.4%, and negative predictive value=76.5). CONCLUSION: Consequently, MPV and MPV/PLT ratios can be used as a diagnostic support parameter in primary malignant bone tumors, but have no prognostic value.

Modified quadruple therapy or bismuth-containing quadruple therapy in the first-line treatment of Helicobacter pylori in Turkey.

AIM: Helicobacter pylori (H. pylori) eradication is still an important issue in countries with high antibiotic resistance. This study aimed to compare the efficacy and safety of two bismuth-containing treatment modalities in H. pylori treatment in Turkey. MATERIAL AND METHODS: subjects with H. pylori infection who were treated with either bismuth-containing quadruple therapy (pantoprazole 40 mg bid, tetracycline 500 mg qid, metronidazole 500 mg tid, bismuth subcitrate 262 mg qid daily) (BQT group) or modified quadruple therapy (pantoprazole 40 mg bid, amoxicillin 1 g bid, metronidazole 500 mg tid, bismuth subcitrate 262 mg qid daily) (MBQT group) for 14 days were compared, retrospectively. The eradication success rate, adverse events related to the medications and compliance were investigated. RESULTS: a total of 128 patients in the BQT group and 102 patients in the MBQT group completed the treatment. The overall rate of adverse events was significantly higher in the BQT group compared with the MBQT group (39.4 % vs 18.6; p: 0.001). Among the adverse events, nausea-vomiting and abdominal discomfort was significantly more frequent in the BQT group than in the MBQT group (p: 0.001). The adverse events were mild-moderate in both groups and life threatening adverse events were not present in any of the patients. CONCLUSION: although both regimens were highly effective and safe in H. pylori eradication, both intention-to-treat (ITT) and per-protocol (PP) eradication rates were higher and adverse events were lower in the modified quadruple therapy group. Modified quadruple therapy should be kept in mind for the first-line treatment of H. pylori in regions with high clarithromycin and metronidazole resistance.

Predictors of Neoplasia in Colonic Wall Thickening Detected via Computerized Tomography.

Introduction Colonic wall thickening (CWT) is frequently observed incidentally via abdominal computerized tomography (aCT). Although the general approach to evaluating incidental CWT is a colonoscopic examination, there is a lack of definitive recommendation guidelines. Thus, we aimed to determine neoplasia rates and identify the factors predictive of neoplasia via colonoscopic examinations of patients with CWT incidentally diagnosed via aCT. Methods We retrospectively reviewed 5,300 colonoscopy reports. A total of 122 patients who had CWT incidentally observed via aCT were included in the study. CWT was graded as mild (3-5 mm), moderate (6-12 mm), or severe (≥12 mm). A logistic regression model was used to determine the predictive factors for neoplasia. Results The mean age of the patients was 60 years, and abnormal findings were noted in 52% of the colonoscopies. Neoplastic lesions were detected in 24 patients (19.6%), while colon adenocarcinoma was detected in 8 patients (6.5%). Multivariate analysis showed that moderate-severe, focal, and asymmetric CWT were independent factors for predicting neoplasia (p=0.049, p=0.033, and p=0.018, respectively). Conclusion Pathological findings can be noted via colonoscopic examination in cases of incidental CWT; therefore, patients with moderate-severe, focal, or asymmetric CWT require colonoscopic examination for the purpose of detecting neoplasia.

Prognostic Value of ABO Blood Groups in Patients with Glioblastoma Multiforme.

OBJECTIVE: To investigate relationship among ABO blood groups and prognosis in patients with glioblastoma multiforme (GBM). STUDY DESIGN: Retrospective observational study. PLACE AND DURATION OF STUDY: Department of Medical Oncology, HSU Dr Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey, from April 2012 to May 2020. METHODOLOGY: Two hundred and thirty-eight patients with the diagnosis of GBM were retrospectively reviewed. Data regarding age, gender, surgery (total or subtotal), type (chemotherapy (CT) or radiotherapy (RT)) and duration of adjuvant therapies, comorbid conditions, ABO blood groups were analysed for survival. Median overall survival (OS) was estimated using Kaplan-Meier method. Cox regression model was used to identify independent prognostic factors. RESULTS: Median age was 57 years (range: 20-83); and 57.6% were male in the study population. The blood group was blood group A in 45.0%, blood group B in 14.7%, blood group AB in 5.4%, and blood group O in 34.9% of patients.  Median OS was 22 months in blood group O whereas 14 months in blood group A, 11 months in blood group B and 6 months in blood group AB (p=0.027).The median OS was shorter in non-O blood groups when compared to blood group O (13.0 vs. 22.0; p=0.008). In addition advanced age, subtotal resection and lack of adjuvant therapy (chemotherapy and/or radiotherapy), non-O blood group were identified as independent poor prognostic factor in multivariate analysis (HR: 1.39; p=0.033). CONCLUSION: An association was detected among ABO blood groups and prognosis in patients with GBM. It was observed that blood groups significantly affected survival and that median survival was significantly shorter in Non-O blood groups when compared blood group O. Key Words: Glioblastoma multiforme, ABO blood group, Prognosis, Survival.

Prognostic Factors in Male Breast Cancer: A Single Centre Experience.

OBJECTIVE: To determine the prognostic factors by assessing the clinicopathological characteristics of the male patients with breast cancer (MBC). STUDY DESIGN: Observational study. PLACE AND DURATION OF STUDY: Department of Internal Medicine, HSU Dr. Abdurrahman Yurtaslan Oncology, Training and Research Hospital, Turkey, between January 2010 and November 2018. METHODOLOGY: Data of patients with MBC were evaluated. Age ≥18 years, diagnosis of breast carcinoma, and male gender were the inclusion criteria of the study. Patients were excluded from the study, if their data were incomplete. Ki-67, the status of estrogen receptor (ER), progesterone receptor (PR), and HER2 receptor were obtained from the hospital records. Kaplan-Meier method was performed for survival analysis. Cox regression analysis was used to determine independent prognostic factors of overall survivall (OS). RESULTS: Out of the 73 patients included in the study, 37 of them aged under 65, while 36 of them aged 65 or over. ER positivity was 94.5%, while PR positivity was 87.7%, and HER2 positivity was 13.7%. It was found that as a result of the univariate analysis, the 5-year OS of the elderly group (≥65 years) was lower compared to the younger group (<65 years, 74.2% vs. 93.3%, p=0.022). Age, tumor grade, and T stage were included in the multivariate Cox regression analysis and only advanced age was found to be an independent poor prognostic factor (HR: 3.068, 95% CI: 1.013-9.293, p=0.047). CONCLUSION: Advanced age might be an independent poor prognostic factor for patients with MBC. Key Words: Breast cancer, Elderly, Male, Prognosis.