Ultrasonography-based Staging of Inflammatory Granulomatous Mastitis and Estimation of Steroid Response.

OBJECTIVE: The aim of this study is to present novel diagnostic ultrasonography-based classification of inflammatory granulomatous mastitis (IGM) and to assess and compare dosage responses of locoregional steroid therapy. MATERIAL & METHODS: From January 2017 through March 2023 total of 230 biopsy-proven IGM patients were reclassified (Grade I, II, and III) according to ultrasonography-based morphological features.The injection applications were grouped in Group1 [40mg/mL between 2017-2019 years] vs. Group2 [80mg/mL between 2019-2023 years] and effectiveness analyzed for each grade in between groups. RESULTS: Total mean age was 31 years old (range: 19-60) with median follow-up period of 7 months. The most common clinical presentation was breast mass accompanying draining skin sinuses of the affected skin and hypoechogenic mass with tubular extensions was the most prevalent feature on USG examination. As per USG-based features 79 (34.3%) patients re-defined as Grade I, 64 (27.8%) as Grade II, and 87 (37.8%) as Grade III.All patients underwent loco-regional steroid injection only. The average treatment in the first group was 6 (±3 SD) with effective dose of 40mg/mL and 4 (±2 SD) with 80 mg/mL in the second group. Generalized linear mixed model investigated effects in between groups (p < 0.05). CONCLUSION: High dose steroid treatment was effective in burnout lesions (Grades II and III), and it was found to be statistically significant in lowering number of treatments irrespective of grade. ADVANCE IN KNOWLEDGE: This novel classification could be a convenient tool in terms of common language between radiologists and clinicians. And our study is the pioneer in comparing steroid dosage with no relapse on IGM patients.

A new possible marker: can pennation angle defined by ultrasound predict the frailty?

BACKGROUND: Frailty indicates older people who are vulnerable to stressors. The relation between ultrasonographic parameters of muscle and frailty among older people has yet to be investigated. AIMS: The aim of the study is to investigate the relationship between frailty and the ultrasonographic measurements of the rectus femoris muscle (RFM). METHODS: This cross-sectional study included 301 participants who were ≥65 years. The FRAIL questionnaire assessed frailty. The thickness, cross-sectional area (CSA), fascicle length, pennation angle (PA), stiffness, and echogenicity of RFM were assessed by ultrasound. The accuracy of parameters in predicting the frailty was evaluated by ROC analysis. RESULTS: Of all 301 participants, 24.6% were frail. Pre-frail and frail participants had significantly lower thickness (p = 0.002), CSA (p = 0.009), and fascicle length (p = 0.043) of RFM compared to robust. PA was significantly lowest in frails (p < 0.001). The multivariate logistic regression analysis showed that PA values lower than 10.65 degrees were an independent predictor of frailty (OR = 0.83, 95% Cl: 0.70-0.97, p = 0.019). Results of ROC analysis demonstrated a satisfactory result between the PA and frailty (AUC = 0.692, p < 0.001). DISCUSSION: Thickness, CSA, and PA of RFM were found to be lower in frail subjects, which may indicate the changes in muscle structure in frailty. Among all parameters, lower PA values were independent predictors of frailty. These findings may indicate a novel ultrasound-based method in frailty, that is more objective and unrelated to the cross-sectional evaluation. CONCLUSIONS: Ultrasonographic measurements of RFM, especially the lower PA may predict frailty in older people. As an objective and quantitative method, PA may be used to define frailty with acceptable sensitivity.

Comparison of long-term outcomes of double kissing crush versus T and minimal protrusion techniques in complex bifurcation lesions: The EVOLUTE-CRUSH II registry.

BACKGROUND: Double kissing (DK)-crush and T-stenting and small protrusion (TAP) techniques are gaining popularity, but the comparison for both techniques is still lacking. This study sought to retrospectively evaluate the long-term outcomes of DK-crush and TAP techniques in patients with complex bifurcation lesions. METHODS: A total of 255 (male: 205 [80.3%], mean age: 59.56 ± 10.13 years) patients who underwent coronary bifurcation intervention at a single-center between January 2014 and May 2021 were included. Angiographic features, procedure details, and in-hospital or long-term outcomes were assessed. The primary endpoint was target lesion failure (TLF), defined as the combination of cardiac death, target vessel myocardial infarction, or clinically driven-target lesion revascularization (TLR). The regression models were adjusted applying by the inverse probability weighted (IPW) approach to reduce treatment selection bias. RESULTS: The initial management strategy was DK-crush in 152 (59.6%) patients and TAP in 103 (40.4%) cases. The SYNTAX scores (24.58 ± 7.4 vs. 24.26 ± 6.39, p = 0.846) were similar in both groups. The number of balloon (6.32 ± 1.82 vs. 3.92 ± 1.19, p < 0.001) usage was significantly higher in the DK-crush group than in the TAP group. The rates of TLF (11.8 vs. 22.3%, p = 0.025) and clinically driven TLR (6.6 vs. 15.5%, p = 0.020) were significantly lower in the DK-crush group compared to the TAP group. The long-term TLF was significantly higher in the TAP group compared to the DK-crush group (unadjusted HR: 1.974, [95% CI: 1.044-3.732], p = 0.035 and adjusted HR [IPW]: 2.498 [95% CI: 1.232-5.061], p = 0.011). CONCLUSION: The present study showed that the DK-crush technique of bifurcation treatment was associated with lower long-term TLF and TLR rates compared to the TAP technique.

The relationship between sarcopenia, sarcopenia related quality of life and ultrasound findings of the rectus femoris muscle in older outpatients.

PURPOSE: Skeletal muscle ultrasonography stands out as a promising method for detecting sarcopenia. We aimed to evaluate the relationship between sarcopenia, sarcopenia related quality of life and US findings of the Rectus Femoris muscle. METHODS: A total of 300 older individuals were included in this cross-sectional study. Sarcopenia was diagnosed according to the European Working Group on Sarcopenia in Older People 2 criteria. Rectus F muscle thickness, cross-sectional area, fascicle length, pennation angle, stiffness and echogenicity were measured by an experienced radiologist using a B-mode US device. Quality of life was determined with the Sarcopenia- Quality of life questionnaire. Correlation analysis, receiver operating analysis, sensitivity and specificity analysis were performed. RESULTS: The median age of participants was 72. 191 (63.9%) and 109 (36.1%) of the participants were male and female, respectively. The prevalence of sarcopenia was 15.6%. Fascicle length, cross-sectional area and thickness showed the highest sensitivity (81%) and specificity (87%) for men. Fascicle length and pennation angle showed the highest sensitivity (87%) and specificity (66%) for women. Rectus Femoris ultrasound parameters differed across SarQoL quartiles, and higher Sarcopenia- Quality of life scores were associated with better ultrasound parameters. All ultrasound parameters had positive correlations with Sarcopenia- Quality of life. CONCLUSION: Different Rectus Femoris ultrasound parameters are useful for detecting sarcopenia according to gender. A combination of these parameters can increase diagnosis accuracy. Ultrasound parameters are associated with sarcopenia related quality of life.

Clinical implication of the Naples prognostic score on transcatheter aortic valve replacement in patients with severe aortic stenosis.

BACKGROUND: One of the hallmarks of frailty in patients with severe aortic stenosis (AS) is malnutrition, for which one of the most up-to-date scoring systems is the Naples prognostic score (NPS). This study sought to investigate the predictive role of the NPS in determining mortality in patients undergoing transcatheter aortic valve replacement (TAVR) under long-term follow-up. METHODS: A total of 430 consecutive patients with symptomatic severe AS who underwent TAVR were included retrospectively. The primary endpoint of the study was the long-term all-cause mortality. The study population was divided into two groups according to the NPS value, including Group 1 (NPS 0-2) and Group 2 (NPS 3-4). RESULTS: The all-cause mortality occurred in 250 patients (62.5%) patients during a follow-up time of 40.6 (22.0-69.4) months. During the follow-up period, all-cause mortality was higher in Group 2 compared with Group 1 (87.9% vs. 42.9%, p < 0.001). Older age (p < 0.001), chronic obstructive pulmonary disease (p = 0.015), left ventricular ejection fraction (p = 0.021), and being in Group 2 (high NPS) (hazard ratio: 7.058, 95% confidence interval: 5.174-9.629, p < 0.001) were found to be independent predictors of all-cause mortality at long-term follow-up. CONCLUSION: The NPS as a malnutrition and inflammation marker in patients with severe aortic stenosis who underwent TAVR provides valuable information for all-cause mortality under long-term follow-up.

Elevating healthcare through artificial intelligence: analyzing the abdominal emergencies data set (TR_ABDOMEN_RAD_EMERGENCY) at TEKNOFEST-2022.

OBJECTIVES: The artificial intelligence competition in healthcare at TEKNOFEST-2022 provided a platform to address the complex multi-class classification challenge of abdominal emergencies using computer vision techniques. This manuscript aimed to comprehensively present the methodologies for data preparation, annotation procedures, and rigorous evaluation metrics. Moreover, it was conducted to introduce a meticulously curated abdominal emergencies data set to the researchers. METHODS: The data set underwent a comprehensive central screening procedure employing diverse algorithms extracted from the e-Nabiz (Pulse) and National Teleradiology System of the Republic of Türkiye, Ministry of Health. Full anonymization of the data set was conducted. Subsequently, the data set was annotated by a group of ten experienced radiologists. The evaluation process was executed by calculating F1 scores, which were derived from the intersection over union values between the predicted bounding boxes and the corresponding ground truth (GT) bounding boxes. The establishment of baseline performance metrics involved computing the average of the highest five F1 scores. RESULTS: Observations indicated a progressive decline in F1 scores as the threshold value increased. Furthermore, it could be deduced that class 6 (abdominal aortic aneurysm/dissection) was relatively straightforward to detect compared to other classes, with class 5 (acute diverticulitis) presenting the most formidable challenge. It is noteworthy, however, that if all achieved outcomes for all classes were considered with a threshold of 0.5, the data set's complexity and associated challenges became pronounced. CONCLUSION: This data set's significance lies in its pioneering provision of labels and GT-boxes for six classes, fostering opportunities for researchers. CLINICAL RELEVANCE STATEMENT: The prompt identification and timely intervention in cases of emergent medical conditions hold paramount significance. The handling of patients' care can be augmented, while the potential for errors is minimized, particularly amidst high caseload scenarios, through the application of AI. KEY POINTS: • The data set used in artificial intelligence competition in healthcare (TEKNOFEST-2022) provides a 6-class data set of abdominal CT images consisting of a great variety of abdominal emergencies. • This data set is compiled from the National Teleradiology System data repository of emergency radiology departments of 459 hospitals. • Radiological data on abdominal emergencies is scarce in literature and this annotated competition data set can be a valuable resource for further studies and new AI models.

Assessment of Renal Function of Bodybuilders Using Anabolic Androgenic Steroids and Diet Supplements.

Introduction Anabolic androgenic steroids (AAS) and diet supplements (DS) are frequently used by bodybuilders. In this specific group, increased muscle mass, the acute effects of exercise, and the use of creatine may affect the creatinine-based estimated glomerular filtration rate (eGFRcr), potentially leading to an underestimation of the GFR. Cystatin C equations offer a more accurate prediction of GFR that is independent of muscle mass. We aimed to assess the renal functions of bodybuilders who use both AAS+DS, as well as those who only use DS, by calculating the GFR based on cystatin C (eGFRcys) and also using a combination of cystatin C and creatinine (eGFRcys/cr). Methods The study included 12 bodybuilders using AAS+DS and 12 bodybuilders using DS. In both groups, serum cystatin C levels, eGFRcys, eGFRcys/cr, urine albumin excretion rates, urine protein excretion rates, and routine tests were examined. Results In AAS+DS users, the average duration of AAS use was 3.08±2.02 years, while for DS users, the duration of supplement use was 3.67±2.49 years. The spot urine albumin/creatinine and protein/creatinine ratios were higher in AAS+DS users (p<0.001 and p=0.006, respectively). Although eGFRcr was found to be similar in the AAS+DS and DS groups (119.67 ± 24.12 ml/min and 122.08 ± 18.03 ml/min, respectively; p=0.426), eGFRcys and the eGFRcys/cr ratio were significantly lower in the AAS+DS group compared to the DS group (eGFRcys: 120.67 ± 19.48 ml/min vs. 122.08 ± 18.03 ml/min, p=0.039; eGFRcys/cr: 121.83 ± 20.62 ml/min vs. 126.33 ± 21.163 ml/min, p= 0.036, respectively). Conclusion Cystatin-based GFR values were found to be significantly lower in AAS+DS users, and urinary albumin and protein excretion were considerably higher compared to DS users. Although these findings suggest a potential link between early kidney damage and the direct use of AAS, the topic requires further investigation.

Microsievert Wide-Volume Versus Spiral Computed Tomography Using an Automatic Exposure Control System in the Diagnosis of Foreign Body Aspiration in Children.

BACKGROUND: Foreign body aspiration (FBA) in childhood is a life-threatening condition that necessitates prompt management to prevent devastating complications. Different imaging methods are used in the diagnosis of FBA. OBJECTIVE: The aim of this study was to compare the diagnostic value and dose of microsievert wide-volume computed tomography (µSv-WV-CT) with multidetector computed tomography using an automatic exposure control system (MDCT-AEC) in children with FBA. MATERIAL AND METHODS: In this single-center cross-sectional study, 102 cases diagnosed with FBA between September 2013 and September 2021 were retrospectively evaluated. The patients were divided into 2 groups according to the diagnostic modality used: group A, µSv-WV-CT (2016-2021) and group B, MDCT-AEC (2013-2021). The diagnostic performance and radiation dose of the 2 groups were statistically compared. RESULTS: The diagnostic performance (sensitivity, specificity, positive predictive value, negative predictive value, and accuracy) of the 2 groups was similar. The mean effective radiation dose of group A was 34.89 ± 0.01 µSv, which was significantly lower than that of group B (179.75 ± 114.88 µSv) ( P < 0.001). CONCLUSION: In children with suspected FBA, µSv-WV-CT at a lower radiation dose had similar diagnostic performance to MDCT-AEC.

A Simple Predictor for Long-Term Mortality After Percutaneous Iliac Artery Intervention: Systemic Immune Inflammatory Index.

BACKGROUND: Peripheral arterial disease is a common disease all over the world. Medical treatment, percutaneous invasive treatment, and operation are the considerable options. Percutaneous treatment is a valid option with a higher patency rate. Systemic immune-inflammatory index (SII) is a formula which is calculated as neutrophil count to platelet count divided into lymphocyte count. This formula demonstrates the active inflammatory state. In our study, we aimed to demonstrate the relationship with SII and the mortality, major cardiovascular events, and success rates of percutaneous treatment of iliac artery disease. METHODS: A total of 600 patients underwent percutaneous intervention due to iliac artery disease were enrolled. The primary end point was mortality and the secondary end points were in-hospital thrombosis, restenosis, residual stenosis, and postintervention complications. The best cut-off value of SII to predict mortality was determined and the patients were divided into 2 groups, as those with higher SII values (1,073.782 <) and as those with lower SII values (1,073.782 >). Each group was evaluated in terms of clinical, laboratory, and technical aspects. RESULTS: After exclusion criteria were applied, 417 patients were enrolled into the study. Patients with high SII values had higher rates of in-hospital thrombosis [0 (0%); 3 (2.2%), P = 0.037] and mortality [38 (13.7%); 46 (33.1%), P < 0.001]. In multivariate logistic regression analysis, chronic kidney disease [odds ratio: 4.104, 95 0.5 confidence interval: 2.250-7.487, P < 0.001] and SII [odds ratio: 3.346, 95 0.5 confidence interval: 1.982-5.649, P < 0.001] were found to be independent risk factors for mortality. CONCLUSIONS: SII is a relatively new, simple, and effective mortality risk predictor in patients with iliac artery disease who underwent percutaneous intervention. To the best of our knowledge, our study is the first study which uses SII to predict mortality in such patient group.

Supramarginal Gyrus and Angular Gyrus Subcortical Connections: A Microanatomical and Tractographic Study for Neurosurgeons.

Background and Objectives: This article aims to investigate the subcortical microanatomy of the supramarginal gyrus (SMG) and angular gyrus (AnG) using a microfiber dissection technique and diffusion tensor imaging (DTI)/fiber tractography (FT). The cortical and subcortical structures of this region are highly functional, and their lesions often present clinically. For this reason, the possibility of post-surgical deficits is high. We focused on the supramarginal gyrus and the angular gyrus and reviewed their anatomy from a topographic, functional and surgical point of view, and aimed to raise awareness especially for neurosurgeons. Methods: Four previously frozen, formalin-fixed human brains were examined under the operating microscope using the fiber dissection technique. Four hemispheres were dissected from medial to lateral under the surgical microscope. Brain magnetic resonance imaging (MRI) of 20 healthy adults was examined. Pre-central and post-central gyrus were preserved to achieve topographic dominance in dissections of brain specimens. Each stage was photographed. Tractographic brain magnetic resonance imaging of 10 healthy adults was examined radiologically. Focusing on the supramarginal and angular gyrus, the white matter fibers passing under this region and their intersection areas were examined. These two methods were compared anatomically from the lateral view and radiologically from the sagittal view. Results: SMG and AnG were determined in brain specimens. The pre-central and post-central gyrus were topographically preserved. The superior and medial temporal gyrus, and inferior and superior parietal areas were decorticated from lateral to medial. U fibers, superior longitudinal fasciculus II (SLF II), superior longitudinal fasciculus III (SLF III), arcuat fasciculus (AF) and middle longitudinal fasciculus (MdLF) fiber groups were shown and subcortical fiber structures belonging to these regions were visualized by the DTI/FT method. The subcortical fiber groups under the SMG and the AnG were observed anatomically and radiologically to have a dense and complex structure. Conclusions: Due to the importance of the subcortical connections of SMG and AnG on speech function, tumoral lesions and surgeries of this region are of particular importance. The anatomical architecture of the complex subcortical structure, which is located on the projection of the SMG and AnG areas, was shown with a DTI/FT examination under a topographic dominance, preserving the pre-central and post-central gyrus. In this study, the importance of the anatomical localization, connections and functions of the supramarginal and angular gyrus was examined. More anatomical and radiological studies are needed to better understand this region and its connections.

Quantitative analysis of lung parenchymal involvement in Behçet's disease by the novel automatic program.

OBJECTIVES: We aimed to quantitatively analyze lung parenchymal changes in Behçet's patients and to detect early parenchymal quantitative changes that occur in the absence of positive visual radiological findings. METHODS: In our study, a total of 31 patients with Behçet's disease, 17 with positive radiological findings and 14 patients without positive radiological findings, and a control group of 33 individuals were evaluated. The automatic program determined lung volumes, lung densities, and opacity volume percentages by evaluating the contrast-enhanced lung computed tomography scans. RESULTS: The total lung volume was 3632.98 ± 1100.53 mL in the Behçet's disease patient group and 4925.70 ± 1098.88 mL in the control group, and there was a significant decrease in the total lung volume in Behçet's disease patients (P < 0.0001). The mean lung density was -723.73 ± 65.16 in the Behçet's disease patient group and -767.35 ± 41.17 in the control group, and there was a significant increase in the mean density in the Behçet's patients (P = 0.0023). A significantly higher correlation was observed between lung density and lung volume in Behçet's patients (P < 0.0001, r = -0.795). The lung volume of Behçet's disease patients with negative radiological findings was significantly lower than that of the control group (P = 0.0342). CONCLUSIONS: Lung volumetric changes in Behçet's disease patients are the quantitative data most affected by the disease. In addition, lung volume decreases in Behçet's patients who do not have visual parenchymal involvement.

Clinical implication of totally occluded infarct-related coronary artery in non-ST-segment elevation myocardial infarction: the TOTAL-NSTEMI study.

BACKGROUND: A subset ofpatients found to have total occlusion of the culprit artery (TOCA), present with non-ST-segment elevation myocardial infarction (NSTEMI) and elevated biomarkers. The aim of this study is to assess the effect of the TOCA in patients presenting with NSTEMI. METHODS: This multicenter observational study was retrospectively conducted between 2015 and 2019. Thrombolysis in myocardial infarction (TIMI) flow grades 0-1 was defined as the TOCA. The primary end point included a combination of all-cause death, myocardial infarction, target vessel revascularization, stent thrombosis, and stroke. RESULTS: Of 3272 patients, TIMI 0-1 flow in the culprit artery was present in 488 (14.9%) patients. TOCA was more likely to be of thrombotic origin (54.1% vs. 10.3%; P < 0.001) and visible collaterals (22.5% vs. 4.4%; P < 0.001). The rates of 30-day (14.3% vs. 7.2%; P < 0.001) and 2-year (25% vs. 19.1%; P = 0.003) primary end points were significantly higher in TOCA patients. Fatal arrhythmias were remarkably higher at 30-day (8.6% vs. 4%; P < 0.001) and 2-year (9% vs. 5.2%; P = 0.001) follow-ups. Mechanical complications were also higher in patients with TOCA at 30 days (0.8% vs. 0.2%; P = 0.013). Moreover, TOCA (OR, 1.379; P = 0.001) was one of the independent predictors of MACCE in NSTEMI patients. CONCLUSION: The current data suggest that patients with TOCA in the context of NSTEMI are at higher risk of MACCE, fatal arrhythmias, and mechanical complications.

Deep brain stimulation for the abernethy malformation related tremor.

Deep brain stimulation (DBS) is introduced for the surgical treatment of movement disorders such as Parkinson's disease, tremor, dystonia, and tics. Electrostimulation of the ventral thalamus or subthalamic area has been found effective in different types of tremors that have different etiologies. Abernethy malformation is a rare congenital abnormality characterized by the presence of a congenital extrahepatic portosystemic shunt between the portal vein and systemic circulation. In this report, we present as a case of Abernethy malformation that caused hyperammonemia congenitally and presented as action and resting tremor in the hands and, treated with DBS.

Carotid artery stenting without embolic protection: A randomized multicenter trial (the CASWEP trial).

BACKGROUND: Carotid artery stenting (CAS) with a carotid protection device (CPD) has become the standard practice in patients with severe carotid stenosis and high surgical risk. However, the clinical efficacy and safety of CPDs are still controversial issues. We aimed to compare the clinical outcomes of the CAS without CPD with CAS combined with CPD. METHODS: This is a multicenter randomized prospective study registered with http://clinicaltrials.gov (NCT02781181). After the exclusion, 279 patients were enrolled (139 patients in the CAS with CPD group and 140 patients in the CAS without CPD group). The primary outcome was a combination of peri-procedural in-hospital transient ischemic attack (TIA), ipsilateral stroke, or death. The secondary outcome was new ischemic brain lesions on post-procedural diffusion-weighted magnetic resonance imaging (DW-MRI). RESULTS: Two patients died in CAS without CPD group, one patient died in CAS with CPD group. TIA was only seen in patients who underwent CAS under protection (n = 5). The combined primary outcome of TIA, ipsilateral stroke, and death rate was not different between groups (5.7% vs. 2.8%; p = 0.254). New defects were noted on the post-procedural DW-MRI in 28% of patients in the CPD group and 27% of patients in the no CPD group (p = 0.881). CONCLUSIONS: This study suggests that CAS without CPD is not associated with higher rates of peri-procedural TIA, stroke, and death or new ischemic brain lesions on post-procedural DW-MRI compared to CAS with CPD in selected symptomatic and asymptomatic patients with significant carotid artery stenosis provided that there is no visible thrombus.

The relationship between sarcopenia and one-year mortality in patients with critical limb ischemia undergoing endovascular therapy below the knee.

OBJECTIVE: Critical limb ischemia (CLI) is a progressive form of peripheral artery disease (PAD). Patients with CLI have poor long-term prognosis. The aim of this study was to investigate the value of sarcopenia in terms of 1-year mortality in patients with below-the-knee lesions who underwent endovascular treatment for CLI. METHODS: A total of 190 patients with critical limb ischemia who underwent endovascular treatment (EVT) for below-the-knee (BTK) lesions were enrolled in this study. Sarcopenia was defined using the psoas muscle index (PMI). PMI was obtained by calculating the average psoas muscle area (APMA) of the left and right psoas muscles at the third lumbar vertebra level and dividing by the square of the height (cm2/m2). The primary endpoint of the study was 1-year mortality and the secondary endpoint was 1-year amputation. Patients were divided into 2 groups according to presence of sarcopenia. RESULTS: We detected sarcopenia in 64 patients. The mean age, height, and EF were higher in sarcopenia group. The psoas muscle area, weight, psoas muscle index, body-mass index, albumin level, and GFR were lower in sarcopenia group. The incidence of amputation (11.9% vs 29.7%, p = 0.003) and mortality (15.1% vs 35.9%, p = 0.001) were higher in patients with sarcopenia. Univariate and multivariate logistic regression analyses were used to determine the independent predictors of amputation and mortality. The survival curve for 1-year using the sarcopenia was analyzed using the Kaplan-Meier method, and statistical analysis was performed with the log-rank test. The presence of sarcopenia, glomerular filtration rate level, and low ejection fraction were found to be independent predictors of mortality. CONCLUSIONS: Sarcopenia was associated with 1-year mortality in patients with CLI undergoing EVT for BTK lesions. Also, patients with sacropenia had higher 1-year amputation rates. Sarcopenia may be a simple method to help patient selection, assessment, and intervention strategy for EVT and may improve patient outcomes.

Evaluation of Outcomes of Peritoneal Dialysis Patients in the Post-COVID-19 Period: A National Multicenter Case-Control Study from Turkey.

INTRODUCTION: There are not enough data on the post-CO-VID-19 period for peritoneal dialysis (PD) patients affected from COVID-19. We aimed to compare the clinical and laboratory data of PD patients after COVID-19 with a control PD group. METHODS: This study, supported by the Turkish Society of Nephrology, is a national, multicenter retrospective case-control study involving adult PD patients with confirmed COVID-19, using data collected from April 21, 2021, to June 11, 2021. A control PD group was also formed from each PD unit, from patients with similar characteristics but without COVID-19. Patients in the active period of COVID-19 were not included. Data at the end of the first month and within the first 90 days, as well as other outcomes, including mortality, were investigated. RESULTS: A total of 223 patients (COVID-19 group: 113, control group: 110) from 27 centers were included. The duration of PD in both groups was similar (median [IQR]: 3.0 [1.88-6.0] years and 3.0 [2.0-5.6]), but the patient age in the COVID-19 group was lower than that in the control group (50 [IQR: 40-57] years and 56 [IQR: 46-64] years, p < 0.001). PD characteristics and baseline laboratory data were similar in both groups, except serum albumin and hemoglobin levels on day 28, which were significantly lower in the COVID-19 group. In the COVID-19 group, respiratory symptoms, rehospitalization, lower respiratory tract infection, change in PD modality, UF failure, and hypervolemia were significantly higher on the 28th day. There was no significant difference in laboratory parameters at day 90. Only 1 (0.9%) patient in the COVID-19 group died within 90 days. There was no death in the control group. Respiratory symptoms, malnutrition, and hypervolemia were significantly higher at day 90 in the COVID-19 group. CONCLUSION: Mortality in the first 90 days after COVID-19 in PD patients with COVID-19 was not different from the control PD group. However, some patients continued to experience significant problems, especially respiratory system symptoms, malnutrition, and hypervolemia.