The impact of COVID-19 pandemic on anxiety levels among patients who have to go to the hospital due to chronic illnesses: A prospective study.

INTRODUCTION: Cancer and hemodialysis (HD) patients are at high risk for COVID-19. In our study, we aimed to evaluate the effect of pandemic on anxiety in these patients. METHODS: One hundred and six oncology and 97 HD patients participated in the study. Anxiety levels were assessed by using the Beck Anxiety Inventory (BAI) and State-Trait Anxiety Inventory (STAI). At the end of 8-month follow-up, these questionnaires were re-administered. RESULTS: During this period, 38 patients (38/203; 18.7%) had COVID-19 infection. Twenty-three patients (23/203; 11.3%) died due to COVID-19 and/or other causes. One hundred and thirteen of the remaining patients were participated in the second questionnaire. Having COVID-19 was not the independent factor for changes in STAI, and BAI scores in any regression models. CONCLUSION: Having COVID-19 does not affect the increased anxiety levels in HD and oncology patients. The effect of the pandemic may have remained in the background, as these patients have more concerns about their own diseases.

Evaluation of the Preoperative Haematological Parameters Predicting the High T-Stage and Fuhrman Grade in Renal Cell Carcinoma.

OBJECTIVE: To investigate the role of cost-effective and widely used hemogram parameters in predicting stage and histological grade. STUDY DESIGN: An analytical study. PLACE AND DURATION OF STUDY: Konya Research and Training Hospital, Turkey from January to June 2020. METHODOLOGY: Pre-nephrectomy hemogram parameters and post-nephrectomy pathology reports of 180 renal cell carcinoma patients, among 553 patients, who had undergone nephrectomy between 2009-2019 were evaluated. The patients were grouped as low risk and high risk in terms of TNM stage and Fuhrman grade; and clinicopathological variables were compared between the groups. Multivariate logistic regression analysis was used to determine the parameters predicting independently the high T stage (T3-T4) and the high Fuhrman grade (G3-G4). RESULTS: While 31 (17.2%) of 180 patients were in the high T stage; 69 (38.3%) were in the high Fuhrman grade. In the logistic regression analysis, NLR, LMR, and hematocrit predicted independently high T stage, while hematocrit and LMR predicted independently the high Fuhrman grade. CONCLUSION: LMR, NLR, and hematocrit were found to be more significant than other parameters, which are among the hemogram parameters that can guide clinicians during staging, which is important for prognosis and treatment decisions. KEY WORDS: Renal cell carcinoma, Tumor staging, Tumor grading.

Effect of anxiety on COVID-19 infection in hemodialysis patients.

Some evidence suggests that anxiety deteriorate the immune system. We aimed to determine the effect of anxiety on COVID-19 infection in hemodialysis (HD) patients. Our study was conducted with 80 HD patients. State-Trait Anxiety Inventory (STAI), and Beck Anxiety Inventory (BAI) questionnaires were administered between April 15 and May 1, 2020. These patients were followed up for about 8 months and COVID-19 infection, hospitalization, and death rates were recorded. Twenty-one (26%) of the patients were diagnosed with COVID-19 infection. Fourteen out of twenty one (66.6%) of the patients were hospitalized, and 8/21 (38%) of them died due to COVID-19. STAI-S (p= 0.006) and BAI (p= 0.021) scores were found to be higher and STAI-T (p= 0.040) score was found to be lower in HD patients who were infected with COVID-19 compared to without, at the follow-up period. It might be concluded in this study that COVID-19 was more common in anxious HD patients.

Adherence to the Mediterranean diet in Turkish hospitalized older adults and its association with hospital clinical outcomes.

AIM: To identify the Mediterranean diet adherence in Turkish older inpatients and its relation to clinical outcomes. METHODS: A total of 200 hospitalized patients over 60 years old (mean age; 72.9 ± 8.5 years, 59.5% female) were included in the study. Beside evaluating the demographic properties, they were evaluated by Elderly Dietary Index (EDI), Mini-nutritional assessment-short form (MNA-SF), and FRAIL index. Length of hospital stay, need of intensive care, and hospital clinical outcomes were also recorded. RESULTS: According to the EDI scoring, the rate of unhealthy diets among study population was 91.5% and 56% of the patients were frail and 17% were malnourished. EDI score was significantly and positively correlated with height (rho=0.183), weight (rho=0.142), MNA-SF score (rho=0.204), glomerular filtration rate (GFR) (rho=0.152), and alanine-aminotransferase (ALT) (rho=0.278) levels (p = 0.009; 0.046; 0.004; 0.032; and <0.001, respectively). EDI scores were higher in male and married patients when compared to female and widow ones (p = 0.001 and 0.023, respectively). There was a negative, moderate, and statistically significant correlation between EDI score and length of hospital stay in patients hospitalized for infectious diseases (rho:-0.510; p = 0.036). EDI score was also significantly related to frailty status (p = 0.017) and malnutrition (p = 0.026). The EDI score was found to be an independent parameter for frailty in a regression analysis model (OR=0.826;%95 CI: 0.713-0.959; p = 0.012). CONCLUSION: It was shown that hospitalized older adults had a low adherence to the Mediterranean diet. Unhealthy diet group might be associated with poor clinical outcomes such as malnutrition, frailty, increased length of hospital stay, and recurrent emergency department admissions.

The Relationship between Polycystic Ovary Syndrome and Serum Periostin Level.

OBJECTIVE: To determine the changes of circulating periostin levels in polycystic ovary syndrome (PCOS) and its relationship with metabolic disorders. STUDY DESIGN: Cross-sectional study. PLACE AND DURATION OF STUDY: Konya Research and Training Hospital, Turkey between September 2018 and April 2020. METHODOLOGY: Patients with PCOS were compared with healthy individuals as control. The demographics, laboratory findings, anthropometric measurements, the levels of serum periostin and carotid intima media thickness (CIMT) were evaluated and compared. RESULTS: There was no significant difference between patients with PCOS (n = 53) and controls (n = 35), according to demographic and laboratory findings and anthropometric measurements. The CIMT in patients with PCOS and control groups were measured as 0.5 ± 0.06 mm and 0.43 ± 0.1 mm, respectively (p <0.003). The levels of periostin in the patients with PCOS and control groups were found to be 6.43 ± 6.19 ng/mL and 3.61 ± 3.79 ng/mL, respectively (p <0.018). No statistically significant correlations were found according to periostin levels and metabolic variables. CONCLUSION: Although there was no significant correlation between the periostin levels and the metabolic variables in patients with PCOS as compared to those without the periostin levels, but CIMT were higher in PCOS group. Key Words: Atherosclerosis, Carotid intima-media thickness, Insulin resistance, Periostin protein, Polycystic ovary syndrome.

Irritable bowel syndrome frequency and related factors in hemodialysis patients.

INTRODUCTION: Irritable bowel syndrome (IBS) is a functional bowel disease that is common in society, does not threaten life, impairs quality of life, and causes serious economic losses. Gastrointestinal system complaints and especially IBS are common in patients with chronic kidney disease. It has also been shown that psychiatric diseases are more common in patients with IBS. In this study, we aimed to determine the frequency of IBS in hemodialysis patients and to investigate the factors associated with IBS. METHODS: In this cross-sectional study, the questionnaire prepared to evaluate depression, anxiety, and abdominal pain was administered face-to-face to 686 patients by the same researcher in seven dialysis centers; 404 patients without exclusion criteria were included in the study. The diagnosis of IBS was made according to Rome IV criteria. A multivariate logistic regression model was used to identify factors that are significantly related to IBS. FINDINGS: In 69 (17.1%) of the patients included in the study, symptoms were consistent with IBS. Binominal logistic regression analysis was performed to evaluate the effect of age, dialysis duration, diabetes, proton pump inhibitor, non-steroidal anti-inflammatory drugs, calcium acetate use, Hamilton depression and anxiety scores associated with IBS in the presence of IBS of the participants. The logistic regression model was statistically significant, χ2 (3) = 69.748, P < 0.001. Independent risk factors for IBS in hemodialysis patients were determined as anxiety, long-term dialysis treatment, and using calcium acetate as a phosphorus binder. DISCUSSION: In hemodialysis patients, IBS occurs approximately twice as often as in a healthy population. Independent risk factors for IBS in hemodialysis patients are anxiety, long-term dialysis treatment, and using calcium acetate as a phosphorus binder.