The significance of cervical discopathy diagnosis in patients with mastalgia.

OBJECTIVE: The primary aim of this study was to explore the involvement of cervical discopathy in the development of non-cyclic mastalgia by employing cervical magnetic resonance imaging (MRI). PATIENTS AND METHODS: A total of 407 patients were included in the study. Individualized management plans were developed for each patient. Pathological findings in MRI results were assessed by specialists in physical therapy and neurosurgery, and appropriate treatment was administered. Visual assessments of patients were conducted. The Analog Scale (VAS) scoring system was used at the initial presentation, and patients were evaluated at 1 and 3 months following the treatment. RESULTS: In the MRI examinations of the patients included in the study, simultaneous cervical disc protrusion was observed in 29% (n: 124) of those with annular bulging. Comparing the VAS scores of patients before treatment, at the 1st and at the 3rd month showed a significant decrease in mastalgia pain (p < 0.001). CONCLUSIONS: The diagnosis of cervical discopathy holds significant importance in the treatment of mastalgia patients. Therefore, clinicians should keep the cervical spine in mind as a potential contributing factor to mastalgia.

Predictive value of immature granulocyte and delta neutrophil index in the diagnosis of complicated acute cholecystitis.

OBJECTIVE: The complicated gallbladder disorders are associated with increased mortality and morbidity. Thus, this study was aimed at evaluating the predictive value of immature granulocyte count and delta neutrophil index in the prediction of complicated cholecystitis. PATIENTS AND METHODS: We retrospectively reviewed patients who underwent surgery for acute cholecystitis between January 2018 and April 2022. Overall, 351 patients fulfilling the inclusion criteria were included in the study. In all patients, demographic data, immature granulocyte count (IGC), delta neutrophil index (DNI), white blood cell (WBC) count, C-reactive protein (CRP), and albumin levels were recorded. Based on operative findings and histopathological examination, the patients were classified into 2 groups uncomplicated (group I) and complicated (e.g., perforation, gangrenous and emphysematous cholecystitis; group II) groups. The IBM SPSS version 26.0 (SPSS Corp, Armonk, NY, USA) was used to assess differences in blood parameters between groups. The predictive values of the parameters evaluated were estimated using ROC analysis. A p-value<0.05 was considered statistically significant. RESULTS: Acute complicated cholecystitis was found in 138 of 351 patients. No significant difference was detected in age and gender distribution between groups (p=0.352 and p=0.214, respectively). When blood parameters were assessed, it was found that IGC, DNI, WBC, and CAR values were significantly higher in group II (p<0.001; p<0.001, p<0.001, and p=0.036, respectively), while there was no significant difference in CRP and albumin between groups (p=0.099 and p=0.53, respectively). In the ROC analysis, the highest AUC value was found for IG count and DNI (0.784 and 0.775, respectively). The sensitivity and specificity were found as 68.8% and 86.9% for IG count and 49.3% and 96.2% for DNI, respectively. CONCLUSIONS: The IG count and DNI are two novel parameters with strong predictive value in the early diagnosis of acute complicated cholecystitis, which may support clinical findings, imaging studies, and other laboratory parameters.

The relationship between papillary thyroid cancer and triglyceride/glucose index, which is an indicator of insulin resistance.

OBJECTIVE: The incidence of thyroid cancer and metabolic syndrome has been increasing at the same rate over the past few decades. We hypothesized that there would be a direct relationship between thyroid papillary cancer and triglyceride/glucose index (TyG). PATIENTS AND METHODS: A total of 382 operated patients were divided into two groups: patients operated on for papillary thyroid cancer and for non-malignant reasons. Each patient's age, gender, operation times, presence of neck dissection, serum thyroid-stimulating hormone (TSH), free triiodothyronine (FT3) and free thyroxine (FT4), fasting blood glucose and triglyceride levels were scanned retrospectively from the archive system. RESULTS: TyG index was statistically higher in the malignant group. Receiver operating characteristic (ROC) curves obtained for TyG levels at the time of diagnosis of thyroid papillary cancer were AUC: 0.608. The threshold value for TyG was 6,252. The sensitivity of this value was 62.8% and the specificity was 49.2%. CONCLUSIONS: In this study, we investigated the predictive effect of the TyG index in differentiating thyroid papillary carcinoma from non-malignant thyroid lesions. We concluded that the TgY index can be used to identify people at high risk of thyroid papillary cancer and to plan treatment.

The role of immature granulocyte count and delta neutrophil index in the early prediction of mesenteric ischemia.

OBJECTIVE: Mesenteric ischemia is a fatal condition leading to ischemia and necrosis of the intestines following the interruption of blood flow in the vessels feeding the intestines. The present study investigated the significance of immature granulocyte count and delta neutrophil index in the early prediction of mesenteric ischemia. PATIENTS AND METHODS: The study included 248 patients who applied to the hospital between 01.01.2020 and 01.04.2022 and underwent emergency and elective bowel resection in the general surgery clinic. The study population was divided into two groups as patients who underwent surgery for causes non-related to mesenteric ischemia (Group 1) and patients with findings of mesenteric ischemia who underwent laparotomy (Group 2). Preoperative immature granulocyte counts, and delta neutrophil index levels were compared between the groups with and without perioperative mesenteric ischemia. RESULTS: No statistical difference was observed between the groups in terms of age or sex. Comparing the two groups regarding immature granulocyte count and delta neutrophil index revealed a statistically significant difference (p<0.001). The median immature granulocyte count was 0.04 (0.02-0.06) in Group 1 and 1.83 (0.18-2.5) in Group 2, with a statistically significant difference (p<0.001). Also, the comparison of delta neutrophil index levels revealed a median value of 0.4 (0.2-0.6) in Group 1 and 5.6 (0.7-8.1) in Group 2, with a statistically significant difference. CONCLUSIONS: The results of this study have demonstrated that immature granulocyte counts, and delta neutrophil index levels are reliable markers that do not require any additional time or expense, can be easily measured in a complete blood count, and can be used for evaluating intestinal necrosis in mesenteric ischemia.

Predictive value of triglyceride/glucose index (TyG) in predicting breast cancer in patients with breast mass.

OBJECTIVE: Since both breast carcinogenesis and the triglyceride glucose index (TyG) are associated with metabolic syndrome, this study aims at focussing on the TyG index in the breast control group to investigate risk factors causing breast cancer. The predictive value of triglyceride glucose score in predicting breast cancer was investigated. PATIENTS AND METHODS: Patients with a pathological diagnosis of cancer and patients with benign breast lesions who were operated on between May 2018 and December 2021 were included in the study. Patients were divided into two groups: those with Breast Cancer (BC) and those with benign breast lesions. The predictive value of the TyG in predicting breast cancer was investigated. The mean standard deviation (SD) or median values with a 25-75 percent interquartile range (IQR) were used to represent the distribution of continuous data. The Student's t-test was used to evaluate parametric values, and the Mann-Whitney U test was used to analyze non-parametric values. The Chi-square test was used to see if categorical variables could be compared. The optimal cut-off points for the TyG value had been determined using receiver operating curve (ROC) analysis. Cut-off points that are optimal for the TyG value were determined using receiver operating curve (ROC) analysis. RESULTS: The patients in the study had a median age of 51 [IQR (25-75) = 44-62]. Of the 510 patients who had been operated for a breast lesion, 13 were male and 499 were female. While the median glucose value of the patients was 97 [IQR (25-75) = 89-109-9], the median triglyceride value was 155 [IQR (25-75): 86-159]. When glucose and triglyceride values were examined, group I seemed to have significantly lower values (p<0.001, p=0.001, respectively). The mass size was larger in group 2 (p<0.001). In addition, ln TyG was statistically higher in the malignant group (p<0.001). Receiver operating characteristic curves were obtained for TyG levels in BC diagnosis. (AUC = 0.606, standard error 0.025, p<0.001; 95% CI = 0.556-0.655). The cut-off value for TyG was 8,628. The sensitivity of this value was 57.5% and the specificity was 42.6%. CONCLUSIONS: In this study, we investigated the predictive effect of the TyG index in distinguishing benign and malignant lesions of the breast and concluded that the TyG index can be used to differentiate BC in patients with BC.

The predictive value of platelet/mean platelet volume ratio in predicting colon diverticulitis relapse.

OBJECTIVE: Diverticulitis is a health problem that has increased in frequency recently. It has a wide spectrum from simple inflammation to fecal peritonitis, sepsis and even mortality. Thus, it is important to predict diverticulitis, especially recurrent diverticulitis, and take measures to prevent it. In this study, we investigated the predictive value of the PLT/MPV ratio, which is an inflammation marker in predicting the recurrence of diverticulitis disease. PATIENTS AND METHODS: In this study, 132 patients diagnosed with diverticulitis were analyzed retrospectively. Patients' gender, age, localization of diverticulitis, number of diverticula in computed tomography (CT), hospitalization status, length of hospitalization, control colonoscopies, polyps' number and localizations in colonoscopies, presence of malignancy, need for surgery, and recurrences were not reported. White blood cell (WBC), Neutrophil (NE), Lymphocyte (LY), Hemoglobin (Hb), PLT, MPV, Albumin, Creatine Kinase (CK) and C-reactive protein (CRP) levels were examined. The patients were divided into two groups as those who did not relapse concerning diverticulitis and those who did, and statistical analysis was performed between the two groups about related parameters. RESULTS: Among all patients, recurrence was seen in 11 (10.1%) patients. The patients were divided into two groups according to their recurrence status and statistical significance was sought between the data. The calculated PLT/MPV ratio of patients who did not relapse was 25.61±8.05 and 34.98±11.37 for those who had a relapse (p=0.006). The sensitivity for MPV was 81.8%, a specificity of 57.1% and a cut-off of 9.85. The cut-off value for PLT was 207.5 with 100% sensitivity and 33.7% specificity. A cut-off value of 25.11 was found for PLT/MPV with 100% sensitivity and 49% specificity. CONCLUSIONS: PLT/MPV ratio was significantly higher in relapsed cases. Since it is easily accessible and inexpensive, it will guide physicians for diagnosis concerning early detection of relapse cases and initiation of appropriate treatment.