Evaluation of renoprotective effect of calcium channel blockers in coronary angiography patients

Aim: To evaluate the effectiveness of contrast-induced acute kidney injury (CI-AKI) prophylaxis retrospectively, using calcium channel blockers (CCB) before and after contrast exposure and comparing them with patients using angiotensin converting enzyme inhibitors (ACEI), which has not been explored by many studies. Methods: The study was performed in Afyon Kocatepe University, Faculty of Medicine Research Hospital, Cardiology Department between January 2014 and June 2016. Eighty patients using dihydropyridine (amlodipine 10 mg), non-dihydropyridine (diltiazem 60 mg) CCB or ACEI in the form of monotherapy before coronary angiography were included. Results: In the CCB and ACEI group, CI-AKI development rates were 15.7% (n=8) and 24.1% (n=7), respectively (p = 0.383; Fisher's exact test). When the CCB group was evaluated as dihydropyridine and non-dihydropyridine subsets, CI-AKI development rates were found to be similar as well (p = 0.445; Fisher’s exact test) in each subset. Conclusion: In our study, we evaluated one of today's important dilemma; the methods related to the prophylaxis of CI-AKI. Our study shows that there is no difference in the development of CI-AKI between patients using the calcium channel blocker group drugs and ACEI as monotherapy. However, in our study, the mean age of patients using CCB was significantly higher than the group using ACEI

Serum uric acid level is associated with type 2 diabetes mellitus and diabetic regulation

Aim: Serum uric acid is a risk factor for cardiovascular and renal diseases. The role of uric acid as a renal and cardiac risk factor is more prominent in subjects with diabetes mellitus and hypertension. In present retrospective analyze, we aimed to compare serum uric acid levels of subjects with well and poorly controlled type 2 diabetes mellitus (T2DM) and healthy population. Methods: Patients with T2DM, who admitted to outpatient clinics of our institution between April 2017 and January 2018 were retrospectively analyzed. Diabetic subjects grouped into well or poorly regulated T2DM groups according to the HbA1c level (patients with an HbA1c lower than 7% were grouped as well regulated while others grouped as poorly regulated T2DM). Control subjects were healthy individuals whom asked for a routine check-up in our institution. Clinical and laboratory parameters of the study groups compared. Results: Serum uric acid levels of well-controlled T2DM, poorly controlled T2DM and control groups were 5.9±1, 6.7±1.8 and 4.3±1 mg/dL, respectively (p<0.001). Post Hoc analysis revealed that uric acid levels of well controlled diabetics were significantly lower than the uric acid levels of poorly controlled diabetics (p=0.04) and significantly higher than that of the control subjects (p<0.001). Conclusion: We suggest that elevated uric acid indicates a cellular level of damage and can be used as a prognostic indicator of pre-diabetes and T2DM. &nbsp

Serum Uric acid is correlated with HbA1c levels in type 2 diabetes mellitus

Aims: Uric acid is the product of purine metabolism and elevated serum uric acid levels are associated with many metabolic conditions. In present retrospective analysis, we aimed to compare serum uric acid levels of well controlled type 2 diabetic subjects to those of poorly controlled type 2 DM patients. Methods: Medical database of type 2 diabetic subjects whom admitted to outpatient clinics of our institution, between January 2017 and August 2017, were retrospectively analyzed. Patients with a HbA1c level lower than 7,5% were classified as well controlled and others were classified as poorly controlled type 2 DM group. Uric acid levels of the groups were compared. Results: Serum uric acid level of well controlled and poorly controlled diabetics were 4.1 (2,8-5,9) mg/dl and 5,9 (4-9,6) mg/dl, respectively. The difference was statistically significant (p<0.001). A Pearson’s correlation test was revealed that serum uric acid was strongly and positively correlated with HbA1c (r=0.81, p<0.001). Conclusion: Serum uric acid levels worsen in poorly controlled type 2 diabetic subjects. Since HbA1c levels reflects changes in 3 months period, variations in serum uric acid levels could be used as a predictor of diabetic control level in shorter time periods

Platelet to lymphocyte ratio in differentiation of benign and malignant thyroid nodules

Aim: Differentiation of thyroid nodules, either as benign or malignant, is a real diagnostic challenge. Inflammation has an important role in development of the malignancy. Therefore, inflammatory markers are associated with malignant thyroid nodules. Platelet /lymphocyte ratio (PLR) is also one of the novel inflammatory indices derived from hemogram tests. We hypothesized whether PLR was associated with malignant thyroid nodules. For this purpose, we compared PLR levels of the patients with benign thyroid nodules to the PLR of the subjects with malignant nodules. Methods: The subjects who visited outpatient internal medicine clinics of our institution with a diagnosis of thyroid nodule were enrolled to the present retrospective study. According to the examination of the fine needle aspiration cytology (FNAC) specimen of the nodules, patients grouped into benign or malignant nodule groups. PLR of groups were compared. Results: Median PLR values of the benign and malignant thyroid nodule groups were 106 (48-432) % and 119 (48-365) %, respectively (p=0.001). PLR value higher than 106% has 69% sensitivity and 51% specificity in detecting malignant nodules (AUC: 0.59, p=0.001, 95% CI: 0.54-0.65). PLR was positively correlated with TSH level (r=0.10, p=0.34). Conclusion: We suggest that elevated PLR could be an additional tool to differentiate malignant thyroid nodules from benign ones in supportive of sonography, scintigraphy and cytology

Mean Platelet volume to platelet and red cell distribution width to platelet ratios in Irritable Bowel Syndrome

Aim: Irritable Bowel syndrome (IBS) is a common gastrointestinal disease worldwide with a broad spectrum of symptoms. In present retrospective study, we aimed to compare mean platelet volume to platelet ratio (MPR) and red cell distribution width to platelet ratio (RPR) values of IBS patients to those of healthy subjects. Methods: Patients whom followed up in internal medicine clinic of our institution between 2014 January to 2018 January were enrolled to the study. IBS subjects divided into constipation dominant or diarrhea dominant IBS groups. Healthy individuals visited our outpatient clinics for a check-up were enrolled as control group. Results: Median MPR of the constipation IBS, diarrhea IS and control groups were 0,034 (0,02-0,06), 0,034 (0,02-0,06), and 0,028 (0,01-0,05), respectively. The difference between groups was statistically significant (p=0.004). Conclusion: We think that elevated MPR in a patient with typical symptoms of IBS could be helpful in the diagnosis of the disease. Therefore, we suggest automatic calculation of MPR in hemogram assays. &nbsp

Millennium pandemic: A review of coronavirus disease (COVID-19)

Coronaviruses, a large family of single-stranded RNA viruses, can infect humans and animals, and can cause neurological, gastrointestinal and hepatic diseases as well as causing various lung diseases, including pneumonia, with shortness of breath, cough and fever. At the end of December 2019, a group of health authorities reported unidentified cases of pneumonia in a seafood market in Wuhan, China. The World Health Organization (WHO) used term 2019 novel coronavirus (COVID-19) to refer to a coronavirus that affected the lower respiratory tract of patients with pneumonia in Wuhan, China on 29 December and the WHO announced that the official name of the 2019 novel coronavirus was coronavirus disease (COVID-19). COVID-19 is seen in many countries around the World and has been accepted as a pandemic by WHO. It is defined as a suspicious case with fever, sore throat, cough, and people with a history of traveling to China or some parts of the country, or someone who contact with a patient who has a history of travel in China or contact with a confirmed COVID-19 infection patient. Currently, there is no proven vaccine or antiviral therapy that can be used against animal or human coronavirus. To control the outbreak, the drugs must be developed as soon as possible. Various drugs have been used in the treatment of COVID-19 and the main ones are chloroquine, remdesivir, lopinavir/ritonavir, oseltamivir, favipiravir. Since the virus affects the whole World, vaccines and/or new curative antiviral drugs are needed to end the pandemic. For this purpose, large-scale observational studies are needed

Could triglyceride to high density lipoprotein-cholesterol ratio predict hepatosteatosis?

Aim: The triglyceride / HDL cholesterol (TG/HDL-c) ratio is increased in a variety of diseases including, coronary heart disease and type 2 diabetes mellitus. However, its role in non-alcoholic hepatosteatosis is not well understood. In present study, we aimed to compare the TG/HDL-c levels of the patients with non-alcoholic hepatosteatosis to those of the healthy subjects. Methods: Medical data of the patients with non-alcoholic hepatosteatosis whom presented to the outpatient internal medicine clinics of our institution were retrospectively analyzed. Healthy subjects whom admissions to our clinics were due to check up were enrolled to the study as control group. TG/HDL-c of the groups compared. Results: TG/HDL-c level of the liver steatosis group (5 (2-22) %) was higher than the control group (2.7 (1-8) %), (p<0.001). TG/HDL-c was significantly and positively correlated with fasting blood glucose (r=0.31, p<0.001), C - reactive protein (r=0.25, p<0.001) and LDL-cholesterol (r=0.3, p<0.001) levels. A TG/HDL-c value greater than 3.1% has 91% sensitivity and 77% specificity in detecting hepatosteatosis. Conclusions: We suggest that TG/HDL-c ratio could be a useful marker of non-alcoholic hepatosteatosis due to its inexpensive and easy to assess nature

A rare non-hemolytic case of ıdiopathic cold agglutinin disease

Background: Cold agglutinin disease is a very rare condition associated with agglutination of erythrocytes in cold environment usually due to IgM type antibodies. Other than hemolytic anemias, it may interfere with routine hemogram tests due to miscalculation of red blood cell count (RBC) and other hemogram parameters calculated with involvement of RBC. Awareness of the condition is important to overcome laboratory errors. Methods: We studied a peripheral blood smear and repeated the hemogram test at 37°C to establish the diagnosis of cold agglutinin disease. Results: Initial hemogram test results of the fifty-eight year-old man was as follows: RBC: 1.34 M/µL, hemoglobin (Hb): 12.4 g/dL, hematocrit (Htc): 11.8%, mean corpuscular hemoglobin (MCH): 92.4 pg, and mean corpuscular hemoglobin concentration (MCHC): 105 gr/dL. Despite the standard indirect Coombs test being negative, repeated tests at room temperature was 4+. We suspected cold agglutinin disease and repeated the hemogram test using the Bain-Marie method at 37°C and the test results showed RBC: 3.4 M/µL, hemoglobin: 12.6 g/dL, hematocrit: 30.2%, MCH: 31.7 pg, and MCHC: 41.8 g/dL. Conclusions: Inappropriate hemogram results may be a sign of underlying cold agglutinin disease. Hemolytic anemia not always accompanies the disease; however, cold exposure may trigger erythrocyte agglutination in vitro and may cause erratic laboratory results

Crónica sobre el Congreso de la IVR "Dignidad, Democracia, Diversidad" - Lucerna, Suiza 2019

Entre los días 8 y 12 de julio de 2019 se celebró el Congreso de la IVR en la Universidad de Lucerna, Suiza, certamen mundial dedicado a la discusión y debate sobre diversos temas de la filosofía del derecho, la teoría del derecho, y la filosofía social. Por vez primera, además, el Congreso albergó un special workshop sobre (Legal) Animal Rights.Between July 8 and 12, 2019, the IVR Congress was held at the University of Lucerne, Switzerland, a world contest dedicated to the discussion and debate on various topics of the philosophy of law, the theory of law, and social philosophy. For the first time, in addition, the Congress hosted a special workshop on (Legal) Animal Rights

The effect of different audio distraction methots on children's postoperative pain and anxiety

Araştırma farklı işitsel dikkat dağıtma yöntemlerinin çocuklarda ameliyat sonrası ağrı ve anksiyete üzerine etkisini belirlemek amacıyla deneysel olarak yapıldı. Araştırmanın evrenini Bursa Dörtçelik Çocuk Hastalıkları Hastanesi çocuk cerrahi kliniklerinde Ocak-Ekim 2017 tarihleri arası ameliyat olan 7-14 yaş grubundaki çocuklar oluşturdu. Araştırmanın örnekleminde ise örneklem seçim kriterlerine uyan toplam 90 çocuk (klasik müzik=30,Türk müziği=30, öykü dinleme=30) yer aldı. Araştırmanın verileri çocuk ve ebeveyn sosyo-demografik veri toplama formu, Görsel Analog Skala (VAS), Wong-Baker Yüzler Ağrı Ölçeği (WBFPS) ve Çocuklar için Durumluk-Sürekli Kaygı Envanteri (ÇDSKE) kullanılarak toplandı. Gruplardaki çocuklara ameliyat sonrası dönemde klasik müzik, Türk müziği ve öykü dinletisi yapıldı. Araştırmanın istatistiksel analizleri için Shapiro Wilk, Kruskal Wallis, Mann Whitney U, Bonferroni, Wilcoxon, Pearson Ki-kare testi ve Fisher-Freeman-Halton testleri kullanıldı. Araştırma grupları ağrı ve anksiyete düzeyini etkileyebilecek cinsiyet, yaş, ameliyat işlemine ilişkin özellikler gibi değişkenler açısından benzerdi (p>0,05). Çalışmada üç grupta yer alan çocuklara dinletilen klasik müzik, Türk müziği ve öykü dinletisi yöntemlerinin ameliyat sonrası ağrı ve anksiyete durumluluk düzeylerini azaltmada etkili olduğu saptandı (p0,05). In the study, it was determined that the methods of listening to classical music, Turkish music and stories that were applied to children in three groups were effective on decreasing postoperative pain and anxiety state levels (p<0,05). As a consequence, it was determined that different audio distraction had a decreasing effect on postoperative pain and anxiety in children