The cartonectin levels at different stages of chronic kidney disease and related factors

Introduction: Cartonectin was defined as a new adipokine released from rat and human adipocyte tissues, which is also known as CORS 26 or CTRP3 protein. Although there are several studies investigating the effects of cartonectin with obesity, anti-inflammatory mechanisms, and cardioprotective effects, there is no study about the effects of cartonectin in patients with chronic kidney disease yet. We aimed to investigate cartonectin levels in predialysis and dialysis patient groups, in other words, at different stages of chronic kidney disease, by comparing with the control group. In addition, we aimed to discuss the probable causes of the differences between the patient groups that would be determined, together with the factors that might be effective. Methods: A total of 150 patients, including 47 hemodialysis patients, 73 predialysis CKD patients, and 30 healthy individuals were enrolled in the study. Serum cartonectin levels were determined by using enzyme-linked immunosorbent assay (ELISA) method. Findings: Serum cartonectin levels were found to be significantly higher in the hemodialysis patient group compared to predialysis group and healthy individuals (p < 0.01). Furthermore, serum cartonectin levels were found to be negatively correlated with GFR, BMI, glucose, LDL, and platelet levels, whereas a positive correlation was observed with creatinine levels. Discussion: In our study, we found that the cartonectin levels increased as GFR decreased and were significantly higher in hemodialysis patients. Cartonectin is structurally closely related to adiponectin. It is remarkable that the level of cartonectin is also high in hemodialysis patients, like adiponectin

Prediabetes Frequency in Patients With Prolaktinoma

Amaç: Prolaktinin (PRL) çeşitli hayvan türlerinde glikoz intoleransı, hiperinsülinemi ve insülin direncini indüklediği daha önce yapılan çalışmalarda gösterilmiştir. Biz bu çalışmada prolaktinoma tanılı hastalarda metabolik etkilere yönelik daha fazla bilgi edinmeyi ve prediyabet sıklığını göstermeyi amaçladık. Yöntemler: Çalışmamıza kliniğimizde takip ettiğimiz bilinen kronik hastalığı olmayan 30 prolaktinoma tanılı hasta ve kontrol grubu olarak benzer yaş, cinsiyet ve vücut kitle indeksi (VKİ)’ne sahip 66 sağlıklı insan dahil edildi. Antropometrik parametreler (boy, kilo, VKİ) ve serum hbA1c, açlık kan plazma glukozu(APG), PRL değerleri ölçüldü. Bulgular: Prolaktinomalı hastalarda prediyabet anlamlı bir şekilde yüksek bulundu. Prolaktinoma ile APG arasında pozitif koreleasyon saptandı. Prolakinoma ile VKİ arasında pozitif koreleasyon saptandı. Sonuç: Prolaktinomalı hastalarda prediyabet sıklığında artış saptandı. Prolaktinoma ile APG yüksekliği ve VKİ’ndeki artış anlamlı bir şekilde ilişkiliydi.Objective: Objective: Studies have shown that prolactin (PRL) induces glucose intolerance, hyperinsulinemia and insulin resistance in various animal species. In this study, we aimed to get more information about the metabolic effects of prolactinoma in patients diagnosed with prolactinoma and to show the frequency of prediabetes in these patients. Methods: The study included 30 patients with prolactinoma without any chronic disease in our clinic and 66 healthy people with similar age, gender and body mass index (BMI) as the control group. Anthropometric parameters (height, weight, BMI), serum HBA1c, fasting blood plasma glucose (FPG) and PRL values were measured. Results: Prediabetes was significantly higher in patients with prolactinoma. There was a positive correlation between prolactinoma and FPG. and BMI. A positive correlation was found between prolactinoma and BMI. Conclusion: An increased frequency of prediabetes was detected in patients with prolactinomas. Prolactinoma was significantly associated with increased FPG and increased BMI

Is circulating survivin altered in acromegaly?

Acromegaly is a chronic disorder which is characterized by growth hormone (GH) excess. In most of cases, GH hypersecretion is derived from somatotroph cell tumors. Survivin is a member of apoptosis protein family, which was recently showed to be expressed in tissue samples of different benign and malignant human tumors. This study is intended to determine circulating levels of survivin in newly diagnosed acromegaly patients with somatotroph adenomas. 19 newly diagnosed acromegaly patients with somatotroph adenomas were inclu-ded in the study. Concurrently, 19 healthy individuals were included as control group. Serum survivin levels, GH, insulin like growth factor-1 (IGF-1) and, some other biochemical parame-ters as fasting glucose, creatinine, alanine aminotransferase, cholesterol, triglyceride, high den-sity lipoprotein cholesterol, low density lipoprotein cholesterol were measured in each subject. Correlation analysis was performed between survivin and GH, IGF-1. Serum survivin levels tended to be higher in acromegaly group, but this was not reach statistical significance (p&gt;0.05). Serum survivin levels were comparable among acromegaly patients and controls. Neither GH nor IGF-1 correlated with serum survivin. Larger scale studies are needed concerning the circulating levels of survivin in patients with acromegaly. [Med-Science 2018; 7(2.000): 265-8

Palyatif bakım alan geriyatrik hastalarda enfeksiyon tanı ve prognozunda laboratuvar belirteçlerin değeri

Objective: Several biomarkers have been used in the evaluation of the diagnosis,prognosis, and response to antibiotherapy. In this study we evaluated biomarkers frequently used in the diagnosis and prognosis of bacterial infections among geriatric patients in palliative care.Methods: In this descriptive, cross-sectional study iinpatients treated in the palliative care unit of our hospital for a period of more than two days between November 2015 and February 2016 were included.Results: A total of 63 palliative care patients with a median age of 80 years were included; 55.6% of the patients were male. Eighty-one percent of the patients developed an infection , so they were treated with an antibiotic. Biomarkers measured on the first day of hospitalization were evaluated in two groups as patients with and without infections. ROC analysis revealed the diagnostic powers of C-reactive protein (CRP) and albumin were 76.2% and 73.9%, respectively (p;lt;0.05). The diagnostic power of the CRP/albumin ratio was 81.3% (p;lt;0.001). In ROC analysis CRP had a predictive power of 83.9% and albumin of 78.0% (p;lt;0.05) predict prognosis in patients with infection, infections, evaluate prognosis and assess treatment response. With a cut-off value of 8.23 mg/dl, CRP showed 75.8% specificity and 88.9% sensitivity in detecting infection; but for albumin, the corresponding values were 44.4% and 93.9% with a cut-off value of 2.27 mg/dl, respectively. The CRP/albumin ratio had a prognostic predictive power of 84.3% (p;lt;0.001) with 72.4% specificity and 94.4% sensitivity in detecting infection at a cut-off value of 2.89.Conclusion: We think that combined evaluation of CRP and albumin which are indicators of inflammation and nutritional status within 24 hours of hospitalization is important in determining prognosis.Amaç: Enfeksiyon tanısı, prognozu ve antibiyotik yanıtının değerlendirilmesinde birçok biyobelirteç kullanılmaktadır. Çalışmamızda, palyatif bakım alan geriatrik hastalardaki bakteriyel enfeksiyon tanı ve prognozunda sık kullanılan biyobelirteçlerin değerlendirilmesi amaçlanmıştır.Yöntemler: Bu çalışmaya Kasım 2015 ve Şubat 2016 tarihleri arasında hastanemiz Palyatif Bakım Ünitesinde iki günden uzun süre yatan bütün hastalar dahil edilmiştir. Araştırma tanımlayıcı-kesitsel tipte bir araştırmadır. Bulgular: Yaş ortalaması 80 yıl olan toplam 63 palyatif bakım hastası çalışmaya alınmıştır. Hastaların %55,6'sı erkektir. Hastaların %81'inde enfeksiyon gelişmiş ve bu nedenle antibiyotik tedavisi kullanılmıştır. Hastane yatışının birinci gününde değerlendirilen biyobelirteçler, enfeksiyon gelişen ve gelişmeyen hasta gruplarında ayrı olarak değerlendirilmiştir. Yapılan ROC analizinde, CRP'nin tanı gücü %76,2, albüminin tanı gücü %73,9 olarak tespit edildi (p0,05). CRP'nin albumine oranın enfeksiyon tanısındaki gücü %81,3 olarak tespit edildi (p0,001).CRP ve albüminin enfeksiyon gelişen hastalarda prognoz tahmini için yapılan ROC analizinde, CRP'nin tanı gücü %83,9; albuminin tanı gücü %78,0 olarak tespit edildi (p0,05). Enfeksiyon tanısında CRP'nin belirlenen 8,23 mg/dl kesme değeri ile özgüllüğü %75,8, duyarlılığı %88,9, albuminin belirlenen 2,27 mg/dl kesme değeri ile özgüllüğü %44,4, duyarlılığı %93,9 olarak tespit edilmiştir. CRP'nin albümine oranının prognoz tahmin gücü %84,3 olarak tespit edildi (p0,001). Enfeksiyon tanısında CRP/albumin belirlenen 2,89 kesme değeri ile özgüllüğü %72,4 duyarlılığı %94,4 olarak tespit edilmiştir.Sonuç: İnflamasyon ve beslenme göstergeleri olan CRP ve albuminin hastane yatışının ilk 24 saatinde birlikte değerlendirilmesinin prognozu belirleme açısından önemli olduğunu düşünmekteyiz

Clinical Characteristics and Outcomes of COVID-19 in Turkish Patients with Hematological Malignancies

Objective: Patients with solid malignancies are more vulnerable to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection than the healthy population. The outcome of SARS-CoV-2 infection in highly immunosuppressed populations, such as in patients with hematological malignancies, is a point of interest. We aimed to analyze the symptoms, complications, intensive care unit admissions, and mortality rates of patients with hematological malignancies infected with SARS-CoV-2 in Turkey. Materials and Methods: In this multicenter study, we included 340 adult and pediatric patients diagnosed with SARS-CoV-2 from March to November 2020. Diagnosis and status of primary disease, treatment schedules for hematological malignancies, time from last treatment, life expectancy related to the hematological disease, and comorbidities were recorded, together with data regarding symptoms, treatment, and outcome of SARS-CoV-2 infection. Results: Forty four patients were asymptomatic at diagnosis of SARSCoV-2 infection. Among symptomatic patients, fever, cough, and dyspnea were observed in 62.6%, 48.8%, and 41.8%, respectively. Sixtynine (20%) patients had mild SARS-CoV-2 disease, whereas moderate, severe, and critical disease was reported in 101 (29%), 71 (20%), and 55 (16%) patients, respectively. Of the entire cohort, 251 (73.8%) patients were hospitalized for SARS-CoV-2. Mortality related to SARS-CoV-2 infection was 26.5% in the entire cohort; this comprised 4.4% of those patients with mild disease, 12.4% of those with moderate disease, and 83% of those with severe or critical disease. Active hematological disease, lower life expectancy related to primary hematological disease, neutropenia at diagnosis of SARS-CoV-2, ICU admission, and first-line therapy used for coronavirus disease-2019 treatment were found to be related to higher mortality rates. Treatments with hydroxychloroquine alone or in combination with azithromycin were associated with a higher rate of mortality in comparison to favipiravir use. Conclusion: Patients with hematological malignancy infected with SARS-CoV-2 have an increased risk of severe disease and mortality