Analysis between Adrenal MRI Mass Size and 1 mg Dexamethasone Suppression Test in Patients with Adrenal Incidentaloma

This study aimed to investigate the correlation of adrenal magnetic resonance imaging (MRI) mass size and 1 mg dexamethasone suppression test results in patients with adrenal incidentaloma diagnosis. Eighty-six patients (82.6% female) with incidentally discovered adrenal masses, diagnosed and treated in the Department of Endocrinology Bakirkoy Dr. Sadi Konuk Education and Research Hospital between June and August 2017, were included in the analysis. All the patients evaluated for their hormonal functionality. 24-h urinary excretion of cortisol did not correlate with tumor size. But there was a positive correlation between longer adrenal nodule diameter and metanephrine, and there was a negative correlation between shorter adrenal nodule diameter and renin levels. We found that smaller and clinically “silent” tumors often do not demonstrate subclinical hormonal activity

Hipoteza studije: dob, spol, prisutnost šećerne bolesti ili hipertenzije i antihipertenzivni lijekovi su neovisni čimbenici rizika za smrtnost kod infekcije COVID-19

We aimed to investigate the effects of comorbid diseases and antihypertensive drugs on the clinical outcome of hospitalized patients with COVID-19 infection. A total of 1045 patients whose data could be gathered and confirmed from both hospital files and Turkish National Health Network records were retrospectively screened, and 264 of 1045 patients were excluded because of having more than one comorbid disease. The study population consisted of a total of 781 patients, of which 482 had no comorbid disease, while the remaining 299 patients had only one comorbid disease. The mortality risk was 7.532 times higher in those over 65 years of age compared to cases younger than 30 years (OR: 7.532; 95% CI: 1.733-32.730); the risk of mortality in men was 2.131 times higher than in women (OR: 2.131; 95% CI: 1.230-3.693); and presence of diabetes mellitus (DM) increased mortality risk 2.784 times (OR: 2.784; 95% CI: 1.288-6.019). While hypertension was not found to be an independent risk factor for COVID-19 mortality, age, gender, and presence of DM were independent risk factors for COVID-19 mortality. There was no association between antihypertensive drugs and mortality. Accordingly, age (>65 years), gender (male), and presence of DM were independent risk factors for COVID-19 mortality, whereas hypertension and use of angiotensin-converting enzyme inhibitors, angiotensin receptor blockers and their combinations with other antihypertensive drugs were not risk factors for COVID-19 mortality.Cilj istraživanja bio je ispitati učinak supostojećih bolesti i antihipertenzivnih lijekova na klinički ishod hospitaliziranih bolesnika s infekcijom COVID-19. Retrospektivnim probirom obuhvaćeno je ukupno 1045 bolesnika čije podatke smo mogli prikupiti i potvrditi iz bolničkih kartona i zapisa Turske nacionalne zdravstvene mreže; od tih bolesnika njih 264 je isključeno, jer su imali više od jedne supostojeće bolesti. Tako je u studiju uključen ukupno 781 bolesnik, od kojih njih 482 nisu imali nikakve supostojeće bolesti, dok je preostalih 299 imalo samo jednu supostojeću bolest. Rizik od smrtnog ishoda bio je 7,532 puta veći kod bolesnika starijih od 65 godina u usporedbi sa slučajevima mlađim od 30 godina (OR: 7,532; 95% CI: 1,733-32,730); rizik od smrtnog ishoda bio je 2,131 puta veći kod muškaraca u nego kod žena (OR: 2,131; 95% CI: 1,230-3,693); prisutnost dijabetes melitusa (DM) povećala je rizik od smrti 2,784 puta (OR: 2,784; 95% CI: 1,288-6,019). Hipertenzija nije utvrđena kao čimbenik rizika za smrtnost kod infekcije COVID-19, ali su se dob, spol i prisutnost DM pokazali neovisnim rizičnim čimbenicima za smrtnost kod infekcije COVID-19. Prema tome, dob (iznad 65 godina), spol (muški) i prisutnost DM utvrđeni su kao neovisni čimbenici rizika za smrtnost kod infekcije COVID-19, dok hipertenzija i uzimanje inhibitora angiotenzin-konvertirajućeg enzima, blokatora receptora angiotenzina i njihovih kombinacija s drugim antihipertenzivnim lijekovima nisu utvrđeni kao rizični čimbenici smrtnosti kod infekcije COVID-19

Hipoteza studije: dob, spol, prisutnost šećerne bolesti ili hipertenzije i antihipertenzivni lijekovi su neovisni čimbenici rizika za smrtnost kod infekcije COVID-19

We aimed to investigate the effects of comorbid diseases and antihypertensive drugs on the clinical outcome of hospitalized patients with COVID-19 infection. A total of 1045 patients whose data could be gathered and confirmed from both hospital files and Turkish National Health Network records were retrospectively screened, and 264 of 1045 patients were excluded because of having more than one comorbid disease. The study population consisted of a total of 781 patients, of which 482 had no comorbid disease, while the remaining 299 patients had only one comorbid disease. The mortality risk was 7.532 times higher in those over 65 years of age compared to cases younger than 30 years (OR: 7.532; 95% CI: 1.733-32.730); the risk of mortality in men was 2.131 times higher than in women (OR: 2.131; 95% CI: 1.230-3.693); and presence of diabetes mellitus (DM) increased mortality risk 2.784 times (OR: 2.784; 95% CI: 1.288-6.019). While hypertension was not found to be an independent risk factor for COVID-19 mortality, age, gender, and presence of DM were independent risk factors for COVID-19 mortality. There was no association between antihypertensive drugs and mortality. Accordingly, age (>65 years), gender (male), and presence of DM were independent risk factors for COVID-19 mortality, whereas hypertension and use of angiotensin-converting enzyme inhibitors, angiotensin receptor blockers and their combinations with other antihypertensive drugs were not risk factors for COVID-19 mortality.Cilj istraživanja bio je ispitati učinak supostojećih bolesti i antihipertenzivnih lijekova na klinički ishod hospitaliziranih bolesnika s infekcijom COVID-19. Retrospektivnim probirom obuhvaćeno je ukupno 1045 bolesnika čije podatke smo mogli prikupiti i potvrditi iz bolničkih kartona i zapisa Turske nacionalne zdravstvene mreže; od tih bolesnika njih 264 je isključeno, jer su imali više od jedne supostojeće bolesti. Tako je u studiju uključen ukupno 781 bolesnik, od kojih njih 482 nisu imali nikakve supostojeće bolesti, dok je preostalih 299 imalo samo jednu supostojeću bolest. Rizik od smrtnog ishoda bio je 7,532 puta veći kod bolesnika starijih od 65 godina u usporedbi sa slučajevima mlađim od 30 godina (OR: 7,532; 95% CI: 1,733-32,730); rizik od smrtnog ishoda bio je 2,131 puta veći kod muškaraca u nego kod žena (OR: 2,131; 95% CI: 1,230-3,693); prisutnost dijabetes melitusa (DM) povećala je rizik od smrti 2,784 puta (OR: 2,784; 95% CI: 1,288-6,019). Hipertenzija nije utvrđena kao čimbenik rizika za smrtnost kod infekcije COVID-19, ali su se dob, spol i prisutnost DM pokazali neovisnim rizičnim čimbenicima za smrtnost kod infekcije COVID-19. Prema tome, dob (iznad 65 godina), spol (muški) i prisutnost DM utvrđeni su kao neovisni čimbenici rizika za smrtnost kod infekcije COVID-19, dok hipertenzija i uzimanje inhibitora angiotenzin-konvertirajućeg enzima, blokatora receptora angiotenzina i njihovih kombinacija s drugim antihipertenzivnim lijekovima nisu utvrđeni kao rizični čimbenici smrtnosti kod infekcije COVID-19

Locomotor differences in Mongolian gerbils with the effects of midazolam administration in the form of eye drops

Background: Midazolam is a sedative-hypnotic agent with amnestic and anticonvulsant properties that can be administrated to mammals through various routes, such as intravenous, intramuscular, oral, intrathecal, rectal, and buccal. Midazolam administration in the form of eye drops through the conjunctiva is not reported in the literature. Aim:This study aims to demonstrate the possible central nervous system effects of midazolam administration as eyes drops in Mongolian gerbils. Materials and Methods: Fourteen gerbils were randomly assigned to one of two equal sized groups. The active arm received 2 ml of 10 mg midazolam as eye drops in both eyes. Control group received a total of 2 ml of physiological saline(0.9% NaCl). We subjected the gerbils to an adapted “Open Field” to determine the possible effects on central nervous system of midazolam. Gerbils were allowed to move freely in the open field. Before and after the drug administration, locomotor activities of each gerbil have been recorded. Frequency of loss of righting reflex was quantified. Results: Conjunctival Midazolam administration resulted with the transient loss of righting reflex (p=0.017) and suppressed exploration motion (p=0.018) in the open field test compared to control subjects. Conclusions: In the present study, administration of conjunctival midazolam as an eye drop may affect gerbil’s locomotor activities and open field behaviors. We argue that, using a sedative and anticonvulsive drug such as midazolam via conjunctival route may be useful in some clinical situations. Therefore, it could be beneficial to develop a new conjunctival formulation of midazolam. Also, there is a need for trials in humans with pharmacokinetic studies.Keywords: Righting reflex; Conjunctival Midazolam; Gerbillinae; Midazolam; Eye drop; New administration routeAfrican Health sciences Vol 14 No. 1 March 201

Comparison of Survival Rates, Tumor Stages, and Localization in between Obese and Nonobese Patients with Gastric Cancer

Purpose. In this study we tried to determine the association between body-mass index (BMI), survival rate, and the stage of tumor at the time of diagnosis in patients with gastric cancer. Methods. A total of 270 gastric cancer patients’ hospital records were retrospectively evaluated. Patients were grouped according to their BMI at the time of tumor diagnosis. Tumor stages at admission were compared according to their BMI values. Results. There were no differences in OS among BMI subgroups (p=0.230). The percent of patients with stage III tumor was significantly higher in nonobese while the percent of stage IV tumor was surprisingly higher in obese patients (p was 0.011 and 0.004, resp.). Percent of patients who did not have any surgical intervention was significantly lower in overweight and obese patients than normal and/or underweight patients. Conclusions. At the time of diagnosis, obese patients had significantly higher percent of stage IV tumor than nonobese patients. Despite of that, there were no differences in survival rates among BMI subgroups. Our study results are consistent with “obesity paradox” in gastric cancer patients. We also did not find any relationship between BMI and localization of gastric tumor

Comparison of risk factors for cardiovascular disease in hemodialysis and peritoneal dialysis patients

OBJECTIVE: In this study, we aimed to compare the cardiovascular risk factors that might be associated with inflammation, atherosclerosis and metabolic syndrome between hemodialysis and peritoneal dialysis patients. METHODS: Fifty hemodialysis and 50 peritoneal dialysis patients who had been receiving dialysis therapy for at least one year were included in the study. Venous blood samples were taken after 12 hours of fasting, and serum glucose, triglyceride, low-density lipoprotein (LDL)-cholesterol, high-density lipoprotein (HDL)-cholesterol, C-reactive protein, fibrinogen and homocysteine levels were measured. The presence of atherosclerotic plaques in the carotid artery was evaluated by carotid Doppler ultrasound. These data were analyzed by Student’s t test, the chi-square test and the Mann-Whitney U test, as appropriate. RESULTS: No difference was found between the hemodialysis (n=50) and peritoneal dialysis (n=50) patient groups regarding mean age, gender distribution, body mass index or dialysis duration (p=0.269, 0.683, 0.426, and 0.052, respectively). LDL-cholesterol, fibrinogen and homocysteine levels were significantly higher in peritoneal dialysis patients (p=0.006, 0.001, and 0.002, respectively). In patients with diabetes mellitus (n=17) who were undergoing renal replacement therapy, LDL-cholesterol and fibrinogen levels were significantly higher than in patients without diabetes mellitus who were undergoing renal replacement therapy (p=0.001 and 0.004, respectively). CONCLUSION: In our study, cardiovascular risk factors (especially LDL-cholesterol) were more frequent in peritoneal dialysis patients than in hemodialysis patients

Comparison of risk factors for cardiovascular disease in hemodialysis and peritoneal dialysis patients

OBJECTIVE:In this study, we aimed to compare the cardiovascular risk factors that might be associated with inflammation, atherosclerosis and metabolic syndrome between hemodialysis and peritoneal dialysis patients.METHODS:Fifty hemodialysis and 50 peritoneal dialysis patients who had been receiving dialysis therapy for at least one year were included in the study. Venous blood samples were taken after 12 hours of fasting, and serum glucose, triglyceride, low-density lipoprotein (LDL)-cholesterol, high-density lipoprotein (HDL)-cholesterol, C-reactive protein, fibrinogen and homocysteine levels were measured. The presence of atherosclerotic plaques in the carotid artery was evaluated by carotid Doppler ultrasound. These data were analyzed by Student’s t test, the chi-square test and the Mann-Whitney U test, as appropriate.RESULTS:No difference was found between the hemodialysis (n=50) and peritoneal dialysis (n=50) patient groups regarding mean age, gender distribution, body mass index or dialysis duration (p=0.269, 0.683, 0.426, and 0.052, respectively). LDL-cholesterol, fibrinogen and homocysteine levels were significantly higher in peritoneal dialysis patients (p=0.006, 0.001, and 0.002, respectively). In patients with diabetes mellitus (n=17) who were undergoing renal replacement therapy, LDL-cholesterol and fibrinogen levels were significantly higher than in patients without diabetes mellitus who were undergoing renal replacement therapy (p=0.001 and 0.004, respectively).CONCLUSION:In our study, cardiovascular risk factors (especially LDL-cholesterol) were more frequent in peritoneal dialysis patients than in hemodialysis patients

The relationship of beck depression inventory with vitamin D levels and visceral fat mass in cancer patients

Purpose: The aim of this study is to determine the relationship between Beck Depression Inventory (BDI) and vitamin D levels, total and visceral fat mass in cancer patients. Methods: A total of 219 patients participated in this study. Patients' blood tests including prealbumin, vitamin D levels, BMI values and total and visceral fat masses were measured. Also, all subjects completed a self-administered BDI questionnaire. Obtained data were analyzed by using NCSS (Number Cruncher Statistical System) 2007 (Kaysville, Utah, USA). Results: A total of 219 patients consisted of 53.9% (n=118) females and 46.1% (n=101) males with median age 52.41 +/- 13.66 (range, 19-84) years. Mean BMI value was 24.70 +/- 3.75 kg/m(2); mean BDI score was 13.02 +/- 8.72; and mean prealbumin level was 0.21 +/- 0.07 g/L. BMI was negatively correlated with BDI in all study groups (P=0.002). Also prealbumin levels, vitamin D levels and hemoglobin levels were negatively correlated with BDI (P0.05). Depression status had a significant relationship with BMI, vitamin D levels, prealbumin levels and malnutrition status in patients (P = 0.008, 0.001, 0.001, and 0.001, respectively). Conclusions: We have determined a significant correlation between vitamin D levels and BDI scores in cancer patients. Also prealbumin and hemoglobin levels may indicate BDI scores in cancer patients. There was no correlation between BDI score and visceral fat mass. There was a negative correlation between BDI score and BMI levels but no correlation was found between BDI score and total or visceral fat mass in cancer patients. Thus vitamin D levels could be used to determine the depression and nutritional status in cancer patients which may help to improve the clinical outcomes in those patients