Intrathorasic parathyroid carcinoma

Paratiroid karsinomu primer hiperparatiroidizmin oldukça nadir nedenlerindendir. Bütün primer hiperparatiroidilerin % 0,41inin nedenini paratiroid karsinomları oluşturur. 64 yaşında bayan hasta primer hiperparatiroidizm tanısı ile opere edilmek üzere kliniğimize yatırıldı. Yapılan klinik incelemelerde intratorasik uzanım gösteren paratiroide ait kitle tespit edildi. Hastaya yapılan paratiroid eksizyonu sonrasında patolojik inceleme sonrasında paratiroid kanseri tespit edilmesi üzerine sağ tiroid lobektomi ve santral boyun diseksiyonu uygulandı ve hasta sorunsuz olarak taburcu edildi.Parathyroid carcinoma is one of the extremelly rare causes of primary hyperparathyroidism. These tumors account for 0.4-1% of all cases of primary hyperparathyroidism. A 64-year-old female patient admitted to our clinic with primary hyperparathyroidism for the operation. Clinical examination revealed a right parathyroid mass towards intra thorasic region. After parathyroidectomy, the pathological investigation revealed parathyroid carcinoma. Rigth thyroid lobectomy and santral neck dissction were performed and the patient was discharged uneventful

Three Cases of Fahr Disease due to Idiopathic Hypoparathyroidism

Bazal ganglionlarda bilateral kalsifikasyona bağlı nörolojik belirtiler Fahr hastalığı olarak bilinmektedir. Fahr hastalığının etiyolojisinde; idiopatik, konjenital, kalsiyum bozuklukları; ağırlıklı olarak hipoparatiroidiler, infeksiyonlar yer almaktadır. Bizim yazımızda hipoparatiroidiye bağlı bazal ganglionlarda bilateral kalsifikasyon ve ekstrapiramidal semptomları olan üç vakadan bahsedilecekBilateral calcifications in the basal ganglia associated with neurological manifestations have been diagnosed as Fahr disease. The most frequent etiology of this syndrome is, together with idiopathic causes and congenital, infections, calcium disorders, mainly primary hypoparathyroidism. We present the cases of three patients with bilateral calcifications in the basal ganglia who presented hypoparathyroidism and extra-pyramidal syndrom

Can "VAI" Better Indicate Metabolic Syndrome Compared with Other Metabolic Syndrome-Related Parameters in Patients with Thyroid Nodules? A Study from Turkey

Background: To investigate the relationship between visceral adiposity index (VAI) and other metabolic syndrome (MetS)-related parameters, and thyroid nodules

Konya bölgesi popülasyonunda CAPN10 genindeki SNP-43 polimorfizmi Tip 2 Diabetes riski ile ilişkilidir

Amaç: Kalpain-10 (CAPN10), Ca+2 bağımlı intrasellüler sistein proteazlar ailesinin atipik bir üyesidir. Birçok dokuda eksprese edilir ve başta insülin sekresyonu ve aktivitesi olmak üzere çok çeşitli hücresel fonksiyonlar için gereklidir. Tanımlanan ilk Tip 2 diyabet (T2D) yatkınlık genidir. Çalışmamızda bir Türk popülasyonunda CAPN10 gen polimorfizmleri (SNP-44, -43 ve -137) ile artmış T2D riski arasındaki ilişkinin analiz edilmesi amaçlandı. Gereç ve Yöntem: Çalışmaya 149 T2D’li hasta ve 48 sağlıklı birey dahil edildi. Genotiplendirme PCR-SSCP tekniği kullanılarak yapıldı, dizi analizi ile doğrulandı. CAPN10 genotiopleri ile T2D gelişimi ve klinik özellikler arasındaki ilişki istatistiksel olarak analiz edildi. Bulgular: Hastalıkla genotip arasındaki ilişkiyi belirlemek için yapılan odds analizi sonuçlarına göre; SNP-44 ile hastalık arasında ilişki gözlenmezken (OR: 1.417 CI:0.452-4.436, P=0.740), SNP-43 ile hastalık arasında anlamlı ilişki bulundu (OR: 0.455 CI:0.235-0.881, P=0.028). SNP-137 genotip dağılımı bakımından tüm hasta ve kontrol bireylerde C/C olarak tespit edildi. Taranan SNP’ler ile klinik parametreler arasında herhangi bir ilişki bulunmadı (P>0.05). Sonuç: Sonuçlarımıza göre; CAPN10 genindeki SNP-43, Türk populasyonunda T2D gelişimi açısından bir risk faktörüdür

COVID-19 healthcare cost and length of hospital stay in Turkey: retrospective analysis from the first peak of the pandemic

Background During the COVID-19 pandemic, health care systems are under extreme pressure. This study analyzed health care resource use (HCRU) and costs in patients admitted to the hospital for COVID-19 and aimed to estimate the one-year direct medical cost of the disease in Turkey. Methods This retrospective cohort study was conducted between March and July 2020 in a tertiary hospital (n = 1056) in Istanbul. Patient demographics, clinical and treatment characteristics at admission, comorbidities, disease severity, and costs from a payer perspective were evaluated using the microcosting method. The results include LOS, hospital costs, and univariate and generalized linear models to investigate influencing factors. The data were extrapolated to provide a country-level estimate. Results The mean length of stay was 9.1 days (SD 6.9). The mean length of stay was 8.0 days (4.7) for patients hospitalized in wards versus 14.8 days (SD 12.0) for patients hospitalized in the ICU. In univariate analysis, several factors, including O-2 therapy (+ 3.7 days), high CRP > 41.8 mg/L (+ 3.8 days), and elevated ferritin (+ 3.5), were found to be associated with a longer LOS (p < 0.05). The direct annual medical cost of COVID-19 was estimated at PPP$ 2.1 billion. The COVID-19 pandemic resulted in a direct medical burden that corresponds to 2.0% of the government health expenditures and 0.8 per thousand of Turkey's gross domestic product (GDP). Conclusions Estimating the impact of this pandemic in terms of HCRU and costs to the health care system can help design strategies to manage the pandemic

Examination of adhesion molecules, homocysteine and hs-CRP in patients with polygenic hypercholesterolemia and isolated hypertriglyceridemia.

Background Increased levels of selectins, adhesion molecules, hs-CRP and homocysteine are considered important as indicators of atherosclerosis. There is a significant amount of evidence that high LDL-C levels are a risk factor for coronary artery disease, whereas the relevance of isolated triglycerides is controversial. The present study aims to compare the levels of homocysteine, hs-CRP, E-selectin, sP-selectin, VCAM-1, ICAM-1 in patients with isolated hypertriglyceridemia and polygenic hypercholesterolemia

Cost-Effectiveness Analysis of Remdesivir Treatment in COVID-19 Patients Requiring Low-Flow Oxygen Therapy: Payer Perspective in Turkey

Introduction This study aims to evaluate the cost-effectiveness of remdesivir compared to other existing therapies (SoC) in Turkey to treat COVID-19 patients hospitalized with < 94% saturation and low-flow oxygen therapy (LFOT) requirement. Methods We compared remdesivir as the treatment for COVID-19 with the treatments in the Turkish treatment guidelines. Analyses were performed using data from 78 hospitalized COVID-19 patients with SpO(2) < 94% who received LFOT in a tertiary healthcare facility. COVID-19 episode costs were calculated for 78 patients considering the cost of modeled remdesivir treatment in the same group from the payer's perspective. The incremental cost-effectiveness ratio (ICER) per quality-adjusted life-year (QALY) was calculated for remdesivir versus the SoC for the population identified. For Turkey, a reimbursement threshold value between USD 8599 (1 x per capita gross domestic product-GDP) and USD 25.797 (3 x GDP) per QALY was used. Results In the remdesivir arm, the length of hospital stay (LOS) was 3 days shorter than the SOC. The low ventilator requirement in the remdesivir arm was one factor that decreased the QALY disutility value. In patients who were transferred to intensive care unit (ICU) from the ward, the mean LOS was 17.3 days (SD 13.6), and the mean cost of stay was USD 155.3/day (SD 168.0), while in patients who were admitted to ICU at baseline, the mean LOS was 13.1 days (SD 13.7), and the mean cost of stay was USD 207.9/day (SD 133.6). The mean cost of episode per patient was USD 3461.1 (SD 2259.8) in the remdesivir arm and USD 3538.9 (SD 3296.0) in the SOC arm. Incremental QALYs were estimated at 0.174. Remdesivir treatment was determined to be cost saving vs. SoC. Conclusions Remdesivir, which results in shorter LOS and lower rates of intubation requirements in ICU patients than existing therapies, is associated with higher QALYs and lower costs, dominating SoC in patients with SpO(2) < 94% who require oxygen support