Mogu li hemocitometrijski parametri poslužiti kao biološki biljezi u razlikovanju adrenalnih adenoma i karcinoma te u prognozi adrenokortikalnih karcinoma?

Recently, studies have reported that inflammatory response and elevated platelet counts are associated with several cancers. In the present study, we aimed to evaluate hemocytometer parameters in differentiating adrenal adenoma and carcinoma, and the prognostic utility of hemocytometer parameters in adrenocortical carcinoma (ACC). We included 30 patients with nonfunctional adrenal adenoma and 13 patients with ACC having undergone surgery between 2005 and 2017 and followed up postoperatively at our centre. The neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), red blood cell distribution width (RDW), mean platelet volume (MPV) and plateletcrit (PCT) were evaluated preoperatively in all patients included in the study. There was a significant difference between the adrenal adenoma and ACC groups in terms of neutrophil and lymphocyte counts, NLR and PLR. There was no significant difference between the two groups in terms of platelet count and MPV, but PCT levels were significantly lower in ACC group. There was no statistically significant difference between recurrent and/or metastasis positive patients and negative ones according to NLR, PLR, RDW and MPV. There was a statistically significant difference in RDW levels and tumor diameter between the groups. Our study is the first to evaluate hemocytometer parameters in differentiating adrenal adenomas and carcinomas, and also in the prognosis of ACC. The present study suggested that the hemocytometer parameters may be a marker in the differential diagnosis of adrenal adenomas and carcinomas. However, our study also showed that these parameters had no prognostic value in ACC.Nedavna istraživanja pokazuju da su upalni odgovor i povišeni trombociti udruženi s nekim vrstama karcinoma. Cilj našega istraživanja bio je procijeniti hemocitometrijske parametre u razlikovanju adrenalnog adenoma i karcinoma, kao i prognostičku vrijednost hemocitometrijskih parametara u adrenokortikalnom karcinomu (adrenocortical carcinoma, ACC). U istraživanje smo uključili 30 bolesnika s nefunkcionalnim adrenalnim adenomom i 13 bolesnika s ACC operiranih između 2005. i 2017. godine i poslije operacije praćene u našoj ustanovi. Kod svih bolesnika uključenih u studiju prijeoperacijski su izmjereni sljedeći parametri: omjer neutrofila i limfocita (neutrophil/lymphocyte ratio, NLR), omjer trombocita i limfocita (platelet/lymphocyte ratio, PLR ), širina distribucije eritrocita (red blood cell distribution width, RDW ), srednji volumen trombocita (mean platelet volume, MPV) i pleteletkrit (PCT). Utvrđena je statistički značajna razlika između skupina bolesnika s adrenalnim adenomom i onih s ACC u broju neutrofila i limfocita, NLR i PLR. Nije bilo značajne razlike među skupinama u broju trombocita i MPV, ali su razine PCT bile značajno niže u skupini s ACC. Nije bilo statistički značajne razlike u NLR, PLR, RDW i MPV između bolesnika s opetovanim ACC i/ili metastazama i onih bez tih stanja. Statistički značajna razlika između skupina nađena je za razine RDW i promjer tumora. Naše istraživanje je prvo te vrste u kojem su se procjenjivali hemocitometrijski parametri u razlikovanju adrenalnih adenoma i karcinoma te u prognozi ACC. Rezultati studije ukazuju na to da bi se hemocitometrijski parametri mogli primijeniti kao biljezi u diferencijalnoj dijagnostici adrenalnih adenoma i karcinoma. Međutim, naše je istraživanje pokazalo kako ovi parametri nemaju prognostičku vrijednost kod ACC

The Treatment and Follow up of Adrenocortical Carcinoma [Adrenokortikal Karsinomlarda Tedavi Ve Izlem]

Adrenocortical carcinoma is a rare endocrine malignancy. Patients present with hormone excess or a local mass effect. The tumor is agressive and characterized by a high risk of recurrence even after complete resection. Recurrence rate (particularly local recurrence) is higher in laparoscopic adrenalectomy and most recurrences occur in the postoperative first two years. Because of the high recurrence rates, most patients need adjuvan treatment after radical resection. Three adjuvant therapotic approach have been suggested: Mitotane, mitotane plus chemotherapeutic agents and radiotherapy of the tumor bed. Adjuvant mitotane is the first line medical treatment but it is associated with some adverse events and in all patients a strict follow up is required because of the drugs narrow therapeutic index. Adverse events are manageable through reduction of the mitotane dose. Patients with adrenocortical carcinoma should be followed up regularly at least 10 years after radical surgery. [Med-Science 2015; 4(2.000): 2098-108

Comparison and evaluation of two C-reactive protein assays based on particle-enhanced immunoturbidimetry

The use of C-reactive protein (CRP) assays is increasing for a wide range of clinical conditions, and consequently the analytical performance requirements for CRP assays are also changing. For this reason, manufacturers have been developing CRP assays based on different methodologies to provide both high sensitivity and a wide measuring range. However, it is questionable whether these methods can meet the desired requirements for CRP assays. CRP Latex on the Cobas Integra 400 and CRP Tina-quant Latex on the Modular Analytics-P were evaluated in terms of detection limit, linearity, intra- and interassay precision, and comparability with 268 patient samples. The intra- and interassay precision of the two methods was 10% in the pool with concentrations of similar to 0.60 mg/L. The detection limits for CRP Latex and Tina-quant Latex were 0.20 and 0.22 mg/L, respectively. Both methods were linear up to 215 mg/L. There was a good agreement between the two assays, except for a scattering at concentrations near the detection limits. Deming regression analysis for CRP Latex (x-axis) and Tina-quant Latex (y-axis) yielded a slope of 1.067 +/- 0.018, an intercept of -0.148 +/- 0.358, and an S-ylx of 5.10 (r=0.996, P < 0.0001). The two assays gave comparable results. Low precision was determined for both assays, except for the low pool with a concentration of similar to 0.60 mg/L. We concluded that both of these assays should be improved to meet high-sensitivity criteria

Is Parenteral Levothyroxine Therapy Safe in Intractable Hypothyroidism?

Case: A 32-year old woman was admitted to the hospital due to intractable hypothyroidism refractory to high dose of oral L-thyroxine therapy. She underwent total thyroidectomy and radioactive iodine therapy due to papillary thyroid cancer. After excluding poor adherence to therapy and malabsorption, levothyroxine absorption test was performed. No response was detected. Transient neurologic symptoms developed during the test. She developed 3 attacks consisting of neurologic symptoms during high dose administration. The patient was considered a case of isolated L-thyroxine malabsorption. She became euthyroid after intramuscular twice weekly L-thyroxine therapy

The Effects of Acute and Chronic Hyperglycemia on Serum Paraoxonase Activity

Objectives: Paraoxonase (PON1) is a high density lipoprotein bound serum esterase that is synthesized by the liver which has ability to metabolize lipid peroxides hence playing an important role in protection against atherosclerosis. Our aim was to evaluate the effect of acute and chronic hyperglycemia on PON1 activity in order to clarify the effect of glucose homeostasis. Besides, the relation of hemoglobin A(1c) with triglyceride, total cholesterol, low density lipoprotein-cholesterol, high density lipoprotein-cholesterol and PON1/high density lipoprotein-cholesterol ratios which play role in the development of atherosclerosis was also evaluated

Artificial Neural Network Approach in Laboratory Test Reporting Learning Algorithms

Objectives: In the field of laboratory medicine, minimizing errors and establishing standardization is only possible by predefined processes. The aim of this study was to build an experimental decision algorithm model open to improvement that would efficiently and rapidly evaluate the results of biochemical tests with critical values by evaluating multiple factors concurrently

How the COVID-19 outbreak affected patients with diabetes mellitus?

Background Global COVID-19 outbreak has been such a stressful experience for most of the people. Using a web-based cross-sectional study, we aimed to evaluate the acute stress response, depression, and anxiety in patients with diabetes mellitus (DM) during the COVID-19 pandemic, and to examine the effect of these psychiatric problems on diet habits and glycemic controls of patients. Methods This web-based survey of COVID-19 was sent to the patients through the Whatsapp platform. All participants reported their demographic data, diabetes-related information, changes in self-monitoring blood glucose measurements, physical parameters, and eating habits after COVID-19, then completed Hospital Anxiety and Depression Scale (HADS) and the Impact of Event Scale, Revised (IES-R) questionnaires which assessed acute stress sypmtoms, anxiety, and depression. Results Three hundred and four patients with DM [(141 type 1 DM (T1D) and 163 type 2 (T2D)] were included in the study. In our study, female gender, higher BMI and weight, decreased in financial income after outbreak, presence of diabetic complications and comorbid diseases (i.e., retinopathy, neuropathy, diabetic foot, hypertension, dyslipidemia), worsened glycemic levels, increased carbohydrate consumption, and snacking were associated with higher anxiety and depression scores. Depression was higher in patients with T2D and duration of illness was correlated with acute stress level. Conclusions It is important to be aware of the possibility of acute stress, depression, and anxiety after pandemic in patients with DM whose glycemic control is impaired. Psychological problems should not be ignored beyond physical inactivity and worsening eating habits

An unusual case of adult-onset multi-systemic Langerhans cell histiocytosis with perianal and incident thyroid involvement

Langerhans cell histiocytosis (LCH) is a rare sporadic disease characterized by histiocytic neoplastic infiltration of various organ systems and a wide spectrum of clinical manifestations, ranging from benign and self-limiting to lethal. Herein, we report a rare case of adult-onset multi-systemic LCH in a 36-year-old male patient with an initial perianal presentation and incidental finding of subsequent thyroid gland involvement in the follow-up period. The patient with a history of perianal LCH treated with surgical excision and local radiotherapy was referred to our Endocrinology Department upon detection of hypermetabolic nodular lesions in the left lateral lobe of thyroid gland on positron emission tomography–computed tomography (PET/CT) scan in the nineth month of follow-up. Current evaluation revealed euthyroid status, a hypoechoic solid lesion of 13 × 9 mm in size with irregular borders in the left thyroid lobe on thyroid USG and cytologic assessment of thyroid nodule. The patient was diagnosed with suspected, oncocytic lesion, Hashimoto thyroiditis or LCH. The patient underwent total thyroidectomy and pathological assessment confirmed the diagnosis of Langerhans cell histiocytosis. Assessments in the sixth month of postoperative follow-up revealed euthyroid status with no thyroid tissue remnants or pathological lymph node on thyroid USG. In view of the multifocal lesions indicating multi-system disease, a systemic chemotherapy protocol with combination of prednisone (PRED) and vinblastine (VBL) has been planned by the hematology department

SERUM PARAOXANASE 1 ACTIVITY PREDICTS ARTERIAL STIFFNESS IN RENAL TRANSPLANT PATIENTS

WOS: 00029486960223