Objective: Acute myeloid leukemia (AML) is characterized by leukemic blasts that are not limited to the bone marrow or peripheral blood, may be presented with granulocytic sarcoma, and leukemic cells outside of the blood or bone marrow are called extramedullary involvement (EMI). Skin, bone, and lymph nodes are the most prevalent locations of extramedullary illness. Granulocytic sarcoma (GS) should be considered in the differential diagnosis of nodules, pustules, or plaque-like lesions, especially in patients with suspected hematological disease. No EMI-specific treatment regimens have been established; patients who are suitable for intensive therapy are typically treated with anthracycline and cytarabine-containing regimens. The most common genetic aberration in adult AML is somatic mutations in exon 12 of the NPM gene (NPM1), which affect up to 60% of individuals with normal karyotype AML and around 35% of all cases. Patients with NPM1 mutations are twice as likely to also have a FMS-like tyrosine kinase internal transmembrane duplications (FLT3-ITD) mutation as patients without NPM1 mutations. AML frequently harbors FLT3 mutations that result in (FLT3-ITD) or alterations to the kinase domain's activating loop (FLT3-TKD). Short remissions and unfavorable outcomes are linked to leukemia cells that have a high mutation proportion of FLT3-ITD molecules on their surface. Case: Here in this study, we report a patient diagnosed with FLT3-ITD and NPM1 double mutation AML (FAB classification M0, M1), admitted with diffuse granulocytic sarcoma.
{"title":"FLT3-ITD and NPM1 Double Mutation Acute Myeloid Leukemia Case Presenting with Diffuse Skin Granulocytic Sarcoma","authors":"R. Çiftçiler, A. E. Ciftciler, S. Kozacıoglu","doi":"10.36472/msd.v10i7.982","DOIUrl":"https://doi.org/10.36472/msd.v10i7.982","url":null,"abstract":"Objective: Acute myeloid leukemia (AML) is characterized by leukemic blasts that are not limited to the bone marrow or peripheral blood, may be presented with granulocytic sarcoma, and leukemic cells outside of the blood or bone marrow are called extramedullary involvement (EMI). Skin, bone, and lymph nodes are the most prevalent locations of extramedullary illness. Granulocytic sarcoma (GS) should be considered in the differential diagnosis of nodules, pustules, or plaque-like lesions, especially in patients with suspected hematological disease. No EMI-specific treatment regimens have been established; patients who are suitable for intensive therapy are typically treated with anthracycline and cytarabine-containing regimens. The most common genetic aberration in adult AML is somatic mutations in exon 12 of the NPM gene (NPM1), which affect up to 60% of individuals with normal karyotype AML and around 35% of all cases. Patients with NPM1 mutations are twice as likely to also have a FMS-like tyrosine kinase internal transmembrane duplications (FLT3-ITD) mutation as patients without NPM1 mutations. AML frequently harbors FLT3 mutations that result in (FLT3-ITD) or alterations to the kinase domain's activating loop (FLT3-TKD). Short remissions and unfavorable outcomes are linked to leukemia cells that have a high mutation proportion of FLT3-ITD molecules on their surface. \u0000Case: Here in this study, we report a patient diagnosed with FLT3-ITD and NPM1 double mutation AML (FAB classification M0, M1), admitted with diffuse granulocytic sarcoma.","PeriodicalId":18486,"journal":{"name":"Medical Science and Discovery","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87915110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mehmet Muzaffer Islam, Merve Osoydan Satici, Enis Ademoğlu, Fahriye Naz Erdil, Turancan Odabaşı, Ayşen Eker, Selma Atay İslam, S. Eroğlu
Objective: The primary outcome of this study is to evaluate the diagnostic performance of the initial delta neutrophil index (DNI) for early identification of severe acute pancreatitis (SAP). Material and Methods: All diagnoses and definitions were made according to the revised Atlanta classification. DNI (delta neutrophil index) was measured automatically using a hematology analyzer. The study included patients aged 18 years and older who were admitted with abdominal pain consistent with acute pancreatitis. The exclusion criteria encompassed patients with a known diagnosis of pancreatic malignancy, iatrogenic endoscopic pancreatitis, those presenting with abdominal trauma, and those experiencing exacerbation of chronic pancreatitis. Results: The median DNI for patients who developed SAP was 0.5 (0.29-1.1), while for non-severe patients, it was 0.2 (0.1-0.41). The difference between the two outcome groups was found to be statistically significant (p<0.001). The area under the curve (AUC) for DNI in predicting SAP was 0.727, with a 95% Confidence Interval (CI) of 0.628-0.825. At the optimal cut-off point, the sensitivity of DNI was determined to be 74.3%, with a 95% CI of 56.7%-87.5%. The specificity was calculated as 68.2% (95% CI=61.6%-74.3%). The positive likelihood ratio (LR+) was 2.34, with a 95% CI of 1.78-3.08, and the negative likelihood ratio (LR-) was 0.38, with a 95% CI of 0.21-0.67. Conclusion: Based on the results, the delta neutrophil index (DNI) shows promise as an essential inflammatory marker for the early diagnosis of SAP. While it may not demonstrate high performance as a standalone marker, our study indicates that DNI could serve as an independent predictor for this outcome. The significant difference observed in DNI values between patients who developed SAP and non-severe patients suggests its potential clinical significance in identifying severe acute pancreatitis cases at an early stage. Further investigations and validation studies are warranted to strengthen the reliability and generalizability of DNI as a diagnostic tool for SAP. Integrating DNI with other relevant clinical and laboratory parameters may enhance its diagnostic accuracy and contribute to more effective patient management strategies. With appropriate intervention and follow-up, the early identification of SAP using DNI may lead to improved patient outcomes and reduced complications, benefiting both the patients and the healthcare system.
{"title":"The role of delta neutrophil index in early identification of severe acute pancreatitis in adult patients: a prospective diagnostic accuracy study","authors":"Mehmet Muzaffer Islam, Merve Osoydan Satici, Enis Ademoğlu, Fahriye Naz Erdil, Turancan Odabaşı, Ayşen Eker, Selma Atay İslam, S. Eroğlu","doi":"10.36472/msd.v10i7.988","DOIUrl":"https://doi.org/10.36472/msd.v10i7.988","url":null,"abstract":"Objective: The primary outcome of this study is to evaluate the diagnostic performance of the initial delta neutrophil index (DNI) for early identification of severe acute pancreatitis (SAP).\u0000Material and Methods: All diagnoses and definitions were made according to the revised Atlanta classification. DNI (delta neutrophil index) was measured automatically using a hematology analyzer. The study included patients aged 18 years and older who were admitted with abdominal pain consistent with acute pancreatitis. The exclusion criteria encompassed patients with a known diagnosis of pancreatic malignancy, iatrogenic endoscopic pancreatitis, those presenting with abdominal trauma, and those experiencing exacerbation of chronic pancreatitis.\u0000Results: The median DNI for patients who developed SAP was 0.5 (0.29-1.1), while for non-severe patients, it was 0.2 (0.1-0.41). The difference between the two outcome groups was found to be statistically significant (p<0.001). The area under the curve (AUC) for DNI in predicting SAP was 0.727, with a 95% Confidence Interval (CI) of 0.628-0.825. At the optimal cut-off point, the sensitivity of DNI was determined to be 74.3%, with a 95% CI of 56.7%-87.5%. The specificity was calculated as 68.2% (95% CI=61.6%-74.3%). The positive likelihood ratio (LR+) was 2.34, with a 95% CI of 1.78-3.08, and the negative likelihood ratio (LR-) was 0.38, with a 95% CI of 0.21-0.67.\u0000Conclusion: Based on the results, the delta neutrophil index (DNI) shows promise as an essential inflammatory marker for the early diagnosis of SAP. While it may not demonstrate high performance as a standalone marker, our study indicates that DNI could serve as an independent predictor for this outcome. The significant difference observed in DNI values between patients who developed SAP and non-severe patients suggests its potential clinical significance in identifying severe acute pancreatitis cases at an early stage. Further investigations and validation studies are warranted to strengthen the reliability and generalizability of DNI as a diagnostic tool for SAP. Integrating DNI with other relevant clinical and laboratory parameters may enhance its diagnostic accuracy and contribute to more effective patient management strategies. With appropriate intervention and follow-up, the early identification of SAP using DNI may lead to improved patient outcomes and reduced complications, benefiting both the patients and the healthcare system.","PeriodicalId":18486,"journal":{"name":"Medical Science and Discovery","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78660266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: The current study aimed to examine the neurocognitive deficits of children with ADHD and/or Developmental Dyslexia (DD) using neurocognitive tests. Material and Methods: The participants of the study consisted of children diagnosed with Dyslexia (N=33), ADHD (N=32), and DD+ADHD (N=37) who applied to the Department of Child and Adolescent Psychiatry, Faculty of Medicine, Ankara University. The control group consists of 30 primary school children aged 7-11 with similar sociodemographic data. K-SADS-PL is used for the DSM-5 diagnoses of the patients and the control group. Stroop Test, Trail Making Test, Verbal Cancellation Test, and Wechsler Intelligence Scale for Children-Revised (WISC-R) were used to evaluate the cognitive functions of the groups in detail. Results: Children with ADHD and/or Dyslexia were evaluated to have significant deficits in all neurocognitive measures such as reaction inhibition, selective attention, sustained attention, shifting attention, and visuospatial short-term memory compared to the healthy control group (p<0.001). Children with ADHD-only revealed the most significant weaknesses in reaction inhibition, and visuospatial short-term memory measures (p<0.001). The comorbid group exhibited significant weakness on almost all neurocognitive measures compared with the control group, but did not perform significantly lower than the ADHD-only and Dislexia-only groups. Conclusion: It has been shown that children with ADHD and/or Dyslexia have multiple neurocognitive deficits, and our study supports the multiple cognitive deficit hypothesis.
{"title":"Neurocognitive Profile in Children with Attention Deficit/Hyperactivity Disorder and Dyslexia","authors":"Yaşar Tanır, B. G. Kılıç","doi":"10.36472/msd.v10i7.995","DOIUrl":"https://doi.org/10.36472/msd.v10i7.995","url":null,"abstract":"Objective: The current study aimed to examine the neurocognitive deficits of children with ADHD and/or Developmental Dyslexia (DD) using neurocognitive tests.\u0000Material and Methods: The participants of the study consisted of children diagnosed with Dyslexia (N=33), ADHD (N=32), and DD+ADHD (N=37) who applied to the Department of Child and Adolescent Psychiatry, Faculty of Medicine, Ankara University. The control group consists of 30 primary school children aged 7-11 with similar sociodemographic data. K-SADS-PL is used for the DSM-5 diagnoses of the patients and the control group. Stroop Test, Trail Making Test, Verbal Cancellation Test, and Wechsler Intelligence Scale for Children-Revised (WISC-R) were used to evaluate the cognitive functions of the groups in detail.\u0000Results: Children with ADHD and/or Dyslexia were evaluated to have significant deficits in all neurocognitive measures such as reaction inhibition, selective attention, sustained attention, shifting attention, and visuospatial short-term memory compared to the healthy control group (p<0.001). Children with ADHD-only revealed the most significant weaknesses in reaction inhibition, and visuospatial short-term memory measures (p<0.001). The comorbid group exhibited significant weakness on almost all neurocognitive measures compared with the control group, but did not perform significantly lower than the ADHD-only and Dislexia-only groups.\u0000Conclusion: It has been shown that children with ADHD and/or Dyslexia have multiple neurocognitive deficits, and our study supports the multiple cognitive deficit hypothesis.","PeriodicalId":18486,"journal":{"name":"Medical Science and Discovery","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79822933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ibrahim Acir, Zeynep Vildan Okudan Atay, M. Atay, V. Yayla
Objective: This study investigated the potential association between varicose veins and daytime sleepiness (DS), as evaluated using the Epworth Sleepiness Scale (ESS). The study also explored various demographic, symptom-related, and laboratory variables in individuals with varicose veins. Material and Method: Out of 169 patients, 160 have been deemed suitable for the study. The Epworth Sleepiness Scale (ESS) was utilized for assessing daytime sleepiness, and demographic information, along with laboratory results, was recorded. Results: The results revealed no significant associations between increased daytime sleepiness and demographic variables, including age and gender (p > 0.05). Additionally, there were no significant correlations between daytime sleepiness and symptoms commonly associated with varicose veins, such as leg pain, varicose vein pack, cramp, and edema (p > 0.05). Smoking status and alcohol use also did not show a clear relationship with daytime sleepiness (p > 0.05). Laboratory variables demonstrated slightly lower Thyroxine (T4) levels in individuals with increased daytime sleepiness (p = 0.048), while vitamin B12 levels were significantly higher in this group (p = 0.010). Conclusion: This study contributes to understanding the potential association between varicose veins and daytime sleepiness. While demographic variables, symptoms, and most laboratory variables did not show significant associations, the findings regarding vitamin B12 and T4 levels warrant further investigation. Understanding this association can guide the development of targeted interventions to improve the quality of life for individuals affected by these conditions.
{"title":"An Evaluation of Daytime Sleepiness in Individuals with Varicosity","authors":"Ibrahim Acir, Zeynep Vildan Okudan Atay, M. Atay, V. Yayla","doi":"10.36472/msd.v10i7.992","DOIUrl":"https://doi.org/10.36472/msd.v10i7.992","url":null,"abstract":"Objective: This study investigated the potential association between varicose veins and daytime sleepiness (DS), as evaluated using the Epworth Sleepiness Scale (ESS). The study also explored various demographic, symptom-related, and laboratory variables in individuals with varicose veins.\u0000Material and Method: Out of 169 patients, 160 have been deemed suitable for the study. The Epworth Sleepiness Scale (ESS) was utilized for assessing daytime sleepiness, and demographic information, along with laboratory results, was recorded.\u0000Results: The results revealed no significant associations between increased daytime sleepiness and demographic variables, including age and gender (p > 0.05). Additionally, there were no significant correlations between daytime sleepiness and symptoms commonly associated with varicose veins, such as leg pain, varicose vein pack, cramp, and edema (p > 0.05). Smoking status and alcohol use also did not show a clear relationship with daytime sleepiness (p > 0.05). Laboratory variables demonstrated slightly lower Thyroxine (T4) levels in individuals with increased daytime sleepiness (p = 0.048), while vitamin B12 levels were significantly higher in this group (p = 0.010).\u0000Conclusion: This study contributes to understanding the potential association between varicose veins and daytime sleepiness. While demographic variables, symptoms, and most laboratory variables did not show significant associations, the findings regarding vitamin B12 and T4 levels warrant further investigation. Understanding this association can guide the development of targeted interventions to improve the quality of life for individuals affected by these conditions.","PeriodicalId":18486,"journal":{"name":"Medical Science and Discovery","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89687350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: This study aims to establish a roadmap for drug supply during potential future pandemic scenarios by examining the variations in drug consumption at Kayseri City Training and Research Hospital during the COVID-19 pandemic compared to the pre-COVID-19 period. Materials and Methods: The study involved an analysis of one-year drug stock data before and after the pandemic. The start date of the pandemic was identified as April 2020 when the first COVID-19 case was admitted to our hospital. Data on drug stock inputs and outputs were obtained from the Hospital Information Management System. The data were calculated as percentages by considering the number of inpatients on a monthly basis. The drug groups investigated included antiviral, antibiotic, antihypertensive, antidiabetic, antifungal, antithrombotic, antitussive, and psychiatric drugs. Specifically, the most commonly used antifungal agents were identified as liposomal amphotericin B, fluconazole, metronidazole, caspofungin, and nystatin; antihypertensive agents included amlodipine, perindopril, carvedilol, and furosemide; antidiabetic agents encompassed insulin glargine, insulin aspart, insulin glulisine, and metformin hydrochloride; psychiatric drugs consisted of quetiapine, escitalopram, and sertraline; antiviral agents were favipiravir, oseltamivir, and remdesivir; and antibiotics comprised ampicillin sodium, ceftriaxone, levofloxacin, moxifloxacin, and clarithromycin. Additionally, enoxaparin sodium was used as an antithrombotic agent, and levodropropizin as an antitussive during the pandemic at our hospital. Results: Comparing the pre-COVID period, an increase in the number of drugs supplied per patient was observed across all drug groups. However, the usage rates of furosemide, carvedilol, metronidazole, liposomal amphotericin B, quetiapine, and metformin decreased in certain months during the pandemic. The drug categories with the highest usage rates were antithrombotics, antivirals, and antibiotics. Notably, antithrombotic consumption increased by a factor of 270 in the first year of the pandemic. Conclusion: This study highlights the potential changes in drug consumption and requirements during pandemic periods, particularly in the case of antimicrobial and antithrombotic drugs, as demonstrated in our findings. It emphasizes the importance of proactive measures to adjust drug supply to meet the demands of clinics and inpatient services during critical periods.
{"title":"COVID-19 Pandemic: Changes in Drug Consumption and Implications for Treatment Strategies","authors":"M. Kara, Esma Yıldırım","doi":"10.36472/msd.v10i7.984","DOIUrl":"https://doi.org/10.36472/msd.v10i7.984","url":null,"abstract":"Objective: This study aims to establish a roadmap for drug supply during potential future pandemic scenarios by examining the variations in drug consumption at Kayseri City Training and Research Hospital during the COVID-19 pandemic compared to the pre-COVID-19 period.\u0000Materials and Methods: The study involved an analysis of one-year drug stock data before and after the pandemic. The start date of the pandemic was identified as April 2020 when the first COVID-19 case was admitted to our hospital. Data on drug stock inputs and outputs were obtained from the Hospital Information Management System. The data were calculated as percentages by considering the number of inpatients on a monthly basis. The drug groups investigated included antiviral, antibiotic, antihypertensive, antidiabetic, antifungal, antithrombotic, antitussive, and psychiatric drugs. Specifically, the most commonly used antifungal agents were identified as liposomal amphotericin B, fluconazole, metronidazole, caspofungin, and nystatin; antihypertensive agents included amlodipine, perindopril, carvedilol, and furosemide; antidiabetic agents encompassed insulin glargine, insulin aspart, insulin glulisine, and metformin hydrochloride; psychiatric drugs consisted of quetiapine, escitalopram, and sertraline; antiviral agents were favipiravir, oseltamivir, and remdesivir; and antibiotics comprised ampicillin sodium, ceftriaxone, levofloxacin, moxifloxacin, and clarithromycin. Additionally, enoxaparin sodium was used as an antithrombotic agent, and levodropropizin as an antitussive during the pandemic at our hospital.\u0000Results: Comparing the pre-COVID period, an increase in the number of drugs supplied per patient was observed across all drug groups. However, the usage rates of furosemide, carvedilol, metronidazole, liposomal amphotericin B, quetiapine, and metformin decreased in certain months during the pandemic. The drug categories with the highest usage rates were antithrombotics, antivirals, and antibiotics. Notably, antithrombotic consumption increased by a factor of 270 in the first year of the pandemic.\u0000Conclusion: This study highlights the potential changes in drug consumption and requirements during pandemic periods, particularly in the case of antimicrobial and antithrombotic drugs, as demonstrated in our findings. It emphasizes the importance of proactive measures to adjust drug supply to meet the demands of clinics and inpatient services during critical periods.","PeriodicalId":18486,"journal":{"name":"Medical Science and Discovery","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82031960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hayriye Bektaş Aksoy, I. Aksoy, Selda Günaydın, Abdülbaki Elmas, A. Dülger
Objective: Immune plasma therapy, a method employed for passive immunization, has been utilized as a treatment modality based on historical precedents during the Covid-19 pandemic, a global crisis resulting in the unfortunate demise of countless individuals. The objective of this study is to investigate the impact of immune plasma therapy on laboratory parameters and the overall survival rate in patients with Covid-19 pneumonia. Material and Methods: Our study was designed as a retrospective analysis, conducted at a tertiary healthcare institution from April 1, 2020, to December 31, 2020. The study population comprised individuals aged 18 and above, presenting with pulmonary involvement, and diagnosed with Covid-19 using the polymerase chain reaction (PCR) method at our hospital. The inclusion criteria encompassed patients who received immune plasma therapy, as well as a control group matched for age, gender, and admission date, who did not undergo immune plasma therapy. Exclusion criteria involved patients with low serum IgA levels, those who did not provide consent for immune plasma therapy, and individuals below the age of 18. Results: The study comprised a total of 72 patients who received immune plasma therapy and 72 patients in the control group, matched for age and gender, all diagnosed with Covid-19. The median age of the patients was 70 years, ranging from 19 to 91, and 56.9% (41) of them were female. When comparing the immune plasma group with the control group, several significant differences were observed (p<0.05). These included elevated levels of leukocytes, neutrophils, neutrophil-lymphocyte ratio (NLR), glucose, aspartate aminotransferase (AST), sedimentation rate, C-reactive protein (CRP), ferritin, fibrinogen, d-dimer, and low levels of platelets and lymphocytes in the control group. Furthermore, in the immune plasma therapy group, significant associations were found between mortality and lymphocyte count, NLR, AST, CRP, and d-dimer elevation after treatment (p<0.05). Additionally, pre- and post-treatment measurements of troponin, procalcitonin, and ferritin were significantly correlated with mortality (p<0.05). Conclusion: The administration of immune plasma therapy, involving the transfer of neutralizing antibodies, has demonstrated a favorable impact on laboratory parameters and overall survival in severe cases of Covid-19 pneumonia, particularly during the early stages of the disease.
{"title":"Effect of Immune Plasma Therapy on Mortality and Morbidity in Patients with Covid-19: A Retrospective Study","authors":"Hayriye Bektaş Aksoy, I. Aksoy, Selda Günaydın, Abdülbaki Elmas, A. Dülger","doi":"10.36472/msd.v10i7.989","DOIUrl":"https://doi.org/10.36472/msd.v10i7.989","url":null,"abstract":"Objective: Immune plasma therapy, a method employed for passive immunization, has been utilized as a treatment modality based on historical precedents during the Covid-19 pandemic, a global crisis resulting in the unfortunate demise of countless individuals. The objective of this study is to investigate the impact of immune plasma therapy on laboratory parameters and the overall survival rate in patients with Covid-19 pneumonia.\u0000Material and Methods: Our study was designed as a retrospective analysis, conducted at a tertiary healthcare institution from April 1, 2020, to December 31, 2020. The study population comprised individuals aged 18 and above, presenting with pulmonary involvement, and diagnosed with Covid-19 using the polymerase chain reaction (PCR) method at our hospital. The inclusion criteria encompassed patients who received immune plasma therapy, as well as a control group matched for age, gender, and admission date, who did not undergo immune plasma therapy. Exclusion criteria involved patients with low serum IgA levels, those who did not provide consent for immune plasma therapy, and individuals below the age of 18.\u0000Results: The study comprised a total of 72 patients who received immune plasma therapy and 72 patients in the control group, matched for age and gender, all diagnosed with Covid-19. The median age of the patients was 70 years, ranging from 19 to 91, and 56.9% (41) of them were female. When comparing the immune plasma group with the control group, several significant differences were observed (p<0.05). These included elevated levels of leukocytes, neutrophils, neutrophil-lymphocyte ratio (NLR), glucose, aspartate aminotransferase (AST), sedimentation rate, C-reactive protein (CRP), ferritin, fibrinogen, d-dimer, and low levels of platelets and lymphocytes in the control group. Furthermore, in the immune plasma therapy group, significant associations were found between mortality and lymphocyte count, NLR, AST, CRP, and d-dimer elevation after treatment (p<0.05). Additionally, pre- and post-treatment measurements of troponin, procalcitonin, and ferritin were significantly correlated with mortality (p<0.05).\u0000Conclusion: The administration of immune plasma therapy, involving the transfer of neutralizing antibodies, has demonstrated a favorable impact on laboratory parameters and overall survival in severe cases of Covid-19 pneumonia, particularly during the early stages of the disease.","PeriodicalId":18486,"journal":{"name":"Medical Science and Discovery","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88536750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: The objective of this study was to investigate the potential impact of radionuclide imaging on filtration in the inguinal lymph nodes of obese patients. We aimed to compare the lymphatic transport after the inguinal lymph nodes between obese patients and normal-weight individuals, while ensuring intact lower extremity lymphatic flow. Methods: A retrospective study design was employed, involving the re-evaluation of patient images. Among the total of 119 patients, 62 were classified as obese, while the remaining patients had body mass indexes within normal limits. All patients included in the study were female, with a mean age of 39 years (ranging from 28 to 47 years). Lymphatic imaging was performed using Tc-99m-labeled nanocolloid particles with a size of 50-70 nm. The nanocolloid was applied to the 1st and 2nd interdigital web areas on the dorsum of both feet. Late images were captured at 45-50 minutes and 2 hours after application. Results: Out of the 119 patients, 62 (52%) were classified as obese. There was no significant difference in terms of age between the two groups. The pre-inguinal average count values, calculated from the counts before the inguinal node, did not show a significant difference between the two groups. However, the post-inguinal average count values obtained after the inguinal nodes were significantly lower in obese patients compared to normal-weight patients (p<0.0005). Conclusion: Our findings suggest that even in the early stages, when functional imaging allows observation of the main lymphatic duct, there are differences in the progression of lymphatic flow between obese patients and normal-weight individuals. Detecting these differences may enable early diagnosis of lymphedema disease, which is a reversible disorder if identified promptly.
{"title":"Effect of Obesity on Lymphatic Fluid Filtration in Inguinal Lymph Nodes","authors":"S. Ceylan","doi":"10.36472/msd.v10i7.972","DOIUrl":"https://doi.org/10.36472/msd.v10i7.972","url":null,"abstract":"Objective: The objective of this study was to investigate the potential impact of radionuclide imaging on filtration in the inguinal lymph nodes of obese patients. We aimed to compare the lymphatic transport after the inguinal lymph nodes between obese patients and normal-weight individuals, while ensuring intact lower extremity lymphatic flow.\u0000Methods: A retrospective study design was employed, involving the re-evaluation of patient images. Among the total of 119 patients, 62 were classified as obese, while the remaining patients had body mass indexes within normal limits. All patients included in the study were female, with a mean age of 39 years (ranging from 28 to 47 years). Lymphatic imaging was performed using Tc-99m-labeled nanocolloid particles with a size of 50-70 nm. The nanocolloid was applied to the 1st and 2nd interdigital web areas on the dorsum of both feet. Late images were captured at 45-50 minutes and 2 hours after application.\u0000Results: Out of the 119 patients, 62 (52%) were classified as obese. There was no significant difference in terms of age between the two groups. The pre-inguinal average count values, calculated from the counts before the inguinal node, did not show a significant difference between the two groups. However, the post-inguinal average count values obtained after the inguinal nodes were significantly lower in obese patients compared to normal-weight patients (p<0.0005).\u0000Conclusion: Our findings suggest that even in the early stages, when functional imaging allows observation of the main lymphatic duct, there are differences in the progression of lymphatic flow between obese patients and normal-weight individuals. Detecting these differences may enable early diagnosis of lymphedema disease, which is a reversible disorder if identified promptly.","PeriodicalId":18486,"journal":{"name":"Medical Science and Discovery","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85029925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: Head trauma is one of the most common causes of emergency admission in elderly patients. The risk of intracranial pathology increases after trauma due to the weakening of bone structures, deterioration in blood parameters, and use of anticoagulants. This study aimed to examine the factors affecting mortality after head trauma in geriatric patients. Material and Methods: Geriatric patients who were admitted to the emergency department with head trauma between 01.01.2015 and 31.12.2015 and underwent cranial computed tomography (cCT) were included in the study. Patient data were analyzed according to gender, age groups, trauma causes, hematological parameters and hospitalization-discharge status. Results: 320 patients were included in the study, 169 were female (52.8%), and 142 were in the 65-74 age group (%44). Intracranial pathology was detected in 34 patients. The most common causes of trauma were falls and traffic accidents. The most common CT pathology was subdural hemorrhage. 76 (24%) of 320 patients were hospitalized. As their final status, 307 patients were discharged (96%), 6 were transferred (1.9%), 7 died (2.2%). Conclusion: In the study, there is no significant correlation between age, gender, mechanism of trauma, hematological parameters and mortality in geriatric head trauma. Geriatric head traumas must be evaluated seriously regardless of the mechanism of injury, age and gender groups, even simple traumas can be dangerous.
{"title":"Investigation of Factors Affecting Prognosis in Geriatric Patients with Head Injury","authors":"H. Aydın","doi":"10.36472/msd.v10i7.976","DOIUrl":"https://doi.org/10.36472/msd.v10i7.976","url":null,"abstract":"Objective: Head trauma is one of the most common causes of emergency admission in elderly patients. The risk of intracranial pathology increases after trauma due to the weakening of bone structures, deterioration in blood parameters, and use of anticoagulants. This study aimed to examine the factors affecting mortality after head trauma in geriatric patients.\u0000Material and Methods: Geriatric patients who were admitted to the emergency department with head trauma between 01.01.2015 and 31.12.2015 and underwent cranial computed tomography (cCT) were included in the study. Patient data were analyzed according to gender, age groups, trauma causes, hematological parameters and hospitalization-discharge status.\u0000Results: 320 patients were included in the study, 169 were female (52.8%), and 142 were in the 65-74 age group (%44). Intracranial pathology was detected in 34 patients. The most common causes of trauma were falls and traffic accidents. The most common CT pathology was subdural hemorrhage. 76 (24%) of 320 patients were hospitalized. As their final status, 307 patients were discharged (96%), 6 were transferred (1.9%), 7 died (2.2%).\u0000Conclusion: In the study, there is no significant correlation between age, gender, mechanism of trauma, hematological parameters and mortality in geriatric head trauma. Geriatric head traumas must be evaluated seriously regardless of the mechanism of injury, age and gender groups, even simple traumas can be dangerous.","PeriodicalId":18486,"journal":{"name":"Medical Science and Discovery","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90107791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Ozcan, E. M. Yorulmaz, Yuksel Yilmaz, M. Hamarat, A. Demirbaş
Objective: In the present study, after adapting the Extracorporeal Shock Wave Lithotripsy (ESWL) video produced by the European Association of Urology (EAU) into the Turkish language and showing it to the participating patients, we evaluated the effect on their anxiety and pain levels using the State-Trait Anxiety Inventory (STAI-I) anxiety form and the Visual Analogue Scale (VAS). Methods: A total of 59 patients, who were assessed at three centers between July 1st and October 1st, 2020, were involved in the study. The patients were divided into two groups, the first of which was asked to fill out a consent form and was shown the video and provided with verbal and written information;. On the other hand, the second group was given a consent form and received verbal and written information exclusively. Each group completed the STAI-I Anxiety form after being given preoperative information, while the VAS was applied after the procedure. Results: The STAI-I anxiety form score was higher in Group 1 than in Group 2, and the difference was statistically significant (p=0.004), and the recorded fluoroscopy time and VAS scores were lower in favor of Group 1 (p=0.045 and p=0.021). Conclusion: While the provision of video-guided information prior to ESWL resulted in heightened anxiety among the patients, it led to improved compliance during the procedure, as well as reduced total fluoroscopy time and pain scores for the patients.
{"title":"The Effect of Video-Guided information on Anxiety and Pain in Extracorporeal Shock Wave Therapy: A control group study","authors":"S. Ozcan, E. M. Yorulmaz, Yuksel Yilmaz, M. Hamarat, A. Demirbaş","doi":"10.36472/msd.v10i7.965","DOIUrl":"https://doi.org/10.36472/msd.v10i7.965","url":null,"abstract":"Objective: In the present study, after adapting the Extracorporeal Shock Wave Lithotripsy (ESWL) video produced by the European Association of Urology (EAU) into the Turkish language and showing it to the participating patients, we evaluated the effect on their anxiety and pain levels using the State-Trait Anxiety Inventory (STAI-I) anxiety form and the Visual Analogue Scale (VAS).\u0000Methods: A total of 59 patients, who were assessed at three centers between July 1st and October 1st, 2020, were involved in the study. The patients were divided into two groups, the first of which was asked to fill out a consent form and was shown the video and provided with verbal and written information;. On the other hand, the second group was given a consent form and received verbal and written information exclusively. Each group completed the STAI-I Anxiety form after being given preoperative information, while the VAS was applied after the procedure.\u0000Results: The STAI-I anxiety form score was higher in Group 1 than in Group 2, and the difference was statistically significant (p=0.004), and the recorded fluoroscopy time and VAS scores were lower in favor of Group 1 (p=0.045 and p=0.021).\u0000Conclusion: While the provision of video-guided information prior to ESWL resulted in heightened anxiety among the patients, it led to improved compliance during the procedure, as well as reduced total fluoroscopy time and pain scores for the patients.","PeriodicalId":18486,"journal":{"name":"Medical Science and Discovery","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90424145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To test the ability of the C-reactive protein-albumin-lymphocyte (CALLY) index to predict in-hospital mortality in hospitalized SARS-CoV-2-infected patients. Material and Methods: The present study was a retrospective, single-center study. The study population consisted of inpatients who tested positive for the reverse transcription-polymerase chain reaction test for SARS-CoV-2 between January 1, 2023, and April 15, 2023. The demographic data of the patients, vital parameters, the presence of respiratory symptoms, comorbidities, laboratory findings, and in-hospital mortality were recorded. The ability of the CALLY index to predict in-hospital mortality was tested with a receiver operating characteristic analysis and odds ratios. Results: The study population consisted of 170 inpatients. The CALLY index was significantly lower in survivors [6.5 (2.8-14.0) vs 2.0 (1.1-5.7) p< 0.001] (Mann-Whitney U test). The area under the curve for the CALLY index, C-reactive protein, albumin, and lymphocyte count were 0.700, 0.670, 0.660, and 0.630, respectively. At a cut-off value of 2.724, the CALLY index had a sensitivity of 76.15% and a specificity of 62.50%. A CALLY index below 2.724 increased the risk of in-hospital mortality by 5.32 times. The risk of in-hospital mortality was increased 4.02 times by a CRP above 152.13 mg/dL, 4.07 times by an albumin value below 33.55 g/dL, 3.84 times by a lymphocyte count below 0.58 103/µL, and 5.32 times by a CALLY index below 2.724. Conclusion: The CALLY index is a predictor of in-hospital mortality among hospitalized SARS-CoV-2-infected patients. This index also showed a superior predictive ability for in-hospital mortality than C-reactive protein, albumin, or lymphocyte count alone.
{"title":"The Importance of the CALLY Index as a Non-Invasive Prognostic Biomarker in SARS-CoV-2 Infected Patients: An Analytical Study","authors":"S. Özdemir, A. Özkan","doi":"10.36472/msd.v10i7.967","DOIUrl":"https://doi.org/10.36472/msd.v10i7.967","url":null,"abstract":"Objective: To test the ability of the C-reactive protein-albumin-lymphocyte (CALLY) index to predict in-hospital mortality in hospitalized SARS-CoV-2-infected patients.\u0000Material and Methods: The present study was a retrospective, single-center study. The study population consisted of inpatients who tested positive for the reverse transcription-polymerase chain reaction test for SARS-CoV-2 between January 1, 2023, and April 15, 2023. The demographic data of the patients, vital parameters, the presence of respiratory symptoms, comorbidities, laboratory findings, and in-hospital mortality were recorded. The ability of the CALLY index to predict in-hospital mortality was tested with a receiver operating characteristic analysis and odds ratios.\u0000Results: The study population consisted of 170 inpatients. The CALLY index was significantly lower in survivors [6.5 (2.8-14.0) vs 2.0 (1.1-5.7) p< 0.001] (Mann-Whitney U test). The area under the curve for the CALLY index, C-reactive protein, albumin, and lymphocyte count were 0.700, 0.670, 0.660, and 0.630, respectively. At a cut-off value of 2.724, the CALLY index had a sensitivity of 76.15% and a specificity of 62.50%. A CALLY index below 2.724 increased the risk of in-hospital mortality by 5.32 times. The risk of in-hospital mortality was increased 4.02 times by a CRP above 152.13 mg/dL, 4.07 times by an albumin value below 33.55 g/dL, 3.84 times by a lymphocyte count below 0.58 103/µL, and 5.32 times by a CALLY index below 2.724.\u0000Conclusion: The CALLY index is a predictor of in-hospital mortality among hospitalized SARS-CoV-2-infected patients. This index also showed a superior predictive ability for in-hospital mortality than C-reactive protein, albumin, or lymphocyte count alone.","PeriodicalId":18486,"journal":{"name":"Medical Science and Discovery","volume":"85 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85655578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：