Objective We aimed to determine the relationship between LMR and MHR and in-hospital and long-term mortality in patients with ACS. Methods We retrospectively collected patients with ACS undergoing coronary angiography between January 2012 and December 2013. Results In total, 825 patients with a mean age of 62.4 ± 12.9 years (71.3% male) were enrolled in the study. Patients were divided into three tertiles based on MHR levels and LMR levels. In-hospital mortality of the patients was significantly higher amongst patients in the upper MHR tertile when compared with the lower and middle MHR tertile groups [30 (10.9%) vs 8 (2.9%) and 14 (5.1%); P < .001, P = .009, respectively]. Five-year mortality of the patients was significantly higher amongst patients in the upper MHR tertile when compared with the lower and middle MHR tertile groups [84 (30.5%) vs 48 (17.5%) and 57 (20.7%); P < .001, P = .005, respectively]. In-hospital mortality of the patients was significantly higher amongst patients in the lower LMR tertile when compared with the upper and middle LMR tertile groups [25 (9.1%) vs 10 (3.6%) and 17 (6.2%); P = .007, P = .130, respectively]. Five -year mortality of the patients was significantly higher amongst patients in the lower LMR tertile when compared with the upper and middle LMR tertile groups [77 (28.0%) vs 47 (17.1%) and 65 (23.6%); P = .001, P = .142, respectively]. Conclusion We have shown that high MHR and low LMR were significant and independent predictors of in-hospital and long-term mortality in patients with ACS.
Globally, the number of cardiac implantable electronic devices (CIEDs) is increasing. In our study, we aimed to investigate whether CHA2DS2-VASc and R2CHA2DS2-VASc scores are predictive of CIED-related complications. Our investigation was carried out with a multicenter retrospective design. Patients who underwent CIED surgery at two cardiac centers in Turkey between January 2011 and May 2023, 1676, were evaluated. The patients were divided into two groups according to their R2CHA2DS2-VASc scores. Patients with R2CHA2DS2-VASc ≥ 5 were included in group 1 (380 patients), and patients with R2CHA2DS2-VASc < 5 (1296 patients) were included in group 2. The primary outcome was defined as the cumulative events. Each component of cumulative events, such as hematoma, pericardial effusion, pneumothorax, and infection, was also defined as a secondary outcome. The study's patient population had an average age of 62.9 ± 14 years. Pneumothorax (1.8% vs. 1.3%, p = 0.444), pericardial effusion or tamponade (0.35% vs. 0.2%, p = 0.659), and clinically significant hematoma (1.1% vs. 0.6%, p = 0.376) were comparable between the groups. Infection-related devices and cumulative events classified as primary outcomes were higher in the R2CHA2DS2-VASc ≥ 5 group (6.1% vs. 1.2%, p < 0.001; 7.6% vs. 3.2%, p < 0.001, respectively). Modeling analyses showed that the CHA2DS2-VASc score and HT were also independent predictors of device-related infection and cumulative events. In the R2CHA2DS2-VASc ≥ 5 groups, infection related to the device system and cumulative events were higher. Patients with an R2CHA2DS2-VASc score of 5 or more and a high CHA2DS2-VASc score should be evaluated more carefully regarding infection and cumulative events before and after the operation.
This subgroup analysis of the MORCOR-TURK (Mortality and Morbidity in Coronary Care Units in Türkiye) trial aimed to determine the short-term prognosis, mortality rates, and predictors for elderly patients followed in coronary care units (CCUs) in Türkiye.
Background and Aims Malnutrition is associated with poor clinical outcomes in many diseases. The Controlling Nutritional Status (CONUT) is an objective index used for evaluating nutritional status of hospitalised patients. The aim of this study was to investigate the relationship between malnutrition assessed by CONUT score and the prognosis in patients undergoing carotid artery stenting (CAS). Methods and Results The study included 170 patients who underwent CAS because of symptomatic or asymptomatic severe carotid artery stenosis. Median follow-up period was 50 (interquartile range [IQR], 41-60) months. Patients were divided into two groups according to the CONUT score as normal CONUT (score <2) and mild-severe CONUT (score ≥2). Primary endpoint was accepted as MACE (major adverse cardiac events) including all-cause death and ischaemic stroke. The prevalence of MACE was significantly higher in the mild-severe CONUT score group (P = .001). Kaplan Meier analysis showed lower survival rates in the mild-severe CONUT score group (log rank = 9.36, P = .002; Figure 5). The Cox regression analysis showed that, the CONUT score was associated with increased risk of MACE for both unadjusted model and age- and gender- adjusted model, while in a full adjusted model the best predictor was age. Conclusion Higher CONUT scores were associated with adverse outcomes in patients with CAS. Malnutrition assessed by the CONUT score is preferable with regards to the detection of MACE in patients with CAS. Larger studies are warranted to investigate if our preliminary findings translate into clinical outcomes in patients with CAS.
While studies on the treatment for the coronavirus disease 2019 (COVID-19) pandemic continue all over the world, factors that increase the risk of severe disease have also been the subject of research. Malnutrition has been considered an independent risk factor. Therefore, we aimed to investigate the clinical effect of dietary habits and evaluate the prognostic value of the Controlling Nutritional Status score in the COVID-19 patients we followed up. A total of 2760 patients hospitalized for COVID-19 were examined. Patients were retrospectively screened from three different centers between September 1 and November 30, 2020. A total of 1488 (53.9%) patients who met the criteria were included in the study. Risk classifications were made according to the calculation methods of prognostic nutritional index and Controlling Nutritional Status scores and total scores. The primary outcome of the study was in-hospital mortality. The groups with severe Controlling Nutritional Status and prognostic nutritional index scores had a significantly higher mortality rate than those with mild scores. In the multivariable regression analysis performed to determine in-hospital mortality, the parameters, such as age (OR 1.04; 95%CI 1.02-1.06, p<0.001), admission oxygen saturation value (SaO2) (OR 0.85; 95%CI 0.83-0.87, p<0.001), and Controlling Nutritional Status score (OR 1.34; 95%CI 1.23-1.45, p<0.001), were independent predictors. The patient groups with a low Controlling Nutritional Status score had a higher rate of discharge with recovery (p<0.001). Higher Controlling Nutritional Status scores may be effective in determining in-hospital mortality in patients with COVID-19. Nutrition scores can be used as a useful and effective parameter to determine prognosis in patients with COVID-19.
Neurofibromatosis type 1 (NF1) is an autosomal dominant inherited multisystem disease associated with several endocrine disorders. Association of NF1 and hyperthyroidism is extremely rare. All previously reported cases were in adult age group. Herein, we present autoimmune thyrotoxicosis associated to NF1 in a pediatric patient presenting with goiter and symptoms of thyrotoxicosis.
Objective: Monocyte to high-density lipoprotein ratio (MHR) is a biomarker of inflammatory response. In this study, we investigated the relationship between MHR and mortality in patients with chronic coronary artery occlusion (CTO).
Method: Retrospective observational study including 493 patients over a follow up period of 73 months. Blood samples were taken before cardiac catheterization for coronary angiography.
Results: Median follow-up was 48 months(26-73) . Patients were seperated into two groups: (I) MHR
Ozet. Dunyanin en buyuk sektorlerinden biri hic suphesiz yazilim sektorudur. Gelistirilen yazilimlarin buyuklugu ve insan hayatinin her alaninda yer almasi bu sektorun onemini daha da arttirmaktadir. Bu yuzden, basarili yazilimlarin gelistirilmesi icin bu konudaki standartlarin ve belirlenmis sureclerin en iyi sekilde uygulanmasi her gecen gun onemini arttirmaktadir. Daha kaliteli ve basarili projeler gelistirilmesine katkida bulunmak icin, yazilim testi ve yazilim kalitesi buyuk bir onem tasimaktadir. test ve kalite faaliyetleri, urun kalitesinin yukseltilmesi ve musteri memnuniyetinin arttirilmasina dogrudan katkida bulunmaktadir. Bu calisma kapsaminda, kamu kurumlarinin katilim sagladigi Yazilim Test ve Kalite Degerlendirme Calistayi nda, yazilim projelerindeki yazilim test ve kalite faaliyetleri ile ilgili test ekipleri, dokumantasyon, basari kriterleri, test senaryolari, kullanabilirlik, performans, kod gozden gecirme, test ve kalite faaliyetleri durum ve sorunlari bakimindan bir anket calismasi ve katilimcilarin gorus ve onerilerinin alindigi oturumlar gerceklestirilmistir. Bu anket calismasindan elde edilen sonuclar incelendiginde, kamu kurumlari yazilim projeleri hakkinda onemli ve ilginc bulgular ortaya cikmistir. Bu sonuclar degerlendirilerek, ilgili faaliyetler kapsaminda sektorun guclu ve zayif yonleri belirlenmistir. Ayrica, bu degerlendirmeler ile ilgili olarak bazi oneriler de bulunulmustur.
Pheochromocytomas (PHEOs) are a group of tumours that leads to multiple symptoms and can induce hypercoagulability and promote thrombosis. Pheochromocytomas may also present without elevated serum and urinary markers. We aimed to provide tips and tricks for the diagnostic and therapeutic management of an unusual case of PHEOs.Thirty-four-year-old woman with the unremarkable medical history presented with epigastric pain and dyspnoea. Electrocardiogram showed ST-segment elevation in the inferior limb leads. She underwent an emergency coronary angiogram, which showed a high thrombus burden in the distal right coronary artery. A subsequent echocardiogram demonstrated a 31 × 33 mm right atrial mass adhering to the inferior vena cava and abdominal computed tomography (CT) scan revealed a 113 × 85 mm necrotic mass in the left adrenal bed, with tumour thrombus extending proximally to the confluence of hepatic veins immediately inferior to the right atrium and distally to iliac vein bifurcation. Blood parameters, thrombophilia panel, vanillylmandelic acid, 5 hydroxy indole acetic acid, and homovanillic acid levels were normal. Tissue sampling confirmed the diagnosis of PHEOs. The surgical procedure was not planned due to the presence of metastatic foci on imaging, including positron emission tomography (PET)-CT. Anticoagulation with rivaroxaban and treatment with 177Lu-DOTATATE-based peptide receptor radionuclide therapy (PRRT) was initiated.The coexistence of arterial and venous thrombosis is extremely rare in patients with PHEOs. Multidisciplinary approaches are required for the care of such patients. Catecholamines likely contributed to the development of thrombosis in our patient. Early recognition of PHEOs is the key point to ameliorate clinical outcomes.