Aim: To evaluate systemic inflammatory parameters derived from hematological parameters in the diagnosis and prognosis of subacute thyroiditis (SAT). Methods: Demographic and laboratory data of 170 patients with SAT and 91 healthy control subjects were analysed retrospectively. The authors compared inflammatory parameters and thyroid function tests between SAT and control groups. Results: The erythrocyte sedimentation rate, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and systemic immune-inflammatory index (SII) were significantly higher in patients with SAT (p < 0.001). There was a significant positive correlation between the SII and erythrocyte sedimentation rate (r: 0.448; p < 0.001), CRP (r: 0.449; p < 0.01), neutrophil-to-lymphocyte ratio (r: 0.861; p < 0.001) and platelet-to-lymphocyte ratio (r: 0.782, p < 0.001). The thyroid stimulating hormone levels were higher in patients with recurrence when compared with those without recurrence (p = 0.007). Conclusions: As a practical biomarker, SII was significantly higher in patients with SAT compared with the control group. SII may be a new diagnostic tool for SAT.
Aim: We assessed the association of monocyte count to high-density lipoprotein cholesterol ratio (MHR) with diabetic peripheral neuropathy (DPN) and its role as a marker for identification of high-risk patients for DPN. Methods: A total of 180 patients with Type II diabetes mellitus (T2DM) were enrolled in the study. MHR, erythrocyte sedimentation rate and serum CRP along with other tests for T2DM and DPN were measured. Results: Duration of T2DM (p = 0.013), insulin use (p = 0.006) and serum CRP levels (p = 0.008) were significantly higher in patients with DPN. MHR was similar between groups (p = 0.447). Duration of diabetes (OR: 1.048; p = 0.038) and the serum CRP levels (OR: 1.073; p = 0.026) were found as independent predictors for the presence of DPN, however, MHR was not. Conclusion: Higher MHR indicates an enhanced inflammation and oxidative stress which was not found to be associated with the presence of DPN.
TURKEYIntroduction and Aims: As well as standard cardiovascular risk factors, non-conventional risk factors such as endothelial dysfunction, oxidative stress and insulin resistance have crucial role for progression of chronic kidney disease and cardiovascular disease. YKL-40 is a glycoprotein based molecule increasing in case of acute and chronic inflammation and takes part in endothelial dysfunction. This study examines how levels of YKL-40 can be linked to endothelial dysfunction and inflammation in chronic kidney disease. Methods: This study includes 29 hemodialysis patients, 101 chronic kidney disease patients and 38 individuals as a healthy control group. Routine blood parameters and YKL-40 levels were measured. Endothelial dysfunction was indirectly calculated by assessing Flow-Mediated Dilatation (FMD) in brachial artery. FMD (%) was calculated by; (diameter of post brachial artery hyperemic current -diameter of basal brachial artery x 100/ Diameter of Basal brachial artery) formula. Results: No meaningful differences were noticed in terms of age, sex, smoking habit between groups ( p>0,05). Chronic kidney disease (CKD) group and hemodialysis (HD) group were similar in terms of accompanying diseases (Diabetes, hypertension, cardiovascular disease) ( p>0,05). YKL-40 Levels were noticed to be meaningfully low in control group (31,73±21,12 ng/ml) compared to both CKD (55,98±22,96 ng/ml) and HD (83,91±16,88ng/ml) groups ( p<0,001). Percentages of FMD measured as a marker for endothelial dysfunction were 13,24±6,34% in control group, 4,82±3,79% in CKD group and 2,97±2,73% in HD group. FMD values were found to be meaningfully low in HD group compared to other groups ( p=0,015). There was strong negative correlation between YKL-40 and Glomerular Filtration Rate (GFR) (r=-0,674, p<0,001). Moreover, YKL-40 level negatively correlated with FMD, albumin, hemoglobin and HDL cholesterol levels. While YKL-40 level increases, FMD percentage decreases significantly (r=-0,471, p<0,001). YKL-40 level were shown to be in positive correlation with CRP, uric acid and triglyceride levels. A weak positive correlation with age was also noticed. Conclusions: This study shows that YKL-40; increases with CKD stage; is negatively correlated with FMD measurements done as a marker for endothelial dysfunction, is positively correlated with CRP levels and other frequently used inflammatory markers and negatively correlated with albumin. We believe that YKL-40 is a considerable marker to asses both endothelial dysfunction and proinflammatory process in CKD.
Introduction: Computerized thoracic tomography (CT) imaging was extensively employed, especially in the early era of the Coronavirus pandemic. An incidental thyroid nodule (ITN) is defined as a nodule not previously detected or suspected clinically but identified by an imaging study. This study aimed to determine the incidence of thyroid nodules incidentally detected in thoracic CTs for the suspicion of Covid-19 pneumonia.Materials and methods Adult patients who underwent thoracic CT in our hospital for Covid-19 management between March 2020 and September 2020 were retrospectively identified. Medical information registered in the hospital and national health system were reviewed. The prevalence of incidental thyroid nodules at CT, thyroid function test results of patients with incidental lesions, correlation of CT findings with ultrasonography (US) findings, and fine-needle aspiration biopsy (FNAB) results were evaluated.Results We determined 36.939 adult patients that had a CT scan. Among these, 624 had a previous history of thyroid operation, and 1201 had already been diagnosed with a thyroid pathology. The final analysis included 35.113 patients. There was information about the thyroid gland in CT reports of 3049 patients. The prevalence of ITN was 3.82% (1343/35113 patients), and thyroid heterogeneity was 1.11% (388/35113 patients). While it was explicitly stated that no pathology was found in the thyroid gland in 3.75% (1318/35113) of the patients, no information was given about the thyroid gland in 91.32% (32064/35113) of the patient. Thus, the number of patients informed about the thyroid was 3049 (8.68%), and the number of patients with thyroid pathology was 1731 (4.93%). It was observed that 308 of 1731 (17.80%) patients had follow-up thyroid US. An FNAB was indicated in 238 (87.50%) patients. Of the 238 patients with biopsy indication, only 115 (48.31%) underwent a thyroid FNAB. The cytological diagnosis was benign in 59 (51.30%), non-diagnostic in 30 (26.08%), atypia of uncertain significance in 22 (19.13%), suspected follicular neoplasia/follicular neoplasia in 4 (3.46%) patients. Thyroidectomy was performed in six more patients due to giant nodules, and the final diagnosis was benign in 2 and papillary thyroid cancer in 3 patients.Conclusion In conclusion, increased use of thoracic CT during Covid 19 pandemic probably caused increased detection of ITNs. In this large-scale study, the prevalence of thyroid nodules reported in thoracic CT was 3.82%, and thyroid cancer was detected in 1.30% of patients evaluated in the US. Therefore, Thoracic CT scans taken for different reasons might provide the opportunity for early diagnosis and treatment of thyroid cancers.
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