Objectives Platelet-to-lymphocyte ratio is a novel biomarker, recently shown to be correlated with atherosclerotic inflammation. This study investigated the role of platelet-to-lymphocyte ratio in patients with carotid artery stenosis and stroke. Methods Patients, who underwent carotid angiography with Multiple Detector Computed Tomography Angiography at our hospital, were retrospectively screened. Patients enrolled were divided into three groups based on the platelet-to-lymphocyte ratio. Patients with a platelet-to-lymphocyte ratio value between 55.0 and 106.71 were assigned to Group I, patients with a platelet-to-lymphocyte ratio value between 106.79 and 160.61 were assigned to Group II and patients with a platelet-to-lymphocyte ratio value between 162.96 and 619.61 were assigned to Group III. The carotid arterial stenosis calculated was classified as per the criteria of North American Symptomatic Carotid Endarterectomy Trial. Results One hundred fifty patients were included in our trial (mean age 61.9 ± 13.1 with 104 males). The rate of carotid arterial stenosis was detected to be higher in patients with a high platelet-to-lymphocyte ratio value (p = 0.010). Additionally, the platelet-to-lymphocyte ratio was positively correlated with the carotid arterial stenosis percentage (r = 0.250, p = 0.002). In the multi-variate regression analysis, platelet-to-lymphocyte ratio was detected to be an independent variable with respect to stroke (odd's ratio = 1.012, confidence interval = 1.001-1.024, p = 0.031). Conclusions Increased platelet-to-lymphocyte ratio could be a simple and practical marker of the clinical course in patients with carotid arterial stenosis.
OBJECTIVE: The purpose of this study is to assess the efficiency of inferior petrosal sinus sampling (IPSS) in the diagnosis of adrenocorticotropic hormone-dependent Cushing’s disease and to compare it with magnetic resonance imaging (MRI). METHODS: The diagnostic efficiency of IPSS in the differentiation of pituitary Cushing’s disease from ectopic Cushing’s disease was retrospectively evaluated in 37 patients who had IPSS in our clinic. Six patients were excluded from the study due to missing data. Hypophysis MRI examinations of 31 patients before IPSS were also evaluated. The contributions of MRI and IPSS to the detection of pituitary adenoma and the determination of lateralization were researched. RESULTS: Bilateral IPSS was successfully performed in 30 patients of the 31 patients in the study group. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of IPSS in differentiating between central and ectopic Cushing’s syndrome before corticotrophin-releasing hormone (CRH) stimulation were 93.3%, 100%, 100%, 33.3%, and 93%, respectively, whereas after CRH stimulation were 100%, 100%, 100%, 100%, and 100%, respectively. The accuracy of both the rates was significantly higher compared with MRI. CONCLUSION: IPSS has the highest diagnostic efficiency in differentiating central Cushing’s disease from ectopic Cushing’s disease.
Background/aim: Coronary artery calcification (CAC) and aortic calcification (AC) are significant risk factors for coronary atherosclerosis. This study investigated how breast arterial calcification (BAC) detected from routine mammography correlates with coronary artery calcification and aortic calcification. Materials and methods: A total of 404 female patients above 40 years of age who, within a 6-month period, had undergone thoracic computed tomography and mammography for various reasons were screened retrospectively at our clinic. Mammographies were assessed for BAC and thoracic CT investigations were assessed for CAC and AC. Patients included in the study were scored as 0 (none), 1 (mild), 2 (moderate), or 3 (severe) depending on the number and shape of CAC, AC, and BAC lesions observed. Results: Four hundred and four females were enrolled in the study. While BAC was detected in 123 patients, no BAC was observed in the other 281 patients. In the BAC-positive patients, the rates of CAC (45.5% vs. 19.9%, P < 0.001) and AC (67.5% vs. 32.4%, P < 0.001) were notably higher than in the BAC-negative patients. In addition, multivariate regression analysis detected the presence of BAC as an independent variable for both CAC and AC. Conclusion: The presence of BAC appeared to be a significant risk factor for CAC and AC, and the BAC grade was considered an independent risk factor for CAC.
Background and Purpose The aim of this study was to investigate the relationship between arterial morphological parameters and the rupture risk of anterior communicating artery (AComA) aneurysms. Methods A hospital database was retrospectively reviewed to identify patients with AComA aneurysms. Morphologic parameters were evaluated on the 3‐dimensional computed tomography angiograms. The patients were divided into two groups as ruptured and unruptured. Patient age, sex, morphological parameters such as aneurysm height and weight, neck diameter, aspect ratio (AR), size ratio (SR), bifurcation angle, aneurysm shape, and diameters of the artery were statistically compared between two groups. Results Ninety‐five AComA aneurysms were analyzed in this study (60 ruptured and 35 unruptured). The aneurysm neck size (p = .005) and the diameter of the A1 segment of the ipsilateral anterior cerebral artery (i‐A1) were smaller in the ruptured group than in the unruptured group (p = .001), but AR (p = .001) was higher. The number of patients with irregular shape aneurysm were higher in the ruptured group (p = .006). There was no significant difference between the two groups in terms of age, sex, aneurysm height and weight, bifurcation angle, and SR. Univariate logistic regression analysis showed that i‐A1 segment diameter (odds ratio [OR]: –2.070, confidence interval [CI]: 0.030‐0.531, p = .005), aneurysm neck diameter (OR: –0.409, CI: 0.491‐0.899, p = .008), irregular shape (OR: 1.197, CI: 1.382‐7.929, p = .007), and AR (OR: 0.880, CI: 1.315‐4.417, p = .004) were significantly correlated with ruptured status. Multivariate regression analysis demonstrated that aneurysm neck diameter (OR: –0.457, CI: 0.410‐0.977, p = .039) was the only independent variable for rupture. Conclusion AComA aneurysm rupture is more likely to occur in aneurysms with smaller i‐A1 segment diameter, smaller aneurysm neck diameter, irregular aneurysm shape, and higher AR. Aneurysm neck diameter may be a more important determinant for rupture prediction.
IntroductionThanks to the advances in supportive neurocritical care and refinements either in surgical or endovascular treatment (EVT), the prognosis of patients with a ruptured cerebral aneurysm has remarkably improved over time [1][2][3][4]. To achieve a much better outcome, many studies have been performed to test the influence of various factors on the functional, as well as cognitive outcomes after aneurysm rupture, mainly regarding consequential disability [5][6][7]. However, no consensus has emerged among researchers over the validity of factors tested, perhaps because of the differences in research design, as well as the ethnicity of the study population. Besides, new variables have been added to the checklist in recent years, including novel inflammatory markers [8]. Given that the therapeutic goal should be the best outcome in patients with aneurysmal subarachnoid hemorrhage [9], in this study, we aimed to identify the predictors of full functional recovery in a contemporary series of endovascularly treated patients with a ruptured cerebral aneurysm. Materials and methods Study populationAfter approval of the local Ethical Committee, a retrospective chart review was conducted using the electronic medical record identifying adult patients who underwent an EVT for cerebral aneurysm, at our angiography unit during the period between January 2015 to May 2020. Among them, patients with an unruptured aneurysm, fusiform aneurysm or unsuccessful treatment were excluded from this study (Figure). Study protocolDemographic characteristics and previous medical history (i.e., history of hypertension, diabetes, coronary artery disease, and cerebrovascular disease) of the patients were identified. In addition, the location and size of the Background/aim: The knowledge of factors influencing functional outcomes after aneurysmal subarachnoid hemorrhage (ASH) has significantly increased in recent decades, still not enough. We aimed to identify the predictors of full functional recovery (FFR) in endovascularly treated patients with ASH. Materials and methods:A retrospective review was performed of adult patients who underwent endovascular treatment for ASH in a 5-year period. The association was evaluated of variables with FFR, defined as a modified Rankin Scale score of 0 or 1 at a 3-month follow-up.Results: This study included 204 patients with a percentage of FFR of 62.7%. On univariate analysis, the following variables were associated with FFR: younger age, male sex, no history of hypertension, posterior circulation aneurysm, better modified-Fisher grade (mFG), better Hunt-Hess grade, better Glasgow Coma score, lower platelet-to-lymphocyte ratio (PLR), lower neutrophil-to-lymphocyte ratio (NLR), and higher platelet-to-neutrophil ratio (PNR). On multivariate analysis, younger age (OR = 0.95, 95% Cl = 0.92-0.98, p = 0.003), better mFG (OR = 0.66, 95% Cl = 0.48-0.97, p = 0.03), lower PLR (OR = 0.993, 95% Cl = 0.990-0.997, p = 0.001), lower NLR (OR = 0.89, 95% Cl = 0.83-0.95, p = 0.01) and higher PNR (OR = 1.08, 95% Cl = ...
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