We aimed to examine independent predictive factors for the severity and survival of COVID‐19 disease, from routine blood parameters, especially the blood urea nitrogen (BUN)/creatinine (Cr) ratio. A total of 139 patients with COVID‐19 were investigated at Siirt State Hospital. According to the disease severity, the patients were categorized as three groups (moderate: 85, severe: 54, and critical: 20). Then, patients were divided into two groups: nonsevere (moderate) and severe (severe and critical). Demographic, clinical data, and routine blood parameters were analyzed. In multivariate model adjusted for potential confounders BUN/Cr ratio (odds ratio [OR] = 1.70; 95% confidence interval [CI]: 1.20‐2.40; P = .002) and neutrophil to lymphocyte ratio (NLR) (OR = 2.21; 95% CI: 1.20‐4.30; P < .001) were independent predictive factors for disease severity. In multivariate Cox proportional hazard model BUN/Cr ratio (hazard ratio [HR] = 1.02; 95% CI: 1.01‐1.05; P = .030), and NLR (HR = 1.17; 95% CI: 1.06‐1.30; P = .020) were independent predictors for survival of COVID‐19 disease. The optimal thresholds of the BUN/Cr ratio at 33.5 and 51.7 had the superior possibility for severe disease and mortality, area under the curve (AUC) were 0.98 and 0.95, respectively. The optimal thresholds of NLR at 3.27 and 5.72 had a superior possibility for severe disease and mortality, AUC were 0.87 and 0.85, respectively. BUN/Cr and NLR are independent predictors for COVID‐19 patient severity and survival. Routine evaluation of BUN/Cr and NLR can help identify high‐risk cases with COVID‐19.
Background The management of adrenal incidentaloma is still a challenge with respect to determining its functionality (hormone secretion) and malignancy. In this light, we performed 18F-FDG PET/CT scan to assess the SUVmax values in different adrenal masses including Cushing syndrome, pheochromocytoma, primary hyperaldosteronism and non-functional adrenal adenomas. Methods Total 109 (73 F, 36 M) patients with adrenal mass (incidentaloma), mean age of 53.3 ± 10.2 years (range, 24–70) were screened by 18F-FDG PET/CT. Data of 18F-FDG PET/CT imaging of the patients were assessed by the same specialist. Adrenal masses were identified according to the calculated standardized uptake values (SUVs). Clinical examination, 24-h urine cortisol, catecholamine metabolites, 1-mg dexamethasone suppression test, aldosterone/renin ratio and serum electrolytes were analyzed. Results Based on the clinical and hormonal evaluations, there were 100 patients with non-functional adrenal mass, four with cortisol-secreting, four with pheochromocytomas and one with aldosterone-secreting adenoma. Mean adrenal mass diameter of 109 patients was 2.1 ± 4.3 (range, 1–6.5 cm). The 18F-FDG PET/CT imaging of the patients revealed that lower SUVmax values were found in non-functional adrenal masses (SUVmax 3.2) when compared to the functional adrenal masses including four with cortisol-secreting adenoma (SUVmax 10.1); four with pheochromcytoma (SUVmax 8.7) and one with aldosterone-secreting adenomas (SUVmax 3.30). Cortisol-secreting (Cushing syndrome) adrenal masses showed the highest SUVmax value (10.1), and a cut-off SUVmax of 4.135 was found with an 84.6% sensitivity and 75.6% specificity cortisol-secreting adrenal adenoma. Conclusions Consistent with the similar studies, non-functional adrenal adenomas typically do not show increased FDG uptake and a certain form of functional adenoma could present various FDG uptake in FDG PET/CT. Especially functional adrenal adenomas (cortisol secreting was the highest) showed increased FDG uptake in comparison to the non-functional adrenal masses. Therefore, setting a specific SUVmax value in the differentiation of malignant adrenal lesion from the benign one is risky and further studies, including a high number of functional adrenal mass are needed.
Polyunsaturated fatty acids (PUFAs) consist of alpha-linolenic acid (ALA) (18:3, n-3) and linoleic acid (LA) (18:2, n-6) (Erdinest, Shmueli, Grossman, Ovadia, & Solomon, 2012). PUFAs are essential forms of fatty acids; thus, they cannot be produced by the human body and must be obtained as nutrients in the diet (Besler, 2006). ALA is a key molecule required for synthesis of arachidonic acid; it also serves as a precursor molecule for the formation of eiocosapentanoic acid (EPA) and docosahexaenoic acid (DHA) that have essential
In late 2019, a pneumonia epidemic began in Wuhan, China's Hubei Province, with a primarily unknown cause, which is now known to have spread significantly worldwide. 1 The virus that caused the disease was initially named the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and later the World Health Organization described this disease as coronavirus disease-2019 This disease usually affects individuals between the ages of 30 and 79 years. About half of those with COVID-19 have mild or indeterminate symptoms. Significant symptoms in symptomatic patients include fatigue, fever, cough, muscle pain and shortness of breath. 2,3 Sometimes, more critical conditions, such as acute respiratory distress syndrome (ARDS) and multi-organ failure can be observed.Patients with these severe conditions often have comorbid diseases, especially hypertension (HT), diabetes mellitus (DM) and heart diseases. 3 Neutrophilia and lymphopenia are the most common laboratory parameters. Abnormal liver function test findings at different rates have also been reported. Serum procalcitonin levels are generally at normal levels, while mild increases in C-reactive protein levels can be seen. Moreover, D-dimer levels are high in 30% of patients. 4,5 Coronaviruses are enveloped RNA viruses that consist of a single chain and have a positive polarity. Therefore, they do not have RNA-dependent RNA polymerase enzymes, but this enzyme code
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