HCV genotypes seem to be different between the normal population and IVDUs according to studies worldwide. Among IVDUs, we detected a dominance of genotype 3 and genotype 2, which is apparently different from the normal population. The reason for this difference can be simply explained by infection through shared needles. However, there may still be a different immunological response in IVDUs, the investigation of which may lead to further studies.
Length of hospital stay, hospital cost, and MR were higher in elderly with CAH. Female gender, hydrochlorothiazides, loop diuretics, and ≥2 comorbid diseases are the leading risk factors associated with CAH in elderly.
Introduction and aimSickle cell anemia (SCA) is the most common hemoglobinopathy worldwide, and cardiovascular diseases are the most common causes of death. In these patients, cardiac remodeling begins from childhood and leads to sickle cell cardiomyopathy in the following years. Concentric hypertrophy and eccentric hypertrophy are known to predict early cardiac events. This study aims to reveal the relationship between cardiac remodeling types and survival in patients with SCA and investigate the factors that may affect left ventricular mass.
Materials and methodsA total of 146 patients with SCA were included in the study, and the left ventricular mass index (LVMI) and relative wall thickness (RWT) of the patients were calculated according to echocardiographic measurements, and the patients were categorized into normal, concentric remodeling (CR), concentric hypertrophy (CH), and eccentric hypertrophy (EH) groups.
ResultsThe median age of the patients is 32 (18-72). In logistic regression analysis, hemoglobin S (HbS) and ferritin levels were independent predictors for LVMI (p = 0.01 and p < 0.001, respectively). It was observed that 56 (38.4%) of the patients had normal left ventricles, 24 (16.4%) had CR, 21 (14.4%) had CH, and 45 (30.8%) had EH. 31 (21.2%) of the patients died. When we look at the survival curves, there was a statistically significant difference between the four groups (log-rank p < 0.001). It was observed that patients with EH were the group with the lowest probability of survival.
ConclusionCardiac death is one of the most common causes of death in patients with SCA. Early detection of cardiac disorders and starting treatment may be important in reducing mortality in these patients.
Background: Non-functional pancreatic neuroendocrine tumors (NF-PNET) are rare tumors increasingly being diagnosed incidentally. Choice of treatment for small (2cm or less) NF-PNETs is difficult as their malignant potential is difficult to predict. This is reflected in the current recommendations-some favor surgery, while others suggest wait-and-see policy.[1e6] As these tumors are rare, previous clinical series are small. The aim of this study was to identify factors affecting prognosis after surgery for small NF-PNETs in a multicenter study. Methods: Patients were identified from the databases of 16 European centers and data was extracted retrospectively. Uni-and multivariate (Cox) analyses were used to identify risk factors for recurrence. Results: 210 patients (median age 60y) were included. Median tumor size was 15mm, 65% were asymptomatic, and 42% underwent parenchyma-sparing surgery. Severe mordibidity was noted in 14% and 1 patient died postoperatively. 10% had metastatic lymph nodes. 5-year disease-free survival was excellent, 93.5%. Tumor size, presence of bile or pancreatic duct dilation, and WHO grade 2-3 were identified as independent risk factors for recurrence. Tumors <11mm in size did not recur during follow-up. Parenchyma-sparing pancreatectomy carried highest risk for pancreatic fistula, but was also associated with favorable disease-free survival. Conclusion: Presence of bile or pancreatic duct dilation or WHO grade 2-3 advocate for surgical treatment of small (2cm or less) NF-PNETs.
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