Purpose: We aimed to study the inflammatory parameters of complete blood count in breast cancer cases. Materials and Methods: This retrospective study covered 178 breast cancer patients and 107 age and body mass index matched healthy women. Complete blood count parameters, neutrophil/lymphocyte ratio (NLR), platelet/ lymphocyte ratio (PLR) and MPV/platelet were analyzed. Results: The leukocyte, neutrophil and neutrophil/ lymphocyte ratio were higher in the patient group (p values 0.001, 0.0001 and 0.0001, respectively) while haemoglobin and hematocrit were higher in the control group (p=0.0001 for both). Logistic regression analysis showed that elevated neutrophils and platelet distribution width (PDW) (OR: 0.627, 95%CI: 0.508-0.774, p=0.001 and OR: 1.191 95%CI: 1.057-1.342 p=0.003) were independent variables for predicting breast cancer. The cutoff value for the neutrophil/lymphocyte ratio was 2.56. Conclusions: According to our study results, neutrophil levels as part of complete blood count may be used as an independent predictor of breast cancer risk.

Our findings suggest that the combination of pentoxifylline with an angiotensin converting enzyme inhibitor in hypertensive type 2 diabetic patients with persistent microalbuminuria causes a significant reduction in urinary albumin excretion and this effect seems independent from blood pressure and glycemic control.

Contrast medium-induced acute kidney injury (CI-AKI) is associated with morbidity and mortality, but the long-term outcomes of patients who do not develop CI-AKI remain unknown. We assessed clinical end points during long-term follow-up in patients at high risk for nephropathy who did not develop CI-AKI. Patients (n = 135) with impaired renal function (estimated glomerular filtration rate: 30-60 mL/min/1.73 m(2)) were divided into 2 groups according to contrast media (CM) exposure. The primary end point of this study was a composite outcome measure of death or renal failure requiring dialysis. Multivariate analyses identified CM exposure to be independently associated with major adverse long-term outcomes (hazard ratio: 2.3; 95% confidence interval, 1.34-6.52; P = .018). Even when CM exposure does not cause CI-AKI in patients with impaired renal function, in the long term, primary end points occur more frequently in patients exposed to CM than in those with no CM exposure.

OBJECTIVE:In this study, we aimed to compare the cardiovascular risk factors that might be associated with inflammation, atherosclerosis and metabolic syndrome between hemodialysis and peritoneal dialysis patients.METHODS:Fifty hemodialysis and 50 peritoneal dialysis patients who had been receiving dialysis therapy for at least one year were included in the study. Venous blood samples were taken after 12 hours of fasting, and serum glucose, triglyceride, low-density lipoprotein (LDL)-cholesterol, high-density lipoprotein (HDL)-cholesterol, C-reactive protein, fibrinogen and homocysteine levels were measured. The presence of atherosclerotic plaques in the carotid artery was evaluated by carotid Doppler ultrasound. These data were analyzed by Student's t test, the chi-square test and the Mann-Whitney U test, as appropriate.RESULTS:No difference was found between the hemodialysis (n=50) and peritoneal dialysis (n=50) patient groups regarding mean age, gender distribution, body mass index or dialysis duration (p=0.269, 0.683, 0.426, and 0.052, respectively). LDL-cholesterol, fibrinogen and homocysteine levels were significantly higher in peritoneal dialysis patients (p=0.006, 0.001, and 0.002, respectively). In patients with diabetes mellitus (n=17) who were undergoing renal replacement therapy, LDL-cholesterol and fibrinogen levels were significantly higher than in patients without diabetes mellitus who were undergoing renal replacement therapy (p=0.001 and 0.004, respectively).CONCLUSION:In our study, cardiovascular risk factors (especially LDL-cholesterol) were more frequent in peritoneal dialysis patients than in hemodialysis patients.

Leptospirosis is an infectious disease caused by pathogenic leptospires and may vary in degree from an asymptomatic infection to severe and fatal illness. Sixteen patients (all males; aged 40+/-17 years) with leptospirosis were admitted to Sişli Etfal Training and Research Hospital between July 1998 and August 2003 and were retrospectively reviewed. Age, gender, occupation, clinical presentation, laboratory features, seasonal distribution of the disease, diagnostical approach, and prognostic factors were evaluated. Eleven patients were cured with no complication; four patients died of hepatic and/or renal failure. Eight patients presented with acute renal failure; seven of them needed dialytic support. One patient developed chronic renal failure and had to undergo regular hemodialysis. All deceased patients (aged 61+/-7 years) were anuric at admission and their serum bilirubin changed between 39-44 mg/dL (mean 41.3+/-2.2 mg/dL). Cured patients ranged in age from 14-62 years (34+/-14 years) and their serum bilirubin levels ranged from 9-35 mg/dL (23.1+/-11.4 mg/dL). Crystalline penicillin G 12 million U/day was administered to all patients. Six patients also received hepatic coma treatment. This study emphasizes that leptospirosis presenting with renal failure is a severe disease, and mortality is frequently related to delays in diagnosis due to lack of clinical understanding. The association of acute renal failure and jaundice should lead the clinician to suspect leptospirosis. We concluded that old age, oliguria/anuria, high serum bilirubin levels (>36 mg/dL), and high serum potassium levels might be risk factors that increase mortality in leptospirosis.

Hepatitis C virus (HCV) infection has recently become the major cause of chronic liver disease among patients on chronic hemodialysis. The use of erythropoietin for treatment of anemia has reduced the number of blood transfusions, but the frequency of HCV infection has not declined in hemodialysis units. The exact mode of transmission of HCV within dialysis units is as yet incompletely defined, but there is evidence to support nosocomial transmission by sharing dialysis machines in the hemodialysis unit. We performed a study to estimate the prevalence of HCV infection in our hemodialysis unit and to evaluate the effect of patient isolation and use of devoted dialysis machines for HCV-positive patients on the spread of HCV infection. A total of 168 patients on chronic hemodialysis (92 males and 76 females; mean age 54 +/- 12) were screened for HCV-antibodies (HCV-Ab) before their admission to the dialysis unit. Seropositive patients were isolated and confined to dedicated dialysis machines. Aminotransferases were measured monthly and HCV-Ab screening was performed second or third generation ELISA test every two months. Seropositive patients were tested by the PCR for the detection of HCV-RNA. Between March 1992 and August 2000, eight of 168 patients showed seroconversion. Seropositive patients were also found HCV-RNA positive. Four of these patients have become seropositive after they had undergone hemodialysis in other dialysis centers on holiday, two patients had received blood transfusions within the six months preceding seroconversion. The prevalence of HCV positivity in our hemodialysis unit is 4.7%. The low prevalence of HCV infection of our unit suggests that patient isolation and use of dedicated dialysis machines for seropositive patients decrease the transmission of HCV infection in hemodialysis units.

Objective: In this study, we compared predialysis and dialysis patients with the controls in terms of insulin resistance and evaluated the association with inflammation that is a risk factor for cardiovascular disease. Materials and methods: A total of 134 non-diabetic patients with controls (n ¼ 33), predialysis (n ¼ 29) and dialysis patient group (n ¼ 72) were included in the study. Fasting blood glucose, insulin, C-peptide, albumin, CRP (C-reactive protein) and homocysteine plasma levels were simultaneously analyzed in all the patients. HOMA-IR index was calculated to show existence of insulin resistance. Results: Mean insulin and HOMA-IR index values were found to be higher in the predialysis and dialysis patient groups than in the control group (p ¼ 0.019, p ¼ 0.014; respectively). When three groups were compared in terms of C-peptide levels; these values were found to be statistically significantly higher in the predialysis patients than in controls (p ¼ 0.017) and in the dialysis group than in the predialysis patients and controls (p ¼ 0.0001, p ¼ 0.0001; respectively). CRP and homocysteine levels were found to be statistically higher (p ¼ 0.0001, p ¼ 0.0001; respectively), while albumin levels were significantly lower (p ¼ 0.0001) in the dialysis patient group. Conclusion: In our study, we demonstrated that insulin resistance was higher in patients in the various stages of chronic kidney disease compared to healthy population. We found that insulin resistance, C-peptid and inflammation related cardiovascular risk factors increased.

Objective: It is known that depression is common in obese individuals. Besides the effects of obesity, pathogenic effects of increase in visceral and abdominal fat mass on depression are also being investigated. Our study aimed to show the relationship between visceral fat percentage detected with practical methods and the presence and severity of depression.Materials and Methods: Our study included 104 obese patients and 50 healthy controls. In all individuals, the severity of depression was assessed using the Beck Depression Inventory (BDI). Anthropometric measurements, visceral fat percentage, and body fat percentage were measured using the bioelectric impedance method.Results: The mean age was 51.5±12.3 years, and 65 participants (62.5%) were women. BDI scores were statistically higher in the obese group than in the control group (23.1±10.9 and 12.1±9.4, p<0.001). In the obese group, 63.5% of patients were depressed, and in the control group, this was 24%. Women were more depressed in the obese group, but there was no significant difference between men and women in the control group. Body fat percentage was the highest correlating parameter with depression severity. Positive correlation was found between depression severity and body mass index, waist circumference, hip circumference, and visceral fat percentage. In the logistic regression analysis, obesity was found as an independent risk factor for depression (OR: 4.84, 2.1-10.7, p<0.001).Conclusion: According to the results of our study, obesity is a significant and independent risk factor for depression. Obesity type and body composition are important factors that determine the severity of depression.Keywords: Obesity, depression, body composition, bioelectric impedance ÖZ Amaç: Depresyonun obezlerde sık görüldüğü bilinmektedir. Obezite varlığının yanında, viseral ve abdominal yağ kitlesindeki artışın depresyon üzerindeki etkileri de araştırılmaktadır. Biz de çalışmamızda pratik yöntem-lerle tespit edilen viseral yağ oranı ile depresyon varlığı ve şiddeti arasındaki ilişkiyi göstermeyi amaçladık.Gereç ve Yöntem: Çalışmamıza 104 obez hasta ve 54 sağlıklı kontrol alındı. Tüm bireylerde depresyon şiddeti Beck depresyon ölçeği ile değerlendirildi (BDI). Antropometrik ölçümler, viseral yağ oranı ve vücut yağ oranı biyoelektrik impedans yöntemi ile ölçüldü.Bulgular: Ortalama yaş 51,5±12,3 olarak bulundu ve vakaların 65 tanesi (62,5%) kadındı. BDI skorları obez grupta kontrol grubuna göre istatistiksel olarak anlamlı biçimde yüksekti (23,1±10,9 ve 12,1±9,4 p<0,001). Obez gruptaki hastaların % 63,5'i, kontrol grubundakilerin ise %24'ü depresifti. Obez gruptaki kadınlarda depresyon daha fazla idi, ancak kontrol grubunda kadınlar ve erkekler arasında anlamlı fark yoktu. Vücut yağ oranı, depresyon şiddeti ile en yüksek korelasyon gösteren parametreydi. Depresyon şiddeti ile vücut kitle indeksi, bel çevresi, kalça çevresi ve viseral yağ oranı arasında pozitif korelasyon vardı. Lojistik regresyon analizinde obezite, depresyon için bağımsız bir risk faktörü ola...