Background: Social media has created a revolution in health services. Information available on the Internet and via social media is now being used as reference guides for sensitive health issues by nonprofessionals, physicians, and medical students. When used by physicians and medical students, social media has the potential to raise issues such as the blurring of the line between professional and private lives, patient relations, and medical ethics. The aim of this cross-sectional study was to evaluate the use of social media and attitudes toward its use in medicine among medical students. Methods: Medical students from Afyon Kocatepe University, Faculty of Medicine (Afyonkarahisar, Turkey) were asked to participate in a survey consisting of two sections, the first containing questions assessing the frequency of social media use and the second regarding attitudes toward the use of social media in medicine.

Aquaporin 0 (AQP0) performs dual functions in the lens fiber cells, as a water pore and as a cell-to-cell adhesion molecule. Mutations in AQP0 cause severe lens cataract in both humans and mice. An arginine to cysteine missense mutation at amino acid 33 (R33C) produced congenital autosomal dominant cataract in a Chinese family for five generations. We re-created this mutation in wild type (WT-AQP0) human AQP0 cDNA by site-directed mutagenesis, and cloned and expressed the mutant AQP0 (AQP0-R33C) in heterologous expression systems. Mutant AQP0-R33C showed proper trafficking and membrane localization like WT-AQP0. Functional studies conducted in Xenopus oocytes showed no significant difference (P>0.05) in water permeability between AQP0-R33C and WT-AQP0. However, the cell-to-cell adhesion property of AQP0-R33C was significantly reduced (P< 0.001) compared to that of WT-AQP0, indicated by cell aggregation and cell-to-cell adhesion assays. Scrape-loading assay using Lucifer Yellow dye showed reduction in cell-to-cell adhesion affecting gap junction coupling (P< 0.001). The data provided suggest that this mutation might not have caused significant alterations in protein folding since there was no obstruction in protein trafficking or water permeation. Reduction in cell-to-cell adhesion and development of cataract suggest that the conserved positive charge of Extracellular Loop A may play an important role in bringing fiber cells closer. The proposed schematic models illustrate that cell-to-cell adhesion elicited by AQP0 is vital for lens transparency and homeostasis.

Background Pro‐inflammatory pathways play an important role in the follow‐ups of patients with intracardiac defibrillators (ICDs) for heart failure (HF) reduced with ejection fraction (HFrEF). A newly defined index ‐ the systemic immune‐inflammation index (SII)—has recently been reported to have prognostic value in patients with cardiovascular disease. This study's aim is to evaluate the SII value regarding its association with long‐term mortality and appropriate ICD therapy during a 10‐year follow‐up. Methods This retrospective study included 1011 patients with ICD for HFrEF. The SII was calculated as the neutrophil—to—lymphocyte ratio × total platelet count in the peripheral blood. The study population was divided into two groups according to the SII's optimal cut‐off value to predict long‐term mortality. The long‐term prognostic impact of SII on these patients was evaluated regarding mortality and appropriate ICD therapy. Results The patients with a higher SII (≥1119) had significantly higher long‐term mortality and appropriate ICD therapy rates. After adjustment for all confounding factors, the long‐term mortality rate was 5.1 for a higher SII. (95% CI: 2.9–8.1). The long‐term appropriate ICD therapy rate was 2.0 for a higher SII (95% CI: 1.4–3.0). Conclusion SII may be an independent predictive marker for both long‐term mortality and appropriate ICD therapy in patients with HFrEF.

Background: Patients with heart failure with reduced ejection fraction (HFrEF) who received implantable cardiac defibrillator (ICD) still remain at high risk due to pump failure and prevalent comorbid conditions. The primary aim of this research was to evaluate the predictive value of C-reactive protein-to-albumin ratio (CAR) for allcause mortality among patients with HFrEF despite ICD implantation. Materials and methods: Those who were implanted ICD for HFrEF in our institution between 2009 and 2019 were included. Data were extracted from hospital's database. CAR was calculated as ratio of C-reactive protein (CRP) to serum albumin concentration. Patients were grouped into tertiles in accordance with CAR at the time of the implantation. During follow-up duration of 38 [17-77] months, survival times of tertiles were compared by using Kaplan-Meier survival method. Forward Cox proportional regression model was used for multivariable analysis. Results: Thousand and eleven patients constituted the study population. Ischaemic cardiomyopathy was the primary diagnosis in 92.3%, and ICD was implanted for the primary prevention among 33.9% of patients. Of those, 14.5% died after the discharge. Patients in tertile 3 (T3) had higher risk of mortality (4.2% vs 11.0% vs 28.5%) compared with those in other tertiles. Multivariable analysis revealed that when patients in T1 were considered as the reference, both those in T2 and those in T3 had independently higher risk of all-cause mortality. This finding was consistent in the unadjusted and adjusted multivariable models. Conclusion: Among patients with HFrEF and ICD, elevated CAR increased the risk of all-cause mortality at long term. K E Y W O R D SC-reactive protein-to-albumin ratio, heart failure with reduced ejection fraction, implantable cardiac defibrillator, mortality 2 of 7 | ÇINIER Et al. How to cite this article: Çinier G, Hayıroğlu Mİ, Kolak Z, et al. The value of C-reactive protein-to-albumin ratio in predicting long-term mortality among HFrEF patients with implantable cardiac defibrillators.

Background The benefit of implantable cardiac defibrillator (ICD) in patients with heart failure and reduced ejection fraction (HFrEF) could be limited in a particular group of patients. Low prognostic nutritional index (PNI) indicates malnutrition and proinflammatory condition. We sought to investigate the value of PNI in predicting long‐term mortality among HFrEF patients with ICD. Methods Electronic database was searched for identifying patients with HFrEF who were implanted ICD in our institution between 2009 and 2019. Demographic and clinical characteristics of included patients were recorded. PNI was calculated according to the formula: 10 × serum albumin (g/dL) + 0.005 × total lymphocyte count (per mm3). Patients were divided into the quartiles according to PNI values. Differences between the groups were analyzed by the log‐rank test. A forward Cox proportional regression model was used for multivariable analysis. Results One thousand and hundred patients were included to the study. The underlying heart failure etiology was ischemic and nonischemic in 77.3% and 22.7% of patients, respectively. Mortality rate in Q1 (5.1%) was considered as the reference. In the unadjusted model the mortality rate was 9.5% (hazard ratio [HR] 1.76, 95% confidence interval [95% CI] [0.92‐3.38]) in Q2, 10.2% (HR 1.88, 95% CI 0.99‐3.58) in Q3, and 39.6% (HR 8.12, 95% CI 4.65‐14.17) in Q4. The same trend was consistent in the age‐ and sex‐adjusted, comorbidities‐adjusted, and covariates‐adjusted models. Conclusion Among patients who were implanted with ICD secondary to HFrEF, lower PNI value predicted all‐cause mortality during long‐term follow‐up. This is the first study demonstrating the value of PNI in this population.