The role of inflammation in cases with gestational diabetes mellitus: Systemic immune inflammatory index according to trimesters

PROBLEM

This study aims to investigate the role of the systemic immune-inflammatory index (SII) in inflammation by analyzing SII values by trimester in gestational diabetes mellitus (GDM).

METHOD OF STUDY

Between May 2019 and June 2020, we retrospectively enrolled 467 pregnant women who were followed from the first trimester to delivery in our hospital. We evaluated the sociodemographic characteristics, laboratory test results, SII values, Apgar scores, and newborn birth weights of pregnant women diagnosed with GDM. We also compared the SII values of GDM for the 1st, 2nd, and 3rd trimesters with the control group.

RESULTS

When examining the SII values of the GDM group in these three trimesters, without including the control group, we found that the SII value of the GDM group in the 3rd trimester was significantly higher than in the 1st trimester, with a gradual increase with each trimester (p = .007). Additionally, the SII value was higher in the GDM group compared to the control group (p = .008). We conducted a Receiver Operating Characteristic (ROC) analysis of the SII value between the groups by trimester. The diagnostic significance of SII between the GDM and control groups was observed in the 3rd trimester, as the area under the curve (AUC) was close to 0.5 and not associated with a specific cutoff value. When examining the relationship between 3rd-trimester SII and study parameters, we found it had a positive and low correlation with the length of prepartum hospitalization, 50 g Oral Glucose Tolerance Test (OGTT), and maximal vertical pocket.

CONCLUSION

SII levels were significantly higher in third-trimester GDM patients; however, despite elevated levels of inflammation, fetuses did not experience harm.

Retrospective analysis of vitamin D status on ınflammatory markers and course of the disease in patients with COVID-19 infection

PURPOSE

The aim of the study was to investigate the association between serum 25-hydroxyvitamin D status within the last 6 months prior to COVID-19 infection and parameters of immune function and clinical outcomes.

METHODS

Fifty-six patients, who were admitted to the emergency clinic and diagnosed with COVID-19 infection, were included in the study. Data on clinical characteristics, inflammatory parameters and vitamin D status were recorded for each patient. All the participants had data on 25-hydroxyvitamin D status within the last 6 months prior to COVID-19 infection.

RESULTS

The patients were stratified as those with vitamin D status less than 20 ng/mL and higher than 20 ng/mL. A group with vitamin D status less than 20 ng/mL had lower lymphocyte counts and lower haemoglobin levels that was statistically significant (respectively; p = 0.021, p = 0.035). Higher C-reactive protein (CRP) levels were seen in the vitamin D-deficient group (p = 0.013). It was observed that vitamin D status of the patients who required oxygen therapy were lower than those who did not require oxygen therapy, not statistically significant (p = 0.05). Patients who did not use vitamin D supplementation within 6 months prior to COVID-19 infection had more likely to be diagnosed with pneumonia (p = 0.004).

CONCLUSION

Cases with lower vitamin D status had increased inflammatory markers and worse clinical outcomes than patients with higher vitamin D status. This study suggests that vitamin D status can be used as a prognostic factor in COVID-19 patients, and vitamin D supplementation can be recommended to improve the clinical outcomes in COVID-19 infection.

The Role of Electrocardiography in Follow up of Pulmonary Thromboembolism

Objective

Electrocardiography (ECG) is a simple, valuable and easily applicable test that can be used in supporting the diagnosis and assessing the severity of pulmonary thromboembolism (PTE). In this study, it was aimed to identify the role of ECG scoring in diagnosis and follow up of PTE in comparison with community acquired pneumonia (CAP).

Methods

Patients with the diagnosis of PTE and CAP were included in the study prospectively between January 2007 and January 2009. ECG scorings were evaluated by two different cardiologists by the method described by Daniel et al at admission (day 0) and day 3, 10 and one month of treatment. Median values of ECG scorings were compared between days and between groups.

Results

Forty-five patients with PTE, 35 patients with CAP were included in the study. Although no statistically significant difference was identified between the ECG scorings of the two groups in each measurement point, ECG scores decreased more rapidly in PTE group within days. Within the PTE group, day 0 ECG score was identified higher in submassive patients than nonmassive ones (p=0.001).

Conclusions

Although ECG score did not differentiate PTE from CAP, depending on its rapid decrease in PTE, it can be used in the follow up. For submassive PTE patients that must be diagnosed and treated immediately, ECG scorings can be used to support the diagnosis and to assess the clinical severity.

CYP2C19 Polymorphisms in Patients with Gastric and Colorectal Carcinoma

BACKGROUND

It has been reported that up to 80% of human cancers arise as a consequence of environmental exposure and host susceptibility factors. Environmental carcinogens are predominantly metabolized by the cytochrome P450 (CYP) superfamily of drug- or xenobiotic-metabolizing enzymes. Genetic variations in these enzymes affect individuals' susceptibility to carcinogens.

AIM OF THE STUDY

The aim of this study was to evaluate the relationship between CYP2C19 polymorphism and susceptibility to these cancers by means of CYP2C19 genotyping among Turkish subjects.

METHODS

DNAof subjects were isolated from leukocytes by high pure template preparation kit (Roche Diagnostics, GmbH, Mannheim, Germany) and genotypes were detected by LightCycler CYP2C19 Mutation Detection Kit by real-time PCR with LightCycler instrument (Roche Diagnostics, cat. no. 3113914).

RESULTS

Being male was associated with a 3.5-fold (OR: 4.27, CI: 2.27-8.05) and 4.27-fold (OR: 3.50, CI: 1.948-6.301) risk for colorectal and gastric carcinoma, respectively. The CYP2C19*3 heterozygote genotype was not found in either gastric or colorectal carcinoma patients. Although the frequency of CYP2C19*2 heterozygote genotype is high in patients with gastric and colorectal carcinoma, it is not significantly associated with cancer (OR: 1.79, CI: 0.829-3.865 and OR: 1.998, CI: 0.961-4.154, respectively).

CONCLUSION

Although the frequency of CYP2C19*2 heterozygote genotype is high in our patients with gastric and colorectal carcinoma, there is no the relationship between CYP2C19 polymorphism and susceptibility to these cancer.