Could ischemia-modified albumin levels predict the severity of disease in SARS-CoV-2 infection?

INTRODUCTION

Ischemia-modified albumin (IMA) level increases in inflammatory conditions. We aimed to investigate the association between IMA levels and the severity of coronavirus disease 2019 (COVID-19) infection in adult patients.

METHODOLOGY

We grouped adult patients with COVID-19 infection: Group A - mild symptoms, but normal computed tomography (CT), Group B - mild/moderate illness, and Group C - severe or critical illness. We measured IMA levels at the time of diagnosis of COVID-19 infection.

RESULTS

Mean age of the total number of patients (n = 90) was 54.43 (± 8.11) year, and 46.7% (n = 42) were female. IMA levels were highest in Group C and lowest in A (p < 0.001). The most important factor predicting COVID-19 disease severity was IMA. Type 2 diabetes was more frequent in Group C (n = 31) than in Group B (n = 30) (p = 0.042). Asthma was less frequent, and coronary artery disease was more frequent in Group C than in Group A (n = 29) and B (p = 0.009). Duration of hospitalization was highest in Group C (p < 0.001).

CONCLUSIONS

We analyzed a sample of patients with COVID-19 infection and found that IMA predicted severe COVID-19 disease. Disease severity grouping was based on patients' clinical and radiological features. IMA level measured when SARS-CoV-2 infection is diagnosed may be a useful marker in predicting likely disease severity or intensive care need.

Role of serum cathelicidin in diagnosis of patient with prostatitis and prostate carcinoma

Background

This study investigated the diagnostic role of 75 levels measured in serum prostatitis and prostate carcinoma and in the differentiation of these two conditions.

Methods

The study was conducted with 75 patients histopathologically diagnosed with prostate carcinoma or prostatitis and followed up at the Departments of Urology and Medical Oncology and 21 healthy male subjects. Serum cathelicidin levels were investigated using the ELISA method. Statistical analyses were performed using the SPSS for Windows 22.0 package software. Compliance of the variables to normal distribution was examined using visual and analytic methods. In the Kolmogorov–Smirnov test, cases with a p value of greater than 0.05 were accepted as normal distribution.

Results

A total of 75 patients including 45 diagnosed with prostate carcinoma and 30 diagnosed with prostatitis, as well as 21 healthy control subjects were included in the study. Prostate-specific antigen (PSA) was detected as 23 (4–1200) ng/mL in the patients with prostate carcinoma and as 9.85 (3.9–405 ng/mL) in the patients with prostatitis. The cathelicidin levels were diagnostically significant when assessed by ROC analysis in the prostate cancer, prostatitis and control groups (p = 0.005). The cutoff values derived from the ROC curve analysis were 3.5151 ng/mL for distinguishing prostate cancer from prostatitis, 2.2620 ng/mL for prostate cancer versus control group and 1.2340 ng/mL for prostatitis versus control group.

Conclusions

In this study we showed that the serum cathelicidin levels were significantly higher in the patients diagnosed with prostate carcinoma. Measurement of serum cathelicidin levels could be used as a diagnostic marker in prostate carcinoma as well as facilitating differential diagnosis to strengthen the diagnostic suspicion before prostate biopsy and distinguish the diagnosis from prostatitis cases.

Does Obesity Have an Effect on the Outcomes of Unicondylar Knee Arthroplasty in Patients with Isolated Medial Gonarthrosis?

PURPOSE OF THE STUDY The aim of this study was to evaluate and compare the functional outcomes and complication rates of patients in the midterm follow-up period when patients applied with medial unicondylar knee arthroplasty (UKA) were grouped according to Body Mass Index (BMI) values MATERIAL AND METHODS The study included 125 patients applied with medial UKA between December 2013 and December 2017 because of isolated medial compartment gonarthrosis and completed at least 2 years of follow-up. The patients were separated into three groups: non-obese with a BMI < 30 kg/m2, obese with BMI of 30-39 kg/m2, and morbidly obese (BMI ≥ 40 kg/m2). The implants used in all surgeries were cemented fixed-bearing implants. All patients were evaluated preoperatively with bilateral orthoroentgenograms, and weight-bearing anteroposterior and flexed lateral knee X-rays. Postoperatively, bilateral orthoroentgenograms and weight-bearing anteroposterior and flexed lateral knee X-rays were taken. Pre- and post-operative clinical outcomes were evaluated using the Knee Society Score (KSS), functional Knee Society Score (fKSS) Oxford Knee Score (OKS) and Visual Analogue Scale (VAS). RESULTS The 125 study patients comprised 83 females and 42 males with a mean age of 54 years (range, 42-71 years). No significant difference was determined between the three groups in respect of age, gender and side distribution (p > 0.05). In all three groups, the fKSS, KSS, OKS and VAS values at the final follow-up examination were statistically significantly improved compared to the preoperative values. No periprosthetic infection was determined in any patient throughout the follow-up period. Revision surgery was applied for various reasons to 5 patients; 2 in the non-obese group, 2 in the obese group, and 1 in the morbidly obese group. DISCUSSION In the last 20 years, a general increase has been seen in the number of obese patients with knee osteoarthritis requiring surgery. The increase in obesity represents an important worldwide public health problem. CONCLUSIONS The results of this study suggest that obesity does not influence the middle term outcomes of UKA. The functional outcome scores after surgery and improvement in these scores were comparable to patients with normal BMI. Key words: medial gonarthrosis, obesity, unicondylar knee arthroplasty.

Role of native Thiol, total Thiol and dynamic Disulphide in diagnosis of patient with prostate cancer and prostatitis

BACKGROUND

Our study investigates whether Native Thiol, Total Thiol and disulphide levels measured in serum of patients with prostate cancer and prostatitis and of healthy subjects, have any role in differential diagnosis.

MATERIALS AND METHODS

Patients followed up for histopathologically verified diagnosis of prostate cancer and prostatitis in 2016-2017 at the Medicalpark Gaziantep Hospital Urology Clinic were included in the study. Native Thiol (NT), Total Thiol (TT), Dynamic Disulphide (DD) levels in serum were measured by a novel automated method.

RESULTS

NT, TT, DD, NT / TT ratios, DD / TT ratio and DD / NT ratio were measured as 118.4 ± 36.8μmoL / L, 150.3 ± 45.3μmoL / L, 15.9 ± 7μmoL / L, 78.8 ± 7μmoL / L, 10.5 ± 3.5μmoL / L, 13.8 ± 5.8μmoL / L respectively in patients with prostate cancer; as 116.4 ± 40.5μmoL / L, 147.5 ± 50.1μmoL / L, 15.5 ± 8.7μmoL / L, 79.7 ± 9μmoL / L, 10.1 ± 4.5μmoL / L, 13.5 ± 7.2μmoL / L in patients with prostatitis and as 144.1 ± 21.2μmoL / L, 191 ± 32.3μmoL / L, 23.4 ± 10.1μmoL / L, 76.1 ± 98.3μmoL / L, 11.9 ± 4.1μmoL / L, 16.4 ± 6.9μmoL / L in healthy subjects. Significant difference was detected between groups of NT, TT and DD levels (p = 0.008, p = 0.001, p = 0.002). No significant difference was detected in terms of the NT / TT, DD / TT and DD / NT rates (p = 0.222, p = 0.222, p = 0.222).

CONCLUSIONS

Serum NT, TT, DD levels in patients with prostatitis and prostate cancer were found significantly lower compared to the control group. This indicates that just as inflammation, prostate cancer also increases oxidative stress on tissues.

Association of high mobility group box 1 protein with coronary artery disease

BACKGROUND

Recently, the role of inflammation in coronary artery disease and the association of inflammatory biomarkers with adverse outcomes have been investigated in many studies. We investigated the relationship between high serum mobility group box 1 protein levels and established risk factors for coronary artery disease.

METHODS

Fifty-five patients who presented to our Cardiovascular Surgery Clinic and subsequently underwent coronary artery bypass surgery for coronary artery disease and 50 healthy subjects presenting to the cardiology outpatient clinic without any cardiovascular problem were included in the study. The mean age was 61.47 ± 9.38 years for patients and 58.20 ± 10.15 years for controls.

RESULTS

There was no statistically significant difference between groups with respect to age or sex. Family history of coronary artery disease, aspirin use, hypertension, and type 2 diabetes were significantly more prevalent in the patient group versus the control group. A significant difference was found between patients and healthy controls with respect to high mobility group box 1 protein levels ( p = 0.001).

CONCLUSIONS

Serum high mobility group box 1 protein was significantly increased in patients with coronary artery disease in comparison to healthy subjects. No associations were found between high mobility group box 1 protein level and certain risk factors for coronary artery disease.

Investigation of Surface Properties of Biodegradable Albumin Microspheres via Phagocytosis Phenomena

The phagocytosis of biodegradable albumin (Alb) microspheres by peripheral blood cells (neutrophils and monocytes) and mouse macrophage cells (peritoneal and lung macrophages) as a carrier matrix in drug targeting applications was investigated. Glutaraldehyde crosslinking was used to produce albumin microspheres with different sizes. Plain (nonmodified) microspheres with diameters of1, 2, and 4 mm were cultured with cells and their uptake was determined as 8, 5, and 1 particles/cell, respectively. Albumin microspheres (2 mm diameter) were also modified with various opsonization and passivation agents, such as fibronectin (Fn), amicasine, and poly(ethylene glycol) (PEG). Plain, Alb-PEG, Alb-Fn, and Alb-amicasine microspheres were phagocytized by monocytes and neutrophils and the number of particles taken up by each cell significantly increased for Alb-Fn microspheres with respect to the plain microspheres. No significant phagocytosis was observed for Alb-PEG microspheres. The number of particles taken up by each cell was less than the plain and amikacin modified albumin microspheres. Almost zero uptake was obtained for the phagocytosis of Alb-PEG microspheres with lung and peritoneal macrophages. For phagocytosis of plain and other modified particles by the macrophages, although the number of particles taken up by each cell increased with respect to those with neutrophils and monocytes, similar tendencies were also obtained.

[Comparison of two different antiseptics on contamination of epidural catheter tip]

OBJECTIVES

The aim of the present study was to compare preventive effects of 10% povidone-iodine, and combination of 2-propanol and benzalkonium chloride skin antiseptics on contamination of epidural catheter tip.

METHODS

Included were 160 patients aged 18-65 years with American Society of Anesthesiologists (ASA) physical status classifications of I-II. Patients were randomized. Povidone-iodine was administered to group P (n=80) prior to insertion of antibiotic prophylaxis catheter; 2-propanol and benzalkonium chloride was administered to group B. Swabs obtained before and after administration of antiseptics were sent for culture. Antiseptics were applied to skin prior to catheter removal, as well as 48 hours after insertion. In sterile conditions, 2-3 cm pieces of catheter tips were sent to laboratory. Preoperative and postoperative complete blood count, body temperature, and signs of postoperative localized skin infection were recorded.

RESULTS

Leukocyte, neutrophil, and lymphocyte counts were all within normal ranges in preoperative and postoperative. Swab cultures obtained following use of antiseptics were positive in 6 group P patients; coagulase-negative Staphylococcus was found in 5 patients, E. coli in 1, and were negative in group B. Difference between groups was statistically significant (p=0.013). Epidural catheter tip cultures were negative.

CONCLUSION

Combination of 2-propanol and benzalkonium chloride was determined to be more effective in reducing skin flora around epidural catheter insertion site.