Mercerpierce0388
To compare the finger-stick β-hydroxybutyrate (β-OHB) method accuracy with dipstick urine test for the detection of ketone bodies to diagnose diabetic ketoacidosis in children.
Cross-sectional study.
Department of Pediatrics, National Institute of Child Health, Karachi, from March to August 2021.
Ninety-six known or newly diagnosed diabetic patients aged 2-15 years with suboptimal glycemic control and diabetic ketoacidosis were included in the study. A urine dipstick test was utilised to evaluate the absence or presence of ketones in the urine. In point-of-care, blood β-OHB levels were recorded.
Among 96 children, with median age of 10 years (IQR=6-11), 11 (11.5%) children had traces of urine ketones, 7 (7.3%) had + urine ketones, 19 (19.8%) had ++ urine ketones, 26 (27.1%) had +++ ketones and 19 (19.8%) had ++++ ketones. In 66 patients (68.75%), capillary blood ketone was observed to be positive by a finger-stick β-OHB method. The finger-stick β-OHB method had a higher sensitivity (90.4% vs. 84.9%), specificity (100% vs. 91.3%), and accuracy (92.7% vs. 86.5%) than the dipstick urine test.
Finger-stick β-OHB method can serve as a more accurate alternative to the urinary dipstick method for the measurement of ketones and to exclude ketosis and diagnosis of diabetic ketoacidosis (DKA) in hyperglycemic children.
Diabetes mellitus, Hyperglycemia, Diabetic ketoacidosis, Point-of-care testing, Ketosis, Urine ketones, Acetoacetates.
Diabetes mellitus, Hyperglycemia, Diabetic ketoacidosis, Point-of-care testing, Ketosis, Urine ketones, Acetoacetates.
To find out the clinical presentation, utility of ultrasound for diagnosis, laparoscopic findings and treatment for clinically impalpable testis.
Cross-sectional study.
Department of Paediatric Surgery, National Institute of Child Health, Jinnah Sindh Medical University Karachi, from September 2019 to April 2020.
Patients with clinically impalpable testis were included. Ultrasound of inguinal region was done to locate testis. Presence of testis and its position was confirmed at laparoscopy and surgical procedure done according to the findings. Data was stratified according to the age and Chi-square test and Student t-test were applied to find out statistical significance among different variables in children below and above five years of age. A p <0.05 was taken as significant.
Ninety-one patients with 113 testes were included. The median age of the children was 48 months. BLU-945 Sixty-nine (75.8%) patients had unilateral undescended testis and 22 (24.2%) bilateral undescended testes. Fifty-three (58.2%) patients were less than five years of age. On ultrasound, testis was found near deep ring in 23 (25.3%) patients. At laparoscopy, 74 (81.3%) testes were found within the abdominal cavity. In 7 (7.7%) patients, only nubbin of tissue was identified and removed. The first stage of Fowler Stephen procedure was done in the majority of the patients. There was statistically no significant difference following stratification in relation to laterality and position of undescended testis (p = 0.556 and p = 0.846, respectively). However, mean size of the testis was found statistically significant (p = 0.032).
Most of the patients were above five years of age. Ultrasound helped in identifying low-lying intra-abdominal testis in more than 80% of patients. Laparoscopy was helpful in further defining the position of the testis and selection of surgical procedure.
Undescended testis, Cryptorchidism, Laparoscopy, Orchiopexy.
Undescended testis, Cryptorchidism, Laparoscopy, Orchiopexy.
To investigate the frequency of sleep-related breathing disorder and the relationship between asthma control and sleep-related breathing disorder in children with persistent asthma.
Comparative cross-sectional study.
University of Health Sciences, Hamidiye Etfal Training and Research Hospital, Istanbul/Turkey, from January 2019 to June 2019.
Children aged 4-11 years with persistent asthma were included. At enrollment, socio-demographic and asthmatic characteristics were investigated, and pediatric sleep questionnaire and childhood asthma control tests were administered.
Out of 120 patients, 75 (62.5%) were males and 45 (37%) females. According to GINA guidelines, asthma was well controlled in 23.3% children, partially controlled in 50.8% children and uncontrolled in 25.8% children. The frequency of habitual snoring was reported as 20.8% and the frequency of sleep-related breathing disorder was 29.2%. The prevalence of sleep-related breathing disorders was significantly higher in the uncontrolled asthma group (p <0.001). Significant-independent efficacy of physician-diagnosed allergic rhinitis, habitual snoring, and low asthma control test scores was observed in predicting sleep-related breathing disorders in multivariate logistic regression model (p <0.001).
Uncontrolled asthma is associated with sleep-related disordered breathing. The authors suggest that allergic rhinitis, habitual snoring, and low asthma control test scores are important risk factors for sleep-related breathing disorders in children with persistent asthma.
Asthma, Asthma control test, Allergic rhinitis, Habitual snoring, Pediatric sleep questionnaire, Sleep-related breathing disorder.
Asthma, Asthma control test, Allergic rhinitis, Habitual snoring, Pediatric sleep questionnaire, Sleep-related breathing disorder.
To test the efficacy of including albumin in the Memorial Sloan Kettering Cancer Center (MKSCC) nomogram (MSKCC+A) on predicting the overall survival.
Descriptive study.
Ankara Training and Research Hospital & Ataturk Training and Research Hospital, Turkey, in 2020, on patients who were operated between 2009 and 2014 to confirm the 5-year survival results.
Patients who underwent R0 resection for colon cancer were evaluated. For each patient in the cohort, the 5-year probability of survival was calculated and compared with actual, using the AJCC (American Joint Committee on Cancer), MSKCC and MSKCC+A estimation systems obtained using logistic regression. The performance of the estimation methods was evaluated by the ROC analysis.
Two hundred and thirty-nine patients were studied. When the patients with more than 5-year overall survival were compared, the AJCC, MSKCC, and enhanced MSKCC survival scores were significantly higher. AUC = 0.699 for the AJCC staging system, AUC = 0.702 for the MKSCC nomogram, and AUC = 0.777 when the albumin level was added to the MKSCC system.
The use of the MSKCC overall survival nomogram in patients with colon cancer appears useful for both clinicians and patients. The prognostic power of this calculator was found to be further enhanced by including the preoperative serum albumin level as an extra variable in the nomogram.
Nomograms, Neoplasm grading, Survival, Colon cancer, Serum albumin.
Nomograms, Neoplasm grading, Survival, Colon cancer, Serum albumin.
To investigate the role of cost-effective and widely used hemogram parameters in predicting stage and histological grade.
An analytical study.
Konya Research and Training Hospital, Turkey from January to June 2020.
Pre-nephrectomy hemogram parameters and post-nephrectomy pathology reports of 180 renal cell carcinoma patients, among 553 patients, who had undergone nephrectomy between 2009-2019 were evaluated. The patients were grouped as low risk and high risk in terms of TNM stage and Fuhrman grade; and clinicopathological variables were compared between the groups. Multivariate logistic regression analysis was used to determine the parameters predicting independently the high T stage (T3-T4) and the high Fuhrman grade (G3-G4).
While 31 (17.2%) of 180 patients were in the high T stage; 69 (38.3%) were in the high Fuhrman grade. In the logistic regression analysis, NLR, LMR, and hematocrit predicted independently high T stage, while hematocrit and LMR predicted independently the high Fuhrman grade.
LMR, NLR, and hematocrit were found to be more significant than other parameters, which are among the hemogram parameters that can guide clinicians during staging, which is important for prognosis and treatment decisions.
Renal cell carcinoma, Tumor staging, Tumor grading.
Renal cell carcinoma, Tumor staging, Tumor grading.
To compare patients with COVID-19 in intensive care units (ICUs) to healthy controls using nailfold videocapillaroscopy (NVC), offering standardised findings about micro-circulation.
A descriptive, cross-sectional study.
Medical Intensive Care Unit, Kayseri City Education and Research Hospital, Kayseri, Turkey between January and May 2021.
The NVC parameters-capillary morphology, loop diameter, capillary density, dilated capillaries, giant capillaries, avascular areas, microaneurysms, and micro-hemorrhages of 32 patients with COVID-19 and 29 controls were recorded.
The most common capillary morphology in the COVID-19 group (18/32, 56.2%) was serpentine, which also characterised some (6/29, 20.7%) patients in the non-COVID-19 group (p <0.001). The median capillary loop diameter was 77.78 ± 3.63 µm in the COVID-19 group and 71.67 ± 2.19 µm in the non-COVID-19 group (p=0.030). Mean capillary density was 6.41 ± 1.21/1 mm in the COVID-19 group and 8.55 ± 1.12/1 mm in the non-COVID-19 group (p <0.001). The COVID-19 group had significantly more enlarged capillaries (p = 0.001), giant capillaries (p = 0.025), avascular areas (p = 0.028), micro-aneurysms (p <0.001), and micro-hemorrhages (p = 0.011). Mean capillary density was 5.50 ± 0.19/1 mm among deceased patients with COVID-19, but 6.71 ± 0.25/1 mm among survivors (p = 0.011).
NVC findings differed between patients with COVID-19 and controls, and capillary density was less among deceased patients with COVID-19 than survivors.
Capillaries, COVID-19, İntensive care unit, Micro-circulation, Nailfold videocapillaroscopy.
Capillaries, COVID-19, İntensive care unit, Micro-circulation, Nailfold videocapillaroscopy.
To compare the effects of cytokine absorption therapy with a resin-based cytokine absorption cartridge to tocilizumab treatment in critically ill COVID-19 patients diagnosed with cytokine release syndrome (CRS).
A descriptive study.
University of Health Sciences, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey from April 2020 to April 2021.
Twenty-four intensive care unit (ICU) patients were included in the study. Inclusion criteria were diagnosis of severe COVID-19, diagnosis of CRS and age of older than 18 years. Exclusion criteria were pregnancy, malignancy, prior COVID-19 vaccination, procalcitonin levels higher than 2 ng/ml and life-threatening comorbidities before ICU admission. Twelve patients received tocilizumab and the other 12 patients received cytokine absorption therapy. The groups were compared for clinical outcomes and inflammatory markers (CRP, fibrinogen, ferritin, D-dimer).
Inflammatory markers showed smilar changes with both treatments, mostly toward improvement, on the same post-treatment days. The mortality rate was 58% (seven patients) in the cytokine absorption group and 50% (six patients) in the tocilizumab group (p = 0.682).
It was found that the cytokine absorption therapy reduces inflammatory mediators in intubated and critically ill Covid-19 patients similar to tocilizumab treatment, and both treatments have comparable clinical outcomes.
SARS-CoV-2, Cytokine release syndrome, Chemokines, Absorption, Tocilizumab.
SARS-CoV-2, Cytokine release syndrome, Chemokines, Absorption, Tocilizumab.
