ABSTRACT
Objective: Idiopathic granulomatous mastitis (IGM) is a rare, relapsing, benign inflammatory breast disease. Due to the conflicting etiology and differential diagnosis, the effect of varied treatment regimens on high recurrence is controversial. Therefore, we aimed to report our clinical experience in determining risk factors for recurrence after patient-tailored treatment. Methods: This study evaluated 122 patients diagnosed with IGM according to sociodemographic characteristics, reproductive history, clinical presentation, time of diagnosis and radiological examinations, treatment management, and outcomes. The patients were classified into three groups based on curative treatment settings: medical therapy alone, surgery alone, and combined therapy. Results: The rates of patients receiving medical therapy alone, surgical therapy alone, and combined therapy were 23, 15.6, and 62.4%, respectively. Low vitamin B12 levels, accompanying rheumatological disease, complaints-fistulae, number of complaints ≥3, presence of erythema nodosum, multicentricity, and treatment modality had a significant effect on disease recurrence (p < 0.05). The effect on IGM recurrence was 2.8 times greater for the patients with lower vitamin B12 levels, 4.5 times greater for those with rheumatological disease, 3.3 times greater for those with fistulae, 2.4 times greater for those presenting with ≥3 complaints, 2 times greater for the presence of multicentricity, 2.3 times greater for the presence of erythema nodosum, and 4.5 times greater for the patients receiving medical therapy alone. Conclusion: Describing a low-risk patient profile can be an alternative while choosing monotherapy methods. For IGM patients at high risk of recurrence, an escalating treatment system may be effective in preventing relapses.
ABSTRACT
BACKGROUND: COVID-19 has become a pandemic and threatened human public health across the world. Determining effective predictive biomarkers that can classify patients according to risk levels is critical to identify cases that can potentially progress to severe complications and death with the rapid progression of the disease. Therefore, we aimed to investigate the utility of the monocyte-to-high-density lipoprotein cholesterol ratio (MHR), a recently emerging inflammatory marker, as a clinically useful inflammation-based marker in determining patients at higher risk of decreased overall survival in patients with COVID-19. METHODS: The demographics, laboratory data, and MHR of 127 patients with laboratory confirmed COVID-19 were evaluated in terms of clinical outcomes. The patients discharged from the hospital constituted the survivor group, while those that died were evaluated as the non-survivor group. RESULTS: The MHR values were found to be significantly higher in the non-survivor group compared to the survivors (p < 0.05). The high-density lipoprotein cholesterol (HDL-C) values were significantly lower in the non-survivor group (p < 0.05), while there was no statistically significant difference in the monocyte values (p > 0.05). Spearman's analyses revealed no correlation between the MHR values and white blood cell, neutrophil, ferritin, D-dimer, and C-reactive protein (CRP) in the non-survivor group (p > 0.05). According to the binary logistic regression analysis model, the neutrophil, ferritin, D-dimer, CRP, and MHR values the most significant factors in predicting survival (p = 0.021, p = 0.004, p = 0.000, p = 0.001, and p = 0.016, respectively), and an increase in the neutrophil, ferritin, D-dimer, CRP and MHR values decreased the survival rate by 1.1, 1.5, 1.8, 1.6, and 1.7 times, respectively. CONCLUSIONS: MHR can help predict the severity of the COVID-19 disease and patient outcomes. Therefore, this parameter can serve as a clinically useful and potentially predictive inflammation-based marker for identifying patients with COVID-19 who are at higher risk of decreased overall survival. Considering the serious consequences of the current and possible future pandemics, the establishment of a risk assessment model, including MHR in COVID-19 and similar infections is of vital importance in reducing morbidity and mortality by identifying potential risk factors that can predict the course of the disease.
Subject(s)
COVID-19 , Monocytes , Biomarkers , Cholesterol, HDL , Humans , Risk Assessment , SARS-CoV-2ABSTRACT
AIMS: To investigate the usefulness of salusin-α and salusin-ß as biomarkers in patients with type 2 diabetes mellitus (T2DM) and to determine whether diabetes severity and obesity have an effect on the salusin levels in diabetic patients. METHODS: The study included a total of 90 patients, comprising 55 diagnosed with T2DM and 35 healthy volunteers with similar demographic characteristics. Salusins were assayed by a commercially available ELISA kit. RESULTS: The salusin-ß levels were found to be significantly higher in T2DM group compared to control group, while the salusin-α levels were lower (p < 0.05, for both). Furthermore, in patient group, Spearman analysis showed a statistically significant negative correlation between salusin-α and fasting glucose and glycated hemoglobin (HbA1c), whereas salusin-ß had a statistically significant positive correlation with fasting glucose and HbA1c (p < 0.05, for both). When analyzed according to the HbA1c groups, the patients with HbA1c > 9% had significantly lower salusin-α and higher salusin-ß levels levels compared to those with HbA1c < 9% (p < 0.05, for both). When examined according to body-mass-index groups, there was no significant difference in the salusin levels of the patient and control groups (p > 0.05). CONCLUSION: We demonstrated that the serum salusin-α level was decreased whereas the salusin-ß level was increased in patients with T2DM compared to healthy subjects, and this was more pronounced as T2DM-deteriorated. We also showed that obesity had no effect on salusin levels among diabetics. This study may provide a basis for the availability of salusin-targeted therapies, especially in uncontrolled T2DM.
