Triglyceride glucose index as a marker of primary patency rate of arteriovenous fistula in diabetic hemodialysis patients.

OBJECTIVE: Arteriovenous fistula (AVF) structures are vital formations used for hemodialysis. Diabetes mellitus (DM) is a critical disease affecting the vascular system. The triglyceride glucose (TyG) index has been shown to be associated with major adverse cardiovascular events in patients with Type 2 DM. In this study, we aimed to investigate the effect of the TyG index on the primary AVF patency of diabetic patients. PATIENTS AND METHODS: Between March 2018 and March 2023, patients with DM who underwent AVF surgery in our clinic due to end-stage renal disease were retrospectively included in this study. The patients who could receive hemodialysis were determined as Group 1, and those who could not were determined as Group 2. RESULTS: A total of 189 patients were included in the study. Those who did not develop AVF primary failure were included in Group 1 [n=138, median age = 59 (22-77) years], and those who did were included in Group 2 [n=51, median age = 63 (20-81) years]. In the multivariate analysis, age >70 years (OR: 0.871, 95% CI: 0.594-0.983, p=0.039), the presence of PAD (OR: 0.582, 95% CI: 0.0.458-0.896, p=0.046), and TyG index (OR: 0.879, 95% CI: 0.591-0.916, p<0.001) were determined as independent predictors for primary AVF failure. CONCLUSIONS: This study demonstrated that the TyG index value, calculated from blood samples taken at the time of hospital admission in hemodialysis patients with diabetes mellitus (DM), is an independent predictor of primary AVF failure following AVF surgery.

Malignant mixed mesodermal tumour of the ovary: clinicopathological features.

Malignant mixed mesodermal tumours of the ovary have been described together with a literature review. The characteristic histological pictures of the various representative tissue elements have been demonstrated and patients characteristics analysed in detail. This confirms the classical features of this group of advanced ovarian malignancy that highlight the aggressive nature of the tumour associated with poor survival. Although generally they are managed in the same line as epithelial ovarian carcinomas the appropriate treatment has yet to be established. Because of their rarity they also illustrate the potential problems of instituting prospective randomised controlled trials.

Congenital double uterus and conglutinatio cervix in labour.

An interesting case of congenital double uterus and the intrapartum events associated with it are described. In view of the rarity of the condition, its implication to the patient, her general practitioner and the obstetrician/gynaecologist is discussed, with special reference to contraception, cervical smear and operative surgical technique.