Platelet indices as a predictor in the differentiation of Behçet's disease from recurrent aphthous stomatitis.

OBJECTIVE: The aim of this retrospective cohort study was to investigate complete blood count parameters in patients with Behçet's disease (BD) who present with oral ulcers and patients with recurrent aphthous stomatitis (RAS) in order to determine whether they could be used as discriminatory biomarkers. PATIENTS AND METHODS: This study was conducted between January 2019 and January 2023. The study population consisted of three groups: patients with BD who had oral ulcer manifestation (n=85, BD-Group), patients with idiopathic RAS (n=186, RAS-Group) and healthy controls (n=90, HC-Group). All data about participants, on their first application, including sociodemographic and clinical data, comorbidity status, laboratory results were collected retrospectively from the hospital computer records and patients' charts. RESULTS: The groups were similar in terms of age (p=0.235) and sex distribution (p=0.450). Mean platelet volume (MPV) and plateletcrit values of the BD-Group were significantly lower, while platelet distribution width (PDW) was significantly higher, compared to the other two groups (p<0.001 for all). Low MPV (<9.15) (56.47% sensitivity and 90.86% specificity), high PDW (≥15.75) (75.00% sensitivity and 94.96% specificity) and low plateletcrit (<0.237) (55.29% sensitivity and 79.46% specificity) could significantly distinguish BD patients with oral ulcer onset from patients with RAS. CONCLUSIONS: PDW, MPV, and plateletcrit may be useful biomarkers in the differential diagnosis of oral ulcers when distinguishing between BD and RAS. However, these results need to be supported by further comprehensive studies.

A new parameter predicting steroid response in idiopathic IgA nephropathy: a pilot study of pan-immune inflammation value.

OBJECTIVE: In this pilot study, we aimed at investigating the predictive power of pan-immune inflammation value (PIV) on response rates at 6 months in idiopathic IgA nephropathy (IgAN) patients who started steroids. PATIENTS AND METHODS: The study was conducted with patients diagnosed with idiopathic IgAN and treated with 3-6 months of conservative treatment and steroid therapy started because proteinuria was above 1 g/day. Patients with proteinuria lower than 0.3 g/day, no macroscopic hematuria, and no hematuria detected in 3 consecutive urinalyses for 6 months were considered to be patients in remission. PIV was calculated by [neutrophil count (103 µL)*platelet count (103 µL)*monocyte count (103 µL)]/lymphocyte count (103 µL)]. Patients were compared according to their remission status in terms of PIV. RESULTS: The mean PIV was significantly higher in patients in the non-remission group than in patients in the remission group (1,869.2±1,781.9 to 574.1±364.5, respectively). The best cut-off for PIV was 752.6 to predict non-remission with a 75% sensitivity and 71.4% specificity. CONCLUSIONS: Our study showed that PIV is a reliable marker for predicting steroid response at the 6th month in patients with idiopathic IgAN.

The novel predictor of metabolic risk in patients with polycystic ovary syndrome: could it be the visceral adiposity index?

OBJECTIVE: Polycystic ovary syndrome (PCOS) is the most common endocrinological disorder in women of reproductive age, often accompanied by high androgen levels, irregular menstrual cycles and polycystic ovaries. In addition, patients with PCOS also present with an increase in abdominal adipose tissue and insulin resistance. Recently, the gender-specific mathematical formulation called visceral adiposity index (VAI) has been widely used in assessing cardiometabolic risk. This study aimed at comparing the VAI values of patients with PCOS, patients with idiopathic hirsutism (IH) and a control group. PATIENTS AND METHODS: We obtained demographic data, laboratory results and anthropometric measurements of patients from the hospital database. We retrospectively grouped all cases included in the study as PCOS (n = 52), IH (n = 57) and control (n = 58) according to the diagnoses. We also took venous samples for hormone and biochemical tests in the early follicular phase of the menstrual cycle, at least 8-10 hours after fasting in the early morning hours. Finally, we evaluated the variables using SPSS 22.0 software (IBM Corp., Armonk, NY, USA). RESULTS: We included 167 female individuals in the study. Of these, 57 (34.1%) were diagnosed with IH, while 52 (31.1%) were diagnosed with PCOS. The control group comprised 58 (34.8%) healthy female individuals. The median age of the study group was 25 years [interquartile range (IQR) = 8 years]. The age, height, weight, body mass index (BMI) and waist circumference values of the groups were similar. We found that the VAI values among the groups were significantly different (p = 0.028). Post-hoc analysis determined that this was due to the difference between the group with PCOS and the control group. In addition, we found significantly high HOMA-IR, fasting insulin and androgen levels in the group with PCOS (p < 0.001). CONCLUSIONS: After comparing data in groups with similar BMI levels, we found significantly high VAI values in patients with PCOS. The results reinforce the idea that VAI is a useful marker easily obtained in daily practice for assessing the cardiometabolic risk of patients with PCOS.

The effect of lymphocyte blood levels on mortality of COVID-19 patients under intensive care unit follow-up.

OBJECTIVE: Lymphocytes are the most important cells in defending the human body against viral pathogens. In this study, we aimed at investigating the relationship between lymphocyte blood levels and patient survival in COVID-19 patients hospitalized in the intensive care unit. PATIENTS AND METHODS: We retrospectively evaluated patients hospitalized with COVID-19 pneumonia in the intensive care unit. Patients were divided into two groups in terms of blood lymphocyte levels; increased lymphocyte and decreased lymphocyte groups on the 5th day of hospitalization. Mortality rates were compared between groups. RESULTS: Two groups were similar in terms of laboratory tests and comorbidities. Overall survival was 63.8% (n=102) in patients with increased lymphocytes and 33.2% (n=68) in patients with decreased lymphocytes. Mortality rates were significantly higher in decreased lymphocyte group than in increased lymphocyte group (p=0.003). CONCLUSIONS: Our study reveals that mortality is higher in patients with a lower lymphocyte count on the 5th day compared to the day of hospitalization.

Effects of low sleep quality on sexual function, in women with fibromyalgia.

Sexual dysfunction is a common experience in women with fibromyalgia. However, the physiopathology of this association is unclear. We aimed to evaluate whether sleep disturbance has an influence on sexual function in women with fibromyalgia. Fifty-four sexually active premenopausal women with fibromyalgia were enrolled in the study. The following questionnaires were used: the Female Sexual Function Index (FSFI), the Pittsburgh Sleep Quality Index (PSQI), the Fibromyalgia Impact Questionnaire (FIQ) and the Beck Depression Inventory (BDI). Appropriate statistical analyses were used by using SPSS 18. The mean FSFI score was 25.344 ± 6.52 and showed no correlation with age, body mass index, BDI or duration of fibromyalgia. However, a positive correlation between sexual dysfunction and low sleep quality was found (r=0.43; P=0.001). In addition, the median FSFI score was 29.2 (27.2-32.4) in patients with higher sleep quality (PSQI⩽5), whereas it was 21.4 (18.9-25.3) in patients with lower sleep quality (PSQI>5) (P<0.001). There was a positive correlation between sexual dysfunction and symptoms of fibromyalgia as indicated by a higher FIQ score (r=0.37; P=0.006). Sexual dysfunction in female patients with fibromyalgia may be due to low sleep quality. Treatment of the sleep disorder may improve female sexual function.

A retrospective series of gut aspergillosis in haematology patients.

Gut invasive aspergillosis is an extremely rare infection in immunocompromised patients. The goal of this retrospective multicentre study is to report on cases of gut aspergillosis in haematology patients, including clinical presentation, risk factors, and outcome. Twenty-one patients from nine centres were identified. Eight had isolated gut aspergillosis, with no evidence of other infected sites, and 13 had disseminated aspergillosis. Thirteen patients had acute leukaemia. Nine were allogeneic stem cell transplant recipients. Clinical symptoms and imaging were poorly specific. The galactomannan antigenaemia test result was positive in 16/25 (64%) patients, including in four of the eight cases of isolated gut aspergillosis. Five of 21 patients had a dietary regimen rich in spices, suggesting that, in these cases, food could have been the source of gut colonization, and then of a primary gut Aspergillus lesion. The diagnosis was made post-mortem in six patients. The mortality rate in the remaining patients at 12 weeks was 7/15 (47%). Gut aspergillosis is probably misdiagnosed and underestimated in haematology patients, owing to the poor specificity of symptoms and imaging. Patients with a persistently positive galactomannan antigenaemia finding that is unexplained by respiratory lesions should be suspected of having gut aspergillosis in the presence of abdominal symptoms, and be quickly investigated. In the absence of severe abdominal complications leading to surgery and resection of the lesions, the optimal treatment is not yet defined.