Obesity without comorbidity may also lead to non-thyroidal illness syndrome.

BACKGROUND: Obesity mediates a series of operations in the body by increasing the production of proinflammatory cytokines. Cytokines play an important role in the development of non-thyroidal illness syndrome (NTIS). OBJECTIVES: The aim of this study was to investigate the association between obesity and NTIS. MATERIAL AND METHODS: A total of 423 subjects were included. The study group was comprised of 219 obese patients without any comorbid disease and the control group was comprised of 204 healthy subjects. Body mass index (BMI), thyroid hormone levels, high-sensitivity C-reactive protein (hs-CRP) levels, erythrocyte sedimentation rate (ESR), complete blood count, and other biochemical parameters were measured. Frequencies of NTIS were calculated. MedCalc 12.5 software program (MedCalc, Ostend, Belgium) was used for statistical analysis. RESULTS: Groups were statistically different according to BMI (p < 0.001). The mean BMIs of the study and the control group were 34.6 ±5.0 kg/m2 and 22.6 ±1.8 kg/m2, respectively. Obese patients had higher serum hs-CRP levels, ESR and white blood cells (WBC) levels (0.99 ±3.17 mg/L vs 0.39 ±1.09 mg/L; 17.2 ±10.6 mm/h vs 12.6 ±8.0 mm/h; 7.8 ±2.1 103/µL vs 6.9 ±1.5 103/µL, respectively; p < 0.001). There were 21 (9.5%) obese patients with NTIS, while there were none NTIS cases in the control group. The difference was statistically significant (p < 0.001). There was a strong association between obesity and NTIS (odds ratio (OR) = 44.2, confidence interval (CI) = 95% 2.66-736.3; p = 0.0082). CONCLUSIONS: Inflammation, which is strongly associated with adipose tissue, may lead to NTIS in obese patients without any comorbid disease.

[A case of ventilator-associated pneumonia due to Pantoea agglomerans]. / Pantoea agglomerans'a Bagli Ventilatörle Iliskili Pnömoni Gelisen Bir Olgu.

Pantoea species, which are the members of Enterobacteriaceae family are gram-negative bacilli that are frequently found on many plants and in soil. They may lead to localized infections in healthy subjects and systemic infections in immunosuppressed patients. In this case report a ventilator-associated pneumoniae due to Pantoea agglomerans was presented. A 55 year-old male patient with chronic renal failure was hospitalized in intensive care unit following cardiopulmonary arrest. The patient developed fever (38.8°C), had pulmonary infiltrations in chest X-ray and leucocytosis. Treatment with piperacillintazobactam was initiated upon diagnosis of nosocomial pneumoniae. Bacterial growth from the deep tracheal aspirate of the patient was identified as P.agglomerans by VITEK2 automated system (bioMérieux, France) and the identification was confirmed by conventional microbiological methods. Since the strain was susceptible to the cephoperazon-sulbactam, tobramycin, tetracycline, gentamicin and levofloxacine, the treatment was changed to levofloxacine and cephoperazon-sulbactam and the patient improved. This case was presented to withdraw attention to rare opportunistic pathogens that may lead to nosocomial infections particularly in patients with underlying diseases.