Evaluation of systemic immune-inflammation index in acute deep vein thrombosis: A propensity-matched.

OBJECTIVE: Deep vein thrombosis (DVT) progressing to pulmonary embolism is an important cause of mortality and morbidity worldwide. At present, color Doppler ultrasound is the most effective examination method for the diagnosis of DVT. The systemic immune-inflammation index (SII) has been introduced as a new indicator of comprehensive systemic immune thrombosis and inflammatory status in the body. We believe that the SII might be more specific and sensitive than the neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR). In the present study, we aimed to evaluate the predictive potential of the SII, NLR, and PLR in the diagnosis of DVT. METHODS: The data of patients aged >18 years who were diagnosed with acute DVT in our hospital between June 2017 and June 2021 were retrospectively reviewed. During the study period, the data of 155 patients with acute DVT and 179 healthy control patients without DVT were included in the study. A propensity score analysis (1:1) was performed to eliminate differences between the two groups, and 63 patients from each group were included in the present study. RESULTS: When the complete blood count parameters were examined between the patients with acute DVT and the control group, the hemoglobin, hematocrit, lymphocyte count, and platelet distribution width were lower in the DVT group. In contrast, the white blood cell count, neutrophil count, platelet count, NLR, PLR, SII, and mean platelet volume were higher in the DVT group. The changes in hemoglobin (P = .001), hematocrit (P = .001), white blood cell count (P = .001), neutrophil count (P = .001), lymphocyte count (P = .001), platelet count (P = .001), NLR (P=.001), PLR (P = .001), SII (P = .001), and mean platelet volume (P = .031) were significant on statistical analysis. However, the changes in the platelet distribution width were not significant (P = .794). The area under the curve for the NLR and PLR was 0.797 (95% confidence interval [CI], 0.747-0.848; P < .001) and 0.788 (95% CI, 0.737-0.840; P = .01), respectively. The sensitivity and specificity for an NLR >3.00 was 71.0% and 68.7%, respectively. The sensitivity and specificity for a PLR >142.66 was 70.3% and 68.5%, respectively. The area under the curve for SII was 0.861 (95% CI, 0.820-0.902; P < .001), with a sensitivity of 78.1% and specificity of 73.1% for an SII >755.54. CONCLUSIONS: The SII can be used as an auxiliary diagnostic test for patients with venous thrombosis. This parameter is superior to the NLR and PLR with high sensitivity and specificity for patients with venous thrombosis.

Protective effects of safranal on kidney tissue in a rat model of distant ischemia-reperfusion injury with infrarenal aortic occlusion.

Background/aim: Ischemia-reperfusion (IR) injury to a part of the body can cause damage to distant organs such as the kidney and heart. This study investigated the protective effects of safranal against IR-induced renal injury. Materials and methods: Used in this study were 24 Wistar Albino male rats, which were divided into 3 equal and randomised groups. The sham group underwent laparotomy only. In the IR group, the infrarenal aorta was clamped for 1 h, and then reperfused for 2 h. In the IR-safranal group, safranal was administered 30 min before the procedure and IR injury was induced in the same way as in the IR group. After the procedure, blood and tissue samples were collected from the rats for biochemical and histopathological analyses. Antioxidant capacity and proinflammatory cytokine analyses were performed on the blood samples. Terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) staining was performed to determine the number of cells undergoing apoptosis in the kidney tissue. Results: The estimated glomerular filtration rate, an indicator of renal function, was lower in the IR group (p1 = 0.024 vs. p3 = 0.041, respectively) compared to the other groups, while creatinine levels were higher in the IR group compared to the other groups (p1 = 0.032 vs. p2 = 0.044, respectively). The blood urea nitrogen level was higher in the IR group than in the other groups (p1 = 0.001vs p2 = 0.035, respectively). The total antioxidant and total oxidant status, indicating tissue oxidative stress, did not differ between groups (p = 0.914 vs. p = 0.184, respectively). Among the proinflammatory cytokines, the interleukin-1ß (IL-1ß) and IL-6 levels were significantly higher in the IR group (p = 0.034 vs. p = 0.001, respectively), but the tumour necrosis factor-α (p = 0.19), and interferon-γ (p = 0.311) levels did not differ between groups. Histopathological examination showed significantly less damage to glomerular and tubular cells in the IR-safranal group (p < 0.001). The number of TUNEL-positive cells was higher in the IR group compared to the other groups (p < 0.001). Conclusion: Safranal may have protective effects against kidney damage caused by distant ischemia-reperfusion injury.

Incidence, follow-up and outcomes of incidental abdominal aortic aneurysms in computed tomography.

OBJECTIVES: The goal of our study was to determine the prevalence of abdominal aortic aneurysms (AAAs) that were incidentally diagnosed by computed tomography applied for different reasons and to discuss the risk factors that may cause AAA. METHODS: A total of 5396 abdominal computed tomography examinations were performed, and the 103 incidentally detected AAAs were included in the study. Patients with and without AAA were compared in terms of age, gender, thoracic and abdominal aortic diameters and comorbid diseases. RESULTS: The prevalence of the AAAs was 1.9%. Old age and male gender were significantly different between the groups (P < 0.001). The reason for applying computed tomography in 52 (50.5%) patients with AAA was associated with malignancy. In the evaluation of all patients in the study, the aortic diameter was determined to be larger in patients with malignancy than in patients without malignancy (18.07 ± 4.1 mm vs 17.7 ± 3.9 mm, respectively; P < 0.001). The thoracic aortic diameter was wider in patients with AAA compared to that in patients without AAA (37.2 ± 3.9 mm vs 33.9 ± 5.2 mm, respectively; P < 0.001). The presence of coronary artery disease, diabetes mellitus, hypertension and a history of smoking in patients with AAA was significantly different from that of patients without AAA (P < 0.001). There was no significant difference between the groups in terms of hyperlipidaemia and chronic obstructive pulmonary disease (P = 0.52 and P = 0.15, respectively). CONCLUSIONS: Screening of older men with diseases such as malignancy, hypertension, diabetes mellitus and coronary artery disease for AAA is important for the early diagnosis and treatment of this disease.

Analysis of the Efficacy of Iloprost Treatment in Amputations Due to Burn.

The aim of our study was to demonstrate the decrease in amputation rates with iloprost treatment in patients who develop vascular injury due to burns. The data of 366 adult burn patients who were admitted to the emergency department of our hospital between 2016 and 2019 were analyzed. Demographic characteristics, burn factors, vascular examination findings, medical treatments, amputation rates, and levels were recorded. The amputation rates of the patients who were treated with iloprost and who were not treated with iloprost were compared. The mean age of 366 adult patients treated for burns was 37.8 ± 16.4 years, and of these patients, 220 (59.9%) were under 40 years of age. Although heat burns (n = 331.85%) were the most common burn etiology, it was found that the incidence of vascular injury was higher in burns caused by electricity (11.7%) and cold (3.3%) (P < 0.001). Vascular injury was detected in 60 (16.3%) of the patients and 21 (35%) of these patients were treated with iloprost. Amputation was observed in 20 (5.5%) of all burn patients, but only one of the patients treated with iloprost underwent amputation (P < .001). The individual and social impacts of amputations caused by burns are unquestionable. The authors are of the opinion that iloprost treatment is effective in reducing amputations due to burns.