Importance of lactate/albumin ratio in pediatric nosocomial infection and mortality at different times.

Aim: To evaluate the lactate/albumin ratio and its relation to mortality in children with nosocomial infections. Materials & methods: One hundred six children were included in this study. Blood gas and albumin levels were analyzed at the first, 24th and 48th h. Results: The types of detected microbial agents, signs of sepsis, development of septic shock and mortality rates were different. The first-, 24th- and 48th h lactate levels of the children who died were higher than those of the living children, but the albumin levels were lower. The highest area under the curve value for the lactate/albumin ratio was detected at the 24th h. Conclusion: Lactate/albumin ratio can be used to predict mortality in children with nosocomial infections.

A hybrid super ensemble learning model for the early-stage prediction of diabetes risk.

Diabetes mellitus has become a rapidly growing chronic health problem worldwide. There has been a noticeable increase in diabetes cases in the last two decades. Recent advances in ensemble machine learning methods play an important role in the early detection of diabetes mellitus. These methods are both faster and less costly than traditional methods. This study aims to propose a new super ensemble learning model to enable an early diagnosis of diabetes mellitus. Super learner is a cross-validation-based approach that makes better predictions by combining prediction results of more than one machine learning algorithm. The proposed super learner model was created with four base-learners (logistic regression, decision tree, random forest, gradient boosting) and a meta learner (support vector machines) as a result of a case study. Three different dataset were used to measure the robustness of the proposed model. Chi-square was determined as an optimal feature selection technique from five different techniques, and also hyper-parameter settings were made with GridSearch. Finally, the proposed new super learner model achieved to obtain the best accuracy results in the detection of Diabetes mellitus compared to the base-learners for the early-stage diabetes risk prediction (99.6%), PIMA (92%), and diabetes 130-US hospitals (98%) dataset, respectively. This study revealed that super learner algorithms can be effectively used in the detection of diabetes mellitus. Also, obtaining of the high and convincing statistical scores shows the robustness of the proposed super learner model.

Association between Hb A1c and Severity of COVID-19 Patients.

This study aimed to examine the relationship between Hb A1c levels and the clinical course of coronavirus-19 (COVID-19) patients. Sixty-six COVID-19(+) patients with high Hb A1c and 46 with average Hb A1c and 30 COVID-19(-) patients with average Hb A1c were included. Hb A1c levels and parameters examined in COVID-19(+) patients were compared between groups, and correlation analysis was performed between these parameters and Hb A1c levels. The effect of Hb A1c levels on intensive care unit (ICU) admission and mortality rate in COVID-19 patients was analyzed with the χ2 test. It was observed that hemoglobin (Hb) and arterial oxygen saturation (SaO2) levels of the COVID-19 (+) groups was lower than the COVID-19 (-) group, while ferritin, D-dimer, procalcitonin (PCT), and C-reactive protein (CRP) levels were higher. The COVID-19 (+) group with high Hb A1c had higher lactate dehydrogenase (LDH), PCT and D-dimer levels than the other two groups, while Hb, partial arterial oxygen pressure (PaO2) levels were lower. The Hb A1c levels of the COVID-19 (+) groups were positively correlated with absolute neutrophil count (ANC), LDH, PCT and (K+) levels, while negatively correlated with Hb and PaO2 levels. Hb A1c was found to be associated with the inflammation process, coagulation disorders and low PaO2 in COVID-19 patients. The COVID-19 patients with high Hb A1c levels had a higher mortality rate than other COVID-19 patients. Using Hb A1c measurements with other prognostic markers would contribute to the patient's risk of death assessment.

Mid-term results in the treatment of varicose veins with N-butyl cyanoacrylate.

Aim To present mid-term results of patients with varicose veins treated with N-butyl cyanoacrylate (VariClose®), a nontumescent endovenous ablation technique. Patients and method Endovenous ablation was performed on 180 patients with saphenous vein incompetence between May and October 2014. One hundred sixty-eight subjects capable of being followed-up for 30 months were included. Patients' pre- and postoperative data were recorded. Results Procedures were performed on the great saphenous vein in 159 patients and on the small saphenous vein in nine patients. Saphenous vein diameters ranged between 5.5 mm and 14 mm. Full ablation was achieved in all patients following the procedure. No complications were encountered. Patients were monitored for 30 months. Ablation rates were 100% at the 3rd month, 98.3% at the 6th month, 96.6% at 1 year, and 94.1% at 30 months. Mean venous clinical severity score was 10.2 before procedures, decreasing to 3.9 at 3 months, 4.2 at 6 months, 2.9 at 12 months, and 2.7 at 30 months ( p = 0.000). Conclusion Due to its high success rate, absence of complications, no tumescent anesthesia requirement and high patient satisfaction, endovenous ablation with N-butyl cyanoacrylate is a good method. However, long-term follow-up results are now needed.

Clinical and subclinical varicocele incidence in patients with primary varicose veins requiring surgery.

BACKGROUND: The purpose of this study was to analyze the incidence of clinical and subclinical varicocele in patients with primary varicose veins requiring surgery. METHODS: A total of 100 patients with primary varicose veins requiring surgery were evaluated. Clinical varicocele was found in each patient through physical examination. Each patient was also evaluated with ultrasound because of evidence of subclinical varicocele. RESULTS: Among the patients with varicose veins, 28 had no clinical sign of varicocele, whereas the remaining 72 had varicocele with different clinical levels (72%). Doppler ultrasound revealed that 32 patients had no reflux flow, whereas the other 68 had different grades of reflux flow (68%). CONCLUSIONS: Clinical or subclinical varicocele may be highly present in patients with severe venous disease. However, these types of varicoceles do not cause infertility in most patients. Nevertheless, infertility may occur in subsequent years, especially in young patients who have venous disease and undergo surgery, and they should be aware of this condition.