An Investigation of the Relationship Between 18F-FDG PET/CT Parameters of Primary Tumors and Lymph Node Metastasis in Resectable Non-small Cell Lung Cancer.

BACKGROUND: Mediastinal lymph node metastasis is an important prognostic factor in non-small cell lung cancer (NSCLC) patients without distant metastases. 18F-2-fluoro-2-deoxy-D-glucose Positron Emission Tomography/Computed Tomography (18F-FDG PET/CT) is recommended for detecting and staging lymph nodes and distant metastases in NSCLC patients. OBJECTIVE: This study aims to investigate whether maximum standardized uptake (SUVmax), mean standardized uptake (SUVmean), metabolic tumor volume (MTV), and tumor lesion glycolysis (TLG) values of the primary tumor measured by 18F-FDG PET/CT in resectable NSCLC can predict preoperative lymph node metastasis. METHODS: This retrospective study included eighty NSCLC patients who underwent preoperative Positron Emission Tomography/Computed Tomography (PET/CT) for diagnosis and staging. The patients were stage I-III and had no distant metastases. Tumor metabolic parameters such as SUVmax, SUVmean, MTV, and TLG at PET/CT imaging were measured for preoperative diagnosis and staging, and the postoperative pathology results of the patients were examined. The pathology results divided patients into two groups; with and without lymph node metastasis. The groups were compared with student's t-test and chi-square test with regard to 18F-FDG PET/CT tumor metabolic parameters and other parameters. RESULTS: Fifteen (18.8%) patients were female, and 65 (81.3%) were male. According to the postoperative pathology results, while 30 (37.5%) patients had lymph node metastasis, 50 (62.5%) did not. There was a significant difference between the groups regarding tumor SUVmax and SUVmean values (p = 0.036, p = 0.045). Overall survival in the N0 group was significantly higher than in the N1 + N2 group (p = 0.034); median survival was 30.2 months in N0 group cases and 27.3 months in N1 and N2 groups. CONCLUSION: SUVmax and SUVmean values are significantly higher in patients with lymph node metastases than in patients without lymph node metastases, and this finding may provide useful information for predicting lymph node metastasis in patients with resectable NSCLC.

Does Iron Deficiency Affect the Heart in Children?

INTRODUCTION: It is well known that serum iron parameters are closely related to cardiovascular health. Iron deficiency may lead to significant cardiac problems, such as atrioventricular conduction abnormalities, and systolic and/or diastolic dysfunction. Studies related to the effect of iron deficiency on cardiac functions are limited in children. Therefore, the aim of this study was to evaluate the effect of low iron stores on cardiac repolarization parameters which are used to predict arrhythmia and cardiac functions. MATERIALS AND METHODS: Onehundred thirty-five children 2 to 18 years of age without structural heart disease who were referred to the Pediatric Cardiology Department for various reasons such as chest pain, heart murmur, or evaluation before sports participation were evaluated prospectively. The cases were separated into 3 groups according to ferritin levels (group 1: ferritin <15 ng/mL [n=48], group 2: ferritin 15 to 25 ng/mL [n=51], and group 3: ferritin >25 ng/mL [n=36]). Evaluations were made with detailed 12-lead surface electrocardiography (ECG) and transthoracic echocardiogram. Cardiac repolarization parameters were measured from surface ECG and systolic functions, left ventricular wall diameters were evaluated from transthoracic echocardiogram. RESULTS: Eighty-four (62.2%) girls and 51 (37.8%) boys are included in the study. The average age of the groups was similar. In children with low ferritin levels (group 1); Pw, Pw max, and Pw dis; QT, QTc, and QTc dis; Tp-Te, Tp-Te dis, Tp-Te/QT, and Tp-Te/QTc were significantly longer compared with the group 3 (P<0.05). There was a negative correlation between ferritin level and Pw, P max, and Pw dis; QT, QT dis, QTc, and QTc dis; Tp-Te, Tp-Te dis, Tp-Te/QT, and Tp-Te/QTc (P<0.05). No correlation was found between ferritin level and Pw min. There was no difference between the groups in respect of ejection phase indices, heart wall measurements, and end-diastolic diameter measurements. CONCLUSION: Iron deficiency may be related to the tendency of arrhythmias in children without structural heart disease. Therefore, careful evaluation of ECG parameters of healthy children with low iron stores, and follow up with intermittent monitoring is highly important.

Vitamin D deficiency is associated with COVID-19 positivity and severity of the disease.

The present study examined the relationship between polymerase chain reaction (PCR) test positivity and clinical outcomes of vitamin D levels measured within the 6 months before the PCR test in coronavirus disease 2019 (COVID-19)-positive patients. In this retrospective cohort study, COVID-19 (227) and non-COVID-19 patients (260) were divided into four groups according to their vitamin D levels: Group I (0-10 ng/ml), Group II (10-20 ng/ml), Group III (20-30 ng/ml), and Group IV (vitamin D > 30 ng/ml). Laboratory test results and the radiological findings were evaluated. In addition, for comparative purposes, medical records of 1200 patients who had a hospital visit in the November 1, 2019-November 1, 2020 period for complaints due to reasons not related to COVID-19 were investigated for the availability of vitamin D measurements. This search yielded 260 patients with tested vitamin D levels. Vitamin D levels were below 30 ng/ml in 94.27% of 227 COVID-19-positive patients (average age, 46.32 ± 1.24 years [range, 20-80 years] and 56.54% women) while 93.07% of 260 non-COVID-19 patients (average age, 44.63 ± 1.30 years [range, 18-75 years] and 59.50% women) had vitamin D levels below 30 ng/ml. Nevertheless, very severe vitamin D deficiency (<10 ng/ml) was considerably more common in COVID-19 patients (44%) (average age, 44.15 ± 1.89 years [range, 23-80 years] and 57.57% women) than in non-COVID-19 ones (31%) (average age, 46.50 ± 2.21 years [range, 20-75 years] and 62.5% women). Among COVID-19-positive patients, the group with vitamin D levels of >30 ng/ml had significantly lower D-dimer and C-reactive protein (CRP) levels, number levels, number of affected lung segments and shorter hospital stays. No difference was found among the groups in terms of age and gender distribution. Elevated vitamin D levels could decrease COVID-19 PCR positivity, D-dime and CRP levels and the number of affected lung segments in COVID-19-positive patients, thereby shortening the duration of hospital stays and alleviating the intensity of COVID-19.

Evaluation of the protective effect of paricalcitol and vitamin D3 at doxorubicin nephrotoxicity in rats with 99mTechnetium-dimercaptosuccinic acid renal scintigraphy and biochemical methods.

AIM: The present study aimed to examine the effect of paricalcitol (PRC) and vitamin D3 (vit D3) on doxorubicin (DOX)-induced nephrotoxicity in rats. MATERIALS AND METHODS: Forty-two Wistar rats were randomly categorized into six groups: control; 2) PRC(0.5 µg/kg) and 3) vit D3(5.000 IU/kg) administered for 14 days; 4) DOX, 18 mg/kg administered on the 12th, 13th and 14th days of the study; 5) PRC (0.5 µg/kg, +DOX(18 mg/kg); vit D3(5.000 IU)+DOX(18 mg/kg). On the 15th day of the experiment, 99mTc-DMSA uptake level and biochemical parameter in serum and tissue were assay. RESULTS: Activities of 99mTechnetium-Dimercaptosuccinic Acid (99mTc-DMSA) were lower in groups receiving DOX and/or PRC+DOX, vit D3+DOX than in control groups. The 99mTc-DMSA level in the group PRC+DOX and vit D3+DOX were importantly higher than DOX group. DOX caused an important increase in blood urea nitrogen (BUN), creatinine, Tumor Necrosis Factor-α(TNF- α), interleukin-6(IL-6) and nitric oxide(NO) levels compared to control groups. However, PRC and vit D3 pretreatments lowered them. Uptake of 99mTc-DMSA level was higher in groups PRC+DOX than in vit D3+DOX group. Administration of PRC and vit D3 alone did not change alterations all of parameters. CONCLUSION: The results indicated that PRC administration protects kidney in DOX-induced nephrotoxic rats. In addition, PRC has a stronger nephroprotective effect than vit D3.

Associations of platelet indices with proteinuria and chronic kidney disease.

OBJECTIVES: Platelet (PLT) indices are predictive in many diseases and conditions. The relationships of these indices with proteinuria and progression of renal disease are not well known. This study aimed to assess PLT indices in patients with primary glomerular nephrotic range proteinuria (PGNRP), with and without chronic kidney disease (CKD), and to compare these indices with those of healthy individuals (His). METHODS: This cross-sectional study was performed from January 2015 to May 2015. HIs (n = 57) and patients with PGNRP (n = 41) were enrolled. PLT indices and blood biochemistry parameters were compared between HIs and patients with PGNRP, as well as between subgroups of patients with PGNRP who had CKD (n = 23) and those who did not have CKD (n = 18). RESULTS: There were no statistically significant differences in any PLT indices (i.e., platelet number, mean platelet volume, plateletcrit, and platelet distribution width) between HIs and patients with PGNRP, or between the subgroups of patients with PGNRP. However, patients with PGNRP who had CKD exhibited higher median C-reactive protein and mean albumin levels, compared with patients who did not have CKD. CONCLUSIONS: Pathological processes in proteinuria and CKD are not associated with PLT indices.

Evaluation of the protective effect of edaravone on doxorubicin nephrotoxicity by [99mTc]DMSA renal scintigraphy and biochemical methods.

To evaluate the nephroprotective effect of edaravone on doxorubicin-induced nephrotoxicity. In this experimental study, twenty-eight Wistar male rats were used. The rats were separated into 4 groups (n = 7); group І (control), rats were treated with saline (4 ml/kg) and group ІІ (doxorubicin), nephrotoxicity was induced by three doses of 18 mg/kg/i.p. doxorubicin, at a 24-h interval on the 12th, 13th, and 14th days. Group ІІІ (edaravone), rats were treated with edaravone (30 mg/kg/for 14 days), and group ІV (edaravone + doxorubicin), rats were treated with edaravone (30 mg/kg/for 14 days) and doxorubicin were injected (18 mg/kg/for 3 days; at a 24-h interval on the 12th, 13th, and 14th days). On the 15th day of the experiment, technetium-99m-labeled dimercaptosuccinic acid ([99mTc]DMSA) uptake was obtained in both kidneys and biochemical parameters from serum and kidney tissue were measured. Doxorubicin led to nephrotoxicity through elevation of serum blood urea nitrogen (BUN), creatinine and tumor necrosis factor-α (TNF-α), nitric oxide (NO), and interleukin-6 (IL-6) in kidney tissue and decreased [99mTc]DMSA uptake level in the kidney when compared with control group (p < 0.01). Pretreatment edaravone significantly decreased BUN and creatinine, also kidney tissue TNF-α, IL-6, NO, and increased [99mTc]DMSA uptake level compared with the doxorubicin. Edaravone has a significant nephroprotective effect through the attenuation of oxidative stress and inflammatory markers during doxorubicin-induced nephrotoxicity in rats.

The Role of Pre-ablative Stimulated Thyroglobulin and Thyroglobulin/Thyroid-Stimulating Hormone Ratio for Predicting Metastasis in Thyroid Cancer

Objectives: In this study, we aimed to investigate the predictive value of pre-ablative stimulated thyroglobulin (Tg) and Tg/thyroid-stimulating hormone (TSH) to identify lymph node metastasis (LNM) or distant metastases (DM) prior to radioactive iodine (RAI) treatment. Methods: Patients without metastasis were included in group 1 (n=100), those with LNM were included in group 2 (n=83), and those with DM constituted group 3 (n=23). Tg and TSH values were measured approximately 4 hours prior to RAI ablation therapy. Results: There was a significant difference between group 3 and other groups (group 1 and group 2) in terms of Tg (p<0.001) and Tg/ TSH (p<0.001). For Tg level and Tg/TSH ratio, the areas under ROC were 0.990 [95% confidence interval (CI): 0.979-1] and 0.991 (95% CI: 0.981-1), respectively. The cut-off points for Tg and Tg/TSH were 102 ng/mL and 1.06, respectively. Conclusion: Our results suggest that Tg and Tg/TSH values can be used to predict DM. On the other hand, our study indicates that patients should be carefully evaluated for LNM even when Tg levels are l ow.

The effects of cigarette smoking on ventricular repolarization in adolescents.

OBJECTIVE: To assess the association between cigarette smoking and ventricular arrhythmias in adolescents. Novel electrocardiographic parameters -Tp-e interval, as well as Tpe/QT and Tpe/QTc ratios - were used to make this assessment. METHODS: The study population consisted of 87 subjects aged between 16-19 years. Fifty-one adolescent smokers with no risk of arrhythmia comprised the Smoker Group, and 36 adolescents who had never smoked cigarettes comprised the Control Group. Smokers were defined as patients smoking more than three cigarettes per day, for at least 1 year. Body mass index, systolic, diastolic and mean blood pressures were measured, and electrocardiograms were performed on all subjects. Heart rate, PR and Tp-e intervals, and Tpe/QT, Tpe/QTc ratio were digitally measured. RESULTS: Adolescents in Smoker Group had smoked cigarettes for 2.9±1.4 years (range 1 to 6 years). The mean age at starting smoking was 13.8±1.4 years. There were no differences between smokers and Control Group as to baseline clinical variables (p>0.05). The PR, QT and QTc intervals were similar in all groups. Tp-e interval (98.4±12.7ms and 78.3±6.9 ms; p<0.001), Tpe/QT (0.28±0.04 and 22±0.03; p<0.01), Tpe/QTc (0.24±0.03 and 0.19±0.01; p<0.001) ratios were significantly higher in Smoker Group. There were no correlations between years of smoking, number of cigarettes per day, Tpe interval, Tpe/QT or Tpe/QTc ratios. CONCLUSION: Cigarette smoking is associated with risk of ventricular arrhytmogenesis with prolonged Tp-e interval and increased Tpe/QT and Tpe/QTc ratios in adolescents.

The effects of cigarette smoking on ventricular repolarization in adolescents / O tabagismo altera a repolarização ventricular em adolescentes

ABSTRACT Objective To assess the association between cigarette smoking and ventricular arrhythmias in adolescents. Novel electrocardiographic parameters -Tp-e interval, as well as Tpe/QT and Tpe/QTc ratios - were used to make this assessment. Methods The study population consisted of 87 subjects aged between 16-19 years. Fifty-one adolescent smokers with no risk of arrhythmia comprised the Smoker Group, and 36 adolescents who had never smoked cigarettes comprised the Control Group. Smokers were defined as patients smoking more than three cigarettes per day, for at least 1 year. Body mass index, systolic, diastolic and mean blood pressures were measured, and electrocardiograms were performed on all subjects. Heart rate, PR and Tp-e intervals, and Tpe/QT, Tpe/QTc ratio were digitally measured. Results Adolescents in Smoker Group had smoked cigarettes for 2.9±1.4 years (range 1 to 6 years). The mean age at starting smoking was 13.8±1.4 years. There were no differences between smokers and Control Group as to baseline clinical variables (p>0.05). The PR, QT and QTc intervals were similar in all groups. Tp-e interval (98.4±12.7ms and 78.3±6.9 ms; p<0.001), Tpe/QT (0.28±0.04 and 22±0.03; p<0.01), Tpe/QTc (0.24±0.03 and 0.19±0.01; p<0.001) ratios were significantly higher in Smoker Group. There were no correlations between years of smoking, number of cigarettes per day, Tpe interval, Tpe/QT or Tpe/QTc ratios. Conclusion Cigarette smoking is associated with risk of ventricular arrhytmogenesis with prolonged Tp-e interval and increased Tpe/QT and Tpe/QTc ratios in adolescents.

RESUMO Objetivo Avaliar a associação entre tabagismo e arritmias ventriculares em adolescentes usando novos parâmetros eletrocardiográficos: intervalo Tp-e, e relações Tpe/QT e Tpe/QTc. Métodos A população do estudo incluiu 87 indivíduos de 16 a 19 anos de idade. Cinquenta e um adolescentes fumantes, sem risco de arritmia, formaram o Grupo Fumantes, e 36 adolescentes, que nunca tinham fumado cigarros, formaram o Grupo Controle. Os fumantes foram definidos como pacientes que fumavam mais de três cigarros por dia, há pelo menos 1 ano. O índice de massa corporal, e a pressão arterial sistólica, diastólica e média foram medidos, e foram realizados eletrocardiogramas em todos os participantes. Frequência cardíaca, intervalos PR e Tp-e, e as relações Tpe/QT e Tpe/QTc foram medidas por instrumentos digitais. Resultados Os adolescentes do Grupo Fumante fumavam há 2,9±1,4 anos (variação 1 a 6 anos). A média de idade ao começar a fumar foi 13,8±1,4 anos. Não houve diferença nas variáveis clínicas iniciais entre os Grupos Fumante e controle (p>0,05). Os intervalos PR, QT e QTc foram semelhantes em todos os grupos. O intervalo Tp-e (98,4±12,7ms e 78,3±6,9ms; p<0,001), e as relações Tpe/QT (0,28±0,04 e 22±0,03; p<0,01) e Tpe/QTc (0,24±0,03 e 0,19±0,01; p<0,001) foram significativamente maiores no Grupo Fumantes. Não houve correlação entre anos de tabagismo, número de cigarros por dia, intervalo Tpe e relações Tpe/QT e Tpe/QTc. Conclusão O hábito de fumar está associado ao risco de arritmogênese ventricular, com interval Tp-e prolongado e aumento nas relações Tpe/QT e Tpe/QTc em adolescentes.