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Objective: The novel coronavirus caused a disease that mainly affected the respiratory system. The effect of severe acute respiratory syndrome coronavirus 2 on the hypot halam ic–pi tuita ry–ad renal axis is unknown. This study assesses the prognostic accuracy of serum cortisol levels and prediction tools in predicting mortality rates in patients with coronavirus disease 2019 (COVID-19). Methods: We prospectively analyzed 106 inpatients (53 COVID-19 positive, 53 non-COVID-19; mean 59.9 ± 17.3 years; 38 males and 68 females) with serum cortisol and adrenocorticotropic hormone levels compared with prognostic scores. Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) scores determined the disease’s severity. The predictive value of serum cortisol, APACHE, and SOFA on mortality was assessed using receiver operating characteristic curve analysis and the area under the curve (AUC). Results: No significant age or sex differences were found between groups. Serum cortisol levels were similar. The APACHE-II scores in the COVID-19 group were higher than in the other group, while SOFA scores showed no significant difference. The AUC for the APACHE-II score in predicting mortality was 0.765 (95% CI 0.672-0.842), with an optimal cutoff (>9) demonstrating 62.5% sensitivity and 86.7% specificity for overall participants. No correlation was found between serum cortisol levels and prediction tools such as APACHE-II and SOFA. Conclusion: The measurement of serum cortisol did not provide additional prognostic information beyond that established by the APACH-II score. This study highlights the significance of assessing novel prognostic tools for predicting outcomes in hospitalized patients with COVID-19. [ABSTRACT FROM AUTHOR]

Objective: This report aimed to examine changes in constituents of body composition that correlate to cardiovascular morbidity and mortality in patients with acromegaly using bioelectrical impedance analysis (BIA). Materials and Methods: This prospective study included 62 patients who were followed up after their acromegaly diagnosis and 40 healthy volunteers. All patients' body compositions were evaluated using a body composition analyzer (TANITA MC-780-Black) with the BIA method. The laboratory and anthropometric measurements and body composition parameters were compared between the patients with acromegaly and the controls. Moreover, these parameters were examined according to the disease activity. Results: This study showed that patients with acromegaly have higher plasma glucose levels than the control group (p=0.001). The homeostasis model assessment-insulin resistance index of patients with acromegaly was significantly higher than that of the controls (p=0.02). The compartments of intracellular water (ICW) and extracellular water (ECW) in the patients with acromegaly were larger than that in the controls (respectively; p=0.02 and p=0.001). The lean mass of the patients with acromegaly in the trunk and extremities was significantly higher than the controls (respectively; p=0.002 and p=0.001). The compartment of muscle was significantly larger than that in the controls (p=0.001). The basal metabolism in patients with acromegaly was significantly higher than that in the controls (p=0.002). Conclusion: Determining the body composition using the BIA method can provide important information about the cardiovascular risks in patients with acromegaly. With the BIA method, cardiovascular risk can be estimated and reduced with effective strategies. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to investigate the sociodemographic and clinical characteristics of the patients using continuous subcutaneous insulin infusion (CSII) therapy. We reported the effects of CSII therapy on some clinical parameters. Materials and methods: One hundred twenty-seven patients using CSII therapy were enrolled in the study. A total of 102 patients were included after 25 cases were excluded due to inadequate data. Sociodemographic, clinical, and laboratory characteristics were obtained from the hospital database. Results: In our study, no relationship was found between educational level and the effective use of carbohydrate counting and diabetes complications. After switching to CSII therapy, patients' glycated hemoglobin (HbA1c) levels were reduced to 8.2% (5.3–14) at their last visit (p = 0.005). Also, total daily insulin dosage with 48 IU/day (7.3–180) was significantly decreased to 40 IU/day (15–276) after CSII therapy (p = 0.001). CSII therapy was significantly associated with less episodes of diabetic ketoacidosis at the last visit than at the initiation of CSII therapy (p = 0.033). Conclusion: Switching to CSII therapy can improve glycemic control, reduce insulin dosage requirements, and improve patient quality of life by reducing episodes of diabetic ketoacidosis. [ABSTRACT FROM AUTHOR]

Objective: We aimed to identify the risk factors for the development of diabetes mellitus after transplantation in liver recipients. Methods: Two hundred twenty-seven patients with a follow-up period >8 months after liver transplantation were included in the study. The clinical and laboratory data of patients with post-liver transplantation diabetes mellitus and without post-liver transplantation diabetes mellitus were compared. Results: Of the 227 patients, 61 patients were diagnosed with diabetes mellitus in the pretransplantation period. Twelve percent of the patients (20 patients) were diagnosed with post-liver transplantation diabetes mellitus and 146 patients were not diagnosed with diabetes mellitus. We found that post-liver transplantation diabetes mellitus was associated with advanced age (95% CI: 1.002-1.142). Male liver recipients were diagnosed with a higher rate of post-liver transplantation diabetes mellitus than female recipients (15.5% and 5.4%, respectively; P = .045). Pretransplantation fasting plasma glucose levels were higher in patients with post-liver transplantation diabetes mellitus than without post-liver transplantation diabetes mellitus, which was not statistically significant (P = .097). While 22.2% of patients with post-liver transplantation diabetes mellitus had complications after transplantation, 14.2% of the patients without post-liver transplantation diabetes mellitus had complications after transplantation (P = .370). Conclusion: As post-liver transplantation diabetes mellitus is associated with graft failure and increased mortality and morbididy, candidates for liver transplantation should be screened for risk factors of diabetes, and blood work for diabetes mellitus should be done regularly in these patients. Since patients with advanced age, male gender, and higher fasting plasma glucose levels in the pretransplantation period have higher risk for the development of post-liver transplantation diabetes mellitus, these cases should be screened more carefully. [ABSTRACT FROM AUTHOR]

Atypical parathyroid tumor is a rare disease that can be challenging to distinguish from parathyroid adenoma. Atypical parathyroid tumor shows some laboratory and histopathological features with parathyroid cancer. This study attempts to compare clinical, laboratory, radiologic, and histopathological characteristics in atypical parathyroid tumor and parathyroid adenoma. This was a retrospective study based on the database of eighty-two subjects who underwent surgery for primary hyperparathyroidism at a tertiary referral center between 2010 and 2021. Forty-one patients with atypical parathyroid tumor were matched by age and gender to controls with parathyroid adenoma. Clinical, laboratory, radiologic, and characteristics were obtained from the hospital database. Forty-five (54.8%) of primary hyperparathyroidism patients were symptomatic, 36 (90%) had nephrolithiasis, 6 (15%) had fracture, and 3 (7.5%) had hypercalcemic crisis. Atypical parathyroid tumor patients present with significantly increased serum calcium, parathormone, and alkaline phosphatase levels (P < .001, all). No significant difference was observed in the results of bone mineral density, T-scores, and Z-scores. The size of adenoma was significantly greater in the atypical parathyroid tumor group (24 (8.8–70) mm vs. 12 (3.8–32) mm, P = 0.005). Our study revealed that increased preoperative serum calcium, parathormone, alkaline phosphatase concentrations, and parathyroid adenoma size on ultrasound may have predicted the atypical parathyroid tumor. [ABSTRACT FROM AUTHOR]