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Aim: Various prognostic risk-scoring systems and parameters have been investigated to predict mortality in patients with coronavirus disease-2019 (COVID-19). In this study, we aimed to evaluate the neutrophil/lymphocyte ratio (NLR) and prognostic nutritional index (PNI) scores to evaluate their predictive value on COVID-19-related mortality. Materials and Methods: A total of 1239 patients were admitted in the study. Patients were followed up for 34 months. Specific variables and biochemical parameters were recorded. NLR and PNI values of the participants were calculated and divided into three equal groups from smallest to largest according to these values (NLR and PNI incrementally from 1 to 3). The terciles of NLR and PNI levels were compared between the survival and non-survival groups. Results: The study included 1.239 patients. The patients were followed up for an average of 22 months (range, 0-34 months). Compared to surviving patients in the mortality group, NLR was also significantly higher and the PNI score was significantly lower (p

Aim:Pulmonary embolism (PE) is a common cardiovascular emergency, and a broad range of conditions must be included in the differential diagnosis because of the frequent and highly non-specific symptoms of PE. Risk stratification scores were created because unnecessary procedures are often performed during the diagnostic process. Modified Geneva and Wells scores are widely used scoring systems, but their reliability remains controversial. In our study, we evaluated these scoring systems according to the predictability of the diagnosis and its correlation with mortality in patients diagnosed with PE.Methods:Our study was conducted in a single center with a retrospective, cross-sectional design. We included 108 patients diagnosed with PE and admitted to the internal medicine clinic between January 2016 and October 2019. The median follow-up period was 19 months. The patients’ initial demographic, clinical, and radiological findings were recorded. The modified Wells, Wells, and Modified Geneva risk scores were calculated according to this information. The relationships among laboratory findings, risk scores, and mortality were evaluated.Results:It was determined that 48 (44%) of the patients died, and 57 (53%) survived during the follow-up period. The death or survival information of three patients could not be obtained because of their foreign nationality. There was no significant difference between the mean ages of female and male patients (p=839). The relationship between patient evaluations according to the score systems and mortality was examined. The analysis determined that only the Modified Geneva score had a significant association with mortality (p=0.001). In contrast, the Wells and Modified Wells scores had no statistically significant relationship with mortality (p=0.396 and 0.391, respectively). Age, malignancy, and dyspnea at admission were independent factors affecting mortality (p=0.001, 0.026, and 0.023, respectively).Conclusion:The risk stratification scoring systems’ diagnosis and mortality predictability are insufficient. These scoring systems must be improved to prevent underdiagnosis and unnecessary testing.

BackgroundCharlson Comorbidity Index (CCI) is the common and valid method to predict mortality by classifying comorbidities such as cardiovascular, metabolic, renal, hepatic, pulmonary diseases, and malignancy. Novel risk factors are not included in the Charlson Comorbidity Index, such as thyroid hormone index (FT3/FT4 ratio) and serum albumin levels. In the present study, we aimed to assess whether the thyroid hormone index and albumin are useful clinical parameters in short and long-term mortality.MethodsIn the retrospective cohort study with a 5 year follow up, the data of 1292 patients who were hospitalized between January 1st-June 30th of 2014 were examined. Three months mortality as short term and 5-year mortality as long term were evaluated.ResultsThree months and 5 years mortality rates for 1064 patients were analyzed. We showed that hypoalbuminemia and thyroid hormone index had statistically significant effects on short and long-term mortality. According to ROC analysis it was demonstrated that the scoring system including biochemical parameters such as thyroid hormone index and serum albumin level was more significant for 3-month mortality. In addition, both scoring systems are equal in demonstrating long-term mortality.ConclusionThyroid hormone index and albumin could improve the prognostic performance of the original Charlson Comorbidity Index in short term mortality. The combined score may offer improvements in comorbidity summarization over existing scores.

Mucormycosis; is a rapidly progressive fungal infection due to filamentous fungi of the mucoraceae family. In this case report, we aimed to present the diagnosis and treatment modalities of a patient who developed rhinoorbital mucormycosis. A 54-year-old patient with a history of hypertension applied to the emergency department with a complaint of wound in the mouth that started four days ago. In the examinations performed here, the patient was diagnosed with diabetic ketoacidosis. In the examination of the patient, it was found that there was a necrotic wound on the left hard palate, a necrotic wound extending from the left inferior turbinate to the nasopharynx, and hyphae in the nasal passage. The patient underwent an aggressive debridement operation on the third day, due to the growth in the fungal culture. In the following clinical examination of the patient, ketone in the urine became negative, and his acidosis status improved. On the same day, the patient was treated with a positive coronavirus disease-2019 (COVID-19) polymerase chain reaction. After 15 days of treatment, the patient died due to COVID-19 pneumonia. Mucormycosis should be doubtful in patients presenting with uncontrolled diabetes mellitus and severe sino-orbital infection. All physicians following diabetic ketoacidosis should be vigilant against this rapidly progressing disease with high mortality.

Objective: Capsular contracture is the most common complication reported after breast augmentation. Recent studies have established the role of leukotriene receptors in capsular contracture formation. Zafirlukast is a leukotriene receptor antagonist, and its effects on experimental models of periprosthetic capsular fibrosis have been shown to decrease capsule thickness and reduce factors that are directly and indirectly involved in capsular contracture. The goal of this study was to improve the periprosthetic capsular formation model in rats and demonstrate the effects of oral Zafirlukast administration on capsular fibrosis. Methods: Forty-eight adult female Sprague-Dawley rats were divided into four groups. Smooth-surfaced, gel-filled prostheses were implanted in 36 rats. Group A: The day of the operation, 12 animals received Zafirlukast treatment for 14 weeks (oral gavage, once a day, 6 days a week, 4 mg/kg/day); Group B: 10 weeks after the operation, 12 animals received Zafirlukast treatment for 4 weeks; Group C: 12 animals were implanted but did not receive treatment; Group D: 12 animals did not have an operation, but for 14 weeks received oral gavage containing water instead of Zafirlukast. At the end of the 14 weeks, the implants with the surrounding capsules were extracted. Blind macroscopic inspectional evaluation of the capsules was performed, and microscopic capsular thickness measurements were made. Results: The mean capsular thickness was 0.033 mm (SD: 0.011) in Group A, and 0.089 mm (SD: 0.023) and 0.125 mm (SD: 0.025) in Groups B and C, respectively. Differences between Groups A and C and between Groups A and B were significant (p0.05). Similarly, Macroscopic Inspectional Fibrosis Scoring showed a significant difference between Groups A and C and a non-significant difference between Groups B and C. Conclusion: Daily prophylactic oral administration of Zafirlukast immediately after implantation significantly diminishes the development of fibrotic capsules around the silicone prostheses. [Arch Clin Exp Surg 2014; 3(3.000): 139-146]

Objective: In this study, we aimed to document the effects of a well-known agent and mdash; and ldquo;insulin-like growth factor (IGF-I) and rdquo; and mdash; on the microvascular anastomosis site. Methods: Sixteen Sprague-Dawley rats were used in this study. The rats were classified randomly into two equally numbered groups (eight rats each): the control (Group 1) and the experiment group (Group 2). The femoral artery was dissected completely in all rats. Following division of the artery, anastomoses were conducted with microvascular techniques. Forty-five minutes after the anastomoses, an Acland milking test was performed in order to check the patency and the first surgical session was terminated. In the second stage, LONG and reg; R3 IGF-I human (Sigma-Aldrich, St. Louis, Missouri, United States) solution was introduced to Group 2 (experimental group) intraperitoneally in doses of 2 mg/kg on the day of the surgery in addition to the third and seventh days postoperatively. On the 4th postoperative week, the patency of the anastomoses was evaluated with the Acland milking test. In addition, one centimeter of a vascular segment including the anastomosis site was excised and stained with hematoxylin-eosin. They were evaluated for edema, inflammation, vascular wall injury, intimal hyperplasia, medial atrophy, thrombus, calcification, foreign body reactions, and the endothelial proliferation. Results: The Acland milking test showed a 100% vascular patency in both groups. A statistically significant difference was found between the experimental and control groups in terms of edema and vascular wall injury (p0.05). Conclusion: Under the light of the obtained data, IGF-I was effective in preventing the edema and vascular wall injury at the anastomosis site. However, the net positive clinical effect on anastomosis patency necessitates further studies. [Arch Clin Exp Surg 2014; 3(2.000): 87-93]