Abstract Objective: We aimed to determine the factors that predict early mortality and morbidity in patients who underwent laparoscopic right hemicolectomy and their superiority over each other. Method: Demographic data, age-adjusted Charlson Comorbidity Index, American Society of Anesthesiologists Score, body mass index, modified-Glasgow Prognostic Score (mGPS), stage of disease, and sarcopenia were evaluated in patients who underwent right hemicolectomy between 2010-2022. Their superiority in predicting short-term outcomes was compared. Results: 78 patients were included in the study. The complication rate was higher in sarcopenic patients (p = 0.002). A high mGPS score was associated with increased mortality risk (p = 0.012). Other methods were not found to be related to short-term results. Conclusions: Sarcopenia is useful for the prediction of complications, and the mortality rate can be estimated by the mGPS score. These are superior to the other short-term results prediction methods. However, randomized controlled studies are needed.

Resumen Objetivo: Determinar los factores que predicen la mortalidad y la morbilidad precoces en pacientes sometidos a hemicolectomía derecha laparoscópica y su superioridad entre ellos. Método: Se evaluaron datos demográficos, el índice de comorbilidad de Charlson ajustado por edad, el puntaje de la American Society of Anesthesiologists, el índice de masa corporal, el puntaje de pronóstico de Glasgow modificado (mGPS), el estadio de la enfermedad y la sarcopenia en pacientes que se sometieron a hemicolectomía derecha entre 2010 y 2022. Se comparó su superioridad en la predicción de resultados a corto plazo. Resultados: Se incluyeron en el estudio 78 pacientes. La tasa de complicaciones fue mayor en los pacientes sarcopénicos (p = 0.002). Una puntuación mGPS alta se asoció con un mayor riesgo de mortalidad (p = 0.012). No se encontró que otros métodos estuvieran relacionados con los resultados a corto plazo. Conclusiones: La sarcopenia es útil para la predicción de complicaciones y la tasa de mortalidad puede estimarse mediante la puntuación mGPS. Estos son superiores a los otros métodos de predicción de resultados a corto plazo. Sin embargo, se necesitan estudios controlados aleatorizados.

Abstract Introduction: Frailty is a condition of elderly characterized by increased vulnerability to stressful events. Frail patients are more likely to have adverse events. The purposes of this study were to define frailty in patients aged ≥ 70 years with chronic coronary syndrome (CCS) and to evaluate mortality and prognostic significance of frailty in these patients. Methods: We included 99 patients, ≥ 70 years old (mean age 74±5.3 years), with diagnosis of CCS. They were followed-up for up to 12 months. The frailty score was evaluated according to the Canadian Study of Health and Aging (CSHA). All patients were divided as frail or non-frail. The groups were compared for their characteristics and clinical outcomes. Results: Fifty patients were classified as frail, and 49 patients as non-frail. The 12-month Major Adverse Cardiac Events (MACE) rate was 69.4% in frail patients and 20% in non-frail patients. Frailty increases the risk for MACE as much as 3.48 times. Two patients died in the non-frail group and 11 patients died in the frail group. Frailty increases the risk for death as much as 6.05 times. When we compared the aforementioned risk factors by multivariate analysis, higher CSHA frailty score was associated with increased MACE and death (relative risk [RR] = 22.94, 95% confidence interval [CI] 3.33-158.19, P=0.001, for MACE; RR = 7.41, 95% CI 1.44-38.03, P=0.016, for death). Conclusion: Being a frail elderly CCS patient is associated with worse outcomes. Therefore, frailty score should be evaluated for elderly CCS patients as a prognostic marker.

RESUMO O Círculo de Willis é um importante sistema colateral que mantém a perfusão à área estenótica da carótida contralateral e da artéria basilar para a região de perfusão cerebral reduzida. O objetivo do presente estudo foi comparar a anomalia do Círculo de Willis em pacientes com doença carotídea assintomática e sintomática unilateral. Resultados Neste estudo retrospectivo, foram analisados 175 pacientes que foram à nossa clínica ambulatorial de AVC, entre janeiro de 2013 e junho de 2015, com doença carotídea assintomática ou sintomática unilateral, e que fizeram angiografia por tomografia computadorizada. Propriedades demográficas, estenose da artéria carótida e anomalia do Círculo de Willis foram registradas. Conclusão Não houve diferença estatisticamente significativa em pacientes com doença carotídea sintomática e assintomática em termos de anomalia do Círculo de Willis.

ABSTRACT The circle of Willis is an important collateral system that maintains perfusion to the stenotic area from the contralateral carotid and basilar artery to the region of reduced brain perfusion. The aim of the present study was to compare the circle of Willis anomaly in patients with unilateral symptomatic and asymptomatic carotid artery disease. Results In this retrospective study, we analyzed 175 patients who presented at our outpatient stroke clinic between January, 2013 and June, 2015 with either unilateral symptomatic or asymptomatic carotid artery disease, and who had had CT angiography imaging performed. Demographic properties, carotid artery stenosis and the anomaly of the circle of Willis was recorded. Conclusion There was no statistically significant difference in patients with symptomatic and asymptomatic carotid artery disease in terms of the anomaly of the circle of Willis.

The aim of this study was to investigate urine early kidney injury molecules, including human kidney injury molecule-1 (KIM-1), liver-type fatty-acid binding protein (L-FABP), N-acetyl-b-D-glucosaminidase A (NAG), and neutrophil gelatinase-associated lipocalin (NGAL) in children with vitamin B12 (cobalamin) deficiency (CD). Twelve children with vitamin B12 deficiency and 20 healthy matched controls were included. Hematologic parameters, serum urea, creatinine (Cr), electrolytes, B12 and folate levels were recorded. Estimated glomerular filtration rate (eGFR) was calculated. Urine protein, electrolytes, andurinary early markers were measured. Patients with CD had significantly higher urine electrolyte/Cr ratios (p <0.05). Significantly higher urinary KIM-1/Cr, L-FABP/Cr, NAG/Cr and NGAL/Cr were found in CD group (p <0.05). Significant negative correlations were found between levels of serum B12 and urinary markers in the patients (p <0.05). Increased urinary kidney injury molecules and electrolytes in children with B12 deficiency suggest a possible subclinical renal dysfunction, which cannot be determined by conventional kidney function tests.

El objetivo de este estudio fue investigar los niveles de moléculas de detección temprana de daño renal en la orina, que incluyen la molécula 1 de lesión renal en humanos (KIM-1), la proteína hepática transportadora de ácidos grasos (L-FABP), el N-acetil-b-D-glucosaminidasa A (NAG) y la lipocalina asociada con la gelatinasa de neutrófilos (NGAL), en niños con deficiencia de vitamina B12 (cobalamina).Seincluyeron 12 niños condeficiencia de vitamina B12 y 20 niños sanos en el grupo de referencia emparejado. Se registraron los parámetros hematológicos, la urea en suero, la creatinina (Cr), los electrolitos, y los niveles de vitamina B12 y folato. Se calculó la tasa de filtración glomerular estimada (TFGe). Se midieronlosnivelesdeproteínas, electrolitos y marcadoresde deteccióntemprana en laorina. Lospacientescon deficiencia de cobalamina tenían un cociente significativamente superior de electrolitos/Cr en la orina (p < 0,05). Se hallaron niveles significativamente superiores de KIM-1/Cr, L-FABP/ Cr, NAG/Cr y N GAL / Cr en la orina en el grupo con deficiencia de cobalamina (p < 0,05). En estos pacientes, también se hallaron correlaciones negativas significativas entre los niveles de vitamina B12 en suero y los marcadores en la orina (p < 0,05). El aumento de los electrolitos y de las moléculas marcadoras de lesión renal en la orina en los niños con deficiencia de vitamina B12 sugiere una posible disfunción renal subclínica, que no puede determinarse mediante las pruebas funcionales renales convencionales.

Objective: The aim of this study was to investigate the spectrum of Mediterranean fever (MEFV) gene mutations and genotype-phenotype correlation in children with familial Mediterranean fever (FMF) in southeast Turkey. Methods: A total of 507 children (274 females) with FMF and MEFV gene mutation(s) were included. A 15-year retrospective evaluation was conducted; parameters analyzed were: age, sex, age at symptoms onset, age at FMF diagnosis, delay between symptoms onset and diagnosis, FMF attack symptoms, and response to colchicine. Disease severity scores were calculated and MEFV mutation analysis was performed via real-time PCR for the 6 most frequent mutations. Children with comorbid diseases or tested negative for MEFV gene mutations were excluded to provide homogeneity. Results: A family history of FMF was found in 60.2% (n= 305) of patients. The most common symptoms reported for FMF attacks were abdominal pain (98.0%), fever (93.9%) and arthralgia (47.3%); 75.0% of patients (n= 380) were heterozygous, 14.2% were homozygous (n= 72) and 10.8% were compound heterozygous (n= 55).The following MEFV gene mutation alleles were identified: E148Q (40.1%), M694V (25.9%), V726A (15.8%), R761H (7.4%), M680I (6.8%), and P369S (4.1%). The M694V subgroup had the lowest mean age of disease onset and the highest mean disease severity score, whereas the E148Q group had later mean disease onset and the lowest mean disease severity score (p<0.05). Conclusion: The highest E148Q mutation frequency and milder disease in the course of FMF in our study population may be due to geographic and ethnic background dissimilarities of southeast Turkey.

Objetivo: El objetivo de este estudio fue investigar el espectro de las mutaciones genéticas localizadas en el gen de la fiebre mediterránea (MEFV) y la correlación entre el genotipo y el fenotipo en niños con fiebre mediterránea familiar (FMF) en el sureste de Turquía. Métodos: En el estudio se incluyeron 507 niños (274 eran de sexo femenino) con FMF y mutaciones genéticas localizadas en el gen MEFV. Se realizó una evaluación retrospectiva de 15 años; y se analizaron los siguientes parámetros: edad, sexo, edad al inicio de los síntomas, edad al diagnóstico de la FMF, demora entre el inicio de los síntomas y el diagnóstico, síntomas de ataque de la FMF y respuesta a la colchicina. Se calcularon los índices de severidad de la enfermedad y se realizó el análisis de la mutación del genMEFV mediante PCR en tiempo real para las seis mutaciones más frecuentes. Con el fin de aportar homogeneidad, se excluyeron los niños con comorbilidades o con un resultado negativo en las pruebas de mutaciones del gen MEFV. Resultados: Se encontró que el 60,2% (n= 305) de los pacientes tenían antecedentes familiares. Los síntomas más frecuentes que manifestaron durante los ataques de FMF fueron dolor abdominal (98,0%), fiebre (93,9%) y artralgia (47,3%); el 75,0% de los pacientes (n= 380) eran heterocigotos; el 14,2% homocigotos (n= 72) y el 10,8% heterocigotos compuestos (n= 55). Se identificaron las siguientes mutaciones en los alelos del gen MEFV: E148Q (40,1%), M694V (25,9%), V726A (15,8%), R761H (7,4%), M680I (6,8%), y P369S (4,1%). En el subgrupo M694V se observó una edad media más joven de inicio de la enfermedad y un puntaje medio más alto de gravedad de la enfermedad, mientras que el grupo E148Q tuvo un inicio medio de enfermedad más tardío y un puntaje medio más bajo de severidad de la enfermedad (p <0,05). Conclusión: La frecuencia más alta de la mutación E148Q y la enfermedad más leve en la evolución de la FMF en la población de nuestro estudio quizás se deba a las diferencias étnicas del sureste de Turquía.