ABSTRACT Background: Pan-immuno-inflammation value is a new and comprehensive index that reflects both the immune response and systemic inflammation in the body. Objective: The aim of this study was to investigate the prognostic relevance of pan-immuno-inflammation value in predicting in-hospital mortality in acute pulmonary embolism patients and to compare it with the well-known risk scoring system, pulmonay embolism severity index, which is commonly used for a short-term mortality prediction in such patients. Methods: In total, 373 acute pulmonary embolism patients diagnosed with contrast-enhanced computed tomography were included in the study. Detailed cardiac evaluation of each patient was performed and pulmonary embolism severity index and pan-immuno-inflammation value were calculated. Results: In total, 60 patients died during their hospital stay. The multivariable logistic regression analysis revealed that baseline heart rate, N-terminal pro-B-type natriuretic peptide, lactate dehydrogenase, pan-immuno-inflammation value, and pulmonary embolism severity index were independent risk factors for in-hospital mortality in acute pulmonay embolism patients. When comparing with pulmonary embolism severity index, pan-immuno-inflammation value was non-inferior in terms of predicting the survival status in patients with acute pulmonay embolism. Conclusion: In our study, we found that the PIV was statistically significant in predicting in-hospital mortality in acute pulmonay embolism patients and was non-inferior to the pulmonary embolism severity index. (Rev Invest Clin. 2024;76(2):97-102)

ABSTRACT Introduction: The relationship between mitral annular calcification (MAC) and the controlling nutritional status (CONUT) score has not been previously studied. In this study, we investigated the relationship between MAC and CONUT score to evaluate the nutritional status of patients with MAC. Methods: A total of 275 patients, including 150 patients with MAC and 125 patients without MAC, who presented to a cardiology outpatient clinic were enrolled in the study. Results: There was no difference in the CONUT score between the two groups. Correlation analysis indicated that CONUT score was positively correlated with left atrial (LA) diameter (r=0.190, P=0.020) and interventricular septum thickness (r=0.179, P=0.028) in the MAC+ group. In multivariate regression analysis, only LA diameter (odds ratio 95% confidence interval = 1,054-1,189, P=0.0001) was independently associated with MAC. Conclusion: The present study investigated the relationship between CONUT score and MAC for the first time in the literature. We demonstrated that CONUT score was not significantly higher in patients with MAC without chronic diseases. However, CONUT score was correlated with LA diameter in patients with MAC. We therefore conclude that, for patients admitted with MAC and high LA diameter, CONUT is a valuable nutritional and inflammatory status index.

Resumo Fundamento A circulação colateral coronária (CCC) proporciona um fluxo sanguíneo alternativo a tecido miocárdico exposto a isquemia e ajuda a preservar as funções miocárdicas. A produção endotelial de óxido nítrico (NO) e o fator de crescimento endotelial vascular (VEGF) foram apontados como os fatores mais importantes no desenvolvimento da CCC. A adropina é um hormônio peptídeo responsável pela hemostasia energética, e é conhecida por seus efeitos positivos no endotélio por NO e VEGF. Objetivo O objetivo deste estudo é investigar a associação entre adropina e a presença de CCC em pacientes com síndrome coronariana crônica (SCC) Métodos Um total de 102 pacientes com SCC, que tinham oclusão total de pelo menos 1 artéria coronária epicárdica importante, foram incluídos no estudo e foram divididos em dois grupos: o grupo de pacientes (n: 50) com CCC ruim (Rentrop 0-1) e o grupo de pacientes (n: 52) com CCC boa (Rentrop 2-3). O nível de significância adotado para a análise estatística foi 5%. Resultados Os níveis médios de adropina identificados foram 210,83±17,76 pg/mL e 268,25±28,94 pg/mL nos grupos com CCC ruim e boa, respectivamente (p<0,001). Detectou-se que os níveis de adropina têm correlação com as razões neutrófilo-linfócito (r: 0,17, p: 0,04) e com os escores de Rentrop (r: 0,76, p<0,001), e correlação negativa com idade (r: -0,23, p: 0,01) e com os escores Gensini (r: -0,19, p: 0,02). O nível de adropina é um preditor independente da boa evolução da CCC (RC: 1.12, IC 95%: (1,06–1,18), p<0,001). Conclusão Este estudo sugere que os níveis de adropina podem ser um fator associado à de CCC em pacientes com SCC.

Abstract Background Coronary collateral circulation (CCC) provides an alternative blood flow to myocardial tissue exposed to ischemia and helps to preserve myocardial functions. Endothelial-derived nitric-oxide (NO) production and vascular endothelial growth factor (VEGF) have been suggested as the most important factors in the development of CCC. Adropin is a peptide hormone responsible for energy hemostasis, and is known for its positive effects on the endothelium through NO and VEGF. Objective The aim of this study is to investigate the association between adropin and the presence of CCC in patients with chronic coronary syndrome (CCS). Methods A total of 102 patients with CCS, who had complete occlusion of at least one major epicardial coronary artery, were included in the study and were divided into two groups: the group of patients (n:50) with poor CCC (Rentrop 0-1) and the group of patients (n:52) with good CCC (Rentrop 2-3). The level of significance adopted in the statistical analysis was 5%. Results Mean adropine levels were found as 210.83±17.76 pg/mL and 268.25±28.94 pg/mL in the poor and good CCC groups, respectively (p<0.001). Adropin levels proved to be positively correlated with neutrophil-to-lymphocyte ratios (r:0.17, p:0.04) and the rentrop scores (r:0.76, p<0.001), and negatively correlated with age (r:-0.23, p:0.01) and Gensini scores (r:-0.19, p:0.02). Adropin level is a strong independent predictor of good CCC development (OR:1.12, 95% CI:(1.06–1.18), p<0.001). Conclusion This study suggests that adropin levels may be a possible factor associated with the presence of CCC in CCS patients.

Background: we investigated the relationships between thyroid function and obesity severity, metabolic syndrome (MS) and MS components in 260 obese children and adolescents 10-17 years of age. Objectives: we aimed to determine the association of thyroid functions with obesity severity and the components of metabolic syndrome (MS) in pediatric obese patients. Methods: only obese children and adolescents were included, and divided the obese children into three groups according to body mass index (BMI)-SDS quartiles. The first quartile was group 1, the second and third quartiles were group 2, and the fourth quartile was group 3. Group 3 indicated severe obesity. The modified WHO criteria adapted for children were used to diagnose MS. We assessed anthropometric data and serum biochemical parameters, including the lipid profile and fasting glucose (FG), insulin, thyroid-stimulating hormone (TSH), free thyroxine (fT4), and free triiodothyronine (fT3) levels. Blood pressure (BP) was measured with a standard digital sphygmomanometer. The homeostasis model assessment of insulin resistance was calculated to determine insulin resistance (IR). Results: TSH level was significantly higher in obese children with MS than that in the others (p = 0.045). Mean TSH level was not different among the BMI-SDS groups (p = 0.590). TSH levels and the fT3/fT4 ratio were not different in children with dyslipidemia, IR or hypertension (p = 0.515, 0.805, 0.973, 0.750, 0.515, and 0.805, respectively). Discussion: obesity severity does not affect TSH level or the fT3/fT4 ratio in obese children and adolescents. IR is in close relationship with TSH level. Elevated TSH level is a risk factor for MS.

Antecedentes: hemos investigado las relaciones entre la función tiroidea y la severidad de la obesidad, el síndrome metabólico (MS) y los componentes del MS en 260 niños y adolescentes obesos de entre 10 y 17 años de edad. Objetivos: pretendemos determinar la asociación de las funciones tiroideas con la severidad de la obesidad y los componentes del síndrome metabólico (MS) en pacientes pediátricos obesos. Métodos: solo se incluyeron niños y adolescentes obesos, y se dividió a los niños obesos en tres grupos según los cuartiles de índice de masa corporal (BM). El primer cuartil fue el grupo 1, el segundo y tercer cuartil fueron el grupo 2, y el cuarto cuartil fue el grupo 3. El grupo 3 indicó obesidad severa. Los criterios WHO modificados adaptados para los niños se utilizaron para diagnosticar MS. Evaluamos los datos antropométricos y los parámetros del suero bioquímico, incluyendo el perfil lípido y los niveles de glucosa en ayunas (FG), insulina, hormona estimulante del tiroides (TSH), tiroxina libre (fT4) y triyodotironina libre (fT3). Se midió la presión sanguínea (BP) con un esfigmomanómetro digital estándar. La evaluación del modelo de homeostasis de la resistencia de la insulina se calculó para determinar la resistencia a la insulina (IR). Resultados: el nivel de TSH fue significativamente mayor en niños obesos con MS que en los demás (p = 0,045). El nivel medio de TSH no fue diferente entre los grupos BMI (p = 0,590). Los niveles de TSH y la proporción fT3/ fT4 no fueron diferentes en niños con dislipidemia, IR o hipertensión (p = 0,515; 0,805; 0,973; 0,750; 0,515 y 0,805, respectivamente). Discusión: la severidad de la obesidad no afecta al nivel de TSH ni a la proporción fT3/fT4 en niños y adolescentes obesos. La IR está en relación directa con el nivel de TSH. El nivel elevado de TSH es un factor de riesgo para el MS.