Introduction Rheumatoid arthritis (RA) is a chronic autoimmune condition that causes systemic inflammation and affects multiple joints. It is characterized by joint warmth, swelling, pain, and the formation of invasive synovial tissue known as pannus, which contributes to cartilage and bone degradation. Pan-immune-inflammation value (PIV), a marker derived from complete blood count parameters, has shown promise in predicting prognosis in various cancer types and pediatric conditions associated with immune abnormalities. This study aims to explore the relationship between RA, characterized by chronic inflammation and immune system involvement, and PIV, potentially shedding light on novel insights into RA's clinical implications. Methods One hundred four participants, including 64 RA patients (both newly diagnosed and established cases) and 40 healthy controls, were included in the study. Exclusion criteria for RA patients included acute infection, cancer, diabetes, or chronic illness, while control participants were excluded for inflammatory disorders, active infection, diabetes, or malignancy. We assessed disease severity using Disease Activity Score 28 (DAS 28) and obtained complete blood count values, including neutrophil, lymphocyte, platelet, monocyte, and red cell distribution width. C-reactive peptide (CRP) and erythrocyte sedimentation rate were also added. Statistical analyses included correlation assessments, t-tests, Mann-Whitney U tests, and multivariate linear regression. A multiclass receiver operating characteristic analysis determined optimal PIV cut-off values for distinguishing control, remission, and active RA groups, with sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, and odds ratios calculated. Results This study comprised a cohort of 104 participants, with a median age of 43.5±17.5. The Remission group was significantly younger than the Control group (p=0.006) but not compared to the Active RA group (p=0.393). CRP levels were significantly higher in the Active RA group (p<0.001). Neutrophil counts were highest in the Active RA group (p<0.001), as were monocyte counts. Lymphocyte counts were significantly lower in the Active RA group (p<0.001). There were no significant differences in sedimentation rate, hemoglobin, platelet count, and mean platelet volume. PIV was significantly elevated in the Active RA group (p<0.001) and higher in the Remission group than in the Control group (p=0.001). A PIV value of 353.48 exhibited 71.4% sensitivity, 86.2% specificity, 86.2% PPV, 71.4% NPV, and 78.13% test accuracy for distinguishing active rheumatoid arthritis (p<0.001). A PIV value exceeding 353.48 substantially increased the likelihood of a patient belonging to the active rheumatoid arthritis group, with a 14.62-fold higher probability. Furthermore, the study explored the relationship between clinical and laboratory variables and disease activity in RA patients, finding significant differences in PIV among DAS groups (p=0.025). Conclusions The PIV offers a notable advantage as its constituent parameters are routinely assessed in rheumatoid arthritis and involve cost-effective and straightforward tests. We demonstrated that PIV serves as a valuable marker for distinguishing between remission and active RA when compared to healthy individuals. Additionally, it proved to be an effective tool for assessing disease activity in patients with active rheumatoid arthritis.

Introduction Diabetic nephropathy associated with end-stage renal disease (ESRD) is a significant public health problem due to its high morbidity and mortality. We aimed to improve the estimation of proteinuria in diabetic patients and potentially enhance risk stratification and clinical management strategies with the assessment of the correlation of the neutrophil/lymphocyte ratio (NLR), low-density lipoprotein/albumin ratio (LAR), and red cell distribution width/albumin ratio (RAR) with the proteinuria in the uncontrolled diabetes patient population. Methods This was a retrospective study including 327 patients with uncontrolled diabetes (HbA1c > 10%) seen in an outpatient clinic. The study enrolled patients over 18 years old, excluding those with active infections, malignancies, immunodeficiency, hematological diseases, pregnancy, breastfeeding, or type I diabetes. Patients using specific drugs affecting proteinuria or lipid levels were also excluded. Data from patients were retrospectively obtained, including gender, age, blood parameters, glucose, creatinine, albumin, cholesterol, triglyceride, and HbA1c levels, as well as spot urine protein and creatinine levels. Proteinuria was assessed using a spot urine protein/creatinine ratio (>0.30 indicated proteinuria). Patients were divided into two groups: group 1 (non-proteinuric with uncontrolled diabetes) and group 2 (proteinuric with uncontrolled diabetes). Demographics, laboratory results, and LAR, NLR, and RAR values were compared between the groups with univariate and multivariate analyses. All statistical analyses were performed using IBM SPSS Statistics for Windows software. For the statistical significance level, p<0.05 was accepted as meaningful. Results Among 327 patients with uncontrolled diabetes, 33.03% were proteinuric. Patients with proteinuria were significantly older (median age 65 vs. 61 years) and had higher NLR and RAR values. There were no significant differences observed in terms of LAR values between groups. Serum albumin levels were lower and urea levels were higher in the proteinuric group. A multivariate analysis was done to identify variables for the prediction of proteinuria. NLR and RAR were found to be independent predictors of proteinuria even after adjusting for potential confounders in the multivariate analysis. The model achieved a 71.9% correct classification rate. An NLR cutoff of 1.93 increased the likelihood of proteinuria 1.93-fold, while a RAR cutoff of 3.30 increased the likelihood 1.63-fold. Conclusions We found that the LAR ratio cannot be used to predict proteinuria in patients with HbA1C levels above 10, but the NLR and RAR ratios can guide the clinician regarding proteinuria and potentially enhance risk stratification and clinical management strategies before a detailed workup.

Chronic kidney disease is a worldwide public health issue with rising incidence, morbidity/mortality, and cost. Depression and chronic renal disease often coexist, and psychological illnesses are associated with poor results. Early identification of depression reduces morbidity and death. Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) are reported as practical biomarkers of inflammation and immune system activation. In this study, we aimed to determine the association of NLR and PLR with depression in dialysis patients. This study included 71 adults over 18 without known hematologic or oncologic disease, drug use, or chronic inflammatory diseases. Comorbid chronic diseases, laboratory data, and Beck depression inventory scores were prospectively recorded. A comparison of 2 groups according to the existence of depression was made, and a binomial logistic regression test was used to determine the association between the variables and the presence of depression after adjusting for confounding factors. A receiver operating curve analysis was used to differentiate groups with and without severe depression. Seventy-one patients met the study criteria, with 46 hemodialysis and 25 peritoneal dialysis patients. The majority had hypertension and diabetes mellitus, with 47.89% having minimal-minor depression and 52.11% having moderate-major depression. The 2 groups were similar regarding chronic diseases, with no significant differences in serum creatinine levels, glucose, lipid profiles, or electrolytes. However, when the NLR of the 2 groups was compared, the median was higher in patients with moderate or major depression. Multivariate analysis showed no significant differences between the groups in PLR, triglyceride to glucose ratio, and C-reactive peptide to albumin ratio. The best NLR cutoff value was 3.26, with 48.6% sensitivity, 88.2% specificity, 81.8% positive predictive value, 61.2% negative predictive value, and 67.6% test accuracy. Depression is one of the most common psychiatric conditions in dialysis patients and is linked to increased morbidity, mortality, treatment failure, expense, and hospitalization. NLR helped predict moderate-to-major depression in dialysis patients, even after controlling for confounding factors in multivariate analysis. This study indicated that an NLR successfully identified depressive groups, and patients with an NLR value >3.26 were 6.1 times more likely to have moderate or major depression.

Background and Objectives: Extubation success in ICU patients is crucial for reducing ventilator-associated complications, morbidity, and mortality. The Rapid Shallow Breathing Index (RSBI) is a widely used predictor for weaning from mechanical ventilation. This study aims to determine the predictive value of serial RSBI measurements on extubation success in ICU patients on mechanical ventilation. Materials and Methods: This prospective observational study was conducted on 86 ICU patients at Hitit University between February 2024 and July 2024. Patients were divided into successful and unsuccessful extubation groups. RSBI values were compared between these groups. Results: This study included 86 patients (32 females, 54 males) with a mean age of 54.51 ± 12.1 years. Extubation was successful in 53 patients and unsuccessful in 33. There was no significant difference in age and intubation duration between the groups (p = 0.246, p = 0.210). Significant differences were found in RSBI-1a and RSBI-2 values (p = 0.013, p = 0.011). The median RSBI-2a was 80 in the successful group and 92 in the unsuccessful group (p = 0.001). The ΔRSBI was higher in the unsuccessful group (p = 0.022). ROC analysis identified optimal cut-off values: RSBI-2a ≤ 72 (AUC 0.715) and ΔRSBI ≤ −3 (AUC 0.648). RSBI-2a ≤ 72 increased the likelihood of successful extubation by 10.8 times, while ΔRSBI ≤ −3 increased it by 3.4 times. Using both criteria together increased the likelihood by 28.48 times. Conclusions: Serial RSBI measurement can be an effective tool for predicting extubation success in patients on IMV. These findings suggest that serially measured RSBI may serve as a potential indicator for extubation readiness.

Introduction Individuals frequently turn to YouTube as a source of information about their medical conditions and potential treatment options. Among the common ailments affecting the general population, hepatosteatosis stands out due to its severe consequences in the absence of proper treatment. The primary objective of this study is to evaluate the quality of hepatosteatosis-related videos available on the YouTube platform, and the secondary objective is to determine if there is a difference in video quality between videos uploaded by medical professionals and other sources. Methods The process of selecting videos for this study involved evaluating their relevance after conducting a search using the keywords "hepatosteatosis," "fatty liver," and "hepatic steatosis" on YouTube. This search was conducted on August 18, 2023. From the search results, we identified and selected the top 50 most-watched videos in the English language. These selected videos were then rigorously assessed for their relevance and content by three independent medical professionals. Additionally, various descriptive attributes of each video, such as the upload date, subscriber count, view count, likes, dislikes, and comments, were meticulously recorded in the dataset. To determine the quality of these videos, we utilized three evaluation tools: the DISCERN Score, the Global Quality Score (GQS), and the Journal of the American Medical Association (JAMA) rating scales. We have used the median±interquartile range (IQR), mean±standard deviation (SD), and the range of minimum to maximum values to convey descriptive statistics. The distribution was evaluated with the Shapiro-Wilks test. Spearman correlation analysis was used to identify relationships between variables. The association between quality indicators and data was examined using multiple regression analysis. The Mann-Whitney U test was used to determine significant differences between groups. A statistical significance level of 0.05 was considered significant. Results Our study revealed notable statistical differences in DISCERN scores when comparing videos uploaded by medical doctors to those uploaded by individuals without medical qualifications (p < 0.001). Likewise, in the comparisons between these two groups, videos created by healthcare professionals consistently demonstrated significantly higher quality scores in both the JAMA and GQS evaluations (p < 0.001 for both comparisons). This suggests that videos uploaded by medical professionals tend to provide higher-quality information on the topic of hepatosteatosis compared to those uploaded by non-medical individuals. Video length and comment counts were also found to be significant in the multivariate linear regression analysis and were predictive of the DISCERN score (p = 0.047 and p = 0.037, respectively). Conclusions The quality of information related to hepatosteatosis on YouTube varies significantly. Surprisingly, there is no noticeable difference in terms of views and popularity between helpful and potentially misleading videos. For individuals seeking reliable information, it is advisable to prioritize videos uploaded by medical professionals. Paying attention to the qualifications of the content creator rather than the video's popularity or view count is crucial when seeking accurate and trustworthy information on hepatosteatosis.

Background and Objectives: Chronic kidney disease (CKD) is a global public health issue with rising incidence linked to substantial morbidity and mortality. Selenium, an antioxidant trace element, has been linked to low serum levels in end-stage renal disease. Restless Leg Syndrome (RLS), a sleep disorder, is prevalent in CKD patients and significantly impacts their quality of life. The objective of this study was to examine the correlation between serum selenium levels and the prevalence of restless leg syndrome in individuals with chronic kidney disease. Materials and Methods: Forty-six CKD patients undergoing serum selenium level assessments between 1 January 2020 and 28 February 2022, at the Hitit University Faculty of Medicine Department of Nephrology Outpatient Clinic or Hemodialysis Unit, were included. Patients over 18 years of age with no history of hematological or oncological diseases or acute or chronic inflammatory conditions were included in the study groups. Patients taking selenium supplements were excluded. Demographic data, comorbidities, and laboratory values were collected, and RLS presence and severity were evaluated. Statistical analyses include descriptive statistics, correlation analysis, the Mann–Whitney U test, Student’s t test, and Chi-square test. Results: Among the 46 patients, 16 (34.78%) had RLS symptoms. The patient group included 34.78% predialysis, 34.78% peritoneal dialysis, and 30.44% hemodialysis patients, with a median age of 47.98 years. There was no difference in age, gender, and Charlson comorbidity between patients with or without RLS (p = 0.881, p = 0.702, p = 0.650). RLS prevalence varied across CKD subgroups, with hemodialysis patients having a higher prevalence (p = 0.036). Clinical parameters such as blood urea nitrogen, creatinine, calcium, phosphorus, platelet counts, and parathyroid hormone levels exhibited significant differences between patients with and without RLS (p < 0.05). Serum selenium levels were not significantly different between patients with and without RLS (p = 0.327). Conclusions: With an increased comorbidity burden, CKD poses a significant healthcare challenge. When accompanied by RLS, this burden can be debilitating. The difference in CKD stages between groups has shed light on a critical determinant of RLS in this population, emphasizing the role of the chronic kidney disease stage. In our study, serum selenium levels were not associated with the presence and severity of RLS. However, prospective studies with larger numbers of participants are needed to draw a definitive conclusion.