Yucel C, et al. World J Mens Health. 2019 Jan;37:e5. https://doi.org/10.5534/wjmh.180105

To investigate the possible relationship between the neutrophil to lymphocyte ratio (NLR) value and the presence and size of thyroid nodules. Data of 216 patients between 18 and 65 years of age, who had presented to the internal medicine department of our hospital between February 2018 and September 2018, were collected retrospectively. A total of 216 patients fulfilling the inclusion criteria were included in the study. An ultrasonographic examination revealed thyroid nodules in 105 patients and no thyroid nodules in 111 patients. Among those with a nodule, 52 had a nodule size of ≤10 mm and 53 had a nodule size of >10 mm. These groups were compared with regard to age, gender, body mass index, thyroid function tests, neutrophil, lymphocyte and platelet count, NLR, and mean platelet volume (MPV). Although the absolute counts of lymphocytes and neutrophils were lower in the group with nodules, no significant difference was observed between the groups. Among those with a nodule, no significant difference was determined between nodule size and thyroid function tests, NLR, or MPV. In the group of patients with a nodule, malignant pathology was reported in 2.7%. Although there are studies suggesting a relationship between NLR, MPV, and the presence of malignancy and mortality, we determined no such relationship between nodule formation and their size in thyroid tissue.

Objectives: Fibromyalgia syndrome (FMS) is an entity that presents with wide-spread chronic pain in musculoskeletal system, disturbed sleep, reduced mental functioning and depressed mood. We aimed to determine the incidence of FMS in our hemodialysis patients and to evaluate the association between FMS, depression and inflammation in patients ongoing hemodialysis.Methods: Among 169 patients, 140 patients were enrolled into our study. Twenty-nine patients were excluded according to exclusion criteria. Demographic characteristics including age, sex, body mass index, duration of dialysis, the etiology of end stage renal disease, the dialysis adequacy (Kt/V) were also recorded. All patients were evaluated through 2010 ACR preliminary diagnostic criteria including widespread pain index (WPI) and total symptom severity. All subjects completed Beck depression inventory (BDI) to determine psychological status.Results: Among 140 hemodialysis patients, 76 (54.2%) patients presented chronic widespread pain and 20 patients (14.2%) met the 2010 ACR criteria for FMS. Patients were divided into FMS (n = 20; 14.2%) and non-FMS (n = 120; 85.8%) groups. FMS group had significantly higher serum C-reactive protein levels and lower serum albumin levels when compared to non-FMS group. BDI (31.4 ± 1.4 vs 14.8 ± 0.6, p < 0.005), WPI (11.2 ± 0.7 vs 2.8± 0.2, p = 0.002) and symptom severity (7.3 ± 0.3 vs 3.7 ± 0.1, p < 0.005) scores were significantly higher in FMS group.Conclusions: The FMS itself and the related symptoms were correlated with depression in maintenance hemodialysis patients. Besides, inflammation and perhaps malnutrition-inflammation sydrome may trigger FMS in this population.

Background and Objectives: Peripheral cytopenia occurs in approximately 2% of the population; however, in up to 0.9%, no cause is identified by conventional tests. Next-Generation Sequencing (NGS) detects somatic variants consistent with clonal hematopoiesis (CH). We aimed to determine the prevalence of CH and pre-myelodysplastic syndrome (pre-MDS) using a 51-gene panel with histopathological assessment. Materials and Methods: Bone marrow samples from 96 consecutive patients evaluated for cytopenia were retrospectively analyzed for genetic alterations. Results: In the overall cohort (n = 96), the median follow-up was 8.1 months (range, 1–20). A total of 37 (39%) out of 96 patients were diagnosed with idiopathic cytopenia of undetermined significance (ICUS), 9 (9%) with clonal cytopenia of undetermined significance (CCUS), 9 (9%) with clonal cytopenia and monocytosis of undetermined significance (CCMUS), 34 (36%) with myelodysplastic syndrome (MDS), and 7 (7%) with myelodysplastic/myeloproliferative neoplasm (MDS/MPN). Among 41 patients in whom no cytogenetic abnormalities were detected by fluorescence in situ hybridization (FISH), somatic variants were identified by NGS. In CCUS, 88% of patients had a single variant, most commonly ASXL1 (44%), followed by TET2 (22%). In CCMUS, ASXL1 and DNMT3A (each 25%) were the most frequent variants. The mean variant allele frequency (VAF) was higher in MDS (33.4%) than in CCUS/CCMUS (13.6%). In MDS patients aged 60 years and older, a higher number of variants were found compared to patients aged less than 60 years (p = 0.028). RUNX1 variants (n = 8) were associated with leukopenia (p = 0.012). Patients with SRSF2 variants (n = 4) had significantly poorer progression-free survival (p = 0.001). EZH2 and SETBP1 variants were associated with inferior overall survival (p = 0.04 and p = 0.019, respectively). In MDS patients (n = 34), thrombocytopenia (plt < 100.000) was associated with shorter PFS (p = 0.005). Conclusions: Given that pre-MDS conditions are considered predictors of hematologic malignancies, conventional diagnostic workup may be insufficient to accurately identify these entities, whereas NGS provides significant additional diagnostic value.

Purpose: The aim of this study is to assess the presence of sarcopenia in multiple myeloma (MM) patients both before and after autologous stem cell transplantation (ASCT) and to investigate if ASCT is a causative factor for sarcopenia. This study is the first to examine the impact of ASCT on sarcopenia in individuals with MM via bioelectrical impedance analysis (BIA), computed tomography (CT), and performance tests simultaneously. Materials and Methods: The prospective study was conducted from January 2022 to April 2023. The median duration of the follow‐up period was 12 months. All of the participants were assessed for sarcopenia by BIA, CT, and performance tests at 1 month (±2 weeks) prior to the conditioning regimen and 6 months (±4 weeks) following the transplant. The EWGSOP 2018 guideline was used for sarcopenia diagnosis. Results: In the study, 102 patients who were ≥ 18 years and diagnosed with MM according to the criteria established by the International Myeloma Working group (IMWG) were enrolled. Pre‐ASCT, 47 (46%) patients and post‐ASCT, 51 patients (50%) were sarcopenic ( p = 0.12). Pre‐ASCT, a low skeletal muscle index (SMI) was identified in 51% of the patients, and this percentage increased to 56% after ASCT ( p = 0.03). In multivariate analysis, female sex (odds ratio [OR]: 1.25; 95% CI: 1.12–1.38; and p = 0.007), higher Hematopoietic Cell Transplantation‐Specific Comorbidity Index (HCT‐CI) score (OR: 1.16; 95% CI: 1.04–1.29; and p = 0.008), and lower body mass index (BMI) (OR per unit increase: 0.94; 95% CI: 0.88–0.99; and p = 0.045) were independently associated with sarcopenia. Conclusions: Our study revealed a high prevalence of sarcopenia among individuals with MM. We demonstrated that individuals with comorbidities, a low BMI, and female sex have a higher predisposition to sarcopenia. There was no increase in the occurrence of sarcopenia after ASCT; however, SMI decreased.