To compare patients with COVID-19 in intensive care units (ICUs) to healthy controls using nailfold videocapillaroscopy (NVC), offering standardised findings about micro-circulation. A descriptive, cross-sectional study. Medical Intensive Care Unit, Kayseri City Education and Research Hospital, Kayseri, Turkey between January and May 2021. The NVC parameters-capillary morphology, loop diameter, capillary density, dilated capillaries, giant capillaries, avascular areas, microaneurysms, and micro-hemorrhages of 32 patients with COVID-19 and 29 controls were recorded. The most common capillary morphology in the COVID-19 group (18/32, 56.2%) was serpentine, which also characterised some (6/29, 20.7%) patients in the non-COVID-19 group (p <0.001). The median capillary loop diameter was 77.78 ± 3.63 µm in the COVID-19 group and 71.67 ± 2.19 µm in the non-COVID-19 group (p=0.030). Mean capillary density was 6.41 ± 1.21/1 mm in the COVID-19 group and 8.55 ± 1.12/1 mm in the non-COVID-19 group (p <0.001). The COVID-19 group had significantly more enlarged capillaries (p = 0.001), giant capillaries (p = 0.025), avascular areas (p = 0.028), micro-aneurysms (p <0.001), and micro-hemorrhages (p = 0.011). Mean capillary density was 5.50 ± 0.19/1 mm among deceased patients with COVID-19, but 6.71 ± 0.25/1 mm among survivors (p = 0.011). NVC findings differed between patients with COVID-19 and controls, and capillary density was less among deceased patients with COVID-19 than survivors. Capillaries, COVID-19, İntensive care unit, Micro-circulation, Nailfold videocapillaroscopy.

Purpose: The aim of the study was to assess the amplitude of accommodation (AA) in patients with type 1 diabetes mellitus (DM) and without diabetic retinopathy. Materials and Methods: In two age- and sex-matched groups—one with twenty-nine eyes of 29 patients with type 1 DM, the other with twenty-nine eyes of 29 healthy individuals—retinal nerve fibre layer thickness and macular volume were determined by using optic coherence tomography in all quadrants, whereas AA was measured with the minus lens technique. The mean values of all three measurements were compared between the groups, and the effect of age, disease duration, HbA_1c and fasting blood glucose on AA were analysed using multiple regression analysis. Results: On average, participants were 25.0 ± 3.3 years old (range 19–30) in both groups (P = 1.000), and patients had type 1 DM for an average of 13.0 ± 3.3 years. Mean AA in the right eye was 7.3 ± 1.1 D among patients and 8.1 ± 1.1 D among controls (P = 0.005), as well as significantly negatively correlated with age in both groups (r = -0.735, P < 0.001 and r = -0.819, P < 0.001, respectively) and disease duration among patients (r = -0.434, P = 0.019). In multivariable regression, age and disease duration significantly affected AA in patients, with an R² value of 0.623 (P < 0.001 and P = 0.025, respectively). Average RNFL thickness was significantly different between the groups (P = 0.014). Mean macular volumes for areas 1, 3 or 5 mm in diameter were similar between the groups. Conclusions: AA was significantly lower among patients with type 1 DM than among healthy individuals, which suggests that the former might experience presbyopia earlier in life than the general population.

Background: To investigate the association between the triglyceride-glucose (TyG) index and newly diagnosed branch retinal vein occlusion (BRVO) in patients. Methods: The study included 57 individuals with BRVO and a control group comprising 50 healthy volunteers matched for age and gender. Detailed eye examinations were conducted, and various blood biochemistry and hematological parameters were recorded. The TyG index was calculated using fasting plasma glucose and triglyceride values. Results: The mean age was 61.4 ± 9.6 years for the BRVO group and 60.6 ± 10.3 years for the control group. The TyG values were significantly higher in the BRVO group when compared to the control group (8.84 ± 0.41 vs. 8.52 ± 0.29, p < 0.001). Multivariate analysis revealed that the TyG index independently predicted BRVO (odds ratio = 2.58, 95% confidence interval = 1.69–3.93; p < 0.001). In receiver operating characteristics analysis, the TyG index had an area under the curve of 0.749, and a TyG index higher than 8.52 predicted BRVO with 83% sensitivity and 70% specificity. Conclusions: This study establishes a significant association between an elevated TyG index and BRVO. Consequently, the TyG index could serve as a valuable predictive tool for identifying individuals at risk for BRVO.

Purpose: To present a patient with bilateral conjunctivitis, testing positive for viral RNA of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in both nasopharyngeal and conjunctival samples. Methods: A 40-year-old man with bilateral acute conjunctivitis and suspicious signs of coronavirus disease 2019 (COVID-19) presented to the hospital. A detailed ophthalmic examination was performed. Samples obtained from conjunctival and nasopharyngeal swabs were tested by reverse transcription PCR (RT-PCR) for the detection of SARS-CoV-2 virus. Ocular findings and duration of the presence of viral RNA in the conjunctival specimens were evaluated at follow-up visits. Results: Slit-lamp biomicroscopy revealed bilateral acute follicular conjunctivitis. The RT-PCR assay demonstrated the presence of viral RNA in the nasopharyngeal and conjunctival specimens at the initial visit and at the 4-day follow-up. Conjunctivitis findings were decreased after 4 days and recovered completely without any sequelae within10 days. The PCR results of both nasopharyngeal and conjunctiva specimens were negative for the viral RNA at 10 days. Conclusions: Bilateral conjunctivitis is rare in patients infected with COVID-19. Although it is difficult to detect viral RNA from conjunctival swabs, conjunctival secretions may be a source of contamination, and protective measures must be taken.

Background and Objectives: The use of additional biomarkers to predict clinical course in diabetic ketoacidosis (DKA) is becoming increasingly important. The aim of this study was to investigate the relationship between interleukin-6 (IL-6) levels and the length of stay in the intensive care unit (ICU) in patients with DKA without signs of infection and to investigate the relationship between the neutrophil–lymphocyte ratio (NLR) and C-reactive protein (CRP) albumin ratio (CAR). Materials and Methods: This retrospective, single-center study included 78 patients with DKA without infection who were treated in the Medical ICU between July 2022 and June 2024. The patients were divided into two groups: moderate DKA (Group 1) and severe DKA (Group 2). The patients’ IL-6 levels, peripheral blood inflammatory markers (CAR, NLR), Acute Physiology and Chronic Health Evaluation (APACHE) II scores, and the duration of ICU stay were recorded. Results: The median duration of stay in the ICU was 2.00 (1–6) days in group 1 and 3.00 (1–26) days in group 2 (p = 0.001). The mean pH, HCO₃, and CO₂ values in Group 1 were 7.20 ± 0.07, 13.58 ± 2.11 mEq/L, and 29.45 ± 6.27 mmHg, while the mean pH, HCO₃, and PCO₂ values in Group 2 were 7.01 ± 0.11, 7.11 ± 1.91 mEq/L, and 20.35 ± 4.91 mmHg (p < 0.001, p < 0.001, p < 0.001, respectively). There was a strong positive correlation between IL-6 levels and the length of stay in the ICU (r = 0.813, p < 0.001). Additionally, there was a moderate positive correlation between the length of stay in the ICU with the severity of DKA (r = 0.475, p < 0.001), CAR (r = 0.336, p < 0.001), and NLR (r = 0.562, p < 0.001). Conclusions: Inflammatory markers such as NLR and CAR, and more specifically IL-6, were found to be associated with the clinical course and duration of stay in the ICU in patients with DKA.

Non-invasive ventilation (NIV) plays a critical role in the management of acute and chronic respiratory failure, offering benefits over invasive mechanical ventilation. However, its use is associated with various adverse events that may impact clinical outcomes. This systematic review aimed to evaluate the types, frequencies, and clinical consequences of complications related to NIV. A systematic search of PubMed, EMBASE, and Cochrane Library databases was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses 'PRISMA' guidelines, covering studies published between 2000 and February 2023. Eligible studies included randomized controlled trials, observational cohorts, and systematic reviews reporting adverse events in adults receiving NIV for respiratory failure. Thirty-two studies involving approximately 6,000 patients were analyzed. NIV-related complications were frequently reported, including, physiological (e.g., hypercapnia 2-10%, hypoxemia 1-5%), mechanical (e.g., skin breakdown 5-15%, air leaks 5-25%), and patient-related events (e.g., discomfort 10-30%, anxiety 5-15%). Face masks were linked to higher rates of air leaks and intolerance, while helmet interfaces showed fewer complications. Helmet interfaces and newer ventilator technologies showed advantages in minimizing certain adverse events. Although NIV offers substantial benefits compared to invasive ventilation, its effectiveness can be compromised by preventable complications. Structured monitoring, early intervention, and a multidisciplinary care approach are essential for maximizing outcomes. Further research is needed to develop strategies that enhance patient comfort, minimize complications, and optimize NIV application across different clinical settings.