Background/Objectives: Pancreatic cancer (PC) is an aggressive malignancy with a poor prognosis, frequently diagnosed at a metastatic stage. The identification of accessible, cost-effective prognostic biomarkers is critical for optimizing treatment strategies. The Endothelial Activation and Stress Index (EASIX), calculated using lactate dehydrogenase (LDH), creatinine, and platelet count, reflects endothelial dysfunction and has shown prognostic value in hematological cancers. However, its utility in metastatic PC remains unexplored. This study is the first to evaluate the prognostic significance of the EASIX in patients with metastatic PC receiving first-line FOLFIRINOX chemotherapy. Methods: This retrospective cohort study analyzed 204 patients diagnosed with metastatic pancreatic adenocarcinoma at Istanbul Training and Research Hospital between 2020 and 2025. All patients received FOLFIRINOX as first-line therapy. EASIX was calculated as LDH (U/L) × creatinine (mg/dL)/platelet count (10⁹/L). A cut-off value of 1.33 was used to stratify patients into low and high EASIX groups. Overall survival (OS) was assessed using Kaplan–Meier analysis and compared with the log-rank test. Results: The mean patient age was 63.0 ± 9.4 years; 61.8% were male. There were no significant differences in baseline characteristics between groups. Patients with EASIX ≥ 1.33 had significantly lower platelet counts and higher LDH and creatinine levels. Median OS was 14 months for EASIX < 1.33 and 8 months for EASIX ≥ 1.33 (p < 0.001). Conclusions: EASIX is a simple, inexpensive prognostic marker associated with overall survival in metastatic PC. Its integration into clinical practice may facilitate early risk stratification. Further prospective studies are needed to confirm its prognostic utility.

Background and Objectives: Cachexia is a systemic wasting syndrome associated with poor outcomes in chronic diseases, including heart failure (HF). Although the cachexia index (CXI), which integrates skeletal muscle mass, serum albumin, and the neutrophil-to-lymphocyte ratio, has shown prognostic value in oncology, its clinical significance in HF remains poorly defined. Materials and Methods: This retrospective single-center cohort study evaluated a selected subgroup of adults hospitalized with decompensated heart failure between January 2020 and January 2025 who had undergone abdominal computed tomography within the preceding 6 months, enabling CT-based body composition assessment. Skeletal muscle index was measured at the L3 vertebral level, and CXI was calculated as (SMI × serum albumin)/neutrophil-to-lymphocyte ratio. Patients were followed for all-cause mortality and HF-related rehospitalizations. Results: A total of 127 patients were included (mean age 70.45 ± 12.73 years; 51.2% male). CXI showed excellent discrimination for mortality (AUC 0.951; 95% CI 0.905–0.996), with an optimal cut-off value of <20.87. Patients with low CXI had significantly higher all-cause mortality (80.5% vs. 4.7%, p < 0.001) and more HF-related hospitalizations [4 (3–5) vs. 0.5 (0–1), p < 0.001] than those with high CXI. Conclusions: In patients hospitalized with decompensated HF, low CXI was strongly associated with all-cause mortality and recurrent hospitalization, suggesting that CXI may serve as an integrative prognostic marker in this population.

Introduction: Social media and internet platforms have transformed access to health information, often encouraging the unsupervised use of over-the-counter (OTC) vitamin supplements. This trend raises concerns about the reliability of online health content and its influence on health behaviors. This study aimed to evaluate the role of social media and internet use in patients' decisions regarding OTC vitamin supplementation. Methods: A cross-sectional survey was conducted among 216 patients attending an internal medicine outpatient clinic. Participants were grouped into two categories: those who independently initiated supplementation and those who were influenced by social media. Demographics, health information sources, social media habits, and supplementation practices were recorded. Serum 25-hydroxyvitamin D and vitamin B12 levels were measured, with deficiencies defined as <20 ng/mL and <200 pg/mL, respectively. Statistical analyses were performed using SPSS version 25.0, with significance set at p<0.05. Results: Among the participants, 55.1% were male and 44.9% were female, with a mean age of 40.8±11.4 years. Social media influenced 37.5% (n=81) of participants to initiate supplementation, most commonly via Instagram (33.3% of those influenced). This group was younger (40.3 vs. 41.4 years; p=0.001), had higher educational attainment (95.1% vs. 76.3% university graduates; p3 h: 76.5% vs. 54.8%; p=0.006). While no significant difference was found in vitamin D levels (p>0.05), the social media group had higher vitamin B12 levels (median, 358 vs. 308 pg/mL; p=0.006) and a lower prevalence of deficiency (1.2% vs. 8.9%; p=0.022). Conclusion: Social media significantly influences public health behaviors, particularly by promoting OTC vitamin use. Although some users may experience benefits, unsupervised supplementation poses risks. Physician guidance and stricter regulation of online health content and influencer marketing are essential to safeguard public health.