Background: COVID-19 may affect many endocrine tissues as well as thyroid gland and hypothalamus-pituitary-thyroid axis. It has been shown that COV D-19 infection suppresses thyroid hormones in some studies and causes subacute thyroiditis in the others so that its effects are still not fully known. The aim of our study is to retrospectively evaluate thyroid functions, clinical findings, biochemical and inflammatory markers in PCR positive patients infected with COVID-19; and to evaluate the relationship between abnormal thyroid function tests (TFT) and clinical and laboratory findings and whether it has potential prognostic significance. Methods: The data of patients aged 18 years and older, 201 patients who applied to Mersin City Training and Research Hospital due to COVID-19 infection between 1st of March and 1st of April in 2021 and received inpatient treatment were evaluated retrospectively Results: Large TFT (TSH, T3, T4, anti-TPO) and laboratory data of 201 patients with mild, moderate or severe pneumonia on CT were scanned retrospectively. 121 (60.2%) of the patients were male, mean age was 51.9 ± 14.6 years, and the most common comorbid disease was hypertension in 65 (32.3%) patients. Conclusions: It has been determined that the deterioration in TFTs is associated with LDH and D-dimer which are indicators of cell and endothelial damage, duration of hospitalization, clinical severity, and having mutant strains and it has been concluded that low TSH can be used as a prognostic indicator in COVID-19 patients. Further studies with healthy control groups, quantitative RT-PCR tests, histological and pathological correlations, and long-term follow-up are needed.

Thyroid cancers are among the most common endocrine cancers. An inflammation is associated with many stages of cancer. Therefore, in this study, we aimed to evaluate whether it has a prognostic significance inflammation marker. Neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, monocyte/lymphocyte ratio, systemic inflammation response, systemic immune-inflammation index, and neutrophils to lymphocytes and platelets ratio (N/LP) in patients diagnosed with thyroid cancer in the internal medicine outpatient clinic and operated between March 1, 2017 and May 1, 2022 were evaluated retrospectively. Three hundred forty patients were diagnosed with thyroid cancer; 275 (80.9%) of them were women and the mean age was 44.6 ± 13.5 years. Multifocality (P = .02) was significant in patients with invasion. High N/LP ratio (odds ratio: 1.4, 95% confidence interval: 1.0–2.0, p: 0.003) and high invasion (odds ratio: 0.2, 95% confidence interval: 0.1–0.4, P < .01) was found to be significant in patients with tumor size ≥2 cm. There is a relationship between multifocality and invasion, and the risk of invasion increases as the tumor size increases in thyroid cancer. The N/LP ratio was significant as it could be a new marker in showing the relationship between thyroid cancer and its prognosis. Further studies are needed in which the prognosis is followed up, longer-term, more comprehensive, and confounding factors are excluded.

Disasters are inevitable causes of trauma, resulting in a high number of deaths and morbidity in survivors requiring prolonged treatment. Crush syndrome (CS), also known as traumatic rhabdomyolysis, is a syndrome with a wide clinical spectrum. A series of clinical complications caused by CS, hyperkalemia, myoglobinuria and especially acute kidney injury (AKI) are the main causes of death. This study has been designed to investigate the effectiveness of neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), lymphocyte-monocyte ratio (LMR) and systemic immune-inflammatory index (SIII) in predicting the need for hemodialysis (HD) in patients with CS following rescue from earthquake. This study was conducted as a single-center retrospective research. which focused on patients with CS among the earthquake victims who were admitted to the hospital after the earthquake centered in Southern Türkiye on February 6, 2023. Demographic, clinical and laboratory data of patients from the earthquake zone were used. T-Test was applied to compare two independent numerical variables. Receiver operating characteristic (ROC) curve analysis was used to assess the predictive capacity of NLR, PLR, LMR and SIII on AKI, HD and mortality (Area Under the Curve (AUC) > 0.600). The level of significance was accepted as p < 0.05. Of the 464 patients included in the study, 45.3% (n = 210) were male and the mean age was 41.2 ± 15.9 years. The most common trauma mechanism was entrapment under debris (46.8%, n = 217). AKI was present in 42% (n = 195) of the cases and 30.1% (n = 140) required HD. The mortality rate was 7.3% (n = 34). The need for HD, hyperbaric therapy and blood replacement was significantly higher in patients who developed AKI (p < 0.001, p = 0.011 and p < 0.001, respectively). The predictive power of NLR on the need for hemodialysis, the development of AKI, and mortality was higher than PLR, LMR and SIII. In the ROC analysis to determine the need for hemodialysis, NLR (AUC = 0.828) was found to be higher in predicting power than PLR (AUC = 0.651), LMR (AUC = 0.787) and SIII (AUC = 0.792). Parameters obtained from blood cell counts such as NLR, PLR, LMR and SIII can be used to predict the severity of AKI and the need for hemodialysis in these patients rescued from earthquake. Not applicable. Deciding on HD in patients who develop post-traumatic CS is a very important decision. The indications for HD have not yet been clearly defined, which needs adjunctive variables. The present study shows that hematological parameters may be useful in making HD decisions in patients with CS.

Introduction. In the aftermath of natural disasters, hospitals often face a surge of patients with emergency injuries, posing significant challenges to emergency medical response systems. Effective biomarkers are essential for patient follow-up, treatment, and prognosis prediction. Studies to date have attempted to identify indicators of crush syndrome. With this study, we aimed to add to the growing body of literature on this subject. Methods. This single-center retrospective study analyzed 185 patients admitted with earthquake-related crush injuries between February and March 2023. They were compared with 1,065 patients who were also trapped during the earthquake but did not develop crush syndrome. Demographic, clinical, and laboratory data were utilized for the analysis. Results. Patients with crush syndrome exhibited significantly higher levels of blood glucose, D-dimer, white blood cell count, hemoglobin, platelet count, absolute neutrophil count, absolute monocyte count, C-reactive protein, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, and systemic inflammatory index compared to those without crush syndrome (p < 0.001). Additionally, they had a higher prevalence of upper extremity fractures, lower extremity fractures, pelvic fractures, abdominal trauma, chest trauma, lower extremity trauma, intracranial hemorrhage, pneumothorax, hemothorax, and intraabdominal bleeding (p < 0.001). Conclusions. Systemic inflammatory indices and biochemical values can be valuable prognostic tools in managing patients after a disaster. Utilizing these indices may enhance the efficient allocation of hospital resources and enable rapid intervention for high-risk patients.

Aim: Secondary infections caused by bacteria or fungi are dangerous because they increase death rates, particularly in patients with COVID-19 who are receiving intensive care. In this study, hospital-associated secondary infections resulting from bacteria and fungi amid COVID-19 patients treated in intensive care units, as well as their distribution according to microbial agents, were investigated. Material and Method: The study comprised 134 COVID-19 patients who were being treated in the Mersin City Hospital of the Ministry of Health intensive care unit between January 1, 2021, and April 30, 2021. The patients’ demographics and clinical records, as well as bacterial and fungal infections in the blood, urine and deep tracheal aspirate samples, were analyzed retrospectively. Results: The rate of secondary infection was found to be quite high in patients hospitalized in intensive care units for over 72 hours (91.4%). The majority of secondary infections were detected in blood samples (n=103, 15%). Secondary infection was detected in 61 (8.9%) deep tracheal aspirate specimens and 59 (8.5%) urine samples. The most common secondary infectious agents were Candida spp. (22.3%), Acinetobacter baumannii (16.8%). In addition, it was determined that ≥60 years and ≥3 days of mechanical ventilation independently increased the probability of developing secondary infection. Conclusion: Our findings are emphasized that the concern of secondary infection due to Candida spp., Acinetobacter baumanii and Stahylococcus epidermidis agents. Evaluation of bacterial superinfections during the later waves of the pandemic may be critical, especially given the changes in the management of these patients, such as the routine use of corticosteroids and the raise of the different variants of the SARS-CoV-2.