Background/Objectives: Acute pancreatitis (AP) remains a pressing clinical challenge, largely due to its potential to lead to life-threatening complications and increased mortality. Over the years, numerous tools have been proposed to evaluate the intensity of AP and estimate likely health outcomes. Despite their usefulness, many of these assessment models are complex and rely on a wide array of clinical inputs, making them less practical in everyday healthcare settings. In contrast, the Aggregate Systemic Inflammation Index (AISI), which is calculated using routine blood count parameters, provides a simpler and more inclusive approach to measuring systemic inflammation. This research focuses on examining how effectively AISI can be used to gauge disease severity and project clinical trajectories in individuals affected by pancreatitis. Methods: This retrospective study reviewed the medical records of 412 individuals diagnosed with acute pancreatitis, all of whom received care at the Internal Medicine Clinic of Ankara Bilkent City Hospital between 1 April 2019 and 1 September 2024. The investigation encompassed a thorough analysis of patients’ demographic characteristics, lab parameters, and clinical findings, with special attention given to inflammatory markers, including the Aggregate Systemic Inflammation Index (AISI), its revised version, the Platelet-to-Lymphocyte Ratio (PLR), the Neutrophil-to-Lymphocyte Ratio (NLR), and the Systemic Inflammatory Response Index (SIRI). Comparative analyses between groups were performed using independent sample t-tests and one-way ANOVA, complemented by Tukey’s post hoc tests where appropriate. Correlations among continuous variables were determined through Pearson’s analysis, and the prognostic accuracy of both AISI and its modified form was assessed using Receiver Operating Characteristic (ROC) curve methodology. Results: The mean age among participants was 63.47 ± 17.92 years, while the average AISI value was calculated as 1183.89 ± 1067.42. Both the original and modified versions of the AISI index showed strong positive correlations with several key clinical measures, including prolonged hospitalization, a Glasgow score of 2 or above, BISAP, Ranson scoring, the revised Atlanta classification, and APACHE II. AISI was also significantly linked to the presence of complications and overall mortality (p < 0.01). Analysis through ROC curves demonstrated that an AISI level above 236.626 effectively predicted hospital stays exceeding 10 days, with a sensitivity of 94.40% and a specificity of 91.00%. Moreover, both AISI and its modified form reliably distinguished patients who had a Ranson score of zero, with high diagnostic accuracy. Conclusions: AISI and its modified version demonstrate a strong association with both the intensity and clinical course of acute pancreatitis. Thanks to their simplicity, low cost, and broad usability in healthcare settings, these indices hold considerable promise as practical and dependable tools for assessing the severity and likely outcomes of this increasingly prevalent disease.

Background: Acute pancreatitis is an abrupt inflammatory disease of the exocrine pancreas and it can occur in different severities. It is becoming more common and more mortal in the gerontal population. The aim of our study was to explore the similarities and differences between young and gerontal patients with acute pancreatitis, with a special emphasis on patients over 80 years of age. Methods: Medical records of patients (n = 1150) with acute pancreatitis were analyzed retrospectively. Several scoring systems including Bedside index for severity in acute pancreatitis, Ranson’s score, Harmless acute pancreatitis score, Acute Physiology and Chronic Health Evaluation, Balthazar Grade, Glasgow score, and Japanese severity score were applied at admission. Patients were divided into 3 groups; group I, young group (n = 706), if they were aged <65 years; group II, older group (n = 338), if they were aged ≥65 years to <80 years; group III, octogenarian group (n = 106), if they were aged ≥ 0 years. Results: In total, 1150 patients with acute pancreatitis were analyzed. Octogenarian group (n = 42, 39.6%) showed a more severe acute pancreatitis compared to patients in group I (n = 15, 2.1%) and II (n = 50, 14.8%, P < .001). Complications were more common in patients in group III (P < .001). Mortality rate was higher in patients in group III (n = 53, 50%) compared to group I (n = 8, 1.1%) and group II (n = 53, 15.7%) (P < .001). Conclusion: Gerontal patients with acute pancreatitis tend to have more severe disease and systemic and local complications. Mortality rates were higher in older patients compared to younger patients. Cite this article as: Asfuroğlu Kalkan E, Kalkan Ç, Kaçar S, et al. Similarities and differences between gerontal and young patients with acute pancreatitis: Evaluation of clinical characteristics and outcomes. Turk J Gastroenterol. 2022;33(10):874-884.

A 56-year-old male admitted to the hospital for generalized weakness and fever. He was treated in hospital for 10 days due to COVID-19. He did not receive any immunosuppressive therapy during admis...

Background: Shiga toxin-producing Escherichia coli (STEC) causes serious bacterial illnesses from consuming undercooked meat and foods contaminated with feces. This study aimed to describe the characteristics of an STEC outbreak associated with hemolytic uremic syndrome (HUS) that emerged in Turkey and affected 21 adults. Material/Methods: The medical records of 21 adult patients who were admitted to Ankara Bilkent City Hospital Internal Medicine Intensive Care Department with the diagnosis of HUS between July and September 2022 were retrospectively evaluated through the system. Results: While a positive correlation was detected between the length of hospital stay and N-terminus pro-B-type natriuretic peptide (NT-proBNP), lactate dehydrogenase (LDH), and troponin during hospitalization, a negative correlation was detected with glomerular filtration rate (GFR). Patients requiring plasmapheresis had higher creatinine, amylase, and LDH values at the time of admission. In patients given eculizumab, high NT-proBNP and creatinine levels and low GFR levels at the time of admission were found to be statistically significant. The use of antibiotics before admission did not change the length of hospital stay. Conclusions: A statistically significant difference was detected between LDH, GFR, troponin, NT-proBNP parameters, and length of hospital stay. Creatine and LDH values of patients requiring eculizumab and plasmapheresis at the time of admission were found to be statistically high. It should be kept in mind that eculizumab and plasmapheresis treatment can be required for patients with elevated creatine and LDH at the time of admission.

Background and Objectives: Rhabdomyolysis is a disorder in which skeletal muscle tissues are damaged, resulting in the escape of their internal substances into the blood circulation. Acute kidney injury (AKI) is a serious complication of rhabdomyolysis that necessitates early recognition to ensure effective clinical management. The objective of this research was to create a practical scoring tool for forecasting AKI in patients experiencing rhabdomyolysis due to trauma or excessive exercise. Materials and Methods: A novel scoring system, termed the growth differentiation factor-15-trauma-creatine kinase acute kidney injury score (GDF-TRACK-AKI score), was established. The model integrates serum levels of growth differentiation factor-15 (GDF-15), creatine kinase (CK), and occurrence of rhabdomyolysis associated with trauma. Clinical and biochemical data were prospectively collected, and the model’s predictive performance was evaluated using receiver operating characteristic ROC curve analysis. Results: Among patients with rhabdomyolysis, those who developed AKI had significantly higher GDF-TRACK-AKI scores (median: 3.00 (IQR: 2.00)) compared to patients without AKI (median: 0.48 (IQR 0.89); p < 0.001). Serum CK and GDF-15 levels were also markedly elevated in the AKI group (p < 0.001). ROC analysis identified a cut-off value of 2.5, providing 67% sensitivity and 98% specificity. Patients with scores ≥ 2 demonstrated a significantly increased risk of AKI. Conclusions: Designed as a practical and dependable tool, the GDF-TRACK-AKI score facilitates prompt identification of kidney injury in patients whose rhabdomyolysis is linked to either trauma or vigorous activity. The integration of trauma history with GDF-15 and CK biomarker data improves risk stratification precision and supports timely treatment decisions. To verify its practical utility and prognostic capabilities, the GDF-TRACK-AKI score should undergo additional evaluation across expansive and demographically varied clinical populations.

Background and Objectives: Circadian fluctuations in blood pressure, particularly the non-dipping pattern characterized by the absence of a nocturnal decline, are associated with an increased risk of microvascular complications. The retina, as a highly sensitive microvascular tissue, offers a valuable window into systemic hemodynamic alterations. However, the literature lacks detailed structural analyses that evaluate all retinal regions by segmenting nighttime into specific time intervals. Notably, the early morning period (04:00–08:00), during which stress hormones such as cortisol and catecholamines rise physiologically, leads to increased blood pressure that may significantly affect retinal microcirculation. This prospective study aims to assess retinal microvascular structures in dipper and non-dipper individuals using structural optical coherence tomography and to investigate their relationship with blood pressure parameters by dividing nighttime into distinct time segments. Materials and Methods: A total of 60 participants were classified as dipper (n = 26) or non-dipper (n = 34) based on 24 h ambulatory blood pressure monitoring results. Structural optical coherence tomography was used to evaluate superficial and deep capillary plexus densities in the foveal, parafoveal, and perifoveal regions, along with the area and perimeter of the foveal avascular zone (FAZ) and flow density (FD). Blood pressure values, including systolic, diastolic, mean arterial, and pulse pressure, were recorded during two nighttime intervals (00:00–04:00 and 04:00–08:00), and correlations with retinal parameters were analyzed. Results: No significant differences were observed in retinal microvascular parameters between the dipper and non-dipper groups. Deep capillary densities, particularly in the parafoveal and perifoveal regions, showed significant positive correlations with serum total protein, albumin, and very low-density lipoprotein (VLDL) levels. Furthermore, systolic and mean arterial pressures measured during the 04:00–08:00 interval demonstrated significant positive correlations with deep retinal vascular densities. The FAZ perimeter was negatively correlated with pulse pressure variability, while FD showed a negative correlation with mean arterial pressure variability. Conclusions: This prospective study is among the first to investigate the effects of circadian blood pressure patterns on retinal microvascular structures by segmenting nighttime into specific intervals and employing comprehensive structural optical coherence tomography across the entire retina. The findings suggest that retinal microvascular structure may be associated with fluctuations in blood pressure. Analyses of blood pressure measurements between 04:00 and 08:00 may offer supplementary insights into the evaluation of retinal microvascular structure.