By FATMA AYERDEN EBİNÇ, GÜLAY ULUSAL OKYAY, SERPİL MÜGE DEĞER, et al., Published on 01/01/22

Background/aim: Acute methanol poisoning (MP) poses a significant public health challenge, with inflammation increasingly recognized as a key factor in its pathophysiology. Identifying accessible and reliable prognostic biomarkers could help enhance clinical outcomes. This study aimed to assess the prognostic value of the Systemic Immune-Inflammation Index (SII) and the Pan-Immune-Inflammation Value (PIV), measured upon emergency department admission, in predicting in-hospital mortality in patients with acute MP.Material and methods: This retrospective study included patients diagnosed with acute MP at two tertiary care centers in Ankara, Türkiye [University of Health Sciences Dışkapı Yıldırım Beyazıt Education and Research Hospital (January 1, 2015–October 1, 2022) and Etlik City Hospital (October 1, 2022–March 11, 2025)]. Demographic, clinical, and laboratory data, along with treatment details and outcomes (discharge or in-hospital death), were systematically recorded. Results: A total of 76 patients were included, of whom 92.1% were male, with a mean age of 49.0 ± 12.4 years. During hospitalization, 48.6% (n = 37) died. Both SII and PIV values at admission were significantly higher in non-survivors (p < 0.001 for SII; p = 0.031 for PIV). In multivariate Cox regression analysis, higher SII (HR: 2.44; 95% CI: 1.05–5.67; p = 0.034) and PIV (HR: 2.08; 95% CI: 1.05–4.13; p = 0.030) were independently associated with increased risk of mortality. Receiver Operating Characteristic (ROC) analysis showed an AUC of 0.750 (95% CI: 0.649–0.865) for SII, with an optimal cutoff of 665.6 (sensitivity: 50%, specificity: 46%), and an AUC of 0.640 (95% CI: 0.519–0.769) for PIV, with a cutoff of 512.5 (sensitivity: 53%, specificity: 47%). Conclusion: SII and PIV measured at hospital admission may serve as useful prognostic markers for predicting in-hospital mortality in patients with acute MP.

Microinflammation and functional iron deficiency are major contributors to anemia and treatment burden in maintenance hemodialysis (HD). Medium cutoff (MCO) membranes enhance the removal of middle‐ and large‐sized solutes implicated in these pathways, yet real‐world data using routinely measured inflammatory and iron‐related markers are scarce. This study examined the effects of MCO‐based expanded HD on inflammatory indices, iron metabolism, and anemia‐related treatment requirements. In this single‐center retrospective study, 22 maintenance HD patients (11 who continued on high‐flux dialyzers and 11 who were switched to MCO dialyzers) were followed for 24 weeks. Baseline and 24‐week assessments included C‐reactive protein (CRP), the CRP/albumin ratio, neutrophil count, and composite inflammatory indices, as well as serum iron, transferrin saturation (TSAT), total iron‐binding capacity (TIBC), and ferritin. Monthly intravenous iron supplementation and weekly erythropoiesis‐stimulating agent (ESA) doses were also documented. Baseline characteristics were comparable between groups. Over the 24‐week period, the MCO group showed a significant decline in neutrophil count ( p = 0.042) and downward trends in CRP and the CRP/albumin ratio, while both markers increased significantly in patients maintained on high‐flux dialyzers. Serum albumin remained stable in all participants. Parallel to the improvement in inflammation, the MCO group demonstrated significant enhancements in iron‐handling parameters, with higher serum iron ( p = 0.008) and TSAT ( p = 0.005), and lower TIBC ( p = 0.007), none of which were observed in the high‐flux group. Between‐group Δ‐differences were significant for CRP ( p = 0.010), CRP/albumin ratio ( p = 0.013), serum iron ( p = 0.040), TIBC ( p = 0.005), and TSAT ( p = 0.005). Hemoglobin levels remained stable in both groups, while intravenous iron and ESA requirements showed modest within‐group reductions in the MCO cohort. In this exploratory retrospective analysis, MCO membrane use was associated with favorable trends in inflammatory markers and iron‐handling parameters, alongside modest within‐group reductions in intravenous iron and ESA requirements, without compromising serum albumin. These findings suggest that MCO therapy may help mitigate microinflammation and support more efficient anemia management in real‐world HD practice.

The aim of this study was to investigate the characteristics of de novo malignancies arising in kidney transplant recipients followed in a tertiary hospital in Turkey and to examine the tumors in the head and neck region as a subgroup. Data from kidney transplant recipients treated at our institution between January 2010 and July 2022 were retrospectively analyzed in this single-center study. Data regarding malignancies were noted according to the pathologists' reports. In situ malignancies and those arising after graft loss were not evaluated. The study population comprised 231 patients (165 men; 71.4%) with a median follow-up of 11 years (2853 patient-years). The recipients had a higher cancer risk than the general population (standardized incidence rate = 3.04; 95% CI, 1.82-4.26). Thirty de novo malignant tumors were detected in 24 patients (10.4%). The mean age at diagnosis of cancer was 54.88 ± 11.44 years. The median time from transplant to cancer diagnosis was 11.5 years (range, 7-18.8 y). Nonmelanoma skin cancers (56.7% of all tumors) were the most common malignancies. Twenty-two lesions (73.3%) that developed in 17 patients (7.4%) were localized to the head and neck region: 15 (68.2%) were cutaneous and 7 (31.8%) were noncutaneous. The median time from transplant to head and neck cancer diagnosis was 12 years (range, 7.5-17.5 y). Mortality rate was higher in cancer patients (10 [41.7%] vs 17 [8.2%]; P < 0.01). The incidence of de novo malignancy in kidney transplant recipients was relatively higher compared with previous data. Nonmelanoma skin cancers were the most common type. Three-quarters of all lesions were in the head and neck region, and two-thirds were of cutaneous origin.