Background and Objectives: Early risk stratification in acute pancreatitis (AP) remains challenging, particularly for identifying patients who initially appear low-risk but later develop complications. The Modified Endothelial Activation and Stress Index (m-EASIX) reflects endothelial injury and systemic inflammation. This study evaluated the prognostic value of dynamic 48 h m-EASIX assessment for predicting adverse clinical outcomes in AP. Materials and Methods: This retrospective cohort study included adult patients hospitalized with AP between January 2020 and June 2025. Propensity score matching (1:1) was performed using age, sex, BISAP score and etiology. Laboratory parameters were recorded at admission and at 48 h. Adverse outcomes were defined as prolonged hospitalization (≥8 days) and/or pancreatic necrosis, abscess, intensive care unit admission or in-hospital mortality. Multivariable logistic regression was used to identify independent predictors of adverse outcomes. Receiver operating characteristic (ROC) analysis evaluated the predictive performance of m-EASIX and compared it with BISAP and Ranson scores. Results: A total of 258 patients were included in the initial cohort, of whom 93 experienced an adverse clinical course. After propensity score matching, 170 patients remained in the final analysis (85 per group). The 48 h m-EASIX score was independently associated with adverse outcomes in both unmatched and matched cohorts. ROC analysis showed a moderate discrimination for composite outcomes (AUC ≈ 0.76) and a stronger discrimination for hard outcomes (AUC up to 0.867). In all analyses, m-EASIX significantly outperformed BISAP and Ranson scores (DeLong test p < 0.001). Dynamic risk reclassification showed that m-EASIX identified a subgroup of patients initially classified as low-risk by BISAP who later developed adverse outcomes. Conclusions: The dynamic assessment of m-EASIX at 48 h provides additional prognostic information for early risk stratification in AP and may help identify patients at an increased risk of unfavorable clinical courses.

Cranial imaging is vital in patients with complaints of sudden speech disorder, deterioration in performance status, urinary and fecal incontinence, and numbness in hands and feet. It provides an investigation of etiology and clarification of diagnosis. Hematological malignancies sometimes present with these symptoms and imaging may be the first method for diagnosis. In this case, we will present a patient diagnosed with primary central nervous system lymphoma, who was found to be HIV-positive during follow-up, and who progressed early and died despite treatment.

A significantly elevated erythrocyte sedimentation rate (ESR ≥100 mm/h) is often linked to serious conditions, including infections, autoimmune disorders, and malignancies. However, because ESR is a nonspecific marker, it can be challenging to prioritize patients for cancer investigations. While conditions like multiple myeloma can be identified through specific tests, there are no equally definitive markers for other malignancies. This study examined whether routine laboratory parameters could enhance diagnostic value. We retrospectively analyzed 124 adult patients with an ESR ≥100 mm/h admitted to Bursa Uludağ University Internal Medicine Clinic from January 2020 to April 2024. After excluding those with incomplete laboratory data, undiagnosed cases, and plasma cell dyscrasias, 46 patients remained in the final cohort. In our analysis, we found that hemoglobin, albumin, and lactate dehydrogenase (LDH) were significant predictors of malignancy in univariate analyses. We developed the HALD score, calculated as (Hemoglobin (g/dL) × Albumin (g/L) / LDH (U/L), which demonstrated good diagnostic performance, with an area under the ROC curve of 0.749 (95% CI: 0.567–0.932). An optimal cut-off value of 1.45 resulted in a sensitivity of 66.7% and a specificity of 84%. These results suggest that combining inexpensive and readily available laboratory parameters into a scoring system can help identify patients with high ESR who should be prioritized for further evaluation of malignancy.

Idiopathic granulomatous mastitis (IGM) is a rare chronic inflammatory breast disease with a relapsing course. The neutrophil-to-lymphocyte ratio (NLR) has been investigated as a potential inflammatory biomarker in various diseases. This study aimed to evaluate the association between NLR and recurrence in patients with IGM. This retrospective single-center study included 130 patients diagnosed with IGM and followed at the Rheumatology Outpatient Clinic of Bursa Uludağ University Faculty of Medicine between January 2019 and April 2024. Demographic characteristics, lesion features, laboratory parameters, treatments, and recurrence data were recorded. Binary Logistic Regression and Receiver operating characteristic (ROC) analyses were performed. All patients were female. The median age at diagnosis was 33 (21–64) years and the median follow-up duration was 16 (2–120) months. Recurrence developed in 63 (48.5%) patients. Multivariable analysis showed that younger age at diagnosis (OR: 0.88, p=0.022), menopause (OR: 122.87, p=0.007), lower NLR levels (OR: 0.14, p=0.003), and longer follow-up duration (OR: 1.06, p<0.001) were significantly associated with recurrence. No significant differences were observed in white blood cell count, neutrophil, platelet, erythrocyte sedimentation rate, or C-reactive protein levels. ROC analysis showed no significant predictive performance of NLR (AUC: 0.498, p=0.959). Lower NLR levels were associated with recurrence in patients with IGM; however, NLR alone did not demonstrate sufficient predictive performance and may be more useful when interpreted together with other clinical parameters.

Background: Hypercalcemia of malignancy (HCM) is associated with poor short-term prognosis, particularly when it represents the initial manifestation of an underlying, as yet uncharacterized malignancy. Serum calcium concentration alone may not adequately capture the systemic biological burden associated with advanced disease. Methods: In this retrospective, single-center cohort study, 71 patients with moderate-to-severe hypercalcemia (corrected calcium ≥12 mg/dL) in whom a hematologic or solid malignancy was subsequently diagnosed were evaluated. The modified Endothelial Activation and Stress Index (m-EASIX = LDH × CRP/platelet count) was calculated at presentation. Univariate and multivariable logistic regression, receiver operating characteristic (ROC) analysis and Kaplan–Meier survival analysis were used to evaluate the association between Log2 m-EASIX and 90-day mortality. Results: Log2 m-EASIX remained independently associated with 90-day mortality in multivariable analysis (adjusted OR = 1.96, 95% CI 1.37–2.82, p < 0.001), whereas white blood cell count and albumin did not reach statistical significance in the same model. Corrected serum calcium was not associated with mortality (p = 0.702). Log2 m-EASIX showed good discriminative performance (AUC = 0.857, 95% CI 0.768–0.946) and stratified 90-day survival in both hematologic (p < 0.001) and solid malignancies (p = 0.002), with no significant interaction between m-EASIX and malignancy subgroup (p = 0.499). Conclusions: m-EASIX, calculated from routinely available laboratory parameters, may provide clinically useful prognostic information for early risk stratification in patients presenting with hypercalcemia of malignancy.

Background: Primary hyperaldosteronism (PHA) is a primarily treatable cause of arterial hypertension characterized by low plasma renin and high aldosterone levels. The prevalence of secondary hypertension as a common endocrine cause is 5-13%. The plasma aldosterone/renin ratio (ARR) is the best available method for PHA screening. One or more confirmatory tests may be required to confirm or exclude patients' diagnoses. One frequently used confirmatory test is the saline infusion test (SİT). We aimed to screen the patients who underwent SİT with the preliminary diagnosis of PHA and to compare the results of the patients diagnosed with essential hypertension (EH) and PHA. Material and Methods: Seventy-seven patients with a history of drug-resistant hypertension or unexplained spontaneous or diuretic-induced hypokalemia or adrenal incidentaloma, or a family history of early-onset hypertension or cerebrovascular accident at a young age (0.05). Basal plasma aldosterone (p