Objectives: The study aimed to assess the relation of anxiety and depression levels with hypertension in COVID-19 outbreak. The analysis of the association of selected socio-demographic and clinical parameters on the presence and severity of psychological distress was also performed. Methods: The study involved 91 patients applying with a medical history supportive of COVID-19 infection. According to the hospitalization criteria and diagnostic result of SARS-CoV-2 nucleic acid test certainty of the disease, three groups were created. Patients with positive SARS-CoV-2 nucleic acid test results were consisted of 31 hospitalized subjects. To assess the applicant psychological state, a specially developed questionnaire was used, as the presence and severities of the symptoms were assessed using the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI). Results: Statistically, a significantly higher average level of depression and a higher incidence of anxiety were demonstrated among applicants in the Covid-19 pandemic (% 24 and % 44). Also a higher level of anxiety was demonstrated in hospitalized patients compared with the outpatient group. Different from the presence of depression symptoms, the presence of anxiety symptoms was associated independently with hypertension in our study group OR 2.6 (95% CI, 0.99–6.78) P = .04). Conclusions: In the aftermath of COVID-19 outbreak both anxiety and depression are common psychological disorders. Also, different from the symptoms of depression, the symptoms of anxiety are associated independently with hypertension. The described socio-demographic parameters and clinical characteristics had no impact on the symptoms of depression and anxiety irrespective of hospitalized status in the investigated groups.
No-reflow is a frequent complication during percutaneous coronary intervention (PCI) for acute ST segment elevation myocardial infarction (STEMI). Available data is limited regarding its impact on short-term outcomes in patients undergoing manual thrombus aspiration. Renal impairment is also associated with higher complication rates in STEMI. Herein, we aimed to evaluate the impact of baseline renal dysfunction on the no- reflow phenomenon and the association of no-reflow phenomenon with early clinical outcomes. A total of 94 consecutive STEMI patients who underwent primary stent-based PCI and thrombus aspiration were enrolled. No-reflow was established by the use of angiographic and electrocardiographic reperfusion criteria, respectively. Additionally angiographic and clinical follow-up data were also recorded. In our study, the no-reflow phenomenon was observed in 10 patients (11%) angiographically and in 23 patients (24%) electrocardiographically. Whereas, the the estimated glomerular filtration rate (eGFR) [odds ratio (OR) 10.4], hypertension (OR 6.2), previous MI (OR 6.5), previous PCI history, (OR 4.2), predilatation (OR 7.2), final balloon pressure (OR 0.9) were found to be the significant predictors of angiographic no-reflow, only reperfusion time was the predictor of electrocardiographic no-reflow (OR 1.12) at univariate analysis. After adjustment, lower eGFR (OR 14.8) was found to be the independent predictor for angiographic no-reflow. In-hospital mortality was more common in patients with either no-reflow condition separately. Longer ischemic time and lower initial eGFR values were associated with no-reflow phenomenon. Irrespective of poor reperfusion criteria, no-reflow phenomenon is associated with in-hospital outcome. Future efforts should be made to reduce the incidence of no-reflow especially in patients with lower initial eGFR values.
7 February 2022 in Journal of Turkish Sleep Medicine
Introduction: Early detection of muscle loss and prediction of prognosis in cancer patients are of great importance for clinical management. This study aimed to investigate the relationship between temporal muscle thickness changes over time and clinical outcomes in patients with advanced solid cancer, and to evaluate the prognostic value of temporal muscle loss rate in predicting 90-day mortality. Methods: In this retrospective observational study, patients with advanced solid cancer who had at least two cranial computed tomography scans during follow-up were included. Temporal muscle thickness was measured on both the right and left sides at two different time points, and the temporal muscle loss rate (mm/month) was calculated. Demographic data, laboratory parameters, and anthropometric measurements were obtained from patient records. Factors predicting mortality were evaluated using logistic regression analysis, and prognostic performance was assessed by receiver operating characteristic analysis. Results: A total of 57 patients were included in the study. 90-day mortality occurred in 78.9% of patients. Neutrophil levels were significantly higher in the mortality group, while albumin and magnesium levels were significantly lower. Baseline temporal muscle thickness measurements were not associated with mortality; however, right and left temporal muscle loss rate were significantly higher in the mortality group. Multivariable logistic regression analysis identified left temporal muscle loss rate and neutrophil level as independent predictors of mortality. Receiver operating characteristic curve analysis demonstrated good discriminative performance, with the left temporal muscle loss rate exhibiting superior predictive ability. Conclusion: Temporal muscle loss rate may serve as a useful dynamic biomarker for predicting short-term mortality in patients with advanced solid cancer.