The coronary artery calcium (CAC) score is used in decision-making for preventive medications in patients with borderline clinical risk scores. Both absolute and percentile CAC scores can be used; however, a percentile CAC score is especially useful in young patients and women. The aim of this study is to present CAC score percentiles across age categories in women and men using a large database. Bilkent City Hospital database was screened for patients who underwent CAC score measurements between January 2021 and March 2022. Of the 4,487 patients, 546 were excluded due to 1) a history of coronary stent implantation or bypass surgery or 2) missing information regarding a history of revascularization or calcium scores. Therefore, the final study population included 3,941 participants. The percentiles for age categories within each sex were tabulated, and percentile plots were created for each sex using locally weighted scatterplot smoothing regression. The proportion of men included in the study was higher compared with that of women (57.09% vs. 42.91%). The mean age was 52.20 ± 11.11 years, and it was higher in women than in men (54.07 ± 10.47 vs. 50.80 ± 11.37, respectively; P < 0.001). A zero CAC score was observed in 2,381 (60.42%) patients; the percentage was higher in women than in men (68.60% vs. 54.27%; P < 0.001). When the cut-off value for the high-risk category was taken as the 75^th percentile, a non-zero CAC score directly assigned a patient into the high-risk category in women aged <55 years and men aged <45 years. Percentile plots were also provided for each sex. In this large-scale study, including patients referred for CAC scoring and/or coronary computed tomography angiography, CAC score percentiles were provided for women and men across the selected age categories which may be in therapeutic decision-making. As an approximate rule of thumb, a non-zero CAC score corresponds to the high-risk category in women aged <55 years and in men aged <45 years.

Coronary artery calcium (CAC) is a marker of subclinical atherosclerosis. We aimed to assess to what extent risk factors and statin use modify the time to occurrence of CAC. The study population included 3484 patients who underwent CAC score measurements and CT angiography between January 2021 and March 2022. To assess to what extent risk factors and statin use modify the time to occurrence of CAC, a time difference for a 50% probability of having a non-zero CAC score between those with and without these factors was calculated. The mean age was 52.1 ± 10.9 years, and 43.1% of the population were women. Age was the most important factor for having non-zero CAC (z value 21.84, p-value <0.001). This is followed by male gender (Odds ratio [OR] and 95% CI 3.53 [2.96-4.21]; p < 0.001), and statin use (OR 3.09 [2.41-3.97], p < 0.001). A non-zero CAC develops on average 10.3 years earlier in men compared with women, and 9.1 years earlier in statin users compared with non-users. Diabetes mellitus, hypertension, and smoking were also associated with earlier occurrence of CAC score, but to a lower extent. Apart from age, male gender and statin use are the major factors for the occurrence of CAC and are associated with CAC occurrence 9-10 years earlier.

Pneumothorax (PTX) and pneumomediastinum (PM) are frequently encountered in patients with Coronavirus disease 2019 (COVID-19) and complicate the management of these patients. In this study, we aimed to evaluate the risk factors that cause PTX/PM complications in patients hospitalized due to COVID-19 pneumonia and the effects of these complications on the course of the disease. A total of 503 patients with COVID-19 hospitalized in the COVID-19 ward or intensive care unit (ICU) between September 2020 and December 2020 were included in the study. The median age of patients was 65 (min-max, 21-99) years. Of the patients 299 (59.4%) were male and 204 (40.6%) were female. Of the cases, 26 (5.2%) developed PTX or PM. The patients who developed PTX/PM were older than patients who did not [58.5 (min-max, 21-96) vs 65 years (min-max, 22-99), p= 0.029]. The percentage of PTX/PM development was significantly higher in male patients [F/M= 4/22 (2/7.4%) vs 200/277 (98/92.6%), p= 0.007]. Hypertension as a comorbidity was more commonly seen in the group without PTX/PM (p= 0.007). Ground-glass opacity was the most common tomographic finding in both groups, it was significantly higher in those who did not develop PTX/PM (p<0.001). The length of hospital stay was shorter in patients with PTX/PM (p<0.001), but mortality was higher (p= 0.04). PTX/PM were relatively more common in COVID-19 patients. These complications may negatively affect the prognosis of the disease.

Background and Objectives: With physiological aging, the pancreas is expected to decrease in size as in every organ. The objective of this study was to examine the correlation between pancreas volume (PV), nutritional status, and glycolyzed hemoglobin A1c (HbA1c) in elderly patients with and without type 2 diabetes mellitus (DM). Materials and Methods: Between July 2020 and April 2022, 109 patients aged ≥ 65 years who applied to geriatrics clinics and outpatient clinics were included in the study. PV was measured from available abdominal contrast-enhanced computed tomography (CT) scans. Patients were divided into two groups according to the presence of DM. The relationship between PV; biochemical parameters, especially HbA1c; and Mini Nutritional Assessment Short Form (MNAsf) score was analyzed between groups. p < 0.05 was considered statistically significant. Results: The mean age of all participants was M: 77.40, with SD: 7.32. A total of 54.1% of the participants were female, and 55 had DM. There were no significant differences in age and gender between those with and without DM. Glucose (p < 0.001), HbA1C (p < 0.001), and triglycerides (p < 0.001) were significantly higher, and HDL (p < 0.001) was significantly lower in patients with DM. PV was also significantly lower in those with DM (p = 0.028). A correlation analysis revealed significant positive correlations between PV, the MNAsf score (rho (109)) = 0.413, p = 0.003), and lipase (rho (109)) = 0.297, p = 0.002). Conclusions: PV, which is expected to decrease with age, was found to be lower in patients with DM in our study in which we evaluated elderly patients with and without DM. We also found that PV was associated with malnutrition. Our study highlights the importance of determining the clinical effects of pancreatic volume in the geriatric population where organ atrophy is expected. Therefore, we believe that more comprehensive studies are needed to clarify the clinical implications of pancreatic volume on our diagnostic and therapeutic decisions.

Background/Objectives: Lupus Nephritis (LN) is a major complication of Systemic Lupus Erythematosus (SLE) leading to significant morbidity. While biopsy is the gold standard, non-invasive tools are needed for longitudinal monitoring. This study aims to evaluate the diagnostic utility of Shear Wave Elastography (SWE) in detecting subclinical renal damage (fibrosis) in SLE patients with a history of LN who are currently in clinical remission (inactive disease), and to compare its efficacy with Doppler ultrasonography (DUS). Methods: This cross-sectional study included 80 SLE patients and 41 age- and sex-matched healthy controls. Crucially, all SLE patients were in the clinically inactive disease (SLEDAI-2K < 6) at the time of evaluation. Patients were stratified into two groups: those with a history of LN (LN Group, n = 37) and those without (Non-LN SLE Group, n = 43). Strict exclusion criteria were applied to eliminate non-SLE renal comorbidities. Renal parenchymal stiffness (kPa) was measured using SWE, and the renal resistive index (RI) was assessed using DUS. SWE findings were correlated with renal function tests and disease activity scores. Results: Despite being in clinical remission, the LN group exhibited significantly higher renal stiffness values (Median: 1.60 kPa) compared to the non-LN SLE group (1.40 kPa, p < 0.001) and healthy controls (1.32 kPa, p < 0.001). No significant difference was observed between the non-LN SLE group and controls. Unlike SWE, renal RI values showed no statistically significant difference among the groups (p > 0.05). Correlation analysis revealed that renal stiffness was positively associated with prior serum creatinine and disease activity (SLEDAI-2K), and negatively associated with eGFR. Conclusions: SWE is superior to DUS (RI) in detecting renal parenchymal changes in LN patients. The persistence of elevated stiffness during the inactive disease suggests that SWE captures cumulative chronic damage (remodeling and fibrosis) rather than just acute inflammation. Consequently, SWE holds promise as a non-invasive surrogate for monitoring disease chronicity in SLE patients.