Karahan Yilmaz, Sevil; Özçiçek, Fatih; Mertoğlu, Cuma; Arslan, Yusuf Kemal

Aim: This study was aimed to investigate visceral adiposity indicators and the atherogenic index of plasma (AIP) in type 2 diabetes mellitus (T2DM) patients. Material and Methods: A total of 353 adults aged between 18 and 74 years were included in this study. Bodyweight, height, waist, and hip circumference were measured; fasting blood glucose, HbA1c, and lipid profile (total cholesterol, triglyceride, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol) values were analyzed. Visceral adiposity index (VAI), lipid accumulation product (LAP), body adiposity index (BAI), body shape index (ABSI), body roundness index (BRI), conicity index (CI), and AIP levels were calculated. Results: The study included 116 (32.9%) males and 237 (67.1%) females, with a mean age of 57.8±11.5 years. AIP z-scores were found to be directly related to T2DM (OR, 5.03; 95% CI: 1.95-13.01), while VAI z-scores were less associated with T2DM (OR, 1.10; 95% CI: 1.03-1.18). According to the ROC curve analysis, although the area under the curve (AUC) is weak to distinguish diabetic patients with VAI, LAP, and AIP, it is statistically significant (p<0.001, AUC: 0.619, cut-off= 5.1, 95% CI: 0.561-0.677; p=0.007, AUC: 0.583, cut-off= 63.2, 95% CI: 0.523-0.642; and p=0.001, AUC: 0.606, cut-off= 0.4, 95% CI: 0.547-0.665, respectively). Conclusion: VAI, LAP, and AIP are strong predictors of diabetes, AIP is a better predictor of predicting diabetes than VAI and LAP.

Tosun, Mustafa; Ölmez, Hasan

Aim: Coronavirus disease 2019 (COVID-19) mostly proceeds with mild respiratory symptoms, but sometimes severe pneumonia, cytokine storm, and acute respiratory distress syndrome can develop. Anti-cytokine treatments are being tried for cytokine storm. In this study, we aimed to examine the effect of tocilizumab on mortality associated with COVID-19. Material and Methods: The study included 146 patients with moderate-to-severe acute respiratory distress syndrome diagnosed with COVID-19. The patients were divided into two groups, receiving only standard treatment (ST group, n=44), and tocilizumab treatment in addition to standard treatment (TCZ group, n=102). Groups were compared in terms of demographic, clinic, and laboratory data. Also, mortality rates were determined to detect the effect of tocilizumab on mortality. Results: Overall, 36.3% (n=53) of the patients were female, 63.7% (n=93) were male, and the mean age was 69.5±14.2 years. The mortality rate was 29.4% (n=30) in the TCZ group and 52.3% (n=23) in the ST group (p=0.009). While C-reactive protein, fibrinogen, and lactate levels on admission to the intensive care unit (ICU) were similar across the groups, the TCZ group had higher ferritin levels (p=0.006). On discharge from ICU, the TCZ group had a significant decrease in C-reactive protein (p<0.001), while their ferritin levels decreased to levels in the ST group (p=0.134). The absence of tocilizumab in the treatment regimen was associated with a 2.63-fold increase in the mortality risk. Conclusion: Tocilizumab reduces the mortality in COVID-19 patients in ICU. However, further studies are warranted to better elucidate the efficacy and side effects of tocilizumab.

Ankarali, Handan; Öztürk, Elif Cihadiye; Önder, Elif; Bolu, Semih; Kılınçel, Özge; Admış, Özlem

Aim: In this study, it was aimed to investigate the distribution of isolated pathogens, the resistance rates of these pathogens to antimicrobials, presence of glycosuria and pyuria in patients with diabetes mellitus (DM) and obesity in adult and pediatric endocrine outpatient clinics with urinary system infections. Material and Methods: Between January 2012 and February 2014, records of 107 patients with DM and obesity in Duzce University Medical Faculty Hospital Adult and Pediatric Endocrine outpatient clinics were retrospectively reviewed. Biochemical/microbiological laboratory results of urine specimens taken from these patients were evaluated. Fisher Exact and Pearson Chi-Square tests were used with statistical evaluation of SPSS 22.0 program. Results: Thirty-two (70%) of the patients were children, 75 (30%) are adults; 84 (78.5%) were female, 23 (21.5%) were male, mean of ages 25.1±23. Number of patients with diabetes and obesity were 76 (71.0%) and 31 (29.0%), respectively. Bacterial growth occurred 28 (26%) of urine cultures (23 (30.2%) of patients with DM, 5 (16.1%) of patients with obesity). E. coli was detected most frequently as causative agent. In patients with pyuria and glycosuria, more bacterial growth were detected and statistically significant correlation was found between pyuria and bacterial growth, but no significant relationship was found with glycosuria. Conclusion: Although glycosuria may increase the risk of infection, it may not be a determining parameter alone, but patients should be assessed considering the current risk; it has also been found that there is a strong relationship between the presence of the pyuria and urinary tract infection. However, it is considered appropriate to start antibiotic treatment according to the causative agent and sensitivity profile isolated in urine culture rather than to start empirical treatment according to the complete urine analysis result.