Metabolic dysfunction-associated steatotic liver disease (MASLD) is increasingly recognized as a systemic metabolic disorder associated with extrahepatic organ damage, including chronic kidney disease (CKD). The Fibrosis-4 (FIB-4) index is a validated non-invasive tool for estimating hepatic fibrosis severity. This study aimed to investigate whether FIB-4-defined hepatic fibrosis is independently associated with reduced estimated glomerular filtration rate (eGFR) in a large, real-world Turkish MASLD cohort. This is a cross-sectional analysis of the prospective, nationwide, multicenter DAHUDER MASLD Study, which enrolled patients from 44 internal medicine outpatient clinics across 31 provinces representing all 12 statistical regions of Türkiye. A total of 10,873 MASLD patients were included. MASLD was defined as ultrasonographic hepatic steatosis in the presence of at least one cardiometabolic risk factor. High FIB-4 was defined as ≥ 1.3 for patients aged < 65 years and ≥ 2.0 for those aged ≥ 65 years, per EASL–EASD–EASO 2024 guidelines. eGFR was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Age-stratified multivariate linear regression models were constructed to identify independent predictors of eGFR. High FIB-4 was detected in 11.2

To investigate the role of lipid-derived indices—the monocyte-to-HDL cholesterol ratio (MHR), visceral adiposity index (VAI), atherogenic index of plasma (PAI), and cardiometabolic index (CMI)—in determining hepatic steatosis and fibrosis among patients with metabolic dysfunction-associated steatotic liver disease (MASLD) across Turkey. This nationwide, multicenter, retrospective cross-sectional study included 14,322 individuals from 44 internal medicine clinics in 31 provinces of Turkey. Anthropometric, clinical, and biochemical data were collected, and Participants were classified as MASLD (+) if ultrasonographic hepatic steatosis was present in the setting of ≥ 1 cardiometabolic risk factor according to current EASL–EASD–EASO guidelines; individuals without ultrasonographic steatosis were classified as MASLD (–). FIB-4 scores were calculated to assess the risk of advanced hepatic fibrosis. Cardiometabolic risk factors included obesity (BMI ≥ 25 kg/m² or increased waist circumference), type 2 diabetes mellitus, hypertension, impaired fasting glucose, and dyslipidemia as defined by international guidelines. The relationships between MHR, VAI, PAI, CMI, and MASLD presence and fibrosis severity were analyzed via nonparametric statistical tests. MASLD was detected in 10,836 participants (75.7%). The VAI, PAI, and CMI were significantly greater in the MASLD (+) group than in the MASLD (–) group (p < 0.001 for all), whereas the MHR was not significantly different (p = 0.453). Among MASLD (+) patients, 1,214 (11.2%) had high FIB-4 scores (≥ 1.3; ≥2.0 if > 65 years) yet none of the lipid indices correlated significantly with FIB-4 levels. In multivariable logistic regression analysis restricted to MASLD-positive individuals, none of the lipid-derived indices were independently associated with high FIB-4 risk after adjustment for metabolic covariates. A weak negative correlation was observed only between FIB-4 score and the MHR (r=–0.030, p = 0.002). VAI, PAI, and CMI are significantly associated with hepatic steatosis in MASLD, suggesting their potential role as supportive, noninvasive markers in identifying individuals at increased risk of MASLD. However, these indices are not reliable predictors of advanced hepatic fibrosis risk based on FIB-4. The combination of these tools with other noninvasive fibrosis assessment tools may increase diagnostic accuracy in MASLD management.

Background: We aimed to investigate the diagnostic performance between the oral glucose tolerance test (OGTT) and HbA1c in diagnosing prediabetes and diabetes among obese individuals, and to evaluate the diagnostic performance of HbA1c for detecting OGTT-defined diabetes in obese individuals referred for evaluation of suspected prediabetes. Methods: Individuals with prediabetes were included between 1 January 2020 and 31 December 2022. Participants were categorized as mildly, moderately, morbidly, or super obese based on body mass index (BMI). According to the 75 g OGTT results, patients were classified into three groups: isolated impaired fasting glucose (IFG), combined IFG + impaired glucose tolerance (IGT), and overt type 2 diabetes mellitus (T2DM). The threshold HbA1c value for T2DM diagnosis in obese patients was determined based on OGTT outcomes. Results: Of the 139 prediabetic obese patients included, 115 (82.7%) were female, with a mean age of 45.18 ± 11.74 years. Based on BMI, 34 patients (24.5%) were mildly obese, 41 (29.5%) moderately obese, 49 (35.3%) morbidly obese, and 15 (10.8%) super obese. According to the 75 g OGTT results, 37.4% (n = 52) had isolated IFG, 45.3% (n = 63) had combined IFG + IGT, and 17.3% (n = 24) had overt T2DM. A weak-moderate positive correlation was observed between HbA1c and fasting blood glucose (Spearman's rho = 0.263, p = 0.002). ROC-AUC analysis showed that HbA1c had significant discriminatory power in detecting T2DM diagnosed by the 75 g OGTT (AUC = 0.881, 95% CI: 0.816-0.946, p < 0.001). The optimal HbA1c cut-off was 6.15%, with 83.3% sensitivity and 80% specificity. The positive predictive value was 46.1%, and the negative predictive value was 95.8%. Conclusions: An HbA1c threshold of 6.15% demonstrated optimal performance for detecting OGTT-defined diabetes in obese individuals with suspected prediabetes. This value should not be interpreted as a population-wide diagnostic threshold. These findings indicate that HbA1c may serve as a useful screening tool to identify obese individuals who warrant confirmatory OGTT testing, rather than as a stand-alone diagnostic criterion. Further large-scale studies are warranted to confirm these results and support future clinical guidelines.

Background: Catheter-related bloodstream infections (CRBSIs) are a significant cause of morbidity and mortality in patients undergoing chronic hemodialysis. Identifying reliable prognostic markers is essential for early risk stratification and clinical decision-making. Methods: This retrospective study included 147 patients with end-stage renal disease receiving chronic hemodialysis via central venous catheter who were hospitalized with confirmed CRBSIs between 2020 and 2024. Demographic, clinical, and laboratory data were collected on admission and on the third day of hospitalization. Inflammatory markers such as white blood cell count (WBC), neutrophil count, mean platelet volume (MPV), and derived indices including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) were evaluated in relation to in-hospital mortality. Results: Thirteen patients (8.8%) died during hospitalization. Age, WBC, neutrophil count, and MPV were significantly higher in the mortality group (p<0.01). While NLR and PLR on admission were not significantly different, third-day PLR values were significantly lower in non-survivors (p=0.033), showing moderate predictive performance (AUC = 0.679). Point biserial correlation and ROC analysis supported the prognostic utility of WBC, neutrophils, and PLR. Conclusions: Age, WBC, neutrophils, MPV, and third-day PLR are potential prognostic markers for in-hospital mortality in hemo-dialysis patients with CRBSIs. Dynamic monitoring of these hematologic indices may support early clinical decision-making.

This study investigates alterations in vaspin levels in hypothyroid patients and their role in metabolic processes and thyroid function. By analyzing the correlation between vaspin levels and hypothyroidism, the research aims to elucidate metabolic dysregulation in thyroid disorders and the potential link between thyroid hormones and adipose tissue function. This study included patients with hypothyroidism and healthy controls. Comprehensive data and laboratory findings were collected from hospital electronic health records. Vaspin levels were analyzed to explore the association with hypothyroidism. The Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) was also calculated. The study included 90 participants: 54 in the hypothyroid group and 36 in the control group. The hypothyroid group had a significantly higher age (49.04 ± 11.89 vs 43.53 ± 9.76 years, P = .019). Thyroid function tests showed substantially higher thyroid-stimulating hormone and lower fT4 levels in the hypothyroid group, confirming impaired thyroid function. Notably, vaspin levels were significantly lower in the hypothyroid group than in the control group (2.24 ng/mL vs 3.51 ng/mL, P = .008). This finding suggests that hypothyroidism may lead to altered adipokine regulation, potentially contributing to metabolic dysfunction. No significant differences were observed between the groups for lipid profile, glucose metabolism, insulin resistance (HOMA-IR), hematological, or liver enzymes. This study found lower vaspin levels in hypothyroid patients, which may be related to metabolic dysregulation. Vaspin could serve as a therapeutic target for addressing metabolic disturbances in hypothyroidism. Further research is needed to explore its clinical implications.

Trust is at the core of the patient-physician relationship. The Trust in Physician Scale (TPS) was specifically developed to measure such interpersonal trust and has high validity and reliability. In this study, we aimed to assess the reliability and validity of the Turkish TPS (TPS-TR) among community-dwelling older adults. This prospective study enrolled community-dwelling older adults aged 65 years and older. The TPS-TR and other scales of generalized anxiety disorder-7 scale (GAD-7), and multidimensional trust in health care systems scale (MTHCSS) subscale-1 “trust in health care providers” were administered to all participants. We assessed the internal consistency, item-total correlations, temporal stability, factor analysis, convergent and discriminant validity of TPS-TR. The study included 230 individuals. TPS-TR demonstrated high internal consistency (Cronbach’s α = 0.866) and remarkable test-retest reliability (ICC = 0.903). The lowest item-to-total correlation was observed for item 5, with a value of 0.375, which was also considered acceptable (> 0.20). TPS-TR was strongly correlated with the MTHCSS subscale-1 (p < 0.001), suggesting high convergent validity, and showed no correlation with GAD-7 (p = 0.087) indicating adequate discriminative validity. The results of our study showed that the TPS-TR has high reliability and validity in measuring the interpersonal trust of community-dwelling older adults in their physicians. Not applicable.

PURPOSE:This study aimed to examine the role of computed tomography (CT)-derived myosteatosis, sarcopenia, and other body composition parameters on overall survival (OS) in patients with metastatic castration-resistant prostate cancer (mCRPC) scheduled to receive lutetium (Lu)-177 treatment. MATERIAL AND METHOD:Patients with mCRPC who underwent 68 Ga-prostate-specific membrane antigen (PSMA) PET/CT imaging before [ 177 Lu]Lu-PSMA-617 treatment and received at least two cycles of Lu-177 PSMA treatment between March 2017 and March 2023 were retrospectively reviewed in this study. Body composition including psoas muscle, skeletal muscle, subcutaneous adipose tissue, and visceral adipose tissue were evaluated at the third lumbar spine vertebra on CT axial sections. RESULTS:Median age of the 76 patients enrolled in this study was 75 years (59-91 years), and the median Gleason score was 8 (6-10). All patients received two to six (median 4) cycles of 7.4 GBq Lu-177 PSMA treatment at 6-8 week intervals. Upon univariant Cox regression analysis, subcutaneous adipose tissue index, right psoas myosteatosis, left psoas myosteatosis, and skeletal muscle index were determined to be prognostic factors for OS ( P  = 0.03, P  = 0.02, P  < 0.001, and P  = 0.04, respectively). However, the left psoas myosteatosis value was an independent prognostic factor for OS as determined by multivariant Cox regression analysis ( P  < 0.001). CONCLUSION:Sarcopenia and myosteatosis before treatment were associated with shorter survival in mCRPC patients who were scheduled for Lu-177 PSMA treatment. Patients with left psoas myosteatosis value ≤26.85 HU had shorter OS, and we showed that OS is an independent prognostic factor.

OBJECTIVE:To investigate the association between fat and muscle mass parameters and overall survival in patients with castration-resistant metastatic prostate cancer (mCRPC) receiving chemotherapy or androgen deprivation therapy. MATERIALS AND METHODS:This retrospective study included mCRPC patients treated with docetaxel, abiraterone, or enzalutamide between January 01, 2017 and December 31, 2022. CT images at the L3 vertebral level were used to measure the cross-sectional areas of psoas muscle (PM), skeletal muscle (SM), visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT). These values were normalized by height (cm²/m²) to calculate indices (PMI, SMI, VATI, SATI). Mean hounsfield unit (HU) values of right and left PM were used to assess myosteatosis. Changes in body composition before and after treatment (eg, ΔVATI, ΔSATI) were also calculated. Survival analysis was performed using (ROC) receiver operating curves and Kaplan-Meier tests. RESULTS:Univariate Cox regression showed significant associations between mortality and age, treatment type, right PM HU (pre and post-treatment), left PM HU (post-treatment), post-treatment VATI, ΔSATI, ΔVATI, and baseline PMI (P < .05 for all). In multivariate analysis, post-treatment right PM HU and VATI were independent prognostic factors (P = .02 and P < .001, respectively). CONCLUSION:Fat mass, sarcopenia, and myosteatosis-especially post-treatment VATI and right PM attenuation-were associated with survival in mCRPC. Fat loss and increased myosteatosis may negatively affect prognosis, highlighting the importance of body composition monitoring during treatment.

Gastrointestinal bleeding is a significant cause of morbidity and mortality among emergency unit patients. Several scoring systems are verified for predicting hospitalization and mortality such as Glasgow Blatchford Bleeding Score (GBS), AIMS65 score, Rockall score (RS), and International Bleeding Risk Score (INBS; ABC score). The aim of this study is to evaluate the efficacy and predictive value of these scoring systems. Adult emergency unit patients with gastrointestinal bleeding were retrospectively enrolled. The age, gender, complaints at admission, vitals and examination results, laboratory findings, outcomes, blood transfusion status, and endoscopic interventions were all reported, and GBS, AIMS65, RS, and INBS (ABC) scores were calculated individually for all enrollies. A total of 311 patients were included. The median age of participants was 70 years (IQR (25–75

The prevalence of metastatic colorectal cancer (mCRC) is increasing and is linked to poor overall survival (OS). Previous studies have aimed to determine the predictive value of scores and laboratory tests for OS in mCRC patients, but their findings have been inconclusive. In this research, we focused on determining the prognostic significance of the fibrosis-4 (FIB-4) index, the aspartate aminotransferase (AST) to platelet (PLT) ratio index (APRI), the albumin–bilirubin (ALBI) score, and the gamma-glutamyl transpeptidase to PLT ratio (GPR) with respect to OS in treatment-naïve mCRC patients. This retrospective study included treatment-naïve mCRC patients. The FIB-4 index, ALBI score, APRI, and GPR were calculated for each participant, and their mortality dates were recorded. The clinical importance of these scores for survival outcomes was evaluated via the Cox regression model, Kaplan–Meier method, and log-rank test. The study enrolled 123 untreated mCRC patients. Univariate Cox regression analysis demonstrated that sex and AST/PLT and ALT/PLT counts were not associated with OS (p > 0.05 for all). However, a higher FIB-4 index (p = 0.025), ALBI score (p < 0.001), GPR (p < 0.001), and AST/ALT ratio (p < 0.001) were all associated with poor OS. Additionally, multivariate Cox regression analysis indicated that age (95

Introduction/Objective. This study aimed to evaluate the relationship between changes in creatine kinase (CK) levels and the need for dialysis in patients with crush syndrome (CS). Methods. We conducted a retrospective analysis of patients with CS who were admitted to our hospital after the earthquake from February to May of 2023. We recorded demographic and laboratory data of the patients and divided them into two groups based on the change in CK levels within 48 hours. The groups were compared based on the need for dialysis and mortality rates. Results. A total of 84 patients with crush injuries participated in the study (41 males and 43 females). The average age was 33.65 ? 13.1 years. Nineteen patients received hemodialysis, and 18 patients underwent fasciotomy due to compartment syndrome. The patients were divided into two groups, Group 1 consisted of patients with more than a 50% decrease in CK levels within 48 hours, while Group 2 included patients with a decrease of less than 50% in CK levels during the same period. We compared the two groups regarding the frequency of dialysis and mortality. No statistically significant differences were found between the groups (p = 0.328 for dialysis and p = 0.89 for mortality). Conclusion. Although CK is an important enzyme for diagnosing CS and indicates ongoing muscle damage, changes in CK levels during follow-up do not reliably predict the need for dialysis or mortality risk.

Heart failure is a clinical syndrome in which the function of the heart muscle and neurohormonal regulation are impaired, resulting in an inability to meet the metabolic needs of tissues. Many different mechanisms are involved in the pathophysiology of heart failure. Therefore, this disease is defined as a chronic disease in which treatment management is difficult for both the patient and the physician. Therefore, although the main goal is to take the necessary precautions before the disease develops, this may not always be possible. The management of the disease and the treatment options are being provided by finding drugs that are effective against existing mechanisms or against new mechanisms that have been discovered. The main goal of treatment is to stop the chain of events that cause and worsen heart failure based on the physiopathology. For this reason, there are various treatment modalities accepted in current guidelines to manage the current process. The aim of these treatments is to reduce symptoms, improve quality of life, and reduce mortality and morbidity rates. Recently, many important developments in the field of heart failure have started to come one after another. In this article, the mechanisms of action of the current treatment options and their effects on mortality have been mentioned, but rather than the current pharmacologic treatments, promising new treatment options, especially phase 3 and phase 4 trials, have been evaluated.

Aims: The impact of the Coronavirus Pandemic, which began in 2019, has considerably diminished; however, its effects still persist. While respiratory symptoms have been prominent during the pandemic, acute kidney disease has emerged as a significant contributor to morbidity and mortality. This study aims to demonstrate that serum albumin levels can serve as a predictor for acute kidney injury (AKI) and mortality, owing to their cost- effectiveness and feasibility for use across various healthcare centers. The goal is to contribute to the reduction of AKI development and mortality rates. Methods: The study was conducted by analyzing data from a total of 350 patients admitted to intensive care units of a training and research hospital due to COVID-19 between March 1, 2020, and April 30, 2021. Of these patients, 179 (51%) were male, and 171 (49%) were female. The data were examined retrospectively. Patients were categorized into two groups based on serum albumin levels: ?2.5 mg/dl (severe hypoalbuminemia) and 2.5-3.5 mg/dl (mild hypoalbuminemia). Subsequently, the patients were further categorized into groups based on the presence or absence of AKI, and these groups were statistically compared. Demographic data, clinical information, and laboratory values of the patients were assessed. The diagnosis of acute kidney injury (AKI) was made according to KDIGO criteria. Data were compared using the SPSS version 24 software. Results: Among the 350 patients included in the study, 115 had serum albumin levels ?2.5 mg/dl (severe hypoalbuminemia), and 235 had levels in the range of 2.5-3.5 mg/dl (mild hypoalbuminemia). Among those who developed AKI, the average albumin level was found to be 2.68 mg/dl, whereas in the group without AKI, the average albumin level was 2.76 mg/dl. Out of the total, 201 (57%) patients developed AKI, and 82% of them experienced mortality. In contrast, among the 149 (43%) patients who did not develop AKI, the mortality rate was 42%. Further subgroup analysis revealed the highest mortality rate of 88% among patients with severe hypoalbuminemia and AKI development. Conversely, the lowest mortality rate of 40% was observed in patients with mild hypoalbuminemia and no AKI. Conclusion: This study aims to establish that low serum albumin levels should be regarded not only as a negative acute-phase reactant but also as a predictive factor for complications including acute kidney disease development and mortality. Lower albumin values are correlated with higher complication rates and increased mortality. Additionally, due to its widespread availability and low cost, serum albumin is a cost-effective diagnostic tool that can be utilized in almost any healthcare setting.

INTRODUCTION:The elderly population is unique and the prognostic scoring systems developed for the adult population need to be validated. We evaluated the predictive value of frequently used scoring systems on mortality in critically ill elderly sepsis patients. METHODOLOGY:In this single-center, observational, prospective study, critically ill elderly sepsis patients were evaluated. Sequential organ failure evaluation score (SOFA), acute physiology and chronic health evaluation score-II (APACHE-II), logistic organ dysfunction score (LODS), multiple organ dysfunction score (MODS), and simplified acute physiology score-II (SAPS-II) were calculated. The participants were followed up for 28 days for in-hospital mortality. Prognostic scoring systems, demographic characteristics, comorbid conditions, and baseline laboratory findings were compared between "survivor" and "non-survivor" groups. RESULTS:202 patients with a mean age of 79 (interquartile range, IQR: 11) years were included, and 51% (n = 103) were female. The overall mortality was 41% (n = 83). SOFA, APACHE-II, LODS, MODS, and SAPS-II scores were significantly higher in the non-survivor group (p < 0.001), and higher scores were correlated with higher mortality. The receiver operator characteristics (ROC) - area under curve (AUC) values were 0.802, 0.784, 0.735, 0.702 and 0.780 for SOFA, APACHE-II, LODS, MODS, and SAPS-II, respectively. All prognostic scoring models had a significant discriminative ability on the prediction of mortality among critically ill elderly sepsis patients (p < 0.001). CONCLUSIONS:This study showed that SOFA, APACHE-II, LODS, MODS, and SAPS-II scores are significantly associated with 28-day mortality in critically ill elderly sepsis patients, and can be successfully used for predicting mortality.

Introduction: Healthcare-associated infections (HAIs) are common in intensive care unit (ICU) patients and may cause devastating consequences. However, the prevalence of HAI and its effects on in-hospital mortality among critically ill COVID-19 patients is ambiguous. We determined the prevalence of HAI and the rate of mortality in critically ill COVID-19 patients and compared it with pre-pandemic ICU patients. Methodology: This retrospective study was conducted with adult ICU patients admitted to Gazi Yaşargil Training and Research Hospital (Diyarbakir,Turkey) in April-November 2019 (defined as the pre-pandemic period) and in April-November 2020 (defined as the pandemic period). All patients in the pandemic period had COVID-19, while none in the pre-pandemic period did. Patients diagnosed with HAIs during the in-hospital follow-up period were recorded. Results: Of 4596 enrollees, 3386 (73.7%) were pandemic-period patients and 1210 (26.3%) were pre-pandemic-period patients. HAI prevalence was significantly higher at 5.9% (n = 71) in the pandemic-period patients and 2.7% (n = 91) in the pre-pandemic-period patients (p < 0.001). Comorbidities including hypertension (63.4% vs 14.2%, p < 0.001), diabetes mellitus (39.4% vs 8.8%, p < 0.001), and coronary artery disease (30.9% vs 10.9%, p = 0.002) were significantly more frequent in pandemic-period HAI-positive patients. The most common HAI was catheter-related bloodstream infection in both groups, with similar frequency (p = 0.652). In-hospital mortality rate was 85.9% versus 65.9% in pandemic- versus pre-pandemic-period HAI-positive patients (p < 0,05). Conclusions: The prevalence of HAI and the in-hospital mortality rate was significantly higher among pandemic-period patients.

Phages are found in a wide variety of places where bacteria exist including body fluids. The aim of the present study was to isolate phages from the urine samples of patients with urinary tract infection. The 10 urine samples were cultured to isolate bacteria and also used as phage sources against the isolated bacteria. From 10 urine samples with positive cultures, 3 phages were isolated (33%) and two of them were further studied. The Klebsiella phage GADU21 and Escherichia phage GADU22 phages infected Klebsiella pneumonia and Escherichia coli , respectively. Among the tested 14 species for host range analysis, the Klebsiella phage GADU21 was able to infect two species which are Klebsiella pneumonia and Proteus mirabilis , and Escherichia phage GADU22 was able to infect four species which are Shigella flexneri , Shigella sonnei and Escherichia coli . Among different isolates of the indicator bacteria for each phage, GADU21 infected half of the tested 20 Klebsiella pneumonia isolates while GADU22 infected 85% of the tested 20 E. coli isolates. The genome sizes and GC ratios were 75,968 bp and 44.4%, and 168,023 bp and 35.3% for GADU21 and GADU22, respectively. GADU21 and GADU22 were both lytic and had no antibiotic resistance and virulence genes. GADU21 was homologue with Klebsiella phage vB_KpP_FBKp27 but only 88% of the genome was covered by this phage. The non-covered parts of the GADU21 genome included genes for tail-fiber-proteins and HNH-endonuclease. GADU22 had 94.8% homology with Escherichia phage vB_Eco_OMNI12 and had genes for immunity proteins. Phylogenetic analysis showed GADU21 and GADU22 were members of Schitoviridae family and Efbeekayvirus genus and Straboviridae family and Tevenvirinae genus, respectively. VIRIDIC analysis classified these phages in new species clusters. Our study demonstrated the possibility to use infected body fluids as phage sources to isolate novel phages. GADU21 is the first reported Klebsiella phage isolated from human body fluid. The absence of virulence and antibiotic resistance genes in their genomes makes the phages a potential therapeutic tool against infections.

The gastrointestinal system consists of the esophagus, stomach, small intestine, large intestine, and rectum. Although they are called accessory organs, the liver, pancreas, and gallbladder are also evaluated in this system with their vital features. Gastrointestinal system disorders (GISD) are observed quite frequently in society. Considering the morbidity and mortality they cause, effective treatment methods become crucial. Situations such as patients’ non-compliance with nutritional recommendations and the inadequacy of pharmacological and surgical methods at some points make different perspectives and treatment methods more valuable. From this point of view, we will try to examine the GISD that causes muscle loss and the physiotherapy modalities that can be applied to these patients in light of the current literature.

In recent years, Hodgkin's and Non-Hodgkin's lymphoma incidence is increasing all over the world. In the United States, lymphomas are the fourth most common malignancies among all. Lymphoid malignancies have a broad spectrum from mild indolent types, such as chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL), follicular lymphoma(FL), marginal zone lymphoma, and cutaneous T-cell lymphoma to aggressive types such as diffuse large B cell lymphoma (DLBCL), mantle cell lymphoma, Burkitt's lymphoma, peripheral T-cell lymphoma. With better response rates to chemotherapy, longer disease-free survival and overall survival rates, lymphomas have satisfactory treatment results rather than solid organ tumors for oncologists. Throughout history, conventional chemotherapy agents, radiotherapy and their combinations have been used for the treatment of lymphoma. Especially, in the early stages of Hodgkin's lymphoma, a rate of 85-90% complete remission and high rate long-term remission can be achieved. However, despite this high response rate, 15-30% of patients are resistant to treatment. With current therapiesresponse rate and persistent long-term remission rate in Non-Hodgkin's lymphomas are around 50%. Therefore, new therapeutic approaches such as immunotherapy and the using of cytotoxic properties of T cells against tumor has been developed and used in recent years for the treatment of refractory lymphoma.

ABO blood types may cause a vulnerability to individuals for conditions such as malignancies or chronic diseases. However, the interaction of ABO blood types and osteoporosis is inexplicit. In this study, we focused on the role of ABO blood types on bone health by comparing bone mineral density (BMD), and the prevalence of low bone mass (LBM) and osteoporosis among postmenopausal women. Non-institutionalized postmenopausal women aged over 50 years were prospectively enrolled in the study following the measurement of BMD by dual-energy X-ray absorptiometry (DEXA). The prevalence of osteoporosis and LBM were interpreted according to T scores of either site. Self-reported blood types of participants were noted. The study included 220 postmenopausal women, and the median age of participants were 59 (11) years (min:50 years, and max:82 years). The mean BMD values at the lumbar spine, femoral total, and femoral neck of participants were 0.821±0.118 g/cm2, 0.810±0.121 g/cm2, and 0.716±0.112 g/cm2, respectively. Both mean BMD and T scores of enrollees for either site were similar across blood types (p-value >0.05 for all). The prevalence of osteoporosis and LBM showed no significant association between blood groups (p=0.45, and p=0.226, respectively).The present study showed evidence of a similar BMD, the prevalence of LBM, and osteoporosis among postmenopausal women over 50 years regardless of ABO blood type.

Aims: Not only severe but also mild to moderate chronic kidney disease (CKD) is an independent risk factor for peripheral artery disease (PAD).In this study, we examined the prevalence of PAD among older adults with mild-to-moderate CKD. Methods:The study was performed using the dataset of participants registered to a previous single-center, cross-sectional study that included non-institutionalized older adults aged 65 years or older in a geriatric outpatient setting.The subjects were patients with mild to moderate CKD.Ankle brachial index (ABI) was measured using a hand-held Doppler.PAD was diagnosed using an ABI value <0.9.The crude and adjusted prevalence of PAD were calculated.Results: A total of 554 patients were included (age: 75.4±6.2years; female: 67.3%).PAD was detected by 8.2%, 27.1%, 60.0%, and 4.7%, in stage 1, 2, 3 and 4 CKD, respectively, with significant difference in stage 2 (p=0.003) and stage 3 (p=0.011)CKD compared with the stage 1 disease.PAD was also more prevalent in patients with reduced estimated glomerular filtration rate (eGFR) (<60 mL/min/1.73m 2 vs. ≥60 mL/min/1.73m 2 : 19.6% vs. 10.9%,p=0.005).However, after adjustment for potential confounders, the increase in the prevalence of PAD in subjects with lower eGFR was no longer significant (Odds ratio: 1.48, 95% confidence interval: 0.87-2.53,p=0.148).Conclusions: This study showed a higher prevalence of PAD among older adults with mild-tomoderate CKD; however, the difference appears to depend on existing confounders.