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    Neutrophil to lymphocyte ratio, stroke severity and short term clinical outcomes in acute ischemic stroke
    (2021) Iyigundogdu, Ilkin; Derle, Eda; Kibaroglu, Seda; Can, Ufuk; 0000-0001-7860-040X; 0000-0002-3964-268X; AAJ-2053-2021; AAJ-2956-2021
    Background: Neutrophil to lymphocyte ratio is an easily evaluated systemic inflammation indicator. However, there are limited reports on neutrophil to lymphocyte ratio and functional outcome in ischemic stroke. In this study, we aimed to evaluate the association of neutrophil to lymphocyte ratio and stroke severity, short term functional outcomes and mortality in patients with acute ischemic stroke. Methods: The clinical data of patients who were > 18 age-old and hospitalized with acute ischemic stroke in Baskent University Hospital, Ankara, Turkey between January 2018 and May 2019 were studied retrospectively. Neutrophil to lymphocyte ratio were measured. The neutrophil to lymphocyte ratio and National Institute of Health Stroke Scale (NIHSS) score at admission, mortality during hospitalization and Modified Rankin Scale (mRS) score at discharge of the patients with acute ischemic stroke were correlated. Results: Among the acute ischemic stroke patients due to the exclusion criteria, the data of 134 patients were evaluated. Median age of the patients were 76 +/- 12.5 years and 82 patients (61.2%) were male. The median NIHSS scores of the patients at admission was 5 +/- 4.5. Mortality during the hospitalization was seen in 8 patients (6%). The median neutrophil to lymphocyte ratio value of the patients at admission were found to be 2.6 +/- 3.4. Neutrophil to lymphocyte ratio and NIHSS scores of the patients at admission, duration of the hospitalization, mRS scores at discharge and mortality during hospitalization were found to be positively correlated. Conclusion: Neutrophil to lymphocyte ratio is a simple and easily measured marker and can be used as a potential indicator for prognosis in acute ischemic stroke. However further prospective multicenter investigations are required to confirm the role of neutrophil to lymphocyte ratio for predicting the prognosis in acute ischemic stroke patients.
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    Comparative analysis of the patients with community-acquired pneumonia (CAP) and health care-associated pneumonia (HCAP) requiring hospitalization
    (2019) Kara, Sibel; Akcay, Muserref Sule; Ekici, Unsal Zuhal; Bozkurt Yilmaz, Hatice Eylul; Habesoglu, Mehmet Ali; 31414641
    Introduction: The recently introduced concept of health care-associated pneumonia (HCAP), referring to patients with frequent healthcare contacts and at higher risk of contracting resistant pathogens is controversial. Materials and Methods: A prospective study comparing patients with HCAP and community-acquired pneumonia (CAP) in the our center. The primary outcome was 30 day mortality. Results: A total of the 169 patients HCAP 36 (21.3%); CAP 133 (78.7%) were evaluated. HCAP patients were older than patients with CAP [median age was 72.5 (43-96), 60.0 (18-91) years p< 0.05]. The most common Klebsiella pneumoniae (16.6%) and Pseudomonas aeruginosa (8.3%) were gram-negative bacteria in the SBIP group; In the TGP group, gram-positive bacteria were more frequently isolated. Polymicrobial agents (22.2% vs. 3.7% p< 0.05) and MDR pathogens (57.1% vs. 24% p< 0.05) were more common in patients with HCAP. Mortality rate (22.2% vs. 6% p< 0.05) was also higher in HCAP more than CAP. Conclusion: HCAP was common among patients with pneumonia requiring hospitalization and mortality rate was high. The patients with HCAP were different from CAP in terms of demographic and clinical features, etiology, outcome.
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    The relation of presenting symptoms with staging, grading, and postoperative 3-year mortality in patients with stage I-III non-metastatic colon cancer
    (2016) Bedir, Osman; Kiziltas, Safak; Kostek, Osman; Ozkanli, Seyma; 27210779
    Background/Aims: To evaluate the association of presenting symptoms with staging, grading, and postoperative 3-year mortality in patients with colon cancer. Materials and Methods: A total of 132 patients-with a mean (standard deviation; SD) age of 63.0 (10.0) years and of whom 56.0% were males-with non-metastatic stage I-III colon cancer were included. Symptoms prior to diagnosis were evaluated with respect to tumor localization, tumor node metastasis (TNM) stage, histological grade, and postoperative 3-year mortality. Results: Constipation and abdominal pain were the two most common symptoms appearing first (29.5% and 16.7%, respectively) and remained most predominant (25.0% and 20.0%, respectively) up to diagnosis. The frequency of admission symptoms significantly differed with respect to tumor location, TNM stage and histological grade. The postoperative 3-year survival rate was 61.4%. Multivariate logistic regression revealed that melena and rectal bleeding increased the likelihood of 3-year mortality by 13.6-fold (p=0.001) and 4.08-fold (p=0.011), respectively. Conclusion: Our findings revealed differences in presenting symptom profiles with respect to the time of manifestation and predominance as well as to the TNM stage, histological grade, and tumor location. Given that melena and rectal bleeding increased the 3-year mortality risk by 13.6-fold and 4.08-fold, respectively, our findings indicate the association of admission symptoms with outcome among patients with colon cancer.