Subacute thyroiditis (SAT) is an inflammatory disorder of the thyroid gland. Although its etiology is not fully understood, it is believed to occur shortly after viral infections and is mostly associated with human leukocyte antigen (HLA)-B*35. Cellular immunity is prominent in SAT. Neopterin is produced by activated monocytes/macrophages and is a marker of cellular immunity. Its production is stimulated by interferon gamma (IFN-γ), provided mainly by activated helper T lymphocytes type 1 (Th1) in the adaptive immune system. Therefore, with these cells’ activation, an increase in serum neopterin levels is expected. We aimed to evaluate neopterin levels in demonstrating cellular immunity in SAT and compared 15 SAT patients with 16 healthy controls. Since all SAT patients were in the active thyrotoxic phase, we found a significant difference in thyroid functions, classical inflammatory markers, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP), were markedly elevated in the patient group. Although we expected to find an increase considering that cellular immunity is at the forefront in the pathogenesis of SAT, we found serum neopterin levels significantly lower in the patient group than in the control group. There is an increase in CD8+ T cells in the thyroid tissue in SAT. The possible relationship with HLA-B*35- MHC class I in SAT, and the antigen presentation to CD8+ T cells may be the reason why we observed low serum neopterin levels in patients due to the cytokine imbalance. Neopterin provides unique and independent data from classical acute phase response indicators.

Background/Aims: Prognostic factors are an important issue in progressive and life-limiting diseases. This study evaluate 3-month mortality in patients admitted to the palliative care unit (PCU). Methods: In this study, the patient's demographics, comorbidities, nutritional status, and laboratory values were recorded. The palliative performance scale (PPS), the palliative prognostic index (PPI), and the palliative prognostic (PaP) score were calculated. The rectus femoris (RF) cross-sectional area (CSA), RF muscle thickness, gastrocnemius (GC) medialis muscle thickness, pennation angle and fascicle length of the GC were measured by ultrasound for survival prediction. Results: A total of 88 patients enrolled during the study period, with a mean age of 73.6 ± 13.3 years and a 3-month mor-2 www.kjim.org

Warfarin, which is frequently used in the treatment of thromboembolism, is a potent anticoagulant. It is a narrow therapeutic index drug and there is a risk of bleeding when the therapeutic dose is exceeded. It interacts with many drugs and foods. Due to drug and food interactions, the effectiveness of treatment decreases or spontaneous bleeding occurs. Although drug interactions constitute a small part of adverse drug reactions, they are important because they cause predictable and preventable mortality and morbidity. Prevention of drug interactions provides shortened hospital stay, reduced readmission rate, and reduced treatment costs. Examining the treatment applied to patients in terms of drug interactions increases the effectiveness and reliability of the treatment. The purpose of this review is to increase the knowledge level of warfarin on drug and food interactions.

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