Background and objectiveBeta-thalassemia is the most frequent monogenic disease in the world. In beta-thalassemia major (BTM) patients, blood transfusions for severe anemia usually cause iron overload, leading to increased morbidity and mortality. In this study, we aimed to examine the iron overload in the kidneys of BTM patients with a 3 Tesla (3T) MRI device and assess the relationship between iron overload in the liver and heart as well as serum ferritin levels. MethodsThis was a retrospective study covering the period between November 2014 and March 2015. MRI was performed on 21 patients with BTM who were receiving blood transfusions and chelation therapy. The control group (n=11) included healthy volunteers. A 3T MRI device (Ingenia, Philips, Best, The Netherlands) using a 16-channel phased array SENSE-compatible torso coil was used. Three-point DIXON (mDIXON) sequence and the relaxometry method were employed to measure iron overload. Both kidneys were analyzed via mDIXON sequence for atrophy or variations. Afterward, the images in which renal parenchyma could be distinguished best were selected. Iron deposition was analyzed via the relaxometry method using a unique software (CMR Tools, London, UK). All data were analyzed using IBM SPSS Statistics v.21 (IBM Corp., Armonk, NY). The Kolmogorov-Smirnov test, independent samples t-test, Mann-Whitney U test, and Pearson's and Spearman's rho correlation coefficient were used. A p-value <0.05 was considered statistically significant. ResultsThere was a statistically significant relationship between beta-thalassemia patients who had cardiac iron deposition and those who did not in terms of T2* time (p=0.02). In contrast, there was no similar relationship for liver iron deposition (p>0.05). Renal T2* values were significantly different between the patient and control groups (p=0.029). T2* times were significantly different between patients who had ferritin levels below 2500 ng/ml and those with ferritin levels above 2500 ng/ml (p=0.042). ConclusionBased on our findings, 3T MRI is a safe and reliable tool for screening iron overload in BTM patients as it makes distinguishing between renal parenchyma and renal sinus much easier and as it is more sensitive to iron deposition.

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Objective: Hospital-related hyponatremia has a significant mortality, and it is widely seen among hospitalized patients. The aim of the present study was to identify the treatments of patients before developing hyponatremia and the relationship between these treatments and severity of hyponatremia, length of hospital stay, and mortality rate. Methods:The present study was conducted retrospectively on 133 patients who developed hyponatremia during their hospitalization for any reason in our hospital between 2012 and 2013. Demographic features of the patients, sodium values after hyponatremia, treatments applied to the patients before developing hyponatremia, length of hospital stay, and mortality rates were analyzed.Results: Diuretics composed the largest part (46.6%) of medical treatments related to hyponatremia before the development of hyponatremia. When any of the treatments that may cause hyponatremia (hypotonic fluids, mannitol, diuretics, other drugs, and surgery) was administered in addition to the current treatment, each factor appeared to prolong the length of hospital stay by 8.1±1.853 days. Conclusion:Although a significant relationship between treatments and mortality rates or hyponatremia severity could not be identified, prolongation in the length of hospital stay was crucial for avoiding complications of hospitalization and also for decreasing the costs of healthcare. This research may also serve as a guide for further prospective case-controlled studies.