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The Role of Mean Platelet Volume in the Diagnosis of Acute Appendicitis: A Retrospective Case-Controlled Study

Background: The level of platelet volume (MPV) has been reported to be a laboratory marker in inflammatory cases. Objectives: The aim of this study was to seek whether MPV has a role in the diagnosis of acute appendicitis. It was also aimed to show the relationship of MPV with leukocyte count and C-reactive protein (CRP) level. Materials and Methods: This study was conducted via retrospective assessment of the hospital records of the adult patients who were operated for acute appendicitis between January 2010 and December 2012 and had a pathology report that confirmed the diagnosis of acute appendicitis. The patients in the control group were selected from healthy adults of similar age who applied to check-up clinic. The number of essential cases was defined by performing power analysis. Age, gender, leukocyte count, CRP, and MPV values were recorded. This study is a case controlled retrospective clinical study. Results: A total of 503 patients in the acute appendicitis group and 121 patients in the control group were included, making up a total of 624 subjects. The median MPV levels were 7.92 ± 1.68 fL in the acute appendicitis group, while 7.43 ± 1.34 fL in the control group. CRP, leukocyte count, and MPV level were significantly higher in the acute appendicitis group (P < 0.001). MPV, leukocyte count, and CRP had a sensitivity and specificity of 66% and 51%; 91% and 74%; and 97% and 41%, respectively. No correlation was found between MPV, CRP, and leukocyte count. Conclusions: MPV level was higher in patients with acute appendicitis. MPV may guide the diagnostic process of acute appendicitis. However, we detected that the sensitivity and specificity of leukocyte count and CRP were superior to those of MPV in the diagnosis of acute appendicitis.

Diagnostic and prognostic value of procalcitonin and phosphorus in acute mesenteric ischemia

BACKGROUND In this study, using an animal model of acute mesenteric ischemia (AMI), we investigated the possible use of procalcitonin and phosphorus in the early diagnosis of AMI. METHODS In this study, 21 New Zealand rabbits were used. Subjects were allocated into three groups as Control, Sham and Ischemia. No intervention was performed in the subjects in the Control group. In the subjects in the Sham and Ischemia groups, laparotomy was performed with midline incision. In the Ischemia group, the superior mesenteric artery was found and tied after laparotomy. Blood was drawn from the animals in all groups at 0, 1, 3 and 6 hours, and procalcitonin and phosphorus levels were studied in these samples. RESULTS In the Ischemia group, the increase in the levels of serum phosphorus and procalcitonin was found to be statistically significant compared to the Control and Sham groups (p<0.05). The levels of phosphorus and procalcitonin were detected to increase from the 1st hour after ischemia onset, and the increase continued for the following 6 hours (p<0.05). CONCLUSION Phosphorus and procalcitonin may be important parameters for use in the early diagnosis and prognosis of AMI.

The role of red cell distribution width in the diagnosis of acute appendicitis: a retrospective case-controlled study

PurposeThe aim of this study was to seek whether red cell distribution width (RDW) has a role in the diagnosis of acute appendicitis. It was also aimed to show the relationship of RDW with leukocyte count and C-reactive protein (CRP) level.MethodsThis study was conducted via retrospective assessment of the hospital records of the adult patients who were operated for acute appendicitis between January 2010 and February 2013 and had a pathology report that confirmed the diagnosis of acute appendicitis. The patients in the control group were selected from healthy adults of similar age who applied to check-up clinic. Age, gender, leukocyte count, CRP, and RDW values were recorded. This study is a case controlled retrospective clinical study.ResultsA total of 590 patients in the acute appendicitis group and 121 patients in the control group were included, making up a total of 711 subjects. The mean RDW levels were 15.4 ± 1.5% in the acute appendicitis group, while 15.9 ± 1.4% in the control group. CRP, leukocyte count were significantly higher in the acute appendicitis group, and RDW level were significantly lower in the acute appendicitis group (p < 0.001, p < 0.001, p = 0.001, respectively). RDW, leukocyte count, and CRP had a sensitivity and specificity of 47% and 67%; 91% and 74%; and 97% and 41%, respectively in acute appendicitis. RDW was not correlated with CRP and leukocyte levels. However, we found a correlation between CRP and leukocyte levels.ConclusionRDW level was lower in patients with acute appendicitis. The magnitude of difference in RDW seen between acute appendicitis and controls was so slight as to be of no utility in diagnostic testing.

Association between Red Blood Cell Distribution Width and Acute Pancreatitis

Background We aimed to determine whether there are any alterations in red blood cell width in patients diagnosed with acute pancreatitis. Material/Methods This was a retrospective study of records of patients treated in emergency units and diagnosed with acute pancreatitis between January 2011 and April 2013. Records were investigated regarding patient age, sex, and causes of acute pancreatitis. Red blood cell width and amylase values obtained from the patients during diagnosis and after a full recovery from acute pancreatitis were added to the records. Results Recorded red blood cell width and amylase values of 104 patients diagnosed with acute pancreatitis were statistically compared according to the time of sample collection. Samples were collected in the post-diagnostic period and after full recovery. Values of red blood cell width and amylase were found to be significantly higher in samples collected during hospital admission in comparison to those obtained from patients after fully recovering from acute pancreatitis (p<0.05). Conclusions An increase in red blood cell width value is a marker of acute pancreatitis; therefore, we suggest that red blood cell width can be used as a tool for the early diagnosis and assessment of disease progression.

The change of neutrophils/lymphocytes ratio in migraine attacks: A case-controlled study

Objective As commonly seen symptoms, headaches are among the most frequently encountered health challenges in emergency rooms by healthcare professionals. Among one of the most commonly seen and primary headaches is migraine. Migraines are mostly accompanied by functional deficits. Aims To observe the changes of neutrophil/lymphocyte ratio occurring during migraine attacks. Method This is a retrospective study where hospital records of patients previously diagnosed with migraine and admitted to the emergency with the complaints of attacks between May 2014 and January 2015 were investigated. All patients in the study were evaluated as to age, gender and complete blood count. Additionally, a healthy control group was formed with individuals with no disorders. By also evaluating the same features in the controls, the values found in the patients and controls alike were compared. Results The values of white blood cell, lymphocyte, neutrophil, hemoglobin, thrombocyte and neutrophil/lymphocyte ratio determined in the patient group (n = 92) were statistically compared with those of the controls (n = 67). Neutrophil/lymphocyte ratio during the attacks was found higher in the patients, compared to the controls. Conclusion Neutrophil/lymphocyte ratio is a sign of inflammation, and we consider that this ratio will also increase during migraine attacks, as with other inflammatory and acute processes.

Diamine oxidase in diagnosis of acute mesenteric ıschemia

OBJECTIVE Acute mesenteric ischemia (AMI) is an important clinical condition with a high mortality rate in abdominal emergencies due to delay in diagnosis in spite of the new strategies in the management. We have studied the role of diamine oxidase (DAO) in the early diagnosis of AMI. METHODS In the study, 21 New Zeland rabbits were used. Subjects were named as the groups of controls, sham, and ischemia. No intervention was performed in the subjects in the control group. In the subjects from sham and ischemia groups, laparotomy was performed with middle line incision. However, superior mesenteric artery was found and tied in those from ischemia group after the performance of laparotomy. From the animals in 3 groups, blood was drawn at the hours of 0, 1, 3, and 6, and DAO and amylase were studied in these samples. RESULTS The increase in serum amylase levels was found to be statistically significant in the ischemia group compared with the control and the sham groups (P < .05). The decrease in serum DAO levels was found to be statistically significant in the ischemia group compared with the control and the sham groups (P < .05). Diamine oxidase levels were found to decrease, beginning from the 1 hour after ischemia had been developed, and this rise was found to continue for 6 hours (P < .05). CONCLUSION Serum DAO levels were decreased in ischemia. Further clinical and experimental investigations would be valuable to confirm the probable role of DAO in AMI.

N Terminal prohormone brain natriuretic peptit level in patients with arhythmia /Aritmili hastalarda n terminal prohormon brain natriuretik peptid duzeyi

Objective: Brain natriuretic peptides are the marker protein structures released in response to wall tension from ventricular myocytes, and have been increasingly used in recent years. The use of N-Terminal Prohormone Brain Natriuretic Peptide is getting more expanded in acute heart failure, left ventricular diseases and acute dyspnea. Here, we aimed at investigating the level of N-Terminal Prohormone Brain Natriuretic Peptide in patients diagnosed with arrhythmias. Materials and Methods: Patients admitted to the emergency department and with any rhythm disorder were included into this study. Bedside echocardiography was performed for each patient. Patients were classified into two groups with and without heart failure. Blood samples of 1 cc were drawn from patients and put into ethylene diamine tetraacetic acid (EDTA)-containing tubes, and N-Terminal Prohormone Brain Natriuretic was investigated. Collected data were recorded into the prepared forms. Statistical analyses were performed with SPSS for Windows 13.0 software package. While average N-Terminal Prohormone Brain Natriuretic level was 25100±10955 pg/Ml in patients with heart failure, average level of NTerminal Prohormone Brain Natriuretic was seen as 5767.61±6225 pg/mL in those with any rhythm disorder but no heart failure. Brain Natrıuretıc Peptıt And Arhythmia Conclusion: N Terminal Prohormon Brain Natriüretik Peptid are important markers in the diagnosis of acute heart failure. In recent years, studies on their association with other diseases have become widespread. In our study, we also found BNP levels more than normal ranges in patients with arrhythmia but no cardiac failure, as well as finding N-Terminal Prohormone Brain Natriuretic levels at higher rates in heart failure patients with dysrhythmia.