Objectives Coronavirus‐19 is a rapidly progressing disease that can result in mortality. We aimed to evaluate the efficacy of the delta neutrophil index in predicting mortality in intensive care patients diagnosed with Coronavirus‐19. Materials and methods Patients with a positive polymerase chain reaction test and/or computed tomography findings compatible with the disease were included in the study. The demographic characteristics of the patients, polymerase chain reaction test results, chest computed tomography findings, blood parameters at the time of presentation, 30‐day mortality, and the number of days in the intensive care unit were assessed. Results Of the 388 patients receiving intensive care, 220 (56.7%) were men and 168 (43.3%) were women. The mean age was 70 ± 15 years. The evaluation of mortality, 264 (68%) of the patients survived and 124 (32%) died. The delta neutrophil index, neutrophil lymphocyte ratio, lactate, interleukin‐6 and C‐reactive protein values were statistically significantly higher and the lymphocyte value was significantly lower in the mortality group ( P = .003, .034, .000, .002, .000 and .024, respectively). In the receiver operating characteristic curve analysis, the area under the curve values of the delta neutrophil index, lymphocyte, neutrophil lymphocyte ratio, lactate, interleukin‐6 and C‐reactive protein levels in predicting mortality were 0.718, 0.416, 0.628, 0.585, 0.701 and 0.684, respectively. Conclusion We consider that the delta neutrophil index can be used as an effective prognostic parameter to show intensive care mortality in patients with Coronavirus‐19.

ConclusionLaboratory parameters alone cannot be sufficient for the diagnosis of acute appendicitis in pregnant patients. If clinical examination, laboratory parameters and USG are not sufficient for diagnosis, MRI is the imaging method that should be considered to reduce negative appendectomy rate.

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BACKGROUND:In acute appendicitis, the treatment approach may vary depending on the age and comorbidities of the patient and whether the appendix is complicated. In this study, we validated the appendistat TM score, including the logistic regression model of complicated appendicitis, and compared the efficacy of this scoring with C-reactive protein in predicting complicated appendicitis.METHODS: Demographic characteristics, pathology, and laboratory results of patients who underwent appendectomy for acute appendicitis were retrospectively screened, those over 18 years of age were included in the study. The appendistat TM scores, including the logistic regression model of complicated appendicitis, were obtained. RESULTS:Complicated appendicitis was present in 13 (10.1%) patients and non-complicated appendicitis in 116 (89.9%). Two (15.4%) of the complicated appendicitis cases were female and 11 (84.6%) were male. The mean age of complicated appendicitis cases was 44 (20-77) years, and their median value of C-reactive protein was 41.00 mg/L. In the ROC curve analysis, the cut-off value for C-reactive protein was 23.5 mg/L and that of the appendistat TM as 9.6. The area under the curve values of the appendistat TM score and C-reactive protein were 0.787 and 0.750, respectively. CONCLUSION:Appendistat TM is a successful scoring system that contains appropriate parameters. However, C-reactive protein detecting or excluding complicated appendicitis at a similar rate to Appendistat TM suggests that the latter does not have a significant advantage in clinical practice.

Aim: The aim of this study is to investigate the efficacy of thiol disulfide homeostasis and Ischemia Modified Albumin (IMA) values in predicting the technical difficulties that might be encountered during laparoscopic cholecystectomy. Materials and Methods: The study included 65 patients who underwent laparoscopic cholecystectomy due to cholelithiasis at the General Surgery Clinic of Ankara Numune Training and Research Hospital. All patients’ demographic data, previous history of cholecystitis, a history of chronic illness, preoperative white blood count (WBC), liver function tests (AST, ALT), amylase and lipase levels, intra-operative adhesion score, the ultrasonographic appearance of gallbladder, duration on hospital stay, duration of operation, thiol disulfide and IMA values were evaluated. Results: Native thiol and total thiol averages were higher in patients without a history of cholecystitis, on the other hand, disulfide, disulfide/native thiol rate, disulfide/total thiol rate, native thiol/total thiol rate and IMA averages were higher in patients with a history of cholecystitis. While there was a statistically significant negative correlation between native and total thiol values and age, duration of surgery and duration of hospital stay; IMA, disulfide, disulfide/Total thiol, Native/Total thiol and disulfide/Native thiol rates were higher in older patients with a longer duration of surgery and hospital stay. In addition, preoperative IMA, disulfide, disulfide/Total thiol, Native/Total thiol and disulfide/Native thiol were observed to increase as the degree of intraoperative pericholecystic adhesion increased. Conclusion: We believe that the evaluation of thiol disulfide homeostasis and IMA parameters prior to laparoscopic cholecystectomy can be used as an effective method for predicting intraoperative difficulties.

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