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.

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.

Objectives: This experimental study aimed to assess the changes in the levels of serum ischemiamodified albumin (IMA) and interleukin-6 (IL-6) by time in cases of acute mesenteric ischemia due to superior mesenteric artery occlusion.Methods: Twenty-one New Zealand rabbits were randomly divided into three groups. Blood samples were collected at hours 0, 1, 3, and 6 from animals in a control group; a sham group following a simple laparotomy; and in an ischemia group following superior mesenteric artery ligation. All blood samples were analyzed for serum IMA and IL-6 levels, and then the time-dependent changes of biomarkers were investigated. Results:The serum IMA levels of the ischemia group at hours 3 and 6 were significantly higher than those of the control and sham groups (hour 3, p = 0.017; hour 6, p = 0.001). The increase in serum IL-6 levels in the ischemia group at hours 1, 3, and 6 compared to the control and sham groups was also significant (hour 1, p = 0.002; hour 3, p = 0.003; hour 6, p = 0.003).Conclusions: IMA may be helpful as a marker in the diagnosis of acute mesenteric ischemia; however, its diagnostic value and use as a routine biochemical test should be assessed in further studies.ACADEMIC EMERGENCY MEDICINE 2010; 17:1233-1238 ª 2010 by the Society for Academic Emergency Medicine M esenteric ischemia is a sudden decrease in intestinal blood flow due to occlusion, vasospasm, or hypoperfusion.1,2 Currently, acute mesenteric ischemia accounts for approximately 0.1% of all hospital admissions, 2 and while it constitutes 1% to 2% of all gastrointestinal diseases, the incidence has recently increased with the increasing age of the population. 3The mortality rate of acute mesenteric ischemia due to all causes is approximately 71%, with a range of 59% to 93%.2-4 Early diagnosis, before the development of intestinal infarction and peritonitis, is essential for patient survival.2,4 In a case series of 21 patients with embolism of the superior mesenteric artery, intestinal viability was found to be 100% in patients who were diagnosed within the first 12 hours of the onset of symptoms, 56% in those diagnosed within 12-24 hours, and 18% in those diagnosed after 24 hours. 5In acute mesenteric ischemia, for which time is vital according to the consensus result of recent studies on biochemical markers, there is no adequately sensitive and specific marker with an early diagnostic power to increase survival. 6 The optimum biochemical marker to be used in the early diagnosis of acute mesenteric ischemia should be released from the intestinal mucosa, should escape from the first-pass effect of the liver, and should be detected in the peripheral blood. The new diagnostic markers, which have recently been developed with this thought, are more promising than older markers. [6][7][8] During ischemia or reperfusion after ischemia, the human serum albumin capacity for metal binding may decrease as a result of loss of a part of the N-terminal connection site of the albumin or significant molecular modification. Th...

ObjectiveAs 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.AimsTo observe the changes of neutrophil/lymphocyte ratio occurring during migraine attacks.MethodThis 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.ResultsThe 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.ConclusionNeutrophil/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.

AMAÇAkut mezenter iskemi (AMİ) modeli kullanılarak yapılan bu çalışmada, serum prokalsitonin ve fosfor düzeylerinin AMİ erken tanısında kullanılabilirliği araştırıldı. GEREÇ VE YÖNTEMÇalışmada 21 adet Yeni Zelanda tavşanı kullanıldı. Denekler Kontrol, Sham ve İskemi grubu olarak adlandırıl-dı. Kontrol grubundaki deneklere herhangi bir girişim yapılmadı. Sham ve İskemi grubundaki deneklere orta hat insizyonu ile laparotomi yapıldı. İskemi grubundaki deneklere ise laparatomi yapıldıktan sonra süperior mezenterik arter bulunarak bağlandı. Her üç gruptaki hayvanlardan 0., 1., 3. ve 6. saatlerde kan alındı, bu numunelerden prokalsitonin ve fosfor çalışıldı. BULGULARİskemi grubunda, serum fosfor ve prokalsitonin düzeyle-rindeki yükselme kontrol ve sham gruplarına göre istatistiksel olarak anlamlı bulundu (p<0,05). Fosfor ve prokalsitonin düzeylerinin, iskemi oluşturulduktan sonra 1. saatten itibaren arttığı ve bu yüksekliğin 6 saat boyunca devam ettiği saptandı (p<0,05). SONUÇFosfor ve prokalsitonin'in AMİ'nin erken tanısında ve prognozunda kullanılabilecek önemli parametreler olabileceğini düşünüyoruz.Anahtar Sözcükler: Akut mezenter iskemi; fosfor; prokalsitonin.

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BackgroundWe aimed to determine whether there are any alterations in red blood cell width in patients diagnosed with acute pancreatitis.Material/MethodsThis 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.ResultsRecorded 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).ConclusionsAn 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.