SummaryBackground: We aimed to investigate the prognostic importance of platelet-lymphocyte ratio (PLR) and neutrophil-lymphocyte ratio(NLR) combination for patients diagnosed with acute pancreatitis and its relationship with mortality. Methods: This retrospective study was included 142 patients diagnosed with acute pancreatitis. Ranson, Atlanta and BISAP 0h, 24h and 48h scores of the patients were calculated by examining their patient files. The patients were divided into three groups as low-risk, medium-risk and high-risk patients according to their PLR and NLR levels. Results: The number of patients with acute pancreatitis complications such as necrotizing pancreatitis, acute renal failure, sepsis and cholangitis was significantly higher in the high-risk group compared to other groups. Mortality rate was found to be 90% in the high-risk group, 16% in the medium-risk group, and 1.9% in the low-risk group. The number of patients with a Ranson score of 5 and 6, a severe Atlanta score, a BISAP 0h score of 3 and 4, a BISAP 24h and 48h score of 4 and 5 was higher in the high-risk group compared to other groups. PLR-NLR combination, Atlanta and Ranson scores, and C-reactive protein level were determined to be independent risk factors predicting mortality in stepwise regression model. PLR-NLR combination had the highest area under curve value in terms of predicting acute
The probability of CBDS was observed to be high in the intermediate and high risk groups. However due to low sensitivity and specificity values, the ASGE guideline needs additional or different predictors.
Background. Most common bile duct (CBD) stones can be removed with standard techniques using endoscopic retrograde cholangiopancreatography (ERCP), but in some cases additional methods are needed. In this study we aimed to investigate the management of patients with difficult stones and the factors that affect the outcome of patients that have undergone periodic endobiliary stenting. Materials and Methods. Data of 1529 patients with naive papilla who had undergone ERCP with an indication of CBD stones was evaluated retrospectively. Stones that could not be removed with standard techniques were defined as “difficult stones.” Cholangiograms of patients who had difficult stones were revised prospectively. Results. Two hundred and eight patients (13.6%) had difficult stones; 150 of these patients were followed up with periodic endobiliary stenting and successful biliary clearance was achieved in 85.3% of them. Both CBD (p < 0.001) and largest stone size (p < 0.001) were observed to be significantly reduced between the first and the last procedure. This difference was even more significant in successfully treated patients. Conclusions. Periodic endobiliary stenting can be used as an effective treatment for patients with difficult stones. Sizes of the CBD and of the largest stone are independent risk factors that affect the success rate.
Background/Aims: We aimed to assess the effect of azathioprine on mucosal healing in patients with inflammatory bowel diseases (IBD). Artificial neural networks were applied to IBD data for predicting mucosal remission. Materials and Methods: Two thousand seven hundred patients with IBD were evaluated. According to the computer-based study, data of 129 patients with IBD were used. Artificial neural networks were performed and tested. Results: Endoscopic mucosal healing was found in 37% patients with IBD. Male gender group showed a negative impact on the efficacy of azathioprine (p<0.05). Responder patients with IBD were older than the nonresponder (p<0.05) patients. According to this study, the cascade-forward neural network study provides 79.1% correct results. In addition to a 0.16033 training error, mean square error (MSE) was taken at the 16 th epoch from the feed-forward back-propagation neural network. This neural structure, used for predicting mucosal remission with azathioprine, was also validated. Conclusion: Analyzing all parameters within each other to azathioprine therapy were shown that which parameters gave better healing were determined by statistical, and for the most weighted six input parameters, artificial neural network structures were constructed. In this study, feed-forward back-propagation and cascade-forward artificial neural network models were used.
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