Retrospective investigation of the effectiveness of fecal occult blood test (FOB), PT-APTT in patients admitted to emergency department with gastrointestinal bleeding

The purpose of our study is to investigate the fact that gastrointestinal system bleeding, which is a major cause of mortality, is not diagnosed faster by any additional laboratory tests except physical examination and endoscopy, but it is negative in terms of time, workload and cost. Our study was retrospective and the hospital information system was scanned and the patients who were referred to Emergency Medicine Clinic between 01.08.2012-08.08.2013 with Gastrointestinal System (GIS) bleeding symptoms and then underwent endoscopic examination were investigated. Demographic characteristics, physical examination findings, vital signs, required examinations, digital rectal examination findings, endoscopy and colonoscopy results were recorded in the study form. For statistical analysis, SPSS (Statistical Package for Social Sciences) 17.0 program was used. A total of 274 patients aged 18 years and over were admitted to the study and 61.7% were male and 38.3% were female. Most of the patients in our diagnostic group were in the 70-79 age group. Sensitivity of Digital Rectal Examination (DRE) value was 79.6% Specificity 92.30%, negative predictive value (NPV) 60%, Sensitivity of Fecal Occult Blood Test (FOB) value was 31.46% NPV 30.49%, sensitivity of international normalized ratio (INR) was 26.25% NPV 32,95%, sensitivity of prothrombin time (PT) was 19.37%, NPV 34.84%, sensitivity of activated partial thromboplastin time (aPTT) was 14.19% NPV 34.43%. Endoscopies were performed in 169 patients with GIS bleeding and no active bleeding detected in 56 (33.1%) patients and in 113 (66.9%) patients active bleeding was detected. In patients with positive digital rectal examination findings, endoscopy results were also highly positive for gastrointestinal system bleeding. Our study suggests that; Running FOB, PT, APTT, INR tests in patients admitted to emergency department with GIS bleeding, is far from giving important and necessary information about the emergency management of the patients to emergency medicine specialists. The results of the digital rectal examination correlate with endoscopy results. It is also an easy and time-consuming examination method. From this point of view, we would like to emphasize that making the DRE of all patients with suspected GIS bleeding is a correct and immediate approach to the emergency physician. [Med-Science 2018; 7(1.000): 30-34

Diagnosis of pulmonary embolism in patients Mean Platelet Volume (MPV), neutrophil / lymphocyte ratio (NLR) and platelet / lymphocyte ratio (PLR) 's foresight

Pulmonary thromboembolic (PTE) is a disease the mortality and the incidence of which is high.Diagnosing PTE can be overlooked because PTE hasnt a hard and an original clinic tableau. Recently, new marker studies continue in the diagnosis and the mortality prudence of MPV, NLR and PLR in pulmonary embolic diagnosis. Also, in our study we purposed to search the foresight of MPV, NLR and PLR in the diagnosis of pulmonary embolic. Through the patients who applied to our emergency room between 1 January 2014 and 1 January 2015, 42 patients diagnosed with pulmonary thromboembolic were taken by scanning retrospective. Thirty healthy people were taken to study for control group. The average age of 42 patients taken to study was 67,90 ± 14,85. 24 (%57,1) of patients are women and 18 (%42,9) of are men. The average D-dimer of patients was 5052,40 ± 5839,95 , the average PLR was 0,19 ± 0,12 , the average NLR was 8,07 ± 6,00 and the average MPV was 9,95 ± 1,01. In the control group, the average PLR was 0,18 ± 0,19 , the average NLR was 4,34 ± 4,26 and the average MPV was 8,79 ± 0,57. The average MPV, NLR and PLR of patients group was higher than control groups. When comparing the patients and the controls group , NLR and MPV was signficantly high (p< 0.005) but PLR was not significantly high. In our study when we compare the group of patients and control, NLR was significantly high but PLR wasnt. [Med-Science 2016; 5(4.000): 1002-4

Gender specific differences in patients with psoriatic arthritis

Objectives: To assess gender related differences in a cohort of patients with psoriatic arthritis (PsA).Methods: Consecutively recruited patients were included and underwent clinical, radiological and laboratory evaluation by using standardized protocol and case report forms.Results: Women (n=115) with PsA had higher symptom duration and body mass index (BMI), tender and swollen joint counts, disease activity score-28 joints (DAS28), Erythrocyte sedimentation rate (ESR) and poorer physical activity and fatigue than men (n=72) with PsA. Psoriasis area and severity index (PASI) were higher in male patients. However quality of life (SF36 physical and mental component scores), articular pattern, extra-articular features (including uveitis, iritis) and family history for psoriasis, spondyloarthritis (SpA) (PsA and ankylosing spondylitis [AS]) were quite similar between men and women.Conclusions: Some of the clinical and laboratory variables tend to be different between men and women with PsA. The extent of quality of life and articular pattern seem to be similar in both genders. Men with PsA are more likely to have higher PASI scores and longer duration to develop arthritis after the onset of psoriasis, while women are more likely to have higher disease activity and report more fatigue and physical activity limitations