Role of Redcell Distribution Weight in Predicting Disease Severity, Mortality and Complication in Patients With Acute Pancreatitis

The goal of the present study was to investigate the significance of the Red Cell Distribution Width (RDW) in identifying the severity, mortality and complications of the disease at an early stage in patients with acute pancreatitis (AP). 343 patients with AP presented to the emergency department during one year were included in this retrospective study. Demographic, laboratory and imaging results were recorded. Bedside Index for Severity in AP (BISAP) score was calculated. The patients who developed pancreatitis-related mortality were recorded. The diagnostic powers of RDW values in the diagnosis of BISAP Score (≥3), exitus, severe pancreatitis and pancreatitis with complication were analysed by means of Receiver Operating Characteristic Curve (ROC) analysis. p<0,05 was considered statistically significant. The mean age of the subjects was 59,7 ± 18,0 years. Area under curve (AUC) in ROC analysis conducted for RDW in patients with BISAP score≥ 3 was 0,649 (95% Cl 0,576-0,722) and p <0,001. For developed complications, AUC for RDW was 0,558 (95% Cl 0,454-0,662) and p was 0,243. For RDW<14,4 cut-off value; the sensitivity was 66,25%, specificity was 71,48% in the prediction of BISAP≥ 3, sensitivity was 87,5%, specificity was 65,14% in the prediction of mortality, sensitivity was 72,73%, specificity was 71,12% in the prediction of severe AP. RDW is as significant as the BISAP score in predicting the severity and mortality of pancreatitis in the patients with acute pancreatitis in the emergency department(ED). But it cannot predict the complications in AP

Strontium Chloride: Can It Be a New Treatment Option for Ulcerative Colitis?

Background/Aims. Patients with ulcerative colitis still need effective therapy without major side effects. It has been found that strontium can suppress NFκB activation induced by TNF-α. This opens a gate to a new anti-TNF agent which is cheap and can be given orally. We for the first time aimed to investigate the effect of strontium chloride (SrCl2) on inflammation in experimental colitis.Methods. Thirty female Wistar albino rats were divided into 5 groups each containing 6 rats. The rats in groups 1 and 2 served as the healthy control and colitis group, respectively. The rats in groups 3, 4, and 5 had colitis and received 40 mg/kg SrCl2, 160 mg/kg SrCl2, and 1 mg/kg prednisolone by oral gavage, respectively. The rats were sacrificed for histological evaluation and determination of serum neopterin, TNF-α, and IFN-γlevels.Results. The neopterin, TNF-αand IFNγlevels of group 2 was significantly higher than the other groups. The neopterin, TNF-α, and IFN-γlevels of controls and other treatment groups were comparable. There were a significant difference in macroscopic and microscopic healing between group 2 and other groups histologically. But there was not a significant difference within treatment receiving groups.Conclusion. SrCl2had comparable therapeutic efficiency with prednisolone.</jats:p

Portal vein thrombosis incidence, serum A-III, protein S, protein C, factor II, factor VII levels and platelet aggregation function in patients with chronic hepatitis and liver cirrhosis

Tıp Fakültesi, İç Hastalıkları Ana Bilim DalıÇeşitli nedenlerle meydana gelen karaciğer sirozu sık olarak görülmektedir. Akut ve kronik karaciğer parankim hasarları hemostaz basamakalannı oluşturan elemanlardan trombositler ve pıhtılaşma mekanizmalarını etkilemektedir. Karaciğer sirozunda pıhtılaşmanın doğal inhibitörleri olan Protein C, Protein S ve Antitrombin HI düzeyleri azalmaktadır. Bu çalışmada 25 kronik, hepatitü ve 27 karaciğer sirozlu hastada Faktör II, Faktör VH, Protein C, Protein S, Antitrombin IH düzeyleri ve trombosit agregasyon fonksiyonu bakıldı. Faktör n, Faktör VII, Protein C7 Protein S, Antitrombin IH düzeyleri karaciğer sirozu bulunan hastalarda kronik hepatitîi hastalara göre anlamlı olarak düşük bulundu. ADP, Epinefiin, Kollajen uyarılmış trombosit agregasyon fonksiyonu karaciğer sirozunda, kronik hepatitîi hastalara göre anlamlı olarak bozulmuş bulundu, karaciğer sirozlu iki hastada portal ven trombozu saptandı. Sonuç olarak karaciğer sirozunda hemostatik işlevlerde bozulma olmaktadır. Bu nedenle bu hastalarda tromboz veya kanama gibi hemostatik bozukluklar sık olarak görülmektedir.Liver cirrhosis is a common disease seen due to several reasons. Acute and chronic liver parenchymal disorders affect platelet and coagulation mechanisms which constitue the steps in haemostasis. Protein C, protein S and Antithrombin III levels which are one of the natural inhibitors of coagulation are decreased in liver cirrhosis. Factor II, Factor VII, Protein C, Protein S, Antithrombin III and platelet'.s aggregation functions were investigated in 25 patients with chronic hepatitis and in 27 patients with liver cirrhosis in this study. Factor IL, Factor VII, Protein C, Protein S, Antithrombin HI levels were decreased significantly in patients with liver cirrhosis when compared with the patients with chronic hepatitis. Platelat aggregation function induced by ADP, Epinefrin and collagen were significantly more destructed in patients with patients, with liver cirrhosis when compared with chronic hepatitis patients. Portal vein thrombosis was observed in two patients. As a result haemostatic functions are destroyed in patients with liver cirrhosis. For this reason complications like thrombosis and bleeding are commonly seen in these patients

EVALUATION OF QTC INTERVAL IN CIRRHOSIS PATIENTS WITH VARICEAL HEMORRHAGE

Objective: In this study, we investigated the effect of the QTc interval in cirrhosis patients on mortality and morbidity in esophageal variceal hemorrhages. Material and Method: It was retrospectively scanned in a single-centred design. The QTC intervals before and during the bleeding were calculated. The demographic characteristics and mortality status were recorded. Results: Bleeding was detected in 117 of the 156 patients. A total of 83% of these were male, and 17% were female. The QTc interval in these patients measured at the time of bleeding was longer than that measured before bleeding (p&lt;0.001). The QTc interval of the patients who died due to bleeding was found to be 509.9 ms. It was calculated for males as 520.6 ms, and 487.4 ms for females. In the ROC analysis that was conducted for the QTc in terms of mortality, the sensitivity was 82.4% and specificity was 79.7% for 464.0 ms in males (AUC:0.785; 95% CI 0.724-0.825). The sensitivity was 77.8% and the specificity was 90.0% for QTc’s 454.0 ms cutoff value for females (AUC:856; 95% CI 0.812-0.862). Conclusion: The QTc interval is prolonged in the case of esophageal variceal hemorrhage in patients diagnosed with cirrhosis. A prolonged QTc interval is associated with mortality and morbidity of patients

Hypertransaminasemia due to possible pantoprazole use

..