scholarly journals Predictive factors in identifying operative risks in cholecystectomies

2019 ◽  
Author(s):  
Murat Kanlioz ◽  
Ugur Ekici
Keyword(s):  
Antibiotic Treatment ◽  
Wall Thickness ◽  
Gallbladder Wall ◽  
Gamma Glutamyl Transferase ◽  
Preoperative Period ◽  
Chi Square ◽  
Peripheral Tissues ◽  
Reactive Protein ◽  
Chi Square Test ◽  
Glutamyl Transferase

AbstractPurposeThis study aims to forecast findings showing the difficulty of operation in cholecystectomy through pre-operative examinations and reduce morbidity and mortality with the predictive data obtained.Materials and MethodsIn the preoperative period, the followings were measured in patients who will undergo cholecystectomy: C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), WBC, Neutrophil ratio (NR), erythrocyte distribution range (RDW), aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma glutamyl transferase (GGT), total bilirubin (TB), direct bilirubin (DB). Following the preoperative ultrasound (USG), the patients were recorded in two groups as patients with “normal” and “increased” gallbladder wall thickness. Also, the patients were asked if they underwent ERCP and whether they received antibiotic treatment in the last 10 days due to their disease in the preoperative period. The appearance of the peroperative gallbladder was recorded in two groups as “has a normal appearance” or “edematous and/or adherent to peripheral tissues”. Whether or not there is a correlation between the preoperative findings and peroperative appearance was evaluated. The recordings and analyzes were made using SPSS statistics program. Correlation between the data were analyzed by Chi-square test. p<0.05 was considered significant.ResultsThe study achieved statistically significant results for the correlation between the “gallbladder edema and/or adhesion to peripheral tissues” in the peroperative period and the following five parameters: increased WBC, increased NR, increased gallbladder wall thickness at USG, compulsory ERCP and receipt of antibiotic treatment for the disease in the last 10 days.(p<0,05).ConclusionTaking into consideration the presence, in the preoperative period, of some or all of the five criteria-namely, increased WBC, increased NR, increased gallbladder wall thickness at USG, receiving antibiotic treatment for the disease in the last 10 days and undergoing ERCP-in patients with cholelithiasis for whom cholecystectomy is envisaged would make it easier to estimate the degree of difficulty of the surgery and the possibility of encountering difficult and complicated cases.

scholarly journals Sonographic gallbladder wall thickness in normal adult population in Nigeria

2010 ◽  
Vol 14 (4) ◽  
pp. 84 ◽  
Author(s):  
S Mohammed ◽  
A Tahir ◽  
A Ahidjo ◽  
Z Mustapha ◽  
Franza O
Keyword(s):  
Wall Thickness ◽  
Adult Population ◽  
Clinical History ◽  
Gallbladder Wall ◽  
Normal Adult ◽  
Chi Square ◽  
Normal Ranges ◽  
Significant Difference ◽  
Chi Square Test ◽  
The Mean

Aim. The aim of the study was to determine the ultrasonic gallbladder wall thickness in normal adult Nigerians so as to create standards for defining gallbladder abnormalities in Nigerians. Method. Four hundred adults comprising 228 (57%) women and 172 (43%) men aged 16 - 78 years, who had normal clinical history and physical findings, were recruited. The gallbladder wall thickness was obtained in the supine, prone and right anterior oblique positions. Differences in gallbladder wall thickness were determined using the chi-square test, while the relationship between the ultrasound-measured gallbladder wall thickness and the subjects’ age, sex, height and weight were analysed using the Pearson product moment correlation. Normal ranges and related statistics were estimated and tabulated according to age group and sex. Results. The mean age of the subjects was 32±13.2 years. The mean gallbladder wall thickness range was 1.8 - 2.8 mm±0.5mm. The thickness range for females was 1.7 - 2.7 mm±0.5 mm, and that for males was 1.9 - 2.9 mm±0.5 mm. There was a statistically significant difference (p

scholarly journals Early Biomarkers of Neurodegenerative and Neurovascular Disorders in Diabetes

2020 ◽  
Vol 9 (9) ◽  
pp. 2807 ◽  
Author(s):  
Aleksandra Gasecka ◽  
Dominika Siwik ◽  
Magdalena Gajewska ◽  
Miłosz J. Jaguszewski ◽  
Tomasz Mazurek ◽  
...  
Keyword(s):  
Neurodegenerative Disorders ◽  
Glycogen Synthase ◽  
Strong Association ◽  
Paraoxonase 1 ◽  
Common Disease ◽  
Diabetic Patients ◽  
Gamma Glutamyl Transferase ◽  
Reactive Protein ◽  
Patients At Risk ◽  
Glutamyl Transferase

Diabetes mellitus (DM) is a common disease worldwide. There is a strong association between DM and neurovascular and neurodegenerative disorders. The first group mainly consists of diabetic retinopathy, diabetic neuropathy and stroke, whereas, the second group includes Alzheimer’s disease, Parkinson’s disease, mild cognitive impairment and dementia. The aforementioned diseases have a common pathophysiological background including insulin resistance, oxidative stress, atherosclerosis and vascular injury. The increasing prevalence of neurovascular and neurodegenerative disorders among diabetic patients has resulted in an urgent need to develop biomarkers for their prediction and/or early detection. The aim of this review is to present the potential application of the most promising biomarkers of diabetes-related neurodegenerative and neurovascular disorders, including amylin, β-amyloid, C-reactive protein (CRP), dopamine, gamma-glutamyl transferase (GGT), glycogen synthase kinase 3β, homocysteine, microRNAs (mi-RNAs), paraoxonase 1, phosphoinositide 3-kinases, tau protein and various growth factors. The most clinically promising biomarkers of neurovascular and neurodegenerative complications in DM are hsCRP, GGT, homocysteine and miRNAs. However, all biomarkers discussed in this review could become a part of the potential multi-biomarker screening panel for diabetic patients at risk of neurovascular and neurodegenerative complications.

scholarly journals 11βHSD1 Inhibition with AZD4017 Improves Lipid Profiles and Lean Muscle Mass in Idiopathic Intracranial Hypertension

2020 ◽  
Vol 106 (1) ◽  
pp. 174-187
Author(s):  
Rowan S Hardy ◽  
Hannah Botfield ◽  
Keira Markey ◽  
James L Mitchell ◽  
Zerin Alimajstorovic ◽  
...  
Keyword(s):  
Intracranial Hypertension ◽  
Muscle Mass ◽  
Idiopathic Intracranial Hypertension ◽  
Hepatic Function ◽  
Lipid Profiles ◽  
Gamma Glutamyl Transferase ◽  
Peripheral Tissues ◽  
Lean Muscle Mass ◽  
Glutamyl Transferase ◽  
The Impact

Abstract Background The enzyme 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) determines prereceptor metabolism and activation of glucocorticoids within peripheral tissues. Its dysregulation has been implicated in a wide array of metabolic diseases, leading to the development of selective 11β-HSD1 inhibitors. We examined the impact of the reversible competitive 11β-HSD1 inhibitor, AZD4017, on the metabolic profile in an overweight female cohort with idiopathic intracranial hypertension (IIH). Methods We conducted a UK multicenter phase II randomized, double-blind, placebo-controlled trial of 12-week treatment with AZD4017. Serum markers of glucose homeostasis, lipid metabolism, renal and hepatic function, inflammation and androgen profiles were determined and examined in relation to changes in fat and lean mass by dual-energy X-ray absorptiometry. Results Patients receiving AZD4017 showed significant improvements in lipid profiles (decreased cholesterol, increased high-density lipoprotein [HDL] and cholesterol/HDL ratio), markers of hepatic function (decreased alkaline phosphatase and gamma-glutamyl transferase), and increased lean muscle mass (1.8%, P &lt; .001). No changes in body mass index, fat mass, and markers of glucose metabolism or inflammation were observed. Patients receiving AZD4017 demonstrated increased levels of circulating androgens, positively correlated with changes in total lean muscle mass. Conclusions These beneficial metabolic changes represent a reduction in risk factors associated with raised intracranial pressure and represent further beneficial therapeutic outcomes of 11β-HSD1 inhibition by AZD4017 in this overweight IIH cohort. In particular, beneficial changes in lean muscle mass associated with AZD4017 may reflect new applications for this nature of inhibitor in the management of conditions such as sarcopenia.

scholarly journals Study of High sensitive C - reactive protein and Gamma-glutamyl transferase in Type 2 Diabetes Mellitus with Hypertension

2020 ◽  
Vol 11 (3) ◽  
pp. 3478-3483
Author(s):  
Ramya S ◽  
Sureka Varalakshmi V ◽  
Uma Maheswari K ◽  
Chandan Bala R
Keyword(s):  
Diabetes Mellitus ◽  
Gamma Glutamyl Transferase ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Significant Difference ◽  
Group A ◽  
Hs Crp ◽  
Group B ◽  
Glutamyl Transferase

C-reactive protein (CRP), produced by the hepatocytes is a primary inflammatory marker of T2DM. Higher levels of gamma-glutamyl transferase enzyme (GGT) and Hs CRP (High sensitive CRP)are associated with the complication of poor glycemic control.This study was aimed to find the association of Hs CRP and GGT for cardiovascular risk factors in Type 2 diabetes mellitus (T2DM)and Hypertension in the suburbs of Chennai. This study includes 57 subjects with T2DM and Hypertension (Group A) and 62 subjects with T2DM (GroupB) within the age group of 40-60 years. FBS, HbA1C, Hs CRP, GGT and blood pressure were determined. Statistical analysis was performed using Statistical Package for the SPSS 17 version. Mean values of FBS, blood HbA1C, Hs CRP and GGT were significantly higher among participants of Group A than Group B. Significant difference of FBS, HbA1C were found between the two groups. In contrast, no significant difference of GGT was found between the groups. Differences were considered statistically significant at two-sided P < 0.05. Within the group, Hs CRP shows the significance and positive correlation with FBS, SBP and DBP. Still, GGT does not show any significance in Group A. In contrast, in Group B, both Hs CRP and GGT shows the importance and positive correlation with FBS and HbA1C.It is concluded that high levels of HsCRP are associated with T2DM and Hypertension, indicating increased cardiovascular risk, and it should be included in regular monitoring of type-2 diabetic patients.

scholarly journals Evaluating the Efficacy and Side Effects of Corticosteroid Therapy in Severely ill COVID-19 Patients

2021 ◽  
Author(s):  
Yun Cai ◽  
Lu Li ◽  
Jing Chen ◽  
Kening Li ◽  
Shenli Zhang ◽  
...  
Keyword(s):  
Corticosteroid Therapy ◽  
Low Dose ◽  
Gamma Glutamyl Transferase ◽  
Efficacy And Safety ◽  
Clearance Time ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Hospital Patients ◽  
Heart Injury ◽  
Glutamyl Transferase

Abstract Background: Cytokine storms are a common complication in severely ill patients with COVID-19, for which corticosteroid therapy (CsT) is used as adjuvant treatment. Therefore, we evaluated the efficacy and safety of CsT in patients with COVID-19.Methods: A single-center, retrospective cohort study was conducted in 1,392 severely ill patients with COVID-19 from Wuhan Huoshenshan Hospital. Patients received at least one dose (1–2 mg·kg-1·day-1 for 3–5 days) of methylprednisolone were divided into CsT group, whereas the rest were assigned into the non-CsT group. Results: Of 1,392 patients, 116 were assigned to the CsT group and 1,226 to the non-CsT group. Patients in the CsT group showed comparable mortality rate (1.8% vs. 1.2%, P > 0.99) and viral clearance time (44.5 days vs. 46.0 days, P = 0.48), but longer hospitalization time (21 days vs. 12 days, P < 0.001) than those in non-CsT group. During CsT, the proportion of lymphocytes was lower (14.7 % vs. 18.5 %, P = 0.01), while neutrophils was higher (77.1 % vs. 69.8 %, P < 0.001), than before treatment. The C-reactive protein (CRP) level was significantly lower after CsT (3.1 mg/L vs. 9.5 mg/L, P < 0.001). Furthermore, indicators of liver function (gamma-glutamyl transferase [GGT], alanine aminotransferase [ALT], and aspartate aminotransferase [AST]) and cardiac function (brain natriuretic peptide [BNP], α-hydroxybutyrate dehydrogenase [α-HBDH], and lactate dehydrogenase [LDH]) increased significantly during CsT but returned to normal after CsT. Patients who developed liver damage showed higher GGT, ALT, AST, LDH, Cre, and CRP; patients who developed heart injury had higher AST, LPH, CRP, lymphocyte (LYM), glucose, BNP, and α-HBDH; and patients who developed kidney failure had higher α-HBDH, LDH, CRP, and LYM values than before CsT. Additionally, patients who received CsT with cardiovascular disease showed a continuous elevation in D-dimer levels.Conclusions: CsT effectively attenuates the inflammatory response in severely ill patients with COVID-19 at a relatively low dose in a short duration; however, CsT increases the risk of hepatic and cardiac abnormalities.

scholarly journals The Association between the Level of Antithrombin III and Mortality in Children with Sepsis

2019 ◽  
Vol 7 (6) ◽  
pp. 959-961
Author(s):  
Indah Nur Lestari ◽  
Chairul Yoel ◽  
Munar Lubis
Keyword(s):  
General Hospital ◽  
Antithrombin Iii ◽  
Complete Blood Count ◽  
Pediatric Intensive Care ◽  
Cross Sectional Study ◽  
Chi Square ◽  
Laboratory Findings ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Chi Square Test

BACKGROUND: Sepsis is a significant cause of morbidity and mortality in children. The diagnosis of sepsis remains continuing to develop which determines treatment and prognostic. Antithrombin III is one of the coagulation markers to evaluate the prognosis of sepsis. AIM: To determine the association between the level of antithrombin III and mortality in children with sepsis in the Pediatric Intensive Care Unit, Haji Adam Malik General Hospital, Medan. METHODS: A cross-sectional study was conducted in Haji Adam Malik General Hospital, Medan from April until June 2015. There were 41 children with sepsis. Sepsis was diagnosed from clinical and laboratory findings. Complete blood count, antithrombin III level, C-reactive protein and procalcitonin were an indicator of unproven sepsis that performed in the laboratory. Meanwhile blood culture was performed in the microbiology laboratory. The association between the level of antithrombin III and mortality was analysed by using chi-square test. RESULTS: Of the 41 participants, the low antithrombin III level was 13 of 41 children (31.7%) meanwhile the normal antithrombin III level was 28 of 41 children (68.3%). There was 8 of 13 (42.1%) and 11 of 28 (57.9%) children in death cases of low and normal antithrombin III level, respectively. Samples with low antithrombin III level had 2.473 higher risk mortality than normal antithrombin III level (P = 0.184; 95% CI 0.641 to 9.5421; PR = 2.473). CONCLUSION: There was no statistically significant association between levels of antithrombin III and mortality in children with sepsis.

scholarly journals Prevalence and Morphology of C-Shaped Canals: A CBCT Analysis in a Korean Population

Scanning ◽  
2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Sung Eun Yang ◽  
Tae Yeon Lee ◽  
Kyung Jae Kim
Keyword(s):  
Wall Thickness ◽  
Statistical Significance ◽  
Anatomical Variations ◽  
Korean Population ◽  
Age Group ◽  
Chi Square ◽  
Root Canals ◽  
Chi Square Test ◽  
The Difference ◽  
Cbct Analysis

This retrospective study of roots with C-shaped canals investigated their prevalence, configuration type, and lingual wall thickness, as well as the panoramic radiographic features of roots in permanent mandibular second molars confirmed to have C-shaped canals on cone-beam computed tomography (CBCT) in a Korean population. In total, 1884 CBCT images of mandibular second molars were examined by two endodontists to analyze the presence of C-shaped canals according to age and sex. The bilateral occurrence of C-shaped roots and their morphology on panoramic radiography were assessed and statistically analyzed using the chi-square test. The classification of Fan et al. was applied to categorize the configurations of C-shaped canals. The lingual wall thickness was calculated in the mesial, middle, and distal areas at the orifice and at 5 mm from the apex. The Mann–Whitney U test was used to analyze the mean difference of lingual wall thickness between the apex and orifice level. A P value of 0.05 was considered to indicate statistical significance in the statistical analyses. Of 2508 mandibular second molars, 924 (36.8%) had C-shaped root canals. The prevalence was significantly lower in the over 61 age group (24.08%) than in the 21–30-year age group (40.02%) and was higher in women (42.32%). Most cases were bilateral (85.9%). The C1 type was the most common (35.3%). The prevalence of C1 type canals decreased, while that of C3b type canals increased with age. In 75.2% of teeth having C-shaped root canals on CBCT, fused roots were observed on panoramic views. The difference in the lingual wall thickness at the orifice and 5 mm from the apex was significant in the middle area in all configurations of C-shaped root canals. When performing nonsurgical or surgical endodontic procedures of the mandibular second molars, clinicians should consider age, sex, ethnicity, and anatomical variations.

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