Utility of leucocytes, inflammatory markers and pancreatic enzymes as indicators of gangrenous cholecystitis

2019 ◽  
Vol 96 (1133) ◽  
pp. 134-138 ◽  
Author(s):  
Liqaa Raffee ◽  
Samer Kuleib ◽  
Alaa Oteir ◽  
Tariq Kewan ◽  
Khaled Alawneh ◽  
...  
Keyword(s):  
Acute Cholecystitis ◽  
Cell Count ◽  
White Cell Count ◽  
Clinical Signs ◽  
Liver Function Tests ◽  
Total Leucocyte Count ◽  
Histopathological Diagnosis ◽  
Gangrenous Cholecystitis ◽  
Increased Risk ◽  
Complete Cell

BackgroundAcute cholecystitis is an emergency condition. If not promptly diagnosed and properly managed, the complication of gangrenous cholecystitis may develop, which may be a life-threatening complication.ObjectivesThe study aims to examine various characteristics and physiological parameters in patients diagnosed with acute cholecystitis to evaluate if significant predictive factors exist for the differential diagnosis of gangrenous cholecystitis.Materials and methodsThis was a retrospective study included patients with acute cholecystitis diagnosis, who presented to ‘blinded for peer review’ from 1 January 2010 to 1 January 2017. Parameters evaluated included liver function tests, complete cell count, C reactive protein, erythrocyte sedimentation rate (ESR), amylase and lipase levels, as well as medical history, and presenting clinical signs. Cases were divided according to whether or not there was a histopathological diagnosis of gangrenous cholecystitis.ResultsA total of 186 (54.5%) female and 155 (45.5%) male cases were examined. Patients with gangrenous cholecystitis tended to be male, showed a significantly higher white cell count, higher neutrophil percentage, lower lymphocyte percentage and higher ESR compared with patients without gangrenous cholecystitis. However, serum amylase and lipase demonstrated no differential diagnostic utilityConclusionMale patients with a high ESR level, high total leucocyte count with a relative high proportion of neutrophils and a low proportion of lymphocytes were found to be at increased risk of the presence of gangrenous cholecystitis.

scholarly journals Pre-operative serum total bilirubin level as an indicator marker of perforated appendicitis.

2019 ◽  
Vol 18 (2) ◽  
pp. 233-237
Author(s):  
Nur Karyatee Kassim ◽  
Aniza M Jelani ◽  
T Salwani T Ismail ◽  
Julia Omar ◽  
Hanim A Ibrahim ◽  
...  
Keyword(s):  
Cell Count ◽  
Clinical Decision Making ◽  
Total Bilirubin ◽  
White Cell Count ◽  
Medical Science ◽  
Perforated Appendicitis ◽  
Total Bilirubin Level ◽  
Liver Function Tests ◽  
Serum Total Bilirubin ◽  
The Impact

Objectives: Acute appendicitis is one of the most common surgical emergencies. Perforated appendicitis can result in increased morbidity and mortality. Thus, early identification of perforation can reduce the impact on patient and improve outcome. Apart from total white cell count (TWCC), serum total bilirubin (SB) has been shown to indicate perforation in appendicitis. The aim of this study was to assess the usefulness of serum total bilirubin (SB) as the preoperative indicator for perforated appendicitis. Materials and Methods: This was a retrospective study of all appendicectomies cases done in Hospital Universiti Sains Malaysia (HUSM) over a one-year period in 2014. Only patients with histopathologically confirmed appendicitis with available liver function tests and total white blood cell count preoperatively were included in the study. These appendicitis cases were further divided into perforated and non-perforated based on histopathological reports obtained. Results: A total of 245 patients had appendicectomy done in 2014 between January to December 2014. Out of 110 from these 245 patients met the inclusion and exclusion criteria. SB was significantly higher (p<0.001) in patients with perforated appendix compared to non-perforated. Conclusion: In conclusion, this study showed that preoperative SB is a useful laboratory parameter for perforated appendicitis to improve clinical decision-making by the clinician. Bangladesh Journal of Medical Science Vol.18(2) 2019 p.233-237

Admission Variables Predictive of Gangrenous Cholecystitis

2012 ◽  
Vol 78 (10) ◽  
pp. 1075-1078 ◽  
Author(s):  
Ann E. Falor ◽  
Michael Zobel ◽  
Amy Kaji ◽  
Angela Neville ◽  
Christian De Virgilio
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Blood Cell ◽  
Acute Cholecystitis ◽  
Cell Count ◽  
White Blood Cell Count ◽  
White Blood Cell ◽  
Open Cholecystectomy ◽  
Blood Cell Count ◽  
Factors Associated ◽  
Gangrenous Cholecystitis

The objective of the present study was to identify admission clinical factors associated with gangrenous cholecystitis (GC) and factors associated with conversion to open cholecystectomy. We retrospectively evaluated 391 patients over a 17-month period who underwent urgent laparoscopic cholecystectomy for a diagnosis of acute cholecystitis. Eighty-nine patients with pathologically proven GC were compared with 302 patients without GC. On multivariable logistic regression, predictors of GC included male gender, white blood cell count greater than 14,000/mm3, heart rate greater than 90 beats per minute, and sodium 135 mg/dL or less. Conversion rate to open cholecystectomy was 7.9 per cent overall, 4 per cent for non-GC, and 19 per cent for GC (odds ratio, 0.2; 95% confidence interval, 0.1 to 0.4; P < 0.00001). Conversion was predicted by increasing number of days to surgery, total bilirubin, and white blood cell count. Complication rate was higher in the GC group (10.1 vs 3.6% in the acute cholecystitis group, P = 0.01). The increased rate of conversion observed with surgery delay suggests that early laparoscopic cholecystectomy may be preferable in most patients.

scholarly journals Periodontitis is associated to increased systemic inflammation in postmyocardial infarction patients

Open Heart ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. e001674
Author(s):  
Ronaldo Lira-Junior ◽  
Elisabeth Almer Boström ◽  
Anders Gustafsson
Keyword(s):  
Cell Count ◽  
Alveolar Bone ◽  
White Cell Count ◽  
White Cell ◽  
Altered Expression ◽  
Postmyocardial Infarction ◽  
Increased Risk ◽  
Artery Disease ◽  
Disease Study ◽  
Study Participants

ObjectivePeriodontitis has been independently associated to cardiovascular disease. However, the biological mechanisms underlying such association are still partially unknown. Thus, this study aimed to discover immunological clues accounting for the increased risk of myocardial infarction (MI) in patients having periodontitis.MethodsWe included 100 patients with a first MI, 50 with and 50 without severe periodontitis, and 100 age-matched, sex-matched and area-matched controls from the Periodontitis and Its Relation to Coronary Artery Disease Study. Participants underwent comprehensive clinical and laboratory examinations 6–10 weeks after the MI and plasma expression of 92 inflammation-related markers was assessed through proximity extension assay.ResultsPatients who had an MI displayed altered expression of CCL19, TNFRSF9 and LAP TGF-β1 in comparison with controls. TNFRSF9 correlated significantly with the amount of alveolar bone loss. MI patients with deep periodontal pockets showed increased white cell count and higher expression of FGF-21, HGF, OSM, CCL20 and IL-18R1 than patients without. White cell count correlated significantly with four of these proteins.ConclusionsCollectively, our results indicate molecular markers that could be responsible for the increased systemic inflammatory activity in patients with MI with periodontitis.

Leucocytes and Thrombosis

1973 ◽  
Vol 30 (01) ◽  
pp. 036-046 ◽  
Author(s):  
D.C Banks ◽  
J.R.A Mitchell
Keyword(s):  
Cell Count ◽  
White Cell Count ◽  
Cell Loss ◽  
White Cell ◽  
Structural Resemblance ◽  
The Masses

SummaryWhen heparinised blood is rotated in a glass flask at 37°C. the white cell count falls and it has been shown that this is due to the adherence and aggregation of polymorphonuclear white cells on the wall of the flask. The masses formed bear a close structural resemblance to thrombi and the mechanisms involved in white cell loss during rotation may therefore increase our knowledge of the thrombotic process.

An Assessment of Red Cell Deformability Using a Simple Filtration Method

1979 ◽  
Author(s):  
M Drummond ◽  
G Lowe ◽  
J Belch ◽  
C Forbes ◽  
J Barbenel
Keyword(s):  
Cell Count ◽  
Shear Viscosity ◽  
White Cell Count ◽  
White Cell ◽  
Red Cell ◽  
Cell Deformability ◽  
Red Cell Deformability ◽  
Simple Method ◽  
Filtration Method ◽  
Significant Difference

We investigated the reproducibility and validity of a simple method of measuring red cell deformability (filtration of whole blood through 5 µ sieves) and its relationship to haematocrit, blood viscosity, fibrinogen, white cell count, sex and smoking. The mean coefficient of variation in normals was 3. 7%. Tanned red cells showed marked loss of deformability. Blood filtration rate correlated with haematocrit (r = 0. 99 on dilution of samples, r = 0. 7 in 120 normals and patients). After correction for haematocrit, deformability correlated with high shear viscosity, but not low shear viscosity, fibrinogen or white cell count. In 60 normals there was no significant difference between males and females, or smokers and non-smokers, but in 11 smokers there was an acute fall in deformability after smoking 3 cigarettes (p<0. 05). Reduced deformability was found in acute myocardial infarction (n = 15, p<0. 01) and chronic peripheral arterial disease (n = 15, p<0. 01). The technique is reproducible, detects rigid cells and appears useful in the study of vascular disease.

scholarly journals The use of routine blood tests to assist the diagnosis of COVID-19 in symptomatic hospitalized patients

2021 ◽  
pp. 000456322199907
Author(s):  
IT Parsons ◽  
AT Parsons ◽  
E Balme ◽  
G Hazell ◽  
R Gifford ◽  
...  
Keyword(s):  
Cell Count ◽  
Retrospective Review ◽  
Blood Test ◽  
Patient Flow ◽  
White Cell Count ◽  
Area Under The Curve ◽  
White Cell ◽  
Test Results ◽  
Rt Pcr ◽  
Blood Tests

Introduction Specific patterns of blood test results are associated with COVID-19 infection. The aim of this study was to identify which blood tests could be used to assist in diagnosing COVID-19. Method A retrospective review was performed on consecutive patients referred to hospital with a clinical suspicion of COVID-19 over a period of four weeks. The patient’s clinical presentation and severe acute respiratory syndrome coronavirus 2 reverse-transcription polymerase chain reaction (SARS-CoV-2 RT-PCR) were recorded. The patients were divided by diagnosis into COVID (COVID-19 infection) or CONTROL (an alternate diagnosis). A retrospective review of consecutive patients over a further two-week period was used for the purposes of validation. Results Overall, 399 patients (53% COVID, 47% CONTROL) were analysed. White cell count, neutrophils and lymphocytes were significantly lower, while lactate dehydrogenase and ferritin were significantly higher, in the COVID group in comparison to CONTROL. Combining the white cell count, lymphocytes and ferritin results into a COVID Combined Blood Test (CCBT) had an area under the curve of 0.79. Using a threshold CCBT of –0.8 resulted in a sensitivity of 0.85 and a specificity of 0.63. Analysing this against a further retrospective review of 181 suspected COVID-19 patients, using the same CCBT threshold, resulted in a sensitivity of 0.73 and a specificity of 0.75. The sensitivity was comparable to the SARS-CoV-2 RT PCR. Discussion Mathematically combining the blood tests has the potential to assist clinical acumen allowing for rapid streaming and more accurate patient flow pending definitive diagnosis. This may be of particular use in low-resource settings.

Torsion of the gallbladder: a rare but important differential to consider when treating acute cholecystitis non-operatively

2021 ◽  
Vol 14 (1) ◽  
pp. e237842
Author(s):  
Arun Ahluwalia ◽  
Matthew George Roy Allaway ◽  
Serena Giga ◽  
Richard James Curran
Keyword(s):  
Acute Cholecystitis ◽  
Inflammatory Markers ◽  
Epigastric Pain ◽  
Vital Signs ◽  
Rare Condition ◽  
Liver Function Tests ◽  
Uneventful Recovery ◽  
Imaging Characteristics ◽  
Gallbladder Torsion ◽  
Torsion Of The Gallbladder

A 79-year-old woman presented with postprandial epigastric pain. She had normal vital signs, inflammatory markers and liver function tests. Ultrasound and CT of the abdomen demonstrated features consistent with acute cholecystitis. Her medical comorbidities and extensive abdominal surgical history prompted the decision to treat non-operatively. Despite optimal medical management, worsening abdominal pain and uptrending inflammatory markers developed. She underwent an emergency laparoscopy which revealed a necrotic gallbladder secondary to an anticlockwise complete gallbladder torsion; a rare condition associated with significant morbidity and mortality if managed non-operatively. Laparoscopic cholecystectomy was achieved without complication and the patient had an uneventful recovery. Preoperative diagnosis of torsion of the gallbladder is difficult. However, there are certain patient demographics and imaging characteristics that can help surgeons differentiate it from acute cholecystitis; a condition which can be safely managed non-operatively in selected patients. The differentiating features are elaborated on in this case report.

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