sB7H3 in Children with Acute Appendicitis: Its Diagnostic Value and Association with Histological Findings

Background. Several efforts have been made to find out a valuable marker to assist the diagnosis and differentiation of gangrenous/perforated appendicitis. We aimed to determine the diagnostic capacity of soluble B7H3 (sB7H3) in acute appendicitis (AA) and its accuracy as a predictor of the severity of appendicitis. Methods. 182 children were allocated into four groups as follows: control group (CG, 90), simple appendicitis (SA, 12), purulent appendicitis (PA, 49), and gangrenous appendicitis (GA, 31). Prior to appendectomy, blood was collected and sent for analysis of routine examination and cytokines (sB7H3 and TNF-α). We compared values of all measured parameters according to histological findings. Furthermore, we assigned AA patients into the nonperforated appendicitis group and the perforated appendicitis group. The diagnostic effects of significant markers were assessed by ROC curves. Results. Only the levels of CRP, FIB, and sB7H3 had a remarkable rising trend in AA-based groups, while differences in the levels of CRP and FIB between simple appendicitis and purulent appendicitis were not statistically significant. In addition, sB7H3 was found as the only marker in children with AA, which was markedly associated with the degree of histological findings of the appendix. Furthermore, sB7H3 had a high diagnostic value in predicting AA and complex appendicitis (PA+GA) in children. However, the diagnostic performance of sB7H3 for distinguishing PA from GA was not remarkable. Additionally, only the levels of CRP and sB7H3 were statistically different between the nonperforated appendicitis group and the perforated appendicitis group. The diagnostic performance of CRP and sB7H3 could not merely predict perforation of AA in children; however, the diagnostic performance was improved after combination. Conclusions. sB7H3 could be used as a valuable marker to predict the presence of AA and complex AA in children. However, the diagnostic value of sB7H3 to predict gangrenous/perforated appendicitis was not found to be remarkable. The combination of sB7H3 and CRP might improve the prediction of perforated appendicitis.

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The diagnostic value of white cell count, C-reactive protein and bilirubin in acute appendicitis and its complications

Annals of The Royal College of Surgeons of England ◽

10.1308/003588413x13511609957371 ◽

2013 ◽

Vol 95 (3) ◽

pp. 215-221 ◽

Cited By ~ 28

Author(s):

I G Panagiotopoulou ◽

D Parashar ◽

R Lin ◽

S Antonowicz ◽

AD Wells ◽

...

Keyword(s):

Acute Appendicitis ◽

Diagnostic Accuracy ◽

Cell Count ◽

Inflammatory Markers ◽

White Cell Count ◽

Perforated Appendicitis ◽

Diagnostic Value ◽

White Cell ◽

C Reactive Protein ◽

Reactive Protein

Introduction Inflammatory markers such as white cell count (WCC) and C-reactive protein (CRP) and, more recently, bilirubin have been used as adjuncts in the diagnosis of appendicitis. The aim of this study was to determine the diagnostic accuracy of the above markers in acute and perforated appendicitis as well as their value in excluding the condition. Methods A retrospective analysis of 1,169 appendicectomies was performed. Patients were grouped according to histological examination of appendicectomy specimens (normal appendix = NA, acute appendicitis = AA, perforated appendicitis = PA) and preoperative laboratory test results were correlated. Receiver operating characteristic (ROC) curve area analysis (area under the curve [AUC]) was performed to examine diagnostic accuracy. Results ROC analysis of all laboratory variables showed that no independent variable was diagnostic for AA. Good diagnostic accuracy was seen for AA when all variables were combined (WCC/CRP/bilirubin combined AUC: 0.8173). In PA, the median CRP level was significantly higher than that of AA (158mg/l vs 30mg, p<0.0001). CRP also showed the highest sensitivity (100%) and negative predictive value (100%) for PA. CRP had the highest diagnostic accuracy in PA (AUC: 0.9322) and this was increased when it was combined with WCC (AUC: 0.9388). Bilirubin added no diagnostic value in PA. Normal levels of WCC, CRP and bilirubin could not rule out appendicitis. Conclusions CRP provides the highest diagnostic accuracy for PA. Bilirubin did not provide any discriminatory value for AA and its complications. Normal inflammatory markers cannot exclude appendicitis, which remains a clinical diagnosis.

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Pediatric Appendicitis Score in differential diagnosis of acute nonspecific abdominal pain in children: age matters

Paediatric Surgery Ukraine ◽

10.15574/ps.2021.70.22 ◽

2021 ◽

pp. 22-31

Author(s):

V.G. Vakulchyk ◽

◽

A.V. Kapytski ◽

Keyword(s):

Differential Diagnosis ◽

Abdominal Pain ◽

Acute Appendicitis ◽

Roc Curves ◽

Diagnostic Value ◽

Diagnostic Significance ◽

Predictive Values ◽

Detection Frequency ◽

Specificity And Sensitivity ◽

Appendicitis Score

Acute nonspecific abdominal pain in children is the most common problem requiring differential diagnosis with acute appendicitis. Scales for integrated assessment of individual symptoms and their combinations have been proposed and are constantly being developed that allow predicting the likelihood of acute appendicitis. Purpose to assess diagnostic value of Pediatric Appendicitis Score (PAS) in groups of children in different ages. Materials and methods. 374 children aged 4 to 15 years with acute abdominal pain were evaluated in prospective randomized blinded study. Statistical analysis: ROC – curves, specificity and sensitivity, positive and negative predictive values; Kullback criteria; logistic regression analysis; discriminant analysis. Results. Detection frequency and diagnostic significance of the PAS scale predictors as well as obtained results by using the Pediatric Appendicitis Score depend on children age significantly. In terms of diagnosis of acute appendicitis, the PAS scale shows the best results in older children. Conclusions. Results of Pediatric Appendicitis Score depend on children ages due to different diagnostic value of predictors used in the PAS scale. Pediatric surgeons should keep in your mind these data. Modification of the scale is required taking into account the patient’s age. Further analysis of the issue of PAS using is needed. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of these Institutes. The informed consent of the patient was obtained for conducting the studies. The authors declare no conflicts of interests. Key words: acute appendicitis, children, diagnosis, PAS scale.

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Abdominal Computed Tomography in the Evaluation of Acute and Perforated Appendicitis in the Community Setting

The American Surgeon ◽

10.1177/000313480707301017 ◽

2007 ◽

Vol 73 (10) ◽

pp. 1002-1005 ◽

Cited By ~ 2

Author(s):

D.O. Vu Huynh ◽

Fariborz Lalezarzadeh ◽

Shokry Lawandy ◽

David T. Wong ◽

Victor C. Joe

Keyword(s):

Computed Tomography ◽

Acute Appendicitis ◽

Predictive Value ◽

Perforated Appendicitis ◽

Community Setting ◽

Diagnostic Value ◽

Academic Community ◽

Negative Appendectomy ◽

Community Based ◽

Abdominal Computed Tomography

Several studies report sensitivity and specificity of abdominal computed tomography scans (CT) for the evaluation of acute appendicitis as high as 98 per cent. Despite increased utilization of CT, the rate of negative appendectomy has remained constant at 10 to 20 per cent. The objective of this study was to assess the effectiveness of CT in the evaluation of acute and perforated appendicitis in an academic community-based setting. A retrospective review of 550 patient charts with International Classification of Diseases-9 (ICD-9) codes for acute and perforated appendicitis from January 2002 to October 2005 was performed. Sensitivity of CT was 87 per cent with a positive predictive value of 92 per cent. Specificity was 42 per cent with a negative predictive value of 29 per cent. Negative appendectomy rates were similar with or without CT (11% vs 13%, respectively). Our data suggests that CT used liberally in everyday practice in a community-based setting to evaluate acute appendicitis may not have as strong of a diagnostic value as those used in protocol-driven research studies. Further prospective studies are needed to formulate criteria to better delineate the role of CT in the evaluation of acute appendicitis.

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The Diagnostic Value of Whole Blood lncRNA ENST00000550337.1 for Pre-Diabetes and Type 2 Diabetes Mellitus

Experimental and Clinical Endocrinology & Diabetes ◽

10.1055/s-0043-100018 ◽

2017 ◽

Vol 125 (06) ◽

pp. 377-383 ◽

Cited By ~ 16

Author(s):

Xuejie Li ◽

Zhenzhou Zhao ◽

Chuanyu Gao ◽

Lixin Rao ◽

Peiyuan Hao ◽

...

Keyword(s):

Noncoding Rna ◽

Diagnostic Value ◽

Differentially Expressed ◽

Control Group ◽

Healthy Individuals ◽

Diabetes Group ◽

The Third ◽

Diagnostic Capacity ◽

Independent Cohort

Abstract This study aims to investigate long noncoding RNA (lncRNA) as biomarker for pre-diabetes and T2DM. LncRNAs in the peripheral blood of 6 healthy individuals and 6 T2DM patients were collected for microarray analysis. Then 5 candidate biomarkers from the differentially expressed lncRNAs were chosen and verified in a larger independent cohort (control group=20; pre-diabetes group=20; and T2DM group=20). The diagnostic capacity of ENST00000550337.1 was further tested in the third cohort (control group, n=60; pre-diabetes group, n=63; and T2DM group, n=64). A total of 17 lncRNAs were found to be differentially expressed between the 2 groups. 14 lncRNAs of these were upregulated in T2DM patients and 3 were downregulated. 5 upregulated lncRNAs were selected as potential biomarkers and verified in the second cohort, and the expression levels of 3 lncRNAs increased gradually from the control group to the pre-diabetes group to the T2DM group. The diagnostic value of ENST00000550337.1 was then tested in the third cohort, and its high diagnostic value for pre-diabetes and T2DM was confirmed. LncRNA ENST00000550337.1 is a potential diagnostic biomarker for pre-diabetes and T2DM.

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Leukocytes, C-Reactive Protein and Interleukin-6 in Acute Appendicitis in Children: Diagnostic Value and Association with Histological Findings

Acta Medica Saliniana ◽

10.5457/ams.128.09 ◽

2009 ◽

Vol 0 (In Press) ◽

Author(s):

Nesad Hotic ◽

Elmir Cickusic ◽

Deso Mesic ◽

Edin Husaric ◽

Amir Halilbasic ◽

...

Keyword(s):

Acute Appendicitis ◽

Interleukin 6 ◽

Diagnostic Value ◽

Histological Findings ◽

C Reactive Protein ◽

Reactive Protein

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Milyen hatása van a COVID–19-járványnak a gyermekkori akut appendicitisekre?

Orvosi Hetilap ◽

10.1556/650.2021.32189 ◽

2021 ◽

Vol 162 (16) ◽

pp. 608-610

Author(s):

Balázs Fadgyas ◽

Gábor István Garai ◽

Zoltán Ringwald

Keyword(s):

Statistical Analysis ◽

Acute Appendicitis ◽

Antibiotic Treatment ◽

Laparoscopic Appendectomy ◽

Perforated Appendicitis ◽

Complicated Appendicitis ◽

Histological Findings ◽

Exact Test ◽

Fisher's Exact Test ◽

Fisher’S Exact Test

Összefoglaló. Bevezetés: A COVID–19-pandémia miatt a gyermekkori appendicitisek kezelésében számos változás történt (laparoszkópia helyett nyílt műtét, antibiotikumkezelés). Világszerte emelkedett a szövődményes appendicitisek aránya. Célkitűzés: Munkánk során a COVID–19-járványnak a gyermekkori akut appendicitisekre kifejtett hatását szerettük volna vizsgálni: lett-e több perforált eset? Módszerek: A 2012 és 2020 között akut vakbélgyulladás miatt operált gyermekeket vizsgáltuk, külön, havi bontásban a 2020-as eseteket. A szövettani diagnózis alapján perforált és nem perforált appendicitis csoportokat alkottunk. A 2020-ban operált betegek COVID–19-statusát is rögzítettük. Statisztikai analízisre a khi2-próbát (’chi2 test for trend’) és a Fisher-féle egzakt tesztet alkalmaztuk. Eredmények: A vizsgált időszakban 1343 appendectomia történt, többségében nem perforált akut appendicitis miatt (1166/1343). 2015-től kezdődően a perforált esetek aránya szignifikáns emelkedést mutat (p = 0,0002). Az igazoltan COVID–19-pozitív betegek között magasabb volt a perforáltak aránya (5/8), mint az igazoltan negatív betegek között (15/92) (p = 0,0075). Megbeszélés: A nemzetközi trendeknek megfelelően 2020-ban osztályunkon is magasabb volt a perforált appendicitisek aránya, mint a korábbi években. Ez az emelkedés 2015-től tart, a pandémiával nem mutat szoros összefüggést. A perforált appendicitisek COVID–19-pozitív betegek között észlelt magas arányának okát nem ismerjük. Következtetés: További vizsgálat indokolt annak feltárására, hogy mi okozza a perforált appendicitisek COVID–19-pozitív betegek között észlelt magas, illetve 2015 óta emelkedő rátáját. Orv Hetil. 2021; 162(16): 608–610. Summary. Introduction: As a result of the COVID-19 pandemic, the management of paediatric appendicitis has changed (open instead of laparoscopic appendectomy, antibiotic treatment). The number of complicated appendicitis cases increased worldwide. Objective: Our aim was to study the effect of the COVID-19 pandemic on paediatric acute appendicitis: has there been more perforated cases? Methods: Children operated because of acute appendicitis between 2012 and 2020 were studied. Cases from the year 2020 were analysed monthly. Patients were divided into perforated and non-perforated appendicitis groups according to their histological findings. COVID-19 status of patients in 2020 was studied. Chi2 test for trend and Fisher’s exact test were used for statistical analysis. Results: In the study period, 1343 appendectomies were performed. The majority of our cases were non-perforated (1166/1343). The rate of perforated appendicitis cases has been increasing from 2015 (p = 0.0002). The number of perforated cases was higher in COVID-19 positive patients (5/8) then in negative ones (15/92) (p = 0.0075). Discussion: In line with the international trend, more perforated appendicitis cases were treated in our departement in 2020. However, this increase started in 2015, and there is no correlation with the COVID-19 pandemic. The cause of the increased number of perforated cases in COVID-19 positive appendicitis patients is unknown. Conclusion: The causes of the high proportion of perforated cases in COVID-19 positive patients and the rising rate of perforated appendicitis cases since 2015 need further studies. Orv Hetil. 2021; 162(16): 608–610.

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Role of Mean Platelet Volume in Diagnosis of Childhood Acute Appendicitis

Emergency Medicine International ◽

10.1155/2012/823095 ◽

2012 ◽

Vol 2012 ◽

pp. 1-4 ◽

Cited By ~ 14

Author(s):

Bunyamin Uyanik ◽

Cemil Kavalci ◽

Engin Deniz Arslan ◽

Fevzi Yilmaz ◽

Ozgur Aslan ◽

...

Keyword(s):

Acute Appendicitis ◽

Mean Platelet Volume ◽

Diagnostic Value ◽

Control Group ◽

Healthy Children ◽

Platelet Volume ◽

Pediatric Age Group ◽

Significant Difference ◽

Group 2 ◽

Group 1

Introduction. Acute appendicitis is the leading cause of abdominal pain in children requiring emergency surgical intervention. The aim of this study is to investigate the diagnostic value of MPV in early diagnosis of acute appendicitis cases in pediatric age group.Methods. This study was performed retrospectively. Three hundred five patients operated on with the diagnosis of appendicitis and pathologically found to be acute appendicitis were classified as Group 1 and 305 healthy children were classified as control Group 2.Results. One hundred ninety-seven of 305 cases in Group 1 are males (64.6%), in Group 2, 151 of 305 cases are males (49.5%). The mean MPV in Group 1 was7.9±0.9(fL), and whereas in Group 2 was7.7±0.8(fL). There was no statistically significant difference regarding MPV values (P>0.05).Conclusion. In our study we detected that mean platelet volume has no diagnostic value in pediatric acute appendicitis cases.

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Soluble myeloid triggering receptor expressed on myeloid cell 1 might have more diagnostic value for bacterial ascites than C-reactive protein

Open Life Sciences ◽

10.1515/biol-2018-0054 ◽

2018 ◽

Vol 13 (1) ◽

pp. 456-462

Author(s):

Qiang Guo ◽

Chuanqin Xu ◽

Chao Sun ◽

Yubao Zhao ◽

Weifu Zhang

Keyword(s):

Predictive Value ◽

Myeloid Cell ◽

Roc Curves ◽

Diagnostic Value ◽

Control Group ◽

Health Examination ◽

C Reactive Protein ◽

Reactive Protein ◽

Sensitivity Specificity ◽

Medical University

AbstractThe timely and accurate diagnosis of ascites is of great significance for early treatment and prognostication. This study explored the value of soluble myeloid triggering receptor expressed on myeloid cell 1 (sTREM-1) and C-reactive protein (CRP) for assessing ascites. A total of 133 patients with ascites who received treatment at the Affiliated Hospital of Taishan Medical University between September 2015 and September 2017 were retrospectively analyzed. The ascites in 22, 45, 33 and 33 patients were tuberculous, bacterial, tumorous, and transudative, respectively. Healthy volunteers (n=30) who received a health examination at the same hospital during the same period constituted the control group. Before treatment, both ascitic sTREM-1 and CRP showed significant differences among the ascites subgroups (P<0.001), with the highest levels in the bacterial subgroup. Serum sTREM-1 and CRP also showed significant differences among the groups. A correlation analysis showed a positive correlation between sTREM-1 and CRP. ROC curves of the bacterial subgroup showed that when the optimal cutoff point was set to 20.2, the sensitivity, specificity, positive predictive value, and negative predictive value of the serum sTREM-1 index were 0.933, 0.955, 0.914, and 0.965, respectively. sTREM-1 may provide more diagnostic value than CRP for the diagnosis of bacterial ascites.

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Significance of peripheral blood indexes in differential diagnoses of SARS-CoV-2 and New Bunia virus

Scientific Reports ◽

10.1038/s41598-021-93519-8 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Wentao He ◽

Xiaoyi Liu

Keyword(s):

Differential Diagnosis ◽

T Lymphocyte ◽

Roc Curves ◽

Diagnostic Value ◽

Blood Parameters ◽

Control Group ◽

Clinical Value ◽

T Lymphocyte Subsets ◽

Reactive Protein ◽

Tnf Α

AbstractWe aimed to provide a laboratory basis for differential diagnosis of COVID-19 and severe fever with thrombocytopenia syndrome (SFTS). Clinical data were collected from 32 COVID-19 patients (2019-nCoV group), 31 SFTS patients (SFTS group) and 30 healthy controls (control group). For each group of hospitalized patients, a retrospective analysis was performed on specific indices, including cytokines, T-lymphocyte subsets, routine blood parameters, C-reactive protein (CRP) and procalcitonin (PCT), and receiver operating characteristic (ROC) curves for the indices revealed the differences among groups. Compared with the 2019-nCoV group, the SFTS group had a significantly and greatly decreased counts of WBC, absolute lymphocyte, PLT and absolute CD4+ T lymphocyte (P < 0.05); the IL-6, TNF-α, D-D and PCT levels of the SFTS group were higher than those of the 2019-nCoV group (P < 0.05). Compared with those of the SFTS group, the CRP and FIB levels of the 2019-nCoV group were greatly increased (P < 0.05). The ROC curves showed that area under the curves (AUCs) for FIB, PLT and TNF-α were greater than 0.85, demonstrating high diagnostic value. At the initial stage of SARS-CoV-2 or SFTS virus infection, PLT, FIB and TNF-α have definitive clinical value for the early and differential diagnosis of these two infections.

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The Diagnostic Value of Irisin in Pediatric Patients with Acute Abdominal Pain

Emergency Medicine International ◽

10.1155/2018/3296535 ◽

2018 ◽

Vol 2018 ◽

pp. 1-6 ◽

Cited By ~ 3

Author(s):

Fatma Sarac ◽

Sevgi Buyukbese Sarsu ◽

Selman Yeniocak ◽

Kamil Sahin ◽

Esma Yucetas ◽

...

Keyword(s):

Differential Diagnosis ◽

Abdominal Pain ◽

Pediatric Patients ◽

Acute Abdominal Pain ◽

Perforated Appendicitis ◽

Peptide Hormone ◽

Diagnostic Value ◽

Control Group ◽

Initial Examination ◽

Significant Difference

Objectives. Diagnosis of pediatric patients presenting to the Emergency Department with acute abdominal pain is not always easy. The purpose of this study was to investigate the effectiveness of irisin, a peptide hormone with reactivity shown in the appendix and neutrophils, in the differential diagnosis of pediatric patients with acute abdominal pain. Methods. 162 subjects consenting to participate, including 112 patients presenting to the Pediatric Emergency and Pediatric Surgery clinics with acute abdominal pain and 50 controls, were enrolled in the study. Blood was collected from all patients following initial examination for irisin, WBC, and CRP investigation. Results. Mean irisin levels in cases of acute appendicitis (AA) and perforated appendicitis (PA) were statistically significantly higher compared to nonspecific abdominal pains and the control group. No statistically significant difference was observed in irisin levels between AA and PA cases. WBC and CRP levels were also significantly higher in cases of AA and PA compared to nonspecific abdominal pains. Conclusions. Differential diagnosis of acute abdominal pains in children and deciding on surgery are a difficult and complex process. Our study shows that irisin can be a useful biomarker in differentiating AA and PA from other acute abdominal pains in children.

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