It is not Appendicitis! It is Appendicitis Epiploica, the Great Pretender

2020 ◽  
Vol 23 (2) ◽  
pp. 95-97
Author(s):  
Farah Nobi ◽  
Shayda Ali ◽  
Md Mostafizur Rahman ◽  
Russel Ahmed Khan Lodi ◽  
Mohammad Arman Zahed Basunia ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Elevated Temperature ◽  
Blood Cell ◽  
Cell Count ◽  
Blood Cell Count ◽  
Spontaneous Thrombosis ◽  
Rebound Tenderness ◽  
Meckel’S Diverticulitis ◽  
Appendices Epiploicae ◽  
Specific Symptoms

Appendicitis epiploica or epiploicae appendagitis, an uncommon cause of abdominal pain, is usually per-operatively diagnosed. The pedunculated fat-filled small pouches or appendices epiploicae on the serosal surface of the colon often become twisted and sometimes spontaneous thrombosis occurs. Such events lead to ischemia and inflammation at the base of the fatty lobes i.e., Appendicitis epiploicae. Symptoms include sharp localized pain in either iliac fossae and in some cases there is elevated temperature and white blood cell count. In a quarter of the patients there is rebound tenderness and very rarely nausea and vomiting, diarrhoea or constipation. This condition is more common among middle aged males and given its non-specific symptoms. It is usually confused with other more common conditions such as Meckel’s diverticulitis and appendicitis. Less than 8% of patients suspected of having appendicitis or diverticulitis are found to actually have appendicitis epiploicae. Here we report two extremely rare cases of appendicitis epiploica in Bangladesh. Journal of Surgical Sciences (2019) Vol. 23(2): 95-97

Insulin Requirements in the Intensive Care Unit in Response to Infection

2008 ◽  
Vol 74 (9) ◽  
pp. 845-848 ◽  
Author(s):  
Nell Maloney ◽  
Rebecca C. Britt ◽  
Gregory D. Rushing ◽  
Scott F. Reed ◽  
Fredric C. Cole ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Blood Glucose ◽  
Elevated Temperature ◽  
Blood Cell ◽  
Cell Count ◽  
Insulin Dose ◽  
Blood Cell Count ◽  
Glucose Levels ◽  
Blood Glucose Levels

Infectious complications in the intensive care unit (ICU) are classically identified when an elevated temperature triggers obtaining cultures. Elevated temperature, however, is a nonspecific marker of infection and may occur well into the course of the infection. The goal of this study was to evaluate whether escalating insulin demands may serve as an earlier marker for infection. A retrospective review of a prospective database from a trauma ICU over a 6-month period was done for all patients who developed infection while in the ICU. All patients in the ICU are placed at admission on an intensive insulin protocol with target blood glucose levels between 80 and 110 mg/dL. Data were collected on infection, insulin needs, blood glucose levels, temperature, white blood cell count, and antibiotic use. Twenty-four infections were identified, with 16 pneumonias, four bloodstream infections, and four urinary tract infections. Twelve of the 24 patients had increasing insulin needs in the 3 days preceding their infection diagnosis, with nine of the 12 requiring continued escalation of insulin needs from preinfection Day 3 to 2 to 1 (D3, D2, D1). In five of the 12 patients, the escalation of insulin dose preceded the elevated temperature, and in three of the 12 patients, the escalation preceded elevation of the white blood cell count above 12. For all 24 patients, the average insulin dose increased steadily, from 1.8 U/hr on D3 preinfection to 2.5 U/hr D2 and 3.1 U/hr D1. Infection does seem to be preceded by escalating insulin demands in many patients. A prospective study to evaluate the value of increased insulin demand as a marker for developing infection is warranted.

scholarly journals C-Reactive Protein and White Blood Cell Count as Triage Test Between Urgent and Nonurgent Conditions in 2961 Patients With Acute Abdominal Pain

Medicine ◽  
2015 ◽  
Vol 94 (9) ◽  
pp. e569 ◽  
Author(s):  
Sarah L. Gans ◽  
Jasper J. Atema ◽  
Jaap Stoker ◽  
Boudewijn R. Toorenvliet ◽  
Helena Laurell ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Blood Cell ◽  
Cell Count ◽  
White Blood Cell Count ◽  
White Blood Cell ◽  
Acute Abdominal Pain ◽  
C Reactive Protein ◽  
Blood Cell Count ◽  
Reactive Protein ◽  
Triage Test

Cigarette Smoking Increases Thromboxane A2 Formation without Affecting Platelet Survival in Young Healthy Females

1992 ◽  
Vol 68 (05) ◽  
pp. 583-588 ◽  
Author(s):  
Annika Dotevall ◽  
Christina Rångemark ◽  
Elsa Eriksson ◽  
Jack Kutti ◽  
Hans Wadenvik ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Cigarette Smoking ◽  
Blood Cell ◽  
Urinary Excretion ◽  
Life Span ◽  
Cell Count ◽  
Thromboxane A2 ◽  
Blood Cell Count ◽  
Platelet Activity ◽  
Pai 1

SummarySmoking is a risk factor for the development of atherosclerotic cardiovascular disease, in men as well as in women. An increased urinary excretion of the thromboxane metabolite 2,3-dinor-thromboxane B2 (Tx-M) has been observed in smokers of both genders, suggesting that cigarette smoking may facilitate cardiovascular disease via an action on the platelets. The present study addressed the hypothesis that the increased Tx-M excretion in female smokers reflects a true facilitation of platelet reactivity in vivo, rather than an increased destruction of the platelets. In healthy female volunteers (aged 20–46 years, 18 smokers and 17 non-smokers) platelet life-span and indices of platelet activity were determined, together with plasma levels of plasminogen activator inhibitor-1 (PAI-1), fibrinogen, peripheral blood cell counts and hematocrit. The urinary excretion of Tx-M was higher in smokers than in non-smokers (361 vs. 204 pg/mg creatinine, respectively, p <0.05), while plasma and urinary β-thromboglobulin, plasma platelet factor 4, platelet mean life-span and platelet production rate did not differ between the groups. PAI-1 activity, white blood cell count and hematocrit were higher in smokers than in non-smokers (p <0.05). These data indicate that smoking facilitates platelet formation of thromboxane A2 without affecting platelet survival; i.e. it increases the activity of platelets without affecting their viability to a measurable extent. Such an increase in platelet activity, operating in parallel to a reduced fibrinolytic activity and a higher hematocrit and white blood cell count, may play an etiological role in smoking-induced cardiovascular disease in women.

Influence of increased doses of fenbendazole supramolecular complex on sheep’s organism

2018 ◽  
Vol 12 (2) ◽  
pp. 46-52 ◽  
Author(s):  
A.I. Varlamova
Keyword(s):  
Blood Cell ◽  
Cell Count ◽  
Biochemical Parameters ◽  
Negative Influence ◽  
Supramolecular Complex ◽  
Control Group ◽  
Blood Cell Count ◽  
Russian Scientific ◽  
Russian Scientific Research Institute ◽  
Hematological And Biochemical Parameters

The purpose of the research: study of the influence of increased doses of fenbendazole supramolecular complex (FSMC) on sheep’s organism. Materials and methods. The experiment was carried out at the Podolsk Department of All-Russian Scientific Research Institute of Fundamental and Applied Parasitology of Animals and Plants named after K. I. Skryabin on 20 manorial invasion-free sheep aged 2-3 years old. Animals were divided according to the principle of analogues into 4 groups, 5 heads in each group. Animals of the 1, 2 and 3 group were orally administered with FSMC given as a single dose of 2, 6, 10 mg/kg, respectively, according to the active substance, i.e in therapeutic and in a dose increased by 3 and 5 times. Sheep of the fourth group didn’t receive the drug and they were as control. Study of clinical, hematological and biochemical parameters of animals from all groups was conducted 1 day before and in 1, 3, 5 days after administration of the drug by means of standard methods. Results and discussion. FSMC in therapeutic dose as well as in a dose increased by 3 and 5 times doesn’t have negative influence on clinical, hematological and biochemical parameters of the sheep. State of the sheep, which received the drug in doses of 20, 60, 100 mg/kg, was within the physiologically normal state and didn’t differ from the state before administration of the drug and from the animals of the control group. Drug security index exceeds 5. Red blood cell count, white blood cell count, hemoglobin count, leukogram parameters as well as biochemical parameters of blood: activity of alkaline phosphatase and amylase, bilirubin, creatinine, urea and glucose counts were within normal limits and didn’t differ from the parameters of the control animals.

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