scholarly journals The Utility of Biomarkers in Diagnosing and Predicting Outcomes in Acute Mesenteric Ischemia

2021 ◽  
Vol 17 (2) ◽  
pp. 119-126
Author(s):  
Cătălin Alexandru Pirvu ◽  
Felix Bratosin ◽  
Cristian Nica ◽  
Dan Cârțu ◽  
Patrascu Ștefan ◽  
...  
Keyword(s):  
Mesenteric Ischemia ◽  
Complete Blood Count ◽  
Significant Risk ◽  
Acute Mesenteric Ischemia ◽  
Cross Sectional ◽  
Vascular Intervention ◽  
Predicted Probability ◽  
General Surgeons ◽  
Cross Sectional Design ◽  
Acute Condition

Background: Acute intestinal ischemia stands as the most lethal acute condition encountered by general surgeons and one of the deadliest pathologies in medicine triggered by thromboembolic events. The patients’ survival decreases dramatically to a lower than 30% rate when diagnosed after 24 hours, thus early diagnosis with proper surgical or vascular intervention is mandatory. This study aims to determine the utility of biomarkers and routine blood tests in assessing the severity and mortality risk for patients with acute mesenteric ischemia. Methods: The study was developed on a prospective cross-sectional design over a period of five years, finding a total of 147 patients who underwent emergency surgery after a high suspicion of acute mesenteric ischemia. The available biomarkers used in our Clinic comprised a complete blood count, total bilirubin, CK, CK-MB, LDH, AST, ALT, amylase, and cholinesterase. Results: The leukocyte count (OR=1.105), hemoglobin (OR=3.912), LDH (OR=1.144), NLR (OR=1.154), and LLR (OR=1.286) were all independent and significant risk factors for AMI diagnosis. These covariates proved a good and reliable tool for diagnosing AMI with a 75.3% predicted probability. Conclusion: The prediction tool proved reliable, although it should only be considered in the clinical context where the surgeon suspects a case of acute mesenteric ischemia. The proposed model should be further investigated and validated in larger studies.

scholarly journals Late Vascular Intervention for Acute Mesenteric Ischemia Is Associated with Early Mortality and Extensive Bowel Resection

2021 ◽  
Vol 73 (3) ◽  
pp. 48-49
Author(s):  
Lillian M. Tran ◽  
Elizabeth Andraska ◽  
Rafael Ramos-Jiminez ◽  
Andrew-Paul Deeb ◽  
Natalie Sridharan ◽  
...  
Keyword(s):  
Mesenteric Ischemia ◽  
Bowel Resection ◽  
Acute Mesenteric Ischemia ◽  
Early Mortality ◽  
Vascular Intervention

scholarly journals Inadequate Protein Intake at Specific Meals Is Associated with Higher Risk of Impaired Functionality in Middle to Older Aged Mexican Adults

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Alejandro Gaytán-González ◽  
María de Jesús Ocampo-Alfaro ◽  
Maritza Arroniz-Rivera ◽  
Francisco Torres-Naranjo ◽  
Roberto Gabriel González-Mendoza ◽  
...  
Keyword(s):  
Risk Factor ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Protein Intake ◽  
Multinomial Logistic Regression ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Cross Sectional ◽  
Mexican Adults ◽  
Cross Sectional Design

Purpose. To describe the proportions of inadequate protein intake (IPI) per day and per meal and their association with functionality in middle to older aged Mexican adults. Materials and Methods. In a cross-sectional design, we evaluated the protein intake and functionality of instrumental activities of daily living (IADL) and activities of daily living (ADL) of 190 middle to older aged Mexican adults. IPI was considered as any protein intake: <1.2 g/kg/day, <30 g/meal, or <0.4 g/kg/meal. Functionality was organized into three groups: high, middle, and low scores. The first was set as the reference, and the other was considered as impaired functionality. With a multinomial logistic regression, we analyzed the association between IPI per day and per meal with impaired functionality. Results. A high proportion of participants showed IPI per day. The meal with the highest proportion of IPI was dinner, followed by breakfast and lunch for both criteria. IPI at lunch was a significant risk factor for impaired functionality in ADL when assessed with the 30 g/meal criterion (low scores, OR 3.82 (95% CI, 1.15–12.65); middle scores, OR 2.40 [1.03–5.62]). For the 0.4 g/kg/meal criterion, IPI at dinner was a significant risk factor for IADL middle scores only (OR 7.64, [1.27–45.85]). Conclusion. IPI per meal is high in middle to older aged Mexican adults, and at specific meals, it is a significant risk factor for impaired functionality in activities of daily living.

scholarly journals RISK FACTORS OF MORTALITY IN CHILDREN WITH WILMS’ TUMOR AT SOETOMO HOSPITAL SURABAYA

2019 ◽  
Vol 26 (2) ◽  
Author(s):  
Maria Christina Shanty ◽  
Sherly Yuniarchan ◽  
Mia Ratwita Andarsini ◽  
I Dewa Gede Ugrasena ◽  
Bambang Permono ◽  
...  
Keyword(s):  
Risk Factors ◽  
Complete Blood Count ◽  
Wilms Tumor ◽  
Significant Risk ◽  
Stage Iv ◽  
Significant Risk Factor ◽  
Cross Sectional Study ◽  
Disease Stage ◽  
Cross Sectional ◽  
Female Ratio

Objective: Wilms’ tumor is the most common childhood renal tumor for about 6% of pediatric malignant disease. The 5-year survival rate in United States increased from approximately from 70% (1970-1973) to 92% (1989-1996). This study was aim to analyze the risk factors of mortality in children with Wilms’ tumor. Material & Methods: A cross-sectional study was conducted in children with Wilms’ tumor at Soetomo Hospital during 2006-2011. The data of demographic, clinical profile, complete blood count, blood urea nitrogen, glomerular filtration rate, histological type, disease stage, metastases and relapse were analyzed as risk factors of mortality using logistic regression. Results: There were 37 Wilms’ tumor children and 5 children were excluded because of incomplete data. The mean age was 3.0 (SD 2.6) years, and male-to-female ratio was 2.5 : 1. There were 5/32 children in stage I, 7/32 children in stage II, 8/32 children in stage III, 11/32 children in stage IV, and 1/32 children in stage V. There were 15/32 children underwent operation. Complete remission occurred in 12/32 children and 1/32 children relapsed. There were 20/32 children died, associated with anemia (P=0.033, OR=6.111, 95% CI=1.056-35.352) and advanced stage (P=0.021, OR=8.000, 95% CI=1.575-40.632). The risk of mortality increased 3.284 folds with every increased stage (P=0.007, 95% CI=1.338-7.775). Conclusion: Disease stage is the significant risk factor of mortality in children with Wilms’ tumor.  

scholarly journals Post-traumatic hollow viscus perforation with mesenteric and bowel ischemia

2021 ◽  
Author(s):  
Niharika Prasad
Keyword(s):  
Mesenteric Ischemia ◽  
Young Male ◽  
Acute Mesenteric Ischemia ◽  
Exploratory Laparotomy ◽  
Bowel Ischemia ◽  
Hollow Viscus ◽  
Cross Sectional ◽  
Occlusive Mesenteric Ischemia ◽  
Partial Colectomy ◽  
Hollow Viscus Perforation

Abstract BackgroundHollow viscus perforation and acute mesenteric ischemia are life-threatening conditions that must be recognized and managed appropriately. Computed tomography (CT) helps to visualize the bowel wall directly, as well as in the timely diagnosis of secondary signs of bowel ischemia.Case PresentationA young male presented with blunt trauma to the upper abdomen. A supine radiograph was suspicious of pneumoperitoneum and CT was performed to rule out perforation. The above finding was confirmed on CT, in addition, lack of enhancement of a segment of colon and non-occlusive mesenteric ischemia was evident. He was managed with exploratory laparotomy and repair of the perforation with partial colectomy.ConclusionsThe radiologist should be familiar with signs of pneumoperitoneum on supine radiographs for detection of hollow viscus perforation. These must be viewed with an index of high suspicion in symptomatic patients, post-trauma, and, further cross-sectional imaging may still be required.

scholarly journals Accuracy of citrulline, I-FABP and d-lactate in the diagnosis of acute mesenteric ischemia

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Alexandre Nuzzo ◽  
Kevin Guedj ◽  
Sonja Curac ◽  
Claude Hercend ◽  
Claude Bendavid ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Mesenteric Ischemia ◽  
Acute Abdominal Pain ◽  
Acute Mesenteric Ischemia ◽  
Cross Sectional Study ◽  
Diagnostic Study ◽  
Cross Sectional ◽  
Fatty Acid Binding ◽  
Stroke Center ◽  
New Biomarkers

AbstractEarly diagnosis of acute mesenteric ischemia (AMI) remains a clinical challenge, and no biomarker has been consistently validated. We aimed to assess the accuracy of three promising circulating biomarkers for diagnosing AMI—citrulline, intestinal fatty acid-binding protein (I-FABP), and d-lactate. A cross-sectional diagnostic study enrolled AMI patients admitted to the intestinal stroke center and controls with acute abdominal pain of another origin. We included 129 patients—50 AMI and 79 controls. Plasma citrulline concentrations were significantly lower in AMI patients compared to the controls [15.3 μmol/L (12.0–26.0) vs. 23.3 μmol/L (18.3–29.8), p = 0.001]. However, the area under the receiver operating curves (AUROC) for the diagnosis of AMI by Citrulline was low: 0.68 (95% confidence interval = 0.58–0.78). No statistical difference was found in plasma I-FABP and plasma d-lactate concentrations between the AMI and control groups, with an AUROC of 0.44, and 0.40, respectively. In this large cross-sectional study, citrulline, I-FABP, and d-lactate failed to differentiate patients with AMI from patients with acute abdominal pain of another origin. Further research should focus on the discovery of new biomarkers.

scholarly journals Akurasi Hitung Jumlah Eritrosit Metode Manual dan Metode Otomatis

2017 ◽  
Vol 3 (2) ◽  
pp. 37
Author(s):  
Neni Oktiyani ◽  
Fahriyan Fahriyan ◽  
Akhmad Muhlisin
Keyword(s):  
Complete Blood Count ◽  
Cost Effective ◽  
Erythrocyte Count ◽  
Cross Sectional ◽  
Manual Method ◽  
Automated Method ◽  
Significant Difference ◽  
Hematological Analysis ◽  
The Mean ◽  
Cross Sectional Design

<p style="text-align: justify;">In a laboratory, an erythrocyte is done by using hemocytometer and microscope. The task is to measure and assess the size and shape of the erythrocyte. But this procedure is time consuming, complex and tedious. As a solution to this problem, to provide an automated, cost-effective and efficient alternative to detection and counting of erythrocyte, hematology analyzers are used. However, false results related either to erythrocyte or other parameters from complete blood count may be observed in several instances. The objective study was to compare the accuracy of erythrocyte count results of automatic hematological analysis by the manual method. The study is an analytic survey with a cross-sectional design. Erythrocyte counting is done by using three types of control blood, namely high, normal and low, with 9 repetitions. In high control blood, the mean erythrocytes count by the manual method was 7.08 million/μl with a bias value of 1.4%, while that by the automated method was 7.03 million/μl with a bias value of 0.7%. The mean erythrocyte count in normal control blood by the manual method was 4.50 million/μl with a bias value of 0.9%, while that by the automated method was 4.4 million/μl with a bias value of 2.4%. And in low control blood, the mean erythrocyte count by the manual method was 1.72 million/μl with 4.4% bias value, while that the automated method was 1.67 million/μl with 1.2% bias value. Statistical analysis showed no significant difference in accuracy between the erythrocyte count of manual methods with automated methods.</p>

Arterial Endovascular Interventions in Acute Mesenteric Ischemia

2018 ◽  
Vol 02 (03) ◽  
pp. 210-216
Author(s):  
Geoffrey Miller ◽  
James Stone ◽  
Luke Wilkins
Keyword(s):  
Mesenteric Ischemia ◽  
Treatment Plan ◽  
Treatment Options ◽  
Traumatic Injury ◽  
Acute Mesenteric Ischemia ◽  
Medical Emergency ◽  
Cross Sectional ◽  
Bowel Infarction ◽  
Endovascular Interventions ◽  
Sudden Decrease

AbstractAcute mesenteric ischemia (AMI) is a true medical emergency and requires a multi-disciplinary treatment approach. AMI occurs when there is a sudden decrease in blood flow resulting in hypoperfusion to the intestines and may lead to bowel infarction. There are many potential etiologies of AMI that include arterial embolus, arterial, or venous thrombosis; traumatic injury; aortic dissection; intestinal obstruction; non-occlusive mesenteric ischemia, and vasculitis. Given mortality rates that approach 90%, rapid diagnosis is essential to decrease risk of bowel infarction. While surgical management has traditionally been the treatment of choice, endovascular management is being used with increasing frequency. Further, utilizing endovascular treatment options together with surgical intervention has shown promising results. The endovascular approach to treatment of AMI will depend on the underlying etiology. In addition, the acuity of patient presentation, presence, or absence of bowel infarction; patient stability; and availability of a hybrid operating room will influence the treatment plan of a patient with AMI. Early diagnosis with advanced cross-sectional imaging along with assessment of the underlying risk factors will optimize chances of early intervention and improve patient outcomes.

scholarly journals Neonatal Jaundice Risk Factors at a District Hospital in Rwanda

2020 ◽  
Vol 3 (2) ◽  
pp. 204-213
Author(s):  
Claudine Murekatete ◽  
Claudine Muteteli ◽  
Richard Nsengiyumva ◽  
Geldine Chironda
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Neonatal Jaundice ◽  
District Hospital ◽  
Significant Risk ◽  
Cross Sectional ◽  
Tailored Interventions ◽  
High Prevalence ◽  
Cross Sectional Design ◽  
Structured Questionnaire

Background Neonatal jaundice is one of the most common reasons for hospital admission in the neonatal unit, and it is associated with significant morbidity and mortality. Objective To assess risk factors associated with neonatal jaundice among newborns at a District Hospital in Rwanda.  Methods A quantitative approach has been used with a retrospective cross-sectional design. Two hundred and ten files were used as sample size. Stratified proportional sampling was used for the years 2016-2018 to select files. Data was collected using a structured questionnaire. Descriptive statistics and inferential statistics were used for the data analysis.   Results The study findings showed that nearly half (44.3%) of 210 newborns were diagnosed with neonatal jaundice. The majority (87.2%) was term, and male gender (60.5%). Nearly a third (29.5%) were Low Birth Weight. Significant risk factors for neonatal jaundice were birth weight (p=0.015), gestational age of the newborn (p=0.002), neonatal gender (p=0.004), method of delivery (p=.000), blood group incompatibility (p=0.001); infections (p =0.000), cesarean section (p= 0.000) and prematurity (p=0.017).  Conclusion There was a high prevalence of neonatal jaundice. Neonatal jaundice risk factors were predominantly demographic, maternal and neonatal. Hence there is need to formulate tailored interventions that mitigate neonatal jaundice. Rwanda J Med Health Sci 2020;3(2):204-213.

Decision Tool for Predicting Outcomes in Geriatric Acute Mesenteric Ischemia

2018 ◽  
Vol 84 (8) ◽  
pp. 1247-1251
Author(s):  
Kyle C. Murphy ◽  
Danielle Kay ◽  
Daniel L. Davenport ◽  
Andrew Bernard
Keyword(s):  
Decision Tree ◽  
Mesenteric Ischemia ◽  
Univariate Analysis ◽  
Significant Risk ◽  
Disease Process ◽  
Acute Mesenteric Ischemia ◽  
Retrospective Chart Review ◽  
Decision Tree Analysis ◽  
Tree Analysis ◽  
Futile Care

Acute mesenteric ischemia is a morbid disease process that is most common in elderly patients who often have multiple medical comorbidities. Intervention can progress to costly and futile care. The goal of this study was to develop a tool for practitioners to assess the risk of mortality. Patients treated at our institution over the past decade diagnosed with acute mesenteric ischemia were identified. Patients aged less than 65 years were excluded. Data were collected by retrospective chart review. Univariate analysis was used to identify significant risk factors for death. Decision tree analysis yielded a prognostic tool to assess death risk. Univariate analysis demonstrated that lactate (P ≤ 0.001) and pressor requirement (P ≤ 0.001) were predictive of death. Decision tree analysis showed that 79 per cent of patients with day of surgery (DOS) lactate ≥5.4 died postoperatively. Seventy per cent of patients with DOS lactate <5.4 progressed to death if they required pressors and had a creatinine >1.18. Only 6.1 per cent patients with a DOS lactate <5.4, creatinine <1.54, and no pressor requirement progressed to death. Several variables can be used to set expectations for families and help guide decision-making. Our tool was predictive of outcomes in 82 per cent of our study population.

Comparison of K2 and K3 EDTA Anticoagulant on Complete Blood Count and Erythrocyte Sedimentation Rate

2021 ◽  
Vol 28 (1) ◽  
pp. 75
Author(s):  
Harida Zahraini ◽  
Yulia Nadar Indrasari ◽  
Hartono Kahar
Keyword(s):  
Erythrocyte Sedimentation Rate ◽  
Sedimentation Rate ◽  
Blood Count ◽  
Complete Blood Count ◽  
Rank Test ◽  
Cross Sectional ◽  
Erythrocyte Sedimentation ◽  
Significant Difference ◽  
The Difference ◽  
Cross Sectional Design

The use of anticoagulants is one of the important pre-analytic factors in hematological tests. Both dipotassium (K2) andtripotassium (K3) Ethylene Diamine Tetraacetic Acid (EDTA) are widely used anticoagulants. International CouncilStandardization of Hematology (ICSH) and several researchers recommend the use of K2 EDTA due to its less hyperosmolareffect on blood cells compared to K3 EDTA. This study aimed to compare the results of Complete Blood Count (CBC) andErythrocyte Sedimentation Rate (ESR) using anticoagulant K2 EDTA and K3 EDTA. This study was an analytic observationalstudy with a cross-sectional design conducted from April to December 2018. The subject of the study were 103 healthyadults selected by consecutive sampling. Blood samples were collected in both anticoagulant tubes with a volume of 3 mLeach. Samples were tested twice, in the first 0 hours and the next 6 hours using Sysmex XN 1000 and Alifax Roller 20 LC.Kolmogorov-Smirnov test, paired T-test and Wilcoxon rank test were used for statistical analysis. The agreement testbetween both anticoagulants was carried out using the Bland Altman plot for parameters with a significant difference. Therewas a significant difference between both anticoagulants for the parameters of hemoglobin, hematocrit MCV, MCHC, RDW,PDW, MPV, PLC-R, and erythrocyte sedimentation rate in both the first and second tests. The agreement test using the BlandAltman plot showed that the difference in these parameters was within the Limit of Agreement (LOA) range of 95%. Thisstudy showed that there were differences in some parameters of complete blood count and erythrocyte sedimentation ratebetween the two anticoagulants (K2 K3 EDTA), but these differences were within the LOA range.

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