ABSTRACT
To assess the value of lactate measurements in addition to standard diagnostic measurement of white blood cell count [WBC] and C-reactive protein [CRP] in the accuracy of preoperative acute appendicitis [AA] diagnosis. A total of thirty-six consecutive patients with histopathologically confirmed acute appendicitis were retrospectively included in the study. Fifteen volunteers were included as control group. Patient characteristics, preoperative ultrasonography [US] and laboratory assessment including WBC, C-reactive protein [CRP] and lactate values were collected. Receiver Operator Characterstics [ROC] curves for discriminant values and sensitivity, specificity, positive and negative predictive values [PPV.NPV] were calculated. The male/female ratio of groups 1 and 2 were 25/11 and 9/6 respectively. Mean age: 34.13 +/- 9.6 years. Area under ROC values for lactate were found significant and discriminant value was found to be 8 mg/dl. Specificity, sensitivity, PPV and NPV calculated for lactate were as follows: 53%, 80%, 77% and 57%. Increased lactate levels as well as other inflammatory parameters should be considered as a diagnostic parameter in diagnosis of AA
Subject(s)
Humans , Male , Female , Adult , Appendicitis/diagnosis , Sensitivity and Specificity , Predictive Value of TestsABSTRACT
OBJECTIVE: Mental fatigue, cognitive disorders, and sleep disturbances seen in chronic fatigue syndrome (CFS) may be attributed to cholinergic deficit. A functional deficiency of cholinergic neurotransmission may cause the hypothalamic-pituitary-adrenal axis hypoactivity seen in CFS. Therefore, we investigated the alterations in stress hormones such as cortisol and dehydroepiandrosterone sulfate (DHEAS) in CFS patients before and after 4-week administration of galantamine hydrobromide, a selective acetylcholinesterase inhibitor, and aimed to investigate whether there are any relationships between the probable hormonal changes and cholinergic treatment. METHODS: Basal levels of cortisol and DHEAS were measured in 29 untreated CFS patients who were diagnosed according to Centers for Disease Control (CDC) criteria and in 20 healthy controls. In the patient group, four weeks after 8 mg/d galantamine hydrobromide treatment, cortisol and DHEAS levels were measured again. After the treatment 22 patients who stayed in study were divided into two subgroups as responders and nonresponders according to the reduction in their Newcastle Research Group ME/CFS Score Card (NRG) scores. RESULTS: Important findings of this study are lower pre-and post-treatment cortisol levels and in all CFS patients compared to controls (F=4.129, p=0.049; F=4.803, p=0.035, respectively); higher basal DHEAS values and higher DHEAS/cortisol molar ratios which were normalized following four weeks' treatment with 8 mg/d galantamine hydrobromide in the treatment-respondent group (F=5.382, p=0.029; F=5.722, p=0.025, respectively). CONCLUSION: The findings of the decrease in basal DHEAS levels and DHEAS/cortisol molar ratios normalizing with galantamine treatment may give some support to the cholinergic deficit hypothesis in CFS.