effects of serum cholesterol, LDL, and HDL levels on gallstone cholesterol concentration

Gallbladder stones are common in the Western world, and 70% to 80% of gallstones are cholesterol stones. This study investigates the effects of serum cholesterol, LDL, and HDL levels on gallstone cholesterol concentration. The gallstones of 75 patients with cholelithiasis were examined using spectrophotometry. High serum cholesterol and LDL levels were associated with high cholesterol stone rates [86.7% vs. 40.0%, P < 0.001; 75.0% vs. 48.9%, P < 0.05, respectively]. Similarly, high serum cholesterol and LDL levels were correlated with high gallbladder stone cholesterol concentrations [63.6% vs. 44.4%, P < 0.001; 62.3% vs. 46.0%, P < 0.001, respectively]. In contrast, low serum HDL levels do not seem to affect the occurrence of gallbladder cholesterol stones [60.0% vs. 58.3%, respectively, P > 0.05] or gallbladder stone cholesterol concentrations [50.8% vs. 52.4%, respectively, P > 0.05]. The relationship between cholesterol, LDL, and HDL levels and cholesterol gallstone formation is multifactorial and complex and is also dependent on other individual properties

Ileosigmoid knotting in the elderly: outcomes of 32 cases over 44.5 years

Ileosigmoid knotting [ISK], in which the ileum wraps around the base of the sigmoid colon, is a rare cause of intestinal obstruction. This study aimed to compare the clinical outcomes of ISK in elderly and nonelderly patients. The clinical records of thirty two elderly patients, sixty years of age or older were reviewed retrospectively at the Department of General Surgery, Faculty of Medicine, Ataturk University from June 1966 to January 2011. The mean age of the elderly patients was 65.5 years, and 24 patients [75.0%] were male. Of the patients, 37.5% had recurrent volvulus, 31.3% had comorbid disease, 78.1% suffered from shock, and these rates were higher in the elderly group [P < 0.05, P < 0.01, and P < 0.01, respectively]. Although the mean symptom duration was longer in the elderly group [51.3 hours vs. 43.5 hours, P < 0.01], the clinical and radiological findings and the preoperative correct diagnosis rates were similar in the elderly and nonelderly groups [P > 0.05, in all]. In addition to the types and the degrees of the torsion, bowel gangrene rate was also similar in both groups [P > 0.05, in all]. Mortality and morbidity rates [34.4% vs. 10.3%, P < 0.05, in both] were higher in the elderly group. Similarly, hospitalization period was longer in the elderly patients [17.1 days vs. 12.2 days, P < 0.01]. ISK is generally present with high percentages of recurrent volvulus, comorbidity, late admission, and shock in elderly patients. Although the clinical features and diagnostic modalities are similar, ISK has a graver prognosis in elderly patients