ABSTRACT
BACKGROUND: Hyperemesis gravidarum (HG) is defined as severe nausea and vomiting in pregnancy and considered as one of the most frequent causes to emergency department (ED) admissions. Previous research has shown that HG is associated with systemic inflammation, but there have been no prospective studies to explore this link. The objective of this study was to assess the impact of inflammation in HG pathophysiology and to investigate the association between severity of HG and neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and CRP in patients who were admitted to ED with nausea and vomiting. METHODS: This prospective study has been conducted in a tertiary clinic between 2015 and 2016. A total of 162 patients with <16â¯weeks gestation with singleton pregnancies and without any chronic diseases enrolled in the study. The study group consisted of 113 patients with HG and the control group included 49 healthy subjects. PUQE Index and VAS were used to evaluate the severity of symptoms. RESULTS: Demographical data were similar between both groups. The study group demonstrated significantly higher NLR, PLR and CRP levels (NLR 3.39 vs 2.5, pâ¯=â¯0.001; PLR 134.3 vs 111.2, pâ¯=â¯0.005; CRP 0.85â¯mg/dL vs 0.19â¯mg/dL, pâ¯=â¯0.001). While NLR and PLR levels were not correlated with severity of HG, CRP levels were associated with severity of disease (pâ¯=â¯0.001) regarding to PUQE index. CONCLUSION: NLR and PLR are easily obtained and routinely used diagnostic tools for various inflammatory diseases. Measurement of this markers might provide useful information in HG pathogenesis and diagnosis.
Subject(s)
Emergency Service, Hospital , Hyperemesis Gravidarum/blood , Hyperemesis Gravidarum/immunology , Inflammation/blood , Adult , Biomarkers/blood , C-Reactive Protein/analysis , Cross-Sectional Studies , Female , Gestational Age , Humans , Inflammation/diagnosis , Lymphocytes/cytology , Neutrophils/cytology , Platelet Count , Pregnancy , Prospective Studies , ROC Curve , Severity of Illness Index , Turkey , Young AdultABSTRACT
Pseudoaneurysm of the superior gluteal artery (SGA) is very rare and the most common causes are blunt or penetrating pelvic traumas. Although pseudoaneurysm can be asymptomatic at the time of initial trauma, it can be symptomatic weeks, months, even years after initial trauma. We present a case of a ruptured superior gluteal artery pseudoaneurysm with hemorrhagic shock twenty days after a bomb injury in the Syria civil war. In addition, we review the anatomy of the SGA, clinical presentation and pitfalls of pseudoaneurysm, and imaging and treatment options.
