Platelet-to-Lymphocyte Ratio as a Potential Indicator of Infection-Associated Emergency Visits of Renal Transplant Recipients.

OBJECTIVES: Infection-associated emergency department use in renal transplant recipients has been increasing as solid-organ transplant has become a more common treatment method for chronic kidney failure. Platelet-to-lymphocyte ratio has been demonstrated to be significantly elevated in nosocomial infections in patients treated at intensive care units and is positively correlated with duration of hospital stay. In this study, we aimed to determine whether the platelet-to-lymphocyte ratio could be used as an indicator of infection in renal transplant patients presenting to emergency departments. MATERIALS AND METHODS: This case-control retrospective study included data from between May 2015 and February 2018. We used the patient information management system to review patient medical records and laboratory test results of study participants. RESULTS: Our study included 156 adults in the patient group (recipients with infection) and 170 adults in the control group (recipients without infection). We observed significant differences between patient and control groups in terms of the number of days of hospital stay; leukocyte, neutrophil, and lymphocyte counts; the platelet-to-lymphocyte ratio; and C-reactive protein levels. We plotted receiver operating characteristic curves to determine the sensitivity and specificity of the platelet-to-lymphocyte ratio along with C-reactive protein. The areas under the curve were 0.892 for C-reactive protein and 0.707 for the platelet-to-lymphocyte ratio. CONCLUSIONS: For systemic inflammation, platelet-to-lymphocyte ratio can be used in conjunction with other biomarkers as an indicator of inflammation in renal transplant recipients who present with infection-associated causes to emergency departments.

Why USB-endoscope laryngoscopy is as effective as video laryngoscopy.

PURPOSE: To compare the efficacy of a low-cost custom-made universal serial bus (USB) endoscope laryngoscope for intubation with a direct laryngoscope and a high-cost video laryngoscope in a mannequin study. METHODS: We used one intubation simulator model (mannequin) in our study. A USB endoscope was mounted to the direct laryngoscope as a custom-made USB endoscope laryngoscope (USB-L). We used a video laryngoscope (Glidescope®, Verathon, USA) and a direct laryngoscope (Macintosh) for comparison. Intubation time and the correct placement of the tube were measured. Intubations were performed by two operators and results were compared. RESULTS: We found a statistically significant difference between the video and direct laryngoscope groups (p < 0.001), as well as between the USB-L and direct laryngoscope groups (p = 0.001) for Operator 1. For Operator 2, there was a statistically significant difference between the video laryngoscope group and the direct laryngoscope group (p = 0.022); however, we did not find a significant difference between the USB-L group and the direct laryngoscope group (p = 0.154). Furthermore, there were no significant differences between the USB-L and video laryngoscope groups for either operator (p=0.347 for Operator 1 and p>0.999 for Operator 2). CONCLUSION: Our study showed that USB endoscope laryngoscope provided similar intubation time to video laryngoscopy at a fraction of the cost; and both had superior times in comparison with direct laryngoscopy.

Serum Neutrophil Gelatinase-Associated Lipocalin Levels In Early Detection Of Contrast-Induced Nephropathy.

PURPOSE: The purpose of this study was to investigate the role of serum neutrophil gelatinase-associated lipocalin (NGAL) levels in the early detection of contrast-induced nephropathy (CIN). METHODS: This prospective study enrolled 74 patients undergoing abdominal tomography with contrast (1 November 2014 - 28 February 2015). Demographic properties (age and sex), symptoms and CT examination results were analysed. Sodium, potassium, urea, creatinine and NGAL levels were measured at 0th, 6th, and 72nd hours. P value < 0.05 was considered statistically significant. RESULTS: CIN developed in 16.2% of the study patients. The mean age was significantly higher in the patients who developed CIN (p0.05). Urea levels did not differ significantly between the groups at 0th and 6th hours (p>0.05) but was significantly higher in the patients with CIN at 72nd hour (p0.05). Creatinine level was not significantly different between the groups (p>0.05) but increased significantly over time (p>0.05). There were no significant differences between the groups with respect to NGAL levels at 0th and 72nd hours (p>0.05) whereas the group with CIN had a significantly higher NGAL level at 6th hour (p.