The role of infectious parameters in the early prediction of complicated colonic diverticulitis.

BACKGROUND: Acute colonic diverticulitis has recently become a significant cause of hospital admissions. Complicated colonic diverticulitis, a severe form of the disease, necessitates medical and surgical intervention. Prompt diagnosis in these patients is crucial. This study aims to assess the role of infectious parameters in the early diagnosis of complicated colonic diverticulitis. METHODS: This retrospective study analyzed 82 adult patients diagnosed with acute diverticulitis. Recorded data included patient demographics, hospital stay duration, disease location, and surgical procedures. Infectious parameters such as white blood cell count (WBC), C-reactive protein (CRP), neutrophil/lymphocyte ratio (NLR), percentage of immature granulocytes (IG%), and systemic immune-inflammatory index (SII) were calculated and noted. Patients underwent abdominal computed tomography upon admission, and based on these results, they were categorized into uncomplicated or complicated diverticulitis groups. Statistical analysis was performed to identify differences between these groups. RESULTS: CRP, NLR, and SII were significantly more predictive of complicated acute colonic diverticulitis. However, no statistical differences in WBC and IG% values were observed between the groups. CONCLUSION: The study found that the percentage of immature granulocytes, previously deemed a reliable marker in many studies, did not significantly predict complicated colonic diverticulitis. Further comprehensive studies are necessary to explore inflammatory markers in colonic diverticulitis more thoroughly.

The role of preoperative ultrasound in predicting conversion from laparoscopic cholecystectomy to open surgery in acute cholecystitis.

BACKGROUND: The aim of this study is to evaluate the role of pre-operative ultrasound findings for conversion from laparoscopic cholecystectomy to open surgery in patients with acute cholecystitis and to evaluate the effects of pre-operative ultrasound findings on operation time and length of stay. METHODS: The study included 80 patients who underwent laparoscopic cholecystectomy for acute cholecystitis between January 1 and June 30, 2023. The relationship between gallbladder wall thickness and the presence of pericholecystic fluid on pre-operative ultrasonography and the duration of surgery, conversion to open surgery, and hospitalization was evaluated. RESULTS: The patient group undergoing open surgery exhibited a statistically significant increase in both the median gallbladder wall thickness (P<0.001) and the frequency of pericholecystic fluid on pre-operative ultrasound (P=0.012). Receiver operating characteristic (ROC) analysis was used to assess the discriminative power of gallbladder wall thickness for predicting the requirement to convert from laparoscopic surgery to open surgery. The area under the curve value was found to be 0.907, indicating a strong discriminative power. Based on the ROC curve, a gallbladder wall thickness of ≥5.75 millimeters showed a sensitivity of 85.7% and specificity of 84.9% in predicting the requirement for open surgery. CONCLUSION: Our study highlights the significance of two factors in predicting the conversion from laparoscopic cholecystectomy to open surgery in patients with acute cholecystitis. The presence of pericholecystic fluid and a gallbladder wall thickness of 5.75 mm or greater are indicators that the laparoscopic procedure may be more challenging in such cases. These results can aid surgeons in making informed decisions and planning the surgical approach accordingly for better patient outcomes.

An effective and reliable marker in grading the severity of acute cholecystitis: Increased immature granulocyte percentage.

BACKGROUND: Acute cholecystitis (AC) is an acute inflammatory disease of gallbladder and it is one of the most common causes of acute abdominal pain. Determining the severity of AC at hospital admission is extremely important to choose the most effective treatment method and predict vital prognosis. The aim of this study was to investigate the effectiveness of immature granulocyte percentage (IG%) in grading AC severity. METHODS: This retrospective study was carried out on 528 patients hospitalized due to AC diagnosis. Demographic data, white blood cell (WBC) count, neutrophil lymphocyte ratio (NLR), IG%, C-reactive protein (CRP) levels, and imaging results of patients were recorded. Furthermore, patients' length of hospital stay was determined. Tokyo Guidelines were used to grade AC severity. According to this grading, patients were classified into three groups as grade 1 (mild), grade 2 (moderate), and grade 3 (severe) AC. Differences among groups were analyzed statistically. RESULTS: There were 386 patients (73.1%) in the mild AC group, 102 patients (19.3%) in the moderate AC group, and 40 patients (7.6%) in the severe AC group. WBC, NLR, CRP and IG% were significant parameters in discriminating mild AC from moderate and severe AC. However, only IG% was a significant parameter in discriminating moderate AC from severe AC. Moreover, the power of IG% to discriminate between patients with mild and moderate AC and those with severe AC was dramatically higher than the other parameters. CONCLUSION: Increased IG% is seen as an effective and reliable predictor in the early determination of AC severity.

Physicochemical water quality of Karabel, Çalti, and Tohma brooks and blood biochemical parameters of Barbus plebejus fish: assessment of heavy metal concentrations for potential health risks.

The present study aims to comparatively examine the physical quality parameters of water samples taken from Karabel, Çalti, and Tohma brooks in Sivas province and the blood biochemical parameters of blood samples of Barbus plebejus fish obtained from these waters. In periods when chemical pollution in water increased and decreased, it was determined that GLU and UA among blood biochemical parameters were significantly affected. Moreover, the potential risk levels of lead (Pb), copper (Cu), cadmium (Cd), and ferrous (Fe) for human health were compared to the international standards. Metal (Fe, Pb, Cu, and Cd) concentrations in the water were determined using atomic absorption spectrophotometer. The highest HQingestion values of Cd were found in Brook Çalti, which were 0.0018 for adults and 0.1980 for children. THQ upper limit set by the United States Environment Protection Agency (USEPA) is < 1. It was determined that HQingestion, HQdermal, and THQ values of all the heavy metals were much lower than this limit. It was concluded that water quality parameters of samples taken from Karabel, Çalti, and Tohma brooks on monthly basis for 12 months were not higher than the limits and the water qualities of brooks were determined to be "good".

Fusion of a cervical sympathetic ganglion with the recurrent inferior laryngeal nerve: a case of false positive non-recurrent inferior laryngeal nerve.

An anastomosis between the recurrent inferior laryngeal nerve (RILN) and the cervical sympathetic ganglion is seen rarely and might be confused with non-recurrent inferior laryngeal nerve (NRILN) in patients undergoing thyroidectomy and parathyroidectomy. In spite of the fact that NRILN is rarely seen and is an important anatomical structure, when damaged, the quality of life of the patient is negatively affected. This case report describes a connection between the RILN and the sympathetic nerve ganglion encountered during nerve dissection in a 43 year old female patient undergoing thyroidectomy and central zone dissection. Key points in the differential diagnosis are discussed.

Preliminary assessment of dietary mannanoligosaccharides on growth performance and health status of gilthead seabream Sparus auratus.

A feeding trial was performed to assess the potential beneficial effect of two levels of mannanoligosaccarides (MOS) on the growth performance, feed utilization, hematological parameters, and liver histopathology of gilthead seabream Sparus auratus (also known as gilthead bream). Mannanoligosaccarides were added at the rates of 2 and 4 g/kg to a fish-meal-based control diet, and each diet was given (twice daily [midmorning and midafternoon] to apparent satiation) to triplicate groups of gilthead seabream growers (mean weight = approximately 170 g) in sea cages. The trial lasted 12 weeks, and the average ambient water temperature ranged from 19.6 degrees C to 24.7 degrees C during the experimental period. At the end of the experiment, fish attained market size (350-450 g) and their health status was evaluated by blood analysis and liver histology. There were no differences in survival rates among fish fed experimental diets. However, there were significant improvements in both growth and feed utilization among fish fed diets supplemented with MOS. Hemoglobin (Hb) and hematocrit (Ht) levels and erythrocyte, leukocyte, and thrombocyte (Thr) counts were unaffected by any dietary MOS. The levels of Hb (g/dL; mean +/- SD) and Ht (%; mean +/- SD) were 11.0 +/- 2.5 and 45.6 +/- 6.7 for the control group, 11.1 +/- 1.7 and 39.3 +/- 8.0 for the 2-g/kg group, and 11.2 +/- 1.9 and 40.2 +/- 8.4 for the 4-g/kg group. The mean Thr count ranged from 47.6 to 53.8 x 10(3)/mm3. Despite the apparently higher Thr counts for fish fed diets supplemented with MOS, these differences were not significant. Moreover, no histopathological differences were observed in liver tissue cross sections between control and treatment groups. These results suggest that supplementation of diets with MOS had no significant effects on general fish health.

Gross pathology, blood chemistry, lipid and peroxide contents in rainbow trout ( Oncorhynchus mykiss Walbaum) affected by experimental Arcobacter cryaerophilus infection at low water temperature.

Arcobacter cryaerophilus was isolated from naturally infected rainbow trout ( Oncorhynchus mykiss Walbaum), and its pathogenicity was tested by intramuscular injection using healthy 1-year-old rainbow trout under cold-water conditions (at 5 degrees C). The lethal dosage of 50% end point (LD 50 ) for A. cryaerophilus was calculated as 7.79 x 10 5 viable cells. Experimental infection caused gross clinical abnormalities such as fallen scales, exophthalmia, oedema in injection region and at the base of fins, pale gills, kidney necrosis, hyperaemic areas in pale liver, haemorrhagic spots in heart, elongated spleen and swollen gallbladder. Activities of aspartate aminotransferase and alkaline phosphatase, and concentrations of glucose, total protein, albumin, cholesterol, triglyceride and calcium in the serum of the experimentally infected rainbow trout were significantly decreased compared with the healthy fish. Positive correlations were observed among blood parameters. Total lipid weights increased in the brain, muscle and liver tissues of infected fish and dropped in the gill and spleen tissues. Lipid peroxide contents in the brain, liver, kidney, spleen, muscle and gill tissues of infected rainbow trout were significantly higher than in healthy animals. The present work shows that A. cryaerophilus can be moderately virulent for rainbow trout at low water temperature, and changes in lipid and lipid peroxide contents of tissues and blood indices can highlight barely detectable effects of A. cryaerophilus infection in rainbow trout under laboratory conditions. However, the application of these indices in farm biomonitoring using rainbow trout will need more detailed studies and a careful consideration of the environmental parameters.