Search

Copyright of Acibadem Saglik Bilimleri Dergisi is the property of Acibadem University Medical School and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A 26-year-old female patient presented to the family medicine outpatient clinic with complaints of diarrhea, widespread abdominal pain, nausea, and vomiting, which had been going on for five days. In the first physical examination findings of the patient, there was widespread sensitivity in the abdomen, but there were no findings of defense or rebound. The patient was re-evaluated with the results of conducted tests, her abdominal examination was repeated, and rebound positivity was detected in the right lower quadrant. The patient was referred to the Emergency Department, and she was taken into operation by the general surgery team with the diagnosis of acute appendicitis. The most important factor in delaying the diagnosis of acute appendicitis is the presence of gastroenteritis. Cases of acute appendicitis presenting with diarrhea have been reported in the medical literature. Since acute pathologies should always be kept in mind in the differential diagnosis of patients who present to primary care with abdominal pain and diarrhea, it is deemed appropriate to present the case with literature. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Ankara University Faculty of Medicine / Ankara Üniversitesi Tip Fakültesi Mecmuasi is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: The prognostic nutritional index (PNI) is calculated using total serum lymphocyte counts and albumin levels. We aimed to analyze the role of PNI in predicting intensive care unit (ICU) referral and mortality in patients with Crimean Congo hemorrhagic fever (CCHF). Materials and Methods: Our target population was adult (age >18) patients who presented between March 2015 and October 2021 within 5 days of symptom emergence and were diagnosed with CCHF. The predictive value of PNI was analyzed by the receiver operating curve analysis. The patients were categorized based on the severity grading scores (SGS) as mild, moderate, and severe. The relationship between PNI and ICU referral and mortality was analyzed by logistic regression analysis. Results: Overall, 115 patients with the diagnosis of CCHF were included. 13.9% (n = 16) of the patients were referred to ICU while 11.3% (n = 13) died. A comparison of the patients with different SGS grades revealed that they were significantly different regarding PNI (p < 0.001). There was a significant negative correlation between PNI and SGS (r = −0.662; p < 0.001). PNI had a PV regarding ICU referral and mortality ([area under the curve [AUC] = 0.723, 95% confidence interval [CI]: 0.609–0.836, p = 0.004 [AUC = 0.738, 95% CI: 0.613–0.863, p = 0.005]). The PNI threshold was 36.1 for ICU referral and mortality. The rates of female patients, hospitalization periods longer than 1 week, platelet apheresis replacement, diabetes mellitus, bleeding history, ICU admission, and mortality were significantly higher in patients with a PNI of lower than 36.1 (p < 0.05). Conclusion: PNI can predict ICU referral and mortality in patients admitted due to CCHF. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Coronavirus disease 2019 is a disease caused by severe acute respiratory syndrome coronavirus 2, a novel type of coronavirus, which causes pneumonia in some hosts. No specific scoring method exists for mortality evaluation in novel coronavirus pneumonia. The aim of this study was to investigate factors affecting coronavirus disease 2019 mortality and comparison of pneumonia scoring systems, pneumonia severity index, CURB-65, and MuLBSTA. MATERIAL AND METHODS: In this single-center clinical study, 151 patients who had been diagnosed with coronavirus disease 2019 infection and pneumonia between March 11 and May 31, 2020, were evaluated retrospectively. Correlation between patients' symptoms, comorbidities, drugs in use, radiological findings, and mortality was investigated. Parameters were also evaluated regarding their contribution to additional treatment requirements and days of fever response. RESULTS: A correlation between mortality and higher scores of pneumonia severity index, CURB-65, and MuLBSTA was found. When parameters were investigated separately, elevated glucose and urea levels, presence of diabetes, renal failure, hypertension, chronic obstructive pulmonary disease, cerebrovascular events and known malignancies, lymphocyte count, smoking history, radiological findings, and age correlated with mortality. In addition to these parameters, elevated calcium, potassium, brain natriuretic peptide, troponin, d-dimer, C-reactive protein, HC03, and lactate dehydrogenase levels were found significant regarding mortality. These parameters were not found statistically relevant regarding additional treatment requirement, fever response day, and total treatment duration. CONCLUSION: A modified version of present pneumonia scoring systems will be required to rigorously evaluate the severity of a patient's condition. A new scoring system that uses components of the present ones may prove useful and with further studies, a similar follow-up algorithm may be created. [ABSTRACT FROM AUTHOR]