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Mutlu H, Sert ET, Kokulu K, Kankılıç NA. Role of the systemic immune-inflammation index in predicting spontaneous stone passage in patients with renal colic. Postgrad Med 2024; 136:325-330. [PMID: 38669143 DOI: 10.1080/00325481.2024.2347198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 04/22/2024] [Indexed: 04/28/2024]
Abstract
OBJECTIVES Renal colic (RC) is one of the most frequent reasons for presentation to the emergency department (ED) and creates a high economic and medical burden. Management strategies for RC range from waiting for spontaneous passage to surgical intervention. However, factors determining spontaneous stone passage (SSP) are still poorly understood. Therefore, in this study, we aimed to investigate the role of the systemic immune-inflammatory index (SII) in predicting SSP. METHODS We retrospectively analyzed the data of 924 patients aged over 18 years, who were diagnosed with RC in our clinic between 1 January 2019, and 30 May 2022, and had ureteral stones of ≤ 10 mm. The patients were divided into two groups according to whether they had SSP. The clinical and laboratory characteristics of the patients in the ED were evaluated. The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and SII (neutrophil count x platelet count/lymphocyte count) values of the patients were calculated. Stone size and location were also recorded. RESULTS In the univariate analysis of SSP, a ureteral stone size of ≤ 5 mm (p < 0.001), distal ureteral location (p < 0.001), SII (p < 0.001), NLR (p < 0.001), and PLR (p = 0.036) were significantly correlated with SSP. ROC analysis showed that an SII level < 721.8 (Sensitivity %82.6, Specificity %74.7, p < 0.001) was an independent predictor of SSP. CONCLUSION Our findings showed that a low SII level was associated with SSP and could be used as a predictive marker of SSP as a more valuable parameter than NLR. SII and NLR, together with other indicators, are inflammatory markers that can be used in the clinical decision-making process for ureteral stone treatment.
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Affiliation(s)
- Hüseyin Mutlu
- Department of Emergency Medicine, Aksaray University Medical School, Aksaray, Turkey
| | - Ekrem Taha Sert
- Department of Emergency Medicine, Aksaray University Medical School, Aksaray, Turkey
| | - Kamil Kokulu
- Department of Emergency Medicine, Aksaray University Medical School, Aksaray, Turkey
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Chen X, Lin Z, Chen Y, Lin C. C-reactive protein/lymphocyte ratio as a prognostic biomarker in acute pancreatitis: A cross-sectional study assessing disease severity. Int J Surg 2024; 110:01279778-990000000-01145. [PMID: 38446844 PMCID: PMC11175793 DOI: 10.1097/js9.0000000000001273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 02/22/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND The C-reactive protein/lymphocyte ratio (CLR) is a prognostic biomarker of various diseases. However, its significance in acute pancreatitis (AP) remains unknown. The main aim of this study was to investigate the association between the CLR and disease severity in patients with AP. METHODS This cross-sectional study included 476 AP patients (mild acute pancreatitis (MAP), n =176; moderately severe acute pancreatitis (MSAP) and severe acute pancreatitis (SAP), n=300). The primary exposure of interest was the baseline CLR. The primary outcome was the incidence of moderate to severe AP. Multivariate logistic regression and restricted cubic spline analyses were performed to evaluate the association between the CLR and the incidence of moderate to severe AP. Receiver operating characteristic (ROC) analysis was conducted to assess the predictive efficacy, sensitivity, and specificity of CLR in predicting the incidence of moderate to severe AP. RESULTS The mean age of the patients was 44±13.2 years, and 76.5% were male. The distribution of CLR was 31.6 (interquartile range, 4.5, 101.7). Moderate to severe AP occurred in 300 cases (63.0%). After multiple adjustments, CLR was independently associated with the incidence of moderate to severe AP (odds ratio [OR], 1.04; 95% confidence interval [CI], 1.03, 1.05; P< 0.001). A nonlinear relationship was found between CLR and the incidence of moderate to severe AP, with a threshold of approximately 45. The effect size and CI below and above the threshold value were 1.061 (1.033-1.089) and 1.014 (0.997-1.031), respectively. The area under the curve (AUC) for CLR was 87.577% (95% CI: 84.443% ~ 90.710%) with an optimal cut-off value of 30.835, resulting in a sensitivity of 73.7% and a specificity of 88.6%. CONCLUSIONS There was a nonlinear relationship with a saturation effect between the CLR and the incidence of moderate to severe AP. The CLR measured within 24 h of admission may serve as a promising biomarker for predicting the emergence of moderate to severe AP, thereby providing a more scientifically grounded basis for preventing such cases. Nonetheless, further research is warranted to validate and strengthen these findings.
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Affiliation(s)
- Xinqi Chen
- Department of Gastroenterology, First Hospital of Quanzhou Affiliated to Fujian Medical University, Quanzhou, Fujian, People’s Republic of China
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Cazacu SM, Parscoveanu M, Cartu D, Moraru E, Rogoveanu I, Ungureanu BS, Iordache S, Florescu DN, Iovanescu VF, Dragomir MI. NLR48 is Better Than CRP, and mCTSI, and Similar to BISAP and SOFA Scores for Mortality Prediction in Acute Pancreatitis: A Comparison of 6 Scores. J Inflamm Res 2023; 16:4793-4804. [PMID: 37881651 PMCID: PMC10596122 DOI: 10.2147/jir.s432408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 10/10/2023] [Indexed: 10/27/2023] Open
Abstract
Introduction The neutrophil-lymphocyte ratio (NLR) has been suggested as a reliable marker for predicting inflammation progression and severity of acute pancreatitis, although the role of the NLR stratified by etiology is still insufficiently studied. However, the NLR's role in mortality prediction was poorly evaluated in the literature. Patients and Methods We performed a retrospective, cross-sectional study to analyze the role of NLR0 (at admission) and NLR48 (at 48 hours) in acute pancreatitis as compared with CRP, BISAP, SOFA, and modified CTSI (mCTSI) for the prediction of mortality and severe acute pancreatitis (SAP) in patients admitted into the Emergency Clinical County Hospital of Craiova during 48 months. The primary assessed outcomes were the rate of in-hospital mortality, the rate of persistent organ failure, and ICU admissions. We analyzed mortality prediction for all acute pancreatitis, for biliary, alcoholic, and hypertriglyceridemic acute pancreatitis, for severe forms, and for patients admitted to the ICU. Results A total of 725 patients were selected; 42.4% had biliary acute pancreatitis, 27.7% had alcoholic acute pancreatitis, and 8.7% had hypertriglyceridemia-induced acute pancreatitis. A total of 13.6% had POF during admission. The AUC for NLR48 in predicting mortality risk and SAP was 0.81 and 0.785, superior to NLR0, CRP48, and mCTSI but inferior to BISAP and SOFA scores. The NLR48/NLR0 ratio did not add significantly to the accuracy. NLR0 and NLR48 performed poorly for mortality prediction in severe forms and in patients admitted to the ICU. NLR48 has good accuracy in our study for predicting death risk in biliary and alcoholic acute pancreatitis but not in hypertriglyceridemic acute pancreatitis. Conclusion NLR48 was a good indicator in predicting mortality risk and severe forms in all patients with acute pancreatitis, but not of death in SAP and in patients admitted to ICU, with good accuracy for predicting death risk in biliary and alcoholic acute pancreatitis but not in hypertriglyceridemic acute pancreatitis.
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Affiliation(s)
- Sergiu Marian Cazacu
- Gastroenterology Department, University of Medicine and Pharmacy Craiova, Clinical Emergency Hospital Craiova, Craiova, Romania
| | - Mircea Parscoveanu
- Surgery Department, University of Medicine and Pharmacy Craiova, Clinical Emergency Hospital Craiova, Craiova, Romania
| | - Dan Cartu
- Surgery Department, University of Medicine and Pharmacy Craiova, Clinical Emergency Hospital Craiova, Craiova, Romania
| | - Emil Moraru
- Surgery Department, University of Medicine and Pharmacy Craiova, Clinical Emergency Hospital Craiova, Craiova, Romania
| | - Ion Rogoveanu
- Gastroenterology Department, University of Medicine and Pharmacy Craiova, Clinical Emergency Hospital Craiova, Craiova, Romania
| | - Bogdan Silviu Ungureanu
- Gastroenterology Department, University of Medicine and Pharmacy Craiova, Clinical Emergency Hospital Craiova, Craiova, Romania
| | - Sevastita Iordache
- Gastroenterology Department, University of Medicine and Pharmacy Craiova, Clinical Emergency Hospital Craiova, Craiova, Romania
| | - Dan Nicolae Florescu
- Gastroenterology Department, University of Medicine and Pharmacy Craiova, Clinical Emergency Hospital Craiova, Craiova, Romania
| | - Vlad Florin Iovanescu
- Gastroenterology Department, University of Medicine and Pharmacy Craiova, Clinical Emergency Hospital Craiova, Craiova, Romania
| | - Manuela Iuliana Dragomir
- Public Health Management Department, University of Medicine and Pharmacy Craiova, Craiova, Romania
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SOYKAN SERT Z, BÜLBÜL R. Erken doğum yapan kadınlarda sistemik immün-inflamasyon indeksinin prediktif değeri. CUKUROVA MEDICAL JOURNAL 2022. [DOI: 10.17826/cumj.1089119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Amaç: Bu çalışmada sistemik immün-inflamatuar indeksin (SII) hamile kadınlarda erken doğum gelişimini tahmin edip edemeyeceği araştırılmıştır.
Gereç ve Yöntem: 1 Ocak 2018-31 Aralık 2021 tarihleri arasında kliniğimize spontan doğum eylemi ile başvuran, membranları intakt olan ve tek canlı fetüsü olan 18 yaş ve üstü gebeler retrospektif olarak değerlendirildi. Kadınlar doğum haftasına göre preterm ve term doğum olmak üzere iki gruba ayrıldı. Kadınların klinik ve laboratuvar özellikleri değerlendirildi. Hastaların trombosit-lenfosit oranı (PLR), nötrofil-lenfosit oranı (NLR) ve SII (nötrofil sayısı x trombosit sayısı/lenfosit sayısı) hesaplandı.
Bulgular: Çalışmaya erken doğum yapan 171 kadın ve sağlıklı term doğum yapan 173 kadın dahil edildi. PLR, NLR ve SII değerleri preterm grupta term grubuna göre istatistiksel olarak anlamlı derecede yüksekti. Çok değişkenli lojistik regresyon analizi, SII'nin (olasılık oranı [OR]: 3.65, %95 güven aralığı [GA]: 2.21–10.07) erken doğum gelişiminin bağımsız bir prediktör olduğunu gösterdi. SII'nin erken doğumu (eğrinin altındaki alan [AUC]: 0.792) tahmin etme gücünün, tek başına NLR (AUC: 0.725) veya PLR'den (AUC: 0.716) daha yüksek olduğunu bulduk. 789.3'ün üzerindeki SII değerleri, %68,4 duyarlılık ve %81.5 özgüllük ile erken doğumu öngördü.
Sonuç: Preterm doğumun erken tespitinde SII’nın NLR ve PLR’den daha değerli olduğunu bulduk. SII, preterm doğum gelişme riski taşıyan gebelerin erken dönemde belirlenmesine yardımcı olabilir.
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Dancu GM, Popescu A, Sirli R, Danila M, Bende F, Tarta C, Sporea I. The BISAP score, NLR, CRP, or BUN: Which marker best predicts the outcome of acute pancreatitis? Medicine (Baltimore) 2021; 100:e28121. [PMID: 34941057 PMCID: PMC8702250 DOI: 10.1097/md.0000000000028121] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 11/16/2021] [Indexed: 01/05/2023] Open
Abstract
Acute pancreatitis is a common disease, and the mortality rate can be high. Thus, a risk assessment should be performed early to optimize treatment. We compared simple prognostic markers with the bedside index for severity in acute pancreatitis (BISAP) scoring system to identify the best predictors of severity and mortality.This retrospective study stratified disease severity based on the revised Atlanta criteria. The accuracies of the markers for predicting severe AP (SAP) were assessed using receiver operating characteristic curves. The sensitivity, specificity, positive predictive value, and negative predictive value were calculated for each marker. Multivariate logistic regression analyses were used to identify independent predictors of SAP and mortality.The area under the curve (AUC) for the BISAP score was classified as fair for predicting SAP. The neutrophil-to-lymphocyte ratio at 48 hours (NLR48 h) and the C-reactive protein level at 48 hours (CRP48 h) had the best AUCs and were independently associated with SAP. When both criteria were met, the AUC was 0.89, sensitivity was 68%, and specificity was 92%. CRP48 h and hematocrit at 48 hours were independently associated with mortality.NLR48 h and CRP48 h were independently associated with SAP but not superior to the BISAP score at admission. Assessing NLR48 h and CRP48H together was most suitable for predicting SAP. The CRP level was a good predictive marker for mortality.
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Affiliation(s)
- Greta Maria Dancu
- Department of Internal Medicine II, Division of Gastroenterology and Hepatology, Center for Advanced Research in Gastroenterology and Hepatology “Victor Babes” University of Medicine and Pharmacy Timisoara, Romania
| | - Alina Popescu
- Department of Internal Medicine II, Division of Gastroenterology and Hepatology, Center for Advanced Research in Gastroenterology and Hepatology “Victor Babes” University of Medicine and Pharmacy Timisoara, Romania
| | - Roxana Sirli
- Department of Internal Medicine II, Division of Gastroenterology and Hepatology, Center for Advanced Research in Gastroenterology and Hepatology “Victor Babes” University of Medicine and Pharmacy Timisoara, Romania
| | - Mirela Danila
- Department of Internal Medicine II, Division of Gastroenterology and Hepatology, Center for Advanced Research in Gastroenterology and Hepatology “Victor Babes” University of Medicine and Pharmacy Timisoara, Romania
| | - Felix Bende
- Department of Internal Medicine II, Division of Gastroenterology and Hepatology, Center for Advanced Research in Gastroenterology and Hepatology “Victor Babes” University of Medicine and Pharmacy Timisoara, Romania
| | - Cristi Tarta
- Department X, 2nd Surgical Clinic, Researching Future Chirurgie 2, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - Ioan Sporea
- Department of Internal Medicine II, Division of Gastroenterology and Hepatology, Center for Advanced Research in Gastroenterology and Hepatology “Victor Babes” University of Medicine and Pharmacy Timisoara, Romania
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Tahir H, Rahman S, Habib Z, Khan Y, Shehzad S. Comparison of the Accuracy of Modified CT Severity Index Score and Neutrophil-to-Lymphocyte Ratio in Assessing the Severity of Acute Pancreatitis. Cureus 2021; 13:e17020. [PMID: 34522501 PMCID: PMC8425492 DOI: 10.7759/cureus.17020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2021] [Indexed: 12/13/2022] Open
Abstract
Background Acute pancreatitis is an acute gastrointestinal emergency with significant morbidity and mortality if not treated. It can lead to local as well as systemic complications and has a prevalence of 51.07%. Laboratory investigations such as amylase and lipase and ultrasound scan are typically used for the diagnosis. A contrast-enhanced CT scan is considered the gold standard. Both laboratory and radiological investigation-based scoring systems have been reported in the literature and are in practice. However, these modalities demand several laboratory investigations and are expensive. Our study aims to determine the congruency of the neutrophil-to-lymphocyte ratio (NLR) and the modified CT severity index score (MCTSI) with the revised Atlanta classification in assessing the severity of acute pancreatitis. In addition, the accuracy of NLR and MCTSI is determined. The secondary objective is to determine whether NLR can predict the severity of acute pancreatitis to the same extent as MCTSI through expensive radiological imaging and other clinical scoring systems through a list of investigations. Methodology The data for this study were collected retrospectively and patients with a diagnosis of acute pancreatitis were included through the nonprobability convenience sampling method. All patients underwent relevant laboratory workup (including complete blood count) and radiological workup (including CT scan) during their hospital stay. The main outcome measures were sensitivity, specificity, and accuracy of NLR and MCTSI, and the congruency of these with the revised Atlanta classification in assessing the severity of acute pancreatitis. Results A total of 166 patients with acute pancreatitis were included, of which 107 (64.45%) were males and 59 (35.55%) were females, with a mean age of 43.7. The sensitivity, specificity, and accuracy of NLR were 67%, 90.9%, and 76%, respectively, whereas the sensitivity, specificity, and accuracy of MCTSI were 95%, 13.6%, and 62%, respectively. The area under the curve for NLR was 0.855 whereas that for MCTSI was determined to be 0.645. Conclusions NLR has a good concordance with the revised Atlanta classification and assesses the disease severity, especially in moderate-to-severe cases of acute pancreatitis compared to MCTSI. In addition, NLR can be used in acute and/or resource-poor settings to predict the severity of acute pancreatitis.
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Affiliation(s)
- Hasan Tahir
- Department of Plastic and Reconstructive Surgery, Liaquat National Hospital and Medical College, Karachi, PAK
| | - Sheeraz Rahman
- Department of General Surgery, Liaquat National Hospital and Medical College, Karachi, PAK
| | - Zahid Habib
- Department of General Surgery, Liaquat National Hospital and Medical College, Karachi, PAK
| | - Yusra Khan
- General Surgery, Karachi Medical and Dental College, Karachi, PAK
| | - Saleha Shehzad
- Department of Radiology, Liaquat National Hospital and Medical College, Karachi, PAK
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Does Monocyte Distribution Width (MDW) Have Prognostic Value in Acute Pancreatitis? JOURNAL OF CONTEMPORARY MEDICINE 2021. [DOI: 10.16899/jcm.888053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Junare PR, Debnath P, Nair S, Chandnani S, Udgirkar S, Thange R, Jain S, Deshmukh R, Debnath P, Rathi P, Contractor Q, Deshpande A. Complete hemogram: simple and cost-effective in staging and predicting outcome in acute pancreatitis. Wien Klin Wochenschr 2021; 133:661-668. [PMID: 33620577 DOI: 10.1007/s00508-021-01821-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 01/22/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND An important goal in management of acute pancreatitis (AP) is early prediction and recognition of disease severity. Various predictive scoring systems are in clinical use with their own limitations and there is always a quest for simple, practical, quantifiable, dynamic and readily available markers for predicting disease severity and outcome. Complete hemogram is routinely ordered in all patients with AP. In recent years red cell distribution width (RDW), neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR) and platelet lymphocyte ratio (PLR) have been found to be independent predictors of prognosis in various benign and malignant conditions. This prospective study evaluated complete hemogram based markers in AP. MATERIAL AND METHODS Complete hemogram analysis was done and NLR, LMR, PLR values were calculated. Development of organ failure, the need for intensive care unit (ICU) admission and interventions, development of complications (local/systemic) and 100-day mortality were assessed. RESULTS In this study 160 subjects of AP were included. Complete hemogram analysis was performed within 24 h after admission. C‑reactive protein, RDW, NLR, PLR and bedside index of severity in acute pancreatitis (BISAP) values were higher in severe AP than moderate AP group than mild AP group, while LMR values were decreased in the corresponding severe, moderate and mild AP groups (p < 0.001). The NLR performed best for prediction of ICU admission, organ failure, interventions and mortality with area under receiver operating curve (AUROC) were 0.943, 0.940, 0.902 and 0.910, respectively. CONCLUSION Hemogram based markers are simple, objective, dynamic and readily available. They can be considered in addition to conventional multifactorial scoring systems for prediction of outcome and prognosis of AP.
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Affiliation(s)
- Parmeshwar Ramesh Junare
- Department of Gastroenterology, Topiwala National Medical College and B.Y.L. Nair Charitable Hospital, Room number 202, New RMO Building, Mumbai, India.
| | - Prasanta Debnath
- Department of Gastroenterology, Topiwala National Medical College and B.Y.L. Nair Charitable Hospital, Room number 202, New RMO Building, Mumbai, India
| | - Sujit Nair
- Department of Gastroenterology, Topiwala National Medical College and B.Y.L. Nair Charitable Hospital, Room number 202, New RMO Building, Mumbai, India
| | - Sanjay Chandnani
- Department of Gastroenterology, Topiwala National Medical College and B.Y.L. Nair Charitable Hospital, Room number 202, New RMO Building, Mumbai, India
| | - Suhas Udgirkar
- Department of Gastroenterology, Topiwala National Medical College and B.Y.L. Nair Charitable Hospital, Room number 202, New RMO Building, Mumbai, India
| | - Ravi Thange
- Department of Gastroenterology, Topiwala National Medical College and B.Y.L. Nair Charitable Hospital, Room number 202, New RMO Building, Mumbai, India
| | - Shubham Jain
- Department of Gastroenterology, Topiwala National Medical College and B.Y.L. Nair Charitable Hospital, Room number 202, New RMO Building, Mumbai, India
| | - Rahul Deshmukh
- Department of Gastroenterology, Topiwala National Medical College and B.Y.L. Nair Charitable Hospital, Room number 202, New RMO Building, Mumbai, India
| | - Partha Debnath
- Department of Gastroenterology, Topiwala National Medical College and B.Y.L. Nair Charitable Hospital, Room number 202, New RMO Building, Mumbai, India
| | - Pravin Rathi
- Department of Gastroenterology, Topiwala National Medical College and B.Y.L. Nair Charitable Hospital, Room number 202, New RMO Building, Mumbai, India
| | - Qais Contractor
- Department of Gastroenterology, Topiwala National Medical College and B.Y.L. Nair Charitable Hospital, Room number 202, New RMO Building, Mumbai, India
| | - Akshay Deshpande
- Department of Surgery, Topiwala National Medical College and B.Y.L. Nair Charitable Hospital, Mumbai, India
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Kokulu K, Özdemir S, Algın A, Akça HŞ. The role of plasmapheresis in the treatment of hypertriglyceridemia-induced acute pancreatitis. Am J Emerg Med 2020; 38:1515. [PMID: 31982220 DOI: 10.1016/j.ajem.2020.01.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 01/16/2020] [Indexed: 10/25/2022] Open
Affiliation(s)
- Kamil Kokulu
- Department of Emergency Medicine, Ümraniye Training and Research Hospital, University of Health Sciences, İstanbul, Turkey.
| | - Serdar Özdemir
- Department of Emergency Medicine, Ümraniye Training and Research Hospital, University of Health Sciences, İstanbul, Turkey
| | - Abdullah Algın
- Department of Emergency Medicine, Ümraniye Training and Research Hospital, University of Health Sciences, İstanbul, Turkey
| | - Hatice Şeyma Akça
- Department of Emergency Medicine, Ümraniye Training and Research Hospital, University of Health Sciences, İstanbul, Turkey
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Tanoğlu A, Düzenli T. Neutrophil-to-lymphocyte ratio alone may not be a true indicator of the severity of acute pancreatitis. TURKISH JOURNAL OF GASTROENTEROLOGY 2019; 30:937. [PMID: 31625940 DOI: 10.5152/tjg.2019.18856] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Alpaslan Tanoğlu
- Department of Gastroenterology, Sultan Abdulhamid Han Training and Research Hospital, İstanbul, Turkey
| | - Tolga Düzenli
- Department of Gastroenterology, Sultan Abdulhamid Han Training and Research Hospital, İstanbul, Turkey
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