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Krishnan N, Pakkasjärvi N, Kainth D, Arredondo Montero J, Danielson J, Verma P, Verma A, Yadav DK, Anand S. Utility of thiol/disulphide homeostasis as a biomarker for acute appendicitis: a systematic review and meta-analysis. Pediatr Surg Int 2024; 40:152. [PMID: 38847871 DOI: 10.1007/s00383-024-05728-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/23/2024] [Indexed: 06/13/2024]
Abstract
The aim of this study was to analyze the role of thiol/disulfide homeostasis (TDH) parameters as an indicator of oxidative stress in acute appendicitis (AA). PubMed, EMBASE, Web of Science, and Scopus databases were systematically searched. Studies reporting on TDH in AA (both complicated and uncomplicated cases) were included. The comparator group were healthy controls. The TDH domain was compared between the groups using anti-oxidant parameters, namely native thiol and total thiol levels, and native thiol/total thiol ratio; and oxidant parameters, namely disulfide level, disulfide/native thiol ratio, and disulfide/total thiol ratio. The statistical analysis was performed using a random-effects model. The methodological quality of the studies was assessed utilizing the Newcastle-Ottawa scale. Eleven studies with a total of 926 subjects, comprising 457 patients with uncomplicated appendicitis, 147 with complicated appendicitis, and 322 healthy controls were included. Our study demonstrated significantly increased oxidative stress in AA as compared to healthy controls in all TDH parameters and significantly lower total thiol levels in complicated AA as compared to uncomplicated AA. Due to a poor methodological quality in five out of eleven studies, future prospective studies with adequate power are essential to validate these observations and refine the diagnostic approaches to AA.
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Affiliation(s)
- Nellai Krishnan
- Department of Pediatric Surgery, All India Institute of Medical Sciences, Ansari Nagar East, New Delhi, 110029, Delhi, India
| | - Niklas Pakkasjärvi
- Department of Pediatric Surgery, New Children's Hospital, Helsinki University Hospital, Helsinki, Finland
- Department of Pediatric Surgery, Section of Urology, University Children's Hospital, Uppsala, Sweden
| | - Deepika Kainth
- Division of Neonatology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | | | - Johan Danielson
- Department of Pediatric Surgery, Section of Urology, University Children's Hospital, Uppsala, Sweden
| | - Pulkit Verma
- Division of Biomedical Informatics, Indian Council of Medical Research, New Delhi, India
| | - Ajay Verma
- Department of Pediatric Surgery, All India Institute of Medical Sciences, Ansari Nagar East, New Delhi, 110029, Delhi, India
| | - Devendra Kumar Yadav
- Department of Pediatric Surgery, All India Institute of Medical Sciences, Ansari Nagar East, New Delhi, 110029, Delhi, India
| | - Sachit Anand
- Department of Pediatric Surgery, All India Institute of Medical Sciences, Ansari Nagar East, New Delhi, 110029, Delhi, India.
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Singh A, Pogorelić Z, Agrawal A, Muñoz CML, Kainth D, Verma A, Jindal B, Agarwala S, Anand S. Utility of Ischemia-Modified Albumin as a Biomarker for Acute Appendicitis: A Systematic Review and Meta-Analysis. J Clin Med 2023; 12:5486. [PMID: 37685553 PMCID: PMC10487779 DOI: 10.3390/jcm12175486] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 08/21/2023] [Accepted: 08/23/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Acute appendicitis is a frequently encountered surgical emergency. Despite several scoring systems, the possibility of delayed diagnosis persists. In addition, a delayed diagnosis leads to an increased risk of complicated appendicitis. Hence, there is a need to identify biological markers to help clinicians rapidly and accurately diagnose and prognosticate acute appendicitis with a high sensitivity and specificity. Although several markers have been evaluated, the pressing concern is still the low specificity of these markers. One such marker is serum ischemia-modified albumin (IMA), which can be a novel biomarker for accurately diagnosing and prognosticating acute appendicitis. METHODS The authors conducted a systematic search of the PubMed, EMBASE, Web of Science, and Scopus databases through February 2023 as per the PRISMA guidelines. The difference in the levels of IMA between patients with acute appendicitis vs. healthy controls, and the difference in the levels of IMA between patients with complicated vs. non-complicated acute appendicitis were taken as the outcome measures. Statistical analysis was performed using a random effects model and mean difference (MD) was calculated. The methodological quality of the studies was assessed by utilizing the Newcastle-Ottawa scale. RESULTS A total of six prospective comparative studies were included in the meta-analysis. The analysis revealed that the mean level of serum IMA was significantly raised in the acute appendicitis group (MD 0.21, 95% CI 0.05 to 0.37, p = 0.01). Similarly, the mean serum IMA levels were also raised in the complicated appendicitis group compared to the non-complicated appendicitis group (MD 0.05, 95% CI 0.01 to 0.10, p = 0.02). Three of the studies included were, however, of poor methodological quality. CONCLUSIONS Serum IMA is a viable potential marker for diagnosing and prognosticating acute appendicitis. However, due to the limited methodological quality of available studies, further prospectively designed and adequately powered studies are needed.
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Affiliation(s)
- Apoorv Singh
- Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi 110029, India; (A.S.); (A.V.); (S.A.)
| | - Zenon Pogorelić
- Department of Surgery, School of Medicine, University of Split, 21000 Split, Croatia;
- Department of Pediatric Surgery, University Hospital of Split, 21000 Split, Croatia
| | - Aniket Agrawal
- Department of Pediatric Surgery, Kokilaben Dhirubhai Ambani Hospital, Mumbai 400053, India;
| | | | - Deepika Kainth
- Division of Neonatology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India;
| | - Ajay Verma
- Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi 110029, India; (A.S.); (A.V.); (S.A.)
| | - Bibekanand Jindal
- Department of Pediatric Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry 605006, India;
| | - Sandeep Agarwala
- Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi 110029, India; (A.S.); (A.V.); (S.A.)
| | - Sachit Anand
- Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi 110029, India; (A.S.); (A.V.); (S.A.)
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Ünsal A, Turhan VB, Ozturk D, Bulus H, Turkes GF, Erel O. The predictive value of ischemia-modified albumin in the diagnosis of acute appendicitis: A prospective case-control study. ULUS TRAVMA ACIL CER 2022; 28:523-528. [PMID: 35485513 PMCID: PMC10521000 DOI: 10.14744/tjtes.2020.58675] [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: 11/08/2021] [Accepted: 03/08/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND Surgical planning is critical for ongoing treatment and prognosis of the disease's course after an appendicitis diag-nosis. Ischemia-modified albumin (IMA) has been used as a biomarker for a variety of ischemia-related disorders in the past. The aim of this study is to determine the IMA level in patients with AA and to evaluate its predictive significance. METHODS A total of 139 participants were enrolled in the trial. After diagnosis and before surgery, the amount of plasma IMA was tested. Patients diagnosed with appendicitis in Group 1 (n=97) and volunteer surgical patients not diagnosed with appendicitis in Group 2 (n=42) were compared as the final diagnostic criterion. RESULTS The data of 139 patients with a mean age of 36.15 were evaluated statistically. IMA values were analyzed in both groups. The mean IMA of all patients was 0.74±0.16 AbsU. When the two groups were compared, it was seen that IMA was statistically higher in Group 1 than in the control group. While the area under the curve for IMA was 0.670, the sensitivity for the cutoff value of 0.715 was 68%, the specificity was 62%. CONCLUSION Our study shows that IMA values provide significant results in predicting acute appendicitis.
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Affiliation(s)
- Abdulkadir Ünsal
- Department of General Surgery, University of Medical Sciences, Keçiören Training and Research Hospital, Ankara-Turkey
| | - Veysel Barış Turhan
- Department of General Surgery, University of Hitit, Erol Olçok Training and Research Hospital, Çorum-Turkey
| | - Dogan Ozturk
- Department of General Surgery, University of Medical Sciences, Keçiören Training and Research Hospital, Ankara-Turkey
| | - Hakan Bulus
- Department of General Surgery, University of Medical Sciences, Keçiören Training and Research Hospital, Ankara-Turkey
| | - Gulsum Feyza Turkes
- Department of Biochemistry, University of Medical Sciences, Keçiören Training and Research Hospital, Ankara-Turkey
| | - Ozcan Erel
- Department of Biochemistry, University of Medical Sciences, Ankara City Hospital, Ankara-Turkey
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MİRAPOĞLU S, GÜLER EM, BEKTAY MY, KOÇYİĞİT A, İZZETTİN F. Dynamic Thiol / Disulfide Homeostasis a promising new marker in the diagnosis of Acute Appendicitis in Children. CLINICAL AND EXPERIMENTAL HEALTH SCIENCES 2022. [DOI: 10.33808/clinexphealthsci.814301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Wang D, Zhang T, Hao H, Zhang H, Ye H, Zhao C. Probiotic properties of a Spaceflight-induced mutant Lactobacillus plantarum SS18-50 in mice. Endocr Metab Immune Disord Drug Targets 2021; 22:525-531. [PMID: 34533451 DOI: 10.2174/1871530321666210917163719] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 08/13/2021] [Accepted: 08/13/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Probiotics are a group of bacteria that play a critical role in intestinal microbiota homeostasis and may help adjunctively treat certain diseases like metabolic and immune disorders. OBJECTIVE We recently generated a space-flight mutated Lactobacillus plantarum SS18-50 with good in vitro probiotic characteristics. In the current research, we designed two in vivo experiments to evaluate whether L. plantarum SS18-50 had the ability to increase beneficial gut bacteria, regulate oxidative status and ameliorate inflammation in mice. METHODS Experiments I: the ICR mice were gavaged with L. plantarum SS18-50 or its wild type L. plantarum GS18 at 107 or 109 CFU/kg BW daily for one month, during which the body weight was recorded weekly. The feces were collected to determine the abundance of two main beneficial bacterial groups including Lactobacillus and Bifidobacterium by selective culturing, while the total triglycerides and cholesterols in sera were determined using commercial kits. Experiment II: the mice were gavaged with loperamide hydrochloride to develop oxidative stress and inflammation phenotypes. At the same time, the experimental mice were gavaged with L. plantarum SS18-50 or wild type L. plantarum GS18 at 107 or 109 CFU/kg BW daily for one month. At the end of experiment, oxidative indicators (SOD and MDA) and inflammatory cytokines (IL-17A and IL-10) were measured by commercial kits. RESULTS Results showed that L. plantarum SS18-50 increased the abundance of Lactobacillus and Bifidobacterium in mice after one month's administration. L. plantarum SS18-50 also showed the anti-oxidant activity by increasing SOD and decreasing MDA, and exerted the anti-inflammatory effect by increasing IL-10 and decreasing IL-17A in Lop treated mice. Both the wild type stain and the space mutant had such biomedical effects, but L. plantarum SS18-50 was better in increasing gut beneficial bacteria and oxidative regulation than the wild type (P<0.05). CONCLUSION we conclude that L. plantarum SS18-50 has a great potential to serve as a dietary functional probiotic supplement and/or adjunctive treatment strategy.
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Affiliation(s)
- Dan Wang
- College of Food Science and Engineering, Jilin University, 5333 Xi'an Rd., Changchun, China
| | - Tiehua Zhang
- College of Food Science and Engineering, Jilin University, 5333 Xi'an Rd., Changchun, China
| | - Hongwei Hao
- Fullarton Bioengineering Technology Co., Ltd, Beijing, China
| | - Hongxing Zhang
- College of Food Science and Engineering, Beijing University of Agriculture, Beijing, China
| | - Haiqing Ye
- College of Food Science and Engineering, Jilin University, 5333 Xi'an Rd., Changchun, China
| | - Changhui Zhao
- College of Food Science and Engineering, Jilin University, 5333 Xi'an Rd., Changchun, China
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A Blood Biomarker for Duchenne Muscular Dystrophy Shows That Oxidation State of Albumin Correlates with Protein Oxidation and Damage in Mdx Muscle. Antioxidants (Basel) 2021; 10:antiox10081241. [PMID: 34439489 PMCID: PMC8389308 DOI: 10.3390/antiox10081241] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 07/14/2021] [Accepted: 07/29/2021] [Indexed: 12/31/2022] Open
Abstract
Duchenne muscular dystrophy (DMD) is a severe X-linked muscle wasting disease with no cure. While the precise mechanisms of progressive dystropathology remain unclear, oxidative stress caused by excessive generation of oxidants is strongly implicated. Blood biomarkers that could track oxidant levels in tissues would be valuable to measure the effectiveness of clinical treatments for DMD; our research has focused on developing such biomarkers. One target of oxidants that has the potential to be harnessed as a clinical biomarker is the thiol side chain of cysteine 34 (Cys34) of the blood protein albumin. This study using the mdx mouse model of DMD shows that in plasma, albumin Cys34 undergoes thiol oxidation and these changes correlate with levels of protein thiol oxidation and damage of the dystrophic muscles. A comparison with the commonly used biomarker protein carbonylation, confirmed that albumin thiol oxidation is the more sensitive plasma biomarker of oxidative stress occurring in muscle tissue. We show that plasma albumin oxidation reflects muscle dystropathology, as increased after exercise and decreased after taurine treatment of mdx mice. These data support the use of albumin thiol oxidation as a blood biomarker of dystropathology to assist with advancing clinical development of therapies for DMD.
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Akkurt G, Akkurt B, Alptekın E, Birben B, Keşkek M, Erel Ö. Efficacy of Thiol Disulfide Homeostasis and Ischemia Modified Albumin Values in Estimating the Degree of Difficulty for Laparoscopic Cholecystectomy. Comb Chem High Throughput Screen 2021; 24:433-440. [DOI: 10.2174/1386207323666200709165910] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 05/04/2020] [Accepted: 05/16/2020] [Indexed: 11/22/2022]
Abstract
Aim:
The aim of this study was to investigate the efficacy of thiol disulfide homeostasis
and Ischemia Modified Albumin (IMA) values in predicting the technical difficulties that might be
encountered during laparoscopic cholecystectomy.
Materials and Methods:
The study included 65 patients who underwent laparoscopic
cholecystectomy due to cholelithiasis at the General Surgery Clinic of Ankara Numune Training
and Research Hospital. All patients’ demographic data, previous history of cholecystitis, a history
of chronic illness, preoperative white blood count (WBC), liver function tests (AST, ALT),
amylase and lipase levels, intra-operative adhesion score, the ultrasonographic appearance of gall
bladder, duration of hospital stay, duration of operation, thiol disulfide and IMA values were
evaluated.
Results:
Native thiol and total thiol averages were higher in patients without a history of
cholecystitis, and on the other hand, disulfide, disulfide/native thiol rate, disulfide/total thiol rate,
native thiol/total thiol rate and IMA averages were higher in patients with a history of cholecystitis.
While there was a statistically significant negative correlation between native and total thiol values
and age, duration of surgery and duration of hospital stay; IMA, disulfide, disulfide/Total thiol,
Native/Total thiol and disulfide/Native thiol rates were higher in older patients with a longer
duration of surgery and hospital stay. In addition, preoperative IMA, disulfide, disulfide/Total
thiol, Native/Total thiol and disulfide/Native thiol were observed to increase as the degree of
intraoperative pericholecystic adhesion increased.
Conclusion:
We believe that the evaluation of thiol disulfide homeostasis and IMA parameters
prior to laparoscopic cholecystectomy can be used as an effective method for predicting
intraoperative difficulties.
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Affiliation(s)
- Gökhan Akkurt
- Ankara City Hospital, General Surgery Universiteler, 1604. Cd. No: 9 D: No: 9, 06800, Ankara, Turkey
| | - Burcu Akkurt
- Mengen State Hospital, Family Medicine Department, Bolu, Turkey
| | - Emel Alptekın
- Ladik State Hospital, Family Medicine Department, Samsun, Turkey
| | - Birkan Birben
- Ankara City Hospital, General Surgery Department, Ankara, Turkey
| | - Mehmet Keşkek
- Ankara City Hospital, General Surgery Department, Ankara, Turkey
| | - Özcan Erel
- Yildirim Beyazit University Faculty of Medicine, Biochemistry Department, Ankara, Turkey
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Yardimci A, Akkoc RF, Tektemur A, Ulker N, Kaya Tektemur N, Erdem Guzel E, Canpolat S, Ozan IE. Chronic Maternal Tobacco Smoke Exposure and/or Alpha-Lipoic Acid Treatment Causes Long-Term Deterioration of Testis and Sexual Behavior in Adult Male Rats. J Sex Med 2020; 17:1835-1847. [PMID: 32798198 DOI: 10.1016/j.jsxm.2020.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 06/26/2020] [Accepted: 07/01/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Tobacco use during pregnancy is known to have several negative effects on the offspring's reproductive health in the long term. The use of alpha-lipoic acid (ALA) as a dietary supplement during pregnancy has increased greatly in recent years and has been known to have positive effects on various pregnancy outcomes including miscarriage, diabetic embryopathy, preterm delivery, and congenital malformations. AIM To evaluate the effects of tobacco smoke exposure (TSE) on sexual behavior, reproductive parameters, and testicles in adult male rats and to reveal the possible role of ALA administration on these parameters. METHODS Pregnant rats (n = 7 per group) were treated with tobacco smoke (TS), ALA (20 mg/kg), and TS + ALA for a total of 11 weeks. The following parameters were compared with 8 control rats: puberty parameters, sexual behavior; levels of serum gonadotropins and testosterone, total antioxidant status, and total oxidant status; the expression of the apoptotic protease-activating factor-1 and caspase 9 mRNA levels in the testis; and assessment of immunohistochemistry and terminal deoxynucleotidyl transferase dUTP nick end labeling assay of testis. MAIN OUTCOME MEASURE Sexual behavior, changes in puberty parameters, and hormonal and genetic alterations were the outcomes analyzed in this study. RESULTS Maternal TSE caused a significant decrease in the number of intromissions compared to the control group. Similarly, ALA decreased erectile function in sexual behavior by decreasing the number of intromissions and intromission ratio in the ALA group compared to the control group. In addition, TSE and ALA treatment caused an impairment of some consummatory sexual behaviors. Also, in parallel with this inhibitory effect, the age of pubertal onset was significantly delayed in the TS + ALA group compared to other groups. Also, histopathological changes in testicular tissue, oxidative stress markers, apoptotic index, and mRNA levels of apoptosis-related genes increased in all treatment groups. CLINICAL IMPLICATIONS The use of ALA and/or tobacco products during pregnancy may adversely affect the reproductive health of male newborns in the long term. STRENGTHS & LIMITATIONS To the best of our knowledge, this study is the first to show the effects of maternal ALA treatment and/or TSE on the sexual behavior and reproductive parameters in male rats; however, the study is based on an animal model, and the present findings partially reflect the characteristics of human sexual behavior. CONCLUSION Maternal TSE and/or ALA treatment may impair sexual behavior in adulthood in male rats because of testicular damage caused by oxidative stress during gonadal development. Yardimci A, Akkoc RF, Tektemur A, et al. Chronic Maternal Tobacco Smoke Exposure and/or Alpha-Lipoic Acid Treatment Causes Long-Term Deterioration of Testis and Sexual Behavior in Adult Male Rats. J Sex Med 2020;17:1835-1847.
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Affiliation(s)
- Ahmet Yardimci
- Department of Physiology, Faculty of Medicine, Firat University, Elazig, Turkey.
| | - Ramazan Fazil Akkoc
- Department of Anatomy, Faculty of Medicine, Firat University, Elazig, Turkey
| | - Ahmet Tektemur
- Department of Medical Biology, Faculty of Medicine, Firat University, Elazig, Turkey
| | - Nazife Ulker
- Department of Physiology, Faculty of Medicine, Firat University, Elazig, Turkey
| | - Nalan Kaya Tektemur
- Department of Histology and Embryology, Faculty of Medicine, Firat University, Elazig, Turkey
| | - Elif Erdem Guzel
- Department of Midwifery, Faculty of Health Sciences, Mardin Artuklu University, Mardin, Turkey
| | - Sinan Canpolat
- Department of Physiology, Faculty of Medicine, Firat University, Elazig, Turkey
| | - Ibrahim Enver Ozan
- Department of Histology and Embryology, Faculty of Medicine, Firat University, Elazig, Turkey
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Guler Y, Dogan P, Sengul S, Calis H, Karabulut Z. Does Scoring System Help Us in the Diagnosis of Acute Appendicitis? A Prospective Clinical Trial. Indian J Surg 2020. [DOI: 10.1007/s12262-019-02043-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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New Oxidative Stress Markers Useful in the Diagnosis of Acute Appendicitis in Children: Thiol/Disulfide Homeostasis and the Asymmetric Dimethylarginine Level. Pediatr Emerg Care 2020; 36:362-367. [PMID: 29135899 DOI: 10.1097/pec.0000000000001339] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVES The aim of this study was to evaluate 2 new oxidative stress markers, thiol/disulfide homeostasis status and the asymmetric dimethylarginine (ADMA) level, in children with acute appendicitis (AA) and to evaluate their diagnostic utility. METHODS This case-control study included 45 patients with AA and 35 healthy children. Age, sex, white blood cell count, neutrophil-to-lymphocyte ratio, high-sensitivity C-reactive protein (hs-CRP) level, ultrasonographic findings, thiol/disulfide homeostasis parameters (native and total thiol levels, native thiol/total thiol ratios [antioxidant parameters], and disulfide, disulfide/native thiol, and disulfide/total thiol ratios [oxidant parameters]), and the ADMA level were compared between the 2 groups. RESULTS The native and total thiol levels, and the native thiol/total thiol ratio, were significantly lower, and the disulfide level and disulfide/native thiol and disulfide/total thiol ratios significantly higher, in the AA compared with the control group (all P < 0.001). The ADMA level was significantly higher in a perforated versus nonperforated subgroup of AA patients, but the thiol/disulfide homeostasis parameters did not differ significantly between the two subgroups. In addition, the hs-CRP level and appendiceal wall thickness were higher in the perforated subgroup. The thiol/disulfide antioxidant parameters and ADMA level correlated negatively with the white blood cell count, the neutrophil-to-lymphocyte ratio, and the hs-CRP level, in the AA group, but correlated positively with oxidant parameters. The sensitivity and specificity of the disulfide/native thiol and disulfide/total thiol ratios were high when used to diagnose AA, whereas the sensitivity of the ADMA level was high when used to diagnose perforated appendicitis. CONCLUSIONS Thiol/disulfide homeostasis and the ADMA level, together with certain other parameters, may be useful biomarkers of AA in children.
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The Diagnostic Values of Ischemia-Modified Albumin in Patients with Acute Abdominal Pain and Its Role in Differentiating Acute Abdomen. Emerg Med Int 2020; 2020:7925975. [PMID: 32509350 PMCID: PMC7244959 DOI: 10.1155/2020/7925975] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 03/12/2020] [Accepted: 04/13/2020] [Indexed: 12/29/2022] Open
Abstract
Aim The aim of this study was to evaluate the diagnostic value of serum ischemia-modified albumin (IMA) levels in patients presenting to the emergency department with acute abdominal pain and its use in differentiating acute surgical abdomen. Methods This single-center prospective cross-sectional study included 334 adult patients who presented to the emergency department. These consisted of 194 patients (Group 1) with nontraumatic abdominal pain commencing in the preceding week, who were definitely diagnosed and either hospitalized in a specific department or planned for discharge, and a control group of 140 patients (Group 2). Results The mean IMA value of the patients diagnosed with acute appendicitis was statistically significantly higher than that of the control group. The mean IMA value of the patients diagnosed with acute appendicitis, ovarian pathologies, and gastritis-peptic ulcer was statistically significantly higher than that of the nonspecific abdominal pain group. Conclusion Serum IMA levels can be used as a diagnostic marker in patients with acute appendicitis. Furthermore, serum IMA levels in patients presenting to the emergency department with abdominal pain may be indicative of patients requiring surgery or of complicated cases, particularly in terms of acute appendicitis and ovarian pathologies.
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Ulusoy E, Çitlenbik H, Akgül F, Öztürk A, Şık N, Ulusoy O, Küme T, Yılmaz D, Duman M. Is Ischemia-Modified Albumin a Reliable Marker in Accurate Diagnosis of Appendicitis in Children? World J Surg 2019; 44:1309-1315. [PMID: 31820057 DOI: 10.1007/s00268-019-05323-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Acute appendicitis is one of the most common abdominal emergencies. Despite all improvements in diagnostic techniques, there are still ongoing problems as proper diagnosis, misdiagnosis and perforated appendicitis. The aim of this study is to demonstrate the clinical value of IMA in patients with appendicitis and to determine the accurate diagnosis of appendicitis in clinically suspected patients. METHODS Pediatric patients with acute abdominal pain who had the Pediatric Appendicitis Score (PAS) ≥ 7 (n = 109) and a control group of 35 patients were included in this prospective case-control study. Patients were divided into two groups: patients with appendicitis (pathologically confirmed) (n = 78) and no appendicitis (n = 31). No appendicitis included observation patients and negative appendectomy. Serum samples were collected for routine laboratory parameters and IMA before surgery. RESULTS Patients with appendicitis had significantly higher IMA levels than no appendicitis and control groups (p = 0.001 and p < 0.001; respectively). Moreover, patients with negative appendectomy had significantly lower IMA levels than patients with appendicitis (p = 0.009). IMA and PAS were used together, and in the ROC analysis, we obtained 0.81 AUC for PAS and 0.89 AUC for PAS and IMA. CONCLUSION The current study indicated that IMA is a reliable marker for accurate diagnosis of appendicitis. The combination of IMA with PAS score has been shown to facilitate the diagnosis of appendicitis.
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Affiliation(s)
- Emel Ulusoy
- Department of Pediatrics, Division of Pediatric Emergency Care, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Hale Çitlenbik
- Department of Pediatrics, Division of Pediatric Emergency Care, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Fatma Akgül
- Department of Pediatrics, Division of Pediatric Emergency Care, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Ali Öztürk
- Department of Pediatrics, Division of Pediatric Emergency Care, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Nihan Şık
- Department of Pediatrics, Division of Pediatric Emergency Care, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Oktay Ulusoy
- Department of Pediatric Surgery, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Tuncay Küme
- Department of Biochemistry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Durgül Yılmaz
- Department of Pediatrics, Division of Pediatric Emergency Care, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Murat Duman
- Department of Pediatrics, Division of Pediatric Emergency Care, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.
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Sarac F, Yeniocak S, Buyukbese Sarsu S, Sahin K, Yucetas E, Koldas M, Katipoglu B. The diagnostic value of ischaemia-modified albumin in acute abdominal pain. J Paediatr Child Health 2019; 55:1247-1250. [PMID: 30723978 DOI: 10.1111/jpc.14394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 01/06/2019] [Accepted: 01/09/2019] [Indexed: 11/30/2022]
Abstract
AIM The differential diagnosis of paediatric patients admitted to the emergency department presenting with acute abdominal pain may be difficult. This study aims to investigate the diagnostic value of ischaemia-modified albumin (IMA) in the differential diagnosis of acute abdominal pain in children and in distinguishing surgical from non-surgical cases. METHODS The study was conducted with a total of 152 subjects who provided informed consent, including 112 patients admitted to the paediatric emergency department and paediatric surgical clinic and 40 healthy control subjects. Blood samples were collected after initial examination to determine IMA, white blood cell (WBC) and C-reactive protein (CRP) values. RESULTS Mean IMA values of patients with acute appendicitis (AA), perforated appendicitis (PA) and non-specific abdominal pain were significantly higher compared to the control group. Mean IMA values of the AA and PA cases were also significantly higher compared to the group with non-specific abdominal pain. No significant difference was determined in mean IMA between the AA and PA groups. WBC and CRP levels of the AA and PA groups were significantly higher compared to the group with non-specific abdominal pain. CONCLUSION Our study shows that IMA, together with WBC and CRP, may be a biomarker capable of assisting the differential diagnosis of acute abdominal pain in children and distinguishing surgical from non-surgical cases.
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Affiliation(s)
- Fatma Sarac
- Department of Pediatric Surgery, Haseki Research and Education Hospital, Istanbul, Turkey
| | - Selman Yeniocak
- Department of Emergency Medicine, Haseki Research and Education Hospital, Istanbul, Turkey
| | - Sevgi Buyukbese Sarsu
- Department of Pediatric Surgery, Cengiz Gökcek Obstetrics and Children's Hospital, Gaziantep, Turkey
| | - Kamil Sahin
- Department of Pediatrics, Haseki Research and Education Hospital, Istanbul, Turkey
| | - Esma Yucetas
- Department of Biochemistry, Haseki Research and Education Hospital, Istanbul, Turkey
| | - Macit Koldas
- Department of Biochemistry, Haseki Research and Education Hospital, Istanbul, Turkey
| | - Burak Katipoglu
- Department of Emergency Medicine, Ufuk University Faculty of Medicine, Ankara, Turkey
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Hakkoymaz H, Nazik S, Seyithanoğlu M, Güler Ö, Şahin AR, Cengiz E, Yazar FM. The value of ischemia-modified albumin and oxidative stress markers in the diagnosis of acute appendicitis in adults. Am J Emerg Med 2019; 37:2097-2101. [PMID: 30871739 DOI: 10.1016/j.ajem.2019.03.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 02/14/2019] [Accepted: 03/07/2019] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION The present study evaluates the predictive value of such markers as ischemia-modified albumin (IMA), malondialdehyde (MDA) and glutathione peroxide (GSH-Px), in addition to parameters associated with inflammation, oxidative stress and ischemia, playing roles in the pathology of acute appendicitis (AA), including c-reactive protein (CRP), procalcitonin (PCT) and complete blood count (CBC) parameters and their ratios, for the diagnosis of AA in adults. MATERIAL AND METHODS The study included 51 patients with histologically confirmed appendicitis and 45 healthy controls who referred to the emergency care unit between January and June 2018. The appendicitis cases were classified into two groups, as complicated and non-complicated, based on postoperative pathological investigations. RESULTS Of all the appendicitis cases, 68.5% (n = 35) were non-complicated and 31.4% (n = 16) were complicated. IMA (positive LR = 3.0, negative LR = 0.1), GSH-Px (positive LR = 0.5, negative LR = 1.8), MDA (positive LR = 1.8, negative LR = 0.6), CRP (positive LR = 7.2, negative LR = 0.2), PCT (positive LR = 0.7, negative LR = 1.3), WBC (positive LR = 2.9, negative LR = 0.3), neutrophil-lymphocyte ratio (positive LR = 3.2, negative LR = 0.1) thrombocyte lymphocyte ratio (positive LR = 1.6, negative LR = 0.5) and IMA/albumin ratio (positive LR = 3.3, negative LR = 0.1) levels in the appendicitis cases were evaluated by a characteristic receiver operating characteristic (ROC) curve. In addition, IMA levels were significantly higher in the complicated cases (0.40 ± 0.05 AbsU) than in the non-complicated cases (0.29 ± 0.04 AbsU) (p < 0.0001). CONCLUSION Our results showed that IMA (negative LR = 0.1), CRP (positive LR = 7.2, negative LR = 0.2), NLR (negative LR = 0.1) and IMA/albumin ratio (negative LR = 0.1) can serve as important diagnostic biomarkers for AA patients. We therefore believe that before clinically confirming an AA diagnosis, these parameters may be used as diagnostic tools in addition to CBC parameters, CRP levels and radiological imaging studies.
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Affiliation(s)
- Hakan Hakkoymaz
- Kahramanmaraş Sütçü İmam University, Department of Emergency Medicine, Kahramanmaraş 46100, Turkey.
| | - Selçuk Nazik
- Kahramanmaraş Sütçü İmam University, Department of Infectious Disease and Clinical Microbiology, Kahramanmaraş 46100, Turkey
| | - Muhammed Seyithanoğlu
- Kahramanmaraş Sütçü İmam University, Department of Biochemistry, Kahramanmaraş 46100, Turkey
| | - Özlem Güler
- Kahramanmaraş Sütçü İmam University, Department of Emergency Medicine, Kahramanmaraş 46100, Turkey
| | - Ahmet Rıza Şahin
- Kahramanmaraş Sütçü İmam University, Department of Infectious Disease and Clinical Microbiology, Kahramanmaraş 46100, Turkey
| | - Emrah Cengiz
- Islahiye State Hospital, Department of General Surgery, Kahramanmaraş 46100, Turkey
| | - Fatih Mehmet Yazar
- Kahramanmaraş Sütçü İmam University, Department of General Surgery, Kahramanmaraş 46100, Turkey.
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15
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A Study Over Thiol Disulfide Homeostasis in Cord Blood in Women With Gestational Diabetes. J Family Reprod Health 2018; 12:217-222. [PMID: 31239850 PMCID: PMC6581655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Objective: To gain insight into the effect of gestational diabetes mellitus (GDM) on cord blood dynamic thiol/disulfide homeostasis. Materials and methods: A prospective case-control study was carried out for 132 pregnant women (62 GDM, 70 controls). The cord blood samples were collected from all the participants, and the native thiol-disulfide exchanges were examined by means of an automated method enabling to measure thiol-disulfide balance. In addition to investigating shifts in thiol disulfide balance between GDM and healthy pregnancies, we sought to correlate the thiol / disulfide homeostasis parameters with other clinical and laboratory characteristics of patients with GDM and using insulin (n = 19) and on a diet only (n = 43). Results: Disulfide amounts, disulfide/native thiol and disulfide/total thiol rates increased (p < 0.001) while native thiol/total thiol decreased in the cord blood of infants born to diabetic mothers (p < 0.001). Furthermore, the patient group administered with insulin and diet only was compared. Disulfide, Disulfide/Native thiol*100, Disulfide/total thiol*100, Native/total thiol*100 differ significantly according to the results (p < 0.05). Disulfide, Disulfide / native thiol * 100, Disulfide/total thiol*100, HbA1c and 75gr are higher than those in patients who do not use insulin. Only Native/total thiol*100 values are higher in patients who use insulin than those who do not. Conclusion: This study suggests that the infants born to diabetic mothers are exposed to increased oxidative stress. In addition, the patients who use insulin better control their blood glucose, thus reducing the need of newborns for intensive care.
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Mijatović S, Alempijević T, Stefanović B, Jeremić V, Krstić S, Radmanović N, Jovanović S, Stefanović B. Influence of Syrgical Trauma on Nitric Oxide and Nitrotyrosine Serum Levels in Patients Undergoing Laparoscopic Or Conventional Cholecystectomy. J Med Biochem 2017; 36:171-176. [PMID: 28680361 PMCID: PMC5471650 DOI: 10.1515/jomb-2017-0004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 12/22/2016] [Indexed: 11/15/2022] Open
Abstract
Background Oxidative stress represents tissue damage caused by reactive forms of oxygen and nitrogen due to the inability of antioxidant mechanisms to reduce reactive forms into more stable ones. The aim of the study was to evaluate the influence of surgical trauma on nitric oxide (NO) and nitrotyrosine (NT) values in patients undergoing conventional and laparoscopic cholecystectomy. Methods A prospective study included sixty patients from the Department of Emergency Surgery, Clinical Centre of Serbia who were operated for gallstone related chronic cholecystitis. All the patients enrolled in the study underwent cholecystectomy; the first group was operated conventionally (30 patients – control group), while the second group was operated laparoscopically (30 patients – treatment group). Results There were no statistically significant differences in the values of NO and its postoperative changes in both groups, the conventionally operated group (p=0.943) and the laparoscopically operated group (p=0.393). We found an increase in NT values 24 hours postoperatively (p=0.000) in the conventionally operated patients, while in the group operated laparoscopically we didn’t find statistically significant changes in the values of NT (conventionally operated group (p=0.943) and laparoscopically operated group (p=0.393)). Conclusions In our study, we found a significant increase in NT values 24 hours postoperatively in conventionally operated patients i.e. the control group, vs. the treatment group. Further randomized studies are needed for a better understanding of the impact of surgical trauma on oxidative stress response.
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Affiliation(s)
- Srdjan Mijatović
- Clinic for Emergency Surgery, Clinical Centre of Serbia, Belgrade, Serbia.,School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Tamara Alempijević
- School of Medicine, University of Belgrade, Belgrade, Serbia.,Clinic for Gastroenterology and Hepatology, Clinical Centre of Serbia, Belgrade, Serbia
| | - Branislava Stefanović
- School of Medicine, University of Belgrade, Belgrade, Serbia.,Department of Anesthesiology, Clinical Centre of Serbia, Belgrade, Serbia
| | - Vasilije Jeremić
- Clinic for Emergency Surgery, Clinical Centre of Serbia, Belgrade, Serbia.,School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Slobodan Krstić
- Clinic for Emergency Surgery, Clinical Centre of Serbia, Belgrade, Serbia.,School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Nikola Radmanović
- Clinic for Emergency Surgery, Clinical Centre of Serbia, Belgrade, Serbia
| | - Sanja Jovanović
- Clinic for Emergency Surgery, Clinical Centre of Serbia, Belgrade, Serbia
| | - Branislav Stefanović
- Clinic for Emergency Surgery, Clinical Centre of Serbia, Belgrade, Serbia.,School of Medicine, University of Belgrade, Belgrade, Serbia
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17
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Kılıç MÖ, Güldoğan CE, Balamir İ, Tez M. Ischemia-modified albumin as a predictor of the severity of acute appendicitis. Am J Emerg Med 2016; 35:92-95. [PMID: 27769665 DOI: 10.1016/j.ajem.2016.10.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 10/04/2016] [Accepted: 10/04/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The early prediction of gangrenous/perforated appendicitis is of great importance for the surgical planning, further treatments, and predicting the course of disease. Ischemia-modified albumin (IMA) was previously reported as a biomarker of various ischemia-based diseases. Our aim is to determine the predictive value of serum IMA in the severity of acute appendicitis. METHODS Sixty-two patients who underwent urgent appendectomy were included in the study. Plasma level of IMA was measured after diagnosis and before treatment. All patients were classified as noncomplicated (acute) appendicitis and complicated (gangrenous/perforated) appendicitis according to histopathological findings, and comparisons were made between the groups. RESULTS The data of 62 patients with a mean age of 30.1 years were statistically evaluated. The pathological diagnoses were acute appendicitis in 33 (53.2%), and gangrenous/perforated appendicitis in 29 (46.8%) patients. There were significant differences in computed tomography (CT) findings (P = .031) and IMA (P = .012) levels between the groups. A strong positive correlation between IMA levels and CT findings was also found (Spearman ρ = +0.688, P = .003). CONCLUSIONS The IMA can be considered as a novel and useful marker to distinguish gangrenous/perforated appendicitis from noncomplicated appendicitis. The correlation of IMA with CT findings also enhances the predictive value of IMA.
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Affiliation(s)
- Murat Özgür Kılıç
- Department of General Surgery, Numune Training and Research Hospital, Ankara, Turkey.
| | - Cem Emir Güldoğan
- Department of General Surgery, Numune Training and Research Hospital, Ankara, Turkey
| | - İlhan Balamir
- Department of Biochemistry, Numune Training and Research Hospital, Ankara, Turkey
| | - Mesut Tez
- Department of General Surgery, Numune Training and Research Hospital, Ankara, Turkey
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A Novel Oxidative Stress Mediator in Acute Appendicitis: Thiol/Disulphide Homeostasis. Mediators Inflamm 2016; 2016:6761050. [PMID: 27642237 PMCID: PMC5011529 DOI: 10.1155/2016/6761050] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 07/06/2016] [Accepted: 07/19/2016] [Indexed: 11/17/2022] Open
Abstract
Aim. To investigate the role of a novel oxidative stress marker, thiol/disulphide homeostasis, in patients diagnosed with acute appendicitis (AA). Methods. In this study, seventy-one (43 male and 28 female) patients diagnosed with AA and 71 (30 male and 41 female) healthy volunteers were included. Age, gender, body mass index (BMI), haemoglobin (Hb), white blood cell (WBC), c-reactive protein (CRP), and thiol/disulphide homeostasis parameters (native thiol, total thiol, disulphide, disulphide/native thiol, native thiol/total thiol, and disulphide/total thiol ratios) were compared between the groups. Thiol/disulphide homeostasis was determined by a newly developed method by Erel and Neselioglu. Results. The native thiol, total thiol, and the native thiol/total thiol ratio levels were statistically significantly decreased in the AA compared with the control group (p < 0.001). Disulphide level and the ratios of disulphide/native thiol and disulphide/total thiol were higher in the AA group than in the control group (p < 0.001). There was a negative correlation of CRP with native thiol, total thiol, and native thiol/total thiol ratio while there was a positive correlation of CRP with disulphide/native thiol and disulphide/total thiol in the AA group. In the stepwise regression model, risk factors as disulphide/native thiol (OR = 1.368; p = 0.018) and CRP (OR = 1.635; p = 0.003) were determined as predictors of perforated appendicitis compared to the nonperforated group. Conclusion. This is the first study examining the thiol/disulphide homeostasis as a diagnostic aid in AA and establishing thiol/disulphide homeostatis balance shifted towards the disulphide formation due to thiol oxidation. Further studies are needed to optimize the use of this novel oxidative stress marker in AA.
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Aktimur R, Gokakin AK, Deveci K, Atabey M, Topcu O. Oxidative stress markers in laparoscopic vs. open appendectomy for acute appendicitis: A double-blind randomized study. J Minim Access Surg 2016; 12:143-7. [PMID: 27073307 PMCID: PMC4810948 DOI: 10.4103/0972-9941.156203] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Oxidative stress is a complicated process, which was defined as an increase in prooxidants and decrease in antioxidants caused by various mechanisms, including inflammation and surgical trauma. The association between acute appendicitis and oxidative stress has been showed in previous studies. However, comparison of oxidative stress in laparoscopic or open appendectomy (OA) has not been established. PATIENTS AND METHODS Patients who were diagnosed as acute appendicitis between October 2012 and January 2013 were randomized to open (OA, n = 50) and laparoscopic appendectomy (LA, n = 50). Blood samples for oxidative stress markers (total oxidant status [TOS] and total antioxidant status [TAS]), C-reactive protein (CRP) and white blood cells (WBC's) were collected just before the surgery and 24 h after surgery. RESULTS There were no differences in preoperative values of WBC and CRP between LA and OA groups (P = 0.523 and 0.424), however, in postoperative 24(th) h, CRP was reduced in LA group (P = 0.031). There were no differences in preoperative levels of TOS, TAS, and oxidative stress index (OSI) between LA and OA groups. In the postoperative 24(th) h, TOS and OSI were found to be significantly higher in OA group when compared to LA group (P = 0.017 and 0.002) whereas no difference was detected in TAS level in the postoperative 24(th) h (P = 0.172). CONCLUSIONS This double-blind, randomized clinical trial provides evidence that LA for uncomplicated appendicitis is associated with significantly lower oxidative stress compared with OA. Some of the advantages of LA may be attributed to the significant reduction of oxidative stress in these patients.
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Affiliation(s)
- Recep Aktimur
- Department of General Surgery, Samsun Training and Research Hospital, Samsun, Turkey
| | - Ali Kagan Gokakin
- Department of General Surgery, Cumhuriyet University, School of Medicine, Sivas, Turkey
| | - Koksal Deveci
- Department of Biochemistry, Cumhuriyet University, School of Medicine, Sivas, Turkey
| | - Mustafa Atabey
- Department of General Surgery, Cumhuriyet University, School of Medicine, Sivas, Turkey
| | - Omer Topcu
- Department of General Surgery, Cumhuriyet University, School of Medicine, Sivas, Turkey
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20
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Bozlu G, Taskinlar H, Unal S, Alakaya M, Nayci A, Kuyucu N. Diagnostic value of red blood cell distribution width in pediatric acute appendicitis. Pediatr Int 2016; 58:202-5. [PMID: 26273790 DOI: 10.1111/ped.12805] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Revised: 07/22/2015] [Accepted: 08/10/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND The aim of this study was to evaluate the diagnostic value of red blood cell distribution width (RDW) in children with acute appendicitis. METHODS In this retrospective study, a total of 344 children aged ≤18 years with clinically suspected acute appendicitis who underwent appendectomy between January 2007 and January 2014 were reviewed, and 200 healthy controls of the same age group were included. Based on histopathology, the patients were classified as having normal appendix, simple or perforated appendicitis, and preoperative white blood cell count (WBC), C-reactive protein (CRP) and RDW were compared. RESULTS Compared with the controls, mean WBC, CRP and RDW were significantly higher in the appendectomy group (P <0.001). The children with simple or perforated appendicitis had significantly higher WBC, CRP and RDW than did those with normal appendix (P <0.001). Mean WBC and CRP were significantly higher in the children with perforated appendicitis (P <0.001), but no statistically significant difference was found in RDW between the simple and perforated appendicitis groups (P = 0.081). CONCLUSIONS Children with histologically proven acute appendicitis have higher RDW than children without appendicitis, but the diagnostic value of RDW was not superior to WBC or CRP in children with acute appendicitis. Although higher RDW may be valuable for aiding the diagnosis of acute appendicitis in children, it is not a useful marker for predicting perforated appendicitis.
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Affiliation(s)
- Gulcin Bozlu
- Department of Pediatrics, University of Mersin Faculty of Medicine, Mersin, Turkey
| | - Hakan Taskinlar
- Department of Pediatric Surgery, University of Mersin Faculty of Medicine, Mersin, Turkey
| | - Selma Unal
- Department of Pediatrics, University of Mersin Faculty of Medicine, Mersin, Turkey.,Division of Pediatric Hematology, University of Mersin Faculty of Medicine, Mersin, Turkey
| | - Mehmet Alakaya
- Department of Pediatrics, University of Mersin Faculty of Medicine, Mersin, Turkey
| | - Ali Nayci
- Department of Pediatric Surgery, University of Mersin Faculty of Medicine, Mersin, Turkey
| | - Necdet Kuyucu
- Department of Pediatrics, University of Mersin Faculty of Medicine, Mersin, Turkey.,Division of Pediatric Infectious Diseases, University of Mersin Faculty of Medicine, Mersin, Turkey
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Reddy VS, Perugu B, Garg MK. Ischemia-modified albumin must be evaluated as an oxidative stress marker together with albumin and bilirubin in individuals with acute appendicitis. Clinics (Sao Paulo) 2015; 70. [PMID: 26222824 PMCID: PMC4496749 DOI: 10.6061/clinics/2015(07)11] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Affiliation(s)
| | - Balananda Perugu
- Department of Physiology, Gitam Institute of Medical Sciences and Research, Andhra Pradesh, India
| | - Mohinder Kumar Garg
- Department of General Surgery, BPS Government Medical College, Haryana, India
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