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Purpose: One of the most widespread surgical conditions is acute appendicitis in industrialized countries. Nevertheless, diagnosis of borderline cases is mostly troublesome and needs subsequent researches. For this reason, we aimed to investigate new parameters to improve estimation of acute appendicitis. Lymphoid hyperplasia, impacted stool, faecolith, caecal or appendiceal tumors have been accepted as causes of appendicitis formation, but anatomic variations of diameter of ileocecal lipomatosis and ileocecal angle have been never discussed before. The aim of this study was to assess the relationship between appendicitis and diameter of ileocecal lipomatosis and ileocecal angle. Materials and methods: 96 Patients (51 women, 45 men) who were found to have acute appendicitis during exploration and 67 patients (32 women, 35 men) who were not pre-diagnosed with acute appendicitis were enrolled in the study. The diameter of ileocecal lipomatosis and also ileocecal angle values were obtained via computed tomography (CT) scans. Results: There were no significant differences between two groups in the mean of ileocecal angle (p > 0.05) but diameter of ileocecal lipomatosis values was significantly higher in the appendicitis-positive group compared with the appendicitis-negative group (p: 0.001). Conclusions: There is a relationship between increase in diameter of ileocecal lipomatosis and appendicitis formation. © 2019, Springer-Verlag France SAS, part of Springer Nature.

Data examining the association between vitamin D and diabetic peripheral neuropathy are limited. This study investigated the serum levels of vitamin D, vitamin D-binding protein (VDBP), and vitamin D receptor (VDR) in diabetics in the Yozgat region of Turkey, and assessed their relationships with diabetic peripheral neuropathy. 69 diabetic patients and 49 age- and sex-matched control subjects were enrolled in this clinical prospective study. All the diabetics underwent conventional sensory and motor nerve conduction studies, and diabetic peripheral neuropathy was confirmed or ruled out according to the electromyography findings and Douleur Neuropathique 4 questions. Serum vitamin D, VDBP and VDR levels were measured using commercial enzyme-linked immunosorbent assay kits. The serum vitamin D levels (p = 0.001) were significantly lower, while the VDR levels (p = 0.003) were higher, in diabetics than in controls. The serum VDBP levels were similar in both groups (p > 0.05). The serum vitamin D levels were significantly lower in diabetics with diabetic peripheral neuropathy than in those without (p = 0.032), whereas the serum VDBP and VDR levels were similar in these two groups (p > 0.05). The lower serum vitamin D levels in diabetics, especially in those with peripheral neuropathy, may suggest a neurotrophic effect of vitamin D.

We report here an instrument designed by Dr Hasan Börekci that provides support to the knot to facilitate knot tying in laparoscopic procedures. We call the device the 'Börekci knot-supporting instrument' and the technique 'Börekci's knot technique'. Materials and methods: To evaluate the efficacy of this instrument, 17 surgeons performing laparoscopic surgery tied 3 knots using the classical intracorporeal method and then using the intracorporeal knot-supporting instrument. The times required to tie each knot were recorded and compared statistically. Results: Comparing the 2 knotting methods, the time spent tying the knots was shorter with the knot-supporting instrument in all 3 trials and the difference was significant (P = 0.026) in the third trial. Conclusion: This alternative technique can be used for all knots in laparoscopic surgery when classical intracorporeal knotting is difficult.

Rivaroxaban is one of the new anti-coagulants that inhibit Factor Xa and rarely cause rectus sheath hematoma and retroperitoneal haemorrhage which are uncommon, life-threatening complications. Here is a case of an elderly patient on rivaroxaban therapy for the stroke prevention in non-valvular atrial fibrillation who developed rectus sheath hematoma and retroperitoneal bleeding.Keywords: Rectus sheath hematoma, retroperitoneal bleeding, rivaroxaban.

WOS:000335444500041 PubMed: 26060490 Background: Atrial fibrillation (AF) is the most common cardiac arrhythmia and increases the risk of stroke and death. Patients with hypertensive have an increased risk of developing atrial fibrillation. RDW (Red blood cell distribution width) levels are elevated in cardiovascular disorders including heart failure, stable coronary disease, acute coronary syndrome, slow coronary flow and stroke. Objective: We aimed to investigate the relation between RDW and AF in patients with hypertensive Method: We retrospectively examined 126 consecutive hypertensive patients (63 hypertensive patients with AF and 63 hypertensive patients without AF matched with age and sex Results: The mean age of the study population was 71,09 +/- 8,50 (af group) and 70,97 +/- 8,24 (non-af group) years. RDW level was different among patients with atrial fibrillation and without atrial fibrillation.(15,13 +/- 1,58 and 14,05 +/- 1,15 p

Evidence suggests that migraine is associated with metabolic syndrome, which is also implicated in non-alcoholic fatty liver disease (NAFLD). Reported for the first time, we aimed to investigate the relationship between migraine and NAFLD in patients with migraine. A total of 90 consecutive migraine patients were enrolled in this cross-sectional study. The diagnosis of migraine was determined according to the International Classification of Headache Disorders-II diagnostic criteria. The diagnosis of NAFLD was based on abdominal ultrasonography findings. Anthropometric indices and the homeostasis model assessment of insulin resistance (HOMA-IR) were calculated, and serum insulin level measurements and other biochemical analyses were performed for each subject. The measurements of body mass index and waist circumference were significantly higher in migraine patients with NAFLD than in those without NAFLD (p0.001). Regarding the laboratory results, insulin (p = 0.024), alanine aminotransferase (p = 0.027), and triglyceride levels (p = 0.001) and the HOMA-IR (p = 0.039) were higher in migraineurs with NAFLD than in those without NAFLD. Among the headache characteristics, the presence of aura was higher, and disease and attack durations were significantly longer in migraineurs with NAFLD than in those without NAFLD (p = 0.005, p = 0.024, and p = 0.023; respectively). However, the headache characteristics did not correlate with either the hepatosteatosis grade or HOMA-IR in migraine patients (p0.05). Our results show that NAFLD may present in migraine patients with higher frequency of auras and longer disease and attack durations.

Evidence suggests that peripheral nerve injury occurs during the early stages of disease with mild glycemic dysregulation. Two proteins, neuron-specific enolase (NSE) and neurofilament light chain (NFL), have been examined previously as possible markers of neuronal damage in the pathophysiology of neuropathies. Herein, we aimed to determine the potential value of circulatory NSE and NFL mRNA levels in prediabetic patients and in those with peripheral neuropathy. This prospective clinical study included 45 prediabetic patients and 30 age- and sex-matched controls. All prediabetic patients were assessed with respect to diabetes-related microvascular complications, such as peripheral neuropathy, retinopathy and nephropathy. mRNA levels of NSE and NFL were determined in the blood by real-time polymerase chain reaction. NSE mRNA levels were similar between prediabetic and control groups (p0.05), whereas NFL mRNA levels were significantly higher in prediabetics than in controls (p0.001). NSE mRNA levels did not significantly differ between prediabetic patients with and without peripheral neuropathy (p0.05), while NFL mRNA levels were significantly higher in prediabetics with peripheral neuropathy than in those without (p = 0.038). According to correlation analysis, NFL mRNA levels were positively correlated with the Douleur Neuropathique 4 questionnaire score in prediabetic patients (r = 0.302, p = 0.044). This is the first study to suggest blood NFL mRNA as a surrogate marker for early prediction of prediabetic peripheral neuropathy, while NSE mRNA levels may be of no diagnostic value in prediabetic patients.

BACKGROUND: Blood neutrophil‐to‐lymphocyte (N/L) ratio is an indicator of the overall inflammatory status of the body, and an alteration in N/L ratio may be found in patients with familial Mediterranean fever (FMF). The aim of this study was to investigate the interrelationship between N/L ratio and FMF. METHODS: One hundred and fifteen patients and controls were enrolled in the study. The cases in the study were categorized as FMF with attack, FMF with attack‐free period, and controls. The neutrophil and lymphocyte counts were recorded, and the N/L ratio was calculated from these parameters. All patients were diagnosed according to Tel Hashomer criteria. RESULTS: A total of 79 FMF patients were included in the study and all subjects were receiving colchicine treatment at the time. The serum N/L ratios of active patients were significantly higher than those of attack‐free FMF patients and controls (P < 0.001). The optimum N/L ratio cut‐off point for active FMF was 2.63 with sensitivity, specificity, positive predictive value, and negative predictive value of 0.62 (0.41–0.80), 0.85 (0.72–0.93), 0.67 (0.44–0.85), and 0.82 (0.69–0.91), respectively. The overall accuracy of the N/L ratio in determination of FMF patients during attack was 71%. CONCLUSION: Our results demonstrate that N/L ratio is higher in patients with active FMF compared with FMF patients in remission and controls, and a cut‐off value of 2.63 can be used to identify patients with active FMF.

Background/aim: The possibility of adverse effects of the oral glucose tolerance test (OGTT) carried out for the screening of gestational diabetes among pregnant women and fetuses is a frequently discussed topic. The purpose of this study was to investigate the effects of the hyperglycemia peak during OGTT on the levels of oxidants and antioxidants in the body.Materials and methods: Eighty individuals who applied to the Outpatient Clinic with suspected diabetes and OGTT indication were included in the study. Glucose, total oxidant capacity status (TOS), total antioxidant capacity (TAS), superoxide dismutase (SOD), and lipid hydroperoxide (LOOH) levels were tested on blood samples collected from these individuals at 0, 60, and 120 min during the OGTT carried out with 75 g of glucose. Oxidative stress index (OSI) was calculated as the ratio of TOS to TAS.Results: While the oxidative parameters TOS and LOOH were significantly increased at 60. min of OGTT, only LOOH was significantly increased at 120. min of OGTT. Significant decreases in antioxidative parameters (TAS, SOD) were observed at 60. and 120. min of the OGTT and OSI was significantly increased at 60. and 120. min of the OGTT.Conclusion: Oxidative stress parameters were increased and antioxidative parameters were decreased during the OGTT. However, more extended studies are required to determine the effects of the increased oxidative stress on pregnant women and fetuses.