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The neutrophil-lymphocyte ratio (NLR) is a prognostic marker predicting in-hospital mortality and stent patency in vascular disorders. This study aimed to investigate whether the NLR obtained at admission can be used to predict vascular remodelling outcomes in spontaneous isolated superior mesenteric dissection (SISMAD) patients.

A total of 109 consecutive SISMAD patients, admitted to a single centre between November 2017 and June 2019, were retrospectively enrolled. Demographics, comorbidities, imaging data, and follow-up results were recorded. NLR at admission was calculated from a routine hemogram. The study endpoint was complete vascular remodelling or follow-up deadline. Patients were divided into two groups complete vascular remodelling (Group 1) and partial vascular remodelling (Group 2). All parameters, including NLR, were compared between the groups. Multivariate logistic regression analysis determined whether NLR is independent of vascular remodelling in SISMAD patients after conservative treatment.

Complete vascular remodelling of SISMAD occurred in 26 patients (23.9%) and partial remodelling in 83 patients (76.1%). Baseline NLR was significantly higher in the partial remodelling group than in the complete remodelling group [(6.32±2.10) vs. (4.90±2.12), p=0.003]. Complete remodelling was higher in the low NLR group than in the high NLR group [(15, 34.1%) vs. (11, 16.9%), p=0.039]. NLR (odd ratio [OR], 1.631; 95% confidence interval [CI], 1.027-2.592; p=0.038) and superior mesenteric artery-distal aorta angle (OR, 9.246; 95% CI, 2.217-38.560; p=0.002) were independent predictors of complete remodelling in multivariate logistic regression analysis. From the receiver operating characteristic curve, the best NLR cut-off value to predict complete vascular remodelling was 5.37, with 72.3% sensitivity and 69.2% specificity.

The inflammation marker NLR may predict worse vascular remodelling in SISMAD patients.

The inflammation marker NLR may predict worse vascular remodelling in SISMAD patients.

Timely intervention is the key to the successful management of penetrating injuries to jugular veins; however, the optimal clinical management of these perforations and associated risk factors for mortality are not fully established. This study examined the trauma characteristics, vital signs, and in-hospital mortality in penetrating external and internal jugular vein injuries (PEJVI and PIJVI, respectively).

In this National Trauma Data Bank database study on patients with penetrating jugular vein injuries (PJVIs), details pertaining to demographics, comorbidities, type of injury, mechanism and intent of injury, Injury Severity Score (ISS), vital signs, treatment, and outcome, were abstracted. Multivariate logistic regression was used to identify the risk factors of in-hospital mortality.

A total of 548 patients with PJVIs were included in the final analysis. Patients with PEJVI were more likely to have a self-inflicted injury (p<.001) than those with PIJVI. In both groups, hemorrhage control surgery was performed in almost 60% of the patients within 24 hrs. of the injury (p=.767). Systolic blood pressure (OR 0.99, 95% CI 0.98-1.00, p=.043), Glasgow coma scale (OR 0.88, 95% CI 0.81-0.95, p<.001), ISS (OR 1.10, 95% CI 1.06-1.14, p<.001), and the firearm as a mechanism of injury (OR 2.85, 95% CI 1.19-6.79, p=.018) were found to be independently associated with the risk of in-hospital mortality.

The injury severity, hemodynamic stability, comma scale, intent, and mechanism of injury differed significantly in PEJVI and PIJVI; however, the type of PJVI did not have an independent association with in-hospital mortality.

The injury severity, hemodynamic stability, comma scale, intent, and mechanism of injury differed significantly in PEJVI and PIJVI; however, the type of PJVI did not have an independent association with in-hospital mortality.

We aimed at investigating the effects of clinical data, urgent thoracotomy (UT) indications and results on prognosis and mortality in traumatic and non-traumatic patients who were and underwent UT in the operating room.

Patients (17-90 years old) who were admitted to the Emergency Department of Afyonkarahisar State Hospital between 01.01.2012 and 31.06.2020 with traumatic and non-traumatic reasons requiring UT were retrospectively conducted from the archive. The patients' age, gender, complaints during admission, trauma classification, reports of thorax images, injury sites accompanying trauma, hospitalization and mortality rates were examined. IBM SPSS 22.0 program was used to compare all the data obtained.

During the 90-month study period, a total of 40 patients who were admitted for traumatic and non-traumatic reasons were applied UT. The mean age of all patients (77.5% male, 22.5% female) was 33.35±14.1 years. There were 55% penetrating injuries, 32.5% blunt injuries and 12.5% non-traumatic causes. Indications for UT in the study were; massive hemothorax (25%), diaphragmatic rupture (22.5 %), hypovolemic shock (25%), heart or great vessel injuries (15%), massive air leak despite thoracostomy (10%), rupture of the pulmonary hydatid cyst into the bronchus and accompanying hemoptysis (2.5%). The time to surgical procedure in patients who underwent thoracotomy was shorter in patients with death. Mean time to thoracotomy was 4.5±6.5 hours. Mortality of UT was 20% with survival of 80%.

In the context of indications, urgent thoracotomy reduces mortality. The cooperation between the emergency physician and the thoracic surgeon is important during the decision phase.

In the context of indications, urgent thoracotomy reduces mortality. The cooperation between the emergency physician and the thoracic surgeon is important during the decision phase.

Wilson's Disease (WD) is an autosomal recessive copper overload. Several mutations of the copper pump named ATP7B have been involved. WD is difficult to diagnose mainly because of its heterogeneity of presentation. The histologic spectrum is wide and not specific, ranging from very mild changes to severe disease. The histological picture of WD may overlap different conditions, including ALD, NAFLD, viral hepatitis or autoimmune liver disease.

We describe our experience on WD based on a single-center series of liver biopsies. One-hundred twenty-seven liver samples from 43 Sardinian WD patients were reviewed. The most reported pattern was steatohepatitis, accounting 82/127 biopsies (64.6%), followed by hepatitis in 25 biopsies (19.7%), and steatosis in 20 biopsies (15.7%).

As for the elementary lesions, inflammation, steatosis, glycogenated nuclei and ballooning were the most frequent, being found in 107, 102, 90 and 86 biopsies out of the 127. Notably, all these lesions showed a predominant periportal location. There was no significant difference in the diagnostic pattern or in each elementary lesion between the biopsies performed at presentation and those performed during the follow-up. Lipogranuloma (significantly more numerous in the follow-up biopsies) and fibrosis (likewise significantly progressed in follow-up biopsies) were the only exceptions.

Our data confirm the variability of the histological pattern in WD. However, the preferential localization of steatosis and balloon cells in periportal zone can be a useful clue for the diagnosis of WD.

Our data confirm the variability of the histological pattern in WD. However, the preferential localization of steatosis and balloon cells in periportal zone can be a useful clue for the diagnosis of WD.

Anemia is the hematological issue that occurs most often as a manifestation in RA. The aim of the study was to assess iron deficiency in RA patients.

The study was carried out on 62 RA patients treated between 2016 and 2017.

A higher percentage of RA patients compared to the control group had TSAT below 20% (43% vs. 5%), ferritin below the reference range (15% vs. 7%), sTfR above 1.59 mg/l (26% vs. 0%) and hepcidin below 14.5 ng/ml (56% vs. 2%). 60% of RA patients had iron deficiency, and 18% - anemia. Correlations were found between reduced levels of ferritin and patients being younger, female, with lower GGT and higher platelet counts. Correlations were also found between iron deficiency and patients being younger, female, having reduced hemoglobin, increased platelet counts, increased GFR, reduced GGT, lower disease activity, and less frequent use of sulfasalazine.

Iron deficiency is common (64%) in RA patients where there is high disease activity. RA patients had lower transferrin, lower ferritin, lower hepcidin, and higher sTfR. Decreased DAS-28 and reduced hemoglobin were the strongest determinants of iron deficiency.

Iron deficiency is common (64%) in RA patients where there is high disease activity. RA patients had lower transferrin, lower ferritin, lower hepcidin, and higher sTfR. Decreased DAS-28 and reduced hemoglobin were the strongest determinants of iron deficiency.

The objective of our study is to investigate whether diabetes mellitus could adversely affect post-laparoscopic sleeve gastrectomy (LSG) weight loss.

A retrospectively recorded database of patients who underwent LSG from September 2018 to September 2019 in our Hospital in L'Aquila was analyzed. The post-operative weight loss was evaluated in terms of body mass index (BMI) variation, percentage of excess weight loss (%EWL) and percentage of total weight loss (%TWL). The association between these parameters and diabetes was analyzed at 3 and 6 months of follow-up.

The two groups (patients with and without diabetes) were considered comparable in terms of anthropometric and preoperative parameters. At 3 and 6 months of follow-up, the decrease in BMI resulted to be directly associated with the time and the group. The mean BMI at 3 and 6 months was higher in patients with diabetes. Changes in % EWL and % TWL were similar in both groups.

It is rational to expect a lower weight loss in obese diabetic patients after LSG. Selleck 1-Thioglycerol This should not be considered as a contraindication to bariatric surgery that, being a metabolic surgery, has as main goal the resolution or improvement of co-morbidities.

It is rational to expect a lower weight loss in obese diabetic patients after LSG. This should not be considered as a contraindication to bariatric surgery that, being a metabolic surgery, has as main goal the resolution or improvement of co-morbidities.

Diabetes mellitus is a non-communicable disease (NCD) with metabolic dysfunction that has attained epidemic proportions worldwide. Vascular complications account for the mortality and morbidity associated with diabetes. Hence, the study aimed to estimate the prevalence and risk factors for vascular complications in patients with type 2 diabetes mellitus (T2DM).

A cross-sectional national multistage survey, the Saudi Health Interview Survey (SHIS), was used in this study, which surveyed individuals aged 15 years or older. After inclusion and exclusion criteria, 1240 diabetic patients' data were analyzed for sociodemographic data, risk factors, and prevalence of micro and macrovascular complications. Binary logistic regression with stepwise backward elimination was performed to build the optimal model to assess the determinants of macrovascular complications in diabetic patients. The strength of the associations was examined by estimating adjusted odds ratios (aOR) with their 95% CI. p-value < 0.05 was considered statistically significant.