Can inflammatory indexes predict the spontaneous passage of common bile duct stones?

OBJECTIVES: We aimed to determine whether inflammatory indexes (II), including the neutrophil-lymphocyte ratio (NLR), the C-reactive protein (CRP) to albumin ratio (CAR), the CRP-lymphocyte ratio (CLR), and the systemic immune-inflammation index (SIII) can be diagnostic for common bile duct stones (CBDSs) excretion before endoscopic retrograde cholangiopancreatography (ERCP). BACKGROUNDS: Because of the spontaneous clearance, it is mandatory to ascertain the presence of CBDSs before ERCP. METHODS: Retrospectively, we evaluated two groups. Group A included 96 records in which CBDSs existed in magnetic resonance cholangiopancreatography (MRCP) and ERCP. Group B included 36 records in which CBDSs existed in MRCP but not ERCP. IIs were calculated on presentation and before ERCP. RESULTS: Stone detection in ERCP had a 3.992-fold (95% 1.769-9.007) higher probability with a stone larger than 3.25 mm in MRCP. Before ERCP, CAR, and CLR values were higher in group A than in group B (3.88 [1.25-14.14] and 1.24 [0.50-9.66], p = 0.027 versus 8.79 [2.19-35] and 2.67 [1.02-20.05], p = 0.029, respectively). Higher CRP, CAR, and CLR values were considered significant for detecting a stone in ERCP (AUC: 0.627 [0.519-0.739], 0.625 [0.513-0.737], and 0.624 [0.514-0.734], respectively). CONCLUSION: Low CRP, CAR, and CLR values might associate with the spontaneous migration of CBDS.

Pentoxifylline has favorable preventive effects on experimental chronic pancreatitis model.

Background: To investigate the protective efficacy of pentoxifylline through biochemical parameters and histopathological scores in a caerulein- and alcohol-induced experimental model of chronic pancreatitis in rats.Methods: A model of chronic pancreatitis with caerulein and alcohol was created in female rats of the genus Sprague Dawley. Pentoxifylline was administered in doses of 25 mg/kg (low dose) and 50 mg/kg (high dose) as a protective agent. Each group contained 8 animals. The groups were: group 1 (control group); caerulein + alcohol, group 2 (low-dose pentoxifylline group); caerulein + alcohol + pentoxifylline 25 mg/kg, group 3 (high-dose pentoxifylline group); caerulein + alcohol + pentoxifylline 50 mg/kg, group 4 (placebo); caerulein + alcohol + saline, group 5 (sham group); only saline injection.Rats were sacrificed 12 h after the last injection, and TNF-α, TGF-ß, MDA, and GPx concentrations were measured in blood samples. The histopathologic examination was conducted by a pathologist who was unaware of the groups.Results: The biochemical results of the treatment groups (group 2 and group 3) were statistically significantly lower compared with the control group (group 1) (p < .05). The difference between the low-dose treatment group (group 2) and high-dose treatment group (group 3) was significant in terms of biochemical parameters (p < .05). The difference between group 2 and the control group was not significant in terms of histopathologic scores (p > .05), whereas the difference between the group 3 and the control group was statistically significant (p < .05).Conclusions: As a result, pentoxifylline, which has anti-inflammatory and antioxidant properties, was shown to have protective efficacy in an experimentally generated model of chronic pancreatitis.

Golimumab Ameliorates Pancreatic Inflammatory Response in the Cerulein-Induced Acute Pancreatitis in Rats.

BACKGROUND: The aim of the study was to evaluate whether a new and successful treatment opportunity can be provided in acute pancreatitis and may prevent symptomatic treatments and show its effect through etiopathogenesis. Therefore, we want to investigate the efficacy of golimumab in an experimental rat model of cerulein-induced acute pancreatitis. METHODS: A total of 35 rats, including 7 rats in each group, were distributed into 5 groups (sham, acute pancreatitis, placebo, acute pancreatitis+golimumab 5 mg/kg, and acute pancreatitis+golimumab 10 mg/kg). An experimental cerulein-induced acute pancreatitis model was accomplished by intraperitoneal cerulein injections. After sacrification, rat blood samples were collected for amylase, IL-6, and IL-1beta measurements. Histopathological analysis of the pancreas was performed with Tunel and hematoxylin and eosin staining. RESULTS: Amylase, IL-6, and IL-1beta levels were found to be increased in the acute pancreatitis group. IL-1beta, amylase, IL-6 levels, and pancreatic inflammation were all significantly decreased in golimumab groups (P < .01). Moreover, in both golimumab groups, golimumab treatment significantly reduced apoptosis in pancreatic tissues (P < .05). Golimumab treatment was found to significantly reduce edema formation, inflammation, vacuolization, and fat necrosis of pancreatic tissues (P < .05). CONCLUSION: Firstly in the literature, we investigated the efficacy of golimumab in the experimental acute pancreatitis model. In the light of our findings, it could be suggested that golimumab may be an effective and safe therapeutic option in the treatment of patients with acute pancreatitis.

Evaluation of N/LP Ratio as a Predictor of Disease Progression and Mortality in COVID-19 Patients Admitted to the Intensive Care Unit.

Objective: This research aimed to evaluate whether the neutrophil to lymphocyte and platelet (N/LP) ratio may be used to predict the risk of admission to the intensive care unit (ICU), the need for mechanical ventilation and in-hospital mortality in Coronavirus disease 2019 (COVID-19) cases. Methods: The study was conducted retrospectively on the data of 134 COVID-19 patients who were admitted to the ICU. The N/LP ratio was calculated as follows: neutrophil count x 100 / (lymphocyte count x platelet count). Each member of the research cohort was categorised into 1 of 2 groups based on their survival status (survivor and non-survivor groups). Results: In total, 82 (61%) patients died during the ICU stay. Patients who required mechanical ventilation and died in the ICU stay had significantly higher N/LP ratio than those who did not require it and survived [10 (IQR=4.94-19.38) vs 2.51 (IQR=1.67-5.49), p<0.001] and [11.27 (IQR=4.53-30.02) vs 1.65 (IQR=1-3.24), p<0.001], respectively. The N/LP ratio was linked with the requirement of mechanical ventilation and in-hospital death according to multivariable analysis. In receiver operating characteristic curve analysis, we found that N/LP in predicting admission to the ICU was >4.18 with 61% sensitivity and 62% specificity, it was >5.07 with 74% sensitivity and 73% specificity for the need for mechanical ventilation, and >3.69 with 81% sensitivity and 81% specificity to predict in-hospital death. Conclusion: To our knowledge, this is the first study showing that the N/LP ratio, which is a novel and widely applicable inflammatory index, may be used to predict the risk of ICU admission, mechanical ventilation and in-hospital death in patients with COVID-19 disease.

Presepsin:albumin ratio and C-reactive protein:albumin ratio as novel sepsis-based prognostic scores : A retrospective study.

OBJECTIVE: To investigate the prognostic value of the presepsin:albumin ratio and C­reactive protein:albumin ratio in patients with sepsis in the intensive care unit (ICU). METHODS: A total of 228 (129 males and 99 females) patients with newly diagnosed sepsis were included in the study. The relationship between the C­reactive protein:albumin ratio, presepsin:albumin ratio, clinicopathologic parameters, and overall survival were investigated. The associations between C­reactive protein:albumin ratio and presepsin:albumin ratio were evaluated alongside other inflammation-based prognostic scores such as quick Sepsis Related Organ Failure Assessment (qSOFA). RESULTS: The presepsin:albumin ratio was significantly higher in non-survivors (p < 0.01). Patients with a high presepsin:albumin ratio had worse overall survival compared with patients with high C­reactive protein:albumin ratio levels (p < 0.001). CONCLUSION: Presepsin and presepsin:albumin ratio are markers of adverse prognosis in patients with sepsis and are superior to C­reactive protein and C­reactive protein:albumin ratio for this purpose. Presepsin:albumin ratio may be a novel marker of poor prognosis in patients with sepsis in intensive care units.