Epidemiology, Pathophysiology, Diagnosis and Treatment
Peter Sagar, Andrew G. Hill, Charles H. Knowles, Stefan Post, Willem A. Bemelman, Patricia L. Roberts, Susan Galandiuk, John R.T. Monson, Michael R.B. Keighley, Norman S. Williams in Keighley & Williams’ Surgery of the Anus, Rectum and Colon, 2019
The basic laboratory workup for diverticulitis generally includes a complete blood count to identify leucocytosis, which is found in 55% of patients with acute diverticulitis.26 A basic metabolic panel will assess electrolytes and renal function and will be useful if the patient has altered their intake of fluids or nutrition due to symptoms.26 Urinalysis can help exclude urinary tract infection from the differential diagnosis and diagnose colovesical fistula.6,26 Some have used C-reactive protein (CRP) as a means of establishing the diagnosis of diverticulitis. Though it has not been prospectively validated, a CRP level of more than 50 mg/L in conjunction with left lower quadrant tenderness and no vomiting is most consistent with acute diverticulitis (likelihood ratio = 18). One study of 247 patients with acute sigmoid diverticulitis identified by CT observed corresponding increases in CRP level with signs of perforation. Only 20% of the patients with a CRP level of less than 50 mg/L had perforated diverticulitis, whilst 69% of the patients with a CRP level of more than 200 mg/L had perforated diverticulitis.26 Although not the most accurate test, the role of CRP in the evaluation and management of diverticulitis is promising.
Large Bowel Obstruction
Stephen M. Cohn, Matthew O. Dolich, Kenji Inaba in Acute Care Surgery and Trauma, 2016
A thorough laboratory evaluation is useful in determining the patient’s overall clinical status and may suggest intestinal ischemia, necrosis, or perforation. Although no level 1 evidence can be found to support the routine ordering of certain laboratory tests, it is well known that patients with colonic obstruction often present with multiple metabolic derangements requiring correction prior to surgical intervention. A basic metabolic panel and complete blood count should be done to evaluate for electrolyte imbalances, anemia, and leukocytosis. Other useful laboratory values include a lactate if there is concern for ischemia and a coagulation panel for operative preparation. Given that the most common cause of large bowel obstruction is cancer, a baseline carcinoembryonic antigen level may be reasonable. A single upright chest radiograph may be useful to screen for free air if there is a high suspicion for obstruction with perforation.
A “C Odyssey”
Qi Chen, Margreet C.M. Vissers in Vitamin C, 2020
But, before proceeding with such clinical experiments, a key precondition was to know the x-axis range for ascorbic acid concentrations in humans. From a clinical perspective, this is not much different from having normal limits on a basic metabolic panel, a common test in clinical care. However, data were limited or unavailable that described whether and how a wide range of different doses of ascorbic acid modulated plasma and tissue concentrations: pharmacokinetic data [30–33]. Comprehensive pharmacokinetic data of this kind were unavailable not just for ascorbic acid but for all vitamins. Without pharmacokinetic information as a foundation, it would be impossible to consider biosynthetic consequences and clinical outcomes in relation to any ascorbic acid concentration. For clinicians, an analogy would be to try to manage diabetes without prior knowledge of normal and abnormal blood glucose concentrations.
Orbital Inflammatory Syndrome and Anterior Uveitis: A Case Series
Published in Ocular Immunology and Inflammation, 2018
Eric L. Crowell, Alden K. Bahr, Ore-ofe O. Adesina, Ankur A. Kamdar, Kartik S. Kumar, Alla Goldberg
On exam, his visual acuity (VA) was 20/20 OD and 20/70 OS. Pupils were equal, round, and reactive without afferent pupillary defect (APD), and intraocular pressure (IOP) was symmetric and normal to palpation bilaterally. Examination of the right eye was within normal limits. Examination of the left eye revealed periorbital tenderness to palpation, 3+ edema of the upper lid, and trace edema of the lower lid. While extraocular movements (EOMs) were full, he had pain with eye movement, watery discharge, and 2+ conjunctival injection with trace chemosis temporally. Anterior and posterior examinations were unremarkable. CT of the face showed left preseptal soft-tissue swelling and mild postseptal edema without exophthalmos or subperiosteal abscess. The optic nerves and extraocular muscles were normal in size and symmetric. Laboratory work revealed normal basic metabolic panel and complete blood count. He was diagnosed with orbital cellulitis and started on intravenous (IV) ampicillin–sulbactam and vancomycin with mild improvement of his symptoms over the next few days. He was discharged home on oral amoxicillin–clavulanic acid and clindamycin.
Assessment of the dose-dependent biochemical and cytotoxicity of zein-coated MgO nanowires in male and female albino rats
Published in Annals of Medicine, 2021
Ghada H. Naguib, Gamal S. Abd El-Aziz, Hisham A. Mously, Sahar M. Bukhary, Mohamed T. Hamed
This study results showed that MgO-zein nanowires in the used doses did not affect the electrolytes levels compared to the control levels. In addition, both male and female rats have exhibited the same responses. Similar results previously reported that administration of various MgO preparations did not change serum potassium ion levels in healthy human volunteers [57]. It was reported that the electrolytes (electrolyte panel) contain many salts and minerals, like sodium, potassium, chloride, and bicarbonate, that are present in the blood and tissues [58]. They function to transfer electrical impulses across the body. Furthermore, electrolytes assist in transferring nutrients and cleaning the cells, preserve a normal water balance, and maintain normal pH [59]. Also, it was documented that any disease conditions that impact the quantity of fluid in the body like dehydration or influence the lung, kidney, metabolism, or breathing influence to induce fluid, electrolytes, or pH imbalance (acidosis or alkalosis). Electrolyte panels can be determined as important components of the basic metabolic panel. In addition, the determination of serum electrolyte concentration can aid to investigate if there is an electrolyte imbalance or not [14].
Outcomes of Patients with COVID-19 from a Specialized Cancer Care Emergency Room
Published in Cancer Investigation, 2022
Sandy Simcha Nath, Nandini Umesh Yadav, Andriy Derkach, Rocio Perez-Johnston, Lisa Tachiki, Kelsey Maguire, Afia Babar, Molly A. Maloy, Adam Klotz, Justin Jee, Ying Taur, Sanjay Chawla, Esther Babady, Ali Raza Khaki, Margaret M. Madeleine, Petros Grivas, Daniel J. Henning, H. Laura Aaltonen, Gary H. Lyman, Jeffrey Groeger
Patient demographic data, laboratory results, anticancer treatment, and disposition from the UCC were automatically obtained from the electronic medical record (EMR). Clinical data, including baseline comorbidities, presenting symptoms, and outcomes, were obtained by chart review. “Basic” metabolic panel includes blood urea nitrogen (BUN), calcium, carbon dioxide, chloride, creatinine, glucose, potassium, and sodium. “Complete” metabolic panel includes all components of the basic metabolic panel but additionally measures albumin, total protein, alkaline phosphatase, alanine amino transferase (ALT or SGPT), aspartate amino transferase (AST or SGOT), and bilirubin. Chest radiography, including chest X-rays and chest CTs, obtained during the UCC visit were independently reviewed by two radiologists and categorized into “unilateral opacity,” “bilateral opacity,” “no changes.” Patients with extensive preexisting lung disease were labelled as “inconclusive.” Severe event includes acceptance to Intensive Care Unit (ICU), mechanical ventilation, or death.
Related Knowledge Centers
- Bicarbonate
- Blood Urea Nitrogen
- Chloride
- Comprehensive Metabolic Panel
- Potassium
- Sodium
- Glomerular Filtration Rate
- Physical Examination
- Electrolyte
- Creatinine