IntroductionAcute appendicitis (AA) is one of the most common acute general surgical presentations affecting 7% of the population at some point in their lifetime. The ability to assess the risk of complicated appendicitis (CA) from uncomplicated appendicitis (UA) in acute appendicitis (AA) could reduce the associated morbidity and mortality. The value of platelet lymphocyte ratio (PLR) as an inflammatory marker increases when its fluctuations are interpreted along with other complementary hematologic indices, such as neutrophil-tolymphocyte ratio (NLR), which provides additional information about the disease activity. Hence, we postulated that NLR and/or PLR could serve as a potential surrogate marker in assessing the severity of AA. AimThis study aims to investigate the use of PLR and/or NLR as a surrogate biomarker in differentiating uncomplicated from complicated appendicitis.
Simultaneous occurrence is seen in 23-38% patients. Cutaneous lesions preceding haematologic findings are very rare (7%) and are known as aleukaemic leukaemia cutis. 1,4 In our case, leukaemia cutis and systemic leukaemia were concurrently diagnosed.Histopathology was confirmatory revealing infiltration of malignant cells typically sparing a epidermis, with a Grenz zone and perivascular, periappendageal or diffuse infiltrate. Immunohistochemistry and cytometry revealed markers of the underlying tumour lineage.Cutaneous involvement in pre-B-cell ALL is a rarity, and so far, only a few isolated cases have been reported in literature. 2 Leukaemia cutis indicates poor prognosis and extramedullary involvement, especially CNS invasion. Various studies have shown a median survival of <1 year after development of leukaemia cutis, with only 15% six-month survival rate. 1,5 Our case was a rarity for two reasons (i) uncommon occurrence of leukaemia cutis in pre-B-cell ALL and (ii) concurrent occurrence with malignancy.
Background The use of urinary catheterisation in neck of femur fracture patients is often debated as common best practice to manage and appropriate fluid assessment. Routine catheterisation increases the risk bacteraemia, genitourinary injury, worsening mobility, risk of pressure sores and predisposition to delirium and falls. There is a need for increased awareness of urinary catheterisation management in conjunction with healthcare-associated infections. NHS improvement has issued a letter aiming to half healthcare-associated Gram-negative bacteraemia, the majority of which is catheter-related. This project aims to identify barriers to safe catheter care in the orthopaedic population; by determining if management of urinary catheters is complaint with NICE quality standards (QS61). Introduction Appropriate perioperative care can help manage the associated risk of neck of femur fractures. The British Hip Society and British Orthopaedic Association have provided little guidance on postoperative care and risk management. Appropriate catheter care will improve overall patient care but reducing mortality and associated morbidity, by shortening stay by early mobilisation and management of complications. Methods All catheterised trauma and orthopaedic patients in a district general hospital over one month (February) were included 67% of which had sustained neck of femur fractures. Data from nursing and doctors’ records on the following parameters were collected: demographics, the reason of admission, indication/location for catheterisation and responsible clinician; the number of days catheterised, the reason for the retention of catheterisation and management of suspected/confirmed catheter-related infection. Data were collected in April following the implementation. Intervention A urinary care pathway was launched based on the HOUDINI algorithm and educational seminars for medical and nursing staff were conducted. Results Mean age of patients was 78. Initial data was suggestive of poor documentation and prolonged, inappropriate retention of urinary catheterisation and not in accordance with current guidance. Data was recollected in April after the launch of the pathway; data was indicative of marginal improvement of catheter care management, reduced time of catheter retention, improved documentation likelihood of review. Conclusions Incorporating a catheter care pathway in managing orthopaedic patients has shown improvement in the overall documentation and management of urinary catheterisation. Despite this improvement demonstrated, implementation of the pathway is still substandard. This pathway will be incorporated into an innovative integrated neck of femur pathway in June.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Copyright © 2025 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.