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Çocuklarda Akut Skrotumun Ayırıcı Tanısında Tiyol-Disülfid ve İskemi Modifiye Albüminin Rolü

Year 2021, Volume 9, Issue 2, 54 - 58, 31.08.2021
https://doi.org/10.21765/pprjournal.977694

Abstract

Amaç: Akut skrotumun en sık nedenleri arasında yer alan testis torsiyonu, gerçek bir cerrahi acildir. Ancak ileri görüntüleme teknikleri ve laboratuvar tetkiklerine rağmen akut skrotuma neden olan diğer patolojilerden ayırt edilmesi zordur. Bu nedenle, tanıyı doğrulamak için daha spesifik laboratuvar testlerine ihtiyaç vardır. Çalışmada, tiyol-disülfid ve iskemi modifiye albümin (İMA) düzeylerini ölçerek çocuklarda akut skrotumun ayırıcı tanısında bir laboratuvar testinin kullanılabilirliğini araştırmayı amaçladık.

Gereç ve Yöntem: 30’u akut skrotumlu ve 30 sünnet için başvuran sağlıklı erkek çocuk olamk üzere 60 erkek çocuk çalışmaya dahil edildi. Native tiyol (SH), total tiyol (SH+SS), dinamik disülfid (SS), SS/ SH+SS yüzde oranı, albümin ve IMA seviyeleri ölçüldü. Hastaların ameliyat öncesi ve ameliyat sonrası ilk gün kan testi sonuçları karşılaştırıldı.

Bulgular: Akut skrotum grubunda SH (p=0,025), SH+SS (p=0,032), SS (p=0,045), albümin (p0.05).

Sonuç: Tiyol-disülfid dengesi ve IMA düzeylerinin değerlendirilmesi sonucu oksidatif stres lehine değişikliklerin saptanması akut skrotumun ayırıcı tanısında yardımcı olabilir, ancak bu sonuçlar testis torsiyonunu epididimo-orşit tanısından ayırmaya yardımcı olamaz.

References

  • 1. Ciftci AO, Senocak ME, Tanyel FC , Büyükpamukçu N. Clinical predictors for differential diagnosis of acute scrotum. Eur J Pediatr Surg. 2004; 14: 333-8.
  • 2. Mushtaq I, Fung M, Glasson MJ. Retrospective review of paediatric patients with acute scrotum. ANZ J Surg. 2003; 73: 55-8.
  • 3. Colodny AH: Acute urologic conditions. Pediatr Ann 23. 207 - 210,1994.
  • 4. Rabinowitz R, Hulbert WC: Acute scrotal swelling. Urol Clin North Am 22: 101 - 105, 1995.
  • 5. Çaman Ş, İnanç C, Pelin A, Cerrah Celayir A. Akut Skrotum; Çocuk Ürolojisinin Önemli Bir Acil Durumu. Zeynep Kamil Tıp Bülteni 2014: 45:49-53
  • 6. Bolukbas C, Bolukbas FF, Horoz M, Aslan M, Celik H and Erel Ö Increased oxidative stress associated with the severity of the liverdisease in various forms of hepatitis B virus infection. BMC Infect Dis. (2005) 31: 5-95.
  • 7. Ozdogan M, Devay AO, Gurer A, Ersoy E, Duygulu Devay S, Kulaçoğlu H et al.Plasma total antioxidant capacity correlates inversely with the extent of acute appendicitis: a case control study. World J. Emerg. Surg. .(2006), 24: 1-6.
  • 8. Serefhanoglu K, Taskin A, Turan H, Ergin Timurkaynak F, Arslan H, Erel Ö. Evaluation of oxidative status in patients with brucellosis. Braz. J. Infect. Dis. (2009), 13[4]: 249-251.
  • 9. McCord JM. Human disease, free radicals, and the oxidant/antioxidant balance.Clin Biochem. 1993 Oct;26[5 ]:351-7.
  • 10. Kundi H, Ates I, Kiziltunc E , Çetin M, Çiçeklioğlu H.,Neşelioğlu S. et al. A novel oxidative stress marker in acute myocardial infarction; thiol/disulphide homeostasis.Am J Emerg Med. 2015 Nov;33[11]:1567-71. doi: 10,1016/j.ajem.2015.06.016. Epub 2015 Jun 14.
  • 11. Circu ML, AwTY. Reactive oxygenspecies, cellular redox systems, andapoptosis. Free Radic Biol Med 2010;48(6):749–62. http://dx.doi.org/10,1016/j.freeradbiomed. 2009.12.022
  • 12. Ozcan Erel, Salim Neselioglu. A novel and automated assay for thiol/disulphide homeostasis. Clinical Biochemistry 47 (2014) 326–332. DOI: 10,1016/ j.clinbiochem. 2014.09.026
  • 13. Wudkowska A, Goch J, Goch A. Ischemia-modified albumin in differential diagnosis of acute coronary syndrome without ST elevation and unstable angına pectoris. Kardiologia Polska 2010; 68[4]: 431-7.
  • 14. Aran T, Unsal MA, Güven S, Kart C, Can Çetin E, Alver A. Carbon dioxide Pneumoperitoneum Induces Systemic Oxidative Stres: a clinical study. Eur J Obstet Gynecol Reprod Biol 2012; 161(1): 80-3.
  • 15. Ma SG, Wei CL, Hong B, Yu W. Ischemia-modified albumin in type 2 diabetic patients with and without peripheral arterial disease. Clinics 2011; 66[10]:1677-80.
  • 16. Mastella AK, Moresco RN, da Silva DB, Becker AM, Duarte M, Giovelli LL el al. Evaluation of ischemiamodified albumin in myocardial infarction and prostatic diseases. Biomed Pharmacother 2009; 63.762-6.
  • 17. Lippi G, Montagnana M; Ischemia Modified Albumin in Ischemic Disorders. Ann Thorac Cardiovasc Surg 2009; 15(2): 137
  • 18. Erel O. Neselioglu S. A novel and automated assay for thiol/disulfide homeostasis. Clin Biochem.DOI:10.1016/j.clinbiochem.2014.09.026
  • 19. Bar-Or D, Lau E, Winkler JV. A novel assay for cobalt–albumin binding and its potential as a marker for myocardial ischemia a preliminary report. J Emerg Med 2000; 19.311-5.
  • 20. Cattolica EV, Karol JB, Rankin KN Klein RS. High testicular salvage rate in torsion of the spermatic cord.J Urol. 1982 Jul;128(1):66-8.

The role of thiol-disulfide and ischemia-modified albumin in the differential diagnosis of acute scrotum in children

Year 2021, Volume 9, Issue 2, 54 - 58, 31.08.2021
https://doi.org/10.21765/pprjournal.977694

Abstract

Aim: Testicular torsion which is the most common cause of acute scrotum, is a real surgical emergency. However, despite imaging techniques and laboratory studies used in the differential diagnosis of pathologies causing acute scrotum, the diagnosis is difficult. Therefore, there is a need for laboratory parameters that confirm the diagnosis of testicular torsion.In our study, we aimed to investigate the usability as a laboratory parameter in the differential diagnosis of acute scrotum causing inflammation in children via thiol-disulfide and ischemia-modified albumin(IMA) levels. Methods: Of 60 children, 30 boys with acute scrotum and 30 healthy boys who were admitted for circumcision were included. The levels of native thiol(-SH), total thiol (SH + SS), dynamic disulfide(SS), dynamic disulfide(SS)/total thiol(SH + SS) % rate, albumin and IMA were measured. Patients’ pre-operative and postoperative first day blood samples’ laboratory findings were also compared. Results: Native thiol(p = 0.025), total thiol(p = 0.032), dynamic disulfide(p = 0.045), albumin(p <0.001) and IMA(p <0.001) levels of the acute scrotum group were significantly higher than controls. IMA levels of epididymo-orchitis subgroup of acute scrotum were found higher than the testicular torsion subgroup. Pre and post-operative laboratory findings of the acute scrotum group were similar (for all variables p>.05). Conclusion: The evaluation of thiol/disulfide homeostasis and IMA levels, and detection of changes in favor of oxidative stress might help in the differential diagnosis of the acute scrotum, but it cannot help to differentiate the testicular torsion from an epididymo-orchitis diagnosis.

References

  • 1. Ciftci AO, Senocak ME, Tanyel FC , Büyükpamukçu N. Clinical predictors for differential diagnosis of acute scrotum. Eur J Pediatr Surg. 2004; 14: 333-8.
  • 2. Mushtaq I, Fung M, Glasson MJ. Retrospective review of paediatric patients with acute scrotum. ANZ J Surg. 2003; 73: 55-8.
  • 3. Colodny AH: Acute urologic conditions. Pediatr Ann 23. 207 - 210,1994.
  • 4. Rabinowitz R, Hulbert WC: Acute scrotal swelling. Urol Clin North Am 22: 101 - 105, 1995.
  • 5. Çaman Ş, İnanç C, Pelin A, Cerrah Celayir A. Akut Skrotum; Çocuk Ürolojisinin Önemli Bir Acil Durumu. Zeynep Kamil Tıp Bülteni 2014: 45:49-53
  • 6. Bolukbas C, Bolukbas FF, Horoz M, Aslan M, Celik H and Erel Ö Increased oxidative stress associated with the severity of the liverdisease in various forms of hepatitis B virus infection. BMC Infect Dis. (2005) 31: 5-95.
  • 7. Ozdogan M, Devay AO, Gurer A, Ersoy E, Duygulu Devay S, Kulaçoğlu H et al.Plasma total antioxidant capacity correlates inversely with the extent of acute appendicitis: a case control study. World J. Emerg. Surg. .(2006), 24: 1-6.
  • 8. Serefhanoglu K, Taskin A, Turan H, Ergin Timurkaynak F, Arslan H, Erel Ö. Evaluation of oxidative status in patients with brucellosis. Braz. J. Infect. Dis. (2009), 13[4]: 249-251.
  • 9. McCord JM. Human disease, free radicals, and the oxidant/antioxidant balance.Clin Biochem. 1993 Oct;26[5 ]:351-7.
  • 10. Kundi H, Ates I, Kiziltunc E , Çetin M, Çiçeklioğlu H.,Neşelioğlu S. et al. A novel oxidative stress marker in acute myocardial infarction; thiol/disulphide homeostasis.Am J Emerg Med. 2015 Nov;33[11]:1567-71. doi: 10,1016/j.ajem.2015.06.016. Epub 2015 Jun 14.
  • 11. Circu ML, AwTY. Reactive oxygenspecies, cellular redox systems, andapoptosis. Free Radic Biol Med 2010;48(6):749–62. http://dx.doi.org/10,1016/j.freeradbiomed. 2009.12.022
  • 12. Ozcan Erel, Salim Neselioglu. A novel and automated assay for thiol/disulphide homeostasis. Clinical Biochemistry 47 (2014) 326–332. DOI: 10,1016/ j.clinbiochem. 2014.09.026
  • 13. Wudkowska A, Goch J, Goch A. Ischemia-modified albumin in differential diagnosis of acute coronary syndrome without ST elevation and unstable angına pectoris. Kardiologia Polska 2010; 68[4]: 431-7.
  • 14. Aran T, Unsal MA, Güven S, Kart C, Can Çetin E, Alver A. Carbon dioxide Pneumoperitoneum Induces Systemic Oxidative Stres: a clinical study. Eur J Obstet Gynecol Reprod Biol 2012; 161(1): 80-3.
  • 15. Ma SG, Wei CL, Hong B, Yu W. Ischemia-modified albumin in type 2 diabetic patients with and without peripheral arterial disease. Clinics 2011; 66[10]:1677-80.
  • 16. Mastella AK, Moresco RN, da Silva DB, Becker AM, Duarte M, Giovelli LL el al. Evaluation of ischemiamodified albumin in myocardial infarction and prostatic diseases. Biomed Pharmacother 2009; 63.762-6.
  • 17. Lippi G, Montagnana M; Ischemia Modified Albumin in Ischemic Disorders. Ann Thorac Cardiovasc Surg 2009; 15(2): 137
  • 18. Erel O. Neselioglu S. A novel and automated assay for thiol/disulfide homeostasis. Clin Biochem.DOI:10.1016/j.clinbiochem.2014.09.026
  • 19. Bar-Or D, Lau E, Winkler JV. A novel assay for cobalt–albumin binding and its potential as a marker for myocardial ischemia a preliminary report. J Emerg Med 2000; 19.311-5.
  • 20. Cattolica EV, Karol JB, Rankin KN Klein RS. High testicular salvage rate in torsion of the spermatic cord.J Urol. 1982 Jul;128(1):66-8.

Details

Primary Language English
Subjects Health Care Sciences and Services
Journal Section Original Articles
Authors

Can İhsan ÖZTORUN (Primary Author)
ANKARA YILDIRIM BEYAZIT UNIVERSITY FACULTY OF MEDICINE DEPARTMENT OF PEDIATRIC SURGERY
0000-0002-5408-2772
Türkiye


Rabia DEMİR
SIRNAK STATE HOSPITAL
Türkiye


Gökhan DEMİRTAŞ
ANKARA CITY HOSPITAL DEPARTMENT OF PEDIATRIC SURGERY
0000-0003-0787-2330
Türkiye


Süleyman Arif BOSTANCI
ANKARA CITY HOSPITAL DEPARTMENT OF PEDIATRIC SURGERY
0000-0002-7512-3895
Türkiye


Ahmet ERTÜRK
ANKARA CITY HOSPITAL DEPARTMENT OF PEDIATRIC SURGERY
Türkiye


Cüneyt KARAGÖL
ANKARA CITY HOSPITAL DEPARTMENT OF PEDIATRICS
Türkiye


Almila ŞENAT
ANKARA YILDIRIM BEYAZIT UNIVERSITY FACULTY OF MEDICINE DEPARTMENT OF BIOCHEMISTRY
0000-0002-5806-562X
Türkiye


Özcan EREL
ANKARA YILDIRIM BEYAZIT UNIVERSITY FACULTY OF MEDICINE DEPARTMENT OF BIOCHEMISTRY
Türkiye


Doğuş GÜNEY
ANKARA YILDIRIM BEYAZIT UNIVERSITY FACULTY OF MEDICINE DEPARTMENT OF PEDIATRIC SURGERY
Türkiye


Müjdem AZILI
ANKARA YILDIRIM BEYAZIT UNIVERSITY FACULTY OF MEDICINE DEPARTMNET OF PEDIATRIC SURGERY
Türkiye


Emrah ŞENEL
ANKARA YILDIRIM BEYAZIT UNIVERSITY FACULTY OF MEDICINE DEPARTMENT OF PEDIATRIC SURGERY
Türkiye

Publication Date August 31, 2021
Acceptance Date September 11, 2021
Published in Issue Year 2021, Volume 9, Issue 2

Cite

Vancouver Öztorun C. İ. , Demir R. , Demirtaş G. , Bostancı S. A. , Ertürk A. , Karagöl C. , Şenat A. , Erel Ö. , Güney D. , Azılı M. , Şenel E. The role of thiol-disulfide and ischemia-modified albumin in the differential diagnosis of acute scrotum in children. Pediatric Practice and Research. 2021; 9(2): 54-58.