Serum IL-6, TNF? levels in snakebite cases occurring in Southern Turkey

PubMedID: 20595711Objective: The snake species Vipera ammodytes meridionalis and Vipera lebetina obtuse are often seen in Southern Turkey and have venom that causes serious systemic and tissue damage. The aim of our study is to assess the relationship between tumour necrosis factor ? (TNF?) and interleukin 6 (IL-6) serum levels, and clinical and laboratory findings in the snakebite patients. Methods: 26 patients who had received snakebites were included in a prospective study. Patients were grouped according to their clinical presentations in order to plan treatment. Results: TNF? serum levels of most patients who went to the emergency room to receive treatment for snakebite were high. This increase was most likely to be related to the clinical severity of the snakebite and the length of time between the snakebite and their arrival at the hospital. In contrast to TNF?, there was no relationship between serum IL-6 levels and clinical and laboratory parameters. Conclusions: Snakebites from Vipera ammodytes meridionalis and Vipera lebetina obtuse lead to increased levels of serum TNF?. However, serum TNF? and IL-6 levels depend on various factors such as the kind of snake, the area the venom was injected into, the amount of venom and the body size of the patients

Complex Dielectric Coefficient of Breast Phantom Prepared for Breast Cancer Detection

Microwave measurement techniques attract attention due to its practical solutions in breast cancer imaging. Early detection of cancer is the purpose of these imaging studies. For these imaging processes, phantoms which reflect the properties of the area to be imaged are produced. The produced homogeneous phantoms are imaged by stepper frequency of radar technology, as the narrow bands are used for heterogeneous mixtures. Phantoms are used since 70's until today. Different methods are experimented for producing phantoms of tissue, muscle, fat, skin, etc. Iron powder, polymer materials, various oils and gelatins used today are the materials used for producing the phantoms. In this study, phantom breast imaging is aimed. Phantoms breast and breast tumor samples are created. For phantoms and tumor samples, reflection and transmittion measurements are done with Network Analyzer in X-Band (8.2-12.4 GHz). Complex permittivity is calculated with Agilent 85071 Material Measurement Software-Fast Method (NIST-iterative method). It was considered breast phantom with tumor model for 3D imagine at 2-3.5 GHz frequency range

Utilization of plasmapheresis in the management of bismuth intoxication with acute renal failure

PubMedID: 28540904A 34-year-old female patient who ingested 2400 mg bismuth subcitrate in a suicide attempt was brought to the emergency department. She had mild encephalopathy and acute renal failure on admission. One session of plasmapheresis was performed to remove bismuth, and needed three sessions of hemodialysis and was discharged on the 24th day of hospitalization with the recovery of the renal function

Comparison of single-dose pralidoxime and pralidoxime infusions for the treatment of organophosphate poisoning [Organofosfat zehirlenmesinin tedavisinde tek doz parlidoksim infüzyonunun karşılaştırılması]

Objective: Organic phosphates (OP) bind covalently to acetylcholinesterase (AChE) and acetylcholine (Ach) accumulates in the synaptic cleft. Administering oximes before aging process causes breakage of the covalent bond between OP-AChE, and allows reactivation of AChE. Pralidoxime (PAM) is the most commonly used oxime. The purpose of this study is to determine the best PAM regimen for the length of hospitalization, the need for mechanical ventilation and reduction of the duration of mechanical ventilation in patients presenting with OP poisoning. Material and Methods: Thirty four patients included in this study were organized according to the order of enrollment, randomized and divided into two groups. Seventeen patients in the group I were given a single dose of 2 g/20 min PAM infusion (bolus dose), while 17 patients in group II were administered a dose of 2 g/20 min followed by 6 g/24 hours PAM infusion (bolus and infusion). Clinical signs and symptoms as well as the serum butyrylcholinesterase (BCHE) levels were used to verify the patients' diagnoses. Results: There were no significant differences between the groups. Conclusion: We suggest that PAM bolus plus infusion therapy does not have any advantage over a single dose of bolus PAM therapy the in treatment of OP poisoning. © 2012 by Türkiye Klinikleri

ST elevation in AVR could be a sign of the left main coronary artery lesion [aVR'de ST yüksekligi sol ana koroner lezyonunu gösterebilir]

PubMedID: 12460837[No abstract available

Perianal basal cell carcinoma: A rare case [Nadi'r görülen bi'r olgu: Peri'anal bazal hücreli' karsi'nom]

Basal cell carcinoma (BCC) is the most common type of non melanoma skin cancers. Because of less exposure to ultraviolet light in perianal and genital regions, BCC is seen rarely in these areas. It is rarely seen in perianal and genital regions where non U.V. exposed areas. In this case report a fifty years old patient who had an ulcerated lesion on his left perianal region for nearly ten years was evaluated. After BCC is diagnosed with incisional biopsy, the lesion was excised with 5mm surgical margins under general anesthesia. The excision material was reported as BCC with clean surgical margins. Neither recurrence nor metastasis was observed in postoperative twelve months follow-up. Differential diagnosis of ulcerated lesions of perianal and genital regions include sexually transmitted diseases (e.g. Syphilis, HSV), pyoderma gangrenosum, Behçet's disease, thrombosed haemorrhoid, fistula secondary to inflammatory bowel disease, and colorectal malignancies. Even it is very rare, BCC must be kept in mind in differential diagnosis of ulcerated perianal and genital lesions

H-FABP in cases of carbon monoxide intoxication admitted to the emergency room

PubMedID: 21075804Introduction: Carbon monoxide (CO) intoxication causes cardiovascular problems as a result of diffuse tissue hypoxia. Cardiac biochemical markers and electrocardiographic changes have been reported in CO intoxications. Human fatty acid-binding protein (H-FABP) has been recently used as a reliable marker in identifying early cardiac damage. In this prospective study, we aimed to investigate the advantages of the use of H-FABP, in evaluating the findings of myocardial ischemia in patients with CO intoxication in our region. Methods: Twenty four successive patients admitted to the emergency department with acute CO intoxication were included in our study. Serum traditional markers and H-FABP were also taken in the earliest period for evaluation of cardiac damage. Results: The creatinine kinase MB (CKMB) levels were positive in 11 of the patients; however, H-FABP and troponin T levels were positive in only 3 of them. One of these subjects had elevated level of H-FABP in the short-term and increasing troponin T level increasing level of troponin T during the follow-up period. Conclusion: The obtained data supports the use of H-FABP, a specific indicator in identifying the cardiotoxicity of CO intoxications at an early phase. © The Author(s) 2010

Evaluation of the process and effectiveness of consultation system in the Department of Emergency Medicine [Acil Tip Anabilim Dali'nda konsültasyon sisteminin işleyişi ve etkinliginin degerlendirilmesi]

PubMedID: 19562540BACKGROUND: Triage, consultations, and radiological and laboratory test processes have different effects on the total waiting time in the emergency department (ED). Under these circumstances, the importance of the consultation system process and effectiveness of consultation becomes very clear. Our aim in this study was to verify the process of the consultation system. METHODS: This prospective and defining study was performed with 276 patients admitted to the ED. A total of 342 consultations were requested. These patients were classified as very urgent, urgent and non-urgent according to their problems, and a survey form was completed by the ED resident. RESULTS: The most frequently requested consultation was to the Department of Internal Medicine (72%). Mean time for reply to the consultation was 29±43 minutes. The earliest reply to the consultation was from Cardiology while the latest responders were the general surgeons. Timeline for replying to the consultation was shorter depending on the urgency of the case. CONCLUSION: In our study, we determined that the most important factor for the effectiveness of consultation was the definition of the urgency of the patients by the residents in the ED. Since the number of patients admitting to the ED will continue to increase in the future, more detailed prospective studies are needed about the efficiency of consultation in the ED

QTc intervals in drug poisoning patients with tricyclic antidepressants and selective serotonin reuptake inhibitors

PubMedID: 19417591Commonly used agents of drug poisoning among patients who come to the emergency services are tricyclic antidepressants (TCAs). These drugs may cause defect in cardiac conduction due to the slowdown in the cardiac depolarization and expansions in the QT interval. Selective serotonin reuptake inhibitors (SSRIs) are less expansion of the QT period and lower cardio toxic side effects. The aim of this study was to investigate QTc intervals and prognosis of the patients who come to the emergency service due to TCA and SSRI group antidepressant drug poisoning. In a study of 96 patients, 75 of whom were diagnosed to be poisoned by TCAs (TCA group) and 21 by SSRIs (SSRI group) were examined. Electrocardiographic alterations and QTc intervals all of patients were evaluated. QTc intervals of patients in TCA group were determined to be slightly more than those in SSRI group and it was not statistically significant. In the SSRI group, only one patient had QTc period more than 500 milliseconds (520 milliseconds); however, TCA overdose showed 9 (12%) patients with QTc interval over 500 milliseconds, and QTc values of 2 patients were over 600 milliseconds. In our study, it was determined that SSRI group drugs caused similar expansion of the QTc period as TCA drugs but they did not reach high values like TCA drugs, and their OTc intervals stayed in more innocent levels. © 2010 Lippincott Williams & Wilkins