Hsp 70, hsCRP and oxidative stress in patients with acute coronary syndromes.

Acute coronary syndromes (ACS) like unstable angina (UA) and acute myocardial infarction (AMI) can lead to the morbidity and mortality. The diagnosis and management of patients with ACS in the earliest times after symptom onset are considerably important in the emergency service. Study aimed to investigate the serum levels of heat shock protein 70 (Hsp 70), high sensitivity C-reactive protein (hsCRP), total creatine kinase (CK) activity, creatine kinase MB (CK-MB), cardiac troponin I (cTnl), leukocyte count (WBCs) and markers of oxidative stress in the first hours of ACS and to view their diagnostic values. 70 patients with ACS after admission and 20 sex-matched healthy controls were included in this study. Serum Hsp 70, hsCRP, CK, CK-MB, cTnl, protein carbonyls, malondialdehyde as well as whole blood WBCs were measured. The level of hsCRP was statistically higher in patients with AMI and UA than that of control group (p<0.001). WBCs and oxidized protein levels were higher in AMI than in UA and control groups. cTnl was related to CK-MB in AMI and UA groups (r=0.731, r=0.806, p<0.001, respectively) and also related with hsCRP in UA group (r=0.824, p<0.001). The mean Hsp 70 level was higher by 32.2% in AMI and 12.7% in UA patients compared to control subjects. hsCRP may have a role in the inflammatory response after ACS. In addition to cTnI and CK-MB, WBCs and hsCRP may be useful as a marker for the identification of ACS patients with chest pain in early diagnosing

Terrier ırkı bir köpekte pankreatik tümöre bağlı ekstrahepatik kolestazis: Olgu sunumu

Haydardedeoğlu, Ali Evren (Aksaray, Yazar)A-10 year-old, intact female terrier breed dog referred to Veterinary Teaching Hospital with the complaints of anorexia and constipation. The mastectomy operation had been obtained 3 years ago accorrding to owner’s information. Clinical and ultrasonographic assessments confirmed the hepatic cholestasis. Medical management with Cefazolin, enrofloxacin, ursodeoxycholic acid, and fluid therapy were initiated. The dog has referred back a month later with the complaints of abrupt anorexia and icterus. Routine blood tests and control ultrasonography confirmed severe cholestasis and enlarged gall bladder without mass. Experimental laparotomy revealed pancreatic tumor compressing bile ducts. Total tumor resection and choleduedonostomy performed. Pancreatic ductal adencarcinoma was proved by the histopathologic examination of the samples. According to owner’s unwilling to chemotherapy and post-operative treatment, dog was euthanized. In this case report; neoplastic mass possibility in dogs with severe cholestasis must be taken into consideration.Bu olgunun materyalini Veteriner Eğitim Hastanesine getirilen 10 yaşlı dişi Terrier ırkı bir köpek oluşturdu. Anamnezde; hastada anoreksi, konstipasyon varlığı ve 3 yıl önce mastektomi operasyonu geçirdiği bilgisi alındı. Klinik ve ultrasonografik değerlendirmeler hepatik kolestazı doğruladı. İki hafta süreli; Sefazolin, Enrofloksasin, Ursodeoksikolik asit ve destekleyici sıvı sağaltımı ile tedaviye başlandı. Bir ay sonra hasta, ani başlayan anoreksi ve sarılık şikayetleriyle tekrar hastaneye başvurdu. Rutin kan analizleri ve ultrasonografi ile şiddetli kolestazis ve safra kesesinde genişleme belirlendi. Deneysel laparotomi ile safra kanallarına bası yapan pankreatik tümör tespit edildi. Total tümör rezeksiyonu ve koleduedenostomi uygulandı. Histopatolojik değerlendirmeler ile pankreatik duktal adenokarsinom belirlendi. Kemoterapi ve post-operatif tedaviye onay verilmemesi sonucu hasta ötenazi yapıldı. Bu olgu sunumuyla; şiddetli kolestazisi bulunan köpeklerde neoplastik kitle ihtimalinin göz ardı edilmemesinin önemi vurgulanmıştır

Evaluation of the Inferior Vena Cava Diameter in Dehydrated Children Using Bedside Ultrasonography

Objective. Bedside ultrasonography (US) is a new imaging modality that has begun to be used in the Pediatric Emergency Unit to evaluate inferior vena cava (IVC) diameter for intravascular volume status. In this article, we aimed to evaluate IVC diameter with bedside US before and after the fluid therapy in dehydrated children. Methods. A total of 124 dehydrated patients were enrolled, aged 8 months to 17 years. The maximum diameters of the IVC and aorta (AO) were measured. IVC/AO ratio and IVC collapsibility index IVC–CI were calculated before and after the fluid therapy and correlation with the degree of dehydration and laboratory parameters was investigated. Results. Of the 124 patients, 49.2% (n = 61) were male, the mean age was 7.5 ± 4.94 years. The IVC/AOs ratio was increased in mild and moderate/severe groups after fluid therapy compared to before fluid administration. While the mean rate of heart rate, blood urea nitrogen (BUN), creatinine, and uric acid values were higher in the moderate/severe group, potassium and HCO3 were lower. There was no significant change in AO diameter and IVC–CI after fluid therapy in all groups. When the factors affecting the IVC/AOs ratio were analyzed with the logistic regression backward model; the IVC/AO ratio was found to increase as the degree of dehydration decreased (Adj.β = −0.318) and as the age (Adj.β = 0.242) and CRP (Adj.β = 0.186) value increased. Conclusion. The IVC/AO ratio can be a promising index for the assessment and grading of dehydration in children, and cutoff values that vary according to age are necessary for a more objective assessment of dehydration

The extrahepatic cholestasis due to pancreatic tumor in a terrier breed dog: Case report

*Haydardedeoğlu, Ali Evren ( Aksaray, Yazar )A-10 year-old, intact female terrier breed dog referred to Veterinary Teaching Hospital with the complaints of anorexia and constipation. The mastectomy operation had been obtained 3 years ago accorrding to owner’s information. Clinical and ultrasonographic assessments confirmed the hepatic cholestasis. Medical management with Cefazolin, enrofloxacin, ursodeoxycholic acid, and fluid therapy were initiated. The dog has referred back a month later with the complaints of abrupt anorexia and icterus. Routine blood tests and control ultrasonography confirmed severe cholestasis and enlarged gall bladder without mass. Experimental laparotomy revealed pancreatic tumor compressing bile ducts. Total tumor resection and choleduedonostomy performed. Pancreatic ductal adencarcinoma was proved by the histopathologic examination of the samples. According to owner’s unwilling to chemotherapy and post-operative treatment, dog was euthanized. In this case report; neoplastic mass possibility in dogs with severe cholestasis must be taken into consideration.Bu olgunun materyalini Veteriner Eğitim Hastanesine getirilen 10 yaşlı dişi Terrier ırkı bir köpek oluşturdu. Anamnezde; hastada anoreksi, konstipasyon varlığı ve 3 yıl önce mastektomi operasyonu geçirdiği bilgisi alındı. Klinik ve ultrasonografik değerlendirmeler hepatik kolestazı doğruladı. İki hafta süreli; Sefazolin, Enrofloksasin, Ursodeoksikolik asit ve destekleyici sıvı sağaltımı ile tedaviye başlandı. Bir ay sonra hasta, ani başlayan anoreksi ve sarılık şikayetleriyle tekrar hastaneye başvurdu. Rutin kan analizleri ve ultrasonografi ile şiddetli kolestazis ve safra kesesinde genişleme belirlendi. Deneysel laparotomi ile safra kanallarına bası yapan pankreatik tümör tespit edildi. Total tümör rezeksiyonu ve koleduedenostomi uygulandı. Histopatolojik değerlendirmeler ile pankreatik duktal adenokarsinom belirlendi. Kemoterapi ve post-operatif tedaviye onay verilmemesi sonucu hasta ötenazi yapıldı. Bu olgu sunumuyla; şiddetli kolestazisi bulunan köpeklerde neoplastik kitle ihtimalinin göz ardı edilmemesinin önemi vurgulanmıştır

Bir köpekte atipik Lokalize benign adneksiyal Tümör (Trikoblastoma)

Haydardedeoğlu, Ali Evren ( Aksaray, Yazar )In this case; a 6-year-old, Setter breed female (neutered) localized benign adnexal tumor in a dog (Trikoblastoma) were detected. An irregular lesion on the upper right buttock limited solid construction, hard consistency, whitish gray mass complaints of 2.51.8 cm with a lesion in the dog complaint was referred to the owner of the Ankara University Veterinary Faculty of Research Hospital. Routin blood work and urine analyses were in normal reference ranges in this case. Samples taken from the lesion for microbiological examination revealed no pathogens. At punch biopsy of the lesion, it was defined histopathologically as Trichoblastoma. The tumor was surgically excised. Any recurrence noted after surgery with no evidence of metastases on follow up chest radiographs. The authors performed the literature on the subject as far as he knew, and based on classical sources, this case in our country are considered as atypical localized Trichoblasto encountered the first time in a dogBu olguda; altı yaşlı, Setter ırkı dişi (kısırlaştırılmış) bir köpekte lokalize benign adneksiyal tümör (Trikoblastoma) tanımlandı. Ankara Üniversitesi Veteriner Fakültesi Eğitim Araştırma Hastanesi'ne sahibi tarafından elden getirilen köpeğin klinik muayenesinde sağ üst gluteal bölgesinde, düzensiz yaklaşık 2.51.8 cm çapında, solid yapıda, sert kıvamlı, beyazımsı gri renkli bir kitle saptandı. Olgunun rutin kan tahlilleri ve idrar analizleri normal referans aralıklarında olduğu; mikrobiyolojik inceleme için ülseratif lezyonlu bölgeden alınan numunelerden herhangi bir patojen etken ya da etkenler saptanmadı. Lezyondan alınan punch biyopsi örneğinin histopatolojik incelemelerinde, olgu Trichoblastoma (benign adneksiyal tümör) olarak değerlendirildi. Tümör cerrahi olarak total eksize edildi. Herhangi bir nüks görülmedi ve takip edilen göğüs radyografileri sürecinde, cerrahi sonrası herhangi bir metastaz bulgusunun olmadığı görüldü. Konu ile ilgili yapılan literatür taramalarına ve klasik kaynaklara dayanarak, bu olgu, Ülkemizde, bir köpekte ilk defa rastlanan atipik lokalize Trichoblastoma olarak değerlendirildi

Hsp 70, hsCRP and oxidative stress in patients with acute coronary syndromes.

Acute coronary syndromes (ACS) like unstable angina (UA) and acute myocardial infarction (AMI) can lead to the morbidity and mortality. The diagnosis and management of patients with ACS in the earliest times after symptom onset are considerably important in the emergency service. Study aimed to investigate the serum levels of heat shock protein 70 (Hsp 70), high sensitivity C-reactive protein (hsCRP), total creatine kinase (CK) activity, creatine kinase MB (CK-MB), cardiac troponin I (cTnl), leukocyte count (WBCs) and markers of oxidative stress in the first hours of ACS and to view their diagnostic values. 70 patients with ACS after admission and 20 sex-matched healthy controls were included in this study. Serum Hsp 70, hsCRP, CK, CK-MB, cTnl, protein carbonyls, malondialdehyde as well as whole blood WBCs were measured. The level of hsCRP was statistically higher in patients with AMI and UA than that of control group (p<0.001). WBCs and oxidized protein levels were higher in AMI than in UA and control groups. cTnl was related to CK-MB in AMI and UA groups (r=0.731, r=0.806, p<0.001, respectively) and also related with hsCRP in UA group (r=0.824, p<0.001). The mean Hsp 70 level was higher by 32.2% in AMI and 12.7% in UA patients compared to control subjects. hsCRP may have a role in the inflammatory response after ACS. In addition to cTnI and CK-MB, WBCs and hsCRP may be useful as a marker for the identification of ACS patients with chest pain in early diagnosing

A study to develop clinical decision rules for the use of radiography in wrist trauma: Karadeniz wrist rules

Tatli, Ozgur/0000-0003-0263-7630; BAYDIN, AHMET/0000-0003-4987-0878; Turedi, Suleyman/0000-0002-6500-3961WOS: 000389517200004PubMed: 27450389Introduction: the aim of this study was to evaluate patients presenting to the emergency department (ED) with wrist trauma using physical examination findings and functional tests and to identify findings with high sensitivity and specificity among the parameters assessed in patients with fracture in the wrist. the ultimate objective was thus to establish a reliable and widely usable clinical decision rule for determining the necessity of radiography in wrist trauma. Methods: This prospective, multicenter study was performed in 8 hospitals. the relation between radiologically determined fracture and clinical findings consisting of physical examination findings and functional tests was assessed in terms of whether or not these were markers of radiography requirement, with the aim of identifying predictive values for fracture. Results: A total of 603 eligible trauma patients presented to the participating EDs during the study period. Fracture was identified in 24.5% of patients (n= 148). the 4-way combination with the highest sensitivity was identified as axial compression and the positive distal radioulnar drawer test, and pain with radial deviation and dorsal flexion. Sensitivity at distal ulna palpation was added as a fifth parameter, and sensitivity and negative predictive value thus increased to 100%. Conclusion: With their 100% sensitivity and 100% negative predictive values, the Karadeniz wrist rules may represent a clinical decision rule that can be used in practice in EDs. If all 5 findings are negative, there is no indication for wrist radiography. (C) 2016 Elsevier Inc. All rights reserved