The impact of the duration of admission to the emergency room on the mortality of intensive care patients

Objective: There are many factors affecting the mortality of patients admitted to the intensive care unit (ICU). Among these are the patientsf age, diagnosis, and concomitant pathology. The aim of this retrospective study was to investigate whether there is an adverse effect of the time between admission to the Emergency Room (ER) and admission to theICU on the mortality of these patients.Materials and Methods: The medical records of the patients who were admitted to the Emergency Department (ED) of the Bolu Izzet Baysal State Hospital and subsequently were admitted to the ICU between December 2009 and August 2011 were analyzed in terms of the time of admission, the season of admission, and the waiting and the stand.by times in the ER.Results: A total of 2380 patients, who were admitted to the ED of the Bolu -zzet Baysal State Hospital and subsequently to the ICU, were included in the study. The median waiting time in the ER was 1.23 h (10 min to 10.02 h). After completion of the admission procedures, the median  hospitalization time in the ER was 0.16 h (3 min to 2.58 h). There was nostatistically significant difference between the patients who died after admission to the ICU and the ones who survived, in terms of the waiting and the stand.by times in the ER (P > 0.05).Conclusion: The waiting times at the ED did not affect the mortality of the ICU patients.Key words: Intensive care, mortality, stand.by tim

The impact of the duration of admission to the emergency room on the mortality of intensive care patients

Objective: There are many factors affecting the mortality of patients admitted to the intensive care unit (ICU). Among these are the patientsf age, diagnosis, and concomitant pathology. The aim of this retrospective study was to investigate whether there is an adverse effect of the time between admission to the Emergency Room (ER) and admission to theICU on the mortality of these patients.Materials and Methods: The medical records of the patients who were  admitted to the Emergency Department (ED) of the Bolu Izzet Baysal State Hospital and subsequently were admitted to the ICU between December 2009 and August 2011 were analyzed in terms of the time of admission, the season of admission, and the waiting and the stand.by times in the ER.Results: A total of 2380 patients, who were admitted to the ED of the Bolu -zzet Baysal State Hospital and subsequently to the ICU, were included in the study. The median waiting time in the ER was 1.23 h (10 min to 10.02 h). After completion of the admission procedures, the median  hospitalization time in the ER was 0.16 h (3 min to 2.58 h). There was nostatistically significant difference between the patients who died after  admission to the ICU and the ones who survived, in terms of the waiting and the stand.by times in the ER (P > 0.05).Conclusion: The waiting times at the ED did not affect the mortality of the ICU patients.Key words: Intensive care, mortality, stand.by tim

Evaluation of simple blood counts as inflammation markers for brain tumor patients.

AIMS: Hemogram parameters in routine blood panels have been proposed as inflammation markers. These parameters, especially the red cell distribution width (RDW) and mean platelet volume (MPV), were evaluated as surrogate inflammatory markers in brain tumor patients. We aimed to observe RDW and MPV values of tumor patients and compare to those in healthy population. METHODS: We recorded white blood cell count, neutrophil count, lymphocyte count, hemoglobin, hematocrit, RDW, platelet count, and MPV of the study group at the time of diagnosis and compared to those of the control subjects. RESULTS: The RDW was significantly elevated in study group compared to that of the control subjects (p=0.001). The MPV was significantly lower in study group than that of the control group (p=0.01). CONCLUSION: Decreased MPV and increased RDW were both associated with brain tumor. However, prospective studies with larger sample sizes are needed to support the results and expose MPV and RDW variations between metastatic and primary brain tumors

Choroidal thickness and retinal vascular caliber correlations with internal carotid artery Doppler variables.

PURPOSE: Decreased retinal arteriolar caliber and increased retinal venular caliber have been associated with increased cardiovascular mortality. This study aimed to evaluate correlations of choroidal thickness and retinal vascular caliber measurements with internal carotid artery (ICA) Doppler ultrasound variables. METHODS: In this cross-sectional and observational study, 43 eyes and ICAs of 43 healthy volunteers were examined. Spectral domain optical coherence tomography was used to measure subfoveal choroidal thickness (SFCT) and retinal vascular caliber. The ICA Doppler ultrasonographic parameters were diameter, flow volume, peak-systolic velocity, end-diastolic velocity, resistance index (RI), and pulsatility index (PI). RESULTS: Negative correlations emerged between ICA RI and SFCT (p = 0.017, r = -0.36) as well as between ICA PI and retinal arteriolar caliber (p = 0.015, r = -0.37). A negative linear correlation appeared between ICA diameter and SFCT (p = 0.005, r = -0.42), although ICA diameter and flow volume showed no association with retinal vessel caliber (p > 0.05). CONCLUSIONS: Choroidal thickness is negatively correlated with ICA diameter and ICA RI, while retinal arteriolar caliber is inversely related with ICA PI in normal volunteers

mortality of intensive care patients

Objective: There are many factors affecting the mortality of patients admitted to the intensive care unit (ICU). Among these are the patients age, diagnosis, and concomitant pathology. The aim of this retrospective study was to investigate whether there is an adverse effect of the time between admission to the Emergency Room (ER) and admission to the ICU on the mortality of these patients. Materials and Methods: The medical records of the patients who were admitted to the Emergency Department (ED) of the Bolu Izzet Baysal State Hospital and subsequently were admitted to the ICU between December 2009 and August 2011 were analyzed in terms of the time of admission, the season of admission, and the waiting and the stand-by times in the ER. Results: A total of 2380 patients, who were admitted to the ED of the Bolu Izzet Baysal State Hospital and subsequently to the ICU, were included in the study. The median waiting time in the ER was 1.23 h (10 min to 10.02 h). After completion of the admission procedures, the median hospitalization time in the ER was 0.16 h (3 min to 2.58 h). There was no statistically significant difference between the patients who died after admission to the ICU and the ones who survived, in terms of the waiting and the stand-by times in the ER ( P > 0.05). Conclusion: The waiting times at the ED did not affect the mortality of the ICU patients

Syndrome

Purpose: We aim to evaluate the clinical and imaging features of "Top of the basilar" syndrome (TOB-S).Method: We retrospectively evaluated the clinical and imaging features of thirty consecutive TOB-S patients. We analyzed the ischemic parenchymal lesions and vascular disturbances with anatomic correlation by using magnetic resonance imaging (MRI), diffusion-weighted MRI (DWI), computed tomography angiography (CTA), magnetic resonance angiography (MRA), and digital subtraction angiography (DSA).Results: Thirty patients (14 males and 16 females) with a mean age of 61 years (range: 32-78 years) were diagnosed as TOB-S based on the neuroimaging and clinical findings. Large artery atherosclerosis (LAA) was the common etiology (63.3%), including the subgroups of in situ steno/occlusive, artery to artery embolus (AA), arterial branch (AB) occlusion, and AA+AB combination. The other etiologies were cardioembolism (CE) (16.6%), arterial dissection (AD) (10.0%), vasculitis (6.6%), and undetermined (3.3%). The patients represented 'superficial', 'deep' and 'superficial plus deep' infarcts with segmental, territorial or scattered patterns. The most clinical manifestations were motor deficits, alteration of consciousness, visual/oculomotor disturbance, cerebellar dysfunction, behavioral disorder and speech disorder.Conclusion: The accurate evaluation of imaging findings in TOB-S is essential for diagnosis and appropriate management. Familiarity with the vascular anatomy, supplying territories, and infarction patterns of the ischemic lesions is crucial

The Importance of Differential Diagnosis In Trigeminal Neuralgia

Purpose: Trigeminal neuralgia (TN), is a disease that is located along one or more of the trigeminal nerve branch which is usually characterized by repetitive pain in the form of knife stab and is triggered by chewing and manipulation of gingiva. The initial atypical symptoms of TN pains are called pre-trigeminal neuralgia (PTN). The purpose of this study is by defining symptoms of oral PTN better, to understand the difference between PTN and odontogenic toothache and to evaluate the effectiveness of treatment of microvascular decompression (MVD) method in TN.Method: A total of 11 patients previously diagnosed with TN (4 women, 7 men; mean age: 57.72) were retrospectively reviewed. In the neurosurgery clinic Pamukkale University School of Medicine, those 11 patients were conducted MVD operation.Results: A total of 11 patients underwent MVD operation which had previously been diagnosed with TN in our clinic. Pain of 90% of patients who underwent MVD were recovered. In the 2-year follow-up of 3 patients, the 3-year follow- up of 3 patients, 1-year follow-up of 4 patients, it was seen that the pain was not repeated. Only in 1 patient, pain was recurred in the same area in the 4th year and it was decided to reoperate the patient.Discussion: Although TN is a disease can be diagnosed by any physician, especially the recognition of PTN and dentists to be knowledgeable about differential diagnosis are very important for the treatment of patients and getting rid of their pain. MVD which is heretofore known the best treatment method in TN, is a treatment method which allows the patients to get rid of their pain completely. In this study, it has been shown a painless life is provided for patients with MVD

Syndrome

Purpose: We aim to evaluate the clinical and imaging features of "Top of the basilar" syndrome (TOB-S).Method: We retrospectively evaluated the clinical and imaging features of thirty consecutive TOB-S patients. We analyzed the ischemic parenchymal lesions and vascular disturbances with anatomic correlation by using magnetic resonance imaging (MRI), diffusion-weighted MRI (DWI), computed tomography angiography (CTA), magnetic resonance angiography (MRA), and digital subtraction angiography (DSA).Results: Thirty patients (14 males and 16 females) with a mean age of 61 years (range: 32-78 years) were diagnosed as TOB-S based on the neuroimaging and clinical findings. Large artery atherosclerosis (LAA) was the common etiology (63.3%), including the subgroups of in situ steno/occlusive, artery to artery embolus (AA), arterial branch (AB) occlusion, and AA+AB combination. The other etiologies were cardioembolism (CE) (16.6%), arterial dissection (AD) (10.0%), vasculitis (6.6%), and undetermined (3.3%). The patients represented 'superficial', 'deep' and 'superficial plus deep' infarcts with segmental, territorial or scattered patterns. The most clinical manifestations were motor deficits, alteration of consciousness, visual/oculomotor disturbance, cerebellar dysfunction, behavioral disorder and speech disorder.Conclusion: The accurate evaluation of imaging findings in TOB-S is essential for diagnosis and appropriate management. Familiarity with the vascular anatomy, supplying territories, and infarction patterns of the ischemic lesions is crucial