100 research outputs found

    Work-related injuries sustained by emergency medical technicians and paramedics in Turkey

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    BACKGROUND: Evaluated in the present study were locations, descriptions, and results of work-related injuries (WRIs) sustained by emergency medical technicians (EMTs) and paramedics in Turkey’s most crowded city, İstanbul. METHODS: After the present study had been accepted by the urban health authority, a questionnaire was emailed to the healthcare personnel of İstanbul’s 195 ambulance stations. RESULTS: Included in the present study were the responses of 901 members of staff (660 EMTs and 241 paramedics), with a mean age of 29.5±6.1 (min: 18; max: 61). The majority of participants (94.9%) had encountered verbal abuse from the public, and 39.8% had encountered physical violence from patients’ relatives. Levels of satisfaction with work in emergency medical services (EMS) was also evaluated, and 510 participants (57.6%) were unhappy. Regarding gender, female employees were more likely to be verbally attacked (p=0.01), while males were more likely to be physically attacked (p=0.001). It was reported that motor vehicle accidents (MVAs) were the most common cause of WRIs (81.4%), followed by needle-stick injuries (52.2%), ocular exposure to blood and other fluids (30.9%), and sharp injuries (22.5%). Only 10.5% (n=95) of WRIs were reported to authorities; 488 (54.2%) of participants just attended to the practice to prevent possible WRIs. CONCLUSION: For paramedics and EMTs, risk of WRI is obviously high. Strategies to decrease and prevent verbal and physical violence should be developed. © 2016 TJTES

    Global Classification of Mast Cell Activation Disorders:An ICD-10-CM–Adjusted Proposal of the ECNM-AIM Consortium

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    Mast cell activation (MCA) is common and occurs in a number of pathologic conditions, including IgE-dependent and independent allergic reactions, atopic disorders, autoimmune processes, and mastocytosis. In a subset of patients, no underlying disease and no known trigger of MCA are found. When the symptoms are severe, systemic, and recurrent, and accompanied by a diagnostic increase in the serum tryptase level or other mast cell mediators, an MCA syndrome (MCAS) may be diagnosed. In these patients, the symptoms typically respond to drugs suppressing MCA, mediator production in mast cells, or mediator effects. In each case, diagnostic consensus criteria must be fulfilled to diagnose MCAS. In other patients, MCA may be local, less severe, or less acute, or may be suspected but not confirmed, so that the diagnostic criteria of MCAS are not fulfilled. In these patients, it may be difficult to prove MCA, for example, by measuring multiple mast cell mediators or basophil activation, the latter as a surrogate of IgE-dependent hypersensitivity. However, validated diagnostic criteria for implicating suspected MCA behind such conditions are lacking, even if some of these conditions have recently been assigned to an International Classification of Diseases-10-Clinical Modification code (ICD-10-CM). In this article, we discuss diagnostic features and criteria and propose a ICD-10-CM–adjusted classification for disorders associated with MCA, herein referred to as MCA disorders (MCADs), with special emphasis on the delineation between confirmed MCAS, MCAD not fulfilling MCAS criteria, and suspected MCAD that is not present. In addition, we discuss the discrimination between overt MCAD and predisposing conditions, such as atopic states, mastocytosis, and hereditary alpha tryptasemia.</p

    Flavaglines Alleviate Doxorubicin Cardiotoxicity: Implication of Hsp27

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    Background: Despite its effectiveness in the treatment of various cancers, the use of doxorubicin is limited by a potentially fatal cardiomyopathy. Prevention of this cardiotoxicity remains a critical issue in clinical oncology. We hypothesized that flavaglines, a family of natural compounds that display potent neuroprotective effects, may also alleviate doxorubicininduced cardiotoxicity. Methodology/Principal Findings: Our in vitro data established that a pretreatment with flavaglines significantly increased viability of doxorubicin-injured H9c2 cardiomyocytes as demonstrated by annexin V, TUNEL and active caspase-3 assays. We demonstrated also that phosphorylation of the small heat shock protein Hsp27 is involved in the mechanism by which flavaglines display their cardioprotective effect. Furthermore, knocking-down Hsp27 in H9c2 cardiomyocytes completely reversed this cardioprotection. Administration of our lead compound (FL3) to mice attenuated cardiomyocyte apoptosis and cardiac fibrosis, as reflected by a 50 % decrease of mortality. Conclusions/Significance: These results suggest a prophylactic potential of flavaglines to prevent doxorubicin-induce

    Palaeozoic-Recent geological development and uplift of the Amanos Mountains (S Turkey) in the critically located northwesternmost corner of the Arabian continent

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    <p>We have carried out a several-year-long study of the Amanos Mountains, on the basis of which we present new sedimentary and structural evidence, which we combine with existing data, to produce the first comprehensive synthesis in the regional geological setting. The ca. N-S-trending Amanos Mountains are located at the northwesternmost edge of the Arabian plate, near the intersection of the African and Eurasian plates. Mixed siliciclastic-carbonate sediments accumulated on the north-Gondwana margin during the Palaeozoic. Triassic rift-related sedimentation was followed by platform carbonate deposition during Jurassic-Cretaceous. Late Cretaceous was characterised by platform collapse and southward emplacement of melanges and a supra-subduction zone ophiolite. Latest Cretaceous transgressive shallow-water carbonates gave way to deeper-water deposits during Palaeocene-Eocene. Eocene southward compression, reflecting initial collision, resulted in open folding, reverse faulting and duplexing. Fluvial, lagoonal and shallow-marine carbonates accumulated during Late Oligocene(?)-Early Miocene, associated with basaltic magmatism. Intensifying collision during Mid-Miocene initiated a foreland basin that then infilled with deep-water siliciclastic gravity flows. Late Miocene-Early Pliocene compression created mountain-sized folds and thrusts, verging E in the north but SE in the south. The resulting surface uplift triggered deposition of huge alluvial outwash fans in the west. Smaller alluvial fans formed along both mountain flanks during the Pleistocene after major surface uplift ended. Pliocene-Pleistocene alluvium was tilted towards the mountain front in the west. Strike-slip/transtension along the East Anatolian Transform Fault and localised sub-horizontal Quaternary basaltic volcanism in the region reflect regional transtension during Late Pliocene-Pleistocene (<4 Ma).</p

    The Normal Range of Baseline Tryptase Should Be 1 to 15 ng/mL and Covers Healthy Individuals With HαT

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    Physiological levels of basal serum tryptase vary among healthy individuals, depending on the numbers of mast cells, basal secretion rate, copy numbers of the TPSAB1 gene encoding alpha tryptase, and renal function. Recently, there has been a growing debate about the normal range of tryptase because individuals with the hereditary alpha tryptasemia (HαT) trait may or may not be symptomatic, and if symptomatic, uncertainty exists as to whether this trait directly causes clinical phenotypes or aggravates certain conditions. In fact, most HαT-positive cases are regarded as asymptomatic concerning mast cell activation. To address this point, experts of the European Competence Network on Mastocytosis (ECNM) and the American Initiative in Mast Cell Diseases met at the 2022 Annual ECNM meeting and discussed the physiological tryptase range. Based on this discussion, our faculty concluded that the normal serum tryptase range should be defined in asymptomatic controls, inclusive of individuals with HαT, and based on 2 SDs covering the 95% confidence interval. By applying this definition in a literature screen, the normal basal tryptase in asymptomatic controls (HαT-positive persons included) ranges between 1 and 15 ng/mL. This definition should avoid overinterpretation, unnecessary referrals, and unnecessary anxiety or anticipatory fear of illness in healthy individuals.P. Valent was supported by the Austrian Science Fund (FWF) grant P32470-B. K. Hartmann was supported by the Swiss National Science Foundation (SNSF) grant 310030_207705. M. C. Carter, J. J. Lyons, and D. D. Metcalfe were supported by the Division of Intramural Research, NIAID, NIH. S. J. Galli was supported by NIH/NIAID U19 AI104209 and NIH R01 AI165373. The content is solely the responsibility of the authors and does not represent the official views of the NIH. V. Sabato is a Senior Clinical Investigator of Flemish Research Council (FWO) grant 1804523N. T. Gülen was supported by the Konsul T.H.C. Bergh Foundation, Sweden; the Swedish Society of Medicine, Sweden; and the Stockholm County Council Research Funds (ALF), Sweden.Peer reviewe

    Suicidal ideation among patients with Behcet's syndrome

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    Objective. To evaluate the frequency of suicidal ideation among Behcet's syndrome (BS) patients compared to healthy and diseased controls and to delineate possible factors predicting an increase in suicidal ideation

    Comparison of Source Regions Affecting SO42- and NO3- Concentrations at the Eastern Mediterranean and Black Sea Atmospheres

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    In this study, source regions of atmospheric sulfate and nitrate in rural areas at the Black Sea and the Mediterranean coasts of Turkey are compared. Stations on the Black Sea and Mediterranean Sea are located at Amasra and Antalya regions, respectively. Source regions of SO42- and NO3- are determined by using potential source contribution function (PSCF). Statistical significance of source regions assigned by PSCF were assured using bootstrapping with 3000 iterations. Source regions affecting sulfate and nitrate concentrations at the Mediterranean and Black Sea regions have some similarities and differences. Emissions from source regions in Russia and Balkan countries affect both the Mediterranean and Black Sea basins
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