Mushroom poisoning: retrospective analysis of 294 cases

OBJECTIVE: The objective of this study was to present special clinical and laboratory features of 294 cases of mushroom poisoning. MATERIALS AND METHODS: In this retrospective study, 294 patients admitted to the Pediatric and Adult Emergency, Internal Medicine and ICU Departments of Cumhuriyet University Hospital were investigated. RESULTS: Of 294 patients between the ages of 3 and 72 (28.97 ± 19.32), 173 were female, 121 were male and 90 were under the age of 16 years. One hundred seventy-three patients (58.8%) had consumed the mushrooms in the early summer. The onset of mushroom toxicity symptoms was divided into early (within 6 h after ingestion) and delayed (6 h to 20 d). Two hundred eighty-eight patients (97.9%) and six (2.1%) patients had early and delayed toxicity symptoms, respectively. The onset of symptoms was within two hours for 101 patients (34.3%). The most common first-noticed symptoms were in the gastrointestinal system. The patients were discharged within one to ten days. Three patients suffering from poisoning caused by wild mushrooms died from fulminant hepatic failure. CONCLUSION: Education of the public about the consumption of mushrooms and education of health personnel working in health centers regarding early treatment and transfer to hospitals with appropriate facilities are important for decreasing the mortality

Nokturnal enuresis Nokturnal enürezis

Nocturnal enuresis (NE) is defined as a complete or near complete micturition in the bed during the sleep. The pathophysiology of NE is still not fully understood. A conceptual model has been proposed for understanding. The remarkable fact is that the great majority of children sleep dry for 8-9 hours or more while sometimes finding it hard to wait for only a couple of hours during daytime. Thus, nocturnal dryness requires functions that are not present during daytime. The basic pathophysiology of NE is simple in that the bladder gets filled to capacity during sleep and needs to be emptied. However, the child not wakes up. If he/she wakes up, he/she walks to the bathroom and performs the socially acceptable act of nocturia. If he/she does not wake up, the socially unacceptable bedwetting ensues. For the management of a child with NE, the most important diagnostic procedure is to identify monosymptomatic enuresis by history and physical examination. Once the history and physical examination has classified the child as monosymptomatic only minimal additional diagnostic work is needed. Daywetting is the most important symptom to exclude in order to classify the enuresis as monosymptomatic. If there is any amount of daytime incontinence present, the enuresis is definitely not monosymptomatic. A dip stick will exclude protein, glucos, hematuria and most urinary pathogens. If there is a history of previous urinary infections, urinary culture should be added. Management of NE is based on 4 principles: (1) Verify the child's motivation to be treated. (2) Information and instruction about daily habits underlining the importance of having regular fluid intake and voidings and relaxed routines at bedtime. (3) Enuresis alarm (4) Antidiuretic medication

The Prevalence of Familial Mediterranean Fever and Behcet's Disease: A Cross-Sectional Study

Objectives: This study aims to investigate the coexistence of familial Mediterranean fever (FMF) and Behcet's disease (BD)

PREVALANCE OF ASTHMA AND ALLERGIC DISEASES IN MID-ANATOLIA

Objective: Allergic diseases are commonly seen in childhood. In this study the prevalences of asthma and other allergic diseases were investigated among the school children in Sivas in the year 2008

Differences in the body composition and biochemistry in women grouped as normal-weight, overweight and obese according to body mass index and their relation with cardiometabolic risk

Morbidity of obesity-related diseases tends to increase due to a rise in the body mass index (BMI). We aimed to investigate how the body composition and biochemical parameters change while BMI increases in adult women were categorized as so: as normal weight, overweight and obese. Our objectives are to study the effects of those changes in the development of metabolic disturbances and to find out which parameters are the most sensitive to predict cardiometabolic risks. Three hundred and twenty two records of adult women (mean age: 38.62 +/- 12.71 year) who admitted to our unit concerning about losing or preserving their weights, were analyzed in the study. All patients had undergone anthropometric measurements and body composition analyses as well as some biochemical tests. Body composition analyses were performed by means of the Bioelectrical Impedance Analyzer (BIA). Increase in BMI significantly increased the body fat, blood sugar, insulin, triglyceride and uric acid levels. BMI and circumference of the waist were significantly and negatively correlated with the ratio of body water and lean mass/fat mass. However they were positively correlated with the ratio of fat mass and basal metabolism. Furthermore, it was also found that BMI and circumference of the waist were significantly and positively correlated with level of fasting blood sugar, insulin, triglyceride, homeostasis model assessment insulin resistance (HOMA-IR), uric acid and fibrinogen levels, and negatively correlated with high density lipoprotein (HDL) cholesterol level. In multiple regression analyses, circumference of waist measurements was significantly correlated with insulin, triglyseride and HDL, whereas the correlation between BMI and these parameters was not found significant. Total body fat mass (as %) showed significant correlation only with HDL-C level. It could be said that obesity which is a disorder that causes many health complications and affects the quality of life in the short and long term could be prevented or cured by keeping negative environmental conditions under control. According to our results, visceral adipose tissue (VAT) measurement was thought to be more related for metabolic and cardiovascular disorders rather than BMI. We also propose to test fasting blood glucose, insulin, triglyceride, HDL, fibrinogen, homocystein (HOM) levels along with VAT measurements to predict more truly about not only global cardiometabolic risk but also dementia in later life

Prevalence and associated factors of day wetting and combined day and night wetting

Background: This study was conducted to determine the prevalence of diurnal enuresis ( DE) and its association with background variables among children aged 5-15 years living in Sivas and Kahramanmaras, Turkey. Methods: The parents of 1,760 children voluntarily completed a questionnaire consisting of 42 items under supervision of a researcher. Results: Overall, the reported prevalence of DE was 4.2%, with a tendency to decrease with increasing age and with no difference between genders. Smoking during pregnancy, delayed initiation and dealing with the child by punishment in toilet training, urination frequency, urgency, soiling, arousal difficulty, urinary infection history, lower school performance, poor social adaptation, wetting history in the family, were all significantly prevalent among diurnal enuretics (p 0.05). 63.9% of all parents reported some level of concern about the wetting problem and 51.7% of the diurnal enuretics had previously visited a physician. Conclusions: The prevalence of DE in our sample is not too different from the prevalence rates reported previously from Turkey and other countries. This type of enuresis seems to be more associated with an organic neurological or urological disorder than is nocturnal enuresis. Copyright (c) 2008 S. Karger AG, Basel

Alterations in body weight and biochemistry in patient treated with different psychotropic drugs in a clinic in Istanbul

Aim Was to compare adult female patients receiving psychiatric drugs with obese adult females who didn't receive any drug treatment with respect to the alterations in body weight land biochemistry, and find out the contrubution of a team approach for the management of these alterations

A comparison of the efficacy of varenicline and bupropion and an evaluation of the effect of the medications in the context of the smoking cessation programme

Introduction Within the context of the support program for smoking cessation, initiated by the Turkish Ministry of Health in 2011, those who present at ‘smoking cessation’ centres and are found to be suitable for pharmacological treatment are given varenicline and bupropion free of charge. As the smoking cessation programme is centralized, the selection of the medication is made randomly to provide a fixed distribution rate. The aim of this study was to evaluate the efficacy of both varenicline and bupropion in smoking cessation and to evaluate the effect of the smoking cessation programme. Material and Methods A total of 405 individuals who met the study criteria were included in the study. Smoking habits and degree of dependence were determined in all the participants with the Fagerstrom test for nicotine dependence (FTND) and bupropion or varenicline therapy was initiated in those who were eligible. Patients were followed up at 15 days then at 1, 2, 3, 6 and 12 months after smoking cessation. A level of CO < 5 ppm and ‘point prevalence abstinence’ were used as the criteria of success for smoking cessation and this evaluation showed the non-smoking status in the previous 7 days. Results The mean age of the participants was 35.19 ± 7.73 years and 82.8% (n = 334) were male. Of the participants, 60.2% (n = 244) were given varenicline and 39.8% (n = 161) bupropion. The mean FTND and package/year was not significantly different between the groups. The rates of success in the 1st and 2nd weeks, and 1st, 3rd and 6th months were significantly higher in the varenicline group than in the bupropion group (p < 0.05). At the end of one year, the rate of smoking cessation was determined as 13.9% (n = 34) in the varenicline group and 6.2% (n = 10) in the bupropion gruop. The difference was statistically significant (p = 0.015). At the end of 1 year when the previous 7 days smoking status was evaluated with the ‘point prevalence abstinence’ measurement as the success criteria, success rates were 20.5% with varenicline and 18.6% with bupropion and the difference was not significant (p = 0.646). The individuals who used the medications for 45 days or longer were more successful in smoking cessation (p < 0.001). The most common reasons given for discontinuing the medication were the side-effects (31.5%). No significant difference was determined between the groups in respect of the side-effects observed. Conclusions Although the rates of smoking cessation in all the other control points were higher with varenicline than with bupropion, no significant difference was found between the success rates of varenicline and bupropion used in smoking cessation based on the last 7 days at the end of one year. Those who used the medications for 45 days or longer were more successful in smoking cessation

MUSHROOM POISONING: RETROSPECTIVE ANALYSIS OF 294 CASES

OBJECTIVE: The objective of this study was to present special clinical and laboratory features of 294 cases of mushroom poisoning