Frequency of skeletal chest injuries associated with cardiopulmonary resuscitation: forensic autopsy

BACKGROUND: Fractured ribs and sternum are frequent complications of thoracic compression during CPR (cardiopulmonary resuscitation) in adults. This study was conducted to determine the incidence of rib and sternal fractures after conventional closed-chest compression in the treatment of cardiac arrest. METHODS: We reviewed the forensic autopsy findings of 231 deaths referred to the Pamukkale University Department of Forensic Medicine over a 12-month period, 2004-2005. CPR-related chest injuries comprising rib and sternum fractures, ecchymosis and subcostal hemorrhage were compared retrospectively in 104 patients. RESULTS: Ninety-one (87.5%) of the 104 patients were adults, and 13 patients (12.5%) were children. The mean (SD) age in the pediatric group (5F/8M) was 5.48 (±5.96) and in the adult group (18F/73M) was 44.88 (±18.31). Forty-four (42.3%) of the 104 patients died of traumatic cause and 60 (57.7%) of non-traumatic cause. Ecchymosis was present in 26 (28.8%) patients, subcostal hemorrhage in 16 (17.6%) patients and fractures (sternal and costal) in 12 (13.2%) patients in adults. There were no significant differences between groups according to age, sex and traumatic-nontraumatic cause in terms of skeletal chest injuries associated with CPR in adult patients (p>0.05). CONCLUSION: This study shows a low incidence of rib and sternal fracture after closed-chest compression in the treatment of cardiac arrest in forensic autopsy cases

Two Cases of an Unusual Childhood Aortic Dissection Resulting in Death

Pediatric aortic dissection is an emergency condition that is difficult to diagnose and is associated with high morbidity and mortality. To draw attention to this issue, we present two male cases diagnosed with aortic dissection because of an autopsy. A 16-year-old man with severe new-onset chest pain had an unremarkable physical examination, electrocardiography, and laboratory values. Aortic dissection was not detected on non-contrast computed tomography or echocardiography. Type A aortic dissection was discovered during the patient's autopsy. In the second case, a 10-year-old male patient complained of fever, vomiting, and abdominal pain. The physical examination and biochemical tests were unremarkable. Type B aortic dissection was discovered during the autopsy. Genetic and congenital causes predisposing to aortic dissection and hypertension or a history of trauma were not detected in either patient. Aortic dissection, which is very rare in children, should be considered in cases of persistent chest pain, and rapid diagnosis with contrast-enhanced tomography is vital

Assessment of the relation of violence and burnout among physicians working in the emergency departments in Turkey

ABSTRACT BACKGROUND: Violence and burnout are frequently seen among medical doctors; however, the relation is not clear. This study aimed to assess the violence and its possible effects on burnout in physicians working in emergency units

Cloning and Determination of Tissue Specific Expression Pattern of Astacus Leptodactylus Na+ Ca 2+ Exchanger Gene

Cytosolic Ca2+ plays an essential role in various cellular functions. Changes in cytosolic Ca2+ concentration is important for different cellular activities like muscle contraction and neurotransmitter release. A set of channels and exchangers are responsible for maintenance of resting calcium concentration and the generation of the calcium transient. Na+/Ca2+ exchanger can move Ca2+ in either direction depending on net electrochemical driving force acting on the exchanger. Structure and function of Na+/Ca2+ exchanger is conserved within the animal kingdom. In the crayfish there are some recent functional studies indicating the presence of Na+/Ca2+ exchanger. However, there is no report focusing onto genetic and molecular properties of the crayfish exchanger yet. To reveal properties of the crayfish Na+/Ca2+ exchanger gene, various molecular techniques have been employed by considering the homology observed among closely related species. As a result, the complete coding sequence of the putative crayfish Na+/Ca2+ exchanger gene has been revealed. Corresponding amino acid sequence has been found to be 58 – 65 % similar to known Na+/Ca2+ exchangers, sharing characteristics of the exchanger protein family. Tissue specific expression pattern of crayfish Na+/Ca2+ exchanger gene indicates that exchanger is expressed in excitable or biologically active tissues like ganglia, muscle and antennal gland while its expression is almost absent in gill which passively filters the neighboring fluid. Future efforts will be dedicated to define structure-function relationship of the discovered gene.Sitozolik Ca2+ birçok hücresel fonksiyonda hayati rol oynar. Sitozolik Ca2+ derişimindeki değişiklikler, kas kasılması ve nörotransmitter salınımı gibi hücresel aktiviteler için önemlidir. İstirahat kalsiyum derişiminin idamesinden ve kalsiyum geçişlerinin gerçekleştirilmesinden bir takım kanallar ve karşı değiştiriciler sorumludur. Na+/Ca2+ karşı değiştirici, üzerine etkiyen net elektrokimyasal sürücü güç uyarınca Ca2+’u iki yönlü taşıyabilir. Na+/Ca2+ karşı değiştiricinin yapısı ve fonksiyonu hayvanlar âlemi içerisinde korunmuştur. Kerevitte Na+/Ca2+ karşı değiştirici varlığını işaret eden bazı fonksiyonel çalışmalar yakın zamanda gerçekleştirilmiştir. Buna rağmen, kerevit karşı değiştiricisinin genetik ve moleküler özelliklerine ilişkin bir rapor henüz mevcut değildir. Kerevit Na+/Ca2+ karşı değiştiricisi geninin özelliklerini açığa çıkarmak amacıyla, yakın türler arasında gözlenen benzerlikler göz önüne alınarak moleküler teknikler kullanılmıştır. Bu çalışmanın sonucunda, kerevit Na+/Ca2+ karşı değiştiricisinin kodlayan bölgesinin sekansının tamamı ortaya çıkarılmıştır. İlgili amino asit sekansı bilinen Na+/Ca2+ karşı değiştiricileri ile % 58 – 65 oranın benzerlik göstermekte ve karşı değiştirici protein ailesinin özelliklerini taşımaktadır. Kerevit Na+/Ca2+ karşı değiştirici geninin doku spesifik ifade deseni, karşı değiştiricinin sinir düğümü, kas ve antennal bez gibi uyarılabilen ya da biyolojik olarak aktif olan dokularda ifade edilirken etrafındaki sıvıyı pasif olarak filtreleyen solungaç gibi dokularda ifade edilmediğini göstermektedir. Devam edecek çalışmalarda bulunan genin yapı-fonksiyon ilişkisinin belirlenmesi amaçlanacaktır

Molecular Propertıes of Crayfısh Potassıum Channels

TUBITAK ARDEB (#218S553),Ergin, B., Molecular Properties of Crayfish Potassium Channels. Hacettepe University Graduate School of Health Sciences, Ph.D. Thesis in Biophysics, Ankara, 2021. Potassium channel family is the largest group in the ion channel superfamily. Family members are reported in all organisms ranging from bacteria to higher mammals. Potassium channels have important roles in cell growth, termination of action potential and determination of cell shape and resting membrane potential. Presence of crayfish potassium channels has been documented in previous functional studies. However, as the genome of the crayfish is not complete yet, there is limited information about the molecular properties of potassium channels. To reveal potassium channel coding genes in the crayfish, conventional cloning methods have been employed. As a result of the present study, gene sequences have been revealed for an Inward Rectifier Potassium Channel (Kir) and a Calcium-activated (KCa) type of Potassium Channel. Gene sequences show strong similarity to known potassium channels from closely related species and they share characteristic features of the potassium channel family. Revealed genes have been cloned to appropriate expression vectors. Crayfish Kir channel has been expressed in Xenopus oocytes and inward currents have been recorded via two electrode voltage clamp. Compiled data indicates that in crayfish genome are present multiple Potassium Channel genes which have been functionally expressed. It was identified that the cloned genes are belonging to two different potassium channels.Ergin, B., Molecular Properties of Crayfish Potassium Channels. Hacettepe Üniversitesi Sağlık Bilimleri Enstitüsü Biyofizik Programı Doktora Tezi, Ankara, 2021. İyon kanalı süper-ailesi içerisindeki en büyük aileyi Potasyum Kanalı ailesi oluşturmaktadır. Bu ailenin üyelerine bakterilerden en gelişmiş memelilere kadar tüm organizmalarda rastlanmaktadır. Potasyum kanalları, hücre büyümesinde, aksiyon potansiyelinin sonlandırılmasında, hücre şeklinin ve zar istirahat potansiyelinin belirlenmesinde önemli rollere sahiptir. Kerevit potasyum kanallarının varlığı yapılan fonksiyonel çalışmalar ile gösterilmiştir. Ancak, kerevit genomunun henüz tamamlanmamış olması nedeniyle Potasyum Kanallarının moleküler özelliklerine dair bilinenler sınırlıdır. Kerevitte Potasyum Kanallarını kodlayan genlerin tespit edilebilmesi için konvansiyonel klonlama teknikleri kullanılmıştır. Bu çalışma sonucunda Kerevit İçe Rektifiye (Kir) ve Kalsiyumla Aktive olan (KCa) Potasyum Kanalı genlerine ait sekanslar ortaya çıkarılmıştır. İlgili sekansların yakın türlere ait bilinen kanal genleri ile yüksek oranda benzerlik gösterdikleri ve Potasyum Kanalı ailesine has temel özellikleri taşıdıkları tespit edilmiştir. Tespit edilen genler uygun birer ifade vektörüne aktarılmıştır. Kerevit Kir Kanalı Xenopus yumurtalarında ifade ettirilerek, iki elektrotlu voltaj kıskacı tekniği ile içe yönelik potasyum akım kayıtları elde edilmiştir. Dizi analizi, üç boyutlu yapısal analiz ve heterelog ifade deneyleri sonucunda klonlanan genin içe rektifiye olan tipte bir potasyum kanalına ait olduğu sonucuna varılmıştır. Bu çalışmada elde edilen bulgular sonucunda kerevit genomunda birden fazla potasyum kanalı geninin mevcut olduğu ve bunların fonksiyonel olarak ifade edildiği ve de novo klonlanmış olan genlerin iki farklı tipte potasyum kanalını kodladığı anlaşılmaktadır

Electromechanical heart tissue model using cellular automaton

In this study, electrical and mechanical properties of the heart tissue are modeled for normal heart beat. Contraction of the tissue via electrical activation has also been considered in terms of time synchronization. “Cellular automaton” method is used for modeling the 2 dimensional heart tissue and electromechanical interactions. Using this method, both the normal heart beat's electrical activation and the arrhythmia excitation could be taken on, without using complex differential equations. To consider the anisotropy of the heart tissue, fiber orientations have also been added to the model

Violence toward health care workers in emergency departments in Denizli, Turkey

This study sought to determine the frequency and types of violence that occurred during the previous year against health care workers in emergency departments in Denizli, Turkey, and to discern the views of workers on the prevention of such aggressive behavior. This study was conducted from March 1 to April 15, 2003, and included a group of 79 health care workers from the emergency departments of 3 hospitals in Denizli, namely, the Hospital of Pamukkale University Medical Faculty, the City Hospital of Denizli, and the Hospital of the Social Insurance Foundation. Data were collected from a self-administered questionnaire. In all, 88.6% of participants had been subjected to or had witnessed verbal violence, and 49.4% of them had been subjected to or had witnessed physical violence during the previous year. The most frequent reason (31.4%) for violence was abuse of alcohol and drugs by perpetrators. The second most frequent reason (24.7%) was the long waiting times typical of emergency departments. The most common type of violence was loud shouting; swearing, threatening, and hitting were the next most frequent violent behaviors. In all, 36.1% of subjects who had experienced violence reported that they developed psychological problems after the incident. Most participants commented on the insufficiency of currently available security systems within emergency departments and on the need for further training about violence. All health care personnel within emergency departments should be aware of the risk of violence and should be prepared for unpredictable conditions and events; in addition, security systems should be updated so that violence within emergency departments can be prevented. ©2006 Health Communications Inc

Effect of Touch Coordinate Display As a Form of Augmented, Concurrent Visual Feedback on The Accuracy of Single-Handed Typing Via Smartphone Virtual Keyboards

This study assessed the effect of an easily perceived real-time visual feedback method on touchscreen typing accuracy. Thirty subjects were asked to hold a smartphone with a capacitive touchscreen in one hand and enter a text using the thumb of the same hand via a custom designed virtual keyboard. There were two types of text entry sessions: with or without visual feedback. The visual feedback consisted of a full-screen crosshair, representing the accurate coordinate of touch in real time. In each session, touch-down time on the virtual keyboard and touch coordinates were recorded for every touch action. Two types of typing errors were defined: 1) centering error (CE), which was calculated as the mm distance between the coordinate of the touch and the center of the key, and 2) incorrect entry (IE), which was the number of missed keys. Student t-tests and Wilcoxon tests were used for mean and mean-rank comparisons of CE and IE, respectively. The results showed that visual feedback decreased CE (mean SD) significantly from 1.34 +/- 0.38 mm to 0.85 +/- 0.24 mm (P < 0.0005), and decreased IE (median and range, # of incorrect entries) significantly from 5.50 and 32.00 to 1.00 and 7.00 (P < 0.005). In conclusion, the accurate, easily perceived, and 2D real-time feedback decreases touch-typing error rates markedly and therefore can be of practical importance for increasing the productivity of smartphone users.WoSScopu

Fallopian tube herniation from trocar-site after laparoscopic appendectomy

Trocar site hernias are a type of incisional hernias and may occur within a variable time shift after surgery. A mean incidence of 1.85% was reported, and the first trocar site hernia was narrated by Maio et al. in 1991 describing small bowel obstruction due to trocar site herniation after laparoscopic cholecystectomy. The 10-mm-trocar port is more frequently problematic, and a trocar site hernia in 5 mm port is very rare. This report unveils a 5mm trocar site herniation of right fallopian tube following laparoscopic appendectomy. In this case study, a 19-year-old female patient applied to the emergency department because of a discharge in the right lower quadrant was reported. She explained that she had undergone laparoscopic appendectomy two days before and discharged the next day uneventfully. The surgical report described a suction drain in the right lower quadrant where the patient was suffering from the discharge. The physical examination revealed no tenderness, but an abdominal CT disclosed an edematous tubular structure herniating from the 5 mm trocar site where the drain was put. She was re-operated laparoscopically due to early trocar site hernia, and the right fallopian tube was observed herniating through the defect. After the reduction into the abdomen, the fallopian tube was observed fine, and the defect was closed using 2/0 polypropylene suture. Trocar site hernias are rare but may cause serious complications after laparoscopic surgery. They may occur early after the surgery, but the time shift is variable. Although mechanical bowel obstructions are more frequent endpoint, it should be remembered that any organ within the abdominal cavity may herniate