Influence of Blood Collection Systems on Coagulation Tests

OBJECTIVE: Coagulation tests are influenced by pre-analytic conditions such as blood collection systems. Change of glass collection tubes with plastic ones will cause alteration of the test results. The aim of this study was to compare three plastic blood collection tubes with a standard glass blood collection tube and each plastic collection tube with the other two for possible additional tube-to- tube differences. METHODS: A total of 284 blood samples were obtained from 42 patients receiving warfarin during their routine controls, besides 29 healthy volunteers. Subgroup analyses were done according to health status. RESULTS: Our study demonstrated that different blood collection tubes have a statistically significant influence on coagulation tests. The magnitude of the effect depends on the tube used. However most of the tests performed on samples obtained from any tube correlated significantly with results obtained from other tube samples. CONCLUSION: Although blood collection tubes with different brands or properties will have distinct effects on coagulation tests, the influence of these blood collection tubes may be relatively small to interfere with decision-making on dose prescription, therefore lack clinical importance. Correlations between the results showed that, one of these plastic blood collection tubes tested in our study, can be used interchangably for a wide variety of coagulation assays

The Human Papilloma Virus Vaccination: Turkish Mothers’ Views

Objectives: This study was conducted in order to analyze the knowledge and opinions of mothers of daughters in Turkey regarding the human papilloma virus (HPV) vaccine. Methods: This descriptive study was conducted at 8 public family health centers at primary health care institutions affiliated with the Ministry of Health located in Ataehir, in Istanbul province. A total of 252 mothers of daughters participated. A sociodemographic characteristics form and an HPV vaccine evaluation questionnaire were used to collect the data. The data were analyzed using percentage, frequency distribution, a chi-square test, and Fisher's exact test. Results: Most of the participating mothers were between the ages of 28 and 47 years (68.7\%), had a high school graduate education or less (82.5\%), were not employed (67.9\%), and had a low family income (57.6\%). The majority (95.6\%) had no experience with cervical cancer in their family, 60.7\% had never heard of HPV infection, 72.2\% did not know that HPV infection is related to cervical cancer, 54.8\% had never heard of the HPV vaccine, 89.7\% had not been advised to have their daughters vaccinated, and 98.8\% had not yet had their daughters vaccinated. Among the factors influencing the mothers' information about HPV infection were age (p=0.021), education level (p<0.001), work status (p<0.001), mothers' marriage age (p<0.001) and family income level (p=0.009). It was determined that a greater education level positively influenced the mothers' intention to get the HPV vaccine for their daughter (p=0.044). Conclusion: This study revealed that the mothers had very limited knowledge of the HPV vaccine and that health professionals do not sufficiently inform parents on this subject. It was also found that the high cost of the vaccine and other influences had a negative impact on intention to pursue obtaining the vaccine.4228-233

Yoğun Bakımda Santral Venöz Kateter Malpozisyonu: İki Olgu Sunumu

Santral venöz kateterizasyon yoğun bakımda tanı ve tedavi için sıklıkla kullanılan girişimsel bir tekniktir. Santral venöz kateterizasyon arter ponksiyonu, damar erozyonu, tromboz, malpozisyon ve enfeksiyon gibi komplikasyonlara neden olabilir. Biz bu makalede santral kateter yerleştirilen iki hastadaki kateter malpozisyonunu değerlendirmeyi amaçladık. 19 ve 72 yaşlarında iki hastamıza farklı iki endikasyonla santral venöz kateter yerleş- tirdik. Her iki hastada işlem sırasında herhangi bir komplikasyon gelişmedi. Ancak işlem sonrasında çekilen akciğer grafisinde kateter malpozisyonlarını tespit ettik. Kateter malpozisyonlarının belirlenmesinde işlem sonrası radyolojik görüntülemenin önemini vurgulamayı amaçladık. Ayrıca ultrason eşliğinde santral venöz kateterizasyon bu tür malpozisyonları önleyebilir ve komplikasyon oranlarını azaltabilir

Surgical and Histopathological Effects of Topical Ankaferd (R) Hemostat on Major Arterial Vessel Injury Related to Elevated Intra-Arterial Blood Pressure

Objective: The aim of this study was to assess the surgical and histopathological hemostatic effects of topical Ankaferd blood stopper (ABS) on major arterial vessel injury related to elevated intra-arterial blood pressure in an experimental rabbit model. Materials and Methods: The study included 14 New Zealand rabbits. ABS was used to treat femoral artery puncture on 1 side in each animal and the other untreated side served as the control. Likewise, for abdominal aortic puncture, only 50% of the aortic injuries received topical liquid ABS and the others did not (control). The experiment was performed under conditions of normal arterial blood pressure and was repeated with a 50% increase in blood pressure. Histopathological analysis was performed in all of the studied animals. Results: Mean bleeding time in the control femoral arteries was 105.0 +/- 18.3 s, versus 51.4 +/- 9.8 s (p<0.05) in those treated with ABS. Mean blood loss from the punctured control femoral arteries was 5.0 +/- 1.5 mg and 1.6 +/- 0.4 mg from those treated with ABS (p<0.05). Histopathological examination of the damaged arterial structures showed that ABS induced red blood cell aggregates. Conclusion: ABS administered to experimental major arterial vessel injury reduced both bleeding time and blood loss under conditions of normal and elevated intra-arterial blood pressure. ABS-induced erythroid aggregation was prominent at the vascular tissue level. These findings will inform the design of future experimental and clinical studies on the anti-bleeding and vascular repairing effects of the novel hemostatic agent ABS. (Turk J Hematol 2011; 28: 206-12)WoSScopu

Coexistence of Obstructive Sleep Apnea and Superior Vena Cava Syndromes Due to Substernal Goitre in a Patient With Respiratory Failure: A Case Report.

Substernal goiter may rarely cause superior vena cava syndrome (SVCS) owing to venous compression, and cause acute respiratory failure due to tracheal compression. Obstructive sleep apnea syndrome (OSAS) may rarely occur when there is a narrowing of upper airway by edema and vascular congestion resulting from SVCS

“Araştırma Nasıl tasarlanır?

Ulus T. İnce CH, Aliustaoğlu FS, Melez TS. “Araştırma Nasıl tasarlanır?&nbsp;Araştırma, veri toplama biçimiönceden bir protokol aracılığı ilebelirlenmiş işlemler dizisidir. Biraraştırmanın sonuçlarının geçerlive güvenilir olabilmesi için bilim-sel yöntemler kullanılmalıdır.Bilimsel yaklaşımda, araştırılmakistenen konunun içerdiği değiş-kenlerin doğru tanımlanması vedeğişkenler arasındaki ilişkilerinedinilmiş önbilgi ve gözlemler-le doğru yorumlanarak başarılıhipotezler oluşturulması önem-lidir. Değişkenler arasındakiilişkilerin doğru yorumlanma-sı ‘nedensellik’ başlığı altındatoplanarak incelenmiş, ilişkininkuvveti, tutarlılığı, özgüllüğü ilebirlikte zamana ve elde bulunantüm bilgilere uygunluk göster-mesi nedenselliğin 5 temel kri-teri olarak belirlenmiştir. Hipotezoluşturulduktan sonra hipotezinsınanması için kullanılan yöntem-ler öncelikle niteliksel(kalitatif)ve niceliksel(kantitatif) yön-temler olarak ayrılmış;niceliksel(kantitatif) araştırmalarkendi içinde gözlemsel, deneyselve metodolojik çalışmalar olaraksınıflanmıştır. Bu araştırma yön-temlerinden gözlemsel çalışmayöntemi kendi içinde yine sınıfla-narak incelenmiştir.Bir araştırmada hipotez ve yöntemdoğru belirlendiğinde çalışmanındoğruluğunu etkileyecek yanlışgruplama, yanlış ölçüm, yanlışistatistik gibi hatalardan kaçınıl-dığında başarı beklenen bir sonuçolarak öngörülmektedir.Anahtar kelimeler: Hipotez, ne-densellik, araştırma yöntemler&nbsp;Ulus T. İnce CH, Aliustaoğlu FS, Melez TS.&nbsp;HOW IS A RESEARCH DESIGNED?ABSTRACTResearch is a sum of serial pro-cedures in which the method ofdata collection is determined witha protocol prepared formerly. Sci-entific methods should be used inorder to be able to have valid andreliable outcomes.Composing a successful hypothe-sis by correct variable descripti-ons and by correct interpretationsof relations among variables withpre-gained information and ob-servation is important accordingto scientific approach. Correct in-terpretatons of relations amongvariables can be subsumed underthe concept of ‘causality’, whereas5 main criteria of causality are thestrength, consistency, specificityof correlation and accordance ofcorrelation with time and all otherdata. After composing the hypot-hesis, testing of hypothesis is donewith many methods which can bedivided as ‘qualitative’ and ‘quan-titative’. Quantitative researchesare also classified into observa-tional, experimental and metho-dological researches. Besides,observational researches can beevaluated again with further clas-sifications.In a research, unless there hap-pens mistakes in grouping, me-asurement, statistics etc., whichmay affect the accuracy of thestudy, success is seemed to be aforeseeable result.Keywords: Hypothesis, causality,research methods&nbsp;</div

Coexistence of Obstructive Sleep Apnea and Superior Vena Cava Syndromes Due to Substernal Goitre in a Patient With Respiratory Failure: A Case Report

Introduction: Substernal goiter may rarely cause superior vena cava syndrome (SVCS) owing to venous compression, and cause acute respiratory failure due to tracheal compression. Obstructive sleep apnea syndrome (OSAS) may rarely occur when there is a narrowing of upper airway by edema and vascular congestion resulting from SVCS. Case Presentation: We presented the clinical course and treatment of acute respiratory failure (ARF) developed in a patient with SVCS and OSAS due to substernal goiter. After treatment of ARF with invasive mechanical ventilation, weaning and total thyroidectomy were successfully performed through collar incision and median sternotomy without complications. Conclusions: Our case showed that if the respiratory failure occurred due to substernal goiter and SVCS, we would need to investigate the coexistence of OSAS and SVCS

The gender differences in the relaxation to levosimendan of human internal mammary artery

Purpose The mechanism of the vasorelaxation to levosimendan varies depending on the vascular bed and species studied. Here, we examined the vasorelaxation to levosimendan as well as its modification by various potassium channel antagonists in human internal mammary artery (IMA) obtained from male and female patients

Hepatic amyloidosis: Morphologic spectrum of histopathological changes in AA and nonAA amyloidosis

WOS: 000313231700004PubMed ID: 23154038In hepatic amyloidosis (HA), the relationships between the pattern and extent of amyloid deposition, morphologic changes, associated diseases and clinical data have not yet been demonstrated. In this study, we sought the correlation between the above mentioned parameters in HA. Liver biopsies of 34 HA were retrospectively analyzed for the type, distribution, and intensity of amyloid deposition and associated morphologic changes. AA and nonAA types were classified on the basis of immunohistochemistry. Follow-up clinical and laboratory findings were reviewed. Twenty-three out of 34 patients (67.6%) had AA, and 11 out of 34 patients (32.4%) had nonAA amyloidosis. The predominant localization pattern in AA amyloidosis was vascular (91.3%), and in nonAA amyloidosis it was mixed with other patterns (72.7%). We confirmed that nonAA amyloid involves the hepatic artery, as well as the portal and central vein, but deposition occurred more frequently in the sinusoidal areas. We detected a portal stromal pattern only in cases of nonAA amyloidosis with a mixed pattern of amyloid deposition. The pattern of amyloid deposition in liver differs between the AA and nonAA type amyloidosis. The distribution of amyloid within the liver is not a reliable method for distinguishing AA from nonAA amyloidosis. However, the histological pattern provides strong clues as to the etiology of the amyloid deposits, and could provide information on the clinical status and prognosis of these patients. (c) 2012 Elsevier GmbH. All rights reserved

Seizure due to multiple drugs intoxication: a case report

The mechanism of the antidepressant effect of bupropion is not fully understood. Besides, using it in the treatment of depression, it is found to be effective in reducing withdrawal symptoms due to smoking cessation. A 28-year-old female patient with a history of depression was admitted to emergency department an hour after ingestion of bupropion, quetiapine, and levothyroxine in high doses to commit suicide. While accepting her into the Intensive Care Unit, she was awake, alert, disoriented and agitated. After 2 h, the patient had a generalized tonic–clonic seizure. The necessary treatment was given and 9 h later with hemodynamic improvement, the patients’ mental status improved.Bupropion may cause unusual behaviors such as delusions, paranoia, hallucinations, or confusion. The risk of seizure is strongly dose-dependent. We want to emphasize the importance of early gastric lavage and administration of activated charcoal. Resumo: O mecanismo do efeito antidepressivo de bupropiona ainda não está bem esclarecido. Contudo, seu uso no tratamento de depressão revelou ser eficaz para reduzir os sintomas de abstinência relacionados à cessação do tabagismo. Uma paciente do sexo feminino, 28 anos, com história de depressão, deu entrada no setor de emergência uma hora após a ingestão de bupropiona, quetiapina e levotiroxina em doses elevadas para cometer suicídio. Ao ser internada em unidade de terapia intensiva, estava acordada, alerta, desorientada e agitada. Após duas horas, apresentou uma crise tônico-clônica generalizada. O tratamento necessário foi administrado e nove horas mais tarde, com a estabilização hemodinâmica, o estado mental da paciente melhorou.Bupropiona pode causar comportamentos incomuns, incluindo delírios, paranoia, alucinações ou confusão mental. O risco de convulsão é altamente dependente da dose. Queremos enfatizar a importância da lavagem gástrica precoce e da administração de carvão ativado. Keywords: Bupripion, Intensive care unit, Seizure, Palavras-chave: Bupropiona, Unidade de terapia intensiva, Convulsã