Turkey and Europe data comparison in terms of the course of the COVID-19 pandemic and health expenses

Introduction: The COVID-19 pandemic has affected the entire world and has been a challenge to the health prospects of the nations infected. The elderly population of the nations and parameters like the countries' health system and the allocation of budget to health are critical factors for explaining the epidemic's development with different mortality rates in various countries. The purpose of the study was to assess the characteristics of the Turkish population, COVID cases, the progression of diseases, and health expenditures compared to those in Europe.Methods: For this study, we used the following databases: the Worldometer digital database, the database of the Organization for Economic Cooperation and Development, and the Turkish National Databases on Economic and Finance references, such as the Turkish National Strategy and Budget Presidency and the database of the Turkish Statistical Institute. The data was for the date 15.12.2021 and the general annual for 2020.Results: By the investigation date as of 15/12/2021, the total number of COVID-19 cases was 9209740 in Turkey and 81556853 in the European Union countries. The incidence of the disease was 107.500 in Turkey and 135.525 in Europe. While the total change/ increase in last-week-new cases was -5% and 8% in Turkey and Europe, respectively, the real change/ increase in last-week-deaths was -1% to -8% in Turkey and Europe. The number of COVID screening tests per one million population was higher in Europe (1.343.256 to 8.790.27 in Turkey and Europe, respectively). The GDP and health expenditure per capita were distinctly higher in Europe.Conclusion: The fact that there is a higher percentage of elderly residents in European countries than in Turkey, that the number of new cases detected every week is higher, and that the death rate and the gradual decline in cases are linked to the large share of health expenditures distributed by nations for the fight against the disease

A delayed diagnosis: stridor secondary to hypocalcemia

Hypocalcemia with stridor is a well-known condition in the pediatric age group but has rarely been reported in the elderly. We report an elderly patient who presented with dyspnea and laryngeal stridor attack caused by hypocalcemia. The patient had been suffering from stridor and dyspnea episodes for 2 years, and the etiology had not been determined until the evaluation in our department. The cause of stridor was hypocalcemia secondary to thyroidectomy. Complete resolution of stridor was achieved by calcium replacement therapy

Base Excess and Lactic Acid Levels as Success Criteria in Cardiopulmonary Resuscitation

WOS: 000493402900018Objective: Cardiopulmonary arrest is a condition with high mortality and morbidity. Although the mortality rate in in-hospital arrest cases is high, the mortality rate in cardiac arrest cases outside hospital is even higher. Therefore, it is important to predict the severity of the arrest. Many studies have been performed to understand the mechanism of cardiac arrest, to improve its prevention, and to increase intervention quality. In this study we aimed to analyze the relationship between acidosis parameters and cardiopulmonary resuscitation success. Methods: We analyzed blood gas data in patients that underwent cardiopulmonary arrest out-of-hospital, had intervention by an ambulance first-aid team and Then were brought to the emergency room for advanced life support. Results: A significant difference in blood lactate levels between the groups was determined. Conclusions: Lactate and Base excess levels are parameters that could be used to assess the success of cardiopulmonary resuscitation

The role of argyrophilic nucleolar organizing region-associated proteins in clinical exacerbation of chronic obstructive pulmonary disease

TURAN SONMEZ, Feruza/0000-0001-8817-8521WOS: 000453601300014PubMed: 30088791Objective To investigate whether argyrophilic nucleolar organizing region-associated protein (AgNOR) parameters can be used as a biomarker that could potentially help with the management and clinical prognosis of chronic obstructive pulmonary disease (COPD) exacerbation. Methods This case-control study enrolled patients with COPD who were admitted to the Emergency Department and healthy sex- and age-matched control subjects. Peripheral blood samples were collected at hospital admission and the peripheral lymphocytes were silver-stained to investigate the quantity and distribution of AgNOR proteins. Fifty nuclei per patient were viewed and the total AgNOR area/total nuclear area (TAA/TNA) ratio and the mean AgNOR number for each patient were calculated. Results A total of 20 patients with COPD exacerbation and 17 healthy control subjects were recruited to the study. The TAA/TNA ratio and the mean AgNOR number were significantly higher in the patients with COPD exacerbation compared with the healthy control subjects. The mean AgNOR number showed a positive correlation with the pCO(2) levels on admission. Conclusion AgNOR protein levels were elevated during a COPD exacerbation compared with healthy control subjects and there was a positive correlation between pCO(2) levels and mean AgNOR number

Alpha-lipoic acid intoxication in an adolescent girl: Case report and review of the literature

Alpha-lipoic acid is a widely used medication that does not need a prescription. Although it is safely used in adults, hitherto no safe dose for children has been reported, and there is no known antidote. The medical literature provides four reports of alpha-lipoic acid intoxication in the pediatric population to date. This case-report is the lowest known dose of alpha-lipoic acid intake leading to poisoning in a teenager.Alfa-lipoik asit, reçeteleme gerektirmeyen, yaygın olarak kullanılan bir ilaçtır. Yetişkinlerde güvenle kullanılırken çocuklar için güvenli doz aralığı belirlenmemiştir ve bilinen bir antidotu yoktur. Dizinde dört adet alfa lipoik asit zehirlenmnesi olgusu sunulmuştur. Şu ana kadar çocuklarda adet alfa lipoik asit zehirlenmesine neden olan en düşük dozu olgumuzla bildirmekteyizWOS:00058038850001

The Role of Computerized Tomography for the Evaluation of Head Trauma in Children

WOS: 000450536200007Amaç: Kafa travması çocukların acil servise sık başvuru nedenlerindendir. Travma nedeniyle iki yaş altı çocukların bilgisayarlı tomografi gerekliliği açısından değerlendirilmesi oldukça zordur. Bu çalışmanın amacı 2 yaş altı çocukların değerlendirilmesinde gereksiz kranial bilgisayarlı tomografi çekimine dikkat çekmektir. Gereç ve Yöntem: Acil Servise, yaşları 0-24 ay arası olan ve Ocak 2011 ile Aralık 2015 tarihleri arasında gelen kafa travmalı 183 olgunun kayıtları geriye dönük olarak incelenmiştir. Bulgular: Çalışmaya dahil edilen 183 olgunun, 93’ü erkek (%50,8), 90’ı kız (%49,2) ve hastaların yaşları ortalama 13.08±6.30 (en küçük 1, en büyük 24) ay idi. Kazaların 139’u (%76) düşme, 24’ü (%13,1) araç dışı trafik kazası, 20’si (%10,9) araç içi trafik kazası sonucu gerçekleşmişti. Olguların %12’sine kranial bilgisayarlı tomografi çekilmezken, %80’ine çekilmişti. Kranial bilgisayarlı tomografi çekilen hastaların 7’sinde (%3,8) frontal kemikte, 1’inde (%0,5) temporal kemikte, 5’inde (%2,7) oksipital kemikte, 5’inde (%2,7) parietal kemikte kırık saptandı. Hastaların yatış süresi 0.54±2,90 ( en küçük 0, en büyük 27) gün idi. Olguların hiçbirinde operasyon gereksinimi olmadı. Sonuç: İki yaş altı çocuklarda, kafa travmalarında bilgisayarlı tomografi çekilme oranındaki yükseklik dikkat çekici bulundu. Bu çalışma ile özellikle hafif kafa travmalı olgularda bilgisayarlı tomografi istenmesi için doğru endikasyon konulması, daha ayrıntılı ve objektif kriterleri belirleyen çalışmalar ile istemin azaltılması gerekliliği vurgulanmıştır.Objective: Head trauma is the cause of the most common reasons for pediatric emergency admissions. The decision for computerized tomography evaluation after minor head trauma is a challenge for children in nonverbal age. This study aims to draw attention to unnecessary cranial computerized tomography scanning in children under two years of age. Methods: The records of 183 head trauma cases between the ages of 0-24 months and between January 2011 and December 2015 were reviewed retrospectively. Results: Of the 183 patients included in the study, 93 were male (50.8%), 90 were female (49.2%), and the mean age of the patients was 13.08 +/- 6.30 months (the youngest 1 months-of-age, the oldest 24 months-of-age). The distribution of the causes of the head trauma was as follow 139 (76%) accidental, 24 (13,1%) non-vehicle traffic accidents and 20 (10,9%) traffic accidents occurred. Cranial computerized tomography was performed in 80% of the cases. Moreover, was not in 12% of the cases. Patients with cranial computerized tomography had 7% (3.8%) of the frontal bone, 1 (0.5%) temporal bone, 5 (2.7%) occipital bone, and 5 (2.7%) parietal a bone fracture was detected. The duration of hospitalization was 0.54 +/- 2.90 (min 0, max 27) days. None of the cases required an operation. Conclusion: In children under two years of age, the height of computerized tomography withdrawal in head trauma was remarkable. This study emphasizes the necessity of putting the right indications for computerized tomography prompting, especially those with mild head trauma, and reducing the need for more detailed and objective criteria

Kounis Syndrome Induced by Oral Intake of Diclofenac Potassium

TURAN SONMEZ, Feruza/0000-0001-8817-8521WOS: 000424115300012PubMed: 29338163An acute coronary syndrome (ACS) occurring during the course of an allergic reaction is called Kounis syndrome (KS). The second case of KS induced by diclofenac potassium (DP) is presented in this report. A 67-year-old man was brought to our emergency department with the possible diagnosis of anaphylactic shock by the ambulance staff. It emerged that widespread erythema and pruritus developed after taking DP. Then, he lost consciousness. Diffuse urticarial lesions were detected on physical examination at the emergency department. He complained of chest pain during his observation, and progressive ST segment elevation was seen in the inferior leads on serial electrocardiograms. His coronary angiography showed 100% occlusion of the right coronary artery. Then, KS was diagnosed. The patient was discharged on the second day, and he was doing well on the control visit 2 weeks later. All allergic reactions may trigger an ACS so physicians should be aware of KS and always keep that unique clinical entity in mind to recognize it promptly and direct the therapy at suppressing the allergic reaction and improving the coronary circulation simultaneously when encountering a patient with symptoms suggesting an allergic reaction and a concomitant ACS

Carbon Monoxide Poisoning: Clinical Manifestations, Consequences, Monitoring, Diagnosis and Treatment of Toxicity

WOS: 000367541600012Carbon monoxide poisoning is a multisystem condition that may present with a wide range of symptoms and can cause a confusing constellation of clinical features. Diagnosis may be easily missed if physician is not alert about. Carbon monoxide intoxication is more frequent than it is reported. It has a simple treatment if diagnosed, and has many long-term sequela if under-treated

An unexpected presentation of sick sinus syndrome: Isolated ventricular asystole

TURAN SONMEZ, Feruza/0000-0001-8817-8521WOS: 000407941000056PubMed: 28460803Sick sinus syndrome is a disorder of sinus node function characterized by various dysrhythmias such as sinus bradycardia or pause, paroxysmal regular or irregular atrial tachycardia, tachycardiabradycardia attacks or atrial fibrillation with slow ventricular response. Ventricular asystole with preserved atrial electrical activity is a rarely seen presenting rhythm in the ED and an extremely rare cause of syncope. A 67-year-old male having a syncope attack was admitted to the emergency department. His Glasgow coma scale score was 15 on admission. He became unconscious during his observation in the emergency department, and cardiopulmonary resuscitation was initiated because he was seen to be apneic; his arterial pulse was impalpable, and ventricular asystole with preserved atrial electrical activity was seen on the monitor. He regained consciousness and normal sinus rhythm was seen on the monitor after 2 min of cardiopulmonary resuscitation. Then, an alternating rhythm with short periods of bradycardia and tachycardia suggesting sick sinus syndrome was developed. A dualchamber pacemaker was placed, and he was discharged after 2 days of in patient follow-up. His symptoms have not recurred after placement of the pacemaker device. When sudden changes in vital parameters and/ or consciousness develop during observation of a patient with sick sinus syndrome, although it is not a common circumstance, accompanying high degree atrioventricular block and simultaneous ventricular asystole should be considered, and cardiopulmonary resuscitation should be initiated immediately because cardiopulmonary arrest is inevitable when ventricular asystole develops even if the atrial electrical activity is maintained. (C) 2017 Elsevier Inc. All rights reserved