Evaluation of the prognostic role of NLR, LMR, PLR, and LCR ratio in COVID-19 patients

We aimed to find the most useful biomarker by examining the prognostic effect of neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR), platelet-lymphocyte ratio (PLR), and lymphocyte-C reactive protein ratio (LCR) in patients with coronavirus disease 2019 (COVID-19). Three hundred and four patients diagnosed with COVID-19 infection in our hospital within 5 months (April-August 2020) were examined. Laboratory values and demographic findings of the patients were analyzed retrospectively. Thirty-six patients were diagnosed with severe cases. The ratio of NLR, LMR, PLR, and LCR of patients with severe and those with nonsevere clinical symptoms were statistically analyzed. The NLR and PLR ratios of those with severe clinical symptoms were significantly higher (p < 0.001), the LCR rate was significantly lower (p < 0.001), and there was no significant difference in the LMR rate (p = 0.199). When we examined other peripheral blood parameters, we found that CRP was high, lymphocyte and monocyte were low (p < 0.001), but neutrophil (p = 0.416) and platelet (p = 0.998) were not statistically different between the groups. According to the results, routine blood values are abnormal in patients with COVID-19. NLR, PLR, and LCR ratios can be used as more significant biomarkers than other values in predicting the prognosis of patients

Does heated erythrocyte suspension transfusion with medical devices containing phthalates increase DEHP and MEHP leveis?

Does heated erythrocyte suspension transfusion with medical devices containing phthalates increase DEHP and MEHP leveis?</p

Characteristics of non-urgent visits in emergency department

Aim: In recent years, the number of patients using the emergency department is increasing and majority of these patients constitute non-emergency patients. In this study, it was aimed to examine the green field patients who applied to the emergency department of a tertiary hospital by non-urgent reasons and define the socio-demographic characteristics, the reasons for preferring the emergency department, to assess the rate of urgency defined by the participant, and to contribute to the literature by obtaining data for our country. Materials and Methods: This is a cross-sectional study in which the subjects were selected among the whole green area patients applied to emergency department in between 02 and 11 November 2018. Among these patients, the subjects who did not accept to be included to the study and didn’t fulfill the inclusion criteria were excluded. As a result, a total of 716 patients who accepted to be in the study and fulfilled the inclusion criteria were included to the study. Then, a questionnaire for the aim of assessing the socio- demographic characteristics and the reasons for preferring the emergency department, involving a scale to define the self-report of urgency were applied to those 716 volunteered patients. Results: In our study, 23.9 % of a total of 5644 patients applied to emergency department in between 02 and 11 November 2018 were grouped as non-urgent green area patients by the triage personnel. Of these green area patients those who accepted to be included to the study and fulfilled the inclusion criteria; 356 were female (49.7 %) and 360 were male (50.3 %). When the participants were evaluated according to their level of educations, 5.4 % were illiterate, 4.1 % were literate but had no school graduate, 30.6 % were primary education graduates and 13.4 % were university graduates. According to the reasons for choosing the emergency department, 48.2 % of the patients stated that they applied to the emergency department in need of emergency treatment, 22.5 % of the visitors declared that they were unable to get permission from their work in their working hours and 13.1 % of the visitors applied due to their opinion that things were progressing faster in the emergency department. In addition, the patients were asked to scale their urgency in a 10-point scale and the mean rate of urgency defined by the participants in the self-report scale was found to be 6 points (0-10) and negative correlation was observed between education levels and urgent levels. Conclusion: In this study, we obtained descriptive data about the green field patients who applied to the emergency department by non-urgent reasons, defined their socio-demographic characteristics, revealed the reasons for non-urgent applications to the emergency department, and assessed the self-rate of urgency defined by the participants. Since it can be predicted that the overcrowding generated by these non-urgent visits has negative effects and consequence on patients and employees; we consider that this study and similar studies may be helpful in describing the current problem, may help to solve the problem by contributing to the literature

Does heated erythrocyte suspension transfusion with medical devices containing phthalates increase DEHP and MEHP levels?

Aims It is commonly known that stored blood and blood products are heated before transfusion to prevent hypothermia, which leads to increased di-(2-ethylhexyl) phthalate (DEHP) content leaching into the blood and blood products and thereby causes greater conversion of DEHP to mono (2-ethylhexyl) phthalate (MEHP). However, there has been no study in the literature reporting on the amount of toxic phthalates in blood following the erythrocyte suspension (ES) transfused via warming. In this study, we aimed to investigate the DEHP and MEHP content in blood following the heated ES transfusions administered by DEHP-containing and DEHP-free infusion sets. Methods The study included 30 patients that were randomly divided into two groups with 15 patients each: group I underwent ES transfusion via DEHP-containing infusion sets warmed with blood-fluid warmers, and group II underwent ES transfusion via DEHP-free infusion sets warmed with blood-fluid warmers. DEHP and MEHP levels were measured both before and after transfusion. Results DEHP-free infusion sets led to no increase in the phthalate content, whereas DEHP-containing infusion sets significantly increased the DEHP and MEHP, where the DEHP level increased almost four times (P = .001). Conclusion DEHP-containing products lead to toxicity. Therefore, using DEHP-free medical devices may prevent toxicity in patients undergoing ES transfusion.Yuzuncu Yil University Individual Research ProjectYuzuncu Yil University [2013-TF-B029]Yuzuncu Yil University Individual Research Project (2013-TF-B029

Toxicity of Lidocaine Improved with Lipid Emulsion Treatment: Case Report

During general anesthesia and intensive care applications that require control of the airway respiratory, cardiovascular reflex responses occur thus myocardial oxygen delivery and consumption can be negatively affected. To prevent these effects, lidocaine, opioids, magnesium, calcium channel blockers, beta- blockers have been used. Local anesthetic toxicity; is usually known to occur when used over the range of safe dose of local anesthetics. It has been shown in a variety of animal and clinical studies that a lipid emulsion used for parenteral nutrition improves resistance to fatal cardiac effects caused by local anesthetics. Herein, we presented a case who had developed sudden bradycardia, asystole by iv. lidocaine which is used for tracheal intubation and improved dramatically after treatment with lipid emulsion in the light of the literatures. According to our knowledge it is the first case which is succesfully resuciatated with clinoleic in local anesthetic toxicity in literature

Delta hepatitis-related thyroid disease: a unique phenomenon

Introduction: Hepatitis delta virus (HDV) infection is a serious health problem worldwide. Thyroid disturbances represent a major limitation to the efficacy of interferon treatment targeting chronic HDV (C-HDV) infection. Moreover, pre-treatment thyroid diseases may be influenced by interferon therapy. Despite this, the characteristic features of the thyroid diseases in C-HDV patients remain poorly characterised

NEUROSURGICAL INJURIES CAUSED BY THE 2011 VAN EARTHQUAKE: THE EXPERIENCE AT THE VAN REGIONAL TRAINING AND RESEARCH HOSPITAL

Background: On October 23, 2011, a devastating earthquake, magnitude 7.2 on the Richter Scale, jolted the province of Van in the east of Turkey and led to hundreds of casualties. Objectives: In this study, we aimed to present our clinical experience in the management of patients with cranial and spinal injuries who were admitted to the Van Regional Training and Research Hospital. Methods: The retrospective study included 44 (77.2%) patients who were referred to the neurosurgery department after being diagnosed with spinal and cranial injuries due to earthquake at the emergency department between October 23 and 27, 2011. Results: The patients comprised 32 male (72.7%) and 12 (27.3%) female patients with a mean age of 23.5 years. The injuries included scalp injury (n=16), burst fracture (n=7), compression fracture (n=3), epidural hematoma (n=9), subdural hematoma (n=3), contusion (n=1), traumatic subarachnoid hemorrhage (n=2), depressed skull fracture (n=3), linear fracture (n=9), cervical fracture (n=2), and pneumocephalus (n=1). Most of the patients (90.9%) had isolated injuries and the others (9.1%) presented with combined cranial and spinal injuries. At discharge, the 3 patients with spinal fractures were paraplegic, and of the 2 patients who were operatively treated due to subdural hematoma, 1 was hemiparesic and the other was hemiplegic. No mortality occurred in our patients. Conclusions: The results of this study demonstrated that, in the aftermath of a natural disaster, conducting correct triage procedures and performing a prompt intervention with appropriate and qualified equipment play key roles in reducing morbidity and mortality. (C) 2015 Elsevier Inc

The levels of trace elements and heavy metals in patients with acute migraine headache

Objective: To compare the levels of trace elements and heavy metal in patients with acute migraine and healthy controls