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

Evaluation of forensic cases admitted to Cumhuriyet University hospital

AMAÇ: Bu çalışmada; adli olguların demografik özellikleri ile adli olgu profilinin ortaya çıkarılması yanı sıra; hekimlerin adli rapor düzenleme aşamasında standardizasyonunun sağlanmasının adli tıp uygulamaları ve yargılama aşamasındaki öneminin vurgulanması amaçlandı. GEREÇ ve YÖNTEM: Bu çalışma; 01.01.2006-31.12.2006 tarihleri arasında Cumhuriyet Üniversitesi Tıp Fakültesi Adli TıpAnabilim Dalı'na adli rapor düzenlenmesi için adli makamlardan gönderilen olguların hastane dosyaları ile adli raporlarının retrospektif olarak incelenmesiyle yapılmıstır. Olguların tıbbi ve adli kayıtları; cinsiyet, yaş, olay türü, olay tarihi, olay yeri, gönderilen makam, yaralanan vücut bölgesi, tedavi olduğu servis, zehirlenme ve cinsel saldırı yönünden, ayrıca adli rapordaki sonuç raporları yönünden değerlendirilerek benzer çalışmalarla karşılastırıldı. BULGULAR: 1,296 olgunun %76.8'i erkekti. Olguların çoğunlukla genç ve orta yaş grubunda olduğu belirlendi. Adli olguların özellikle ağustos ayında (%10.9) daha yoğun olduğu ve çoğunlukla acil serviste (%29.9) tanı ve tedavi sonrası taburcu edildikleri saptandı.Yaşamsal tehlikeye neden olacak yaralanma oranı ise %17.4 olarak tespit edildi. Yaralanmaların en sık (%44.6) baş-boyun bölgesinde olduğu, %30.8 ile trafik kazalarının adli olguların önemli bir kısmını olusşturduğu gözlendi. SONUÇ: Hekim güvenliği ve hasta mağduriyetinin önlenmesi açısından adli olguların özellikle raporlama aşamasının daha özenli yapılması için mezuniyet sonrası adli tıp eğitimi ve adli tıp uzmanları ile koordineli çalışma gereklidir.OBJECTIVE: The aim of this study is to reveal demographic properties and profile of forensic cases in addition to emphasize the importance of forensic report standardization in forensic medical practises and judicial process. MATERIALS and METHODS: This study, were reviewed retrospectively hospital files and forensic reports of cases who have been sent to Cumhuriyet University Medical Faculty Department of Forensic Medicine from by judicial authorities for organizing the forensic reports between the dates 01.01.2006-31.12.2006. The medical and judicial data that were evaluated according to gender, age, event type, event date, event location, sent to the authorities, injuring the body regions, the treatment services, intoxication, sexual assaults and also the results of forensic reports were compared with similar studies. RESULTS: Among 1.296 patients 76.8% were men. Most of the cases were young and middle aged group. Forensic cases were higher in number especially in August (10.9%) and discharged following diagnosis and treatment in emergency services (29.9%). Injuries with vital severity were identified as 17.4%. Injuries were most frequent (44.6%) at head-neck region and a significant ratio of forensic cases were caused by traffic accidents (%30.8). CONCLUSION: As a conclusion; to protect physcian and patients' rights, to control forensic reports more carefully, a coordinated study with forensic medical specialists is required during post graduation education of forensics

Procalcitonin and other acute phase reactants in patients with chronic obstructive pulmonary disease exacerbation

The aim of this study was to investigate the correlation between procalcitonin and other acute phase reactants, and also analyze their relationship with clinical situation in chronic obstructive pulmonary disease (COPD) acute exacerbations.Materials and methods: The study was made with 122 acute COPD exacerbated patients, who were admitted to emergency service. Patients with below 0.25 ng/ml PCT value included Group 1, and the patients with PCT values ≥ 0.25 ng/ml Group 2. Serum procalcitonin levels, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) values and white blood cell (WBC) counts were measured. Also, patients hospitalization time and mortality rates were recorded and compared with PCT.Results: Patients were divided in 3 groups according to their clinical diagnosis; Pneumonia (n=27), Mycoplasma-Chlamydia pneumonia (n=11) and the patients with only COPD exacerbation(n=84). Mean PCT values according to the groups were 9.47 ± 8.1 ng/ml, 0.41 ± 0.2 ng/ml, and 0.21 ± 0.05 ng/ml respectively. The relationship between PCT with CRP and white blood cell has been found between significiant (p=0.001, p=0.005 respectively), whereas the relationship between PCT and ESR was nonsignificant (p=0.55). Procalcitonin and CRP had a positive correlation with the hospitalization time (p=0.034, p=0.022 respectively). The mean ± standard error of PCT for the patients who died was 28.3 ± 27.5 ng/ml, and the difference between patients who died or were discharged was statistically significant (p= 0.012).Conclusion: PCT can be a useful indicator for morbidity and prognosis in COPD patients

The Clinical Significiance of Multimarker Index for Early Diagnosis Among the Patients Admitted to the Emergency Department with Suspected Stroke

Objective: Cerebrovascular diseases have a high rate in emergency services. We investigated the value of MMX in plasma for early diagnosis among the patients with suspected cerebrovascular disease and the correlation between the emergency, triage and neurology physician diagnoses. Material and Methods: It is a prospective study carried out with 83 patients. Pre-prepared forms were filled with the data about the patients. Samples of 1cc venous blood were measured for MMX and the results classified as normal or pathologic. The correlation between the results and physician diagnosis was investigated. Results: 44 (53%) of 83 patients were male, 39 (47%) were female. The average age was 69.1 (37-90) years. Neurology physician diagnosis, accepted as the gold standard, was compared with the triage, emergency physician diagnosis and MMX results by ROC curve analysis, and the difference was not significiant (p>0.05). When the diagnoses of the emergency physician were compared with the MMX results, the compatiblity for definite and probable strokes were 100% and 92.1%. The rates for triage physician were 100% and 96.4%. Conclusion: As a result of this study we can say that the stroke probablity is high if MMX is high in patients with suspected cerebrovascular disease, but more studies with large population groups are needed for specifity assessment