Analyzing Main and Interaction Effects of Length of Stay Determinants in Emergency Departments

Background: Measuring and understanding main determinants of length of stay (LOS) in emergency departments (EDs) is critical from an operations perspective, since LOS is one of the main performance indicators of ED operations. Therefore, this study analyzes both the main and interaction effects of four widely-used independent determinants of ED-LOS.Methods: The analysis was conducted using secondary data from an ED of a large urban hospital in Izmir, Turkey. Between-subject factorial analysis of variance (ANOVA) was used to test the main and interaction effects of the corresponding factors. P values <.05 were considered statistically significant.Results: While the main effect of gender was insignificant, age, mode of arrival, and clinical acuity had significant effects, whereby ED-LOS was significantly higher for the elderly, those arriving by ambulance, and clinically-categorized high-acuity patients. Additionally, there was an interaction between the age and clinical acuity in that, while ED-LOS increased with age for high acuity patients, the opposite trend occurred for low acuity patients. When ED-LOS was modeled using gender, age, and mode of arrival, there was a significant interaction between age and mode of arrival. However, this interaction was not significant when the model included age, mode of arrival, and clinical acuity. Conclusion: Significant interactions exist between commonly used ED-LOS determinants. Therefore, interaction effects should be considered in analyzing and modelling ED-LOS

Comparison of rapid antibody test and thorax computed tomography results in patients who underwent RT-PCR with the pre-diagnosis of COVID-19

Introduction In this study, it is planned to compare the real-time reverse transcription-polymerase chain reaction (RT-PCR) test, which is the gold standard in the diagnosis of COVID-19, with thorax computed tomography (CT) and rapid antibody test results. Methods Patients who were admitted to the emergency service of Izmir cigli Training and Research Hospital between 01.04.2020 and 31.05.2020 and who were suspected of having COVID-19 infection were included in the study. The medical records of the patients were retrospectively analysed through the hospital data processing database. Age, gender, hospitalisation, status of home quarantine, real-time RT-PCR, thorax CT and rapid antibody test results of the patients were examined. The relationship between RT-PCR, thorax CT and rapid antibody test results was compared statistically. Results A total of 181 patients, 115 (63.5%) male and 66 (36.5%) female, with an average age of 56.4 +/- 18.06 years were included in the study. The nasopharyngeal swab PCR result obtained at the first admission of the patients to the emergency department was positive in 71 (39.2%) patients. Rapid antibody tests performed at hospital admission were positive in 57 (31.5%) patients. Thorax CT was performed in 173 (95.6%) patients who applied to the emergency department, and 112 (64.7%) of them had findings that could be compatible with COVID-19. According to the thorax CT findings in patients, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for detecting COVID-19 infection were, respectively, 76.1%, 43.1%, 48.2% and 72.1% (kappa: 0.176, P < .001). According to the rapid antibody test results, sensitivity, specificity, PPV and NPV for detecting COVID-19 infection were 57.5%, 85.5%, 71.9% and 75.8%, respectively (kappa: 0.448, P < .001). In our study, the mortality rate for COVID-19 was found to be 2.8%. Conclusion Rapid antibody test and thorax CT examinations were found to have low diagnostic value in patients who admitted to the emergency department of our hospital and whose first RT-PCR SARS-CoV-2 test was positive. Studies involving larger patient groups are needed for their use alone in diagnosis and screening

A novel biochemical marker for predicting the severity of ACS with unstable angina pectoris: Asprosin

WOS: 000439103800039PubMed ID: 29274804Ischemic Heart Disease (IHD) is the leading cause of death world-wide, accounting for 12.7% of global mortality[1] . Acute Coronary Syn-drome (ACS) covers a wide spectrum of clinical conditions ranging fromunstable angina to Non-ST Elevation Myocardial Infarction (N-STEMI)and ST Elevation Myocardial Infarction (STEMI). New treatments andmanagement guidelines emerge for the care of patients with ACS; riskstratification is the cornerstone in the initial evaluation of these patients[2] . That inflammatory mediators play a role duringthe evolution of ACSis indicated by the widespread coronary inflammation found during un-stable angina pectoris (UAP), throughout theentire coronary artery bed,and in the extent that ACS outcome is related to a concurrent inflamma-toryresponse[3,4] . Circulatingasprosin,a protein hormone, responds tolow dietary glucose by triggering the release of liver glucose stores, andthe reduction of asprosin protects against the hyperinsulinism associat-ed with metabolic syndrome

Romatizmal hastalık ndeni ile hidroksiklorokinin kullanımının Covid-19'a yakalanma ve hastalık seyri üzerine etkisi

Giriş: COVID-19 virüsü dünya çapında yayılmaya ve öldürmeye devam etmektedir. Hidroksiklorokinin etkinliği ve güvenilirliği kanıtlanmadığı için klinik araştırmalar dışında profilaksi için kullanılmaması gerektiği bildirilmiştir. Ancak yerel bir alanda yaptığımız bu çalışmanın sonuçlarının literatür verilerine katkı sağlayacağını düşünüyoruz. Gereç ve Yöntem: Bu çalışmada romatolojik hastalıkları nedeniyle hidroksiklorokin kullanan ve kullanmayan erişkin hastalar retrospektif değerlendirildi. Hidroksiklorokin kullanmayan hastalar kontrol grubu olarak belirlendi. PCR sonuçları ile hastaların hidroksiklorokinin kullanım özellikleri karşılaştırıldı. Bulgular: Hastaların çoğunluğunu (ortanca yaş: 51.8- 17-89 arası) kadınlar (en sık ev hanımı) oluşturmakta idi. Hidroksiklorokin kullanan hasta grubundaki 22 (%5.72) hastanın COVİD-19 şüphesiyle PCR testi yaptırdığı ve sadece ikisinde (%0.52) PCR pozitifliği saptandığı tespit edilmiştir. Kontrol grubunda ise (n=299) PCR testi yapılan 65 hastanın (%21,73) 24'ünde (%8.02) COVİD-19 tespit edildiği görülmektedir. PCR pozitifliği hidroksiklorokinin kullanan grupta istatistiksel olarak daha düşük tespit edildi (n = 2, %0.52, n = 24, %8.02, p = 0.0001). Sonuç: Çalışmamız, hidroksiklorokinin kullanmayanlara göre düzenli olarak hidroksiklorokinin kullananlarda PCR pozitifliğinin daha düşük olduğunu desteklemektedir

Determination of serum trace elements (Se, Fe, Zn), macrominerals (Ca, Na, Cl), and physical activity levels in COVID-19 patients

Objective: This study mainly aims to determine serum trace elements, macrominerals, and physical activity levels in COVID-19 patients compared to healthy con-trols. Materials and methods: This prospec-tive study was conducted among COVID-19 patients (group I, n = 20) and healthy con-trols (group II, n = 20). Serum trace element levels (Se, Fe, and Zn), macrominerals (Ca, Na, and Cl), vitamin D, ferritin, and physical activity levels were determined. Results: Of the participants in group I, 90% had Se defi-ciency, 65% had Fe deficiency, and 35% had Zn deficiency. In addition, 45% of the par-ticipants in group II had Se deficiency. There was Ca deficiency (60%), Na deficiency (40%), and Cl deficiency (30%) in COVID-19 patients. Healthy controls did not have any macromineral deficiencies. The trace ele-ment levels including Se, Fe, and Zn were not statistically significant (p > 0.05); how-ever, the micromineral levels including Ca, Na, and Cl were significantly lower between groups (p < 0.05). There were vitamin D de-ficiencies in 90% and 70% of the participants in group I and group II, respectively. Ferritin levels were significantly higher in group I than group II (p < 0.05). All the participants had low physical activity levels in group I, and 40% of the participants had low physi-cal activity levels in group II. Conclusion: This study showed that COVID-19 patients might have lower Ca, Na, and Cl levels than healthy adults. In addition, high rates of Se, Fe, Ca and vitamin D deficiencies, and ferritin lev-els may be seen in COVID-19 patients. More-over, COVID-19 patients may have low levels of physical activity

Histological and Biochemical Examination of the Effect of Oxytocin on Diabetic Cardiomyopathy Rat Model

Amaç: Son yıllarda prevalansı hızla artan, çeşitli kardiyak bozukluklara neden olan Diyabetes mellitus kronik metabolik bir hastalıktır. Sedanter yaşam şekli ve beslenme alışkanlıklarındaki yanlışlıklara bağlı olarak önemli bir sağlık problemi haline gelmiştir. Bu çalışmada, deneysel sıçan diyabetik kardiyomiyopati modelinde hiperglisemi ile oluşturulmuş hücresel hasar üzerinde oksitosin etkilerinin histolojik ve biyokimyasal olarak incelenmesi amaçlanmıştır. Yöntemler: On iki adet sıçanın intraperitoneal (i.p) streptozosin enjeksiyonu ile diyabetik olmaları sağlandı. Sıçanların geri kalanına (n=6) herhangi bir verilmedi. Çalışma kapsamına 250 mg/dl ve daha yüksek kan şekeri düzeylerine sahip olan diyabetik kabul edilerek çalışmaya alındı. Daha sonra, diyabetik hale getirilmiş olan sıçanlar (n=12) rastgele, 1 mL/kg salin ile tedavi edilen diyabet grubu ve 28 gün boyunca 160 ?g/kg/gün i.p oksitosin ile tedavi edilen diyabet grubu olmak üzere 2 gruba ayrıldı. Hayvanlar 28 günün sonunda sakrifiye edilip kalpten alınan kan ile biyokimyasal analizler, kalp kasından da histopatolojik incelemeler yapıldı. Bulgular: Diyabetik sıçanlarda oksitosin uygulaması ile histolojik olarak kardiyomiyosit kalınlığının azaldığı, biyokimyasal olarak ise TGF-?1 immünoekspresyonun, TGF-?, malondialdehit ve pentraxin-3 seviyelerinin azaldığı gözlemlenmiştir. Sonuç: Bu çalışmada elde edilen bulgular oksitosinin diyabetik kardiyomiyopatide olumlu etkilerinin olabileceğini göstermektedir.Objective: Diabetes mellitus is a chronic metabolic disease which has caused a various cardiac disorders, has dramatically increasing prevalance in recent years. Inaccuracies of the life style and eating habits made it an important health problem. In this study, it was aimed to investigate histochemical and biochemical effects of oxytocin on cellular damage induced by hyperglycaemia in experimental rat diabetic cardiomyopathy model. Methods: Streptozocin are injected to 12 rats intraperitoneally (i.p.) to make them diabetic. No agent was injected to the rest of the rats (n = 6). Rats with blood glucose levels of 250 mg/dl and higher were included into the study. Then, 12 diabetic rats were randomly divided into 2 groups; diabetes group treated with 1 mL/kg saline and diabetes group treated with 160 ?g/kg/day oxytocin for 28 days, intraperitonally. Animals were sacrificed at the end of 28 days, then biochemical examinations were performed with cardiac puncture and histopathologic examinations were performed with myocardium. Results: It was observed that oxytocin administration in diabetic rats decreased cardiomyocyte thickness, TGF-?1 immunosuppression, TGF-?, malondialdehyde and pentraxin-3 levels. Conclusion: Results of this study show that oxytocin have positive effects on diabetic cardiomyopathy

Sıçan karaciğerinde subakut deltametrin maruziyetinin etkileri: Histokimyasal, immünohistokimyasal ve biyokimyasal çalışma

İstanbul Bilim Üniversitesi, Tıp Fakültesi.Objectives: This study aims to determine deltamethrin’s effects on early diagnosis of toxicity and liver toxicity markers in an animal model. Materials and methods: A total of 36 male rats weighing 200-220 gram were separated into four groups. Group 1 rats were given deltamethrin 15 mg/kg/day, group 2 rats were given deltamethrin 30 mg/kg/day, group 3 rats were given deltamethrin 60 mg/kg/day, and group 4 rats (control group) were given 0.9% sodium chloride 1 mL/kg/day for 30 days by oral gavage. Results: Deltamethrin ingestion resulted in edema, nuclear hypertrophy, and parenchymal and stromal inflammation on the histopathological examination. Malondialdehyde levels increased and glutathione levels decreased when compared with the control group as the treatment döşe increased. Alanine transaminase levels increased significantly when compared with the control group. The changes correlated directly with increasing dose. Conclusion: Deltamethrin usage causes liver toxicity in a dose dependent manner on rats. This toxicity is observed both biochemically and histopathologically. Liver biomarkers and oxidative stress parameters can effectively be used for potential toxicity monitorization.Amaç: Bu çalışmada bir hayvan modelinde deltametrinin toksisitenin erken tanısı ve karaciğer toksisitesi göstergeleri üzerindeki etkileri değerlendirildi. Gereç ve yöntemler: İki yüz-iki yüz yirmi gram ağırlığında toplam 36 erkek sıçan dört gruba ayrıldı. Grup 1 sıçanlarına deltametrin 15 mg/kg/gün, grup 2 sıçanlarına deltametrin 30 mg/kg/gün, grup 3 sıçanlarına deltametrin 60 mg/kg/gün ve grup 4 sıçanlarına (kontrol grubu) %0.9 sodyum klorür 1 mL/kg/ gün 30 gün boyunca oral gavaj yolu ile verildi. Bulgular: Histopatolojik incelemede deltametrin sindirimi ödem, nükleer hipertrofi ve parankimal ve stromal enflamasyon ile sonuçlandı. Kontrol grubu ile karşılaştırıldığında, tedavi dozu arttıkça malondialdehid düzeyleri arttı ve glutatyon düzeyleri azaldı. Kontrol grubu ile karşılaştırıldığında, alanin transaminaz düzeyleri anlamlı şekilde arttı. Değişiklikler artan doz ile doğrudan ilişki idi. Sonuç: Sıçanlarda deltametrin kullanımı doza bağımlı olarak karaciğer toksisitesine yol açmaktadır. Bu toksisite hem biyokimyasal hem histopatolojik olarak gözlemlenmektedir. Karaciğer biyogöstergeleri ve oksidatif stres parametreleri olası toksisite monitörizasyonunda etkili şekilde kullanılabilir

Histological and Biochemical Examination of the Effect of Oxytocin on Diabetic Cardiomyopathy Rat Model

Amaç: Son yıllarda prevalansı hızla artan, çeşitli kardiyak bozukluklara neden olan Diyabetes mellitus kronik metabolik bir hastalıktır. Sedanter yaşam şekli ve beslenme alışkanlıklarındaki yanlışlıklara bağlı olarak önemli bir sağlık problemi haline gelmiştir. Bu çalışmada, deneysel sıçan diyabetik kardiyomiyopati modelinde hiperglisemi ile oluşturulmuş hücresel hasar üzerinde oksitosin etkilerinin histolojik ve biyokimyasal olarak incelenmesi amaçlanmıştır. Yöntemler: On iki adet sıçanın intraperitoneal (i.p) streptozosin enjeksiyonu ile diyabetik olmaları sağlandı. Sıçanların geri kalanına (n=6) herhangi bir verilmedi. Çalışma kapsamına 250 mg/dl ve daha yüksek kan şekeri düzeylerine sahip olan diyabetik kabul edilerek çalışmaya alındı. Daha sonra, diyabetik hale getirilmiş olan sıçanlar (n=12) rastgele, 1 mL/kg salin ile tedavi edilen diyabet grubu ve 28 gün boyunca 160 ?g/kg/gün i.p oksitosin ile tedavi edilen diyabet grubu olmak üzere 2 gruba ayrıldı. Hayvanlar 28 günün sonunda sakrifiye edilip kalpten alınan kan ile biyokimyasal analizler, kalp kasından da histopatolojik incelemeler yapıldı. Bulgular: Diyabetik sıçanlarda oksitosin uygulaması ile histolojik olarak kardiyomiyosit kalınlığının azaldığı, biyokimyasal olarak ise TGF-?1 immünoekspresyonun, TGF-?, malondialdehit ve pentraxin-3 seviyelerinin azaldığı gözlemlenmiştir. Sonuç: Bu çalışmada elde edilen bulgular oksitosinin diyabetik kardiyomiyopatide olumlu etkilerinin olabileceğini göstermektedir.Objective: Diabetes mellitus is a chronic metabolic disease which has caused a various cardiac disorders, has dramatically increasing prevalance in recent years. Inaccuracies of the life style and eating habits made it an important health problem. In this study, it was aimed to investigate histochemical and biochemical effects of oxytocin on cellular damage induced by hyperglycaemia in experimental rat diabetic cardiomyopathy model. Methods: Streptozocin are injected to 12 rats intraperitoneally (i.p.) to make them diabetic. No agent was injected to the rest of the rats (n = 6). Rats with blood glucose levels of 250 mg/dl and higher were included into the study. Then, 12 diabetic rats were randomly divided into 2 groups; diabetes group treated with 1 mL/kg saline and diabetes group treated with 160 ?g/kg/day oxytocin for 28 days, intraperitonally. Animals were sacrificed at the end of 28 days, then biochemical examinations were performed with cardiac puncture and histopathologic examinations were performed with myocardium. Results: It was observed that oxytocin administration in diabetic rats decreased cardiomyocyte thickness, TGF-?1 immunosuppression, TGF-?, malondialdehyde and pentraxin-3 levels. Conclusion: Results of this study show that oxytocin have positive effects on diabetic cardiomyopathy