The protective effect of infliximab against carbon tetrachloride-induced acute lung injury

cure, erkan/0000-0001-7807-135X; Cure, Medine Cumhur/0000-0001-9253-6459WOS: 000380177400015PubMed: 27482351Objective(s): Carbon tetrachloride (CCl4) causes pulmonary toxicity. Infliximab (Ib) is a potent inhibitor of tumor necrosis factor-alpha (TNF-alpha). We aimed to investigate whether Ib has a protective effect on CCl4 induced lung injury. Materials and Methods: Rats were divided into control, CCl4, and CCl4+Ib groups. A single dose of 2 ml/kg CCI4 was administered to CCI4 group and a single dose of 7 mg/kg Ib was given to CCl4+Ib group 24 hr before applying CCI4. Results: TNF-alpha, malondialdehyde (MDA), nitric oxide (NO) and caspase-3 levels of the CCl4 group were markedly higher than both the control and CCl4+Ib groups. the CCI4+Ib group had lower histopathological injury than the CCl4 group. Conclusion: Ib as a strong TNF-alpha blocker decreases the production of proinflammatory cytokines, MDA, and oxidative stress leading to a protective effect against CCl4 induced lung tissue injury

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Approach to severe hypertension in children

Hipertansif kriz olarak da adlandırılan ciddi hipertansiyon (HT) kan basıncının akut olarak uç organ hasarına neden olabilecek düzeyde yükselmesidir. Çocukluk çağında sık olmamakla birlikte potansiyel olarak yaşamı tehdit edici medikal bir acildir. Hipertansif kriz klasik olarak santral sinir sistemi (SSS), kalp, göz ve böbrek gibi uç organ tutulumun olup olmamasına göre hipertansif öncelikli durum ve hipertansif acil olmak üzere ikiye ayrılır. Kan basıncında hedef organ hasarının eşlik etmediği akut ciddi yükselme hipertansif öncelikli durum (aciliyet), hedef organ hasarı veya ciddi semptomların eşlik ettiği akut ciddi yükselme ise hipertansif acil olarak tanımlanır.Severe symptomatic hypertension which is also called hypertensive crisis is an acute elevation in blood pressure to a level that has the potential to cause end-organ damage. Although not common in childhood, it is a life-threatening medical emergency. Hypertensive crises are classically distinguished into hypertensive urgency and hypertensive emergency depending on end-organ involvement including central nervous system (CNS), heart, eye, and kidney. A severe elevation in blood pressure without evidence of acute target organ damage describes hypertensive urgency. Hypertensive emergency is defined as severe hypertension complicated with severe symptoms or acute target organ dysfunction

Mad honey-related intoxication in an infant: A case report

Kalkan, Asim/0000-0002-5800-0201WOS: 000385740100007Introduction: the nutraceutical value and ingredients of honey make it attractive for complementary and alternative medicine. Herein, we report a case of mad honey intoxication in an infant following the ingestion of honey for an intractable cough. Case Report: A 5-month-old male infant was given two teaspoons of honey by his mother with his breakfast for coughing for the past 2 days. Four hours later following ingestion, he started to vomit and became drowsy. on arrival at the emergency department, he was drowsy and his Glasgow Coma Scale score was 10. With respect to systemic examination, abdominal sonography, performed to exclude any intraabdominal and renal pathology, revealed no pathology. Urine examination revealed proteins and hemoglobin. He was not given any other treatment except fluid replacement. At the fifth hour of arrival, his symptoms and physical examination findings all resolved. He was thought to have honey poisoning and was admitted to the pediatric clinic for follow-up. Conclusion: Mad honey is a natural product, but because of its ability to cause allergic reactions in susceptible people, honey should not be given to infants younger than 1 year. Intoxication should be considered in emergency department patients in the eastern Black Sea region of Turkey. Although not clearly established, there might be nephrotoxic effects in human beings

Review of techniques for the removal of trapped rings on fingers with a proposed new algorithm

Kose, Ozkan/0000-0002-7679-9635; Kalkan, Asim/0000-0002-5800-0201; tas, mahmut/0000-0002-3894-4766WOS: 000326274200015PubMed: 24070977Various removal techniques for rings trapped on the finger have been described in the current literature. However, despite this being a frequently encountered situation in emergency departments, there is no comprehensive algorithm to manage and follow these patients in the current literature. the purposes of this study were to describe the most commonly used ring removal techniques and to establish an algorithm for the removal of rings trapped on fingers. We performed a comprehensive literature search in several databases to identify all articles, case reports, letters, and book chapters that focus on ring removal techniques in English language from 1960 to the present. There are 2 methods of removal: (1) noncutting techniques in which the rings can be removed without breaking the integrity of the ring and (2) various ring-cutting equipments and tools. All these techniques are classified into distinct groups and described in detail with illustrations. Furthermore, an algorithm for handling such patients is established according to case-based patient care. Following an algorithm for the removal of trapped rings on the finger will be useful for patients and emergency physicians. It will also prevent possible complications and will save time. (C) 2013 Elsevier Inc. All rights reserved

Acil Servis Personelinin Triaj Uygulamasına Bakış Açısı

Amaç: Üniversite hastaneleriyle ortak hizmet veren Sağlık Bakanlığı Hastaneleri'nde triaj hizmeti vermesi planlanan personelin eğitim öncesinde bu uygulamaya bakış açısının değerlendirilmesidir. Gereç ve Yöntemler: Bu çalışmaya gönüllü 33 çalışan dahil edildi. Anket formu sosyo-demografik bilgiler, acil sağlık hizmetleri ve triaja ilişkin konularda görüş isteyen 19 sorudan oluşan yargısal anket ölçeğiyle hazırlanmıştır. Bulgular: Örneklem grubunun %75,8'i kadın ve yaş ortalaması 28,94±6,11 idi. Çalışmaya dahil olan tüm katılımcılar acil servisin toplum tarafından gereksiz kullanıldığını belirtti. Acil servise herhangi bir nedenle başvuran hastaların ne kadarının acil kriterlerine uygun olduğu sorgulandığında ise %54,5 katılımcı bu oranın %10 ve daha az olduğunu bildirildi. Grubun %54,5'i, triaj uygulamasının acil servis kalabalığını azaltacağını düşünmekteydi.Sonuç: Triajın acil serviste uygulanması hem öncelikli hastaların bakımı hem de sağlık çalışanlarının sunduğu hizmetin kalitesini açısından önemlidir. Bu konuda çalışanların eğitimi kadar toplumsal bazlı bilgilendirmenin de yapılması gerekmektedir.Objective: The aim of this study was to evaluate pre-training perspectives of the staff, who were scheduled to undertake triage in hospitals of Ministry of Health, working in collaboration with university hospitals on the triage system.Materials and Methods: This study included 33 workers who volunteered to participate. A questionnaire consisting of 19 questions on demographic characteristics and perspective on triage system was prepared. Results: Of the sample group, 75.8% were female and the average age was 28.94±6.11 years. All participants in the study considered that emergency department was overused by the society. When the percentage of patients who were admitted to the emergency department for causes complying with the emergency criteria was questioned, 54.5% stated that 10% or less of the admissions were actual emergency cases. Triage practice was suggested by 54.5% of the participants to reduce crowding in emergency departments. Conclusion: Triage practice which allows correct identification of patients who need the most urgent intervention in emergency departments is important in terms of both giving the right care to the right patients and quality of service provided by healthcare workers. Community-based education as well as training of workers on this subject is a necessity

A Rare and Dangerous Complication of Central Venous Catheterization: Intimal Injury

Central venous catheters are frequently used for urgent patient resuscitation and for prolonged intravenous route requirements. However, the patient may be injured or may need additional intervention due to complications associated with catheter insertion. Various mechanical complications such as catheter malposition, arterial puncture, hemothorax and pneumothorax can be seen in 5-19% of patients and early recognition has a vital effect. Here, we present a case of pleural effusion leading to significant hypoxemia due to intimal injury to the superior vena cava which developed in the second day of catheter insertion

Acil Servis Personelinin Triaj Uygulamasına Bakış Açısı

Amaç: Üniversite hastaneleriyle ortak hizmet veren Sağlık Bakanlığı Hastaneleri'nde triaj hizmeti vermesi planlanan personelin eğitim öncesinde bu uygulamaya bakış açısının değerlendirilmesidir. Gereç ve Yöntemler: Bu çalışmaya gönüllü 33 çalışan dahil edildi. Anket formu sosyo-demografik bilgiler, acil sağlık hizmetleri ve triaja ilişkin konularda görüş isteyen 19 sorudan oluşan yargısal anket ölçeğiyle hazırlanmıştır. Bulgular: Örneklem grubunun %75,8'i kadın ve yaş ortalaması 28,94±6,11 idi. Çalışmaya dahil olan tüm katılımcılar acil servisin toplum tarafından gereksiz kullanıldığını belirtti. Acil servise herhangi bir nedenle başvuran hastaların ne kadarının acil kriterlerine uygun olduğu sorgulandığında ise %54,5 katılımcı bu oranın %10 ve daha az olduğunu bildirildi. Grubun %54,5'i, triaj uygulamasının acil servis kalabalığını azaltacağını düşünmekteydi.Sonuç: Triajın acil serviste uygulanması hem öncelikli hastaların bakımı hem de sağlık çalışanlarının sunduğu hizmetin kalitesini açısından önemlidir. Bu konuda çalışanların eğitimi kadar toplumsal bazlı bilgilendirmenin de yapılması gerekmektedir.Objective: The aim of this study was to evaluate pre-training perspectives of the staff, who were scheduled to undertake triage in hospitals of Ministry of Health, working in collaboration with university hospitals on the triage system.Materials and Methods: This study included 33 workers who volunteered to participate. A questionnaire consisting of 19 questions on demographic characteristics and perspective on triage system was prepared. Results: Of the sample group, 75.8% were female and the average age was 28.94±6.11 years. All participants in the study considered that emergency department was overused by the society. When the percentage of patients who were admitted to the emergency department for causes complying with the emergency criteria was questioned, 54.5% stated that 10% or less of the admissions were actual emergency cases. Triage practice was suggested by 54.5% of the participants to reduce crowding in emergency departments. Conclusion: Triage practice which allows correct identification of patients who need the most urgent intervention in emergency departments is important in terms of both giving the right care to the right patients and quality of service provided by healthcare workers. Community-based education as well as training of workers on this subject is a necessity

A different reason for cerebrovascular disease

Kalkan, Asim/0000-0002-5800-0201;WOS: 000318965100045PubMed: 23399346Bee stings are commonly encountered worldwide. Various manifestations after a bee sting have been described. Local reactions are common. Unusually, manifestations such as vomiting, diarrhea, dyspnea, generalized edema, acute renal failure, hypotension, and collapse may occur. Rarely, vasculitis, serum sickness, neuritis, and encephalitis have been described, which generally develop days to weeks after a sting. We report a case of a 35-year-old man who developed neurologic deficit 6 hours after a bee sting, which was confirmed to be left parietooccipital infarction on magnetic resonance imaging scan. We report this case due to its rarity