Retrospective investigation of the effectiveness of fecal occult blood test (FOB), PT-APTT in patients admitted to emergency department with gastrointestinal bleeding

The purpose of our study is to investigate the fact that gastrointestinal system bleeding, which is a major cause of mortality, is not diagnosed faster by any additional laboratory tests except physical examination and endoscopy, but it is negative in terms of time, workload and cost. Our study was retrospective and the hospital information system was scanned and the patients who were referred to Emergency Medicine Clinic between 01.08.2012-08.08.2013 with Gastrointestinal System (GIS) bleeding symptoms and then underwent endoscopic examination were investigated. Demographic characteristics, physical examination findings, vital signs, required examinations, digital rectal examination findings, endoscopy and colonoscopy results were recorded in the study form. For statistical analysis, SPSS (Statistical Package for Social Sciences) 17.0 program was used. A total of 274 patients aged 18 years and over were admitted to the study and 61.7% were male and 38.3% were female. Most of the patients in our diagnostic group were in the 70-79 age group. Sensitivity of Digital Rectal Examination (DRE) value was 79.6% Specificity 92.30%, negative predictive value (NPV) 60%, Sensitivity of Fecal Occult Blood Test (FOB) value was 31.46% NPV 30.49%, sensitivity of international normalized ratio (INR) was 26.25% NPV 32,95%, sensitivity of prothrombin time (PT) was 19.37%, NPV 34.84%, sensitivity of activated partial thromboplastin time (aPTT) was 14.19% NPV 34.43%. Endoscopies were performed in 169 patients with GIS bleeding and no active bleeding detected in 56 (33.1%) patients and in 113 (66.9%) patients active bleeding was detected. In patients with positive digital rectal examination findings, endoscopy results were also highly positive for gastrointestinal system bleeding. Our study suggests that; Running FOB, PT, APTT, INR tests in patients admitted to emergency department with GIS bleeding, is far from giving important and necessary information about the emergency management of the patients to emergency medicine specialists. The results of the digital rectal examination correlate with endoscopy results. It is also an easy and time-consuming examination method. From this point of view, we would like to emphasize that making the DRE of all patients with suspected GIS bleeding is a correct and immediate approach to the emergency physician. [Med-Science 2018; 7(1.000): 30-34

The Demographic Analysis of the Probable COVID-19 Cases in Terms of RT-PCR Results and Age

Background: Despite global prevention and quarantine efforts, the incidence of COVID-19 disease continues to increase. As a possible cause, our aim was to investigate which parameters increase the sensitivity or protection against COVID-19 between RT-PCR positive and RT-PCR negative cases in patients admitted to the emergency department. Methods: In the pandemic process, patients admitted to the hospital with suspicion of COVID-19 were evaluated retrospectively. RT-PCR test was divided into + (for Group 1) and - (Group 2). The gender, age, clinical information, application symptoms, and comorbidity data of the patients were evaluated. Results: One hundred and sixty-seven cases were evaluated in the study. Group 1: 88 cases, M/F ratio: 46/42 and average age 48 +/- 17.3 years, Group 2: 79 cases, M/F ratio was approximately 3/2, and the average age was 48.3 +/- 19.4 years. When the groups were compared in terms of symptoms, fever, cough, weakness, and headache were prominent in Group 1, whereas the contact was significantly higher in Group 2 (p < 0.05). Among the comorbid diseases, only COPD showed a significant difference between the groups, and it was found significantly higher in Group 2 (p < 0.05). Conclusions: Cough, headache, and fever were found valuable in the detection of cases. Attention should be paid to contact isolation to circumvent the pandemic process with less damage. Having chronic diseases, especially COPD, increases the risk of infection with SARS-CoV-2. Close monitoring and control of chronic diseases can positively change the course of COVID-19.WOS:0006487463000232-s2.0-85104571315PubMed: 3386525

SERUM INTERLEUKIN-32 (IL-32) LEVELS MAY HAVE DIAGNOSTIC AND PROGNOSTIC ROLES IN PATIENTS WITH PANCREATIC ADENOCARCINOMA

Background: Pancreatic adenocarcinoma (PA) is a very lethal malignancy. Different parameters have been found to be predictive and prognostic. This study was conducted to investigate the serum levels of interleukin-32 (IL-32) in patients with PA and the relationship with tumor progression and known prognostic parameters

Skeletal and molecular findings in 51 Cleidocranial dysplasia patients from Turkey

Loss or decrease of function in runt-related transcription factor 2 encoded by RUNX2 is known to cause a rare autosomal-dominant skeletal disorder, cleidocranial dysplasia (CCD). Clinical spectrum and genetic findings in 51 CCD patients from 30 unrelated families are herein presented. In a majority of the patients, facial abnormalities, such as delayed fontanel closure (89%), parietal and frontal bossing (80%), metopic groove (77%), midface hypoplasia (94%), and abnormal mobility of shoulders (90%), were recorded following clinical examination. In approximately one-half of the subjects, wormian bone (51%), short stature (43%), bell-shaped thorax (42%), wide pubic symphysis (50%), hypoplastic iliac wing (59%), and chef's hat sign (44%) presented in available radiological examinations. Scoliosis was identified in 28% of the patients. Investigation of RUNX2 revealed small sequence alterations in 90% and gross deletions in 10% of the patients; collectively, 23 variants including 11 novel changes (c.29_30insT, c.203delAinsCG, c.423 + 2delT, c.443_454delTACCAGATGGGAinsG, c.505C > T, c.594_595delCTinsG, c.636_637insC, c.685 + 5G > A, c.1088G > T, c.1281delC, Exon 6-9 deletion) presented high allelic heterogeneity. Novel c.29_30insT is unique in affecting the P1-driven long isoform of RUNX2, which is expected to disrupt the N-terminal region of RUNX2; this was shown in two unrelated phenotypically discordant patients. The clinical findings highlighted mild intra-familial genotype-phenotype correlation in our CCD cohort