RELATION OF FEMUR FRACTURES LOCATION WITH CLINICAL OUTCOMES IN ELDERLY PATIENTS

ABSTRACT Objectives: This study was designed to investigate the possible relationship between the anatomical location of the PFF (head-neck fractures) and the demographic features, comorbidities, and risk factors of elderly patients. Methods: 233 patients aged 65 years and over, who were admitted to the emergency department with a diagnosis of proximal femur fracture were included in this study. Results: Most patients (59.6%) had a trochanteric fracture. The incidence of trochanteric fractures had a statistically significant positive correlation with age. Falls at ground level were found to be highly associated with trochanteric fractures (92,8%). At least one complication was observed in 57 (41,0%) cases and 31 (22,3%) died in one year, of the patients with trochanteric fractures. Comorbidity was not related to fracture location statistically. Fall ground level (p = 0.013), complication rate (73.7%; p <0.001), and Charlesen comorbidity index (p = 0.019) were statistically significantly associated with death. The logistic regression analysis of variables determined that only the quantity of comorbidities may be related to femoral neck fractures (p = 0.047). Conclusion: Female patients with trochanteric fractures were found to be older than male patients. Fall ground level, mortality, and complications were more frequently seen in patients with trochanteric fractures. Level of Evidence II, Retrospective study

Spontaneous Subcutaneous Orbital Emphysema Following Sneezing

[Cukurova Med J 2015; 40(1.000): 193-194

Effects of atropine and pralidoxime pretreatment on serum and cardiac oxidative stress parameters in acute dichlorvos toxicity in rats

Recent several studies have reported that oxidative stress could be an important component of the mechanism of cardiotoxicity due to organophosphate-induced toxicity. The aim of this study is to evaluate the oxidative and antioxidative parameters in cardiac toxicity of organophosphate poisoning, and determine the effects of atropine and pralidoxime on this parameters. The experimental groups were randomly divided into five groups as control (corn oil), dichlorvos (30 mg/kg), atropine (10 mg/kg), pralidoxime (40 mg/kg), and atropine (10 mg/kg) + pralidoxime (40 mg/kg) groups. Serum cholinesterase levels were suppressed with dichlorvos, and these reductions were inhibited with atropine and/or pralidoxime pretreatment. Serum, but not cardiac, total free sulfhydryl groups and paraoxonase activities were significantly increased in the pralidoxime group when compared to the control group. Serum arylesterase activities were elevated in the dichlorvos, atropine, pralidoxime, and atropine + pralidoxime groups when compared to the control group (P < 0.05). Total oxidant status, oxidative stress index, malondialdehyde and catalase activities in serum and cardiac tissues were not markedly different between the groups. No significant changes were also observed with cardiac myeloperoxidase and serum ceruloplasmin activities. In conclusion, these results showed that acute dichlorvos administration did not cause marked cardiac damage, and oxidative stress probably does not play a major role in dichlorvos-induced poisoning. On the other hand, especially pralidoxime treatment markedly increased the serum total free sulfhydryl groups, paraoxonase and arylesterase activities. However, the underlying mechanisms for these changes are not exactly known. © 2010 Elsevier Inc

Formulation of effects of atropine, pralidoxime and magnesium sulfate on cardiac tissue levels of nitric oxide, malondialdehyde and glutathione in organophosphate poisoning using artificial neural network

Anticholinesterase poisoning is an important health problem in our country, and a complete understanding of its underlying mechanisms is essential for the emergency physician. So, this study focused on two purposes. First one was aimed to investigate the biochemical analysis to determine the tissue levels of malondialdehyde (MDA), glutathione and nitric oxide (NO). Secondly, it was planned to model and formulate the effects of some drugs on cardiac tissues levels of NO, MDA and glutathione in acute organophosphate poisoning in rats by the application of neural network based on experimental results. It has been planned to determine whether artificial neural network (ANN) is appropriate tool to analyze and formulate it. As a result, it has been considered that ANN can be effectively used to model NO, MDA and glutathione level. The performances of ANN formulation versus target experimental values are found to be quite high. It is concluded that, proposed NN models are also presented as simple explicit mathematical functions for further use by researchers. Crown Copyright © 2009

A case of headache, double vision and ptosis in emergency department: Tolosa-Hunt syndrome

Headache and double vision symptoms can be seen especially neurological and optical problems. We present Tolosa-Hunt syndrome in a 34-year-old female patient who presented to the emergency department (ED) with the complaints of unilateral severe headache, double vision and ptosis, presented asymmetric contrast enhancement in the right superior cavernous sinus on MR. This pain was reduced with steroid therapy. Pulse steroid therapy of 1 mg/kg/day was planned based on the patient's clinical manifestation, MRI findings and presumed diagnosis of THS. It was observed at patient's follow-up that there were occasional headache, ptosis and double vision were disappeared and MRI findings were regressed.In the differential diagnosis of patients presenting to the ED with the complaints of headache and double vision, rare pathologies such as THS should be considered in addition of common pathologies such as neurological and ocular diseases. Keywords: Headache, Double vision, Ptosis, Steroid treatmen

Cardiac damage in acute organophosphate poisoning in rats: Effects of atropine and pralidoxime{star, open}

Anticholinesterase poisoning is an important health problem in our country, and a complete understanding of its underlying mechanisms is essential for the emergency physician. Thus, we aimed to investigate the cardiac biochemical parameters and mortality in dichlorvos-induced poisoning in rats. Rats were randomly divided into 5 groups as control (corn oil), dichlorvos, atropine, pralidoxime, and atropine+pralidoxime groups. Immunohistochemical analyses of apoptosis and inducible nitric oxide synthase showed no change in cardiac tissue for all of the groups. Serum cholinesterase levels were suppressed with dichlorvos, and these reductions were inhibited with atropine and/or pralidoxime pretreatment. Serum levels of creatine kinase, creatine kinase-MB, cardiac troponin I, myoglobin, and N-terminal probrain natriuretic peptide were not affected with poisoning. Malondialdehyde and glutathione levels were not statistically significant between the groups. Although serum nitric oxide levels in the dichlorvos group were lower than those in the control group, cardiac nitric oxide levels in the atropine+pralidoxime group were markedly higher than those in the dichlorvos group. Atropine, pralidoxime, and atropine+pralidoxime pretreatments markedly reduced the mortality. In conclusion, our results implied that measured cardiac markers especially N-terminal probrain natriuretic peptide may not contribute to the early (first 6 hours) diagnosis of cardiotoxicity in dichlorvos-induced poisoning in rats. These results also showed that acute dichlorvos administration did not cause significant cardiac damage, and oxidative stress does not play a marked role in dichlorvos-induced poisoning. Besides, cardiac nitric oxide may produce protective effect on myocardium with atropine+pralidoxime therapy in rats. © 2009 Elsevier Inc. All rights reserved

Comparative etiological analysis of critical patients presenting to the emergency department with altered consciousness across age groups: A prospective observational study

Abstract Introduction The aim of our study is to assess the relationship between altered consciousness in patients presenting to the emergency department (ED) without a history of trauma and the physiological changes associated with aging. Additionally, we aim to compare diagnostic differences between patients under the age of 65 and those aged 65 and above. Methods This prospective study was conducted at the ED of Uludağ University Medical Faculty Hospital over a 1‐year period from December 2012 to November 2013. Patients aged 18 and above presenting with non‐traumatic altered consciousness were included, and they were categorized into two groups based on age: <65 years and ≥65 years. Comparison between age groups included gender, seasonal presentation, vital signs, consciousness level, Glasgow Coma Scale (GCS) score, requested consultations, diagnoses, and outcomes. Results Out of 646 patients, 312 (48%) were female, and 334 (52%) were male, with a mean age of 64.9 ± 16.4 years. The highest number of admissions for altered consciousness occurred during the summer season (n = 200, 31%). In the 65 and above age group, a statistically significant elevation was found in the mean systolic blood pressure (p < 0.05). In neurological diagnoses, cerebrovascular events were observed most frequently, while in non‐neurological diagnoses, endocrine/metabolic diseases were more common. It was observed that GCS scores were lower in neurological diagnoses (p = 0.020). Discharges were more frequent in the under 65 age group, with a statistically significant difference (p < 0.05). It was found that the mortality rate was higher in non‐neurological diagnoses, and this was statistically significant (p < 0.001). Conclusion When determining the cause of altered consciousness in patients with such symptoms, a comprehensive understanding of physiological changes in elderly individuals is crucial. While high blood pressure may indicate neurological diagnoses, tachycardia, tachypnea, and fever may suggest non‐neurological causes