Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure < 100 mmHg (n = 1127), estimated glomerular filtration rate < 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation

Önsöz

[No abstract available

Türkiye Makrofungusları İçin İki Yeni Kayıt

Mantar örnekleri 1998 ve 2004 yıllarında İstanbul ve Balıkesir illerinden toplanmıştır. Toplanan örneklerin makroskobik ve mikroskobik özelliklerinden yararlanarak teşhisleri yapılmıştır. Bu makrofunguslar arasından 2 tür Türkiye de ilk kez rapor edilmiştir. Bunlar Chalciporus piperatus (Bull.: Fr.) Bat. ve Russula carminea (Schaeff.) Kühner & Romagn.'dır. Bu türler tanımlanmış ve resmedilmiştir

Examination of morbidity and mortality of cases according to intra-vehicle position and accident mechanism [Araç içi pozisyon ve kaza mekanizmasına göre olguların morbidite ve mortalitesinin incelenmesi]

PubMed ID: 29786816BACKGROUND: Traffic accidents are still an important public health issue in our country and intra-vehicle accidents cause substantial morbidity and mortality. In this study, we aimed to investigate the effect of seating position on morbidity and mortality in traffic accidents. METHODS: Patients who were admitted to the Emergency Department, Faculty of Medicine, Ege University between May 1, 2014 and November 30, 2014 due to injuries in motor vehicles and who signed informed consent were included. RESULTS: In total, 519 cases were included, and 329 (63.4%) were male and 190 (36.6%) were female. The average age was 33.11±16.86 (range, 0–85) years. It was noted that the accidents most frequently occurred between 18.00 and 23.59 (36.3%) hours, in the car (79%), and due to collision with another car (61.7%). Although 39.5% of the injured individuals were drivers, 26.4% were front seat passengers. From a forensic medicine perspective, life-threatening injuries were approximately twice more common (37.5%– 13.6%) in accidents with >110 km/h speed compared with accidents with 110 km/h speed caused approximately twice the amount (56.3%–26.3%) of injuries that cannot be resolved with simple medical intervention compared with accidents with <110 km/h speed. CONCLUSION: Since most people who are injured or die in traffic accidents have an active professional life, significant rehabilitation expenditure and labor loss occur along with diagnosis and treatment costs. Our study and similar studies not only show the effectiveness of the measures taken but also provide an insight into changing injury profiles and precautions to prevent them. © 2018 Turkish Association of Trauma and Emergency Surgery

Massive carbamazepine overdose: Any role of hemodialysis?: Case report [İleri derecedeki karbamazepin doz aşi{dotless}mlari{dotless}nda hemodiyaliz uygulanmali{dotless} mi{dotless}?]

Massive carbamazepine (CBZ) overdose is associated with life-threatening hemody- namic complications that present challenges for clinicians. We describe the highest-reported dose of CBZ intoxication in a patient who survived and discuss early hemodialysis option in a CBZ-poisoned patient. Although hemodialysis is reported to increase the elimination of CBZ despite its partiall effectiveness due to the poor water-solubility of CBZ, massive CBZ overdose can induce an acute renal failure and renal function should be monitored closely, and the data obtained from this case that standard low-flux HD might be used and is effective in the management of acute CBZ overdose in patients with associated electrolyte disorders and acute renal failure. © 2011 by Türkiye Klinikleri

Thrombotic thrombocytopenic purpura mimicking acute ischemic stroke

Thrombotic thrombocytopenic purpura (TTP) is an autoimmune disorder characterised by thrombocytopenia, haemolytic anemia, fluctuating neurological deficits, fever, and renal impairment. This case report is about a young man who presented with acute onset right sided paralysis, dysarthria, and central facial paralysis, suggestive of cerebrovascular accident, but eventually diagnosed as TTP. In addition, the clinical presentation of TTP is discussed and some teaching points for the emergency physicians are emphasised

Acute hepatitis associated with Thymus Vulgaris oil ingestion: Case report

Many plants traditionally used in folkloric medicine can cause poisoning. Typically known as "thyme", "Thymus Vulgaris" continues to be one of the most commonly used folkloric herbs in Turkey. Here, we report a case of toxic hepatitis due to the ingestion of concentrated thyme oil. The patient was reported to have ingested a total of 25 ml of thyme oil which was routinely sold in the local market. The total dose was taken in two consecutive days in different amount. The patient then developed nausea, vomiting and diarrhea, and he was subsequently admitted to the emergency unit, with high transaminase levels. He was placed on observation unit for two days. His elevated aminotransferase levels and symptoms gradually decreased during the observation period. Thyme, which is known to be a nonpoisonous plant, is one of the most commonly used herbs; however, plants similar to thyme are not necessarily as harmless as they seem to be