Evaluation of scoring systems in terms of early prediction of severe acute pancreatitis and mortality in patients over 65 years of age.

Purpose: The aim of this study is to investigate the power of disease severity scores to predict the development of Severe Acute Pancreatitis (SAP) and mortality in the early period over 65 years old diagnosed with acute pancreatitis in the emergency department. Materials and Methods: We calculated RANSON (on admission) and Computed Tomography Severity Index (CTSI) in addition to Bedside Index for Severity in Acute Pancreatitis (BISAP) score on admission to the emergency department. Results: One hundred and sixty patients (46.9% over 80 years of age) were included in the study. We observed statistically higher length of hospitalization, longer duration of stay in the intensive care unit, SAP and higher mortality in patients over 80 years of age. When we examined the ROC curve, we determined that the AUC values of the BISAP score were highest in both SAP and mortality estimation (AUC: 0.911, 95% CI 0.861-0.962; AUC: 0.918, 95% CI 0.864-0.9722, respectively). Binary logistic analysis indicated a 4.7-fold increased risk for SAP and a 12.3-fold increased mortality for each unit increase in BISAP score value. Conclusion: BISAP may be a good predictor for SAP and mortality estimation on admission to the emergency department in patients over 65 years of age with acute pancreatitis

İskemik İnmede TOAST ve BANFORD Sınıflaması ile Hemogram Parametrelerinin Mortalite Açısından Karşılaştırılması

Purpose: Patients with ischemic stroke who attends emergency departments frequently and have high mortality and morbidity. Purpose of this study is to determine risk groups of ischemic stroke patients by using TOAST and Banford classifications and search whether is there a relationship between red cell distribution width (RDW), mean platelet volume (MPV) and mortality. Methods: We included patients older than 18 years old and who attend-ed XXX Numune Research and Training Hospital Emergency Department throughout two years between 01.07.2014-30.06.2016, patients aged 18 years and older who were diagnosed with ischemic stroke and hospitalized and had sufficient file information were included. Results: We included 404 patients this study. In our study 53.2% (n=215) of all cases were male, 46.8% (n=189) were female. When we look patients age distribution range the biggest group was over 65 years group with 57.7% (n=233) rate. Patients were groupped according to TOAST and Banford classification. MPV and RDW values of patients according to TOAST classification were low risk group 8.3±1.6, 15.7±2.3 and high risk group 8.0±1.5, 16.0±2.4 (p=0,096, p=0,054) respectively. MPV and RDW values were 7.9±1.5, 15.8±2.1 and 8.2±1.6, 15.9±2.6 (p=0,167, p=0,943) respectively in low risk group and high risk group according to Banford classification of patients. Conclusion: There are current studies investigating the utility of hematologic parameters in predicting mortality in emergency department management of patients with ischemic stroke. In the light of the data we obtained in our study, it was concluded that hematological parameters, especially MPV and RDW values were not an effective parameter in determining the prognosis

1997-1998 yılları arasında acil servise zehirlenme nedeniyle başvuran hastaların retrospektif analizi

TEZ3284Tez (Uzmanlık) -- Çukurova Üniversitesi, Adana, 1999.Kaynakça (s. 48-55) var.v, 55 s. ; 30 cm.

Ultrastructural changes in rat liver treated with pralidoxime following acute organophosphate poisoning

PubMedID: 15592660We investigated the ultrustructural effects of methamidophos and the positive effects of 2-pralidoxime (2-PAM) on the liver. Male Wistar-albino rats were assigned to 4 groups and all were treated per os: Group 1 (n=10) received 30 mg/kg methamidophos; Group 2 (n=7) (serving as controls for Group 1) received physiologic NaCl; Group 3 (n=10) received 30 mg/kg methamidophos and was treated with 2-PAM and atropine when cholinergic symptoms were noted; and Group 4 (n=7) (serving as controls for Group 3) was treated with physiologic NaCl. Plasma cholinesterase was measured using radioimmunoassay. Liver tissues were prepared for electron microscopic studies. Methamidophos treatment of Group 1 led to serious changes in hepatocytes and organelles. These changes were not detected in Group 3. In Group 1, the chromatin content of some hepatocyte nuclei and cytoplasmic density increased; these cells also became vacuolar in appearance as a result of lysis in the mitochondrial matrices. In some cells, the lipid content constituted the majority of the cytoplasm. Furthermore, these cells were surrounded by glycogen accumulation. In some areas of the perisinusoidal zone, collagen fibers had increased to form bands. None of these changes were noted in Group 3. These findings suggest that acute organophosphate poisoning causes serious histopathological effects in rat liver, but that these changes are reversible with appropriate treatment strategies. © The Mount Sinai Journal of Medicine

Ingestion of caustic substances by adults

WOS: 000240407200187

Significance of Tomography and CRP in Abdominal Pain Management

Purpose: We evaluated whether abdominal tomography is necessary for patients who have been admitted to the emergency service because of non traumatic abdominal pain and effect of C-Reactive Protein (CRP) and tomography to the patient management. Materials and Method: On retrospective study, we recorded demographic data, tomography diagnoses, CRP and leucocyte values operation and following decisions of 199 patient who were 18 years old and over and were admitted to emergency service because of abdominal pain and were scanned abdominal tomography. 104 patient were hospitalized and their CRP values, tomography diagnoses, end of operation diagnoses were recorded from patient files. The statistical analysis was performed using the Chi-square test and the diagnostic value was assessed through the logistic regression test. Results: A statistically significant relationship was observed between anormal tomography findings and high CRP and leukocyte values of the 199 patients included in the study. The tomography findings and CRP values were found to be efficient in discharge and hospitalization rates. When tomography finding and CRP value were combined, the operation decision was effected. Conclusion: Based on our study; in the event of abdominal pain, CRP can predict abnormal tomography finding and it is more valuable than leucocyte. When tomography was used with CRP, it affects the operation decision. [Cukurova Med J 2015; 40(4.000): 766-773

Comparison of clinical, hematologic, biochemical findings in amitraz poisoning and the effect of naloxone to the treatment: Experimental study

Amaç: Bu çalışmada amitraz zehirlenmesinde naloksonun tedaviye katkı sağlayıp sağlayamayacağını ve klinik ve laboratuvar bulgula-- rını araştırmayı amaçladık. Yöntemler: Deneyde ortalama ağırlıkları 220-260 gr olan Wistar albino tipi 60 adet ergin, dişi sıçan kullanıldı. Sıçanlar gruba ayrıldı. 1. 3. ve 4. gruplara orogastrik yoldan 800 mg/kg dozunda amitraz verildi. 2. grup ise kontrol grubu olarak belirlendi. Tüm gruplarda solu-- num ve kalp hızlarındaki değişiklik her 20 dakikada bir kaydedildi. Üçüncü ve 4. gruplardaki sıçanlarda zehirlenme bulguları görülünce tedaviye başlandı.Tedavi amacıyla peritoniçi yolla 20 mI/kg serum fizyolojik ve kalp hızları 250 atım/dakika altına düşünce 0,1 mg/ kg atropin verildi. Dördüncü gruba 3. gruptaki tedaviye ek olarak 0,3 mg/kg nalokson uygulandı. Tüm hayvanlardan anestezi sonrası hematolojik ve biyokimyasal inceleme için kalp içi yoldan kan örneği alınarak hayvanlar öldürüldü. Hematolojik incelemede tam karı sayımı yapıldı. Bk, Rbc, Hgb, Hct, Trombosit sayısı değerlendirildi. Biyokimyasal incelemede BUN, krea, Glukoz, Na+, Ca++, SGOT, SGPT değerlerine bakıldı. Elde edilen veriler SPSS 13.0 programı kullanılarak değerlendirildi. Bulgular: Hematolojik değerlendirmede Bk, Rbc, Hgb, Hct değerlerinde gruplar arasında anlamlı ölçüde farklılık belirlenmiştir (p<0,05). Biyokimyasal değerlendirmede BUN, kreatinin, Glukoz, Na+, SGOT, SGPT değerlerinde gruplar arasında anlamlı ölçüde farklılık belirlen-- miştir (p<0,05). Nalokson tedavisinin destek tedaviye üstünlüğü istatistiksel olarak anlamlı bulunmadı. Sonuç: Sonuç olarak, amitraz zehirlenmesinde hematolojik (Bk değerlerinde klinikolarak anlamlı) ve biyokimyasal değerlerde değişiklik olmaktadır ve bu değişiklik destek tedavisi ile düzelmektedir. Naloksonun tedaviye ek bir katkısı yoktur. CAYD 2015;2(2):71-6.Objectiv

A comparison of the effectiveness of sublingual losartan, sublingual captopril and sublingual nifedipine in hypertensive urgency

The use of sublingual captopril and nifedipine has been indicated in hypertensive emergencies and in patients with essential hypertension, with the assumption that by this route, there would be a faster absorption and thus a more rapid effect on blood pressure (BP) than by the oral route. A comparative study of the effects of Losartan, angiotensin II receptor antagonist, captopril and nifedipine on blood pressure was carried out in patients with hypertensive urgency. Sixty patients with hypertensive urgency were subdivided into 3 groups of 20 patients each. The first group received sublingual captopril (25 mg), the second group received sublingual nifedipine (10 mg) and the third group received sublingual losartan (50 mg). In the captopril, nifedipine and losartan groups, the mean systolic pressures at the onset of hypertensive urgency were 188.00±23, 190.00±35 and 190.50±21 mmHg respectively. At 90 minutes, in the captopril, nifedipine and losartan groups, the mean systolic blood pressures were 138.50±18, 144.50±25 and 146.25±21 mmHg respectively. In the captopril, nifedipine and losartan groups, the mean diastolic blood pressures at the onset of hypertensive urgency were 116.00±15, 121.50±22 and 109.25±14 mmHg respectively. In the captopril, nifedipine and losartan groups, at 90 minutes, mean diastolic blood pressures were 84.75±10, 95.25±19 and 88.50±12 mmHg respectively. A significant (<0.05) hypotensive effect of sublingual captopril, nifedipine and losartan therapy occurred at 90 minutes. The results of the study indicate that sublingual losartan is an effective drug in patients with hypertensive urgencyThe use of sublingual captopril and nifedipine has been indicated in hypertensive emergencies and in patients with essential hypertension, with the assumption that by this route, there would be a faster absorption and thus a more rapid effect on blood pressure (BP) than by the oral route. A comparative study of the effects of Losartan, angiotensin II receptor antagonist, captopril and nifedipine on blood pressure was carried out in patients with hypertensive urgency. Sixty patients with hypertensive urgency were subdivided into 3 groups of 20 patients each. The first group received sublingual captopril (25 mg), the second group received sublingual nifedipine (10 mg) and the third group received sublingual losartan (50 mg). In the captopril, nifedipine and losartan groups, the mean systolic pressures at the onset of hypertensive urgency were 188.00±23, 190.00±35 and 190.50±21 mmHg respectively. At 90 minutes, in the captopril, nifedipine and losartan groups, the mean systolic blood pressures were 138.50±18, 144.50±25 and 146.25±21 mmHg respectively. In the captopril, nifedipine and losartan groups, the mean diastolic blood pressures at the onset of hypertensive urgency were 116.00±15, 121.50±22 and 109.25±14 mmHg respectively. In the captopril, nifedipine and losartan groups, at 90 minutes, mean diastolic blood pressures were 84.75±10, 95.25±19 and 88.50±12 mmHg respectively. A significant (<0.05) hypotensive effect of sublingual captopril, nifedipine and losartan therapy occurred at 90 minutes. The results of the study indicate that sublingual losartan is an effective drug in patients with hypertensive urgenc

Are analysis of parent-female adolescent relationships in female adolescent suicides

WOS: 000252435700005PubMed ID: 18265739This study analyzed Turkish female adolescent-family relations, which is believed to be one of the significant factors in female adolescents' suicide attempts, from a multidimensional perspective. The Parent-Adolescent Relationship Inventory, a multidimensional evaluation tool based on the behavioral family-system approach was used as a research tool. The inventory consists of the concepts and techniques of behavioral theory, family system theory, and cognitive theory in parent-adolescent' problems and conflicts. Based on these theories, the parent-adolescent relations inventory (PARQ), involves three main dimensions: problem solving and communication skills, cognitive/internalized beliefs, and functions and structures in family systems. There are two forms of the inventory, the adolescent form and the parent form. Only the adolescent form of PARQ, including 284 items, was used in this research. The inventory also consists of 16 subscales. It was adapted into Turkish by Eryuksel (1996). The subjects of the study were 52 female adolescents who had attempted suicide and were taken to the Emergency Department of The Faculty of Medicine in Cukurova University, and 52 normal female adolescents from two different secondary schools at the southern province in Turkey. The age range of the clinical and normal groups were 14-18 ((x) over bar = 16). The results of the study revealed that the general stress level of female adolescents who attempted suicide is higher than those of normal groups. The examination of family structures of these female adolescents made it clear that mothers were the mediator between fathers and adolescents. It was also observed that both mothers and fathers shared many somatic concerns

Tumor Necrosis Factor Beta A329G Gene Polymorphism and the Association Between Patients With Acute Myocardial İnfarction

Giriş: Bu çalışmada; acil servise göğüs ağrısı şikayeti ile başvuran ve miyokard infarktüsü (MI) tanısı konulan hastalarda tümör nekroz faktör-beta (TNF-?) A329G gen polimorfizminin etkinliğinin araştırılması amaçlanmıştır. Materyal ve Metod: Prospektif, randomize, kontrollü olarak yapılması planlanan çalışmamıza Çukurova Üniversitesi Tıp Fakültesi Etik Kurulu'ndan onay alındıktan sonra başlandı. Çalışmaya onam veren hastalardan kan örneği alındı. Alınan kan örneklerinin analizi Mersin Üniversitesi Tıp Fakültesi Biyokimya Laboratuvarı'nda çalışıldı. DNA izolasyonu, DNA izolasyon kiti (High Pure PCR Template Preparation kit, Roche Diagnostic, Germany) ile yapıldı. TNF-? A329G gen polimorfizmi Light Cycler mutasyon belirleme kiti (Roche diagnostic, GmbH, Mannheim, Germany) kullanılarak Light Cycler cihazında Real Time PCR ile saptandı. Verilerin istatistiksel analizi SPSS 11.5 paket programı ile yapıldı. Tüm testlerde istatistiksel önem düzeyi p < 0.05 olarak alındı. Bulgular: Bu çalışmaya miyokard infarktüsü tanısı konulan 90 hasta (78 erkek, 12 kadın) ve kontrol grubu olarak 78 sağlıklı birey (28 erkek, 50 kadın) dahil edildi. Tümör nekroz faktör-beta A329G polimorfizmi ile miyokard infarktüsü arasında istatistiksel olarak anlamlı bir ilişki bulunamadı. Miyokard infarktüs' lü hastaların % 42.2'sinde AG genotipi ve % 6.7'sinde ise GG genotipi saptandı. MI olan hastalarda kontrol grubuna göre LDL düzeyinin istatistiksel olarak anlamlı derecede yüksek olduğu (p = 0.021), HDL düzyinin ise istatistiksel olarak anlamlı derecede düşük olduğu (p = < 0.001) saptandı. Sonuç: TNF-? A329G gen polimorfizmi ile Miyokard İnfarktüsü arasında bir ilişki olmadığı saptandı. Yüksek LDL ve düşük HDL düzeylerinin Mİ için risk faktörleri olduğu tespit edildi. Ülkemizde Türk toplumuna yönelik TNF-? A329G gen polimorfizmi ile MI arasındaki ilişkiyi belirlemeye yönelik yapılan ilk çalışma olması açısından bu çalışma önemlidir. Bu çalışma, diğer çalışmalara ışık tutabilir ve tümör nekroz faktörün diğer polimorfizmleri araştırılarak muhtemel olası anlamlı bulgular elde edilebilir.Purpose: In this study, we aim to evaluate the efficacy of the tumor necrosis factor-beta A329G gene polymorphism in patients admitted to emergency department with chest pain complaint and diagnosed acute myocardial infarction. Material and Methods: This study was planned as a prospective, randomized, controlled study and we started the study after the approval of Cukurova University Ethics Committee. Blood samples were taken from the patients who gave permission. Analysis of blood samples were studied in the Biochemistry Laboratory of Mersin University. DNA was extracted by High Pure PCR Template Preparation kit (High Pure PCR Template Preparation kit, Roche Diagnostic, Germany). TNF-? gene polymorphism A329G mutations were determined by using the Light Cycler instrument detection kit (Roche diagnostic, GmbH, Mannheim, Germany) in Light Cycler Real Time PCR. Statistical analysis of data was performed with SPSS 11.5 software package. The statistical significance level of p <0.05 was taken for all tests. Results: 90 patients (78 men, 12 females) with myocardial infarction and 78 healthy controls (28 men, 50 females) were included to this study. Tumor necrosis factor-beta A329G gene polymorphism was not significantly associated with myocardial infarction. 42.2 % of subjects had AG genotype and 6.7 % of subjects had GG genotype in patients with myocardial infarction. LDL levels in patients with MI were significantly higher than the control group (p = 0.021) and HDL levels were significantly lower in patients with MI (p = <0.001). Conclusion: It was observed that there has not been any relationship between tumor necrosis factor-beta A329G gene polymorphism and myocardial infarction. High LDL and low HDL levels were found to be the risk factors for MI. This study is important because it is the first study try to determine the relationship between MI and TNF-? A329G polymorphism of the gene for the Turkish community in our country. This study could lighten other studies, other polymorphisms of tumor necrosis factor can be investigated and the potential possible significant findings can be obtained