Liporotein-Associated Phospholipase-A2 Can Be A Diagnostic Marker İnthe Early Stage Diagnosis Of Acute Mesenteric İschemia

Background/aim: The purpose of this experimental study was to investigate the role of lipoprotein-associated phospholipase-A2 (LpPLA2 ) in the diagnosis of acute mesenteric ischemia (AMI) in the early stage. Materials and methods: Twenty-seven New Zealand rabbits were randomly divided into 3 groups in this study. Blood specimens were obtained from the groups at hours 0, 1, 3, and 6. Using the blood samples drawn from all groups, Lp-PLA2 and C-reactive protein (CRP) parameters were investigated. Results: There was a significant rise in the levels of both Lp-PLA2 and CRP starting at hour 1 (P > 0.05) (hour 1; Lp-PLA2 , P 0.003) in the ischemia group. In the sham group, the levels of Lp-PLA2 and CRP started to rise at hour 3 (P > 0.05) (hour 3; Lp-PLA2 , P 0.011). At hour 6 of ischemia, the area under the ROC curve was 100%, and the cut-off value of 63.91 ng/mL revealed a sensitivity of 88% and a specificity of 100% for Lp-PLA2 . Conclusion: These findings showed the role of serum Lp-PLA2 and CRP levels in the early diagnosis of AMI. Thus, further studies are needed to describe the role of Lp-PLA2 in the early diagnosis of AMI

Association of Severity of Coronary Lesion with Markers of Acute Infection and Inflammation in Patients with Acute Coronary Syndrome

Aim: Inflammation and some infectious agents play a key role in acute coronary syndrome (ACS) caused by atherosclerosis. The purpose of this study was to assess the effects of inflammatory markers and the positivity of Chlamydia pneumoniae (CP), Helicobacter pylori (HP), and Cytomegalovirus (CMV) on the level of atherosclerosis in patients with ACS. Materials and Methods: Patients (57) that were referred to the emergency unit with classic angina symptoms or angina equivalent symptoms and were determined to have critical lesions in the coronary angiography (0.001 and p0.030, respectively) at hour 48 than originally found at hour 0. Conclusion: There is no association between the severity of coronary lesions and cytokine levels and positivity of infectious agents in ACS since the levels of proinflammatory cytokines in ACS are higher than those in atherosclerosis. The changes in cytokine levels at hour 48 were found to be significan

İki olgu sunumu: turnike sendromu

Saç-iplik turnike sendromu nadir, tehlikeli fakat önlenebilir bir durumdur. El ve ayak parmakları dışında, penis ve klitoris gibi genital organ tutulumları bildiril- miştir. Bu raporda sağ ayak baş parmağında şişlik şikâyeti olan 4 yaşında kız ve sağ 3 ve 4. parmağında şişlik şikayeti olan 2 aylık erkek bebek sunulmaktadır. Olayın gelişimi ve saç-ipliğin uzaklaştırılması arasında geçen süre önemlidir. Klinik basit bir ödemden ülserasyon, nekroz ve uzvun ampütasyonuna kadar değişebilir. Acil hekimleri nedeni açıklanamayan huzursuzluğu olan bir çocuk- ta turnike sendromunu düşünmelidir. (JAEM 2013; 12: 220-1)The Hair-Thread Tourniquet syndrome is a rare and dangerous, but prevent- able condition. Involvements of the genitalia, such as of the penis and clitoris, have been reported as well as that of the fingers and toes. We report two patients: a 4-year-old girl with swelling of her 4th finger of the right foot and a 2-month-old infant with swelling of the 3rd and 4th fingers of the right foot. The time interval between the initiation and removal of the hair-thread is critical. Clinical presentation may vary from simple oedema to ulceration, ne- crosis, and amputation of the organ. Emergency physicians should consider tourniquet syndrome for children with unexplained restlessness. (JAEM 2013; 12: 220-

The role of soluble urokinase plasminogen activator receptor (SuPAR) as an indicator of the severity of acute pancreatitis

WOS:000452890300015PubMed ID: 30541244Background/aim: Soluble urokinase plasminogen activator receptor (suPAR) has been reported to have a positive correlation with theactivation degree of the immune system. This study’s aim is to investigate the efficiency of SuPAR serum levels in acute pancreatitis (AP)patients in determining the severity of disease.Materials and methods: This prospective research involves patients who arrived at the emergency service, were over 18 years old, hadnontraumatic abdominal pain and diagnosis of AP, and agreed to join the study. Demographic characteristics, contact information,laboratory and imaging test parameters, Ranson’s criteria, the Balthazar Severity Index, the Rapid Acute Physiologic Score (RAPS), andthe modified Glasgow (Imrie) score of all patients were recorded. Two study groups were created as score of 3 (mild, Group I) and 3(severe, Group II) for pancreatitis according to Ranson’s criteria.Results: During the study period, 59 sequential patients with AP were included in the study. It was seen that 79.7% of the study group(n 47) were in Group I. Etiologically 67.8% (n 40) cases were biliary and 32.3% (n 19) were nonbiliary diseases. According to theresults, suPAR level was effective in distinguishing the severity of AP (AUC 0.902, P 0.001 (95% CI: 0.821–0.984)). With regardto determining severe disease, suPAR had an optimum cutoff value of 6.815 ng/mL, sensitivity of 91.66%, specificity of 82.97%, andnegative predictive value of 97.5%.Conclusion: Our study was performed the determine the efficiency of suPAR level in predicting severe disease in AP patients. We foundit significant in indicating the severity of disease according to the study results