Serum Nuclear Factor Erythroid-2 Related Factor-2 (NRF2) as an Indicator of Oxidative Stress is Related to Coronary in-Stent Restenosis

Objective: In the treatment of coronary artery disease, stent implantation has become the standard treatment, but development of in-stent restenosis (ISR) limits the benefit of this treatment modality. Methods: Based on the connection between oxidative stress and thiol/disulphate and NRF2, it was intended to measure NRF2 and thiol/disulphate levels. Results: Coronary angiography images of 76 stable angina pectoris patients were evaluated. Of the 51 patients with a history drug eluting stent implantation, we determined 25 patients with ISR (Group 1) and 26 patients without ISR (Group 2). Twenty-five patients with normal coronary arteries were included in the study as control group (Group 3). NRF2 level was found to be significantly higher in patients who did not develop ISR (p=0.01). Total thiol was significantly higher in group 3 (738.76 micromole/L) compared to group 1 (626.11 micromole/L) and group 2 (630.27 micromole/L) (p=0.014). Native thiol was also significantly higher in group 3 (570.53 micromole/L) compared to group 1 (483.91 micromole/L) and group 2 (501 micromole/L) (p=0.006). Conclusion: We think that total and native thiol levels might be useful as an indicator of oxidative stress in early diagnosis of coronary artery disease, and the NRF2 level can be used in predicting patients who might develop coronary ISR

The Effect of Epinephrine Administration on Return of Spontaneous Circulation and One-Month Mortality with Cardiopulmonary Arrest Patients

Objective: The objective of this study is to determine the effect of epinephrine administration on the return of spontaneous circulation (ROSC) and one-month mortality in patients with cardiopulmonary arrest.Methods: We conducted this study between August 1, 2016 and May 31, 2017. Importantly, we included the witnessed cases (?18years) of in-emergency department cardiopulmonary arrest (IEDCA) and out-of-hospital cardiopulmonary arrest (OHCA) in thestudy. We divided the patients into two groups: the adrenaline group (Group 1) and the non-adrenaline group (Group 2). Thereafter, we investigated ROSC and one-month mortality in them.Results: We included 183 patients (50.3% of males and 49.7% of females with a mean age of 64.2±16.8 years) in the study. Thepercentages of IEDCA and OHCA cases were 25.1% and 74.9%, respectively. Epinephrine was administered to 100 (54.6%) patients(Group 1). Among these patients, 15.9% (n=29) of the patients had shockable rhythms (ventricular fibrillation, pulseless ventriculartachycardia) and 84.1% (n=154) of them had non-shockable rhythms (asystole, pulseless electrical activity) as the initial rhythm.ROSC and one-month mortality rate of these patients were 24% (n=44) and 72.8% (n=36), respectively. The one-month mortalityrates of Group 1 (30% of patients had IEDCA and 70% of patients had OHCA) and Group 2 were 43.8% and 56.2%, respectively(p=0.0231). The ROSC and one-month mortality rates of Group 1 and Group 2 cases, whose initial rhythm was a shockable rhythm,were 26.6% and 50% vs. 42.8% and 66.6%, respectively.Conclusion: In this study, we found no significant difference in terms of obtaining ROSC between the shockable rhythm and ROSCin the IEDCA and OHCA cases (p=0.963 and p=0.141, respectively). The effect of epinephrine administration on patients with IEDCA and OHCA whose ROSC was obtained on one-month mortality was not statistically significant (p>0.05).WOS:00057445920000

Workplace violence in emergency departments in Turkey

Background Studies on workplace violence against physicians in emergency departments (EDs) in Turkey are lacking. Methods To describe the frequency and types of workplace violence, a 34-question online survey of the past 12 months was sent to physicians working in EDs in Turkey. Types of violence were categorized as verbal threats, physical assaults, confrontation, stalking, and sexual harassment. Results A total of 366 physicians completed the survey; 4 were excluded (minimum 20 hours/week). Sixty-two percent of respondents were men. Ninety-nine percent reported verbal abuse and 54% reported physical violence. Family members, not patients, were the most common perpetrators of every form of workplace violence. Hospitals limiting the number of visitors and loitering had 14% reduction in physical threats. Only 23% of respondents indicated that their hospital offered information about preventing and managing workplace violence even though 86% noted interest. Only 1% never had fear, even though 89% indicated they had security staff. Over 89% felt that hospital security was lacking in number and ability to protect. For 82%, workplace violence affected their ability to provide patient care. Ninety percent indicated that current laws do not adequately protect them. There was also no statistically significant difference in any type of workplace violence based on the timing or length of shifts, type of hospital, or number of hours worked. Of all types of violence reported, only stalking demonstrated a statistically significant difference between men and women. Conclusion Workplace violence is a real danger for physicians working in EDs in Turkey, similar to other countries, demonstrating that this problem transcends borders. Further studies should assess root causes of violent behaviors of patients and their visitors, as well as possible (administrative, social, and legal) mechanisms to minimize such violence. Hospitals that limited the number of visitors and empowered security officers were associated with decreased violence

The Effect of Epinephrine Administration on Return of Spontaneous Circulation and One-Month Mortality with Cardiopulmonary Arrest Patients

Objective: The objective of this study is to determine the effect of epinephrine administration on the return of spontaneous circulation (ROSC) and one-month mortality in patients with cardiopulmonary arrest. Methods: We conducted this study between August 1, 2016 and May 31, 2017. Importantly, we included the witnessed cases (>= 18 years) of in-emergency department cardiopulmonary arrest (IEDCA) and out-of-hospital cardiopulmonary arrest (OHCA) in the study. We divided the patients into two groups: the adrenaline group (Group 1) and the non-adrenaline group (Group 2). Thereafter, we investigated ROSC and one-month mortality in them. Results: We included 183 patients (50.3% of males and 49.7% of females with a mean age of 64.2 +/- 16.8 years) in the study. The percentages of IEDCA and OHCA cases were 25.1% and 74.9%, respectively. Epinephrine was administered to 100 (54.6%) patients (Group 1). Among these patients, 15.9% (n=29) of the patients had shockable rhythms (ventricular fibrillation, pulseless ventricular tachycardia) and 84.1% (n=154) of them had non-shockable rhythms (asystole, pulseless electrical activity) as the initial rhythm. ROSC and one-month mortality rate of these patients were 24% (n=44) and 72.8% (n=36), respectively. The one-month mortality rates of Group 1 (30% of patients had IEDCA and 70% of patients had OHCA) and Group 2 were 43.8% and 56.2%, respectively (p=0.0231). The ROSC and one-month mortality rates of Group 1 and Group 2 cases, whose initial rhythm was a shockable rhythm, were 26.6% and 50% vs. 42.8% and 66.6%, respectively