Appropriateness of emergency department visits in a Turkish university hospital

Aim. To determine the patterns and appropriateness of patients' use of a university hospital emergency department

Oral deltamethrin ingestion due in a suicide attempt

PubMedID: 20568424Deltamethrin intoxication is uncommon throughout the world. The toxicity of insecticides containing pyrethroids is considered relatively lower than that of other insecticides such as compounds containing orga-nophosphate. Acute deltamethrin poisoning due to oral ingestions is relatively rare. This report describes a case of a 32-year-old woman admitted to the emergency department (ED) with irritability, muscle cramps, discomfort, sensation of burning, loss of sensation in her feet and arms and dyspnea due to deltamethrin ingestion. Deltamethrin intoxication should be considered as a differential diagnosis in patients presented to ED with nonspecific neurological symptoms. The supportive treatment in acute phase of intoxication is critical in the management of these patients since higher doses of deltamethrin ingestion may cause severe symptoms

The value of point-of-care fatty acid binding protein in patients with chest pain in determining myocardial infarction in the emergency setting

WOS: 000279973600004Introduction: Detecting patients in the early hours of acute myocardial infarction is still a challenge for emergency physicians. Fatty acid binding protein (FABP) was thought to be released into the intravascular space earlier than cardiac troponins. The aim of this study was to determine the diagnostic value of point-of-care FABP test either in diagnosing or excluding myocardial infarction during the initial admission of patients presenting with typical chest pain to the emergency department. Methods: This study was performed in a tertiary care emergency department. Patients with typical chest pain were included into the study. Point-of-care FABP was studied during the initial admission and two hours after admission. Patients were diagnosed as myocardial infarction or not ultimately by ECG and troponin levels. Results: A total of 224 patients were included into the study, 73 of them (32.6%) were diagnosed as acute myocardial infarction. FABP had a sensitivity and specificity of 41.0% (95%CI 29.7 to 53.2) and 100% (95%CI 97.6 to 100) and myoglobin had a sensitivity and specificity of 57.5% (95%CI 45.4 to 69.0) and 90.7% (95%CI 85.0 to 95.0) during the initial admission. Cardiac troponin T had a sensitivity of 45.2% (95%CI 33.7 to 57.2) and specificity of 100% (95%CI 97.0 to 100) during the initial admission. Two hours after admission, FABP had a sensitivity of 56.0% (95%CI 40.0 to 71.0) and specificity of 99.0% (95%CI 96.4 to 100) respectively. Conclusions: Point-of-care FABP is good at diagnosing acute myocardial infarction in patients presenting with chest pain. However, FABP was found to be not better than either myoglobin or cardiac troponin T in excluding acute myocardial infarction in patients presenting with chest pain. (Hong Kong j.emerg.med. 2010;17:224-229

Must antidysrhythmic agents be given to all patients with new-onset atrial fibrillation?

We investigated the spontaneous conversion rate of new-onset atrial fibrillation (AF) in emergency department patients and the recurrence rate of AF during al month follow up period. Sixty-six consecutive hemodynamically stable patients presenting to a university hospital emergency department with new-onset atrial fibrillation (less than 72 hours duration) comprised the study population. Patients were initially monitored for 8 hours and observed for spontaneous conversion of AF to sinus rhythm. If conversion did not occur in the first 8 hours, an oral loading dose (600 mg) of propafenone was given, and patients were observed for an additional 8 hours. All patients were reevaluated at 24 hours and at 1 month, The spontaneous conversion rate in patients presenting within 6 hours of AF onset during the initial 8-hour observation period was 71%. The spontaneous conversion rate for ail patients during the initial observation period was 53%, The conversion rates between patients presenting "early" (less than 6 hours) and "late" (7-72 hours) were significantly different (P < 0.001). Many patients with new-onset AF, especially those with atrial fibrillation duration less than 6 hours, may need observation only, rather than immediate intervention, to treat their dysrhythmia, (Am J Emerg Med 1999;17:659-662. Copyright (C) 1999 by W.B. Saunders Company)

Predictors of success in the conversion of new—onset atrial fibrillation using oral propafenone

We have investigated the relationship of clinical variables to successful cardioversion of atrial fibrillation (AF) to sinus rhythm using an oral loading dose of propafenone. Fifty consecutive patients with recent onset (< 72 hours) atrial fibrillation of various aetiologies were included in the study cohort. All patients were given the study medication while in the emergency department and then monitored for 8 hours. All patients converting to sinus rhythm (39 out of 50, 78%) were discharged and re-evaluated at 24 hours and 30 days. We investigated the effect of clinical factors such as age, sex, presence of hypertension (HT), chronic obstructive lung disease (COPD), diabetes mellitus (DM), mitral stenosis (MS), congestive heart failure (CHF), coronary artery disease (CAD) and the duration of atrial fibrillation on conversion to sinus rhythm. Of these factors, univariate and multivariate analysis showed that only the duration of atrial fibrillation was a significant predictor of conversion (p = 0.002). Our results suggest that most patients with new-onset AF can be converted successfully to sinus rhythm with a low incidence of adverse reactions using oral propafenone in the emergency department. © 1998 Lippincott Williams and Wilkins

Preparation of RF sputtered AZO/Au thin film hydrogen peroxide sensitive electrode for utilization as a biosensor

In this study, hydrogen peroxide (H2O2) sensitive Al doped ZO(AZO)/Au thin film electrode has been developed for the utilization as a biosensor. A preferred c-axis oriented AZO/Au thin film was deposited on quartz substrate by RF magnetron sputtering at room temperature. Structural, morphological and optical properties of the AZO film were analyzed by X-ray diffraction, atomic force microscopy and photoluminescence. The sensor performance was characterized by electrochemical analysis device. The sensibility of prepared thin film electrodes to H2O2 was studied. The dependence of amperometric response current on the glucose and cholesterol concentrations was also investigated