The impact of the duration of admission to the emergency room on the mortality of intensive care patients

Objective: There are many factors affecting the mortality of patients admitted to the intensive care unit (ICU). Among these are the patientsf age, diagnosis, and concomitant pathology. The aim of this retrospective study was to investigate whether there is an adverse effect of the time between admission to the Emergency Room (ER) and admission to theICU on the mortality of these patients.Materials and Methods: The medical records of the patients who were  admitted to the Emergency Department (ED) of the Bolu Izzet Baysal State Hospital and subsequently were admitted to the ICU between December 2009 and August 2011 were analyzed in terms of the time of admission, the season of admission, and the waiting and the stand.by times in the ER.Results: A total of 2380 patients, who were admitted to the ED of the Bolu -zzet Baysal State Hospital and subsequently to the ICU, were included in the study. The median waiting time in the ER was 1.23 h (10 min to 10.02 h). After completion of the admission procedures, the median  hospitalization time in the ER was 0.16 h (3 min to 2.58 h). There was nostatistically significant difference between the patients who died after  admission to the ICU and the ones who survived, in terms of the waiting and the stand.by times in the ER (P > 0.05).Conclusion: The waiting times at the ED did not affect the mortality of the ICU patients.Key words: Intensive care, mortality, stand.by tim

The impact of the duration of admission to the emergency room on the mortality of intensive care patients

Objective: There are many factors affecting the mortality of patients admitted to the intensive care unit (ICU). Among these are the patientsf age, diagnosis, and concomitant pathology. The aim of this retrospective study was to investigate whether there is an adverse effect of the time between admission to the Emergency Room (ER) and admission to theICU on the mortality of these patients.Materials and Methods: The medical records of the patients who were admitted to the Emergency Department (ED) of the Bolu Izzet Baysal State Hospital and subsequently were admitted to the ICU between December 2009 and August 2011 were analyzed in terms of the time of admission, the season of admission, and the waiting and the stand.by times in the ER.Results: A total of 2380 patients, who were admitted to the ED of the Bolu -zzet Baysal State Hospital and subsequently to the ICU, were included in the study. The median waiting time in the ER was 1.23 h (10 min to 10.02 h). After completion of the admission procedures, the median  hospitalization time in the ER was 0.16 h (3 min to 2.58 h). There was nostatistically significant difference between the patients who died after admission to the ICU and the ones who survived, in terms of the waiting and the stand.by times in the ER (P > 0.05).Conclusion: The waiting times at the ED did not affect the mortality of the ICU patients.Key words: Intensive care, mortality, stand.by tim

The HLA Class II Allele Allele DRB1*15 is over-represented in patients with Idiopathic Pulmonary Fibrosis

BACKGROUND: Idiopathic pulmonary fibrosis (IPF) is a progressive and medically refractory lung disease with a grim prognosis. Although the etiology of IPF remains perplexing, abnormal adaptive immune responses are evident in many afflicted patients. We hypothesized that perturbations of human leukocyte antigen (HLA) allele frequencies, which are often seen among patients with immunologic diseases, may also be present in IPF patients. METHODS/PRINCIPAL FINDINGS: HLA alleles were determined in subpopulations of IPF and normal subjects using molecular typing methods. HLA-DRB1*15 was over-represented in a discovery cohort of 79 Caucasian IPF subjects who had lung transplantations at the University of Pittsburgh (36.7%) compared to normal reference populations. These findings were prospectively replicated in a validation cohort of 196 additional IPF subjects from four other U.S. medical centers that included both ambulatory patients and lung transplantation recipients. High-resolution typing was used to further define specific HLA-DRB1*15 alleles. DRB1*1501 prevalence in IPF subjects was similar among the 143 ambulatory patients and 132 transplant recipients (31.5% and 34.8%, respectively, p = 0.55). The aggregate prevalence of DRB1*1501 in IPF patients was significantly greater than among 285 healthy controls (33.1% vs. 20.0%, respectively, OR 2.0; 95%CI 1.3-2.9, p = 0.0004). IPF patients with DRB1*1501 (n = 91) tended to have decreased diffusing capacities for carbon monoxide (DL(CO)) compared to the 184 disease subjects who lacked this allele (37.8±1.7% vs. 42.8±1.4%, p = 0.036). CONCLUSIONS/SIGNIFICANCE: DRB1*1501 is more prevalent among IPF patients than normal subjects, and may be associated with greater impairment of gas exchange. These data are novel evidence that immunogenetic processes can play a role in the susceptibility to and/or manifestations of IPF. Findings here of a disease association at the HLA-DR locus have broad pathogenic implications, illustrate a specific chromosomal area for incremental, targeted genomic study, and may identify a distinct clinical phenotype among patients with this enigmatic, morbid lung disease

A novel selection of optimal statistical features in the DWPT domain for discrimination of ictal and seizure-free electroencephalography signals

Properly determining the discriminative features which characterize the inherent behaviors of electroencephalography (EEG) signals remains a great challenge for epileptic seizure detection. In this present study, a novel feature selection scheme based on the discrete wavelet packet decomposition and cuckoo search algorithm (CSA) was proposed. The normal as well as epileptic EEG recordings were frst decomposed into various frequency bands by means of wavelet packet decomposition, and subsequently, statistical features at all developed nodes in the wavelet packet decomposition tree were derived. Instead of using the complete set of the extracted features to construct a wavelet neural networks-based classifer, an optimal feature subset that maximizes the predictive competence of the classifer was selected by using the CSA. Experimental results on the publicly available benchmarks demonstrated that the proposed feature subset selection scheme achieved promising recognition accuracies of 98.43–100%, and the results were statistically signifcant using z-test with p value <0.0001

Bronchial Secretory Immunoglobulin A Deficiency Correlates With Airway Inflammation and Progression of Chronic Obstructive Pulmonary Disease

Rationale: Although airway inflammation can persist for years after smoking cessation in patients with chronic obstructive pulmonary disease (COPD), the mechanisms of persistent inflammation are largely unknown

Age- and region-specific hepatitis B prevalence in Turkey estimated using generalized linear mixed models: a systematic review

Toy M, Önder FO, Wörmann T, et al. Age- and region-specific hepatitis B prevalence in Turkey estimated using generalized linear mixed models: a systematic review. BMC infectious diseases. 2011;11(1): 337.BACKGROUND: To provide a clear picture of the current hepatitis B situation, the authors performed a systematic review to estimate the age- and region-specific prevalence of chronic hepatitis B (CHB) in Turkey. METHODS: A total of 339 studies with original data on the prevalence of hepatitis B surface antigen (HBsAg) in Turkey and published between 1999 and 2009 were identified through a search of electronic databases, by reviewing citations, and by writing to authors. After a critical assessment, the authors included 129 studies, divided into categories: 'age-specific'; 'region-specific'; and 'specific population group'. To account for the differences among the studies, a generalized linear mixed model was used to estimate the overall prevalence across all age groups and regions. For specific population groups, the authors calculated the weighted mean prevalence. RESULTS: The estimated overall population prevalence was 4.57, 95% confidence interval (CI): 3.58, 5.76, and the estimated total number of CHB cases was about 3.3 million. The outcomes of the age-specific groups varied from 2.84, (95% CI: 2.60, 3.10) for the 0-14-year olds to 6.36 (95% CI: 5.83, 6.90) in the 25-34-year-old group. CONCLUSION: There are large age-group and regional differences in CHB prevalence in Turkey, where CHB remains a serious health problem

Comparative effect of interactive mobiles (clickers) and communicative approach on the learning outcomes of the educationally disadvantaged Nigerian pupils in ESL classrooms

Effective teaching that promotes learners’ active engagement and the development of communicative proficiency has been a challenge to teachers of English as a second language (ESL). Previous research on second language (L2) teaching has shown that L2 learners improve better in communicative skills when they are actively engaged, participate in communicative tasks that facilitate interaction and are provided with the opportunity to use the target language in the classroom. This study focuses on improving ESL learners’ learning outcomes in remotely-located primary schools in Nigeria. The study aimed to test whether the introduction of Personal Response System (PRS) and communicative approach can improve pupils’ English-language communicative competences and their attitudes towards English learning. Specifically, this study examined the extent to which significant differences exist in pupils’ communicative competence performance scores and learning gains based on teachers’ use of a communicative approach, PRS and lecture methods in the ESL classroom. Furthermore, the research also attempted to find out whether pupils’ attitudes towards the learning of English would significantly differ based on teaching strategy. Attitudes of pupils and teachers towards the interventions were also investigated. A pre-test and post-test non-randomised control group design was adopted in this study. Some qualitative data were also collected to augment the quantitative main data. Ninety nine pupils from three intact classes in different schools in Ijebu-North local government, Ogun-State, Nigeria were assigned to two experimental groups and one control group. In addition to the traditional use of textbooks, one of the experimental groups was taught using communicative activities, while the second experimental group experienced communicative tasks blended with the use of a personal response system. The control group received the conventional classroom instruction (lecture method), including the use of the English language textbook. In order to provide answers to the research questions and the hypothesis of this study, English Language Listening Tests and English Language Speaking Tests, Pupils’ Attitude to English Language Lesson Questionnaire, Pupils’ Attitude to Clickers’ Questionnaire and Pupils’ Attitude to Communicative Approach Questionnaire were administered at the pre-and post-test stages of the research. These instruments were also complemented with data from classroom observation, video recording of the instructional process, and audio-recorded interviews with the teachers and selected pupils in the experimental groups. The results indicate that the two experimental groups showed greater improvement in communicative competence than did the control group; but the PRS group improved more than the communicative approach group both in listening and speaking skills development. Moreover, pupils’ learning gains were statistically different, with the PRS group having the highest gain scores above the communicative approach group, while the control group did not experience increased learning gains. The results also reveal pupils’ mixed-reactions with respect to their attitudes toward the English language lesson and the interventions. Teachers’ attitudes toward the interventions were in the positive direction

Synthesis of macrocyclic receptors with intrinsic fluorescence featuring quinizarin moieties

An unprecedented class of macrocycles with intrinsic fluorescence consisting of phenolic trimers and quinizarin is developed. Though they are lacking strong hydrogen bonds as observed in calixarenes, the two examples introduced here each adopt a vase-like conformation with all four aromatic units pointing in one direction (syn orientation). This “cone” conformation has been confirmed by NMR spectroscopy, molecular modeling, and X-ray crystallography. The laminar, electron-rich fluorophore as part of the macrocycle allows additional contacts to enclosed guest molecules