End-tidal carbon dioxide measurements in unintentional non-fire-related carbon monoxide poisoning

Background: Poisoning with carbon monoxide occurs occasionally worldwide, and the gold diagnostic standard is to measure carboxyhemoglobin level in the blood. This study investigated the correlation between carboxyhemoglobin and the end-tidal carbon dioxide levels in 50 patients with carbon monoxide poisoning. Methods: We recruited 50 volunteer patients who had been admitted to the Emergency Services of Istanbul Medipol University Hospital between January 2017 and January 2018. They had been diagnosed with carbon monoxide poisoning unrelated to fire accidents. The arterial and venous blood gases, and other blood and clinical parameters were also measured. The patients' end-tidal carbon dioxide levels were measured from the nose and mouth air, using a Capnostream 20p bedside monitor. Pearson's correlation analyses were performed and the results were compared with the end-tidal carbon dioxide, carboxyhemoglobin and oxygen saturation in the arterial and venous blood samples. Results: The Mean±SD age was 33.98±10.89 years. The Mean±SD arterial and venous carboxyhemoglobin values were 18.05±7.10 and 12.11±9.67, respectively. There were no statistically significant differences between the oxygen saturation, and the arterial and venous blood levels of carboxyhemoglobin (P=0.870, P=0.950), respectively. Also, no statistically significant correlations were found between the end-tidal carbon dioxide, and the arterial and venous carboxyhemoglobin levels (P=0.529, P=0.601), respectively. Conclusion: The results from the blood analyses demonstrated that there was no statistically significant difference between the end-tidal carbon dioxide and the carboxyhemoglobin levels in these patients who had been earlier diagnosed with carbon monoxide poisoning, unrelated to fire accidents

Zehirlenme nedeniyle acil servise başvuran hastaların klinik özellikler ve maliyet açısından değerlendirilmesi

Objective In this study, it is aimed to evaluate the demographic, etiologic and clinical characteristics of the poisoning cases admitted to emergency room along with their costs to Social Security Institution. ( Sakarya Med J 2019, 9(3):470-478 ).Materials and MethodsThis is a descriptive study. The data were obtained by retrieving the files of the patients who were registered for poisoning to a university hospital adult emergency service between October 2015 and October 2017 from the automation system.Results Of the patients, 60.3% were in the 18-24 age group, 30.6% were in the 25-34 age group and 60.0% were females. Of the admissions, 56.8% were due to suicide attempt. In the 18-24 age group and in women, poisonings were found more likely to be a suicide attempt. Of the patients, 50.6% admitted with drug poisoning. The second common cause of poisoning after drugs was carbon monoxide (CO) with 20.6%.Conclusion Poisoning is an important public health problem requiring urgent diagnosis and treatment. Most of the drug poisonings, which have a significant share in all poisonings, are suicide attempts. For this reason, the presence of psychiatric symptoms must be investigated in patients with drug poisoning. The second common cause of poisoning after drugs was found to be CO in our study. This situation should be taken into account especially for applications in winter period. Poisoning is also costly in terms of the health economy. It is important to raise public awareness of poisoning in order to prevent both health-related and financially adverse consequences.Amaç Bu çalışmada acil servise başvuran zehirlenme olgularının demografik, etiyolojik ve klinik özellikleri ile bunların sosyal güvenlik kurumuna olan maliyetlerinin değerlendirilmesi amaçlanmıştır. ( Sakarya Tıp Dergisi 2019, 9(3):470-478 ) Gereç ve Yöntemler Çalışmamız tanımlayıcı tiptedir. Veriler, Ekim 2015-Ekim 2017 tarihleri arasında bir üniversite hastanesi yetişkin acil servisine zehirlenme ön tanısıyla kaydı yapılan hastaların dosyalarının otomasyon sisteminden retrospektif olarak incelenmesi ile elde edilmiştir. Bulgular Hastaların %60,3’ü 18-24, %30,6’sı 25-34 yaş grubunda olup, %60,0’ı kadındır. Başvuruların %56,8’inde etkenle maruziyet, intihar amacıyla gerçekleşmiştir. 18-24 yaş grubunda ve kadınlarda zehirlenmelerin daha çok intihar amaçlı olarak gerçekleştiği bulunmuştur. Hastaların %50,6’sı ilaç nedenli zehirlenme ile başvurmuştur. İlaç dışı başvuruların en sık nedeni ise %20,6 ile karbonmonoksit (CO) zehirlenmesi olmuştur. Sonuç Zehirlenmeler, acil tanı ve tedaviyi gerektiren önemli bir halk sağlığı sorunudur. Tüm zehirlenmeler içinde önemli bir paya sahip olan ilaca bağlı zehirlenmelerin büyük bölümü intihar amaçlı alım sonucu gerçekleşmiştir. Bu nedenle ilaç zehirlenmesi ile gelen hastalarda psikiyatrik tabloların varlığı mutlaka araştırılmalıdır. Çalışmamızda ilaç dışı nedenlerle gerçekleşen zehirlenmelerin en büyük nedeni CO olarak bulunmuştur. Özellikle kış döneminde gelen başvurularda bu durum dikkate alınmalıdır. Zehirlenmeler, sağlık ekonomisi açısından da maliyetlidir. Zehirlenmelerin gerek sağlıkla ilgili, gerekse de mali açıdan yarattığı olumsuzlukların önlenmesi açısından toplumsal farkındalığın arttırılması önemlidir

Serum amphiregulin and cerebellin-1 levels in severe preeclampsia

Purpose: Preeclampsia is a form of hypertensive disorders of pregnancy and defined as the presence of new-onset hypertension and proteinuria or other end organ damage occurring after 20-week gestation. Preeclampsia can be a destructive process that can cause maternal and infant mortality. The exact etiopathogenesis of preeclampsia is still undefined. We aimed to compare serum amphiregulin and cerebellin-1 levels of severe preeclampsia patients with healthy pregnant women and healthy control subjects. Materials and methods: A total of 88 women were enrolled in this study. Patients diagnosed with severe preeclampsia were group 1 (n?=?28), healthy non-pregnant normotensive women group 2 (n?=?30), and healthy pregnant women group 3 (n?=?30). The participants in each group were matched for age. Pregnant women in groups 1 and 3 were also matched for gestational age. Serum amphiregulin and cerebellin-1 levels were measured using ELISA. Results: Serum amphiregulin levels were 3413???1.38?ng/ml (1748?7739), 8510???7213?ng/ml (2019?24,000), and 6580???5360?ng/ml (2484?24,000) in preeclampsia patients, controls and healthy pregnant women, respectively. Amphiregulin levels were significantly lower in preeclampsia patients than healthy pregnant women (p=.008) and controls (p?=?.015). Amphiregulin levels were similar between healthy controls and healthy pregnant women (p??=??1.00). Cerebellin-1 levels were 222.039???92.681?pg/ml (138,580?557,757) in preeclamptic patients, 537.043???525.117?pg/ml (150,432?1,600,000) in controls and 415.091???436.580?pg/ml (137,284?1,600,000) in healthy pregnant women. Cerebellin-1 levels were similar among groups (p?=?.272). Serum amphiregulin and cerebellin-1 levels were significantly and positively correlated with each other in preeclampsia patients (r??=??0.693, p?<?.001), controls (r??=??0.882, p?<?.001), and healthy pregnant women (r??=??0.591, p?=?.001). Serum level of amphiregulin ?3590?pg/ml had a sensitivity of 67.9% and specificity of 63.3% in the diagnosis of preeclampsia (AUC: 0.751; p?=?.001). Conclusions: Serum amphiregulin decreases in severe preeclampsia patients

Evaluation of occupational accidents in a tertiary emergency department introduction

Aim: Our study aimed to determine the characteristics of occupational accident cases admitted to an emergency department and evaluate these accidents in terms of emergency service cost.Materials and Methods: This descriptive study evaluated the age and gender of the patients, admission time, reason for admission and the sector in which the patient works. Trauma to the body area and the patients' cost covered by Social Security Institution were also evaluated according to the hazard classification for business organisations.Results: The study included a total of 410 patients admitted to the emergency department due to occupational accidents. Of these, 95.9% were male, of which 30.0% were working in construction sectors. The maximum number of admissions was between 800 and 1200 hours at a frequency of 34.6%. Furthermore, the costs of occupational accidents that the workers were exposed to in very dangerous sectors were the highest (p=0.012).Conclusion: Occupational accidents result in the highest number of deaths after traffic and home accidents. They have a significantly negative impact on both the workers' health and national economy. In particular, in work places classified as dangerous and very dangerous, the employees are at a risk of accidents that may cause permanent injury and/or death