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OBJECTIVES: The aim of this study is to determine the role of Respiratory Rate Oxygenation (ROX), shock, and diastolic shock indexes ââin predicting mortality in coronavirus disease 2019 (COVID-19) patients admitted to the emergency department. BACKGROUND: The COVID-19 spread worldwide in a short time and caused a major pandemic. The ROX, shock, and diastolic shock indexes are used in various life-threatening clinical situations. The use of these indexes in triage at emergency departments can accelerate the determination of COVID-19 patients' severity. METHODS: The ROX, shock and diastolic shock indices were calculated and recorded. Patients were divided into three groups; 1) who were discharged from the hospital, 2) who were admitted to the hospital and 3) who were admitted to the intensive care unit. RESULTS: Increased diastolic shock index and decreased ROX index were found to be independent risk factors for mortality. In the prediction of mortality, the sensitivity and specificity of the diastolic shock index were 61.2% and 60.8%, respectively. However, the sensitivity and specificity of ROX index was 73.1% and 71.5%, respectively. CONCLUSION: In conclusion, we found that the ROX index had higher sensitivity and specificity than other indexes in predicting mortality in the evaluation of COVID-19 patients (Tab. 3, Fig. 2, Ref. 18).
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COVID-19 , Taxa Respiratória , Choque , Humanos , COVID-19/mortalidade , COVID-19/diagnóstico , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Choque/mortalidade , Índice de Gravidade de Doença , Serviço Hospitalar de Emergência , SARS-CoV-2 , Sensibilidade e Especificidade , Adulto , Fatores de RiscoRESUMO
BACKGROUND: The aim of this study was to determine how Ramadan fasting (RF) affected the recently described new obesity indices [visceral adiposity index (VAI), waist circumference to height ratio (WHtR), body adiposity index (BAI)], and serum concentration of apelin-13 (RF) in healthy adult men. MATERIAL AND METHODS: For this purpose, 42 healthy adult men were selected. Anthropometric parameters were measured and a sample of venous blood was obtained for biochemical assays on the first and last days of Ramadan. When all subjects were evaluated, all anthropometric parameters changed except VAI. Serum apelin-13, triglyceride (TG), HDL-cholesterol (HDL-C), and insulin levels did not change. When patients were divided into 3 groups according to body mass index (BMI), BAI decreased in normal-weight subjects and WHtR decreased in other groups, but VAI and apelin-13 did not change in any groups. RESULTS: We demonstrate for the first time that while some anthropometric parameters changed, VAI and serum apelin-13 levels did not change with RF. BMI, waist circumference (WC), TG, and HDL-C were evaluated together in calculation of VAI. TG, VAI, and HDL-C remained unchanged by RF. Even if body weight (BW) and BMI decreased, apelin-13 was not affected by RF. The data on serum apelin-13 may have been influenced by the small-percentage decrease in BW, as well as insignificant improvements in metabolic parameters such as lipid profiles, glucose, and insulin. CONCLUSIONS: We found that Ramadan fasting in healthy adult men was associated with significant decreases in BW, BMI, WHtR, and BAI, but we found no significant changes in VAI and serum apelin-13 concentrations.
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Adiposidade/fisiologia , Jejum/sangue , Peptídeos e Proteínas de Sinalização Intercelular/sangue , Gordura Intra-Abdominal/metabolismo , Islamismo , Adulto , Apelina , Índice de Massa Corporal , HDL-Colesterol/sangue , Humanos , Masculino , Turquia , Razão Cintura-EstaturaRESUMO
BACKGROUND: The aim of this study was to estimate the effects of exposure to chemical compounds on systemic biochemical inflammatory markers in printing industry workers. MATERIAL/METHODS: Fifty-eight printing workers from 19 different small- and medium-sized enterprises in the printing sector were investigated. For comparison, 80 healthy workers not subjected to workplace chemicals served as control subjects. RESULTS: No significant differences were observed between the printing workers and control subjects with respect to age, BMI, waist circumference/hip circumference ratio, smoking, and alcohol consumption. Printing workers had significantly higher serum TNF-alpha levels (11.02 ± 5.34 vs. 9.26 ± 3.87 pg/ml, p=0.039), plasma fibrinogen levels (1.74 ± 0.49 vs. 1.38 ± 0.5 mg/dl, p=0.012), and red blood cell distribution width (RDW-SD) (49.77 ± 3.09 vs. 47.3 ± 2.88 p<0.01) compared to control subjects. CONCLUSIONS: Elevation of RDW, serum TNF-alpha, and plasma fibrinogen levels in printing workers may be due to systemic toxic effects of chemical compounds used in this sector. TNF-alpha is an inflammatory cytokine that has a wide spectrum of biological activities, and fibrinogen plays an important role in pathological processes. Some compounds may be carcinogenic or mutagenic. Better designed workplaces and working conditions will help to reduce the hazardous effects of chemical compounds.
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Eritrócitos/efeitos dos fármacos , Substâncias Perigosas/efeitos adversos , Inflamação/induzido quimicamente , Exposição Ocupacional/efeitos adversos , Impressão , Contagem de Células Sanguíneas , Estudos de Casos e Controles , Eritrócitos/citologia , Fibrinogênio/análise , Humanos , Imunoensaio , Estatísticas não Paramétricas , Fator de Necrose Tumoral alfa/sangue , TurquiaRESUMO
BACKGROUND: The aim of this study was to determine the relationship between hematuria and volume, position of stone, and hydronephrosis in patients with a solitary stone, using unenhanced multidetector computed tomography (MDCT). MATERIAL AND METHODS: This retrospective study evaluated the clinical and radiological records of 83 patients undergoing MDCT for the evaluation of acute flank pain and suspected renal colic, who also underwent a microscopic urinalysis at the emergency department of our hospital during a 1-year period. Inclusion criteria of the MDCT study were solitary urolithiasis and cumulative stone diameter under 1 cm. RESULTS: A total of 83 patients were included in the study, with a mean age of 42.1±14.4 years; 48 (57.8%) were females and 35 (42.2%) were males. Detection of 5 or more red cells on urinalysis was regarded as microscopic hematuria, and was positive in 46 patients (55.4%). There was a positive correlation between the position of the stone (especially upper two-thirds ureteral stones) and microhematuria rate (r: 0.28, p=0.009). There was a statistically significant difference in presence of hydronephrosis between the microhematuria (36 patients, 78%) and non-microhematuria (12 patients, 32%) groups (p<0.001). The median stone volume between the microhematuria and non-microhematuria groups were not statistically different, 37.5 mm3 (range 5-425) and 28 mm3 (range 4-412), respectively (p=0.39). CONCLUSIONS: Although stone volume is one of the best indicators of stone burden, it was not correlated with microhematuria. However, in patients with renal colic, microhematuria requires ultrasound examination whether hydronephrosis and ureteral stones are present or not. Further studies with larger sample sizes are warranted.
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Hematúria/complicações , Hidronefrose/complicações , Urolitíase/complicações , Urolitíase/patologia , Adulto , Feminino , Hematúria/diagnóstico por imagem , Humanos , Hidronefrose/diagnóstico por imagem , Masculino , Tomografia Computadorizada Multidetectores , Urolitíase/diagnóstico por imagemRESUMO
INTRODUCTION: An experimental study was conducted to investigate the effects of erythropoietin on the acute phase of esophageal burn damage induced by sodium hydroxide. MATERIALS AND METHODS: A standard esophageal alkaline burn was produced by the application of 10% sodium hydroxide to the distal esophagus in an in vivo rat model. Fifty-six female rats were allocated into three groups: Group BC (baseline control, n = 8) rats were uninjured and untreated, Group PC (positive control, n = 24) rats were injured but untreated and Group EPO (erythropoietin-treated, n = 24) rats were injured and given subcutaneous erythropoietin (1,000 IU/kg per day), 15 min, 24, and 48 h after administration of the NaOH solution. Six animals from Group PC and six from Group EPO were killed at 4, 24, 48, and 72 h after application of NaOH to the esophagus. All of animals in Group BC were killed 4 h after exposure to 0.9% NaCl. Oxidative damage was assessed by measuring levels of malondialdehyde (MDA) and nitric oxide (NO), and activities of superoxide dismutase (SOD) and catalase (CAT) in homogenized samples of esophageal tissue. Histologic damage to esophageal tissue was scored by a single pathologist blind to groups. RESULTS: MDA levels in the BC and EPO groups were significantly lower than those in the PC group (p < 0.05). CAT and SOD activities, and NO levels in the BC and EPO groups were significantly higher than in the PC group (p < 0.05). Esophageal tissue damage measured at 4, 24, 48, and 72 h after NaOH application was significantly less in the EPO group than in the PC group (p < 0.05). CONCLUSIONS: When administered early after an esophageal burn induced by 10% sodium hydroxide in this rat model, erythropoietin significantly attenuated oxidative damage, as measured by biochemical markers and histologic scoring.
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Reação de Fase Aguda/prevenção & controle , Queimaduras Químicas/tratamento farmacológico , Eritropoetina/uso terapêutico , Esôfago/lesões , Estresse Oxidativo/efeitos dos fármacos , Reação de Fase Aguda/etiologia , Reação de Fase Aguda/patologia , Animais , Queimaduras Químicas/metabolismo , Queimaduras Químicas/patologia , Catalase/metabolismo , Cáusticos/toxicidade , Modelos Animais de Doenças , Relação Dose-Resposta a Droga , Esôfago/metabolismo , Esôfago/patologia , Feminino , Injeções Subcutâneas , Malondialdeído/metabolismo , Óxido Nítrico/metabolismo , Ratos , Ratos Sprague-Dawley , Hidróxido de Sódio/toxicidade , Superóxido Dismutase/metabolismo , Índices de Gravidade do Trauma , Resultado do TratamentoRESUMO
BACKGROUND/AIM: The collection of fluids, blood, pus, or air in the pleural cavity is a pathological condition requiring pleural drainage. A newly designed thorax drainage catheter in the prototype phase was used in this experimental study to test its efficacy. MATERIALS AND METHODS: A hemopneumothorax was first caused by a penetrating injury on the frontal axis of the sixth intercostal space on the right hemithorax with a scalpel on 6 female Sus domesticus swine subjects. After resting for 5 min, a tube or catheter was inserted. The same procedure with a tube thoracostomy or thorax drainage catheter was repeated on the left hemithorax. The time periods were recorded. After all procedures were completed, the thoracic organs were assessed for iatrogenic injuries. RESULTS: In terms of time elapsed for procedure, statistically significant differences between the tube thoracostomy and thorax drainage catheter applications were identified (P < 0.05). Additional iatrogenic injuries were nonexistent for both groups. During the thorax drainage catheter application, a surgical set or the use of sutures was not required. CONCLUSION: This study showed promising results regarding the efficacy of the thorax drainage catheter for convenient use in prehospital and hospital settings by physicians with little experience with tube thoracostomy.
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Toracostomia , Toracotomia , Animais , Catéteres , Drenagem , Feminino , SuínosRESUMO
BACKGROUND: This study was planned to analyze the internal and external anatomical findings of cardiac injuries and the presence of accompanying pulmonary injuries in intentionally inflicted thoracic injuries to swine models. METHODS: We inflicted a penetrating heart injury in six suis domesticus female swine models. Two cardiac injuries, one on the left paratracheal of fourth intercostal space (ICS) and the other on the right side were inflicted on each model by the same researcher using a 20-cm long scalpel. All animals were then sacrificed for morphological evaluation. RESULTS: After strikes to the left fourth ICS, external evaluation showed that 50% of the subjects suffered a single laceration and that 33% suffered multiple lacerations. Internal evaluation showed additional intracardiac injuries in all five subjects. However, the subject that suffered a single laceration on the outer surface of the heart had multiple internal injuries while another subject that had multiple outer lacerations had only one intracardiac injury. Only three subjects suffered cardiac injuries and only two out of those three with pulmonary injuries after right fourth intercostal intrusions. CONCLUSION: This experiment has shown that external evaluation of the heart tissue may not alone be sufficient to determine the extent of cardiac injuries and accompanying pulmonary injuries caused by penetrating thoracic injuries.
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Traumatismos Cardíacos/fisiopatologia , Lesão Pulmonar/fisiopatologia , Ferimentos Penetrantes/fisiopatologia , Animais , Modelos Animais de Doenças , Feminino , SuínosRESUMO
BACKGROUND: This study was planned to evaluate both the histopathological changes under light microscope as well as the systemic organ effects following application of Ankaferd Blood Stopper® (ABS) (a mixture of five plant extracts) in an animal model of deep tissue hemorrhage. METHODS: A total of 50 Wistar Albino rats were divided into five groups of 10 rats each. The rats underwent femoral vein puncture and were treated with ABS tampon, ABS spray, or Surgicel, and one group was left untreated. After two weeks, each group underwent partial tissue excision from the same femoral region as well as from the brain, heart, kidney, and liver. RESULTS: The specimens from all groups were obtained from the femoral region after two weeks and evaluated under light microscope. The light microscope revealed no histopathological changes in neurovascular structures or in deep connective tissues in any of the groups. CONCLUSION: ABS provided hemostasis and was observed to stop bleeding. There were no histopathological changes at the tissue level and no pathological effects in other organs tissues under light microscope, and the remote organ tissue remained clear.
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Hemorragia/terapia , Técnicas Hemostáticas , Extratos Vegetais/uso terapêutico , Animais , Feminino , Artéria Femoral/lesões , Ratos , Ratos Wistar , Tampões CirúrgicosRESUMO
BACKGROUND/PURPOSE: The aim of the study was to evaluate the effects of selenium (Se) on ischemia/reperfusion (I/R) injury in rat ovaries. METHODS: Thirty-five female Sprague-Dawley rats were randomly divided into 5 groups (n = 7): sham (S), I/R1, I/R2, Se1, and Se2. In the I/R1 and Se1 groups, 4 hours of ischemia was followed by 6 hours of reperfusion, and in the I/R2 and Se2 groups, 4 hours of ischemia was followed by 12 hours of reperfusion. In the Se groups, 30 minutes before reperfusion, a single dose of 0.2 mg/kg Se was administered intraperitoneally. The ovarian tissue levels of malondialdehyde (MDA) and nitric oxide (NO), and the activities of superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) were measured biochemically. Tissue damage to ovarian tissue was scored by histopathologic examination. RESULTS: The I/R groups had significantly higher MDA levels and lower CAT, SOD, and GPx activities than the sham group (P < .05). Although NO levels were significantly higher in the I/R1 group than in the sham group (P < .05), the NO levels in the I/R2 and sham groups were similar. Selenium pretreatment significantly lowered tissue MDA and NO levels and increased tissue SOD and GPx activities in the Se groups, compared with those in the I/R groups (P < .05). Catalase activities were significantly higher in the Se2 group than in the I/R2 group (P < .05). Catalase activities were higher in the Se1 group than in the I/R1 group, but the difference was not statistically significant. Treatment with Se significantly decreased the ovarian tissue damage scores in the Se2 group compared with those in the I/R2 group (P < .05). CONCLUSION: Selenium is effective in preventing tissue damage induced by I/R in rat ovaries.
Assuntos
Antioxidantes/uso terapêutico , Doenças Ovarianas/complicações , Traumatismo por Reperfusão/prevenção & controle , Selênio/uso terapêutico , Anormalidade Torcional/complicações , Animais , Biomarcadores/metabolismo , Modelos Animais de Doenças , Esquema de Medicação , Feminino , Injeções Intraperitoneais , Laparotomia , Ovário/irrigação sanguínea , Ovário/metabolismo , Ovário/patologia , Distribuição Aleatória , Ratos , Ratos Sprague-Dawley , Traumatismo por Reperfusão/etiologia , Traumatismo por Reperfusão/metabolismo , Traumatismo por Reperfusão/patologia , Resultado do TratamentoRESUMO
UNLABELLED: In recent years, there has been an emerging preference by patients for emergency services due to the efficiency of transactions and the increased quality of service. As a result, emergency departments have experienced an extreme density of patients. Nevertheless, patients require the same standard of care and should be evaluated carefully. The emergency physician should evaluate the patient as a whole in light of the findings and not merely according to the recommendations of the consultant. We describe in this case report a rare complication occurring after laparoscopic cholecystectomy, shortness of breath, which could easily be disregarded. KEYWORDS: Laparoscopic cholecystectomy complication; Dyspnea; Intrahepatic subcapsular hematoma.
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BACKGROUND AND OBJECTIVES: Organophosphate poisoning (OP) is a serious clinical condition that may sometimes be fatal. The aim of this study was to determine whether the Glasgow coma scale (GCS), and serum acetylcholinesterase and leukocyte levels have prognostic value in acute OP poisoning. DESIGN AND SETTING: Retrospective review of records of patients admitted to the intensive care unit of Selcuk University, Meram Medical Faculty, Emergency Department, Konya, Turkey, between January 2006 and January 2009. METHODS: We studied acutely OP-poisoned patients admitted within 24 hours after OP exposure. RESULTS: The mean age of the 25 patients was 37 years (range, 20-80 years). Three (12%) of the 25 patients (male-female ratio, 12:13) died. The mean GCS values of the patients who died were significantly lower compared to those of the group that survived (4 vs 11.7, respectively P<.05). While the mean serum acetylcholinesterase levels were lower in the patients who died, the difference in the mean serum acetylcholinesterase levels between the patients who died and the ones who survived was not statistically significant (3841 IU/L vs. 1768 IU/L, respectively). CONCLUSION: Although serum cholinesterase values can be used in the quick diagnosis, their efficiency at predicting outcome in patients with OP poisoning has not been established. It has also been determined that serum leukocyte values have no prognostic value in OP poisoning, but GCS values have been found to be effective in predicting the outcome.