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The aim of the study is to determine the usefulness of base excess (BE) and creatine kinase (CK) in predicting the extent of damage to the extremities, the need for hemodialysis, and the likelihood of mortality in crush injuries. Our study included patients who were affected by the earthquakes that occurred in Kahramanmaras/Turkey on February 6, 2023 and were diagnosed with crush injuries. The study was a retrospective observational study. We used chi-square test, independent sample t test, analysis of variance (ANOVA) to examine whether CK and BE values can be used to predict damage to the extremities, hemodialysis requirement, and mortality. A total of 299 patients were included in the study. A statistically significant relationship was found between BE and extremity damage, hemodialysis requirement, and mortality (Pâ <â .005). A statistically significant difference was also seen in terms of extremity damage and hemodialysis requirement with CK (Pâ <â .001), while there was no statistically significant difference seen in mortality (Pâ =â .204). BE may serve as a predictive biomarker for the development of extremities damage, hemodialysis requirement, and mortality. CK is not predictive of mortality.
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Lesiones por Aplastamiento , Síndrome de Aplastamiento , Terremotos , Humanos , Creatina Quinasa/sangre , Lesiones por Aplastamiento/complicaciones , Lesiones por Aplastamiento/mortalidad , Síndrome de Aplastamiento/terapia , TurquíaRESUMEN
It is important to examine the ocular hemodynamic changes after carotid artery stenting (CAS) and carotid endarterectomy (CEA) in patients with internal carotid artery stenosis (ICAS). We aimed to compare the differences in retinal and optic nerve head blood flow after 2 surgical methods. The ipsilateral eyes of 34 patients who had over 50% ICAS with no ocular findings and 30 healthy controls were included in the study. Foveal avascular zone vessel density in the superficial retinal capillary plexus, deep retinal capillary plexus (DCP), and radial peripapillary capillary plexus (RPCP) were measured with an optical coherence tomography angiography device. These measurements were repeated 1 month after CAS or CEA in patients with ICAS. The preoperative and postoperative values of the patients were compared both within themselves and with the control group. When patients with ICAS were compared with the control group, lower vessel density values were found in the DCP parafovea, RPCP whole image, and peripapillary regions both before and after the procedure. There was no significant difference in terms of other parameters. Furthermore, there was no significant difference in any parameter examined between the pre- and postprocedural values of the patients who underwent CAS and CEA. DCP and RPCP are mostly affected in patients with ICAS. We observed that after application of the CAS and CEA methods, the effects on ocular blood flow were similar.
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Estenosis Carotídea , Endarterectomía Carotidea , Stents , Tomografía de Coherencia Óptica , Humanos , Estenosis Carotídea/cirugía , Estenosis Carotídea/diagnóstico por imagen , Endarterectomía Carotidea/métodos , Tomografía de Coherencia Óptica/métodos , Masculino , Femenino , Anciano , Persona de Mediana Edad , Vasos Retinianos/diagnóstico por imagen , Arteria Carótida Interna/cirugía , Arteria Carótida Interna/diagnóstico por imagen , Disco Óptico/irrigación sanguínea , Disco Óptico/diagnóstico por imagenAsunto(s)
Acidosis/inducido químicamente , Antioxidantes/administración & dosificación , Sobredosis de Droga/terapia , Servicios Médicos de Urgencia , Fluidoterapia/métodos , Ácido Tióctico/administración & dosificación , Acidosis/fisiopatología , Acidosis/terapia , Administración Oral , Adulto , Antioxidantes/efectos adversos , Sobredosis de Droga/fisiopatología , Femenino , Humanos , Intento de Suicidio , Ácido Tióctico/efectos adversos , Resultado del TratamientoRESUMEN
OBJECTIVES: This study aimed to investigate the ability of the biomarkers to predict the surgery treatment and mortality in patients above 18 years of age who were hospitalized with the diagnosis of bowel obstruction from the emergency department. METHODS: This is a 2-year retrospective study. The patients' demographic data, laboratory parameters on admission to emergency department, treatment modalities, and the length of hospital stay were recorded. Patients were divided into two groups: conservative and surgical treatment. Statistical analysis was performed to investigate the value of biomarkers in predicting mortality and the need for surgery. Data were analyzed using IBM SPSS version 22. RESULTS: A total of 179 patients were included in this study. Of these, 105 (58.7%) patients were treated conservative and 74 (41.3%) were treated operatively. The elevated procalcitonin (PCT) level, C-reactive protein, blood urea nitrogen-to-albumin ratio, and lactate-to-albumin ratio were significantly correlated with surgical treatment, length of hospital stay, and mortality. procalcitonin threshold value of 0.13 ng/mL was able to predict the need for surgical treatment, with a sensitivity of 79% and a specificity of 70.3%. Procalcitonin threshold value of 0.65 ng/mL was able to predict the mortality rate of the patients, with a sensitivity of 92.9% and a specificity of 78.1%. CONCLUSIONS: Biomarkers, especially procalcitonin, may be useful in bowel obstruction treatment management and may predict mortality.
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Proteína C-Reactiva , Obstrucción Intestinal/diagnóstico , Polipéptido alfa Relacionado con Calcitonina , Biomarcadores , Proteína C-Reactiva/análisis , Humanos , Valor Predictivo de las Pruebas , Pronóstico , Estudios RetrospectivosRESUMEN
The authors aimed to examine the effect of death anxiety on the reports of health-promoting behaviors and to determine the role of age in this relation using a terror-management theory perspective. Participants were 100 individuals from young adult (those who were 20-35 years of age) and older adult (those who were 60 years of age and older) groups whom the authors assigned to the death anxiety or control conditions. The questionnaire set included a demographic information sheet and the Health-Promoting Lifestyle Profile II (S. Walker, K. R. Sechrist, & N. J. Pender, 1987). Before administering the scales, the authors gave the participants in the experimental condition a brief excerpt whose content induced death-related thoughts and led the participants to think about their own death. The authors calculated a 2 (young adults vs. older adults) x 2 (death anxiety vs. no death anxiety) between-subjects factorial analysis of variance (ANOVA) to test their hypotheses. Although ANOVA results did not yield a significant main effect for age, the main effect of the conditions was significant, indicating that people in the death anxiety condition reported more health-promoting behaviors than did people in the control condition. The interaction of the age and conditions was also significant. The authors discuss the strengths, limitations, and implications of the findings.
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Adaptación Psicológica , Envejecimiento/psicología , Ansiedad/psicología , Actitud Frente a la Muerte , Miedo , Conductas Relacionadas con la Salud , Promoción de la Salud , Estilo de Vida , Adulto , Anciano , Mecanismos de Defensa , Femenino , Humanos , Masculino , Persona de Mediana Edad , Inventario de Personalidad , Adulto JovenRESUMEN
SUMMARY OBJECTIVES: This study aimed to investigate the ability of the biomarkers to predict the surgery treatment and mortality in patients above 18 years of age who were hospitalized with the diagnosis of bowel obstruction from the emergency department. METHODS: This is a 2-year retrospective study. The patients' demographic data, laboratory parameters on admission to emergency department, treatment modalities, and the length of hospital stay were recorded. Patients were divided into two groups: conservative and surgical treatment. Statistical analysis was performed to investigate the value of biomarkers in predicting mortality and the need for surgery. Data were analyzed using IBM SPSS version 22. RESULTS: A total of 179 patients were included in this study. Of these, 105 (58.7%) patients were treated conservative and 74 (41.3%) were treated operatively. The elevated procalcitonin (PCT) level, C-reactive protein, blood urea nitrogen-to-albumin ratio, and lactate-to-albumin ratio were significantly correlated with surgical treatment, length of hospital stay, and mortality. procalcitonin threshold value of 0.13 ng/mL was able to predict the need for surgical treatment, with a sensitivity of 79% and a specificity of 70.3%. Procalcitonin threshold value of 0.65 ng/mL was able to predict the mortality rate of the patients, with a sensitivity of 92.9% and a specificity of 78.1%. CONCLUSIONS: Biomarkers, especially procalcitonin, may be useful in bowel obstruction treatment management and may predict mortality.
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Humanos , Proteína C-Reactiva/análisis , Polipéptido alfa Relacionado con Calcitonina , Obstrucción Intestinal/diagnóstico , Pronóstico , Biomarcadores , Valor Predictivo de las Pruebas , Estudios RetrospectivosRESUMEN
OBJECTIVES: Ectopic pregnancy (EP) may cause significant morbidity and mortality. In this study, we aimed to evaluate the demographic characteristics, presence of risk factors and diagnostic parameters of the patient with EP and predicting parameters for ruptured EP. METHODS: Patients who presented to emergency department (ED) and diagnosed as EP within one year were included to the study. The demographic characteristics, ß-human chorionic gonadotropin (ß-HCG) levels, transvaginal ultrasonography (TVUSG) findings, treatment protocols, pathology reports and hemoglobin levels at the time of admission to ED were obtained from patient files and hospital automation system and statistical analysis was performed. RESULTS: Total 35 patients were included to the study. The mean age of the patients was 30 ± 5.6 years. Among the patients, 46% had a history of caesarean section (C-section). The complaints of the patients at presentation, their age, gestational week and the ß-HCG levels were found to be inefficient in predicting ruptured EPs. TVUSG was found statistically significant in terms of demonstrating ruptures in EP. The ratio of salpingectomies was observed to be higher in the surgical treatment of ruptured EPs. CONCLUSIONS: C-section was most frequently seen with EP. There is no absolute diagnostic parameter for predicting ruptured EPs and TVUSG may be a clue for diagnosis. The final diagnosis is made through surgery.
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OBJECTIVES: Chronic Obstructive Pulmonary Disease (COPD) is associated with high mortality and morbidity and is projected to be the third most common cause of death worldwide by 2020. For a variety of reasons, there is a drive to manage a greater number of individuals as outpatients. Preventing readmissions can reduce associated morbidity and subsequent healthcare costs. METHODS: The aim of the present study was to determine the factors affecting the relapse of COPD exacerbated patients in the emergency department (ED). This study combines data from two prospective cohort studies. Patients included in the study were above 18 years of age, had a previous diagnosis of COPD, and presented to the ED for the treatment of acute exacerbation. All the information relevant to the study was collected during the patient's visit to the ED. Relapse was defined as an unscheduled visit to an ED or primary physician within 2 weeks of initial ED visit for worsening COPD symptoms. Telephone follow-up was done on all patients at the end of 2 weeks. RESULTS: The cohort consists of 196 patients. Relapse rate in this study was 27%. Mean respiratory rate, exacerbations in previous year, home nebulizator therapy, home oxygen therapy, admission to intensive care or hospital ward due to COPD exacerbation, previous intubation and abnormal chest x-ray were associated with increased re-visit in univariate analysis. However, after multivariate analysis, exacerbations in previous year (OR: 1.08, 95%CI: 1.01-1.15) and abnormal chest X-ray (OR: 2.5, 95%CI: 1.10-6.11) were still significant. CONCLUSIONS: In conclusion, the number of ED visits previous year and abnormal chest x-ray can predict the revisit of a COPD exacerbated patient within 14 days of an ED visit.