Thyroid hormone levels predict mortality in intensive care patients with cirrhosis.

INTRODUCTION: Mortality rates of intensive care patients are quite high. The aim of this study was to determine the availability of thyroid function tests and predictive scoring systems on the outcome of cirrhotic patients admitted to the intensive care unit. METHODS: A total of 106 patients were included in the final analysis, of which 32 were men (30.2%) and 74 were women (69.8%). Predictors of mortality that were investigated include acute physiology and chronic health evaluation (APACHE II), model for end-stage liver disease (MELD), Child-Turcotte-Pugh (CTP) and sequential organ failure assessment (SOFA) scores and thyroid function tests including free triiodo-L-thryronin (fT3), free tetraiodothyronine/thyroxine (fT4) and thyroid-stimulating hormone/thyrotropin (TSH) levels. RESULTS: High APACHE II, MELD, CTP and SOFA score and suppression of fT3 were all found to be associated with higher mortality in our intensive care patients who have cirrhosis (P < 0.001). Suppression of fT3 was also found to be reciprocally correlated with high APACHE II, MELD, CTP and SOFA scores (P < 0.001). fT4 had also reciprocal correlation with APACHE II, MELD, CTP and mortality. There is no correlation between TSH levels and predictive scores or mortality. CONCLUSIONS: Calculation of APACHE II, MELD, CTP and SOFA scores and measurement of fT3 and fT4 levels may all be useful as predictors of mortality in intensive care patients who have cirrhosis.

Successful management of bleeding after dental procedures with application of blood stopper: a single center prospective trial.

AIM: Ankaferd Blood Stopper (ABS), as an herbal complementary medicine, has been approved for the management of clinical hemorrhages in Turkey, including dental interventions. Basic, preclinical and clinical studies disclosed the settings of the topical hemostatic use of ABS. The aim of this study is therefore to assess the efficacy and safety of ABS as an antihemorrhagic agent in the bleedings associated with dental procedures in patients with normal and impaired hemostasis. MATERIALS AND METHODS: ABS has been topically applied by homogeneously spraying to the 113 patients during dental interventions within its on-label indications. A median of 0.5 ml (IQR:0.5-1 ml) ABS was administered after tooth extraction with prolonged hemorrhages. RESULTS: After the administration, bleeding stopped in less than 10 seconds in 59 (52.2%) patients, and below 22.5 seconds (IQR: 18, 8-30) in 54 patients (47.8%). A total of 141 procedures were performed in these 113 patients, and nearly 72.5 ml ABS was used with a total cost of 98 €. CONCLUSION: ABS as a new herbal medicine was found to be an effective method for controlling bleeding related to dental procedures. No patient had wound infection and the healing process appeared to be normal. Topical ABS could be useful for the local hemostasis and wound healing in periodontal surgeries. CLINICAL SIGNIFICANCE: In this prospective study ABS, for the first time, has demonstrated its potential for being an effective hemostatic agent for the management of bleedings due to dental procedures.