The utility of the systemic immune inflammation and systemic inflammation response indices in suspected intermediate-risk pulmonary embolism.

AIM: To evaluate the utility of the systemic immune inflammation index (SII) and systemic inflammation response index (SIRI) in diagnosing pulmonary embolism (PE) in emergency medicine. METHODS: We retrospectively reviewed the data of patients who presented to the emergency department and underwent contrast-enhanced computed tomography pulmonary angiography for suspected PE between January 1 and December 31, 2021. In 81/168 patients, the diagnosis of PE was confirmed and in 87/168 it was rejected. The data were analyzed with receiver operating characteristic analysis and binary logistic regression analysis. RESULTS: Patients with PE had a higher white blood cell count (P<0.001), neutrophils (P=0.002), monocytes (P=0.013), neutrophil/lymphocyte ratio (P<0.001), SII (P<0.001), and SIRI (P<0.001), and a lower lymphocyte count (P=0.002). The SII had a sensitivity of 75.31% and a specificity of 71.26%, while the SIRI had a sensitivity of 82.72% and a specificity of 68.97%. Binary logistic regression analysis showed that the Wells score, D-dimer level, and SII independently influenced the diagnosis of PE. CONCLUSION: The SII and SIRI may be used to support the diagnosis of PE in the emergency department.

Effect of Comorbid Diseases on Hospitalization and In-Hospital Mortality of Elderly Patients Who Reapplied to the Emergency Department Within 72 Hours.

OBJECTIVE: This study aimed to determine the effects of comorbidities on hospitalization and in-hospital mortality in patients aged 65 years and older who returned to the emergency department within 24, 48, and 72 hours of an initial visit. METHODS: This study was conducted at the Department of Emergency Medicine, Firat University Faculty of Medicine, Elâzig, Turkey. It has a retrospective design and received local ethics committee approval from the university. Patients aged 65 years and older who presented to the emergency department within a one-year period (2022) were examined to identify those who returned to the emergency department within 24, 48, and 72 hours of an initial visit. RESULTS: A total of 763 (3.2%) patients >65 years of age returned to the emergency department within the first three days of their initial visit. Of these returning patients, 349 returned within 24 hours (Group 1), 227 within 48 hours (Group 2), and 187 within 72 hours (Group 3). Being female, polypharmacy, the presence of at least one comorbidity, cancer, and chronic renal failure were found to be independent predictors of hospitalization, whereas polypharmacy was found to be an independent predictor of in-hospital mortality. CONCLUSION: Patients returning to the emergency department shortly after an initial visit should be assessed more diligently due to the risk of mortality.

Spexin level in acute myocardial infarction in the emergency department.

Background: We aimed to determine the serum spexin level in patients with acute myocardial infarction (AMI) admitted to the emergency department. Methods: A total of 100 patients with AMI (50 with ST-segment elevation myocardial infarction (STEMI) and 50 with non-ST-segment elevation myocardial infarction (NSTEMI)) and 50 control group patients with non-cardiac chest pain were included in the study. A detailed anamnesis was taken, a physical examination was performed, and 12-lead electrocardiograms and venous blood samples were taken at the time of admission. Spexin levels were measured via enzyme-linked immunosorbent assay. Results: Serum spexin levels were significantly lower in the AMI group than in the non-cardiac chest pain group (p<0.001). There was no significant difference in serum spexin levels between STEMI and NSTEMI patients (p=0.83). In receiver operating curve analysis, we detected 58% sensitivity, 76% specificity, 82.9% positive predictive value, and 47.5% negative predictive value with an optimal cutoff value of 532 pg/mL for the diagnosis of AMI. Conclusions: In this study, serum spexin levels were significantly lower in AMI patients compared to patients with non-cardiac chest pain. The decrease in spexin levels suggests that it has the potential to be used as a diagnostic marker in AMI patients.

The relationship between defence mechanisms and clinical variables in myocardial infarction patients.

Introduction: Although patients with myocardial infarction (MI) history exhibit individual differences, several psychological problems can be observed in these patients. The present study aimed to investigate the correlation between defence mechanisms and other clinical and sociodemographic data in the early period in patients with MI history. Material and methods: Sixty patients diagnosed with MI and hospitalized in the cardiology department were included in the study. The Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Defence Styles Questionnaire (DSQ) were applied. Results: It was determined that the mean BDI score of the participants was 15.9 ±11.2, and the mean BAI score was 15.98 ±10.9. There was a positive correlation between the depression and immature defence mechanism scores of the patients, and there was a negative correlation between the depression and mature defence mechanism scores of the patients (p = 0.001, r = 0.412; p = 0.005, r = -0.359). A negative correlation was determined between anxiety scores and mature defence mechanism scores (p = 0.002, r = -0. 397). Conclusions: The findings demonstrated that depressive complaints of the post-MI patients increased as the immature defence mechanism score increased, and depressive complaints decreased as the maturity defence mechanism score increased. The correlation between the defence mechanisms adopted by MI patients and depression and anxiety symptoms should not be neglected.

Health Anxiety, Health Perception, and Healthy Lifestyle Behavior Among Psychiatric Patients During the COVID-19 Pandemic.

Objective: To compare the health anxiety and healthy lifestyle behavior experienced by psychiatric patients due to the coronavirus disease 2019 (COVID-19) pandemic with that of a control group.Methods: The study included 120 outpatients (aged 18-65 years) diagnosed with a psychiatric illness (DSM-5 criteria) who presented to a psychiatry outpatient clinic between June and August 2020. The control group included 120 healthy individuals with a similar age and sex distribution as the patient group. Data were collected with a questionnaire developed by the authors to determine the participants' adherence to COVID-19 hygiene rules and associated behavioral norms. The Health Anxiety Scale-Short Form, Health Perception Scale, and Health-Promoting Lifestyle Profile were completed by all participants.Results: The mean Health Anxiety Scale score was significantly lower in the patient group compared to the control group (P < .01). Health anxiety was high in 8% of the patients and 32% of the controls. Also, the mean Health-Promoting Lifestyle Profile score was statistically significantly lower in the patient group compared to the control group (P < .01). There was no significant difference between the groups based on health perception scores and adherence to hygiene rules.Conclusions: As expected, the healthy lifestyle behavior of individuals without psychiatric illness was higher compared to those with mental disorders. However, health anxiety about COVID-19 was higher among healthy individuals compared to those with a psychiatric disorder. Thus, it could be suggested that individuals without a psychiatric illness prior to the pandemic could need psychiatric assistance after the pandemic.

Effects of N-acetyl cysteine on TRPM2 expression in kidney and liver tissues following malathion intoxication.

We investigated the effects of N-acetyl cysteine (NAC) on transient receptor potential melastatin 2 (TRPM2) channel expression in rat kidney and liver tissues following experimental malathion intoxication. We used seven groups of six male Wistar albino rats: control group, NAC, pralidoxime + atropine, malathion, malathion + pralidoxime + atropine, malathion + pralidoxime + atropine + NAC, and malathion + NAC. Single doses of 100 mg/kg N-acetyl cysteine, 40 mg/kg pralidoxime, 2 mg/kg atropine and 1/3 the lethal dose of malathion were administered. No difference in malondialdehyde (MDA) levels, apoptosis or TRPM2 immunoreactivity was found in liver tissue among the groups. In kidney tissue, MDA levels, apoptosis and TRPM2 immunoreactivity were increased significantly in the malathion and malathion + NAC groups compared to the control group. We found that organophosphate intoxication did not affect MDA, apoptosis or TRPM2 immunoreactivity in rat liver during the acute period. By contrast, we found that in kidney tissue, MDA, apoptosis, and TRPM2 immunoreactivity were increased significantly following administration of malathion. Also, NAC given in addition to pralidoxime and atropine reduced MDA to control levels.

The Effectiveness of Ischemia Modified Albumin in Determining Acute Cholecystitis and its Severity.

BACKGROUND: Acute cholecystitis (AC) is caused by chemical and bacterial inflammation of the gallbladder. The use of Tokyo guidelines is recommended in determining the diagnosis of AC and its clinical severity. In the early stages of AC, many cytokines are secreted due to the local inflammatory cell activation, leading to exacerbation of inflammation and organ failure. Ischemia modified albumin (IMA) is a type of albumin that occurs in ischemia and oxidation and is used as a marker of hypoperfusion and oxidative stress. This study aims to investigate the effectiveness of ischemia modified albumin, C-reactive protein (CRP), and some other inflammation parameters in predicting the severity of the AC on admittance. METHODS: Forty-two patients diagnosed with AC and 30 healthy individuals in the control group were included in the study. The severity assessment of the patients was performed based on the revised Tokyo guidelines (TG 13). The patients were divided into 3 groups according to severity of the disease. Blood samples were taken from the subjects on admittance. Serum IMA levels were studied using an ELISA kit. SPSS 22.00 package program was used for statistical analysis. RESULTS: Thirty (71.4%) of the participants were in the mild group, while 12 (28.6%) were in the moderate group. There were no patients in the severe group. Leukocyte, CRP, and IMA values in the patient group were higher than those of the control group (p > 0.05). According to the Tokyo classification, a significant difference was found between the groups with mild and moderate grades in terms of CRP and IMA values (p < 0.001 and p < 0.05, respectively). When the cutoff value of IMA was 84 ng/mL, the sensitivity was found to be 76% and specificity was determined to be 40% (AUC: 0.665, p = 0.017, 95% Confidence Interval). CONCLUSIONS: It is considered that IMA could be useful in predicting the clinical severity of TG13-based acute cholecystitis and, therefore, could be used in the management of treatment by the clinician such as medical treatment, early surgery, and interval surgery.

Evaluation of risk factors for Suicide Attempts in Turkey's East: A Five-Year Study.

OBJECTIVES: Suicide attempt has different risk factors for each community. In the study we aimed to reveal the causes of suicide attempt in Turkey's Eastern part and to make suggestions to prevent suicide. METHODS: For this study, 130 patients who were admitted to the Emergency Department of the University Hospital due to suicide attempt between January 2013 and December 2017 were included. Our University Hospital is the largest hospital in the East of Turkey. The data were obtained from hospital records and files of judicial investigations. Clinical progress records were obtained from the hospital archive. Investigation files were received from local judicial units. RESULTS: Fifty six percent of the patients (n = 73) were female. 48% of female cases (n = 35) were married. There was major depressive disorder in 34% (n = 44) of the cases. Medicine taking was the most frequent suicide method with 63% (n = 82). The main reason for suicide was parental conflicts for female cases; and psychiatric and financial problems for males. CONCLUSION: Family therapy for married individuals would reduce suicide attempts in females. Psychiatric history is an important risk factor and it should be ensured that these patients are followed up regularly by the health institutions and their relatives. To prevent drug abuse, there should not be too much medicine in homes. If medicine is available at home, it should be kept in a safer environment.

Diagnostic and Prognostic Relevance of Serum Irisin Level in Patients with Pulmonary Embolism.

BACKGROUND: We aimed to determine the diagnostic and prognostic value of serum irisin level in patients with acute pulmonary embolism (PE) admitted to the emergency department. METHODS: Ninety patients who underwent computed tomography pulmonary angiography (CTPA) due to suspected PE were included in the study. Demographic data, PE risk factors, and associated diseases, vital signs, Wells score, Revised Geneva score, pulmonary embolism severity index (PESI), and simplified PESI (sPESI) were recorded. Irisin levels were measured by enzyme linked-immunosorbent assay. RESULTS: Serum irisin level in patients with confirmed PE (n = 45) was significantly lower than that in patients (n = 45) without PE (p = 0.001). On receiver operating characteristic curve analysis, use of optimal irisin cutoff level of 8.6 µg/mL for diagnosis of PE was associated with 82.2% sensitivity, 60% specificity, 67.3% positive predictive value (PPV), and 77.1% negative predictive value (NPV) [area under the curve (AUC): 0.744, 95% confidence in-terval (CI): 0.641 - 0.830, p < 0.001)]. Use of optimal D-dimer cutoff level of 1,720 µg/L was associated with 86.7% sensitivity, 62.2% specificity, 69.6% PPV, and 82.4% NPV (AUC: 0.801, 95% CI: 0.704 - 0.878, p < 0.001). Irisin level showed no significant correlation with Wells score or revised Geneva score; however, irisin level showed a significant negative correlation with PESI and sPESI. CONCLUSIONS: Patients with acute PE showed significantly lower serum levels of irisin. The sensitivity, specificity, NPV, and PPV of irisin level for diagnosis of PE were lower than those of D-dimer.

Evaluation of ubiquitin C-terminal hydrolase-L1 enzyme levels in patients with epilepsy.

OBJECTIVE: Ubiquitin C-terminal Hydrolase-L1 (UCH-L1) enzyme levels were investigated in patients with epilepsy, epileptic seizure, remission period, and healthy individuals. METHODS: Three main groups were evaluated, including epileptic seizure, patients with epilepsy in the non-seizure period, and healthy volunteers. The patients having a seizure in the Emergency department or brought by a postictal confusion were included in the epileptic attack group. The patients having a seizure attack or presenting to the Neurology outpatient department for follow up were included in the non-seizure (remission period) group. RESULTS: The UCH-L1 enzyme levels of 160 patients with epilepsy (80 patients with epileptic attack and 80 patients with epilepsy in the non-seizure period) and 100 healthy volunteers were compared. Whereas the UCH-L1 enzyme levels were 8.30 (IQR=6.57‒11.40) ng/mL in all patients with epilepsy, they were detected as 3.90 (IQR=3.31‒7.22) ng/mL in healthy volunteers, and significantly increased in numbers for those with epilepsy (p<0.001). However, whereas the UCH-L1 levels were 8.50 (IQR=6.93‒11.16) ng/mL in the patients with epileptic seizures, they were 8.10 (IQR=6.22‒11.93) ng/mL in the non-seizure period, and no significant difference was detected (p=0.6123). When the UCH-L1 cut-off value was taken as 4.34 mg/mL in Receiver Operating Characteristic (ROC) Curve analysis, the sensitivity and specificity detected were 93.75 and 66.00%, respectively (AUG=0.801; p<0.0001; 95%CI 0.747‒0.848) for patients with epilepsy. CONCLUSION: Even though UCH-L1 levels significantly increased more in patients with epilepsy than in healthy individuals, there was no difference between epileptic seizure and non-seizure periods.

Evaluation of ubiquitin C-terminal hydrolase-L1 enzyme levels in patients with epilepsy / Avaliação dos níveis de enzima ubiquitina C-terminal hidrolase-L1 em pacientes com epilepsia

ABSTRACT Objective: Ubiquitin C-terminal Hydrolase-L1 (UCH-L1) enzyme levels were investigated in patients with epilepsy, epileptic seizure, remission period, and healthy individuals. Methods: Three main groups were evaluated, including epileptic seizure, patients with epilepsy in the non-seizure period, and healthy volunteers. The patients having a seizure in the Emergency department or brought by a postictal confusion were included in the epileptic attack group. The patients having a seizure attack or presenting to the Neurology outpatient department for follow up were included in the non-seizure (remission period) group. Results: The UCH-L1 enzyme levels of 160 patients with epilepsy (80 patients with epileptic attack and 80 patients with epilepsy in the non-seizure period) and 100 healthy volunteers were compared. Whereas the UCH-L1 enzyme levels were 8.30 (IQR=6.57‒11.40) ng/mL in all patients with epilepsy, they were detected as 3.90 (IQR=3.31‒7.22) ng/mL in healthy volunteers, and significantly increased in numbers for those with epilepsy (p<0.001). However, whereas the UCH-L1 levels were 8.50 (IQR=6.93‒11.16) ng/mL in the patients with epileptic seizures, they were 8.10 (IQR=6.22‒11.93) ng/mL in the non-seizure period, and no significant difference was detected (p=0.6123). When the UCH-L1 cut-off value was taken as 4.34 mg/mL in Receiver Operating Characteristic (ROC) Curve analysis, the sensitivity and specificity detected were 93.75 and 66.00%, respectively (AUG=0.801; p<0.0001; 95%CI 0.747‒0.848) for patients with epilepsy. Conclusion: Even though UCH-L1 levels significantly increased more in patients with epilepsy than in healthy individuals, there was no difference between epileptic seizure and non-seizure periods.

RESUMO Objetivo: Níveis da enzima ubiquitina C-terminal hidrolase-L1 (UCH-L1) foram investigados em pacientes com epilepsia, crise epiléptica, período de remissão e indivíduos saudáveis. Método: Foram avaliados três grupos principais, incluindo crise epiléptica, epilepsia no período não convulsivo e voluntários saudáveis. Pacientes com convulsão no departamento de emergência ou trazidos por confusão pós-ictal foram incluídos no grupo de crise epiléptica. Os pacientes que tiveram crise epiléptica ou foram ao ambulatório de Neurologia para acompanhamento foram incluídos no grupo não convulsivo (período de remissão). Resultados: Os níveis da enzima UCH-L1 de 160 pacientes com epilepsia (80 pacientes com crise epiléptica e 80 pacientes com epilepsia no período não convulsivo) e 100 voluntários saudáveis foram comparados. Enquanto os níveis da enzima UCH-L1 foram 8,30 (IQR=6,57‒11,40) ng/mL em todos os pacientes com epilepsia, os níveis detectados foram de 3,90 (IQR=3,31‒7,22) ng/mL em voluntários saudáveis e aumentaram significativamente na epilepsia (p<0,001). No entanto, ao passo que os níveis de UCH-L1 foram 8,50 (IQR=6,93‒11,16) ng/mL nos pacientes com crise epiléptica, foram 8,10 (IQR=6,22‒11,93) ng/mL no período não convulsivo, e nenhuma diferença significativa foi detectada (p=0,6123). Quando o valor de corte de UCH-L1 foi considerado 4,34 mg/mL com base na análise da curva ROC, sensibilidade e especificidade foram detectadas como 93,75 e 66,00%, respectivamente (AUG=0,801; p<0,0001; IC95% 0,747‒0,848) para os pacientes com epilepsia. Conclusão: Embora os níveis de UCH-L1 tenham aumentado significativamente nos pacientes com epilepsia em relação aos indivíduos saudáveis, não foi observada diferença entre crise epiléptica e períodos não convulsivos.

Can we define migraine patients with blood high-sensitivity C-reactive protein and galectin-3 levels in the emergency department?

INTRODUCTION: Migraine, the most widespread cause of headache in young adults, is a frequent reason for presentation to emergency departments. The aim of this study was to determine the diagnostic value of serum galectin-3 and high-sensitivity C-reactive protein (hsCRP) levels in migraine patients. MATERIAL AND METHODS: Serum galectin-3 and hsCRP levels were measured using enzyme-linked immunosorbent assay in 70 migraine patients and 70 healthy control subjects. RESULTS: The mean values of hsCRP and galectin-3 levels were significantly higher in the migraine group than those in the control group (1.67 ±0.49, 1.12 ±0.38 mg/l, p < 0.001; and 3.76 ±1.45, 2.05 ±0.29 ng/ml, p < 0.001, respectively). When the diagnostic values of the biomarkers were assessed in the migraine attack and control groups, the sensitivity and specificity of the test for hsCRP at the cut-off point of 1.32 mg/l were 70% and 73% (AUC = 0.805, 95% CI: 0.74-0.88, p < 0.001), and for galectin-3 at the cut-off point of 2.4 ng/ml, 89% and 90% (AUC = 0.97, 95% CI: 0.95-0.99, p < 0.001), respectively. CONCLUSIONS: This study showed the presence of a relation between high serum levels of hsCRP and galectin-3 in migraine patients. However, well-controlled, carefully executed longitudinal studies are required to confirm these findings.

The Relationship between Ghrelin and Copeptin Levels, and Anxiety and Depression Levels in Suicide Attempts.

OBJECTIVE: It was aimed to detect acylated ghrelin (AG), unacylated ghrelin (UG) and copeptin levels in patients with suicide attempts and to determine if these biomarkers are risk factors for suicide attempts. METHODS: Serum copeptin, AG and GU levels were screened in 128 patients who were admitted to emergency department with suicide attempts and 59 healthy controls. Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) were applied simultaneously, and the data were compared statistically. RESULTS: AG, UG and copeptin levels were higher in the patient group compared with the healthy control group. BAI scores of patients were found to be positively correlated with BDI scores. While there was a significant difference (p=0.0064) between psychiatric and non-psychiatric patients with suicide attempts in terms of BAI scores, there were no differences in BDI scores and levels of biomarkers. We found significantly increased BDI and BAI scores and increased levels of AG, UG and copeptin in psychiatric and non-psychiatric patients compared with healthy individuals. The specificities yielded by receiver operating characteristic curve analysis in patients with suicide attempts were as follows: 91.53% for AG, 72.88% for UG and 94.92% for copeptin. CONCLUSION: Serum levels of AG, UG and copeptin increase with increasing anxiety and depression in patients with suicide attempts. Increased levels of AG, UG and copeptin could be considered a risk factor for suicide attempts.

Investigation of UCH-L1 levels in ischemic stroke, intracranial hemorrhage and metabolic disorder induced impaired consciousness.

OBJECTIVE: We aimed to determine the levels of ubiquitin C-terminal hydrolase-L1 (UCH-L1) in patients admitted to the emergency department with impaired consciousness due to metabolic or neurological reasons. MATERIALS - METHODS: The study included 80 patients with ischemic stroke (IS), 40 patients with intracranial hemorrhage (ICH), 80 patients with metabolic disorder induced impaired consciousness (MDIC) and 40 healthy controls. RESULTS: The levels of UCH-L1 [median (IQR)] were as follows: 5.59ng/mL (3.90-9.37) in IS, 5.44ng/ml (4.01-13.98) in ICH, 3.34ng/ml (2.29-5.88) in MDIC and 3.94ng/ml (3.31-7.95) in healthy volunteers. Significantly higher levels were detected in IS and ICH than in MDIC and healthy volunteers. In ROC curve analysis, we detected 63.75% sensitivity and 62.5% specificity (AUC=0.626, p<0.0199, 95% CI: 0.533-0.713) with a cutoff value of 4.336ng/ml for IS and 75% sensitivity and 55% specificity (AUC=0.664, p<0.0071, 95% CI: 0.549-0.766) with a cut-off value of 4.036ng/ml for ICH. However, the sensitivity and specificity for MDIC was 36.25% and 77.5%, respectively, with a cut-off value of 3.256ng/ml (AUC=0.525, p=0.6521, 95% CI: 0.432-0.617). UCH-L1 levels were found to increase significantly with increasing time between the onset of symptoms and blood sampling (r=0.345, p<0.001). However, no correlation was found between UCH-L1 levels and age (r=0.014, p=0.833), GCS (r=-0.115, p=0.074), mRS (r=0.063, p=0.475) and NIHSS (r=0.056, p=0.520). CONCLUSION: In this study, we detected significantly higher levels of UCH-L1 in patients with IS and ICH compared to patients with MDIC and healthy volunteers.

Copeptin Levels in Cerebral Infarction, Intracranial Hemorrhage and Subarachnoid Hemorrhage.

BACKGROUND: To determine copeptin levels in patients with suspected intracranial events and to determine whether copeptin levels could be used in the discrimination of cerebral infarction, intracranial hemorrhage, and subarachnoid hemorrhage in the emergency room. METHODS: Blood samples were obtained from the patients prior to imaging to determine the levels of copeptin. Patients were divided into diagnostic groups after the imaging. One hundred and seventy-six participants, who were enrolled in the study, were as follows: 50 cerebral infarction (CI) patients (M/F: 24/26), 47 intracranial hemorrhage (ICH) patients (M/F: 27/20), 29 subarachnoid hemorrhage (SAH) patients (M/F: 17/12) and 50 healthy controls. Differences and correlations between groups were analyzed. RESULTS: Plasma levels of copeptin in patients with CI, ICH, and SAH were 5.49 ng/dL (IQR 4.73 to 6.96), 4.50 ng/dL (IQR 3.04 to 9.77), and 5.90 ng/dL (IQR 3.11 to 13.26), respectively. It was found to be 2.0 ng/dL (IQR 1.57 to 2.5) in healthy volunteers. There was no significant correlation between copeptin levels and Intracerebral Hemorrhage Score (ICHS) (r = 0.231, p = 0.118). However, significant positive correlation was found between copeptin levels with the National Institutes of Health Stroke Scale (NIHSS) (r = 0.365, p = 0.009) and the BotterelHunt and Hess Scale (BHHS) (r = 0.590, p = 0.001). The copeptin levels of 41 (32.5%) patients who died were found to be significantly higher than those 85 (67.5%) patients who were discharged (p < 0.001). CONCLUSIONS: Copeptin levels in patients with CI, ICH, and SAH are significantly higher than healthy volunteers, but the plasma level of copeptin is not decisive in the discrimination of CI, ICH, and SAH.

Serum Salusin Levels in ST-Segment Elevation Myocardial Infarction.

BACKGROUND: In our study, we aimed to determine the change in levels of salusin-alpha and salusin-beta at admission and after the treatment in patients with STEMI, who have active atherosclerosis. METHODS: Serum salusin-alpha and beta levels of 50 patients diagnosed with STEMI in the emergency department were measured at admission and on 7th day post-treatment and compared with serum salusin levels of 50 healthy volunteers. RESULTS: In STEMI patients, salusin-alpha levels were found to be significantly decreased (p < 0.001) and salusinbeta levels were found to be significantly increased (p < 0.001) compared to healthy volunteers in the control group. 7th day post-treatment salusin-alpha levels were found to be lower and salusin-beta levels were found to be at a higher level compared to healthy individuals (p < 0.001). Negative correlation (r = -.322 p = 0.023) was found between salusin-alpha levels and pulse rate. But no significant correlation was found between salusin-beta levels and biochemical parameters. CONCLUSIONS: The data of this study support the fact that salusin-alpha levels decrease and salusin-beta levels increase in acute cases such as STEMI.

Copeptin levels and blood lipid profile in borderline patients with or without self-mutilation.

PURPOSE: Self-mutilation, known as self-harming behaviour of an individual without the intention of suicide, is commonly observed in individuals with borderline personality disorder. The objective of this study is to compare copeptin levels that are known to be related to aggressive behaviour and blood lipid profiles in borderline patients with and without self-mutilation. METHODS: Twenty patients with self-mutilation [SM(+)] and 20 patients without self-mutilation [SM(-)] between the ages of 18 and 49, diagnosed with borderline personality disorder based on DSM-IV-TR(8) diagnostic criteria and attended to by Firat University Psychiatry Polyclinic, participated in the study. Socio-demographic and clinical data form, Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale (HAMA) and Barrat Impulsivity Scale (BIS) were applied to all participants. Copeptin levels and plasma lipid levels were studied in the blood samples taken from the participants. RESULTS: Mean copeptin level found in SM(+) group (37.54 ± 18.8 ng/mL) was statistically significantly higher than SM(-) group (18.53 ± 16.6 ng/mL) (p = 0.002). A negative correlation was found between mean copeptin and mean total cholesterol levels (r = -0.436; p = 0.005), and between copeptin and low-density lipoprotein cholesterol (LDL) levels (r = -0.403; p = 0.01) in both SM(+) and SM(-) patient groups. HAMA mean score for SM(+) group was found as 36.45 ± 13.2, and for SM(-) group, it was found as 35.7 ± 12.9. There was a statistically significant difference between the depression points achieved by the two groups (p = 0.046). BIS total points average for SM(+) group was determined as 71 ± 9.71, whereas it was determined as 66.8 ± 7.92 in SM(-) group. There was no statistically significant difference between the groups based on anxiety points. Barrat planning, Barrat motor and Barrat attention points for SM(+) group were higher than the SM(-) group. However, the difference was not statistically significant (p > 0.05). CONCLUSION: Findings of the study demonstrated that as cholesterol and LDL levels decreased, copeptin levels increased, and that could be related to the self-mutilation behaviour.

Neuron-Specific Enolase, S100 Calcium-Binding Protein B, and Heat Shock Protein 70 Levels in Patients With Intracranial Hemorrhage.

The authors evaluated neuron-specific enolase (NSE), S100 calcium-binding protein B (S100B), and heat shock protein 70 (HSP 70) levels and their relationships with in-hospital mortality, Glasgow Coma Scale (GCS) scores, and National Institute of Health Stroke Scale (NIHSS) scores. In total, 35 patients older than 18 years were presented to our emergency department and were diagnosed with non-traumatic intracranial hemorrhage (ICH) and 32 healthy controls were included. Blood samples were drawn on days 0 and 5. S100 calcium-binding protein B and HSP levels were significantly higher in patients than in controls on days 0 and 5. Neuron-specific enolase levels were higher in patients than in controls on day 0, but there was no significant difference on day 5. S100 calcium-binding protein B was negatively correlated with GCS, whereas it was positively correlated with NIHSS and bleeding volume. There was also a negative correlation between NSE and GCS, but it was not statistically significant. In addition, no significant correlation was found in terms of bleeding volume or NIHSS. Heat shock protein 70 was negatively correlated with GCS and positively correlated with bleeding volume and NIHSS, but these results were not statistically significant. S100 calcium-binding protein B and HSP 70 levels were significantly higher in those who died compared with survivors. The areas under the curve of S100 B, NSE, and HSP 70 for mortality were 0.635, 0.477, and 0.770, respectively. Neuron-specific enolase, S100B, and HSP 70 levels are simple, inexpensive, and objective measures in cases of ICH. These tests can be used to support an assessment for screening ICH patients with clinical scoring systems, such as GCS and NIHSS.

Paraoxonase-1 gene in patients with chronic obstructive pulmonary disease investigation Q192R and L55M polymorphisms.

BACKGROUND: The effect of increased oxidative stress on the development of chronic obstructive pulmonary disease (COPD) is well known. One of the antioxidative systems against oxidative stress in human body is paraoxonase (PON) enzyme that protects low density lipoproteins (LDL) against oxidation. This study aimed to explore the polymorphisms on PON1, Q192R, L55M genes of patients with COPD. METHODS: DNAs extraction was obtained from blood samples of 50 patients diagnosed with COPD and 50 patients as a control group who were presented to emergency clinic. Genotypes were obtained with polymerase chain reaction (PCR) and AIw I and Hsp92II restriction enzymes were used for Q192R and L55M polymorphisms, respectively. Analysis of data was done with the Chi-square test and Fisher's exact test. RESULTS: A statistically significant difference in Q192R polymorphism was found between the COPD patients and the control group (P=0.05). There was no statistically significant difference in L55M polymorphisms between the patient and control groups (P>0.05). Q192R polymorphism was significantly correlated with the PON1 gene and cigarette smoking; however other risk factors did not show any significant correlation with this polymorphism. Though L55M polymorphism was significantly correlated with family history and tuberculosis, there was no significant correlation with other risk factors. CONCLUSION: We believe that more studies are needed to study the correlation of L55M polymorphism with other factors.

The effect of meteorological parameters on the number of renal colic patients.

In this study, we investigated the effect of meteorological parameters on the number of renal colic patients who admitted to the emergency department regarding patients' gender, patients' age and season. Patients who were admitted to the emergency department with renal colic during a year were studied retrospectively. The number of patients admitted daily was divided into groups according to gender, age and seasons, and correlations between the daily meteorological parameters were examined. In our study, a total of 1890 patients were enrolled and of those 64.9% (n=1227) were male. The mean age of the patients was 38±14.7/years (18-94). The number of patients admitted daily was 5±2.9/patients (1-18). Positive correlation was found between the daily number of patients and daily maximum temperature (p<0.001, r=0.212), and daily minimum temperature (p=0.003, r=0.160) and daily temperature difference (p<0.001, r=0.218). Additionally, a negative correlation with the daily relative humidity (p=0.001, r=-0.169) was detected. As a result of multivariate regression analysis, age was found to independently affect the number of RC patients admitted to the emergency department (R2 0.0079, t -3.56, p<0.001). Negative correlation was found between relative humidity and female patients, patients in the 30-39 years of age group, and the daily number of RC patients admitted in spring. We found positive correlation between temperature and the number of patients under the age of 39 years, but we concluded that the daily number of patients above the age of 40 years did not significantly correlate with temperature rise. In our study, we determined that meteorological parameters have an effect on renal colic and that this effect varies depending on the patients' age, patients' gender and season.