Medium Cut-Off Membrane Can Be a New Treatment Tool in Amanita phalloides Poisoning.

Mushroom poisoning is a common health problem that can be seen seasonally and geographically. Most mushroom poisoning requiring treatment worldwide is due to Amanita phalloides. Although liver failure and kidney injury are frequent, poisoning can also lead to more serious clinical situations, such as shock, pancreatitis, encephalopathic coma, cardiac failure, disseminated intravascular coagulation, and multiple organ dysfunction syndrome, and may cause death. In addition, when standard treatment approaches fail, extracorporeal treatment methods are often used. We report 2 cases in which hemodialysis with medium cut-off membrane was performed. We observed an improvement in liver and kidney function in both of our cases. The first case recovered, but the second case proved fatal owing to Acinetobacter sepsis, despite an improvement in renal function. Medium cut-off membrane hemodialysis may be an alternative option in the treatment of Amanita phalloides poisoning.

Laboratory markers has many valuable parameters in the discrimination between acute appendicitis and renal colic.

BACKGROUND: Only one diagnostic parameter is not available for acute appendicitis. For the establishment of diagnosis, combination of medical history, clinical, laboratory tests, and radiological imaging modalities are used so as to decrease the rates of negative laparotomy and morbidity secondary to delay in diagnosis. Thepresent study aimed to determine haematological and inflammatory markers which will be used in the discrimination of acute appendicitis (AA) and renal colic which are the most frequent and indistinguishable causes of abdominal pain in patients applying to the emergency service. METHODS: A total of 215 patients who presented with abdominal pain and who were histopathologically diagnosed as AA, and 200 patients who presented with abdominal pain and who were diagnosed as renal colic were included into the study. Control group consisted of 61 patients without any complaints who came to the outpatient clinics of internal medicine only for blood counts. Analyzed blood samples were WBC, RDW, Hb, MCV, MPV, neutrophil, lymphocyte, NLR and PLR. All differences associated with a chance probability of.05 or less were considered statistically significant. RESULTS: A statistically significant intergroup difference was seen between AA and renal colic groups as for age, WBC, Hb, MCV, neutrophil, lymphocyte, NLR and PLR. A statistically significant intergroup difference was seen between AA and control groups regarding age, WBC, Hb, RDW, MPV, neutrophil, lymphocyte, NLR and PLR. A statistically significant intergroup difference was seen between renal colic and control groups as for age, WBC, RDW, MPV, neutrophil and NLR. In ROC curve analysis, the area under AUCs for WBC, neutrophil, NLR and PLR were 0.896, 0.916, 0.888 and 0.725, respectively (p≤0.05). CONCLUSION: In the discrimination between patients with renal colic and those without any illness, WBC, RDW, MPV, neutrophil and NLR; in the differentiation between the patients with AA and healthy individuals, WBC, RDW, MPV, neutrophil, lymphocyte, NLR and PLR; and more importantly in the discrimination between patients with AA and those with renal colic who presented to emergency services with abdominal pain WBC, neutrophil, lymphocyte, PLR and NLR can be useful parameters.

Predictors of slow flow in angiographically normal coronary arteries.

INTRODUCTION: Slow coronary flow (SCF) is a well-known angiographic finding; however, the pathophysiology of SCF remains only partially understood. In this study, we have examined the risk factors of slow coronary flow. METHODS: Seventy patients with angiographically proven SCF were studied along with 60 control participants. Patients were divided into 2 groups based on the angiographic findings as with or without SCF. In both groups, clinical information was collected and laboratory parameters were measured and compared. RESULTS: Patients with SCF had higher serum uric acid, creatinine and hemoglobin levels. They also more commonly had a history of smoking. On the other hand, C-reactive protein and hematologic parameters such as mean platelet volume (MPV), red cell distribution width (RDW), and neutrophil to lymphocyte (N/L) ratio did not differ significantly between the two groups. In the logistic regression analysis, only uric acid (odds ratio [OR]=1.583, 95% confidence interval [CI]=1.011-2.349, P=0.034) was found as an independent correlate of SCF. CONCLUSIONS: This study demonstrates that serum uric acid level is significantly correlated with SCF and may play a role in the development of the condition. These findings provide impetus for additional studies to confirm these results and treatment of SCF.

A Large Intra-Abdominal Hiatal Hernia as a Rare Cause of Dyspnea.

Giant hiatal hernias, generally seen at advanced ages, can rarely cause cardiac symptoms such as dyspnea and chest pain. Here, we aimed to present a case with a large hiatal hernia that largely protruded to intrathoracic cavity and caused dyspnea, particularly at postprandial period, by compressing the left atrium and right pulmonary vein. We considered presenting this case as large hiatal hernia is a rare, intra-abdominal cause of dyspnea.

Seroepidemiological Study of Toxocariasis among Volunteers Animal Husbandry Workers and Veterinary in Southern Anatolia in Turkey in 2014.

BACKGROUND: Human toxocariasis is a parasitic infection caused by the larvae of Toxocara canis. We examine the Toxocara seroprevalance in veterinarians and animal husbandry workers living in the Mugla Province, Turkey to evaluate better the risk factors for Toxocara exposure. METHODS: In 2014, 376 volunteers participated in the study in 2014. All blood specimens were tested using a commercial enzyme immunoassay kit and ELISA positive samples were confirmed by Western Blot (WB) method. RESULTS: The seroprevalence of Toxocara, as determined by WB, was 8%. A statistically significant correlation was evident between patient age and Toxocara positivity among animal husbandry workers (P = 0.029). A strong association was also evident between sex and seropositivity in the animal husbandry group (P=0.024). Veterinarians working in pet clinics did in fact exhibit higher Toxocara seropositivities relative to those of other groups (P = 0.029). A statistically significant difference was detected between the rural geographic areas surveyed (P = 0.04). CONCLUSION: In Mugla Province, seroprevalence of Toxocara is lower than other regions. Despite the low seroprevalence observed, especially in high risk professions toxocariasis remains an important medical concern within the region.

EDTA-induced pseudothrombocytopenia in association with bladder cancer.

Pseudothrombocytopenia is the detection of low platelet counts by an autoanalyser despite lack of shortage in platelets. EDTA-induced pseudothrombocytopenia, the most frequently seen form in clinical practice, occurs mainly due to reaction of antiplatelet antibodies. Pseudothrombocytopenia is not only seen in healthy individuals but it is also reported in association with autoimmune, cardiovascular and liver parenchyma diseases and malignancy. We aimed to review approaches to pseudothrombocytopenia by presenting a case in which EDTA-dependent thrombocytopenia in association with bladder tumour was detected during examination for haematuria.

Loss via peritoneal fluid as a factor for low 25(OH)D3 level in peritoneal dialysis patients.

BACKGROUND/AIMS: In patients with end-stage renal disease (ESRD), the 25-hydroxyvitamin D3 (25(OH)D3) level is known to be lower compared to that of the normal population. In the present study, we evaluated the influences of dialysis methods on the serum 25(OH)D3 level in patients with ESRD who are treated with hemodialysis and peritoneal dialysis. METHODS: Thirty-nine peritoneal dialysis (PD), 49 hemodialysis (HD) patients, and 33 healthy controls were included in the present study. The mean HD period was 30.38 +/- 21.81 months and the mean PD period was 26.35 +/- 24.04 months. Serum samples from the HD and PD patients and healthy controls were examined in terms of 25(OH)D3, intact parathyroid hormone (iPTH), and other biochemical laboratory tests. Additionally, the 25(OH)D3 level in the peritoneal fluid was analyzed in the PD group. RESULTS: The mean 25(OH)D3 levels in the control, HD, and PD groups were 26.63 +/- 10.89, 21.65 +/- 12.38, and 13.46 +/- 9.41 nmol/l, respectively (P < 0.001). The mean peritoneal fluid 25(OH)D3 level was 28.53 +/- 7.66 nmol/l. Moreover, blood and PD fluid 25(OH)D3 levels were 34 compared in the PD group. The 25(OH)D3 level in dialysate was higher than that of serum in PD patients (P < 0.001). CONCLUSION: The significantly lower blood levels of 25(OH)D3 in PD patients compared to those of HD patients were thought to be due to 25(OH)D3 loss via peritoneal fluid.