Evaluation of cerebrospinal fluid levels for ALOX5, S100B, DEFA1, and GFAP in infectious meningitis.

BACKGROUND: The aim of this study was to determine how the levels of peptide and protein-based biomarkers in cerebrospinal fluid change in bacterial, tuberculous, and aseptic meningitis, and to determine the success of these agents in distinguishing between different types of infectious meningitis. METHODS: The levels of arachidonate-5-lipoxygenase, S100 calcium-binding protein B, defensin-α 1, and glial fibrillary acidic protein in cerebrospinal fluid samples from 20 tuberculosis, 40 bacterial, 25 aseptic meningitis patients, and 55 control groups were measured and compared using an enzyme-linked immunosorbent assay. RESULTS: The mean age of the patients was 37.9 ±â€…14.4 years. The parameter that contributed the most to the differential diagnosis of the infectious meningitis groups was S100 calcium-binding protein B. The S100 calcium-binding protein B levels were significantly higher in the tuberculous meningitis group than in the other groups, and arachidonate-5-lipoxygenase levels were significantly higher in the tuberculous meningitis and bacterial meningitis groups (P < .05). CONCLUSION: This study showed that cerebrospinal fluid arachidonate-5-lipoxygenase, and S100 calcium-binding protein B levels may differ in bacterial, aseptic, and tuberculous meningitis, and the results obtained may be quite effective as important potential biomarkers in the differential diagnosis of different types of meningitis.

Neuromuscular degenerative effects of Ankaferd Blood Stopper® in mouse sciatic nerve model.

PURPOSE: Ankaferd Blood Stopper® (ABS), a licenced medicinal herbal extract, is commonly used as an effective topical haemostatic agent. This study is designed to investigate whether topical ABS application may cause peripheral nerve degeneration and neuromuscular dysfunction in a mouse sciatic nerve model. METHODS: Twenty mice were randomly divided into two groups; an ABS treated experimental group and a saline-treated control group. Left sciatic nerves were treated with 0.3 ml of ABS in the experimental group and 0.3 ml of sterile saline in the control group for 5 min. Peripheral nerve degeneration and neuromuscular dysfunction were evaluated by behavioural tests, electrophysiological analysis and weight ratio comparison of target muscles. RESULTS: The motor function, assessed by the sciatic function index, was significantly impaired in ABS-treated animals as compared to the animals treated with saline. Motor coordination, evaluated with the rotarod test, was significantly decreased (-42%) in ABS-treated animals compared to the saline-treated animals. The degree of pain, assessed by the reaction latency to thermal stimuli (hot-plate test), was significantly prolonged (313%) in ABS-treated mice when compared to the saline-treated mice. ABS-treated mice showed a significant reduction in motor nerve conduction velocity (MNCV) (-52%) and the compound muscle action potential (CMAP) (-47%); however, it significantly prolonged onset latency (23%). The gastrocnemius muscles weight ratio of the ABS group was considerably lower than that of the control group. CONCLUSIONS: These findings demonstrate that ABS triggers peripheral nerve degeneration and functional impairment and, thus promotes a deterioration of sciatic nerves.

Fournier's gangrene: Causes, presentation and survival of sixty-five patients.

OBJECTIVE: To report our experience with Fournier's Gangrene (FG) over the past eight years and evaluate the predisposing factors which affect the mortality. METHODS: Sixty-five patients who were admitted to emergency surgical unit of our institution presenting with FG between January 2006 and August 2014 were included. The anatomical site of infective gangrene, predisposing factors, etiological factors, and outcomes were retrospectively reviewed. RESULTS: Our cases included 8 women and 57 men. The average age of men was 51±13.9 (range 19-75) and the average age of women was 63±10.5 (range 52-76). Average hospitalization time was 9.2±6.6 days (range 5-25) days. The most frequent comorbid disease was diabetes mellitus and the most frequent etiology was perianal abscess. Colostomy was performed in 11 patients, orchidectomy in two patients, cystostomy in two patients. Notably, all of the 8 (12.3%) patients who died from FG had diabetes and low socioeconomic status. A total of six patients who died required more than one surgical debridement. CONCLUSIONS: Fournier's gangrene is a severe surgical emergency, with a high mortality rate. Low socioeconomic status, diabetes and more than one debridement play a major role in mortality and morbidity.

Isolated renal pelvis rupture secondary to blunt trauma: Case report.

INTRODUCTION: Isolated rupture of the renal pelvis is a very rare condition and thus causes delays in the diagnosis of the rupture. It is most commonly seen in the setting of obstructive ureteric calculus. Other rare causes include neoplasms, trauma, and iatrogenic procedures. Diagnosis is usually established on computed tomography (CT) which demonstrates the extravasation of the contrast in the peripelvic, perinephric, or retroperitoneal collections. PRESENTATION OF CASE: A 27-year-old male patient was admitted to our hospital due to multiple traumas associated with motor vehicle accidents. The patient had clear urine output. A large pelvic rupture was detected by abdominal contrast-enhanced CT and after consulting with other departments, emergency repair of the renal pelvis was performed and a ureteral stent was implanted. DISCUSSION: Only a few isolated cases of pelvis rupture with resultant extravasation have been reported in the literature. The treatment of pelvic rupture should be preceded by the removal of underlying causes, followed by conservative management. However, surgical intervention should be warranted in the emergency cases presenting with the symptoms that may impede the decision-making process and in the cases whose diagnosis cannot be clarified by radiological techniques. CONCLUSION: Renal pelvic injury must be considered in the differential diagnosis of blunt trauma. Surgical intervention may be necessary in some cases. We present a case who underwent surgery due to isolated renal pelvis rupture caused by blunt abdominal trauma.

Treatment of tar burns: two case reports.

Hot tar burns are still a challenging clinical form because the removal of tar is very difficult for the emergency physician and there is no specified appropriate agent for the removal of tar. In this study, two patients with hot tar burns who were treated with diesel, sunflower oil and mayonnaise are presented.

Serum adenosine deaminase activity in cutaneous anthrax.

BACKGROUND: Adenosine deaminase (ADA) activity has been discovered in several inflammatory conditions; however, there are no data associated with cutaneous anthrax. The aim of this study was to investigate serum ADA activity in patients with cutaneous anthrax. MATERIAL AND METHODS: Sixteen patients with cutaneous anthrax and 17 healthy controls were enrolled. We measured ADA activity; peripheral blood leukocyte, lymphocyte, neutrophil, and monocyte counts; erythrocyte sedimentation rate; and C reactive protein levels. RESULTS: Serum ADA activity was significantly higher in patients with cutaneous anthrax than in the controls (p<0.001). A positive correlation was observed between ADA activity and lymphocyte counts (r=0.589, p=0.021) in the patient group. CONCLUSIONS: This study suggests that serum ADA could be used as a biochemical marker in cutaneous anthrax.

Evaluation of crush syndrome patients with extremity injuries in the 2011 Van Earthquake in Turkey.

AIMS AND OBJECTIVES: To perform a descriptive analysis of crush syndrome patients with extremity injuries, which will be used as a reference for future disasters. BACKGROUND: In disasters like earthquake, cooperation among medical workers is very important for the follow-up and treatment of patients. Knowing the complications that may emerge with the crush syndrome is one of the responsibilities of the nurses. DESIGN: Descriptive analysis. METHODS: The medical records of patients with crush syndrome following the 2011 Van Earthquake were retrospectively reviewed. The results were compared with the current literature. RESULTS: Of the 46 patients with crush syndrome who had extreme trauma, 26 (57%) were men, 20 (43%) were women, and the average age was 38.9 ± 12.5. Fasciotomy was performed in 21 of the patients due to progressive compartment syndromes. Amputations were performed in seven patients who had previously undergone a fasciotomy. Sepsis was observed in seven patients, wound infection in 18, pericardial effusion in three and pleural effusion in two. Additionally, femoral fracture was observed in one patient, tibial fractures in five, haemothorax in three, abdominal traumas in seven and pulmonary embolism in one. CONCLUSION: Wound care and antibiotic treatment are important to prevent infections in crush injury. In addition to this, dehydration and electrocardiography changes in hyperkalaemia are observed in crush syndrome. Nurses have significant responsibilities to follow up these observations and their implications. RELEVANCE TO CLINICAL PRACTICE: The results of this study may provide the basis for developing strategies in future for optimising attempts to rescue and the nurse care planning of survivors with crush injuries and crush syndrome after earthquakes.

The analysis of the cases of aspired fuel oil and gasoline through siphonage method.

Accidental aspiration of petroleum products in children can also be witnessed in adults working with petroleum products by siphonage or swallowing fire for demonstration purposes. Ten cases admitted to Yuzuncu Yil University Emergency Service due to fuel oil and gasoline aspiration in a three-year period were retrospectively analysed. All cases were males and their average age was determined as 32,4 +/- 7.83 years. Three of the patients aspirated gasoline and 7 fuel oil. Blood gas values in all patients were at normal levels and their average white blood cell values were 16,590. The most frequent symptom for referral to our service was shortness of breath. Infiltration was confirmed in the chest X-ray of 2 patients with aspirated fuel oil and all cases of gasoline aspiration. All patients received methylprednisolone and IV proton-pump inhibitors for treatment. Eight patients were given antibiotics. All victims were discharged from the hospital after recovery. Aspiration of petroleum products which is normally rarely seen is witnessed more frequently in under developed countries. Since the findings determined by screening methods are often nonspecific, history is important for making a diagnosis.

Pregnancy and trauma: analysis of 139 cases.

OBJECTIVE: The aim of this study was to examine the diagnoses and treatment methods and demographical and clinical characteristics of pregnant women who were exposed to trauma and in additon, review of the literature was carried out in this regard. MATERIAL AND METHODS: One hundred thirty-nine pregnant women who presented at the Yüzüncü Yil University between January 2006 and September 2009 with local or general body trauma complaints were analysed retrospectively. RESULTS: The average age of the cases was 26.72±6.29 years and the age group ranging from 21-34 composed the majority. When they were studied according to their etiologies, falls during daily activities formed 43.9%. When they were analyzed in terms of their gestational weeks, 64.46% were in the 3(rd) trimester. Pregnant cases with trauma resulted in maternal (3 cases) and fetal (9 cases) loss. It was found that 19 cases who had imaging techniques involving radiation and whose gestation was continuing had a problem-free gestation period and healthy children. CONCLUSION: It is mandatory to evaluate both mother and fetus together when trauma exposure is in question, the general well-being of the fetus should be provided and the mother should be informed about the presence of advanced trauma life support.

[The effects on complications and myopathy of different voltages in electrical injuries]. / Elektrik çarpmalarinda voltaj farkinin komplikasyonlar ve miyopati üzerine etkisi.

BACKGROUND: The purpose of this study was to investigate the demographic and clinical characteristics of electrical injuries, laboratory findings, complications, and mortality and morbidity rates of these injuries. METHODS: Patients with electrical injuries admitted to the emergency department between January 2006-2010 were retrospectively analyzed. The cases were evaluated by age, gender, source of electrical power (low-high voltage), seasonal distribution, ECG changes, laboratory findings, clinical care units, complications, and mortality rate. RESULTS: Eighty-four (57.1%) of the cases were exposed to low-voltage electricity (Group I), while 63 (42.9%) of the cases were exposed to high-voltage electricity (Group II). The majority of cases with electrical injuries were aged 26-45 years. Thirty of the women (85.7%) were wounded by low-voltage while 58 of the men (51.8%) were wounded by high-voltage electricity. Alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, creatine kinase, and CK-MB levels were higher and the level of calcium was lower in Group II. Complications (pathologies due to fall from high levels, cardiac dysrhythmias, compartment syndrome) and the mortality rate were higher in Group II. CONCLUSION: In cases with high-voltage electrical injuries, cardiac complications, complications due to fall from high levels and the mortality rate increase in conjunction with the degree of the muscle damage.