Comparison of national early warning score-2 and qSOFA in predicting the prognosis of older adults with altered mental status.

BACKGROUND: Altered mental status occurs in one in four older adults, and the risk increases with age. Numerous scoring systems have been improved to predict mortality, but data are limited for these scoring systems to interpret older adult patients. AIM: We aimed to compare qSOFA and National Early Warning Score-2 (NEWS2) scores in predicting the prognosis of older adults with altered mental status. METHOD: We included 500 older adults with altered mental status. We noted the qSOFA and NEWS2 scores of the patients. We compared the qSOFA and NEWS2 scores for the prediction of 30-day mortality, 48-h mortality, hospitalization clinic, outcome, and hospitalization length. RESULTS: The mean NEWS2 score was 6.4, and the mean qSOFA score was 1.3. For 30-day mortality, the sensitivity and specificity of the NEWS2 score ≥ 5 were 68.29% and 69.6%, respectively, and those of qSOFA score > 1 were 47.14% and 78.75%, respectively. AUC values for 30-day mortality prediction were 0,725 (CI: 0.683-0.763) and 0.631 (CI: 0.587-0.673). For intensive care unit hospitalization prediction, the sensitivity and specificity of the NEWS2 score ≥ 5 were 52.73% and 77.67%, respectively, and those of qSOFA score > 1 were 35.32% and 81.55%, respectively. In patients with a NEWS2 score > 10 points, the predicted 48-h mortality had a specificity of 80.6%, which was higher than the qSOFA score. CONCLUSION: NEWS2 score can be used to predict 48-h mortality, 30-day mortality, and intensive care unit hospitalization compared with qSOFA in older adults with altered mental status.

Prediction of prognosis and outcome of patients with pulmonary embolism in the emergency department using early warning scores and qSOFA score.

OBJECTIVE: To determine the prediction ability of the National Early Warning Score (NEWS), National Early Warning Score 2 (NEWS2), and quick Sequential Organ Failure Assessment (qSOFA) score for the prognosis of pulmonary embolism (PE) in the emergency department. METHODS: This retrospective study involved 245 patients with PE. The NEWS, NEWS2, and qSOFA scores were compared according to the hospitalization clinic (ward vs. intensive care unit), hospitalization length (<10 vs. >10 days), severity of embolism (massive vs. submassive), and outcome (discharged vs. died). RESULTS: The areas under the curve of the NEWS, NEWS2, and qSOFA score for 1-week mortality were 0.854 (sensitivity, 78%; specificity, 73%; cutoff, 7.5; confidence interval, 0.807-0.902), 0.870 (sensitivity, 83%; specificity, 73%; cutoff, 5.5; confidence interval, 0.825-0.915), and 0.789 (sensitivity, 83%; specificity, 51%; cutoff, 0.5; confidence interval, 0.720-0.858), respectively. CONCLUSION: The NEWS2 more accurately predicts 1-week mortality than do the NEWS and qSOFA score in patients with PE.

The Role of Procalcitonin in Predicting Necessity of Antivenom Administration and Clinical Severity in Snake Bites.

One of the most important steps for preventing deaths due to snake bites is to administer snake antivenom to the eligible patients in a swift manner. In our study, we aimed to investigate whether procalcitonin is useful for predicting the clinical severity and the necessity of antivenom therapy at the early stages in patients presenting with snake bite. A total of 78 patients over the age of 18 who applied to the emergency department within the first 24 hours were included in this retrospective cross-sectional study. Age and sex of patients, severity of snake bites, total antivenom vials administered, observation periods and outcomes were recorded. Patients were graded according to their clinical severity after the snake bite. Procalcitonin, complete blood count and biochemical parameters of the patients were recorded. According to their clinical severity, the patients' grades were as follows: 21 (26.9%) patients were grade 0; 21 patients (26.9%) were grade 1; 16 patients (20.5%) were grade 2; and 20 patients (25.6%) were grade 3. Snake antivenom was administered to 57 (73.1%) patients. There was a statistically significant difference between procalcitonin levels of patients in respect to their grade (P < 0.001). Sensitivity and specificity of procalcitonin levels of 13.45 and above were 100% and 100% respectively, both for the need of antivenom administration and for the blister formation in the patients. According to our study, we believe that elevated procalcitonin levels should alert the clinicians for possible blister formation, higher clinical severity, and increased requirement for antivenom administration.

Biochemical and Morphological Characteristics of Some Macrofungi Grown Naturally.

Recently, the production of macro-fungi (mushrooms) has steadily increased, and so has their economic value, in global terms. The use of functional foods, dietary supplements, and traditional medicines derived from macro-fungi is increasing as they have numerous health benefits as well as abundant nutrients. This study aimed to determine some biochemical contents (pH, soluble solid contents (SSC), total antioxidant capacity (TAC) and total phenolic contents (TPC)) of eight edible macro-fungi species growing naturally (in the wild) in Turkey. The samples were collected in the Van Yuzuncu Yil University (VAN YYU) campus area in the months of April-May 2018, in different locations, and brought to the laboratory, and the necessary mycological techniques were applied for their identification. Location, habitats, collection dates and some morphological measurements were determined for all identified species. Biochemical parameters of the macro-fungi species were analyzed separately both in cap and stem. The color values (L, a, b, Chroma and hue) were separately evaluated on cap surface, cap basement and stem. Results showed that there were significant differences for most of the biochemical parameters in different organs between and within species. The pH, SSC, TAC and TPC values varied from 6.62 to 8.75, 2.25 to 5.80° brix, 15.72 to 57.67 TE mg-1 and 13.85 to 60.16 gallic acid equivalent (GAE) fresh weight basis. As a result of the study, it was concluded that the parameters such as total antioxidant capacity, total phenolic content and soluble content in Morchella esculenta, Helvella leucopus, Agaricus bitorquis and Suillus collinitus were higher than for the other species and clearly implied that they may be further exploited as functional ingredients in the composition of innovative food products.

Maintaining the Quality and Storage Life of Button Mushrooms (Agaricus bisporus) with Gum, Agar, Sodium Alginate, Egg White Protein, and Lecithin Coating.

Button mushrooms have a very short shelf life after harvesting and are sensitive to mechanical damage and browning. This can be a severe problem in enlarging the market and the long-distance exportation of this product. In this respect, edible coatings could be an alternative treatment to extend the shelf life of button mushrooms, maintaining their quality during long-term storage. The aim of this study was to investigate the impact of gum, agar, sodium alginate, egg white protein, and lecithin on the postharvest weight loss, color, browning, respiration rate, ethylene production, and storage life of button mushrooms. The results showed that the above-mentioned edible coatings are a promising way to extend the life and maintain the quality of button mushrooms. Significant differences (p < 0.05) were observed between the control and edible coating-treated samples in all parameters. Sodium alginate and gum were more effective in preventing weight loss, coloring, and browning than other edible coatings. On the other hand, the respiration rate and ethylene production were more suppressed by the agar and lecithin coatings compared to the others. In conclusion, it can be recommended that the above-mentioned edible coatings could be used as novel coatings in commercial treatments for maintaining the quality of button mushrooms during a long-term storage period.