Early Endoscopy Decrease the Length of Hospital Stay and the Costs in Patients with Upper Gastrointestinal Bleeding.

BACKGROUND: Acute gastrointestinal (GI) bleeding is a common cause of hospitalization. There are conflicting results regarding the effectiveness of early endoscopy in patients with upper GI bleeding. OBJECTIVE: The study aimed to determine the benefit of early endoscopy and the epidemiological characteristics of patients presenting to the emergency department with non-variceal acute upper GI bleeding. METHODS: Patients over 18 years of age who presented to the emergency department with upper GI between 2015 and 2016 and underwent endoscopy were included in the study. The patients were divided into two groups: early endoscopy group (endoscopy within the 24 h) and late endoscopy group (endoscopy after 24 h). RESULTS: Of 104 patients, 57.7% were man, and the mean age was 66.27 ± 17.64 years. Of the patients who underwent endoscopy, 80 (76.9%) were in the early endoscopy group. There was no difference in blood transfusion needs (P = 0.388), re-bleeding (P = 0.137), the need for surgery, and mortality rates with regard to the timing of endoscopy. The results of the receiver-operating characteristics curve analysis revealed patients with a GBS ≥ 9 were taken as high-risk, and a prognosis analysis was performed accordingly. However, in patients undergoing early endoscopy, a difference was detected with respect to the length of hospital stay (P = 0.011) and treatment costs (P = 0.030). In the comparison with the admission time (working/non-working h) and variables, there were no significant differences in the length of hospital stay (P = 0.230), transfusion needs (P = 0.348), re-bleeding frequency (P = 0.905), and treatment costs (P = 0.094). CONCLUSION: Endoscopy within 24 h in the setting of acute upper non-variceal GI bleeding is associated with an increase in the length of hospital stay and treatment costs, but is not associated with re-bleeding, transfusion needs, need for surgery, and mortality.

Frequency of psychiatric disorders in nonemergent admissions to emergency department.

OBJECTIVES: Repeated admissions of patients with undiagnosed psychiatric problems in emergency departments (ED) is a major contributor to patient unsatisfaction and overcrowding in EDs. We evaluated the presence of psychiatric disorders in non-emergent admissions in the ED of a tertiary care hospital. MATERIALS AND METHODS: This cross-sectional study was carried out in Eskisehir Osmangazi University Hospital between December 2015 and March 2016. The study group consists of 4320 non-emergent patients (31% of all admissions to non-emergent ED). Psychiatric assessments of patients were done using the Primary Care Evaluation of Mental Disorders (PRIME-MD) scale prior to their discharge from the ED. The Mann-Whitney U, Kruskal-Wallis and Chi-square tests, as well as multivariate logistic regression, were performed for statistical analysis. RESULTS: The mean age was 30 ± 11.7 years years ranging from 18 to 78 years. Among non-emergent cases, 44% had at least one psychiatric disorder. The most frequent psychiatric disorder was mood disorder (major and minor depression). Females with a comorbid disease and lower education level had increased risk for mood disorders, anxiety disorders, and somatoform disorders. Single males with a comorbid disease had increased risk for alcohol dependence. CONCLUSIONS: Undiagnosed patients with psychiatric disorders appear to be frequent users of medical emergency department services. These results might be helpful in developing more effective strategies to serve the mental health needs of the undiagnosed. People's awareness of psychiatric disorders should be increased.

The effects of incubation temperature on the sex of Japanese quail chicks.

The effects of incubation temperature on the sex of Japanese quail chicks were investigated in this study. The study was conducted on Japanese quail. In all, 4500 eggs obtained from 2 generations were used. At the beginning of the study, a new flock was formed from available hatching eggs. Hatching eggs were gathered at 3 different ages (8 to 10 weeks, 16 to 18 weeks and 22 to 24 weeks of age) from the laying period in this flock. These eggs were exposed to 5 different incubation temperatures (36.7, 37.2, 37.7, 38.2, and 38.7°C). The hatching results were evaluated for each group. Chicks obtained from these temperature groups were reared separately to obtain quail for breeding. Eggs for incubation were gathered from these breeding quail when they were between 15 and 18 weeks of age. These eggs were placed in an incubator at a standard (37.7°C) temperature, separated by F(1)-generation temperature groups. The chicks in all groups were reared separately, and the sex of the chicks was determined at maturity. Statistical differences (P < 0.05) were found for the sex of the chicks in the third group (22 to 24 weeks) of the F(1) generation, compared with other groups. This result confirmed the hypothesis that different incubation temperatures for the first generation (at the embryo stage) might influence the sex of the next generation of chicks. Further studies are needed to investigate the effects of incubation temperature on chicks from different perspectives.

Surgery for Peripheral Nerve Sheath Tumours of the Buttocks, Legs and Feet in 90 Patients With Neurofibromatosis Type 1.

BACKGROUND/AIM: Neurofibromatosis type 1 (NF1) is an autosomal dominant tumour predisposition syndrome that can cause plexiform neurofibromas (PNFs). This study examines the surgical procedures that have been performed on large PNFs of the lower extremities. PATIENTS AND METHODS: Surgical procedures on the lower extremity performed on 90 patients with NF1 with PNFs were evaluated. The topography of the tumours was classified according to dermatomes and functional units. RESULTS: A total of 243 surgical interventions on the regions of interest were performed. Neurological complications were rarely noted and usually occurred temporarily. There was no preference for dermatomes affected by PNF. The proportion of patients with malignant peripheral nerve sheath tumours (MPNSTs) in this group was 4/90 (4.4%). CONCLUSION: PNFs often require repeated local interventions to achieve the treatment goal. Local tumour recurrences are to be expected even after extensive tumour reduction. Rapid tumour growth combined with new pain sensations can be signs of a MPNST.

Effect of different egg storage periods on some egg quality characteristics and hatchability of partridges (Alectoris graeca).

The effect of 1 to 2-, 3 to 4-, 5 to 6-, 7 to 8-, 9 to 10-, 11 to 12-, and 13 to 14-d storage periods on quality characteristics and hatchability of partridge (Alectoris graeca) eggs was studied. There was no significant effect of storage period on egg weight, shell weight, shell ratio, and shell thickness as external quality characteristics of partridge eggs (P > 0.05). Storage periods affected internal quality characteristics of partridge eggs (P < 0.05). An increase in yolk ratio (P < 0.05) and decrease in albumen ratio, yolk index, albumen index, and Haugh unit (P < 0.001) occurred when storage periods were lengthened. However, storage period had no significant effect on hatchability (P > 0.05). This study shows that long storage periods do not have negative effects on hatchability of partridge eggs to the extent that occurs in other poultry species. Because of a lack of knowledge about this subject, these studies will be useful in terms of successful intensive partridge breeding.