Pediatric Penile Bee Sting.

OBJECTIVES: The aims of this study, for the first time in the literature, are to evaluate the symptoms, clinical course, and treatment management of penile bee stings in children and to discuss whether bee stings can be evaluated within the scope of summer penile syndrome. METHODS: Records of all pediatric patients presented to the emergency department of our hospital from June 2020 to October 2021 due to bee sting of penis were reviewed. Only patients with isolated penile bee stings were included in the study. Patients were evaluated in terms of the age at presentation, time of occurrence, symptoms, and treatment modality. RESULTS: There were 10 patients treated for penile bee sting. Patients ranged in age from 3 to 7 years (mean, 4.2 years). The most common complaints of the patients at presentation were pain (100%), swelling (100%), and dysuria (70%). Three of the patients were unable to void. The gauze moistened with warm saline was applied to the penis of these patients who developed glob, and all of these patients urinated after the warm application. Three of the patients had progressive erythema on the penile skin. These patients were admitted to the pediatric surgery department to monitor whether skin necrosis would develop. In all patients, the erythema regressed significantly within 48 hours and regained its completely normal appearance at the end of 72 hours. CONCLUSIONS: The probability of the development of serious local reactions and urological problems in penile bee stings is low. Oral nonsteroidal anti-inflammatory drug and warm, wet dressing are usually sufficient to treat local reactions. Penile bee stings may be evaluated within the scope of summer penile syndrome because their symptoms, clinical findings, and treatments are almost similar.

Check the diastolic blood pressure twice in aortic dissection as it is associated with prognosis.

OBJECTIVE: In this study we aimed to determine the prediction level of admission diastolic blood pressure (DBP) on the prognosis and mortality in aortic dissection patients over 65 years old and under 65 years old. METHODS: We included 72 patients in this retrospective study and study groups were divided into two groups according to 65 age. Demographic data, dissection type (Stanford A-B), DBP, systolic blood pressure (SBP), mean arteriel pressure (MAP), heart rate (/min) main complaints, preoperative length of stay, hospitalisation clinic (clinic/intensive care unit), length of hospitaliisation, complications during hospitalisation (renal failure etc..) and the outcome (death/dischargement) results were noted. Preoperative lenth of stay, hospitalisation length, outcome and complications were compared between groups according to SBP, DBP, MAP and heart rate. RESULTS: Mean blood pressure values of the Stanford type B patients over 65 years old were higher than the other group (p<0.05). Fifty percent of patients under 65 years old were discharged but this ratio was 26.9% in the elder group. DBP was positively correlated with preoperative length of stay and hospitalisation length and negatively correlated with mortality. DBP under 65 mmHg was significantly related with high mortality (p<0.05). When the age and presentation time heart rate is added to each other, the values over 142 were significantly related with high mortality (p<0.05). CONCLUSIONS: The presentation time vital signs especially the DBP may be helpful for emergency clinicians to predict the prognosis and outcome in aortic dissection patients which has high mortality ratio in patients over 65 years of age.

The prediction levels of emergency clinicians about the outcome of the ambulance patients and outpatients.

AIM: The increased number of emergency clinic patients causes the length of stay in the emergency department, low patient satisfaction and dismiss of real emergency patients. In this study, we aimed to determine the prediction levels of emergency clinicians according to working year on the outcome of the ambulance patients and outpatients presented to the emergency department (ED). MATERIALS & METHODS: This prospective study included patients over 18 years old. The triage of outpatients was made by a senior nurse and patients were divided into three triage categories such as green, yellow and red. Then these patients were evaluated by the emergency physician at the examination areas. Ambulance patients were directly evaluated by the emergency physician. These ambulance patients were noted as yellow or red according to triage categories. The main complaints, triage category, presentation method, vital signs, predicted outcome noted by the clinicians. RESULTS: The correct prediction levels of hospitalisation (clinic/intensive care unit) were higher in clinicians whose working year is between 6 and 10 years (p < 0.05). There was no significant difference between 6-10 year and >10 year group according to prediction level (p > 0.05). Prediction of dischargement was higher in 0-5 year group than 6-10 year (p < 0.05) and >10 year (p < 0.05) group. CONCLUSION: Experienced clinicians can make much more accurate prediction on length of stay and the prognosis of the emergency patients so crowded follow-up areas of the emergency room can be planned much more effectively.

Evaluation of Pulmonary Artery Stiffness in Patients with Obstructive Sleep Apnea Syndrome.

OBJECTIVE: To investigate whether obstructive sleep apnea syndrome (OSAS) has any effect on pulmonary artery stiffness (PAS) derived from echocardiographic calculation. METHODS: Fifty-two patients with newly diagnosed OSAS and forty-two subjects without OSAS matched by age and sex were enrolled in the study. OSAS was categorized according to apnea hypopnea index (AHI, event/h) as follows: normal (AHI<5), mild OSAS (AHI 5-15), moderate and severe OSAS (AHI>15). All participants were evaluated by echocardiography to determine PAS and right ventricle functions. PAS was calculated throughout pulmonary artery flow by the formula; PAS (kHz/sec) = maximal frequency shift/acceleration time. RESULTS: Demographic and clinical parameters were similar in both groups. PAS significantly increased in OSAS compared with the control group (26.9 ± 6.1 vs. 18.0 ± 3.5, P < 0.001). Additionally, PAS in severe and moderate OSAS was considerably high compared with that in mild OSAS and control group (P < 0.001). Right ventricular myocardial performance index (MPI) and mean pulmonary artery pressures (mPAP) were considerably higher in OSAS group than control group (P < 0.001). Tricuspid E/A, right ventricle tissue Doppler E'/A', and right ventricular ejection time (RVET) decreased in OSAS group compared with control group (P < 0.001). There was a significantly positive correlation between PAS and AHI, mPAP, and MPI (P < 0.001), and a significantly negative correlation between PAS and tricuspid E/A, E'/A', and RVET (P < 0.001). Linear regression analyses showed that PAS was an independent factor for mPAP (ß = 0.595, P = 0.034). CONCLUSION: Elastic properties of pulmonary artery deteriorate with severity of OSAS and may be responsible for right ventricular dysfunctions in OSAS.

Negative effects of acute sleep deprivation on left ventricular functions and cardiac repolarization in healthy young adults.

BACKGROUND: Sleep deprivation (SD) is associated with an increased incidence of adverse cardiovascular events, we aimed to determine the impact of acute SD on structural and functional alterations of the left ventricle (LV) and on electrocardiogram (ECG) markers including T wave peak-to-end interval (TpTe), QT interval, and TpTe/QT ratio in healthy subjects after a night of SD. METHODS: The study population consisted of 40 healthy young adults (19 males, 21 females; mean age: 28.2 ± 3.86 years). Echocardiographic images and ECGs were obtained from the participants after a night of regular sleep (RS) and SD. The average sleep time of the subjects was 6.67 ± 1.76 hours during RS and 1.25 ± 0.74 hours during a night of SD. RESULTS: The myocardial performance index, isovolumic relaxation time, and deceleration time values were significantly higher after SD. In addition, the corrected TpTe interval, corrected QT interval (QTc) max, and TpTe/QT ratio were significantly increased after a night of SD when compared with a night of RS (78.5 ± 6.8 ms vs 70.7 ± 7.6 ms, P < 0.001; 407.5 ± 18.6 ms vs 395.07 ± 21.3 ms, P = 0.001; and 0.189 ± 0.014 ms vs 0. 0.179 ± 0.016 ms, P < 0.001, respectively). However, subjects had similar QTp interval values (defined as beginning of the QRS complex to peak of the T wave) after a night of SD as a night of RS (294.6 ± 19.0 vs 291.9 ± 18.5, P = 233). CONCLUSION: Our crossover study revealed the presence of subclinical LV diastolic functional changes and increased QT intervals, TpTe intervals, and TpTe/QT ratios in healthy young adults after one night SD. Therefore, the increased QT interval occurred secondary to the increased TpTe interval in this population.

Effectiveness and Safety of Selective Neck Dissection in Lymph Node-Positive Squamous Cell Carcinoma of the Head and Neck.

The aim of this study was to investigate the effectiveness and safety of selective neck dissection in patients with lymph node-positive head and neck squamous cell carcinoma to determine regional control and survival rates. Eighty patients with lymph node-positive head and neck squamous cell carcinoma who underwent selective dissection were included in the study. Regional control, survival rates, and factors affecting survival were analyzed. Regional control was 90%, disease-specific survival was 93.4%, and the overall survival rate was 87.25%. T stage, N stage, age, and extracapsular spread were included in hazard regression models. None of the factors were statistically significant. Selective neck dissection is an effective and oncologically safe treatment option in selected cases. T stage, N stage, and extracapsular spread had no significant impact on disease-specific survival.

[Evaluation of subclinical atherosclerosis in chronic sinusitis patients]. / Kronik sinüzitli hastalarda subklinik aterosklerozun degerlendirilmesi.

OBJECTIVE: This study aimed to assess the impact of chronic sinusitis (CS) on carotid-intima-media thickness (CIMT), a marker of early atherosclerotic changes in the arterial bed. METHODS: The study included 50 patients with CS (25 male, 25 female, mean age 26.6 ± 5.34 years), and 50 healthy subjects (25 male, 25 female, mean age 25.8 ± 4.76 years), aged 18 to 35 years without atherosclerotic risk factors, normal body mass index and normal metabolic parameters. CIMT was measured in all patients by ultrasonography. CS was confirmed by medical history and computed tomography scan of the paranasal cavities. RESULTS: No significant difference existed between the groups in terms of age, sex, body mass index (BMI), waist circumference, plasma creatinine, glucose, low-density lipoprotein (LDL), high-density lipoprotein (HDL) cholesterol values (p>0.05). However, mean values of CIMT (mm) were significantly greater in CS patients than in healthy subjects (0.51 ± 0.09 vs. 0.40 ± 0.07, p<0.001). Duration of CS disease was 6.0 (3.0-13.0) years. Significant correlation was found between CIMT mean values and age, BMI, waist circumference, HDL and LDL-cholesterol values and duration of CS (r=0.413; p<0.001, r=0.353; p<0.001, r=0.355; p<0.001, r=-0.266; p=0.007, r=0.327; p<0.001 and r=0.425; p=0.002 respectively). Multiple linear regression analysis revealed that waist circumference, HDL and LDL-cholesterol and duration disease of CS were independent predictors of CIMT (ß=0.523; p=0.001, ß=-0.176; p=0.045, ß=0.297; p=0.002, and ß=0.436; p<0.001, respectively). CONCLUSION: Our cross-sectional study revealed the presence of a negative effect of CS on the atherosclerotic process. Therefore, it is believed that effective treatment of CS may be beneficial in slowing the process of atherosclerosis.

The relationship between BMI and blood pressure in children aged 7-12 years in Ankara, Turkey.

OBJECTIVE: Recent studies have reported an increasing prevalence of childhood hypertension. Obesity is probably the most important risk factor. The relationship between hypertension and BMI in children has not been studied in Ankara, which is the second largest city in Turkey. DESIGN: Cross-sectional study analysing direct data on height, weight and blood pressure of students. SETTING: Population-based study in Ankara, the capital city of Turkey. SUBJECTS: In three schools, 2826 students aged 7-12 years. RESULTS: The overall prevalence of hypertension was 7·9 %. Among the 222 hypertensive children, 124 (56 %) were boys and ninety-eight (44 %) were girls (P=0·40). In the whole group, 3·6 % had only systolic hypertension, 0·7 % had only diastolic hypertension and 3·5 % had both systolic and diastolic hypertension. The prevalences of overweight and obesity were both 13·9 %. BMI was significantly correlated with blood pressure (P<0·001). Overweight and obesity were more common in boys (P<0·001). CONCLUSIONS: Hypertension was more common than has been reported in other studies. Blood pressure measurement should be routine and frequent in children, especially obese children.

[Long QT-induced ventricular tachycardia associated with Takotsubo cardiomyopathy]. / Takotsubo sendromu ile iliskili uzun QT'nin tetikledigi ventrikül tasikardisi.

Takotsubo cardiomyopathy (TC) is a syndrome characterized by transient left ventricular apical ballooning associated with electrocardiogram changes and mimicking acute myocardial infarction in patients without significant coronary disease on angiography. We report an unusual case of a patient who presented with TC associated with long-QT syndrome-induced ventricular tachycardia. QT interval prolongation was normalized and ventricular tachycardias were stopped within the same day with metoprolol treatment.

Neutrophil to lymphocyte ratio predicts poor functional capacity in patients with heart failure.

OBJECTIVES: We aimed to assess the relationship between neutrophil to lymphocyte ratio (N/L ratio) and functional capacity (FC) of patients with compensated heart failure (CHF). STUDY DESIGN: A total of 94 consecutive CHF patients and age-gender matched 70 subjects with normal echocardiographic examination were enrolled. Peripheral venous blood samples were drawn before echocardiography examination and treadmill test in all study population. The treadmill test based on modified Bruce protocol was used to determine the functional status of CHF patients. Poor FC was defined as <5 metabolic equivalant (MET) in the exercise test. Afterwards, patients with CHF were divided into two groups with respect to the top and bottom 3 of the N/L ratio. RESULTS: FC (3.2 ± 2.05 MET vs. 6.1 ± 2.04 MET, p<0.001), ejection fraction (%31.5 ± 7.64 vs. %34.8 ± 6.82, p=0.028) were found to be lower and N-terminal pro-brain natriuretic peptide (NT-proBNP) level (3360 ± 2742 pg/dl vs. 1613 ± 1334 pg/dl, p<0.001) pulmonary artery pressure (46.3 ± 11.50 mmHg vs. 41.5 ± 9.45 mmHg, p=0.049), left atrial diameters (4.6 ± 0.52 cm vs. 4.3 ± 0.43 cm, p=0.005), E/Ea ratio (12.2 ± 4.37 vs. 9.2 ± 3.20, p<0.001) were found to be higher in CHF patients with an N/L ratio >3 than with an N/L ratio <3. The N/L ratio, and log-NT-proBNP level were determined to be a predictive factor of poor FC (odds ratio [OR]=3.085, 95% confidence interval [CI]= 1.520-6.260, p=0.002 and OR=1.585, 95% CI=1.201-2.091, p=0.001, respectively). A cut-off point of 2.74 for the N/L ratio had 79.4% sensitivity and 80% specificity in predicting poor FC. CONCLUSION: N/L ratio can be used to predict poor FC in patients with CHF.

A new marker for myocardial injury in carbon monoxide poisoning: T peak-T end.

OBJECTIVES: Carbon monoxide (CO) poisoning frequently affects repolarization, resulting in abnormal electrocardiography findings. The goal of this study was to examine the effect of CO poisoning on the novel transmyocardial repolarization parameters T peak-T end (Tp-e), Tp-e dispersion, and Tp-e/QT and the relationship of these parameters to myocardial injury (MI). METHODS: This prospective study included 94 patients with CO poisoning and 40 healthy controls. Participants received an electrocardiography and had their blood drawn at admission and 6 and 24 hours after admission. The QT, Tp-e, Tp-e dispersion, and the Tp-e/QT ratio were calculated. Myocardial injury was determined based on an elevation in troponin any time during the first 24 hours. The patients were divided into 2 subgroups: those with and without MI. RESULTS: T peak-T end, Tp-e dispersion, and the Tp-e/QT ratio were higher at admission than after 6 and 24 hours of hospitalization and were higher than the control group (P < .001). There was a correlation between the carboxyhemoglobin level at admission and Tp-e and Tp-e dispersion (P < .001). The MI subgroup (n = 14) had a higher Tp-e at admission than did the non-MI subgroup (n = 80) (96 [11] milliseconds vs 87 [12] milliseconds, P = .03). There were no any significant differences in the Tp-e dispersion or the Tp-e/QT ratio between the 2 MI subgroups. Receiver operating characteristic analysis showed that a Tp-e cutoff value for MI of 91.5 milliseconds had a sensitivity of 72.7% and a specificity of 67.2%. CONCLUSION: Transmyocardial repolarization parameters indicative of arrhythmia were prolonged in patients with CO poisoning. T peak-T end was associated with MI.

ESR and TL investigations on gamma irradiated linden (Tilia vulgaris).

Electron spin resonance (ESR) and thermoluminescence (TL) signals induced by gamma irradiation in linden (Tilia vulgaris) were studied for detection and dosimetric purposes. Before irradiation, linden leaf samples exhibit one singlet ESR signal centred at g = 2.0088. Besides this central signal, in spectra of irradiated linden samples, two weak satellite signals situated about 3 mT left (g = 2.0267) and right (g = 1.9883) were observed. Dose-response curves for the left satellite signal and the central single signal were constructed, and it was found that both of these curves can be described best by the combination of two exponential saturation functions. Variable temperature and fading studies at room temperature showed that the radiation-induced radicals in linden leaf samples are very sensitive to temperature. The stabilities of the left satellite (g = 2.0267) and the central single (g = 2.0088) signal at room temperature over a storage period of 126 days turned out to be best described by a sum of two first-order decay functions. The kinetic features of the left satellite signal were studied over the temperature range of 313-373 K. The results indicate that the isothermal decay curves of the left satellite ESR signal also proved to be best fitted by the combination of two first-order decay functions. Fading and annealing studies suggested the existence of two different radiation-induced free radical species. At the same time, Arrhenius plots evidenced two different kinetic regimes with two different activation energies. TL investigation of polyminerals from the linden samples allowed to discriminate clearly between irradiated and unirradiated samples even 75 days after irradiation.

Management of upper aerodigestive tract amyloidosis.

OBJECTIVES: The aim of this study was to discuss the treatment options for upper aerodigestive tract amyloidosis. METHODS: Four patients with histologically confirmed amyloidosis were included in the study. All patients underwent surgical treatment. Three patients had laryngeal amyloidosis, and 1 patient had tonsillar amyloidosis. RESULTS: Two of the cases of laryngeal amyloidosis were successfully treated with a combination of surgery and radiation therapy. One case of laryngeal amyloidosis was treated with surgery alone. The tonsillar amyloidosis was removed by tonsillectomy. None of the cases showed systemic involvement. Long-term follow-up of the patients showed no recurrence or evidence of systemic disease. CONCLUSIONS: Surgical resection is the primary treatment for patients with upper aerodigestive tract amyloidosis. Radiation therapy is especially effective in cases of recurrent amyloidosis with submucosal involvement. Pedunculated polypoid lesions may be treated with surgery alone, and in cases of recurrence, irradiation following the surgical removal should be considered. Tonsillectomy is usually sufficient for treating tonsillar amyloidosis.

Systemic steroid versus combined systemic and intratympanic steroid treatment for sudden sensorineural hearing loss.

OBJECTIVE: The aim of this study was to evaluate the effectiveness of oral steroid treatment versus combined oral and intratympanic dexamethasone injection for idiopathic sudden sensorineural hearing loss. METHODS: This was a retrospective case review in which 30 patients in the oral steroid group and 39 patients in the combined oral and intratympanic steroid injection group were compared. RESULTS: The comparison of the initial pure tone audiometry (PTA) threshold results revealed a significant difference between the systemic steroid (SS) group and the systemic and intratympanic steroid group. The initial PTA was 74.33 ± 22.64 dB (mean ± SD) in the SS group and 87.49 ± 26.22 dB (mean ± SD) in the intratympanic steroid group. The difference in the initial PTA results was statistically significant between the SS group and intratympanic steroid group (P < 0.05, P = 0.032). The pure-tone gain in the SS group was 20.97 ± 27.47 dB (mean ± SD), and that of the group treated with both systemic and intratympanic steroids was 19.36 ± 22.16 dB (mean ± SD) (P = 0.49). CONCLUSIONS: The results of this study indicate that, in sudden sensorineural hearing loss, the administration of intratympanic steroids in conjunction with SS therapy appears to have the same effect on the restoration of hearing "as the effect obtained using SS therapy alone."

A new multimodal magnetic nanozyme and a reusable peroxymonosulfate oxidation catalyst: Manganese oxide coated-monodisperse-porous and magnetic core-shell microspheres.

Monodisperse-porous, polydopamine and manganese oxide coated, core-shell type, magnetic SiO2 (MagSiO2@PDA@MnO2) microspheres 6.4 µm in size were synthesized for the first time, using magnetic, monodisperse-porous SiO2 (MagSiO2) microspheres 6.2 µm in size as the starting material. MagSiO2 microspheres were obtained by a recently developed method namely "staged shape templated hydrolysis and condensation protocol". In the synthesis, MagSiO2 microspheres were consecutively coated by polydopamine (PDA) and then by a MnO2 layer in the aqueous medium. The pore volume and the specific surface area of monodisperse-porous MagSiO2@PDA@MnO2 microspheres were measured as 0.59 cm3 g-1 and 154 m2 g-1, respectively. Their Mn and Fe contents were determined as 66 ± 1 mg g-1 and 165 ± 5 mg g-1 respectively. MagSiO2@PDA@MnO2 microspheres exhibited multimodal enzyme mimetic behavior with highly superior catalase-like, oxidase-like and peroxidase-like activities. The effective production of singlet oxygen (1O2) and superoxide anion (O2-*) radicals in MagSiO2@PDA@MnO2-peroxymonosulfate (PMS) system was demonstrated by ESR spectroscopy. By evaluating this property, MagSiO2@PDA@MnO2 microspheres were tried as a reusable catalyst for dye removal via peroxymonosulfate (PMS) activation in batch experiments for the first time. The degradation runs were made with, rhodamine B (Rh B), methyl orange (MO) and methylene blue (MB) as the pollutant. The core-shell type design allowing the deposition of porous MnO2 layer onto a large surface area provided very fast, instant removals with all dyes, via both physical adsorption and degradation via PMS activation. In the reusability experiments, the removal yields of MO and Rh B decreased 1.8% and 8.9% over five consecutive runs in batch fashion. MagSiO2@PDA@MnO2 microspheres exhibited very good functional and structural stability in consecutive dye degradations. No significant change was observed in Fe content of microspheres while Mn content exhibited a decrease of 7.4% w/w over 5 consecutive degradation runs.

Detection of gamma irradiated fig seeds by analysing electron spin resonance.

Seeds of fig produced in Turkey were studied by electron spin resonance (ESR) technique for detection purposes. Unirradiated fig seeds (control) exhibited a weak ESR singlet at g=2.0052±0.0003 (native signal). Irradiation induced at least one additional intense singlet overlapping to the control signal and caused a significant increase in signal intensity without any changes in spectral patterns. Variation of ESR signal intensity of irradiated samples at room temperature with time in a long-term showed that free radicals responsible from the ESR spectrum of fig seeds were not stable but detectable after 80days. Annealing studies at five different temperatures were used to determine the kinetic behaviour and activation energy of the radiation-induced radicals in fig seeds. A study on microwave saturation characteristics and thermal behaviour of the ESR singlet (g=2.0052) in irradiated and unirradiated fig seed samples was also carried out by using ESR technique. These preliminary results indicate that microwave saturation characteristics of the ESR signal at room and low temperatures may be useful method to distinguish irradiated fig seeds from unirradiated ones.

A Case of Pseudomonas mendocina Bacteremia in an Elderly Man With Bilateral Leg Lesions.

Pseudomonas mendocina is a gram-negative, aerobic, rod-shaped bacterium that rarely causes disease in humans. Documented infections can be severe with varying etiologies, often requiring intensive care. We describe a rare case of bacteremia with P. mendocina in an elderly male, with a comprehensive review of the literature. An 81-year-old Caucasian male presented with bilateral lower leg erythema and drainage but was afebrile. His past medical history included atrial fibrillation, chronic kidney disease, and congestive heart failure. Labs showed leukocytosis and a blood culture was obtained revealing Pseudomonas mendocina. The pathogen was susceptible to all antibiotics tested and he was successfully treated on cefepime inpatient and a two-week course of ciprofloxacin on discharge. Our case and literature review presents a successful treatment of a rare cause of bacteremia likely stemming from a soft tissue nidus. P. mendocina has a favorable susceptibility profile and the antibiotics preferred differ from Pseudomonas aeruginosa, a more common pathogen. Worldwide there have been only 18 other documented cases of P. mendocina infection, all successful and with no mortality. Physicians can confidently utilize usual antibiotics in the treatment of this pathogen despite its rare clinical manifestations.

Effects of statin use on total oxidant and antoxidant capacity and ceruloplasmin activity.

PURPOSE: Oxidative damage plays an important role in atherosclerosis development. Statin drugs have anti-oxidant properties, but the clinical value of their antioxidant properties remains unclear. In this study, our aims were: (1) to assess the anti-oxidant effects of statins in patients with coronary artery disease (CAD) using a newly developed valid measure of total oxidant and anti-oxidant capacity; and (2) to identify whether statins influence ceruloplamin levels. METHODS: Within a cross-sectional study, 67 dyslipidemic CAD patients on atorvastatin for at least three months were compared with 69 age- and gender-matched CAD patients not using atorvastatin. All patients were either newly-diagnosed with or already had established CAD. Patients and controls were selected from among patients who had undergone coronary angiography for a variety of reasons. Immediately prior to angiography, plasma total oxidant and antioxidant capacity and ceruloplasmin (Cp) levels were measured by means of a relatively new and highly-reliable method. RESULTS: Total oxidant capacity levels were significantly lower and total antioxidant capacity significantly higher in those on atorvastatin; serum seruloplasmin levels also were significanly increased in the atorvastatin groups (all p < 0.05). On multivariate analysis, atorvastatin use was a significant determinant of Cp increase, independent of any antioxidant effect. CONCLUSIONS: This study clearly demonstrates increased anti-oxidant capacity and decreased oxidative stress with statin use. Atorvastatin use may also increase Cp levels although this effect appears to be independent of its anti-oxidant effects.

Shot range estimation of shotgun grain-loaded cartridges.

Commercial grain-loaded cartridges for shotguns have been recently associated with injuries and fatalities. These cartridges are generally used as a scare gun for large animals, with a little probability of causing harm. Almost all grain-loaded cartridges contain one type of cereal grain, such as bulgur wheat, wheat or vetch seed, instead of lead pellets. Our study aimed to investigate the shot range estimation of grain-loaded cartridges and assess the variations from conventional lead pellet cartridges. In this study, eight different brands of grain-loaded cartridges were used. The inspections and measurements were made with cartridges that contain cereal grains, gunpowder and wads. Shots were made from 50, 100, 200, 300, 500cm with modified and improved cylinder chokes. Diameter of grain distribution patterns on targets were measured. These measurements were evaluated statistically considering brand, choke and distance variables. Both satellite entry holes and central entry holes were detected in all shots that were fired from 50cm distance. The smallest average diameter of grain distribution pattern between 8 different brands were measured as 14.3, 38.3, 58.5 and 83.4cm for 100, 200, 300 and 500cm respectively with modified choke. Gathered data from this study was compared with the studies conducted with conventional cartridges and differences were determined. It was detected that the grain-loaded cartridges showed much wider distribution on targets at the same shooting distance with the same and similar barrel lengths and choke values compared to conventional lead pellet containing cartridges.

Comparison of high-flow oxygen treatment and standard oxygen treatment in patients with hypertensive pulmonary edema.

OBJECTIVE: The aim compares the blood gases, vital signs, mechanical ventilation requirement, and length of hospitalization in patients with hypertensive pulmonary edema treated with standard oxygen therapy (SOT) and high-flow oxygen therapy (HFOT). METHODS: This prospective observational study was conducted in patients with tachypneic, hypoxemic, hypertensive pulmonary edema. The patients' 0th, 1st, and 2nd hour blood gas results; 0th, 1st, and 2nd hour vital signs; requirement of endotracheal intubation, length of hospitalization, and the prognosis were recorded on the study form. RESULTS: A total of 112 patients were included in this study, of whom 50 underwent SOT and 62 received HFOT. The initial blood gas analysis revealed significantly lower levels of pH, PaO2, and SpO2 and significantly higher levels of PaCO2 in the HFOT group. Patients in the HFOT group had significantly higher respiratory rate and pulse rate and significantly lower SpO2 values. The recovery of vital signs was significantly better in the HFOT group (p<0.05). Similarly, follow-up results of arterial blood gas analysis were better in the HFOT group (p<0.05). Both length of stay in the emergency department (p<0.05) and length of intensive care unit hospitalization s significantly shorter in the HFOT group (p<0.05). CONCLUSION: HFOT can be much more effective in patients with hypertensive pulmonary edema than SOT as it shortens the length of stay both in the emergency service and in the intensive care unit. HFOT also provides better results in terms of blood gas analysis, heart rate, and respiratory rate in the follow-up period.