RESUMEN
OBJECTIVE: In this study, our purpose was to determine whether plasma BNP level can be useful or not in determining the severity of myocardial injury formed by CO poisoning and to compare plasma BNP level with serum cTnI level. MATERIALS AND METHODS: In the study, 46 female Wistar Albino rats were used. Rats were divided into four groups, one control group and three poisoning groups. The mixture of pure CO and air was injected for 60 minutes to provide 3000 ppm CO concentration. Blood samples of groups were collected to measure COHb, BNP and cTnI levels. Blood samples of poisoning groups were collected at the 1st, 6th and 12th hours after poisoning. After biochemical procedures, findings were analysed statistically and compared with each other. RESULTS: Eight rats which died in poisoning groups were excluded and 38 rats were evaluated. BNP levels were high in all poisoning groups compared to control group and the difference between them was statistically significant (p < 0.05). cTnI levels were high in 6th and 12th hours poisoning groups compared to control and 1st hour group but only 12th hour group had statistically significant difference (p < 0.05). A statistically positive relation was established between BNP and cTnI levels in 6th and 12th hour groups (R: 0.76 - p < 0.05 - n:38). CONCLUSIONS: It was found that BNP levels increased earlier than cTnI levels in acute severe CO poisoning. BNP levels of the cases which were determined to have increased cTnI levels showing myocardial injury increased as well. BNP can show myocardial injury and its severity in acute CO poisoning.
Asunto(s)
Intoxicación por Monóxido de Carbono/sangre , Péptido Natriurético Encefálico/sangre , Troponina I/sangre , Animales , Carboxihemoglobina/análisis , Femenino , Ratas , Ratas Wistar , Troponina I/metabolismoRESUMEN
INTRODUCTION: Tetanus is a serious and acute life-threatening disease caused by toxins of "Clostridium tetani". Although it is generally a disease of developing countries, its lower incidence is encountered also in developed countries. Since the principal treatment of this disease is known to be based on vaccination and wound care, the emergency physicians play a key role in its management. MATERIAL AND METHOD: In the present study, we reviewed its uncommon clinical course along with demographic and clinical features of five cases that have presented with various complaints to our Emergency Department. Presenting signs, demographic features, injury history, and the time from the occurrence of injury to the beginning of symptoms were evaluated. RESULTS: Four of five cases were female. The mean age of cases was 56.8 (34-73). Three of them had hand injury, one had foot injury, and the fifth case had facial injury. The initial symptoms included difficult jaw movement, back muscle spasm, and pain. Two cases died. CONCLUSION: Tetanus cases may present to ED with different symptoms. Therefore, physicians should be aware of the early signs of tetanus. Careful and meticulous wound management of cases presented to ED following an injury should be considered a significant factor, which can help in reducing the tetanus cases (Tab. 2, Ref. 18).
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Tétanos/diagnóstico , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Tétanos/terapia , Heridas Punzantes/complicacionesRESUMEN
OBJECTIVE: In the present study, we aimed to investigate demographic and clinical characteristics of the cases presented to the Emergency Department with an acute upper gastrointestinal system hemorrhage, and to identify the initial evaluation and treatments along with explaining possible causes of hemorrhage. MATERIALS AND METHODS: This prospective study was conducted between October 1, 2006 and September 30, 2007. Characteristics of the patients were evaluated in terms of age, gender, presenting symptoms, medical history, risk factors, coexisting symptom and diseases, results of the rectal examination and nasogastric evaluation, endoscopy findings, received treatments, duration of Emergency Department stay, admitting departments, and outcomes. RESULTS: 128 patients who presented to the Emergency Department during the study period were included in the study. As 27.3 % of the patients were female, 72.7 % were male. The mean age was 59.3 (+/- 16). 51.6 % of patients had a history of NSAID and aspirin use. Endoscopy was performed in 111 (86.7 %) patients. The most common finding among endoscopy results was gastric ulcer with a rate of 20.4 % followed by duodenal ulcer in 18.3 %. The mean hospitalization period in the Emergency Department was found to be 18 hours. CONCLUSION: In conclusion, acute upper gastrointestinal hemorrhages are first evaluated and treated in Emergency Departments. Endoscopy was carried out on most of the patients during the monitoring in the Emergency Department. NSAIDs and aspirin are still the most important risk factors and peptic ulcer is the most frequently encountered underlying cause (Tab. 4, Fig. 1, Ref. 27). Full Text in free PDF www.bmj.sk.
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Servicio de Urgencia en Hospital , Hemorragia Gastrointestinal/diagnóstico , Hemorragia Gastrointestinal/terapia , Enfermedad Aguda , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Hemorragia Gastrointestinal/etiología , Humanos , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
The epidemiological characteristics and clinical results of patients who presented with acute upper gastrointestinal haemorrhage (AUGIH) during the month of Ramadan (October 2007) were compared with those who presented with AUGIH during another, non-Ramadan, month (December 2007). The following were evaluated: age, gender, symptoms, gastrointestinal disease history, risk factors, co-existing diseases, results of rectal, nasogastric and endoscopic examinations, treatment modalities and clinical outcomes. Significantly more patients were diagnosed with AUGIH during Ramadan compared with the non-Ramadan month (43 versus 28, respectively). Significantly more patients diagnosed during Ramadan had a history of previous haemorrhage compared with the non-Ramadan month (72.1% versus 42.9%, respectively). Peptic ulcer was the most common event in both groups and overall endoscopy findings differed between the groups. No other significant differences were found. In conclusion, the number of patients presenting with AUGIH during Ramadan was significantly higher than that of an ordinary month, which suggests that fasting during Ramadan reactivates and aggravates pre-existing gastrointestinal diseases.
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Ayuno/efectos adversos , Hemorragia Gastrointestinal/epidemiología , Hemorragia Gastrointestinal/etiología , Islamismo , Enfermedad Aguda , Demografía , Endoscopía , Femenino , Hemorragia Gastrointestinal/terapia , Humanos , MasculinoRESUMEN
The objective of this study was to describe the demographic and clinical features of patients who were admitted to the emergency department (ED) due to wild mushroom poisoning and to point the importance of mushroom poisonings in our area. This study was performed by examining the files of wild mushroom poisoning patients who were admitted to the ED of Firat University, Faculty of Medicine, between January 2000 and June 2004, retrospectively. Patients>or=16 years of age were included in the study. The frequency of wild mushroom poisoning, age and sex of the patients, season, place of the residence, laboratory findings, treatment and outcome of the patients were investigated. During the study period, 64 patients with wild mushroom poisoning were admitted to the ED. From 64 overall patients, 25 (39.1%) were males. The most common complaints during the admission were nausea, vomiting and abdominal discomfort. The duration of hospitalization was two (range 1-4 days) days. No death was observed. Severity of mushroom poisoning depends on the type of mushroom eaten, the time lag between the poisoning and admission to the hospital, and the rapid and correct treatment given to the patient either in the ambulance or at health centre.
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Dolor Abdominal/epidemiología , Servicio de Urgencia en Hospital/estadística & datos numéricos , Intoxicación por Setas/epidemiología , Náusea/epidemiología , Vómitos/epidemiología , Dolor Abdominal/etiología , Adolescente , Adulto , Anciano de 80 o más Años , Femenino , Humanos , Tiempo de Internación/estadística & datos numéricos , Masculino , Intoxicación por Setas/complicaciones , Intoxicación por Setas/terapia , Náusea/etiología , Características de la Residencia/estadística & datos numéricos , Estudios Retrospectivos , Estaciones del Año , Índice de Severidad de la Enfermedad , Factores de Tiempo , Resultado del Tratamiento , Turquía/epidemiología , Vómitos/etiologíaRESUMEN
Chlorine gas is a potent pulmonary irritant that causes acute damage in both the upper and lower respiratory tract.
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Cloro/envenenamiento , Productos Domésticos/envenenamiento , Enfisema Mediastínico/inducido químicamente , Adulto , Albuterol/uso terapéutico , Aminofilina/uso terapéutico , Broncodilatadores/uso terapéutico , Quimioterapia Combinada , Urgencias Médicas , Femenino , Gases , Glucocorticoides/uso terapéutico , Humanos , Ipratropio/uso terapéutico , Enfisema Mediastínico/diagnóstico por imagen , Enfisema Mediastínico/terapia , Metilprednisolona/uso terapéutico , Terapia por Inhalación de Oxígeno , Tomografía Computarizada por Rayos XRESUMEN
Organophosphate poisoning is a common cause of severe morbidity and mortality in emergency departments. Acute pancreatitis is a frequently reported consequence of organophosphate poisoning, but preventing this potentially severe complication has not been the subject of much research. We tested whether interleukin-10, a cytoprotective agent, could prevent or diminish pathological signs of acute pancreatitis caused by organophosphate poisoning. Thirty rats were divided into three equal groups. Group 1 did not receive any agent during the experiment. Group 2 received 0.8 g/kg fenthion intraperitoneally, followed by 6 ml/kg intraperitoneal normal saline 30 min and 3 h later. Group 3 received 0.8 g/kg fenthion intraperitoneally, followed by 2 microg/kg of interleukin-10 intraperitoneally 30 min and 3 h later. All rats underwent laparotomy and thoracotomy while still under anesthesia at 6 h, and tissue samples were obtained from the pancreas. After blood samples were taken by cardiac puncture, the animals were sacrificed. Organophosphate poisoning resulted in significant elevations of serum amylase and glucose. Interleukin-10 significantly reduced pancreatic damage as determined by pathologic scoring, but not by enzyme elevations. Interleukin-10 should be considered for larger studies in other animal models to confirm its ability to decrease pancreatic damage after organophosphate poisoning treatment with interleukin-10.
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Inhibidores de la Colinesterasa/envenenamiento , Fentión/envenenamiento , Insecticidas/envenenamiento , Interleucina-10/uso terapéutico , Pancreatitis/tratamiento farmacológico , Enfermedad Aguda , Amilasas/sangre , Animales , Glucemia , Femenino , Pancreatitis/inducido químicamente , Pancreatitis/patología , Ratas , Ratas WistarRESUMEN
This paper reports a case of prolonged bleeding following application of leeches to treat chronic pain. The paper discusses the characteristics of the wounds and possible complication of prolonged bleeding following medicinal leech application. The principles of treatment are also described.
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Mordeduras y Picaduras/complicaciones , Hemorragia/etiología , Hirudo medicinalis , Aplicación de Sanguijuelas/efectos adversos , Adulto , Mordeduras y Picaduras/terapia , Hemorragia/terapia , Humanos , Pierna , Masculino , Manejo del Dolor , Resultado del TratamientoRESUMEN
Obstructive jaundice is associated with high morbidity and mortality. Major complications such as pulmonary dysfunction, renal failure and sepsis are frequently encountered. Recent studies and observations suggest that the free oxygen radicals (FORs) produced in obstructive jaundice may play a significant role in the etiopathogenesis of acute renal failure (ARF). Thirty rats were divided into three groups, as sham, control and treatment groups containing 10 rats each. Laparatomy was performed on each animal in the control and treatment groups and common bile ducts were ligated. Common bile duct was observed but was not ligated for the rats in the sham group. Saline solution injection was begun on the first day of surgical procedure and repeated once a day during the following 5 days. The same procedure was performed with oxygen radical scavenger dimethyl sulfoxide (1.5 mg/kg/day i.p.) instead of saline in the treatment group. The rats were sacrificed on the 7th postoperative day. On the 7th postoperative day, the bilirubin, urea and creatinine levels of the control and treatment groups were significantly higher in comparison with the sham group (p < 0.01). Although there was no statistically significant difference between the bilirubin levels of the control and treatment groups (p > 0.05), the urea and creatinine levels in the treatment group were significantly lower (p < 0.01). On the 7th postoperative day, the erythrocyte superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) levels of the control and treatment groups were significantly lower than those of the sham group (p < 0.01), whereas renal and erythrocyte malondialdehyde (MDA) levels were significantly higher (p < 0.01). Although SOD and GSH-Px levels did not differ significantly between the treatment and control groups (p > 0.05), renal and erythrocyte MDA levels of the treatment group were significantly lower than those of the control group (p < 0.01). The histopathological scores were significantly higher in the control and treatment groups (p < 0.01); there was no significant difference between the control and treatment groups (p > 0.05). FORs seem to play a significant role in the etiopathogenesis of renal failure in obstructive jaundice. Antioxidant treatment may decrease oxidative damage due to FORs and may prevent renal failure.