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BACKGROUND: Harmless acute pancreatitis score (HAPS), neutrophile/lymphocyte ratio and red blood cell distribution width (RDW) are used to determine the early prognosis of patients diagnosed with nontraumatic acute pancreatitis in the emergency department (ED). METHODS:Patients diagnosed with acute pancreatitis (K 85.9) in the ED according to the ICD10 coding during one year were included in the study. Patients with chronic pancreatitis and those who had missing data in their files were excluded from the study. Patients who did not have computed tomography (CT) in the ED were not included in the study. RESULTS:Ultimately, 322 patients were included in the study. The median age of the patients was 53.1 (IQR=36-64). Of the patients, 68.1% (n=226) had etiological causes of the biliary tract. The mortality rate of these patients within the fi rst 48 hours was 4.3% (n=14). In the logistic regression analysis performed by using Balthazar classification, HAPS score, RDW, neutrophile/lymphocyte ratio, age, diabetes mellitus and systolic blood pressure, the only independent variable in determining mortality was assigned as Balthazar classifi cation (OR: 15; 95% CI: 3.5 to 64.4).CONCLUSIONS: HAPS, neutrophile/lymphocyte ratio and RDW were not effective in determining the mortality of nontraumatic acute pancreatitis cases within the fi rst 48 hours. The only independent variable for determining the mortality was Balthazar classifi cation.

Thoracic sympathectomy is effective in the permanent cure of primary axillary and palmar hyperhidrosis and facial blushing, which can be so troublesome for patients that their social and professional relations can be affected. Between October 1988 and April 1994, a total of 50 thoracic sympathectomies (10 surgical and 40 endoscopic) were performed on 5 and 23 patients, respectively. The operations were performed unilaterally, followed by the contralateral intervention after a period of 6-8 weeks. The thoracic ganglia T2-T5 were resected for hyperhidrosis. If the patient suffered from blushing, the lower 1/3 of the stellate ganglion was also resected. Postoperatively, all the operated limbs were warm and dry. In the group of patients who were operated bilaterally, only one had persistent facial blushing. The efficacy for blushing in this series was therefore 93.3%. The late relapse rate of sympathetic activity was 14.3%. Compensatory sweating was seen in 67%, gustatory sweating in 37.5% and phantom sweating in 29% of the patients. None of them considered these side effects to be troublesome. Although there is no difference between transaxillary thoracic sympathectomy and the endoscopic intervention in terms of efficacy, the latter is associated with less postoperative pain, shorter hospital stay and a rapid recovery. The thoracic sympathectomy is the treatment of choice for primary hyperhidrosis and excessive facial blushing.

The aim of this study is to investigate the potential antioxidant and anti-infl ammatory effects of thymoquinone (TQ) on ceruleine-induced acute pancreatitis. MATERIAL AND METHODS: A total of 14 male Wistar albino rats were divided into 2 groups as follows: (1) normal saline-treated group and (2) thymoquinone-treated groups. For achieving acute pancreatitis, intraperitoneal (IP) cerulein, a stable cholecystokinin (CCK) analogue, was applied in a 50 mcg/kg dose 2 times in onehour interval in total. One hour after last ceruleine injection, IP 2 ml/kg isotonic saline solution was applied to the saline group and IP 5 mg/kg TQ was applied. The rats were sacrifi ced by decapitation 12 h after the last injection of last medication. Blood samples were taken, and serum interleukin-1β (IL-1β), amylase, lipase pancreatic, total antioxidant capacity (TAC), total oxidant status (TOS), and pancreatic Schoenberg scores were determined. Oxidative stress index (OSI) was calculated for each group. Results are given as mean ± SD. A value of p < 0.05 was accepted as statistically signifi cant. SPSS for Windows v15.0 was used for statistical analyses. RESULTS: The increased serum amylase, lipase levels and histopathological scoring of pancreatic tissue showed that acute pancreatitis was present in both groups. Furthermore, serum IL-1β level was signifi cantly reduced in TQ-administered group (p < 0.05). Although serum TAC level was high and TOS level was low, those changes were not statistically signifi cant. Nevertheless, OSI index, which was driven from TOS/TAC, was signifi cantly low in TQ groups (p < 0.05). Although TQ partially ameliorated the acute pancreatitis in terms of histopathological evaluations, the main effect of it was brought about by reducing the hemorrhage in acute pancreatitis (p < 0.05). CONCLUSION: In this study, it was shown that TQ can reduce the infl ammation and has a positive effect on the oxidative status of organism in infl ammatory cases such as acute pancreatitis. This is consistent with partial amelioration of acute pancreatitis in rats given TQ (Tab. 2, Fig. 4, Ref. 31). Text in PDF www.elis.sk.

BACKGROUND AND OBJECTIVES:Organophosphate poisoning (OP) is a serious clinical condition that may sometimes be fatal. The aim of this study was to determine whether the Glasgow coma scale (GCS), and serum acetylcholinesterase and leukocyte levels have prognostic value in acute OP poisoning.DESIGN AND SETTING:Retrospective review of records of patients admitted to the intensive care unit of Selcuk University, Meram Medical Faculty, Emergency Department, Konya, Turkey, between January 2006 and January 2009.METHODS:We studied acutely OP-poisoned patients admitted within 24 hours after OP exposure.RESULTS:The mean age of the 25 patients was 37 years (range, 20-80 years). Three (12%) of the 25 patients (male-female ratio, 12:13) died. The mean GCS values of the patients who died were significantly lower compared to those of the group that survived (4 vs 11.7, respectively P<.05). While the mean serum acetylcholinesterase levels were lower in the patients who died, the difference in the mean serum acetylcholinesterase levels between the patients who died and the ones who survived was not statistically significant (3841 IU/L vs. 1768 IU/L, respectively).CONCLUSION:Although serum cholinesterase values can be used in the quick diagnosis, their efficiency at predicting outcome in patients with OP poisoning has not been established. It has also been determined that serum leukocyte values have no prognostic value in OP poisoning, but GCS values have been found to be effective in predicting the outcome.

Peripheral vascular disease is common in diabetes, but most are asymptomatic.

IntroductionAcute myocardial infarction (AMI) is still one of the most common causes of death worldwide. In recent years, for diagnosis of myocardial ischemia, a new parameter, called ischemia modified albumin (IMA), which is thought to be more advantageous than common methods, has been researched.AimIn this study, systematic analysis of parameters considered to be related to myocardial ischemia has been performed, comparing between control and myocardial ischemia groups.Material and methodsWe selected 40 patients with AMI and 25 healthy controls for this study. Ischemia modified albumin levels, glutathione peroxidase (GPx), superoxide dismutase (SOD), and catalase (CAT) antioxidant enzyme activities and non-enzymatic antioxidants such as retinol, α-tocopherol, β-carotene and ascorbic acid levels were investigated in both groups. Glutathione (GSH) and malondialdehyde (MDA) levels, which are indicators of oxidative stress, were compared between patient and control groups.ResultsIschemia modified albumin levels were found significantly higher in the AMI diagnosed group when compared with controls. The MDA level was elevated in the patient group, whereas the GSH level was decreased. SOD, GPx and CAT enzyme levels were decreased in the patient group, where it could be presumed that oxidative stress causes the cardiovascular diseases.ConclusionsDue to the increased oxidative stress, non-enzymatic and enzymatic antioxidant capacity was affected. Systematic investigation of parameters related to myocardial infarction has been performed, and it is believed that such parameters can contribute to protection and early diagnosis of AMI and understanding the mechanism of development of the disease.

Wound healing represents an ancient problem for humans, and various materials and methods have been tried for wound dressing. A dressing should protect against infection and shorten healing; moreover, it should not cause tissue damage and should be nonallergenic, cost effective and easy to apply. These are characteristics that may be found in herbal extracts. An absorbable polysaccharide haemostat (APH) is a plant-based haemostatic agent. We aimed to evaluate the effect of APH on wound healing. A total of 24 Wistar rats were divided into three groups, each consisting of eight rats. We generated triangular tissue defects on the dorsal regions of the rats. The wound size of each rat was drawn on acetate paper on the 3rd, 7th and 14th days and dressed with APH, saline and wheat meal. Wound healing rates were calculated using planimetric software. Scar tissue excision was performed on the 14th day and histopathological examination was carried out. The mean wound contraction rate was statistically higher in the APH group than in the wheat meal and saline groups on the 14th day (P < 0.05). There was no significant difference in polymorphonuclear leukocytes intensity between the saline and APH groups when stained with haematoxylin and eosin (P > 0.05). However, the intensities of fibroblasts (P < 0.01), vascular proliferation (P = 0.01) and inflammatory score (P = 0.02) were significantly different in the saline and APH groups. APH has favourable effect on wound healing. In addition to its blood-stopping effect, APH may be useful for tissue defects, which arise after trauma or surgical procedures.