BackgroundThe wound healing process is complex and still poorly understood. Sericin is a silk protein synthesized by silk worms (Bombyx mori). The objective of this study was to evaluate in vivo wound healing effects of a sericin-containing gel formulation in an incision wound model in rats.Material/MethodsTwenty-eight Wistar-Albino rats were divided into 4 groups (n=7). No intervention or treatment was applied to the Intact control group. For other groups, a dorsal skin flap (9×3 cm) was drawn and pulled up with sharp dissection. The Sham operated group received no treatment. The Placebo group received placebo gel without sericin applied to the incision area once a day from day 0 to day 9. The Sericin Group 3 received 1% sericin gel applied to the incision area once a day from day 0 to day 9. Hematoxylin and eosin stain was applied for histological analysis and Mallory-Azan staining was applied for histoimmunochemical analysis of antibodies and iNOS (inducible nitric oxide synthase), and desmin was applied to paraffin sections of skin wound specimens. Parameters of oxidative stress were measured in the wound area.ResultsEpidermal thickness and vascularization were increased, and hair root degeneration, edema, cellular infiltration, collagen discoloration, and necrosis were decreased in Sericin group in comparison to the Placebo group and the Sham operated group. Malonyldialdehyde (MDA) levels were decreased, but superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) activities were increased in the sericin group.ConclusionsWe found that sericin had significant positive effects on wound healing and antioxidant activity. Sericin-based formulations can improve healing of incision wounds.

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SUMMARYObjectivesTo compare the differences between conventional radiography and digital computerized radiography (CR) in patients presenting to the emergency department.MethodsThe study enrolled consecutive patients presenting to the emergency department who needed chest radiography. Quality score of the radiogram was assessed with visual analogue score (VAS-100 mm), measured in terms of millimeters and recorded at the end of study. Examination time, interpretation time, total time, and cost of radiograms were calculated.ResultsThere were significant differences between conventional radiography and digital CR groups in terms of location unit (Care Unit, Trauma, Resuscitation), hour of presentation, diagnosis group, examination time, interpretation time, and examination quality. Examination times for conventional radiography and digital CR were 45.2 and 34.2 minutes, respectively. Interpretation times for conventional radiography and digital CR were 25.2 and 39.7 minutes, respectively. Mean radiography quality scores for conventional radiography and digital CR were 69.1 mm and 82.0 mm. Digital CR had a 1.05 TL cheaper cost per radiogram compared to conventional radiography.ConclusionsSince interpretation of digital radiograms is performed via terminals inside the emergency department, the patient has to be left in order to interpret the digital radiograms, which prolongs interpretation times. We think that interpretation of digital radiograms with the help of a mobile device would eliminate these difficulties. Although the initial cost of setup of digital CR and PACS service is high at the emergency department, we think that Digital CR is more cost-effective than conventional radiography for emergency departments in the long-term.

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Backround: High rates in trauma-related mortality pose a major health problem and increase every day. Early diagnosis and treatment can be lifesavers for this patient group in the emergency departments, which serve as the first place to admit trauma patients in a hospital. Objectives: We aim to determine high-risk criteria to indicate trauma patients getting the most use from whole-body tomography in patients with multiple traumas and reduce unnecessary computed tomography. Methods: We examined retrospectively all electronic files and computed tomography results of patients, who had been admitted to emergency department due to trauma, and who had undergone whole-body computed tomography. Results: We found that possibility of multiple injuries increased by 5.9 times in patients requiring mechanical ventilation. Possibility of multiple injuries in patients with free fluid in the Focused Assessment with Sonography for Trauma increased by 5.6 times. We also observed that possibility of multiple injuries in patients with Glasgow Coma Score < 13 increased by 4.3 times. Possibility of multiple injuries in hypoxic patients increased by 3.2 times. Possibility of multiple injuries in patients with a pulse ≥ 120/min increased by 1.8 times. Possibility of multiple injuries in patients with shock index ≥ 0.9 increased by 1.7 times. Conclusion: High-risk group in terms of multiple traumas involves mechanical ventilation need in trauma patients, positive Focused Assessment with Sonography for Trauma, Glasgow Coma Score being under 13, hypoxia, tachycardia, positive shock index, and extravehicular traffic accidents. Whole-body computed tomography should be performed in this patient group.

Bu yazıda, hipertrigliseridemik akut pankreatit (HTGAP) tanısı alan hastalarda acil servis yönetimi ile ilgili deneyimlerimizi paylaşmayı amaçladık. Gereç ve Yöntem: Ekim 2015-Ekim 2016 tarihleri arasında, acil servisimize başvuran ve HTGAP tanısı alan hastaların lipaz, amilaz, trigliserid değerleri ve aldıkları tedavi rejimleri incelendi. Ortalama 1 gün/24 saat boyunca acil serviste takip edilen hastaların, klinik durumları ve başlangıç ile 24 saat sonraki trigliserid, amilaz, lipaz düzeyleri değerlendirmeye alındı. Bulgular: Çalışma süresi boyunca acil servisimize toplam 142.482 hasta başvurdu. Bu hastalardan akut pankreatit (AP) tanısı alan hasta sayısı 370' ti. Bu hastalar içerisinde HTGAP tanılı 23-56 yaş aralığındaki 10 hastanın yaş ortalaması 36.2±19.8 olup 6' sı kadındı. Hastaların 7' sinde hiperlipidemi, 6' sında diyabet, 2' sinde hipotroidi öyküsü vardı. Altı hasta daha önce pankreatit atağı geçirmişti. Hastaların hepsine, tanı anından itibaren acil serviste insülin infüzyon tedavisi başlandı. Ortalama 1 gün boyunca acil serviste takip edilen hastaların, klinik durumu ve 24 saat sonraki trigliserid, amilaz, lipaz düzeylerinin gerilediği görüldü. Sonuç: Acil serviste AP' li hastalarda, etiyolojide hipertrigliseridemi akılda bulundurulmalıdır. HTGAP tanısı alan hastalarda komplikasyonları azaltmak için acil serviste erken tedavi başlanabilir ve insülin infüzyonu tedavisi, aferez tedavisine göre daha pratik ve takibi daha kolay olduğu için tüm hastalarda ilk seçenek olarak tercih edilebilir.

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