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Background:The presence of notched R or S waves without accompanying typical bundle branch blocks, or the existence of an additional wave like RSR' pattern in the original QRS complex (with a duration of <120 ms) has been defined as narrow QRS fragmentation. Persistence of the fQRS found on the admission electrocardiogram (ECG) in patients with acute ST segment elevation myocardial infarction (STEMI) will have prognostic significance in the short term.Methods: The study was carried out using retrospectively collected data of 296 consecutive patients diagnosed as acute STEMI .fQRS group had fQRS both in admission and latest ECGs (n = 80, 27%), and non-fQRS group had no fQRS in last ECG (n = 216, 73%). Primary end points were in-hospital cardiovascular mortality, hemodynamic instability, and electrical instability.Results: MI localization, symptom duration, reperfusion therapy (RPT) rate, RPT modality, rate of successful reperfusion did not differ. Mean ejection fraction was lower and all end points were more frequent in the fQRS group. Irrespective of the RPT modality and success of RPT, mortality rate was higher in patients with persistent fQRS. GRACE score >120 points (OR = 4.765), age >70 years (OR = 4.041), anterior MI localization (OR = 3.148), and presence of fQRS (OR = 2.484) were significant predictors of primary end points. fQRS increased the predictive ability of GRACE score >120 about two folds (OR = 7.305, P < 0.001).Conclusion: Persistent fQRS on ECG is associated with poor prognosis and there is a lack of expected mortality benefit of RPT, particularly that of fibrinolytic therapy, in STEMI patients with fQRS.

Aim Acute poisoning is one of the major topics in emergency medicine practices. Despite the recent developments in toxicology, technological advances and changing lifestyles reveal new factors, and poisoning cases remain to be a problem. All poisonings should be considered serious and independent from their clinical presentation at the time of admission. Identifying the cause and prompt initiation of treatment is life-saving. Causes of poisoning vary between countries and different regions of the same country. In the present study, cases admitted to the Emergency Department of Internal Medicine at Haseki Training and Research Hospital were evaluated and causes of acute poisoning were investigated. Subject and methods Medical records of 675 cases of acute poisoning were retrospectively evaluated in the present study.Results The mean age of 675 cases included was 29.24± 13.71 years of age of which 66.4% were women. Drugs were the most common cause of poisoning (74.2%), which was followed by carbon monoxide (8.7%) and alcohol (8.4%) poisoning. Poisoning was deliberate in 73.5% and accidental in 25.6% of the cases. Treatment in intensive care unit was required in 6.6% of the patients. Conclusion Knowing the causes of poisonings will be beneficial in management approach and determining prevention strategies. Increased awareness of health professionals and public about regional causes of poisoning and prevention strategies will reduce morbidity and mortality associated with acute poisonings.

group (p=0.006; p=0.039; p=0.003, respectively). UAE was inversely correlated with DLCO, DLCO/VA, DLCO/VA% and DLCO% (p=0.050; p=<0.001; p=0.001; p=0.004, respectively). Conclusion This study demonstrated that alveolar gas exchange capacity is significantly decreased in diabetic patients. Microalbuminuria may be one of the predictors of this decline.

Our findings indicate that women with metabolic syndrome have a better antioxidant status and higher ApoA levels compared with men. Our findings suggest the existence of a higher oxidative stress index in men with metabolic syndrome. Considering the higher risk of atherosclerosis associated with men, these novel oxidative stress parameters may be valuable in the evaluation of patients with metabolic sydrome.

Background and objectives: Hypertension is a global health problem and a major risk factor for cardiovascular diseases. Vitamin D deficiency is closely related to high blood pressure and the development of hypertension. This study investigated the relationship between the vitamin D and blood pressure status in healthy adults, and their 8-year follow-up was added. Materials and Methods: A total of 491 healthy middle-aged participants without any chronic illness, ages 21 to 67 at baseline, were divided into two groups as non-optimal blood pressure (NOBP) and optimal blood pressure (OBP). NOBP group was divided into two subgroups: normal (NBP) and high normal blood pressure (HNBP). Serum 25-hydroxy vitamin D levels were measured with the immunoassay method. 8-year follow-up of the participants was added. Results: The average vitamin D level was detected 32.53 ± 31.50 nmol/L in the OBP group and 24.41 ± 14.40 nmol/L in the NOBP group, and a statistically significant difference was found (p < 0.001). In the subgroup analysis, the mean vitamin D level was detected as 24.69 ± 13.74 and 24.28 ± 14.74 nmol/L in NBP and HNBP, respectively. Together with parathyroid hormone, other metabolic parameters were found to be significantly higher in the NOBP. During a median follow-up of 8 years, higher hypertension development rates were seen in NOBP group (p < 0.001). Conclusions: The low levels of vitamin D were significantly associated with NBP and HNBP. The low levels of vitamin D were also associated with the development of hypertension in an 8-year follow-up.

Background:  The intima–media thickness (IMT) of the carotid artery is highly correlated with cardiovascular events in Type 2 diabetes mellitus (T2DM). The aim of the present study was to undertake a cardiovascular risk assessment in a group of patients (n = 102) who had been followed‐up for 10 years. Methods:  Framingham risk score (FRS), IMT, and various other clinical parameters were evaluated retrospectively using Student’s t‐test, regression analysis, and χ2 tests. Primary endpoints were defined as cardiovascular death, non‐fatal myocardial infarction, angina, and ischemic stroke. Results:  The IMT (1.09 ± 0.32 vs 0.89 ± 0.25; P < 0.001) and percentage coronary risk as determined by the FRS (24.33 ± 11.07 vs 16.54 ± 8.35; P = 0.001) were significantly higher in patients presenting with any of the primary endpoints compared with patients in whom no cardiovascular morbidity or mortality was recorded. Other factors that significantly predicted cardiovascular mortality and morbidity included diastolic blood pressure and urinary albumin excretion (UAE; P < 0.001). The likelihood of primary endpoints could be predicted by UAE >30 mg/day, carotid artery IMT ≥0.9 mm, and FRS ≥20 (odds ratios 8.800, 3.377, and 2.807, respectively). Conclusion:  Although FRS predicts 10‐year risk for cardiovascular mortality and morbidity in T2DM, we suggest that UAE and carotid artery IMT should also be considered in risk assessments.

Objectives:In order to ascertain the impact of diabetes and diabetic complications on the risk of depression in the Turkish population, the Beck Depression Inventory (BDI) was used to investigate the frequency of depression in type 1 and type 2 diabetes mellitus patients (T1DM and T2DM) compared to controls (nondiabetic population). The influence of sociodemographic and other baseline characteristics on depression in DM patients and controls was also investigated. Patients and Methods: A total of 500 consecutive diabetic outpatients and 90 healthy individuals (control group) completed the BDI test. Metabolic parameters, complications, and sociodemographic characteristics were also recorded. Results: T1DM patients had significantly higher BDI scores than T2DM patients and controls (P Ͻ 0.001, for each) no significant difference was found between T2DM patients and controls (P ϭ 0.950). Following microvascular complications, the most frequently encountered complications were retinopathy and neuropathy in patients with T1DM (49.4%) and T2DM (50.1%), respectively. The rates of depression were found significantly higher in the group with diabetic complications compared to the group without diabetic complications. By linear regression analysis, significant predictors for depression were unmarried status, T1DM, younger age, and microvascular complications. Conclusion: These results provide strong evidence for an increase in the frequency of depression in diabetic patients with complications.