Background: Trauma severity scoring systems are routinely used to monitor trauma patient outcomes. Yet, the most accurate scoring system remains an elusive target. Objective: We aim to compare trauma severity scales (ISS, NISS, RTS, TRISS, and BIG) in multitrauma patients and investigate BIG as one of the new trauma severity scoring systems. Methods: The demographic data of the patients, vital signs, injury mechanisms, body regions exposed to trauma, final diagnosis, the injury severity scales—Injury Severity Score (ISS), New Injury Severity Score (NISS), Revised Trauma Score (RTS), base deficit, international normalized ratio, and Glasgow Coma Scale (BIG), and Trauma and Injury Severity Score (TRISS)—the length of stay in hospital, and the progress of the patients were examined. Results: A total of 426 cases were included in the study. The best performing score in determining mortality was TRISS (area under the curve [AUC]: 0.93, sensitivity 97.1% and specificity 76.7%). This was followed by the NISS, BIG, ISS, and RTS, respectively. For the prediction of intensive care unit admission, the NISS was the most successful with an AUC value of 0.81. There was a significant relationship in terms of the length of stay in all trauma scores (p < .05). Conclusions: The most successful score in predicting mortality in trauma patients was the TRISS, whereas the NISS was the most successful in predicting intensive care unit admission. The newly developed BIG score can be used as a strong scoring method for predicting prognosis in trauma patients.
In this study, we aimed to investigate the importance of copeptin in the diagnosis of acute pulmonary embolism, detection of right ventricular dilatation and clinical severity and prognosis of pulmonary embolism. Materials and Methods: In the study three groups were created; Group 1: Pulmonary embolism patients with right ventricular dilatation in echocardiography, Group 2: Pulmonary embolism patients without right ventricular dilatation in echocardiography, Group 3: Healthy people. Five mL of venous blood was collected for the measurement of serum copeptin from the patients and control group. D-dimer and troponin were studied with routine blood samples. Complaints, symptom and physical examination findings, tomography and echocardiography results, laboratory results of patients and treatments they received were recorded for the statistical analysis. Results: Copeptin levels of acute pulmonary embolism patients were significantly higher than healthy individuals (P < 0.001). Copeptin values of Group 1 patients were significantly higher than Group 2 patients and Group 3 patients (P < 0.001). There was a statistically significant difference the levels of copeptin, D-dimer and troponin between patients with right ventricular dilatation and patients without right ventricular dilatation (P < 0.05). AUC value in detecting right ventricular dilatation of copeptin was found to be 0.82, while specificity was 83.3% and sensitivity was 69.6%. Copeptin, D-dimer and troponin levels of patients with increased pulmonary artery pressure were statistically significantly higher than patients with normal pulmonary artery pressure (P < 0.05). Conclusion: Copeptin can be used in the diagnosis of acute pulmonary embolism and in the detection of right ventricular dilatation in pulmonary embolism. K E Y W O R D S biomarker, echocardiography, heart failure, prognosis, pulmonary embolism 1 | INTRODUCTION Pulmonary embolism (PE) is a common life-threatening cardiopulmonary disorder in which a venous thrombus obstructs pulmonary arterial bed. 1,2 The obstruction of pulmonary arterial bed may cause acute but reversible right ventricular failure. 1,2 Right ventricular dysfunction is an important prognostic value in patients with PE. In patients with right How to cite this article: Usul E, Ozkan S, Höke MH, Kaya AE, Ucar F, Cimen T. Relationship between right ventricular dilatation and blood copeptin levels in patients with acute pulmonary embolism.
Colchicine is a well-recognized drug, that is used for the treatment of familial Mediterranean Fever, acute gout arthritis, amyloidosis and primary biliary cirrhosis. Colchicine is an alkaloid drug that is derived from Colchium autumnale.Diarrhea, sickness, vomiting, abdominal pain, excessive deficiency of electrolytes and fluid are common symptoms of intoxication due to higher absorption of colchicine from gastrointestinal surface. Colchicine has a narrow therapeutic index and suicide attempted with this drug has a higher mortality.Colchicine intoxication is a critical and life-threatening condition for patients so that pyhsicians should be aware of over dose and complications of this drug. Herein, we reported a case of colchicine overdose for suicide attempt.
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