Intravenous dexketoprofen is superior to placebo in relieving migraine headaches in the ED. It may be a suitable therapy with minimum side effects in patients presenting with a migraine headache to the ED.

Statin nonadherence or discontinuation is associated with increased cardiovascular events. Many factors related to the physicians or the patients are influential in this. We aimed to compare the compliance with statin therapy between the patients who first presented with ST-elevation myocardial infarction (STEMI), non-ST-elevation myocardial infarction (NSTEMI), and unstable angina pectoris (UA) based on the target achievement according to the current dyslipidemia guidelines.We retrospectively acquired all the information about demographic characteristics, in-hospital revascularization procedures, prescribed treatments, and index and up to 6-month follow-up laboratory results of the first acute coronary syndrome patients. Acute coronary syndrome patients were divided into 3 groups as STEMI, NSTEMI, and UA.The STEMI group consisted of 260 patients, NSTEMI group consisted of 560 patients, and UA group consisted of 206 patients. Seventy-six percent of patients underwent percutaneous coronary interventions, 18.3% were managed medically, and 5.7% were referred for coronary artery bypass grafting. There was a significant decrease in low-density lipoprotein-cholesterol (LDL-C) values with the statin treatment at the follow-up in all 3 groups (for all P < .001). In the STEMI group, the percentage of those achieving the target LDL-C level was significantly higher than those who did not achieve the target according to both The American College of Cardiology/American Heart Association (ACC/AHA) and European Society of Cardiology dyslipidemia guidelines. The LDL-C target achievement rates were also higher in the STEMI group than in the NSTEMI and UA groups.Our study concluded that statin treatment goals were more attained in STEMI patients than NSTEMI and UA. All physicians should encourage lifelong intensive statin treatment in UA and NSTEMI patients such as STEMI patients.

The physicians' perception of the patients' pain differs significantly from the pain that the patient is experiencing. VAS helps to bring the physicians impression of pain perception to the level of pain that the patient is actually experiencing and resulted in ordering more analgesics to the patients. Implementation of a pain assessment tool can raise the physician's perception of the pain and may improve pain management practices and patient satisfaction.

The aim of the present study is to investigate if the melatonin has any protective effect on diabetic cardiomyopathy and antioxidant enzymes via phosphorylation of vascular endothelial growth factor-A (VEGF-A). A total of 40 male Wistar rats were enrolled in the study. Rats were divided into four groups: group 1 (control, n=10), group 2 (DM, n=10), group 3 (melatonin, n=10), and group 4 (melatonin+DM, n=10). Melatonin was injected intraperitoneally at a dose of 50 mg/kg/day for 56 days to group 3 and group 4. We investigated expression and phosphorylation of the VEGF-A in coronary vessels of all groups. Staining intensities, biochemical, immunohistochemistry analysis, and transthoracic echocardiography were performed. In comparison to the group 1, DM induced a decrease in p-VEGF-A in coronary vessels of group 2. The lower constitutive phosphorylation of VEGF-A in the group 2 was also increased in coronary vessels after melatonin treatment (p<0.05). Diabetic rats developed myocardial hypertrophy with preserved cardiac function (p<0.05). Cardio-protective effect of melatonin may reduce the damages of diabetes mellitus on the heart muscle fibers and coronary vessels via the phosphorylation of VEGF-A. Melatonin-dependent phosphorylation of VEGF-A in coronary angiogenesis may be associated with the physiological as well as with the pathological cardiac hypertrophy.

Background and Aims. Pulmonary thromboembolism (PTE) is a frequent disease with difficult diagnosis and high mortality. Misdiagnosis occurs in 2/3 patients and mortality rates reach up to 30%. The aim of our study was to investigate the role of adiponectin used in emergency service in diagnosis of PTE. Materials and Methods. 95 patients with suspected PTE included in the study. Plasma adiponectin and D-dimer levels were measured and chest X-ray and multidetector row computed tomography scan obtained. Diagnosis was supported by vascular filling defect on tomography. Control group consisted of patients with suspected PTE and normal chest computed tomography findings. Results. Mean D-dimer level was 4241.66 ± 1082.98 ng/mL in patients and 2211.21 ± 1765.53 ng/mL in the control group (p ≤ 0.05). Mean adiponectin level was 5.46 ± 4.39 μg/mL in patients and 7.68 ± 4.67 μg/mL in the control group (p ≤ 0.05). Wells and Geneva scores were higher in patients compared to the control group. Conclusions. As a result, we conclude that lower adiponectin levels have an important role in the diagnosis of PTE.