Background: As anorexia and hypermetabolism are common in cirrhosis, leptin levels may be increased in this disease. In this study, we investigated the relation between the severity of disease and serum leptin levels in post-hepatitis cirrhosis and the role of body composition, gender and viral aetiology of cirrhosis in this association.
Hiyoid kemik kırıkları nadir görülür. Hiyoid kemik kırığı-nın tanı konması zor olup, yüksek şüphe ile tanısı konulabilir. Bu yazıda, künt travmaya bağlı gelişen izole hiyoid kırığı olgusu sunuldu. Yirmi altı yaşında kadın hasta araç içi trafik kazası kazası sonucu acil servisimize başvurdu. Hasta yutma güçlüğü, boyunda ağrı ve rahatsızlık hissinden şikayetçiydi. Fiziksel incelemede boyunda hiperemi ve hassasiyet mevcuttu. Boyun bilgisayarlı tomografisi çeki-len hastada hiyoid kırığı gözlendi. Hastaya ilaç tedavisi uygulanarak 24 saat gözlendi. Poliklinik kontrolü önerilerek taburcu edildi. Acil hekimi, künt travmalarda hiyoid kırığı oluşma riskini dikkate almalıdır. Hiyoid kırıklı hastalar 24 saat gözlenmelidir. Genellikle bu hastalar için ilaç tedavisi yeterli sonuçları vermektedir.Anahtar Sözcükler: Hiyoid, kırık; künt travma.Fractures of the hyoid bone are very rare. Diagnosis of hyoid fracture is difficult and can be made only with a strong degree of suspicion. We report a case of isolated hyoid bone fracture due to blunt trauma to the neck. A 26-year-old woman was admitted to emergency department for motor vehicle accident. She complained of dysphagia and anterior neck discomfort. Physical examination showed hyperemia and tenderness of neck. A tomographic scan of neck was performed. The findings demonstrated hyoid fracture. Patient was observed with medical therapy for 24 hours and discharged with recommendation of outpatient control. Emergency physician has to be aware of the possibility of hyoid fractures in blunt traumas. Patients with hyoid fracture should be observed for 24 hours. Generally, medical treatment is satisfactory in isolated hyoid fractures.
We investigated the associations of injury severity scores (ISSs) with the mean platelet volume, the serum levels of two interleukins (IL1β and IL6), and the serum levels of tumour necrosis factor-α (TNFα) and C-reactive protein (CRP). We sought to identify biochemical parameters that could be used as components of a new biochemical parameter-based ISS system. The levels of CRP, TNFα, IL1β, and IL6 differed significantly (all p values < 0.05) between severely injured patients and controls. The mean platelet volume (MPV) did not correlate with the ISSs (p > 0.05). The TNFα and IL6 levels were useful for determining the severity of injury, and the CRP level was elevated in all trauma patients but did not correlate with the ISS. The IL1β level was higher in the study group but did not increase as the ISS increased. IL6 and TNFα levels were higher in the study group and increased as the ISS increased. We found no significant difference between the trauma group and healthy individuals in terms of MPV values. IL6 and TNFα levels can be used to assess trauma severity. However, neither the MPV nor the CRP or IL1β level is useful for this purpose.
Hastaların çoğu destek tedavisi ile taburcu olmuştur. Hastaların hastanede kalış süresi ortalama 16,6 ± 10.6 saattir (2-48 saat). Bir hasta beta bloker kullanımına bağlı kardiyojenik şok sonucu ölmüştür. Sonuç: Bu araştırma ACE inhibitörleri ile intoksikasyonlarda bir artış olduğunu göstermiştir. Son zamanlarda kardiyovasküler ilaçların kolay bulunması nedeniyle, özellikle genç intoksikasyon hastalarında aile de ilaç kullanım öyküsü daha detaylı sorgulanmalıdır. Kardiyovasküler ilaçların satışındaki kontrolün ve kısıtlamanın arttırılması bu ilaçlarla olan suicidal girişimleri azaltabilir. Anahtar kelimeler: Kardiovasküler ilaçlar, zehirlenme, ilaçlı intihar, epidemiyolojiAbstract Objectives: As elderly population in Turkey increases, patients using cardiovascular drugs increases.Access to these drugs for suicide attempt gets easier due to common use. Aim of the study is to evaluate the results of intoxication with cardiovascular drugs. Methods: Data of 1399 patients admitted to two level 1 hospital emergency departments for drug intoxication were reviewed from July 2009 to March 2014 retrospectively. Cardiovascular drug intoxication was diagnosed in 81 patients. Results: The average age of 1318 patients with other drug intoxication was 25.9± 10.8 years (72,9% female, 27,1% male); the average age of 81 patients (72,8% female, 27,2% male) with cardiovascular drug toxicity was 27,3± 13,6 years. Ten different group cardiovascular drugs were taken. The most common cardiovascular drug (39.5%) was found ACEI group. Beta blocker intoxication was 37%. Most of the patients required supportive treatment. Average length of stay was 16,6±10,6 h (range: 2-48 h). One patient died from cardiogenic shock due to beta blocker toxicity. Conclusion: Our study shows an increase in suicidal ACE inhibitor and beta blocker intoxication in cardiovascular drugs. All drug intoxications are more common between 18:00 and 02:00 o'clock. Seasonal distribution of suicide attempts showed a peak incidence in fall. Especially in young intoxication patients, physicians should take detailed information about the use of cardiovascular drugs by family members to rule out possible cardiovascular drug intoxication.
Background/aim: This study aimed to evaluate traumatic thorax complications in post-CPR patients and to investigate whether or not there has been a decrease in these complications since the adoption of current chest compression recommendations. Materials and methods: Post-CPR patients with return of spontaneous circulation (ROSC) were admitted between January 2014 and January 2016 were analyzed retrospectively. Patients admitted to the ED in 2014 were resuscitated according to 2010 AHA CPR guidelines, while those admitted to the ED in 2015 were resuscitated according to current ERC CPR guidelines. Results: The study population comprised 48 male and 35 female patients. Of the 2010 AHA guideline patients, 39.21% experienced pulmonary contusion, while 54.83% of 2015 ERC guideline patients had pulmonary contusion. It was found that 11.76% of 2010 AHA guideline patients and 3.22% of 2015 ERC guideline patients had pneumothorax, while 9.8% of 2010 AHA guideline patients and 12.9% of 2015 ERC guideline patients experienced hemothorax. Incidence rates of lung contusion, pneumothorax, and hemothorax were higher in patients with rib fractures. Conclusion: In this study, traumatic thoracic complications were investigated in patients with ROSC after CPR. The incidence of CRP-related injuries did not decrease on application of the new 2015 ERC CPR guideline recommendations. The most common injury in this study was rib fracture, followed by sternal fracture, lung contusion, hemothorax, and pneumothorax. Statistically, rib fracture had a positive relationship with lung contusion, hemothorax, and pneumothorax.
In the cotton zone of Punjab, Pakistan, only 20% of wheat is sown at the optimum sowing time, i.e. the first fortnight of November, while the remaining sowing is done from late November (30%) to December (50%) (Khan et al. 2002). Wheat has a determinate growth habit and a delay of each day in sowing from mid-November onward decreases the number of tillers, leaf area, and total dry matter. Moreover, late sowing of wheat also delays anthesis, which ultimately reduces grain yield at a rate of 30-40 kg day -1 ha -1 (Hussain et al. 1998;Akmal et al. 2011). Late-sown wheat has to complete its life cycle in a short duration because starch accumulation terminates at the same time in both normal and late-sown plants ( Khan et al. 2010). Late sowing results in poor germination and delayed emergence due to the prevalence of low temperatures at that time. In consequence, a weak crop stand and less tillering affect grain yields. Moreover, high temperatures at later growth stages enforce shortening of the grain filling period and early maturity.Limited availability of canal irrigation water and low precipitation are also common in the cotton-wheat cropping system of the South Punjab, Pakistan, and when coupled with late sowing, they severely affect wheat yields. Crop production in this region mainly depends on irrigation, but unfortunately per capita water availability is declining at an alarming rate, from 5260 m 3 in 1951 to 1066 m 3 in 2010, and it will be less than 870 m 3 per capita by 2025 (Ahmad et al. 2009). Due to scarcity in irrigation and water supply, and increasing competition for water demand from nonagricultural sectors, the focus is already shifting from maximizing the production per unit area towards the maximization of the production per unit of water consumed, often termed as water productivity (Fereres and Soriano 2007). For that purpose, and to optimize crop economic returns under conditions of less irrigation water use (irrigation supply below full crop water requirement, evapotranspiration [ETo]), new strategies should be developed. These challenges may be overcome either by minimizing the water losses or by improving the crop water use efficiency. These can be achieved by promoting a large and early canopy development of growing plants.
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