BACKGROUND: Measuring and monitoring end-tidal carbon dioxide (P ETCO 2 ) is an important aspect of caring for critically ill patients. The 2 methods used for P ETCO 2 measurement are the mainstream and sidestream methods. OBJECTIVE: To assess the agreement between P ETCO 2 measurements performed by mainstream and sidestream methods with the P aCO 2 values. METHODS: This was a prospective observational study. A total of 114 subjects were enrolled in the study. P ETCO 2 measurements using mainstream and sidestream methods were performed simultaneously with the arterial blood sampling in subjects who were observed in the emergency department and required arterial blood gas analysis. Agreement between the P ETCO 2 measurements and the P aCO 2 values obtained from arterial blood gas analysis were evaluated using the Bland-Altman method. RESULTS: Sixty subjects (52.6%) were female, and the mean age was 60.9 years (95% CI 58.3-63.6). The mean P aCO 2 was 35.16 mm Hg (95% CI 33.81-36.51), the mainstream P ETCO 2 was 22.11 (95% CI 21.05-23.18), and the sidestream P ETCO 2 was 25.48 (95% CI 24.22-26.75). Bland-Altman analysis showed an average difference between mainstream P ETCO 2 and P aCO 2 values of 13 mm Hg (95% limits of agreement ؊0.6 to 25.5) and moderate correlation (r ‫؍‬ 0.55, P < .001). The average difference between the sidestream P ETCO 2 and P aCO 2 values was 9.7 mm Hg (95% limits of agreement ؊5.4 to 24.7) and poor correlation (r ‫؍‬ 0.41, P < .001). CONCLUSIONS: P ETCO 2 values obtained by mainstream and sidestream methods were found to be significantly lower than the P aCO 2 values. There was essentially no agreement between the measurements obtained by 2 different methods and the P aCO 2 values.

Objectives: Vertigo is a common presenting complaint resulting from central or peripheral etiologies. Because central causes may be life-threatening, ascertaining the nature of the vertigo is crucial in the emergency department (ED). With a broad range of potential etiologies, distinguishing central causes from benign peripheral causes is a diagnostic challenge. Cranial magnetic resonance imaging (MRI) is the recommended neuroimaging method when clinical findings are ambiguous. However, MRI scanning for every patient with an uncertain diagnosis may not be efficient or possible. Therefore, to improve ED resource utilization for patients with vertigo, there is a need to identify the subset most likely to have MRI abnormalities. It has previously been shown that S100B protein provides a useful serum marker of stroke, subarachnoid hemorrhage, and traumatic brain injury. This study evaluated whether S100B levels could predict central causes of vertigo as identified by cranial MRI in the ED.Methods: This prospective, observational study was conducted with adult patients with acute-onset vertigo (within 6 hours) in the ED of a teaching hospital in Kocaeli, Turkey. Patients with nausea or dizziness complaints without previously known vertigo or cranial pathology, and who agreed to participate in the study, were included. Patients with trauma or with neurologic findings that developed concurrent with their symptoms were excluded. Serum levels of S100B were measured with an electrochemiluminescence immunoassay kit. All subjects underwent cranial MRI. The predictors of positive MRI results were evaluated using logistic regression analysis. Sensitivity and specificity of S100B levels for identifying subjects with central causes of vertigo on MRI were calculated with receiver operating characteristic (ROC) curve.Results: Of the 82 subjects included in the study, 48 (58.5%) were female, and the mean (AESD) age was 51 (AE16) years. Thirty-one (37.8%) subjects had positive MRI results. Median (with interquartile range [IQR]) serum S100B levels were significantly different between MRI-negative and MRI-positive groups (median = 27.00 pg/mL, IQR = 10.00 to 44.60 vs. median = 60.94 pg/mL, IQR = 38.25 to 77.95, respectively; p = 0.04). In logistic regression analysis, subjective "he or she is spinning" (p = 0.030, odds ratio [OR] = 1.63, 95% confidence interval [CI] = 1.38 to 2.49), systolic blood pressure (sBP; p = 0.045, OR = 1.044, 95% CI = 1.021 to 1.080), and serum S100B level (p = 0.042, OR = 1.22, 95% CI = 1.018 to 1.445) were found to be independent predictors of MRI abnormalities. In the ROC analysis, S100B > 30 pg/mL predicted the clinical outcome with 83.9% sensitivity (95% CI = 66.3% to 94.5%) and 51.0% specificity (95% CI = 36.6% to 65.2%). The area under the ROC curve was 0.774 (95% CI = 0.666 to 0.881). Conclusions:To the best of our knowledge this is the first study assessing the utility of serum S100B levels for diagnosis of acute-onset vertigo. Serum S100B levels are associated with the presence of central ...

BACKGROUND: Protocatechuic acid (PCA), which has antioxidant property, is a simple phenolic compound commonly found in many plants, vegetables, and fruits, notably in green tea and almonds. Present study was an investigation of the effects of PCA on rat kidney with ischemia/reperfusion (IR) injury.

Serum Mg level is an independent predictor of electrocardiographic no-reflow and long-term mortality in patients with STEMI.

Despite its relatively protected position, the liver is the most frequently injured solid intra-abdominal organ. 1 Most liver injuries can be managed conservatively, but about 5% to 10% require urgent laparotomy, usually when the mechanism of injury involves a vehicle accident and hemodynamic instability persists, in spite of 40 mL/kg of blood transfusion. 2,3 In particular, grades IV and V liver injuries may pose a challenge to the surgeon trying to control hemorrhage, the leading cause of mortality. 4 Traumatic injuries to the portal vein are rare but devastating. The mortality rate for portal vein injury ranges from 50% to 70%. A recent study of portal triad injuries has highighted the higher mortality rates associated with combination injuries involving multiple portal triad components, especially those that include portal vein injury. 5 This case study describes a unique case of relatively minor trauma in a child resulting in portal triad injury, sudden demise, and surgical repair. RÉSUMÉMalgré sa position relativement bien protégée, le foie est l'organe solide, intra-abdominal le plus souvent lésé (1). Dans la plupart des cas de lésion traumatique du foie, un traitement conservateur suffit, mais, dans environ 5 à 10 % des cas, il faut procéder à une laparotomie d'urgence, généralement lorsque ces lésions résultent d'un accident de véhicule et qu'elles entraî-nent une instabilité hémodynamique persistante, malgré des transfusions de sang à raison de 40 ml/kg (2,3). Les lésions hépatiques du 4 e ou 5 e degré en particulier peuvent compliquer la tâche du chirurgien, qui tente de réprimer l'hémorragie, cause principale de mortalité (4).Les lésions traumatiques de la veine porte sont rares, mais elles peuvent être mortelles. Le taux de mortalité lié aux lésions de la veine porte varie de 50 à 70 %. D'après une étude récente sur les lésions des espaces portes, les taux de mortalité les plus élevés sont associés à la concomitance de blessures touchant plusieurs constituants des espaces portes, notamment la veine porte (5). Sera exposé ici le cas plutôt exceptionnel d'un enfant ayant subi un trauma relativement peu important, qui a causé une lésion des espaces portes, s'est soldé par un effondrement soudain et a nécessité une réparation chirurgicale. CASE REPORTA 9-year-old boy was admitted to our hospital with abdominal pain after falling from his bike. His medical history revealed that he fell from his bike facedown 15 minutes before admission. His Glasgow Coma Scale (GCS) was normal at 15. Abdominal examination revealed tenderness on all abdominal quadrants by palpation. Initial vital signs were normal; however, focused assessment with sonography for trauma (FAST) showed common free fluid in the abdomen mainly on perihepatic, Morrison's pouch. His general condition was stable, so abdominal computed tomography (CT) was ordered. The CT scan showed a grade IV liver laceration on the falciform ligament enhancing left portal vein 6 cm in diameter, leading to free fluid