No abstract

No abstract

PTX3 was found to be significantly higher in patient with acute appendicitis compared to the control group and the patients with non-specific abdominal pain. PTX3 can be used as an aid in the diagnosis of acute appendicitis.

Objective: The objective was to compare the protective effects of N-acetylcysteine (NAC) plus normal saline (NS), sodium bicarbonate (NaHCO 3 ) plus NS, and NS alone in the prevention of contrast-induced nephropathy (CIN) after computed tomography pulmonary angiography (CTPA) in emergency patients.Methods: This study was planned as a randomized, controlled clinical research. Patients undergoing contrast-enhanced CTPA on suspicion of pulmonary embolism (PE) in the emergency department and with at least one risk factor for development of CIN were included in one of three different prophylaxis groups. The groups received 3 mL/kg intravenous (IV) NAC+NS or NaHCO 3 +NS solution or NS alone 1 hour before CTPA and 1 mL/kg IV per hour for a minimum of 6 hours after CTPA. CIN was evaluated as the primary outcome and moderate or severe renal insufficiency and in-hospital mortality as secondary outcomes.Results: A total of 257 patients were enrolled in the study. The total level of CIN development was 23.7% (61/257), the level of moderate and severe renal failure was 12.5% (32/257), and the in-hospital mortality rate was 12.8% (33/257). Rates of CIN development in the drug groups were 23.5% in the NAC group (20/ 85), 21.2% (18/85) in the NaHCO 3 group, and 26.4% in the NS group (23/87). Rates of development of moderate or severe renal insufficiency were 9.4% in the NAC group (8/85), 10.6% in the NaHCO 3 group (9/ 85), and 17.2% in the NS group (15/87). In-hospital mortality rates were 12.9% in the NAC group (11/85), 11.8% in the NaHCO 3 group (10/85), and 13.8% in the NS group (12/87). No difference was determined between the drug groups in terms of CIN, moderate or severe renal injury, or hospital mortality. Conclusions:Our results indicate that there is a high risk of CIN in patients with suspected PE despite three different types of prophylaxis being administered, and no statistically significant differences were observed among prophylactic NAC, NaHCO 3 , and NS in prevention of CIN following contrast-enhanced CTPA.

ÖZETAmaç: İki farklı radyolojik parametre, pulmoner arter obstrüksiyon indeksi (PAOI) ve sağ ventrikül/sol ventrikül oranı (RV/LV) temel alınarak, radyolojik görüntüleme-esaslı pulmoner embolizm şiddet skoru ile D-dimer ve iskemi modifiye albümin (IMA) düzeyleri arasındaki muhtemel ilişkiyi incelemek. Yöntemler: Bu prospektif kohort çalışmasında, acil servise başvuran ve spiral bilgisayarlı tomografi (CT) ile PE kesin tanısı konulan kırk yedi hasta çalış-maya dahil edildi. D-dimer ve IMA düzeyleri sırasıyla immuno-turbidimetrik ve kolorimetrik metodlarla belirlendi. Bilgisayarlı tomografi görüntülerinden PAOI ve RV/LV oranları hesaplandı. Biyokimyasal parametrelerin gruplar arasındaki seviyeleri Mann-Whitney U test ve Kruskal-Wallis test kullanılarak karşılaştırıldı ve radyolojik skorlar ile ilişkileri Spearman korelasyon testi kullanılarak belirlendi. Bulgular: Hesaplanan PAOI ve RV/LV oranlarının analizi aralarında belirgin bir ilişki olduğunu yansıttı (r=0.036, p=0.023). PAOI temelinde oluşturulan hafif (< %40), orta (%40 -%60) ve şiddetli (> %60) PE grupları arasında D-dimer düzeyleri göze çarpan oranda farklıydı (p=0.039). Bu fark hafif grup, PAOI< %40, ile şiddetli grup, PAOI> %60 arasındaki D-dimer seviyelerindeki farklılıktan kaynaklanıyordu (p=0.02; Z= -2.328). Aynı zamanda, D-dimer düzeyleri ile PAOI pozitif bir korelasyon gösteriyordu, fakat D-dimer düzeyleri ile RV/LV oranı arasında benzer bir korelasyon yoktu. İskemi modifiye albümin düzeyleri ile D-dimer düzeyleri, PAOI ve RV/LV oranı arasında anlamlı bir korelasyon yoktu. Sonuç: Radyolojik parametreler temelinde PE'nin şiddetinin biyokimyasal olarak belirlenmesinde D-dimer, yeni bir marker olarak önerilen IMA'ya göre daha uygun bir marker olabilir. (Anadolu Kardiyol Derg 2010; 10: 346-52) Anah tar ke li me ler: D-dimer, iskemi modifiye albümin, pulmoner embolizm, pulmoner arter obstrüksiyon indeksi, radyolojik ciddiyet, spiral bilgisayarlı tomografi ABS TRACTObjective: To investigate possible relationship between the D-dimer and ischemia-modified albumin (IMA) levels and radiological imagingbased severity scores in pulmonary embolism (PE) based on two different radiological characteristics; the pulmonary arterial obstruction index (PAOI) and the right ventricle/left ventricle (RV/LV) ratio. Methods: In this prospective cohort study, forty-seven patients presenting to the emergency department and definitively diagnosed with PE using spiral computerized tomography (CT) were initially enrolled in the study. Levels of IMA and D-dimer were assessed colorimetrical and immuno-turbidimetric methods, respectively. The PAOI and RV/LV ratios were calculated from CT images. The levels of biochemical parameters between the groups were compared with use of Mann-Whitney U and Kruskal-Wallis tests and relationship between the radiological scores were assessed using the Spearman correlation test. Results: Analysis of the calculated PAOI and RV/LV ratio revealed a significant correlation between them (r=0.36, p=0.023). D-dimer levels differed considerably among the...

No abstract

ObjectivesCarbon monoxide is a potentially fatal form of poisoning. The exact incidence is unclear, due to cases being undiagnosed or reported as fewer than the real number. Hyperbaric oxygen therapy (HBOT) is of proven efficacy in the treatment of CO intoxication.The purpose of this study was to describe the general characteristics of carbon monoxide (CO) intoxications presenting to the emergency department and to investigate troponin I values and the effectiveness of hyperbaric oxygen therapy (HBOT) in these patients.Material and methodsPatients presenting to the emergency department with CO intoxication over one year and patients with such intoxications receiving HBOT were examined retrospectively.ResultsOne hundred seventy-one patients were included; 140 (81.9%) were poisoned by stoves, 18 (10.5%) by hot water boilers and 10 in (5.8%) by fires. COHb levels were normal in 49 of the 163 patients whose values were investigated, and were elevated in 114 patients. Mean COHb value was 16.6. Troponin I values were investigated in 112 patients. These were normal in 86 patients and elevated in 26. Mean troponin I value was 0.38 ng/ml. One hundred twenty-three of the 171 patients in the study were discharged in a healthy condition after receiving normobaric oxygen therapy, while 48 patients received HBOT. Forty-two (87.5%) of the patients receiving HBOT were discharged in a healthy condition while sequelae persisted in five (10.4%). One patient died after 15 session of HBOT.ConclusionAlthough elevated carboxyhemoglobin confirms diagnosis of CO intoxication, normal levels do not exclude it. Troponin I levels may rise in CO intoxication. No significant relation was observed between carboxyhemoglobin and receipt of HBOT. A significant correlation was seen, however, between troponin I levels and receipt of HBOT.

No abstract