rare cause of trauma in the elderly: Mobitz type-II second-degree atrioventricular block

Cardiac rhythm problems are frequently seen in the geriatric population, and they can experience trauma after syncope. A 78-year-old female was examined for thoracic trauma after falling. With a history of -blocker use, arterial blood pressure measured 60/30 mmHg and pulse rate was 30 bpm. Electrocardiogram showed a Mobitz type-II second-degree atrioventricular block. There was no response to atropine, so a transcutaneous external pacemaker and after that a transvenous pacemaker were applied. On the 4th day, the pacemaker was removed and the patient was discharged

Floating forearm: perilunar and elbow dislocation without a fracture

Traumatic perilunar and elbow dislocation is rarely seen together. There are only a few reported cases in the literature. Limitation of joint movement, deformity and pain are generally the presenting symptoms. A case of perilunar and elbow dislocation without fracture admitted to the emergency department due to a traffic accident and treated with closed reduction after sedoanalgesia and benefited from closed reduction

Factors affecting the B-type natriuretic peptide levels in stroke patients

<p><b>INTRODUCTION</b>This study aims to evaluate the relationship between increased B-type natriuretic peptide (BNP) levels in stroke patients and clinical parameters such as age, sex, medical history, blood pressure, Glasgow Coma Score (GCS) and National Institutes of Health Stroke Scale (NIHSS).</p><p><b>MATERIALS AND METHODS</b>This is a prospective study of 123 stroke patients at the Emergency Department. The patients were divided into 3 groups according to the NIHSS scores. The analysis of the mean difference between continuous variables and plasma BNP levels was assessed using the Mann-Whitney and Kruskal-Wallis. Spearman correlation analysis was performed for BNP and other clinical parameters.</p><p><b>RESULTS</b>The BNP levels of patients who had a medical history of hyperlipidaemia, chronic obstructive pulmonary disease, diabetes mellitus and coronary artery disease were significantly higher than in patients without these diseases. Patients who had atrial fibrillation (AF) in their electrocardiography had significantly higher BNP levels than patients with sinus rhythm. A positive correlation was found between plasma BNP levels with age, blood urea nitrogen (BUN) and NIHSS and a negative correlation was found between plasma BNP levels and GCS. There was a significant difference between the BNP levels of NIHSS groups.</p><p><b>CONCLUSION</b>We consider that plasma BNP levels could help us in interpreting the general clinical severity, functional capacity and clinical progress of stroke patients at the time of admission in the Emergency Department. In evaluating the high BNP levels in stroke patients, we must keep in mind that age, AF, BUN and medical history can affect the BNP levels.</p>