ABSTRACT
To investigate diagnostic value of ischemia-modified albumin [IMA] levels in patients applying to emergency with symptoms of acute coronary syndrome [ACS] and acute ischemic stroke [AIS]. Two patient groups [ACS and AIS] and a control group were constituted. The study was discontinued upon reaching 30 patients in each group. Following patient approval at the initial visit, a total of 10 ml venous blood sample was obtained from all patients with a high clinical suspicion of ACS and AIS. The Troponin I and the IMA levels were determined in the blood samples. Statistically significant higher IMA values were determined in the patient groups compared to the control group [p < 0.001 for both groups]. No statistically significant correlation was found between the IMA and the Troponin I values in the ACS and the AIS groups [p>0.05 for both groups]. The sensitivity of IMA was 83% and 87% for ACS and AIS, respectively. The specificity of IMA was 90% and 87% for ACS and AIS, respectively. The sensitivity and specificity values, determined according to the optimal cut-off values in the groups demonstrated that IMA could be a useful diagnostic marker in ACS and AIS patients
Subject(s)
Humans , Female , Male , Stroke/diagnosis , Brain Ischemia/diagnosis , Acute Coronary Syndrome/diagnosis , Acute Disease , Ischemia , Emergency MedicineABSTRACT
Ultrasonography [USG] is widely used in emergency departments to assist in the diagnosis and treatment of patients. An increasing number of studies in the unconventional use of USG in thorax and lung examination have been conducted in recent years. Sliding lung sound [SLS] has been researched extensively during the last decade was accepted as a radiologic sign in 2008. However, determining SLS requires a certain degree of clinical experience since it is a subjective indicator. We have discovered the "pleural sliding sign [PSS]", which is as valuable as the SLS, but more objective sign. PSS is present at any time when SLS is present; furthermore, it can be used as a diagnostic sign even when the SLS is doubtful. In this study, we present our views on PSS and in particular wish to share this information with clinicians who are interested in performing emergency USG. We also aim to stimulate further research on this subject.
ABSTRACT
We aimed to evaluate the trauma scoring systems on gunshot injured patients to predict trauma severity. All patients with gunshot injury admitted to the emergency department [ED] from January 2007 through January 2009 were enrolled in the study. The demographic characteristics of patients such as age, gender, cause of the injury, type of the weapon used, the injured body parts, Glasgow Coma Scale [GCS], Shock Index [SI], the length of stay in the hospital and mortality were recorded from the patient charts. Injury Severity Score [ISS], Revised Trauma Score [RTS] and Trauma and Injury Severity Score [TRISS] have been calculated. The differences between the groups for these parameters were compared using the Mann-Whitney U test. The mean age of patients was 33.2 +/- 16.1 and 79 of 87 patients were male. The causes of GSIs were homicidal in 73.6% and bullet cartridge in 51.7%. Calculated GCS, ISS, RTS, TRISS and SI were 13.8 +/- 2.9, 13.0 +/- 9.3, 7.38 +/- 1.1, 93.9 +/- 14.9% and 1.9 +/- 0.9 respectively. GCS, RTS and TRISS scores for survivors were significantly higher than non-survivors [p<0.001]. ISS score and SI for survivors were significantly lower than non-survivors [p<0.001]. There were no statistically significant differences between the groups in terms of the length of stay in hospital [p>0.05]. There was no statistically significant correlation of the length of stay in hospital with GCS, RTS and TRISS [p>0.05]. The length of stay in hospital was found to correlate with ISS and SI positively [p<0.001]. It is concluded that Gun Shot Injury [GSI] is much more likely in young males than the other types of trauma in the population. We recommend that trauma scoring systems should be used to show trauma severity and mortality
ABSTRACT
Organophosphate poisoning [OP] is a serious clinical condition that may sometimes be fatal. The aim of this study was to determine whether the Glasgow coma scale [GCS], and serum acetylcholinesterase and leukocyte levels have prognostic value in acute OP poisoning. Retrospective review of records of patients admitted to the intensive care unit of Selcuk University, Meram Medical Faculty, Emergency Department, Konya, Turkey, between January 2006 and January 2009. We studied acutely OP-poisoned patients admitted within 24 hours after OP exposure. The mean age of the 25 patients was 37 years [range, 20-80 years]. Three [12%] of the 25 patients [male-female ratio, 12:13] died. The mean GCS values of the patients who died were significantly lower compared to those of the group that survived [4 vs 11.7, respectively P<.05]. While the mean serum acetylcholinesterase levels were lower in the patients who died, the difference in the mean serum acetylcholinesterase levels between the patients who died and the ones who survived was not statistically significant [3841 IU/L vs. 1768 IU/L, respectively]. Although serum cholinesterase values can be used in the quick diagnosis, their efficiency at predicting outcome in patients with OP poisoning has not been established. It has also been determined that serum leukocyte values have no prognostic value in OP poisoning, but GCS values have been found to be effective in predicting the outcome