Evaluation of serum GH, IGF-1, and IGFBP-3 levels as biomarkers in the diagnosis of acute myocardial infarction

This study aimed to determine the role of the serum growth hormone and insulin-like growth factor-binding proteins 3 levels measured in the first 24 h in the diagnosis and pathophysiology of acute myocardial infarction [AMI]. The levels of serum Growth hormone, insulin-like growth factors1, and insulin-like growth factor-binding proteins 3 of the patients diagnosed with AMI in the first 24 h of onset and that of the control group at the time of admission were compared between January 1 and August 31, 2010. The average age of the patient group was 59.36 +/- 13:25 years, and 79.4% of the patients were males. The serum growth hormone and insulin-like growth factor-binding proteins 3 levels were significantly higher in the patient group [P < 0.05]. However, no differences were found between insulin-like growth factors 1 levels in both the groups [P > 0.05]. The sensitivity of growth hormone was 84.1% with a cutoff value of 0.14; the sensitivity of insulin-like growth factors1 was 33.6% with a cutoff value of 162; and the sensitivity of insulin-like growth factor-binding proteins 3 was 75.7% with a cutoff value of 2862. The present study showed that growth hormone and insulin-like growth factor binding proteins 3 markers play important roles in the pathophysiology of myocardial infarction. Hence, it is thought that they can be used in the diagnosis of AMI. Further studies are needed to validate the conclusion

Comparison of end-tidal carbon dioxide levels with cardiopulmonary resuscitation success presented to emergency department with cardiopulmonary arrest

To measure end-tidal carbon dioxide pressure [PetCO2] in preset interval in order to evaluate the efficiency of cardiopulmonary resuscitation [CPR] performed on patients in cardiopulmonary arrest, evaluate the validity of PetCO2 in predicting the mortality and finally assess the PetCO2 levels of the patients in cardiopulmonary arrest based on the initial presenting rhythm. This prospective study was conducted at the Ankara Training and Research Hospital on patients who presented with cardiopulmonary arrest. Standard ACLS [Advanced Cardiac Life Support] protocols were performed. Patients were categorized in two groups based on their rhythms as Ventricular Fibrillation and Asystole. Patients' PetCO2 values were recorded. PetCO2 levels of the Return of Spontaneous Circulation [ROSC] group in the 5th, 10th, 15th and 20th minutes were significantly higher compared to the exitus group [p < 0.001]. In distinguishing ROSC and exitus, PetCO2 measurements within 5-20 minute intervals showed highest performance on the 20th and lowest on the 5th minutes. PetCO2 values are higher in the ROSC group. During the CPR, the most reliable time for ROSC estimation according to PetCO2 values is 20th minute. None of the patients who had PetCO2 levels less than 14 mmHg survived

Comparison of the effectiveness of intravenous piracetam and intravenous dimenhydrinate in the treatment of acute peripheral vertigo in the emergency department

<p><b>INTRODUCTION</b>We aimed to compare the effectiveness of intravenous piracetam with that of intravenous dimenhydrinate in the treatment of acute peripheral vertigo in the emergency department.</p><p><b>METHODS</b>This double-blind study comprised a total of 200 patients, aged between 18 and 70 years, who had presented to the emergency department of Ankara Training and Research Hospital and were diagnosed with peripheral vertigo. Evaluation of the severity of the patients' vertigo was performed using a visual analogue scale, before and after drug administration.</p><p><b>RESULTS</b>Both drugs were found to be effective (p < 0.001) and had comparable effects (p < 0.474). Dimenhydrinate was also found to have about two times the side effects of piracetam. Drowsiness was found to be the most common side effect of these two drugs.</p><p><b>CONCLUSION</b>Dimenhydrinate and piracetam have similar levels of effectiveness with regard to acute vertigo. We conclude that piracetam, which has fewer side effects than dimenhydrinate, better vestibular compensation, and is effective for both acute and chronic vertigo, could be more frequently used in the emergency treatment of acute vertigo.</p>

unusual etiology of epigastric mass

Bezoar is described as presence of indigested or poorly digested material forming a mass in the gastrointestinal lumen. Patients may present with abdominal pain, dyspeptic complaints, gastrointestinal obstruction, perforation or bleeding, as well as, incidental abdominal mass in asymptomatic patients. We report a 30-year-old female patient with no history of previous illness who was presented to the emergency ward with complaints of epigastric pain and abdominal bloating. The diagnostic features and treatment of bezoar are presented