CHAMPS score in predicting mortality of patients with acute nonvariceal upper gastrointestinal bleeding.

OBJECTIVE: The aim of this study was to evaluate the performance of the Charlson Comorbidity Index ≥2, in-hospital onset, albumin <2.5 g/dL, altered mental status, Eastern Cooperative Oncology Group performance status ≥2, steroid use score in predicting mortality in patients with nonvariceal upper gastrointestinal bleeding and compare it with the Glasgow-Blatchford score; the albumin, international normalized ratio; alteration in mental status, systolic blood pressure, and age 65 score; the age, blood tests, and comorbidities score; and Complete Rockall score. METHODS: The data of patients with acute upper gastrointestinal bleeding who visited the emergency department during the study period were obtained from the hospital automation system by using the classification of disease codes and analyzed in this retrospective study. Adult patients with endoscopically confirmed nonvariceal upper gastrointestinal bleeding were included in the study. Patients with bleeding from the tumor, bleeding after endoscopic resection, or missing data were excluded. The prediction accuracy of the Charlson Comorbidity Index ≥ 2, in-hospital onset, albumin < 2.5 g/dL, altered mental status, Eastern Cooperative Oncology Group performance status ≥ 2, steroid use score was calculated using the area under the receiver operating characteristic curve and compared with that of Glasgow-Blatchford score, the albumin, international normalized ratio; alteration in mental status, systolic blood pressure, and age 65 score, the age, blood tests, and comorbidities score, and Complete Rockall score. RESULTS: A total of 805 patients were included in the study, and the in-hospital mortality rate was 6.6%. The performance of the Charlson Comorbidity Index ≥ 2, in-hospital onset, albumin < 2.5 g/dL, altered mental status, Eastern Cooperative Oncology Group performance status ≥ 2, steroid use score (area under the receiver operating characteristic curve 0.812, 95%CI 0.783-0.839) was better than Glasgow-Blatchford score (area under the receiver operating characteristic curve 0.683, 95%CI 0.650-0.713, p=0.008), and similar to the the age, blood tests, and comorbidities score (area under the receiver operating characteristic curve 0.829, 95%CI 0.801-0.854, p=0.563), the albumin, international normalized ratio; alteration in mental status, systolic blood pressure, and age 65 score (area under the receiver operating characteristic curve 0.794, 95%CI 0.764-0.821, p=0.672), and Complete Rockall score (area under the receiver operating characteristic curve 0.761, 95%CI 0.730-0.790, p=0.106). CONCLUSION: The performance of the Charlson Comorbidity Index ≥ 2, in-hospital onset, albumin < 2.5 g/dL, altered mental status, Eastern Cooperative Oncology Group performance status ≥ 2, steroid use score in predicting in-hospital mortality for our study population is better than Glasgow-Blatchford score and similar to the the age, blood tests, and comorbidities score, the albumin, international normalized ratio; alteration in mental status, systolic blood pressure, and age 65 score, and Complete Rockall score.

CHAMPS score in predicting mortality of patients with acute nonvariceal upper gastrointestinal bleeding

SUMMARY OBJECTIVE: The aim of this study was to evaluate the performance of the Charlson Comorbidity Index ≥2, in-hospital onset, albumin <2.5 g/dL, altered mental status, Eastern Cooperative Oncology Group performance status ≥2, steroid use score in predicting mortality in patients with nonvariceal upper gastrointestinal bleeding and compare it with the Glasgow-Blatchford score; the albumin, international normalized ratio; alteration in mental status, systolic blood pressure, and age 65 score; the age, blood tests, and comorbidities score; and Complete Rockall score. METHODS: The data of patients with acute upper gastrointestinal bleeding who visited the emergency department during the study period were obtained from the hospital automation system by using the classification of disease codes and analyzed in this retrospective study. Adult patients with endoscopically confirmed nonvariceal upper gastrointestinal bleeding were included in the study. Patients with bleeding from the tumor, bleeding after endoscopic resection, or missing data were excluded. The prediction accuracy of the Charlson Comorbidity Index ≥ 2, in-hospital onset, albumin < 2.5 g/dL, altered mental status, Eastern Cooperative Oncology Group performance status ≥ 2, steroid use score was calculated using the area under the receiver operating characteristic curve and compared with that of Glasgow-Blatchford score, the albumin, international normalized ratio; alteration in mental status, systolic blood pressure, and age 65 score, the age, blood tests, and comorbidities score, and Complete Rockall score. RESULTS: A total of 805 patients were included in the study, and the in-hospital mortality rate was 6.6%. The performance of the Charlson Comorbidity Index ≥ 2, in-hospital onset, albumin < 2.5 g/dL, altered mental status, Eastern Cooperative Oncology Group performance status ≥ 2, steroid use score (area under the receiver operating characteristic curve 0.812, 95%CI 0.783-0.839) was better than Glasgow-Blatchford score (area under the receiver operating characteristic curve 0.683, 95%CI 0.650-0.713, p=0.008), and similar to the the age, blood tests, and comorbidities score (area under the receiver operating characteristic curve 0.829, 95%CI 0.801-0.854, p=0.563), the albumin, international normalized ratio; alteration in mental status, systolic blood pressure, and age 65 score (area under the receiver operating characteristic curve 0.794, 95%CI 0.764-0.821, p=0.672), and Complete Rockall score (area under the receiver operating characteristic curve 0.761, 95%CI 0.730-0.790, p=0.106). CONCLUSION: The performance of the Charlson Comorbidity Index ≥ 2, in-hospital onset, albumin < 2.5 g/dL, altered mental status, Eastern Cooperative Oncology Group performance status ≥ 2, steroid use score in predicting in-hospital mortality for our study population is better than Glasgow-Blatchford score and similar to the the age, blood tests, and comorbidities score, the albumin, international normalized ratio; alteration in mental status, systolic blood pressure, and age 65 score, and Complete Rockall score.

Relationship between root canal merging and presence of C-shaped canal in fused rooted maxillary molar teeth / Relação entre a fusão do canal radicular e a presença de canal em forma de C em dentes molares maxilares fundidos e enraizados

Objective: This study aimed to evaluate the prevalence of root fusion and the incidence of C-shaped canals in maxillary first molar (MFM) and maxillary second molar (MSM) teeth using cone-beam computed tomography. Material and Methods: In this study, a total of 1233 MFMs and 1406 MSMs from 802 patients were analyzed. First, the number of fused rooted teeth and the type of root fusion were determined. Subsequently, incidence and number of C-shaped canals were ascertained according to the type of fusion, location, position, and level of canal merging in teeth with fused roots. Six types were established according to the C-shape configurations observed. Presence of root fusion and the C-shaped canal according to gender, age, and tooth position were evaluated by chi-square test. Values with p< 0.05 were considered significant in statistical tests. Results: The incidence of fusion in the MFM and MSM teeth was 6.16% and 22.40%, respectively. Only three MFMs (0.24%) and 3.77% of the MSMs had C-shaped canals. While the incidence of fusion was higher in women (p< 0.05), the C shaped morphology was not affected by sex (p> 0.05). Individuals over the age of 50 years had a lower incidence of C-shaped canals (p< 0.05). Conclusion: C-shaped canal morphology was more commonly associated with complex types of root fusion involving three roots; 16.83% of MSMs with fused roots had C-shaped canals (AU).

Objetivo: o objetivo deste estudo foi avaliar a prevalência de fusão radicular e a incidência de canais em C nos dentes do primeiro molar superior (MFM) e do segundo molar superior (MSM) por meio da tomografia computadorizada de feixe cônico. Material e Métodos: Neste estudo, um total de 1233 MFMs e 1406 MSMs de 802 pacientes foram analisados. Primeiro, o número de dentes com raízes fundidas e o tipo de fusão radicular foram determinados. Posteriormente, a incidência e o número de canais em forma de C foram verificados de acordo com o tipo de fusão, localização, posição e nível de fusão do canal nos dentes com raízes fundidas. Seis tipos foram estabelecidos de acordo com as configurações em forma de C observadas. A presença de fusão radicular e do canal em C de acordo com sexo, idade e posição dentária foram avaliadas pelo teste do qui-quadrado. Valores com p <0,05 foram considerados significativos nos testes estatísticos. Resultados: A incidência de fusão nos dentes MFM e MSM foi de 6,16% e 22,40%, respectivamente. Apenas três MFMs (0,24%) e 3,77% dos MSMs tinham canais em forma de C. Enquanto a incidência de fusão foi maior em mulheres (p <0,05), a morfologia em forma de C não foi afetada pelo sexo (p> 0,05). Indivíduos com mais de 50 anos apresentaram menor incidência de canais em C (p <0,05). Conclusão: a morfologia do canal em forma de C foi mais comumente associada a tipos complexos de fusão radicular envolvendo três raízes; 16,83% dos HSH com raízes fundidas tinham canais em forma de C (AU).

High postoperative serum levels of surfactant type B as novel prognostic markers for congenital heart surgery.

OBJECTIVE: Congenital heart diseases are observed in 5 to 8 of every 1000 live births. The presence of a valuable biomarker during the surgical periods may aid the clinician in a more accurate prognosis during treatment. METHODS: For this reason, surfactant protein B plasma levels may help to evaluate patients with cardiac problems diminishing the alveolocapillary membrane stability. In this study, plasma levels of this biomarker were measured in the preoperative and postoperative periods. This study was conducted to detect the differences between pulmonary hypertensive and normotensive patients. The differences before and after cardiopulmonary bypass were examined. RESULTS: The differences in cardiopulmonary bypass time, cross-clamp time , inotropic support dose, and duration of intensive care of patients with and without pulmonary hypertensive were found to be statistically significant (P<0.05). The results revealed that this pathophysiological state was related to other variables that were studied. We believe that the differences in preoperative and postoperative SPB levels could be attributed to alveolocapillary membrane damage and alveolar surfactant dysfunction. We found that this pathophysiological condition was significantly associated with postoperative parameters. CONCLUSION: The findings of the current study showed that surfactant protein B was present in the blood of patients with a congenital heart disease during the preoperative period. Long by-pass times may exert damage to the alveolocapillary membrane in patients with pulmonary hypertension and preoperative heart failure, and it is recommended to keep the option of surfactant therapy in mind during the postoperative course at the intensive care unit before preparing the patients for extubation.