Compare of optic coherence tomography parameters in recreational synthetic tetrahydrocannabinol use and healthy control.

PURPOSE: To evaluate retinal thickness (RT), retinal nerve fiber layer thickness (RNFLT), and choroidal thickness (CT) changes in synthetic cannabinoid (SC) users. METHODS: This prospective study evaluated the RT, RNFLT, and CT values of 56 SC users and 58 healthy controls. The individuals using SCs were referred to us by our hospital's forensic medicine department. Retinal and choroidal images were obtained using spectral-domain optical coherence tomography (OCT). Measurements (one subfoveal, three temporals, three nasal) were taken at 500 µm intervals up to 1500 µm using the caliper system. Only the right eye was used for subsequent analysis. RESULTS: Mean ages were 27.7 ± 5.7 years in the SC-user group and 25.4 ± 6.7 in the control group. Subfoveal Global RNFLT was in the SCs group 102.3 ± 10.5 µm and 105.6 ± 20.2 µm in the control group (p = 0.271). Subfoveal CT was in the SC group mean of 316.1 ± 100.2 µm and in the control group mean 346.4 ± 81.8 µm (p = 0.065). RT, T500 (283.3 ± 36.7 µm, 296.6 ± 20.5 µm, p = 0.011) and N1500 (355.1 ± 14.3 µm, 349.3 ± 18.1 µm, p = 0.049) were significantly higher in the SC group than in the control group, respectively. CONCLUSION: Analysis of OCT findings of individuals who had been using SC for more than one year revealed no statistically significant difference between RNFLT and CT, although N1500 was significantly higher in RT. Further studies in the field of OCT are important to explore the pathology of SC.

The role of argyrophilic nucleolar organizing region-associated proteins in clinical exacerbation of chronic obstructive pulmonary disease.

OBJECTIVE: To investigate whether argyrophilic nucleolar organizing region-associated protein (AgNOR) parameters can be used as a biomarker that could potentially help with the management and clinical prognosis of chronic obstructive pulmonary disease (COPD) exacerbation. METHODS: This case-control study enrolled patients with COPD who were admitted to the Emergency Department and healthy sex- and age-matched control subjects. Peripheral blood samples were collected at hospital admission and the peripheral lymphocytes were silver-stained to investigate the quantity and distribution of AgNOR proteins. Fifty nuclei per patient were viewed and the total AgNOR area/total nuclear area (TAA/TNA) ratio and the mean AgNOR number for each patient were calculated. RESULTS: A total of 20 patients with COPD exacerbation and 17 healthy control subjects were recruited to the study. The TAA/TNA ratio and the mean AgNOR number were significantly higher in the patients with COPD exacerbation compared with the healthy control subjects. The mean AgNOR number showed a positive correlation with the pCO2 levels on admission. CONCLUSION: AgNOR protein levels were elevated during a COPD exacerbation compared with healthy control subjects and there was a positive correlation between pCO2 levels and mean AgNOR number.

Kounis Syndrome Induced by Oral Intake of Diclofenac Potassium.

An acute coronary syndrome (ACS) occurring during the course of an allergic reaction is called Kounis syndrome (KS). The second case of KS induced by diclofenac potassium (DP) is presented in this report. A 67-year-old man was brought to our emergency department with the possible diagnosis of anaphylactic shock by the ambulance staff. It emerged that widespread erythema and pruritus developed after taking DP. Then, he lost consciousness. Diffuse urticarial lesions were detected on physical examination at the emergency department. He complained of chest pain during his observation, and progressive ST segment elevation was seen in the inferior leads on serial electrocardiograms. His coronary angiography showed 100% occlusion of the right coronary artery.  Then, KS was diagnosed. The patient was discharged on the second day, and he was doing well on the control visit 2 weeks later. All allergic reactions may trigger an ACS so physicians should be aware of KS and always keep that unique clinical entity in mind to recognize it promptly and direct the therapy at suppressing the allergic reaction and improving the coronary circulation simultaneously when encountering a patient with symptoms suggesting an allergic reaction and a concomitant ACS.

Predicting the outcome in children with head trauma: comparison of FOUR score and Glasgow Coma Scale.

BACKGROUND: Because of the limitations of the Glasgow Coma Scale (GCS), many scoring systems have emerged and been compared with GCS. Herein, we investigated whether the Full Outline of Unresponsiveness (FOUR) score is better than GCS in predicting morbidity and mortality in children with head trauma. METHODS: Patients 2-17 years of age who admitted to the emergency department with head trauma and presented with altered level of consciousness were included in this study. In-hospital mortality, hospitalization of more than three days, and Glasgow Outcome Score (GOS) at discharge and after three months were used as the primary outcome measures. RESULTS: A total of 100 children were included in the study. The median age was 6 years, and 69% were male. The in-hospital mortality rate was 10%. The cut-off values for predicting in-hospital mortality were 9 for FOUR score and 7 for GCS. Area under the curve (AUC) values in predicting in-hospital mortality, poor GOS (score of 1-3) at discharge, and poor GOS after three months were similar for GCS and FOUR score. CONCLUSION: FOUR score provides no significant advantage over GCS in predicting morbidity and mortality in children with head trauma.