Causes of acute poisoning in adults: a retrospective study, in a hospital in Istanbul, Turkey

Aim  

Acute poisoning is one of the major topics in emergency medicine practices. Despite the recent developments in toxicology, technological advances and changing lifestyles reveal new factors, and poisoning cases remain to be a problem. All poisonings should be considered serious and independent from their clinical presentation at the time of admission. Identifying the cause and prompt initiation of treatment is life-saving. Causes of poisoning vary between countries and different regions of the same country. In the present study, cases admitted to the Emergency Department of Internal Medicine at Haseki Training and Research Hospital were evaluated and causes of acute poisoning were investigated.     

Risk factors for the development of PTSD and depression among child and adolescent victims following a 7.4 magnitude earthquake

Objective. PTSD and major depression occur frequently following traumatic exposure, both as separate disorders and concurrently. Although much of Turkey is under threat of severe earthquakes, risk factors for developing psychiatric disorders among Turkish children have not yet been studied. The aim of the study was to examine risk factors for PTSD and depression develpoment in children. Method. A total of 160 survivors (102 girls and 58 boys) severely impacted by Turkey's 7.4-magnitude quake participated in a psychiatric interview 6–20 weeks after the disaster. The mean age was 14.43. Logistic regression was used to test effects of pre-disaster, disaster-related and post-disaster factors on diagnoses, yielding odds ratios (OR). Results. CAPS indicated that 96 (60%) had PTSD, and psychiatric interview found 49 (31%) with depression. Children diagnosed with PTSD were more likely to have witnessed death (OR=2.47) and experienced an extreme parental reaction (OR=3.45). Children with depression were more likely to be male (OR=4.48), have a higher trait anxiety score (OR=1.12 for every additional point), sustain injury (OR=4.29), and have lost a family member in the quake (OR=10.96). Focusing on the 96 children with PTSD, those with comorbid depression were more likely male, have a higher trait anxiety score, and have lost of family member. Conclusions. Mental health professionals should offer support to children witnessing death or losing a family member in a disaster. The ability of the family to remain calm and reassuring also may be a key factor in preventing PTSD.     

Comparison of the morphokinetic parameters of embryos according to ovarian reserve in IVF cycles

The aim of this study is to evaluate the impact of ovarian reserve and age of women on early morphokinetic parameters of embryos with a time-lapse monitoring system. In total, 197 infertile couples with poor ovarian reserve (Group 1, n?=?41), normal ovarian reserve (Group 2, n?=?59), or polycystic ovaries (Group 3, n?=?97) were included. The time from insemination to the following events were analyzed: pronuclear fading (Pnf) and cleavage to 2, 3, 4 and 5 cells. The optimal ranges for morphokinetic parameters of t5, s2 and cc2 in each group were also evaluated. In total, 1144 embryos were evaluated. Morphokinetic parameters did not differ statistically between the groups. Data were analyzed according to different age groups (20–30, 30–40,?>40). The morphokinetic parameters did not differ statistically in Group 1 and 3. In Group 2, the times from insemination to tPnf, t2, t3, t4 were significantly shorter in the younger age group than the older age group (p?相似文献   

Knowledge level of primary school teachers regarding traumatic dental injuries and their emergency management before and after receiving an informative leaflet

Abstract – Aim: The aim of this study was to evaluate via a questionnaire the knowledge level of primary school teachers in Ankara, Turkey, regarding dental trauma; to inform them on the subject through a leaflet; and to evaluate the effectiveness of the leaflet by reapplying the questionnaire. Materials and methods: A questionnaire was distributed to 500 teachers in seven randomly selected primary schools. The questionnaire consisted of four different scenarios presented with photographs and a total of eight questions on crown fracture, lateral luxation, root fracture, and avulsion. After responding to the questionnaire, teachers were given a leaflet containing information about traumatic dental injuries and their emergency management. After 1 month, the same questionnaire was distributed, and the responses collected. Results: A total of 450 of 500 teachers responded to the questionnaire. Initial responses indicated the knowledge level of teachers to be quite low. Following the distribution of the information leaflet, the rate of correct answers increased for each of the individual questions, and the total scores for the questionnaire increased significantly (P = 0.0001). Conclusion: There is a clear need to inform teachers about traumatic dental injuries. The use of educational leaflets can be a successful and appropriate means of providing teachers with information.     

Urotensin Inhibition with Palosuran Could Be a Promising Alternative in Pulmonary Arterial Hypertension

Pulmonary arterial hypertension (PAH) is a progressive and a life-threatening disease with its high morbidity and mortality ratios. On searching for new shining targets in pathogenesis, we noticed, in our previous studies, urotensin-II (UII) in systemic sclerosis with potent angiogenic and pro-fibrotic features. Owing to the mimicking properties of UII with endothelin-1 (ET1), we attempted to investigate the effect of palosuran in a PAH rat model. Thirty rats were randomly divided into three groups, with each group comprising 10 rats: group 1 (control group) received the vehicle subcutaneously, instead of monocrotaline (MCT) and vehicle; group 2 (MCT group) received subcutaneous MCT and vehicle; and group 3 (MCT + palosuran group) received subcutaneous MCT and palosuran. Serum UII, ET1, transforming growth factor-β1 (TGF-β1) levels, pulmonary arteriolar pathology of different diameter vessels, and cardiac indices were evaluated. The ET1, TGF-β1, and UII levels were significantly diminished in the treatment group, similar to the controls (p?<?0.001). Right ventricular hypertrophy index and mean pulmonary arterial pressure scores were also significantly reduced in the treatment group (p?=?0.001). Finally, in the 50–125-μm diameter arterioles, in contrast to Groups 3 and 1, there was a statistically significant thickness (p?<?0.01) in the arteriolar walls of rats in Group 2. The treatment effect on arteries of more than 125-μm diameters was found to be valuable but not significant. Owing to its healing effect on hemodynamic, histological, and biochemical parameters of MCT-induced PAH, palosuran as an antagonist of UII might be an optional treatment alternative for PAH.     

Effects of micro-osteoperforations on intraoral miniscrew anchored maxillary molar distalization

Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie - The aim was to study the effects of micro-osteoperforations (MOPs) on miniscrew-supported maxillary molar distalization....     

Risk factors for avascular bone necrosis in patients with systemic lupus erythematosus

The objective was to investigate the predictive factors for avascular necrosis (AVN) of bone in patients with systemic lupus erythematosus (SLE). The records of 868 patients with SLE from four centers were reviewed retrospectively. Forty-nine patients with AVN were identified. A total of 154 patients with SLE who did not have clinically apparent AVN during the follow-up were evaluated as a control group. The demographic, clinical, laboratory and management characteristics of these two groups of patients were recorded according to predefined protocol and compared. The prevalence of AVN was detected 6% in our SLE population. The highest dose corticosteroid administered within 4?months and total cumulative prednisolone dose were significantly higher in the SLE patients with AVN. The use of cytotoxic agent significantly higher proportion of patients with AVN. AVN tends to develop more frequently in male gender and younger patients. Oral ulcer, pleuritis, Raynaud??s phenomenon, cutaneous vasculitis, lymphadenopathy, autoimmune thyroiditis, peripheral neuropathy and Sj?gren??s syndrome were higher incidence in SLE patients with AVN. The bilateral femoral heads were the commonest site of involvement of AVN in our patients with SLE.     

Evaluation of hearing loss in patients with Graves' disease

Hearing loss has commonly been reported in association with thyroid disorders and during treatment with propylthiouracil. The relationship between hyperthyroidism and the auditory system has not been previously investigated. The aim of this cross-sectional, case-control study was to investigate hearing loss in patients with Graves' disease (GD). The study population consisted of patients with newly diagnosed GD and healthy controls. Pure tone audiometry at frequencies of 250, 500, 1000, 2000, 4000 and 8000 Hz, along with immittance measures including tympanometry and acoustic reflex tests, were performed in all participants. Twenty-two GD patients and 22 healthy controls consented to inclusion in the study. The differences between groups with regards to age and gender distribution were statistically insignificant (P = 0.567 and P = 0.757, respectively). The hearing thresholds of right and left ears were also similar in both groups (P > 0.05). When single-ear evaluations were taken into account (total of 44 ears for both groups), hearing thresholds in the GD group were significantly higher than healthy controls at all frequencies (P < 0.05). Following testing at the designated frequencies, the only significant effect of thyrotoxicosis was observed with frequencies of 4000 and 8000 Hz. The odds ratio for having hearing loss at a frequency of 8000 HZ associated with GD was 14.97 (95% confidence interval 4.03-55.64). In patients with GD, right and left pure tone audiometric findings at a frequency of 8000 Hz correlated positively with FT3, FT4 and negatively with TSH. Our results are highly suggestive of a decrease in hearing ability in patients with GD, particularly at high frequencies. Further studies are needed to help elucidate the mechanisms behind hearing loss which develops in association with GD.     

Effects of Rosiglitazone on Cardiac Function in CAPD Patients: A Tissue Doppler Study

Background. Insulin resistance was an independent predictor of cardiovascular mortality in uremic patients without diabetes. Rosiglitazone (ROS) improves insulin sensitivity in the liver, muscle, and adipose tissue. We prospectively investigated the effects of ROS on cardiac functions by standard (SDE) and tissue Doppler echocardiography (TDI) in continuous ambulatory peritoneal dialysis (CAPD) patients. Methods. A total of 24 CAPD patients (13 males, 11 females; mean age 42.2 ± 14.8 years) were included. Routine blood samples were examined. Left and right ventricular functions were assessed, and myocardial performance index (MPI) was calculated by SDE and TDI at baseline and after 12-month ROS therapy. Left and right atrial volumes were measured and indexed to body surface area. Results. When compared with baseline, after 12 months of ROS treatment, it was shown that early (E) and late (A) diastolic velocities of atrioventricular valves, E/A ratio, mitral E-wave deceleration time (DT), isovolumetric relaxation time (IVRT), and MPI were similar (p > 0.05). Also, no significant changes were detected in LV dimensions, LV mass index, LVEF, LA volume index, or RA volume index measured by SDE before and after ROS therapy (p > 0.05). Left and right ventricular function parameters measured by TDI including Sm, Em, Am, Em/Am ratio, E/Em ratio, and MPI were similar. Conclusion. It was found that there was no negative effect of long-term ROS therapy on cardiac functions measured by SDE and TDI in CAPD patients.