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.     

Use of Telemedicine and Helicopter Transport to Improve Stroke Care in Remote Locations

Intravenous recombinant tissue plasminogen activator is the only medication approved by the US Food and Drug Administration for treatment of acute stoke. Despite established efficacy, less than 3% of stroke patients receive treatment, and that number is even smaller for patients living in remote locations. This is in part due to a lack of neurologists and stroke specialists in these rural communities. The traditional model of “ship and drip” wastes crucial time, resulting in delays or loss of treatment. In this review, we discuss strategies to overcome geographic disparities in stroke care and improve acute treatment in remote locations. Helicopter transport from field to stroke center is one option to rapidly deliver patients to stroke centers. However, geography, weather, and unnecessary transport are potential drawbacks. Alternatively, “telestroke” facilitates remote evaluation of acute stroke patients via an audiovisual link and transmission of computerized tomography images. Despite the physical separation, stroke specialists are able to examine patients, review brain imaging and make correct treatment decisions; transfer to a stroke center can then be performed as appropriate. A cost-benefit analysis of telestroke is needed, although the recent proliferation of telestroke networks suggests an economic asset to some hospital systems.     

Spirometry in patients with clinical and subclinical hypothyroidism

It is well known that respiratory functions are affected at clinical hypothyroidism. Simple spirometry which is a cheap and simple method is performed to the patients with subclinical hypothyroidism in order to determine if respiratory functions are affected or not. Recently diagnosed 87 patients with clinical hypothyroidism, 120 patients with subclinical hypothyroidism and 60 healthy subjects were enrolled in the study. Serum plasma levels of fT3, fT4 and TSH were measured and spirometry test is performed to healthy subjects and patients with clinical and subclinical hypothyroidism. There was a significant difference when groups with subclinical and clinical hypothyroidism were compared with control group. The comparison of subclinical and clinical hypothyroidism revealed a slight elevation at all of the spirometric parameters in favor of subclinical hypothyroidism which did not reach statistical significance (p> 0.05). Respiratory functions may be affected in patients with subclinical hypothyroidism as it is with clinical hypothyroidism; therefore we think that recommend community screening for respiratory functions in patients who may be at risk of subclinical hypothyroidism may be helpful.     

Additional value of carotid artery intima-media thickness in cardiovascular risk assessment by Framingham risk-score in Type 2 diabetes: a retrospective cohort study

Background: The intima–media thickness (IMT) of the carotid artery is highly correlated with cardiovascular events in Type 2 diabetes mellitus (T2DM). The aim of the present study was to undertake a cardiovascular risk assessment in a group of patients (n = 102) who had been followed‐up for 10 years. Methods: Framingham risk score (FRS), IMT, and various other clinical parameters were evaluated retrospectively using Student’s t‐test, regression analysis, and χ² tests. Primary endpoints were defined as cardiovascular death, non‐fatal myocardial infarction, angina, and ischemic stroke. Results: The IMT (1.09 ± 0.32 vs 0.89 ± 0.25; P < 0.001) and percentage coronary risk as determined by the FRS (24.33 ± 11.07 vs 16.54 ± 8.35; P = 0.001) were significantly higher in patients presenting with any of the primary endpoints compared with patients in whom no cardiovascular morbidity or mortality was recorded. Other factors that significantly predicted cardiovascular mortality and morbidity included diastolic blood pressure and urinary albumin excretion (UAE; P < 0.001). The likelihood of primary endpoints could be predicted by UAE >30 mg/day, carotid artery IMT ≥0.9 mm, and FRS ≥20 (odds ratios 8.800, 3.377, and 2.807, respectively). Conclusion: Although FRS predicts 10‐year risk for cardiovascular mortality and morbidity in T2DM, we suggest that UAE and carotid artery IMT should also be considered in risk assessments.     

Is β-Thalassaemia Minor Associated with Metabolic Disorder?

Objective

To investigate the frequency of metabolic syndrome and its components in subjects with β-thalassaemia minor.

Subjects and Methods

A total of 194 subjects, i.e. 92 subjects with β-thalassaemia minor (study group) and 102 subjects without β-thalassaemia minor (control group), were enrolled into this case-control study. Haemoglobin electrophoresis was performed on all patients. The waist circumference and systolic and diastolic blood pressure of the subjects were recorded. Fasting blood glucose and serum lipid levels were measured.

Results

Both groups were similar in terms of age and sex (p > 0.05 for each). The percentages of haemoglobin A₂ (4.3 ± 0.4 vs. 2.0 ± 0.3) and haemoglobin F (3.38 ± 1.4 vs. 0.26 ± 0.4) and the mean corpuscular volumes (64 ± 4.7 vs. 81.5 ± 9.3) of the groups were statistically different (p < 0.001 for each). The frequency of metabolic syndrome and its components was similar in both groups (p > 0.05 for each). According to correlation analyses, the percentage of haemoglobin A₂ correlated with fasting insulin, fasting glucose, systolic blood pressure, high-density lipoprotein, and low-density lipoprotein levels (p < 0.05).

Conclusions

No association was found between β-thalassaemia minor and metabolic syndrome despite insulin resistance, which was shown in subjects with β-thalassaemia minor.Key Words: β-Thalassaemia minor, Metabolic syndrome, Metabolic syndrome components, Insulin resistance     

Correlation Between Physicomechanical and Swelling Properties of Weakly Basic Copolymer Hydrogels Based on (Meth)acrylate Polycations as New Smart Materials

2‐Hydroxyethyl methacrylate (HEMA) is incorporated to N,N‐dimethylaminoethyl methacrylate (DMAEMA) fabricating a series of stimuli‐responsive copolymer hydrogels by free radical copolymerization. The increasing comonomer content via adding more HEMA results in a higher network density and, therefore, a lower equilibrium swelling ratio. The uniaxial compressive testing results showed that increasing HEMA in the feed improved the mechanical strength of P(DMAEMA‐co‐HEMA) hydrogels. As HEMA increased, the elastic modulus as well as the effective crosslinked chain density increased. The work strives to provide method to tune mechanical and physical properties for weakly basic copolymer hydrogels based on (meth)acrylate polycations, which is hopefully to guide the design of hydrogels with desirable properties.