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Amaç: Metanol zehirlenmesi ülkemizde son zamanlarda sıkça karşılaşılan bir zehirlenme türüdür. Zehirlenme durumunda vakaların hızla tanınıp tedavi altına alınması sayesinde mortalite ve morbidite oranları azaltılabilir. Bu çalışmanın amacı, acil servise başvuran metanol zehirlenmesi hastalarının demografik özellikleri, fizik muayene bulguları ve laboratuvar sonuçları ile sağ kalım arasındaki ilişkiyi araştırmaktır.Gereç ve Yöntemler: Hastalar metanol zehirlenmesi sonrası eksitus olanlar ve hayatta kalanlar olmak üzere 2 farklı gruba ayrıldı. Tüm hastaların demografik özellikleri, başvuru şikayetleri, fizik muayene bulguları ve laboratuvar sonuçları ve klinik sonlanımları kaydedildi. Grupların karşılaştırılmasında Chi-square, Student t-test ve Mann-Whitney U testi kullanıldı. p

Introduction: Insulin is a highly used parenteral medication in emergency departments. Although most severe insulin overdoses occur as suicide attempts, medication errors can be the reason. We aimed to highlight the potential medication errors in emergency departments due to the poor control of critical drugs like insulin and the similarities between the brand names of drugs, as we experienced during this case. Case Report: We present a 75-year-old diabetic woman with an extreme insulin overdose. A total of 3000 UI of insulin was administered by subcutaneous and intramuscular routes. She developed typical and atypical episodes of hypoglycemia requiring intravenous dextrose, a high-calorie diet, and glucagon administration. Almost all of the classic side effects of glucagon occurred during her intensive care unit follow-up. She recovered without any sequela or recurrence of hypoglycemia at the end of 5 days of admission.Conclusion: Insulin overdose can be a life-threatening condition by causing hypoglycemia. Albeit rare, insulin overdose can occur as a medication error in hospitals. To prevent such incidents for emergency departments, the medication errors should be objectively laid out, and proactive strategies should be integrated without adversely affecting acute care., Giriş: İnsülin acil servislerde sıklıkla kullanılan parenteral bir ilaçtır. Çoğu şiddetli insülin doz aşımı intihar girişimi olarak ortaya çıksa da, nedeni ilaç hataları da olabilir. Bu vakada tecrübe ettiğimiz gibi, acil servislerde insülin gibi kritik ilaçların yetersiz kontrolü ve ilaçların marka isimleri arasındaki benzerlikler nedeniyle ortaya çıkabilecek olası ilaç hatalarını vurgulamayı amaçladık.Olgu Sunumu: Aşırı insülin doz aşımı olan 75 yaşında diyabetik bir kadın sunmaktayız. Hastanın subkütan ve kas içi yollarla toplam 3000 UI insülin alımı oldu. Hastada intravenöz dekstroz, yüksek kalorili diyet ve glukagon uygulaması gerektiren, tipik ve atipik hipoglisemi atakları gelişti. Glukagonun klasik yan etkilerinin neredeyse tamamı yoğun bakım ünitesi takibi sırasında ortaya çıktı. Hasta hastaneye yatışından sonraki 5. günün sonunda herhangi bir sekel veya hipoglisemi nüksü olmadan taburcu oldu.Sonuç: İnsülin doz aşımı, hipoglisemiye neden olarak yaşamı tehdit eden bir durum olabilir. Nadir de olsa insülin doz aşımı hastanelerde ilaç hatası olarak ortaya çıkabilir. Acil servislerde bu tür olayları önlemek için, ilaçla ilgili hatalar objektif bir şekilde ortaya konulmalı ve akut bakımı olumsuz yönde etkilemeden proaktif stratejiler entegre edilmelidir.

DINDAR BADEM, NERMIN/0000-0002-5095-7818 WOS: 000476722600009 PubMed: 31030571 Carbon monoxide (CO) is an important cause of deaths via poisoning. CO poisoning causes inhibition of O-2 transport and development of tissue hypoxia, which then causes cell apoptosis. A significant indicator of cell apoptosis, soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK) protein, is important for the stimulation of apoptosis. The primary purpose of this study is to determine whether apoptosis occurs during acute CO poisoning and to show that sTWEAK protein is an indicator of apoptosis that can be analyzed as a marker in the peripheral blood sample. The secondary aim is to determine the diagnostic and prognostic values of sTWEAK protein. The study was performed prospectively on 43 patients with CO poisoning and 30 healthy volunteer control individuals. The anamneses were taken from all patients, who also underwent physical examination. Complete blood count, biochemical markers, cardiac enzymes, and arterial blood gas measurements were analyzed. All the patients' sTWEAK protein levels were also analyzed. The sTWEAK protein level of patients with CO poisoning was 2278 pg/mL (1197-7234), while the level of the control group was 1609 pg/mL (310-3721). The patients' sTWEAK levels were significantly higher than the controls (area under the curve: 0.77 (0.66-0.89); p < 0.001), and the cutoff value was determined as 1895.50 pg/mL. The cutoff level had a sensitivity of 74.4%, a specificity of 76.7%, a positive predictive value of 82.0%, and a negative predictive value of 67.6%. sTWEAK is a significant indicator of apoptosis in CO poisoning that can be analyzed in the peripheral blood. However, further clinical trials are needed in terms of prognostic criteria. Kirikkale University Scientific Research Projects UnitKirikkale University [2015/019] The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was funded by Kirikkale University Scientific Research Projects Unit, project number 2015/019.

Background and aim Carbon monoxide poisoning is a toxicological emergency that causes neurological complications. High serum neurogranin can be detected in acute or chronic conditions where brain tissue is damaged. This study aimed to investigate the diagnostic value of serum neurogranin level and its role in demonstrating neurological damage in patients admitted to the emergency department with carbon monoxide poisoning. Materials and methods The study was conducted prospectively on patients with carbon monoxide poisoning (patient group) and healthy volunteers (control group). Demographic characteristics and serum neurogranin level of all participants and symptoms at admission, neurological examination findings, laboratory results, and Diffusion-Weighted Magnetic Resonance Imaging results of the patient group were recorded. We used an independent sample t-test to compare neurogranin levels and bivariate correlation analysis to compare the relationship between serum neurogranin levels and data belonging to the patient group. Results Sixty eight participants (patient group, n = 36; control group, n = 32) were included in the study. Serum neurogranin level was significantly higher in patients with carbon monoxide poisoning (0.31 ± 0.16 ng/ml) compared to control group (0.22 ± 0.10 ng/ml) (p = 0.015). The mean Glasgow Coma Scale of the patients with carbon monoxide poisoning was 14.59 ± 0.23, and of Diffusion Weighted Magnetic Resonance Imaging results were completely normal in 94.4% (n = 34). There was no correlation between serum neurogranin level and Diffusion Weighted Magnetic Resonance Imaging results (r = −0.011; p = 0.953). Conclusion Serum neurogranin level may be a new diagnostic biomarker in patients admitted to the emergency department with carbon monoxide poisoning. The high serum neurogranin levels detected in patients with normal diffusion-weighted imaging after carbon monoxide poisoning suggest that there is neurological damage in these patients, even if imaging methods cannot detect it.

WOS:000582143700006 PubMed: 32856885 Background: Considering the critical role of early diagnosis and management of acute ischemic stroke, biomarkers that can reliable assist in the diagnosis are still needed. These biomarkers should rapidly analyze, have high specificity for brain damage, and be available in the emergency settings for early diagnosis and exclusion of other conditions that mimic acute ischemic stroke. Soluble tumor necrosis factor-like weak inducer of apoptosis, a protein involved in the regulation of several biological functions, could be a potential acute ischemic stroke biomarker. Aims: To investigate the diagnostic value of soluble tumor necrosis factor-like weak inducer of apoptosis in patients with acute ischemic stroke and examine the relationship between ischemic area volume determined at diffusion-weighted magnetic resonance imaging and soluble tumor necrosis factor-like weak inducer of apoptosis. Study Design: A prospective, case-control study. Methods: This case-control prospective study included 36 patients with acute ischemic stroke and 36 healthy volunteers. Information on age, sex, presence of chronic disease, neurological examination findings, times of presentation to the emergency department after acute ischemic stroke, soluble tumor necrosis factor-like weak inducer of apoptosis levels, ischemic area volumes at diffusion-weighted magnetic resonance imaging, and 6-month mortality rates after stroke were recorded. The results were analyzed on SPSS 22.0 software (SPSS Inc., Chicago, IL, USA), and p

Objectives: The severity of inflammation occurring during chronic obstructive pulmonary disease (COPD) is closely associated with oxidative stress. The aim of this study was to investigate the diagnostic value of Thiol/disulphide homeostasis (TDH) and ischemia modified albumin (IMA) levels in evaluating oxidative stress in COPD patients. Methods: This prospective study was performed with COPD patients presenting to the Kırıkkale University Hospital and with healthy volunteers. Subjects’ demographic data (age, sex, body mass index, and smoking status), native thiol (NT), total thiol (TT), disulphide (Ds), IMA levels and Ds/NT, Ds/TT and NT/TT ratios were recorded. Statistical analysis was performed with SPSS 21.0 software. Results: One hundred ninety subjects were enrolled in the study, 141 COPD patients and 49 healthy volunteers. No difference was determined between the patient and control groups in terms of age, sex or body mass index. The antioxidant markers; NT and TT levels and NT/TT ratio were significantly lower in the patient group compared to the control group (p < 0.001, p < 0.001, and p < 0.003, respectively). The oxidant markers; IMA levels and Ds/NT and Ds/TT ratios were significantly higher in the patient group (p = 0.006, p = 0.003, and p = 0.003, respectively). Significant negative correlation was determined between antioxidant and oxidant parameters. Sensitivity values were NT: 87.2%, TT: 83.3%, Ds/NT ratio: 68.1%, Ds/TT ratio: 68.1%, and IMA: 77.8%. Conclusions: TDH was impaired in favor oxidants in COPD patients. TDH parameters and IMA can be used to monitor oxidative stress emerging in COPD.