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The aim of the present study is to investigate the efficiency of colchicine in the experimental rat ovarian torsion model in the light of histological and biochemical data.A total of 35 Wistar albino female rats were randomly divided into 5 groups, group 1: (control-sham operated, n = 7); group 2: (torsion/detorsion, n = 7) 2 hours of ischemia and 2 hours of reperfusion; group 3: (torsion/detorsion, n = 7), 2 hours of ischemia and 5 days of reperfusion; group 4: (torsion/detorsion, n = 7) 2 hours of ischemia and 2 hours of reperfusion and a signal dose of oral 1 mL/kg colchicine; and group 5: (torsion/detorsion, n = 7), 2 hours of ischemia and 5 days of reperfusion and 5 days of oral 1 mg/kg colchicine. Histopathologic evaluation was performed by a scoring that assesses congestion, bleeding, edema, and cellular degeneration in the ovarian tissue. Catalase, tissue malondialdehyde (MDA), and protein carbonyl levels were calculated.The histopathologic scores, MDA, and protein carbonyl levels in the control and colchicine groups were significantly lower than groups 2 and 3 (P.001). Catalase activities were significantly higher in the control and colchicine groups than in groups 2 and 3 (P.001). The results of the histopathologic parameters and biochemical markers showed that protective effects of colchicine treatment persisted up to 5 days.Our study results revealed that colchicine reduced ovarian ischemia-reperfusion injury in experimental rat ovarian torsion model. As the ovarian detorsion is the first choice of the treatment modality in the early phase, antioxidant and anti-inflammatory treatment modalities like colchicine might be used to reduce ovarian ischemia-reperfusion injury.

3,4-methylenedioxymethamphetamine (MDMA), popularly known as “ecstasy”, is a synthetic, psychoactive drug. MDMA has been reported to have several severe adverse effects including rhabdomyolysis, acute renal failure, liver failure and even sudden death. Herein, we present the case of a young man who presented with severe rhabdomyolysis and renal failure after taking 2 ecstasy pills. The patient initially received supportive care but he eventually needed hemodialysis. kEy words: Ecstasy, Rhabdomyolysis, Acute renal failure

Licorice originates from the root of Glycyrrhiza glabra, which has a herbal ingredient, glycyrrhizic acid, and has a mineralocorticoid-like effect. Chronic intake of licorice induces a syndrome similar to that found in primary hyperaldosteronism. Excessive intake of licorice may cause a hypermineralocorticoidism-like syndrome characterized by sodium and water retention, hypertension, hypokalemia, metabolic alkalosis, low-renin activity, and hypoaldosteronism. In this case report, an association of hypokalemia, edema, and thrombocytopenia that is developed due to the excessive intake of licorice is presented. There are case reports in the literature, which suggest that toxicity findings may emerge with hyperaldosteronism-like manifestations such as hypokalemia, edema, and hypertension. However, any knowledge of thrombocytopenia as a resultant was not encountered among these reported toxic effects. Our case is important because it shows that the excessive intake of licorice may cause a toxic effect in the form of thrombocytopenia. This report is the first presented case to show thrombocytopenia due to licorice syrup consumption.

Introduction: Dystonia is anabnormal contraction due to primary and secondary causes of the muscles in the body. Case Report: In the literature, although many cases of congenital or edynsel with dystonia have been reported, a case as a result of a bee sting has not. Conclusion: We aimed to present a case with recurrent dystonia as a result of a bee sting.

Aim: Natural disasters, terrorist bombings, transportation and industrial accidents can lead to many deaths and injuries. The number of deaths and injuries in these situations are closely related to cooperation among police, fire fighters, ambulances and hospital staff. Practice and organized positioning can improve such cooperation and experiences. In this study, we aimed to investigate the medical situation of the patients admitted to our hospital emergency service after the terrorist bombing attack occurred on Saturday May 11th, 2013 at about 14:00 pm in the Reyhanli province and to evaluate our hospital applications. Material and Method: Data including gender, age, Glascow Coma Scale score, Injury Severity Score-ISS , K-Revise Trauma Score(RTS), type of transportation and injury, duration of treatment and prognosis of the patients injured after the explosion were collected retrospectively from the hospital records. Results: The terrorist bombing attack was the bloodiest event in the history of the Republic of Turkey. After the explosion, 51 people died. 27 of the 146 injured patients were admitted to our hospital. 20 of them were male and 7 were female. The mean age of the patients was 31,85 (1-63). Glascow Coma Scale scores were 3-8 for 3 patients, 9-13 for 6 patients and 14-15 for 18 patients. The most frequent injuries were observed in the extremities and soft tissues. 15 patients were discharged after their treatment and 9 patients were hospitalized by different services related to their medical conditions. Three patients died in the emergency department. The size of the event and the number of injured patients were evaluated by the doctors in charge in emergency service and the 112 paramedics. Then, other relevant doctors, administrative officers and health care staffs were instructed and called to the hospital. Appropriately triaged, monitored and treated patients were resulted after evaluating their conditions. Discussion: The soft tissue injuries were the most common case group in relation to the size of the event. The relationship was determined between trauma score values and mortality. Therefore, emergency services should be prepared to the cumulative injuries such as bombing events.

Giris Degisik klinik ozelliklere sahip olan akrep sokmasi vakalari ulkemizde en sik Guneydogu Anadolu’da gorulmektedir. Akrep zehiri icerdigi cesitli enzimler nedeniyle farkli klinik tablolara neden olmakta ve ozellikle cocuklarda kalp etkilenimi nedeniyle olum gorulebilmektedir. Akrep sokmasi sonucu ventrikul yetersizligi, miyokart islev bozuklugu, sistemik hipertansiyon, pulmoner odem ve kardiyojenik sok gorulebilmektedir. Kalp etkilenimi gorulen olgularda pozitif inotrop destegi yaninda alfa blokor ilaclar da kullanilmakta prazosin ve doksazosin bu grupta yer almaktadir. Prazosin katekolamin artisi sonucu olusan kalp hasarini onleyerek etki gostermekte ve tasikardi, hipertansiyon, hipersalivasyon, terleme gibi sempatik bulgularin gelistigi olgularda kullanilabilmektedir. Prazosin yerine ayni etkili doksazosin de tedavide kullanilmakta, ancak etkinligi ve kullanimi konusunda literaturde yeterli veri bulunmamaktadir. Bu yazida, doksazosin kullandigimiz olgu sunuldu. Akrep Sokmalarinda Doksazosinin Etkinligi; Cocuk Olgu Sunumu Effectiveness of Doxazosin in Scorpion Stings; Child Case Report

Background: Diabetes mellitus affects the systolic and diastolic function of the left ventricle (LV). The aim of the present study was to evaluate the index of myocardial performance (IMP), a new Doppler index, in asymptomatic, normotensive patients with type 2 diabetes mellitus (T2DM). Methods: The study population consisted of 40 asymptomatic normotensive patients with T2DM (22 women, 18 men; mean [±SD] age 49 ± 7 years) and 20 healthy controls (13 women, seven men; mean age 45 ± 4 years). M-Mode and two-dimensional Doppler echocardiography was performed in all subjects to calculate IMP. Venous blood samples were collected for analysis and body mass index (BMI) was calculated. Results: In normotensive T2DM patients, the mitral E wave was decreased, whereas mitral A wave, mitral E/A ratio, and septal wall thickening were increased compared with values obtained for the control group. The IMP was higher in normotensive T2DM patients than in the control group (P = 0.004). There was a significant correlation between IMP and triglyceride (TG) levels (P

Summary Background: The aim of this study was to investigate the association between the aortic elastic properties and the left ventricular diastolic function measured by tissue Doppler echocardiography (TDE) in asymptomatic type 2 diabetes mellitus. Methods: Fifty-seven asymptomatic patients with type 2 diabetes (33 women, mean age: 49 ± 6 years) and 25 healthy control subjects (19 women, mean age: 46 ± 7 years) were included in the present study. Diastolic filling indices were measured by conventional (CE) and tissue Doppler echocardiography. The aortic elastic properties [Aortic stiffness index (ASI), aortic distensibility and strain] were measured as previous definition. Results: Compared with control subjects, the ratio of LV diastolic abnormalities measured by CE and TDE were found higher in patients with type 2 diabetes (36% and 73.6%, p = 0.001, respectively, and 52% and 89.4%, p

The immunosuppressive agent cyclosporine A (CsA) has been reported to exert measurable hepatotoxic effects. One of the causes leading to hepatotoxicity is thought to be reactive oxygen radical formation. The aim of this study was to investigate the effects of N-acetylcysteine (NAC) treatment on CsA-induced hepatic damage by both analysing superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), aspartate aminotransferase (AST) and alanine transaminase (ALT) activities with malondialdehyde (MDA) and nitric oxide (NO) levels, and using an histological approach. CsA administration produced a decrease in hepatic SOD activity, and co-administration of NAC with CsA resulted in an increase in SOD activity. MDA and NO levels increased in the CsA group and NAC treatment prevented those increases. A significant elevation in serum AST and ALT activities was observed in the CsA group, and when NAC and CsA were co-administered, the activities of AST and ALT were close to the control levels. CsA treatment caused evident morphological alterations. Control rats showed no abnormality in the cytoarchitecture of the hepatic parenchyma. The co-administration of NAC with CsA showed no signs of alteration and the morphological pattern was almost similar to the control group. In conclusion, CsA induced liver injury and NAC treatment prevented the toxic side effects induced by CsA administration through the antioxidant and radical scavenging effects of NAC.

Background: A significant number of applications to emergency services consists of elderly patients. Elderly patients are at increased risk for abdominal aortic aneurysms. Therefore, we measured the diameter of the aorta in patients over the age of 65 and compared with the risk factors, Amaç:Acil servislere başvuruların önemli birkısmını oluşturan yaşlı hastalarda abdominal aortanevrizma riski fazladır. Bu sebeple 65 yaş ve üzerihastaların aort çapı ölçülerek risk faktörleri ilebirlikte değerlendirilmesi amaçlanmıştır.Gereç ve Yöntem:65 yaş ve üzeri 150 hastaçalışmaya dahil edildi. Travma ile acil servisegelenler, vasküler olabilecek şikayet veya bulgu ilegelenler çalışmaya dahil edilmedi. Hastaların renalarter ayrım yerinden ve iliak bifurkasyo üzerindenolmak üzere iki yerden aort çapları ölçülmüştür veaort boylu boyunca taranarak diğer arada kalanalanlar da değerlendirildi. Veriler SPSS 20.0istatistik programı ile değerlendirilmiş ve t-test, kikaretestleri uygulandı.Bulgular:Abdominal aort anevrizması (AAA)tesbit edilen 3 hastanın 2’si kadın cinsiyette idi.Aort çapları sigara içen hastalarda içmeyenlere göredaha geniştir(p

Aim: Inflammatory mechanisms had played a major role in the formation and prognosis of acute myocardial infarction. Inflammatory mediators was assciated with negative consequences of acute myocardial infarction. This study tested the hypothesis that in the acute phase of acute coronary syndrome, leukocyte count, neutrophil count, neutrophil lymphocyte ratio, and high sensitivity C reactive protein (hsCRP) are predictive of angiographic thrombus formation in the infarct related artery. Material and Method: This prospective study included 150 consecutive patients with acute coronary syndrome. Patients were assigned to a thrombus formation group (n=65) and a non thrombus formation group (n=85). Blood samples for measurement of hsCRP and for routine blood laboratory studies were collected before to coronary angiography. Numerical data were expressed as mean ± Standard deviation. Nominal data were expressed as the number and percentage. Comparisons between groups, chi-square test was used for nominal variables. Comparisons between groups, t-test was used for numerical data. All statistical analyzes, p

Objective: The aim of this study was to investigate effect of loss weight on P wave dispersion in obese subjects. Research Methods and Procedures: After a 12-week weight loss program (diet and medical therapy), a total of 30 (24 women and six men) obese subjects who had lost at least 10% of their original weight were included in the present study. All subjects underwent a routine standard 12-lead surface electrocardiogram. Electrocardiograms were transferred to a personal computer by a scanner and then magnified 400 times by Adobe Photoshop software (Adobe Systems, Mountain View, CA). P wave dispersion, which is also defined as the difference between the maximum P wave duration and the minimum P wave duration, was also calculated. Results: After a 12-week weight loss program, BMI (p < 0.001), maximum P wave duration (p < 0.001), and P wave dispersion (p < 0.001) significantly decreased. The mean percentage of weight loss was 13% (10% to 20.3%). The decrease in the level of P wave dispersion (21 ± 10 and 7 ± 12 ms, p < 0.002) was more prominent in Group II (≥12% loss of their original weight) than Group I (

The aim of this study was to investigate increase of QTc dispersion and P-wave dispersion during migraine attacks. Fifty-five patients (16–65 years of age, 49 women, six men) with migraine were included in our study. Heart rate, QTc interval, maximum and minimum QTc interval, QTc dispersion, maximum and minimum P-wave duration and P-wave dispersion were measured from 12-lead ECG recording during migraine attacks and pain-free periods. ECGs were transferred to a personal computer via a scanner and then used for magnification of x400 by Adobe Photoshop software. Maximum QTc interval (454 ± 24 ms vs. 429 ± 23 ms, P < 0.001), QTc interval (443 ± 26 ms vs. 408 ± 22 ms, P

Familial Mediterranean fever (FMF) may pose a risk for cardiovascular diseases due to continuous inflammatory status observed during the course of the disease. Recently, the presence of fragmented QRS (fQRS) has been recognized as a predictor of myocardial fibrosis. In this study, we aim to investigate the frequency of fQRS and its relation to Doppler-based indices. This study consisted of 80 FMF patients and 30 healthy control subjects. fQRS pattern was defined as the presence of additional R waves or RSR’, evidenced by notched R or S wave on electrocardiography (ECG). The patient and the control groups underwent conventional echocardiography and tissue Doppler echocardiography. There was no significant difference between groups regarding age (29 ± 12 vs 29 ± 15). FMF patients exhibited a statistically higher frequency of fQRS (% 56 vs % 13) (p

Introduction: Severe amitriptyline toxicity may cause cardiac dysrhythmias, severe hypotension, convulsions and CNS depression, including coma. Management with gastric lavage, activated charcoal, alkalinization and supportive care with mechanical ventilation, antiarrhythmics and anticonvulsants, if required, is the general approach. Case report: A 33-year-old woman who has taken overdose antidepressants (amitriptyline and tianeptine) was admitted to the emergency service. She was intubated because she had pure respiratory arrest. Besides hypotension (80/60 mmHg), she was unresponsive to verbal and painful stimuli and her Glasgow coma score was 6. Hemogram and serum biochemical parameters and electrocardiography were within normal limits. The patient was examined for substance dependence and no trace of the injector was found in the body. Patient underwent a coma cocktail (naloxone 2 mg/kg, 5% dextrose 25 g/body and tiamin 100 g/body). Activated charcoal and intravenous alkalinization by NaHCO3 were initiated. Spontaneous respiration started again 20 min after being given the coma cocktail. She became responsive to verbal stimuli first hour after the coma cocktail, and her Glasgow coma score improved to 13. She had spent 2 days in the service and was discharged by the second day of admission, without any complications. Discussion: Herein, we report successful treatment in a case of severe amitriptyline and tianeptine poisoning by naloxone in addition to the above supportive care. Naloxone treatment may have a beneficial role in lethal doses of amitriptyline ingestion because amitriptyline may affect opioid receptors.

We report here an 11-year-old previously healthy girl with isoniazid intoxication who sustained a seizure-induced thoracic compression fracture. The following might be the first such case reported in the medical literature. Isoniazid toxicity should be suspected in any patient who comes to the emergency department with refractory seizures and metabolic acidosis. Forceful muscle contractions during a convulsive seizure can result in vertebral compression fracture, especially in the midthoracic region. A complaint of back pain after isoniazid-induced seizures in patients raises a strong suspicion of vertebral fracture and should be evaluated radiologically.

Snakebites are relatively rare medical emergency cases that might lead to serious consequences. This study aims to evaluate snakebite cases in terms of medical follow-up, antivenom therapy and antivenom reactions. Medical records of patients admitted to emergency department between January 1, 2006 and December 31, 2010 were retrospectively investigated. Snakebite-related cases of a total of 125 patients were included in the scope of the study. Of the total 125 cases, 54.4% were male and 45.6% were female. Most of cases ( n: 65, 52%) were aged over 30 years, while the mean age was 34.87 ± 19.29 years. Snakebite-related applications to the emergency department were mostly seen in June with 27 cases. Upon admitting, all patients were recorded to be conscious and showing good general conditions; however, they suffered from pain and edema at the site of bite. Of all, 25 patients only suffered from bite injury and ecchymosis due to snakebite. The site of bite was upper extremities in 66 patients (52.8%), whereas it was lower extremities in 58 (46.4%). Of all, antivenom was unnecessary in 25 (20%) patients, while four antivenoms were administered to each of the 23 (18.4%) patients. Furthermore, six (4.8%) patients needed nine antivenom administrations for each. Anaphylaxis ( n: 2, 1.6%), compartment syndrome ( n: 2, 1.6%) and serum sickness ( n: 1, 0.8%) encountered in remaining cases. Of all, 86 (68.8%) patients were hospitalized in the emergency department, while 25 (20.0%) patients were followed up by observation in emergency service. Only one patient was treated and followed up in intensive care unit. Implementation of antivenom therapy is considered unnecessary for the treatment of all snakebite cases. Antivenom reactions and number of related cases might be reduced by continuous close monitoring, appropriate prophylaxis and controlled slow infusion administration of medications.

İnsanlar tarafından atmosfere salınan gazların (karbondioksit, diazot monoksit, metan, su buharı, kloroflorokarbon) miktarlarının artması sonucunda dünya yüzeyinde sıcaklığın artması küresel ısınma olarak tanımlanmaktadır. Bunun sonucunda kışın sıcaklıklar artmakta, hayvanların göç dönemleri ve iklimler değişmekte ve değişikliklere dayanamayan bitki ve hayvan türleri de azalmaktadır. Sıcak bölgelerde yaşayan soğukkanlı hayvanlardan olan yılan gibi hayvanların da yaşam siklusu değişebilmektedir. Yılan ısırması vakaları ülkemizde özellikle yaz aylarında güney ve güneydoğu bölgesinde sıkça rastlanan vaka grubudur. Biz de yaz ayları dışında literatürde rastlanmayan böyle bir vakayı sunmayı amaçladık. The increase in the Earth's temperature due to the inctrease in the amount of gases (carbon dioxide, nitrous oxide, methane, water vapor, and chlor- ofluorocarbons) released into the atmosphere by humans is defined as global warming. Therefore, temperature increases in Winter, migration periods and climates change and thus species of fauna and animals which cannot tolerate such changes decrease. Life cycles of cold-blooded animals such as snakes living in warm areas vary. Cases of snake bites are frequently observed in the south and south-east of Turkey, especially in Summer. Therefore,we aimed to present a case which is not encountered in the literature except during Summer

Özofagus korozif yanıklarında erken dönem striktürün engellenmesinde N-asetil kullanımının etkinliğini araştırmaktır. Gereç ve Yöntemler: Özofagusun yakıcı maddeler nedeniyle gelişen darlıkları, sıvı veya katı nitelikteki yakıcı maddelerin ağız yoluyla alınması sonucu ortaya çıkmaktadır. Bulgular: Konvansitonel+N-Asetil sistein kullanılan grupta 1 hastada, konvansiyonel tedavi uygulanan grupta 7 hastada darlık gelişti. Sonuç: Tek başına konvansiyonel tedavi ve konvansiyonel tedavi + N-asetil sisteinin birlikte kullanım etkinliğini değerlendirmek için randomize prospektif bir çalışma yapıldı. Evre 2b ve evre 3 yanıklı 50 hasta incelendi. Yoğun n-asetil sistein tedavisi ileri evre korozif özofajiti bulunan hastalarda striktür gelişim sıklığını azaltabilir. Daha fazla sayıda hasta içeren gruplar veya deneysel çalışmalarla bulgularımızın destekleneceğini umuyoruz. (JAEM 2011; 10: 73-5), Esophageal stricture early corrosive burns to investigate the eff ectiveness in preventing the use of N-acetyl-cysteine. Strictures of the esophagus due to caustic substances occur with the ingestion of solid or liquid corrosive materials. Materials and Methods: A prospective randomized study was performed to evaluate the eff ectiveness of conventional therapy alone and conventional therapy + N-acetyl cysteine. Fifty patients with grade 2b and grade 3 burnt were analyzed. Intensive n-acetyl cysteine therapy can reduce the incidence of stricture development in patients with advanced grade corrosive esophagitis. Results: N-acetyl cysteine group+ Konvansitonel used in 1 patient, stenosis developed in 7 patients in the group with conventional treatment. Conclusion: We believe that our fi ndings will be better supported with the groups including larger number of patients or with the experimental studies. (JAEM 2011; 10: 73-5)

Scorpion stings represent an important and serious public health problem worldwide due to their high incidence and potentially severe and often fatal clinical manifestations. Children are at greater risk of developing severe cardiac, respiratory, and neurological complications due to lesser body surface area.Alpha receptor stimulation plays important role in the pathogenesis of pulmonary edema. Prazosin, a post synaptic alpha blocker, can be recommended as an effective drug in the treatment of serious scorpion envenomations with significant sympathetic symptoms. Oral prazosin is fast acting, easily available, relatively cheap, free from any anaphylaxis and highly effective.

Objectives: To investigate the protective role of thymoquinone (TQ) on unilateral testicular ischemia-reperfusion (I/R) injury in mice. Materials and Methods: Experiments were performed on male C57BL/6 mice (8 weeks old, 20–25 g). The animals were divided into 3 groups including 6 mice in each group: control (sham), torsion/detorsion (TD) and TD+TQ. Mice, except the sham-operated group, were subjected to left unilateral torsion (720° rotation in the clockwise direction). The experiments were finished after sham operation time for controls, 120 min torsion and 240 min detorsion for the other groups. In the TD+TQ group 10 mg TQ was injected intraperitoneally 30 min before detorsion. Results: In the TD group total oxidative stress (TOS), oxidative stress index (OSI) and malondialdehyde (MDA) levels were higher than in the controls. TQ treatment decreased MDA, TOS and OSI values, but did not affect the total antioxidant capacity and myeloperoxidase activity in the TD+TQ group. Upon histological examination, mice in the TD group displayed moderate-to-severe disruption of the seminiferous epithelium. Treatment with TQ resulted in significantly reduced histological damage associated with I/R injury. Conclusion: Our results suggested that TQ treatment may have a protective effect on testicular I/R injury.

We investigated the effects of erdosteine on acetaminophen (APAP)-induced hepatotoxicity in rats. Superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-Px), AST (aspartate aminotransferase), and ALT (alanine transaminase) activities, and malonyldialdehyde (MDA) and nitric oxide levels as oxidant/antioxidant biochemical parameters were investigated with light microscopic evaluation in adult female Wistar Albino rats. APAP administration produced a decrease in hepatic SOD, CAT, and GSH-Px activities, and coadministration of erdosteine (150 and 300 mg/kg) resulted in increases in the activities. MDA and NO levels increased in the APAP group, and erdosteine treatments prevented these increases. Significant elevations in serum AST and ALT levels were observed in the APAP group, and when erdosteine and APAP were coadministered, their serum levels were close to those in the control group. Light microscopic evaluation of livers showed that there were remarkable centrilobular (zone III) hepatic necrosis and mild to moderate sinusoidal congestion in the APAP group, whereas in the erdosteine group, cellular necrosis was minimal and the hepatocytes maintained a better morphology when compared to the APAP group. Erdosteine prevented APAP-induced liver injury and toxic side effects probably through the antioxidant and radical scavenging effects of erdosteine.

Cyclosporine A (CsA) is used for the treatment of autoimmune and inflammatory disorders. However, CsA-induced nephrotoxicity remains an important clinical problem, and oxidative stress has been implicated as a possible responsible mechanism. We assessed the protective ability of N-acetylcysteine (NAC), an antioxidant, against CsA-induced nephrotoxicity.Wistar albino rats were randomly assigned into four groups. Group 1 rats were treated with sodium chloride as control, group 2 with CsA, group 3 with CsA and NAC, and group 4 with NAC alone. Animals were sacrificed and blood samples were analyzed for blood urea nitrogen (BUN), serum creatinine (Cr), malondialdehyde (MDA) and nitric oxide (NO) levels, and superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) activities. Kidney sections were analyzed for MDA and NO levels and SOD and GSH-Px activities, as well as histopathological changes.Overall, the treatment of rats with CsA alone produced significant increases in NO and MDA levels and significant decreases in SOD and GSH-Px activities in serum and renal samples. Morphological changes, including tubular epithelial atrophy, vacuolizations, and cellular desquamations, were clearly observed in the rats treated with CsA alone. Concurrent NAC administration with CsA improved renal function, as indicated by lower BUN and Cr values. Moreover, NAC significantly reduced MAD and NO levels and increased SOD and GSH-Px activities in serum and renal tissue, as well as provided a histologically proven protection against CsA-induced nephrotoxicity.These results indicate that NAC produces a protective mechanism against CsA-induced nephrotoxicity and suggest a role for oxidative stress in pathogenesis.

The prognostic significance of white coat hypertension (WCH) remains controversial. Consecutive patients (955 cases, 566 females) aged between 15 and 70 years were divided into 3 groups, those with sustained normotension (NT), WCH, and hypertension (HT), and the prevalences of obesity, impaired glucose tolerance (IGT) or type 2 diabetes mellitus (DM), coronary heart disease (CHD), and dyslipidemia were compared among the groups. Although the prevalences of all of the disorders showed significant progression from the sustained NT group towards the WCH and HT groups, the prevalence of dyslipidemia was significantly higher in the WCH group (P < 0.05 for all). Due to the gradually increased prevalences of obesity, IGT or DM, and CHD from the sustained NT group towards the WCH and HT groups and the highest prevalence of dyslipidemia in the WCH group, WCH should preferentially be accepted as an alarming sign of a deterioration in health rather than being a predisposing factor of HT or atherosclerosis alone. The significantly higher prevalence of dyslipidemia in the WCH group than in the HT group may be explained by the increased amount of adipose tissue in the HT cases, since the prevalence of obesity was the highest in the HT group. Thus, the high prevalence of WCH even in early decades may represent increased susceptibility to future weight gain, and dyslipidemia in patients with WCH may be a preliminary sign of obesity. Therefore, the management of WCH should focus on the prevention of dyslipidemia and excess weight gain.

WOS: 000255262000003 PubMed ID: 18410806 Similar to the cases seen around the world, snakebite causes mortality and morbidity in Turkey. The venom of different types of snake in the region of Cukurova causes serious systemic and local tissue damage. Methods: We performed this prospective study on 45 patients who complained of snakebite. We grouped the patients according to their clinical presentations to facilitate treatment and follow-up period procedures. Results: Whereas the patients with grade I envenomation did not receive any antivenom, grades 2 and 3 patients received 2.70 +/- 0.77 and 4.88 +/- 1.65 vials of antivenom, respectively. One of our patients had to undergo finger amputation but there were no deaths. Allergic reactions developed after antivenom therapy in 8 patients (17.8%). Conclusions: When we considered the cost and complications of the antivenom treatment, it was seen that low-dose antivenom treatment effectively treated the patients with venomous snakebite injuries in our region. (c) 2008 Elsevier Inc. All rights reserved.

PubMedID: 18165215 This study was conducted to evaluate the demographic, causative, and biologic characteristics of patients with organophosphate (OP) poisoning who were admitted to tertiary teaching and research hospitals at 2 different universities. All patients admitted to the emergency departments of Cukurova University Hospital in Adana, Turkey, between 2001 and 2003 and the Hospital of Mustafa Kemal University in Hatay, Turkey, between 2004 and 2006 were included. The study group consisted of subjects with a mean age of 28.5±14.1 y (range, 14-80 y), and the maximum number of cases in the second decade of life; the female-to-male ratio was 2.2:1. In all, 27 of 43 females and 16 of 20 males were married. Most subjects (n=55) had graduated from primary school; 3 were illiterate and 5 were highly educated. A total of 36 (57.1%) subjects belonged to lower socioeconomic groups. Fifty-three patients intended to commit suicide, and 10 cases were accidental. Mean arrival time of subjects to the hospital after poisoning was 9.9±16.1 h (range, 1-96 h); mean Glasgow Coma Scale score was 10.2±2.9 (range, 3-15). A total of 19 subjects were intubated, and 4 died. A total of 59 patients recovered completely. The mortality rate (6.3%) depended on various factors such as OP compound consumed, amount ingested, time interval before hospitalization, and patients' general health. Chances for recovery were greater when the patient was hospitalized at the earliest indication. In conclusion, OPs especially affected young single females, and most cases were due to attempted suicide. Because OP poisoning is an important cause of morbidity and mortality, therapy should be started immediately to avoid undesirable consequences. ©2007 Health Communications Inc.

In this study, the investigators explored the relationship between mortality rate and serum levels of C-reactive protein (CRP), erythrocyte sedimentation ratio (ESR), albumin, and hemoglobin, leukocyte, and platelet counts of patients at the time of first admission to the intensive care unit (ICU). A total of 123 patients were admitted to 2 different ICUs. In the emergency departments, serum levels of CRP, ESR, and albumin and hematologic parameters of 81 patients who died and 42 patients who survived were compared. A Student t test and the ? 2 test were used for statistical analyses. Mean CRP and ESR levels and leukocyte counts were higher in nonsurvivor than in survivor groups (P

P wave dispersion (PWD) is a sign for the prediction of atrial fibrillation (AF). The aim of this study was to assess P wave dispersion and its relation with clinical and echocardiographic parameters in patients with rheumatoid arthritis (RA). Thirty RA patients (mean age 49 +/- 10 years) and 27 healthy controls (mean age 47 +/- 8 years) were included in the study. We performed electrocardiography and Doppler echocardiography on patients and controls. Maximum and minimum P wave duration were obtained from electrocardiographic measurements. PWD defined as the difference between maximum and minimum P wave duration was also calculated. Maximum P wave duration and PWD was higher in RA patients than controls (P = 0.031 and P = 0.001, respectively). However, there was no significant difference in minimum P wave duration between the two groups (P = 0.152). There was significant correlation between PWD and disease duration (r = 0.375, P = 0.009) and isovolumetric relaxation time (r = 0.390, P = 0.006). P wave duration and PWD was found to be higher in RA patients than healthy control subjects. PWD is closely associated with disease duration and left ventricular (LV) diastolic dysfunction.

Increased QTc dispersion is a predictor for ventricular arrhythmias. The aim of this study was to investigate whether QTc dispersion decreases after weight loss program with diet and medical treatment.Total 30 (24 women and 6 men, mean age: 44+/-8 years) obese subjects who lost at least 10% of their original weight after 12 week weight loss program were included in present study. Obesity was defined asor =30 kg/m(2) of body mass index (BMI). Normal weight was defined asor = 25 kg/m(2) of BMI.After 12 week weight loss program, BMI decreased from 42+/-5 kg/m(2) to 36+/-4 kg/m(2) (p0.001) and mean weight of obese subjects decreased from 110+/-17 kg to 95+/-15 kg (p0.001). The mean amount of weight loss was 14.5+/-5.0 kg (range 9-32 kg). The average percent of weight loss was 13% (10.0%-20.3%). Maximum QTc interval (from 446+/-19 ms to 433+/-27 ms, p=0.024) and QTc dispersion (from 66+/-18 ms to 52+/-25 ms, p=0.024) significantly decreased after weight loss program. A statistically significant correlation was found between decrease in level of QTc dispersion and amount of weight loss (r=0.487, p=0.007).Substantial weight loss in obese subjects is accompanied by significantly decreased QTc dispersion. The degree of QTc dispersion reduction is associated with amount of weight loss.

Acute angle-closure glaucoma is a rare form of glaucoma occurring when the filtration mechanism for the aqueous humor is obstructed by apposition of the peripheral iris to the trabecular meshwork. It may be precipitated by pupillary dilatation in a predisposed eye. In this case report, a possible relationship between local tiotropium absorption and acute angle-closure glaucoma attack is presented.

The clinical symptoms of migraine are widely accepted to be related to the involvement of the autonomic nervous system, and especially to dysfunction in the regulation of the circulatory system and autonomic balance. Disturbance of the autonomic nervous system is a primary characteristic of migraine Therefore, patients with migraine have a variety of symptoms, such as vasodilatation (flushing), pilo-erection, nausea, vomiting, diarrhea, cutaneous vasoconstriction (pallor), and diaphoresis. The electrocardiographic changes seen during a migraine attack compared with the pain-free period could be secondary to reversible disturbances of the state of autonomic innervation of the heart and coronary arteries. Dysfunction of ANS may affect atrial and ventricular repolarization. For instance, increased sympathetic activity causes sinus tachycardia, but increased parasympathetic activity causes sinus bradycardia, atrioventricular block, and ST-segment and T-wave abnormalities. Comprehensive electrocardiographic analyses have been providing more details in terms of the detection of abnormalities in atrial and ventricular repolarization which potentially may result in arrhythmias in patients with migraine. However, there is no information in literature reporting the frequency of cardiac arrhythmias in migraine patients who had cardiac repolarization abnormalities. In this review, detailed electrocardiographic findings and their relation with the autonomic nervous system, including recent observations, have been evaluated. However, further studies are needed to investigate the association between autonomic dysregulation and cardiac repolarization abnormalities in patients with migraine.

PubMedID: 16180092 Cisplatin, one of the most active cytotoxic agents against cancer, has several toxicities. Hepatotoxicity is one of them occurred during high doses treatment. The aim of this study was to determine the effects of erdosteine against cisplatin-induced liver injury through tissue oxidant/ antioxidant parameters and light microscopic evaluation. The rats were randomly divided into three groups: control (n=5), cisplatin (10 mg/kg, n=6) and cisplatin+erdosteine (50 mg/kg/day oral erdosteine, n=8) groups. The rats were sacrificed at the 5th day of cisplatin treatment. The liver tissues were examined with light microscopy and oxidant/ antioxidant biochemical parameters. The malondialdehyde (MDA) and nitric oxide (NO) levels were increased in the cisplatin group in comparison with the control and cisplatin+erdosteine groups (p

Reptile bites are rarely seen cases in emergency departments. But particularly in the warm summer months, the prevalence is relatively higher in rural areas. Snakebites during pregnancy is little known and only a few cases have been reported in the literature. However, in case of pregnancy, the outcomes may be different both for mother and the fetus. Interestingly, there is limited number of reptile bite cases during pregnancy in the literature. We report here a woman who was bitten at her 28th week of gestation. Obstetric consultation with ultrasonography was performed and seen that fetus was normal according to a 28-week gestation. We infused four vials of antiserum in a period of 1 h in a saline solution. In all, 30 min after the initiation of the antiserum infusion, the lesion started to regress. Her obstetric consultation was repeated 1 h, 36 h, and before discharge were performed and seen that the fetus was normal. After a period of five days, the patient and fetus were evaluated once more, and nothing was abnormal for both.