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OBJECTIVE: Behçet's disease etiology is uncertain, and no specific diagnostic markers exist in the laboratory. This retrospective study aimed to evaluate the role of inflammatory and hematological parameters, mainly Pan-Immune-Inflammation-Value (PIV), in predicting vascular Behçet's disease (VBD). PATIENTS AND METHODS: A total of 85 patients with VBD and 92 patients without vascular involvement (non-VBD) were included in this study. Neutrophil, monocyte, platelet, and lymphocyte subsets are all included in the PIV, a new blood-based biomarker. RESULTS: The optimal cut-off values for the PIV were determined to be ≥261.6. White blood cell, neutrophil, monocyte, hemoglobin, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration (MCHC), red cell distribution, platelet, plateletcrit, PIV, neutrophil- to-lymphocyte ratio, platelet-to-lymphocyte ratio, sedimentation, c-reactive protein (CRP) values were significantly associated with VBD in univariate analysis. After multivariate analysis, PIV [odds ratio (OR): 2.758; 95% confidence interval (CI): 1.327-5.736; p=0.007] and CRP (OR: 4.029; 95% CI: 1.924-8.438; p<0.001) were found to be a positive predictor for VBD, while MCHC (OR: 0.722; 95% CI: 0.530-0.983; p=0.039) was seen as a negative predictor. CONCLUSIONS: Based on our results, PIV, an easily accessible, cost-effective, and new composite biomarker, has a significant predictive value in VBD. [ABSTRACT FROM AUTHOR]

Background : Secukinumab is a monoclonal antibody against interleukin 17 approved for patients with axial spondyloarthritis (axSpA), psoriatic arthritis (PsA), and psoriasis. Treating axSpA and PsA patients with a history of malignancy is a challenge. While initial results on the applicability of secukinumab in this patient group are positive, the number of studies on this topic remains limited. This study aimed to investigate the drug's survival time and the efficacy and safety of secukinumab treatment in this specific patient group. Methods : This retrospective study included 30 patients with a history of malignancy who were followed up in rheumatology outpatient clinics in 12 centers throughout Turkey and treated with secukinumab between May 2018 and March 2024 with a diagnosis of axSpA and PsA. Results: The mean follow-up time was 29.8 ± 19.3 months. The drug retention rate was 89.7% after 12 months and 80.6% after 24 months. The most common tumor in our study was papillary thyroid carcinoma ( n = 5, 16.7%). During follow-up, local tumor recurrence was observed in a patient with urothelial carcinoma of the bladder. Conclusions : In the largest cohort reported to date, treatment with secukinumab in axSpA and PsA patients with a history of malignancy was not shown to cause oncologic recurrence except for one local tumor recurrence. Drug retention rates were also high, and disease activation and function improved compared to baseline. Therefore, secukinumab could be a safe and effective option for this patient group.

Patients with axial spondyloarthritis (axSpA) who receive immunosuppressive therapy are at risk of infection due to impaired immune function and immunosuppressive medication. Vaccination plays a crucial role in preventing infections in this population. However, vaccination rates and factors influencing vaccination uptake in axSpA patients still need to be adequately studied. This study was designed to determine the vaccination rates of vaccines covered by health insurance in this particular group in Turkey and attitudes towards vaccines and infections. This survey included 199 patients with axSpA who visited our outpatient clinic in June, July, and August 2023 and received biologic and targeted synthetic disease-modifying antirheumatic drugs. The mean age of the participants was 43.7 ± 0.7 years, and the majority were male (66.3%). The majority of the patients were vaccinated against COVID-19 (85.4%), followed by hepatitis B (41.2%), influenza (20.1%), and pneumococcal pneumonia (10.5%). While awareness of COVID-19 vaccination was widespread (100%), knowledge of other vaccines was lower (hepatitis B 80.9%, influenza 70.3%, pneumococcal 60.3%, respectively). Educational interventions targeting patients and healthcare professionals are needed to improve vaccination rates in this population. Our findings emphasize the need for strategies to increase vaccination rates in axSpA patients receiving immunosuppressive therapy. Removing barriers to vaccination and raising awareness of the importance of vaccination are critical to optimizing vaccination practices in this vulnerable population.

Familial Mediterranean fever (FMF) is characterized by recurrent episodes of fever and serositis. Blood-based biomarkers determined in FMF patients during attack-free periods could be used to predict the risk of amyloidosis and the severity of the disease. The recently defined pan-immune-inflammation value (PIV) comprises four distinct subsets of blood cells and serves as an easily accessible and cost-effective marker. The objective of this study was to assess the role of PIV in predicting amyloidosis and moderate-to-severe disease. Clinical characteristics and laboratory values during the attack-free period were retrospectively analyzed in 321 patients over 18 years of age diagnosed with familial Mediterranean fever (FMF). In our tertiary adult rheumatology outpatient clinic, disease severity and laboratory markers were evaluated during the first attack-free interval. At baseline, patients with amyloidosis were excluded. Patients were categorized based on the presence of amyloidosis and the severity of the disease. When focusing on amyloidosis in receiver operating characteristic (ROC) analysis, optimal cut-off values for pan-immune-inflammation value (PIV), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio were determined as ≥518.1, ≥2.3, and ≥127.2, respectively. In multivariate analysis, PIV, C-reactive protein (CRP), and the presence of the M694V homozygous mutation emerged as independent risk factors for both amyloidosis and moderate-to-severe disease. Additionally, NLR was identified as an independent risk factor for amyloidosis, while red blood cell distribution width was associated with moderate-to-severe disease. In patients with FMF, especially in the presence of the M694V homozygous mutation, CRP and PIV may be useful in predicting both amyloidosis and moderate-to-severe disease.

Objective: To determine the rate of unintentional monotherapy (UM; switching to monotherapy from combination therapy of patients' own volition) in rheumatoid arthritis patients receiving tofacitinib and to evaluate tofacitinib survival rate., Methods: This national, multicenter study included patients' data from the TURKBIO Registry. Demographics, clinical characteristics, disease duration and activity, comorbidities, and treatments were analyzed., Results: Data of 231 rheumatoid arthritis patients (84.8% female, median age, 56 years) were included; 153 were initially prescribed combination therapy and continued to their therapies; 31 were initially prescribed combination therapy but switched to monotherapy on their own volition (UM); 21 were initially prescribed monotherapy and switched to combination therapy; 26 were initially prescribed monotherapy and continued to their therapies. The rate of comorbidities at the time of data retrieval was higher in the UM group than in the combination group (83.3% vs. 60.3%, p = 0.031). Presence of comorbidities was a significant factor affecting switching to monotherapy ( p = 0.039; odds ratio, 3.29; 95% confidence interval, 1.06-10.18). The combination and UM groups did not differ regarding remission rate assessed by Disease Activity Score 28-joint count C-reactive protein (60.5% and 70%, respectively; p = 0.328). Drug survival rates of the UM and combination groups did not differ. The median drug survival duration of tofacitinib was 27+ months with 1- and 4-year drug survival rates of 89.6% and 60.2%, respectively, in the UM group., Conclusions: Although 13.4% of the study population started monotherapy unintentionally, drug survival and remission rates of the UM and combination groups were not different. Comorbidity was a factor affecting transition from combination therapy to monotherapy., Competing Interests: A.Y. has received project grant from Roche Pharmaceuticals, Turkey. C.S.B. and T.Y.C. are employees of Pfizer Pharmaceuticals, Istanbul, Turkey. S.A. is an employee and shareholder of Pfizer Inc., Istanbul, Turkey. N.I., K.Y.A., M.A.O., A.T., H.K., I.S., G.C., Y.E., Y.P., H.E.D., T.O., A.C., A.S.S., S.A., E.D.-E., S.S.K., R.P.-S., S.Y., S.G., O.S.-G., and F.O. declare no conflicts of interest., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)

Introduction: Idiopathic granulomatous mastitis (IGM) is a rarely seen chronic and benign disease of the breast. IGM usually emerges in women between 30 and 45 years of age and within the first 5 years after lactation. There is no consensus on the treatment of the disease. Steroids, immunosuppressive agents such as methotrexate and azathioprine, antibiotics, and surgical and conservative treatments can be preferred. In the present study, it was aimed to demonstrate the treatment options and follow-up data of the patients with IGM and to investigate the effective factors on recurrence if developed in the follow-up period., Materials and Method: The data of 120 patients diagnosed with idiopathic granulomatous mastitis were evaluated for this cross-sectional retrospective study. The demographic, clinical, treatment, and follow-up features of the patients were obtained from the file records., Results: The median age value of the 120 female patients included in the study was 35 (24-67) years. Of the patients, 45%, 79.2%, 49.2%, and 15% had a past history of surgical intervention, steroid use, methotrexate use, and azathioprine use, respectively. Recurrent lesion developed after the treatment in 57 (47.5%) patients. The recurrence rate was 66.1% in the patients who underwent surgical intervention in the initial treatment. There was a statistically significant difference between the patients with and without recurrence regarding the presence of abscess, the presence of recurrent abscess, and having surgical intervention as the initial treatment in the past history. The rate of having surgery was statistically significantly higher compared with the administration of steroid therapy alone and the combination of steroid and immunosuppressive therapy in the initial treatment of the patients who developed recurrence. The rate of having surgery together with the administration of steroid and immunosuppressive therapy was statistically significantly higher than the administration of steroid and immunosuppressive therapies., Discussion: Our study showed that surgical intervention and the presence of abscess increased recurrence in the treatment of IGM. Key Points • This study has shown that surgical intervention and the presence of abscess increase recurrence. • A multidisciplinary approach to the treatment of IGM and management of the disease by the rheumatologists may be critical., (© 2023. The Author(s), under exclusive licence to International League of Associations for Rheumatology (ILAR).)

Background: Spontaneous bacterial peritonitis (SBP) is an important reason for mortality in cirrhosis. This study aimed to identify the factors associated with mortality in SBP., Materials and Methods: A total of 69 patients with cirrhosis and 74 with SBP attacks that occurred in this group were assessed. Demographic data, symptoms at admission, comorbidities, laboratory parameters, treatment protocols, causes of cirrhosis, scoring characteristics, cirrhosis complications, and mortality were analyzed., Results: Model for end-stage liver disease (MELD; p = 0.001), sodium-MELD ( p = 0.001), and Child-Pugh-Turcotte (CTP) ( p < 0.001) scores were correlated with mortality in patients with SBP episodes. Hepatorenal syndrome ( p = 0.001) and esophageal variceal bleeding ( p < 0.001) related to mortality. Serum lactate dehydrogenase (LDH) ( p = 0.007), serum leukocyte ( p = 0.017), and serum hemoglobin ( p = 0.010) values had a statistically significant effect on mortality in multivariate regression analysis., Discussion: The mortality rate can be reduced by identifying factors influencing death in patients with SBP episodes., How to Cite This Article: Ocak T, Gülten M. Retrospective Investigation of Factors Affecting Mortality in Spontaneous Bacterial Peritonitis. Euroasian J Hepato-Gastroenterol 2023;13(1):5-9., Competing Interests: Source of support: Nil Conflict of interest: None, (Copyright © 2023; The Author(s).)

Objective: Studies related to the epidemiology of trauma play a major role in determining the health status of the communities living in the vicinity of the centers that they are conducted. We have found no epidemiological study related to emergency service admission conducted only on preschool-aged children in the literature. Our aim was to determine characteristics of trauma in this age group, to analyze encountered trauma types, and to investigate possible associations among epidemiological factors, characteristics of the trauma victims, and trauma itself in pediatric patients admitted to our emergency service., Methods: We conducted a prospective study with patients aged 66 months and younger, admitted to Emergency Service of Istanbul Kanuni Sultan Suleyman Training and Research Hospital between July 1, 2015, and December 31, 2015. Data related to age, sex, occupational status of parents, number of siblings, Glasgow coma scale score, transport mode, admission time period of the day, general health status, type of trauma, the trauma site, involved body regions, radiologic imaging and laboratory results, consultations, clinical diagnosis and outcome, duration of emergency service stay, and treatment cost were collected and statistically analyzed., Results: A total of 688 preschool-aged cases were admitted owing to trauma. The major mode of transport was a private vehicle (98.3%), and the major cause was falling (64.0%). The major traumatized body region was head and neck (51.0%), and the major diagnosis was soft tissue trauma (90.1%). The average duration of stay was 122.01 minutes and affected by sibling number, trauma type, and employment status. The total service fee was interrelated with the type of trauma and the site that trauma occurred; it also was strongly correlated with duration of emergency service stay., Conclusions: Our results suggest that both in-hospital and social/environmental aspects should be improved to reduce the clinical and social burden of trauma., Competing Interests: Disclosure: The authors declare no conflict of interest., (Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Headache is the most common symptom in carbon monoxide (CO) poisoning. While the mechanism of CO-induced headache is not well defined, it is felt that cerebral vasodilation plays a role. Clinical experience has demonstrated oxygen breathing is effective in resolving CO headache. However, the effectiveness of normobaric oxygen has never been compared to hyperbaric oxygen in this regard., Methods: A 2016 paper by Ocak, et al. reported the response of CO headache pain severity to four hours of normobaric oxygen breathing in 82 patients using a 0-10 analog scale. The demographics, carboxyhemoglobin levels and response to therapy from that report were compared to data obtained by Hampson, et al. in an earlier study, but never published, using the same pain assessment method in 73 patients with CO headache and treated with hyperbaric oxygen., Results: Comparing the normobaric and hyperbaric groups, neither average age nor presenting carboxyhemoglobin levels were significantly different. Baseline pain intensity scores were 6.5 ± 3.1 vs. 6.2 ± 2.6 (p=0.444) and post-treatment scores 1.5 ± 2.6 vs. 1.0 ± 1.5 (p=0.184) respectively on a 0-10 scale., Conclusions: In these two well-matched populations of patients with CO-induced headache pain, degree of resolution was not significantly different between normobaric and hyperbaric oxygen treatment., Competing Interests: The authors of this paper declare no conflicts of interest exist with this submission.

Purpose: To compare the diagnostic value of ultrasonography (USG), which is rapid, inexpensive, simple, and does not involve radiation, with that of direct radiography for identifying fractures in the nasal bones of pediatric patients presenting in the emergency department with nasal trauma., Equipment and Methods: Patients under 18years old presenting with nasal trauma at the emergency department included prospectively. The patients' age and sex distribution, trauma type, GCS, physical examination findings, direct radiography, and USG results were recorded. The physical examination made by the emergency medicine specialist on arrival was accepted as the gold standard for diagnosis., Findings: In total, 133 patients, 34.6% female and 65.4% male, were included in this study. The average patient age was 7.44±5.05years, with the greatest proportion (21.8%, n=29) of patients in the age ranges of 0-2 and 6-8years. The most frequently observed finding on physical examinations was swelling (51.1%, n=68). In total, 50 (37.6%) patients had nasal fractures according to their first physical examination, which was performed by emergency medicine specialists. That is, fractures were detected by direct radiography in only 11 of the 34 cases who were diagnosed with fractures by USG., Conclusions: We consider that USG should be preferred over direct radiography for use at the bedside of pediatric patients who present at emergency department with nasal trauma, because of its superior diagnostic ability and the lack of a requirement for radiation., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Background: There is a lack of specificity of the analgesic agents used to treat headache and underlying acute carbon monoxide poisoning., Objective: To compare effectiveness of "oxygen alone" vs "metoclopramide plus oxygen" vs "metamizole plus oxygen" therapy in treating carbon monoxide-induced headache., Design: A prospective, multicenter, double-blind, controlled trial., Setting: Three emergency departments in Turkey., Population: Adult carbon monoxide poisoning patients with headache., Methods: A total of 117 carbon monoxide-intoxicated patients with headache were randomized into 3 groups and assessed at baseline, 30 minutes, 90 minutes, and 4 hours., Main Outcome Measure: The primary outcome was patient-reported improvement rates for headache. Secondary end points included nausea, need for rescue medication during treatment, and reduction in carboxyhemoglobin levels., Results: During observation, there was no statistical difference between drug type and visual analog scale score change at 30 minutes, 90 minutes, or 4 hours, for either headache or nausea. No rescue medication was needed during the study period. The reduction in carboxyhemoglobin levels did not differ among the 3 groups., Conclusion: The use of "oxygen alone" is as efficacious as "oxygen plus metoclopramide" or "oxygen plus metamizole sodium" in the treatment of carbon monoxide-induced headache., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Antibiotics are natural or synthetic substances that are used to control bacterial infections because antibiotics are by definition only effective against bacteria. A 30-year-old female came to our emergency clinic complaining rubor in both eyes, especially in the left eye, with swelling, rubor and pain in ears, and eruption in lips extremities. In her anamnesis, it has been determined that she did not have any medical disease that requires regular utilization of drugs. After the patient received cefuroxime axetil for acute tonsillitis, she observed eruptions in lip extremities on the 3rd day, but she did not care about it. On the 5th day, rubor in both eyes and, especially in the left eye, have been developed, and complaints such as unable to look toward light and pain have started together with swelling, rubor, and pain in both ears. She came to our clinic because she was very much worried about the situation. In this study, we aimed to discuss a drug reaction characterized by face and ear skin observations, due to uveitis after the use of antibiotics including cefuroxime axetil for acute tonsillitis.

Cardiac and cerebrovascular illnesses are major causes of mortality and morbidity. Thromboembolisms, which are the result of cardiac arrhythmia, are important causes of ischemic stroke. In this study, we present a rare case of multicentric ischemic stroke induced by Mobitz type II atrioventricular block., Competing Interests: The authors declare no competing interest.

Background: During the Eid al-Adha ("Sacrifice Feast") religious holiday in Muslim communities animal sacrifices are made over a period of 3 days every year., Objectives: The aim of this study was to determine the type of sacrifice-related injuries, the characteristics of patients, treatments for injuries, and relationships between these factors to determine precautions that could be taken to avoid or mitigate sacrifice-related injuries., Design: Retrospective study of medical records., Setting: Emergency units at two hospitals from 2010 to 2013., Patients and Methods: Patients admitted for treatment for injuries associated with sacrificial cutting during the four annual sacrifice feasts were classified as professional butchers, apprentice butchers, and third persons who were neither professional butchers nor apprentices., Main Outcome Measure(s): Injuries associated with animal sacrifice., Results: Of 592 patients, 22 (3.7%) were professional butchers, 149 (25.2%) apprentice butchers, and 421 (71.1%) third persons. Significant relationships were found between the profession of the injured person and the injury and subsequent treatment (P < .05)., Conclusion: To prevent and minimize the injuries associated with sacrificial cutting, there should be an area designated for sacrificing animals. Moreover, sacrifices should be performed by professionals in possession of a sacrificial cutting certificate. If owners of sacrificial animals insist on slaughtering animals, they should be trained by professional butchers who have a teaching certificate. To deal with an increasing number of such injuries during the sacrifice feast, hospital emergency units need to be adequately resourced with adequate equipment and staff., Limitations: Regional and local data could not be assessed completely. Patients who presented on the 4th day were not included in the study.

Introduction: Tularemia is a zoonotic disease caused by Francisella tularensis. Here we present an epidemic occurring in Bolu province, located in northwestern Anatolia in Turkey, and some features of the cases., Methodology: The data was provided by the Bolu Provincial Health Directorate. All of the antibody response tests were studied in the National Health Institute (formerly named Refik Saydam Hygiene Department), the reference laboratory of the Ministry of Health of the Turkish Republic. A total of 393 individuals were tested by microagglutination test (MAT) for tularemia between 2006 and 2011. A total of 218 patients whose demographical data were available were included in the study; 83 were accepted as the patient group and 135 were the controls. Of the patients, 31 (37.3%) were male and 52 (62.7%) were female., Results: Fever (p < 0.001), URTI symptoms (p = 0.047), conjunctivitis (p = 0.004), and rash (p = 0.026) were significantly higher in the patient group. A positive association was found between MAT and fever (r = 0.324; p < 0.001), and a negative association was found between MAT and both lymphoadenopathy (r = -0.25; p = 0.013) and chills (r = -0.218; p = 0.035). Higher MAT titers were detected in oropharyngeal tularemia (r = 0.306; p = 0.003)., Conclusions: In conclusion, tularemia must be considered in differential diagnosis in patients presenting with fever and LAP in non-endemic regions. Furthermore, water sources and contact with rodents must be investigated.

Objective: To investigate the diagnostic importance of mean platelet volume (MPV) on acute pulmonary embolism (APE) in the emergency Department (ED)., Methods: Subjects were selected from patients admitted to ED with clinically suspected APE. Demographic, anthropometric and serologic data were collected for each patient., Results: A total of 315 consecutive patients were analyzed, including 150 patients (53.44 ± 15.14 y; 92 men/58 women) in APE group and 165 patients (49.80 ±13.76y; 94 men/71 women) in the control group. MPV in the APE group was significantly higher than in the control group (9.42±1.22 fl vs. 8.04±0.89 fl, p<0.0001). The best cut-off values for MPV when predicting APE in patients with clinically suspected APE presenting at the ED were 8.55 fl (sensitivity 82.2%; specificity 52.3%)., Conclusions: MPV is a helpful parameter for the diagnosis of APE in ED, for the first time in the literature.

Background: The diagnosis of palpitation can be difficult in the emergency department (ED) and the waiting time for a first appointment with an arrhythmia clinic can be very long. The inflammation is sufficient to facilitate the initiation of supraventricular tachyarrhythmia (SVT). The increased mean platelet volume (MPV) is closely correlated with inflammation and to reflect inflammatory burden in different condition., Objective: In this study, we aimed to investigate the relation between MPV and SVT in patient with documented atrial tachyarrhythmia in ED., Methods: Two study groups were compared; a SVT group with arrive at the ED with documented SVT (n=122) and 100 healthy adult without any palpitation symptom, arrhythmic disease, and with normal physical examination results that were brought for checkups to the cardiology polyclinic were classified as control group. Blood samples were obtained from all patients for determining the hematologic counts and MPV during first hour in ED period., Results: In terms of the focus of the study, hemoglobin, neutrophil count, mean cell volume (MCV), red cell distribution width (RDW), platelet, white blood cell (WBC), and lymphocyte counts were similar in both group (p>0.05). MPV in the SVT group was signifi cantly higher than in the control group (9.12±1.22 fl vs 8.64±0.89 fl , p<0.001). Multivariate logistic regression analysis showed that just MPV was independent predictor of SVT in patients with palpitation in ED (odds ratio [OR] 8.497, 95% confidence interval (6.181 to 12.325), p=0.012)., Conclusions: Our study described that MPV is helpful parameter for the diagnosis of SVT in emergency department, for the first time in the literature.

Aim: To evaluate the effects of montelukast and Hypericum perforatum against ischemia/reperfusion (I/R)-induced intestinal damage., Materials and Methods: Twenty-eight hamsters were divided into 4 groups following midline abdominal laparotomy: control group (n = 7), I/R group (n = 7), montelukast and I/R (MIR) group (n = 7), and Hypericum perforatum and I/R (HPIR) group (n = 7). After 60 min of ischemia through obstruction of the superior mesenteric artery, 24 h of reperfusion was maintained. Ten minutes prior to the reperfusion period, the MIR group received 7 mg/kg of intraperitoneal montelukast and the HPIR group received 7 mg/kg of intraperitoneal Hypericum perforatum. Malondialdehyde, glutathione, myeloperoxidase, and cardiotrophin-1 levels were measured from blood samples. A semiquantitative histological evaluation was performed., Results: Montelukast and Hypericum perforatum significantly reduced malondialdehyde levels and increased glutathione levels compared to the I/R group (P < 0.008). A statistically significant difference was also found between the I/R group and MIR and HPIR groups in terms of myelqperoxidase levels (P < 0.008). The MIR and HPIR groups showed increased cardiotrophin- 1 levels compared to the control and I/R groups (P < 0.008 for all). The MIR and HPIR groups showed significantly lower histological scores compared to the I/R group (P = 0.03 and P = 0.007, respectively)., Conclusion: This study demonstrated the preventive effects of montelukast and Hypericum perforatum on I/R-induced intestinal injury.

Aim: We aimed to investigate the relation between mutations and polymorphisms playing roles in the onset of clinical findings of Familial Mediterranean Fever (FMF) and clinical phenotypic reflections manifesting with painful episodes, such as dysmenorrhea., Material and Methods: A total of 1000 female patients who had not responded well to non-steroidal anti-inflammatory drugs in the menstrual period, and who had presented to the emergency room with the complaint of recurrent pain episodes were included in the study. All the patients were Turkish women living in Istanbul. In this study, the mutations most frequently seen in the Mediterranean Fever Gene (MEFV), namely M694V, E148Q, M680I(G/C), V726A, P369S, R761H, A744S, M694I, K695R, F479L, M680I(G/A), and I692del were examined using the DNA sequence analysis following DNA isolation., Results: The number of individuals who had a mutation in at least one allele for FMF was 511 out of 1000 patients. Of these 511 patients, homozygous mutations were found in 21% (n = 109), compound heterozygous mutations were found in 27% (n = 136), and heterozygous mutations were found in 52% (n = 266). The most frequent homozygous genotype seen in our study population was M694V/M694V. The most common compound heterozygote genotypes were M694V/M680I, M694V/V726A, M694V/E148Q, and M680I/V726A; and 11.7% (n = 60) of the families in whom mutations were found had consanguinity., Conclusion: Women who present to the emergency room with the complaint of dysmenorrhea that is irresponsive to non-steroidal anti-inflammatory drugs may have several types of MEFV mutations that are responsible for FMF., (© 2013 The Authors. Journal of Obstetrics and Gynaecology Research © 2013 Japan Society of Obstetrics and Gynecology.)

Cardiac and cerebrovascular illnesses are among the leading causes of mortality and morbidity today. Thromboembolic cases, which are the result of cardiac arrhythmia, are one of the important causes of cerebral stroke. However, various abnormalities, especially ST-T wave changes on electrocardiography can be seen in patients who do not have any heart disease history but had ischemic cerebral stroke. In this study, we have presented an interesting case of Torsades de Pointes due to ischemic cerebral stroke.

We report a case of a 33-year-old woman who developed severe brain edema and pseudo-subarachnoid hemorrhage (SAH) at 36-hour follow-up after successful cardiopulmonary resuscitation for anaphylactic shock as a result of a bee sting. The patient died on the sixth day of the follow-up due to multiple organ failure and brain herniation. Our case suggests that the SAH-like findings on computed tomography scanning were not a new complication ("real" SAH) arising from the bee sting; rather, it was a pseudo-SAH related to prolonged cardiopulmonary resuscitation).

To evaluate the epidemiological characteristics, etiology, and therapeutic outcome of gastrointestinal disorders in 269 patients who underwent emergency upper gastrointestinal (EUGI) endoscopy at the Emergency Department. Abdominal pain was the most common clinical indication, in 90 (33.5%) patients. The clinical reasons for emergency admission were significantly related to endoscopic diagnostic yield. Non-erosive gastritis was the most common diagnosis, in 76 (28.3%) of EUGIE patients. Erosive duodenitis and gastric ulcer were found to be the other most common clinical indications, in 69 (25.7%) and 31 (11.5%) of EUGIE patients, respectively. The majority of patients who presented with abdominal pain and loss of appetite were between the age of 41 and 60 years, while a significant number of patients presenting with the same symptoms did so during the winter season. Emergency endoscopy is a procedure of choice for the investigation of upper gastrointestinal complaints. Emergency endoscopy is not only a diagnostic tool but also a therapeutic modality.

Unlabelled: Amitraz is an insecticide/acaricide of formamidine pesticides used worldwide for ectoparasites in animals. Because of its widespread use, amitraz poisoning is frequently encountered in Turkey., Case Report: A 36-year-old, comatose female was admitted to the hospital. Although it was stated that she had taken a glass of water containing amitraz, the exact volume of the substance was unknown. On admission, her Glasgow Coma Scale score was 10/15. Clinical findings were vomiting, miosis, bradycardia and hypotension. The patient's vital signs were body temperature 37.2 degrees C, pulse 54 bpm, blood pressure 80/50 mmHg and pulseoximetry 84%. Supportive treatment consisting of oxygen, fluid replacement and gastric lavage, activated charcoal and atropine was administered. On the second day, signs of Ogilvie's syndrome characterized by severe tenderness, distension and pain in the abdomen were seen. On the third day, the patient's condition improved except for abdominal distension and pain, inability to pass faeces or flatus through the anus. Although continuous nasogastric tube decompression was performed, her complaints were not resolved completely. Neostigmine was administered on the fourth day. On the fifth day, abdominal pain and distension were decreased, and stool passage began. She had a complete clinical and laboratory improvement, which warranted her discharge on the seventh day of admission.