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This study aimed to determine the relationship between the frontal QRS-T angle, the severity of the disease, and mortality, calculated with the ECG data taken during admission to the hospital. In this retrospective study, patients hospitalized in intensive care units and regular services with Covid-19 disease at Health Sciences University Mehmet Akif Inan Training and Research Hospital between April-September 2020 were included. Patients who were not given Covid-19 medication except for five days of Hydroxychloroquine (HC) and Azithromycin (AZ) with no cardiac disease history and daily taken ECGs were included in the study. A total of 135 patients were included in this study. While 45.9% of the patients received only HC treatment, 54.1% also received additional AZ treatment. It was observed that the frontal QRS-T angle was significantly longer in intensive care patients and intubated patients (p =<0.001). ROC curve analysis demonstrated that the best cut-off value for predicting mortality was 101.5o. The in-hospital mortality rate was significantly higher in patients with widened frontal QRS-T angle (p = 0.008). QRS widening, QTc prolongation, and QRS-T angle widening were substantially more frequent in intensive care patients (p=0.001, p<0.001, and p<0.001, respectively). Significantly QTc prolongation was observed more frequently in patients hospitalized in intensive care and followed up intubated (p<0.001 and p=0.003, respectively). The most common QTc prolongation time was on the 4th day of treatment in both groups (43.8% and 46.8%). Multivariate logistic regression analysis showed that frontal QRS-T angle ≥ 101.5o (OR: 7.08, 95%CI: 1.17-42.75, P = 0.033) was an independent predictor of mortality. The prolonged frontal QRS-T angle in Covid-19 patients increases the severity of the disease and mortality rates. The frontal QRS-T angle can be used to determine the prognosis of Covid-19 patients due to its advantages, such as easy evaluation and no extra costs. [ABSTRACT FROM AUTHOR]

Background: Snake and scorpion envenomation is a common public health problem in many regions of the world. Life-threatening emergencies may occur in patients with snake and scorpion envenomation; therefore, these patients may be required intensive care unit (ICU) follow-up. Our objective was to present the demographic and clinical characteristics, treatment modalities and short term outcomes of patients with snake and scorpion envenomation who followed up in our tertiary hospital ICU. Methods: Patient records were retrospectively searched and snake or scorpion envenomation patients with ICU stay were identified with relevant keywords and ICD-10 codes between January 2010 and September 2019. All cases with ICU stay were included for study analysis, regardless of patient age. Scorpion and snake envenomation managed in outpatient clinic were excluded from our data. Poisoning severity score (PSS) system was used to present signs and symptoms and PSS was calculated. Primary and critical care treatment modalities were identified and analyzed. Results: Forty patients (25 with snake bites [62.5%] and 15 with scorpion sting [37.5%]) were included in this retrospective study. Local and systemic effects have been reported in 33 (82.5%) and in 27 patients (67.5%), respectively. Majority of patients suffered from pain or disturbances in sensory neural, hematological, cardiovascular or metabolic systems. Median PSS was 2 (0-4) and median length of stay in ICU was 2 days (1-12). Mortality rate was 2.5%. Antivenom immunoglobulins (n=32, %80.0), systemic antibacterial agents (n=24, 60%), and paracetamol (n=21, 52.5%) were the most common systemically administered treatments. Surgical interventions were performed in 4 patients (10%). Conclusions: We reported that snake and scorpion envenomation were mostly admitted to the ICU with local and/or systemic symptoms for advanced monitoring and observation. Although life treating emergencies and mortality was uncommon in our study, we think that these patients should be closely followed up in ICU. [ABSTRACT FROM AUTHOR]

Objective: According to previous studies, anaesthesia type has an important effect on immune response. However, there are limited data determining the effect of low-flow and normal-flow desflurane anaesthesia on inflammatory parameters. This study aimed to investigate the effect of low-flow and normal-flow desflurane anaesthesia on inflammatory parameters in patients undergoing laparoscopic cholecystectomy. Methods: A total of 92 patients who underwent laparoscopic cholecystectomy were retrospectively included in this study. The patients were divided into the following 2 groups according to the type of anaesthesia they received: low-flow desflurane anaesthesia group (fresh gas flow rate: 0.5 L min-1) and normal-flow desflurane anaesthesia group (fresh gas flow rate: 2 L min-1). Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were obtained before the procedure and 6 hours after the end of the procedure for all patients. Results: Although pre-procedural NLR and PLR were similar between the normal-flow and low-flow anaesthesia groups, post-procedural NLR (4.38±2.00 vs. 3.51±1.37, p=0.023) and PLR (144.38±71.04 vs. 120.58±35.35, p=0.037) were significantly higher in the normal-flow anaesthesia group. In addition, compared with pre-procedural values, post-procedural NLR (from 2.31±1.02 to 4.38±2.00, p<0.001) and PLR (from 125.60±50.97 to 144.38±71.04, p=0.017) were significantly increased in the normal-flow anaesthesia group, whereas post-procedural NLR (from 2.88±2.51 to 3.51±1.37, p=0.135) and PLR (from 121.86±42.78 to 120.58±35.35, p=0.847) did not change significantly in the low-flow anaesthesia group. Conclusion: The study results indicated that postoperative inflammatory response was significantly lower with low-flow desflurane anaesthesia than with normal-flow desflurane anaesthesia. [ABSTRACT FROM AUTHOR]

Objective: Acute Kidney Injury (AKI) development is not a rare complication after cardiac surgery, and is often associated with a high risk of morbidity and mortality. In-hospital mortality rates of patients in need of dialysis can reach up to 70%. Our aim was to determine the risk factors for the development of AKI and the results of AKI development by examining the cases of AKI developed after cardiac surgeries performed in our hospital in a 8 year- period. Method: A total of 594 patients who underwent cardiovascular surgery between January 2010- September 2018 were retrospectively included in the study. Demographic data, preoperative risk factorsi, intraoperative variables, intensive care unit data, and mortality rates were recorded. Clinically important ones among the significant data were again divided into three groups according to duration of AKI in days: 1-3 days AKI (Group 1), 3-7 days AKI (Group 2) and ≥7 days AKI (Group 3). Results: AKI was observed in 31.1% of the patients. Duration of intubation (p<0.001), intensive care unit (ICU) (p<0.001), and hospital stay (p<0.001) and average time to exitus (p<0.001) were significantly longer in this patient group., in all subgroups except for Group 1. Mean time to exitus was longer only in Group 3 (p=0.002). Conclusion: Development of AKI after cardiac surgery is one of the important factors affecting mortality and morbidity after cardiac surgery. It is directly proportionate not only to AKI development after cardiac surgery, but also fundamentally to duration of AKI, duration of ICU, hospital stay and mortality. [ABSTRACT FROM AUTHOR]

Air embolism is a rare clinical entity that must be well recognized with high morbidity and mortality rates. Sensitive early diagnosis methods are available for air embolism, but these methods are not always easy to reach. With the detection of venous air embolism, mortality and morbidity can be reduced by rapid aspiration of air and concomitant treatment. It is important to recognize and prevent the problems that embolism may cause in the early period. venous air embolism, the amount of aspirated air is directly proportional to mortality and morbidity. The most important approach here is to try to prevent the development of air embolism and to make an early diagnosis in possible cases, keeping in mind that it can always develop. In this case report, we present a 51-year-old female patient with the diagnosis of air embolism in the postoperative period and the treatments applied. [ABSTRACT FROM AUTHOR]

Amaç: Zehirlenmeler, intihar amaçlı ilaç ya da madde alınması, farkında olmadan yüksek dozda ilaç kullanılması ya da istenmeyen ilaç reaksiyonları olarak ortaya çıkabilmektedir. Zehirlenmeler; alınan ilaç/maddeye, hastaneye başvuru süresine bağlı olarak ciddi sonuçlar doğurabilmektedir. İlaçlara bağlı meydana gelen zehirlenmelerde mortalite daha düşük iken, intihar amacıyla alınan pestisitlerde mortalite artmaktadır. Ülkemizde acil servise başvuran zehirlenme olgularının sayısının, tüm olguların %0,46- 1,57’sini oluşturduğu bilinmektedir. Acil servise başvuran bu hastalardan bir kısmı yoğun bakım tedavisi gerektirmektedir. Yoğun bakım üniteleri yataklarının %5-30 kadarı zehirlenme olguları için kullanılmaktadır. Bu çalışmada, periferde yer alan bir hastanenin erişkin yoğun bakım ünitelerinde üç yıl içerisinde (2017-2020) takip edilen zehirlenme olgularının demografik ve etiyolojik özelliklerini, yoğun bakım kalış sürelerini retrospektif olarak sunmayı amaçladık Gereç ve Yöntem: Çalışmamızda Ocak 2017-Aralık 2020 tarihleri arasında yoğun bakım ünitesine kabul edilen 166 akut zehirlenme olgusunun yaş, cinsiyet dağılımları, GKS ve APACHE II bilgileri, zehirlenme nedenleri, yoğun bakım kalış süreleri ve sağkalım durumları dosya takiplerinden retrospektif olarak değerlendirildi. Ayrıca hangi mevsimde intoksikasyonun meydana geldiği, yoğun bakımdan çıkış durumları değerlendirildi. Bulgular: Çalışmamıza Ocak 2017 yılından itibaren hastanemiz yoğun bakım ünitesinde suisid ve intoksikasyon nedeniyle takip edilen toplam 166 dahil edildi. Hastaların 59’u (%35,5) erkek, 107’si (%64,4) kadın idi. Hastaların yaş ortalaması 29,8 (minimum: 18-maksimum: 90) yıl idi. Erkek hastaların yaş ortalaması 31,4 (minimum: 19-maksimum: 68) yıl, kadınların yaş ortalaması 28,8 (minimum: 18-maksimum: 90) yıl idi. Hastaların ortalama yoğun bakım yatış süresi 1,33 (minimum: 1-maksimum: 10) gün idi. Takiplerinde 22 hasta tedaviyi reddederek taburcu edildi. Dört hasta entübe halde takip edildi. Dört hastanın daha önceden suisid girişimi var idi. Üç hastaya gastroskopi yapıldı. Bir hastada derin asidoz sonrası kardiyak arrest gelişti, kardiyopulmoner resüsitasyon yapılarak pacemaker takıldı. Bir hasta hemodiyalize alındı. Üç hastaya da asist infüzyonu uygulandı. Yüz on dört (%68,6) hastada tek toksik madde kullanımı mevcut iken, 52 (%31,3) hastada çoklu toksik madde kullanımı mevcut idi. Kullanılan ilaçlar sınıflandırıldığında; antipsikotikler, antidepresanlar, parasetamol, antihipertansifler, antibiyotikler, analjezikler, antiepileptikler, antidiyabetikler, antitiroid ilaçlar ve diğer ilaçlar (antiagregan, vitamin, demir, miyorelaksan, vb.) bulunmakta idi. Bunların haricinde fare zehiri, pestisidler, alkol, çamaşır suyu ve antifiriz kullanımı sonrası da zehirlenmeler mevcut idi. Mevsimlere bakıldığında en sık yaz aylarında (%28,9) zehirlenme gözlenmişken, mevsimler arasında anlamlı bir fark gözlenmemiştir (p=0,587). Sonuç: Yoğun bakım ünitemizde takip ettiğimiz zehirlenme olgularının büyük bir kısmını kadınların ve gençlerin oluşturduğu tespit edilmiştir. Kolay ulaşılabilen analjezik ve antidepresanlar intihar amaçlı kullanıldığı ve kaza ile en çok organofosfatlara maruz kalındığı sonucuna varılmıştır. Tarımsal ilaç kullanımı hakkında halkın bilinçlendirilmesi, etiketlerinin açık, net ve anlaşılır olması ve gıdalarla aynı ortamda bulundurulmaması sonucu zehirlenme olgularının önemli oranda azalacağını düşünmekteyiz. [ABSTRACT FROM AUTHOR]

Objective: Hydatid cyst disease is a helminthic infection caused by Echinococcus granulous , which is encountered with cysts in many organs, especially the liver and lungs. Soft tissue and intramuscular hydatid cyst are rare even in endemic countries. It is challengig to distinguish subcutaneous and intramuscular hydatid cysts from soft tissue tumors. This study aimed to present the clinical features of primary soft tissue hydatid cyst cases without liver and lung hydatid cyst in the Southeast Anatolian region, where hydatid cyst disease is endemic., Methods: Patients admitted to the Şanlıurfa Training and Research Hospital General Surgery and Orthopedics and Traumatology Outpatient Clinic between September 2018 and December 2019 with complaints of pain and/or swelling under the skin and soft tissue were evaluated. After the examinations, the records of the patients who were operated on with a pre-diagnosis of hydatid cyst and whose histopathologic evaluation was reported as a hydatid cyst were reviewed retrospectively., Results: Eight patients were included in the study. The mean age of the patients was 39.75±14.80 years. Lesions were located in neck (12.5%), left thoracic posterior area (25%), gluteus (25%), thigh (12.5%), right upper quadrant of abdominal wall (12.5%), and under the right clavicle (12.5%). When imaging methods were examined, ultrasonography was performed in 7 patients (87.5%), chest computed tomography was performed in 1 patient (12.5%), and magnetic resonance imaging was performed in 2 patients (25%)., Conclusion: Diagnosis of hydatid cyst should be considered in the differential diagnosis of soft tissue tumors in countries of endemic regions for hydatid cyst disease such as Southeastern Anatolia Region, Turkey., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors., (©Copyright 2022 Turkish Society for Parasitology)