Search

Objective: Organophosphates are the insecticides commonly used worldwide. Inadequate treatment for organophosphates poisoning increases morbidity, and mortality. Purpose of the work was to determine the effect of standard treatment alone versus standard treatment plus plasmapheresis on the levels of serum pseudo-cholinesterase, and erythrocyte acetyl cholinesterase in severe patients with organophosphates poisoning. Material and Method: This research is a prospective study. Patients diagnosed with organophosphates poisoning were included in the work. The patients were divided into two groups as the intervention group, and the standard group. The intervention group, plasmapheresis was performed in addition to the standard treatment. Results: The research was conducted with forty cases. (Intervention group n=21, standard group n=19). Serum pseudo-cholinesterase values were 482.5 u/L at baseline, 3723 u/L after plasmapheresis. Erythrocyte acetyl cholinesterase values were 1.91 u/mL on admission, 2.53 u/mL after plasmapheresis. Erythrocyte acetyl cholinesterase and serum pseudo-cholinesterase values were compared between the two groups daily from the admission of patients to intensive care units during the first 5 days, and on the last day in the intensive care units. There was no statistical difference between two groups (p> 0.05), except for the second day. It was observed that there was a statistically significant difference between the pseudo-cholinesterase values in the second day comparison of both groups (p=0.028). Conclusion: In conclusion, plasmapheresis treatment may contribute positively to pseudo-cholinesterase level. This treatment may have provided additional time for the organophosphates to be eliminated from the body. Although acetyl cholinesterase reactivation is achieved with oxime treatment, the clinical effect of this treatment is not clear. [ABSTRACT FROM AUTHOR]

Background & Objective: Ischemic stroke is the leading cause of death and long-term disability worldwide. In patients with ischemic stroke, both cell loss and inflammation are observed. GAS6/sAXL signaling is effective in both inflammation and clearance of dead/dying cells. This study investigated the GAS6/sAXL pathway and its role in patients with acute stroke. Specifically, we evaluated whether GAS6/sAXL was associated with stroke severity and infarct volume. Methods: This study involved 53 patients with acute ischemic stroke (AIS) and 49 healthy controls. GAS6 and sAXL proteins were collected in the first 24 hours in the acute stroke. NIHSS scores, GCS, and demographic data of the patients at the time of admission to the hospital were recorded. The infarct area was calculated using cranial magnetic resonance imaging. Results: Mean age of the patients was 64±12 years, 60% were female. HDL was lower in AIS group (40.5±13.01 mg/dl) than in the control group (55.4±14.9 mg/dl) (p<0.05). The GAS6 levels of patients with ischemic stroke (30.58 [1.58-162.33] ng/dL) were significantly lower than the control group (83.33 [10.71-181.96] ng/dL) (p < 0.001). There was a significant difference in the GAS6/sAXL ratio between the AIS (8.60 [0.55-48] ng/mL) and control groups (14.78 [1.82-53.71] ng/mL) (p < 0.001). The serum GAS6 level and MR infarct area was positively correlated (r = 0.381 p = 0.005). The GAS6/sAXL ratio was positively correlated with the NIHSS and infarct area (p = 0.004). The GAS6/sAXL ratio and GCS showed a negative correlation (p = 0.001). Conclusion: Plasma GAS6 levels were positively correlated with infarct size, and the GAS6/sAXL ratio was positively correlated with the NIHSS score and infarct area in patients with AIS. Plasma GAS levels and GAS6/sAXL ratio can be used as an indicator of severity of AIS. [ABSTRACT FROM AUTHOR]

Myalgia and headache are relatively common in COVID-19 disease, but a serious neurological disease is uncommon. In this case, we describe the symptoms and clinic of AMSAN, a rare variant of Guillain Barre syndrome (GBS) due to COVID 19. We presented a case of AMSAN, a rare variant of GBS, in a 46-year-old male patient with poor overall condition that did not recover after COVID-19 disease, loss of strength and decreased sensation in distal limbs. electromyography-nerve conduction study findings were suggestive acute motor and sensory axonal neuropathy. Cerebrospinal fluid analysis was elevated protein with a normal white blood cell count. The clinical diagnosis of AMSAN supported by results of diagnostic testing such as cerebrospinal fluid and electromyography-nerve conduction study. We added another GBS case due to Covid-19 infection to the literature. It should always be kept in mind that GBS may develop after the COVID-19 disease. [ABSTRACT FROM AUTHOR]

Aim: This study was designed to analyze demographic, clinical and laboratory characteristics beside risk factors that affect the mortality rate of patients hospitalized in ICUs with diagnosis of CNS infection. Methods: Patients that have been hospitalized at ICU on pre-CNS infection were retrospectively studied. Beside the clinical laboratory characteristics of the patients, mortality rate and risk factors that affect the mortality were recorded to be analyzed later. Results: Following the evaluation of 118 ICU patients who were suspected to have CNS infection, 62 of them, with full diagnosis of CNS infection, were included in the study. Bacterial meningitis was the diagnosis for 40 (66%) of these patients while 18 of the total (30%) was diagnosed with viral encephalitis and 3 of them (4%) was diagnosed with tuberculous meningitis. When these factors were investigated in a multivariable study, age and time from the onset of symptoms to hospital admission were independent risk factors (CI: 1,098(1,031-1,169), 1,614(1,037-1,278). Conclusion: The mortality rate of the patients that were subjects of the study was 52,5%. Age and time from the onset of symptoms to hospital admission were independent risk factors that affect the mortality. [ABSTRACT FROM AUTHOR]

Background: Gastrointestinal (GI) dysfunction is common in the intensive care unit (ICU), although there is no consensus on biomarkers of GI dysfunction. We aimed to evaluate ultrasound-based gastric antrum measurements and serum intestinal fatty acid-binding protein (IFABP) and citrulline levels in relation to GI dysfunction in critically ill patients., Methods: Adult critically ill patients receiving enteral nutrition and stayed for in the ICU for ≥48 h was included. GI dysfunction was described using Gastrointestinal Dysfunction Score (GIDS). Gastric antrum measurements, including craniocaudal (CC) diameter, anteroposterior diameter, and antral-cross sectional area (CSA), as well as serum levels for IFABP and citrulline, were prospectively recorded at baseline and on day 3 and day 5 of enteral nutrition. The receiver operating characteristic (ROC) analysis was performed to evaluate gastric ultrasound parameters, serum IFABP, and citrulline concentrations in predicting GI dysfunction., Results: Thirty-nine participants with a median age of 60 years were recruited and 46.2% of participants had GI dysfunction. ROC analysis revealed that the cutoff value of CSA score to predict GI dysfunction was 4.48 cm 2 , which provided 72.7% sensitivity and 77.2% specificity (area under the curve = 0.768, 95% CI: 0.555-0.980). At baseline, gastric residual volume was highly correlated with CC diameter and CSA (r = 0.764, P < 0.001 and r = 0.675, P < 0.001, respectively). Serum IFABP and citrulline levels had no correlation with GI dysfunction or gastric ultrasound parameters (P > 0.05)., Conclusion: CSA was associated with GI dysfunction in critically ill patients. Serum IFABP and citrulline concentrations were poor in predicting GI dysfunction., (© 2023 American Society for Parenteral and Enteral Nutrition.)