Burak Katipoglu

The diagnostic value of serum pentraxin 3 levels in pulmonary contusion

Purpose: To investigate the difference in pentraxin 3 (PTX 3) levels between patients with pulmonary contusion and healthy volunteers. Materials and methods: This study was conducted with a group of 20 trauma patients diagnosed with pulmonary contusion and 30 healthy individuals enrolled as a control group in a tertiary university hospital. Results: Median PTX 3 levels were 7.05 (3.29–13.1), ng/ml in the contusion group and 1.03 (0.7–1.58) ng/ml in the control group. PTX 3 titers were significantly higher in patients with pulmonary contusion compared to those of the control group (p < 0.001). An area under the curve (AUC) value of 0.968 investigated using ROC analysis to determine the diagnostic value of the PTX‐3 in pulmonary contusion patients was measured. A PTX‐3 cut‐off value of 2.06 produced 95.5% sensitivity and 86.7% specificity. Conclusion: PTX 3 levels in pulmonary contusion increased significantly compared to the healthy control group. If supported by wider series, PTX 3 may be expected to be capable of use as a marker in pulmonary contusion.

Diagnostic Value of Plasma Pentraxin-3 in Acute Appendicitis

ABSTRACT Purpose: To measure serum PTX3 levels in patients admitted with right lower quadrant pain to emergency department and to investigate whether this parameter will be helpful for the diagnosis of acute appendicitis. Materials and methods: This study was conducted with a group of 89 patients over 17 years of age who were admitted with the complaint of right lower quadrant pain to ED and had a preliminary diagnosis of acute appendicitis clinically and the control group of 31 healthy volunteers in a tertiary university hospital for 3 months. Results: Median PTX3 levels were 3.28 (1.08-30.24) ng/mL in the acute appendicitis groups and 0.97 (0.34-2.62) ng/mL in the control group. A significant difference was observed between acute appendicitis groups and the control group (p < 0.05). Conclusion: PTX3 was found to be significantly higher in patient with acute appendicitis compared to the control group and the patients with non-specific abdominal pain. PTX3 can be used as an aid in the diagnosis of acute appendicitis.

Urine Dipstick of Sputum for the Rapid Diagnosis of Community Acquired Pneumonia

INTRODUCTION Community acquired pneumonia (CAP) is responsible for an important part of treatment costs across the world. Even though posterior-anterior lung radiography (PALG) and direct sputum smear microscopy are required or routine diagnoses. The purpose of this study is to determine the diagnostic value of the bedside urine strip tests in CAP. METHODS Patients who attended the emergency department (ED) between from February 2016 to September 2016 with expectoration complaints and suspicion of pneumonia. The sensitivity, specificity, and accuracy rate of the urine strip tests, direct sputum smear microscopy, and PALG were calculated and analyzed using SPSS 15.0. RESULTS During the study period, 100 patients with pneumonia suspicion were evaluated in the ED. The sample was divided into two groups: negative and positive diagnosis of CAP. The leukocytes detecting by urine strip tests are statistical differences between the two groups (p: 0.003). The results show that the sensitivity, specificity, and accuracy rate of leukocytes detected in sputum with urine strip tests in the pneumonia diagnosis were 83.3%, 44.2% and 63% respectively. CONCLUSION According to the study, it is believed that the method of determination of leukocytes with urine strip tests in sputum combined with more detailed results. They can become part of CAP diagnosis methods.

A bedside ultrasound technique for fluid therapy monitoring in severe hypovolemia: Tissue Doppler imaging of the right ventricle

Fluid therapy is one of the main issues for hemodynamic resuscitation. Tissue Doppler imaging (TDI) of the right ventricle (RV) with bedside ultrasound (BUS) technique is a new dynamic method to identify fluid responsiveness in patients with hypotension. Here, we present the case of a hypotensive patient monitored with TDI measurements of RV. A 75-year-old male patient was admitted to the emergency department (ED) with the complaint of diarrhea. He was in severe hypovolemia, with hypotension, tachycardia, and tachypnea. His laboratory results were normal. BUS was performed on the patient by the ED physician. The velocity of the excursion of the tricuspid valve measured at presentation was 14.47 cm/s and, together with collapsed inferior vena cava (IVC), this finding led to the decision to begin fluid therapy immediately. The patient underwent 2 L of fluid therapy with 0.9% NaCl in a 2-h period. Control BUS after fluid therapy revealed decreased TDI velocity of tricuspid annulus to 11.81 cm/s and dilated IVC not collapsing sufficiently with respiration. The patient received his maintenance therapy after admission to the internal medicine department and was discharged from the service after 3 days. TDI in fluid responsiveness may find a clinical role in the future by the clinical studies.

Acute Management of Spinal Cord Injury at the Out-of-Hospital and Emergency Department Settings

Burak Katipoğlu1, Arman Dagal2, Semih Korkut3, Abdullah Osman Koçak4 1Department of Emergency Medicine, Ankara Training and Research Hospital, Ankara, Turkey 2Department of Anesthesiology and Pain Medicine, Harborview Medical Center, University of Washington, Seattle, Washington, USA 3Public Hospitals Union, İstanbul, Turkey 4Department of Emergency Medicine, Atatürk University School of Medicine, Erzurum, Turkey

Post-traumatic stress disorder after terrorist attack in healthcare professionals

INTRODUCTION: On the date of 15 July 2016 a terrorist organization launched a terrorist attack using helicopters and heavy combat weapons in the city centers of Istanbul and Ankara simultaneously. Numerous civilian were hurt and many of them lost their lives during the attacks. Terrorism is a form of combat designed to cause the highest psychological influence on the masses. Post-traumatic stress disorder (PTSD) is one of the most common psychological disorders after such disasters. The aim of this study is to determine the associated risk factors and PTSD rates in healthcare professionals who were on call during the 15 July 2016 terrorist attacks. METHOD: Since the hospital is in a neighbouring the street to where terror attacks occurred, all healthcare professionals ≥ 18 years of age who were on duty that night in the Dr. Ridvan Ege Training and Research Hospital and were auditory or visual witnesses of the event were included in the study as the first group while healthcare professionals who work in the same hospital but were not on duty that night were included as the control group. RESULTS: The mean post-traumatic diagnostic scale stress score of the control group was 11.87. The mean post-traumatic diagnostic scale stress score of the Group 1 was 21.91. There was a significant difference between the groups in terms of posttraumatic diagnostic scale stress score (p < 0.05). While the healthcare professionals on duty on July 15, 2016 (Group 1) had moderate-severe (21.91 ± 5.11) stress disorder, the healthcare professionals who were not at the hospital on July 15, 2016 (Control Group) had moderate stress disorder (11.87 ± 6.86). CONCLUSION: Our country is at risk from the fact that such attacks may be experienced again because of its unique conditions. The results of our work support the data on the high level of exposure to PTSD when exposed to a terrorist attack. For this reason, the identification of the characteristics of pre-traumatic health individuals at risk is useful in planning the presentation of preventive and curative health services. At the same time, there is a need for longer-term work and wider samples to reveal the psychological consequences of such attacks.