Cemil Kavalcı

Elevated serum S100B protein and neuron-specific enolase levels in carbon monoxide poisoning

OBJECTIVE Carbon monoxide (CO) poisoning causes cerebral and generalized hypoxia. This study aimed to assess the possible use of serum glial marker S100B protein and neuron-specific enolase (NSE) as biochemical markers of hypoxic brain damage in acute CO poisoning. METHODS Patients with acute CO poisoning admitted to the ED of 2 training hospitals (Ankara, Turkey) were included in this cross-sectional study. Serum levels of S100B and NSE were measured on admission. The patients were divided into 2 groups (unconscious and conscious). Twenty healthy adults were included in the study to serve as controls. RESULTS A total of 70 patients poisoned by CO (mean age +/- SD, 36.6 +/- 16.3 years; 64.3% women) were enrolled. Although S100B concentrations were higher in patients than in the control group (P = .018), no significant difference was determined between patient and control groups with respect to NSE concentrations (P = .801). A positive correlation was noted between levels of S100B and NSE (r = 0.388; P = .001). The S100B and NSE values were higher in unconscious patients than in the control group (P = .002 and P = .013, respectively). Furthermore, S100B and NSE values were higher in unconscious vs unconscious patients (P = .047 and P = .005, respectively). CONCLUSION Elevated serum S100B and NSE levels were associated with loss of consciousness in CO poisoning in this series of patients. Serum S100B and NSE may be useful markers in the assessment of clinical status in CO poisoning.

Role of mean platelet volume in diagnosis of childhood acute appendicitis.

Introduction. Acute appendicitis is the leading cause of abdominal pain in children requiring emergency surgical intervention. The aim of this study is to investigate the diagnostic value of MPV in early diagnosis of acute appendicitis cases in pediatric age group. Methods. This study was performed retrospectively. Three hundred five patients operated on with the diagnosis of appendicitis and pathologically found to be acute appendicitis were classified as Group 1 and 305 healthy children were classified as control Group 2. Results. One hundred ninety-seven of 305 cases in Group 1 are males (64.6%), in Group 2, 151 of 305 cases are males (49.5%). The mean MPV in Group 1 was 7.9 ± 0.9 (fL), and whereas in Group 2 was 7.7 ± 0.8 (fL). There was no statistically significant difference regarding MPV values (P > 0.05). Conclusion. In our study we detected that mean platelet volume has no diagnostic value in pediatric acute appendicitis cases.

Poisoning from wild mushrooms in Eastern Anatolia region: analyses of 5 years

The objective of this study was to describe the demographic and clinical features of patients who were admitted to the emergency department (ED) due to wild mushroom poisoning and to point the importance of mushroom poisonings in our area. This study was performed by examining the files of wild mushroom poisoning patients who were admitted to the ED of Firat University, Faculty of Medicine, between January 2000 and June 2004, retrospectively. Patients ≥16 years of age were included in the study. The frequency of wild mushroom poisoning, age and sex of the patients, season, place of the residence, laboratory findings, treatment and outcome of the patients were investigated. During the study period, 64 patients with wild mushroom poisoning were admitted to the ED. From 64 overall patients, 25 (39.1%) were males. The most common complaints during the admission were nausea, vomiting and abdominal discomfort. The duration of hospitalization was two (range 1—4 days) days. No death was observed. Severity of mushroom poisoning depends on the type of mushroom eaten, the time lag between the poisoning and admission to the hospital, and the rapid and correct treatment given to the patient either in the ambulance or at health centre. Human & Experimental Toxicology (2007) 26: 579—582.

Epidemiologic and clinical characteristics and outcomes of scorpion sting in the southeastern region of Turkey

BACKGROUND Scorpion sting resulting in envenomation is a life-threatening emergency and causes serious health problems in tropical and subtropical regions. The aim of this study was to present the epidemiologic and clinical features of 123 cases presenting with symptoms of scorpion poisoning, a cause of preventable mortality and morbidity. METHODS This study retrospectively analyzed the epidemiologic and demographic features of a total of 123 patients who presented to Diyarbakır State Hospital Emergency Service with scorpion sting between January 2008 and December 2009. RESULTS Among 123 patients who presented to Diyarbakır State Hospital Emergency Service with scorpion sting between January 2008 and January 2009, 62.6% (n=77) were female and 37.4% (n=46) were male. The mean age of the patients was 33.5±17.3 years (2-80), and 27 (22%) patients were younger than 18 years. The place of residence was rural region in 98 (79.7%) patients and the city center in 25 (20.3%). The majority of victims were stung by scorpions while they were at active work (42.3%) or asleep (19.5%) in bed. Eleven (8.95%) patients were stung by a scorpion while putting on their own clothes. CONCLUSION This simple descriptive study will hopefully help healthcare providers take measures to prevent scorpion stings, which should take into consideration local epidemiological features.

Analysis of Trauma Cases Admitted to the Emergency Department

Aim: Trauma is a serious problem affecting especially the young population in the world. In our study, we aimed to investigate to the clinical and demographic characteristics of trauma cases admitted to our emergency department. Material and Method: The research data were collected from 1267 patients who applied to the Ankara Numune Training and Research Hospital Emergency Service with trauma. The patients’ demographic data, vital sign and symptoms at the application time, the trauma mechanism, requested consultations, and the patients’ discharge or hospitalization procedure were recorded on the forms. Results: The average age of the patients was determined as 35.3±15.4. Male ratio of the patients was 75.4%. The most frequently trauma type was resulted from motorized vehicle accident (55.8%). While the mechanism of blunt trauma was significantly at a high rate (83.1%), the most frequently exposed anatomical region was upper extremities (44.8%). Discussion: Trauma affects young adult males more frequently.

Cervicofacial emphysema and pneumomediastinum after a high-speed air drill endodontic treatment procedure

Cervicofacial subcutaneous emphysema is defined as the abnormal introduction of air in the subcutaneous tissues of the head and neck. It is mainly caused by trauma, head and neck surgery, general anesthesia, and coughing or habitual performance of Valsalva maneuver. The occurrence of subcutaneous emphysema after dental treatment is rare, and diffusion of gas into the mediastinum is much rarer, especially when the procedure is a nonsurgical treatment. The most common dental cause of pneumomediastinum is the introduction of air via the air turbine handpiece during surgical extraction of an impacted tooth. Only 6 cases of pneumomediastinum after endodontic treatment have been reported between 1960 and 2008. Pneumothorax is defined clinically as an “accumulation of air or gas between the parietal and visceral pleurae,” and although it is often not a medical emergency, it can result in respiratory distress, tension pneumothorax, shock, circulatory collapse, and even death. Although there are many possible causes of dyspnea during a dental procedure, 1 rare complication is pneumothorax. Although specific closed turbine systems are available for oral surgical procedures, these drills may be used in exodontia to section teeth and facilitate tooth extraction. We report a case of cervical subcutaneous emphysema and pneumomediastinum occurring after an endodontic treatment of right first molar using an air-tribune drill. We present here in a case of massive pneumomediastinum and cervicofacial subcutaneous emphysema that occurred after opening the access cavity for endodontic treatment. We describe its etiologies and guidelines for its prevention during nonsurgical endodontic treatment.

Hair tourniquet syndrome.

The hair tourniquet syndrome is a rare disorder. This syndrome has been described as involving the fingers, the toes and even the genitals. We report a case of hair tourniquet syndrome affecting multiple toes of an infant. After the hair fiber was removed there was a fast healing period and no signs of tissue necrosis were seen. The prompt diagnosis and treatment of the condition is vital to attain a good outcome and prevent further harm to the child.

Analysis and injury paterns of walnut tree falls in central anatolia of turkey.

IntroductionFalls are the second most common cause of injury-associated mortality worldwide. This study aimed to analysis the injuries caused by falls from walnut tree and assess their mortality and morbidity risk.MethodsThis is a retrospective hospital-based study of patients presenting to emergency department (ED) of Ahi Evran Univercity between September and October 2012. For each casualty, we computed the ISS (defined as the sum of the squares of the highest Abbreviated Injury Scale (AIS) score in each of the three most severely injured body regions). Severe injury was defined as ISS ≥ 16. The duration of hospital stay and final outcome were recorded. Statistical comparisons were carried out with Chi-Square test for categorical data and non-parametric spearman correlation tests were used to test the association between variables. A p value less than 0.05 was considered to be statistically significant.ResultsFifty-four patients admitted to our emergency department with fall from walnut tree. Fifty (92.6%) patients were male. The mean age was 48 ± 14 years. Spinal region (44.4%) and particularly lumbar area (25.9%) sustained the most of the injuries among all body parts. Wedge compression fractures ranked first among all spinal injuries. Extremities injuries were the second most common injury. None of the patients died. Morbidity rate was 9.25%.ConclussionFalls from walnut trees are a significant health problem. Preventive measures including education of farmers and agricultural workers and using mechanized methods for harvesting walnut will lead to a dramatic decrease in mortality and morbidity caused by falls from walnut trees.

Temporomandibular Joint Dislocation after Gastroendoscopy: A Case Report

Temporomandibular joint (TMJ) dislocation is defined as excessive forward movement of the mandibular condyle beyond the articular eminence with complete separation of the articular surfaces and fixation in that position. A 54 years old man attended our Eme rgency Department (ED) with complaints of slurred speech and inability to close his mouth after upper gastroendoscopic procedures. Lateral craniography was obtained and illustrated bilateral anterior dislocation of the patients mandibular condyles. To con firm the diagnosis urgent radiographic imaging is required without delay as the risk of complications occurring increases as time elapses.

The Value Of Serum Bnp For Dıagnosıs Of Intracranıal Inury In Head Trauma

Objectives Head injuries are the leading cause of death in persons less than 45 years old. In order to diagnose these patients, cranial computed tomography (CT) is used. Brain natriuretic peptide (BNP) was isolated first from the cerebral ventricles. The aim of this study was to research whether bedside BNP measurement has a place in determining intracranial injury in patients admitted to the emergency department (ED) with head trauma.