Feruza Turan Sönmez

The role of argyrophilic nucleolar organizing region-associated proteins in clinical exacerbation of chronic obstructive pulmonary disease

OBJECTIVE To investigate whether argyrophilic nucleolar organizing region-associated protein (AgNOR) parameters can be used as a biomarker that could potentially help with the management and clinical prognosis of chronic obstructive pulmonary disease (COPD) exacerbation. METHODS This case-control study enrolled patients with COPD who were admitted to the Emergency Department and healthy sex- and age-matched control subjects. Peripheral blood samples were collected at hospital admission and the peripheral lymphocytes were silver-stained to investigate the quantity and distribution of AgNOR proteins. Fifty nuclei per patient were viewed and the total AgNOR area/total nuclear area (TAA/TNA) ratio and the mean AgNOR number for each patient were calculated. RESULTS A total of 20 patients with COPD exacerbation and 17 healthy control subjects were recruited to the study. The TAA/TNA ratio and the mean AgNOR number were significantly higher in the patients with COPD exacerbation compared with the healthy control subjects. The mean AgNOR number showed a positive correlation with the pCO2 levels on admission. CONCLUSION AgNOR protein levels were elevated during a COPD exacerbation compared with healthy control subjects and there was a positive correlation between pCO2 levels and mean AgNOR number.Objective To investigate whether argyrophilic nucleolar organizing region-associated protein (AgNOR) parameters can be used as a biomarker that could potentially help with the management and clinical prognosis of chronic obstructive pulmonary disease (COPD) exacerbation. Methods This case–control study enrolled patients with COPD who were admitted to the Emergency Department and healthy sex- and age-matched control subjects. Peripheral blood samples were collected at hospital admission and the peripheral lymphocytes were silver-stained to investigate the quantity and distribution of AgNOR proteins. Fifty nuclei per patient were viewed and the total AgNOR area/total nuclear area (TAA/TNA) ratio and the mean AgNOR number for each patient were calculated. Results A total of 20 patients with COPD exacerbation and 17 healthy control subjects were recruited to the study. The TAA/TNA ratio and the mean AgNOR number were significantly higher in the patients with COPD exacerbation compared with the healthy control subjects. The mean AgNOR number showed a positive correlation with the pCO2 levels on admission. Conclusion AgNOR protein levels were elevated during a COPD exacerbation compared with healthy control subjects and there was a positive correlation between pCO2 levels and mean AgNOR number.

Assessment of Electrocardiographic and Echocardiographic Features in Patients Admitting with Syncope

Amac: Bu calismanin amaci senkop ile acil servise gelen hastalarda, EKG ve EKO bulgulari ile senkop nedenini ve senkop ozelliklerini ortaya koymak, EKG ve EKO parametrelerle iliskisini arastirmaktir. Gerec ve Yontem: Acil servisimize 01.01.2016 ile 31.12.2016 tarihleri arasinda senkop nedeniyle basvuran toplam 90 hasta calismaya dâhil edilmistir. Prospektif kesitsel bir vaka calismasi olarak tasarlanmistir. Elektrokardiyografik ve ekokardiyografik parametreleri olculerek kaydedildi. Istatistiksel anlamlilik icin tip-1 hata duzeyi 0,05 olarak belirlendi. Bulgular: Hastalarin 40’i (%44,4) kadin, 50’si (%55,6) erkek idi. Hastalarin genel yas ortalamasi 63,5 ± 18,0 olarak saptanmistir. Olgularin buyuk cogunlugu (%57,8) ayaktan takip karari ile taburcu edilmis, 36 hasta hastaneye yatirildi ve %2,2’si olumle sonuclanmistir. Hastalarin senkop sureleri ile basvuru esnasindaki ve 6. saatteki PR, QRS ve QT sureleri arasindaki iliski incelendiginde sadece QRS sureleri ile senkop suresi arasinda istatistiksel olarak anlamli iliski saptanmistir. Hastalara ait kalp kapak hastaliklari incelendiginde siklik sirasina gore trikuspit yetmezlik (%41.1), mitral yetmezlik (%37.8), aort yetmezligi (18.9), mitral darlik (%6.7) ve aort stenozu (%5.6) tespit edilmistir. Hastalarin EF degerlerinin ortalamasi %50,3, ortalama PAB ise 30,8 mmHg idi. Sonuc: Senkop nedeniyle basvuran tum hastalara EKG ve EKO uygulanmasi kardiyak kokenli senkop hastalarini ayirt etmek, senkopa neden olan hastaligin tanisini koymak ve riskli hasta grubunu saptamakta oldukca faydalidir.

An unexpected presentation of sick sinus syndrome: Isolated ventricular asystole

Abstract Sick sinus syndrome is a disorder of sinus node function characterized by various dysrhythmias such as sinus bradycardia or pause, paroxysmal regular or irregular atrial tachycardia, tachycardiabradycardia attacks or atrial fibrillation with slow ventricular response. Ventricular asystole with preserved atrial electrical activity is a rarely seen presenting rhythm in the ED and an extremely rare cause of syncope. A 67‐year‐old male having a syncope attack was admitted to the emergency department. His Glasgow coma scale score was 15 on admission. He became unconscious during his observation in the emergency department, and cardiopulmonary resuscitation was initiated because he was seen to be apneic; his arterial pulse was impalpable, and ventricular asystole with preserved atrial electrical activity was seen on the monitor. He regained consciousness and normal sinus rhythm was seen on the monitor after 2 min of cardiopulmonary resuscitation. Then, an alternating rhythm with short periods of bradycardia and tachycardia suggesting sick sinus syndrome was developed. A dual‐chamber pacemaker was placed, and he was discharged after 2 days of in patient follow‐up. His symptoms have not recurred after placement of the pacemaker device. When sudden changes in vital parameters and/or consciousness develop during observation of a patient with sick sinus syndrome, although it is not a common circumstance, accompanying high degree atrioventricular block and simultaneous ventricular asystole should be considered, and cardiopulmonary resuscitation should be initiated immediately because cardiopulmonary arrest is inevitable when ventricular asystole develops even if the atrial electrical activity is maintained.