Semra Akgoz

An analysis of carbon monoxide poisoning cases in Bursa, Turkey

Carbon monoxide (CO) poisoning from coal and gas heaters is a public health concern in Turkey. This study estimated the prevalence, mortality rate and clinical predictors of severity of CO poisoning cases treated at the emergency unit of the Uludağ University Medical School, Bursa from 1996 to 2006. Of 305 patients treated over a 10-year period, only 1 case was recorded as suicide. The CO source was a coal heater in 85.9% of cases. Mean Glasgow coma score (GCS) on admission was 12.8 (SD 0.2) and mean carboxyhaemoglobin level was 21.6% (SD 0.92%). There were statistically significant associations between higher GCS score, older age and higher HbCO level. Better education of the public is vital for the prevention of these injuries.

A comparison of the efficacy and tolerability of reboxetine and sertraline versus venlafaxine in major depressive disorder: A randomized, open-labeled clinical trial

The aim of the study was to compare the efficacy and tolerability of the combination of reboxetine and sertraline to venlafaxine XR (extended release) in major depressive disorder (MDD). The study consisted of 40 patients with MDD, aged 18-65 years. Patients were evaluated six times during a 10-week period. Treatment was started as venlafaxine XR 75 mg/day once a day (od) or reboxetine 4 mg/day twice a day (bid)+sertraline 50 mg/day od. In the second week, venlafaxine XR was increased to 150 mg/day od and reboxetine 8 mg/day bid while sertraline was kept at the same dose. The Hamilton Depression Rating Scale (HDRS), Montgomery and Asberg Depression Rating Scale, Clinical Global Impressions-Severity of Illness and Clinical Global Impressions-Global Improvement Scale were applied on each visit. Beginning from the second visit, both groups showed significant declines in each scale. There were no significant differences between treatment response rates. Remission rates defined as HDRS<or=10 were significantly higher in the venlafaxine XR group at visit 4 only. However, when remission was accepted as HDRS<or=7, no significant difference was observed. Side effect frequency was similar between the treatment groups. We may suggest that the reboxetine+sertraline combination is not superior to venlafaxine treatment.

The Significance of Hemosiderin Deposition in the Lungs and Organs of the Mononucleated Macrophage Resorption System in Infants and Children

Hemosiderin deposition is not often recognized on routine examination with hematoxylin and eosin staining; however, iron stains may be helpful in the evaluation of hemosiderin deposition in infant autopsies. This report describes the data obtained from autopsy of 86 infants and children whose deaths were investigated at the Forensic Medicine Council Bursa Morgue Department from January 2000 to January 2003. A histochemical technique was used to identify hemosiderin in lung, liver and spleen specimens, which was correlated with other descriptive variables such as the reported cause of death, postmortem interval, trauma history, gender, and age. There was a weakly positive but significant correlation between lung and liver hemosiderin scores (Spearmans rank correlation coefficient, rho=0.348, p=0.001); i.e., given an increase in lung hemosiderin scores, an increase in liver hemosiderin scores was also observed. Similarly, a marked positive correlation between spleen and liver hemosiderin scores (Spearmans rank correlation coefficient, rho=0.335, p=0.002) was observed. The probability of spleen hemosiderin-positive cases belonging to the age group under 6 months was found to be 4.3 times greater than those who were hemosiderin-negative (95% confidence interval, 1.6-11.8). After the major differential diagnoses were ruled out, this study demonstrated, that depending on the statistically assessed morphometric grounds, the presence of hemosiderin deposits in the liver and spleen were significantly higher in the age group under 6 months.

Glial fibrillary acidic protein (GFAP) and CD34 expression in the human optic nerve and brain in methanol toxicity

IntroductionThe toxicity of methanol is as a result of its metabolites, formaldehyde and formic acid. Formic acid induces severe metabolic acidosis causing death, and is the primary agent responsible for ocular toxicity. Glial fibrillary acidic protein (GFAP) immunostaining is the most commonly used method for examining astrocyte proliferation and hypertrophy after various central nervous system injuries. The antigen CD34 is expressed widely on vascular endothelium, including that of the central nervous system and high endothelial venules.MethodsIn this study, GFAP and CD34 were immunohistochemically localised in the post-mortem optic nerve head, and brain tissue (basal ganglia putamen) samples were collected from methanol-exposed and non-methanol-exposed (control) subjects.ResultsThere was a positive correlation between the GFAP and CD34 intensity of staining scores in the methanol-exposed group (P=0.711, P=0.010). Furthermore, there was also a positive correlation between the brain putamen and optic nerve head GFAP extent of staining in the methanol-exposed group (P=0.720, P=0.008). A statistically significant difference was found between the methanol-exposed group and the control group optic nerve CD34 intensity scores (P=0.014), but no significant difference was found between optic nerve CD34 and GFAP extent scores (P=0.05).ConclusionThe study revealed that methanol affects brain putamen and the optic nerve selectively. We detected a positive significant correlation between brain and optic nerve GFAP expression. CD34 expression was markedly decreased by the toxic effects of methanol.