Yeltekin Demirel

Mushroom poisoning: retrospective analysis of 294 cases

OBJECTIVE The objective of this study was to present special clinical and laboratory features of 294 cases of mushroom poisoning. MATERIALS AND METHODS In this retrospective study, 294 patients admitted to the Pediatric and Adult Emergency, Internal Medicine and ICU Departments of Cumhuriyet University Hospital were investigated. RESULTS Of 294 patients between the ages of 3 and 72 (28.97 ± 19.32), 173 were female, 121 were male and 90 were under the age of 16 years. One hundred seventy-three patients (58.8%) had consumed the mushrooms in the early summer. The onset of mushroom toxicity symptoms was divided into early (within 6 h after ingestion) and delayed (6 h to 20 d). Two hundred eighty-eight patients (97.9%) and six (2.1%) patients had early and delayed toxicity symptoms, respectively. The onset of symptoms was within two hours for 101 patients (34.3%). The most common first-noticed symptoms were in the gastrointestinal system. The patients were discharged within one to ten days. Three patients suffering from poisoning caused by wild mushrooms died from fulminant hepatic failure. CONCLUSION Education of the public about the consumption of mushrooms and education of health personnel working in health centers regarding early treatment and transfer to hospitals with appropriate facilities are important for decreasing the mortality.

Acute amitraz intoxication: retrospective analysis of 45 cases.

Objective: To present special clinical and laboratory features of 45 cases (44 adult cases) who were intoxicated through oral route. Design: Retrospective study. Setting: Intensive care unit (ICU) of a university hospital. Patients: Forty-five patients admitted to the ICU of Cumhuriyet University Hospital. Results: Forty-five patients between 4 and 97 years of age were evaluated. Intoxication was the result of a suicide attempt in 67% of cases and accidental in 33% of cases. Unconsciousness, nausea and vomiting were the common initial symptoms. The major clinical findings in the ICU were bradycardia, myosis, hypothermia, hyperglycemia, hypotension, coma and respiratory depression. Blood glucose level was increased in 64% of cases. No problem was noted in the patient or the fetus in a pregnant, 27-year-old patient, who was intoxicated with 10 mL of 12.5% amitraz. The length of stay in the ICU was between 2 and 15 days. None of the patients died. All patients were discharged without neurological sequela. Conclusion: The prognosis of amitraz intoxications through oral route is benign and results in complete healing; however, we suggest that these cases should be well monitored and followed-up in ICUs.

The Oral Toxicity of Resorcinol During Pregnancy: A Case Report

Resorcinol (1,3 benzenediol; m‐dihydroxybenzene: resorcin) is a pharmaceutical agent used topically in dermatological treatments such as acne and related skin conditions. It could also be used in combination with the other acne treatment agents such as sulphur. It could be very hazardous if taken orally and there are limited reports on its toxic effects in human. The present work aimed to report a resorcinol poisoning case in which resorcinol was taken accidentally by a woman at 30 weeks of pregnancy. The major clinical findings were unconsciousness, drowsiness, and respiratory failure that required mechanical ventilation along with tonic‐clonic seizures and hypothermia. In addition, the laboratory findings were leucocytosis, high bilirubin levels, severe metabolic acidosis, and green‐colored urine. The fetus was considered dead 24 h after delivery; however, mothers prognosis was well with supportive management. It could be concluded that the basic approach to the patient with resorcinol poisoning should include the initial stabilization of immediate life‐threatening problems and elimination of the toxin. This is the first report on resorcinol poisoning in pregnant women, indicating its major clinical and laboratory findings.

Combined Effect of Factor V Leiden, MTHFR, and Angiotensin-Converting Enzyme (Insertion/Deletion) Gene Mutations in Hypertensive Adult Individuals: A Population-Based Study from Sivas and Canakkale, Turkey

BACKGROUND Hypertension is one of the leading causes of mortality and morbidity in the world, which is influenced by environmental and genetic factors. The methylenetetrahydrofolate reductase (MTHFR) and angiotensin-converting enzymes (ACE) are possible candidate genes that may influence both body fatness and blood pressure (BP). The purpose of this study was to examine the carriage of gene combinations of the ACE (insertion/deletion [I/D]), MTHFR 677T and 1298C, and lipid profiles in patients with essential hypertension (EH) in Turkey. METHODS A total of 150 adult individuals (50 hypertensive, 50 first-degree relatives, and 50 healthy controls) from Sivas/Turkey with the same age and gender were assessed for body composition, lipid profiles, resting BP, and gene profiles. Additionally, 149 individuals (99 hypertensive, 50 controls) from Canakkale/Turkey had been investigated for ACE I/D polymorphism. Peripheral blood samples were genotyped using strip assay reverse-hybridization multiplex polymerase chain reaction tests for target genes. RESULTS Heterozygous mutation in FV Leiden was found to be higher in the hypertensive and first-degree relatives when compared with the control group (p<0.05). Homozygous DD alleles of the ACE gene were also higher than the ACE I/D and control groups (p<0.05). The high rates of cholesterol and low-density lipoprotein and low rates of high-density lipoprotein were found in patients with EH when compared with the control. CONCLUSION Results show that ACE with DD alleles and mutated alleles of FV Leiden and MTHFR genes were significantly different between genotypes and have a combined effect on EH in Turkish population. Further studies are needed to investigate the genetics of obesity, EH, and BP phenotypes in the current adult population.

Prevalence and Associated Factors of Day Wetting and Combined Day and Night Wetting

Background: This study was conducted to determine the prevalence of diurnal enuresis (DE) and its association with background variables among children aged 5–15 years living in Sivas and Kahramanmaraş, Turkey. Methods: The parents of 1,760 children voluntarily completed a questionnaire consisting of 42 items under supervision of a researcher. Results: Overall, the reported prevalence of DE was 4.2%, with a tendency to decrease with increasing age and with no difference between genders. Smoking during pregnancy, delayed initiation and dealing with the child by punishment in toilet training, urination frequency, urgency, soiling, arousal difficulty, urinary infection history, lower school performance, poor social adaptation, wetting history in the family, were all significantly prevalent among diurnal enuretics (p < 0.05). Socioeconomic or sociodemographic factors based on families and stressful life events were not associated with DE (p > 0.05). 63.9% of all parents reported some level of concern about the wetting problem and 51.7% of the diurnal enuretics had previously visited a physician. Conclusions: The prevalence of DE in our sample is not too different from the prevalence rates reported previously from Turkey and other countries. This type of enuresis seems to be more associated with an organic neurological or urological disorder than is nocturnal enuresis.

In vivo Evaluation of the Genotoxic Effects of Clomiphene Citrate on Rat Reticulocytes: A Micronucleus Genotoxicity

Objective: To determine the genotoxic effects of clomiphene citrate (CC) on rat reticulocytesin vivo. Methods: In this prospective, randomized, controlled study, rats were each assigned randomly to the CC 50, CC 100, CC 200, or control group and were given repeat doses of 0.16, 0.32 or 0.64 mg CC, or normal saline, respectively. Each study group received its CC dose in 2 ml of saline intraperitoneally for 5 days, while the control group received only 2 ml of saline. Each treatment cycle was repeated six times. Six months later, the rats were euthanized. Bone marrow tissues were removed, and pluripotent reticulocyte cells with micronuclei, nuclear buds, and binuclear abnormalities were analyzed using an in situmicronuclei assay under light microscopy. The proportion of micronucleated erythrocytes was measured. Results: Fewer cells with nuclear buds and binuclear abnormalities were detected in the CC 50 group and controls. The CC 100 and 200 groups had significantly (p < 0.05) more nuclear buds and binuclear abnormalities compared with the CC 50 group and controls in the cytogenetic analysis of bone marrow stem cells. Conclusion: In rats, the micronucleus genotoxicity assay suggests a dose-dependent CC effect on genomic instability in bone marrow stem cells in vivo.

Differences in the body composition and biochemistry in women grouped as normal-weight, overweight and obese according to body mass index and their relation with cardiometabolic risk

Morbidity of obesity-related diseases tends to increase due to a rise in the body mass index (BMI). We aimed to investigate how the body composition and biochemical parameters change while BMI increases in adult women were categorized as so: as normal weight, overweight and obese. Our objectives are to study the effects of those changes in the development of metabolic disturbances and to find out which parameters are the most sensitive to predict cardiometabolic risks. Three hundred and twenty two records of adult women (mean age: 38.62±12.71 year) who admitted to our unit concerning about losing or preserving their weights, were analyzed in the study. All patients had undergone anthropometric measurements and body composition analyses as well as some biochemical tests. Body composition analyses were performed by means of the Bioelectrical Impedance Analyzer (BIA). Increase in BMI significantly increased the body fat, blood sugar, insulin, triglyceride and uric acid levels. BMI and circumference of the waist were significantly and negatively correlated with the ratio of body water and lean mass/fat mass. However they were positively correlated with the ratio of fat mass and basal metabolism. Furthermore, it was also found that BMI and circumference of the waist were significantly and positively correlated with level of fasting blood sugar, insulin, triglyceride, homeostasis model assessment insulin resistance (HOMA-IR), uric acid and fibrinogen levels, and negatively correlated with high density lipoprotein (HDL) cholesterol level. In multiple regression analyses, circumference of waist measurements was significantly correlated with insulin, triglyseride and HDL, whereas the correlation between BMI and these parameters was not found significant. Total body fat mass (as %) showed significant correlation only with HDL-C level. It could be said that obesity which is a disorder that causes many health complications and affects the quality of life in the short and long term could be prevented or cured by keeping negative environmental conditions under control. According to our results, visceral adipose tissue (VAT) measurement was thought to be more related for metabolic and cardiovascular disorders rather than BMI. We also propose to test fasting blood glucose, insulin, triglyceride, HDL, fibrinogen, homocystein (HOM) levels along with VAT measurements to predict more truly about not only global cardiometabolic risk but also dementia in later life.