Secret History: Return of the Black Death Channel 4, 7-8pm In 1348 the Black Death swept through London, killing people within days of the appearance of their first symptoms. Exactly how many died, and why, has long been a mystery. This Secret History documentary follows experts as they pick through the evidence and reveal why the plague killed on such a scale. And they ask, what might be coming next?

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Assay for lipid peroxides in animal tissues by thiobarbituric acid reaction

The study group.

Central venous pressure (CVP) and right atrial pressure (RAP) are important parameters in the complete hemodynamic assessment of a patient. Sonographic measurement of the inferior vena cava (IVC) diameter is a non-invasive method of estimating these parameters, but there are limited data summarizing its diagnostic accuracy across multiple studies. We performed a comprehensive review of the existing literature to examine the diagnostic accuracy and clinical utility of sonographic measurement of IVC diameter as a method for assessing CVP and RAP. We performed a systematic search using PubMed of clinical studies comparing sonographic evaluation of IVC diameter and collapsibility against gold standard measurements of CVP and RAP. We included clinical studies that were performed in adults, used current imaging techniques, and were published in English. Twenty one clinical studies were identified that compared sonographic assessment of IVC diameter with CVP and RAP and met all inclusion criteria. Despite substantial heterogeneity in measurement techniques and patient populations, most studies demonstrated moderate strength correlations between measurements of IVC diameter and collapsibility and CVP or RAP, but more favorable diagnostic accuracy using pre-specified cut points. Findings were inconsistent among mechanically ventilated patients, except in the absence of positive end-expiratory pressure. Sonographic measurement of IVC diameter and collapsibility is a valid method of estimating CVP and RAP. Given the ease, safety, and availability of this non-invasive technique, broader adoption and application of this method in clinical settings is warranted.

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The efficacy of sonographic measurement of inferior vena cava diameter as an estimate of central venous pressure

The purpose of the present study is to contribute to understanding violence in a family environment, especially in terms of childhood, and is formulated as a theoretical review of the theme. Based on book and article consultations, violence against children is looked at throughout history along with the protection of their rights. The application of disciplinary measures over time is approached, along with an understanding surrounding attitudes related to what can today be classified as abuse and violence against a child. Childhood was not always understood in the same manner it is today. The punishment, humiliation and even murder of children were tolerated over extended periods of history. Parents seem to have had supreme power over the life and death of their children. Changes in relation to this perception occurred mainly over the last few centuries. From then on, the relationship between parents and children became progressively permeated by more devoted attitudes, thus initiating significant changes that coincide with the scientific study of childhood. An important evolution is noted in terms of Law, in the sense of protecting children's rights, which had been recognized. However, it is shown that in spite of all the measures taken in terms of protection and a guarantee of rights, violence against children continues in our contemporary reality. [#] [K]

Violence against children...

Background/aim: The aims of this study were to investigate the significance of oxidative stress parameters in the pathogenesis of ischemic stroke and hemorrhagic stroke and to investigate their effects on stroke severity using the National Institutes of Health Stroke Scale (NIHSS). Materials and methods: A total of 92 patients, including 74 with ischemic stroke and 18 with hemorrhagic stroke, and 75 volunteers were enrolled in the study. Total oxidant status (TOS), total antioxidant status (TAS), paraoxonase, stimulating paraoxonase, arylesterase, and thiol levels were measured in both the patient and volunteer groups. NIHSS and oxidative stress index (OSI) scores were calculated. Results: TOS and OSI levels were significantly higher in the ischemia and hemorrhagic stroke groups than in the control group (P 0.05). Conclusion: Oxidative stress may play a role in the pathogenesis of both ischemic stroke and hemorrhagic stroke in terms of oxidants. We do not think that oxidative stress has any effect in determining stroke severity in either type of stroke.

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The relation between oxidative stress parameters, ischemic stroke, and hemorrhagic stroke.

Objective: We aimed to present inferior vena cava (IVC) diameter as a guiding method for detection of relationship between IVC diameter measured noninvasively with the help of ultrasonography (USG) and central venous pressure (CVP) and evaluation of patient’s intravascular volume status. Methods: Patients over the age of 18, to whom a central venous catheter was inserted to their subclavian vein or internal jugular vein were included in our study. IVC diameter measurements were recorded in millimeters following measurement by the same clinician with the help of USG both at the end-inspiratory and end-expiratory phase. CVP measurements were viewed on the monitor by means of piezoelectric transducer and recorded in mmHg. SPSS 18.0 package program was used for statistical analysis of data. Results: Forty five patients were included in the study. The patients had the diagnosis of malignancy (35.6%), sepsis (13.3%), pneumonia, asthma, chronic obstructive pulmonary disease (11.1%). 11 patients (24.4%) required mechanical ventilation while 34 (75.6%) patients had spontaneous respiration. In patients with spontaneous respiration, a significant relationship was found between IVC diameters measured by ultrasonography at the end of expiratory and inspiratory phases and measured CVP values at the same phases (for expiratory p = 0.002, for inspiratory p= 0.001). There was no statistically significant association between IVC diameters measured by ultrasonography at the end of expiration and inspiration and measured CVP values at the same phases in mechanically ventilated patients. Conclusions: IVC diameter measured by bedside ultrasonography can be used for determination of the intravascular volume status of the patients with spontaneous respiration.

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The relationship between inferior vena cava diameter measured by bedside ultrasonography and central venous pressure value.

Drug-induced hepatotoxicity is a major cause of hepatocellular injury in patients admitting to emergency services with acute liver failure. Hepatic necrosis may be at varying degrees from mild elevations in transaminases to fulminant hepatitis, and even death. The case of a 53-year-old female patient with toxic hepatitis due to levofloxacin and multiple organ failure secondary to toxic hepatitis is presented. Patient suffered itching, redness, and rash after receiving a single dose of 750 mg of levofloxacin tablets for pulmonary infection 10 days ago. Skin lesions had regressed within 3 days, but desquamation formed all over the body. After the fifth day of drug intake, complaints of abdominal pain, vomiting, and yellowing in skin color had started. The patient was referred to our emergency department with these complaints 10 days after drug intake. Patient was thought as a candidate for liver transplant, but cardiopulmonary arrest occurred, and the patient died before she could be referred to a transplant center. This case is important because hepatotoxicity and death due to levofloxacin is uncommon in the literature.

Levofloxacin-induced hepatotoxicity and death.

Cocuk istismari, ciddi yaralanmalara, sakatliklara ve hatta olumlere neden olabilen tibbi, hukuki, sosyal yonleri olan onemli bir halk sagligi sorunudur. Tekrarlayan istismarin erken evrede onlenmesi istismarin uzun vadeli etkilerini sinirlamak icin gereklidir. Ne yazik ki bu cocuklar siklikla acil servisi kullanmalarina ragmen acil serviste tani alamamaktadirlar. Biz bu derlemede gunumuzde oldukca onemli toplumsal boyutu olan cocuk istismari ve ihmalinin degerlendirilme ve yonetimini son bilgiler isiginda gozden gecirmeyi amacladik.

/pdf/cocuk-istismari-ve-ihmalinin-degerlendirilmesi-2nc6rljcmy.pdf

Çocuk İstismarı ve İhmalinin Değerlendirilmesi

Introduction We aimed to investigate the effect of stress (acute) hyperglycemia in patients with acute coronary syndrome who had not been previously diagnosed with diabetes mellitus (DM) on the prognosis of the disease in terms of mortality. Material and methods Patients who were admitted to the Adana Numune Training and Research Hospital Emergency Service Clinic between August 2010 and August 2013 and whose plasma blood glucose level was over 140 mg/dl at the time of admission but were not previously diagnosed with DM, who were over the age of 18 and considered to have acute myocardial infarction were included. Results A total of 259 patients whose data were fully attainable were included in the study. 80.3% (n = 208) of the patients were male and 19.7% (n = 41) were female. Non-ST elevation myocardial infarction was found in 71.6%, ST elevation myocardial infarction was found in 28.4% of the patients with stress hyperglycemia. It was determined that 10.1% of patients with stress-related hyperglycemia and 1.3% of patients without stress-related hyperglycemia had died. Conclusions The plasma blood glucose level at presentation of patients diagnosed with acute myocardial infarction at the emergency room is associated with early in-hospital mortality.

https://www.termedia.pl/Journal/-102/pdf-37441-10?filename=Does stress hyperglycemia.pdf

Akkan Avci

Papers

The relation between oxidative stress parameters, ischemic stroke, and hemorrhagic stroke.

The relationship between inferior vena cava diameter measured by bedside ultrasonography and central venous pressure value.

Levofloxacin-induced hepatotoxicity and death.

Çocuk İstismarı ve İhmalinin Değerlendirilmesi

Does stress hyperglycemia affect mortality? Acute myocardial infarction - case control study.