Purpose Acute myocardial infarction (AMI) is the most common cause of death in the world. Comprehensive risk assessment of patients presenting with chest pain and eliminating undesirable results should decrease morbidity and mortality rates, increase the quality of life of patients, and decrease health expenditure in many countries. In this study, the advantages and disadvantages of the enzymatic and nonenzymatic biomarkers used in the diagnosis of patients with AMI are given in historical sequence, and some candidate biomarkers - hFABP, GPBB, S100, PAPP-A, RP, TNF, IL6, IL18, CD40 ligand, MPO, MMP9, cell-adhesion molecules, oxidized LDL, glutathione, homocysteine, fibrinogen, and D-dimer procalcitonin - with a possible role in the diagnosis of AMI are discussed. Methods The present study was carried out using meta-analyses, reviews of clinical trials, evidence-based medicine, and guidelines indexed in PubMed and Web of Science. Results These numerous AMI biomarkers guide clinical applications (diagnostic methods, risk stratification, and treatment). Today, however, TnI remains the gold standard for the diagnosis of AMI. Details in the text will be given of many biomarkers for the diagnosis of AMI. Conclusion We evaluated the advantages and disadvantages of routine enzymatic and nonenzymatic biomarkers and the literature evidence of other candidate biomarkers in the diagnosis of AMI, and discuss challenges and constraints that limit translational use from bench to bedside.

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Biomarkers in acute myocardial infarction: current perspectives

Because only 25% of cases of premature ovarian insufficiency (POI) have a known etiology, the aim of this review was to summarize the associations and mechanisms of the impact of the environment on this pathology. Eligible studies were selected from an electronic literature search from the PUBMED database from January 2000 to February 2016 and associated references in published studies. Search terms included ovary, follicle, oocyte, endocrine disruptor, environmental exposure, occupational exposure, environmental contaminant, pesticide, polyaromatic hydrocarbon, polychlorinated biphenyl PCB, phenol, bisphenol, flame retardant, phthalate, dioxin, phytoestrogen, tobacco, smoke, cigarette, cosmetic, xenobiotic. The literature search was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We have included the human and animal studies corresponding to the terms and published in English. We have excluded articles that included results that did not concern ovarian pathology and those focused on ovarian cancer, polycystic ovary syndrome, endometriosis or precocious puberty. We have also excluded genetic, auto-immune or iatrogenic causes from our analysis. Finally, we have excluded animal data that does not concern mammals and studies based on results from in vitro culture. Data have been grouped according to the studied pollutants in order to synthetize their impact on follicular development and follicular atresia and the molecular pathways involved. Ninety-seven studies appeared to be eligible and were included in the present study, even though few directly address POI. Phthalates, bisphenol A, pesticides and tobacco were the most reported substances having a negative impact on ovarian function with an increased follicular depletion leading to an earlier age of menopause onset. These effects were found when exposure occured at different times throughout the lifetime from the prenatal to the adult period, possibly due to different mechanisms. The main mechanism seemed to be an increase in atresia of pre-antral follicles. Environmental pollutants are probably a cause of POI. Health officials and the general public must be aware of this environmental effect in order to implement individual and global preventive actions.

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Environmental pollutants, a possible etiology for premature ovarian insufficiency: a narrative review of animal and human data

Interleukin-10 (IL-10) is an important anti-inflammatory cytokine expressed in response to brain injury, where it facilitates the resolution of inflammatory cascades, which if prolonged causes secondary brain damage. Here, we comprehensively review the current knowledge regarding the role of IL-10 in modulating outcomes following acute brain injury, including traumatic brain injury and the various stroke subtypes. The vascular endothelium is closely tied to the pathophysiology of these neurological disorders and research has demonstrated clear vascular endothelial protective properties for IL-10. In vitro and in vivo models of ischemic stroke have convincingly directly and indirectly shown IL-10-mediated neuroprotection; although clinically, the role of IL-10 in predicting risk and outcomes is less clear. Comparatively, conclusive studies investigating the contribution of IL-10 in subarachnoid hemorrhage are lacking. Weak indirect evidence supporting the protective role of IL-10 in preclinical models of intracerebral hemorrhage exists; however, in the limited number of clinical studies, higher IL-10 levels seen post-ictus have been associated with worse outcomes. Similarly, preclinical traumatic brain injury models have suggested a neuroprotective role for IL-10; although, controversy exists among the several clinical studies. In summary, while IL-10 is consistently elevated following acute brain injury, the effect of IL-10 appears to be pathology-dependent and preclinical and clinical studies often paradoxically yield opposite results. The pronounced and potent effects of IL-10 in the resolution of inflammation and inconsistency in the literature regarding the contribution of IL-10 in the setting of acute brain injury warrant further rigorously controlled and targeted investigation.

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Role of Interleukin-10 in Acute Brain Injuries.

Inflammation and insulin/IGF-1 resistance as the possible link between obesity and neurodegeneration

Neurotoxic effects of organophosphorus pesticides and possible association with neurodegenerative diseases in man: A review.

Abstract Objective: Measurements of electrolyte levels made by blood gas analyzers or routine methods based on membrane and selective electrodes are expected similar performance characteristics that do not show significant differences. It is clinically important that those measurements should give equivalent results and confirm the closeness to the absolute value. In this study, it was aimed to compare sodium (Na), potassium (K), chlorine (Cl), hemoglobin (Hb) and hematocrit (Hct) values measured with blood gas analyzer and standard automatic devices in the laboratory (lab) from venous blood samples. Methods: A prospective, randomized study was conducted in simultaneous venous samples from antecubital regions of patients admitted to emergency department for various reasons, were analyzed for Na, K, Cl, Hb and Hct values on blood gas analyzer and standard automatic devices in the lab. The obtained data were compared statistically. Results: A total of 100 patients were included in the study. A statistically significant correlation was found between laboratory and venous blood gas (vbg) Na, K, Cl, Hb and Hct values (p<0.001). The average difference between them was -7.9 mEq/L (r=0.720) for Na, 0.5 mEq/L (r=0.785) for K, -5.1mEq/L (r=0.790) for Cl, -0.14 grams/dL (r=0.757) for Hb and -% 1.54 (r=0.749) for Hct, respectively. Their correlation was formulated (Lab Na=vkg Nax0.621+46.081; Lab K=vkg Kx0.23+1.977; Lab Cl=vkg Clx0.847+11.050; Lab Hb=vkg Hbx0.583+5.015; Lab Hct=vkg Hctx0.565+15.024). Conclusion: In our study, it was detected that there is a statistically significant positive correlation between venous blood Na, K, Cl, Hb and Hct values of blood gas analyzer and standard automated devices in lab, and closeness of the desired performance is provided.

Comparison of Na, K, Cl, Hb and Hct values measured by blood gas analyzer and laboratory auto-analyzer / Kan gazı analiz cihazı ve laboratuvar otoanalizörü tarafından ölçülen Na, K, Cl, Hb ve Hct değerlerinin karşılaştırılması

Prognostic relationship between complete blood count parameters and transient ischemic attack, ischemic stroke and hemorrhagic stroke

Snake bites can cause severe morbidity and mortality. Patient admissions to emergency services due to snake bites are observed to be increased in especially rural areas of our country and in summer months. In this compilation, the current knowledge about snake species living in our country, discrimination of poisonous snakes and non-venomous snakes, and approaches to snake bites has been reviewed.

Management of Snake Bites

Purpose: In this study, we aimed to determine the success rate of cardiopulmonary resuscitation performed in the patients with diagnosis of cardiac arrest, and demographic characteristics of these patients. Material and Methods: The patients admitted to Adana Numune Education and Research Hospital, Department of Emergency Medicine between 01.01.2011 and 31.12.2012, and who underwent cardiopulmonary resuscitation were included to this study planned as retrospectively. The age, gender, status of judicial cases, causes and time of cardiac arrest, first observed arrest rhythm, the diseases prior to the arrest, means of arrival to emergency department, duration of cardiopulmonary resuscitation, results of cardiopulmonary resuscitation, the name of the hospitalised clinic, the existence of the operation, and outcome of the patients who underwent cardiopulmonary resuscitation in accordance with current advanced life support protocols were recorded in standard data entry form. Results: A total of 290 patients with completely accessible data were included to the study. Most of these patients were men (65.2%). The mean ages were 61 ± 19 years for men, 67 ± 14 years for women (p = 0.018). The most common diagnosis were ischemic heart disease and heart failure according to the analysis of the patient's medical history. 92 patients (31.7%) were brought to the emergency department after death, and all of these patients were unsuccessful following to cardiopulmonary resuscitation. 198 patients (68.3%) had cardiac arrest in the emergency department, and we determined that cardiopulmonary resuscitation application of 102 patients were successful. The most common causes of cardiac arrest were myocardial infarction and heart failure. Mostly first observed rhythm in the monitor was asystole. The response rate of cardiopulmonary resuscitation in patients with ventricular fibrillation and ventricular tachycardia was higher. Most patients were hospitalised to the coronary intensive care unit, and 11 of the 21 patients who underwent percutaneous coronary intervention were discharged from hospital in good health. Total 15 (5%) of all patients included to the study were discharged in good health. Conclusion: The lower rate of success in cardiopulmonary resuscitation showed the presence of defects in all stages of the chain of life, and suggests that some actions should be performed to correct them.

/pdf/kardiyopulmoner-resusitasyon-da-basarilimiyiz-2bk197dqr4.pdf

Kardiyopulmoner Resüsitasyon"da Başarılımıyız?

Amac: Travma acil servise en yaygin basvuru nedenlerinden birisidir. Bu calismada, acil servisimize basvuran eriskin travma hastalarinin demografik ozellikleri, etyolojileri, mortalite ve morbidite oranlarinin belirlenmesi amaclanmistir. Materyal ve Metod: Acil servise 01 Mart 2011 ile 31 Agustos 2011 tarihleri arasinda travma ile basvuran 18 yas uzeri hastalar calismaya dahil edilmistir. Hasta muayene kartlari, yatis dosyalari ve hastane otomasyon sistemine ICD 10 kodlari ile girilen kayitlar incelenmistir. Bilgilerine eksiksiz ulasilamayan hastalar calisma disi birakilmistir. Bulgular: Calisma suresi boyunca 110495 hastanin acil servise basvurdugu ve bunlarin 13585’inin (%12,29) travmaya bagli basvuru oldugu belirlenmistir. Basit ekstremite travmasi (%38,28) ve dusmenin (%31,7) en yaygin etyolojik nedenler oldugu, hastalarin %99,71’inin Glaskow Koma Skalasi skorunun 13 ile 15 arasinda oldugu tespit edilmistir. Travmali hastalarin %9,6’sina Bilgisayarli Tomografi (BT) cekildigi, bunlarin %84,5’inin normal oldugu ve en sik Beyin BT cekildigi belirlenmistir. Hastalarin sadece %6’sinin hastaneye yatirildigi, %0,9’unun ise eksitus oldugu gorulmustur. Bayanlarda yuksekten dusmenin, erkeklerde ise trafik kazalarinin en sik olum nedeni oldugu saptanmistir. Sonuc: Acil servise basit travma ile basvuran hastalarin buyuk cogunlugunun ayrintili hikaye ve dikkatli fizik muayene sayesinde taburcu edilebilecegi belirlenmistir. Gereksiz tibbi tetkikler, zaman kaybi ve para israfi azaltilmalidir. Bu yolla agir hastalara daha fazla zaman ve isgucu ayrilabilir.

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Mehmet Oğuzhan Ay

Papers

Comparison of Na, K, Cl, Hb and Hct values measured by blood gas analyzer and laboratory auto-analyzer / Kan gazı analiz cihazı ve laboratuvar otoanalizörü tarafından ölçülen Na, K, Cl, Hb ve Hct değerlerinin karşılaştırılması

Prognostic relationship between complete blood count parameters and transient ischemic attack, ischemic stroke and hemorrhagic stroke

Management of Snake Bites

Kardiyopulmoner Resüsitasyon"da Başarılımıyız?

Analysis of Adult Trauma Patients Admitted to Emergency Department