Olanzapine is an antipsychotic drug used in psychiatric diseases. At high doses it exhibits cardiovascular and neurological sideeffects in particular. Lipid emulsion therapy for the removal of medication from plasma in high-dose lipophilic drug use has recently become very widespread. In the light of current literature, this report discusses the successful treatment of a patient within 4 hrs of olanzapine overdose as an attempted suicide, who presented with agitation and clouded consciousness

ÖZGiriş: Akut bronşiyolit tedavisinde nebülize beta agonist kullanıl-makla birlikte etkinliği konusunda görüş birliği yoktur.Çalışmanın amacı akut bronşiyolitli çocuklara verilen inhale salbutamolün elektrokardiyografik değişiklikler üzerine etkilerini incelemektir. Gereç ve Yöntem:Çalışmaya akut bronşiyolit tanısıyla hastanemiz çocuk aciline kabul edilen 1 ay-2 yaş arası 80 çocuk alındı. Hastalar randomize olarak eş sayıda iki grubuna ayrıldı. Birinci gruptakilere 0.15 mg/kg/dozdan tek doz nebulize salbutamol, diğerine 20 dakika arayla 3 doz nebulize salbutamol verildi. Her iki grubun acil geliş ve salbutamol verildikten sonraki elektrokardiyografi bulguları değerlendirildi. Bulgular:Grupların bazal demografik özellikleri benzerdi. Her iki grubun salbutamol kullanımı sonrası kalp hızlarında ilk gelişlerine göre anlamlı artış meydana geldi p=0.0001;.05 dk, p=0.009). Ayrıca her iki grupta PR intervalinde de anlamlı kısalma tespit edildi. (Grup I:102-98 ms, p=0.013; Grup II:105-100 ms, p=0.001). Grup II' de nebulize salbutamol sonrası ortalama QTc aralığı Grup I' e göre daha uzundu (384.75-395.13 ms; p=0.031). Her iki grubun diğer elektrokardiyografik parametrelerinde anlamlı değişiklik saptanmadı. ABSTRACTObjective: Nebulized beta agonists are being used in acute bronchiolitis treatment, but there is no consensus on the efficacy of this regimen.The purpose of this study was to investigate the electrocardiographic (ECG) effects of nebulized salbutamol in children with acute bronchiolitis. Materials and Methods:The study was conducted with 80 children aged 1 month to 2 years who presented to our pediatric emergency department (ED) with a diagnosis of acute bronchiolitis. Patients were randomly assigned to two groups equal in number. Group I was given one dose of nebulized salbutamol (0.15 mg/kg/dose) and Group II three consecutive doses of nebulized salbutamol (0.15 mg/ kg/dose) at 20-minute intervals. ECG measurements were assessed at the start of the ED visit and after nebulized salbutamol in both groups.Results: Baseline demographics of the two groups were similar. Heart rates were significantly higher in both groups after nebulized salbutamol in comparison to the initial evaluation. (Group I 155.25 vs. 166.35 beats/min; p=0.0001; Group II 158.20 vs. 166.05 beats/ min; p=0.009). PR intervals were also significantly shorter in both groups (Group I: 102 vs. 98 ms, p=0.013; Group II: 105 vs. 100 ms, p=0.001). The mean QTc intervals were longer in Group II patients

Klippel-Feil syndrome (KFS) is a complex syndrome associated with osseous and visceral anomalies that include the classical clinical triad of short neck, limitation of head and neck movements and low posterior hairline. Multiple congenital anomalies have been associated with this disease. We reported the fi rst case of KFS presented with the symptoms of duodenal obstruction and annular pancreas detected intraoperatively.

Background Chronic venous disorders (CVD) that conventionally refers to disease of lower and upper extremity venous system encompass a large spectrum of abnormalities in the venous system. Recently, various venous disorders such as hemorrhoids, varicocele and lower extremity varicose veins have been gathered under the term of dilating venous disease (DVeD). So, vascular wall pathology itself has been supposed to be the underlying mechanism of DVeD in different vascular systems. Migraine is a neurovascular disorder which cerebral venous congestion might have role in pathogenesis. Both vascular and neurogenic theories have been postulated for the pathophysiology of migraine. We hypothesized that pathophysiology of migraine might related with DVeD due to vascular theory. Purpose The objective was to assess the association between venous disease and migraine by using the Venous Insufficiency Epidemiological and Economic Study-Quality of Life/Symptoms (VEINES-QoL/Sym) questionnaire in migraineurs and non-migraineurs. Methods The study was designed as a non-randomized, prospective cohort study and consisted of patients diagnosed with migraine. The control group included age- and sex-matched healthy subjects. All participants were examined for the presence of CVD. Presence of lower extremity venous system disease and subsequent classification has been assessed and categorized according to clinical component of clinical, etiological, anatomical and pathological (CEAP) classification. VEINES-Sym questionnaire was applied to assess venous symptoms. The Migraine Disability Assessment (MIDAS) questionnaire was used to assess the severity of disease in migraineurs. Results Participants were classified into two groups as migraine (+) group (n=130) and migraine (−) group (n=130) (Figure 1). Migraine patients and control group were comparable in terms of clinical status and demographic parameters. The mean score of night cramps, burnings, itching, tingling and throbbing were found to be lower in migraineurs than those of non-migraineurs. In addition, the presence of venous symptoms, aching legs, night cramps, heat/burning sensation, throbbing and tingling were found to be significantly higher in patients with migraine compared with those without migraine (Figure 2). Also, total VEINES-Sym score was lower in patients with migraine compared to control group (34.4±8.7, 37.6±8.12, p=0.003, respectively). Additionally, there was a significant negative correlation between VEINES-Sym score and total MIDAS disability score (r=−0.33, p<0.001) and MIDAS severity levels (r=−0.266, p=0.003) of the migraineurs. Logistic regression analysis revealed that VEINES-Sym score is an independent and statistically significant associate of migraine (OR: 0.95, 95% CI: 0.92–0.98, p=0.001). Conclusions We have documented an independent association between migraine and VEINES-Sym score indicating possible pathophysiological link between migraine and CVD. FUNDunding Acknowledgement Type of funding sources: None.