No abstract

Wound healing represents an ancient problem for humans, and various materials and methods have been tried for wound dressing. A dressing should protect against infection and shorten healing; moreover, it should not cause tissue damage and should be nonallergenic, cost effective and easy to apply. These are characteristics that may be found in herbal extracts. An absorbable polysaccharide haemostat (APH) is a plant-based haemostatic agent. We aimed to evaluate the effect of APH on wound healing. A total of 24 Wistar rats were divided into three groups, each consisting of eight rats. We generated triangular tissue defects on the dorsal regions of the rats. The wound size of each rat was drawn on acetate paper on the 3rd, 7th and 14th days and dressed with APH, saline and wheat meal. Wound healing rates were calculated using planimetric software. Scar tissue excision was performed on the 14th day and histopathological examination was carried out. The mean wound contraction rate was statistically higher in the APH group than in the wheat meal and saline groups on the 14th day (P < 0.05). There was no significant difference in polymorphonuclear leukocytes intensity between the saline and APH groups when stained with haematoxylin and eosin (P > 0.05). However, the intensities of fibroblasts (P < 0.01), vascular proliferation (P = 0.01) and inflammatory score (P = 0.02) were significantly different in the saline and APH groups. APH has favourable effect on wound healing. In addition to its blood-stopping effect, APH may be useful for tissue defects, which arise after trauma or surgical procedures.

BACKGROUND:Bleeding is a major problem in warfarin pretreated patients who need emergency surgical procedures. APH is a hemostatic agent with ultra-hydrophilic and particulate properties. This study aimed to evaluate the in vivo hemostatic effect of APH in rats pretreated with warfarin.

Bu çalışmanın amacı, bir üniversite hastanesinin acil yoğun bakım biriminde takip edilen çoklu travma hastalarının değerlendirilmesidir. Yöntemler: Çalışmaya Ocak 2006-Ocak 2009 tarihleri arasında fakültemizin acil yoğun bakım biriminde takip edilen çoklu travma hastaları alındı. Travma sonrası ilk altı saat içinde hayatını kaybedenler, kronik böbrek yetmezliği, kronik karaciğer hastalığı, konjestif kalp yetersizliği ve metastatik kanser hastaları çalışma dışı bırakıldı. Travmanın nedeni, yoğun bakım ve mekanik ventilatörlerde kalış süreleri, aldığı destek tedaviler, travma skorları ve mortalite oranları belirlendi. Elde edilen bulgular istatistiksel olarak değerlendirildi. Bulgular: Çalışmaya alınan hastaların yaş ortalaması 31±21.82 (aralık 1-80) yıl idi. Hastaların 112'si (%81.2) erkek 26'sı (%18.8) kadın idi. Çoklu travmanın en sık nedenleri araç içi trafik kazaları (%40.6) ve araç dışı trafik kazaları (%37) idi. Ortalama yoğun bakımda ve mekanik ventilatörde kalış süreleri sırasıyla 5.3 gün (1-30 gün) ve 2.2 gün (0-30 gün) idi. Hastalardan 56'sı (%43.5) mekanik ventilatör desteği alırken, 34 (%26.4) hastanın beslenme desteği aldığı ve 22 (%14.5) hastanın inotrop desteği aldığı belirlenmiştir. Bu hastaların mortalite oranları sırasıyla %50, %44.1 and %77.7 idi. Mekanik ventilasyondaki, inotrop ve beslenme desteği alan çoklu travma hastalarındaki mortalite oranları tüm hastalardaki mortalite oranlarından yüksek bulunmuştur. Sonuç: Çoklu travma yaralanmalarının en sık nedeni motorlu araç kazaları olup, özellikle genç erkekleri etkilemektedir. Hastaların mekanik ventilasyon, inotrop ve beslenme desteği ile ilgili komplikasyonlar travma yoğun bakım merkezlerindeki ölüm ve sakatlıklar üzerinde etkili olmaktadır.

The aim of this study was to investigate the correlation between procalcitonin and other acute phase reactants, and also analyze their relationship with clinical situation in chronic obstructive pulmonary disease (COPD) acute exacerbations. Materials and methods: The study was made with 122 acute COPD exacerbated patients, who were admitted to emergency service. Patients with below 0.25 ng/ml PCT value included Group 1, and the patients with PCT values ≥ 0.25 ng/ml Group 2. Serum procalcitonin levels, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) values and white blood cell (WBC) counts were measured. Also, patients hospitalization time and mortality rates were recorded and compared with PCT. Results: Patients were divided in 3 groups according to their clinical diagnosis; Pneumonia (n=27), Mycoplasma-Chlamydia pneumonia (n=11) and the patients with only COPD exacerbation(n=84). Mean PCT values according to the groups were 9.47 ± 8.1 ng/ml, 0.41 ± 0.2 ng/ ml, and 0.21 ± 0.05 ng/ml respectively. The relationship between PCT with CRP and white blood cell has been found between significiant (p=0.001, p=0.005 respectively), whereas the relationship between PCT and ESR was nonsignificant (p=0.55). Procalcitonin and CRP had a positive correlation with the hospitalization time (p=0.034, p=0.022 respectively). The mean ± standard error of PCT for the patients who died was 28.3 ± 27.5 ng/ml, and the difference between patients who died or were discharged was statistically significant (p= 0.012). Conclusion: PCT can be a useful indicator for morbidity and prognosis in COPD patients.