We investigated the diagnostic value and the relationship with clinicopathological features of total and free prostate-specific antigen by measuring the concentrations of these markers in the sera of 75 women with colorectal carcinoma and in 30 healthy women. Measurements were performed by immunoradiometric assay which utilizes monoclonal and polyclonal antiprostate-specific antigen antibodies; the lowest detection level for both markers was 0.01 ng ml 71. Free prostate-specific antigen levels were significantly higher in women with colorectal carcinoma than healthy women (P=0.006). The percentage of free prostate-specific antigen predominant (free prostate-specific antigen/total prostate-specific antigen 450%) subjects was 20% in colorectal carcinoma patients and 3.3% in healthy women (P=0.035). Cut-off values were 0.34 ng ml 71 for total prostate-specific antigen and 0.01 ng ml 71 for free prostate-specific antigen. In women with colorectal carcinoma, total prostate-specific antigen positivity was 20% and free prostate-specific antigen positivity was 34.6%. When compared to negatives, total prostate-specific antigen positive patients had a lower percentage of well-differentiated (P=0.056) and early stage (stages I and II) tumours (P=0.070). However, patients with predominant free prostate-specific antigen, had a higher percentage of well-differentiated (P=0.014) and early stage tumours (P=0.090) than patients with predominant bound prostate-specific antigen. In conclusion, although the sensitivity of free prostate-specific antigen predominancy is low (20%), in distinguishing women with colorectal carcinoma than healthy women, its specificity is high (96.7%). Free prostate-specific antigen predominancy tends to be present in less aggressive tumours. These findings may indicate clinical significance of preoperative measurement of serum total and free prostate-specific antigen in women with colorectal carcinoma.

Aims: Acute pancreatitis is a severe inflammation of the pancreas presenting sudden onset with high morbidity and mortality. Simple, accessible, cost-efficient and feasible laboratory tests are still needed to demonstrate the prognosis of the patients. The aim of the present study was to search the efficiency of CRP/Alb ratio as a biochemical marker on mortality and clinical progress in the patients diagnosed with acute pancreatitis in correlation with APACHE-2. Methodology: This prospective case-control study was conducted with the patients diagnosed with acute pancreatitis through Atlanta criteria and healthy volunteers as a control group in the emergency department. Demographic characteristics, vital signs, ultrasound reports, clinical outcomes, neutrophil, lymphocyte, neutrophil/lymphocyte ratio (NLR), CRP, albumin and CRP/Alb ratio, APACHE-2 score within control and patient groups were recorded. Logistic regression analysis was performed to distinguish healthy volunteers from acute pancreatitis cases. Results: There was a statistically significant difference between CRP/Albumin and NLR measurements according to the groups and we found that the measurements of the patient group were significantly higher than the control group. The cut-off point for CRP/Albumin and NLR was found to be respectively 1.08, 4.04 and above. (Respectively; sen: 76.64%, 78.50%; spe: 97.20%, 97.20%; PPV: 96.47%, 96.55%; NPV: 80.62%, 81.89%; the accuracy: 86.92%, 87.85%). APACHE-2 scores ranged from 0 to 16, with a mean of 5.80±3.92. The probability of acute pancreatitis was significantly higher in patients with high CRP/Albumin and NLR. Conclusion: This study showed that CRP/Alb ratio and NLR were positively correlated with APACHE-2 scores that designed for prognosis in patients with acute pancreatitis.

BACKGROUND: The aim of the present study was to detect the prognostic importance of lactate and other blood gas parameters for mortality prediction in patients with critical malignancies referring to the emergency service. The general condition of patients with malignancy who have referred to the emergency department should be evaluated and it should be shown that they are not in any oncological emergency. It is a highly significant predictor of mortality after sepsis and shock in hyperlactatemia accompanying metabolic acidosis. It is significantly used for treatment monitoring.METHODS: This study was planned prospective and observational study. The patients enrolled were divided into two groups including survivor and non-survivor depending on 30-day mortality. The primary outcome of the study was determined as following the mortality within 30 days.RESULTS: The mean lactate level was 1.9 (1.4-2.5) mmol/L in the survivor group, and 2.6 (1.9-4.4) mmol/L in the non-survivor group; a significant difference was obtained between both groups (p<0.001). When the cut-off value of the lactate was determined as >2.95 mmol/L in order to differentiate the survivors from nonsurvivors, the sensitivity and specificity were detected as 35.0% and 86.1%, respectively. It was detected by the multivariate regression analysis that lactate predicts the 30-day mortality with a higher significance level in patients with critical malignancies.CONCLUSIONS: It was concluded that lactate is a good predictor and may be used safely in predicting 30-day mortality in patients with any critical malignancy referring to the emergency department.

Aim: Through advances in technology and medicine, life expectancy is longer than before. The area covered by elderly people in the population pyramid has been changing over the years. Emergency departments are often used by elderly patients. It increases the density and fullness in already-crowded departments. In this study, we aimed to examine characteristics of the admissions of old-old people through the EDs and we wanted to discuss the precautions and regulations that might be taken in order to improve the quality of care and management. Methodology: This study was carried out cross-sectionally and retrospectively in the one-year period between 01.01.2017-31.12.2017 in a department of emergency medicine. Patients' age, gender, the hours of admissions to the emergency department, the month of admissions, reasons for admissions, diagnoses, consultations, final status, the place of hospitalization, the name of the hospitalization department and the number of readmissions in a one-year period were recorded in the study form. The study data were analyzed with SPSS for Windows 22.0. P < 0.05 was considered statistically significant. Results: 4331 of these patients were included in the study. The mean age of the patients was 85.25 ± 3.90 and 60.5% of them were female. According to the months, the first three of the admission months were December, November and October (9.7%, 9.6%, 9.2% respectively). The most common admission was in the 08: 00-15: 59 time zone with 47%, followed by 41.8% with the 16: 00-23: 59 time zone.4331 patients included in the study admitted to the emergency department 12.988 times during the study period. 46.2% of the patients admitted to the department once, 53.8% of them admitted 2 times and more. The discharge rate of patients who were admitted only once was 84.2% and the rate was 88.4% for twice and more admissions. Conclusion: The existence and increasing number of this population should not be forgotten in changes to be made in emergency departments and other parts of the health system. Efforts should be made to improve the quality of care and to train staff to manage these patients more quickly and safely.

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