No abstract

The cardiovascular manifestations of acute ischemic stroke have been well known. Several electrocardiography (ECG) abnormalities have been reported in patients following acute stroke, including QT interval prolongation, ST segment deviation and T-wave changes. This study aimed to investigate the changes in transmyocardial repolarization parameters, in ischemic stroke patients. The study is a prospective, blind, and controlled clinical study. The patients without cardiac disease who received ischemic stroke diagnoses were included in the study. ECG was received from the patients in the first hour and 72 h. The P, QT, T , T dispersion, and the T /QT ratio were calculated. Moreover, fifty-five stroke patients and 35 control subjects were included to the study. All dispersion values and T/QT ratio in patients group were higher than those of control group (p < 0.05 for all values). When evaluated between ECGs' on first and third days, it was found that decreasing on all dispersion values and T /QT ratio in ECGs on third day than ECGs on first day (p < 0.05 for all values). QT, QT, and T dispersions values in patients who have insular lobe involvement were higher than those of patients who do not have insular lobe involvement (p< 0.001 for all values). In this study, we showed that acute stroke increases that P , QT, QT and new repolarization markers T and T/QT, during first 24 and 72 h in acute stroke patients without cardiovascular disease compared with the control group. The physicians should be aware about ventricular dysrhythmias in patients with ischemic stroke and these patients closely observed with cardiac monitoring, especially within first 24 h, and especially patients with insular lobe involvement.

Introduction: Licorice ingestion is well-described with its hypokalemic and hypertensive effects in the literature. To our knowledge, up to now, hypocalcemia due to licorice ingestion has not been described. Our aim is to create awareness for hypocalecemia concomittant with hypokalemia in patients with chronic licorice ingestion. Case Report: A 51-year old male patient presented to our Emergency Department (ED) with complaint of numbness on his whole body. On anamnesis, it was determined that he has been consuming licorice to regulate his hypertension for 3 months. Laboratory analysis revealed hypokalemia and hypocalcemia. After replacement therapy, the patient was discharged from the hospital with full recovery. Conclusion: Focusing on hypokalemia may lead to misdiagnosis of hypocalcemia in patients with chronic licorice ingestion. Physicians must be aware of other electrolyte disturbances not described in the literature yet.

Objectives Developments in medical technology have increased life expectancy around the world thereby, the population of elderly patients increases. While diagnosing the elderly patients, besides factors like physiological changes, comorbidities, multiple medications and admittance to the Emergency Department (ED) for serious causes, a lack of information and experience complicate the work of emergency physicians. Elderly people are admitted to ED with medical or traumatic complaints; nevertheless, independent of the reason for admittance to the ED their presenting condition should be simultaneously assessed for comorbidities. In this study, we aimed to compare social support and stress levels in geriatric patients admitted to the ED for trauma and medical reasons. Methods This was a single-center, prospective, descriptive, epidemiologic trial conducted in the ED of a training and research hospital between October 1st, 2015, and April 1st, 2016. Participants consisted 197 patients who were older than 65 years and presented to ED with medical reasons or trauma whose Emergency Severity Index (ESI) was ≥3. A socio-demographic and clinical data form, and the DUKE Social Support and Stress Scale (DUSOCS) were completed for each patient. Results Patients presenting with medical problems had higher family support levels than patients presenting with traumatic incidents, and this difference was statistically significant ( p = 0.028). Concurrently, when both groups’ family stress and social stress levels are viewed, patients presenting with trauma had higher levels of stress, and this difference was also statistically significant ( p < 0.001). Conclusion This study revealed that the patients admitted to the ED for trauma have lower social support levels than patients admitted for medical reasons. Moreover, social stress levels were also higher in these patients.

Öz Amaç: Erken gebelikte vajinal kanama acil servise en sık başvuru sebepleri arasındadır. Bu olgularda inflamasyonun önemli bir rol oynadığı ve ilerleyen dönemde oluşabilecek düşüklerin habercisi olabileceği düşünülmektedir. Çalışmanın amacı, abortus imminens (AI) tanısı ile acil servise başvurup hospitalize edilen hastalarda nötrofil-lenfosit oranı (NLO) ve platelet-lenfosit oranlarının (PLO) incelenmesi ve bu belirteçlerin gebelik sonuçlarını öngörmedeki etkinliklerinin değerlendirilmesidir. Materyal ve Metot: Üniversite hastanesi acil servisine, gebeliğinin ilk 14 haftası içerisinde vajinal kanama şikâyeti ile başvurup AI tanısı alan toplam 121 hasta çalışmaya dahil edilmiştir. Bu hastalar; gebeliklerini abortus nedeniyle kaybedenler (n=73; %60,33) ve 24. hafta sonrasında gebeliği devam edenler (n=48; %39,66) olarak iki gruba ayrılmış olup, demografik veriler, inflamatuar belirteçler ve diğer hematolojik parametreler açısından karşılaştırılmıştır. Bulgular: Gruplar arasındaki demografik veriler benzer olarak saptanmıştır. Abortus grubunda NLO anlamlı şekilde yüksek bulunmuştur (3,92±2,01 ve 2,94±1,20; p<0,001). PLO açısından gruplar arasında anlamlı fark izlenmemiştir (p=0,071). Receiver operating characteristics (ROC) analiz ile değerlendirildiğinde NLO için %77 duyarlılık ve %63 özgüllük ile eşik değer 2,93 olarak belirlenmiştir. Sonuç: AI patogenezinde inflamasyon önemli rol oynamaktadır. NLO kullanımı, acil servislerde gebelik sonuçlarını öngörmede faydalı olabilir. Kolay ulaşılabilir ve maliyet etkin olmaları sebebiyle inflamatuar belirteçlerin kullanıldığı daha büyük populasyon çalışmaları ile abortus olguları açısından önemli bilgiler edinilebilir.