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Objective: To evaluate the reliability of blood gas test electrolyte results by comparing them with biochemistry results. Material and Methods: A total of 722 patients with blood gas (BG) and biochemistry results, admitted to our emergency department in May 2013, were evaluated retrospectively. Patients were grouped as acidosis group, normal pH group, and alkalosis group. The obtained data were analyzed with SPSS 16.0 software for their frequencies and distributions and then interpreted using paired-sample t-test. Results: There was a statistically significant difference between BG and biochemistry potassium results in the normal pH group (p<0.01). Also, there was a statistically significant difference between blood gas and biochemistry chlorine results in acidic, normal pH, and alkaline blood samples (p<0.01). However, no statistical significance was found between BG and biochemistry sodium results in all pH values or between BG and biochemistry potassium results in acidic and alkaline blood (p>0.01). Conclusion: It was found that BG potassium results in normal pH and BG chlorine results in all pHs were not statistically reliable. Blood gas electrolyte values should be used for the initial treatment of critically ill patients in the emergency department. However, we need to be aware that the results of blood gas electrolyte testing are not reliable. These results have to be confirmed with routine biochemistry electrolyte, EKG, and physical examination findings soon.

SUMMARYObjectivesThe aim of this study was to determine the antibiotic resistance of infectious and non-infectious E. coli species in order to increase the success of empirical antibiotic treatment in urinary system infections.MethodsThe antibiotic susceptibility of 464 E. coli strains that were isolated from urine samples of patients who visited Derince Training and Research Hospital Emergency Department between January 1 and December 31, 2012 were retrospectively evaluated from records. The antibiogram results were classified as susceptible, moderately susceptible or resistant. Moderately susceptible strains were assumed to be resistant.ResultsBacterial proliferation was seen in 563 (28.1%) of the 1998 urine cultures tested. One hundred and twelve cultures could not be evaluated due to contamination, and there was no proliferation in 1323 cultures. E. coli strains were isolated in 464 (82.4%) of the cultures in which proliferation was seen. Three hundred and sixty seven (79%) of the patients were female, 97 (21%) were male, and the mean age of all of the patients was 41.1±24.1 years (min: 1, max: 90). The antibiograms of the E. coli strains revealed that meropenem had the lowest resistance (0%), while ampicillin-sulbactam had the highest resistance (36.8%).ConclusionsIn this study, we investigated the antibiotic resistance of E. coli strains isolated from urine cultures in our region. Future studies, perhaps similar to this one, can be performed in the future to increase the success of treatments.

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ÖzetAmaç: Bu ara|tirnnanin amací, acil serviste diyabetik ketoasidoz (DKA) tablosu ile bajvuran hastalarda yeni taní diyabet (DM) oranini arajtirmaktir Yöntem: Arajtirmaya 01 Nisan 2009-01 Nisan 2011 tarihieri arasmda Ístanbul Göztepe Egitim ve Arajtirma Hastanesi erijkin acil servisine bajvuran ve diyabetik ketoasidoz tanisi konulan hastalar içinde dosya bilgileri tam olan 57 hasta alindi. Hastalarm klinik ve laboratuvar verileri hasta dosyalarindan geriye dönük olarak incelendi. Bulgular: Arajtirmaya aliñan hastalardan, %45.6'smda tip 1, %33.3'ünde tip 2, %21'inde ise yeni tam diyabet sap-tandi. DKA tanisi alan hastalarm bajvuru arter kan gazi pH, HC03 degerleri, serum sodyum ve potasyum, bajvuru zamaní, plazma glukoz degeri açismdan tip 1, tip 2 ve yeni tam DM hastalari arasmda istatistiksel olarak anlamli fark görülmezken (p>0.05), HbAlc degerleri yeni tam DM hastalarinda istatistiksel oiarak anlamli derecede yüksekti.Sonuç: Diyabetik ketoasidoz tanisi konulan farkli tiplerdeki hastalarda diyabet tipleri açismdan etiyolojik nedenler, ya5 ve HbAl c degerleri dijinda istatistiksel acidan anlamli bir veriye rastlanmadi. Acil servise bajka nedenlerle baj-vuran hastalarda kan lekeri yüksekliginin tespit edilmesi nadir degildir. Bu tip hastalarda altta yatan diabetes mellitus açismdan dikkatli olunmasi olasi diyabetik ketoasidoz ataklarmín engellenmesi bakimmdan önemlidir (Haseki Abstract Aim: The aim of this study v^/as to investigate the rate of new-onset diabetes meilitus (DM) in patients presenting to our emergency department with diabetic ketoacidosis. Methods:We retrospectively evaluated hospital records of patients who presented to the Emergency Department at Istanbul Goztepe Research and Training Hospital between 01 April 2009 and 01 April 2011 and were diagnosed with diabetic ketoacidosis. 57 patients having complete clinical data were included in the study Results: 45.6%of patients had type 1 DM, 33.3%-type 2 DM, and 21%of them were with new-onset DM. No statistically significant difference was found between type 1 DM, type 2 DM and new-onset DM patients with respect to arterial blood pH and HC03 levels and serum sodium, potassium and plasma glucose levels at presentation as well as time of presentation (p>0.05), while HbAI c levels showed statistically significant difference in new-onset DM patients. Conclusion:No statistically significant difference was found between types of DM in patients diagnosed with diabetic ketoacidosis except for precipitating factors, age and HbAlc. Detecting high blood glucose levels in patients presenting to emergency room for reasons other than DM is not a rare condition. Cautious evaluation and recognition of these patients in emergency room for the possibility of undiagnosed DM is important for prevention of future diabetic ketoacidosis episodes. (Tiie Medical Bulletin of Haseki 2013; 51: 168-72)