BackgroundTo evaluate the etiological and demographic characteristics of adult poisoning patients followed up in a toxicology unit in Konya, Turkey.MethodsPatients (≥ 15 years old) followed up with the diagnosis of poisoning in our toxicology unit in 2011 were included in this retrospective study. The patients’ medical records were investigated. Age, gender, medical history, the first medical center the patient had been admitted to, the routes and causes of poisoning, the toxins involved, the number of the pills taken, treatments, complications, the length of stay in the hospital and the outcome were recorded.ResultsA total of 623 patients were included in the study. The mean age of patients was 28.1 ± 15.1. Four hundred and forty-five (71.4%) of patients were female, 541 (86.9%) of them were poisoned via the oral route and 75 (12.0%) of them were poisoned by inhalation. The causes of poisoning were drugs in 408 (65.5%) patients, pesticides/insecticides in 58 (9.3%) patients and carbon monoxide in 49 (7.9%) patients. The commonly used drugs were as follows: analgesics (57.2%), antidepressants (25.4%) and gastrointestinal system drugs (15.8%). The poisonings were suicidal in 489 (78.5%) patients, accidental in 120 (19.3%) patients and overdose in 14 (2.2%) patients. The number of women was higher in the suicide group. At the end of the treatment, 604 (97.0%) of the patients were discharged and 3 (0.4%) of them died. The duration of follow-up was 39.2 ± 37.5 h.ConclusionThe most common causes of poisoning are drugs, pesticides/insecticides and carbon monoxide. Health and educational policies at a national level are needed in order to prevent this medicosocial problem. Furthermore, specially equipped toxicology units should be constructed for the treatment and follow-up of the poisoned patients in order to reduce the morbidity and mortality to a significant extent.
ObjectiveIn this study, we aimed to determine whether plasma NGAL levels could be used as a biomarker for distinguishing between AKI and CKD in emergency medicine.Materials and methodsThis prospective study was conducted at the ED of a training and research hospital over a six-month period in 2015. Three groups were defined: an AKI group – defined as a new onset of at least a 1.5-fold or ≥0.3 mg increment increase of SCr values from the normal baseline, a stable CKD group – only included presence of stages 2 through 4 of CKD according to the National Kidney Foundation's KDIGO 2012, and a control group. After the initial evaluation of patients, venous blood samples were taken for routine biochemical, counter blood cell, and plasma NGAL measurement at admission.ResultsA total of 25 patients with AKI, 22 patients with stable CKD, and 22 control subjects were enrolled. Level of plasma NGAL in AKI group was higher than those of the stable CKD group (median: 794 ng/ml IQR: 317–1300 & 390 ng/ml IQR: 219–664, p < 0.001). AUC was measured as 0.68 (p = 0.02, 95% CIs: 0.54–0.84) to assess the utility of plasma NGAL levels at varying cut-off values for distinguishing between AKI and CKD. For plasma NGAL, the best cut-off level was found to be 457 ng/ml (sensitivity: 72.0%, specificity: 64%).ConclusionThis study has clearly demonstrated that plasma NGAL levels were higher in AKI patients than in CKD patients. However, in clinical practice, the use of plasma NGAL levels to distinguish between AKI and CKD is limited.
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