Background and objectives: Although there are several hypotheses about the mechanism of action, intravenous lipid emulsion (ILE) therapy has been shown to be effective in the treatment of toxicities due to local anaesthetics and many lipophilic drugs. In this study, we had hypothesized that ILE therapy might also be effective in preventing mortality and cardiorespiratory depressant effects due to propofol intoxication. Materials and methods: Twenty-eight Sprague-Dawley adult rats were randomly divided into four groups. Saline was administered to the subjects in the control group. The second group was administered propofol (PP group); the third group was administered ILE (ILE group), and the fourth group was administered propofol and ILE therapy together (ILE+PP group). Systolic blood pressure (SBP), diastolic blood pressure (DBP), respiratory rate (RR), heart rate (HR), and mortality were recorded at 10 time-points during a period of 60 min. A repeated measures linear mixed-effect model with unstructured covariance was used to compare the groups. Results: In the PP group; SBP, DBP, RR, and HR levels declined steadily; and all rats in this group died after the 60-min period. In the ILE+PP group, the initially reduced SBP, DBP, RR, and HR scores increased close to the levels observed in the control group. The SBP, DBP, RR, and HR values in the PP group were significantly lower compared to the other groups (p < 0.01). The mortality rate was 100% (with survival duration of 60 min) for the PP group; however, it was 0% for the remaining three groups. Conclusions: Our results suggest that the untoward effects of propofol including hypotension, bradycardia, and respiratory depression might be prevented with ILE therapy.

Background and objective: Propofol is an anesthetic agent that is frequently used in anesthesia induction, maintenance and sedation. Propofol has severe side effects such as hypotension, bradycardia and respiratory depression. Although propofol is commonly used, there is no known antidote for its toxic effects. An approach to prevent toxic effects of propofol would be beneficial. The aim of this study was to assess the effects of intravenous lipid emulsion (ILE) therapy in the prevention of depressive effects of propofol on cardiovascular and respiratory systems. Materials and methods: Twenty-eight Sprague-Dawley adult rats were randomly divided into 4 groups. The saline-administered group was determined as the Control group. The second group was administered propofol (PP group); the third group was administered ILE (ILE group), and the fourth was administered propofol with ILE therapy (ILE+PP group). Systolic blood pressure (SBP), Diastolic blood pressure (DBP), Mean arterial blood pressure (MAP), Respiratory rate (RR), Heart rate (HR) and mortality were recorded at 10 points during 60 minutes. A repeated measures linear mixed-effect model with unstructured covariance was used to compare the groups. Results: In the PP group, SBP, DBP, MAP, RR and HR levels were declining steadily; all rats in this group died after 60 minutes. In the ILE+PP group, after a while, the decreased SBP, DBP, MAP, RR and HR levels increased SBP, DBP, MAP, RR and HR levels of the Propofol group were found to be significantly lower than those of the other groups (p&lt;0.01). The mortality rate was 100% (surviving period, 60 min) for the PP group, whereas 0% for the ILE, ILE+PP and Control groups. Conclusion: Our results suggest that undesirable side effects that can be seen after propofol application such as hypotension, bradycardia and respiratory depression might be prevented by using ILE therapy.

Background/Aim: Diabetic ketoacidosis (DKA) is an endocrinological emergency frequently seen in emergency departments (ED). It can result in mortality if not treated appropriately. The aim of this study was to examine the relationship between baseline lactate levels and patient outcomes in DKA patients admitted to the emergency department (ED). Methods: This retrospective cohort study was carried out in the ED of a tertiary hospital between May 2022 and November 2022 using the data of patients diagnosed with DKA. Patients with missing data, patients transferred from another hospital, patients with a diagnosis other than DKA, and patients who could not be followed up were excluded from the study. The primary outcome of the study was admission to the intensive care unit (ICU) and/or in-hospital mortality. The area under the curve (AUC) was calculated by receiver operating characteristic (ROC) regression analyses to predict critically ill patients with lactate levels. Results: The study was completed with 95 patients. The mean age of the patients was 53.1 years and n = 46 were female. Twenty (21.1%) of these patients were admitted to the intensive care unit and 22 (23.2%) died. The statistical analysis showed that lactate levels were statistically significant in predicting critically ill patients (P < 0.001). ROC analysis showed that a lactate level of 2.6 mmol/dL could predict critically ill patients. The area under the curve was 0.823 (95% confidence interval: 0.731-0.894, sensitivity: 71.4, Specificity: 69.8), the Youden index was 0.476, and the P-value was 0.001. Conclusion: According to the results of this study, there is a significant relationship between the initial lactate levels in DKA patients and patients who will require critical care. Therefore, lactate can be used as an appropriate follow-up tool in the management of DKA patients.

Propofol is the general anesthetic used for the anesthesia induction and its continuation. Propofol is generally safe and it doesn't have an antidote. Propofol has severe side effects such as cardiovascular depression and hypotension. The aim of this study was observed the effects of intravenous lipid emulsion (ILE) treatment in the preventı̇on of depressive effects of propofol on cardiovascular and respiratory system. Twenty-eight Sprague-Dawley adult rats randomly divided into 4 groups. The saline administered group was defined as the control group. The second group administered propofol, the third group administered ILE, and the fourth administered propofol with ILE therapy. Systolic blood pressure (SBP), Diastolic blood pressure (DBP), Median arterial blood pressure (MAP), Respiratory rate (RR), Heart rate (HR) and mortality were recorded during 60 minutes of follow-up. In the propofol group, SBP, DBP, MAP, RR and HR scores were decline steadily, after 60 minutes all rats in this group died. In the ILE group with propofol, after a while, decreased SBP, DBP, MAP, RR and HR scores was increased, and these values were observed close to the control group. The mortality ratio of the propofol group was detected as 100%, and survival ratio was found 100% in ILE + propofol group. The side effects such as hypotension, bradycardia and respiratory depression which can be seen after propofol application in rats could be recovered with ILE treatment and mortality due to these side effects were prevented.

SUMMARY OBJECTIVE: Gastrointestinal bleeding is an important part of gastrointestinal emergencies. This study aimed to examine the association between ABO blood groups and mortality in patients who were admitted to the emergency department and diagnosed with upper gastrointestinal bleeding. METHODS: The patients with upper gastrointestinal bleeding in the emergency department of a tertiary hospital in Turkey and the data of healthy blood donors were studied. The data of these patients were analyzed, and it was determined that the primary outcome was in-hospital mortality. RESULTS: The study was completed with 274 patients and 274 control group. The mean age of these patients was 65.1±18.2 years, and 64.2% of patients were males. It was found that the in-hospital mortality rate of patients with O blood group (16.2%) was statistically significantly higher than non-O blood group (7.5%) (p:0.032). CONCLUSION: The study concluded that the mortality rate of gastrointestinal bleeding patients with O blood group was higher compared to patients with other blood groups. Physicians can use ABO blood groups to predict mortality risk in gastrointestinal bleeding.