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PurposeThis study evaluated whether serum lactate levels (SLL) at admission in patients with cardiac arrest (CA) can predict successful return of spontaneous circulation (ROSC) or short-term survival, especially within the first 24 h.Materials and methodsThis prospective, observational study was conducted in the emergency department (ED) of a training and research hospital from April 2015 through February 2016. It included all patients older than 18 years who presented to the ED during the study period with non-traumatic out-of-hospital cardiac arrest (OHCA). The study measured two outcomes: whether ROSC was achieved and whether short-term survival was achieved. ROSC was defined as the presence of spontaneous circulation for the first hour after cardiopulmonary resuscitation (CPR). Survival was defined as having survived for a minimum of 24 h after ROSC.ResultsThe study included 140 patients who were admitted to the ED with OHCA. ROSC was achieved in 55 patients (39.3%), and survival for 24 h following CA was achieved in 42 patients (30%). The mean SLL in the ROSC (+) and ROSC (-) groups were 9.1 ± 3.2 mmol/L and 9.8 ± 2.9 mmol/L, respectively. The mean SLL in the survivor and non-survivor groups were 8.6 ± 2.9 mmol/L and 10 ± 3.1 mmol/L, respectively. These differences were not statistically significant (p = 0.1). A multivariate regression model assessing the factors that predicted both ROSC and 24-h survival showed the odds ratio (OR) of initial SLL was 1.3 (95% CI: 1.05–1.6) and 1.1 (95% CI: 0.9–1.3), respectively.ConclusionsThis study showed that in OHCA patients, SLL on admission was not associated with increased ROSC achievement or 24-h survival.

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Poisoning by Organophosphates is a public health problem particularly in developing countries. Although they are commonly used in agriculture as pesticides, unfortunately, their use as weapons in chemical warfare is not rare. Due to lack of control, they are usually available in stores. Individuals may be effected by these compounds either by accidents or suicidal attempts. Poisoning may ocur following peroral, inhalational or dermal intake. Due to structure of the compound (highly soluble), exposure by each route causes high morbidity and mortality. Organophosphates inhibit both acetylcholinesterase (AChE) and pseudocholinesterase. Inhibition of AChE results in accumulation of acetylcholine. This mechanism is the main reason for toxic effects. Toxic effects may present as muscarinic, nicotinic and central nervous system (CNS). Progression of the poisoning may be seen in three stages: cholinergic phase, intermediate syndrome and delayed neuropathy. Although cardiovascular, gastrointestinal, respiratory, ocular, musculoskeletal and CNS manfestations of the poisoning are well-described in the literature, its effects on renal system remains as a neglected field due to its scarcity. In this mini-review, our aim was to determine hazardous effects of OP poisoning on renal system and emphasize the importance of monitorization and early intervention.

Amaç: Tükenmişlik sendromu (BS), yaygın olarak insanların yüz yüze çalıştığı mesleklerde bireylerin, duygusal yönden kendilerini tükenmiş hissetmeleri, işleri gereği karşılaştıkları insanlara karşı duyarsızlaşmaları ve kişisel başarı duygularında azalma şeklinde görülen bir sendromdur. Tükenmişlik sendromu; duygusal tükenme (EE), duyarsızlaşma (DEP) ve azalmış kişisel başarı (PA) ile karakterizedir. Maslach Tükenmişlik Envanteri (MBI) bu üç boyutu ayrı ayrı belirlemek için 22 sorudan oluşan bir ankettir. Bu çalışmada amacımız yoğun bakım ünitesinde (YBÜ) çalışanların BS prevelansını ve risk faktörlerini MBI kullanarak değerlendirmektir. Materyal ve Metod: YBÜ personeline; demografik verileri, çalışma yıllarını, YBÜ düzeyini ve mesleğini ve MBI'yi içeren bir anket uygulanmıştır. Çalışmaya toplam 115 çalışan katıldı. Bulgular: Yüz on beş katılımcının MBI sonuçları değerlendirildiğinde, %68,7'sinin yüksek MBI-EE seviyesine sahip olduğu, %62,6'sının yüksek MBI-PA'ya ve %38,3'ünün orta düzeyde MBI-DEP'ye sahip olduğu belirlendi. Alt gruplarda erkek cinsiyete sahip olanlar değerlendirildiğinde; PA bayanlarda daha fazla idi (p<0.001). Seviye 2 YBÜ'de çalışanlarda DEP seviye 3'e göre daha fazla (p=0.029) PA daha az idi (p=0.010). Hemşirelerde PA doktorlara göre daha fazla iken (p=0.011) DEP doktorlara göre daha az idi (p<0.001). Sonuç: Seviye 2 yoğun bakım ünitesinde çalışan kırk yaş üstü personellerin ve deneyimli çalışanların tükenmişlik sendromu riski daha fazladır. Doktorların tükenmişlik düzeyleri hemşirelerden daha fazlaydı.