Introduction: The aim of this study was to determine the risk assessment of acute coronary syndrome and prediction of major adverse cardiac events by HEART (History, ECG, Age, Risk factors, Troponin) and HEARTS3 (HEART + 3S = Sex, Serial 2-h ECG, and Serial 2-h delta Troponin) scoring systems in patients admitted to the emergency department with chest pain. Methods: This is a single-center prospective cohort study. This study was conducted in patients admitted to the emergency department with chest pain, without ST-elevation myocardial infarction, who were 18 years or older, and agreed to participate in the study. The primary endpoint is the occurrence of major adverse cardiovascular events within 30 days. The receiver operating characteristic curve was used to assess the power of HEART and HEARTS3 scores to predict major adverse cardiovascular events. Results: The mean age of 239 patients was 47.91 ± 13.93 years and 72.4% (173) were male. Major adverse cardiovascular events developed in 20.1% (48) of the patients. The mean HEART and HEARTS3 scores of the patients with major adverse cardiovascular events (5.67 ± 1.46 and 9.38 ± 3.91, respectively) were both statistically and significantly higher than the scores of the patients without major adverse cardiovascular events (2.33 ± 1.44 and 2.22 ± 1.39; p = 0.001). The area under the curve values of HEART and HEARTS3 scores were found to be 0.943 (95% confidence interval: 0.905–0.968) and 0.990 (0.968–0.999), respectively. Conclusion: In our study, the power of HEARTS3 score to predict major adverse cardiovascular events was better in the risk assessment of acute coronary syndrome in patients admitted to the emergency department with chest pain compared to the HEART score. We think that patients with a low HEARTS3 score can be safely discharged from emergency department without further cardiac examination.

Denatured alcohol, also called methylated spirit, is a blue/purple colored and methanol containing liquid which is used as a solvent for cleaning purposes or as a fuel for alcohol burners and camping stoves. Methanol is a clear, colorless, and highly toxic liquid which is a common component of antifreeze solutions, paints, varnishes, gasoline mixtures and various solvents. Even though methanol is used only in industry, when ingested accidentally or for suicide it may cause methanol intoxication which has high mortality rates.Methanol intoxication is generally seen after accidental or suicidal oral intake, and although rare, some cases of poisoning have been reported due to inhalation or transdermal absorption (1-4). In this case report we present a case of transdermal methanol intoxication and aim to emphasize that methanol intoxication rarely occurs after dermal exposure, and to draw attention to the possible serious results of alternative medicine practices that can be fatal.

Background: Hematological parameters, such as white blood cell count (WBC), mean platelet volume (MPV), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and WBC to MPV ratio (WMR), could provide data in prognosis, risk stratification, and optimal management in patients with acute coronary syndromes. Aim: We aimed to investigate the prognostic value of hematological parameters and their relationship with the TIMI risk score in non-ST elevation myocardial infarction (NSTEMI) patients. Material and Methods: A total of 259 adult patients with NSTEMI were included in this retrospective and observational cohort study. During a 1-year follow-up period, the efficacy of the main hematological parameters in predicting major adverse cardiovascular events (MACE) and their correlation with the TIMI risk score was analyzed. Results: Among the 259 patients, 188 (72.6%) were male, and the mean age was 60.4 ± 11.9 years. MACE was observed in 60 patients (23.2%). Elevated baseline levels of WBC, neutrophils, NLR, PLR, and WMR were associated with MACE development throughout the 1-year follow-up. Moreover, WBC, WMR, and NLR were correlated with the TIMI risk score. When the predictive power of these parameters for MACE was evaluated by ROC analysis, the AUC values for WBC, WMR, and NLR were 0.670 (95% CI 0.590–0.750), 0.666 (95% CI 0.582–0.746), and 0.689 (95% CI 0.610–0.767), respectively. Conclusion: WBC, NLR, and WMR predicted MACE in NSTEMI patients and were consistent with the TIMI risk score. On this basis, they could provide supportive data for early risk stratification and optimized therapeutic approach, particularly in high-risk patients.

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İnme, dünyadaki önemli morbidite ve mortaliteye neden olan ikinci önemli nedendir. Bununla birlikte akut iskemik ataklar pediatrik ve genç yaş gruplarında çok nadirdir (% 5-10). Bu olguda, genç yetişkinlerde ve pediyatrik hastalarda inmenin akılda tutulması gerektiğine dikkati çekmeyi amaçladık. 15 yaşında erkek hasta acil servise başın sol tarafında ciddi akut baş ağrısı şikayetiyle başvurdu. Yaşamsal belirtiler normaldi. Fiziki muayenesinde Sağ hemiparezi mevcuttu. BT bulguları normaldi. Difüzyon MRG'da akut enfarktüs tespit edildi. Akut inme tanısı ile pediatrik nöroloji servisine başvurdu. Çocukluk çağı inmeleri ihmal edilmiş bir alandır, hem profesyoneller hem de genel halk problemin ve bunun potansiyel sonuçlarının farkında değildir.