The lack of a specific biomarker that can be used in the diagnosis of acute cholecystitis, a common cause of admission to the emergency department, delays physician efforts to diagnose and treat these patients. Therefore, the aim of this study was to measure plasma YKL-40 levels and investigate their diagnostic value in patients with acute cholecystitis (AC). This study was carried out between February 2020 and September 2020 in the adult emergency department of a tertiary university hospital. Permission was obtained from the Ethics Committee of Scientific Research on 03/02/2020 with Decision No. 03/16. The study included 80 patients who were diagnosed with acute cholecystitis and 80 healthy volunteers without known chronic diseases. The median YKL-40 protein level was 798.66 pq/mL in the patient group and 392.45 pq/mL in the control group. A statistically significant difference in YKL-40 protein levels was found between the two groups. YKL-40 protein levels were significantly higher in patients diagnosed with acute cholecystitis than in healthy individuals (p < 0.001). A positive correlation was found between YKL-40 protein levels and ALT, AST, LDH, and GGT levels (r = 0.272, p = 0.015; r = 0.397, p < 0.001; r = 0.386, p < 0.001; and r = 0.264, p = 0.018; respectively). When evaluated together with physical examination, radiological imaging and other laboratory parameters, we think that plasma YKL-40 levels can be used effectively in the diagnosis of acute cholecystitis.

Carbon monoxide (CO) poisoning is a clinical condition with serious cardiotoxic effects. This study compares two cases of CO poisoning to evaluate whether Tp-e/QTc ratio and blood lactate levels can serve as earlier indicators of cardiac ischemia than troponin levels. Two male patients, aged 37 and 47, who presented to the emergency department due to CO exposure, were analyzed. Their electrocardiographic (ECG) parameters, troponin levels, and lactate values were compared. Additionally, the clinical course of both patients was assessed. In the first case (37 years old), ST depression in leads V1-V6 was detected on ECG, and troponin levels showed a progressive increase. Coronary angiography revealed no significant narrowing of the epicardial coronary arteries. The patient’s QTc interval was 481 ms at admission, Tp-e duration was 79 ms, and Tp-e/QTc ratio was 0.16. Upon discharge, these values returned to normal. The second case (47 years old) had normal ECG and laboratory findings and was discharged without complications. Furthermore, in the first case, lactate levels were significantly higher at admission and remained elevated for a prolonged period. Minimal QTc prolongation and a significant increase in lactate levels following CO poisoning may serve as early indicators of cardiac ischemia. Despite normal troponin levels, the first case required further cardiac evaluation. These findings suggest that monitoring QTc and lactate levels may help in the early detection of cardiac involvement in CO poisoning. However, further research is required to establish the prognostic value of these markers.

The aim was to compare the hemodynamic and metabolic effectiveness of manual chest compressions and a mechanical chest compression device during in-hospita

Aim: The clinical and epidemiological characteristics of patients presenting to the emergency department with burn injuries were evaluated. The treatments were compared with current studies, and the findings were presented to contribute to the literature. Material and Method: The study included patients admitted to the hospital with burn injuries in 2022 year. Electronic records, e-prescriptions, and patient files were retrospectively reviewed. The obtained data were analyzed and presented. Results: A large portion of the 131 patients in our study are adolescents and children (32.8%). The most affected area is the upper extremities, and second-degree burns are generally observed (37.4%). The type of injury is usually thermal burns and scalds (56.4%). Cases are most seen in the summer months (32.1%). While burn injuries are more common during working hours in the general population, these injuries occur out of working hours’ (59%) and at home (95.4%) in the pediatric age group. Patients were generally given wound dressing, wound cleaning (It involves washing the wound with isotonic saline solution and removing necrotic tissue and foreign bodies, if present), analgesia, and tetanus prophylaxis. At the time of the first visit, 27.5% of the patients were treated with antibiotics, and 31.3% were prescribed antibiotics at discharge. Conclusion: Burn injuries are common traumas. The use of antibiotics during initial intervention and discharge is remarkably high. Children are more frequently affected by burn injuries. Particularly in this age group, there is a need to develop protective and preventive approaches.

Amaç: Polifarmasi, özellikle yaşlılarda, ilaç etkileşimlerine bağlı toksik sendrom riskini artırır. Bu olgu sunumu, polifarmasiye bağlı birden fazla toksik sendromun özelliklerini eş zamanlı gösteren bir vaka ve tanısal zorlukları vurgulamayı amaçlamaktadır. Olgu: 86 yaşında, polifarmasi öyküsü olan erkek hasta, bilinç değişikliği ve uykuya meyil şikayetleriyle başvurdu. Nörolojik muayenesinde artmış kas tonusu, kasılma nöbetleri ve hiperrefleksi saptandı. Laboratuvar ve görüntüleme tetkiklerinde enfeksiyöz, metabolik veya serebrovasküler patolojiye rastlanmadı. Klinik tablo, antikolinerjik sendrom, serotonin sendromu ve nöroleptik malign sendromun bir kombinasyonunu düşündürdü. Hastanın kullandığı ilaçlar gözden geçirilerek, potansiyel toksik etkileri değerlendirildi. Destekleyici tedavi ile hasta yoğun bakımda takip edildi ve dördüncü gün sonunda taburcu edildi. Sonuç: Polifarmasiye bağlı çoklu toksik sendromlar, yaşlı hastalarda tanı ve tedaviyi zorlaştırabilir. Bu tür vakalarda, hastanın kullandığı ilaçların detaylı analizi, toksik sendromların erken tanınması ve multidisipliner yaklaşım kritik öneme sahiptir. İlaç kullanımının optimizasyonu, hasta ve aile eğitimi ile bu riskler azaltılabilir.