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  • Küçük Resim
    Öğe
    Diagnostic and Prognostic Significance of Neutrophil Gelatinase- Associated Lipocalin and Pentraxin-3 in Acute Coronary Syndrome
    (2017) Özer, Muhammet Raşit; Ergin, Mehmet; Kılınç, İbrahim; Dündar, Zerrin Defne; Özer, Nejla; Önal, Mehmet Akif; Girişgin, Abdullah Sadık; Koçak, Sedat; Gül, Mehmet; Cander, Başar
    Aim: The aim was to evaluate the levels of serum pentraxin-3 (PTX-3) and neutrophil gelatinase-associated lipocalin (NGAL) and the efficiency of making a diagnosis and to estimate the prognosis in patients with chest pain.Materials and Methods: The study was conducted in the Necmettin Erbakan University Meram Medicine School Emergency Department. Patients who had chest pain and met the inclusion criteria were accepted. They were divided into the following groups: acute coronary syndrome (ACS), a diagnosis other than ACS (non-ACS), and control. The patients in theACS and non-ACS groups were divided into five sub-group -groups: ST Elevated Myocardial Infarction (STEMI) Non- ST Elevated Myocardial Infarction (NSTEMI), Unstable Angina Pectoris (USAP), stable angina, and pulmonary embolus. For all patients, serum PTX-3, serum NGAL, troponin I, and creatine kinase-MB fraction (CK-MB) levels were measured.Results: There were 199 patients in the ACS and non-ACS groups and 30 patientsin the control group. There was no significant difference among the study groups in terms of age and PTX-3 and NGAL levels. When comparing survival and non-survival in terms of in-hospital death, CK-MB and troponin I levels were significantly higher in the ACS and non-ACS groups than in the control groups, whereas there was no significant difference in terms of PTX-3 and NGAL levels.Conclusion: The results of our study demonstrated that PTX-3 and NGAL are not effective biomarkers in the differential diagnosis and the determination of in-hospital mortality in ACS. However, the limitations of the study should be considered. The results confirmed that CK-MB and Troponin I can be safely used in the differential diagnosis and the prediction of mortality.
  • Küçük Resim
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    'Lichtenberg Figure' as a Result of Lightning Shock
    (2014) Ergin, Mehmet; Önal, Mehmet Akif; Dikmetaş, Cesarettin; Cander, Başar
    A 30 year-old-male was found unconscious while working outdoors. After completion of the initial evaluation, the Primary Health Care Center referred him to our emergency department. He couldn’t remember what had happened to him and he was complaining of chest and back pain. His vital signs were in the normal ranges, and his physical examination values were normal except for the skin findings. The findings in his ECG, complete blood count, other laboratory results and braincomputed tomography were in the normal ranges. Mainly six types of cutaneous findings occur as a result of being struck by lightning. They include linear burns, punctate burns, Lichtenberg figures (LF), contact burns from overlying metal objects, superficial erythema and their combinations. Moreover, entry and outlet holes of lightning strikes are rarely seen. The painless, hyperemic, spreading and ferning patern figure on the skin is called Lichtenberg figure (LF). It matches no anatomical, vascular, or neural patterns. Contrary to thermal and electrical burns, it is harmless to epidermis and deeper tissues. Although the exact mechanism is unknown, it is thought that they represent red blood cells extravasated into the superficial layers of the skin from capillaries secondary to the dielectric breakdown of the skin and subsequent massive electron shower. Our patient was admitted to the observation unit. The patient, who was on observation status for 48 hours, discharged from the hospital and recommended to attend the outpatient clinic. If a victim found unconscious outdoors, strike of lightning should be considered in the differential diagnosis. Pathognomonic skin findings should not be overlooked.