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    THE EFFECT OF SERUM CALCIUM LEVEL ON THE MORBIDITY AND MORTALITY OF PATIENTS WITH GASTROINTESTINAL BLEEDING
    (Carbone Editore, 2014) Koylu, Ramazan; Dundar, Zerrin Defne; Koylu, Oznur; Akilli, Nazire Belgin; Akinci, Emine; Gonen, Mustafa Onder; Cander, Basar
    Introduction: The aim of this study was to investigate the relation of serum calcium, corrected calcium and ionized calcium levels with morbidity and mortality in patients followed-up with the diagnosis of gastrointestinal system bleeding. Methods: Patients over 18 years of age who had presented to the emergency clinics with a suspicion of gastrointestinal bleeding and followed-up at the intensive care units between January 2009 and December 2011 were included in this retrospective study. The demographic properties, biochemical and haematological parameters of the patients, the amount of blood transfusions, the durations of hospital stay and the outcomes were recorded. The patients were divided into two groups, as those who survived (Survival group) and those who died (Exitus group). They were also divided into three groups according to their ionized calcium levels. The differences between the groups were investigated. The relations of the variables with each other were also evaluated in the overall patient group. Findings: A total of 191 patients were included in the study, 126 of whom were male (66.0%) with a mean age of 63.8 +/- 19.0 years. The mean hemoglobin level was 9.4 +/- 2.8 g/dL, the mean calcium level was 8.2 +/- 0.7 mg/dL, the mean corrected calcium level was 8.9 +/- 0.6 mg/dL, and the mean ionized calcium level was 0.88 +/- 0.25 mmol/L. No significant differences were observed in the calcium, corrected calcium and ionized calcium levels between the group that had survived and the group which had died (p>0.05). A positive correlation was observed between the hemoglobin levels and the calcium levels (r=0.45, p<0.001), corrected calcium levels (r=0 37, p<0.001) and the ionized calcium levels (r=0.33, p=0.002). Conclusion: No correlation was observed between the calcium, corrected calcium and ionized calcium levels and the erythrocyte transfusion requirement, duration of hospital stay and mortality in patients with GIS bleeding. However, a weak correlation was observed between the calcium, corrected calcium and ionized calcium levels and the hemoglobin levels.
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    INFLUENCE OF NEUTROPHIL/LYMPHOCYTE RATIO ON PROGNOSIS IN MUSHROOM POISONING
    (Carbone Editore, 2014) Koylu, Ramazan; Dundar, Zerrin Defne; Koylu, Oznur; Gunaydin, Yahya Kemal; Akilli, Nazire Belgin; Mutlu, Huseyin; Gonen, Mustafa Onder
    Objective: Mushroom poisoning is a severe poisoning which is commonly seen, particularly, in spring and autumn and may be fatal. This study aimed to study the influence of the neutrophil/lymphocyte ratio on prognosis in patients hospitalized in the toxicology unit with a diagnosis of mushroom poisoning. Methods: A total of 236 patients, admitted to the emergency room and hospitalized due to mushroom poisoning between July 2008 and March 2013, were retropsectively analysed. Patients were analysed in terms of age, gender, medical history, type of mushroom ingested, onset time of symptoms, complaints upon admission, and whether they received extracorporeal therapy and laboratory tests. Results: The mean age of patients hospitalized with mushrom poisoning was 41.88 +/- 17.81 years. Of the patients, 95 (40.3%) were male and 141 (59.7%) were female. In their medical history, 15 (64%) patients had diabetes mellitus, 8 (3.4%) had hypertension and 7 (3.0%) had coronary artery disease. 100 (42.4%) patients had eaten cultivated mushrooms, and 104 (44.1%) had eaten wild mushrooms. The mushroom type could not be determined in 32 (3.6%) patients. Symptoms appeared within the first 6 hours in 99 (843%) patients and after 6 hours in 37 (15.7%). Patients were usually admitted with nausea, vomiting, abdominal pain and diarrhea. 24 (10.2%) patients required hemoperfusion during their follow-up and treatment. Duration of hospital stay was 2.28 +/- 2.20 days in patients with normal liver functions, and 2 (0.8%) patients died. Neutrophil/lymphocyte ratio was 15.14 +/- 15.76 in patients with impaired liver functions, and this was statistically significant compared to patients with normal liver function tests (5.48 +/- 7.69) (p=0.001). Conclusions: These results indicated that patients whose neutrophil/lymphocyte ratio is high upon admission should be monitored carefully both for prognosis and hemoperfusion requirement considering longer duration of hospital stay and more aggressive treatment options.