Nazlı Karakuş Kenan

Objectives: Poisoning is a significant global health concern, leading to higher mortality and morbidity rates. The present study aimed to assess demographic details, hospital admission patterns, laboratory findings, and applied pharmacological treatments for patients presenting to the Emergency Department with drug poisoning.Materials and Methods: From August 5, 2020, to August 5, 2021, a cross-sectional, retrospective analysis was conducted on patients who presented to the Emergency Department of a tertiary care hospital with a drug poisoning diagnosis. Information gathered included patient demographics, the identified poisoning agent, laboratory findings, and the implemented treatment strategies.Results: The mean age for the 584 drug poisoning cases was 30.0±10.9 years; the majority, 44.9%, were between 18-25 years old, with a female preponderance (63.0%). The most frequently implicated drug groups were anti-inflammatory/anti-rheumatic products and psychoanaleptics, each accounting for 13.7% of all identified drugs.Conclusion: These findings suggest the need for improved awareness, monitoring, and rational use of commonly accessible medications. Strengthening regulations on over-the-counter drug availability may also help reduce poisoning incidents.

Sternal fractures (SF) are relatively uncommon but clinically important injuries, frequently accompanied by rib fractures, pulmonary complications, and the need for intensive care unit (ICU). Despite advances in imaging and trauma management, prognostic assessment in SF remains challenging. In particular, the comparative performance of commonly used trauma severity scores-Injury Severity Score (ISS), New Injury Severity Score (NISS), and Trauma and Injury Severity Score (TRISS)-has not been clearly established in this patient group. This retrospective observational study included 393 adult patients diagnosed with SF at a tertiary trauma center. The prognostic performance of ISS, NISS, and TRISS for ICU admission was evaluated using ROC analysis, pairwise ROC comparison, multivariable logistic regression, and exploratory decision-tree modeling. In-vehicle traffic accidents were the most common mechanism of injury (60.1%). Most patients were managed conservatively (95.7%), with an overall mortality rate of 3.1%. ROC analysis showed good discriminatory ability for ICU admission with NISS (AUC [Area Under the Curve] 0.876) and ISS (AUC 0.847), whereas TRISS performed moderately (AUC 0.743). In multivariable models, ISS and NISS remained independently associated with ICU admission. Decision-tree analysis identified rib fractures, abnormal respiratory findings, and high injury severity scores as key predictors of ICU admission. Although mortality is low, SF are associated with considerable morbidity. Rib fractures, fracture location, and injury severity scores are important prognostic indicators. In this exploratory single-center cohort, ISS and NISS showed better discrimination for ICU admission than TRISS; however, these findings should be interpreted cautiously and require validation in larger prospective studies.

The neutrophil-to-lymphocyte ratio (NLR) and glucose-to-potassium ratio (GPR) are simple, readily available markers reflecting inflammatory and metabolic responses in acute stroke. However, their diagnostic value in emergency department (ED) presentations remains uncertain. This study evaluated the association of NLR and GPR with stroke among patients presenting with stroke-like symptoms. This retrospective study included 475 participants (286 stroke, 189 controls). Demographic, clinical, and laboratory data were analyzed. Independent predictors were identified using multivariable logistic regression, and diagnostic performance was assessed with receiver operating characteristic (ROC) analysis. Stroke patients were older than controls (59 vs. 43 years, p<0.001) and had higher prevalences of hypertension, diabetes mellitus, and coronary artery disease (all p<0.05). NLR, GPR, and C-reactive protein levels were higher (all p<0.001), while lymphocyte counts (p=0.015) and albumin levels (p=0.018) were lower. Age was an independent predictor of both ischemic and hemorrhagic stroke (p<0.001). GPR was independently associated with ischemic stroke (OR=1.08, 95% CI: 1.05–1.12, p<0.001). In hemorrhagic stroke, both NLR (OR=1.40, 95% CI: 1.20–1.65, p<0.001) and GPR (OR=1.13, 95% CI: 1.06–1.21, p<0.001) remained significant. Hypertension showed the strongest association with hemorrhagic stroke (p<0.001). ROC analysis demonstrated moderate discrimination (AUC: 0.636 for NLR; 0.729 for GPR). NLR and GPR were elevated in stroke and showed moderate diagnostic performance. GPR was associated with ischemic stroke, whereas both markers were linked to hemorrhagic stroke, suggesting complementary pathophysiological roles.

OBJECTIVE: The aim of this study was to assess the diagnostic accuracy of immature granulocyte count and neutrophil-to-lymphocyte ratio in acute appendicitis against traditional markers like white blood cell count and C-reactive protein.

Background/Aim: This study was designed to elucidate the relationship between the AIS 90 thoracic score, which is commonly used to assess the severity of trauma in trauma patients, and the relatively limited studies and data available on the Glucose Potassium Ratio (GPR). Additionally, the study aims to highlight the superiority, if any, of GPR in terms of trauma severity and prognosis, along with the Neutrophil Lymphocyte Ratio (NLR), which plays an important role in trauma severity and prognosis. Material-Methods: Between June 2020 and June 2022, individuals aged 18 and older admitted to the emergency department with isolated thoracic trauma were included in the study. Data pertaining to these patients were retrospectively analyzed with the AIS 90 thoracic score serving as the reference point. The retrospective screening data of the patients enrolled in the study facilitated the categorization of individuals into three groups based on criteria delineating outpatient treatment, hospitalization and admission to the intensive care unit. The mean values of the GPR and the NLR across these three groups were assessed utilizing Analysis of Variance (ANOVA). Tukey tests were used for homogeneous groups and Tamhane tests were used for non-homogeneous groups to determine specific groups that caused significant differences. ANOVA homogeneity was checked by the Levene test and if homogeneity could not be achieved, the Welch test was used. Results: The analysis of 89 patients with isolated thoracic trauma revealed no statistically significant difference in the GPR values between the three groups (Levene p < 0.05, ANOVA p=0.025). However, further exploration through Tukey multiple comparisons indicated that the observed significant difference was attributable to patients admitted to the intensive care unit. Likewise, a statistically significant difference was observed between the three groups in the analysis of NLR values. (Levene p=0.252, Welch p=0.028). Following Tukey’s multiple comparisons, it was determined that the significant difference could be attributed to patients hospitalized in the intensive care unit. Conclusion: The findings of the study support the conclusion that individuals with an AIS 90 thoracic score above 3 and who need to be admitted to intensive care show higher GPR values than other groups. The association between high GPR values and heightened lung parenchymal injury was evident. Consequently, it can be inferred that a high GPR value may serve as an indicator of lung parenchymal damage, suggesting a greater need for intensive care unit admission in such patients.

Aims: Acute myocardial infarction (AMI) remains one of the leading causes of cardiovascular mortality. However, the parameters used to predict short-term mortality are limited. Glucose-potassium ratio (GPR) is a new biomarker that has been recently used. This study aimed to investigate the usefulness of GPR in predicting short-term mortality in patients diagnosed with AMI in the emergency department. Methods: This retrospective cohort study was conducted between January 1, 2022, and June 30, 2022, and included patients registered in the hospital emergency health system with IRB (Institutional Review Board) approval. Patients were identified based on inclusion criteria, and their demographic data, laboratory findings, and outcomes were recorded in the hospital registration system. Data comparisons between deceased and non-deceased patients were performed using the Student's t-test. Correlation analysis was performed using Spearman's correlation coefficients. A binary logistic regression model was created to determine the predictive parameters, and odds ratios and 95% confidence intervals (CI) were presented. Results: A total of 665 patients diagnosed with AMI were included in the study, with 75.9% of all patients being male and an average age of 62.14±11.62. A total of 6.6% of the patients included in the study died due to various causes during hospitalization. When laboratory values of deceased AMI patients were examined, statistically significant increases in glucose, urea, creatinine, WBC, neutrophil, lymphocyte, troponin, ckmb, and lactate levels were observed. The effects of GPR, NLR, PLR, lactate, and troponin levels on in-hospital mortality were analyzed using univariate logistic regression. GPR (95% CI 1.015-1.036, p=0.000), troponin (95% CI 1.001-1.001, p=0.000), and lactate (95% CI 1.437-1.908, p=0.000) were found to be the most important factors associated with mortality in patients with AMI. The ability to predict in-hospital mortality in AMI was compared, and GPR was found to have a higher predictive ability than troponin, a biomarker of myocardial damage (AUC: 0.729; P?=?0.000; Sensitivity:70%; Specificity:70%; Cut-off: 38.21). Conclusion: GPR, as a new and inexpensive biomarker, can be used to determine in-hospital mortality in patients with AMI. This index has a better predictive ability than troponin, NLR, and PLR, but is weaker than lactate.