Impact of the terrorist bombings of the Hong Kong Shanghai Bank Corporation headquarters and the British Consulate on two hospitals in Istanbul, Turkey, in November 2003.

Background: The authors sought to estimate the impact of the terrorist bombings of the Hong Kong Shanghai Banking Corporation headquarters and the British consulate in Istanbul, Turkey, on November 20, 2003, on two nearby hospitals, in terms of epidemiologic outcomes, resource utilization, and time course of emergency needs.

Methods: The authors used data from hospital records of injured survivors who used the emergency departments (EDs) at the Taksim Education and Research State Hospital (TERSH) and the American Hospital (AH) in Istanbul on November 20, 2003, to determine the totals and rates of mortality (early, late, and critical), injury, critical injury (Injury Severity Score > 15), ED use, hospitalization, operative care, and in-hospital overtriage and the time intervals of ED arrival.

Results: The TERSH received 184 victims in the first hour after the initial blast, of which 88 (48%) were brought by emergency medical services, 171 (93%) had lacerations, 7 (4%) had penetrating eye injuries, 28 (15%) were hospitalized, 18 (10%) received operative care, and 7 (4%) were critically injured.

Medical experience of a university hospital in Turkey after the 1999 Marmara earthquake.

Objectives: This study aimed to provide an overview of morbidity and mortality among patients admitted to the Hospital of the Medicine Faculty of Uludag University, Bursa, Turkey, after the 1999 Marmara earthquake.

Methods: Retrospective analysis of the medical records of 645 earthquake victims. Patients' demographic data, diagnosis, dispositions, and prognosis were reviewed.

Impact of the terrorist bombings of the Neve Shalom and Beth Israel Synagogues on a hospital in Istanbul, Turkey.

Objectives: The authors sought to estimate the impact of the open-air mass-casualty terrorist bombings of the Neve Shalom and Beth Israel Synagogues in Istanbul, Turkey, on November 15, 2003, on the American Hospital (AH) in terms of resource utilization, epidemiologic outcomes, and time course of emergency needs.

Methods: A retrospective descriptive study using data from hospital records of injured survivors who used the emergency department at AH on November 15, 2003, to determine the number and percentage of injured survivors who were hospitalized, received operative care, had specific injury types, had an Injury Severity Score >/=16, died, and arrived within certain time intervals.

Results: AH received 69 (91%) injured survivors from the scene, of which nine (12%) were hospitalized and three (4%) received operative care.

Mass-casualty terrorist bombings in Istanbul, Turkey, November 2003: report of the events and the prehospital emergency response.

Background: This paper describes the two mass-casualty, terrorist attacks that occurred in Istanbul, Turkey in November 2003, and the resulting pre-hospital emergency response.

Methods: A complex, retrospective, descriptive study was performed, using open source reports, interviews, direct measurements of street distances, and hospital records from the American Hospital (AH) and Taksim Education and Research State Hospital (TERSH) in Istanbul.

Results: On 15 November, improvised explosive devices (IEDs) in trucks were detonated outside the Neve Shalom and Beth Israel Synagogues, killing 30 persons and injuring an estimated additional 300.

Compliance with protocols in transferring emergency patients to a tertiary care centre.

Study Objectives: We evaluated compliance with standard patient transfer protocols in a pre- and post-interventional study among patients transferred from other hospitals to our tertiary care university hospital.

Methods: In the first phase, transfer information was recorded on the arrival in 174 consecutive patients transferred to our emergency department (ED) over a 2-month period in 1999. Emergency caregivers throughout the province then received education about proper transfer procedures.

[The effects of lactated ringer's resuscitation on tissue blood flows and oxidant injury in experimental crush injury in rats].

Background: In an experimental model of crush injury, tissue blood flow, the extend of oxidant injury and the effect of lactated ringer's resuscitation were investigated.

Material And Method: Rats were divided into sham (n: 8), crush injury (n: 8), and crush injury + lactated ringer's resuscitation (n: 8) groups. Arterial and venous catheterization were performed in all groups.

Hypertonic saline dextran alleviates hepatic injury in hypovolemic rats undergoing porta hepatis occlusion.

To monitor the ischemic and/or reperfusion injury after porta hepatis occlusion (Pringle maneuver) in livers subjected to hypotension, serum alanine amino transferase (ALT), liver malondialdehyde (MDA), and liver glutathione (GSH) levels were measured. MDA is a by-product of oxidant-induced lipid peroxidation, and GSH is an endogenous antioxidant. The effects of lactated Ringer's (LR) and hypertonic saline (7.

Oxothiazolidine carboxylate provides protection against hepatocellular injury seen after porta hepatis occlusion (Pringle maneuver) under hypovolemic conditions.

The sensitivity of liver to warm ischemia has always been a concern for surgeons. To monitor the ischemia and/or reperfusion injury after the Pringle maneuver (occlusion of porta hepatis) in livers subjected to hemorrhage, blood pressure, blood pH, base deficit (BE), serum alanine aminotransferase (ALT), serum and liver malondialdehyde (MDA), and liver glutathione (GSH) levels were measured. MDA is a by-product of oxidant induced lipid peroxidation, and GSH is an endogenous antioxidant.

[Epidemiologic and clinical features of childhood falls].

Background: Trauma is a leading cause of morbidity and mortality for childhood and young adults. Falls are the most common mechanism. for injury children.

[Trauma and resuscitation course (TRC): evaluation of the first 2 years].

Eight Trauma and resuscitation Courses (TRC): two instructor and 6 student courses have been organized in Turkey between December 1998 and November 2000. Questionnaire results of 121 students and 63 instructors were reviewed. We strongly believe that these results will be supportive for the courses in the future.

[Do emergency departments comply with the rules of patient transportation?].

Emergency departments must comply with the rules of patient transportation. The aim of this study was to find out the compliance of the emergency departments in our region with patient transport the rules and regulations. 180 patients transported to our emergency department by an ambulance from another hospital, between 01.

[The analysis of traumatized patients who were admitted to the Uludag University Medical School Hospital after the Marmara earthquake].

The aim of this study was to analyze the victims of the Marmara earthquake who injured, especially had the crush syndrome. Our hospital received a total of 645 victims after the earthquake and admitted 330. Victims were classified into five different groups according to their diagnosis (crush syndrome, vital organ injury, vertebral and pelvic injuries, others and unknown) and their mortality rates were determined.

Outcome of major trauma in a Turkish university hospital: did integrated approach make a difference?

The aim of this study was to determine the effect of the institution in an in-hospital integrated approach to trauma on the mortality of severely injured patients in a university hospital in Turkey. We examined the effects of several risk factors, namely physiological parameters, anatomical findings, and the timeliness of therapeutic approaches, on the mortality of major trauma patients before and after the institution of integrated trauma care. The investigated risk factors were injury severity score (ISS), revised trauma score (RTS), anatomical localization of the injury, the type of injury, prehospital time, emergency room time, and referral from another hospital.

Financial burden of trauma care on a university hospital in a developing country.

Background: Trauma care is expensive and more so for the hospitals not subsidized by the government, as is the case in developing countries. In this study, the burden of trauma care on a typical Level I trauma center in Turkey was investigated.

Methods: Medical, demographic, and financial records of trauma patients who were hospitalized in the calendar year of 1996 were analyzed.

L-glutamine enemas attenuate mucosal injury in experimental colitis.

Purpose: The aim of this study was to investigate the role of 1-glutamine, short chain fatty acid, prednisolone, and mesalazine (5-aminosalicylic acid) enemas on mucosal damage and inflammation in experimental colitis.

Methods: Colitis was induced in rats with trinitrobenzene sulfonic acid in ethanol. Saline (n = 14), prednisolone (n = 13), 5-aminosalicylic acid (n = 14), 1-glutamine (n = 14), and short chain fatty acid (n = 13) enemas were applied twice daily to the rats for seven days after the induction of colitis.

Prostaglandin synthetase inhibition reduces peritonitis-induced early liver oxidant stress.

This study was undertaken to determine whether or not the prostanoid metabolism contributes to peritonitis-induced early liver oxidant stress. Lipid peroxidation products, malondialdehyde (MDA) and conjugated dienes (CD), were used to monitor oxidant stress. The rats were given a 5-cc intraperitoneal (i.

Effects of vitamin E and cimetidine on peritonitis-induced lipid peroxidation.

To investigate the effects of acute fecal peritonitis on plasma and tissue lipid peroxidation and possible protective effects of vitamin E (Vit E) and cimetidine at 4 h in a rat peritonitis model, four groups were designated as: controls, peritonitis, Vit E and cimetidine. Plasma, liver, lung and kidney thiobarbituric acid reactive substances (TBARS) and conjugated diene (CD) levels were measured to monitor oxidative injury. The present fecal peritonitis model caused a significant elevation in liver TBARS; however, neither Vit E nor cimetidine was effective in preventing TBARS formation.

Laparoscopic cholecystectomy for acute cholecystitis.

Thirty-five patients with acute cholecystitis were operated on in a period of 17 months at Bayindir Medical Center. Open cholecystectomy (OC) was performed in 12 patients, and laparoscopic cholecystectomy (LC) was attempted in 23 of the patients. LC was successfully completed in 20 patients (conversion rate 13%).

Thromboxane receptor blockade with BM 13,177 following toxic airway damage by smoke inhalation in sheep.

Thromboxane may play an important role in the pathogenesis of smoked mediated injury. We studied this possibility in 13 chronically instrumented sheep, which had the left lung exposed to smoke. BM 13,177, a thromboxane receptor antagonist, was given intravenously to six animals prior to smoke inhalation and during the experimental period.

Postburn gastrointestinal vasoconstriction increases bacterial and endotoxin translocation.

Splanchnic ischemia has been associated with bacterial translocation and increased endotoxin absorption from the gut. To study the effects of major burn on splanchnic circulation, minipigs were randomized to receive 40% flame burn and Parkland resuscitation or sham burn and maintenance fluids. Total and fractionated blood flow, O2 delivery and consumption, mucosal pH of the intestine, and endotoxin levels in the superior mesenteric vein were measured for 48 h, and then abdominal organs were harvested for bacteriological culture and histopathological analysis.