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    The assessment of QT intervals in acute carbon monoxide poisoning
    (Turkish Soc Cardiology, 2009) Yelken, Birguel; Tanriverdi, Belkis; Cetinbas, Ferda; Memis, Dilek; Sut, Necdet
    Objective: Carbon monoxide (CO) poisoning is known to cause myocardial toxicity and life threatening arrhythmias. QT interval measured from electrocardiogram is an indirect measure of the heterogeneity of ventricular repolarization, which may contribute to ventricular arrhythmias. The purpose of the study was to investigate whether the carboxyhemoglobin (COHb) level may be related to the changes of QT, corrected QT (QTc), (IT dispersion (QTd), corrected Qtd (QTdc) and cardiac enzymes during carbon monoxide poisoning. Methods: We conducted an observational study; 104 patients who had been diagnosed with CO intoxication were included in the study. Measurement of QT, QTc, QTd and QTdc intervals were performed form electrocardiogram on admission, 24 and 48 hours after admission. Cardiac enzymes were measured at each time-point. The myocardial perfusion scan was determined in all patients I week after admission. Results: The QT interval level in 24h was significantly higher than admission level (p<0.001), additionally QTc interval levels in 24h and 48h were significantly lower than admission levels (p<0.001 and p<0.001, respectively). Carboxyhemoglobin level only significantly correlated with QT intervals (r=-0.288; p=0.019), troponin T (r=-0.297; p=0.007), and creatine kinase MB levels (r=0.262; p=0.020). As a result of ROC analysis the QT interval level was significantly powerful parameter to predict COHb (p=0.022). Conclusion: Our data indicate COHb level correlated with QT intervals and cardiac enzymes. Clinicians should possibly avoid QT prolonging drugs and carefully monitor the QT, QTc, QTdc intervals in patients at high risk of cardiac disability due to high levels of COHb after CO poisoning. (Anadolu Kardiyol Derg 2009; 9: 397-400)
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    The effect of the prebiotic solutions in treatment of severe sepsis
    (Aves Yayincilik, Ibrahim Kara, 2007) Memis, Dilek; Yelken, Birguel; Sahin, Sevtap Hekimoglu; Vatan, Ilke; Yardim, Tarik
    Objectives: In this double blind, prospective and randomized study, the effects of the enteral administration of a prebiotic preparation containing oligofructose and inulin on upper gastrointestinal colonization and systemic inflammation in intensive care patients with severe sepsis were investigated. Patients and Methods: A total of 50 patients admitted to an intensive care unit were randomized to receive either prebiotic (group 1, n=25) or placebo preparations (group 2, n=25). The prebiotic preparation consisted of prebiotic fiber inulin-oligofructose (0.8 g/100 mL, A, D3, E vitamins). Gut barrier function was assessed by culture of nasogastric aspirate on the first and eighth days. All septic complications, acute physiology and chronic health evaluation II (APACHE II) scores, ventilation days, gastrointestinal culture results, biochemical parameters, C-reactive protein (CRP) and mortality ratios were recorded. Results: There were no differences between the groups in terms of age, sex, APACHE II scores, CRP, ventilation days. There were no significant differences between the groups in terms of gastrointestinal culture, septic complications or mortality. Conclusion: The administration of prebiotic solution in intensive care patients with severe sepsis had no effect on gastrointestinal permeability, gastric colonisation, the systemic inflammatory response and morbidity.