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    The role of urine trypsinogen-2 test in the differential diagnosis of acute pancreatitis in the Emergency Department
    (Turkish Assoc Trauma Emergency Surgery, 2010) Cevik, Yunsur; Kavalci, Cemil; Ozer, Mehmet; Das, Murat; Kiyak, Guelten; Ozdogan, Mehmet
    BACKGROUND The aim of the study was to investigate the role and importance of the urine trypsinogen-2 dipstick test in the differential diagnosis of acute pancreatitis in the Emergency Department and to compare results with those of conventional tests. METHODS The study was performed prospectively in the patients admitting to the Emergency Department due to upper abdominal pain. Thirty-two of the 87 patients included in the study had acute pancreatitis diagnosis. Serum amylase, lipase, C-reactive protein (CRP) and urine trypsinogen-2 using Actim pancreatitis dipstick were studied in all patients. The statistical analysis was performed using SPSS 11.5 package program. RESULTS Urine trypsinogen-2 was found positive in 21 (65.6%) of 32 patients. The sensitivity of the test for pancreatitis was identified as 64%, specificity as 85%, positive predictive value as 72%, and negative predictive value as 81%. These values were statistically significant compared to the control group (p<0.01). CONCLUSION Although it has lower sensitivity and specificity compared to amylase and lipase, we suggest that urine trypsinogen-2 test may be an important diagnostic tool in excluding the diagnosis of acute pancreatitis, since it provides results within 5 minutes in the Emergency Department, is cheaper, has a higher negative predictive value, and is easy to use.
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    Severe Theophylline Intoxication, Rhabdomyolysis, Disseminated Intravascular Coagulopathy And Death: Case Report
    (Emergency Medicine Physicians Assoc Turkey, 2010) Cevik, Yunsur; Kavalci, Cemil; Das, Murat; Izdes, Seval
    Background: Severe intoxication which is induced by theophylline which is used in the treatments of broncospastic pulmonary diseases is quite rare. In literature, there is limited number of rhabdomyolysis cases induced by theophylline toxicity. The statement of disseminated intravascular coagulopathy which develops after theophylline intoxication has not been detected in the literature. Case report: We present the case which has resulted with rhabdomyolysis, disseminated intravascular coagulopathy and death after overdose theophylline intake of a female patient at the age of seventeen. Conclusion: The overdose theophylline intake can cause quite mortal toxicity as a result of negative effects it causes on cardiovascular, neurological and metabolic systems. It should not be forgotten that in severe intoxications, rhabdomyolysis and disseminated intravascular coagulopathy can be developed, although the patient's condition is good, she/he should be monitored with close monitorization under intensive care conditions.