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    Ischemia-modified albumin and the IMA/albumin ratio in the dignosis and staging of hemorrhagic shock: A randomized controlled experimental study
    (TURKISH ASSOC TRAUMA EMERGENCY SURGERY, 2020-01-01) Turedi, Suleyman; Sahin, Aynur; Akca, Metehan; Demir, Selim; Kose, Gokcen Derya Reis; Cekic, Arif Burak; Yildirim, Mehmet; Yulug, Ersin; Mentese, Ahmet; Turkmen, Suha; Acar, Sami
    BACKGROUND: To determine the value of ischemia-modified albumin (IMA) and IMA/albumin ratio (IMAR) in the diagnosis and staging of hemorrhagic shock (HS). METHODS: A pressure-targeted HS model was established in this study. The control and shock groups were monitored for 30 min and 60 min to simulate varying durations of exposure to HS. All subjects underwent invasive arterial monitoring during the experiment and were further divided into mild and severe shock groups based on decreases in mean arterial pressure (MAP). Biochemical and histologic comparisons were performed between the groups. RESULTS: Our results revealed higher IMA, IMAR, lactate, total oxidant status (TOS) and oxidative stress index (OSI) levels in both the 30- and 60-min shock groups compared to the control group. Concerning MAP-based shock staging, IMA, IMAR, lactate, TOS and OSI levels in the 30-min and 60-min mild and severe shock groups were higher than those of the controls. However, there was no significant difference between the mild and severe shock groups. A significant correlation was determined between all the biomarkers evaluated and HS-induced damage in various organs. This correlation was highest in lactate and IMAR levels. CONCLUSION: IMA and IMAR levels may be used in the early diagnosis of HS and also have the potential for use in determining the severity of HS. IMA and IMAR measurement may also be considered as an alternative or in addition to lactate measurement in the diagnosis of HS.
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    Traumatic posterior tibial artery occlusion in a soccer player: A case report
    (BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK, 2018-01-01) Aslim, Erdal
    A 24-year-old male professional soccer player sustained a right ankle contusion due to blunt kick toward the medial malleolus level during a soccer game. He stopped playing due to pain, coldness, and paresthesia on his right foot. Computed tomography angiography revealed a 4.5 cm occlusion on the posterior tibial artery at the right ankle level of which the distal segment was filled with collateral arteries. After the diagnosis of the traumatic occlusion, the patient underwent angiography for recanalization with thrombolysis in an external center, which was unsuccessful. Crural artery injuries after blunt sport traumas are very rare. In knee and ankle traumas with ischemic symptoms, vascular injuries should be excluded with prompt examination.