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Biomedical subjects

E Aksay

Publications and source records attributed to E Aksay.

6 recordsLinked to original sources

A national survey of Turkish emergency physicians perspectives regarding family witnessed cardiopulmonary resuscitation.

We investigated Turkish emergency physicians' views regarding family witnessed resuscitation (FWR) and to determine the current practice in Turkish academic emergency departments with regard to family members during resuscitation. A national cross-sectional, anonymous survey of emergency physicians working in academic emergency departments was conducted. Nineteen of the 23 university-based emergency medicine programs participated in the study. Two hundred and thirty-nine physicians completed the survey. Of the respondents, 83% did not endorse FWR. The most common reasons for not endorsing FWR was reported as higher stress levels of the resuscitation team and fear of causing physiological trauma to family members. Previous experience, previous knowledge in FWR, higher level of training and the acceptance of FWR in the institution where the participant works were associated with higher rates of FWR endorsement for this practice among emergency physicians.

Adult↗

Brugada syndrome, manifested by propafenone induced ST segment elevation.

We report a case of a 43 year old man who was diagnosed with Brugada syndrome after propafenone administration for chemical cardioversion of new onset atrial fibrillation. Brugada syndrome has been described in the medical literature and is thought to be responsible for the majority of sudden cardiac deaths in patients without ischaemic heart disease. This syndrome has not yet been extensively discussed in the emergency medicine literature despite its importance. Emergency physicians should consider Brugada syndrome in patients who present to the emergency department with right bundle branch block and ST segment elevation in the right precordial leads, which is the classic electrocardiographic pattern of this syndrome.

Adult↗

Spontaneous eye movements in goldfish: oculomotor integrator performance, plasticity, and dependence on visual feedback.

To quantify performance of the goldfish oculomotor neural integrator and determine its dependence on visual feedback, we measured the relationship between eye drift-velocity and position during spontaneous gaze fixations in the light and in the dark. In the light, drift-velocities were typically less than 1 deg/s, similar to those observed in humans. During brief periods in darkness, drift-velocities were only slightly larger, but showed greater variance. One hour in darkness degraded fixation-holding performance. These findings suggest that while visual feedback is not essential for online fixation stability, it may be used to tune the mechanism of persistent neural activity in the oculomotor integrator.

Animals↗

Massive hydroxychloroquine overdose.

We report a case presenting with massive overdose of hydroxychloroquine who survived without any sequelae. A 17-year-old girl presented to the Emergency Department 45 min after the ingestion of 22 g of hydroxychloroquine in a suicide attempt. We believe this is highest dose yet reported in the medical literature. The patient developed hypotension, life-threatening ventricular arrhythmias and mild hypokalemia. She was managed with saline infusion and dopamine for hypotension, gastric lavage and activated charcoal for decontamination, lidocain, magnesium sulfate and defibrillation for pulseless ventricular tachycardia. Potassium replacement and bicarbonate administration were performed. Quick treatment of hypotension, gastric decontamination, continuous long-term cardiac monitoring, and treatment of arrhythmias are the cornerstones of hydroxychloroquine overdose management.

Adolescent↗

In vivo intracellular recording and perturbation of persistent activity in a neural integrator.

To investigate the mechanisms of persistent neural activity, we obtained in vivo intracellular recordings from neurons in an oculomotor neural integrator of the goldfish during spontaneous saccades and fixations. Persistent changes in firing rate following saccades were associated with step changes in interspike membrane potential that were correlated with changes in eye position. Perturbation of persistent activity with brief intracellular current pulses designed to mimic saccadic input only induced transient changes of firing rate and membrane potential. When neurons were hyperpolarized below action potential threshold, position-correlated step changes in membrane potential remained. Membrane potential fluctuations were greater during more depolarized steps. These results suggest that sustained changes in firing rate are supported not by either membrane multistability or changes in pacemaker currents, but rather by persistent changes in the rate or amplitude of synaptic inputs.

Action Potentials↗

Anatomy and discharge properties of pre-motor neurons in the goldfish medulla that have eye-position signals during fixations.

Previous work in goldfish has suggested that the oculomotor velocity-to-position neural integrator for horizontal eye movements may be confined bilaterally to a distinct group of medullary neurons that show an eye-position signal. To establish this localization, the anatomy and discharge properties of these position neurons were characterized with single-cell Neurobiotin labeling and extracellular recording in awake goldfish while monitoring eye movements with the scleral search-coil method. All labeled somata (n = 9) were identified within a region of a medially located column of the inferior reticular formation that was approximately 350 microm in length, approximately 250 microm in depth, and approximately 125 microm in width. The dendrites of position neurons arborized over a wide extent of the ventral half of the medulla with especially heavy ramification in the initial 500 microm rostral of cell somata (n = 9). The axons either followed a well-defined ventral pathway toward the ipsilateral abducens (n = 4) or crossed the midline (n = 2) and projected toward the contralateral group of position neurons and the contralateral abducens. A mapping of the somatic region using extracellular single unit recording revealed that position neurons (n > 120) were the dominant eye-movement-related cell type in this area. Position neurons did not discharge below a threshold value of horizontal fixation position of the ipsilateral eye. Above this threshold, firing rates increased linearly with increasing temporal position [mean position sensitivity = 2.8 (spikes/s)/ degrees, n = 44]. For a given fixation position, average rates of firing were higher after a temporal saccade than a nasal one (n = 19/19); the magnitude of this hysteresis increased with increasing position sensitivity. Transitions in firing rate accompanying temporal saccades were overshooting (n = 43/44), beginning, on average, 17.2 ms before saccade onset (n = 17). Peak firing rate change accompanying temporal saccades was correlated with eye velocity (n = 36/41). The anatomical findings demonstrate that goldfish medullary position neurons have somata that are isolated from other parts of the oculomotor system, have dendritic fields overlapping with axonal terminations of neurons with velocity signals, and have axons that are capable of relaying commands to the abducens. The physiological findings demonstrate that the signals carried by position neurons could be used by motoneurons to set the fixation position of the eye. These results are consistent with a role for position neurons as elements of the velocity-to-position neural integrator for horizontal eye movements.

Abducens Nerve↗