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We studied the magnetic properties of self-assembled aggregates of BiFeO3 nanoparticles (∼20 nm–40 nm). The aggregates formed two different structures—one with limited and another with massive crosslinking—via the “drying-mediated self-assembly” process following dispersion of the nanoparticles within different organic solvents. They exhibit large coercivity HC (>1000 Oe) and exchange bias field HE (∼350–900 Oe) in comparison to what is observed in isolated nanoparticles (HC ∼ 250 Oe; HE ∼ 0). HE turns out to be switching from negative to positive depending on the structure of the aggregates, with ∣+HE∣ being larger. Magnetic force microscopy reveals the magnetic domains (extending across 7–10 nanoparticles) as well as the domain switching characteristics and corroborates the results of magnetic measurements. Numerical simulation of the “drying-mediated self-assembly” process shows that the nanoparticle–solvent interaction plays an important role in forming the “nanoparticle aggregate structures” observed experimentally. Numerical simulation of the magnetic hysteresis loops, on the other hand, points out the importance of spin pinning at the surface of nanoparticles as a result of surface functionalization of the particles in different suspension media. Depending on the concentration of pinned spins at the surface pointing preferably along the easy-axis direction—from greater than 50% to less than 50%—HE switches from negative to positive. Quite aside from the bulk sample and isolated nanoparticle, nanoparticle aggregates—resulting from surface functionalization—therefore offer remarkable tunability of properties depending on structures.

Life-threatening arrhythmias, shock and airway compromise represent the most crucial situations to treat in the daily routine of acute medicine. Rapid access to automated external defibrillators (AEDs) and other necessary equipment increases survival rates significantly. The unmanned aerial vehicles (UAV) appear to revolutionize prehospital medicine enabling advanced health care delivery to those in austere environments and difficult regions for both defibrillators and blood products (BP). Although there are still many factors to consider, drone networks show potential to greatly reduce lifesaving equipment travel times for those with cardiac arrest (CA). More research should be performed to fill the gaps in routine practice of operating drones in different clinical scenarios, and geographical variations. As far as delivery of BP via drones, key benefits are minimized risk to human life, cost, speed of delivery and ability to cover areas beyond those of conventional planes. Challenges can be airspace management of BP, decisions on appropriate level of care to deliver during transit and user acceptability. Appropriate integration of drones to ambulances and emergency medical services facilitates efforts to improve healthcare, particularly in difficult and underserved regions. In brief, indications of drone use should be individualized to deliver vital equipment and care to the victim in emergency need, while the effectivity of UAVs must be evaluated case by case basis. This article aims to review the current status of above-mentioned technology and pluses and minuses of UAVs used worldwide, along with future projections.

Objective: The aim of this study is to analyze the diagnostic value of Quick Sequential Organ Failure Assessment (qSOFA), modified qSOFA, National Early Warning Score (NEWS) and NEWS + Lactate (NEWS + L) scores in the detection of severe community-acquired pneumonia (CAP). Methods: This research is a retrospective cohort study. Patients admitted to the Emergency Department (ED) with the diagnosis of CAP were divided into severe and mild pneumonia regarding their Pneumonia Severity Index (PSI) scores. The accuracies of lactate, procalcitonin (PCT) values, NEWS and qSOFA scores, as well as score combinations (NEWS + L and qSOFA + PCT) in predicting patients with severe CAP were analyzed. Results: Median qSOFA value in the severe CAP group (0 [IQR 0–1]) was found to be higher than median qSOFA value (0 [IQR 0-0]) in the mild CAP group (p

Aim:Dynamic changes in troponin levels have been shown to be effective indicators of acute injury and useful for distinguishing acute injuries from chronic injuries. This study investigates the role of the change in troponin I (TnI) values in the prediction of acute myocardial infarction (AMI) and its relationship with the findings of percutaneous coronary angiographies.Materials and Methods:The patients included here were divided into two groups: a group of patients with AMI and a group of patients without AMI. The patients diagnosed with AMI were subsequently divided into two subgroups as those with and without critical stenosis. The relative troponin change in these patients was calculated as the percentage of the difference between the first and second troponin measurements; the second measurement was taken two hours later after admission.Results:The receiver operating curve analysis revealed that increases of more than 83.18% in ΔTnI were significant predictors of AMI and critical stenosis [sensitivity 45.24%, specificity 89.67%, area under the curve (AUC)=0.698 (95% confidence interval (CI): 0.639-0.752, p=0.001), sensitivity 56.00%, specificity 87.92%, AUC value of 0.681 (95% CI: 0.620-0.738, p

Community-acquired pneumonia (CAP) is among the most common causes of death and one of the leading healthcare concerns worldwide. It can evolve into sepsis and septic shock, which have a high mortality rate, especially in critical patients and comorbidities. The definitions of sepsis were revised in the last decade as “life-threatening organ dysfunction caused by a dysregulated host response to infection”. Procalcitonin (PCT), C-reactive protein (CRP), and complete blood count, including white blood cells, are among the most commonly analyzed sepsis-specific biomarkers also used in pneumonia in a broad range of studies. It appears to be a reliable diagnostic tool to expedite care of these patients with severe infections in the acute setting. PCT was found to be superior to most other acute phase reactants and indicators, including CRP as a predictor of pneumonia, bacteremia, sepsis, and poor outcome, although conflicting results exist. In addition, PCT use is beneficial to judge timing for the cessation of antibiotic treatment in most severe infectious states. The clinicians should be aware of strengths and weaknesses of known and potential biomarkers in expedient recognition and management of severe infections. This manuscript is intended to present an overview of the definitions, complications, and outcomes of CAP and sepsis in adults, with special regard to PCT and other important markers.

Objective: To evaluate clinical and demographic characteristics of the emergency department (ED) patients using Hospital Anxiety and Depression Scale (HADS) which includes anxiety (HAD-A) subscale. Materials and methods: In this cross-sectional study, all consecutive adult patients admitted to the community hospital-based ED in the study period were enrolled prospectively. HAD-A items were responded by the patients themselves. Demographic characteristics, history, and clinical findings were analyzed. Results: Four hundred and ninety-eight consecutive ED patients with eligible conditions were enrolled. Mean age was 44.1 ± 16.5 (range 18–90) and 53.0% (n = 264) were female. The presence of pathological examination finding was significantly associated with a tendency to have a HAD-A score higher than 10 (p = .044). Presence of systemic disease was significantly associated with higher anxiety scores (t-test, p = .029). Patients presented with acute exacerbation of a chronic illness and those with psychological condition had significantly higher HAD-A scores (p = .014 and p = .008, respectively). Conclusions: High acuity, presence of pathological finding, higher income, presence of a systemic disease, acute exacerbation of a chronic illness were significantly associated with higher anxiety scores. Keywords: Emergency department, Hospital anxiety subscale, Anxiety disorder, Anxiety, HADS

Background: Dysmenorrhea is one of the most common acute pain disorders among women of reproductive age. Aims: To compare the effects of IV paracetamol with dexketoprofen in patients presenting with primary dysmenorrhea to the emergency department. Study Design: Randomized controlled trial. Methods: Patients over 18 years old presenting with pelvic pain related to menstruation were eligible for the study. Study patients received 1 g paracetamol or 50 mg dexketoprofen in 100 mL normal saline with a 4-5 minute infusion via the intravenous route. Pain intensity was measured by a visual analog scale at 15 and 30 minutes. Patients were randomized and assigned to either of two study arms via sealed envelopes. Study drugs were identical in color, and thus both personnel and patients were blinded to the study drug. The dexketoprofen group comprised 49 patients, and the paracetamol group had 50 patients in the final analysis. Results: The mean age of the study subjects was 20.9±2.5 and the mean duration of the pain was 1.9±1.7 (median: 1, interquartile range: 1 to 2) hours. Both dexketoprofen (median change: 33, 95% CI: 24 to 38) and paracetamol (median change: 21, 95% CI: 12 to 32) effectively reduced the pain at 15 minutes, which was repeated at 30 minutes (median change: 63, 95% CI: 57 to 65 vs 55.5, 95% CI: 50 to 59, respectively). Pain improvement in the dexketoprofen group was better than in the paracetamol group at 15 (median difference: 8, 95% CI: 0 to 16, p=0.048) and 30 (median difference: 6, 95% CI: 1 to 12, p=0.028) minutes, which was statistically significant but not clinically significant. Conclusion: Dexketotoprofen has a better visual analogue scale score that is not clinically relevant compared to paracetamol.

Objectives: To analyze descriptive data and characteristics of work-related eye injuries (WREI) admitted into the emergency department (ED) and obtain information to utilize in planning measures to prevent WREI. Materials and Methods: This prospective study recruited patients with WREI admitted to the center in the two-year study period. Only the casualties occurred at the workplace and while working constituted the sample. The data were collected via face-to-face contact in the ED. Results: Males comprised the majority of the sample (95.3%, n = 778) and mean age of the patients was 28.1 ± 6.5 (range: 15-54) with the biggest percentage in between 25 and 34 years of age (46.2%, n = 377). Most patients were working in the metal and machinery sectors (66.4%, n = 542). Nearly half of the patients had less than 1 year of experience (50.4%, n = 411). The most common mechanism of WREI was noted to be exposures to welding light (26.9%, n = 219), followed by drilling/cutting injuries (21.1%, n = 172). "Carelessness" and "hurrying up" were the most commonly reported causes of WREIs among ′worker-related causes′ (21.4% and 16.1%, respectively). Lack of protective measures ranked the highest among workplace-related causes (18.7%, n = 207). Conclusions: Programs to increase awareness on workplace safety and sound preventive strategies for both parties-employers and employees are to be pursued. Occupational safety efforts should include training on workplace eye safety and campaigns to raise knowledgeability on this disease among workers.

Internal jugular vein thrombosis (IJVT) is an elusive vascular disease that is rarely seen, with potentially lethal complications such as sepsis and pulmonary embolism. Spontaneous IJVT is considered when no apparent predisposing cause of thrombosis is present. A previously healthy, 31-year-old woman presented to the university-based emergency department because of painless swelling in the right anterior side of her neck. Physical examination revealed a painless, soft and immobile mass in the right anterior side of her neck beneath the sternocleidomastoid muscle, without hyperemia or local heat. On ultrasonographic examination, a hyperechogenic mass was visualized around the thoracic entrance of the right internal jugular vein, which was suggestive of a thrombus. The patient was administered intravenous antibiotic and low-molecular-weight heparin followed by oral coumadin as anticoagulant therapy. Her complaints were relieved within 5 days. She was completely well after 6 months. Venous thrombosis generally results from impaired blood flow locally or systemically that leads to activation of coagulation. Primary care physicians should sustain a high index of suspicion in patients who present with undiagnosed swelling in the neck, or other signs and symptoms attributed to IJVT.

Anorectal injuries due to autoerotic activity with rectal foreign bodies were identified in four male patients. The objects were bottle in one patient, glasses in two patients, and showerhead in one patient. Foreign bodies were extracted within lithotomy position after anal dilatation, under general anesthesia in 3 patients. One patient presented with peritoneal irritation and had a diagnosis of rectal perforation. He underwent transanal rectal repair with proximal fecal diversion. In this paper we described 4 patients who had anorectal injuries due to autoerotic activity with foreign bodies and reviewed the management options in literature.

Self-mutilation is a general term for a variety of forms of intentional self-harm without the wish to die. Although there have been many reports of self-mutilation injuries in the literature, none have reported self-cannibalism after self-mutilation. In this article we present a patient with selfcannibalism following self-mutilation. A 34-year-old male patient was brought to the emergency department from the prison with a laceration on the right leg. Physical examination revealed a well-demarcated rectangular soft tissue defect on his right thigh. The prison authorities stated that the prisoner had cut his thigh with a knife and had eaten the flesh. [West J Emerg Med. 2014;15(6):701-702]