Search

Aim: Fournier’s gangrene (FG) is a rapidly progressive, fulminant necrotizing fasciitis of the anogenital region. Treatment of FG consists of aggressive surgical debridements. The current scoring systems in FG focus on mortality. However, simple biomarkers could be useful. Here we aim to investigate the clinical usefulness of monocyte-to-lymphocyte ratio (MLR) in determining the number of debridements in FG patients. Method: Fifty-nine patients were diagnosed with FG and operated in the emergency unit between 2010 and 2016. The patients were separated into a single-debridement group and a multiple-debridement group. The groups were compared in terms of mean age, gender, duration of symptoms, predisposing factors, wound culture positivity, MLR values at admission, treatment protocols, and mortality rates. Results: The two groups differed significantly in wound culture results and colostomy status (p=0.001 and p=0.008). There was no significant difference in mortality rate (p=0.749). Furthermore, there were no significant differences between the groups in terms of predisposing factors or duration of symptoms (p=0.069 and p=0.091). The multiple-debridement group had a significantly higher MLR value (p

Aim: Acute appendicitis (AA) is the most common acute surgical disease worldwide. Despite the use of preoperative advanced radiological instruments, preoperative determination of complicated cases is still difficult and remains an important concern. The aim of this study is to evaluate the predictive value of the platelet-to-lymphocyte ratio and of the presence of elevated white blood cells to discriminate between complicated and uncomplicated AA. Method: All patients who were admitted to the emergency care unit and underwent urgent laparotomy for AA were analyzed retrospectively. The platelet-to-lymphocyte ratio and white blood cell count were measured. Patients were divided into two groups: uncomplicated cases (group 1) and complicated cases (group 2). White blood cell count and platelet-to-lymphocyte ratio were compared between the two groups. Results: There were 196 patients in group 1 and 43 patients in group 2. The gender distribution between groups was homogeneous (p=0.020); the mean age of group 2 was higher than group 1 (p

Background and Objective: Chest pain is a common and important admission complaint of patients in the emergency department (ED). The differential diagnosis especially in terms of acute coronary syndrome (ACS) should be done carefully by emergency physicians. The present study aims to identify patients with chest pain according to presence of ACS in the ED. Material and Methods: The patients who admitted to the ED of a university hospital in a year period with chest pain complaint were enrolled into the study prospectively. The information that include age, gender, type of chest pain, duration of pain, medical history, transporting way to the ED, duration time of electrocardiography (ECG) recording, main diagnosis, consultation status, last condition of patients and length of stay of patients were recorded. The data were analyzed by SPSS 17.0 program.Results: Totally 325 patients with chest pain complaint were enrolled into the study. 24.3% of patients with chest pain were diagnosed as ACS.It was found that most of the patients (42.5%) came to ED by the ambulance.110 (33.8%) of 325 patients with chest pain were consulted with cardiologists. The older age was found to be related with ACS significantly (p, Giriş ve Amaç: Göğüs ağrısı, acil serviste yaygın ve önemli bir başvuru şikayetidir. Özellikle akut koroner sendromu (AKS) içeren ayırıcı tanı acil servis hekimleri tarafından dikkatlice yapılmalıdır. Sunulan bu calışma acil servise göğüs ağrısı şikayeti ile gelen hastaların AKS olup olmamalarına göre incelenmesini amaçlamaktadır

Objectives Methemoglobinemia (MetHb) is a rare condition that may have mortal consequences. Literature shows cases of methemoglobinemia due to the use of lidocaine and other local anesthetics. This is a cross-sectional study to determine the incidence of methemoglobinemia after the application of lidocaine. Methods In this study, 88 patients admitted to the emergency department of a university hospital between May 2014 and May 2015 and needed lidocaine application for small surgical procedures were included. When compared before and after the administration of lidocaine 2 mg/kg, there was not a significant difference in the level of methemoglobin, hemoglobin, or in the hematocrit (p=0.604, p=0.502, and p=0.367, respectively). Results Mean age of the patients was 33.85 (±17.58) years, and 83% of the patients were male. Methemoglobin levels were not significantly different before and after the procedures (p>0.05). Conclusion The results of our study were consistent with the literature; lidocaine associated methemoglobinemia is a rare complication.

Yıldırım, Ali Cihat (Balikesir Author), Despite its relatively protected position, the liver is the most frequently injured solid intra-abdominal organ.1Most liver injuries can be managed conservatively, but about 5% to 10% require urgent laparotomy, usually when the mechanism of injury involves a vehicle accident and hemodynamic instability persists, in spite of 40 mL/kg of blood transfusion.2,3In particular, grades IV and V liver injuries may pose a challenge to the surgeon trying to control hemorrhage, the leading cause of mortality.4Traumatic injuries to the portal vein are rare but devastating. The mortality rate for portal vein injury ranges from 50% to 70%. A recent study of portal triad injuries has highighted the higher mortality rates associated with combination injuries involving multiple portal triad components, especially those that include portal vein injury.5This case study describes a unique case of relatively minor trauma in a child resulting in portal triad injury, sudden demise, and surgical repair.

Acute appendicitis is the most frequent emergency procedure that requires acute surgical intervention. The mortality risk is higher in geriatric patients. There is not a single parameter to diagnose it easily and negative appendectomy is traditionally accepted however the operation itself can cause morbidity and mortality especially in elderly patients. The neutrophil-to-lymphocyte ratio is a predictor of acute inflammation and was recently studied for the diagnosis of AA. The aim of this study is to analyze the diagnostic value of NLR on positive appendectomy rates amongst geriatric and nongeriatric patients.755 patients admitted to the emergency department, with abdominal pain who underwent urgent laparotomy after diagnosed as acute appendicitis. Patients' ages, genders, laboratory results, and intraoperative findings were collected. Geriatric patients were analyzed in group one, and nongeriatric patients were in group 2. Groups then sorted into subgroups by means of positive and negative appendectomies.Although NLR was higher in positive appendectomy subgroup in group 1 it was not statistically significant. NLR could not independently predict positive appendectomy in geriatric patients. In group 2, male gender was significantly higher in the positive appendectomy group (p0.001). NLR was also significantly higher in the positive appendectomy group (p0.001). In group 2 NLR could independently predict positive appendectomy (p0.001).NLR could not predict positive appendectomy rates in the geriatric population but could in the nongeriatric patient group. To find the optimal NLR levels, prospective randomized studies are needed.

Amaç: Baş ağrısı acil servislerde görülen en sık şikayetlerdendir. Birincil baş ağrılarına semptomatik yaklaşım gereklidir. Ancak, hayatı tehdit eden ikincil baş ağrılarını en kısa zamanda tanımlamak gereklidir. Çalışmamızda, acil servise başvuru zamanı ile ikincil baş ağrıları arasındaki ilişkiyi araştırmayı amaçladık. Çalışmanın amacı, başvuru zamanının erken tanı için ipucu verip vermeyeceğini belirlemek. Materyal ve metot: 1350 hastanın dosyası retrospektif olarak incelendi. Çalışmaya dahil etme kriterlerine göre 711 hasta çalışmaya alındı ve iki gruba ayrıldı. Uluslararası Baş ağrısı Derneği 2004 kriterlerine göre birincil baş ağrısı tanısı alanlar Grup A içerisine, ikincil baş ağrısı tanısı alanlar Grup B içerisine alındı. 08:00 ile 18:00 arasında baş ağrısı şikayetiyle başvuran hastalar Alt grup 1 içerisine, 18:00 ile 08:00 arasında başvuran hastalar Alt grup 2 içerisine alındı. Çalışmanın amacı, ikincil baş ağrıları ile başvuru zamanı arasındaki ilişkiyi incelemektir. Bulgular: Yaş, cinsiyet ve başvuru zamanına ilişkin yapılan araştırmada, hiçbir parametre baş ağrısı tipini etkileyen bağımsız faktör olarak değerlendirilmedi (sırasıyla p:0.078, p:0.705 ve p:0.547). Sonuç: Acil servise baş ağrısıyla başvuran hastaların başvuru zamanı tanı koyma açısından anlamlı bulunmadı.