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Mustafa Gokalp Ataman,1 Gorkem Sariyer,2 Caner Saglam,3 Arif Karagoz,1 Erden Erol Unluer3 1Department of Emergency Medicine, Bakırçay University Çiğli Training and Research Hospital, İzmir, Turkey; 2Department of Business Administration, Yaşar University, İzmir, Turkey; 3Department of Emergency Medicine, University of Health Sciences Bozyaka Training and Research Hospital, İzmir, TurkeyCorrespondence: Mustafa Gokalp Ataman, Department of Emergency Medicine, Bakırçay University Çiğli Training and Research Hospital, 8780/1 Street No: 18 Yeni Mahalle Ata Sanayi / Çiğli, İzmir, Turkey, Tel +90 232 398 37 00, Fax +90 444 35 30, Email gokalpataman@gmail.comPurpose: The purpose of this study is to investigate the factors increasing waiting time (WT) and length of stay (LOS) in patients, which may cause delays in decision-making in the emergency departments (ED).Patients and Methods: Patients who arrived at a training hospital in the central region of Izmir City, Turkey, during the first quarter of 2020 were retrospectively analyzed. WT and LOS were the outcome variables of the study, and gender, age, arrival type, triage level determined based on the clinical acuity, diagnosis encoded based on International Classification of Diseases-10 (ICD-10), the existence of diagnostic tests or consultation status were the identified factors. The significance of the differences in WT and LOS values based on each level of these factors was analyzed using independent sample t-tests and ANOVA.Results: While patients for which no diagnostic testing or consultation was requested had a significantly higher WT in EDs, their LOS values were substantially lower than those for which at least one diagnostic test or consultation was ordered (p≤ 0.001). Besides, elderly and red zone patients and those who arrived by ambulance had significantly lower WT and higher LOS values than other levels for all groups of patients for which laboratory-type or imaging-type diagnostic test or consultation was requested (p≤ 0.001 for each comparison).Conclusion: Besides ordering diagnostic tests or consultation in EDs, different factors may extend patients’ WT and LOS values and cause significant decision-making delays. Understanding the patient characteristics associated with longer waiting times and LOS values and, thus, delayed decisions will enable practitioners to improve operations management in EDs.Keywords: emergency department, waiting time, length of stay, delay

This study was conducted to determine the spray angle and flow uniformity of different hydraulic spray nozzles at different spray pressures with the aid of image processing operations. Spray images were captured with a digital camera to determine spray angles and spray patterns. Captured images were transferred to computer environment and analyzed with different image processing software. The spray angle at 3 bar pressure was measured as 107.2° for anti-drift nozzles, as 105.6° for air-injection nozzles, as 69.9° for ST 80 flat-fan nozzles, as 84.0° for ST 90 flat-fan nozzles, as 103.2° for ST 110 flat-fan nozzles and as 54.2° for hollow-cone Ø1.0 mm nozzles. Cone angle at 3 bar pressure was measured as 106.7° for anti-drift nozzles, as 103,9° for air-injection nozzles, as 75.1° for ST 80 flat-fan nozzles, as 86.4° for ST 90 flat-fan nozzles, as 105.2° for ST 110 flat-fan nozzles and as 46,4° for hollow-cone Ø1.0 mm nozzles. Spray pattern obtained with the image processing method was identical with the flow uniformity obtained with line-profile method. It was concluded that spray pressures had significant effects on spray angles (p =0.05) of all nozzles. [ABSTRACT FROM AUTHOR]

The aim of this study is to compare the diameter of the inferior vena cava with mitral annular plane systolic excursion measurement in order to determine the volume loss before and after blood donation in healthy volunteers.

The population parameters of stargazer ( Uranoscopus scaber Linnaeus, 1758) were studied regarding age composition, sex ratio, growth, survival and mortality rates, and the exploitation rate in the southeastern Black Sea near the coast of Turkey during the 2011-2012 fishing season. According to ageing analysis of the samples, age group 1 is the most abundant (47.76%), followed by age 2 (41.04%), age 3 (9.33%), age 0 (1.12%) and age 4 (0.75%). Mean totals as well as total lengths and weights for males and females were 14.5 ± 0.22 cm and 12.9 ± 0.19 g, 16.6 ± 0.24 cm and 62.1 ± 2.76 g, and 37.2 ± 1.92 cm and 87.1 ± 3.88 g, respectively. The mean condition factor was K = 0.0167, while the sex ratio was 53.98% female, 38.75% male and 7.27% immature. Length-weight, age-length and age-weight equations were W = 0.014 × L3.059, L( t)=44.5*[1−e−0.148*( t +1.242)] and W( t)=1544.4*[1−e−0.148*( t + 1.242)]3.059, respectively. The computed survival rate (S), instantaneous total mortality rate (Z), annual mortality rate (A), natural mortality rate (M) and fishing mortality rate (F) were S = 28.94%, Z = 1.24 year−1, A = 71.06%, M = 0.26 year−1 and F = 0.98 year−1, respectively. The exploitation rate was 0.79, which is above the optimum exploitation levels. [ABSTRACT FROM AUTHOR]

Listeria monocytogenes is a very important life-threatening bacteria in certain risk groups such as neonates, pregnant women, elderly people, transplant recipients and others with impaired cell-mediated immunity. However, its infections are very rare in healthy children. Reports of listeriosis in newborn period are limited. We report a case of neonatal listeriosis with erythematous rash, intractable convulsions, severe early neonatal sepsis, disseminated intravascular coagulation, multiple organ dysfunction syndrome and death. Although an empirical antibiotic therapy including ampicillin (semisentetic penicillin) and aminoglycoside combination is effective by the means of a probable Listeria infection, the progression of the very early-onset disease may be fatal, despite vigorous treatment efforts as in our case. [ABSTRACT FROM AUTHOR]

The incidence of severe consecutive repetition of lordosis-kyphosis involving three flexions was reported in a specimen of the atherinid fish Atherina boyeri Risso. The values for the angles lay between the lines passing through the sides of the vertebral column and enclosing the curvatures, and the depth of the curvatures of the angles was obtained. Also, the ratio of the vertebral column to the fish total length of deformed and normal specimens of this species was calculated. Possible causes for these anomalies are discussed.

Sunflower, apart being the plant of cooking oil, is grown as an ornamental plant in parks and gardens. Protein, carbohydrate and fat is found in sunflower pulp utilized as animal feed apart being used as cooking oil. While its seeds are being used as snacks, its stems and slabs are used in the paper industry. In this study, sunflower widely cultivated in Tekirdağ province, Tunca MR (5580) sunflower variety grown in the basic soils of Banarli Village in Hayrabolu District and antioxidant activities of plant extracts during physiological and harvest periods were researched with β-carotene Linoleic Acid Method and it was compared with Butylated Hydroxy Toluene (BHT), which is a synthetic antioxidant, and Trolox as a standard. Total antioxidant activity was determined with βF carotene Linoleic Acid Method. In this study, however, antioxidant capacities of sunflowers were compared by considering their seeds in terms of soil and climate. [ABSTRACT FROM AUTHOR]

The European cranberry bush, known for its health benefits, can only be consumed through fermentation. This study aimed to develop a fruit leather made from European cranberry bush using quince seed gel and the foam drying method. For this purpose, quince seed gel was added to European cranberry juice to increase consistency. Then, European cranberry fruit leather was obtained by drying at 70, 80, and 90 °C air temperatures using foam mat drying technology. Spectral reflectance, color, drying kinetics, anthocyanin, ascorbic acid, and total phenolic content, antiradical activity, and macro-micronutrient concentrations of the resulting fruit pulp were investigated. The foam mat drying process at 90 °C had the greatest values of ascorbic acid (0.996 mg g - 1 ), anthocyanin (275.9 mg kg - 1 ), DPPH (47.77%), and ABTS. + (68.76 µg TE g - 1 ). In addition, the highest value of total phenolic content (37.75 mg g - 1 ) was obtained in the foam mat drying process at 80 °C. The highest concentration of P, Na, Mg, K, Ca, and Mn in fruit leather was obtained at 70 °C, and the highest concentration of S, Cu, and Zn was obtained at 90 °C. The lowest spectral reflectance values were measured at 90 °C. In conclusion, the present study explored the fact that adding quince seed gel, extremely rich in biochemical content, significantly enhanced the bioactivity properties of European cranberry bush fruit leather., (© 2024. The Author(s).)

Introduction: Radial artery puncture has been performed by palpation as a standard method in many emergency departments and intensive care units. Nurses play an important role in the care of patients in various settings. Ultrasonography can be performed and interpreted not only by physicians but also by nurses. This study aimed to evaluate whether emergency nurses would be more successful in radial artery puncture procedure by using ultrasonography instead of palpation., Methods: This single-center, prospective, randomized controlled study was conducted in the emergency department. The patients included in the study were randomized into 2 groups as ultrasonography and palpation groups. Data were recorded on the number of interventions, the duration of the procedure in seconds, total time in seconds, whether the puncture was successfully placed, whether there were complications, the types of complications (hematoma, bleeding, and infection), or whether it was necessary to switch to an alternative technique., Results: A total of 72 patients, 36 patients in the ultrasonography group and 36 patients in the palpation group, participated in the study. The success rate at the first attempt was statistically significantly higher in the ultrasonography group. Although hematoma formation among the complications occurred in the entire palpation group, it was observed in 72.2% of the ultrasonography group. Puncture time and total time were statistically significantly lower in the ultrasonography group., Discussion: Our study shows that emergency nurses can use bedside ultrasonography for radial artery puncture successfully., (Copyright © 2024 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.)

Introduction: The last two decades have seen a shift towards blended learning in education due to technological advancements. This study focuses on dental education, comparing two blended learning models -enriched virtual and fully online flipped classroom - in terms of academic achievement, aligning with the Association for Dental Education in Europe's competencies., Materials and Methods: The research was modelled in a quantitative design with a pre-post-test control group experimental design. The study was conducted at Ege University Faculty of Dentistry in Turkey for 4 weeks with the experimental (n = 44) and control (n = 39) groups divided into two groups by impartial assignment. To the experimental group, the theoretical part of the course was tried to be conveyed before each lesson with video lessons prepared with EdPuzzle containing reinforcement questions and a question set consisting of case questions. The practical learning objectives of the course were tried to be gained through the discussion of the previously presented case questions in the online synchronous course. As tools for collecting data, a unique academic achievement test, a course evaluation form and a semi-structured qualitative data collection form were used., Results: It was seen that the flipped classroom model had a more positive effect on students' academic achievement than the enriched virtual classroom model. The general satisfaction levels of the participants regarding these two models are also higher in favour of the flipped classroom model., Conclusion: This study provides significant findings for educational institutions, policymakers and educators about the impact of fully online teaching methods on academic achievement. In this context, the flipped classroom method can be preferred both in cases where education is blocked and in dental education institutions that want to ensure digital transformation efficiently and partially remotely., (© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Ultrasound is used more and more in determining acute blood loss. This study is to compare tricuspid annular plane systolic excursion (TAPSE) and mitral annular plane systolic excursion (MAPSE) measurement to determine volume loss pre and post blood donation in healthy volunteers. The systolic, diastolic and mean arterial blood pressures and pulses of the donors were measured in the standing and supine position by the attending physician, then, inferior vena cava (IVC), TAPSE and MAPSE measurements were made pre and post blood donation. Statistically significant differences were found in systolic blood pressure and pulse rate values that obtained in the standing position, and in the systolic blood pressure, diastolic blood pressure, mean arterial pressure and pulse values that obtained in the supine position (p < 0.05). The difference between IVC expiration (IVCexp) pre and post blood donation was 4.76 ± 2.94 mm, and the difference in IVC inspiration (IVCins) was 2.73 ± 2.91 mm. In addition, the MAPSE and TAPSE differences were 2.16 ± 1.4 mm and 2.98 ± 2.13 mm, respectively. Statistically significant differences were found between IVCins-exp, TAPSE and MAPSE values. TAPSE and MAPSE can be helpful in the early diagnosis of acute blood loss., (© 2023. The Author(s), under exclusive licence to Società Italiana di Medicina Interna (SIMI).)

Background: Drying is one of the most important post-harvest processes in order to ensure that the products harvested in certain periods are consumed throughout the year. In this study, Golden Delicious, Oregon Spur and Granny Smith apple cultivars (fallen apples) were dried in open-sun, a controlled glasshouse, microwave oven (200 W), hybrid system (100 W + 60 °C), convective greenhouse (70 °C) and freeze-dryer (-55 °C) with and without ultrasound pretreatments., Results: Present findings revealed that the longest drying duration was observed in freeze-drying and the shortest in microwave drying. The greatest color change (ΔE) was observed in ultrasound pretreated Oregon Spur apples dried in a controlled glasshouse. The greatest total phenolics (40.08 mg GAE g -1 ), DPPH (2,2-diphenyl-1-picrylhydrazyl) inhibition activity (46.96%), FRAP (ferric reducing ability of plasma) antioxidant activity (68.01 μg Trolox g -1 ) and ascorbic acid content (1.52 mg AAE g -1 ) were observed in open sun-dried Granny Smith apples without ultrasound pretreatment., Conclusions: Generally, microwave and hybrid drying yielded better outcomes for bioactive, HMF (5-hydroxymethyl-2-furfural) and drying characteristics of windfall apples. © 2022 Society of Chemical Industry., (© 2022 Society of Chemical Industry.)

Ovariectomized (OVX) rodents show behavioral despair and anxiety-like behaviors. Glucagon-like peptide-1 receptor agonists (GLP-1RA) possess neuroprotective effects by reducing oxidative stress and neuroinflammation, thereby preventing synaptic loss. The objective of the present study is to evaluate the effect of GLP-1RA, namely liraglutide, on emotional behaviors, and to identify the level of oxidative stress, neuroinflammation, and BDNF signaling in the hippocampus of OVX rats. Forty female young Wistar rats were divided into 5 groups: Control, Control+liraglutide treated, OVX, OVX+fluoxetine, and OVX+liraglutide (150 µg/kg for 15 days, sc). Open field test and elevated plus-maze test were used to evaluate behaviors that are suggestive of anxiety. A forced swimming test was used to evaluate behavioral despair. At the end of the experiments, blood glucose level and body weight gain were measured. The levels of BDNF, CREB, Nrf2, and lipocalin 2 in the hippocampal tissue were measured by ELISA. Malondialdehyde (MDA) and glutathione levels were also evaluated. Statistical analysis was conducted through ANOVA and Bonferroni tests. Seven weeks post-OVX rats exhibited high anxiety related behavior and behavioral despair in comparison with the control groups. These behavioral changes were associated with increased lipocalin 2 and MDA levels in rats. Moreover, BDNF, CREB, and Nrf2 levels decreased significantly in the hippocampus of OVX rats. Liraglutide treatment limited the reduction of BDNF and Nrf2 levels in the hippocampus, maintaining them at the control levels. Liraglutide treatment also prevented the symptoms of behavioral despair and anxiety related behavior. As the main finding of the study GLP-1RA reduced behavioral despair and anxiety level and this may be related to the preservation of BDNF/Nrf2 levels and the decrease in oxidative stress and lipocalin 2 levels in the hippocampus., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Background: Hip fractures (HF) are among the most common fractures present in the emergency department and are very painful. Pericapsular nerve group block (PENG) is a new regional anesthesia technique developed for analgesia in total hip arthroplas-ties. We aimed to determine the effectiveness of PENG block used to reduce pain in patients with HF in the emergency department., Methods: This single-center, randomized, and prospective study was carried out in the emergency department. The patients in-cluded in the study were selected according to the suitability of the personnel who will perform the procedure. The sealed envelope system was used for randomization., Results: Statistical analysis was performed with 39 patients (18 patients in the PENG group, 21 patients in the control group). Thir-teen (33.3%) of the patients were female and 26 (66.7%) were male. The mean age was 75.3. At rest post-procedure, the mean Numeric Rating Scale (NRS) scores of the patients at the 30th min, 2nd, 6th, and 24th h were 1.78±1.83, 0.00±0.00, 0.00±0.00, and 1.28±1.41 in the PENG group. On the other hand, it was 3.38±1.86, 0.05±0.22, 2.86±2.37, and 4.95±1.47 in the control group, respectively. The mean NRS scores of the patients at 15° elevation of the leg at the 30th min, 2nd, 6th, and 24th h were 3.06±1.80, 0.06±0.24, 0.22±0.43, and 2.44±1.50 in the PENG group and it was 5.24±1.81, 1.05±0.92, 4.29±2.35, and 7.14±1.24 in the control group, respectively., Conclusion: PENG block can reduce pain and the need for systemic analgesics as a practical option in patients with HF.

Background: Specific granule deficiency (SGD) is a rare immunodeficiency associated with CCAT/enhancer-binding protein epsilon (CEBPE) gene variants. It can cause severe recurrent infections and is lethal without successful stem cell transplantation. Few cases with SGD of both type 1 and type 2 have been described in the literature. In this study, we present the first report of a case with a novel homozygous c.511 C > T (p.Gln171Ter) mutation in the SMARCD2 gene of SGD type 2, which was successfully treated with bone marrow transplantation. Case: A male infant presented to our neonatal intensive care unit on the second day of life with an icteric appearance and mild hypotonia. He was evaluated for immunodeficiency as the cause of delayed cord separation and refractory neutropenia. At 6 weeks of age, SGD type 2 with a new variant was diagnosed and successfully treated by bone marrow transplantation. Conclusion: SGD is an immunodeficiency disease that is quite rare. However, we believe that SGD diagnosis and associated new variants can be detected more frequently with the widespread use of all whole-exome sequencing techniques.

Introduction: Endotracheal intubation is a lifesaving procedure frequently performed in emergency departments. It is associated with some potential risks. Rapid and reliable confirmation of endotracheal tube placement during intubation is critical. Nurses play an important role in the care of patients in various settings. Ultrasound can be performed and interpreted not only by physicians but also by nurses. The aim of this study was to evaluate how well nurses without previous ultrasound experience can determine both esophageal and tracheal localization of endotracheal tubes in cadavers after a short ultrasound training., Methods: This was a repeated measures study with an educational intervention and no control/contemporaneous comparison group. The study was performed to evaluate the ability of emergency nurses to confirm correct endotracheal tube placement and identify esophageal intubations. A total of 7 emergency nurses were given theoretical education and hands-on training about ultrasound. They diagnosed tracheal or esophageal intubation using ultrasound., Results: Four cadavers were used 8 times each for the study. A total of 32 intubation procedures were evaluated with ultrasound by each nurse. In the analysis based on 224 responses, sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and overall accuracy of ultrasound applied by nurses to detect tracheal intubation were 95.61% (90.06%-98.56%), 97.27% (92.24%-99.43%), 35.06 (11.48-107.10), 0.05 (0.02-0.11), and 96.43% (93.08%-98.45%), respectively. The mean time to evaluate the tube location by ultrasound was 6.57 seconds., Discussion: The results support that ultrasound can be performed by nurses for the confirmation for esophageal and tracheal intubations quickly and accurately., (Copyright © 2022 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.)

Aim: The aim of this study is to compare the diameter of the inferior vena cava with tricuspid annular plane systolic excursion (TAPSE) measurement in order to determine the volume loss before and after blood donation in healthy volunteers., Methods: This Institutional Review Board-approved single center, prospective, cross-sectional study included 60 healthy blood donors donating in a tertiary care hospital's blood bank. After obtaining written consent, systolic, diastolic, and mean arterial blood pressures along with pulse rate of the donors were measured in sitting and supine positions by the attending physician, then, inferior vena cava (IVC) and TAPSE measurements were made before and after blood donation., Results: Statistically significant differences was found between standing systolic blood pressure and pulse rate, lying systolic blood pressure and pulse rate, IVC and TAPSE values before and after blood donation (p < 0.05). There was no difference between the other variables before and after blood donation., Conclusion: Our study revealed that, low IVC and TAPSE values correlated in determining blood loss after blood donation. TAPSE may be useful to predict blood loss in early stages of hypovolemic shock., Competing Interests: Declaration of Competing Interest There are no conflicts of interest (including financial and other relationships)., (Copyright © 2021. Published by Elsevier Inc.)

Purpose: The aim of this study was to investigate the effect of compression on the Visual Analog Scale (VAS) score following the application of 3-in-1 femoral nerve block (FNB), used for pain palliation in patients with hip fractures., Methods: This was a randomized controlled trial study on application of pressure versus no pressure following FNB in patients with hip fractures. Their VAS scores were recorded and an ultrasound-guided 3-in-1 FNB was performed as a standardized procedure. After the procedure, patients were randomized into two groups and a weight with 2 kg pressure was applied to the treated area in one group. After 30 min, VAS scores were recorded again. VAS scores of all patients recorded before and after the procedure, and post-procedural VAS scores of pressure-applied and no pressure-applied groups were statistically compared., Results: 34 patients were included in this study with 17 patients falling in the compression group (group C), and the remaining half in the non-compression group (group NC). The pre-procedural mean VAS scores were 9.35 (95% CI; 8.95-9.76)), while the post-procedural mean VAS scores dropped to 2.35 (95% CI; 1.65-3.06) in group C. The pre-procedural mean VAS score was 9.12 (95% CI; 8.64-9.59), while the post-procedural mean VAS score was 5.06 (95% CI; 4.09-6.03) in group NC. When the average reductions in VAS score following the procedure were compared, the mean difference between the two groups was calculated to be 2.94 (95% CI; 1.69-4.19) which favours group C. This difference was statistically significant (p < 0.001)., Conclusion: Our study shows that, the application of simple compression after 3-in-1 FNB in patients with hip fractures provides a significant reduction in VAS scores., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. The authors declare the following financial interests/personal relationships which may be considered as potential competing interests., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Objectives: Our aim was to evaluate the accuracy of emergency physicians (EPs) in the detection of regional wall motion abnormalities (RWMAs) using focused cardiac ultrasound (FOCUS) in patients suspected of non-having ST-elevation myocardial infarction., Methods: We prospectively enrolled patients with chest pain. Three EPs underwent didactics and hands-on-training, of 3 hours each, by an experienced cardiologist, on detecting RWMAs using 2-dimensional echocardiography. They performed a FOCUS examination to evaluate for RWMAs and recorded the echo images. Our reference standard for the detection of RWMAs was accepted as a blinded cardiologist review of the prerecorded video clips. We calculated the corrected sample size and inter-rater agreement between the EPs (82 and 0.83, respectively). The analysis of the study was performed on 89 patients., Results: Eighty-nine patients with chest pain were screened. Emergency physicians demonstrated the detection of RWMAs with good sensitivity and even excellent specificity: 76.9% (95% confidence interval [CI], 56.4%- 91.0%) and 92.1% (95% CI, 82.4%-97.4%), respectively. The accuracy of FOCUS was 87.6% (95% CI, 79.0%-93.7%). The area under the curve from a receiver operating characteristic curve analysis, which evaluated the EPs' rate of detecting the presence or absence of RWMAs, was 0.845 (95% CI, 0.753-0.913)., Conclusions: Our study results suggest that EPs with training in bedside echocardiography can accurately rule in patients with RWMAs in suspected non-ST-elevation myocardial infarction cases., (© 2020 American Institute of Ultrasound in Medicine.)

Objectives: The novel coronavirus disease 2019 (Covid-19) outbreak began in China. The characteristic of the disease is development of pneumonia. We aimed to investigate the accuracy of bedside lung ultrasound (BLUS) for diagnosing Covid-19 pneumonia, and its effectiveness for the correct triage of patients with suspected Covid-19 in the emergency department (ED)., Methods: This study was a prospective, cross-sectional cohort study. During their shifts, 3 accredited and certificated emergency physicians performed BLUS using BLUE protocol at the triage area of the ED on patients with suspected Covid-19. All of the patients underwent chest computed tomography. The BLUS findings were statistically compared with formal radiology reports of computed tomographies as the criterion standard for the diagnosis of Covid-19 pneumonia. Kolmogorov-Smirnov analysis, Shapiro-Wilk test, and Q-Q plots were performed with 95% confidence intervals (CIs) for statistical analysis., Results: A total of 72 patients were included in the study. The sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy of BLUS were 96.9% (95% CI, 84.2%-99.9%), 92.3% (95% CI, 79.1%-98.3%), 84.3% (95% CI, 64.5%-94.1%), 98.6% (95% CI, 91.1%-99.8%), and 93.7% (95% CI, 85.3%-98.0%), respectively. The positive and negative predictive values were 84.3% (95% CI, 64.5%-94.1%) and 98.6% (95% CI, 91.1%-99.8%), respectively. The area under curve was found to be 0.946 (95% CI, 0.866-0.986; P < 0.0001)., Conclusions: Bedside lung ultrasound can be used to detect the presence of pulmonary involvement in suspected cases of Covid-19 for the effective triage of patients in the ED.

Background: Firearm injuries are criminal events that may cause severe morbidity and mortality and concerned with Emergency Medicine and Forensic Medicine. The present study aims to evaluate the wound characteristics of the cases who presented to emergency services due to firearm injuries., Methods: In this study, 213 patients who were 18 years of age or older who applied to the Sağlık Bilimleri University Bozyaka Training and Research Hospital Emergency Service with gunshot injury were included., Results: Of the 213 cases examined, 182 (85.4%) were male. The ages of the cases ranged from 18 to 78 years, and the mean age was found as 33.2±12.6. The most common months were April (n=28, 13.2%) and May (n=25, 11.6%). The findings showed that 194 (91.1%) of 213 patients were discharged after completing the treatment in the hospital, and 19 patients (8.9%) died despite all interventions., Conclusion: Our study presents an important cross-section of the gunshot injury patterns and their consequences in Turkey, but it contains regional data. In this regard, multicentre and multidisciplinary studies covering the country, in general, are considered to be a significant contribution to the literature.

Breast tuberculosis is a rare form of extrapulmonary tubercular infection. Our aim is to highlight the nonspecific clinical presentations, diagnostic difficulties and therapeutic approaches of mammarian tuberculosis. Forty-six patients diagnosed with breast tuberculosis between 2005 and 2015 were reviewed retrospectively. Clinical features, all diagnostic methods, and the outcomes of treatment were analysed. All cases were female with a mean age of 36.4 years. Breast mass and pain were the most common complaints. While 34.8% of the cases had a physical examination with suspicions for malignancy, 43.5% of the patients had Breast Imaging Reporting and Data System (BI-RADS) 4 or 5 lesions suggested malignancy radiologically. Definitive diagnosis was based on histopathologic examination through core needle biopsy (n = 29), excisional biopsy (n = 12), and open biopsy (n = 5) taken from the abscess wall during drainage. Standard antiTB therapy for 6 months was given to all cases. Thirty-three patients recovered with standard 6-month therapy while extended treatment for 9-12 months was needed in 13 (28.2%) cases. Surgery was carried out in 17 cases. Two patients developed recurrence. Breast tuberculosis can be easily confused with breast cancer, suppurative abscess, and other causes of granulomatous mastitis, both clinically and radiologically. A multidisciplinary approach is required to prevent diagnostic delays and unnecessary surgical interventions. Although antiTB therapy is the mainstay treatment of breast TB, surgery is usually indicated in patients refractory to medical treatment., (Copyright © 2016. Published by Elsevier Taiwan.)

Objective: Children with Turner syndrome (TS) have a specific growth pattern that is quite different from that of healthy children. Many countries have population-specific growth charts for TS. Considering national and ethnic differences, we undertook this multicenter collaborative study to construct growth charts and reference values for height, weight and body mass index (BMI) from 3 years of age to adulthood for spontaneous growth of Turkish girls with TS., Methods: Cross-sectional height and weight data of 842 patients with TS, younger than 18 years of age and before starting any therapy, were evaluated., Results: The data were processed to calculate the 3rd, 10th, 25th, 50th, 75th, 90th and 97th percentile values for defined ages and to construct growth curves for height-for-age, weight-for-age and BMI-for-age of girls with TS. The growth pattern of TS girls in this series resembled the growth pattern of TS girls in other reports, but there were differences in height between our series and the others., Conclusion: This study provides disease-specific growth charts for Turkish girls with TS. These disease-specific national growth charts will serve to improve the evaluation of growth and its management with growth-promoting therapeutic agents in TS patients.

Purpose: Necrotizing enterocolitis (NEC) is a severe disease of mostly premature infants with high morbidity and mortality rates. There is no reliable biomarker for detecting newborns at risk for NEC development. We aimed to investigate small intestinal lactoferrin (LF) and calprotectin (CAL) levels as predictors and indicators of disease severity in an experimental newborn rat model., Materials and Methods: Newborn pups were randomly divided into two groups, NEC and control. The NEC group pups were decapitated on the second, third and fourth days of the experiment for an assessment of the different stages of NEC. In the study group, hypoxia-reoxygenation model used to induce NEC. As biochemical parameters, small intestinal LF and CAL levels were measured with an enzyme-linked immunosorbent assay technique and intestinal injury scoring was evaluated as a pathologic parameter., Results: Small intestinal levels of both LF and CAL increased in the second and the third day groups, but began to decrease by the fourth day. The first, second and third day levels of LF and CAL were higher than controls. The intestinal injury scores of all NEC groups were significantly higher than the control group., Conclusion: Small intestinal lactoferrin and calprotectin were good markers for demonstrating NEC. However, instead of spot testing, monitoring the levels of these markers may be more informative., (Copyright © 2015 Medical University of Bialystok. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.)

Objective: Our aim was to determine if N-terminal pro-brain natriuretic peptide (NT-proBNP) or sonographic measurements of inferior vena caval (IVC) diameters and collapsibility index (IVC-CI) have a role in the monitoring of acute heart failure (AHF) therapy., Methods: Inferior vena caval diameters of 50 healthy people (control group) were measured to determine the normal values of the IVC parameters. We then prospectively enrolled patients who were admitted to the emergency department (ED) with a primary diagnosis of AHF. At presentation, IVC diameters were measured during expiration and inspiration, and blood was drawn for NT-proBNP. We repeated the measurement of the IVC parameters and collected a second blood sample 12 hours after the therapy was administered. The data were analyzed in SPSS 15.0 (IBM, Armonk, NY) using the Student t test and Mann-Whitney U test., Results: A total of 97 subjects were enrolled: 47 in the patient group and 50 in the control group. The mean IVC during expiration was 2.10 ± 0.37 cm before and 1.57 ± 0.24 cm after the therapy (P < .001). The mean IVC during inspiration was 1.63 ± 0.40 cm before and 0.90 ± 0.26 cm after the therapy (P < .001). The mean IVC-CI rose from 22.80% ± 10.97% to 43.09% ± 13.63% (P < .001). After the therapy, there was no difference between the IVC-CI of the patients and controls (P = .246). There was no significant change in the mean NT-proBNP levels after the therapy., Conclusion: Inferior vena caval collapsibility index may be helpful in monitoring AHF patients' responses to therapy in the ED., (Copyright © 2014 Elsevier Inc. All rights reserved.)

The objectives of this study were to determine the role of clinical parameters in detecting intracranial injury and to find out whether cranial computed tomography (CT) is routinely needed for mild head injury (MHI) in Turkey. This retrospective study was conducted by reviewing the records of patients with MHI who underwent cranial CT in our emergency department. We carried out multiple logistic regression analysis, and odds ratios with 95% confidence intervals were calculated by using SPSS 15.0. This study included 923 patients. Positive cranial CT findings were determined in 17 patients (1.8%) and six of them (0.6%) underwent surgery. Statistically significant correlations were found among headache, presence of clinical findings of skull fracture, focal neurological deficit and positive cranial CT findings. Although the incidence of the intracranial lesions, especially those requiring surgery, is low in MHI, the liberal use of CT scanning in MHI seems to be justified in countries such as Turkey.