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Background: The literature on scientific publication errors in medical research is limited, and no studies on emergency medicine publications have been conducted yet. This study aimed to investigate the characteristics of the publication errors in emergency medicine literature.Methods: This bibliometric study reviewed intervened publication errors in the manuscripts of seven high-impact emergency medicine journals from 2000 to 2020, covering twenty years, and evaluated the corrections in the forms of an erratum, corrigendum, addendum, and retracted papers. The detected publication error rate and the trend, error severity, and error types were calculated.Results: We detected 257 intervened scientific papers consisting of 251 corrections due to one or more publication errors and six retractions. Authors were the primary source of the errors (93.2%). Most of the errors were in the author attribution section (40.5%). The published errors of 7.2% had an impact on the paper's conclusion. Simple typographic errors were the most common error type (62.5%). The corrected publication error rate was 1.3%, with a steady trend over the twenty years.Conclusions: Publications errors are inevitable, but it is possible to minimize them. The number of corrections in emergency medicine literature is at a low rate and show many similarities with the previous literature.

Purpose Even if migraine is not fatal, it is a common and challenging disease with adverse effects on individuals' lives. The lack of objective diagnostic tools causes delays in diagnosis and treatment initiation. The primary aim of this study is to reveal the diagnostic value of Calcitonin Gene-Related Peptide (CGRP) and Pentraxin-3 (PTX-3) in acute migraine. To this aim, we compared the serum CGRP and PTX-3 levels of migraine patients with acute attacks to those in healthy individuals. Material and method A total of 135 individuals (85 patients with migraine attacks with or without aura and 50 healthy controls) participated in the study. Serum CGRP and PTX-3 levels were measured with ELISA analysis. A p value less than 0.05 was considered significant. Results Serum CGRP [146.70 (21.52-413.67) vs. 65.90 (3.80-256.60) pg/mL] and PTX-3 levels [12.71 (0.62-33.97) vs. 1.01 (0.06-9.48) ng/mL] were higher in patients with migraine attack than the control group (p < 0.01 and p < 0.01, respectively). ROC analysis showed that the cutoff value for serum CGRP was 121.39 pg/mL (AUC: 0.751, Sen:%61, Spe:%64) whereas the cutoff value for PTX-3 was 4,06 ng/mL (AUC:0.876, Sen:%73, Spe:%76). Serum CGRP levels were positively correlated with pain intensity. Serum CGRP and PTX-3 levels did not differ across gender groups and presence of aura in subgroup analysis. Conclusion Patients with acute migraine attacks have higher serum CGRP and PTX-3 levels than controls. Both biomarkers show high potential for the diagnosis of a migraine attack.

Objectives: Stroke is a frequently encountered life-threatening medical condition in emergency departments (EDs). Despite all worldwide efforts, a reliable circulating biomarker has not been identified yet. This study investigates the diagnostic and prognostic value of neurogranin (Ng) in acute ischemic stroke (AIS). Methods: This prospective case-control study was conducted on ED patients with AIS and healthy volunteers. We collected the basic demographics, measured serum Ng levels of the patients vs. controls, and followed up the patient group for 6-month by phone or clinical notes to assess the functional outcomes. Results: Data analysis was completed with 142 subjects (86 patients vs. 55 controls). The groups did not differ in terms of age and gender. The median serum Ng level of the patient group was significantly higher compared to the control group [160.00 (75.93) vs. 121.26 (90.35) ng/mL and p ˂ 0.001, respectively]. Serum Ng level of 25 patients admitted to the ED within the first 6 hours from the onset of AIS was 177.93 (24.03) ng/mL, while serum Ng level of 61 patients admitted to the ED within 6-24 hours was 131.84 (76.44) ng/mL. AUROC results were 0.717 vs. 0.868 vs. 0.874 for stroke patients admitted during the first 24 hours, 6 hours, and 4.5 hours after the onset, respectively. Lesion volume, NIHSS, and modified Rankin Scale scores (mRS) at admission showed no significant correlation with Ng levels as well as 6-month mortality and 6-month mRS. Conclusions: Timely AIS diagnosis is still a challenge for emergency departments due to the dependency on imaging. Serum Ng can be a promising diagnostic biomarker for AIS patients admitted in the first 24 hours. Even it outperformed in the first 4.5 and 6-hour time windows. However, it did not show a significant prognostic value.

Anti-tumor necrosis factor agents are widely used in treating ankylosing spondylitis, but they increase the risk of infection by suppressing the immune response. Therefore, physicians should be careful about recurrent infections in patients under anti-tumor necrosis factor agents.

Introduction: Insulin is a highly used parenteral medication in emergency departments. Although most severe insulin overdoses occur as suicide attempts, medication errors can be the reason. We aimed to highlight the potential medication errors in emergency departments due to the poor control of critical drugs like insulin and the similarities between the brand names of drugs, as we experienced during this case. Case Report: We present a 75-year-old diabetic woman with an extreme insulin overdose. A total of 3000 UI of insulin was administered by subcutaneous and intramuscular routes. She developed typical and atypical episodes of hypoglycemia requiring intravenous dextrose, a high-calorie diet, and glucagon administration. Almost all of the classic side effects of glucagon occurred during her intensive care unit follow-up. She recovered without any sequela or recurrence of hypoglycemia at the end of 5 days of admission.Conclusion: Insulin overdose can be a life-threatening condition by causing hypoglycemia. Albeit rare, insulin overdose can occur as a medication error in hospitals. To prevent such incidents for emergency departments, the medication errors should be objectively laid out, and proactive strategies should be integrated without adversely affecting acute care., Giriş: İnsülin acil servislerde sıklıkla kullanılan parenteral bir ilaçtır. Çoğu şiddetli insülin doz aşımı intihar girişimi olarak ortaya çıksa da, nedeni ilaç hataları da olabilir. Bu vakada tecrübe ettiğimiz gibi, acil servislerde insülin gibi kritik ilaçların yetersiz kontrolü ve ilaçların marka isimleri arasındaki benzerlikler nedeniyle ortaya çıkabilecek olası ilaç hatalarını vurgulamayı amaçladık.Olgu Sunumu: Aşırı insülin doz aşımı olan 75 yaşında diyabetik bir kadın sunmaktayız. Hastanın subkütan ve kas içi yollarla toplam 3000 UI insülin alımı oldu. Hastada intravenöz dekstroz, yüksek kalorili diyet ve glukagon uygulaması gerektiren, tipik ve atipik hipoglisemi atakları gelişti. Glukagonun klasik yan etkilerinin neredeyse tamamı yoğun bakım ünitesi takibi sırasında ortaya çıktı. Hasta hastaneye yatışından sonraki 5. günün sonunda herhangi bir sekel veya hipoglisemi nüksü olmadan taburcu oldu.Sonuç: İnsülin doz aşımı, hipoglisemiye neden olarak yaşamı tehdit eden bir durum olabilir. Nadir de olsa insülin doz aşımı hastanelerde ilaç hatası olarak ortaya çıkabilir. Acil servislerde bu tür olayları önlemek için, ilaçla ilgili hatalar objektif bir şekilde ortaya konulmalı ve akut bakımı olumsuz yönde etkilemeden proaktif stratejiler entegre edilmelidir.

Diffuse large B-cell lymphoma (DBCL) is the largest subgroup of non-Hodgkin's lymphomas. Primary dural lymphoma, primary skull vault lymphoma, and primary sternum lymphoma are the rare lymphomas. We present the case of a 69-year-old patient with scalp, skull, and dura involvement that accompanying sternum involvement. It should be kept in mind that in the differential diagnosis of high-grade diffuse large B-cell lymphoma in patients presenting with a mass in the skull or sternum.

Background: Traumatic brain injuries (TBIs) are serious morbidity and mortality risk for especially in the young population. Primary and secondary injury mechanisms may cause cerebral edema and intracranial hypertension. The target point of the TBI treatment is lowering the intracranial pressure medically or surgically if indicated. Methods: The files of the patients with severe brain injury admitted between January 2015 and December 2017 were reviewed retrospectively. Patients who underwent decompression surgery due to severe brain injury ([The Glasgow Coma Scale [GCS] score]

Background and aim Carbon monoxide poisoning is a toxicological emergency that causes neurological complications. High serum neurogranin can be detected in acute or chronic conditions where brain tissue is damaged. This study aimed to investigate the diagnostic value of serum neurogranin level and its role in demonstrating neurological damage in patients admitted to the emergency department with carbon monoxide poisoning. Materials and methods The study was conducted prospectively on patients with carbon monoxide poisoning (patient group) and healthy volunteers (control group). Demographic characteristics and serum neurogranin level of all participants and symptoms at admission, neurological examination findings, laboratory results, and Diffusion-Weighted Magnetic Resonance Imaging results of the patient group were recorded. We used an independent sample t-test to compare neurogranin levels and bivariate correlation analysis to compare the relationship between serum neurogranin levels and data belonging to the patient group. Results Sixty eight participants (patient group, n = 36; control group, n = 32) were included in the study. Serum neurogranin level was significantly higher in patients with carbon monoxide poisoning (0.31 ± 0.16 ng/ml) compared to control group (0.22 ± 0.10 ng/ml) (p = 0.015). The mean Glasgow Coma Scale of the patients with carbon monoxide poisoning was 14.59 ± 0.23, and of Diffusion Weighted Magnetic Resonance Imaging results were completely normal in 94.4% (n = 34). There was no correlation between serum neurogranin level and Diffusion Weighted Magnetic Resonance Imaging results (r = −0.011; p = 0.953). Conclusion Serum neurogranin level may be a new diagnostic biomarker in patients admitted to the emergency department with carbon monoxide poisoning. The high serum neurogranin levels detected in patients with normal diffusion-weighted imaging after carbon monoxide poisoning suggest that there is neurological damage in these patients, even if imaging methods cannot detect it.

Objectives: Insertion of a temporary transvenous pacemaker (TTPM) is one of the life-saving interventions performed in the emergency department (ED). The aim of the study was to determine demographic, clinical characteristics, and in-hospital outcomes of patients who underwent TTPM insertion due to hemodynamically unstable bradyarrhythmia in the ED. Methods: In our study, 234 consecutive patients who underwent TTPM insertion at the bedside in the ED between January 2014 and October 2019 were included in the study. Etiological characteristics, electrocardiographic (ECG) findings, requirements for permanent pacemaker (PPM), and in-hospital mortality of the patients were analyzed retrospectively. Results: Extrinsic causes were the most common etiology of unstable bradyarrhythmia (57.6%). Most extrinsic causes were drug therapy-related factors (60.7%). Bradyarrhythmia persisted in 60% of patients after extrinsic causes were eliminated. The most common ECG finding was a high-degree atrioventricular block (62%). PPM was implanted in 44% of patients. In-hospital mortality rate was 19.7%. In the multivariate regression analysis, the left ventricular ejection fraction (LVEF) and diastolic blood pressure (DBP) measured at admission (p

WOS:000582143700006 PubMed: 32856885 Background: Considering the critical role of early diagnosis and management of acute ischemic stroke, biomarkers that can reliable assist in the diagnosis are still needed. These biomarkers should rapidly analyze, have high specificity for brain damage, and be available in the emergency settings for early diagnosis and exclusion of other conditions that mimic acute ischemic stroke. Soluble tumor necrosis factor-like weak inducer of apoptosis, a protein involved in the regulation of several biological functions, could be a potential acute ischemic stroke biomarker. Aims: To investigate the diagnostic value of soluble tumor necrosis factor-like weak inducer of apoptosis in patients with acute ischemic stroke and examine the relationship between ischemic area volume determined at diffusion-weighted magnetic resonance imaging and soluble tumor necrosis factor-like weak inducer of apoptosis. Study Design: A prospective, case-control study. Methods: This case-control prospective study included 36 patients with acute ischemic stroke and 36 healthy volunteers. Information on age, sex, presence of chronic disease, neurological examination findings, times of presentation to the emergency department after acute ischemic stroke, soluble tumor necrosis factor-like weak inducer of apoptosis levels, ischemic area volumes at diffusion-weighted magnetic resonance imaging, and 6-month mortality rates after stroke were recorded. The results were analyzed on SPSS 22.0 software (SPSS Inc., Chicago, IL, USA), and p

OBJECTIVES/HYPOTHESIS The aims of this study were to evaluate the diagnostic test features of bedside ultrasonography in pediatric patients with nasal trauma and to investigate whether it is a preferable alternative method to conventional radiography (CR). STUDY DESIGN Cross-sectional prospective study. METHODS This prospective study was conducted from March 1, 2019, through November 1, 2019. Thirty-one patients under the age of 18 years who had nasal trauma were consecutively included. CR and ultrasonographic imaging tests were investigated in patients with clinical indications for nasal bone fracture. The sensitivity, specificity, and accuracy of ultrasonography and CR were calculated with respect to detecting nasal fractures according to the gold standard method. RESULTS Participants were between 3 and 16 years old and the median age was 8 (5-13) years. Nasal bone fracture was clinically detected in 18 patients. While 13 of these fractures were detected with ultrasonography, only 11 were also detected with CR. The sensitivity and specificity of ultrasonography and CR in detecting nasal fractures were 72.2% (95% confidence interval [CI]: 46.5-90.3) and 76.9% (95% CI: 46.2-95.0) for ultrasonography and 61.1% (95% CI: 35.8-82.7) and 69.2% (95% CI: 38.6-90.9) for CR. CONCLUSIONS According to the results of this study, ultrasonography may be used with confidence as a first imaging method in the investigation of nasal fractures, particularly with consideration for avoiding the effects of radiation as much as possible. Our findings point to the next step of conducting trials with a greater number of patients in order to define the diagnostic test features of ultrasonography in pediatric patients. LEVEL OF EVIDENCE 2 Laryngoscope, 131:1398-1403, 2021.

Introduction: Spinal angiolipoma is a rare clinical entity and usually presents with clinical signs and symptoms of spinal cord compression. It has two types; non-infiltrating and infiltrating. It is more common in females at the ages of 40-50 and at the mid-thoracic levels. Case report: We discussed an incidentally diagnosed non-infiltrating angiolipoma in the lower thoracic spine level in a 33-year-old female patient who presented to the emergency department with severe low back pain after trauma in this case report. Conclusion: Spinal angiolipoma should not be forgotten in the differential diagnoses of the patients presenting with severe back pain after trauma.

Amaç: Bu çalışmanın konusu karbon monoksit (CO) zehirlenmelerinde,başvuru anındaki laktat düzeylerinin ölçülmesi ve 6 saat sonra alınan laktatdüzeylerine göre laktat klirens hızına bakarak tedavide metabolik cevabıdeğerlendirilmesindeki kullanılabilirliğini belirlemektir.Gereç ve Yöntemler: Ankara Eğitim ve Araştırma Hastanesi Acil servise, Kasım 2010-Şubat 2011 tarihleri arası CO zehirlenmesi nedeniyle başvuran 18 yaş üstühastalar dâhil edildi. Geliş laktatı (laktat 1) ve 6. saatteki laktat (laktat2) sonuçlarından laktat klirensi hesaplandı. Laktat> 1.7 mmol/lt ve üzeripozitif kabul edildi.Bulgular: Çalışmaya 100 hasta dâhil edilmiştir. Hastaların %62'sikadın, %38'i erkektir. Hastaların %94’ünde hastaneye başvuru anlarındaki laktatoranları yüksekti. Hastaların laktat düzeyleri ile CO seviyelerinebakıldığında, laktat düzeyi yüksek olan grupta, normal olan gruba göre COdüzeyi anlamlı olarak daha büyüktü. Standart oksijen tedavisi alan gruptalaktat klirensi %52 iken hiperbarik alan grupta %64 idi ve bu durum hiperbarikoksijen tedavisi alan grupta laktatın ortadan kaldırılması daha hızlı olduğunugöstermektedir.Sonuç: Bizim çalışmamıza göre CO zehirlenmelerinde laktatyükselmektedir ve düzeyleri karboksi hemoglobin (COHb) düzeyleri ile koreledir.Tedavi etkinliğini değerlendirmede laktatklirens hızı kullanılabilir. Özelliklebelirgin laktat yüksekliği ve metabolikasidozu olan hastalar erken dönemdehiperbarik oksijen tedavisine gönderilmelidir., Objective: This study aims to determine the feasibility of usingthe rate of lactate clearance to evaluate the metabolic response to treatmentin patients with carbon monoxide (CO) poisoning after their lactate levels weremeasured on initial presentation to the emergency department (ED).Material and Methods: Patients older than 18, who presented with COpoisoning to the ED of Ankara Training and Research Hospitalbetween November 2010 and February 2011 were enrolled in the study. Lactatelevels upon admission (Lactate-1) and after 6 hours of treatment (Lactate-2)were compared to calculate the lactate clearance rate. Lactate levels of 1.7mmol/l or greater were considered as positive.Results: A total of 100 patients were enrolled in the study (62females and 38 males). We found that 94% of patients had elevated lactatelevels on admission to the ED. When lactate levels and CO values were compared,the CO values were found to be significantly higher in the elevated lactatelevel group compared to non-elevated patients. The rate of lactate clearancewas 52% in the standard oxygen therapy group compared to 64% in the hyperbaricoxygen therapy (HOT) group, which suggests a faster removal of lactate withthis treatment modality.Conclusion: We conclude that lactate levels increase in patientswith CO poisoning, and that those levels are correlated with carboxyhemoglobin(COHb) levels. The rate of lactate clearance can be used to evaluate theeffectiveness of therapy. Patients with metabolic acidosis and significantlyincreased lactate should be referred for HOT in early phases of management.

Emergency department (ED) consultation is an important part of acute patient care and one of the major determinants of ED length of stay (LOS). ED consultations between physicians who may not be in the same location frequently, require a tool to reach out one another and communicate. This paper reviews the historical change and development of consultation tools. The literature on ED consultation methods have been accumulating for the last two decades as the diversity of these methods has increased with technology. Most of the studies demonstrate that high tech systems are useful and safe to reach the consultant and share medical information flow. Moreover, t he future of the area offers new developments regarding consultation tools that are hard to imagine yet like augmented reality.

Cannabis – the most commonly used illegal drug – also has some medical applications. Cannabis is being legalised more and more in the Western world, however it is not a safe substance as many people think. It can cause detrimental acute and chronic lung injuries such as bullous lung disease, chronic bronchitis, chronic obstructive pulmonary disease, pneumothorax, pneumomediastinum, pulmonary emphysema. A clear mechanism for acute pulmonary pathologies has not been established, but pneumothorax and/or pneumomediastinum can be considered as a typical presentation in cannabis users. We present a cannabis user case with simultaneous pneumomediastinum and bilateral spontaneous pneumothorax.

Epiploik apendiks kolonun çoğunu kaplayan omental uzantılardır. Patolojik değişikliklerin çoğu spontan torsiyon veya venöz tromboz sonrası oluşan enflamasyon ile ilişkilidir ve primer epiploik apandajit olarak adlandırılır. Nispeten nadir görülen bu intra-abdominal patoloji için herhangi bir patognomonik semptom, bulgu veya laboratuvar testi yoktur. Sağ veya sol alt kadranda akut başlangıçlı lokalize karın ağrısı olan non-toksik görünümdeki hasta tipik prezentasyondur. İntra-abdominal patolojilerin ayırıcı tanısında primer epiploik apandajit farkındalığı ile ultrason ve tomografi gibi görüntüleme çalışmaları doğru tanı koymada anahtar role sahiptir. Konservatif tedavi çoğu durumda yeterli olduğundan doğru ve zamanında tanı ile uygun hasta yönetimi sağlanıp gereksiz hastane yatışları ve girişimler önlenebilir., Epiploic appendices are extensions of omentum which covers most of the colon. Most of the pathologic changes are related with spontaneous torsion or venous thrombosis culminating with inflammation and is referred as primary epiploic appendagitis (PEA). There is no pathognomonic symptom, finding or laboratory test for this relatively rare intra-abdominal inflammation. A non-toxic patient with acute onset localized abdominal pain in the right or left lower quadrant is the typical presentation. Imaging studies such as ultrasound and tomography with the awareness of PEA in differential diagnoses of intra-abdominal pathologies are the key to correct diagnosis. Since the conservative treatment is sufficient in most of cases, accurate and timely diagnosis can ensure the appropriate patient management and can prevent unnecessary hospitalizations and interventions.

Introduction: Methyl alcohol (methanol) is an industrial solvent and toxic liquid used in such as anti-freezes, paint removers, cologne, perfumes and defroster and also it is the most used denaturant in spirits (methylated spirits) to make it unconsumable. Even oral route seems to be the only way for poisoning, in rare cases inhalation and transdermal routes are possible. We present a case report with transdermal exposure applied according to the folk remedial use of methylated spirit for analgesic effects. Case Report: A thirty-four year old woman was brought to the emergency department by her relatives with extreme fatigue, vomitting, difficulty in walking and sitting, rapid breathing and also confusion. Her laboratory tests suggested deep metobolic acidosis with high anyon gap. She was admitted to intensive care unit and received hemodialysis. After her treatment, she was fully recovered without any vision defisit. Conclusion: Prompt diagnosis and treatment are the keys to avoid sequels and deaths due to methanol intoxications by all routes. At least to avoid potential sources, harmful folk medicine applications are should be defined clearly and society-based measurements should be implemented.

Apendiksin mukoseli, apendiks lümeninin anormal müsinöz sekresyonu sebebiyle dilatasyonu ile karakterize nadir görülen klinik bir durumdur. İnflamatuar bir duruma veya tümör kaynaklı olabilir. Mukosel, mukozal hiperplazi, müsinöz kistadenom veya müsinöz kistadenokarsinom sonucunda oluşabilir. Apendiks müsinöz kistadenomu en sık görülen şekli olup çok farklı klinik durumlarla kendini belli eder. Apendektomi spesimenlerinin %0.2?0.3’ünde saptanır. Preoperatif tanı konması zordur ve sıklıkla laparotomide saptanır. Rüptür riski, klinik olarak cerrahları zorlamaktadır. Cerrahi planlanmasında tam bir konsensus olmamakla birlikte genellikle apendektomi ya da sağ hemikolektomi ameliyatları uygulanır. Bu yazımızda plastron apendisit tanısıyla takip edilip sağ alt kadran ağrısı ve kitle saptanan apendiks mukosel olgusunu literatür eşliğinde tartıştık. Appendiceal mucocele is a rare clinical condition characterized by dilatation of the appendix lumen due to abnormal mucin secretion. It may be due to inflammatory conditions or neoplastic lesions. Mucocele may occur as a result of mucosal hyperplasia, mucinous cystadenoma or mucinous cystadenocarcinoma histopathologically. Mucinous cystadenoma is the most common form and it manifests itself as many different clinical pictures. It is detected in 0.2?0.3%of appendectomy specimens. As preoperative diagnosis is often difficult, it is generally detected during laparotomy. Appendiceal mucocele is a clinical challenge for surgeons due to its risks of perforation and dissemination. Although there is no consensus for type of surgical treatment, appendectomy or right hemicolectomy are usually prefered. Herein, we present an appendiceal mucocele cystadenoma case with right lower quadrant pain and palpable mass who was followed up with the pre-diagnosis of plastron appendicitis in the context of the literature.

Colonic diverticula and related complications are common pathologies in elderly patients. In older patients, colonic diverticulum perforation is more common in the sigmoid colon, whereas right colon diverticulum perforation is rather rare. In younger patients, especially in patients under 30 years of age, right colon diverticula are more common than left colonic diverticula. Therefore, right colon diverticulum perforation should be considered in patients with acute abdomen in this age group. In this case, right column diverticulum perforation is presented in a patient with acute abdomen findings.

Amac: Cocuk istismari ve ihmali, karmasik nedenleri ve trajik sonuclari sebebiyle tibbi, yasal, gelisimsel ve psikososyal bir halk sagligi sorunudur. Toplum icindeki gercek insidansi tam olarak bilinmemektedir. Calismamizda acil servislerde calisan hekimler ve yardimci saglik personelinin cocuk istismari ve ihmali hakkinda bilgi duzeylerini olcmeyi; elde edilen sonuclari saglik calisani olmayan kontrol grubuyla karsilastirmayi amacladik. Gerec ve Yontemler: Calismamiza Ankara Ilindeki Egitim Arastirma, Universite ve Devlet hastanelerinde calisan acil doktorlari, pediatri hekimleri ve diger saglik calisanlarindan olusan 400 kisilik bir calisma grubu ve 105 katilimcidan olusan kontrol grubu dahil edilerek yapilmistir. Katilimcilara hem demografik sorulardan olusan hem de cocuk istismari ve ihmali konusunda genel olarak inanilan mitleri iceren birer anket uygulanmistir. Bulgular: Demografik sorular ve mitler iceren ankette, doktorlar ve yardimci saglik calisanlarinin calistiklari kurumlarin mitlere bakis acisini etkiledigi, deneyim suresinin saglik calisanlari icin bir degisken oldugu, cocuk istismari konusunda egitim almis olmanin belirleyici oldugu fakat cocuk sahibi olmanin cevaplardaki dogrulugu anlamli sekilde etkilemedigi tespit edilmistir (p>0,05). Kontrol grubunun basari oranlari her mit icin yardimci saglik personeli ile benzerlik gostermistir (p> 0,05). Ancak kontrol grubunun 7, 18, 19, 22, 25, 27, 30 ve 35 numarali mitlerde doktorlara gore dusuk dogruluk oranlari tespit edilmistir. Sonuclar: Acil servislerinde ve cogunlukla cocuk yas grubunun bakildigi pediatrik acil servislerinde calisan tum saglik calisanlarinin cocuk istismari ve ihmaline dair belirti ve bulgularini bilmeleri gerekmektedir. Ayrica yasal birimlere bildirmeye yonelik sorumluluklari mevcuttur. Bu konudaki mitleri curutmeye yonelik duzenli egitim programlari hem saglik sisteminde hem de toplum duzeyinde uygulanmalidir.

Imbalance between antioxidant and oxidant systems in the body play an important role in the pathogenesis of coronary atherosclerosis and its complications. The aim of this clinical study was to investigate total serum thiol (TS-H) levels in patients with non ST Elevation Acute Coronary Syndrome (NSTE-ACS) patients and relationships between these results and cardiac markers. This study included 55 patients and a control group consisted of 50 healthy people. Samples for serum total TS-H levels were obtained from the patients considered with NSTE-ACS at the time of admission to emergency department. The patient group was divided into two subgroups according to troponin levels; that is patients with positive troponin levels in the non-ST-elevation myocardial infarction (NSTEMI) group and, and patients with negative troponin levels in the unstable angina pectoris (USAP) group. SPSS for Windows Ver. 15.0 software packages were used for statistical analysis of data in patient and control groups. The patients group included a total of 55 patients with 40 men (72.7%) and 15 women (27.3%) and the control group included 50 healthy individuals people with 28 men (56%) and 22 women (44%). Total serum TS-H values were significantly lower in patients group when compared with the control group. Serum total TS-H values were significantly lower in USAP subgroup when compared with patients with NSTEMI. In addition, negative correlations between total serum TS-H values and troponin I and CK-MB were found. According to this study, total serum levels of thiol which is antioxidant marker TS-H may be useful as a confirming test in diagnosis of patients with NSTE-ACS and in differentiating patients with NSTEMI and USAP. J. Exp. Clin. Med., 2013; 30:295-299

Doğada sayısız çeşitte bitki bulunmaktadır. Bu bitkilerin bir kısmının insan hayatını tehdit edici özelliklere sahip olduğu bilinmekteyken, bir kısmının ise çiğnenerek, yutularak, içilerek, tüttürülerek veya sürülerek kullanılmasının bazı hastalıkları tedavi ettiğine inanılmaktadır. Çok eski zamanlardan beri devam eden bitkilerle tedavi etme alışkanlığı, bugün internet gibi kullanım ve ulaşım sahası sınırsız olan bir dünyada, her an gözümüze çarpmakta ve daha düne kadar halk arasında “kocakarı ilacı” olarak tarif edilen birtakım bitkiler, bilimsel formüllerle insanlara sunulmaktadır. Bitkisel tedavi kürü olarak sunulan bu formüller, hayatı tehdit edici zehirlenmelere neden olabilir. Bu yazıda internetten edinilen bir tarif sonrası, hemoroid tedavisi için kullanılan Datura Stramonium bitkisine bağlı zehirlenme olgusunun sunulması amaçlanmıştır. There are numerous kinds of plants in the world. While it is known that some of these plants have features that threaten human life, it is also believed that chewing, swallowing, drinking, smoking or driving some plants can treat some diseases. There is a habit of treatment with plants that have been going on since ancient times. Today, in the unlimited world of the internet, there are numbers of plants which are described as nostrum and are presented to people with scientific formulas. These formulas, which are offered as a herbal cure, can cause life-threatening poisoning. In this article, we aimed to present a case of poisoning due to Datura stramonium plant used for hemorrhoid treatment after a prescription obtained from internet.

acquired diaphragmatic rupture is often associated with trauma, rarely it may be spontaneous (atraumatic). Spontaneous diaphragmatic rup- ture is one of the rarest thoracoabdominal emergencies, and is harder to de- tect in patients without visceral damage. Diagnosis may be delayed by several months or even years. A sceptical approach, combined with thorough physi- cal examination and the correct interpretation of the chest X-ray, are very im- portant in diagnosis. In this report we present a patient who was admitted to the emergency department with stomach pain, nausea, vomiting and hic- cups lasting for 3 days, and was diagnosed with spontaneous diaphragmatic rupture. The patient was treated with thoracotomy, and the defect was re- paired primarily. (JAEM 2013 doi:10.5152/jaem.2013.024)

BACKGROUND: In this intervention study which competency based training approach was used, it was aimed to determine behaviors of 6-14 years of age children about hand hygiene and to change their hand-washing skills in the “positive” way after the training. METHODS: Ninety children participated in the study (participation rate= %88.2). A standard check-list was used for both training and evaluation of the behaviors. The data were processed and statistically analyzed with the SPSS for Windows 15.0 software. Mc Nemar and chi square tests were used for analysis of the data. RESULTS: Mean age of the children was found to be 9.76±2.02. Fifty six point seven percent of the participants were females and 43.3% of them were males. Nine out of ten steps of the “hand washing check-list” was found higher in percentage among participants in the post-training evaluation compared to the pre-training assessment (p

Introduction and Aim Being one of the major problems in the world and in Turkey, traffic accidents require being accurately examined and solved . The purpose of this study is to reveal the effects of blood alcohol level on the severity of injury and death as a result of motor vehicle accident traumas and to review and command on the social importance of this issue.Materials and Methods Four hundred forty-five patients who were admitted to Ataturk Training and Research Hospital Emergency Department between January 2010 and December 2011, after motor vehicle accidents are enrolled in the study. Patients’ ages, gender, blood alcohol levels and vehicle types were recorded retrospectively. Abbreviated Injury Score (AIS) and Injury Severity Score (ISS) were detected for each patient according to trauma regions and severity. The patients were divided into two groups according to the blood alcohol levels (

Giriş: Acilservise şiddete maruz kalma nedeni ile başvuran kadınların ve şiddetuygulayıcılarının sosyo-demografik özelliklerini, şiddetin türü, sıklığı veşeklini belirlemek ve tedavi masraflarının yaklaşık maliyetini hesaplamaktır.Gereç veYöntem: Bu çalışma 01.11.2012-01.06.2013 tarihleri arasında Ankara Eğitim ve Araştırma Hastanesi Acil TıpKliniğine şiddete maruz kalma beyanı ile başvuran tüm kadınların dahil edildiğiprospektif bir çalışmadır. Bu çalışmada şiddet mağduru ve şiddetuygulayıcılarının sosyodemografik özellikleri, şiddetin türü, sıklığı, şekli vehastane maliyeti arasındaki ilişki Pearson ki-kare testi ve Fisher’in kesintesti kullanılarak araştırıldı.Bulgular: Altı aylık süre içerisinde darp nedeni ile acilservisimize başvuran toplam 656 kadın hastanın 303’ü çalışmaya dahiledilmiştir. Yaş ortalamaları 32.87±11.38 olup, minimum yaş 18, maksimum yaş92’dir. Evli (%79.2), çocuklu (%75.9). gelir getiren bir işte çalışmayan (%71)ve öğrenim durumu ortaokul ve altı (%67) olan kadınların şiddete daha çok maruzkaldığı tespit edilmiştir. Partneriyle birlikte yaşayan kadınlar evli kadınlaragöre daha sık cinsel şiddet görmektedir (p, Introduction: The aim of this study is to identify thesocio-demographic data of women who have been subjected to violence andperpetrators of this violence, to define the type, frequency, and form of theviolence and to calculate the hospital costs.Material andMethods: Thisstudy was a prospective clinical study conducted in the adult EmergencyDepartment (ED) of an urban tertiary care training and research hospitalbetween November 2012 and June 2013. In this study we evaluated; thesocio-demographic characteristics of victims and perpetrators of violence, the frequency, the type, the way of the violence andthe cost of hospitalization to demonstrate relationship by using the Fisherexact test and Pearson chi-square test.Results: Total of 656 female patients admitted to the ED becauseof a physical assault and 303 were included in the study. The mean age of thepatients was 32.87±11.38 (min 18, max 92). It was identified that married women(79.2%), women with children (75.9%), women who have no income, and women at orbelow secondary school education level were exposed to violence more likely.Women living with their partners were subjected to sexual violencestatistically significant (p

A 39-year-old male patient was admitted to the emergency department with the complaints of difficulty swallowing, a sensation of something “stuck” in his throat and a swollen uvula that he had seen in the mirror while brushing his teeth. His complaints had started 1 day before with sore throat as well as difficulty and pain when eating and drinking. He denied any fever, cough or breathing difficulties. His vital signs were stabile with blood pressure 120/70 mmHg, heart rate 86/min, respiration rate 12/min and body temperature 36.6°C. On physical examination, his lung sounds were normal. No lymphadenopathy was noted, but his uvula was erythematous and edematous (Fig. 1). No tonsillar hypertrophy was seen. His laboratory tests showed no significant results; there was no leukocytosis or any alterations in the neutrophil, basophil or eosinophil counts. The postero-anterior chest x-ray was normal. A bedside nasopharyngeal scope revealed a normal epiglottis and vocal cords, with significant uvular edema. He had no medical history of trauma, known food or drug allergy, asthma or frequently repeating infections. The only remarkable point in his medical history was that 1 week before he had been prescribed oral pinaverium bromide 50 mg (Dicetel®) for irritable bowel syndrome. He was treated with intravenous pheniramine hydrogen maleate (Avil®) and dexamethasone (Dekort®) in the emergency department and prescribed oral antihistaminic tablets for the next 48 h. Fig. 1 Oropharyngeal examination of a 39-year-old patient: isolated uvular angioedema (the patient's consent was obtained for the photograph) Isolated uvular angioedema was first defined by Quincke in 1882 [1]. Isolated uvular angioedema, or Quincke's disease, is a relatively rare presentation of angioedema of the upper airway [2]. Several causes of uvular edema have been described, including hereditary angioedema, trauma, inhalation exposure, medication reactions and infectious causes [3, 4]. Isolated uvular angioedema is usually caused by a type I hypersensitivity reaction [2, 3]. This should be differentiated from uvulitis, which is infectious and frequently has concomitant epiglottitis. Direct visualization or a lateral neck plain radiograph should be considered to help rule out epiglottitis [3, 5]. In this situation, the primary strategy should invovle maintaining the airway. In spite of being a rare condition, uvular edema may cause obstructive respiratory distress and require immediate airway care. The general treatment strategies in the emergency department consist of intravenous H1 and H2 histamine blockers, corticosteroids and infrequently epinephrine [2]. Dexamethasone has been considered the medication of choice considering its potent anti-inflammatory properties and long half-life.