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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.

Aim:To evaluate subclinical inflammatory markers in hyperemesis gravidarum (HEG) cases and to determine the relationship of these markers with the gestational age at delivery and birth weight in pregnant women with HEG.Methods:Fifty-two patients who presented to our hospital between 1 May 2017 and 1 September 2019 with HEG and 60 pregnant women as the control group were included in this retrospectively designed study. The relationship of subclinical inflammatory markers such as the neutrophil-to-lymphocyte ratio (NLR), the platelet-to-lymphocyte ratio (PLR), the lymphocyte-to-monocyte ratio (LMR) with HEG, and their relationship with birth week and birth weight in HEG cases were examined.Results:In HEG cases, NLR and PLR values were higher (p=0.006 and p=0.004, respectively), whereas LMR values were lower (p

The purpose of the study is to evaluate sleep disorders in dysmenorrhea patients and investigate the relationship between sleep disorders and anxiety and depression levels in these patients. This cross-sectional study included 55 primary dysmenorrhea patients who were admitted to the emergency department as well as 47 healthy control subjects. All participants were assessed using Beck Depression Inventory, Beck Anxiety Inventory, Epworth Sleepiness Scale (ESS), Berlin Questionnaire, Insomnia Severity Index (ISI), and Pittsburgh Sleep Quality Index (PSQI). Presence of restless legs syndrome (RLS) was evaluated according to International Restless Legs Syndrome Study Group criteria. Primary dysmenorrhea patients had significantly higher ISI, PSQI overall and ESS scores compared to the control group (p = 0.009, p

INTRODUCTION: The main factors in the development of ST-segment elevation myocardial infarction (STEMI) are inflammatory processes and pathophysiological changes due to oxidant stress. The aim of this study is to evaluate the association of prevalent STEMI with markers of inflammatory and oxidative stress. The platelet to monocyte ratio (PMR) was evaluated as a new hematological inflammatory marker. MATERIAL AND METHODS: The study is a retrospective observational study conducted in the emergency department between January 2018 and January 2019. In the study, all patients who were diagnosed with STEMI were considered in the study group. Evaluations of inflammatory and oxidant stress markers, PMR value of STEMI patients were performed. RESULTS: Neutrophil to lymphocyte ratio (NLR) value of 5.63 (3.35–7.84), Monocyte count to high-density lipoprotein cholesterol ratio (MHR) value of 16.10 (12.73–19.52), gamma-glutamyl transferase (GGT) value of 31.00 (21–39) and CRP value of 5.10 (2.77–9.34) were significantly higher in STEMI cases (p < 0.005). The lymphocyte to monocyte ratio (LMR) value of 2.57 (2.00–3.61) and the PMR value of 24.52 ± 7.60 in STEMI cases were significantly lower (p < 0.001, p = 0.014). CONCLUSIONS: In STEMI patients NLR, GGT, and MHR rates increase significantly and LMR decreases. PMR values were also lower in STEMI cases. This shows us that PMR is a new determinant that can be used in inflammatory events. However, none of these inflammatory markers and oxidant stress markers can be used as diagnostic tests, rather they should be considered as surrogate markers for disease.

COPD with the development of inflammation in the alveoli as a result of exposure of harmful gases to the bronchi and bronchioles in the lungs, irreversible airflow restriction and respiratory symptoms occur. In our study;It is aimed to evaluate the serum D vitamin level in COPD patients with acute respiratory failure and to investigate the effect of vitamin D in COPD stages. This study is a prospective cross-sectional study. The study was conducted with a total of 75 COPD patient groups and 65 control groups. GOLD score, CAT score and Mmrc score were used in the study. Kruskal-Wallis H test and Mann-Whitney U test were used for statistical analysis.The results were evaluated in terms of 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.

After blunt chest trauma, life-threatening arrhythmias may occur in the early post-injury period, as well as a few days after the injury. This study aimed to evaluate the risk of arrhythmias in blunt chest trauma patients using Tp-e interval, Tp-e/QT ratio and Tp-e/QTc ratio.In this study, patients who applied to the emergency department due to blunt chest trauma were examined prospectively. The 12-lead ECG was performed to both blunt chest trauma and control group. ECG measurements of QT and Tp-e intervals were performed from both groups.A total of 81 participants; 41 blunt chest trauma patients and 40 healthy volunteers were included in this study. Tpe, Tpe/QT, Tpe/QTc values were statistically significant in the trauma group compared to the control group (p0.001). Although Tpe/QTc, max QT and min QT were statistically significant (p0.05) in patients with a rib fracture, no difference was detected concerning Tpe, Tpe/QT compared to no-rib fracture group (p0.05).Tp-e interval, Tp-e/QT ratio and Tp-e/QTc ratio in ECG predict the arrhythmias that may occur in blunt cardiac trauma, especially in blunt chest trauma patients.

Objective: This study aims to investigate the relationship between work-related stress and sleep disorders in healthcare personnel working in emergency department and in other departments. Material and Methods: This cross-sectional study included 34 emergency department healthcare personnel (emergency group [EG]) and 35 healthcare personnel working in other departments (non-emergency group [NEG]) and was conducted between November 10, 2019 and March 1, 2020. All participants were administered the following questionnaires: work-related strain inventory (WRSI), Epworth sleepiness scale (ESS), Berlin questionnaire, insomnia severity index (ISI), Pittsburgh sleep quality index (PSQI), Beck depression inventory (BDI), and Beck anxiety inventory (BAI). Results: While the mean WRSI score of EG was 39.53±7.77, the mean WRSI score of NEG was 30.06±7.26 (t=5.236, p

Aim:Among cardiovascular diseases, pulmonary embolism (PE) is a serious emergency with high mortality. Right ventricular dysfunction due to an excessive increase in pulmonary artery pressure is considered a major cause of death in vigorous PE. We aimed to assess the predictive value of computed tomographic pulmonary angiography (CTPA)-based morphometric measurements of right heart function in the diagnosis of PE.Materials and Methods:This is a retrospective, case-controlled study. A total of 198 cases were included in the study during the study phase. CTPA results of 102 patients with PE were recorded, and the patients were grouped according to clot localisation. The diameters of the inferior vena cava (IVCA), aorta, pulmonary artery and right and left ventricles were assessed.Results:IVCA area/aortic area significantly predicted embolism in the main pulmonary artery [area under the curve (AUC)=0.957, p

Kounis Syndrome is the development of acute coronary syndrome (ACS) because of allergic reactions; allergens, such as foods, insect venom, iodine contrast agent or drugs can cause this syndrome. Hirudotherapy (leech therapy) is increasingly used as a useful therapeutic option in a variety of medical and surgical procedures, and potential complications related to this therapy include Aeromonas species infections, bleeding, anemia and allergic reactions. Here, we present a patient diagnosed as Type 1 Kounis Syndrome after using hirudotherapy for her knee aches. 41-year-old woman admitted to emergency department with sudden onset of face edema, shortness of breath and chest pain complaints and diagnosed as an allergic reaction and anaphylaxis due to leech therapy. Kounis Syndrome should be considered in acute coronary syndrome patients who were admitted to emergency department with anaphylaxis clinic. Keywords: Acute coronary syndrome, Emergency medicine, Leech therapy

Özet Akut interhemisferik subdural hematom akut subdural hematomun nadir görülen bir tipi olup genellikle kafa travmasından sonra ortaya çıkmaktadır. Bu hematomda görülen klinik belirti ve bulgular arasında baş ağrısı, bulantı kusma, nöbet, demans, görme bozukluğu, monoparezi, ve hemiparezi bildirilmiştir. Bu yazıda bunalma ve terleme hissi gibi atipik şikayetlerle başvuran 54 yaşındaki bir erkek hastada saptanan interhemisferik subdural hematom olgusunu sunulmaktadır. Hasta sadece klinik gözlem ile takip edilmiş olup 10 gün sonra hematomum tamamıyla rezorbe olduğu görülmüştür. Sonuç olarak, interhemisferik subdural hematomda vital bulguların ve nörolojik durumun stabil seyretmesi durumunda sadece izlem yeterli olabilmektedir.

Background: ONSD (optic nerve sheath diameter) is a method used for indirect measurement of the increased intracranial pressure. In previous studies, the relation between the increased intracranial pressure and ONSD was analyzed in the patients suffering from cerebrovascular diseases (CVD). In our study, the patients suffering from ischemic CVD were categorized into 4 subgroups according to Oxfordshire Community Stroke Project classification (OCSP); the relationship between each group and ONSD, and the influence on each eye were analyzed.& para;& para; Methods: The study included the patients over the age of 18 applying to the emergency department of Malatya State Hospital with the symptoms of stroke between the dates of 1/1/2015 and 1/9/2016 . The patients diagnosed with stroke by means of clinical and neuroradiological imaging were examined in 4 subgroups according to Oxfordshire Community Stroke Project, The aim of the study is to predict the intracranial pressure (ICP) levels of the patients through ONSD measurement and CT images.& para;& para; Results: In the comparison of The right and left optic nerve sheath diameters of CVD group and control group, the obtained results were found to be statistically significant (p < 0.001). When the CVD subgroups were compared with the control group in terms of right and left optic nerve sheath diameters, the highest right-left optic nerve sheath diameter was detected to be in TACI (Total Anterior Circulation Infarction) group (p < 0.001).& para;& para; Discussion/conclusion: In the early cases of CVD, mortality and morbidity can be decreased through the early diagnosis of the possible existence of ICP increase according to ONSD level. (C) 2017 Elsevier Inc. All rights reserved.

Unilateral hyperlucent lung was firstly described by Swyer and James 1950s. After that, some patients with same disease were detected by Macleod . Then this syndrome was named as Swyer- James-Macleod syndrome (SJMS), and this syndrome includes a smaller or normal sized unilateral hyperlucent lung. The diagnosis of SJMS includes a detailed evaluation and the exclusion of other reasons of unilateral hypertranslucency. In literature, small groups of patients with this syndrome have been described. This paper reports a 45-year-old male presented to our emergency department with chest pain after fall from height 24 h ago. In his computed tomography no rib fracture, pneumothorax and hemothorax. But an abnormal image (5.5 cm hyperlucent area) was seen in his left lung. This report aims to present one of incidentally diagnosed rare case of SJMS.