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Aim: Cancer is a systemic disease, and can affect all systems differently at each stage. Cancer patients often admit emergency departments due to acute symptoms directly or indirectly caused by their current malignancies. With this study, the purpose was to investigate the causes of admission and common problems of oncology patients admitting to the emergency department.Method: This study has a cross-sectional and retrospective design. At the end of the evaluation in the emergency department, all cases who were aged 18 and over, who were evaluated based on malignant neoplasm diagnoses according to ICD-10, and recorded in the patient registration computer made up the study sampling. Descriptive statistics were used in the demographic examination of the patients.In the study, in case the data were qualitative, the Chi-Square (χ²) Test or Fisher’s Exact Test were used.Results:A total of 75 patients were included in the study during the specified period, including 43 (58.1%) women and 32 (42.6%) men. The most common complaint was pain with 77% (n=57), followed by shortness of breath with 34.6% (n=26), and %33.3(n=25) nausea and vomiting. In patients, the top 3 most common malignancies were lung 26.7% (n=20), 14.6% (n=11) prostate, and 10.7% (n=8) breast cancer, respectively.Conclusion:In today’s conditions, the quality of life of patients with increased malignancies is reduced because of the cancer disease and treatment protocols. We believe that specific units can be opened in emergency medicine clinics in cooperation with oncology specialists for this patient group in the future because of the discomfort in which the disease is reflected in the body, and due to the side effects that occur during treatment, which will contribute to the determination of special approach policies in emergency department planning., Amaç:Kanser, sistemik bir hastalık olup her evresinde tüm sistemleri farklı şekilde etkileyebilir. Kanserli hastalar mevcut malignitelerinin doğrudan veya dolaylı neden olduğu akut semptomlar nedeniyle sıklıkla acil servise başvurmaktadırlar. Bu çalışma ile acil kliniğine başvuran onkoloji hastalarının başvuru nedenleri ve sık karşılaşılan problemlerinin araştırılması amaçlanmıştır.Yöntem: Bu çalışma kesitsel retrospektif bir çalışmadır. Bu başvurulardan acil servisteki değerlendirme sonunda acil servis tanılarının yanında ICD-10’a göre malign neoplazm tanılarından değerlendirilip, hasta kayıt bilgisayarına kaydedilen 18 yaş ve üzerindeki tüm olgular örneklemi oluşturmaktadır. Hastaların demografik incelemesinde betimleyici istatistlik kullanıldı. Çalışmada verileri değerlendirilirken nitel olması halinde ki-kare( χ² ) testi veya Fisher exact testi uygulandı.Bulgular: Belirtilen dönemde çalışmaya 43’ü (%58.1) kadın, 32’si (%42.6) erkek olmak üzere 75 hasta dahil edildi. En sık rastlanılan şikayet %77( n=57) ağrı şikayeti olup sırası ile %36.5(n=26) nefes darlığı, %35.1(n=25) bulantı-kusma idi. Hastalarda mevcut maligniteler içinde en sık görülen ilk üç kanser sırasıyla akciğer %26.7(n=20), %14.6 (n=11) prostat ve %10.7(n=8) meme kanserleri idi. Sonuç: Günümüz şartlarında artan malignite hastalarının hem kanser hastalığına bağlı hemde tedavi protokollerinden dolayı yaşam kaliteleri düşmektedir. Özellikli bu hasta grubu hem hastalığın vücuda yansıdığı rahatsızlık hem de tedavi esnasında oluşan yan etkilerden dolayı ileri dönemlerde bu özellikli hasta grupları için onkoloji uzmanları ile işbirliği ile acil tıp kliniklerine üniteler açılabileceği ve acil servis planlamalarında özel yaklaşım politikalarının belirlenmesinde katkı sağlayacağı kanısındayız.

İÇİNDEKİLER BÖLÜM 1....................................................................................................................... 5 Slap Lezyonlari Uzm. Dr. Yunus Emre BULUM BÖLÜM 2.................................................................................................................... 23 Kısmi Kalinliktaki (Parsiyel) Rotator Manşet Yırtıkları Tedavisi Uzm. Dr. Yunus Emre BULUM BÖLÜM 3.................................................................................................................... 39 Geriatrik Kalça Kırıklarında Uygulanacak Cerrahide Gecikmenin Mortaliteye Etkisi Dr. Mustafa YALIN BÖLÜM 4.................................................................................................................... 51 Ayak Bileği Burkulmaları Uzm. Dr. Aybars KIVRAK

CONTENTS CHAPTER 1 .................................................................................................................. 7 Examining the Level of Knowledge About Apitherapy and its Uses Dr. İbrahim Hakkı ÇAĞIRAN Prof. Gülçin SAĞDIÇOĞLU CELEP CHAPTER 2 ............................................................................................................... 21 Suicide Among Doctors Assoc. Prof. Mesut YILDIZ CHAPTER 3 ............................................................................................................... 29 Propiıoceptıon in Children Researcher, Dilan DEMIRTAS KARAOBA CHAPTER 4 ............................................................................................................... 47 Infantile Hypertrophic Pyloric Stenosis Mehmet SARIKAYA CHAPTER 5 ............................................................................................................... 57 Current Prospective of Migraine Headache Treatment Asst. Prof. Dr. Yavuz YÜCEL Asst. Dr. Mohamed Sheikh HASSAN CHAPTER 6 ............................................................................................................... 69 Preventing Effects of Moss Extract (Homalothecium Sericeum (Hedw.) Schimp.) and Quercetin on Pancreatic Tissue in Diabetic Rats TONGUC YAYINTAS, O.* OZTURK, S. IRKIN, Latife C. DEMIR, N. CHAPTER 7 ............................................................................................................... 83 Biomarkers From A Clinical And Application Point of View Merve Gulsen BAL ALBAYRAK, PhD 4 CHAPTER 8 ................................................................................................................ 93 Antımıcrobıal and Antibiofilm Activities of Trigonella Monspelıaca L. Assist. Prof. Ş. Selma URAS GÜNGÖR, Ph.D. CHAPTER 9 ............................................................................................................. 105 Natural Source Drug Molecules Targeting Alzheimer’s Disease Assist. Prof. Nigar KANTARCI ÇARŞIBAŞI ............................................... 106 CHAPTER 10 .......................................................................................................... 121 Long Non-Coding Rnas in Human Breast Cancer Assoc. Prof. Ayşe Feyda NURSAL, Ph.D. CHAPTER 11 .......................................................................................................... 131 Covid-19 Infection and Pregnancy ................................................................ 132 Dr. Enes KARAMAN, M.D. Dr. Erol KARAKAŞ, M.D. CHAPTER 12 .......................................................................................................... 151 Pregnancy and Cancer Dr. Erol KARAKAŞ, M.D. Dr. Enes KARAMAN, M.D. CHAPTER 13 .......................................................................................................... 169 The Roles of Current Peptide and Protein-Based Hormones in the Development and Follow-Up of Diabetic Retinopathy Mehmet Kaan KAYA Sermal ARSLAN Suleyman AYDIN CHAPTER 14 .......................................................................................................... 181 Ocular Behçet's Disease and Current Laboratory Markers of Inflammation Sermal ARSLAN Mehmet Kaan KAYA Suleyman AYDIN 5 CHAPTER 15 .......................................................................................................... 191 Common Diabetic Complications and Endocrinal and Plastic Surgical Approaches to These Complications Kader UGUR Erhan Cahit OZCAN Suleyman AYDIN CHAPTER 16 .......................................................................................................... 205 A Brief Historıcal Journey With An Up-To-Date Perspectıve On Cataract Pathophysiology and Surgery Mehmet Kaan KAYA Sermal ARSLAN Suleyman AYDIN CHAPTER 17 .......................................................................................................... 217 The Relationship Between Exercise and Gut Mıcrobiota in Humans Assistant Professor, Ozgenur YILMAZ Research Assistant, Ozan GUR CHAPTER 18 .......................................................................................................... 239 Measurement Tools Used in Dental Implant Assessment ..................... 240 Ass. Prof. Tuğba ŞAHİN CHAPTER 19 .......................................................................................................... 251 Development of Revised Dysmenorrhea Impact Scale Short Form (Disr) Asst. Prof. Dr. Çiğdem GÜN KAKAŞÇI Prof. Nurdan DEMIRCI, Ph.D CHAPTER 20 .......................................................................................................... 281 The Use of Clinical Pathway in Nursing Education and Practice RN, Ph.D. Res. Asst, Dilek ERDEN 6 CHAPTER 21 .......................................................................................................... 289 Skin Tattoos From The Perspective Of Midwifery Nazan TUNA ORAN PhD Elif NACAROĞLU Msc CHAPTER 22 .......................................................................................................... 307 Modeling the Mortality Prediction of Patients With Stemi Undergoing Primary Pci Using Data Mining Prof. Mithat ZEYDAN, Ph.D. Dr. Gülhan TOĞA CHAPTER 23 .......................................................................................................... 343 Linear Iga Dermatosis and Dermatitis Herpetiformis ........................... 344 Dr. Fatih KILIÇ Assist. Prof Dr. Selami Aykut TEMIZ CHAPTER 24 .......................................................................................................... 373 Musculoskeletal Disorders After Traumatic Brai-in Injury Dr. Sedef ERSOY CHAPTER 24 .......................................................................................................... 373 Cancer and MicroRNA: An Overview of Human and Canine Mammary Tumors Öğretim Gör. Melih Sercan USTAOĞLU Prof. Serbülent YİĞİT, Ph.D.

İÇİNDEKİLER Bölüm 1 ......................................................................................................................... 5 Trakeostomi Prof. Dr. Yekta Altemur Karamustafaoğlu Bölüm 2 ...................................................................................................................... 23 Temel Yaşam Desteği R. Nil KIRŞAN Bölüm 3 ...................................................................................................................... 33 Acil Hemşirelerinin Adli Vakalarda Delil Koruma Yaklaşimları ve Yasal Sorumlulukları Öğr. Gör. Tuğba DUZCU Bölüm 4 ...................................................................................................................... 49 Crush Sendromu ve Acil Bakım Öğr. Gör. Dr. Tuğba DUZCU Bölüm 5 ...................................................................................................................... 61 Afet Tıbbı Acil Tıp Uzmanı Dr. Fatih Cemal TEKİN Bölüm 6 ...................................................................................................................... 83 Acil Tıp Servislerinde Sağlıkta Şiddet Olgusunun Diğer Sağlık Hizmetlerine Göre Değerlendirilmesi Erkan BOĞA

CONTENTS CHAPTER 1 ...................................................................................................... 5 Erythema Multiforme: A Review of Clinical Manifestations, Diagnosis, and Management Res. Assist. Tuğçe GÜNGÖR Assoc. Prof. Bilge TARÇIN Prof. Birsay GÜMRÜ CHAPTER 2 ................................................................................................... 21 Retention in Orthodontics Assist. Prof. Esra ÇİFÇİ ÖZKAN, Ph.D CHAPTER 3 ................................................................................................... 43 A Genetic Overview of Temporomandibular Disorders Assist. Prof. Serkan YILDIZ, Ph.D CHAPTER 4 ................................................................................................... 57 Alveolar Bone Resorption Assist. Prof. Zeynep Dilan ORHAN, Ph.D. Assoc. Prof. Levent CİĞERİM, Ph.D. DDS Mohammad ALSMADI CHAPTER 5 ................................................................................................... 73 Pain and Dental Anxiety Assist. Prof. Zeynep Dilan ORHAN, Ph.D. Assoc. Prof. Levent CİĞERİM, Ph.D. DDS Mohammad ALSMADI. CHAPTER 6 ................................................................................................... 89 Toothpaste: Overview Asistant Professor Hasibe Sevilay BAHADIR Specialist Dentist Selin POLATOĞLU 4 CHAPTER 7 ................................................................................................ 119 Dental Plaque Diagnosis and Imaging Methods Res. Assist. Dt. Simge MEŞELİ Assoc. Prof. Bora KORKUT, Ph.D. Prof. Dilek TAĞTEKİN, Ph.D. CHAPTER 8 ................................................................................................ 139 The Management of Transverse Maxillary Deficiency With Rapid Maxillary Expansion Uzm. Dt. Soukrie SEKERTZI (Şükriye ŞEKERCİ)

In our case report, we aimed to describe a patient who was diagnosed with ankylosing spondylitis and developed anaphylactoid reaction after receiving infliximab treatment for the second time. Case Report A 21-year-old female patient presented to the emergency department with an allergic reaction after intravenous infliximab administration. It was learned that he received the treatment for the second time. It was observed that the general condition of the patient was moderate-poor, GCS:15, swelling of the tongue and lips and difficulty in breathing. We were informed that he had ankylosing spondylitis and familial Mediterranean fever in his history and that he was using prednol. In laboratory examinations, WBC was 31.26 KµL. The patient was monitored in the emergency department. Adrenaline, prednol and avil treatment was given. About 2 hours later, the patient's clinical and vital signs improved. After 12 hours of emergency follow-up, he was discharged with recommendations. Conclusion Infiximab, which is preferred in autoimmune diseases, should be applied carefully in terms of allergic reactions and close follow-up should be planned, even if no side effects are observed in the first application., Amaç Olgu sunumumuzda Ankilozan spondilit tanısı olan ve infliximab tedavisini 2. kez aldıktan sonra anafilaktoid reaksiyon gelişen hastayı anlatmayı amaçladık. Olgu 21 yaşında kadın hasta intravenöz İnfliksimab alımı sonrası alerjik reaksiyon ile acil servise başvurdu. Tedaviyi ikinci kez aldığı öğrenildi. Genel durum orta-kötü, GKS:15 olan hastanın dilde ve dudakta şişmesi olduğu ve nefes almakta zorlandığı gözlendi. Özgeçmişinde ankilozan spondilit ve ailevi akdeniz ateşi olduğu ve prednol kullandığı tarafımıza bildirildi. Labaratuvar tetkiklerinde WBC:31.26 KµL idi. Hasta acil serviste monitorize edildi. Adrenalin, prednol ve avil tedavisi verildi. Yaklaşık 2 saat sonra hastanın kliniği ve vital bulguları düzeldi. 12 saat acil servis takibinin ardından önerilerle taburcu edildi. Sonuç Otoimmun hastalıklarda tercih edilen infiksimab, ilk uygulamada yan etki görülmese bile alerjik reaksiyonlar açısından dikkatli uygulanmalı ve yakın takibi planlanmalıdır.

Objective: This study aimed to examine the effect of the pandemic on hospital mortality and patient admission in four months since March 2020 when the Ministry of Health announced the first confirmed COVID-19 case in Turkey and the first wave occurred. Material-Method: This research is a single-centre, retrospective, cross-sectional descriptive study. It covers the periods between March 01 and Jun 30 of 2018, 2019, and 2020. Results: Between 2018-2020, 897522, 972799, and 395438 patients were admitted to our Hospital, respectively. It was observed that the number of admissions decreased by 55-60% in 2020 compared to the previous years (p=0.001). Moreover, 205318 (22.9%) of the admissions in 2018, 229278 (23.6%) of the admissions in 2019, and 1127293 (32%) of the admissions in 2020 were emergency room (ER) admissions. Especially in 2020, there was a significant increase in the overall in-hospital (p=0.001) and ER (p=0.001 mortality rates compared to previous years. In-hospital mortality was found to be higher, especially in patients with suspected COVID-19 (p=0.001). It was found that the number of deaths due to respiratory causes was significantly increased in 2020 compared to the previous years (p=0.001). Conclusion: The COVID-19 pandemic has led to significant changes in mortality rates and causes of mortality compared to previous years. Although the pandemic has affected all healthcare systems, ER and intensive care units (ICU) are seriously affected.

Amac: Kisinin bilincli olarak ve isteyerek yasamina son vermesine intihar denir. Intihar ile ilgili en cok arastirilan konulardan biri de zihinsel bozukluklardir. Son yillarda bircok kronik hastaligin tedavisinde D vitamininin onemli bir rol oynadigi bildirilmistir. Artan kanitlarda gunes isiginin veya D vitaminin, noropsikiyatrik hastaliklarin etiyolojisinde onemli bir cevresel faktor oldugu bildirilmektedir. Bu calismanin amaci acil servisimize intihar girisimi nedeniyle basvuran D vitamini duzeylerini arastirmak ve sonuclara gore klinik uygulamalarin tedavisine katkida bulunmakti. Yontemler: Calismaya intihar girisimi olan 59 kisi ve kontrol grubu olan 42 kisi dahil edildi. Sosyodemografik Bilgi Formu (SBF) Hastalarin cinsiyeti, yasi, egitim duzeyi, medeni durumu ve ekonomik durumu, daha once psikiyatrik tedavi almis veya intihar girisiminde bulunmus olmasi her hasta icin ayri bir forma kaydedildi. Kategorik (nominal veya sirali) ve ikili degiskenlere dayali istatistiksel degerlendirmeler icin Mann Whitney U testleri kullanildi. Bulgular: Calisma grubunun laboratuvar D vitamini duzeyleri minimum 4,4 ng/ml maksimum 33 ng/ml degerleri bulundu. Intihar girisiminde bulunanlarin D vitamin ortalamasi 9,6 ng/ml, kontrol grubunun D vitamin ortalamasi 13,8 ng/ml idi. D vitamini duzeyleri ile psikiyatrik hastalik varligi arasindaki iliski istatistiksel olarak anlamli bulundu (P

Aim:This study aimed to investigate the efficacy of C-reactive protein (CRP), lactate, procalcitonin and albumin levels and procalcitonin/ albumin ratio used as indicators of infection on mortality in critical patients admitted to the intensive care unit and their relationships with APACHE-II and SOFA scores.Materials and Methods:This study was conducted using patients’ hospital records and patient file scans. Demographic characteristics; procalcitonin, CRP, albumin and lactate levels and APACHE-II and SOFA scores were recorded. Spearman’s rank correlation was used to assess non-parametric data. ROC curve analysis was performed to determine the threshold values of blood parameters. Results: A total of 61 patients were enrolled in the present study [35 males (57.4%) and 26 females (42.6%); average age, 69.0 years]. A positive, weakly significant association was detected between APACHE-II score and procalcitonin levels. When the APACHE-II score and lactate level and procalcitonin/ albumin ratio were evaluated,Results:APACHE-II score was positively significant and weakly correlated with lactate and the procalcitonin/albumin ratio. A moderate negative correlation was found between albumin level and the APACHE-II score. The SOFA score was positively associated with both procalcitonin and lactate levels. SOFA score was positively significant and weakly correlated with the procalcitonin/albumin ratio.Conclusion:Procalcitonin, lactate and albumin levels and the procalcitonin/albumin ratio can be considered prognostic markers according to the cut-off points in terms of mortality in critically ill patients. In addition, these blood parameters were found to be useful in clinical follow-up as they are related to the APACHE-II and SOFA scoring systems used in intensive care units.

Objective: To evaluate the effect of testosterone on the status of burnout and job satisfaction. Methods: The prospective study was conducted at the Kanuni Sultan Suleyman Education and Research Hospital, Istanbul, Turkey, from April 1 to May 1, 2019, and comprised all female employees working in the emergency department. Data was collected using the Maslach Burnout Inventory and Minnesota Job Satisfaction Scale. Blood samples 5 cc were taken to measure the testosterone hormone level. Data was analysed using SPSS 20. Results: There were 95 females with a mean age of 33.6±7.1 years (range: 18-53 years). The level of exhaustion was high in 64(67.3%) subjects, intermediate in 20(21%) and low in 11(11.5%). the difference among the groups in relation to testosterone levels was significant (p0.05). Conclusion: Hormone levels released from endocrine systems were found to be affected by psychosocial factors. Key Words: Testosterone, Burnout Syndrome, Job satisfaction. Continuous...

Dermoid cysts are one of the most common causes of ovarian torsion. The causes of acute abdominal pain are mostly caused by the diagnosis of acute appendicitis, acute pancreatitis, and mesenteric ischemia, and the incidence of ovarian torsion is not known exactly. Although ovarian torsion is very rare, it ranks first among the indications for gynecological emergency surgery. A rare case of a non-ruptured dermoid cyst causing ovarian torsion in the emergency room is presented.

Background: Traffic accidents have been a bleeding wound due to developing technology and increasing number of vehicles. Improvement in socio-economic level has led to an increase in number of vehicles and traffic accidents with injury and death increase accordingly. High costs appear by tests and treatments as well as further health problems and loss of labour power in traffic accidents. The aim of this study was to evaluate the trauma scores, clinical outcomes and hospital cost of patients presenting to the emergency department with road traffic accidents. Methods: Patients information; hospital automation system, forensic records and patient files were recorded. Cost information was received in hospital automation system. Hospital costs include examinations and treatments that have been performed since the first visit of the patients. According to the data obtained from the patients files, GCS (Glasgow Coma Scale), AIS(Abbreviated Injury Scale) and ISS(Injury Severity Score) scores of each patient were calculated separately. All variables were tested for conformity to normal distribution, Kolmogorov Smirnov test and compliance with parametric test criteria. The data obtained by the study carried out within the scope of clinical research are statistically nonparametric. For this reason, Kruskal-Wallis H tests were used for statistical evaluation of associated variables according to dependency status. Spearman rank correlation in non-parametric data and Pearson correlation in parametric data were used as correlation methods. The results were evaluated for a significance level of P < .05. Results: The average cost of traffic accidents was found to be 247.38 Turkish Lira.The average cost of motor vehicle accidents was 246.53 Turkish Lira.The average cost of extra vehicular traffic accident was 235.3 Turkish Lira. Cost average was 265.9 Turkish Lira.The effect of clinical outcomes on the cost was found statistically significant. There was a statistically significant effect of GCS, AIS, ISS trauma scores on the cost. AIS and ISS and the cost was moderately significant and a positive correlation was found. Conclusion: Frequency of the traffic accidents, higher hospitalization rates and higher medical expenses have made the traffic accidents a significant public health problem economically We believe that community education should be increased in order to reduce traffic accidents in terms of health as well as the national economy.

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

Çocuk acil servisinde travmanın en yaygın nedeni trafik kazalarıdır. Bu çalışmada trafik kazası geçiren çocuk travma hastalarında trafik kazası tipini ve anatomik travma skorlarını değerlendirmeyi amaçladık. Bu çalışma hastane otomasyon sistemi, adli kayıtlar ve pediatrik hasta dosyaları incelenerek retrospektif olarak yapıldı. Tam kayıtları olan 443 hasta çalışmaya dahil edildi. Çalışmaya alınan hastaların% 64.1'i erkek,% 35.2'si kadın ve ortalama yaş 8.9 idi. Trafik kazası türlerine göre% 60.5 Araç dışı trafik kazası, % 32.3 Araç içi trafik kazası ve% 7.2 hasta motosiklet kazalarıydı. AIS skorunun ortalaması 1.91± 1.28, ISS skorunun ortalaması 3.32±3.76 idi. Trafik Kazası Tipine göre AIS ve ISS travma skorları arasında istatistiksel olarak anlamlı bir fark bulunmadı. AIS ve ISS travma skorları hastaneye yatış ve taburculuk açısından ROC analizi ile değerlendirildiğinde, AIS skoru kesme noktasının 4 üzerindeydi ve kesme noktası 7'nin üzerinde olan ISS skoru hastaneye yatış açısından değerlendirilen kesme noktalarıdır. Sonuç olarak AIS ve ISS skorları; Travma merkezlerinin derecesine göre, transfer planlamasında zaman kaybetmemek için kullanılabilecek puanlar olduğunu düşünüyoruz. The most common cause of trauma in the pediatric emergency department is traffic accidents. In this study, we aimed to evaluate the type of traffic accident and anatomical trauma scores in pediatric trauma patients admitted with traffic accidents. This study was performed retrospectively by examining hospital automation system, forensic records and patient files of the pediatric. 443 patients with complete records were included in the study. Of the patients included in the study, %64.1 were male, 35.2% were female and the mean age was 8.9. According to the traffic accident types patients involved in 60.5% NVTA, 32.3% RTA and 7.2% were motorcycle accidents. The mean AIS score was 1.91±1.28, and the ISS score was 3.32±3.76. No statistically significant difference was found between trauma scores AIS and ISS with regards to Traffic Accident Type. When the AIS and ISS trauma scores were evaluated by ROC analysis in terms of hospitalization and discharge, the AIS score was above cut-off point 4, and ISS score having cut-off point above 7 are the cut off points evaluated with regards to hospitalization. As a result, AIS and ISS scores; According to the degree of trauma centers, we think there are points that can be used in order not to waste time in transfer planning.

To determine the differences between the factors such as return of spontaneous circulation positivity, duration of cardiopulmonary resuscitation, and cardiac rhythm at first arrival affecting neurological outcomes in cardiac-arrest cases.This study was conducted at the Malatya State Hospital, Malatya, Turkey, from January to December 2014, and comprised patients who had received cardiopulmonary resuscitation. Patients were divided into two groups; in-hospital cardiac arrest and out-of-hospital cardiac arrest. The groups were compared in terms of gender, age, initial rhythm, cardiopulmonary resuscitation durations, cardiopulmonary resuscitation results (exitus, return), return of spontaneous circulation rates observed after cardiopulmonary resuscitation, and neurological outcome responses of the cases in which return of spontaneous circulation was observed. SPSS 22 was used for data analysis.Of the 321 cases, 88(27.41%) were in-hospital and 233(72.59%) were out-of-hospital cardiac arrest cases. Besides, 189(58.9%) of the patients were men and 132(41.1%) were women with an overall mean age of 67.21±15.25 years (range: 18-98 years). Moreover, 16(18.2%) in-hospital cases and 47(20.2%) out-of-hospital cases had shockable rhythms at the time of arrival. Cardiopulmonary resuscitation was applied to 74(23%) patients for less than 20 minutes and to 247(76.9%) for more than 20 minutes. Return of spontaneous circulation positivity was recorded in 134(41.7%) patients, of whom 62(70.5%) were in-hospital and 72(30.9%) were out-of-hospital cases. Moreover, 19(5.9%) patients were discharged with good neurological outcome. In cases where cardiopulmonary resuscitation was applied for less than 20 minutes, return of spontaneous circulation positivity was present in 43(100%) in-hospital and 31(100%) out-of-hospital cases. Return of spontaneous circulation positivity and good neurological outcome rate of the patients having shockable rhythms was 48(76.2%) and 8(12.7%), respectively.Return of spontaneous circulation positivity, favourable neurological outcome response and survival rates were significantly higher among in-hospital cardiac arrest cases.

OBJECTIVE: Upper gastrointestinal bleeding is a common reason of admission to the emergency department. Risk stratification on admission to emergency department is important in treatment and follow up of the patients. Herein, the values of Rockall and Blatchford risk scoring and mean platelet volume in prediction of mortality are investigated.METHODS: In this prospective cross-sectional study, in seven month period, 134 patients admitted to the emergency department with gastrointestinal bleeding included the study. Rockall and Blatchford scoring are evaluated. The relationship between mortality and these scores and MPV is evaluated.RESULTS: The most frequently seen endoscopic pathology was erosive gastritis 30 patient, 22.4% . The mortality of the patients with high MPV value 40%. The cut-off value of Rockall score in mortality prediction was 6, the area under curve value was 0.888; the cut-off value of Blacthford score was 11, the area under curve was 0.818. CONCLUSION: The first evaluation of the patients admitted to the emergency department with upper gastrointestinal bleeding should be done by Rockall and Blatchford score and the patients with high risk should be followed closely., AMAÇ: Üst gastrointestinal sistem kanamaları acil servise sık başvuru nedenlerindendir. Bu hastaların acil servise başvurularında risk sınıflamasının yapılması hastaların takip ve tedavisi açısından değerlidir. Bu makalede acil servise üst gastrointestinal sistem kanaması ile başvuran hastaların Rockall ve Blatchford sınıflaması ve ortalama platelet hacminin MPV mortalite öngörüsünde değerliliği araştırıldı.YÖNTEMLER: Bu prospektif kesitsel çalışmaya yedi aylık süreçte acil servise üst gastrointestinal sistem kanaması ile başvuran 134 hasta dahil edildi. Hastaların Rockall ve Blatchford sınıflaması yapıldı. Bu skorlamaların ve MPV’nin mortalite ile ilişkisi araştırıldı. BULGULAR: Hastalara yapılan endoskopi sonucunda en sık görülen tanı eroziv gastrit 30 hasta, %22.4 idi. MPV değeri yüksek olan hastaların %40’ında hastane içi mortalite görüldü. Rockall risk skorunun mortalite öngörüsünde eşik değeri 6 idi ve ROC eğrisinde eğri altında kalan alan 0.888 idi; Blatchford risk skorunun mortalite öngörüsünde eşik değeri 11 idi ve ROC eğrisinde eğri altında kalan alan 0.818 idi.SONUÇ: Gastrointestinal sistem kanamaları ile acil servise başvuran hastaların ilk değerlendirmesi Rockall ve Blatchford skorları ile değerlendirilmeli ve yüksek riskli olan hastalar yakından takip edilmelidir.