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BACKGROUND: Numerous measurement techniques for intra-abdominal pressure have been explored, with the Kron Technique established as the gold standard. Despite its prominence, the search for alternative methods persists due to its lengthy application time, the requirement for additional equipment, and overall impracticality. This study investigated a quicker, more accessible method for effective intra-abdominal pressure measurement in the emergency department. It aimed to compare intra-abdominal pressure measurements in patients diagnosed with ileus using a digital manometer and the Kron Technique. METHODS: Conducted from October 2022 to February 2023, this single-center, prospective, single-blind method comparison study involved patients diagnosed with ileus at a tertiary emergency department. Intra-abdominal pressure was measured using both the Kron Technique and a digital manometer by separate practitioners blinded to the study results. RESULTS: The study included 30 patients. No statistically significant difference was observed in the intra-abdominal pressure measurements between the two methods (p<0.237). A very strong correlation existed between the two methods (Spearman’s Rho = 0.998). Bland-Altman analysis showed a bias value of 0.091 mmHg for the digital manometer, with upper and lower agreement limits of -0.825 and 1.007 mmHg, respectively. The measurement time was significantly shorter with the digital manometer than with the Kron Technique (15 vs. 390.5 seconds; p<0.001). CONCLUSION: We believe that the intra-abdominal pressure measurement technique using a digital manometer is a method that can be effectively employed by healthcare professionals in emergency departments. This technique offers ease of use, requires minimal equipment, provides rapid results, and delivers reliable measurement values compared to the Kron Technique. [ABSTRACT FROM AUTHOR]

Objective: The number of admissions to the emergency department (ED) of elderly patients who reside in nursing homes with a diagnosis of pneumonia continues to grow. This study was designed to assess factors that predicted mortality in the patient group defined as those with nursing home-acquired pneumonia (NHAP). Materials and Methods: This was a prospective, observational study conducted in a hospital ED. The data of nursing home patients admitted to the ED with a pneumonia presentation (NHAP) were compared with those of patients with communityacquired pneumonia (CAP). Factors that predicted mortality in the NHAP group were analyzed. SPSS for Windows, Version 16.0 software (SPSS Inc., Chicago, IL, USA) was used to perform the statistical analysis. Results: A total of 98 patients >18 years of age, 36 of whom were NHAP patients, were included in the research. The risk level and rates of intensive care admission and mortality were significantly higher in the NHAP group (p<0.05), and the thiol level, an antioxidant parameter, was lower in the NHAP group than that of the CAP group (p<0.001). Evaluation of the NHAP group alone revealed a higher mortality rate in patients with congestive heart failure, those hospitalized in intensive care, and those with high risk scores (p<0.05). The shock index (SI) value was found to be an independent predictor of mortality in the NHAP group. The study results indicated that each 0.1 unit increase in the SI increased mortality 3.637 times (95% confidence interval: 1.024-12.921) (p=0.046). Conclusion: The findings suggest that the SI could serve as a valuable marker for predicting mortality in NHAP patients. [ABSTRACT FROM AUTHOR]

Objectives: Oxidative stress refers to formation of more reactive oxygen species (ROS) than that are eliminated by cellular defense mechanisms (antioxidants). The aim of this study is to determine oxidative stress developed in CO poisoning, to measure oxidant and antioxidant parameters and to study the effects of the NBO and HBO treatments on these parameters. Materials and Methods: On admission to emergency department and at the end of 24th hour after the oxygen therapy, total oxidant status (TOS) was measured as an oxidative stress parameter, total antioxidant status (TAS), paraoxonase (PON), serum paraoxonase (SPON), arylesterase (ARES), and thiol (TTL) levels were measured as indicators of antioxidant capacity. Results: TAS, TTL and ARES levels were found to be significantly lower in the patient group when compared to control group. There were no differences in both inital and 24th hour levels of oxidative stress parameters between the patients who received hyperbaric therapy and normobaric therapy. Conclusion: Continuing decrease of TAS, PON, SPON, ARES, and TTL may be because the antioxidant capacity has not yet been replaced or reperfusion ischemia is caused by treatment. The results of our study support that oxidative balance turns against antioxidants in cases of CO poisoning. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to investigate the dynamic thiol-disulfide balance in the early period of patients diagnosed with acute pulmonary thromboembolism in the emergency department. Materials and Methods: Serum thiol-disulfide levels in venous blood samples drawn from 58 patients diagnosed with acute pulmonary embolism in the emergency department were analyzed using the newly developed Erel-Neşelioğlu method, and the results were compared with the measurements of the healthy control group. In the emergency department, the pre-diagnosis of pulmonary embolism was considered with clinical and laboratory findings and confirmed with contrast-enhanced thorax computed tomography angiogram. Results: Mean native thiol and total thiol levels were significantly lower in pulmonary embolism patients compared to the control group (308.53 ± 78; 414.13 ± 50.86; p <0.002; 346.03 ± 81.13; 453.05 ± 52.46 μmol/l, p <0.003 respectively). Disulphide/native thiol and disulphide/total thiol ratios were found to be significantly higher in pulmonary embolism patients compared to the control group (p <0.001). Conclusion: Thiol-disulfide balance is altered oxidatively in patients with pulmonary embolism. This may play a role in the pathogenesis of the disease. [ABSTRACT FROM AUTHOR]

Copyright of Ankara Medical Journal is the property of Yildirim Beyazit Üniversity and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Peripheral venous catheterization is one of the most used medical procedures in hospitals worldwide. Recent researches state that using intravascular devices is a risk factor for both local and systemic complications. In this study, we aimed to test that addition of tissue adhesive to the insertion site of peripheral intravenous catheters (PIVC) in the emergency department (ED) would reduce the device failure rate at 6 h and 24 h following insertion. Material and methods: We designed a single-site, two-arm, randomized, controlled trial. We inserted 115 PIVCs into 115 adult patients. Results: PIVC device failure for the 6th hour follow up was 15.4% in the tissue adhesive group (95% CI: 4.1-26.7) vs. 25.6% with standard care group (95% CI: 11.9-39.3). There was no statistically significant difference between two groups (p=0.33). Discussion: In this study, the routine use of tissue adhesives in addition to standard care to reduce PIVC failure for patients 65 years or older in ED was not supported due to not clear benefits and cost effectivity. Conclusion: Even though the routine use of tissue adhesives is not recommended according to the study results, it may be reasonable to use tissue adhesives for long term hospitalization expected patients to protect from related complications due to current literature. [ABSTRACT FROM AUTHOR]

Copyright of Ankara Medical Journal is the property of Yildirim Beyazit Üniversity and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Ankara Medical Journal is the property of Yildirim Beyazit Üniversity and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Ankara Medical Journal is the property of Yildirim Beyazit Üniversity and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Ankara Medical Journal is the property of Yildirim Beyazit Üniversity and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: The emergency department is the most common site of presentation for patients suffering from acute mushroom poisoning; therefore, emergency physicians should be familiar with it. We present a case of mushroom poisoning that was initially misdiagnosed as a cerebrovascular event. Case Report: A 59-year-old male patient was referred to our emergency service from another hospital with the presumptive diagnosis of a cerebrovascular event. He had presented to the other hospital with complaints of a decrease in consciousness and hallucinations that started 2 h ago. Upon presentation he was unconscious. Family members stated that 30 min before his symptoms started, he had eaten mushrooms that he had collected himself from nature. Active charcoal was administered after gastric lavage. Diazepam was given for agitations. Fifteen hours after the ingestion of mushrooms, the patient was fully conscious. He was monitored for 36 hours and was discharged uneventfully. Conclusion: Pantherina syndrome is a type of mushroom poisoning that has been classified as glutaminergic neurotoxic syndrome with early onset. Treatment is mainly supportive and should be guided by the patient's symptoms rather than by attempts at mushroom identification. Elimination of the mushroom from the gastrointestinal tract by gastric lavage and the administration of activated charcoal is recommended. Generally, the symptoms are mild and require no further treatment. Emergency physicians should consider mushroom poisoning in the evaluation of patients with acute onset delirium who may be intoxicated by natural substances. [ABSTRACT FROM AUTHOR]

Over the last few years scientists have been the targets for cybercrime in a few different ways. Hijacked or fake journals and predatory journals have emerged, and many scientists have been victimized by these journals. Those journals are trying to deceive authors and readers intentionally by not doing what they say they are doing, but still charging the authors for the services that they do not provide like peer review or editorial review. They also do not follow traditional standards for the acceptance of articles. Our goal is to disseminate knowledge and awareness about such journals and offer some basic skills to the authors so that they avoid fake or predatory publishers. One must be careful because predatory journals may take away not only your money but also, more importantly, your prestige and reputation. [ABSTRACT FROM AUTHOR]

Depression in the elderly is a common psychiatric disorder, and significantly reduces the quality of life. Suicidal behavior in the elderly varies in a wide spectrum from wish to die to completed suicide. In elderly severe depression may not be diagnosed and unfortunately suicide is the most important complication in this group. The incidence of suicides varies among societies and there is significant difference between the sexes in terms of suicidal behavior. The strong association between depression and suicide attempts in the elderly has been pointed out in many works. The risk of suicide increases with age, regardless of the gender and physical health. Penetrating injuries are more rarely observed than other suicide methods. In this case report, we present an elderly patient with depression who tried a different method of suicide. [ABSTRACT FROM AUTHOR]

Ecballium elaterium, whose juice is used for the symptomatic treatment of rhinosinusitis in folk medicine, has been reported as causing significant allergic reactions including upper airway oedema. Due to its strong anti-inflammatory effects, the juice is widely used by people in the eastern Mediterranean region. A 57 year old healthy man presented to the emergency department with dysphagia and severe uvular oedema. He had dripped the juice of Ecballium elaterium intranasally for the symptomatic treatment of his rhinosinusitis, which was caused by an allergic reaction and presented with dysphagia and dyspnea. Emergency physicians should be familiar with the adverse effects of herbal remedies, which have been frequently used in folk medicine. [ABSTRACT FROM AUTHOR]

Objective: Our goal was to study the effects of fasting and mean weather temperature on blood biochemical parameters and urine test results in a group of patients that present with renal colic to an emergency department during the month of Ramadan. Material and Methods: Patients who presented to our emergency department from August 1-29, 2011 with a diagnosis of renal colic were included in the study. Patient demographic characteristics, major complaints, laboratory values and the average temperature of the day were recorded. Results: During the 29-day period, 61 patients were diagnosed with renal colic. Thirty-five patients were fasting, while 26 of them were not. In the comparison of fasting and non-fasting patients, there were no statistically significant differences in terms of age, arterial blood pressure, body temperature, blood glucose level, serum urea and creatinine levels, urine erythrocytes, leukocytes, ketones and density or in the chief complaint (p>0.05). Conclusion: Low urine volume reflects low fluid intake or excessive fluid loss, and directly increases kidney stone risk by increasing the urinary saturation of stone-forming salts. Fasting may result in limited fluid intake and increase renal colic presentations by affecting blood chemistry and urine concentration. In this study, no significant differences were observed between fasting and non-fasting patients in terms of the mechanisms that can cause renal colic. [ABSTRACT FROM AUTHOR]

Objective: In this study, our goal was to assess the theoretical levels of knowledge of emergency medicine residents, to determine the subjects that they are more successful and less successful in, and to compare the levels of knowledge of residents in university and training/research hospitals; by evaluating the results of a general examination that was set for the residents of emergency medicine throughout Turkey. Material and Methods: The examination results of a total number of 30 training/ research hospitals and university hospitals that agreed to take the examination were analysed. The results of training/research hospitals and university hospitals were compared regarding distribution of main topics. Results: A total of 320 residents participated in the examination, of whom 207 (64.7%) were working in university hospitals and 113 (35.3%) were in training and research hospitals. According to results, there was statistically significant difference between university hospitals and training hospitals in some subgroups (pediatric emergencies, gynecologic emergencies, internal medicine), however the number of correct answers did not vary. Conclusion: Widespread increase in academic emergency departments necessitate standardization of educational efforts. Emergency medicine residents should be directed according to appropriate guidelines in this area. [ABSTRACT FROM AUTHOR]

Hemorrhagic complications due to warfarin use are frequently seen in emergency departments. However, nontraumatic massive hemothorax is an unexpected complication. We report a 59-year-old woman with warfarin overdose, who hadmassive hemothorax in right lung without any history of trauma. Her main complaint was significant dyspnea, which has gradually increased in three days. On her physical examination, she was tachypneic and had decreased lung sounds on her right hemithorax. She took warfarin regularly for aortic and mitral valve replacement for 18 years. Her INR level was 12.9 (0.8-1.2). Computed tomography of thorax revealed massive hemothorax with mediastinal shift. Fresh frozen plasma infusion was started immediately. Tube thoracostomy was performed for reexpansion of right lung and 2000 cc blood was drained in 5 minutes. Although hemorrhagic complications can be expected in warfarin therapy, thoracic hemorrhage related to warfarin therapy is relatively rare (3% of all hemorrhagic complications due to warfarin therapy). To our knowledge, massive hemothorax due to warfarin use is an extremely rare condition. [ABSTRACT FROM AUTHOR]

Objective: In our study, we aimed to compare the effect of standard rapid sequence intubation protocol and the application of rocuronium priming technique on the procedure time and hemodynamic profile., Methods: Patients who applied to the emergency department and needed rapid sequence intubation were included in our study, which we conducted with a randomized controlled design. Randomization in the study was made according to the order of arrival of the cases. Rapid sequence intubation was performed in the standard group. In the priming group, 10% of the rocuronium dose was administered approximately 3 min before the induction agent. Intubation time, amount of drug used, vital signs, and end-tidal CO2 level before and after intubation used to confirm intubation were recorded., Results: A total of 52 patients were included in the study, of which 26 patients were included in the standard group and 26 patients in the priming group. While intubation time was 121.2±21.9 s in the standard group, it was calculated as 68.4±11.6 s in the priming group (p<0.001). While the mean arterial pressure was 58.3±26.6 mmHg in the standard group after intubation, it was 80.6±21.1 mmHg in the priming group (p=0.002)., Conclusion: It was observed that priming with rocuronium shortened the intubation time and preserved the hemodynamic profile better., Clinical Trial Registration Number: NCT05343702.

Objective: Mechanical chest compression (CC) devices are frequently used in in-hospital and out-of-hospital settings. In this study, mechanical and manual CC in in-hospital cardiac arrest was compared in terms of survival., Methods: Adult patients who were admitted to the emergency department (ED) for 2 years period and had cardiac arrest in the ED were included in this retrospective, observational study. Return of spontaneous circulation (ROSC), 7-day and 30-day survival and hospital discharge data were compared between the two groups of patients who underwent manual CC and those who had mechanical CC with the Lund University Cardiac Assist System-2 device., Results: Although the rate of ROSC in the mechanical CC group was lower than in the manual CC group, this difference was not statistically significant (41.7% vs. 50.4%; P = 0.133). The 7-day survival rate was found to be statistically significantly higher in the mechanical CC group (19.4% vs. 8.9%; P = 0.012). The 30-day survival rate was also found to be high in the mechanical CC group, but this difference was not statistically significant (10.6% vs. 7.3%; P = 0.339)., Conclusion: In the light of these results, we can say that the use of piston-based mechanical CC devices in ED may be beneficial. More reliable results can be obtained with a prospective study to be performed in the ED., Competing Interests: None Declared., (Copyright: © 2022 Turkish Journal of Emergency Medicine.)