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Objective: The aim of this study is to identify the lack of knowledge about subcutaneous injection application of nurses and to examine the effectiveness of the training given to increase their knowledge, skills in this direction.Methods: The study was a quasi-experimental study using a pretest-posttest design involving 42 nurses (21 in the intervention group and 21 in the control group) selected by lottery from a public hospital in Türkiye. The intervention group received training on subcutaneous injection administration, while the control group did not receive any training. Data were collected through three follow-up sessions by two observers using forms containing skill checklists and information suggestions for nurses.Results: Significant differences were found between the intervention and control groups before (Z=-2.231, p=.026), after (Z=-5.590, p

Objective: Two earthquakes of 7.7 and 7.6 magnitudes on the Richter scale occurred in Kahramanmaraş on February 6, 2023, resulting in 50,000 deaths and significant devastation. Our aim was to assess the anxiety levels of emergency healthcare professionals (HPs) providing medical services in earthquake-stricken areas following the Kahramanmaraş earthquake. Materials and Methods: This study included survivor and volunteer HPs. Only 89 of 159 HPs completed the questionnaire, resulting in a response rate of 57.1%. Results: The mean Beck anxiety inventory (BAI) score for survivor HPs was 29.53±13.25, and for volunteer HPs was 7.62±11.12. The average BAI score for all HPs working in the earthquake zone was 19. The difference between these scores was statistically significant (95% confidence interval: 16.77-27.05, p=0.000). Conclusion: Our study indicates that HPs providing first-line health services in earthquake-stricken areas exhibit high anxiety scores. The BAI scores of survivor HPs were higher than those of volunteer HPs. As the duration of work in earthquake-stricken areas increased, anxiety levels increased accordingly.

Aim:The aim of this study was to examine the basic mechanisms that play a role in the acute nephrotoxicity caused by diclofenac sodium.Materials and Methods:Only water was given to the control group; however, the diclofenac sodium group was group intoxicated by giving water-soluble, 240 mg/kg, oral single dose diclofenac sodium. After 24 hours, all animals were sacrificed and histopathological analyzes were performed. The levels of spesific biomarkers [vascular endothelial growth factor (VEGF), nuclear factor-kappa B (NF-κB), matrix metalloproteinase-9 (MMP-9), metalloproteinase tissue inhibitor-1 (TIMP-1) and carcinoembryonic antigen (CEA)] that may be related to the nephrotoxicity mechanism were evaluated.Results:As a result of biochemical analysis, we found that VEGF, TIMP-1, NF-κB and CEA levels were significantly higher and MMP-9 levels were significantly lower in diclofenac sodium group compared to control group. Nephrotoxicity related histopathological changes were observed in the sections of diclofenac sodium group.Conclusion:This study has shown that the biomarkers we evaluated in the diclofenac sodium-induced acute high-dose intoxication model we created can help us to identify the nephrotoxicity and to explain the nephrotoxicity mechanism with the three main steps (the hemodynamicrelated pathway, the inflammation-related pathway, and the oxidative stress-related pathway). With a simple version of this panel adapted to emergency departments, we may be able to diagnose diclofenac sodium-related nephrotoxicity.

BACKGROUND: Migraine is a prevalent disabling primary headache disorder that is classified into two major types: migraine without aura and migraine with aura. New therapeutic methods to reduce migraine headaches in the emergency department (ED) include intradermal mesotherapy. OBJECTIVE: Compare the efficacy of intradermal mesotherapy versus a systemic therapy in pain control in patients with headache related to migraine without aura. DESIGN: Prospective parallel-group randomized controlled trial. SETTING: University hospital in Turkey. PATIENTS AND METHODS: Patients 18 years of age and older who were admitted to the ED over a 15-month period with headache related to migraine without aura were eligible for inclusion if they had a VAS score of 4 or above. Patients were randomly allocated to one session of mesotherapy or intravenous dexketoprofen. Changes in pain intensity were measured by the score on a visual analog scale (VAS) at 30, 60, and 120 minutes and 24 hours after treatment. Efficacy was also assessed by the need for use of an analgesic drug within 24 hours, by readmission with the same complaint to the ED within 72 hours, and by adverse effect rates. MAIN OUTCOME MEASURE: Pain intensity on the VAS scale. SAMPLE SIZE: 148 patients (154 enrolled and treated; 1 patient in the mesotherapy and 5 patients in the systemic therapy group lost to follow up). RESULTS: Pain intensity on the VAS scale decreased from a median score of 8 to 4 in the mesotherapy group and from 8 to 5 in the systemic therapy group. These differences were statistically significant from baseline for all time intervals (P=.001 to 30 minutes, P=.004 to 60 minutes, P=.005 to 120 minutes, and P=.002 to 24 hours). The need to use analgesics and the rate of readmission to the ED were higher in the systemic therapy group (P=.013 and P=.030, respectively). Adverse effect rates were minimal and similar in the study groups during the one-week follow-up period. CONCLUSIONS: Mesotherapy is more efficacious than intravenous dexketoprofen in the management of acute attack of migraine without aura in the ED. LIMITATIONS: Unblinded. Valid for assessing short-term pain relief, but not sufficient to predict long-term efficacy. Not generalizable because single center and small sample size. CONFLICT OF INTEREST: None. REGISTRATION: ClinicalTrials.gov (NCT04519346)

Aim:The aim of our study is to investigate the predictive value of the neutrophil lymphocyte ratio (NLR) assessed in the emergency department to distinguish complicated and uncomplicated patients with acute appendicitis (AA).Materials and Methods:In our study, the files of the patients with AA who visited our emergency clinic between 01.06.2015 and 01.01.2016 and then were operated in our hospital were reviewed retrospectively. The age, gender, the imaging method performed in the emergency clinic with an AA preliminary diagnosis, the result of the radiologic report in terms of AA and histopathological examination results were recorded according to the patients’ records. The patients were divided into two groups: Complicated AA (group 1) and uncomplicated AA (group 2) based on their histopathological analysis results. The laboratory parameters of the patients, which were seen within the first 30 minutes after they visited the emergency clinic, were examined.Results:One hundred and twenty one of the 154 patients who were involved in the study were in group 1 and 33 of the patients were in group 2. A statistically significant difference was found between two groups in terms of the number of white blood cells and NLR (p=0.000). The cut-off value for NLR in the complicated AA distinction was detected as 7.3 (75.8% sensitivity, 81.8% specifity).Conclusion:As an easy and effective analysis method, we think that NLR might be a good guide to diagnose complicated patients with AA quickly.

Aim: In this study, we aimed to assess whether there is any difference between the time and effectiveness seen in the diagnostic stage of acute appendicitis when an appropriate imaging method is selected for the patients in different age groups.Materials and Methods: During the 6-month period between October 1, 2015, and April 1, 2016, we retrospectively reviewed the files of patients who visited our emergency clinic, which is a third-step emergency department of a university hospital, and who then underwent operations at our hospital. Patients were evaluated according to their age: Group 1, 40 years and younger; Group 2, 40–60 years; Group 3, 60 years and older.Results:In this study, 97 patients (59.1%) were male and 67 patients (40.9%) were female. Their ages ranged from 19 to 86 years (mean age, 36.7±14.7 years). The percentage of patients who underwent only ultrasonography (US) was 52.3% in the first age group, 39.5% in the second age group, and 0.0% in the third age group (p

Aim: The aim of this study was to evaluate patients with spontaneous pneumothorax who were admitted to the Medeniyet University Goztepe Training and Research Hospital and to emphasize that effective treatment can be performed in emergency departments by emergency physicians.Materials and Methods: Patients who were treated for spontaneous pneumothorax between January 1, 2013 and January 1, 2015 were retrospectively evaluated. Patient records were reviewed for variables, including patient age, sex, body mass index, smoking history, comorbidities, presenting complaints, localization and extent of pneumothorax, treatment method, surgical indications, relapse, morbidity and mortality rates, and duration of hospitalization.Results: In total, 50 spontaneous pneumothorax cases were evaluated in this study (41 males and 9 females), and the mean age was 33.3±14.9 years. Of these, 38 (76.0%) were primary and 12 (24.0%) were secondary spontaneous pneumothorax cases. Spontaneous pneumothorax cases were observed more often during the winter months (46.0%). The leading presenting symptom of patients with comorbidities was dyspnea (71.4%), whereas that of patients without comorbidities was chest pain (66.7%). Complications due to tube thoracostomy occurred in 15.1% of the patients. The mean duration of hospitalization for patients with spontaneous pneumothorax was 5.0±2.2 days.Conclusion: Spontaneous pneumothorax is a common condition that requires effective treatment in emergency medicine practice. Emergency physicians should be well aware of the significance of this clinical condition and its treatment methods. Tube thoracostomy, with its low complication rate, is a procedure that can be safely performed by emergency physicians in emergency departments in hospitals.

Rectus sheath hematoma (RSH) is one of the reasons for acute abdominal pain in patients using low-molecular-weight heparin. The diagnosis can be confused with other diseases or even can be missed if not brought to notice. RSH may be fatal in the case of misdiagnosis or delayed treatment. Therefore, these cases are specific for emergency medicine practices. Recent studies and case series about RSH were mostly published by general surgery clinics. Emergency department is the first place where patients with RSH visit. However, limited case reports from the emergency departments have been published. This study highlights the importance of diagnosis and proper management of rectus hematomas in emergency clinics in the light of the three presented cases.