The role of lung ultrasonography in evaluation of COVID-19 pneumonia

After a few months it emerged in Wuhan (China), Coronavirus Disease 2019 (COVID-19) caused by 2019 novel coronavirus (2019-nCoV) was declared as a pandemic by the World Health Organization (WHO). Diagnosis of the disease is mainly based on real time polymerase chain reaction (PCR) test by nasopharyngeal swab. However, due to excess of numbers of false-negative PCR test results, chest computed tomography (CT) is commonly used as a supplementary modality. However, CT has some disadvantages. Firstly, a normal chest CT scan does not exclude the diagnosis of COVID-19 pneumonia. Additionally, the radiation exposure and a weak diagnostic value are other challenges. When the infection is limited to upper respiratory system or performed in the early stage, false-negative results may be obtained on CT scan.  Recently lung ultrasonography (LUS) has emerged as a easy-to-use, cost-effective and radiation-free tool in diagnosis, management and follow-up of COVID-19 pneumonia. In this narrative review, our aim is to clarify the utility of LUS in COVID-19 pneumonia with its advantages and disadvantages. We also aimed to guide clinicians to use LUS as a practical tool

Investigation of anxiety levels of patients with chest pain admitted to emergency department

AbstractIntroductionWe aimed to investigate the demographical features, anxiety levels and clinical findings of the patients admitted to our Emergency department (ED) due to chest pain.MethodsPatients with chest pain older than 18 years were included into the study. Demographical features such as age, sex and education level, initial diagnosis in the ED, whether they were hospitalized or coronary intervention performed, were recorded. To determine the anxiety levels of the patients, State-trait Anxiety Inventory (STAI) was performed.ResultsTwo-hundred and eight adult patients with chest pain were included into the study. We could not determine a relationship between STAI levels of patients according to demographical findings, however, STAI scores tended to decrease by age. Considering the education levels of the patients, it was determined that STAI scores of university graduates were higher than others. The STAI scores of patients discharged from the ED were higher than those hospitalized. When patients were compared according to whether coronary intervention (CI) was performed or not, it was determined that patients who did not require CI had higher STAI scores. When coronary lesion localization of the patients hospitalized was investigated, any relationship could not be determined.ConclusionIn this study, we determined that anxiety levels of the patients with chest pain do not correlate with the severity of the disease. Higher anxiety levels of patients discharged from ED when compared to those with ACS is a challenging problem for both ED physicians and cardiologists

Interleukin-33 (IL-33) as a Diagnostic and Prognostic Factor in Traumatic Brain Injury

Interleukin-33 (IL-33) is a cytokine involved in interleukin-1 family. Role of IL-33 in immune system activation is well described in the literature. IL-33 has been identified as an endogenous alarm signal (alarmin) to alert various types of immune cells to trauma. In this narrative review, we aimed to underline the diagnostic and prognostic importance of IL-33 in trauma, particularly in brain trauma

Occipital condyle fracture as a rare cause of shoulder pain

Occipital condyle fractures (OCFs) usually occur due to high energy trauma and are often associated with serious injuries, particularly in the brain. Because it is difficult to determine this fracture on plain radiographs, it can easily be misdiagnosed. In this report, we present a patient admitted to our emergency department with one and only complaint of shoulder pain following a motor vehicle accident. We aimed to underline the importance of physician’s elaboration and attention in the diagnosis of this rare entity

Acute ischemic stroke and severe multiorgan dysfunction due to multiple bee stings

Various manifestations after bee sting have been described. Local reactions, such as pain, wheal, flare, edema and swelling, are common and generally self-limiting. Uncommonly manifestations like vomiting, diarrhea, dyspnea, generalized edema, acute renal failure, anaphylactic shock, myocardial infarction, hypotension, collapse, pulmonary hemorrhage, acute hemorrhagic pancreatitis, and atrial fibrillation may occur. We report a 59 year-old man who sustained ischemic stroke and multi-organ dysfunction following multiple bee stings. Keywords: Bee sting, Acute stroke, Emergency departmen

Investigation of Geriatric Patients with Abdominal Pain Admitted to Emergency Department

Introduction. The aim of this study is to detect the possible reasons of abdominal pain in the patients aged 65 and older admitted to emergency department (ED) with complaint of abdominal pain which is not related to trauma, to determine the length of hospitalization of old (65–75 age) and elderly (aged 75 and older) patients, and to define the hospitalization and mortality rates. Material and Methods. In the study, 336 patients were included. Groups were compared in respect to gender, internal or surgical prediagnoses, complaints accompanying abdominal pain, vital findings, comorbidities, requested consultations, hospitalizing service, waiting time in the ED and in the hospital, and treatment methods. Results. Of the patients, 48.2% were male, and 51.8% were female. While 52.4% of the patients were in 65–74 age group, 47.6% of them were aged 75 years and above. An internal disease was detected in 76.8% of the patients as an origin of abdominal pain. Most common prediagnoses were biliary diseases and diseases related to biliary tract followed by nonspecific abdominal pain, abdominal pain secondary to malignity, ileus, and acute gastroenteritis, respectively. The most frequent finding accompanying abdominal pain was vomiting. The most frequent chronic disease accompanying abdominal pain was hypertension in both age groups. We observed that 75.9% of the patients required consultation. We detected that 48.8% of the patients with abdominal pain were hospitalized and they were hospitalized mostly by gastroenterology ward (24.8%). Surgical treatments were applied to the 17.6% of the patients with abdominal pain. Conclusion. Clinical findings become indistinct by age, and differential diagnosis of abdominal pain gets more difficult in geriatric patients. Therefore, physicians should consider age related physiological changes in order to distinguish geriatric patients admitted to emergency service with abdominal pain from pathological cases requiring immediate surgical operation