Comparison of The Anxiety Levels Between The Family Members of The Patients Presenting to The Pediatric Trauma Unit and Pediatric Emergency Units

INTRODUCTION: It is not the right behaviour to accept every anxiety pathologically. On the contrary, the sense of anxiety is an indicator of the response of individuals to internal or external changes. More importantly, anxiety is a beneficial affective state for individuals who contribute to the development of self and bodily adaptability to the new environment in which they live. MATERIAL AND METHODS: This is a prospective study. The study was conducted on the parents of the patients who applied to the paediatric emergency department and paediatric trauma units of the emergency department at Atatürk University Faculty of Medicine. Beck Anxiety Scale was administered to one of the relatives who brought the patient to the hospital. Beck anxiety test was filled in by using face-to-face interview method. Pre-defined study forms for patients included in the study were completed. RESULTS: The study was completed with 68 family members in both groups. The values of the patients who were admitted to the paediatric emergency and adult emergency departments on the Beck Anxiety Scale were equal. CONCLUSIONS: family members of paediatric patients admitted to hospital were compared; The family members of the paediatric trauma unit and the family members of the paediatric emergency department have the same level of anxiety

Analysis of Patients Who Present to Emergency Departments During Ramadan

INTRODUCTION: Fasting is one of the five basic obligations of Islam. Muslims fast during the month of Ramadan according to the lunar calendar. Fasting during Ramadan involves abstinence from food and drinks from sunrise to sunset. The present study investigated the effect of fasting during Ramadan in patients who presented to emergency departments. Results of this study may guide healthcare authorities in countries that provide health services to Muslim communities because of increased migration. MATERIAL AND METHODS: This is the first prospective multicentre study to examine emergency department applications for Ramadan. The study was performed between 05.26.2017 and 06.24.2017. Patients were classified according to cardiopulmonary complaints, trauma-associated complaints, neurological complaints, gastrointestinal complaints, headache, renal colic, upper respiratory tract complaints, and malaise. Vital signs, age, gender, presentation type, complaint type, hospital stay duration, requested laboratory examination, radiological examination, treatment outcomes, application time, smoking status, and fasting status of the study patients were recorded by using a questionnaire. RESULTS: Fasting and non-fasting patients showed a significant difference with respect to presentation type, gastrointestinal complaints, upper respiratory tract complaints, hospitalization status, requested radiological and biochemical examinations, hospitalization duration, and application time (p < 0.05). CONCLUSIONS: To the authors’ knowledge, the present study is the first to compare the complaints of fasting and non-fasting patients during Ramadan. The authors feel that this study is superior to several previous studies because it has been performed using a different perspective and provides more accurate and objective data than those reported in previous studies

The Bibliometric Qualities of Original Research Published in the EurasianJournal of Emergency Medicine between the Years 2010-2014

Aim: Bibliographic work in the Turkish emergency medicine community is very scarce. We aim to improve upon the shortcomings in this area.Materials and Methods: Original research published in the Eurasian Journal of Emergency Medicine (EAJEM) (formerly known as the Academic Journal of Emergency Medicine) within the 5-year period between 2010 and 2014 was retrospectively reviewed.Results: While retrospective publications stood out the most (n81, 54.7%), they were followed by prospective (n38, 25.7%) and sectional (n29, 93.9%) works. A vast majority of the work was concentric (n139, 93.9%). Here 6.1% publications were sourced overseas. The most commonly studied subjects in the articles published in the EAJEM were medical emergencies (26.35%), trauma (20.27%), and emergency service (19.59%). Further, 52.7% (n78) texts were written in English and 47.3% (n70) were written in Turkish. In 15.5% (n23) articles, an emergency medicine resident and/or emergency medicine specialist was not among the authors. The original research most commonly had 3 keywords (n73, 49.3%). There were 12 (8.1%) articles in which no tables were used and 70 (47.3%) articles in which there were no figures. According to our findings, a total of 2981 references were used in the 148 articles that were reviewed, and the median reference value per article was 17 (min: 6; max: 50). In our study, 38 references were self-references (12.85) and 727 (24.4%) references were references to texts published in journals in the Turkish index. Within all the references, there were 43 (14.4%) references to the Turkish Journal of Emergency Medicine (TJEM), 41 (13.8%) references to the EAJEM, and only 3 (1.1%) references to Journal of Emergency Medicine Case Reports (JEMCR). The median value of references made to texts in the journals in the Turkish index per article was 2 (min: 0; max: 32). The number of references to the TJEM per article was 43/148 (29.1%), that to the EAJEM was 41/148 (27.7%), and that to JEMCR was 3/148 (2%). While the acceptance period ranged between 1 and 350 days, the average period was 49 days.Conclusion: We believe that preference should be given to the printing of prospective and multi-centric publications and those with more keywords

Assessment of the Accuracy of Cardiopulmonary Resuscitation Videos in English on YouTube according to the 2015 AHA Resuscitation Guidelines

Over the last decade, YouTube has become one of the largest online resources for medical information. However, uploaded videos are published without any peer review or quality control, so incorrect and incomplete information can be easily disseminated via the virtual platform and can be perceived as correct. The YouTube website was searched for videos in English uploaded between 15 October 2015 and 21 October 2016 using the following keywords: “CPR,” “cardiopulmonary resuscitation,” and “basic life support.” This study had a cross-sectional analytical design. In the first evaluation, the accuracy of the videos was checked according to the information contained in the basic cardiac life support algorithm. In the second evaluation, we assessed whether advanced-level, innovative medical information was included in these videos; when included, the accuracy of such information was checked. Of 774 videos evaluated, 92 videos were included in the study after application of the exclusion criteria. The videos were scored on a scale ranging from 0 to 20 points. The mean total score, based on all criteria, was 4.79 ± 2.88. The highest mean total score was achieved by videos uploaded by official medical organizations (6.43 ± 3.57), followed by those uploaded by health professionals and organizations (4.25 ± 2.49), and those uploaded by unidentified sources. YouTube videos are insufficient in providing information about the basic life support algorithm and advanced-level information according to the 2015 AHA resuscitation guidelines for health professionals. The educational material published by health institutions that are constantly working in the area is a more reliable source of information on subjects that directly affect human life, such as cardiopulmonary resuscitation

Clinical utility of EDACS-ADP in patients admitted with chest pain to an emergency department

Introduction: Acute coronary syndrome (ACS) is a common cause of mortality and morbidity. An ACS diagnosis can be made with electrocardiogram (ECG) and cardiac markers. However, despite medical advances, 2-5% of ACS patients are undiagnosed and discharged from emergency departments (EDs) because clinicians often find it difficult not only to diagnose and treat high-risk patients but also to define nonemergency diseases or safely discharge healthy patients. Risk stratification can be prevented, and inappropriate diagnosis and treatment protocols can be identified. The ED Assessment of Chest Pain Score-Accelerated Diagnostic Protocol (EDACS-ADP) scoring system, developed to identify patients with chest pain but at low risk for a major adverse cardiac event (MACE), is the first score based on clinical data from emergency medicine. Aim: This study investigates the usability of EDACS-ADP in Turkey. Material and Methods: This is a prospective observational study of 392 patients. The primary outcome was a major adverse cardiovascular event (MACE) within thirty days. Results: A total of 116 MACEs occurred in 65 (16,6%) patients during a one-month follow-up. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (+ LR), and negative likelihood ratio (-LR) values of the EDACS-ADP score for the evaluation of 30-day MACE rate in patients who admitted with chest pain for two months were as follows: 96.9%, 64.5%, 35.2%, 99.1%, + LR: 2.73, and -LR: 0.05. Conclusions: Most of these patients were classified by the EDACS-ADP as low risk and suitable for discharge. The 30-day MACE rate of development was significantly low (0.9%) and acceptable in patients grouped as low risk

Comparison of topical capsaicin and topical piroxicam in the treatment of acute trauma-induced pain: A randomized double-blind trial

Background: This study aimed to compare the analgesic efficacy of topical capsaicin and topical piroxicam in acute musculoskeletal injuries. Methods: This is a prospective, randomized, controlled, double-blinded study. The data for the 67 patients in the piroxicam group and the 69 in the capsaicin group were examined. The initial visual analog scale (VAS) scores were compared with the 60th and 120th minute as well as the 24th and 72nd hour values. Differences between the VAS scores, clinical effectiveness of the treatment and side effects were evaluated. Results: In the capsaicin group, the mean difference in the delta VAS scores was significantly higher at each measurement time. The mean of the percentage of reduction in the VAS scores of the topical capsaicin group was significantly higher than that in the topical piroxicam group. The highest difference in terms of both outcomes was determined at the 72nd hour VAS change. Mean differences were 1.53 (95% CI: 0.85-2.221) and 19.7 (95% CI: 12.4-27.2) respectively (p < 0.001). In the capsaicin group, the clinical effect of the treatment was found significantly higher (p < 0.01). The difference between the clinical effectiveness of the groups regarding the treatment outcomes was also statistically significant (p < 0.001). There was no significant difference between the patient groups regarding the presence of side effects. Conclusion: Topical capsaicin can be used as an alternative to topical piroxicam initially and at follow-up in patients presenting to the emergency department with acute pain as there were no observable differences in side-effects between the two groups. (c) 2020 Elsevier Inc. All rights reserved

Colistin nephrotoxicity increases with age

WOS: 000342202800002PubMed ID: 25073536Background: Colistin (COL) has become the backbone of the treatment of infections due to extensively drug-resistant (XDR) Gram-negative bacteria. The most common restriction to its use is acute kidney injury (AKI). Methods: We conducted a retrospective cohort study to evaluate risk factors for new-onset AKI in patients receiving COL. The cohort consisted of 198 adults admitted to 9 referral hospitals between January 2010 and October 2012 and treated with intravenous COL for >= 72 h. Patients with no pre-existing kidney dysfunction were compared in terms of risk factors and outcomes of AKI graded according to the RIFLE criteria. Logistic regression analysis was used to identify associated risk factors. Results: A total of 198 patients met the inclusion criteria, of whom 167 had no pre-existing kidney dysfunction; the mean patient age was 58.77 (+/- 18.98) y. Bloodstream infections (34.8%) and ventilator-associated pneumonia (32.3%) were the 2 most common indications for COL use. New-onset AKI developed in 46.1% of the patients, graded as risk (10%), injury (15%), and failure (21%). Patients with high Charlson co-morbidity index (CCI) scores (p = 0.001) and comparatively low initial glomerular filtration rate (GFR) estimations (p < 0.001) were more likely to develop AKI, but older age (p = 0.001; odds ratio 5.199, 95% confidence interval 2.684-10.072) was the major predictor in the multivariate analysis. In-hospital recovery from AKI occurred in 58.1%, within a median of 7 days. Conclusions: COL-induced nephrotoxicity occurred significantly more often in patients older than 60 y of age and was related to low initial GFR estimations and high CCI scores, which were basically determined by age