The Effect of Hemorrhage Volume on Mortality in Spontaneous Intracerebral Hemorrhages

INTRODUCTION: Spontaneous intracerebral hemorrhage is associated with severe morbidity and mortality. In this study, it was aimed to investigate the effect of hemorrhage volume and other known prognostic factors on mortality in spontaneous intracerebral hemorrhages. METHODS: The study was performed retrospectively in patients diagnosed with spontaneous intracerebral hemorrhage at a state hospital emergency department between 01/01/2014- 31/12/2019. Ethical approval was obtained from the Local Clinical Research Ethics Committee for the study. Patients' age, gender, systemic disease, antiaggregant or anticoagulant medication use, systolic blood pressure (SBP) and Glasgow Coma Scale (GCS), INR, hemorrhage volume, ventricular extension of hemorrhage and location determined by computed tomography (CT), ICH (Intracerebral Hemorrhage) Score, 30-day mortality data were retrospectively assessed for the study. RESULTS: A total of 55 patients, 26 males (47.27%), 29 females (52.73%) were included in the study. The mean age was detected as 70 +- 13. The 30-day mortality rate was 49.09%. Mortality was significantly higher in patients with ventricular extension of hemorrhage (p <0.001). When subgroup analysis was done, in the group with mortality in supratentorial hemorrhages, the volume of hemorrhage was significantly higher (p <0.001). A moderate to high degree of negative correlation was found between GCS and hemorrhage volume (p <0.001; rho = -0.599). When multivariate analysis of factors predicting mortality was performed, only GCS had an effect on mortality. DISCUSSION AND CONCLUSION: Hemorrhage volume is associated with increased mortality in spontaneous intracerebral supratentorial hemorrhages. Lower GCS on admission was associated with mortality in our retrospective cohort study

Needle sticks and injuries due to surgical instruments in health care providers

Objective: Health caregivers are facing various risks andhazards in their working environment. In this study theevaluation and examination of measures to be taken wasaimed among occupational injuries in our hospital in thelast three years.Methods: This study was performed as a retrospectiveinvestigation of 40 records of injury for health care providersthat detected by infection control committee of atertiary care university hospital between May 2010 andApril 2013.Results: Forty health care providers mean aged 28.5±7.8years submission were included. There were 21 male and19 female subjects. Most cases were the nurses (16/40).The majority of the injuries occurred in the surgical wards.Among the submissions, only 3 were working in the emergencyservice. The type of injuries were needle stick in 36cases and injuries due to surgical instruments in 2 casesand mucosal exposure in 2 cases. Following injury, 39cases confirmed that they cleaned the injured area. Inone case, the injured area was exsanguinated by squeezing.The cause of injury was known by 25 cases; however,15 cases did not know the causative material. In one casehepatitis B developed after injury. This case did not applyto the infection committee early stage but referred afterthe development of signs of active hepatitis.Conclusions: Health care providers should be educatedabout the risks of occupational body fluids and blood exposuresand after exposure to blood or blood productsthey should apply to the infection control committee withoutdelay.Key words: Hepatitis B, needle stick, health care provider

Investigation of the relationship between emergency department applications and prognoses of geriatric patients

The World Health Organization (WHO) stated that the elderly population constituted 12% of the population of people over 60 years old in 2015. In the coming years, by 2030, 1 out of 6 people in the world will be 60 years or older, and this ratio will increase to 22% in 2050. In addition, it is estimated that the proportion of the elderly population will be 11.0% in 2025, 12.9% in 2030, 16.3% in 2040, 22.6% in 2060 and 25.6% in 2080. The number of admissions to the emergency services of geriatric patients, the hospital treatment process, and even the mortality and morbidity rates increase in elderly patients. In this direction, it was aimed to retrospectively analyze the data of patients over 65 who applied to a tertiary hospital emergency department and determine the factors affecting the mortality of geriatric patients. The presented study is a cross-sectional and retrospective study. All patients over the age of 65 who applied to the emergency department of Ordu University Medical Faculty Training and Research Hospital between 01 July 2022 and 31 2022 were retrospectively analyzed. Demographic features of the cases, the way they applied to the emergency room (112 Emergency Service Ambulance, others: with their own vehicle, by taxi, etc.), the last diagnosis in the emergency department (neurological, cardiovascular, respiratory, metabolic, trauma and others), treatment methods (outpatient, inpatient, intensive care), their motility and the relationship of these data with each other were examined. Between the specified dates, a total of 28459 patients over the age of 18 were admitted to the emergency department. It was determined that 10.16% (n=2894) of these patients consisted of patients over 65 years of age. The relationship between the treatment modalities and mortality according to the way the patients came to the hospital was found to be statistically significant (p [Med-Science 2023; 12(1.000): 9-13

Prolonged bleeding on the neck in leech therapy: Case report

Superficial skin bleeding can usually be stopped by applying short-time compression, unless the patient suffers from coagulation disorders or uses anticoagulant. Because of the anticoagulant component of leech saliva, a leech bite may cause long-time bleeding, which cannot be stopped via compression. In this study, the case of a patient who applied leech therapy on her neck for the treatment of migraine has been presented. [Arch Clin Exp Surg 2015; 4(4.000): 234-237

Kounis syndrome due to hirudotherapy (leech therapy) in emergency department; a case report

Kounis Syndrome is the development of acute coronary syndrome (ACS) because of allergic reactions; allergens, such as foods, insect venom, iodine contrast agent or drugs can cause this syndrome. Hirudotherapy (leech therapy) is increasingly used as a useful therapeutic option in a variety of medical and surgical procedures, and potential complications related to this therapy include Aeromonas species infections, bleeding, anemia and allergic reactions. Here, we present a patient diagnosed as Type 1 Kounis Syndrome after using hirudotherapy for her knee aches. 41-year-old woman admitted to emergency department with sudden onset of face edema, shortness of breath and chest pain complaints and diagnosed as an allergic reaction and anaphylaxis due to leech therapy. Kounis Syndrome should be considered in acute coronary syndrome patients who were admitted to emergency department with anaphylaxis clinic. Keywords: Acute coronary syndrome, Emergency medicine, Leech therap