6 research outputs found

    Evaluation of the diagnostic value of platelet indices in pediatric acute appendicitis

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    Objective: Abdominal examination findings in pediatric acute appendicitis (AA) significantly vary by age. Therefore, grading systems have been developed for diagnosing pediatric appendicitis, and laboratory and radiological findings have an important role in this diagnosis. However, there is a need to develop new parameters for diagnosing AA. This study aimed to investigate the diagnostic value of platelet indices in AA. Methods: This retrospective, observational study included 207 pediatric patients who were admitted to the Emergency Department and operated on for AA. The patients were divided into three groups on the basis of their surgical and histopathological findings (non-AA, uncomplicated AA, and complicated AA). Results: There was no significant difference in the mean platelet volume/platelet count (MPV/PC) ratio among the groups. The white blood cell (WBC) count and the MPV/PC ratio showed a significant negative relationship (r = −0.239). The specificity for MPV was 61.8% and the sensitivity was 68.8%. Receiver operating curve analysis of WBC and MPV showed significance for diagnosing AA. Conclusion: There is a negative, but weak, relationship between the WBC count and the MPV/PC ratio. However, the MPV/PC ratio could be a useful parameter for diagnosing pediatric AA according to receiver operating curve analysis. © The Author(s) 2020

    Effect of parental pressure on emergency physicians for computerized tomography imaging request in children with head trauma

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    Background: Both minor and major head traumas constitute an important proportion of childhood emergency admissions. In this study, the findings of cranial computed tomography (CCT) scans performed as a result of the parental pressure were evaluated. Methods: The frequency and findings of CCT scans performed as a result of parental pressure were examined in a separate subgroup. Results: A total of 227 patients were included in the study; 158 (69.9%) patients had undergone CCT scans; a pathological finding was detected in 24 (10.6%) of these patients and undergone a consultation by the neurosurgeon (most common finding was isolated linear fracture; n = 12; 50%). The patients undergoing CCT scans were divided in two subgroups: the PECARN group [n = 123 (77.8%)] and the Parental pressure group [n = 33 (22.2%)]. Conclusion: One third of the parents of children who presented to the emergency department with head trauma and had no indication for CCT according to PECARN rules insisted on CCT imaging, and none of these cases showed ciTBI, surgical operation, or mortality. None of the patients in the parental pressure group had a history of surgical intervention or mortality within one month after discharge. © 2020 Elsevier Inc

    Impact of desert dust storms, PM10 levels and daily temperature on mortality and emergency department visits due to stroke

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    ObjectiveIt is known that the inhalation of air pollutants adversely affects human health. These air pollutants originated from natural sources such as desert storms or human activities including traffic, power generating, domestic heating, etc. This study aimed to investigate the impacts of desert dust storms, particulate matter ≤10 μm (PM10) and daily maximum temperature (MT) on mortality and emergency department (ED) visits due to stroke in the city of Gaziantep, Southeast Turkey.MethodThe data on mortality and ED visits due to stroke were retrospectively recruited from January 1, 2009, to March 31, 2014, in Gaziantep City Centre.ResultsPM10 levels did not affect ED visits or mortality due to stroke; however, MT increased both ED visits [adjusted odds ratio (OR) = 1.002, 95% confidence interval (CI) = 1.001–1.003] and mortality (OR = 1.006, 95% CI = 0.997–1.014) due to stroke in women. The presence of desert storms increased ED visits due to stroke in the total population (OR = 1.219, 95% CI = 1.199–1.240), and all subgroups. It was observed that desert dust storms did not have an increasing effect on mortality.ConclusionOur findings suggest that MT and desert dust storms can induce morbidity and mortality due to stroke

    Stranger in the garden: Ricinus communis, 17 cases of intoxication

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    Introduction: Ricinus communis is used as a decoration in landscape gardening in Turkey. In industrialized countries, however, it is used in many sectors, including the chemical, pharmaceutical, and fertilizer sectors; it is also used in cosmetics and biodiesel fuel production. In this presentation, 17 patients who ingested R. communis seeds are examined. Cases: Seventeen patients who ate the seeds of an unknown plant that grows in their gardens came to the emergency department with nausea, vomiting, and stomach ache complaints 4 h after ingesting the seeds. All patients were admitted to the critical care unit, monitored, and started on supportive treatment. After the treatment, patients’ vital signs and laboratory parameters were stable. Seven patients were discharged the next day upon the regression of symptoms. The remaining 10 patients were successfully discharged 2 days after the treatment. There are cases in medical literature where consumption of one-half of a R. communis seed resulted in death. In our presentation, each patient consumed one to four (2.18 on average) R. communis seeds, and the symptoms were over within 2 days. The clinical course ended without any cases of death, and all patients were discharged in good condition. Conclusion: Emergency physicians have to know the clinical course and medical methods regarding intoxication due to oral consumption of toxic plants. Severe toxicity and even mortality can be observed with the ingestion of the seeds of the plant. Similar symptoms (nausea, vomiting, and abdominal pain) were observed in all our cases, but no mortality was observed

    Unknown biological materials brought to the emergency department

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    Objective: This study is unique as it examines biological materials brought to the emergency department. The purpose of this study was to investigate the reasons behind the presence of nonhuman biological material in the emergency department. Methods: The materials brought were photographed and a pre-prepared survey form was filled in following examination. Results: A total of 46 biological materials were brought to the emergency department within a 12-month period. Ticks were the most frequently brought material, and the most common reason for bringing them was to get the creature removed from the body. Situations in which the physician did not have knowledge about the material were more frequent among those that were neutral about being satisfied with the attitude of the physician towards the material brought, and satisfaction was higher in cases when the physician was knowledgeable, although this was not statistically significant. Conclusion: Physicians should not condemn biological materials brought into the department after exposure. If possible, they should try to gain more knowledge about them. If the material is not to be stored, once it is made sure that it is not dangerous, it should be disposed of in a medical waste bin. Physicians should be knowledgeable toward the frequency and the types of such agents in their region

    The Effect of Epinephrine Administration on Return of Spontaneous Circulation and One-Month Mortality with Cardiopulmonary Arrest Patients

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    Objective: The objective of this study is to determine the effect of epinephrine administration on the return of spontaneous circulation (ROSC) and one-month mortality in patients with cardiopulmonary arrest.Methods: We conducted this study between August 1, 2016 and May 31, 2017. Importantly, we included the witnessed cases (?18years) of in-emergency department cardiopulmonary arrest (IEDCA) and out-of-hospital cardiopulmonary arrest (OHCA) in thestudy. We divided the patients into two groups: the adrenaline group (Group 1) and the non-adrenaline group (Group 2). Thereafter, we investigated ROSC and one-month mortality in them.Results: We included 183 patients (50.3% of males and 49.7% of females with a mean age of 64.2±16.8 years) in the study. Thepercentages of IEDCA and OHCA cases were 25.1% and 74.9%, respectively. Epinephrine was administered to 100 (54.6%) patients(Group 1). Among these patients, 15.9% (n=29) of the patients had shockable rhythms (ventricular fibrillation, pulseless ventriculartachycardia) and 84.1% (n=154) of them had non-shockable rhythms (asystole, pulseless electrical activity) as the initial rhythm.ROSC and one-month mortality rate of these patients were 24% (n=44) and 72.8% (n=36), respectively. The one-month mortalityrates of Group 1 (30% of patients had IEDCA and 70% of patients had OHCA) and Group 2 were 43.8% and 56.2%, respectively(p=0.0231). The ROSC and one-month mortality rates of Group 1 and Group 2 cases, whose initial rhythm was a shockable rhythm,were 26.6% and 50% vs. 42.8% and 66.6%, respectively.Conclusion: In this study, we found no significant difference in terms of obtaining ROSC between the shockable rhythm and ROSCin the IEDCA and OHCA cases (p=0.963 and p=0.141, respectively). The effect of epinephrine administration on patients with IEDCA and OHCA whose ROSC was obtained on one-month mortality was not statistically significant (p>0.05).WOS:00057445920000
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