Characteristics of school injuries presenting to the emergency department

School injuries account for approximately one-fifth of pediatric injuries. We aimed to investigate the frequency and severity of school injuries among school-aged children and determine clinical diagnoses and surgery requirement data. Methods In this prospective study, children who were admitted to the emergency department due to school accidents over a 5-month period were included. Demographics, activity during trauma, mechanism of trauma, nature, severity, emergency department outcomes, and surgery requirement were evaluated. Results The study included a total of 504 school-aged children, of whom 327 (64.9%) were male and 177 (35.1%) were female. Of the children, 426 (84.5%) had no evidence of injury or minor injury, while 78 (15.5%) had moderate or severe injury. There was a statistically significant difference between these two groups in terms of gender ( p = 0.031). Of the 78 children with moderate or severe injuries, 45 had extremity fractures, 18 had lacerations, 5 had maxillofacial injuries, 4 had cerebral contusion, 1 had lung contusion, and 1 had cervical soft-tissue damage. Two patients with fractures and two with eyelid lacerations were treated surgically, and four patients with brain contusion were hospitalized for a close follow-up. Conclusion This study revealed that the most common moderate or severe injuries in school accidents referred to emergency department were distal radius fractures and lacerations

Evaluation of the presence of reinfection in patients presenting to the emergency department with COVID-19 symptoms after recovery

This study aimed to evaluate COVID-19 reinfection in patients that presented to the emergency department with similar or different COVID-19 symptoms after recovery from the disease. This retrospective study included patients aged over 18 years presenting to the emergency department between January 1, 2021 and July 1, 2021, who had been previously diagnosed with COVID-19 and received treatment for the disease. Statistical analysis was performed using SPSS version 22.0.A total of 199 patients, 54.3% female, were included in the study. PCR positivity was present in 2.5% of the patients, and it was statistically significantly low(p<0.001). The most common symptom was fatigue (46.2%), and the least common symptom was loss of taste (3.0%). However, there was a statistically significant correlation between the loss of taste and smell and PCR positivity (p=0.024 and p=0.043, respectively). The logistic regression analysis revealed that the loss of taste and loss of smell alone did not have an effect on PCR positivity (p=0.848, 95% confidence interval: 0.005-71.83 and p=0.287, 95% confidence interval: 0.001-9.369). In the Covid-19 management and treatment guide, it is necessary to make changes in terms of symptoms for people who have had Covid-19 disease

The role of erythrocyte distribution width in predicting poor outcomes in geriatric patients with acute pancreatitis

Introduction and aim. In our study, our aim was to evaluate the relationship between red cell distribution width (RDW) values and prognosis in geriatric patients with acute pancreatitis. Material and methods. Patients over the age of 65 and diagnosed with acute pancreatitis who applied to the Emergency Department of Ümraniye Training and Research Hospital between 16.07.2021 and 15.05.2022 were included in our retrospective study. RDW levels were recorded using the hospital data system. Results. Our study included 184 patients, 19 (10.3%) of which died. Sixty-five percent of our patients were women. The mean hospital stay was 5 days (from 3 to 9). A statistically significant relationship was also observed between high RDW and mortality (p=0.006). The diagnostic test performance analyses of CRP, and RDW in predicting mortality revealed that they were statistically significant in predicting mortality, with the AUC value being calculated as 0.66 (0.6061–0.7368) for CRP, with a cut-off value of 22; and 0.69 (0.6909–0.7368) for RDW, with a cut-off value of 14.5 (p=0.019, p=0.006, respectively). Conclusion. Hematological parameters can help predict a prognosis in patients with acute pancreatitis. Although RDW is not statistically more significant than CRP, it can be used as a prognostic marker in patients with acute pancreatitis

Can the Neutrophil/Lymphocyte*Platelet Ratio Predict Acute Appendicitis? An Analytical Study

Aim: Our primary aim is to determine whether the neutrophil/lymphocyte*platelet ratio (NLPR) has the ability to predict acute appendicitis. Our secondary aim is to show whether the NLPR is effective in differentiating complicated and non-complicated acute appendicitis. Materials and Methods: Our study was planned retrospectively, and patients over 18 years of age who were diagnosed with acute appendicitis and admitted to the Health Sciences University Turkey, Ümraniye Training and Research Hospital between 01.04.2022 and 01.04.2023, were included in the study. Results: A total of 492 patients were included in our study, and 242 (49.18%) of them were diagnosed with acute appendicitis. Neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR) and NLPR were statistically significantly higher in patients with acute appendicitis compared to the control group (p<0.001, p<0.001, p<0.001, respectively) (the area under the curve was 0.96, 0.70, 0.94, respectively). Conclusion: NLR, PLR and NLPR can be used as predictors for the diagnosis of acute appendicitis, but according to our study, NLR, PLR and NLPR should not be used as prognostic indicators of acute appendicitis

Comparison of blood gas analysis&nbsp;parameters, biochemical tests&nbsp;and hematological parameters in&nbsp;geriatric patients admitted to the&nbsp;emergency department

Aim: The primary aim is to compare blood gas parameters (sodium, potassium, glucose, hemoglobin, hematocrit) with biochemical test and hospital hemogram results and thus to investigate the compatibility of blood gas estimation with other laboratory tests in geriatrics. The secondary aim is to compare the effects of these parameters on patient mortality. Material and methods: Patients over the age of 65 who applied to the emergency department were included in our retrospective study. Statistical Package for Social Sciences (SPSS Inc., version 20.0; Chicago, IL) was used for statistical analyzes applying to the emergency department. Statistical significance was accepted as p&lt;0.05. Results: 102 patients were included in our study and 51.97% were male. 9.8% of our patients died. The diagnostic test performance analyzes of BG (blood gas) hemoglobin, hemoglobin, BG hematocrit, hematocrit, BG glucose, glucose, BG sodium, sodium, BG potassium, potassium in predicting mortality revealed with the AUC(area under curve) value being calculated as unsuccessful for BG hemoglobin, hemoglobin, BG hematocrit and hematocrit (AUC value: 0.47, 0.45, 0.46, 0.50). AUC (area under curve) value being calculated as weak for BG glucose, glucose and BG sodium (AUC value: 0.64, 0.61, 0.63 respectively). AUC value being calculated as medium for sodium (AUC value: 0.71). Conclusion: There is no superiority of blood gas parameters over hematological and biochemical parameters in predicting mortality in the geriatric patient group. However, blood gas parameters can be used in patient management as they correlate with other laboratory tests

Comparison of geriatric pulmonary embolism severity index (G-PESI) with PESI and s-PESI in predicting prognosis and mortality

Our objective is to investigate the effect of geriatric pulmonary embolism severity index score on mortality independent of age and to compare it with pulmonary embolism severity index and simplified pulmonary embolism severity index. Material and Method: This is a retrospective observational study including patients over 65 years of age diagnosed with pulmonary embolism, who presented to the emergency medicine clinic of tertiary hospital between January 1, 2016 and January 1, 2021. The relationship between the original PESI and 30-day mortality was evaluated, and age was removed from the original score in the G-PESI. A univariate analysis of PESI, s-PESI, and G-PESI was performed using the chi-square test, Fisher’s exact test, Student’s t-test, and Mann–Whitney U test as appropriate to determine the association of these scores with 30-day mortality. Statistical analysis was performed using SPSS version 26.0. Results: This study included 167 patients, of whom 113 (67.7%) were women. According to the diagnostic test performance analysis report, the pulmonary embolism severity index, simplified pulmonary embolism severity index and geriatric pulmonary embolism severity index scores were statistically significant in predicting mortality, with the area under the curve values of 0.736 (0.34-1.91), 0.635 (0.74-1.81), and 0.739 (0.50-2.18) at the cut-off values of >110, >2, and >40, respectively (p<0.001, p<0.001, and p=0.004 respectively). When the area under the curve values of these three scores were compared, there was no statistically significant difference between pulmonary embolism severity index and geriatric pulmonary embolism severity index (p=0.7241). Discussion: Geriatric pulmonary embolism severity index, similar to pulmonary embolism severity index, can be accepted as an independent predictor in geriatric patients diagnosed with pulmonary embolism

Evaluation of the relationship of hemogram parameters with prognosis in older adults with acute abdominal pathologies

We aimed to investigate the effects of hemogram parameters on the short-term mortality of older adults with acute abdominal pathologies. Secondly, it was aimed to investigate the effect of hemogram parameters on mortality in operated and non-operated patients. Material and Method: This retrospective observational study was conducted in an emergency medicine clinic between June 1, 2019, and June 1, 2020. Data on patients over 65 years of age who presented to the emergency department with acute abdominal pathologies were analyzed. Hemogram parameters, as in our patient group over 65 years old, who presented with all acute abdomen pathologies; It was examined in terms of its relationship with prognosis in our operated and non-operated patient group. Statistical analysis was performed using SPSS v. 26.0. Results: The study included a total of 744 patients, of whom 391(52.6%) were women. Mortality was seen in 114(15.32%) patients, and 83(11.2%) patients underwent surgery. AUC and cut off values are for leukocytes count 0.590 and 10.83 for neutrophils count 0.596 and 9.64 for neutrophil-lymphocyte ratio 0.606 and 8.24 to predict mortality (p=0.002, p=0.001, and p>0.001, respectively Conclusion: In this study, among the hemogram parameters; leukocytes, neutrophils and neutrophil-lymphocyte ratio were determined to have a statistically significant ability to predict mortality in older adults both operaple and non operabl groups groups presenting with acute abdominal pathologies, but their accuracy rates were low

Ischemic Stroke after Head Trauma in a Child: case report

Pediatric traumas are an important cause of morbidity and mortality. Symptoms in children may differ from those in adult patients. Although the findings of physical examinations and imaging may be normal in the early posttraumatic period, patients may develop various symptoms and signs in the late term. Herein, we present the case of an 11 year old boy who had normal physical examination and imaging findings in the early posttraumatic period, but who later presented with severe headache and was found to have cerebral infarct, and make a review of related literature

Diagnostic value of lateral ankle radiography in achilles tendon rupture

Achilles tendon rupture (ATR) is a common sports injury, but approximately 20% of acute ATR cases are misdiagnosed as ankle sprains at first presentation. This study aimed to investigate the diagnostic value of lateral ankle radiography in the diagnosis of acute ATR. Methods: This was a retrospective case-control study in which the lateral ankle radiographs of patients who presented to the emergency department between January 1, 2015 and December 31, 2019 were examined. The study included a total of 154 patients with acute ATR, who underwent lateral ankle radiography at the presentation and were surgically or magnetic resonance imaging (MRI) confirmed to have ATR in our hospital. The lateral ankle radiographs of the patients were examined by 2 clinicians blinded to clinical data for the following 3 findings: Kager’s fat pad sign, tibio-first metatarsal angle, and tibiocalcaneal angle. The same procedure was repeated for 308 controls who underwent lateral ankle radiography and were diagnosed with ankle sprain

Effect of the prognostic nutritional index and systemic immuneinflammatory index in predicting short-term mortality in geriatric patients with SARS-CoV-2 infection

Introduction and aim. We aimed to investigate whether systemic immune inflammatory index (SII) and prognostic nutritional index (PNI) were associated with short-term mortality in geriatric patients with SARS-CoV-2.Material and methods. Our study was designed retrospectively. The data of patients that presented to a single center. The primary outcome of the study was the diagnostic value of SII and PNI in predicting 28-day mortality in geriatric patients with SARS-CoV-2 pneumonia. Results. 272 geriatric patients with SARS-CoV-2 included. The median PNI was 42.5, and the median SII was 687.6 (430–1404.2). In univariant analysis, PNI and SII has a significant relationship with mortality (p40.1) and SII (<1.267) for 30-day mortality were determined as 1.12 , and 1. Conclusion. In conclusion, the blood tests used to calculate PNI and SII are routinely included in complete blood count and biochemistry tests that can be performed in every hospital. According to the results of the current study, the mortality group had significantly higher SII values and significantly lower