Epidemiological and Clinical Characteristics of Anterior Shoulder Dislocation Patients in Emergency Departments in Turkey: A Single-Center Experience

Objective: This study evaluated the general epidemiological and clinical characteristics of patients admitted to the emergency department with shoulder dislocation. Methods: This single-center retrospective cross-sectional study, which included patients with anterior shoulder dislocation, was conducted as a chart review at the Emergency Department of the Tekirdag State Hospital between 01 January 2018 to 31 December 2019. Results: A total of 165 patients (median age 50 years and 60% of males) with anterior shoulder dislocation were included. The most common mechanism was traumatic dislocation (65.5%), the primary reduction technique was traction/countertraction (80.6%). Two-thirds of the patients had right shoulder dislocation, traumatic dislocation, and sedoanalgesia was not required. Age was lower in men, but spontaneous dislocation was more common. The diagnosis was made with an x-ray at a rate of 99%. Emergency physicians were 96% successful. Conclusions: Direct radiography successfully makes the diagnosis of anterior shoulder dislocation. Anterior dislocation management by emergency physicians is highly successful. It should be considered that atraumatic dislocations are more common in young male patients

Geleceğin Sağlık Profesyonellerinin Afet Tıbbı Bilgi Düzeyi ve Eğitim Yaklaşımlarının Değerlendirmesi

Amaç: Bu çalışma, afet müdahalesinin önemli faktörleri olan sağlık öğrencilerinin afet tıbbı bilgi düzeylerini ve afet tıbbına yönelik eğitim yaklaşımlarını belirlemeyi amaçlamıştır. Gereç ve Yöntem: Bu kesitsel tanımlayıcı tasarım çalışması, Türkiye’de Tekirdağ Namık Üniversitesi’ndeki Hemşirelik Bölümü, Acil Yardım ve Afet Yönetimi (AYAY) Bölümü ve Tıp Fakültesi son sınıf öğrencileri ile gerçekleştirilmiştir. Veriler yüz yüze uygulanan anket yoluyla toplanmıştır. Bulgular: Araştırmaya katılan 159 kişiden %49’u (n=78) afet tıbbı eğitimi almıştır. AYAY öğrenci grubunun bilgi düzeyi ortalaması (78,96±10,5) hemşirelik (65,49±12,84) ve tıp (72,33±10,56) öğrenci gruplarına göre daha yüksek bulunmuştur. Bilgi düzeyi yüksek olan öğrencilerin büyük kısmı (n=56, %58,9) afet tatbikatına katılmıştır. Kişisel koruyucu ekipman (KKE) (n=30, %18,8), dekontaminasyon (n=52, %32,7) ve triyaj (n=60, %37,7) konularına ait sorular sırasıyla en düşük oranda doğru yanıtlanan sorular olarak tespit edilmiştir. Afet tıbbı eğitimi almayan öğrenciler (n=82, %92,1) afet tıbbı eğitimi almak istediklerini belirtmiş ve çoğu öğrenci (n=115, %72,3) afet tıbbı derslerinin acil tıp uzmanları tarafından verilmesini tercih etmiştir. Sonuç: Sağlık mesleklerinin temel müfredatında KKE kullanımı, dekontaminasyon prosedürleri ve triyaj gibi konulara özel vurgu yapılan afet tıbbı derslerine yer verilmeli ve öğrenme çıktıları afet tatbikatları ile pekiştirilerek öğrencilerin afet tıbbı konusundaki kişisel bilgi ve yeterlilik algıları desteklenmelidir

The peroneus brevis tendon at its insertion site on fifth metatarsal bone

Background: The differences at the attachment site of peroneus brevis (PB) to the fifth metatarsal bone isimportant in terms of the forces exerted on the bone and hence the mechanism of fractures involving thisstructure. In this study, we investigated the anatomical properties of PB at the insertion site to the base offifth metatarsal bone, its possible intertendinous connections with peroneus tertius (PT) and theirpossible effects on the fracture occurrence at the bony attachment site.Methods: The length and the width of PB tendons at their mid- and end-points were measured andclassified according to the insertion types. Besides, the length and the width of the base of fifth metatarsalbone were assessed. The slips extending from the PB tendons and their relationship with PT were alsoevaluated. The data was compared statistically with each other and between the right and left sides.Results: The length of PB tendon was measured 79.57 15.40 mm on the right side; 81.48 14.31 mm on theleft. The width of PB tendon at the mid-point was 4.46 0.80 mm on the right side; 4.42 0.94 mm on the left.The width of the tendon at its insertion point was measured 14.85 3.40 mm and 15.16 3.42 mm on the rightand left sides respectively. PB was divided into three types according to its attachment to base of fifth metatarsalbone (5thMB). Type I, Type II and Type III were observed at the rates of 59.5%, 28.6% and 11.5% respectively. It wasobserved that the slips to the bone were extending more commonly from PB than from PT and that the largemajority of them were single having their insertions on the base of the proximal phalanx of the fifth toe.Conclusions: Knowing the width and insertional types of PB aids in understanding the mechanism offractures at the site of bony attachment. The existence of slips may help the surgeon in the proceduresinvolving PB or the lateral side of the forefoot

Elevated serum calprotectin as an inflammatory marker in obstructive sleep apnea

OBJECTIVE To investigate the serum calprotectin (SCal) levels and neutrophil/lymphocyte ratio (NLR) values in patients with obstructive sleep apnea (OSA). METHODS Sixty-seven OSA patients and 46 healthy volunteers without any sleep disorders were included in the study. The patient group was divided into three subgroups according to the severity of OSA. The SCal levels and NLR values were compared among subgroups and between the experimental and control groups. RESULTS The mean SCal level and NLR value were higher in the study group than in the control group (p = 0.002 and p = 0.001, respectively). The SCal levels were significantly higher in patients with severe OSA than in those with moderate and mild OSA (p = 0.004 and p = 0.001, respectively). DISCUSSION Unlike NLR, the SCal level may inform the severity of OSA and could be used as an indicator for OSA

A Reliability and Validity Study of the Turkish Version of the Parenting Scale

Aim:This study was conducted for the purpose of determining the validity and reliability of the Parenting scale in a Turkish sample.Materials and Methods:The study was conducted as a methodological-descriptive-cross sectional study. The study sample consisted of 355 parents who had applied to Child and Adolescent Psychiatry Polyclinic of Uludağ University. However; as 85 parents did not precisely fill the scales, they were excluded from the sample and the analyses were conducted on the basis of 270 parents. The study data were collected using the Demographic Data Collection Form and the Parenting scale. Validity analyses of the scale were examined via explanatory and confirmatory factor analysis. The internal consistency of the scale was evaluated via Cronbach alpha, Spearman-Brown and Guttman split-half coefficients. The relationship between item-total score and item-subscale total score was examined via Pearson correlation analysis.Results:The Cronbach alpha values of the Parenting scale were determined as; 0.935 in the lower dimension of Laxness, 0.916 in the lower dimension of Over-reactivity, 0.770 in the lower dimension of Hostility (use of verbal or physical force) and 0.829 in the total scale. The factor loads varied between; 0.52 and 0.98 in the lower dimension of Laxness, 0.75 and 0.92 in the lower dimension of Over-reactivity and 0.46 and 0.95 in the lower dimension of Hostility. It was determined that the total scale scores and correlations of items in the scale varied between 0.20-0.66. It was also determined that item-subscale total score correlations varied between; 0.61-0.96 in the lower dimension of Laxness, 0.70-0.86 in the lower dimension of Over-reactivity and 0.68-0.91 in the lower dimension of Hostility.Conclusion:The Parenting scale is a valid and reliable tool that can be used in Turkish culture

Acil Servise Başvuran Onkolojik Tanılı Hastaların Demografik İncelenmesi

Amaç: Hasta bakımındaki iyileşmeler sayesinde kanser hastalarının yaşam süresindeki uzamalar tüm dünyada kanserli hasta sayısının giderek artmasına neden olmaktadır. Bununla beraber acil servise başvuran onkolojik hastaların sayısı da gün geçtikçe artmaktadır. Bu çalışma ile kanserli hastaların acil servise başvuru nedenleri ve prognozu etkileyen faktörleri demografik olarak incelenmiştir. Gereç ve Yöntem: Çalışmaya Tekirdağ Namık Kemal Üniversitesi Hastanesi Acil Servisi’ne 1 Mart 2018 tarihi ile 31 Ağustos 2018 tarihi arasında başvuran ve klinik/patolojik/onkolojik tanısı olan 18 yaş ve üzeri hastalar dahil edildi. Çalışma prospektif olup, başlamadan önce etik kurul onayı alındı. Bulgular: Çalışmaya onkoloji tanısı patoloji raporları ile kesinleşmiş 265 hasta dahil edildi. Olguların yaş ortalaması 60±12 yıl olup, kadınlardaki yaş ortalamasının 58±13 yıl olduğu görüldü. En sık başvuru şikayeti %13,6 (n=36) ile “ağrı” oldu. Kliniklere ve yoğun bakım ünitelerine en sık yatış nedeninin %6,8 (n=18) ile gastrointestinal sistem patolojileri ve respiratuvar patolojiler olduğu görüldü. Yatışı yapılan 90 hastadan %63,3’ünün (n=57) hastaneden taburcu edildiği ve %33,3 (n=30) hastanın ise yatırıldığı kliniklerde vefat ettiği saptandı. Sonuç: Onkolojik hasta gruplarının yaş ortalaması yüksek olduğu için morbiditesi ve mortalitesi diğer hasta gruplarına göre daha yüksektir. Bu sebeple bu hasta grupları acil servise diğer hasta gruplarına göre farklı şikayetlerle gelebilmektedirler. Onkolojik hastaların tetkik ve tedavilerinin daha dikkatli düzenlenmesi gerekmektedir

A nationwide multicentre study in Turkey for establishing reference intervals of haematological parameters with novel use of a panel of whole blood

IntroductionA nationwide multicentre study was conducted to establish well-defined reference intervals (RIs) of haematological parameters for the Turkish population in consideration of sources of variation in reference values (RVs). Materials and methodsK2-EDTA whole blood samples (total of 3363) were collected from 12 laboratories. Sera were also collected for measurements of iron, UIBC, TIBC, and ferritin for use in the latent abnormal values exclusion (LAVE) method. The blood samples were analysed within 2 hours in each laboratory using Cell Dyn and Ruby (Abbott), LH780 (Beckman Coulter), or XT-2000i (Sysmex). A panel of freshly prepared blood from 40 healthy volunteers was measured in common to assess any analyser-dependent bias in the measurements. The SD ratio (SDR) based on ANOVA was used to judge the need for partitioning RVs. RIs were computed by the parametric method with/without applying the LAVE method. ResultsAnalyser-dependent bias was found for basophils (Bas), MCHC, RDW and MPV from the panel test results and thus those RIs were derived for each manufacturer. RIs were determined from all volunteers’ results for WBC, neutrophils, lymphocytes, monocytes, eosinophils, MCV, MCH and platelets. Gender-specific RIs were required for RBC, haemoglobin, haematocrit, iron, UIBC and ferritin. Region-specific RIs were required for RBC, haemoglobin, haematocrit, UIBC, and TIBC. ConclusionsWith the novel use of a freshly prepared blood panel, manufacturer-specific RIs’ were derived for Bas, Bas%, MCHC, RDW and MPV. Regional differences in RIs were observed among the 7 regions of Turkey, which may be attributed to nutritional or environmental factors, including altitude

Modeling route choice behaviour in transportation networks by using fuzzy logic and logistic regression techniques

Route choice is a complex problem in which the individual benefit is maximized by using many parameters. The effectiveness of a route choice model depends on well-definition of the users' behaviors. The purpose of this study is to model the route choice problem of an important network in Denizli with fuzzy logic using the real data gathered by a survey. Four important parameters; namely travel time, traffic safety, congestion and environmental effects are used in the fuzzy model. The fuzzy logic concepts are especially used to take into account the characteristics of route choice behavior such as imprecision, vagueness and uncertainty. The fuzzy logic model is compared with Logistic Regression Models and the best results are obtained with the Fuzzy Logic Model