Are scoring systems sufficient for predicting mortality due to sepsis in the emergency department?

Objectives: Scoring systems have been used to risk stratify in intensive care units (ICU), but not routinely used in emergency departments. The aim of this study was to determine accuracy for predicting mortality in emergency medicine with Sequential Organ Failure Assessment (SOFA), Mortality in ED Sepsis (MEDS) score and Simplified Acute Physiology Score (SAPSII). Methods: This is a prospective observational study. Patients presenting with evidence of sepsis were all included. SAPSII, MEDS, and SOFA scores were calculated. Analysis compared areas under the receiver operator characteristic (ROC) curves for 28-day mortality. Results: Two hundred patients were included; consisting of 31 (14.3%) septic shock. 138 (69%) severe sepsis and 31 (15.5%) infection without organ dysfunction. 53 (26.5%) patients died within 28 days.Area under the ROC curve for mortality was 0.76 for MEDS (0.69–0.82), 0.70 for SAPSII (0.62–0.78); and 1.68 for SOFA (0.60–0.76) scores. Pair wise comparison of AUC between MEDS, SAPSII, SOFA and Lactate were not significant. Conclusion: According to our results; SOFA, SAPSII and MEDS were not sufficient to predict mortality. Also this result, MEDS was better than other scoring system. Keywords: Sepsis, Septic shock, Scoring systems, SOFA, SAPSII, MEDS, Lactate, Emergency medicin

Investigation of the reasons that affect nurses mentally negatively during the Covid-19 pandemic

It was aimed to investigate the causes of negative psychological states that may occur in nurses due to the COVID-19 pandemic and the degree of importance of these reasons. This is a cross-sectional study conducted in two government hospitals. The data were obtained from 134 nurses by the face-to-face survey method. First, scientific studies on the topic were examined, and the authors created a pool of criteria. These criteria were examined one by one under the supervision of experts with experience in the field. In the review, the criteria that dealt with a similar topic were combined, the unsuitable criteria were removed from the pool, and the criteria that dealt with the topic in the same scope were grouped under headings. As a result, 20 final criteria in total were determined under 3 different headings. The headings were grouped as negative situations that individuals feel about themselves (5 criteria), negative situations that individuals feel about their families (5 criteria) and negative situations that individuals feel about their profession (10 criteria). In the second part, 16 questions were created to collect the participants' demographic and work-related information. The Analytic Hierarchy Process Method was used to analyze the data. When the answers (general) were examined, regardless of sociodemographic and working conditions, it was seen that "the feeling of hopelessness and uncertainty" was the primary feeling among the identified negative situations that the individuals felt about themselves. At the top of the participants' negative feelings regarding their families, "the anxiety of transmitting the virus to their family, friends and colleagues" was found, whereas "inequality in supporting employees in terms of wages" came at the top of their negative situations related to their profession. In the fight against the pandemic, measures taken by policymakers and decision-makers are of great importance in protecting nurses and ensuring the sustainability of the health system. This study demonstrates the primary corrective-preventive actions by revealing in which cases nurses feel more negativity. [Med-Science 2022; 11(1.000): 346-53

A case of acute hepatitis following mad honey ingestion

Acute hepatitis is characterized by liver inflammation and liver cell necrosis. The most frequently observed underlying cause thereof is viruses, but various other causes, such as alcohol, medication, or toxins may also lead thereto.In this paper, a case of acute hepatitis presenting with bradycardia, hypotension, and a prominent increase in liver enzymes following mad honey ingestion is discussed. Since there are only few cases of acute hepatitis following mad honey ingestion in the literature, we want to present this subject matter. Keywords: Mad honey poisoning, Mad honey intoxication, Bradycardia, Hypotension, Acute hepatiti

IoT-Enabled Design and Implementation of an Endotracheal Tube Cuff Pressure Controller Device

This work presents the design and implementation of an IoT enabled Endotracheal Tube Cuff Pressure Controller Device. This device, a fusion of electronics, control, and software engineering, aims to automatically regulate the cuff pressure of an Endotracheal Tube placed in a patient’s trachea, ensuring that it remains within the optimal pressure range. The ideal pressure range, established to be between 20–30 cmH2O, can be adjusted to accommodate different patients’ needs. The device is designed as an IoT device and includes an emergency button for shutting down the system in case of an emergency. The total cost of the system, which amounts to approximately 70 USD, makes it a cost-effective solution compared to other commercially available options. In order to verify the device’s capability to accurately read and supply pressure, it is benchmarked against the gold standard (Fluke 729 300G FC) using quantitative tests including Pearson’s r test, the paired t-test, and Bland-Altman analysis. The results from these assessments confirmed that the performance characteristics of the device are notably comparable to the Fluke 729 300G FC, which will be further examined in this study. These outcomes, along with the device’s economic viability, validate it as a workable and reasonable alternative. The necessity for an automated and continuous monitoring system is further reinforced by the fact that manual cuff pressure measurement is prone to error and may even put the patient through discomfort

18F-Fdg Pet/Ct Rarely Provides Additional Information Other Than Primary Tumor Detection In Patients With Pulmonary Carcinoid Tumors

Aim: The purpose of this study was to assess the contribution of (18) F-fluorodeoxyglucose (FDG) Positron Emission Tomography (PET)/Computed Tomography (CT) in detection and staging of pulmonary carcinoid tumors. Methods: A total of 22 patients with pulmonary carcinoid tumors (14 typical, 8 atypical) were reviewed in this retrospective study. PET/CT images of all patients were evaluated for primary tumor as well as metastatic regional lymph nodes, bone and other distant metastases. PET/CT positivity of primary tumors was determined by visual interpretation. Tumor size, SUVmax and Hounsfield Unit (HU) values of the tumors were used to test for differences between tumor groups (typical carcinoids and atypical carcinoids). Results: SUVmax of carcinoids ranged from 1.24 to 11.1 (mean, 5.0; median, 2.67). The mean largest diameter of primary tumors was 2.7 1.3 cm, ranging from 1 to 5.5 cm. The overall sensitivity of FDG PET/CT for detection of pulmonary carcinoid tumors was 81.8%. Tumor size, SUVmax and Hounsfield Unit (HU) values of the atypical carcinoids were higher than those for typical carcinoids. However, the results were not statistically meaningful (P > 0.05). The sensitivity and specificity of FDG PET/CT in the detection of mediastinal and hilar lymph nodes metastases were 25% and 83% respectively. One patient had bone metastasis. Conclusion: Although FDG PET/CT can be a useful tool for the detection of pulmonary carcinoid tumors and distant metastasis, it cannot discriminate typical carcinoids from atypical ones and absence of an FDG avid lesion cannot exclude pulmonary carcinoid tumors. Moreover, PET/CT is not a reliable tool in the staging of mediastinal and hilar lymph nodes especially for those patients with typical carcinoids.Wo

Systemic comorbidities associated with rosacea: a multicentric retrospective observational study

WOS: 000472185200024PubMed ID: 30575019BackgroundOnce considered a disorder limited to the skin, rosacea is now known to be associated with systemic disorders. The aim of this study was to determine what systemic comorbidities accompany rosacea and to determine the relationship between the type, severity, and duration of rosacea, and the presence of and type of systemic comorbidities. MethodsThis retrospective multicenter study was conducted by the Turkish Society of Dermatology Acne Study Group. Thirteen dermatology clinics throughout Turkey participated in the study. A structured physician-administered questionnaire was used to collect patient demographics, clinical findings, and lifestyle data. The principal rosacea subtype, physician global assessment of severity, and duration of rosacea were recorded. Physicians recorded each participant's medical history, including current and past comorbidities, duration of any such comorbidity, and the use of medications to treat any comorbidities. ResultsThe study included 1,195 rosacea patients and 621 controls without rosacea aged 18-85years. As compared to the controls, more of the rosacea patients had respiratory tract, gastrointestinal system, and metabolic and hepatobiliary system disorders in a rosacea's severity- and duration-dependent manner. ConclusionClinicians must be aware of the potential for systemic comorbidities in rosacea patients, which becomes more likely as disease duration and severity increase