Comparison of Satisfaction Levels between COVID-19 and Non-COVID-19 Patients in the Emergency Department

Background: Patient satisfaction in the emergency department is an indicator of the quality of healthcare service provided. The increased workload and stress of healthcare workers due to the ongoing pandemic can affect the quality of patient care and thus patient satisfaction. This study compares the satisfaction levels of COVID-19 and non-COVID-19 patients in the emergency department. Tools and Methods: In this prospective, observational survey study, the brief emergency patient satisfaction scale (BEPSS) was used to establish the satisfaction levels of patients. Results: Satisfaction levels were significantly higher, while waiting times were quite shorter for COVID-19 patients than for non-COVID-19 patients. The triage categories had no effect on the satisfaction of non-COVID-19 patients, while satisfaction levels were significantly lower in patients with green triage tags than in those with yellow and red triage tags among the COVID-19 patients. Conclusion: The satisfaction levels of COVID-19 patients were higher than those of non-COVID-19 patients. The short waiting times for COVID-19 patients in the emergency department have a significant impact on patient satisfaction

Osteoporozu olan yaşlı hastalarda kas iskelet sistemi ağrısı: Çok merkezli bir çalışma

Amaç: Çalışmanın amacı kas iskelet sistemi (KİS) yakınması ile başvuran yaşlı hastalar içerisinden osteoporozu (OP) olanları belirlemek, bu hastaların ağrıyan bölgelerinin dağılımını ve KİS hastalıklarına yönelik kullandıkları ilaçları değerlendirmektir. Gereç ve Yöntem: Dokuz farklı şehirdeki polikliniklere ardı sıra başvuran 1141 hasta OP tanısına yönelik olarak tarandı. Hastaların yaşları, cinsiyetleri, kas iskelet sistemine dair başvuru yakınmaları, tanıları ve ilaç kullanımları kaydedildi. Bulgular: Yaş ortalaması 71,9±5,3 yıl olan 382 hastanın (341 kadın, 41 erkek) OP tanısı mevcuttu. Her iki cinste de hastaların en sık başvuru yakınmaları bel (%54,5) ve sırt ağrısı (%39,6) olarak belirlendi. Bunları sırasıyla diz, kalça, boyun ve omuz ağrısı takip ediyordu. OP’ye en sık eşlik eden tanılar arasında osteoartrit (%36), lomber spondiloz/stenoz (%21) ve servikal spondiloz/stenoz (%10) ilk sıralarda yer alıyordu. Hastaların kullanmakta olduğu ortalama ilaç sayısı 3±1,2 idi. OP tedavisine yönelik olarak en sık reçetelenen ilaçlar bifosfonatlardı (%59). KİS ağrıları için hastaların %46,6’sı non-steroidal antiinflamatuvar ilaçlar (sistemik ve/veya topikal), %24,6’sı ise parasetamol kullanıyordu. Sonuç: OP’si olan yaşlı hastalarda bel ağrısının altta yatan nedeninin açığa çıkarılması için tam bir fizik muayene yapılması çok önemlidir. Bununla birlikte, çoklu ilaç kullanımını en alt düzeye getirmek için farmakolojik olmayan yaklaşımların KİS hastalıklarının tedavisinde kullanılabileceği mutlaka akılda tutulmalıdır.Objective: The aim of this study was to identify the ones with osteoporosis (OP) in elderly patients presenting with musculoskeletal complaints and to evaluate the distribution of region of pain and the medications used for the musculoskeletal disease(s) in these patients. Materials and Methods: 1141 elderly patients who were consecutively admitted to the outpatient clinics in nine different provinces were screened for the diagnosis of OP Age, gender, complaints, diagnosis and current . medications related to musculoskeletal system disorder(s) were recorded. Results: 382 elderly (341 female, 41 male) with a mean age of 71.9±5.3 years had the diagnosis of OP Low (54.5%) and upper back (39.6%) . pain were the most common complaints in both sexes. These were followed by knee, hip, cervical and shoulder pain, respectively. Osteoarthritis (36%), lumbar (21%) and cervical spondylosis/stenosis (10%) were the most common musculoskeletal diseases accompanying OP The mean number of drugs used was 3.0±1.2. The most commonly . prescribed anti-osteoporotic agents were bisphosphonates (59%). For the musculoskeletal pain, non-steroidal anti-inflammatory drugs (systemic and/or topical) were used in 46.6% and paracetamol in 24.6% of patients. Conclusion: It is crucial to perform a thorough physical examination to reveal the underlying cause of back pain in elderly osteoporotic patients. Besides, in order to minimize polypharmacy, it should be kept in mind that non-pharmacological approaches can be used for the management of musculoskeletal diseases

A rare and fatal cause of seızure ın emergency servıce: Cerebral venous sınus thrombosıs complıcated wıth hemorrhagıc ınfarct

Serebral venöz sinüs tromboz (SVST) nadirdir. Tüm yaş gruplarını etkileyebilir ancak daha çok genç kadınlarda görülür. Klinik semptom ve bulguların çeşitliliği nedeni ile tanısı kolay de- ğildir. Baş ağrısı, fokal defisit, kasılmalar ve koma genel bulgulardır. En sık semptom şiddetli baş ağrısıdır. SVST sonuçları ölümden iyileşmeye kadar değişkendir. Erken tanı ve tedavisi mortalite ve morbiditeyi azaltmada çok önemlidir. Biz 31 yaşında daha öncesinde sağlıklı olup, acil servise nöbet geçirme şikayetiyle getirilen, oral kontraseptif (OKS) kullanan ve hemorajik enfarktla komplike SVST tanısı koyulan bir hastayı sunarak acil servis hekiminin farkındalığını arttırmayı amaçladık.Cerebral venous sinus thrombosis (CVST) is rare. CVST can affect more young women than common. Due to the variety of clinical signs, symptoms are difficult to diagnose. Headache, focal deficits, seizures and coma are common findings. The most common symptom is a severe headache. CVST results are variable from healed to death. Early diagnosis and treatment is very important for reducing mortality, morbidity. A previously healthy 31 years old female patient using of oral contraceptives, brought to the emergency department with complaints of seizures diagnosed CVST complicated with hemorrhagic infarct. In this case we aimed to emergency physicians raise awareness

Evaluation of Chronic Subdural Hematoma Volume Calculated via Cavalieri's Principle

WOS: 000487340900015Objective: Chronic subdural hematoma (CSDH) is a frequently encountered entity in neurosurgery. The objective of this study was to describe the use of unbiased Cavalieri principle to assess CSDH volume to total brain volume fraction (Percentage) and compare it with the clinical features of the patients. Methods: A total of 33 patients were included in the study. Computed tomography (CT) was acquired from the hospital-imaging database. The ratio of hematoma volume, brain volume, and hematoma volume to brain volume were measured via CT by two clinicians. Measurements were compared with clinical findings. Results: The sample consisted of 22 males and 11 females and mean age 67,27 +/- 12,63 years. The measured hematoma volume was 89,78 +/- 54,13 cm3, the brain volume was 1329,91 +/- 2098,35 cm3 and the percentage volume was 8,14 +/- 4,92 cm3. The brain volume values of the cases with impaired consciousness were found to be statistically significant (p <0.05). Conclusions: It should be kept in mind that the bleeding volume of patients with vomiting may be higher

Dokuz Eylul Triage System: A five category triage algorithm in Turkey, reliability and validity study

Introduction: Triage systems are useful tools to detecting severity of illness in the emergency department’s waiting areas. Because of the lack of similarity in terms of disease and the patient profile each triage system may not be effective in another country. Dokuz Eylul Triage System was developed as a five-level triage system and this paper evaluates validity and reliability of Dokuz Eylul Triage System to use in a tertiary Turkish emergency department. Methods: This study was performed in a tertiary emergency department. Patients with any symptoms who were admitted to the emergency department in one-month period and selected by systematic sampling method were included into the study. Hospital admission, length of stay in the emergency department, 48h mortality, resource uses were assessed for validity and blinded paired triage assignments were compared with weighted kappa analysis for reliability. Results: Five-hundred-sixty-seven patients were enrolled; 30 were excluded. The resulting of 537 patients was 55% female and had a median age of 46 years. Seven of them were triage level-1 (1.3%), 142 of them were level-2 (26.4%), 167 of them were level-3 (31.1%), 166 of them were level-4 (30.9%) and 55 of them were level-5 (10.3%). Weighted kappa for triage assignment was found as 0.825. Resource use, hospitalization rates, mean length of stay and 48h mortality were found as strongly associated with triage level. Over-triage rate was 15.5%, under-triage rate was 3.7% and the sensitivity and specificity of the triage system were calculated 99.3% and 96%. Conclusions: Dokuz Eylul Triage System is a reliable and validated five-category triage algorithm for Turkey to be implanted into clinical practice of a tertiary emergency department. We report that Dokuz Eylul Triage System could be able to detect and sieve the patients safely who need resuscitation and emergent care</p

A rare and fatal cause of seızure ın emergency servıce: Cerebral venous sınus thrombosıs complıcated wıth hemorrhagıc ınfarct

Serebral venöz sinüs tromboz (SVST) nadirdir. Tüm yaş gruplarını etkileyebilir ancak daha çok genç kadınlarda görülür. Klinik semptom ve bulguların çeşitliliği nedeni ile tanısı kolay de- ğildir. Baş ağrısı, fokal defisit, kasılmalar ve koma genel bulgulardır. En sık semptom şiddetli baş ağrısıdır. SVST sonuçları ölümden iyileşmeye kadar değişkendir. Erken tanı ve tedavisi mortalite ve morbiditeyi azaltmada çok önemlidir. Biz 31 yaşında daha öncesinde sağlıklı olup, acil servise nöbet geçirme şikayetiyle getirilen, oral kontraseptif (OKS) kullanan ve hemorajik enfarktla komplike SVST tanısı koyulan bir hastayı sunarak acil servis hekiminin farkındalığını arttırmayı amaçladık.Cerebral venous sinus thrombosis (CVST) is rare. CVST can affect more young women than common. Due to the variety of clinical signs, symptoms are difficult to diagnose. Headache, focal deficits, seizures and coma are common findings. The most common symptom is a severe headache. CVST results are variable from healed to death. Early diagnosis and treatment is very important for reducing mortality, morbidity. A previously healthy 31 years old female patient using of oral contraceptives, brought to the emergency department with complaints of seizures diagnosed CVST complicated with hemorrhagic infarct. In this case we aimed to emergency physicians raise awareness

Osteoporozu olan yaşlı hastalarda kas iskelet sistemi ağrısı: Çok merkezli bir çalışma

Amaç: Çalışmanın amacı kas iskelet sistemi (KİS) yakınması ile başvuran yaşlı hastalar içerisinden osteoporozu (OP) olanları belirlemek, bu hastaların ağrıyan bölgelerinin dağılımını ve KİS hastalıklarına yönelik kullandıkları ilaçları değerlendirmektir. Gereç ve Yöntem: Dokuz farklı şehirdeki polikliniklere ardı sıra başvuran 1141 hasta OP tanısına yönelik olarak tarandı. Hastaların yaşları, cinsiyetleri, kas iskelet sistemine dair başvuru yakınmaları, tanıları ve ilaç kullanımları kaydedildi. Bulgular: Yaş ortalaması 71,9±5,3 yıl olan 382 hastanın (341 kadın, 41 erkek) OP tanısı mevcuttu. Her iki cinste de hastaların en sık başvuru yakınmaları bel (%54,5) ve sırt ağrısı (%39,6) olarak belirlendi. Bunları sırasıyla diz, kalça, boyun ve omuz ağrısı takip ediyordu. OP’ye en sık eşlik eden tanılar arasında osteoartrit (%36), lomber spondiloz/stenoz (%21) ve servikal spondiloz/stenoz (%10) ilk sıralarda yer alıyordu. Hastaların kullanmakta olduğu ortalama ilaç sayısı 3±1,2 idi. OP tedavisine yönelik olarak en sık reçetelenen ilaçlar bifosfonatlardı (%59). KİS ağrıları için hastaların %46,6’sı non-steroidal antiinflamatuvar ilaçlar (sistemik ve/veya topikal), %24,6’sı ise parasetamol kullanıyordu. Sonuç: OP’si olan yaşlı hastalarda bel ağrısının altta yatan nedeninin açığa çıkarılması için tam bir fizik muayene yapılması çok önemlidir. Bununla birlikte, çoklu ilaç kullanımını en alt düzeye getirmek için farmakolojik olmayan yaklaşımların KİS hastalıklarının tedavisinde kullanılabileceği mutlaka akılda tutulmalıdır.Objective: The aim of this study was to identify the ones with osteoporosis (OP) in elderly patients presenting with musculoskeletal complaints and to evaluate the distribution of region of pain and the medications used for the musculoskeletal disease(s) in these patients. Materials and Methods: 1141 elderly patients who were consecutively admitted to the outpatient clinics in nine different provinces were screened for the diagnosis of OP Age, gender, complaints, diagnosis and current . medications related to musculoskeletal system disorder(s) were recorded. Results: 382 elderly (341 female, 41 male) with a mean age of 71.9±5.3 years had the diagnosis of OP Low (54.5%) and upper back (39.6%) . pain were the most common complaints in both sexes. These were followed by knee, hip, cervical and shoulder pain, respectively. Osteoarthritis (36%), lumbar (21%) and cervical spondylosis/stenosis (10%) were the most common musculoskeletal diseases accompanying OP The mean number of drugs used was 3.0±1.2. The most commonly . prescribed anti-osteoporotic agents were bisphosphonates (59%). For the musculoskeletal pain, non-steroidal anti-inflammatory drugs (systemic and/or topical) were used in 46.6% and paracetamol in 24.6% of patients. Conclusion: It is crucial to perform a thorough physical examination to reveal the underlying cause of back pain in elderly osteoporotic patients. Besides, in order to minimize polypharmacy, it should be kept in mind that non-pharmacological approaches can be used for the management of musculoskeletal diseases