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

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

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

Problems of control of mini unmanned aerial vehicle (MINIUAV)

It was introduced suggestions and results concerning some of control miniUAV problems in this article. They were formulated on base of theoretical and experimental investigations. Now the own construction miniature system avionics is being investigated. This system is designed to stabilisation of miniUAV and to control of navigation with GPS signal. Now system is used also as flight control recorder. The avionics control system which lets for very good and saved navigation miniUAV should be created. more over this system should use GPS signal and miniature sensors. Especially, a block Junction diagram of a miniature avionics unit - miniBSP MSOP. = 3 accelerometers, 3 rate gyroscopes, static pressure sensor, dynamic pressure sensor, control path in the autopilot channel of pitch and roll during the Start and Steady Flight stage, Control path in the draught control channel during Start and Steady Flight stage, general scheme of a ground-based flight control to pilot miniBSP unmanned aircrafts, visualization of the ground-based flight control station operation, airframe for testing during flight, positions of equipment items in the miniBSP airframe are presented in the paper

Point-of-care emergency ultrasonography in non-traumatic cardiac arrest and near-arrest emergency patients; A pilot trial

Introduction: In this study, we evaluated the applicability and interpretation of point- of- care emergency ultrasound (POCEUS) performed by an emergency physician (EP) in non-traumatic adult cardiac arrest and near-arrest patients at presentation to the Emergency Department (ED). Methods: POCEUS was performed in 5 steps on 73 adults to assess; 1. Qualitative global cardiac function, cardiac chambers and presence of pericardial effusion; 2. Presence of pleural sliding, B-lines, A-lines or consolidation on anterior-superior; 3. Presence of an abdominal aorta aneurysm and pelvic free fluid; 4. Presence of pleural effusion, consolidation, free fluid on lateral-inferior; 5. Qualitative width and collapsibility of the inferior vena cava. A fulfilled checklist and real-time images of ultrasonography were sent by WhatsApp to the head of the study to generate the evidence and collect the data. The process of patient care, in-hospital diagnosis and survival were retrieved from digital hospital records. This prospective multicenter sample study was conducted from November 16, 2015, to January 5, 2016. Results: The most common findings of POCEUS were performed and interpreted to have a first prediction of patients' acute clinic problem by EPs were compatible with global systolic dysfunction (n = 16, 22.9%), pulmonary edema (n = 17, 23.3%), pulmonary embolus (n = 6, 8.2%), distributive/hypovolemic shock (n = 12, 16.4%), cardiac tamponade or pericardial effusion (n = 5, 6.8%), and pneumonia (n = 31, 42.5%) at presentation. The kappa correlation coefficient value of the POCEUS at presentation versus the final, traditional clinical diagnosis of the admitted ward, was 0.773 (95% CI, 0.747-0.892; p = 0.064, McNemar). Conclusions: POCEUS performed by an EP at presentation had a good agreement between in qualitative prediction of the first differential diagnosis in life-threatened patients and the last diagnosis obtained during hospitalization. Furthermore, this study showed the requirement of evidence in comparison of measurements to the qualitative manner and new descriptive processes in POCEUS for unexplained situations and questions. © 2020 Via Medica

Can hematological and biochemical parameters fasten the diagnosis of COVID-19 in emergency departments?

INTRODUCTION: The primary aim of the study was to compare the laboratory and radiological parameters of COVID-19 positive and negative patients confirmed by Real-Time Reverse Transcription Polymerase Chain Reaction (RT-PCR), and Chest Computed Tomography (CCT) of patients admitting with the suspicion of COVID-19. The secondary purpose of the study was to find objective parameters to speed up the clinician for further examination, treatment or referral decision in COVID-19 suspicion. MATERIAL AND METHODS: A total of 61 COVID-19 suspected patients were evaluated in the study. Swab samples were taken for RT-PCR analysis. CCT was taken for 42 patients who described dyspnea. According to CCT and RT-PCR results, the patient population was divided into 2 groups as COVID-19 positive group (n = 32); and COVID-19 negative group (n = 29). Between two groups; demographic, clinical, laboratory and radiological parameters were compared. RESULTS: Male gender (p = 0.03), PLR value (p = 0.021) and CO-RADS scores were higher in the COVID-19 positive group. Oxygen saturation (SaO2) (p = 0.027) and PCT, WBC, Neutrophil count, Lymphocyte count values were significantly low in COVID-19 positive group (p = 0.03, p = 0.001, p = 0.017, p = 0.021, respectively). PLR showed a positive correlation with fever, CRP, neutrophil count and NLR, which are indicators of inflammation. CONCLUSIONS: SaO2, WBC, lymphocyte count, neutrophil count and low PCT levels, and PLR elevation showed a significant difference in COVID-19 patients in our retrospective cohort study examining the Turkish population. We believe that these results will allow clinicians to make quick decisions in patient management more simply. Copyright © 2020 Via Medic

Effects of Dust Storms and Climatological Factors on Mortality and Morbidity of Cardiovascular Diseases Admitted to ED

Objective. This study was designed to investigate the effects of Desert Dust Storms and Climatological Factors on Mortality and Morbidity of Cardiovascular Diseases admitted to emergency department in Gaziantep. Method. Hospital records, obtained between September 01, 2009 and January 31, 2014, from four state hospitals in Gaziantep, Turkey, were compared to meteorological and climatological data. Statistical analysis was performed by Statistical Package for the Social Science (SPSS) for windows version 24.0. Results. 168,467 patients were included in this study. 83% of the patients had chest pain and 17% of patients had cardiac failure (CF). An increase in inpatient hospitalization due to CF was observed and corresponded to the duration of dust storms measured by number of days. However, there was no significant increase in emergency department (ED) presentations. There was no significant association of cardiac related mortality and coinciding presence of a dust storm or higher recorded temperature. The association of increases in temperature levels and the presence of dust storms with “acute coronary syndrome- (ACS-) related emergency service presentations, inpatient hospitalization, and mortality” were statistically significant. The relationship between the increase in PM10 levels due to causes unrelated to dust storms and the outpatient application, admission, and mortality due to heart failure was not significant. The increase in particle matter 10 (PM) levels due to causes outside the dust storm caused a significant increase in outpatient application, hospitalization, and mortality originated from ACS. Conclusion. Increased number of dust storms resulted in a higher prevalence of mortality due to ACS while mortality due to heart failure remained unchanged. Admission, hospitalization, and mortality due to chest pain both dependent and independent of ACS were increased by the presence of dust storms, PM10 elevation, and maximum temperature

An ethnobotanical survey of medicinal plants used in the East Sepik province of Papua New Guinea

© 2015 Koch et al. Background: Rapid modernization in the East Sepik (ES) Province of Papua New Guinea (PNG) is resulting in a decrease in individuals knowledgeable in medicinal plant use. Here we report a synthesis and comparison of traditional medicinal plant use from four ethnically distinct locations in the ES Province and furthermore compare them to two other previous reports of traditional plant use from different provinces of PNG. Methods: This manuscript is based on an annotated combination of four Traditional Medicines (TM) survey reports generated by University of Papua New Guinea (UPNG) trainees. The surveys utilized a questionnaire titled Information sheet on traditional herbal preparations and medicinal plants of PNG , administered in the context of the TM survey project which is supported by WHO, US NIH and PNG governmental health care initiatives and funding. Regional and transregional comparison of medicinal plant utilization was facilitated by using existing plant databases: the UPNG TM Database and the PNG Plant Database (PNG Plants) using Bayesian statistical analysis. Results: Medicinal plant use between four distinct dialect study areas in the ES Province of PNG showed that only a small fraction of plants had shared use in each area, however usually utilizing different plant parts, being prepared differently and to treat different medical conditions. Several instances of previously unreported medicinal plants could be located. Medicinally under- and over-utilized plants were found both in the regional reports and in a transregional analysis, thus showing that these medicinal utilization frequencies differ between provinces. Conclusions: Documentation of consistent plant use argues for efficacy and is particularly important since established and effective herbal medicinal interventions are sorely needed in the rural areas of PNG, and unfortunately clinical validation for the same is often lacking. Despite the existence of a large corpus of medical annotation of plants for PNG, previously unknown medical uses of plants can be uncovered. Furthermore, comparisons of medicinal plant utilization is possible if databases are reformatted for consistencies that allow comparisons. A concerted effort in building easily comparable databases could dramatically facilitate ethnopharmacological analysis of the existing plant diversity