Is there a difference between the readabilities of informed consent forms used for procedures in the emergency services of state and university hospitals in Turkey?

Aim: The aim of the present study was to evaluate the readability levels of informed consent forms (ICFs) used for procedures in the emergency services of state and university hospitals by comparing through readability formulas. Materials and Methods: ICFs used in emergency medicine clinics in different university and state hospitals in Turkey were collected, and forms that were the same were included in the evaluation only once. A total of 32 ICFs, with 15 from university hospitals and 17 from state hospitals, were evaluated. Average word number, syllable number, and words with syllable number of four and above were calculated. Different formulas were used to determine readability levels. Results: Although the readability of ICFs used in university hospitals was found to be better than those in state hospitals, the readability levels of the ICFs for both groups were detected to have medium difficulty according to the Atesman formula, very difficult according to the Flesch-Kincaid formula, difficult according to the Gunning-Fog formula, and at high school level according to the Bezirci-Yilmaz formula. Conclusion: In conclusion, the readability rates of emergency procedure ICFs in both state hospitals and university hospitals were detected to be rather low according to the present study. The education level of our country and the local environment should be considered while preparing these ICFs

Thrombolysis in STEMI at Prehospital Settings

Thrombolysis is a rapidly available but semi-effective treatment, whereas percutaneous coronary intervention is a potentially delayed but highly effective therapy. What about thrombolysis in the prehospital setting for ST-elevated myocardial infarction? Does scientific evidence support or oppose? Which patient group is more eligible for prehospital thrombolysis? Is there any skirmish between emergency medicine and cardiovascular professionals? You can find a history of prehospital thrombolysis on the basis of scientific evidence in this writin

The role of oxidative stress in ?-amanitin-induced hepatotoxicity in an experimental mouse model

Background/aim: This study aimed to evaluate oxidative stress markers of liver tissue in a mouse α-amanitin poisoning model with three different toxin levels. Materials and methods: The mice were randomly divided into Group 1 (control), Group 2 (0.2 mg/kg), Group 3 (0.6 mg/kg), and Group 4 (1.0 mg/kg). The toxin was injected intraperitoneally and 48 h of follow-up was performed before sacrifice. Results: Median superoxide dismutase activities of liver tissue in Groups 3 and 4 were significantly higher than in Group 1 (for both, P 0.001). The catalase activity in Group 2 was significantly higher, but in Groups 3 and 4 it was significantly lower than in Group 1 (for all, P 0.001). The glutathione peroxidase activities in Groups 2, 3, and 4 were significantly higher than in Group 1 (P 0.006, P 0.001, and P 0.001, respectively). The malondialdehyde levels of Groups 3 and 4 were significantly higher than Group 1 (P 0.015 and P 0.003, respectively). The catalase activity had significant correlations with total antioxidant status and total oxidant status levels (r 0.935 and r 0.789, respectively; for both, P > 0.001). Conclusion: Our findings support a significant role for increased oxidative stress in α-amanitin-induced hepatotoxicity

Time-Dependent Changes Of Hematological Parameters In Patients With Acute Organophosphate Poisoning

Objective: To investigate the prognostic value of the time-dependent changes of hematological parameters in patients with acute organophosphate poisoning. Methods: All patients admitted to emergency departments from 2010 through 2013 due to organophosphate poisoning were enrolled in the study. Demographic data, route of exposure, serum cholinesterase levels, complete blood count results of 5 consecutive days, mechanical ventilation requirement, length of stay in hospital, and outcomes were recorded. Results: Mechanically ventilated patients had higher leukocyte and neutrophil counts than nonventilated patients during the whole follow-up period, and both of them had a trend of decrease in both patient groups. There was no difference between patient groups in terms of lymphocyte counts at day 1, but mechanically ventilated patients had lower lymphocyte counts than nonventilated patients after day 2. Hemoglobin levels had a trend of decrease during the whole follow-up period in both patient groups. Conclusion: The parameters obtained from complete blood count can be used as sensitive follow-up parameters in patients with acute organophosphate poisoning by serial measurement

Is There a Difference Between the Readabilities of Informed Consent Forms Used for Procedures in the Emergency Services of State and University Hospitals in Turkey?

WOS:000456457100010Aim: The aim of the present study was to evaluate the readability levels of informed consent forms (ICFs) used for procedures in the emergency services of state and university hospitals by comparing through readability formulas.Materials and Methods: ICFs used in emergency medicine clinics in different university and state hospitals in Turkey were collected, and forms that were the same were included in the evaluation only once. A total of 32 ICFs, with 15 from university hospitals and 17 from state hospitals, were evaluated. Average word number, syllable number, and words with syllable number of four and above were calculated. Different formulas were used to determine readability levels.Results: Although the readability of ICFs used in university hospitals was found to be better than those in state hospitals, the readability levels of the ICFs for both groups were detected to have medium difficulty according to the Atesman formula, very difficult according to the Flesch-Kincaid formula, difficult according to the Gunning-Fog formula, and at high school level according to the Bezirci-Yilmaz formula.Conclusion: In conclusion, the readability rates of emergency procedure ICFs in both state hospitals and university hospitals were detected to be rather low according to the present study. The education level of our country and the local environment should be considered while preparing these ICFs

Liporotein-Associated Phospholipase-A2 Can Be A Diagnostic Marker İnthe Early Stage Diagnosis Of Acute Mesenteric İschemia

Background/aim: The purpose of this experimental study was to investigate the role of lipoprotein-associated phospholipase-A2 (LpPLA2 ) in the diagnosis of acute mesenteric ischemia (AMI) in the early stage. Materials and methods: Twenty-seven New Zealand rabbits were randomly divided into 3 groups in this study. Blood specimens were obtained from the groups at hours 0, 1, 3, and 6. Using the blood samples drawn from all groups, Lp-PLA2 and C-reactive protein (CRP) parameters were investigated. Results: There was a significant rise in the levels of both Lp-PLA2 and CRP starting at hour 1 (P > 0.05) (hour 1; Lp-PLA2 , P 0.003) in the ischemia group. In the sham group, the levels of Lp-PLA2 and CRP started to rise at hour 3 (P > 0.05) (hour 3; Lp-PLA2 , P 0.011). At hour 6 of ischemia, the area under the ROC curve was 100%, and the cut-off value of 63.91 ng/mL revealed a sensitivity of 88% and a specificity of 100% for Lp-PLA2 . Conclusion: These findings showed the role of serum Lp-PLA2 and CRP levels in the early diagnosis of AMI. Thus, further studies are needed to describe the role of Lp-PLA2 in the early diagnosis of AMI

Künt Göğüs Travmasından Sonra Kardiyak Kontüzyonda Elektrokardiyografik Görüntülemenin Önemi: Olgu Sunumları

Künt göğüs travması geçiren hastaların takip ve monitorizasyonu önemlidir.İzole künt göğüs travmasına bağlı kardiyak kontüzyon takiben akut koroner sendrom gelişebileceği unutulmamalıdır. Künt göğüs travması sonucu akut koroner sndrom gelişen iki hasta tanımlamaya çalıştık.Hastarın EKG lerinde inferior derivasyonlarda ST elevasyonu tespit ettik,hastalar medikal tedavi ve koroner anjiografi yapıldı. koroner anjiografi sonucu koroner arterlerde herhangi bir patoloji saptanmadı.Onların durumu, travma ve stres nedeniyle kardiyak kontüzyona bağlandı.Kardiyak kontüzyon izole künt göğüs travmalarında oluşabilir, bununla birlikte hertürlü travma ve stres sonucu akut koroner sendromu gelişebileceği unutulmamalıdır.Tracking and monitoring of patients with blunt chest trauma, especially blunt trauma is very important. As in all kinds of trauma, cardiac contusion in isolated chest trauma may result in acute coronary syndromes. We describe two patients who present with acute coronary syndrome after blunt chest trauma. Their ECG confirmed ST elevations in the inferior derivations, medical therapies and coronary angiography were carried out. Coronary angiographies have revealed no pathology in the coronary arteries. Their conditions were considered to be related to cardiac contusion due to trauma and stress. Cardiac contusion may occur in isolated chest traumas; however, it should be remembered that acute coronary syndrome may develop along with stress after any kind of trauma

Warfarin Tedavisine Bağlı Nadir Bir Komplikasyon: Jejunumda Spontan İntramural Hematom

Warfarin is an oral anticoagulant drug that prevents clotting, used in treating many diseases as well as prophylaxis. Despite its widespread use and efficacy, it may lead to a wide range ofadverse effects, mainly bleeding, due to its quite narrow therapeutic index and interaction withother medications. Most commonly, it may result in epistaxis, hematuria and subcutaneous hemorrhage. In addition, it is likely to cause bleeding in the gastrointestinal tract, soft tissues, and cerebral region. It is rare to develop intramural hematoma in the jejunum resulted from warfarintoxicity. Here, we present a case admitted to the emergency department with abdominal pain, anddiagnosed with intramural hematoma after physical examination, laboratory findings and imaging.Emergency physicians should consider intestinal hematoma as differential diagnosis in patientsusing warfarin and presenting with abdominal pain.Warfarin pıhtılaşmayı önleyen oral antikoagulan ilaçtır. Birçok hastalık tedavisinde ve profilaksisinde kullanılmaktadır. Yaygın kullanım alanına ve etkinliğine rağmen, terapötik indeksininoldukça dar ve ilaçlarla etkileşimin olması, kanama başta olmak üzere birçok yan etkilere sebep olmaktadır. En sık epistaksis,hematüri,cilt altı hemorajiye sebep olabilir. Bunun yanı sıra gastrointestinal sistem, yumuşak doku, serebral bölgede kanamalara yol açabilir. Warfarin toksisitesine bağlıjejunumda intramural hematom gelişmesi nadir görülen bir olaydır. Acil servise karın ağrısı ile başvuran, ayrıntılı hikaye, fizik muayene, laboratuvar bulguları ve görüntülemeler sonrası intramural hematom tanısı konulan olgu sunuldu. Acil servise karın ağrısı ile başvuran ve warfarin kullananhastalarda ayırıcı tanıda intestinal hematom düşünülmelidir

The effectiveness of Glasgow-Blatchford Score in early risk assessment of hemodialysis patients

In the emergency departments (ED), the incidence of admission is increasing gradually due to gastrointestinal system (GIS) complications of hemodialysis (HD) patients. With this increasing number of patients, there are many classification systems developed in early risk assessment before endoscopy. In this study, we aimed to evaluate the Glasgow-Blatchford Score's (GBS) effectiveness in HD patients with suspected GIS hemorrhage in the ED.The files of 169 patients who received HD treatment were retrospectively reviewed. 64 patients who were examined and treated for reasons other than GIS hemorrhage in the ED were excluded, and the files of a total of 105 were analyzed retrospectively. The demographic characteristics and laboratory values of the patients were recorded from the patient files. When the patients were evaluated according to GBS parameters, a significant difference was found between the two groups in terms of pulse pressure, systolic blood pressure, hemoglobin value, melena, and accompanying comorbid diseases (p < 0.05). Of the 16 patients who presented to the ED due to syncope, 2 were in the GIS hemorrhage (+) group, and 14 patients were in the control group. In this study, we aimed to show that the increase in the number of admissions in the ED due to complications secondary to HD treatment and the accompanying serious changes in laboratory parameters may cause misleading results in patients with suspected GIS hemorrhage, and it is necessary to plan comprehensive and multi-center studies on new alternative scoring systems to GBS in specific patient groups such as HD patients.WOS:0007072804000012-s2.0-85117049751PubMed: 3465128

The Bibliometric Qualities of Original Research Published in the EurasianJournal of Emergency Medicine between the Years 2010-2014

Aim: Bibliographic work in the Turkish emergency medicine community is very scarce. We aim to improve upon the shortcomings in this area.Materials and Methods: Original research published in the Eurasian Journal of Emergency Medicine (EAJEM) (formerly known as the Academic Journal of Emergency Medicine) within the 5-year period between 2010 and 2014 was retrospectively reviewed.Results: While retrospective publications stood out the most (n81, 54.7%), they were followed by prospective (n38, 25.7%) and sectional (n29, 93.9%) works. A vast majority of the work was concentric (n139, 93.9%). Here 6.1% publications were sourced overseas. The most commonly studied subjects in the articles published in the EAJEM were medical emergencies (26.35%), trauma (20.27%), and emergency service (19.59%). Further, 52.7% (n78) texts were written in English and 47.3% (n70) were written in Turkish. In 15.5% (n23) articles, an emergency medicine resident and/or emergency medicine specialist was not among the authors. The original research most commonly had 3 keywords (n73, 49.3%). There were 12 (8.1%) articles in which no tables were used and 70 (47.3%) articles in which there were no figures. According to our findings, a total of 2981 references were used in the 148 articles that were reviewed, and the median reference value per article was 17 (min: 6; max: 50). In our study, 38 references were self-references (12.85) and 727 (24.4%) references were references to texts published in journals in the Turkish index. Within all the references, there were 43 (14.4%) references to the Turkish Journal of Emergency Medicine (TJEM), 41 (13.8%) references to the EAJEM, and only 3 (1.1%) references to Journal of Emergency Medicine Case Reports (JEMCR). The median value of references made to texts in the journals in the Turkish index per article was 2 (min: 0; max: 32). The number of references to the TJEM per article was 43/148 (29.1%), that to the EAJEM was 41/148 (27.7%), and that to JEMCR was 3/148 (2%). While the acceptance period ranged between 1 and 350 days, the average period was 49 days.Conclusion: We believe that preference should be given to the printing of prospective and multi-centric publications and those with more keywords