Mücahit Günaydin

Objective: The purpose of this study was to estimate the presence of fracture and to determine radiography requirements through results obtained by evaluating the physical examination findings in elbow injury. Material and Methods: This was a single center prospective study. All patients were evaluated in terms of trauma mechanism, inspection findings, presence of pain at palpation, pain with active movement, circulatory examination and loss of sensation. Sensitivity, specificity, positive and negative predictive value (NPV) were determined for each sign and each examination finding. Results: The study was performed with 47 patients. Fracture was determined in 10 patients (21.2%). Presence of pain at the elbow extansion, forearm supination (FS), medial epicondyle (ME) palpation and forearm pronation tests exhibited high sensitivity (100%, 100%, 90%, and 80%, respectively) and high NPV (100%, 95%, 96.4%, and 91%, respectively) for elbow fracture. These four tests produced significant p values (0.088, 0.012, 0.001, and 0.079, respectively) in elbow fractures. Combining the pain at FS and ME palpation tests exhibited 90% sensitivity, and 96.7% NPV. Conclusions: Positivity on any one of the four tests employed increases the probability of fracture and is sufficient for elbow radiography to be recommended in patients presenting due to elbow injury. However, radiography may not be required if combined FS and ME palpation test findings are negative in this patients.

Anthrax is a zoonosis affecting herbivorous animals. Its agent is Bacillus anthracis and it is gram positive, aerobic or facultative anaerobic, immobile and has a capsule in the polypeptide structure. The incidence is gradually decreasing in the world and in our country. The disease is especially seen in areas where stock breeding is common. In this case series, 3 cases, one of them was mortal, took place after anthrax infected cow was eaten in February 2018 in Trabzon was shared. In the first case, as a result of the animal's meat was eaten, gastrointestinal anthrax and associated sepsis were seen. This patient's blood culture was positive and she was died. Second case after contacting the patient who died, and third case after contacting the animal and eating its meat, diagnosed with cutaneous anthrax. Doxycycline treatment was started with cutaneous anthrax patients, these cases were recovered without any complications. We presented this article, to update our information about gastrointestinal anthrax and other anthrax types which are become a current issue again especially due to bioterrorism and also to keep it in mind in the differential diagnosis although it is rarely seen in our stock raising areas.

Objective: Carbon monoxide (CO) is the main cause of death and morbidity associated with poisoning in developed countries. The most important mortality and morbidity cause of CO poisoning is cerebral hypoxia. Near-infrared spectroscopy (NIRS) is a useful method for assessing brain oxygenation. In this study, we aimed to evaluate the brain oxygenation of CO poisoning patients with NIRS and to investigate its benefits in patients follow up and treatment. Materials and Methods: The study was conducted as a single-center, prospective clinical trial with 33 patients who were diagnosed by measuring blood CO-Hb level or referred from other hospitals diagnosed with CO poisoning. Patients were divided into two groups as normobaric oxygen therapy (NBOT) group and hyperbaric oxygen therapy (HBOT) group according to the treatment method applied. Results: Although average cerebral saturation (ScO2) levels after treatment were higher in the NBOT group than before treatment, no statistically significant difference was found except the left frontal ScO2 values. In HBOT group, there was no difference between ScO2 values before and after treatment sessions. Conclusion: Our study concluded that NIRS may be useful in assessing brain oxygenation in CO poisoned patients, but not in determining the HBOT start-up, and not in monitoring the effectiveness of HBOT.

Background Aim: Many Syrian civil war refugees are housed in carefully designed camps, however 60% of all refugees in host countries reside outside of specifically designated camps. Turkey hosts the largest number of refugees displaced in the civil war of Syria. In the present study, we aimed to illustrate healthcare services provided to Syrian refugees in Turkey. Data presented in this retrospective observational registry study was obtained from multiple sources including official websites and written communications contributed by Turkish Disaster and Emergency Management Agency(AFAD), Turkish Ministry of Health and Turkish Red Crescent as well as the United Nations High Commissioner for Refugees(UNHCR). The number of refugee camps, total number of refugees housed in these camps, the demographic characteristics of the refugees and a breakdown of social and healthcare services provided in the camps including the number of healthcare professionals serving in the refugee camps were analyzed. According to data from UNHCR as of January 12, 2017, there are 4,904,021 registered refugees from Syria of which 2,854,968 (58.2%) are residing in Turkey. Organized health care services specifically for Syrian refugees in Turkey was first established in April 29, 2011 in Hatay. Preventative health services are also provided for Syrian refugees. Among refugees living in the camps 25% and 33% were not vaccinated for polio and measles respectively. The percentage of unvaccinated refugees living outside the camps were even higher for these viruses (45% for polio and 41% for measles). This poses a public health threat for the population where these refugees reside. One of the major concerns for countries hosting refugees from Syria is the introduction of infectious diseases. Of the major deficiencies in refugee health care has been preventative services. Within refugee camps, preventative services for pregnant woman, newborns and young children as well as family planning services are not at optimal levels. These services are even more restricted for refugees living outside of established camps. There have also been shortcomings in the care of the elderly and those with chronic health problems.

The value of plasma SCUBE1 and oxidative stress parameters in the early diagnosis of acute ovarian torsion

The corpus callosum is the most important pathway enabling the exchange of information between the two cerebral hemispheres. Transient splenium lesions may develop in association with various pathologies and infections. We report a case presenting to the emergency department with transient visual loss and in which a transient lesion was determined in the splenium of the corpus callosum (SCC). A 24-year-old woman presented to the emergency department due to sudden onset visual loss. An area of restricted diffusion was determined in the SCC at diffusion magnetic resonance imaging (MRI) of the brain. The patient was admitted to the ward with a diagnosis of SCC lesion. The lesion had resolved entirely at control MRI performed 2 weeks later. There may be many causes of transient SCC lesions, and patients may present with different clinical manifestations, particularly altered consciousness and rarely visual loss like our present case.

Objective: The purpose of this study was to investigate the value of signal peptide-CUB-EGF domain-containing protein 1 (SCUBE1) in the diagnosis of angina pectoris in patients presenting to the emergency department.Material and Methods: This prospective research was planned as a cross-sectional, single-center clinical study. Patients presenting to the emergency department with angina pectoris symptoms over a period of five months from receipt of ethical committee approval were included. Patients presenting with ischemic chest pain were divided on the basis of etiology into stable angina pectoris (SAP), unstable angina pectoris (UAP), non-ST elevation myocardial infarction (NSTEMI), and ST segment elevation myocardial infarction (STEMI) groups. Clinical, laboratory and demographic characteristics were recorded. SCUBE1 levels from each group were compared with a healthy control group.Results: 118 individuals were enrolled in the study, 78 patients meeting the inclusion criteria and 40 healthy controls. Patients’ mean age was 54.36 ± 14.03 years, and 88.5% (n=69) were male. Hypertension (59%) and smoking (62%) predomination over other risk factors. NSTEMI was the most common factor (46.1%) in patients enrolled due to ischemic chest pain. No statistically significant difference was determined between patients’ serum SCUBE1 levels at time of presentation and at 6 h and 12 h and the control group (p>0.05).Conclusion: On the basis of our study findings, SCUBE1 is of no value in the diagnosis of ischemic chest pain etiologies.

The diagnostic value of the serum irisin level in patients with acute pericarditis and acute myopericarditis

Journal of Emergency Medicine Case Reports