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Fresh Frozen Plasma versus Prothrombin Complex Concentrate for Warfarin Reversal in the Emergency Department: A Retrospective Cohort Study of Clinical Outcomes and Costs - Eurasian Journal of Emergency Medicine

Kan sayımı (KS) ve hemoglobin (Hb) ölçümleri, klinik tanı ve hasta yönetiminde temel ve kritik laboratuvar testleridir. Bu ölçümler, hematolojik bozukluklar, anemi, enfeksiyon, kanama ve koagülopati gibi durumların tanı ve takibinde değerli bilgiler sağlar. KS, eritrosit, lökosit ve trombosit sayımı ile hastanın hematolojik profilini değerlendirirken, hemoglobin ölçümü anemi tanısı ve transfüzyon kararlarında kritik rol oynar. Günümüzde bu testler, merkezi laboratuvarlarda kullanılan statik laboratuvar analizörleri ile hasta başında hızlı sonuç sunan mobil sistemler aracılığıyla gerçekleştirilmektedir. Statik laboratuvar analizörleri, yüksek doğruluk, geniş parametre analizi ve otomasyon avantajlarıyla “altın standart” olarak kabul edilirken, mobil sistemler hızlı ve yerinde sonuç sunarak acil ve kritik durumlarda klinik karar süreçlerini hızlandırır. Kan sayımı ve hemoglobin ölçümlerinde kullanılan farklı teknikler dikkate alındığında, her iki sistemin dengeli kullanımı hem klinik doğruluk hem de hızlı sonuç elde edilmesi açısından optimal çözüm sunar. Sonuç olarak, bu ölçümler hem rutin hem de acil klinik uygulamalarda, hasta yönetimi ve risk değerlendirmesi için vazgeçilmez bir tanısal araçtır.

The Effect of Stretcher Level and Angle on Successful First-Pass Orotracheal Intubation - Eurasian Journal of Emergency Medicine

Introduction: During the COVID-19 pandemic, there were difficulties in diagnostic applications in patients who applied to the emergency department with dyspnea. We aimed to compare the Oxygen, Predisposing factors, Effusion, Radiology, Age (OPERA) scoring that we determined to be fast in diagnosis and treatment, with the Modified Early Warning Score (MEWS) scoring and imaging findings. We investigated the effectiveness of scoring in predicting prognosis and mortality. Method: Our retrospective cross-sectional study included 271 patients who presented to a university emergency department between 07 April and 31 July 2020 with dyspnea. MEWS and OPERA scores, demographic characteristics, vital signs, serological tests and detailed findings of computed tomography (CT) of the patients included in the study were scanned. Patients were analyzed in terms of diagnosis, need for intensive care, and two-month mortality. Results: A total of 271 patients (149 (55%) women, mean age 60.6 ± 18.1 years old) who presented to the emergency department with dyspnea were included in our study. While 43 (15.9%) patients died in the last two months, 69 (25.5%) patients needed intensive care. When the value of 4 was determined as the limit for the MEWS score, 21 (14.1%) patients admitted to the intensive care unit were found to be

Objective: Burnout syndrome is characterized by physical, emotional, and mental symptoms. This study aims to investigate the relationship between S100B protein levels and burnout syndrome and depression in emergency department staff. Materials and Methods: The study included nurses and paramedics working in the emergency department of our university hospital. Depression levels and burnout severity were assessed using the Beck Depression Inventory (BDI) and the Maslach Burnout Inventory (MBI) before shifts. Blood samples were collected before and after shifts to measure S100B levels. Results were compared with S100B levels, and data were analyzed using SPSS. Results: The study included 29 nurses (65.9%) and 15 paramedics (34.1%). Participants had an average emotional exhaustion score of 27.2 ± 7.4 (median (IQ) = 28 (22.3-33.0)), depersonalization score of 11.3 ± 4.1 (median (IQ) = 11 (9.0-13.8)), and personal accomplishment deficiency score of 30.0 ± 6.4 (median (IQ) = 28.5 (25.0-35.8)). The average BDI score was 34.4 ± 8.0 (median (IQ) = 33.5 (29.0-36.8)). Pre-shift S100B levels were 77.0 ± 21.8 (median (IQ) = 72.4 (66.4-80.6)), while post-shift S100B levels were 113.0 ± 129.6 (median (IQ) = 72.5 (65.7-87.8)). A statistically significant increase in S100B levels was observed between pre- and post-shift (p = 0.046). However, there was no significant correlation between post-shift serum S100B levels and emotional exhaustion, depersonalization, personal accomplishment deficiency, or BDI scores (p > 0.05). Conclusion: Although there is a significant change in S100B levels before and after shifts, S100B levels are not correlated with BDI scores and MBI dimensions. These findings suggest that while S100B may not be a long-term predictor of burnout and depression in emergency staff, it could be used to determine shift durations for effective management.

Objective: For the phenotype classification, it is important to determine the relationship between enzyme activity and the severity of the COVID-19 disease. Reaching significant differences between healthy and infected individuals in terms of genotype and allele distributions may be a guide in the fight against the COVID-19 pandemic. This study, it was aimed to investigate the relationship between serum arylesterase PON1 enzyme activity and disease severity in COVID-19 patients. Methods: Patients over the age of 18 who applied to the Emergency Service between 01-30 April 2020 and were examined with a preliminary diagnosis of COVID-19 were included in the study. In the study, serum PON1 activity was measured in the venous blood of 56 patients diagnosed with Covid-19 disease by either CT or RT-PCR and who have not received any systemic treatment yet. Results: The Arylesterase (AREase) and Paraoxonase (POase) activity levels of the study and control groups were 131.49 ± 52.75 kU/L 142.29 ± 38.82 kU/L, 276.48 ± 220.4 U/L 505.30 ± 301.4 U/L, respectively. It was found that 64.3 % of those infected with Covid-19 had the low-activity PON1 phenotype (p= 0.007) Conclusion: Genetic variability in PON1 may be associated with exposure to or risk of developing the disease. As a result, vaccination of individuals with low activity phenotype can be given priority at the vaccination stage in order to reduce the mortality rate in the fight against the pandemic. Awareness and protection measures of societies with low activity phenotypes can be increased.

History, electrocardiogram, age, risk factors, troponin risk score and troponin level follow-up are used to safely discharge low-risk patients with suspected non-ST elevation acute coronary syndrome from the emergency department for a 1-month period. We aimed to comprehensively investigate the 6-month mortality of patients with the history, electrocardiogram, age, risk factors, troponin risk score.

Aims: Epilepsy is one of the most common neurological diseases. It is classified into three groups: focal onset, generalized onset and unclassifiable. A seizure type is difficult to determine. The malate dehydrogenase (MDH) enzyme has a critical role in the excitability of the brain, and it has been reported that recurrent seizures are seen when its regulation is disturbed. We investigated the contribution of MDH enzyme levels as a biomarker to seizure classification. Methods: Our study was conducted prospectively by patients who were admitted to the emergency department of our hospital within a six-month period. Included in the study were 65 patients diagnosed with epilepsy, according to the International League Against Epilepsy (ILAE) classification. The patients were divided into two groups according to seizure type: focal onset and generalized onset. They were compared in terms of enzyme activity. Results: The MDH value was 47.56 ± 38.65 in patients with focal-onset epilepsy and 109.76 ± 128.44 in patients with generalized-onset epilepsy. Conclusion: Our results reveal the potential of MDH as a biomarker that can be used in epilepsy. In addition, the statistically significant difference between focal-onset and generalized-onset epilepsy indicates that it can be a usable biomarker in seizure classification

Background SCUBE 1-has been used as a biomarker for the diagnoses of myocardial infarction, stroke, mesenteric ischemia, and gastric cancer in some recent studies. In this study, we investigated the relationship between serum SCUBE−1 levels and return of spontaneous circulation (ROSC) in patients who received cardiopulmonary resuscitation (CPR).Methods Patients over 18 years of age who were not pregnant and received CPR were divided into two groups: those who achieved ROSC and those who died. There were 25 patients in each group. SCUBE−1 and other routine biochemical parameters were studied in blood samples taken at the time of admission.Results There was no significant difference between the age and gender distribution of the patients between the two groups. The SCUBE−1 value of the ROSC group was significantly higher than that of the non-survivor group (p ˂ 0.05). At a cut-off value of 9 ng/mL, SCUBE−1 had a sensitivity of 100%, a positive predictive value of 65.8%, specificity of 48%, and a negative predictive value of 100% in predicting ROSC.Conclusions The SCUBE−1 values were found to be significantly higher in the ROSC group compared with the non-survivor group.

Introduction: More than half of all worldwide deaths and disabilities were caused by stroke. Large artery atherosclerosis is identified as a high etiological risk factor because it accounts for 20% of ischemic stroke.Objectives: To identify the significance of TRAIL and adropin release and the relative changes related to S100B levels, as well as the relationship between these biomarkers and the final infarct core, the clinical outcome, and the presence of large artery atherosclerosis in acute stroke patients.Materials and methods: Over a one-year period, demographic, clinical, and neuroimaging findings of 90 consecutive patients with acute ischemic stroke were evaluated.Results: The mean age of participants was 69.28 ± 10 and 39 patients were female. The increased level of S100B and the decreased levels of sTRAIL with adropin were significantly associated with moderate to severe neurologic presentation (p=0.0001, p=0.002, p=0.002, respectively). On the control CT, a large infarct core was significantly associated with decreased serum levels of sTRAIL and adropin (p=0.001 and p=0.000, respectively); however, the levels of S100B were not significantly associated with good ASPECTS score (p=0.684). Disability and an unfavorable outcome were significantly related to the decreased level of sTRAIL and adropin (p=0.001 and p=0.000 for THRIVE score>5, respectively). Decreased sTRAIL and adropin levels and an increased S100B level were correlated with the presence of large artery atherosclerotic etiologic factors (p=0.000, p=0.000, p=0.036, respectively).Conclusion: TRAIL and adropin serum levels were associated with poor clinical outcomes and greater infarcted area in acute ischemic stroke patients.