Pub Date : 2022-12-28DOI: 10.54996/anatolianjem.1223561
Nurcan Biçakçi, Onur Karakayali
Depremler günümüzde, nerede ve ne zaman oluşacakları kesin olarak bilinemeyen, önlenemeyen doğal olaylardır. Depremler yaşam ve mal kayıplarına neden olan doğal afetlere neden olabilirler. Bu afetlerde ortaya çıkan medikal etkiler karmaşık, çeşitli şekillerde görülebilir. Uygun hazırlık ve etkili müdahale için, depremler sonrasında ortaya çıkan medikal etkilerin iyi bilinmesi, sağlık profesyonellerinin bu durumlara uygun hazırlıklarının olması ve toplum sakinlerine kendilerini depremin medikal etkilerinden korumaları için eğitimler verilmesi son derece önemlidir. Bu makalede depremlerden, depremlerin medikal etkilerinden korunmak için halka verilecek bilgilerden ve depremlerin en sık medikal etkilerinden bahsedilmektedir.
{"title":"Depremler ve Medikal Etkileri","authors":"Nurcan Biçakçi, Onur Karakayali","doi":"10.54996/anatolianjem.1223561","DOIUrl":"https://doi.org/10.54996/anatolianjem.1223561","url":null,"abstract":"Depremler günümüzde, nerede ve ne zaman oluşacakları kesin olarak bilinemeyen, önlenemeyen doğal olaylardır. Depremler yaşam ve mal kayıplarına neden olan doğal afetlere neden olabilirler. Bu afetlerde ortaya çıkan medikal etkiler karmaşık, çeşitli şekillerde görülebilir. Uygun hazırlık ve etkili müdahale için, depremler sonrasında ortaya çıkan medikal etkilerin iyi bilinmesi, sağlık profesyonellerinin bu durumlara uygun hazırlıklarının olması ve toplum sakinlerine kendilerini depremin medikal etkilerinden korumaları için eğitimler verilmesi son derece önemlidir. \u0000Bu makalede depremlerden, depremlerin medikal etkilerinden korunmak için halka verilecek bilgilerden ve depremlerin en sık medikal etkilerinden bahsedilmektedir.","PeriodicalId":110760,"journal":{"name":"Anatolian Journal of Emergency Medicine","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126640261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-21DOI: 10.54996/anatolianjem.1215717
Ramazan Saral, Özlem Yigit, Süleyman İbze, Gülşen Öztürk
Introduction Emergency departments (EDs) are units in which acute management of traumatic and medical emergencies are provided; but also guidance on public health is provided as well as ensuring personal health and awareness. In this study, it was aimed to determine the level of knowledge about women’s and reproductive health and possible disease symptoms in female patients aged 18 years and older who applied to the emergency department, regardless of the complaint of admission. We also aimed to determine the role of EDs in contributing to the correct referral of these patients. Material and Methods This was a descriptive cross-sectional study which took place in a tertiary care center. Women aged 18 years and older who applied to the emergency department with any complaint were assessed with a structured questionnaire consisting of 18 questions and multiple-choice options about women’s health. Participants' sociodemographic characteristics, fertility, menstrual cycle and contraception patterns, their knowledge about cancer prevention, gynecological and urological complaints were asked. It was also asked whether the ED physician gave any guidance on issues related to women's health, before discharge from ED. Results Totally 523 women were included in the study. The mean age was 38.89±14.32 years. Most of them (91.6%) were lived in city center, 63.3% were married and 60% were high school and university graduates. The ratio of not using any contraceptive method and total number of pregnancies were higher at the lower education levels (p=0.003 and 0.004, respectively). The knowledge of women about cancer screening was low and 42.4% of them did not have information about screening issues. In comparison according to educational status, it was seen that the ratio of screening awareness, breast self-examination, HPV test, and mammography were higher and statistically significant in university graduates (p=0.000). ED physicians conducted appropriate outpatient clinic referral for screening and follow-up in 53.6% of 114 patients with gynecological complaints. Conclusions The level of knowledge about women’s health are still not at the desired level. Although there are a wide variety of effective and modern methods available, not to use a contraceptive method is still common. With the increase, dissemination and continuity of reproductive health education and consultancy services, the lack of information on this subject will be eliminated to a large extent and wrong practices will be prevented. Emergency departments are places for preventing public health, besides managing acute conditions. Key words: Reproductive Health, Contraception, Cancer Screening, Emergency department
{"title":"Determination of Women and Reproductive Health Awareness in Emergency Department: A Descriptive Cross-sectional Study","authors":"Ramazan Saral, Özlem Yigit, Süleyman İbze, Gülşen Öztürk","doi":"10.54996/anatolianjem.1215717","DOIUrl":"https://doi.org/10.54996/anatolianjem.1215717","url":null,"abstract":"Introduction \u0000Emergency departments (EDs) are units in which acute management of traumatic and medical emergencies are provided; but also guidance on public health is provided as well as ensuring personal health and awareness. In this study, it was aimed to determine the level of knowledge about women’s and reproductive health and possible disease symptoms in female patients aged 18 years and older who applied to the emergency department, regardless of the complaint of admission. We also aimed to determine the role of EDs in contributing to the correct referral of these patients. \u0000Material and Methods \u0000This was a descriptive cross-sectional study which took place in a tertiary care center. Women aged 18 years and older who applied to the emergency department with any complaint were assessed with a structured questionnaire consisting of 18 questions and multiple-choice options about women’s health. Participants' sociodemographic characteristics, fertility, menstrual cycle and contraception patterns, their knowledge about cancer prevention, gynecological and urological complaints were asked. It was also asked whether the ED physician gave any guidance on issues related to women's health, before discharge from ED. \u0000Results \u0000Totally 523 women were included in the study. The mean age was 38.89±14.32 years. Most of them (91.6%) were lived in city center, 63.3% were married and 60% were high school and university graduates. The ratio of not using any contraceptive method and total number of pregnancies were higher at the lower education levels (p=0.003 and 0.004, respectively). The knowledge of women about cancer screening was low and 42.4% of them did not have information about screening issues. In comparison according to educational status, it was seen that the ratio of screening awareness, breast self-examination, HPV test, and mammography were higher and statistically significant in university graduates (p=0.000). ED physicians conducted appropriate outpatient clinic referral for screening and follow-up in 53.6% of 114 patients with gynecological complaints. \u0000Conclusions \u0000The level of knowledge about women’s health are still not at the desired level. Although there are a wide variety of effective and modern methods available, not to use a contraceptive method is still common. With the increase, dissemination and continuity of reproductive health education and consultancy services, the lack of information on this subject will be eliminated to a large extent and wrong practices will be prevented. Emergency departments are places for preventing public health, besides managing acute conditions. \u0000Key words: Reproductive Health, Contraception, Cancer Screening, Emergency department","PeriodicalId":110760,"journal":{"name":"Anatolian Journal of Emergency Medicine","volume":"106 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122696820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-11-13DOI: 10.54996/anatolianjem.1177098
Seyran Bozkurt Babuş, Çağrı Safa Buyurgan, Akif Yarkac, A. Köse, Gülhan Temel, H. Aytan
Objective: The aim of this study was to describe the relative change in the presentations to the emergency department owing to the COVID-19 pandemic and to reveal the profile of patients presenting to the emergency department. Methods: The data of patients who presented to the emergency department during a specific period of the pandemic and non-pandemic period were retrospectively analyzed. Results: The rate of patient presentation to emergency department was 69.6% in the non-pandemic period, it was calculated to be 30.4% in the pandemic period (p < 0.001). The rate of patients transferred by an ambulance, rate of presentation of “very urgent” patients, rate ofhospitalized patients, and mortality rate were higher during the pandemic period (p < 0.001).The total invoice amount was higher in patients who presented during the non-pandemic period, and the mean invoice amount was higher in patients who presented during the pandemic period (p < 0.001). Patients who presented during the pandemic period had a higher risk of being transferred to emergency department by an ambulance (OR 9.947, CI 8.65–11.44), being in the very urgent triage category (OR 1.892, CI 1.712–2.09), and in-hospital mortality (OR 2.263, CI 1.69–3.03), and the total invoice amount increased by 1.004 times foreach unit increase. Conclusion: During the pandemic period, although the rates of general patient presentation and non-urgent patient presentation to emergency department decreased, the presentation rate of “very urgent” patients, mortality, and cost per patient increased.
目的:本研究的目的是描述由于COVID-19大流行而到急诊科就诊的相对变化，并揭示到急诊科就诊的患者概况。方法:回顾性分析流感大流行期间和非流感大流行期间急诊就诊的患者资料。结果:非流行期就诊率为69.6%，流行期就诊率为30.4% (p < 0.001)。在大流行期间，救护车转诊的病人比例、“非常紧急”病人的就诊比例、住院病人比例和死亡率都较高(p < 0.001)。非大流行期间就诊的患者总发票金额较高，大流行期间就诊的患者平均发票金额较高(p < 0.001)。大流行期间就诊的患者被救护车转至急诊科的风险(OR 9.947, CI 8.65 ~ 11.44)、属于非常紧急的分类类别(OR 1.892, CI 1.712 ~ 2.09)和住院死亡率(OR 2.263, CI 1.69 ~ 3.03)较高，每增加一个单位，总发票金额增加1.004倍。结论:大流行期间，虽然普通患者就诊率和非紧急患者就诊率下降，但“非常紧急”患者就诊率、死亡率和人均费用上升。
{"title":"Do really urgent cases present to the emergency department: What a pandemic has shown","authors":"Seyran Bozkurt Babuş, Çağrı Safa Buyurgan, Akif Yarkac, A. Köse, Gülhan Temel, H. Aytan","doi":"10.54996/anatolianjem.1177098","DOIUrl":"https://doi.org/10.54996/anatolianjem.1177098","url":null,"abstract":"Objective: The aim of this study was to describe the relative change in the presentations to the emergency department owing to the COVID-19 pandemic and to reveal the profile of patients presenting to the emergency department. \u0000Methods: The data of patients who presented to the emergency department during a specific period of the pandemic and non-pandemic period were retrospectively analyzed. \u0000Results: The rate of patient presentation to emergency department was 69.6% in the non-pandemic period, it was calculated to be 30.4% in the pandemic period (p < 0.001). The rate of patients transferred by an ambulance, rate of presentation of “very urgent” patients, rate ofhospitalized patients, and mortality rate were higher during the pandemic period (p < 0.001).The total invoice amount was higher in patients who presented during the non-pandemic period, and the mean invoice amount was higher in patients who presented during the pandemic period (p < 0.001). Patients who presented during the pandemic period had a higher risk of being transferred to emergency department by an ambulance (OR 9.947, CI 8.65–11.44), being in the very urgent triage category (OR 1.892, CI 1.712–2.09), and in-hospital mortality (OR 2.263, CI 1.69–3.03), and the total invoice amount increased by 1.004 times foreach unit increase. \u0000Conclusion: During the pandemic period, although the rates of general patient presentation and non-urgent patient presentation to emergency department decreased, the presentation rate of “very urgent” patients, mortality, and cost per patient increased.","PeriodicalId":110760,"journal":{"name":"Anatolian Journal of Emergency Medicine","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130225658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-27DOI: 10.54996/anatolianjem.1159676
Özlem Güneysel
Real knowledge is obtained through scientific research. The highest level of knowledge is the ability to discover/solve scientific problems. An important scientific work is also a team work and is a prerequisite for success. Scientific and professional work is primarily an educational tool and its content can be presented in different ways. Science is a connecting key in the education system, it reflects the culture of nations and the real source of knowledge of humanity. A scientist is a very hardworking, focused person in most situations. When a person enters the world of scientific work, it means that he has accepted to make extraordinary efforts and to compromise his daily life. Plagiarism; It is defined as “the use of other people's expressions, inventions or ideas in one's work as if they were his own without citing the source”.
{"title":"Publication Ethics and Plagiarism","authors":"Özlem Güneysel","doi":"10.54996/anatolianjem.1159676","DOIUrl":"https://doi.org/10.54996/anatolianjem.1159676","url":null,"abstract":"Real knowledge is obtained through scientific research. The highest level of knowledge is the ability to discover/solve scientific problems. An important scientific work is also a team work and is a prerequisite for success. Scientific and professional work is primarily an educational tool and its content can be presented in different ways. Science is a connecting key in the education system, it reflects the culture of nations and the real source of knowledge of humanity. A scientist is a very hardworking, focused person in most situations. When a person enters the world of scientific work, it means that he has accepted to make extraordinary efforts and to compromise his daily life. Plagiarism; It is defined as “the use of other people's expressions, inventions or ideas in one's work as if they were his own without citing the source”.","PeriodicalId":110760,"journal":{"name":"Anatolian Journal of Emergency Medicine","volume":"113 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124358310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-23DOI: 10.54996/anatolianjem.1119584
Ibrahim Toker, Ayşin Kılınç Toker, İrfan Gökçek, E. Bulbul, Gökhan Yilmaz, Mustafa Silcan, Saban Irmak, M. Altuntaş
OBJECTIVE: Our study examined young, middle, and oldest-old patients who visited the emergency department (ED) and their differences. METHODS: The research was executed retrospectively, utilizing the medical data of patients aged 65 and over who applied to the ED of a research hospital in Kayseri for the two years between January 1, 2020, and December 31, 2021. The patients were young-old, between 65 and 74 years old; aged 75 to 84 were middle-old, and those aged 85 and over were classified as oldest-old. RESULTS: 84415 (13.7%) older patients visited the ED during the study period. The patients’ median age was 74 years, IQRs (69- 80) and 53.9% (n=45466) were female. 53.4% of the patients were young-old, 33.4% middle-old, and 13.2% were oldest-old. 7.2% (n=6060) of the hospitalized patients were admitted to the intensive care unit, and 7.8% (n=1719) died. Among the first three reasons for admitting the patients to the ED, 20% (n=16874) had COVID-19, 14.4% (n=12131) had gastrointestinal symptoms, and 13.9% (n=11718) had circulatory system symptoms. Oldest-old patients were brought to the ED by ambulance more (38.4% vs. 50.9% vs. 63.2% p< 0.001), stayed longer in the ED (81 vs. 103 vs. 116 minutes, p
{"title":"Retrospective analysis of the oldest-old patients who applied to the emergency department and their differences from the young-old and middle-old","authors":"Ibrahim Toker, Ayşin Kılınç Toker, İrfan Gökçek, E. Bulbul, Gökhan Yilmaz, Mustafa Silcan, Saban Irmak, M. Altuntaş","doi":"10.54996/anatolianjem.1119584","DOIUrl":"https://doi.org/10.54996/anatolianjem.1119584","url":null,"abstract":"OBJECTIVE: Our study examined young, middle, and oldest-old patients who visited the emergency department (ED) and their differences. \u0000METHODS: The research was executed retrospectively, utilizing the medical data of patients aged 65 and over who applied to the ED of a research hospital in Kayseri for the two years between January 1, 2020, and December 31, 2021. The patients were young-old, between 65 and 74 years old; aged 75 to 84 were middle-old, and those aged 85 and over were classified as oldest-old. \u0000RESULTS: 84415 (13.7%) older patients visited the ED during the study period. The patients’ median age was 74 years, IQRs (69- 80) and 53.9% (n=45466) were female. 53.4% of the patients were young-old, 33.4% middle-old, and 13.2% were oldest-old. 7.2% (n=6060) of the hospitalized patients were admitted to the intensive care unit, and 7.8% (n=1719) died. Among the first three reasons for admitting the patients to the ED, 20% (n=16874) had COVID-19, 14.4% (n=12131) had gastrointestinal symptoms, and 13.9% (n=11718) had circulatory system symptoms. Oldest-old patients were brought to the ED by ambulance more (38.4% vs. 50.9% vs. 63.2% p< 0.001), stayed longer in the ED (81 vs. 103 vs. 116 minutes, p","PeriodicalId":110760,"journal":{"name":"Anatolian Journal of Emergency Medicine","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129418190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-23DOI: 10.54996/anatolianjem.1053506
Canan KARA GENOĞLU, A. Köse, Seyran Bozkurt Babuş, Ibrahim Toker, S. Erdoğan, N. Muşlu, A. Çelik
Aim: This study aimed to compare the three dyspnea scales (Likert, VAS, and NRS) in patients with acute heart failure (AHF) in the emergency department (ED). Materials and Methods: This study enrolled 114 patients prospectively diagnosed with AHF in the ED. We assessed the dyspnea scales for severity at admission and the 4th hour. We used the Likert scale, Visual Analogue Scale (VAS), and the Numerical Rating Scale (NRS). Results: Sixty-five patients were women. The mean age of the patients was 72.1 ± 11.7 years. 74.1% of the patients whose dyspnea was relieved were discharged. Seventy-seven of the patients were discharged from ED, while 37 were hospitalized, and 51.7% of the hospitalized patients had no improvement in dyspnea. The severity of dyspnea decreased after the treatment on each scale (p< 0.05). The 4th-hour scores were lower for all three scales (p< 0.01), but VAS and NRS scores on the 4th hour were higher in hospitalized patients than in discharged (p< 0.01). There was a similarly significant relationship between the admission and 4th hour of dyspnea scales (p
{"title":"Assessment of dyspnea in acute heart failure patients with three scales in the emergency department","authors":"Canan KARA GENOĞLU, A. Köse, Seyran Bozkurt Babuş, Ibrahim Toker, S. Erdoğan, N. Muşlu, A. Çelik","doi":"10.54996/anatolianjem.1053506","DOIUrl":"https://doi.org/10.54996/anatolianjem.1053506","url":null,"abstract":"Aim: This study aimed to compare the three dyspnea scales (Likert, VAS, and NRS) in patients with acute heart failure (AHF) in the emergency department (ED). \u0000Materials and Methods: This study enrolled 114 patients prospectively diagnosed with AHF in the ED. We assessed the dyspnea scales for severity at admission and the 4th hour. We used the Likert scale, Visual Analogue Scale (VAS), and the Numerical Rating Scale (NRS). \u0000Results: Sixty-five patients were women. The mean age of the patients was 72.1 ± 11.7 years. 74.1% of the patients whose dyspnea was relieved were discharged. Seventy-seven of the patients were discharged from ED, while 37 were hospitalized, and 51.7% of the hospitalized patients had no improvement in dyspnea. The severity of dyspnea decreased after the treatment on each scale (p< 0.05). The 4th-hour scores were lower for all three scales (p< 0.01), but VAS and NRS scores on the 4th hour were higher in hospitalized patients than in discharged (p< 0.01). There was a similarly significant relationship between the admission and 4th hour of dyspnea scales (p","PeriodicalId":110760,"journal":{"name":"Anatolian Journal of Emergency Medicine","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125389635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-18DOI: 10.54996/anatolianjem.1092947
Burçin Durmuş, Sefer Özkaya
Amaç: ‘Venöz anjiom’, ‘serebral venöz malformasyon’ olarak isimlendirmeler olsa da günümüzde gelişimsel venöz anomaliler olarak adlandırılmaktadır. Venöz anomalilerin en sık görülen şekli serebral vasküler malformasyonlardır. Genellikle BT veya MRG taramalarında insidental saptanırlar. Bunun yanısıra hemoraji, iskemik inme, epileptik nöbet veya başağrısı ile klinik pratikte karşımıza çıkabilir. Makalemizde ilk epileptik nöbet ile acil servise başvuran, yapılan muayene ve tetkikler sonucunda serebral venöz anomali tanısı alan bir vakamızı sunmak istedik. Olgu Sunumu: 24 yaşında erkek hasta ilk kez olan bayılma ve kasılma şikayeti ile acil servise başvurdu. İki dakika süren tüm vücutta kasılma, idrar inkontinansı, ağızda köpürme ve çenede kitlenme olduğu ve 1 saat boyunca kendine gelemediği öğrenildi. Öz geçmiş ve soy geçmişinde özellik yoktu. Bilinç açık koopere oryante idi. Vital bulgularında; kan basıncı: 125/80 mmHg, nabız: 88 atım/dk, solunum sayısı: 13/dk, ateş: 36°C olarak ölçüldü. Nörolojik sistem dahil diğer tüm sistem muayeneleri olağandı. Kontrastlı beyin MRG’nde sağ oksipitalde cilt altı bölgeden parankime uzanan T1 ve T2 sekansta hiperintens, kontrastlı sekansta heterojen kontrast geçişi şeklinde görünüm izlendi. Beyin MR venografide oksipitalde cilt altından serebral venöz sisteme uzanıp drene olan venöz malformasyon saptandı. Hastanın nöroradyolojik açıdan patolojik bir risk faktörü olması sebebiyle, ilk epileptik nöbeti olmasına rağmen hastaya antiepileptik tedavi olarak 1000 mg/gün levetirasetam başlandı. Sonuç: Gelişimsel venöz anomaliler hemoraji, iskemik inme, epileptik nöbet, fokal nörolojik defisitlerle veya başağrısı ile klinik pratikte karşımıza çıkabilir. Nöroloji kliniklerinde genç yaş ilk epileptik nöbet olguları sıklıkla primer epileptik nöbetler olarak karşımıza çıkmaktadır. Ancak bu vakada olduğu gibi nadir görülen klinik tabloların da genç yaş hastalarda epileptik nöbet ile karşımıza çıkabileceği unutulmamalı ve yapılacak etiyolojik tetkikler özenle planlanmalıdır. Bu bağlamda; nörolojik vakalarda, acil servis-nöroloji klinikleri arasında tetkik algoritması açısından dikkat ve düzen anlamında yeterli iletişim olması halinde, nadir görülen olgulara acil servis izleminde optimal olarak tanı konulup tedavi başlanabileceği konusunda ilgi çekici bir olgu olduğunu düşündük.
{"title":"Epileptik Nöbet ile Prezente Olan Nadir Bir Serebral Venöz Anomali Olgusu","authors":"Burçin Durmuş, Sefer Özkaya","doi":"10.54996/anatolianjem.1092947","DOIUrl":"https://doi.org/10.54996/anatolianjem.1092947","url":null,"abstract":"Amaç: ‘Venöz anjiom’, ‘serebral venöz malformasyon’ olarak isimlendirmeler olsa da günümüzde gelişimsel venöz anomaliler olarak adlandırılmaktadır. Venöz anomalilerin en sık görülen şekli serebral vasküler malformasyonlardır. Genellikle BT veya MRG taramalarında insidental saptanırlar. Bunun yanısıra hemoraji, iskemik inme, epileptik nöbet veya başağrısı ile klinik pratikte karşımıza çıkabilir. Makalemizde ilk epileptik nöbet ile acil servise başvuran, yapılan muayene ve tetkikler sonucunda serebral venöz anomali tanısı alan bir vakamızı sunmak istedik. \u0000Olgu Sunumu: 24 yaşında erkek hasta ilk kez olan bayılma ve kasılma şikayeti ile acil servise başvurdu. İki dakika süren tüm vücutta kasılma, idrar inkontinansı, ağızda köpürme ve çenede kitlenme olduğu ve 1 saat boyunca kendine gelemediği öğrenildi. Öz geçmiş ve soy geçmişinde özellik yoktu. Bilinç açık koopere oryante idi. Vital bulgularında; kan basıncı: 125/80 mmHg, nabız: 88 atım/dk, solunum sayısı: 13/dk, ateş: 36°C olarak ölçüldü. Nörolojik sistem dahil diğer tüm sistem muayeneleri olağandı. Kontrastlı beyin MRG’nde sağ oksipitalde cilt altı bölgeden parankime uzanan T1 ve T2 sekansta hiperintens, kontrastlı sekansta heterojen kontrast geçişi şeklinde görünüm izlendi. Beyin MR venografide oksipitalde cilt altından serebral venöz sisteme uzanıp drene olan venöz malformasyon saptandı. Hastanın nöroradyolojik açıdan patolojik bir risk faktörü olması sebebiyle, ilk epileptik nöbeti olmasına rağmen hastaya antiepileptik tedavi olarak 1000 mg/gün levetirasetam başlandı. \u0000Sonuç: Gelişimsel venöz anomaliler hemoraji, iskemik inme, epileptik nöbet, fokal nörolojik defisitlerle veya başağrısı ile klinik pratikte karşımıza çıkabilir. Nöroloji kliniklerinde genç yaş ilk epileptik nöbet olguları sıklıkla primer epileptik nöbetler olarak karşımıza çıkmaktadır. Ancak bu vakada olduğu gibi nadir görülen klinik tabloların da genç yaş hastalarda epileptik nöbet ile karşımıza çıkabileceği unutulmamalı ve yapılacak etiyolojik tetkikler özenle planlanmalıdır. Bu bağlamda; nörolojik vakalarda, acil servis-nöroloji klinikleri arasında tetkik algoritması açısından dikkat ve düzen anlamında yeterli iletişim olması halinde, nadir görülen olgulara acil servis izleminde optimal olarak tanı konulup tedavi başlanabileceği konusunda ilgi çekici bir olgu olduğunu düşündük.","PeriodicalId":110760,"journal":{"name":"Anatolian Journal of Emergency Medicine","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132754347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-18DOI: 10.54996/anatolianjem.1075136
Asım Enes Özbek, M. Pekdemir, Ü. Tural, H. Acar, A. Tomo
Introduction: The aim of this study is to determine pain and anxiety levels in patients who presented to the emergency department due to acute pain and investigate the effect of additional anxiolytic treatment on standard analgesic treatment on pain and anxiety levels. Methods: This is a prospective, randomized, controlled, double-blind study. As the study group received dexketoprofen trometamol plus midazolam, the control group received dexketoprofen trometamol alone. At the 0th, 30th, 60thand 120th minutes of treatment, patients' pain and anxiety levels were measured. Patients' overall anxiety levels were measured. The primary outcome measure was comparing pain and anxiety change at 0-30 minutes. Results: The study was conducted with 90 patients in each group. The median pain change was 33.5 (IQR, 38) for the control group and 30 (IQR, 33) for the study group, and the mean difference was 3.5 (95% CI; -7.2 to 14.2). The median anxiety change was 9.5 (IQR, 41) for the control group and 20 (IQR, 40) for the study group, and the mean difference was -10.5 (95% CI; -24.37 to 3.37). The need for rescue therapy, treatment satisfaction, and preference for the same treatment in the future were similar between the control and the study group, respectively (26.7% vs. 40%, p=0.058; 64% vs. 57%, p=0.770; 90% vs. 89%, p=0.802). Conclusion: In patients who present to the emergency department due to an acute pain complaint, adding anxiolytic treatment to the analgesic treatment does not reduce pain and anxiety.
简介:本研究的目的是确定因急性疼痛而就诊于急诊科的患者的疼痛和焦虑水平，并探讨在标准镇痛治疗的基础上，额外的抗焦虑治疗对疼痛和焦虑水平的影响。方法:前瞻性、随机、对照、双盲研究。研究组给予右酮洛芬曲美他莫联合咪达唑仑治疗，对照组单独给予右酮洛芬曲美他莫治疗。在治疗第0、30、60和120分钟时，测量患者的疼痛和焦虑水平。研究人员测量了患者的总体焦虑水平。主要结局指标是比较0-30分钟的疼痛和焦虑变化。结果:每组90例。对照组的中位疼痛变化为33.5 (IQR, 38)，研究组的中位疼痛变化为30 (IQR, 33)，平均差异为3.5 (95% CI;-7.2至14.2)。对照组的焦虑变化中位数为9.5 (IQR, 41)，研究组为20 (IQR, 40)，平均差异为-10.5 (95% CI;-24.37 - 3.37)。对照组和研究组患者对抢救治疗的需求、治疗满意度和对未来同样治疗的偏好相似，分别为(26.7% vs. 40%， p=0.058;64% vs. 57%， p=0.770;90% vs 89%， p=0.802)。结论:在因急性疼痛主诉到急诊科就诊的患者中，在镇痛治疗的基础上增加抗焦虑治疗并不能减轻疼痛和焦虑。
{"title":"Evaluation of the effect of changes in anxiety levels on pain perception in patients who applied to the emergency department with acute pain: A randomized, double-blind, controlled study.","authors":"Asım Enes Özbek, M. Pekdemir, Ü. Tural, H. Acar, A. Tomo","doi":"10.54996/anatolianjem.1075136","DOIUrl":"https://doi.org/10.54996/anatolianjem.1075136","url":null,"abstract":"Introduction: The aim of this study is to determine pain and anxiety levels in patients who presented to the emergency department due to acute pain and investigate the effect of additional anxiolytic treatment on standard analgesic treatment on pain and anxiety levels. \u0000Methods: This is a prospective, randomized, controlled, double-blind study. As the study group received dexketoprofen trometamol plus midazolam, the control group received dexketoprofen trometamol alone. At the 0th, 30th, 60thand 120th minutes of treatment, patients' pain and anxiety levels were measured. Patients' overall anxiety levels were measured. The primary outcome measure was comparing pain and anxiety change at 0-30 minutes. \u0000Results: The study was conducted with 90 patients in each group. The median pain change was 33.5 (IQR, 38) for the control group and 30 (IQR, 33) for the study group, and the mean difference was 3.5 (95% CI; -7.2 to 14.2). The median anxiety change was 9.5 (IQR, 41) for the control group and 20 (IQR, 40) for the study group, and the mean difference was -10.5 (95% CI; -24.37 to 3.37). The need for rescue therapy, treatment satisfaction, and preference for the same treatment in the future were similar between the control and the study group, respectively (26.7% vs. 40%, p=0.058; 64% vs. 57%, p=0.770; 90% vs. 89%, p=0.802). \u0000Conclusion: In patients who present to the emergency department due to an acute pain complaint, adding anxiolytic treatment to the analgesic treatment does not reduce pain and anxiety.","PeriodicalId":110760,"journal":{"name":"Anatolian Journal of Emergency Medicine","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131261832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-18DOI: 10.54996/anatolianjem.1103611
Elgin Bahçeli̇, Mehtap Bulut
Giriş ve Amaç: Amacımız dünyada ölüm nedenleri arasında ön sıralarda yer alan iskemik inme ile kolay ulaşılabilir, ucuz ve hızlı bir test olan hematolojik parametrelerin ilişkisini araştırmaktır. Gereç ve Yöntem: Araştırma tek merkezli, retrospektif olup Medipol Mega Üniversitesi Hastanesi Acil Servisine başvuran 18 yaş ve üzeri akut iskemik inme ve GİA tanısı alan hastalar dahil edildi. Hastaların hematolojik parametreleri ile TOAST sınıflamasına göre inme alt grupları, acil serviste klinik sonlanma durumları ve yatış süreleri değerlendirildi. Hematolojik parametrelerin yoğun bakım ünitesine (YBÜ) yatış durumunu öngörmedeki etkinlikleri ROC (Receiver Operating Characteristic) eğrisi kullanılarak karşılaştırıldı. Bulgular: Toplam 152 hastanın 97’si (%63,8) erkek ve 55’i (%36,2) kadındı. Hastaların yaş ortalaması 64,38 ± 13,69 olarak saptandı. YBÜ’de takip edilen hastaların lökosit (WBC), nötrofil, monosit ve lökositin ortalama platelet hacmine oranı (WMR) servis hastalarına göre istatistiksel olarak yüksek bulundu. Ortalama eritrosit hacminin platelete oranı (MPR) YBÜ’de takip edilen hastalarda servis hastalarına göre daha düşük bulundu. WBC, nötrofil, monosit, ortalama eritrosit hacminin platelete oranı (MPR) ve WMR değerlerinin acil servisten yoğun bakıma yatışı öngörme başarısı istatistiksel olarak anlamlı bulunmuş olup WMR’nin öngörme gücü (AUC: 0,699 ± 0,056) en yüksek saptandı. Sonuç: Sonuç olarak GİA ve iskemik inmeli hastalarda WBC, nötrofil, monosit, WMR ve MPR, YBÜ’ye yatışı öngörmede kullanılabilir. Anahtar Kelimeler: Acil servis, hematolojik parametreler, iskemik inme, MPR, WMR
{"title":"Acil Serviste İnme ve Hematolojik Parametreler Arasındaki İlişki İncelemesi","authors":"Elgin Bahçeli̇, Mehtap Bulut","doi":"10.54996/anatolianjem.1103611","DOIUrl":"https://doi.org/10.54996/anatolianjem.1103611","url":null,"abstract":"Giriş ve Amaç: Amacımız dünyada ölüm nedenleri arasında ön sıralarda yer alan iskemik inme ile kolay ulaşılabilir, ucuz ve hızlı bir test olan hematolojik parametrelerin ilişkisini araştırmaktır. \u0000Gereç ve Yöntem: Araştırma tek merkezli, retrospektif olup Medipol Mega Üniversitesi Hastanesi Acil Servisine başvuran 18 yaş ve üzeri akut iskemik inme ve GİA tanısı alan hastalar dahil edildi. Hastaların hematolojik parametreleri ile TOAST sınıflamasına göre inme alt grupları, acil serviste klinik sonlanma durumları ve yatış süreleri değerlendirildi. Hematolojik parametrelerin yoğun bakım ünitesine (YBÜ) yatış durumunu öngörmedeki etkinlikleri ROC (Receiver Operating Characteristic) eğrisi kullanılarak karşılaştırıldı. \u0000Bulgular: Toplam 152 hastanın 97’si (%63,8) erkek ve 55’i (%36,2) kadındı. Hastaların yaş ortalaması 64,38 ± 13,69 olarak saptandı. YBÜ’de takip edilen hastaların lökosit (WBC), nötrofil, monosit ve lökositin ortalama platelet hacmine oranı (WMR) servis hastalarına göre istatistiksel olarak yüksek bulundu. Ortalama eritrosit hacminin platelete oranı (MPR) YBÜ’de takip edilen hastalarda servis hastalarına göre daha düşük bulundu. WBC, nötrofil, monosit, ortalama eritrosit hacminin platelete oranı (MPR) ve WMR değerlerinin acil servisten yoğun bakıma yatışı öngörme başarısı istatistiksel olarak anlamlı bulunmuş olup WMR’nin öngörme gücü (AUC: 0,699 ± 0,056) en yüksek saptandı. \u0000Sonuç: Sonuç olarak GİA ve iskemik inmeli hastalarda WBC, nötrofil, monosit, WMR ve MPR, YBÜ’ye yatışı öngörmede kullanılabilir. \u0000Anahtar Kelimeler: Acil servis, hematolojik parametreler, iskemik inme, MPR, WMR","PeriodicalId":110760,"journal":{"name":"Anatolian Journal of Emergency Medicine","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125315150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-04DOI: 10.54996/anatolianjem.1147015
Çiğdem Özpolat, Erhan Altunbaş
Giriş: Acil hemodiyaliz hayat kurtarıcı bir tedavidir. Literatürde kronik böbrek yetmezliği ya da akut böbrek yetmezliği nedeniyle acil servise başvuran ve sonrasında acil hemodiyaliz ihtiyacı ile hemodiyalize alınan hastalarla ilgili tanımlayıcı çalışma sınırlı sayıdadır. Bu çalışmada Marmara Üniversitesi Tıp Fakültesi Acil Tıp Kliniğine çeşitli şikâyetlerle başvuran ve yapılan tetkikleri neticesinde acil diyaliz endikasyonu konulan hastaların demografik özellikleri, klinik ve laboratuvar bulgularının belirlenmesi amaçlandı. Materyal-Metod: Bu çalışmaya hastanemiz acil servisine başvuran, acil tıp hekimi değerlendirmesinin ardından konsültasyon sonrası hemodiyalize alınan hastalar dahil edildi. Hastaların demografik, klinik ve laboratuvar verileri, diyaliz endikasyonları ve sonraki süreçleri retrospektif olarak toplandı. Veriler SPSS 22.0 programı ile analiz edildi. Bulgular: Çalışmamıza toplam 380 hasta alınmıştır. Hastaların %56.6’sı erkek olup yaş ortalamaları 63.3±17.3’dir. Hastaların %71.7’sinin bilinen kronik böbrek yetmezliği olup %67’si rutin hemodiyaliz programına girmektedir. En sık başvuru şikayeti nefes darlığıdır. Hastaların %75’i ilk 12 saat içinde hemodiyalize alınmıştır. %54.2 hastaya acil kateter takılması gerekmiştir. Hastaların büyük çoğunluğuna servis ya da yoğun bakım yatışı gerekmiş olup 3 hasta exitus olmuştur. Sonuç: Acil hemodiyalize alınması gereken hastaların çoğunluğuna yatış gerekmekte olup bu hastalar kritik hasta grubunu oluşturmaktadır. Bu hastaların daha iyi tanınması ve acil servis süreci öncesi hastalıklarının kontrol altına alınması için daha geniş tanımlayıcı çalışmalara ihtiyaç vardır.
{"title":"Acil Serviste Acil Hemodiyaliz Endikasyonu Konulan Hastaların Retrospektif Analizi","authors":"Çiğdem Özpolat, Erhan Altunbaş","doi":"10.54996/anatolianjem.1147015","DOIUrl":"https://doi.org/10.54996/anatolianjem.1147015","url":null,"abstract":"Giriş: Acil hemodiyaliz hayat kurtarıcı bir tedavidir. Literatürde kronik böbrek yetmezliği ya da akut böbrek yetmezliği nedeniyle acil servise başvuran ve sonrasında acil hemodiyaliz ihtiyacı ile hemodiyalize alınan hastalarla ilgili tanımlayıcı çalışma sınırlı sayıdadır. Bu çalışmada Marmara Üniversitesi Tıp Fakültesi Acil Tıp Kliniğine çeşitli şikâyetlerle başvuran ve yapılan tetkikleri neticesinde acil diyaliz endikasyonu konulan hastaların demografik özellikleri, klinik ve laboratuvar bulgularının belirlenmesi amaçlandı. \u0000Materyal-Metod: Bu çalışmaya hastanemiz acil servisine başvuran, acil tıp hekimi değerlendirmesinin ardından konsültasyon sonrası hemodiyalize alınan hastalar dahil edildi. Hastaların demografik, klinik ve laboratuvar verileri, diyaliz endikasyonları ve sonraki süreçleri retrospektif olarak toplandı. Veriler SPSS 22.0 programı ile analiz edildi. \u0000Bulgular: Çalışmamıza toplam 380 hasta alınmıştır. Hastaların %56.6’sı erkek olup yaş ortalamaları 63.3±17.3’dir. Hastaların %71.7’sinin bilinen kronik böbrek yetmezliği olup %67’si rutin hemodiyaliz programına girmektedir. En sık başvuru şikayeti nefes darlığıdır. Hastaların %75’i ilk 12 saat içinde hemodiyalize alınmıştır. %54.2 hastaya acil kateter takılması gerekmiştir. Hastaların büyük çoğunluğuna servis ya da yoğun bakım yatışı gerekmiş olup 3 hasta exitus olmuştur. \u0000Sonuç: Acil hemodiyalize alınması gereken hastaların çoğunluğuna yatış gerekmekte olup bu hastalar kritik hasta grubunu oluşturmaktadır. Bu hastaların daha iyi tanınması ve acil servis süreci öncesi hastalıklarının kontrol altına alınması için daha geniş tanımlayıcı çalışmalara ihtiyaç vardır.","PeriodicalId":110760,"journal":{"name":"Anatolian Journal of Emergency Medicine","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121018839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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