Pub Date : 2022-12-09DOI: 10.4274/eajem.galenos.2022.83713
E. Gürbüz, İ. Üzün, Erdem Hösükler, Bilgin Hösükler
Aim: This study aimed to increase the awareness of physicians working in adult and pediatric emergency departments (ED) about malpractice allegations. Materials and Methods: A retrospective analysis was conducted of cases with malpractice allegations occurring in ED from the lawsuit files decided by the First Specialization Board of the İstanbul Forensic Medicine Institute between 01/01/2012-31/12/2014. Results: Evaluation was made of 556 cases, comprising 357 (64.2%) males and 199 (35.8%) females, with a mean age of 38.92±24.8 years (minimum: 0, maximum: 87), with the highest number of cases in the 40-59 years age group (n=157, 28.2%). Two-thirds (n=377, 67.8%) of the cases with alleged medical malpractice occurred in a public hospital. The board decided that 24.4% (n=136) of the cases were medical malpractice. Of 556 cases, 1.102 physicians were accused and 151 physicians (13.7%) were found to be at fault by the board. More than half of the physicians accused of medical malpractice (51.7%) were general practitioners. The most common cause of malpractice in 136 files was diagnostic error (n=79, 58.1%). The most common actions of malpractice were failure to diagnose on time, and misdiagnosis (n=29, 21.3%). The most frequent diagnosis was trauma (n=156, 28.1%). Conclusion: Most of the malpractice allegations against the physicians working in the ED were unfounded and dismissed by the board. order to avoid diagnostic errors, it can be recommended that novice general practitioners should not be employed alone in ED without the support of more experienced colleagues.
{"title":"Malpractice Allegations in Adult and Pediatric Emergency Departments Resulting in Death","authors":"E. Gürbüz, İ. Üzün, Erdem Hösükler, Bilgin Hösükler","doi":"10.4274/eajem.galenos.2022.83713","DOIUrl":"https://doi.org/10.4274/eajem.galenos.2022.83713","url":null,"abstract":"Aim: This study aimed to increase the awareness of physicians working in adult and pediatric emergency departments (ED) about malpractice allegations. Materials and Methods: A retrospective analysis was conducted of cases with malpractice allegations occurring in ED from the lawsuit files decided by the First Specialization Board of the İstanbul Forensic Medicine Institute between 01/01/2012-31/12/2014. Results: Evaluation was made of 556 cases, comprising 357 (64.2%) males and 199 (35.8%) females, with a mean age of 38.92±24.8 years (minimum: 0, maximum: 87), with the highest number of cases in the 40-59 years age group (n=157, 28.2%). Two-thirds (n=377, 67.8%) of the cases with alleged medical malpractice occurred in a public hospital. The board decided that 24.4% (n=136) of the cases were medical malpractice. Of 556 cases, 1.102 physicians were accused and 151 physicians (13.7%) were found to be at fault by the board. More than half of the physicians accused of medical malpractice (51.7%) were general practitioners. The most common cause of malpractice in 136 files was diagnostic error (n=79, 58.1%). The most common actions of malpractice were failure to diagnose on time, and misdiagnosis (n=29, 21.3%). The most frequent diagnosis was trauma (n=156, 28.1%). Conclusion: Most of the malpractice allegations against the physicians working in the ED were unfounded and dismissed by the board. order to avoid diagnostic errors, it can be recommended that novice general practitioners should not be employed alone in ED without the support of more experienced colleagues.","PeriodicalId":11814,"journal":{"name":"Eurasian Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2022-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43573477","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 : 2022-12-09DOI: 10.4274/eajem.galenos.2022.71224
Fatma Selman, Ertuğ Günsoy, Aslıhan Yürüktümen Ünal, Y. Şenol
Aim: With its widespread use for emergency patient care, point-of-care ultrasound (PoCUS) is included in postgraduate education in Turkey, but its practice may vary depending on the training program. Our study aimed to determine the content of practices regarding PoCUS training in Turkey, and to present a future perspective by revealing the relationship between years of education and competence perceptions. Materials and Methods: This is a descriptive study conducted on emergency medicine students who were still residents approximately 2018-2019. The first part includes demographic data, theoretical and practical training content. The second part is created according to the Likert scale for self-assessment that questions the competence. The survey was conveyed to. Results: In our study, including 249 residents, the participants reported their practical training hours for emergency ultrasound (US) use as 12.5 h, and theoretical training hours as 12.1 h. For all sonographic evaluations, it was found that 10.1% of the practices were performed under the supervision of an academic member. Conclusion: It was found that Emergency Medicine clinics in Turkey had adequate equipment for the use and training of US, residents had a certain level of competence to using US, but there was no regular training with curriculum and assessment criteria in clinics.
{"title":"Content and Adequacy of Emergency Medicine Point of Care Ultrasound Training: Evaluation of Turkey","authors":"Fatma Selman, Ertuğ Günsoy, Aslıhan Yürüktümen Ünal, Y. Şenol","doi":"10.4274/eajem.galenos.2022.71224","DOIUrl":"https://doi.org/10.4274/eajem.galenos.2022.71224","url":null,"abstract":"Aim: With its widespread use for emergency patient care, point-of-care ultrasound (PoCUS) is included in postgraduate education in Turkey, but its practice may vary depending on the training program. Our study aimed to determine the content of practices regarding PoCUS training in Turkey, and to present a future perspective by revealing the relationship between years of education and competence perceptions. Materials and Methods: This is a descriptive study conducted on emergency medicine students who were still residents approximately 2018-2019. The first part includes demographic data, theoretical and practical training content. The second part is created according to the Likert scale for self-assessment that questions the competence. The survey was conveyed to. Results: In our study, including 249 residents, the participants reported their practical training hours for emergency ultrasound (US) use as 12.5 h, and theoretical training hours as 12.1 h. For all sonographic evaluations, it was found that 10.1% of the practices were performed under the supervision of an academic member. Conclusion: It was found that Emergency Medicine clinics in Turkey had adequate equipment for the use and training of US, residents had a certain level of competence to using US, but there was no regular training with curriculum and assessment criteria in clinics.","PeriodicalId":11814,"journal":{"name":"Eurasian Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2022-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47458588","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 : 2022-12-09DOI: 10.4274/eajem.galenos.2022.75508
Deniz Heppekcan, M. Sabak
Aim: The effect of smoking on patients hospitalized in the intensive care unit (ICU) due to Coronavirus disease-2019 (COVID-19) infection is unknown. The study determines the relationship between COVID-19 and smoking status on the development of disease and critical illness. Materials and Methods: The patient files and hospital information system records of COVID-19 patients over the age of eighteen who were hospitalized in the ICU of our hospital between March 2020 and January 2021 and confirmed by polymerase chain reaction method were retrospectively reviewed. Results: 1.003 of 226 COVID-19 patients included in the study, 58% were male, and the mean age was 65.38 (+/- 14.99). The patients' smoking status was categorized as non-smokers, ex-smokers, and current daily smokers (74.8%;23%;2.2%;respectively). The most common comorbid disease of the patients was hypertension (58%). One hundred seventy-nine patients were given respiratory support with invasive mechanical ventilation (IMV), and 37.2% were discharged. The mean duration of IMV application, hospitalization, and hospitalization in the ICU was 7.11 (+/- 5.51);14.42 (+/- 10.25), respectively;it was 7.58 (+/- 6.29) days. The average APACHE-II score was 23.87 +/-;8.86. Mortality was statistically significantly higher in those who received mechanical ventilator support from patients with no smoker stage and without the comorbid disease (p=0.009). Conclusion: Although the percentage of current smokers in patients hospitalized in the ICU due to COVID-19 is relatively low, we believe that polygenetic and multiple factors can explain it. It should not be recommended that tobacco products be administered for either preventive or therapeutic purposes in the case of COVID-19 infection.
{"title":"Association of Smoking Status with Outcomes in Intensive Care Unit with COVID-19","authors":"Deniz Heppekcan, M. Sabak","doi":"10.4274/eajem.galenos.2022.75508","DOIUrl":"https://doi.org/10.4274/eajem.galenos.2022.75508","url":null,"abstract":"Aim: The effect of smoking on patients hospitalized in the intensive care unit (ICU) due to Coronavirus disease-2019 (COVID-19) infection is unknown. The study determines the relationship between COVID-19 and smoking status on the development of disease and critical illness. Materials and Methods: The patient files and hospital information system records of COVID-19 patients over the age of eighteen who were hospitalized in the ICU of our hospital between March 2020 and January 2021 and confirmed by polymerase chain reaction method were retrospectively reviewed. Results: 1.003 of 226 COVID-19 patients included in the study, 58% were male, and the mean age was 65.38 (+/- 14.99). The patients' smoking status was categorized as non-smokers, ex-smokers, and current daily smokers (74.8%;23%;2.2%;respectively). The most common comorbid disease of the patients was hypertension (58%). One hundred seventy-nine patients were given respiratory support with invasive mechanical ventilation (IMV), and 37.2% were discharged. The mean duration of IMV application, hospitalization, and hospitalization in the ICU was 7.11 (+/- 5.51);14.42 (+/- 10.25), respectively;it was 7.58 (+/- 6.29) days. The average APACHE-II score was 23.87 +/-;8.86. Mortality was statistically significantly higher in those who received mechanical ventilator support from patients with no smoker stage and without the comorbid disease (p=0.009). Conclusion: Although the percentage of current smokers in patients hospitalized in the ICU due to COVID-19 is relatively low, we believe that polygenetic and multiple factors can explain it. It should not be recommended that tobacco products be administered for either preventive or therapeutic purposes in the case of COVID-19 infection.","PeriodicalId":11814,"journal":{"name":"Eurasian Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2022-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41832278","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 : 2022-12-09DOI: 10.4274/eajem.galenos.2021.79836
Y. Çevik, F. Karaarslan, Ş. K. Çorbacıoğlu, Gülsüm Feyza Türkeş, E. Emektar
Aim: The aim of this study was to examine the relationship between immature granulocyte (IG) counts and the severity of the disease and to evaluate the effectiveness of IG in predicting the poor outcomes in polymerase chain reaction-confirmed Coronavirus disease-2019 (COVID-19) cases. Materials and Methods: The study was conducted prospectively and observationally at the emergency department. Patients were divided into three groups according to the clinical severity indicators such as mild, moderate and severe. The IG level was measured from the whole blood samples taken at the admission to the emergency department. Intensive care unit admission, ventilation support, and death within the first 28 days after the admission were evaluated as composite outcomes. Results: The study group consisted of 203 adults, of whom 91 (44.8%) were women. According to the severity of the illness, 40 patients (19.7%) were classified as mild, 67 patients (33.0%) as moderate, and 96 patients (47.3%) as severe. When comparing IG levels between the groups, there was a statistically significant difference between the mild and severe groups (p=0.047) and between the moderate and severe disease groups (p=0.036). There was no statistically significant relationship between IG counts and the composite outcome (p > 0.05) Conclusion: The IG level, which could be measured faster than other laboratory tests without any additional cost, could be used for the determination of the clinical severity of patients with COVID-19. However, we conclude that this parameter is not effective in determining poor outcomes during the admission.
{"title":"The Effectiveness of Immature Granulocyte Count for Predicting COVID-19 Severity and Poor Outcomes","authors":"Y. Çevik, F. Karaarslan, Ş. K. Çorbacıoğlu, Gülsüm Feyza Türkeş, E. Emektar","doi":"10.4274/eajem.galenos.2021.79836","DOIUrl":"https://doi.org/10.4274/eajem.galenos.2021.79836","url":null,"abstract":"Aim: The aim of this study was to examine the relationship between immature granulocyte (IG) counts and the severity of the disease and to evaluate the effectiveness of IG in predicting the poor outcomes in polymerase chain reaction-confirmed Coronavirus disease-2019 (COVID-19) cases. Materials and Methods: The study was conducted prospectively and observationally at the emergency department. Patients were divided into three groups according to the clinical severity indicators such as mild, moderate and severe. The IG level was measured from the whole blood samples taken at the admission to the emergency department. Intensive care unit admission, ventilation support, and death within the first 28 days after the admission were evaluated as composite outcomes. Results: The study group consisted of 203 adults, of whom 91 (44.8%) were women. According to the severity of the illness, 40 patients (19.7%) were classified as mild, 67 patients (33.0%) as moderate, and 96 patients (47.3%) as severe. When comparing IG levels between the groups, there was a statistically significant difference between the mild and severe groups (p=0.047) and between the moderate and severe disease groups (p=0.036). There was no statistically significant relationship between IG counts and the composite outcome (p > 0.05) Conclusion: The IG level, which could be measured faster than other laboratory tests without any additional cost, could be used for the determination of the clinical severity of patients with COVID-19. However, we conclude that this parameter is not effective in determining poor outcomes during the admission.","PeriodicalId":11814,"journal":{"name":"Eurasian Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2022-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47753162","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 : 2022-12-09DOI: 10.4274/eajem.galenos.2021.05900
Vildan Özer, A. Küçük, A. Eroğlu, K. Y. Güven, Hüseyin Çetin Ketenci, A. Şahin, Z. Kazzi
U.S.A
美国
{"title":"Successful Management of Severe Verapamil Overdose with VAECMO","authors":"Vildan Özer, A. Küçük, A. Eroğlu, K. Y. Güven, Hüseyin Çetin Ketenci, A. Şahin, Z. Kazzi","doi":"10.4274/eajem.galenos.2021.05900","DOIUrl":"https://doi.org/10.4274/eajem.galenos.2021.05900","url":null,"abstract":"U.S.A","PeriodicalId":11814,"journal":{"name":"Eurasian Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2022-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46806087","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 : 2022-12-09DOI: 10.4274/eajem.galenos.2022.82687
B. Masoumi, Razieh Bagheri, Farhad Heydari, Abaris Massoumi, B. Ansari, Mohammad Nasr-Esfahani
Aim: Vertigo is a common presenting complaint to the emergency department (ED). Distinguishing between acute central and peripheral vertigo can be challenging. During recent years, several biomarkers have been introduced for use in distinguishing central and peripheral vertigo. The current study determined whether S100 calcium-binding protein B (S100B) and neuron-specific enolase (NSE) serum concentrations could effectively predict the central causes of vertigo. Materials and Methods: This was a prospective study performed on 117 patients with acute vertigo who were admitted to the ED. All patients underwent magnetic resonance imaging (MRI) and the results of the MRI were considered the gold standard. S100B and NSE from blood samples taken <8 h after the onset of symptoms were measured in all patients. Results: Finally, 117 patients were enrolled in the study, of which 43 patients had central vertigo and 74 patients had peripheral vertigo. The serum levels of S100B and NSE in the central group were significantly higher (60.62 vs 28.01 pg/mL, and 11.86 vs 7 ng/mL, p<0.001, respectively). The receiver-operating characteristic analysis demonstrated an AUC of 0.91 [95% confidence interval (CI): 0.84-0.96] and 0.93 (95% CI: 0.87-0.97) for S100B and NSE for predicting central vertigo and reported a sensitivity of 97.7% and 93% and a specificity of 87.8% and 89.2% for detecting the central cause of vertigo with S100B and NSE. Conclusion: The serum S100B and NSE concentrations in central vertigo were significantly higher, and could be useful markers in screening central from peripheral vertigo in the ED.
{"title":"Diagnostic Value of S100B and Neuron-specific Enolase in Distinguishing Acute Central and Peripheral Vertigo","authors":"B. Masoumi, Razieh Bagheri, Farhad Heydari, Abaris Massoumi, B. Ansari, Mohammad Nasr-Esfahani","doi":"10.4274/eajem.galenos.2022.82687","DOIUrl":"https://doi.org/10.4274/eajem.galenos.2022.82687","url":null,"abstract":"Aim: Vertigo is a common presenting complaint to the emergency department (ED). Distinguishing between acute central and peripheral vertigo can be challenging. During recent years, several biomarkers have been introduced for use in distinguishing central and peripheral vertigo. The current study determined whether S100 calcium-binding protein B (S100B) and neuron-specific enolase (NSE) serum concentrations could effectively predict the central causes of vertigo. Materials and Methods: This was a prospective study performed on 117 patients with acute vertigo who were admitted to the ED. All patients underwent magnetic resonance imaging (MRI) and the results of the MRI were considered the gold standard. S100B and NSE from blood samples taken <8 h after the onset of symptoms were measured in all patients. Results: Finally, 117 patients were enrolled in the study, of which 43 patients had central vertigo and 74 patients had peripheral vertigo. The serum levels of S100B and NSE in the central group were significantly higher (60.62 vs 28.01 pg/mL, and 11.86 vs 7 ng/mL, p<0.001, respectively). The receiver-operating characteristic analysis demonstrated an AUC of 0.91 [95% confidence interval (CI): 0.84-0.96] and 0.93 (95% CI: 0.87-0.97) for S100B and NSE for predicting central vertigo and reported a sensitivity of 97.7% and 93% and a specificity of 87.8% and 89.2% for detecting the central cause of vertigo with S100B and NSE. Conclusion: The serum S100B and NSE concentrations in central vertigo were significantly higher, and could be useful markers in screening central from peripheral vertigo in the ED.","PeriodicalId":11814,"journal":{"name":"Eurasian Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2022-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44614761","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 : 2022-12-09DOI: 10.4274/eajem.galenos.2022.03206
Samuel Campbell, H. Wiemer, Ryan Fitzpatrick, C. Carriere, S. Teed, P. Hico, A. Snook
Aim: The Cunningham method allows for the reduction of anterior shoulder dislocations (ASD) without procedural sedation and analgesia (PSA) in some patients. This pilot study evaluates the feasibility of investigating whether the administration of inhaled methoxyflurane (I-MEOF) increases the success rate of Cunningham reduction of ASD. Materials and Methods: Twenty patients with uncomplicated ASD underwent reduction attempts using the Cunningham method supported by I-MEOF analgesia (Cunningham/I-MEOF). Outcomes included the success rate without the requirement for PSA, emergency department length of stay (LOS), and operator and patient satisfaction. Results: Of the patients enrolled. 80% were male, median age was 38.6 years (range 18-71) and 55% were the first dislocations. 35% (8/20 patients) were successfully reduced using Cunningham/I-MEOF. The remainder of patients proceeded to successful closed reduction under PSA. 60% of operators reported good to excellent satisfaction with the process. Operators identified the primary cause of failed initial reduction attempts as inadequate muscle relaxation. 80% of patients reported good to excellent satisfaction. Patients whose initial reduction attempt with Cunningham/I-MEOF was successful had an average LOS of 149 min, compared with 216 min for those who proceeded to reduction under PSA. Conclusion: Success with ASD reduction by the Cunningham technique was marginally increased with the use of I-MEOF, although 65% of patients still required PSA to facilitate reduction. Both providers and patients found the process generally satisfactory, suggesting that early administration of analgesia is appreciated.
{"title":"A Pilot Study of Inhaled Low-dose Methoxyflurane to Support Cunningham Reduction of Anterior Shoulder Dislocation","authors":"Samuel Campbell, H. Wiemer, Ryan Fitzpatrick, C. Carriere, S. Teed, P. Hico, A. Snook","doi":"10.4274/eajem.galenos.2022.03206","DOIUrl":"https://doi.org/10.4274/eajem.galenos.2022.03206","url":null,"abstract":"Aim: The Cunningham method allows for the reduction of anterior shoulder dislocations (ASD) without procedural sedation and analgesia (PSA) in some patients. This pilot study evaluates the feasibility of investigating whether the administration of inhaled methoxyflurane (I-MEOF) increases the success rate of Cunningham reduction of ASD. Materials and Methods: Twenty patients with uncomplicated ASD underwent reduction attempts using the Cunningham method supported by I-MEOF analgesia (Cunningham/I-MEOF). Outcomes included the success rate without the requirement for PSA, emergency department length of stay (LOS), and operator and patient satisfaction. Results: Of the patients enrolled. 80% were male, median age was 38.6 years (range 18-71) and 55% were the first dislocations. 35% (8/20 patients) were successfully reduced using Cunningham/I-MEOF. The remainder of patients proceeded to successful closed reduction under PSA. 60% of operators reported good to excellent satisfaction with the process. Operators identified the primary cause of failed initial reduction attempts as inadequate muscle relaxation. 80% of patients reported good to excellent satisfaction. Patients whose initial reduction attempt with Cunningham/I-MEOF was successful had an average LOS of 149 min, compared with 216 min for those who proceeded to reduction under PSA. Conclusion: Success with ASD reduction by the Cunningham technique was marginally increased with the use of I-MEOF, although 65% of patients still required PSA to facilitate reduction. Both providers and patients found the process generally satisfactory, suggesting that early administration of analgesia is appreciated.","PeriodicalId":11814,"journal":{"name":"Eurasian Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2022-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41679511","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 : 2022-12-09DOI: 10.4274/eajem.galenos.2022.81905
Sarah Mohammed Bin Hariz, Ahmed Hasan AlZaabi, Ghazy Habeeb Lutf, B. Tesfayohannes, Ayesha Almemari
Mesenteric cysts are rare benign intra-abdominal pediatric lesions. It has a variable clinical presentation from an asymptomatic mass to an acute abdomen that appears in the omentum or mesentery of the gastrointestinal tract. Abdominal ultrasound and complete surgical resection are the modality of choice for diagnosis and treatment. Here, we present 15 months old boy who presented to the emergency department with constipation and abdominal pain and was found to have a huge mesenteric cyst that was excised surgically
{"title":"Mesenteric Cyst in a Child with Abdominal Pain: A Perspective from Emergency Department Attendance","authors":"Sarah Mohammed Bin Hariz, Ahmed Hasan AlZaabi, Ghazy Habeeb Lutf, B. Tesfayohannes, Ayesha Almemari","doi":"10.4274/eajem.galenos.2022.81905","DOIUrl":"https://doi.org/10.4274/eajem.galenos.2022.81905","url":null,"abstract":"Mesenteric cysts are rare benign intra-abdominal pediatric lesions. It has a variable clinical presentation from an asymptomatic mass to an acute abdomen that appears in the omentum or mesentery of the gastrointestinal tract. Abdominal ultrasound and complete surgical resection are the modality of choice for diagnosis and treatment. Here, we present 15 months old boy who presented to the emergency department with constipation and abdominal pain and was found to have a huge mesenteric cyst that was excised surgically","PeriodicalId":11814,"journal":{"name":"Eurasian Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2022-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42165671","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 : 2022-12-09DOI: 10.4274/eajem.galenos.2022.79446
L. Akcan Yıldız, A. Tagiyev, Ö. Tekşam
Aim: We investigated the characteristics of patients involved in bicycle accidents, along with the mechanisms of accidents and clinical outcomes in children. Our secondary aim was to assess the characteristics of patients with serious clinical consequences, such as traumatic brain injury (TBI) and permanent neurological sequelae. Materials and Methods: Children admitted to the pediatric emergency department of a tertiary referral hospital during a four-year period due to bicycle accidents were included. The mechanism of the accident was classified into two groups; high-energy trauma and low-energy trauma. Statistical analyses were performed to recognize injury patterns and clinical outcomes associated with the mechanism of the accident. Results: Three hundred-sixty children were included. Two of the injured patients were using a bicycle helmet. Twenty-nine patients (8.1%) required surgery. Fourteen patients had clinically important TBI. Eighteen patients had handlebar trauma to the abdomen. Eight patients had permanent neurological sequelae (vision loss in three, hearing loss in three, spasticity and hemiparesis in two patients) and two patients had finger amputations. Abrasions/soft tissue injuries, scalp fractures, maxillofacial fractures and TBI were also significantly more common types of injury in high-energy trauma. Conclusion: Although the recommendation of using helmets while riding was made two decades ago, the rate of helmet use is still very low in our country. In this retrospective cohort with low rate and no obligatory regulation of helmet use, high-energy bicycle accidents have caused significant clinical outcomes, including maxillofacial-scalp fractures, TBI, permanent sensory (visual and hearing) or motor (spasticity and hemiparesis) disability.
{"title":"Retrospective Analysis of Bicycle Accidents at a Referral Pediatric Emergency Department: Mechanisms, Outcomes and Perspectives","authors":"L. Akcan Yıldız, A. Tagiyev, Ö. Tekşam","doi":"10.4274/eajem.galenos.2022.79446","DOIUrl":"https://doi.org/10.4274/eajem.galenos.2022.79446","url":null,"abstract":"Aim: We investigated the characteristics of patients involved in bicycle accidents, along with the mechanisms of accidents and clinical outcomes in children. Our secondary aim was to assess the characteristics of patients with serious clinical consequences, such as traumatic brain injury (TBI) and permanent neurological sequelae. Materials and Methods: Children admitted to the pediatric emergency department of a tertiary referral hospital during a four-year period due to bicycle accidents were included. The mechanism of the accident was classified into two groups; high-energy trauma and low-energy trauma. Statistical analyses were performed to recognize injury patterns and clinical outcomes associated with the mechanism of the accident. Results: Three hundred-sixty children were included. Two of the injured patients were using a bicycle helmet. Twenty-nine patients (8.1%) required surgery. Fourteen patients had clinically important TBI. Eighteen patients had handlebar trauma to the abdomen. Eight patients had permanent neurological sequelae (vision loss in three, hearing loss in three, spasticity and hemiparesis in two patients) and two patients had finger amputations. Abrasions/soft tissue injuries, scalp fractures, maxillofacial fractures and TBI were also significantly more common types of injury in high-energy trauma. Conclusion: Although the recommendation of using helmets while riding was made two decades ago, the rate of helmet use is still very low in our country. In this retrospective cohort with low rate and no obligatory regulation of helmet use, high-energy bicycle accidents have caused significant clinical outcomes, including maxillofacial-scalp fractures, TBI, permanent sensory (visual and hearing) or motor (spasticity and hemiparesis) disability.","PeriodicalId":11814,"journal":{"name":"Eurasian Journal of Emergency Medicine","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2022-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45205541","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 : 2022-12-09DOI: 10.4274/eajem.galenos.2021.38247
M. Kaya, Simge Fidan Sarı
A 55-year-old male patient presented to our outpatient clinic with complaints of dark urine and fatigue. The laboratory parameters were as follows: alanine aminotransferase 821 IU/L, aspartate aminotransferase 1042 IU/L, alkaline phosphatase 412 IU/L gamma-glutamyl transferase 268 IU/L and the complete urinalysis revealed hematuria, while other laboratory parameters were normal. The patient's abdominal ultrasonography (USG) and Doppler USG showed no pathological finding. Hepatitis and the other serologies were negative. The patient, who did not exhibit any symptoms of Coronavirus disease-2019 (COVID-19) initially, exhibited bilateral opacities in the middle zones on chest X-ray taken after the development of fever and dyspnea on the third day of hospitalization. The computed tomography scan revealed segmental consolidation across the subpleural regions, mostly in the middle zones, and was evaluated to be consistent with COVID-19. COVID-19 treatment was planned for the patient whose nasopharyngeal swab tested positive for severe acute respiratory syndrome-Coronavirus-2.
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