Ulus Travma Acil Cer
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Ulus Travma Acil Cer · Jan 2022
Case ReportsNon-traumatic spontaneous ruptured hepatocellular adenoma after selective transcatheter arterial chemo-embolization for reduction of tumor mass: A case report.
It is important to detect hepatic adenomas, which are generally well-confined lesions, as urgent treatment is required due to the risk of bleeding and conversion to malignancy. Dimensions can vary between 1 and 15 cm, and the risk of hemorrhage is higher in large and multiple-focus adenomas. The case is here presented of a patient with spontaneous ruptured liver adenoma after selective transcatheter arterial chemo-embolization for reduction of tumor mass, with discussion of the clinical, computed tomography, angiographic findings, and treatment strategies.
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Ulus Travma Acil Cer · Jan 2022
Determination of factors associated with perforation in patients with geriatric acute appendicitis.
Recognition and management of abdominal emergencies in geriatric patients are more complicated compared to the younger population. We aimed to investigate the demographic characteristics of geriatric patients diagnosed with acute appendicitis and to investigate the factors associated with perforation in the early stages in this study. ⋯ Geriatric patients with chronic kidney disease can be at higher risk of perforated appendicitis due to inadequate abdominal physical examination results. In addition, male gender and an elevated neutrophil count are independent predictors of perforation.
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Ulus Travma Acil Cer · Jan 2022
Prediction of adverse outcomes using non-endoscopic scoring systems in patients over 80 years of age who present with the upper gastrointestinal bleeding in the emergency department.
The emergency department (ED) admission rate for elderly patients with non-variceal upper gastrointestinal bleeding (UGIB) is increasing. The AIMS65 and Glasgow-Blatchford score (GBS) are two distinct scoring systems proposed to predict in-hospital and post-discharge mortality, length of stay (LOS), and health-related costs in these patients. The objective of the present study is to evaluate the accuracy of these scoring systems, in conjunction with the Charlson comorbidity index (CCI), to predict 30-day mortality and LOS in UGIB patients who are 80 years of age or older METHODS: A retrospective analysis was undertaken of 182 patients with non-variceal UGIB who were admitted to the ED of Canakkale Onsekiz Mart University Hospital. The AIMS65, GBS, and CCI scores were calculated and adverse patient outcomes were assessed. ⋯ The AIMS65 is a simple, accurate, and non-endoscopic scoring system that can be performed easily in ED settings. It is superior to GBS and CCI in predicting 30-day mortality in elderly patients with UGIB.
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Ulus Travma Acil Cer · Jan 2022
The effect of Fournier gangrene severity index and microbial culture results on hospital length of stay, frequency of debridement, and mortality.
Fournier gangrene (FG) is a rapidly progressive soft-tissue necrosis that may be life-threating unless aggressive treatment is applied immediately. FG severity index was described first by Laor et al. to predict mortality rate but there are few studies on the prognostic significance of FG severity index and especially the microbial agents isolated from debridement on patient prognosis. Hence, in the present study, it has been aimed to investigate the significance of FG severity index and infective agents on hospital stay, frequency of debridement, and mortality. ⋯ FG severity index was found to be insufficient in determining the frequency of debridement and the hospital stay but it accurately predicts the rates of mortality and survival. The patients who were infected with clostridial and atypical agents are more likely to develop mortality and tend to be need more aggressive surgical interventions than the others.
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Ulus Travma Acil Cer · Jan 2022
Evaluation of forensic reports issued in emergency departments and comparison with reports issued by the Council of Forensic Medicine.
Identify the deficiencies in the forensic reports prepared by the emergency physicians and to identify the frequent mistakes in these reports by comparing the forensic reports issued by the emergency physicians in the context of offences against physical integrity and the forensic reports issued by the Second Forensic Medicine Specialization Board for the same forensic cases. ⋯ Regardless of whether the physicians working in the emergency departments are general practitioners or emergency specialists, their sensitivity and knowledge level regarding the preparation of a forensic report was found to be insufficient. We believe that with the increase of coordinated planned multidisciplinary trainings that include emergency medicine and forensic medicine, the forensic reports that are arranged incorrectly will decrease and the awareness of physicians about the results of forensic reports will increase.