Background/aim: The number of elderly people (≥65 years old) is increasing both in Turkey and internationally due to improved living conditions and decreased mortality rates. Knowing the characteristics of elderly patients admitted to emergency departments can provide guidance for diagnosis and treatment approaches. In this study, we analyzed the characteristics of very old patients (≥85 years old) admitted to the emergency department and put together data for use in forward planning in healthcare services. Materials and methods:This retrospective study included all patients aged ≥85 years admitted to the Adult Emergency Department of Gazi University Medical Faculty Hospital between 01.01.2014 and 31.12.2014. Data concerning the patients' age, sex, date of admission, weekday or weekend admission, reason for admission, length of stay, number of readmissions, admission from within or outside the province, and whether they were hospitalized or not were evaluated.Results: In this study, 1105 admissions of 780 patients aged ≥85 years to the emergency department were analyzed. The median age of the patients was 87 years and 59% were female. The most frequent admissions were in January (11.4%). Most patients (63.1%) were admitted only once to our emergency department within the study period. A total of 40.5% of patients were hospitalized in the clinics or intensive care units. The rate of mortality at first admission was 1.5% (12 patients). The most common complaints at admission were infection (13.3%) and soft tissue traumas (crashes, sprains, fractures, dislocations) related to the musculoskeletal system (11.8%). Readmissions were more frequent in males. It was seen that male patients were more frequently admitted due to deterioration of general health status and genitourinary system symptoms, despite pain being more common among women. Conclusion:Due to the changing population structure, emergency staff in Turkey as well as internationally encounter old and very old patients more frequently. It is now imperative that emergency departments acquire the necessary infrastructure, human resources, knowledge, and equipment needed to meet the needs of these patients.
World Health Organization has declared coronavirus disease-19 (COVID-19) as a pandemic. Although there are studies about this novel virus, our knowledge is still limited. There is limited information about its diagnosis, treatment and prognosis. We aimed to investigate the effect of methemoglobin and carboxyhemoglobin levels on the prognosis of COVID-19. In this observational study, patients who were diagnosed with COVID-19 during March 1–April 31, 2020 in a secondary-level state hospital in Turkey were included in the study. COVID-19 diagnosis was confirmed with reverse transcription polymerase chain reaction method, with nasal, oral or sputum specimens. During the period this study was performed, 3075 patients were tested for COVID-19 and 573 of them were hospitalized. Among the hospitalised patients, 23.2% (133) of them had a positive polymerase chain reaction result for COVID-19. A total of 125 patients, 66 (52.8%) males and 59 (47.2%) females, with an average age of 50.2 ± 19.8 years, were included in the study. The most common findings in chest radiogram were ground-glass areas and consolidations, while one-third of the patients had a normal chest radiogram. Computed thorax tomography was performed for 77.6% (97/125) of the patients. The 24.7% of computed tomographies (24/97) did not reveal any pathological findings, and the most common findings were ground-glass appearance and consolidation. Those who needed intensive care had statistically significantly lower platelet count ( P = 0.011) and higher lactate dehydrogenase levels ( P < 0.001). No statistically significant difference was found in carboxyhemoglobin ( P = 0.395) and methemoglobin ( P = 1.000) levels. We found that carboxyhemoglobin and methemoglobin levels had no effect on COVID-19 prognosis, but low platelet level played a role in predicting COVID-19 prognosis. This study was approved by the Ethical Committee of Harran University Faculty of Medicine on May 11, 2020 with approval No. 09.
Bu çalışmada öncelikle karbon muhasebesi kavramı tanımlanmış, Türkiye'nin imzaladığı sözleşme ve protokoller, yayınlanan kanun, yönetmelik, tebliğler makro ve mikro ölçekte açıklanarak, ülkemizin karbon muhasebesi ile ilgili Çevre ve Şehircilik Bakanlığı tarafından yayınlanan karbon emisyonunun izlenmesi ve raporlanmasına ilişkin "Doğrulama Ve Yetkilendirme Tebliği Doğrulama Kılavuzu" nda uygulama aşamaları incelenmiştir. Ardından karbon muhasebesi kavramı; Uluslararası Muhasebe Standartları (IAS) kapsamında, "TMS 38 Maddi Olmayan Duran Varlıklar" Standardı, "TMS 20 Devlet Teşviklerinin Muhasebeleştirilmesi ve Devlet Yardımlarının Açıklanması" Standardı", "TMS 37 Karşılıklar, Koşullu Borçlar ve Koşullu Varlıklar Standardı" ve Tekdüzen Hesap Planı çerçevesinde ilgili düzenlemelere yer verilmiştir. Karbon muhasebesine ilişkin muhasebe kaydı yapılarak çalışma sonlandırılmıştır.
Background/Aim: Technology is gaining importance in medical education, along with distance learning and technology-enhanced learning systems. In certain conditions, such as the Covid-19 outbreak, adapting technology to our medical education is essential. Computer-based simulation is one of those technologies that can be used in medical education. We aimed to measure the contribution of computer-based simulation to students' knowledge of cardiac rhythms in the advanced cardiac life support (ACLS) curriculum, compared to the classic educational method. Methods: Interns (6 th -grade medical students) were included in this observational study and divided into a study group and a control group. Both groups received a 2.5-hour-long ACLS rhythms lecture. Afterward, case studies were completed with a computer-based simulation program in the study group and with the classical didactic method in the control group. The participants took a multiple-choice test to measure the level of knowledge before (pre-test) and 4 weeks after (post-test) the training. "ACLS Simulator 2016" licensed program was used. Results: A total number of 80 medical students were included in the study. There were 35 (43.75%) males and 45 (56.25%) females, with a mean age of 23.7 (1.1) years. The mean number of correct answers in the pre-training test was 12.6 (3.2), and similar between the two groups (P=0.131), but significantly increased to 15.7 (3.3) (P<0.001) after the training. In the post-training test, the study and the control groups answered 16.0 (3.6) and 15.5 (3.1) questions correctly, respectively (P=0.477). Conclusion: Adapting a computer-based simulation program improves students' level of knowledge. Case scenario training with a computer-based simulation is as effective as the classical method.
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