The combination of both parameters is effective in predicting these outcome measures with higher sensitivities and NPVs. Further studies on the subject are required.
Objective: Computerized tomography remains the gold standard imaging in renal colic patients. In this study, we develop a scoring system to select patients in emergency department for unnecessary computerized tomography imaging in order to decrease radiation exposure. Methods: Computerized tomography imaging of patients with renal colic in emergency department were retrospectively reviewed. Symptoms, laboratory results were recorded. Significant parameters were determined by univariate and multivariate analysis. Coefficients were found to obtain score points and receiver operating curve was used to find a cut-off value. Results: A total of 123 patients with a mean age of 42 years (18-75 years) were enrolled in the study. About, 20.3% of patients were stone-free in computerized tomography. Mean stone size was 6.1 ± 1.89 mm. According to analysis, four parameters were significant; nausea, stone history, creatinine, and hematuria with a total score 9 called as Osmangazi University STONE score. Cut-off value was found as >3, which computerized tomography imaging is recommended. Conclusion: Osmangazi University STONE score is useful and simple tool in emergency department to reduce unnecessary computerized tomography imaging in renal colic patients and also lowers cost and ionizing radiation exposure.
Rektal karsinomlarda cerrahi ve sonrasında (adjuvan) kemoradyoterapi ile pelvik nüks oranı oldukça yüksektir. Bu nedenle neoadjuvan kemoradyoterapi (KRT), rektal kanserlerde giderek daha fazla kullanılan bir tedavi protokolüdür. Çalışmamızda rektal kanserlerde tedavi cevabını ortaya koymayı ve hangi klinik-morfolojik prognostik parametrelerin tedavi cevabını tahmin etmede etkili olduğunu belirlemeyi amaçladık. 2016-2019 yılları arasında tanı almış ve neoadjuvan KRT tedavisi görmüş 46 rektal kanserli hasta çalışmaya dahil edildi. Vakalar prognostik parametreler ve tümör regresyon derecesi (TRD) açısından iki patolog tarafından tekrar değerlendirildi. TRD'yi değerlendirmek için Modifiye Ryan Skorlama sistemi kullanıldı. Tedavi öncesi tümör çapı ve uzak metastaz gibi bazı parametrelerle Mikrosatellit instabilite (MSİ) durumunu gösteren veriler, bilgisayarda hasta dosyaları araştırılarak elde edildi. Çalışmaya dahil edilen 46 olgunun 19'u kadın 27'si erkektir. Olguların 44 tanesi klasik adenokarsinom, 2 tanesi müsinöz adenokarsinomdur. Tedavi sonrası yanıtı değerlendirmek için kullanılan TRD'ye göre, olguların 1'i (%2,2) tam yanıt (Skor 0), 8'i (%17,4) tama yakın yanıt (Skor 1), 18'i (%39,1) kısmi yanıt (Skor 2) ve 19'u (%41,3) ise yanıt yok ya da kötü yanıt (Skor 3) göstermiştir. Prognostik parametrelerden yalnızca tümör derecesi ile tedavi cevabı arasında istatiksel olarak anlamlı bir ilişki saptanmıştır (p = 0,021). KRT sonrası tedavi cevabı patolojik tümör derecesi ile ters orantılıdır. Düşük dereceli tümörlerde tedavi cevabı daha iyidir. KRT alan rektal kanserli hastalarda sağ kalım, tedavi öncesi klinik evre tarafından değil, daha çok tedavi sonrası TRD'yi de içeren patolojik evre tarafından belirlenmektedir. Rektal kanserli hastalarda KRT'ye tümör yanıtı adjuvan kemoterapi planlanmasında da etkili olmaktadır.
The aim of this study was to evaluate mortality and morbidity in patients referred to our emergency department with cardiac arrest and whom emergency coronary catheterization was performed. Between 2012-2015, patients who were referred to the emergency department of Eskisehir Osmangazi University Medical Center, Eskisehir, TURKEY with cardiac arrest and on whom emergency catheterization was performed after return of spontaneous circulation following cardiopulmonary resuscitation and with determined pathology on ECG were analyzed. A total of 15 patients (11 males) were included. The average duration of cardiopulmonary resuscitation was 18,60 minutes. Post-resuscitation ECG revealed ST segment elevaiton in 10 patients, ST-T changes in 4 patients, and nodal rhythm in 1 patient. Mean door-to-balloon time was 60,73 minutes (min: 27, max: 110). Following treatment, 9 patients were discharged while the remaining 6 were declared as exitus. Emergency coronary catheterization increases survival in patients who were referred to the emergency department following cardiopulmonary resuscitation. In patients referred to the emergency department with cardiac arest and in whom management is performed in accordance with related algorithms and return of spontaneous circulation, Emergency physicians should evaluate ECG rather quickly. Joint protocols of the Emergency and Cardiology Departments is important in terms of decreased mortality and morbidity for emergency coronary invasive treatment in patients with abnormal ECG findings
The aim of the study was to evaluate the compliance of the number of B-lines on focused lung ultrasound with the clinical heart failure classification of the New York Heart Association (NYHA) and NT-proBNP levels in the emergency department. This prospective study was conducted in a tertiary university hospital emergency department. Patients over 18 years of age complaining of shortness of breath or heart failure diagnosis between January 2016 and July 2016. The number of B-lines according to the BLUE point regions was measured. Correlations between the clinical heart failure stage, NT-proBNP level and number of B-lines on ultrasonography were analyzed. Of the 143 patients, 92 (64.3%) were male and 51 (35.7%) were female. The median age was 73.00 (66.00-79.00). There was a very strong correlation between the number of B-lines and NYHA stages for each region (r > 0.85 for all variables; p <0.001 for all). There was also a strong and direct correlation between the number of B-lines and the NT-proBNP levels for each region (r > 0.70; p <0.001). Regarding the shortness of breath numerical score (r > 0.45; p <0.001), there was an inverse relationship with ejection fraction (EF). The relationship between the EF and BLUE points was moderate, but negative and significant (p <0.001). NT-proBNP levels, the NHYA classification, and lung ultrasound can be used as a tool in the emergency department for a faster diagnosis and decision-making in lung congestion.
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