SUMMARYPalliative care (PC) is a new and developing area. It aims to provide the best possible quality of life for patients with life-limiting diseases. It does not primarily include life-extending therapies, but rather tries to help patients spend the rest of their lives in the best way. PC patients often are admitted to emergency departments during the course of a disease. The approach and management of PC include differences with emergency medicine. Thus, there are some problems while providing PC in the ED. With this article, the definition, main features, benefits, and problems of providing PC are presented, with the primary aim of emphasizing the importance of PC integration into the ED.
Background and Objective. A tick bite has been an emergency of increased importance in recent years since it can cause a progressive, fatal disease such as Crimean-Congo hemorrhagic fever (CCHF). This issue should be considered by physicians working not only in endemic areas but also in the entire world, taking into account immigration, overseas trips, etc. In our study, we aimed to increase the awareness of the issue by evaluating the emergency department admissions of tick bite complaints in an endemic area. Material and Methods. In total, 251 patients who had been admitted to the emergency department with a complaint of a tick bite within 10 months were included into the study. The data were obtained by collecting main complaints, demographic characteristics, cell counts on admission, and biochemical tests as well as CCHF findings in the RT-PCR test. The patients were divided into 2 groups according to the results of real-time polymerase chain reaction (PCR+ and PCR–). Results. All the patients complained of tick bites. As for the additional complaints, 46% of the overall study population had fatigue and 36% experienced fever. Fever was the most common complaint in the PCR+ group (39%). The platelet and white blood cell counts were significantly lower and the AST level was significantly higher in the PCR+ group than the PCR– group (P<0.01). Conclusions. In CCHF, where an early diagnosis is very important in reducing mortality, and the symptoms such as a tick bite, fever, and fatigue should be taken seriously by emergency medicine physicians. Leukopenia and thrombocytopenia and higher levels of enzymes in the liver function tests should be taken into account.
Aim: Palliative care is an increasingly important issue in emergency departments worldwide. The present study aimed to evaluate the perspectives and experienced problems of emergency physicians about palliative care.
Materials and Methods:A questionnaire that includes main topics of palliative care was prepared, and it was sent through internet access to all emergency physicians who work in Turkey. The whole data were statistically analyzed by Predictive Analytics Software (PASW) 18 and Statistical Package for the Social Sciences (SPSS) software 15.0 for Windows.Results: Ninety-five emergency physicians participated in the study. Most respondents reported reported getting no training about palliative care (77%). Most agreed that special training is required to acquire palliative care skills (91%), and 69% of emergency physicians want to get training on palliative care.
Conclusion:Increasing awareness about palliative care is important in emergency departments and makes it possible for an early recognition and appropriate management of palliative care patients. The present study not only indicates the importance of education about palliative care but also contributes to increasing awareness on this issue. (JAEM 2015; 14: 75-8)
We found an association between MTHFR C677T/A1298C combined mutations and PE in the Turkish population. Future genetic studies investigating combined mutations could be very helpful to identify risk population in PE.
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