SUMMARYObjectivesIn recent years, and especially in the past few months, the number of synthetic cannabinoid (bonsai) users has increased in our country. The aim of this study was to draw attention to the consumption of bonsai among young people and reveal the demographic and basic clinical characteristics of these users.MethodsThis was a retrospective study conducted at the Ümraniye Training and Research Hospital. All of the adult patients (≥18 year old) with synthetic cannabinoid intoxication who presented to the Emergency Department throughout the two years of the study (July 1st 2012–June 30th 2014) were enrolled. The frequencies were given as the median and inter-quartile range).Results197 patients were included in this study, with 190 male patients (96.4%) and 7 (3.6%) female patients. Two of the four hospitalized patients were exitus, 52 left on their own will and a total of 141 patients were discharged after 6-12 hours of observation in the ED.ConclusionsThe use of synthetic cannabinoids (bonsai) in the recent years, especially in the summer months of 2014 was investigated in this study. Although these patients can have a benign clinical course, the process can also be fatal. It should especially be noted that patients with depressed respiration, low GCS scores and high PaCO2 values are at higher risk for mortality and the necessity of early intubation should be kept in mind.
Jo ur na l of Ac ad em ic Em er ge nc y M ed ici ne Ak ad em ik Ac il Tıp Olg u Su nu ml arı De rgi si
Introduction: Spontaneous subclavian artery injuries are extremely rare vascular emergencies. We aimed to present a case with subclavian artery transection after sneezing.Case Report: An 18-year-old male presented to the emergency department with the complaint of right shoulder pain after sneezing. His vital signs and physical examination were all normal. On the chest radiography, the mediastinal width was 7 cm. He was discharged. He presented to the emergency department after 5 hours from discharge with complaints of chest pain and dyspnea. He was hypotensive and tachycardic. Brachial and radial pulses were not palpable. A massive hemothorax was detected. Tube thoracostomy was performed, and his hemodynamic parameters deteriorated rapidly. Urgent thoracotomy was performed, and cardiac arrest occurred during the hemorrhage control. In the postmortem exploration, a complete subclavian artery transection was confirmed at the outlet of the arcus aorta. Conclusion:Sneezing is a minor trauma that precipitates spontaneous artery dissection. It was known that a mediastinal width of over 6 cm is associated with increased mortality. An advanced radiological assessment will be useful for patients who present to the emergency department with complaints of chest, back, shoulder, or arm pain after a sudden movement and have a mediastinal width of over 6 cm.
Unexplained pneumonia cases caused by a new coronavirus known as SARS-COV-2, occurred in Wuhan, China since December 2019. Culprit of the worldwide pandemic of the coronavirus disease 2019 (COVID-19), SARS-CoV-2 attach to the angiotensin-converting enzyme 2 receptor, affecting multiple systems such as respiratory, vascular, renal and central nervous system. Most common neurological symptoms are headache, dizziness, nausea, vomiting, myalgia, anosmia, ageusia and altered consciousness; however, there are reports that suggests an association between Guillain-Barre syndrome (GBS) and COVID-19 infection. Guillain-Barre syndrome (GBS) is an autoimmune polyradiculoneuropathy that characterized with progressive weakness of the limbs and reduction or loss of tendon reflexes. Protein concentrations of cerebrospinal fluid (CSF) are increased and the white cell count is normal. Plasma exchange and intravenous immunoglobulin (IVIG) used in treatment with supportive care and most of patients have full recovery. In this paper we aimed to present a patient with positive real time polymerase chain reaction (RT-PCR) test presenting to the emergency department (ED) with the symptoms of GBS.
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