Further studies in this area are needed due to the popular use of mobile telephones and relatively high exposure on developing brain.

Diagnosis and measuring the level of increase in intracranial pressure (ICP) is critical, especially for the management of trauma patients in the emergency department and intensive care unit. However, measurements are operator-dependent as in all of the sonographic diagnoses. The aim of this study is to assess the operator variations in the measurement of optic nerve sheath diameter (ONSD). There were four emergency medicine specialists involved in the study. Each had at least 1 year of experience of ultrasound scans and performed at least 25 prior ocular scans examining the ONSD. Two measurements were made 1 week apart from both axial and longitudinal planes. Sixty healthy adults were involved in the study and every investigator obtained four measurements from each. Intra-interobserver reliabilities were tested. The investigators performed 60 ocular ultrasounds on individual healthy adults and obtained two measurements in axial and longitudinal planes 1 week apart. Therefore, 960 measurements were analyzed. The levels of compatibilities for most of the measurements were found at acceptable levels statistically. However, it is not possible to say that there was a perfect compatibility among the sonographers according to the previously conducted reliability studies of ultrasound measurements. According to our results, it is hard to say that sonographic measurement of the ONSD is a highly reliable method both in longitudinal and transverse planes.

No abstract

Wellens' Syndrome is a pattern of electrocardiographic T-wave changes associated with critical, proximal left anterior descending (LAD) artery stenosis. Diagnostic criteria of Wellens' Syndrome are history of chest pain, little or no cardiac enzyme elevation, little or no ST-segment elevation, no loss of precordial R waves, no pathologic precordial Q waves and typical T-wave changes. Urgent cardiac catheterization is vital to prevent myocardial necrosis. Here we are presenting two cases with Wellens' Syndrome who had been sent for catheterization before marked myocardial infarction developed.The first case was 63 years old woman admitted to emergency room with a typical chest pain lasting for 7 h. Electrocardiography (ECG) revealed characteristic Type A Wellens' Syndrome. The second case was also a 64 years old female patient. She was admitted to emergency room with a chest pain lasting for 2 days. Type B Wellens' Syndrome was considered according to ECG and clinical findings. Emergency angiography revealed critical LAD occlusions which were resolved before marked MI occurred in both of the cases.It is important for the emergency physicians, to recognize the typical ECG findings of Wellens' Syndrome, because these characteristic ECG findings are considered as a marker for critical LAD occlusions.

No abstract

This study aimed to determine the predictability of platelet mass index (PMI) for short-term mortality in patients with COVID-19. Material and Method: This retrospective, observational, cohort study included corrected COVID-19 patients. Demographics, clinical characteristics, biochemical and hematological parameters and the data of all-cause mortality within 30 days after admission were noted. The receiver operating characteristic curve analysis and odds ratio were performed to determine the discriminative ability of the scores. Results: Of the 1564 patients, with mean of age of 44±16 years included in the study. A total of 57 (3.6%) patients died within 30 days of emergency department presentation. There was a statistically significant difference between the survivor and nonsurvivor groups in terms of the platelet count, mean platelet volume (MPV) and PMI. According to the best Youden's index, the cut-off value for the platelet count was determined as 146 (sensitivity: 91.8%, specificity: 87.2%), and the area under curve (AUC) value was 0.593 (95% confidence interval 56.7-61.9). According to the best Youden's index, the cut-off value for the MPV was determined as 11 (sensitivity: 24.6%, specificity: 91%), and the AUC value was 0.579 (95% confidence interval 55.2-60.5). According to the best Youden's index, the cut-off value for the PMI was determined as 1513 (sensitivity: 28.1%, specificity: 87.2%), and the AUC value was 0.555 (95% confidence interval 52.8-58.2). Conclusion: Platelet count, MPV and PMI were not predictor of 30day mortality in patients with confirmed COVID-19 in emergency department.

No abstract

Background: To compare the ability of the Modified Early Warning Score (MEWS), Rapid Emergency Medicine Score (REMS), and Rapid Acute Physiology Score (RAPS) to predict 30 day-mortality in patients with SARS-CoV-2 infection aged 65 years and over. Methods: This prospective, single-center, observational study was carried out with 122 volunteers aged 65 years and over with patients confirmed to have SARS-CoV-2 infection according to the RT-PCR test, who presented to the emergency department between March 1, 2020 and May 1, 2020. Demographic data, comorbidities, vital parameters, hematological parameters, and MEWS, REMS and RAPS values of the patients were recorded prospectively. Results: Among the 122 patients included in the study, the median age was 71 (25th-75th quartile: 67-79) years. The rate of 30-day mortality was 10.7% for the study cohort. The area under the receiver operating characteristic curve values for MEWS, RAPS and REMS were 0.512 [95% confidence interval (CI): 0.420-0.604, p = 0.910], 0.500 (95% CI: 0.408-0.592, p = 0.996), and 0.675 (95% CI: 0.585-0.757, p = 0.014), respectively. The odds ratios of MEWS (≥2), RAPS (>2) and REMS (>5) for 30-day mortality were 0.374 (95% CI: 0.089-1.568, p = 0.179), 1.696 (95% CI: 0.090-31.815, p = 0.724), and 1.008 (95% CI: 0.257-3.948, p = 0.991), respectively. Conclusion: REMS, RAPS and MEWS do not seem to be useful in predicting 30-day mortality in geriatric patients with SARS-CoV-2 infection presenting to the emergency department.