Snakebites are relatively rare medical emergency cases that might lead to serious consequences. This study aims to evaluate snakebite cases in terms of medical follow-up, antivenom therapy and antivenom reactions. Medical records of patients admitted to emergency department between January 1, 2006 and December 31, 2010 were retrospectively investigated. Snakebite-related cases of a total of 125 patients were included in the scope of the study. Of the total 125 cases, 54.4% were male and 45.6% were female. Most of cases (n: 65, 52%) were aged over 30 years, while the mean age was 34.87 ± 19.29 years. Snakebite-related applications to the emergency department were mostly seen in June with 27 cases. Upon admitting, all patients were recorded to be conscious and showing good general conditions; however, they suffered from pain and edema at the site of bite. Of all, 25 patients only suffered from bite injury and ecchymosis due to snakebite. The site of bite was upper extremities in 66 patients (52.8%), whereas it was lower extremities in 58 (46.4%). Of all, antivenom was unnecessary in 25 (20%) patients, while four antivenoms were administered to each of the 23 (18.4%) patients. Furthermore, six (4.8%) patients needed nine antivenom administrations for each. Anaphylaxis (n: 2, 1.6%), compartment syndrome (n: 2, 1.6%) and serum sickness (n: 1, 0.8%) encountered in remaining cases. Of all, 86 (68.8%) patients were hospitalized in the emergency department, while 25 (20.0%) patients were followed up by observation in emergency service. Only one patient was treated and followed up in intensive care unit. Implementation of antivenom therapy is considered unnecessary for the treatment of all snakebite cases. Antivenom reactions and number of related cases might be reduced by continuous close monitoring, appropriate prophylaxis and controlled slow infusion administration of medications.
INTRODUCTION: In this study, we evaluated the applicability and interpretation of point-of-care emergency ultrasound (POCEUS) performed by an emergency physician (EP) in non-traumatic adult cardiac arrest and near-arrest patients at presentation to the Emergency Department (ED). METHODs: POCEUS was performed in 5 steps on 73 adults to assess; 1. Qualitative global cardiac function, cardiac chambers and presence of pericardial effusion; 2. Presence of pleural sliding, B-lines, A-lines or consolidation on anterior-superior; 3. Presence of an abdominal aorta aneurysm and pelvic free fluid; 4. Presence of pleural effusion, consolidation, free fluid on lateral-inferior; 5. Qualitative width and collapsibility of the inferior vena cava. A fulfilled checklist and real-time images of ultrasonography were sent by WhatsApp to the head of the study to generate the evidence and collect the data. The process of patient care, in-hospital diagnosis and survival were retrieved from digital hospital records. This prospective multicenter sample study was conducted from November 16, 2015, to January 5, 2016. REsUlTs: The most common findings of POCEUS were performed and interpreted to have a first prediction of patients' acute clinic problem by EPs were compatible with global systolic dysfunction (n = 16, 22.9%), pulmonary edema (n = 17, 23.3%), pulmonary embolus (n = 6, 8.2%), distributive/hypovolemic shock (n = 12, 16.4%), cardiac tamponade or pericardial effusion (n = 5, 6.8%), and pneumonia (n = 31, 42.5%) at presentation. The kappa correlation coefficient value of the POCEUS at presentation versus the final, traditional clinical diagnosis of the admitted ward, was 0.773 (95% CI, 0.747-0.892; p = 0.064, McNemar). CONClUsIONs: POCEUS performed by an EP at presentation had a good agreement between in qualitative prediction of the first differential diagnosis in life-threatened patients and the last diagnosis obtained during hospitalization. Furthermore, this study showed the requirement of evidence in comparison of measurements to the qualitative manner and new descriptive processes in POCEUS for unexplained situations and questions.
Introduction: Reactions due to bee stings ranging from local reactions to anaphylactic shock may occur in clinical presentations. Cardiac side effects and death may occur as a result of bee stings.Case Report: This study described a 53-year-old man with no history of cardiac disorders or anaphylaxis whose lip was stung by a bee. The patient was brought to the emergency department with anaphylactic shock. There was acute atrial fibrillation shown on the electrocardiogram, and echocardiogram and biochemical markers were normal.Conclusion: In the literature, three patients developed atrial fibrillation and atrial flutter as a result of bee stings. We also aim to share the diagnosis and treatment of such a case.
BACKGROUND:The present objective was to evaluate clinical stages, complications, treatment modalities, and termination of treatment in patients who presented to the emergency department with snakebite.
Legionella pneumophila is a bacterium, which can grow inwater pipe networks and climate systems. Contaminationoccurs by aspiration of infected water or aerosol inhalation.It is usually presented with fever, bradycardia, andchange in mental status, hyponatremia, elevation of liverenzymes and deterioration of renal function. The definitediagnosis is established by detection of the antigens andcultivating in the culture medium. Also, malign lung tumorscan encounter with the same clinical findings, so lungcancer should be remembered in differential diagnosis.The patient hospitalized for the Legionella pneumophiladue to the physical examination and laboratory findingsduring the first evaluation in the emergency department.However, further examinations pointed to the cancer. Weaimed to emphasize the probability of malignant tumorsin terms of hyponatremia, increase in the liver enzymes,and failure in the renal functions, which were usually experiencedin emergency unit. J Clin Exp Invest 2013; 4(3): 390-392Key words: Legionella pneumophila, pneumonia, lung malignanc
arım ilaçlarına bağlı olan zehirlenmeler istenmeyerek alım veya öz-kıyım amaçlı olmakta ve ölümle sonuçlanabilmektedir. Bu çalışmada, bir olgu üzerinden ölümle sonuçlanabilen; literatürde az rastlanan bir herbisit olan 2,4-diklorofenoksi asetik asit dimetil amin (2,4-D) tuzunun (Best Amin
Anahtar KelimelerAkut Koroner Sendrom; İnflamatuar Mediatörler; Trombüs Oluşumu Abstract Aim: Inflammatory mechanisms had played a major role in the formation and prognosis of acute myocardial infarction. Inflammatory mediators was assciated with negative consequences of acute myocardial infarction. This study tested the hypothesis that in the acute phase of acute coronary syndrome, leukocyte count, neutrophil count, neutrophil lymphocyte ratio, and high sensitivity C reactive protein (hsCRP) are predictive of angiographic thrombus formation in the infarct related artery. Material and Method: This prospective study included 150 consecutive patients with acute coronary syndrome. Patients were assigned to a thrombus formation group (n=65) and a non thrombus formation group (n=85). Blood samples for measurement of hsCRP and for routine blood laboratory studies were collected before to coronary angiography. Numerical data were expressed as mean ± Standard deviation. Nominal data were expressed as the number and percentage. Comparisons between groups, chi-square test was used for nominal variables. Comparisons between groups, t-test was used for numerical data. All statistical analyzes, p <0.05 was considered significant. Results: The levels of hsCRP , total leukocyte counts, neutrophil counts, and neutrophil/ lymphocyte ratios were substantially higher in the thrombus formation group than in the non thrombus formation group patients (for each, P < 0.05). T-test analyses identified hsCRP , leukocyte count, neutrophil count, and neutrophil/lymphocyte ratio as independent predictors of thrombus formation in the infarct-related artery (for each, P < 0.05). Discussion: In patients with acute coronary syndrome, higher leukocyte conut, neutrophil count, neutrophil / lymphocyte ratio and level of hsCRP are predictors to indicate thrombus formation.
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