Radiological findings and their relationship with mortality in acute pulmonary embolism.

OBJECTIVE: The aim of the study was to investigate whether sarcopenia had the potential to predict mortality by analyzing epicardial and visceral fat thickness measurements, which are among the radiological findings and scores known to be crucial in determining the prognosis and risk classification of patients diagnosed with acute pulmonary embolism (PE) in the emergency department. PATIENTS AND METHODS: The study included patients diagnosed with acute PE in the emergency department from January 2019 to December 2022 and involved the retrospective examination of their demographic characteristics, clinical parameters, and radiological data obtained from computed tomography pulmonary angiography (CTPA) [main pulmonary artery (MPA) diameter, pulmonary artery obstruction, right and left ventricular diameters, epicardial and visceral tissue thicknesses, and pectoralis muscle thickness (PMT)]. The primary endpoint was mortality during the hospitalized treatment and follow-up processes, and the secondary endpoint was mortality within 90 days after diagnosis. RESULTS: Of the 389 patients included in the study, 11.6% had a fatal outcome in the early period following hospitalization for treatment, and 22.6% had a fatal outcome within the 90-day (late) period after diagnosis. In patients with late-period mortality, pleural fluid (30.8%), pericardial fluid (16.7%), and atelectasis (32.6%) were found to be statistically significantly higher. Among the markers obtained from imaging examinations, only PMT - right: 9.4 [interquartile range (IQR): 6.0-14.0]; left: 9.1 (IQR: 5.4-13.8) - was associated with mortality. According to logistic regression analysis, the MPA diameter was associated with early-period mortality, and it was determined that the right ventricular diameter and the right and left PMT values had a predictive effect on late-period mortality. CONCLUSIONS: To predict mortality, CTPA-based scoring systems that include markers such as PMT, pericardial and pleural fluid, and atelectasis would be more effective; however, large-scale studies are needed to enrich these findings.

Brain computed tomography in centenarians presenting to the emergency department: is age an indication to CT scan?

OBJECTIVE: This study aimed to explore the relationship between admission complaints and brain computed tomography (CT) examinations. Also, we evaluated the relationship between age and CT scan results in centenarians admitted to the emergency department for non-traumatic reasons. PATIENTS AND METHODS: This study was a retrospective analysis of patients aged 100 years and older who presented to the tertiary hospital emergency department for non-traumatic reasons between 2012 and 2021. Demographic characteristics, admission complaints, and indications used for brain CT were evaluated. The Fazekas grade and Evans index were compared with a younger population aged 85-90 years. RESULTS: Brain CT was ordered in 41.1% (n: 15/34) of the patients due to their atypical symptoms. While no acute pathology was found in the CT scans, 23.5% of the patients had an incidental intracranial mass and/or chronic ischemic areas. When the leukoencephalopathy findings of the centenarian patients were compared to the patients aged 85-90, it was determined that the Fazekas grade increased with age (p = 0.002). Concerning the ventricle diameter, there was a significant difference between the two groups (p = 0.017), with larger values detected in the 85-90 years group. CONCLUSIONS: Although no acute pathology was found in the brain CT scans of the centenarian patients who presented to the emergency department for any reason other than trauma, CT plays a fundamental role in determining emergency diagnosis and management strategies in patients presenting with atypical symptoms. While the degree of leukoencephalopathy increased with age, the ventricle diameter was significantly larger in the younger age group than in the centenarian patients.

The prophylactic efficacy of Anatolian propolis in individuals at high risk of COVID-19.

OBJECTIVE: No prophylactic treatment is available for individuals at high risk of developing COVID-19. This study, which was conducted between December 25, 2020, and January 25, 2021, is one of the first clinical studies to evaluate the efficacy of Anatolian propolis supplement against COVID-19. The aim was to obtain evidence on the prophylactic use of Anatolian propolis in individuals at high risk of developing COVID-19. SUBJECTS AND METHODS: This volunteer-based study was conducted in two centers. The study involved 209 healthcare professionals (physicians, nurses, medical secretaries) from Emergency Medicine Department of Medical Faculty of Ataturk University and Emergency Medicine Department of Rize Recep Tayyip Erdogan University. 204 participants meeting the study criteria were divided into two groups as experimental group and control group. The experimental group received 20 drops of BEE'O UP (BEE&YOU) 30% Propolis drops twice a day during a follow-up period of 1 month. The control group received no supplement but was followed up. The participants showing symptoms during the study and all the participants at the end the study were subjected to PCR testing. RESULTS: The evaluation of the results of PCR testing at the end of the study has shown that 14 participants from the control group and only 2 participants from the experimental group, who received Anatolian propolis supplement, were reported as positive cases. CONCLUSIONS: It has been found that a statistically significant protection was induced against COVID-19 infection in 98% of the experimental group, who received Anatolian propolis, compared to the control group.