Information on Measles, Mumps and Rubella Vaccine in the Copenhagen School Health Records Register.

BACKGROUND: The Copenhagen School Health Record Register (CSHRR) includes health information from school examinations and is now updated with information on measles, mumps and rubella vaccines for the cohorts born from 1977 to 1994. AIM: The aim of this study is to provide a comprehensive description and validation the newly digitised vaccine information in the CSHRR. METHODS: We describe the data collection and the newly digitalised information in the CSHRR. We investigate the extent to which the full CSHRR population is representative of Copenhagen and the entire Danish population. Furthermore, we explore how the registry information on vaccination uptake based on reimbursement data matches the vaccine information obtained from CSHRR for the period during which both data are available. RESULTS: The CSHRR population matches closely the complete population of all schoolchildren in Copenhagen, and information on vaccine uptake in CSHRR matches with vaccine registry data for later cohorts. However, a sizable proportion of the immigrant children in the CSHRR have missing information on vaccination. Removing children who have had no additional immunisations enhances data quality. CONCLUSIONS: The CSHRR covers a large share of the Danish population and includes detailed vaccine information. By linking the data to other registry data, the updated CSHRR is valuable resource for future research.

Use of bee venom in preventive medicine: An experimental hepatic encephalopathy study in rats.

OBJECTIVES: Bee venom is used for medicinal purposes, including the treatment of neurological and liver diseases, but its use as a primary health care approach for preventive purposes requires further exploration. The aim of this study was to provide the first investigation into the possible protective effects of bee venom against hepatic encephalopathy, a serious neurodegenerative disease. MATERIALS AND METHODS: An experimental animal study was conducted in which healthy albino Sprague-Dawley rats were randomized into three groups: healthy, control and bee venom groups. All rats were tested for locomotor activity at the beginning and end of the study. No intervention was made in the healthy group, whereas hepatic encephalopathy was induced in the control and bee venom groups by the administration of thioacetamide (TAA) (200 mg/kg/day). The bee venom group also received bee venom (5 mg/kg/day) subcutaneously every day for 14 days prior to the TAA administration. RESULTS: The results for the final locomotor activity tests were statistically better in the bee venom group than in the control group, supporting a beneficial effect of prophylactic bee venom application. Blood ammonia levels and liver weights, determined as indicators of inflammation, were lower in the bee venom group than in the control group and were close to levels in the healthy group, but not statistically significant. CONCLUSIONS: Bee venom administration has protective effects against the development of hepatic encephalopathy and offers a promising therapeutic opportunity in preventive medicine.

How to diagnose COVID-19 in family practice? Usability of complete blood count as a COVID-19 diagnostic tool: a cross-sectional study in Turkey.

OBJECTIVE: COVID-19 is currently diagnosed in hospital settings. An easy and practical diagnosis of COVID-19 is needed in primary care. For this purpose, the usability of complete blood count in the diagnosis of COVID-19 was investigated. DESIGN: Retrospective, cross-sectional study. SETTING: Single-centre study in a tertiary university hospital in Erzurum, Turkey. PARTICIPANTS: Between March 2020 and February 2021, patients aged 18-70 years who applied to the hospital and underwent both complete blood count and reverse-transcription-PCR tests for COVID-19 were included and compared. Conditions affecting the test parameters (oncological-haematological conditions, chronic diseases, drug usage) were excluded. OUTCOME MEASURE: The complete blood count and COVID-19 results of eligible patients identified using diagnostic codes [U07.3 (COVID-19) or Z03.8 (observation for other suspected diseases and conditions)] were investigated. RESULTS: Of the 978 patients included, 39.4% (n=385) were positive for COVID-19 and 60.6% (n=593) were negative. The mean age was 41.5±14.5 years, and 53.9% (n=527) were male. COVID-19-positive patients were found to have significantly lower leucocyte, neutrophil, lymphocyte, monocyte, basophil, platelet and immature granulocyte (IG) values (p<0.001). Neutrophil/lymphocyte, neutrophil/monocyte and IG/lymphocyte ratios were also found to be significantly decreased (p<0.001). With logistic regression analysis, low lymphocyte count (OR 0.695; 95% CI 0.597 to 0.809) and low red cell distribution width-coefficient of variation (RDW-CV) (OR 0.887; 95% CI 0.818 to 0.962) were significantly associated with COVID-19 positivity. In receiver operating characteristic analysis, the cut-off values of lymphocyte and RDW-CV were 0.745 and 12.35, respectively. CONCLUSION: Although our study was designed retrospectively and reflects regional data, it is important to determine that low lymphocyte count and RDW-CV can be used in the diagnosis of COVID-19 in primary care.

Use of the PaO2/FiO2 Ratio in Pulmonary Embolism: Evaluation of its Correlation with Pulmonary Arterial Computed Tomography Obstruction Index.

RATIONALE AND OBJECTIVES: The pulmonary arterial computed tomography obstruction index ratio (PACTOIR) is a parameter that provides an idea of the clinical severity of acute pulmonary embolism (APE). This study aimed to examine the correlation between the PaO2 /FiO2 ratio and PACTOIR in patients who presented to the emergency department and received a preliminary diagnosis of APE. MATERIALS AND METHODS: This study was conducted prospectively in the emergency department. The patients' sociodemographic characteristics, vital signs, PACTOIR, and PaO2 /FiO2 ratio were obtained. The correlation between PACTOIR and PaO2 /FiO2 ratio was then statistically evaluated. RESULTS: The study included 50 patients, of whom 31 (62%) were women, and 19(38%) were men. The female patients had a PaO2 /FiO2 ratio of 209 ± 67 and PACTOIR of 36.3 ± 15.5. The male patients had a PaO2 /FiO2 ratio of 169 ± 43 and PACTOIR of 39.7 ± 19. The PaO2 /FiO2 ratio of the patients with APE was negatively correlated with the PACTOIR value at a statistically significant level (r = -0.308, p = 0.031). The regression equation was as follows: PACTOIR = (-0.0869) x (PaO2 / FiO2) + (54.489). CONCLUSION: By calculating the PaO2 /FiO2 ratio in patients with APE, the degree of pulmonary artery obstruction and clinical severity can be predicted. Therefore, the ratio PaO2 /FiO2 can be used instead of PACTOIR.

The Effects of Laboratory Parameters on the Prognosis of COVID-19.

OBJECTIVE: While the coronavirus disease 2019 pandemic is an ongoing issue across the world, understanding the course of the disease is important for early diagnosis and treatment. We aimed, with this study, to determine the differences between laboratory parameters in different clinical pictures of coronavirus disease 2019. MATERIALS AND METHODS: The study included 443 patients who presented to Atatürk University Medical Faculty Hospital between March 15, 2020, and June 15, 2020, and were diagnosed with coronavirus disease 2019 upon a positive Real Time Polymerase Chain Reaction (RT-PCR) result. The hospitalized patients were divided into 4 groups based on their clinical status. The roles of these markers in determining the severity of coronavirus disease 2019 were statistically evaluated. RESULTS: A total of 443 patients with RT-PCR confirmation were included in the study. The mean age was 46.0 ± 19.1 years and 54.4% of the patients were male. According to the clinical classification, 16.3% of the cases were asymptomatic, 25.7% uncomplicated, 35.7% mild/moderate, and 22.3% severe. The first 3 most frequent symptoms were cough (21.3%), fever (17.7%), and fatigue (15.5%). Hypertension (36.1%) was the major comorbidity among the patients. During the follow-up of severe cases, 39.4% developed the need for intensive care. The overall mortality rate, on the other hand, was 4.7%. Regarding laboratory parameters, procalcitonin (PCT), serum ferritin, erythrocyte sedimentation rate, C-reactive protein, neutrophil count, D-dimer, troponin, and lactate dehydrogenase were at the highest level in the severe patient group while albumin, platelet, and lymphocyte count were found to be at the lowest level in the same group. A statistically significant difference was detected between the groups (P < .001). CONCLUSION: The increase in C-reactive protein, PCT, erythrocyte sedimentation rate, ferritin, troponin, D-dimer, lactate dehydrogenase, and neutrophil count and the decrease in albumin, platelet, and lymphocyte count are significant in the severe patient group; it has been concluded that they can be used to determine the severity of coronavirus disease 2019.

Does Intravitreal Dopamine Agonist and Antagonist Administration Have Effects on the Brain? An Experimental Study in Rats.

OBJECTIVE: There might be dopaminergic connections between the retina and the brain. In this context, the study was aimed to investigate the possible interaction between the retina and basal ganglia through the dopaminergic system. MATERIALS AND METHODS: In total, 32 healthy rats were randomized into 4 groups: healthy, Sham, dopamine antagonist injected group (risperidone, 0.04 mg/kg intravitreally), and dopamine agonist injected group (apomorphine, 0.4 mg/kg intravitreally). The locomotor activity and Morris water maze tests were applied to all rats twice, before the injection and 28 days after, to detect changes in movement, memory, and attention. Histopathologically, the basal ganglia and hippocampus regions were removed and examined. RESULTS: In the locomotor activity test, a statistical significance was found between the first and last measurement values of the apomorphine group and a decrease in activities and an increase in resting times (P < .05). In the Morris water maze test, a statistical significance was detected between the first and last tests of the control group and the apomorphine groups and showed significantly shorter learning times (P < .05). Histological analyses of the substantia nigra and hippocampus were noteworthy in that the number of damaged neurons in the risperidone group was considerably higher than the other groups. The number of damaged neurons in the apomorphine group was significantly lower than in the healthy group. CONCLUSION: Intravitreal administration of dopamine agonists and antagonists has given rise to alterations in the cerebral dopaminergic system, leading to changes in locomotor activity and memory and histopathological changes.

Ultra-low-dose computed tomography and its utility in wrist trauma in the emergency department.

BACKGROUND: The use and frequency of computed tomography (CT) are increasing day by day in emergency departments (ED). This increases the amount of radiation exposed. PURPOSE: To evaluate the image quality obtained by ultra-low-dose CT (ULDCT) in patients with suspected wrist fractures in the ED and to investigate whether it is an alternative to standard-dose CT (SDCT). MATERIAL AND METHODS: This is a study prospectively examining 336 patients who consulted the ED for wrist trauma. After exclusion criteria were applied, the patients were divided into the study and control groups. Then, SDCT (120 kVp and 100 mAs) and ULDCT (80 kVp and 5 mAs) wrist protocols were applied simultaneously. The images obtained were evaluated for image quality and fracture independently by a radiologist and an emergency medical specialist using a 5-point scale. RESULTS: The effective radiation dose calculated for the control group scans was 41.1 ± 2.1 µSv, whereas the effective radiation dose calculated for the study group scans was 0.5 ± 0.0 µSv. The effective radiation dose of the study group was significantly lower than that of the control group (P < 0.01). The CT images in the study group showed no significant differences in the mean image quality score between observer 1 and observer 2 (3.4 and 4.3, respectively; P = 0.58). Both observers could detect all fractures using the ULDCT images. CONCLUSION: ULDCT provides high-quality images in wrist traumas while reducing the radiation dose by approximately 98% compared to SDCT without any changes in diagnostic accuracy.

The role of adropin, HIF-1α and apelin biomarkers in the diagnosis of acute mesentaric ischemia.

OBJECTIVE: The absence of a specific biomarker for acute mesenteric ischemia diagnosis results in a delay in diagnosis and treatment, as well as a high mortality rate. The current research examined whether the proteins adropin, HIF-1α, and apelin may be used to help in the early detection of acute mesenteric ischemia. MATERIALS AND METHODS: A total of 20 patients with acute mesenteric ischemia, 20 patients with abdominal pain, and 20 healthy controls were included in the study. The levels of adropin, HIF-1, and apelin in the serum were determined using the ELISA method. RESULTS: Adropin concentrations were significantly higher in the acute mesenteric ischemia group than in the abdominal pain and healthy control groups (p < 0.05). HIF-1α levels were considerably greater in patients with acute mesenteric ischemia compared to both the abdominal pain group and the healthy control group (p < 0.05). There was no difference in apelin levels between the acute mesenteric ischemia and abdominal pain groups (p > 0.05). HIF-1α was found to be moderate (AUC: 0.705) and adropin was found to be a weak biomarker (AUC: 0.692) in the ROC analysis for acute mesenteric ischemia. CONCLUSION: In this study of 20 patients with acute mesenteric ischemia, we found adropin and HIF-1α levels to be increased compared to patients with abdominal pain who did not have acute mesenteric ischemia.

Child Access Prevention Laws and Juvenile Firearm-Related Homicides.

Debate over safe-storage gun regulations has captured public attention in the aftermath of several high-profile shootings committed by minors. To date, the existing literature provides no evidence that these laws are effective at deterring gun crime, a conclusion that has prompted the National Rifle Association to assert that such regulations are "unnecessary" and "ineffective." Using data from the FBI's Supplementary Homicide Reports for the period 1985-2013, we find that child access prevention (CAP) laws are associated with a 17 percent reduction in firearm-related homicides committed by juveniles. The estimated effect is stronger among whites than nonwhites and is driven by states enforcing the strictest safe-storage standard. We find no evidence that CAP laws are associated with firearm-related homicides committed by adults or with non-firearm-related homicides committed by juveniles, suggesting that the observed relationship between CAP laws and juvenile firearm-related homicides is causal.

Association between local public housing authority policies related to criminal justice system involvement and sexually transmitted infection rates.

The policies of U.S. local public housing authorities influence which populations have access to stable housing, an important resource for health. We assessed whether the restrictiveness of local public housing authority policies related to people with criminal justice histories-a population at high risk for HIV/STIs-were associated with HIV/STI rates at the local-level. An ecological analysis was conducted using data from 107 local public housing authority jurisdictions. The independent variable was a score that quantified the presence/absence of eight policies related to the ability of people with criminal justice histories to obtain and retain public housing. The dependent variables were county-level rates of HIV, gonorrhea, syphilis, and chlamydia. Ordinary least squares regression with state fixed effects was used. We find that the restrictiveness of housing authority policies towards people with criminal justice histories were significantly associated with higher HIV and gonorrhea rates, but not syphilis or chlamydia. For example, local housing authorities with a policy score more restrictive than the median score had an additional 6.05 cases of HIV per 100,000 population (32.9% increase relative to the mean rate) and 84.61 cases of newly diagnosed gonorrhea (41.3% increase). Local public housing authority policies related to people with criminal justice histories could affect HIV/STI risk at the population-level. These policies should be considered in studies and interventions at the intersection of housing, health, and justice involved populations.

An antihypertensive agent benidipine is an effective neuroprotective and antiepileptic agent: an experimental rat study.

BACKGROUND: Benidipine is an L, N and T type calcium channel blocker drug that is widely used as an antihypertensive drug. OBJECTIVE: For the first time in the literature, it was aimed to investigate the effectiveness of benidipine in controlling epileptic seizure and preventing the development of neurodegeneration in epilepsy. METHODS: An experimentally epilepsy model was produced with pentylenetetrazole, and rats were divided into seven groups, in different benidipine treatment doses or with valproic acid combinations. The epileptic activities of all rats were recorded according to the Fisher&Kittner classification. Biochemical parameters, histopathological Caspase-3 activity, Wyler hippocampal sclerosis, gliosis and neuronal degenerations were investigated. RESULTS: It was found that in the post-hoc analysis of epileptic activities, there was a similar antiepileptic scores among the treatment groups. IL-1 level was found to be significantly lower in the benidipine 4 mg/kg group, and TNF-alpha was lower in the group given valproic acid+benidipine 2 mg/kg (p<0.05). The other biochemical parameters were not found to be significant. Neural degeneration levels in the brain tissues were statistically significant (p<0.001). Compared with the healthy group, the most neural degeneration was in the control group, the least neural degeneration was in the valproic acid+benidipine 4 mg/kg group. CONCLUSIONS: For the first time in the literature, benidipine, alone or combined with valproic acid, were found to have a statistically significant antiepileptic efficacy, and provided neuroprotection when combined with valproic acid. Benidipine will be a promising agent in the treatment of epilepsy with its antiepileptic and neuroprotective effects.

10% Lidocaine spray as a local anesthetic in blood gas sampling: A randomized, double-blind, placebo-controlled study.

AIM: Radial artery blood gas sampling is a very common procedure undertaken in the emergency department to evaluate respiratory and metabolic parameters. This intervention causes both anxiety and pain for the patient. Therefore, the current study aimed to examine the analgesic efficacy of lidocaine spray compared to a placebo during radial artery blood gas sampling. METHODS: This study was conducted in the emergency department of a tertiary hospital with a randomized, double-blind, placebo-controlled design. A total of 144 patients were randomly divided into two groups: One group (n = 72) received 10% lidocaine spray and the other (n = 72) was the placebo group. The analgesic efficacy of the 10% lidocaine spray was compared with the placebo group using the Visual Analog Scale (VAS). RESULTS: In the evaluation of the analgesic efficacy of the 10% lidocaine spray, the VAS score was 1.5 [interquartile range (IQR): 2.0] for the lidocaine group and 5 (IQR: 2.0) for the placebo group. The role of lidocaine spray in reducing pain was statistically significant compared to the placebo (p = 0.000). CONCLUSION: In blood gas sampling, 10% lidocaine spray has analgesic efficacy. Therefore, we recommend the use of lidocaine spray while performing arterial blood gas sampling in emergency departments.

Analysis of Incidentally Diagnosed Patients with Coronavirus Disease 2019 at the Emergency Department: Single-Center Clinical Experience.

OBJECTIVE: Asymptomatic patients with coronavirus disease 2019 can present with signs of various diseases to hospitals. We aimed to present patients who presented to the emergency department without any coronavirus disease 2019 symptoms and were incidentally diagnosed with coronavirus disease 2019 in addition to the diagnosis related to their complaints on presentation. MATERIALS AND METHODS: The study included patients presented to the emergency department of a hospital in Erzurum (Turkey) with non-coronavirus disease 2019 symptoms and were incidentally diagnosed with coronavirus disease 2019 on the basis of their chest computed tomography findings. The patients' primary diagnoses were evaluated, and a reverse transcriptase-polymerase chain reaction was performed to confirm the incidental coronavirus disease 2019 diagnoses. RESULTS: The 42 patients included in the study had various complaints, and the most common complaint was abdominal pain in 8 patients (19%). The other complaints were at different rates. The most common diagnose was ST-elevated myocardial infarction in 6 patients (14.3%), and the other diagnoses were rib fracture in 3 patients (7.1%) and other similar diseases in the remaining patients. CONCLUSION: Patients with highly the contagious coronavirus disease 2019 can sometimes be asymptomatic and can be incidentally diagnosed with coronavirus disease 2019 after presenting to emergency departments with symptoms and manifestations other than those of coronavirus disease 2019. Therefore, healthcare professionals working in the emergency department should approach all patients who present to the emergency service as potential coronavirus disease 2019 carriers and wear their protective equipment and take necessary precautions.

The compliance of emergency healthcare personnel with isolation precautions during the COVID-19 pandemic: A cross-sectional questionnaire study.

OBJECTIVES: Isolation precautions are very important for emergency personnel faced with this high risk. This is cross-sectional study carried out to determine the compliance of emergency healthcare personnel with isolation precautions during the COVID-19 pandemic. METHODS: The study was carried out in the Emergency Services department of Erzurum Atatürk University and Erzurum Regional Training and Research Hospital from May 2020 to June 2020. The study population comprised 184 healthcare professionals working in emergency services, and the sample comprised 138 healthcare professionals who agreed to participate in the study. Data were collected using the "Healthcare Professionals Sociodemographic Form" and the "Compliance with Isolation Precautions Scale". Percentage distribution, t test, variance analysis (ANOVA), Mann-Whitney U test and Kruskal-Wallis test were used to analyse the data. Permission to conduct the study was obtained from the ethics committee and the Ministry of Health. RESULTS: Of the participants, 58.7% were male, 37.7% had worked for 1-5 years, 31.2% were nurses and the mean age was 30.78 ± 7.17. Of the participants, 86.2% wanted to receive training on isolation precautions, 87% knew the type of isolation practiced, 81.2% were able to identify suspected patients and 84.1% knew suspected patients were put into isolation. The emergency healthcare personnel's mean score on the isolation precautions compliance scale was determined as 67.63 ± 4.64. CONCLUSION: It was concluded that the emergency healthcare personnel had high levels of knowledge about the COVID-19 pandemic; however, they had an average level of compliance with isolation precautions.

The effects of progressive muscle relaxation exercises on the anxiety and sleep quality of patients with COVID-19: A randomized controlled study.

PURPOSE: This study aimed to determine the effects of progressive muscle relaxation exercises on the anxiety and sleep quality of patients with coronavirus disease 2019 (COVID-19). MATERIALS AND METHODS: This is an experimental study. Its data were collected in the infectious diseases clinic of a research hospital from May to August, 2020. This study was carried out with 67 COVID-19 patients (33 in the experimental group and 34 in the control group). The data were collected using a personal information form, the state-trait anxiety inventory, and the Richards-Campbell Sleep Questionnaire. The progressive muscle relaxation exercises were performed twice a day for 5 days with the researcher's supervision. The data were analyzed using means, numbers, percentage distributions, the χ 2 test, the dependent t test, and the independent t test. RESULTS: Statistically significant differences were found between the experimental and control groups' mean posttest scores on the State-Trait Anxiety Inventory and the Richards-Campbell Sleep Questionnaire (p < 0.05). The in-group comparison of the experimental group found a statistically significant difference between their mean pretest and posttest scores on the State Anxiety Scale (p < 0.05). The in-group comparison of the control group found no statistically significant changes in their mean pretest and posttest scores on the State Anxiety Scale (p > 0.05). CONCLUSION: The progressive muscle relaxation exercises effectively reduced the anxiety and improved the sleep quality of patients with COVID-19.

The effectiveness of intradermal sterile water injection for low back pain in the emergency department: A prospective, randomized controlled study.

AIM: Low back pain (LBP) is a common musculoskeletal complaint among emergency department (ED) admissions. In this study, it was aimed to compare the effectiveness of systemic treatment with intradermal sterile water injection (ISWI) treatment protocol combined with systemic therapy in patients with LBP of unclear chronicity. METHODS: A prospective randomized, unblinded, controlled clinical study was conducted on patients admitted to the ED for LBP of unclear chronicity. One hundred twelve patients were randomly assigned to two groups; Group ISWI (n = 56) administered ISWI in the LBP region of patients along with systemic intravenous dexketoprofen therapy, while the other group (n = 56) received only systemic intravenous dexketoprofen therapy. The treatment methods' effectiveness was compared by measuring the pain intensity with the Visual Analog Scale (VAS) at admission, 10th minutes, 20th minutes, 30th minutes, and 24 h later. Also, opioid and analgesic consumptions in 24 h after treatment and patient satisfactions were compared. RESULTS: In the treatment of LBP, ISWI treatment was found to be more effective in relieving pain than systemic therapy alone (p < 0.001). Also, it was observed that opioid consumption in the ED and analgesic consumption within 24 h after treatments were decreased in the ISWI group (p < 0.001). The patient satisfaction in the ED was statistically increased (p < 0.001). DISCUSSION: In this unblinded study, ISWI with systemic therapy improved pain outcomes more than systemic therapy alone. Further research is needed to determine whether this was due entirely to placebo effect.

Can ultrasound-guided infraclavicular block be an alternative option for forearm reduction in the emergency department? A prospective randomized study.

OBJECTIVE: Ultrasound-guided infraclavicular nerve block (IB) has become a well-established method in several outpatient procedures; however, its use in emergency departments (EDs) remains limited. The aim of this study was to compare procedural sedation and anlagesia (PSA) and IB in the pain management for patients who underwent forearm fracture reduction in the ED. METHODS: This prospective randomized study included 60 patients aged 18 to 65 years, who visited the ED with forearm fractures. They were randomly divided into two groups: Group PSA (n=30) and Group IB (n=30). The pain scores of patients were evaluated before and during the procedure with the visual analog scale. Complications and patient and operator satisfaction levels were recorded. RESULTS: There was no difference between the two groups in terms of demographic characteristics. The median (interquartile range) pain scores observed during the procedures were significantly higher in Group PSA than in Group IB (4 [4-6] vs. 2 [0-2], respectively; P<0.001). Patient and operator satisfaction levels were significantly higher in Group IB (P<0.001). Oxygen desaturation was statistically higher in Group PSA than in Group IB (40.00% vs. 3.33%, respectively; P=0.002). CONCLUSION: IB was an effective alternative for reducing pain and increasing patient satisfaction in ED patients undergoing forearm fracture reduction.

Sedoanalgesia Versus Infraclavicular Block for Closed Reduction of Pediatric Forearm Fracture in Emergency Department: Prospective Randomized Study.

OBJECTIVE: Procedural sedoanalgesia is commonly used in pediatric patients in the emergency department (ED) for interventional procedures, diagnosis, and treatment. However, this method causes serious systemic complications, such as respiratory and cardiac depression. To minimize these complications, ultrasound-guided regional anesthesia methods have been used in recent years. We aimed to compare the use of procedural sedoanalgesia (PSA) and infraclavicular block (ICB) in the pain management of pediatric patients who underwent closed reductions of forearm fractures. MATERIALS AND METHODS: This prospective, randomized, clinical study included patients aged 3 to 15 years who presented to the ED with forearm fractures. The patients were divided into 2 groups: the procedural sedoanalgesia group (group PSA, n = 30) and ultrasound-guided ICB group (group ICB, n = 30). Pain scores of the patients were evaluated using the Wong-Baker FACES Scale before and during the procedure. Pain scores and parental and operator satisfaction were compared between the groups. RESULTS: There was no statistical significance in terms of demographic data. The pain scores observed during the procedures were significantly higher in the group PSA than in the group ICB (3.07 ± 1.55 vs 0.47 ± 0.86, respectively; P < 0.001). The parental and operator satisfaction of the ICB group was significantly higher than that of the PSA group (P < 0.001). CONCLUSIONS: Ultrasound-guided ICB is a safe and effective method in the management of pain during closed reduction of forearm fracture in pediatric patients in EDs. It can be used safely in emergency rooms and has a high level of both parental and operator satisfaction.

Erector spinae plane block vs non-steroidal anti-inflammatory drugs for severe renal colic pain: A pilot clinical feasibility study.

AIM: Ultrasound-guided plane blocks are increasingly used in the multi-modal analgesic concept for reducing opioid consumption. The present study was conducted to compare the analgesic effect of intravenous non-steroidal anti-inflammatory drugs (NSAIDs) and erector spinae plane (ESP) block in renal colic patients. METHODS: In this prospective randomised study, 40 patients with renal colic pain were randomly assigned into two groups: Group NSAID (n = 20) received an intravenous infusion of 50 mg of dexketoprofen trometamol and Group ESP (n = 20) received ultrasound-guided ESP block with 30 ml 0.25% bupivacaine at the T8 level. The pain severity of patients was assessed using the visual analogue scale (VAS) at baseline, 5, 15, 30, 45 and 60 minutes after intervention. Opioid consumption, patient satisfaction and side effects were recorded. RESULTS: In the ESP group, the VAS scores were significantly lower than the NSAID group at 5, 15, 30, 45 and 60 minutes after the procedure (P < .001). Opioid consumption was significantly higher in the NSAID group compared with the ESP group (10/20 vs 0/20, respectively; P < .001). Patient satisfaction was significantly higher in the ESP group (P < .001). CONCLUSIONS: ESP block can be an alternative, efficient and safe method for the relief of acute renal colic pain.

The new ultralow dose CT protocol for the diagnosis of fractures of the ankle: A prospective comparative study with conventional CT.

PURPOSE: Computerized tomography (CT) imaging is increasingly being used to evaluate patients with ankle trauma. However, conventional CT (C CT) has a significantly higher radiation dose (RD) than plain radiography. This study aimed to evaluate the diagnostic accuracy and reliability of ultra-low-dose CT (ULDCT) protocol for ankle fractures. METHODS: Ninety-eight consecutive patients who had ankle CT for suspected ankle fracture were included in our prospective study. C CT and ULDCT protocols were simultaneously performed on these 98 patients. Two observers independently evaluated ULDCT and C CT images. The effective RD of the ULDCT and C CT groups was calculated. RESULTS: The interobserver agreement was 1 (perfect). ULDCT and C CT group images showed no significant difference in image quality. The effective RD of the ULDCT was significantly lower than the C CT (p < 0.001). CONCLUSIONS: By evaluating the results of this study, ULDCT proved to be a reliable diagnostic imaging method for fractures of the ankle. The satisfactory diagnostic image quality of the ULDCT protocol provides promising results. LEVEL OF EVIDENCE: Level II/lesser quality RCT or prospective comparative study.