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1.
Turk J Med Sci ; 53(4): 1001-1011, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38031950

RESUMO

BACKGROUND: The respiratory muscles of patients with chronic obstructive pulmonary disease (COPD) exhibit structural and functional changes that can be evaluated and monitored by ultrasonography. METHODS: This single-center, prospective study was conducted in the emergency department (ED) of a tertiary care hospital over an eight-month period (September 2020-May 2021). Diaphragmatic excursions, end-expiratory thickness, and thickening fractions, as well as right and left intercostal muscle thicknesses, of all adult subjects manifesting COPD exacerbation, were assessed. The data were analyzed regarding ward/intensive care unit (ICU) hospitalization or discharge from the ED, mortality, and readmission within 15 days. RESULTS: Sixty-three subjects were recruited for the study. Diaphragmatic excursion, end-expiratory diaphragmatic thickness, and intercostal muscle thickness measurements were significantly different between the ward, ICU, and discharge groups (p < 0.001) but lower in the deceased subjects (all p < 0.05). The diaphragmatic excursion value of 3.25 cm was the threshold value measured for distinguishing discharge from ED, and 1.82 cm was measured for admission to the ICU, both with 100% sensitivity and selectivity (AUC = 1). DISCUSSION: Diaphragmatic excursion, diaphragmatic end-expiratory thickness, and right and left intercostal muscle thicknesses vary in the prognosis of subjects presenting with COPD exacerbation.


Assuntos
Músculos Intercostais , Doença Pulmonar Obstrutiva Crônica , Adulto , Humanos , Estudos Prospectivos , Músculos Respiratórios , Doença Pulmonar Obstrutiva Crônica/diagnóstico por imagem , Ultrassonografia
2.
Am J Emerg Med ; 56: 223-227, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35461026

RESUMO

INTRODUCTION: Non-traumatic back pain constitutes roughly 5% of the admissions to emergency departments. This study seeks to compare the efficacy of intravenously administered paracetamol, dexketoprofen, and ibuprofen in patients with non-traumatic acute low back pain. METHODS: This study was designed as a randomized, double-blinded investigation and carried out at a tertiary hospital. 210 eligible patients without trauma who presented with low back pain were recruited for the study and randomized into paracetamol (n = 71), dexketoprofen (n = 70), and ibuprofen (n = 69) groups. The measurements at 0, 15, 30 and 60 min were noted down by using a 100 mm VAS, and the relevant comparisons were made. RESULTS: The VAS scores at 0 and 60 min in the paracetamol, dexketoprofen, and ibuprofen groups decreased on average by 40 mm, 42 mm, and 43 mm, respectively. The baseline and final pain scores of each drug group differed significantly (p < 0.05), though the between-group analysis revealed no significant difference (p > 0.05). CONCLUSION: Given the obtained data, we did not note a significant difference between intravenous paracetamol, dexketoprofen and ibuprofen with respect to pain efficacy in non-traumatic acute low back pain. Based on the patients' clinical conditions and histories, we concluded that the choice of medication might not change the efficacy of the treatment and patient comfort.


Assuntos
Dor Aguda , Analgésicos não Narcóticos , Dor Lombar , Acetaminofen/uso terapêutico , Dor Aguda/tratamento farmacológico , Analgésicos não Narcóticos/uso terapêutico , Anti-Inflamatórios não Esteroides/uso terapêutico , Método Duplo-Cego , Humanos , Ibuprofeno/uso terapêutico , Cetoprofeno/análogos & derivados , Dor Lombar/tratamento farmacológico , Trometamina
3.
Int J Clin Pract ; 2022: 8436248, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35685578

RESUMO

Aims: In this study, we aim to unravel the relationship between coagulation parameters together with D-dimer and the severity of coronavirus disease (COVID-19) during hospitalization as well as hospitalization in the intensive care unit (ICU). Methods: This retrospective study was conducted in the Emergency Department (ED) of Pamukkale University Hospital (Denizli, Turkey) between March 1 and April 30, 2020. SARS-CoV-2 polymerase chain reaction (PCR) tests and laboratory tests, including international normalized ratio (INR), prothrombin time (PT), D-dimer, and activated thromboplastin time (APTT), were requested from 289 people presenting to the ED with symptoms of upper respiratory tract infection (URTI), such as cough, fever, and sore throat. Results: While 110 patients turned out to be polymerase chain reaction (PCR) positive, 181 individuals were PCR negative. The mean D-dimer level of the patient group was 147 ng/ml DDU (min: 9, max: 2948), and their mean PT level was found as 12.8 seconds (min: 10.3, max: 34.7). Besides, the mean APTT was 31.25 seconds (min: 19, max: 46.9), and the mean INR level was calculated as 1.09 (min: 0.88, max: 2.93). 35 of the patients were not hospitalized, while 43 were admitted to the Infectious Diseases, 20 to the Chest Diseases, and 12 to the ICU. Conclusions: It can be concluded from our findings that D-dimer, PT, and INR levels remained elevated in the COVID-19-diagnosed patients, but these parameters were unable to discriminate accurately between the patients with positive and negative SARS-CoV-2 results. Our findings also suggest that coagulation parameters might occupy a critical role in documenting clinical severity in patients with COVID-19 infection and requiring hospitalization.


Assuntos
COVID-19 , SARS-CoV-2 , Testes de Coagulação Sanguínea , COVID-19/diagnóstico , Humanos , Coeficiente Internacional Normatizado , Estudos Retrospectivos
4.
Am J Emerg Med ; 42: 110-114, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33503532

RESUMO

INTRODUCTION: Patients diagnosed with COVID-19 have presented to emergency departments (EDs) worldwide with a wide range of symptoms. In this study we reported the clinical, laboratory and radiological features of the cases diagnosed with COVID-19. METHODS: This is a single-center, retrospective, descriptive, and observational study. The patients who have admitted to ED between March 11 and May 31, 2020 and diagnosed COVID-19 infection. RESULTS: 130 (73 male and 57 female) patients with COVID-19 polymerase chain reaction (PCR) positive test were included in the study. The average age of the study group was calculated as 52.63 ± 17.95 year. While 15.4% of the patients were asymptomatic, the most common symptom was identified as cough (46.2%), followed by dyspnea (23.1%), fever (17.7%). The computed tomography (CT) severity scores proved significantly higher in the patients with hypertension and coronary artery disease (CAD) than in those without these diseases (p = 0.010 and p = 0.042, respectively). The moderate positive correlation between serum ferritin level and CT severity score is another finding worth noting (rho = 0.530 and p = 0.0001). In a similar vein, the high level of D-dimer in the CT-positive group and its positive moderate correlation with CT severity (rho = 0.375 and p = 0.0001). CONCLUSION: In our study, serum ferritin and D-dimer levels were observed to be high in the CT-positive group and have moderate positive correlation with CT severity. We thus argue that D-dimer and ferritin levels measured at the time of admission to the ED can be taken into consideration to predict radiological severity.


Assuntos
COVID-19/sangue , COVID-19/diagnóstico por imagem , Pulmão/diagnóstico por imagem , Adulto , Idoso , COVID-19/complicações , Teste de Ácido Nucleico para COVID-19 , Feminino , Ferritinas/sangue , Produtos de Degradação da Fibrina e do Fibrinogênio/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Reação em Cadeia da Polimerase Via Transcriptase Reversa , SARS-CoV-2/isolamento & purificação , Índice de Gravidade de Doença , Avaliação de Sintomas , Tomografia Computadorizada por Raios X , Turquia
5.
Am J Emerg Med ; 40: 55-59, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33348224

RESUMO

INTRODUCTION: This study seeks to determine the utility of D-dimer levels as a biomarker in determining disease severity and prognosis in COVID-19. METHODS: Clinical, imaging and laboratory data of 120 patients whose COVID-19 diagnosis based on RT-PCR were evaluated retrospectively. Clinically, the severity of COVID-19 was classified as noncomplicated or mild or severe pneumonia. Radiologically, the area of affected lungs compatible with viral pneumonia in each patient's computed tomography was classified as either 0-30% or ≥ 31% of the total lung area. The D-dimer values and laboratory data of patients with COVID-19 were compared with inpatient status, duration of hospitalization, and lung involvement during treatment and follow-up. To assess the predictive value of D-dimer, receiver operating characteristic (ROC) analysis was conducted. RESULTS: D-dimer elevation (> 243 ng/ml) was detected in 63.3% (76/120) of the patients. The mean D-dimer value was calculated as 3144.50 ± 1709.4 ng/ml (1643-8548) for inpatients with severe pneumonia in the intensive care unit. D-Dimer values showed positive correlations with age, duration of stay, lung involvement, fibrinogen, neutrophil count, neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR). When the threshold D-dimer value was 370 ng/ml in the ROC analysis, this value was calculated to have 77% specificity and 74% sensitivity for lung involvement in patients with COVID-19. CONCLUSION: D-Dimer levels in patients with COVID-19 correlate with outcome, but further studies are needed to see how useful they are in determining prognosis.


Assuntos
COVID-19/sangue , Produtos de Degradação da Fibrina e do Fibrinogênio/análise , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , COVID-19/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Índice de Gravidade de Doença , Adulto Jovem
6.
Am J Emerg Med ; 40: 77-82, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33360021

RESUMO

BACKGROUND: This study aimed to compare the therapeutic efficacy of dimenhydrinate and metoclopramide in patients with nausea and vertigo. METHODS: A prospective, double-blind, randomized clinical trial was performed on patients who presented to the emergency department (ED) with nausea and vertigo in the six month period between Nov 1st 2012 and May 1st 2013. Adult patients who were 18 to 65 years old presenting to the ED with nausea and vertigo or motion sickness were included in the study. A total of 200 patients were divided into 2 groups who were admitted to ED with complaints of vertigo accompanied by nausea. In the first group, 50 mg dimenhydrinate and 10 mg metoclopramide infusions were given intravenously for 15 min. The efficacy of treatment was measured by using a 10 mm Visual Analog Scale (VAS) performed at 0, 15 and the 30th minute. The primary outcome variable was a reduction in vertigo intensity documented on the VAS at the 30th minute after medication administration. RESULTS: A total of 200 patients were included in the randomization (n=100 in both groups). The baseline vertigo VAS scores were 7.57±1.42 in the dimenhydrinate (DMT) group and 7.27±1.40 in the metoclopramide (MTP) group (p=0.09). In the 30th minute of treatment, the average vertigo VAS score was 2.46 ± 2.39 in the DMT group and 2.31±1.96 in the MTP group; no significant differences were detected between groups. The baseline nausea VAS scores were 7.62±1.48 in the DMT group and 7.45±1.27 in the MTP group (p=0.36). In the 30th minute of treatment the average vertigo VAS score decreased to 2.27±2.24 in the DMT group and 2.70±2.48 in the MTP group, no significant differences were detected between groups. No significant differences were detected between nausea VAS changes and vertigo VAS changes at 30th minutes of the treatment (p=0.06, p=0.85 respectively). Rescue medication need was similar in both treatment groups (p=0.94). No significant differences were detected about the side effects which are sedation (p=0.56) and hypotension (p=0.57). CONCLUSIONS: In conclusion, this prospective, double-blind, randomized study showed that both DMT and MTP have similar efficacy in reducing nausea and vertigo symptoms in the ED.


Assuntos
Antieméticos/uso terapêutico , Dimenidrinato/uso terapêutico , Serviço Hospitalar de Emergência , Metoclopramida/uso terapêutico , Náusea/tratamento farmacológico , Náusea/etiologia , Vertigem/tratamento farmacológico , Adolescente , Adulto , Idoso , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Vertigem/complicações
7.
Am J Emerg Med ; 40: 110-114, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33309506

RESUMO

INTRODUCTION: In this study, we aimed to investigate and compare the prognostic impacts of C-reactive protein (CRP), white blood cell (WBC) count, neutrophil (NEU)-to-lymphocyte (LYM) ratio (NLR), platelet-to-lymphocyte ratio (PLR), Red Cell Distribution Width (RDW) biomarkers in laboratory-confirmed COVID-19 cases as well as to explore the most useful diagnostic biomarkers and optimal cutoff values in COVID-19 patients. METHODS: A total of 233 patients were admitted to Emergency Department (ED) of Pamukkale University Hospital during two months (March-April 2020) and underwent Sars CoV-2 PCR (Polymerase Chain Reaction), complete blood count (CBC), and CRP tests in sequence due to complaints of COVID-19. The laboratory results and demographic findings were collected from the public health management system retrospectively. The patients with positive Sars CoV-2 PCR test along with hospitalization data were also recorded. RESULTS: The CRP (p = 0.0001), lactate dehydrogenase (LDH) (p = 0.038), PLR (p = 0.0001) and NLR (p = 0.001) remained significantly higher in the patients with positive Sars CoV-2 PCR test result. By contrast, eosinophil (p = 0.0001), lymphocyte (p = 0.0001), platelet levels (p = 0.0001) were calculated as significantly higher in negative Sars CoV-2 patients. CONCLUSION: In the light of the obtained results, the CRP, LDH, PLR and NLR levels remained significantly higher in COVID-19 positive patients, while eosinophil, lymphocyte, and platelet levels were significantly elevated in COVID-19 negative patients.


Assuntos
Plaquetas , COVID-19/sangue , COVID-19/diagnóstico , Linfócitos , Monócitos , Neutrófilos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Contagem de Células Sanguíneas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Estudos Retrospectivos , Índice de Gravidade de Doença , Adulto Jovem
8.
Int J Clin Pract ; 75(9): e14361, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33993614

RESUMO

BACKGROUND: Fournier's gangrene (FG) is a disease with high mortality rate. The first diagnosis is performed in the emergency department (ED). In this study, we investigated the importance of the time period for diagnosis in the ED. METHODS: The data of patients who were treated for FG between 1 January 2010 and 2020 were retrospectively analysed. Waiting period of the patients in ED was calculated. Risk factor score calculations were calculated to predict FG mortality and prognosis. The effects of the ED waiting period on the duration of admission to the hospital, the number of debridements and mortality status and relationship with FG mortality risk factor scores were investigated. RESULTS: In a 10-year period, a total of 66 patients were included in the study. It was found that the median age of the patients was 56 years. ED waiting period median (IQR) was 105 (115) minutes. It was observed that there was a significant positive correlation between the ED waiting period, duration of admission to hospital (rs: 0.537, P < .001) and patients mortality status (rs: 0.482, P < .001). The ED waiting period was higher in patients with FG mortality. It was observed that the ED waiting period holds a diagnostic value in predicting mortality (P < .001). The cut-off limit predicted for this value was determined as 136 minutes. CONCLUSION: FG is a urological emergency. ED waiting period affects mortality rate and length of hospital stay. The earlier the diagnosis and treatment is conducted in the ED, the lower the mortality rate and length of stay in the hospital will be.


Assuntos
Gangrena de Fournier , Serviço Hospitalar de Emergência , Gangrena de Fournier/diagnóstico , Gangrena de Fournier/terapia , Humanos , Tempo de Internação , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos
9.
Int J Clin Pract ; 75(10): e14511, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34118123

RESUMO

OBJECTIVES: Sore throat is one of the most prevalent causes of emergency visits. The chief purpose of this clinical report is to investigate the effectiveness of intravenous (IV) dexketoprofen and paracetamol drugs relative to each other in relieving the pain induced by sore throat in emergency visits. METHODS: This prospective, randomised, double-blind, controlled study was conducted at a tertiary-level emergency unit. The eligible population (n = 200) with confirmed pharyngitis diagnosis on the Tonsillo Pharyngitis Assessment and moderate to severe sore throat was randomly divided into two cohorts to be administered with 50 mg of dexketoprofen (n = 98) or 1000-mg paracetamol (n = 102). The study drugs dissolved in 150-mL saline were administered by rapid IV infusion. All the recruited patients were re-assessed by Sore Throat Pain Intensity Scale (STPIS), Difficulty Swallowing Scale (DSS) and Swollen Throat Scale (SwoTS) at 15, 30, 45, 60, 90 and 120 minutes. In addition, presence of sore throat was re-evaluated by Sore Throat Relief Scale (STRS) at these time points. RESULTS: A total of 200 patients completed the study. The median age in dexketoprofen and paracetamol cohort was 25 (18-57) and 29 (17-76), respectively. Dexketoprofen and paracetamol provided relief in sore throat pain, with Total Pain Relief scores (TOTPAR0-120 min ) being 5.68 ± 2.06 mm in the former case and 6.03 ± 1.76 mm in the latter (P > .05). The IV administration of paracetamol and dexketoprofen decreased STPIS, DSS and SwoTS scores over time, while increasing STRS scores. The average value of STRS was measured as 4.41 ± 1.18 in the paracetamol cohort and 4.15 ± 1.23 in the dexketoprofen cohort during 0-120 minutes (P = .545). CONCLUSION: In emergency department, IV dexketoprofen and paracetamol reduced sore throat pain equally, providing similar analgesic efficacy.


Assuntos
Acetaminofen , Faringite , Acetaminofen/uso terapêutico , Anti-Inflamatórios não Esteroides/uso terapêutico , Método Duplo-Cego , Humanos , Cetoprofeno/análogos & derivados , Dor/tratamento farmacológico , Dor/etiologia , Faringite/tratamento farmacológico , Estudos Prospectivos , Trometamina
10.
Arch Psychiatr Nurs ; 35(5): 504-510, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34561066

RESUMO

BACKGROUND: The Covid-19 pandemic has forced healthcare staff into an unprecedented situation, such as making tough decisions and practising under enormous pressure. AIM: This study was designed to investigate the effect of Covid-19 on sleep quality, anxiety and depression in healthcare staff at a tertiary hospital. METHODS: This descriptive and cross-sectional study recruited healthcare staff working at a tertiary hospital. Those who had given their informed consent participated in this study between April 17 and May 17, 2020. Data were collected using the introductory information form, the Pittsburg Sleep Quality Index (PSQI), and the Hospital Anxiety Depression Scale (HADS). The data were then analyzed on the Statistical Package for the Social Sciences (SPSS) v.24. RESULTS: The mean scores of the respondents derived from the HADS-Anxiety (HADS-A) and HADS-Depression (HADS-D) scales were 7.89 ± 4.60 and 7.22 ± 4.13, respectively. Their depression levels were established to be at risk, though their anxiety levels were not. The mean PSQI score turned out to be 8.42 ± 2.30 for the participants, most of whom (92.9%) experienced poor sleep quality. Total sleep quality of the respondents exhibited a moderate positive correlation with HADS-A scores and a weak positive correlation with HADS-D scores (p < 0.05). CONCLUSION: Our major conclusion from the collected data is that healthcare staff suffered from poor sleep quality, and that their depression levels, but not anxiety levels, were at risk. Providing appropriate information about the health care of patients diagnosed with Covid-19 as well as offering regular psychoeducation-psychological support services and resting areas can reduce the susceptibility of healthcare staff to anxiety and depression and improve their overall sleep quality.


Assuntos
COVID-19 , Depressão , Ansiedade , Estudos Transversais , Atenção à Saúde , Humanos , Pandemias , SARS-CoV-2 , Sono , Centros de Atenção Terciária , Turquia
11.
Turk J Med Sci ; 51(3): 991-1000, 2021 06 28.
Artigo em Inglês | MEDLINE | ID: mdl-33641314

RESUMO

Background/aim: To investigate the relationship between imaging findings and peripheral blood cell counts of COVID-19 patients and the degree of thymus fat involution of these patients. Materials and methods: Computed tomography (CT) images of 87 patients with COVID-19 positive through RT-PCR testing were evaluated retrospectively by two radiologists. Ground glass densities and other signs of viral pneumonia were recorded, lung involvement was scored quantitatively. The patients thymus fat involution was graded on CT. Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratios (PLR), lymphocyte and platelet counts were calculated. Imaging findings and degrees of thymus fat involution were compared with laboratory data. Results: Quantitative scoring of lung involvement was calculated at mean 6.63 ± 4.70 (1­23) for observer 1 and mean 6.55 ± 4.65 (1­23) for observer 2 (K = 0.824­1.000). Statistical significance was determined between the increase in age and the increase in scores of lung findings (p = 0.003). Lymphocyte count (p = 0.0001) and PLR (p = 0.001) were significantly lower in patients with severe CT involvement. A statistically significantcorrelation was found between increased thymus fat component and presence of COVID-19 lung involvement in CT (r = 0.461). Conclusion: The severity of imaging findings for COVID-19 patients significantly correlates with the degree of fat involution in patients' thymus tissue.


Assuntos
COVID-19/diagnóstico , Pulmão/diagnóstico por imagem , Pandemias , Timo/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Adulto , COVID-19/sangue , COVID-19/epidemiologia , Feminino , Seguimentos , Humanos , Contagem de Linfócitos , Masculino , Contagem de Plaquetas , Estudos Retrospectivos , Índice de Gravidade de Doença , Turquia/epidemiologia , Adulto Jovem
12.
Am J Emerg Med ; 38(7): 1542.e5-1542.e8, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32276813

RESUMO

The primary cause of cyanide intake is suicidal attempts, most of which result in death. People who interfere with suspicion of cyanide intoxication may also be exposed to cyanide poisoning. During the autopsy of the corpse in the morning of that day, five people in the autopsy room within the hospital were admitted to the ED with suspicion of cyanide intoxication. Meanwhile, a 36-year-old patient who had come into contact with the patient at night also presented to the ED. Some of the precautionary measures to be taken against inhalation of cyanide may be wearing appropriate masks as well as suitable clothes and keeping the surroundings below 28 °C when exposed to cyanide.


Assuntos
Poluentes Ocupacionais do Ar/efeitos adversos , Autopsia , Cianetos/intoxicação , Doenças Profissionais/induzido quimicamente , Exposição Ocupacional/efeitos adversos , Adulto , Gasometria , Tontura/induzido quimicamente , Dispneia/induzido quimicamente , Feminino , Cefaleia/induzido quimicamente , Humanos , Masculino , Pessoa de Meia-Idade , Náusea/induzido quimicamente , Taquipneia/induzido quimicamente
13.
Med Sci Monit ; 25: 571-577, 2019 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-30661078

RESUMO

BACKGROUND This study aimed to compare the clinical validity and reliability of two wireless telemetry electrocardiogram (ECG) devices in the Emergency Medicine Department. MATERIAL AND METHODS Patients who attended the Emergency Medicine Department underwent wireless telemetry ECG testing (N=245) using the Infron Micro Cor and the Nihon Kohden Cardiofax M 1350 K devices. ECG recordings included heart rate, P-wave amplitude, PR segment length, QRS duration, QT and QTc intervals, ST depression and elevation, the number of ECG artifacts, the ECG diagnosis, and duration. Statistical analysis of reliability included the use of Cohen's kappa (κ) values. RESULTS One hundred women (40.8%) and 145 men (59.2%) were included in the study. The duration for the Infron Micro Cor ECG readings (57.5±0.93 seconds) was significantly shorter compared with the Nihon Kohden Cardiofax M ECG readings (65.2±9.72 seconds) (p=0.0001). The Infron Micro Cor ECG readings contained significantly more lead artifacts (93 or 37.9%) compared with the Nihon Kohden ECG readings (71 or 28.9%) (p=0.01). There was no difference between the two devices in terms of the other ECG parameters. The compatibility of ST-segment elevation detection was found to be almost in complete agreement between the Infron Micro Cor and Nihon Kohden Cardiofax M ECG devices, as determined by the k-values for ST elevation and ST depression. CONCLUSIONS Two wireless telemetry ECG devices were found to be reliable for use in the Emergency Medicine Department. The Infron Micro Cor wireless telemetry ECG device provided more rapid results.


Assuntos
Eletrocardiografia/instrumentação , Eletrocardiografia/métodos , Telemetria/instrumentação , Adulto , Idoso , Idoso de 80 Anos ou mais , Diagnóstico Diferencial , Medicina de Emergência , Serviço Hospitalar de Emergência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Tecnologia sem Fio
14.
Med Sci Monit ; 25: 157-164, 2019 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-30612134

RESUMO

BACKGROUND NSAIDs are the most common agents used in dysmenorrhea treatment. They reduce menstrual pain by reducing uterine pressure and PGF2alpha levels in the menstrual fluid. The aim of this study was to compare the effects of piroxicam and diclofenac sodium as treatments for primary dysmenorrhea. MATERIAL AND METHODS The study was conducted using a randomized and double-blind method. Patients with Visual Analogue Scale (VAS) scores greater than 5 were accepted into the study. The patients who were suitable for inclusion were randomized into 2 groups and received either intramuscular piroxicam or diclofenac sodium. The patients' pain levels were measured at baseline and at 15, 30, 45, and 60 min. A VAS of 10 cm, a numeric scale, a verbal scale, and additional symptoms, as well as pain relapse after 24 hours and required analgesics, were recorded. RESULTS The study included 400 patients. Overall, 200 patients (50%) were in the proxicam group, and 200 patients were in the diclofenac sodium group. The average decrease on the VAS after piroxicam or diclofenac administration was measured as 7.9±1.8 cm and 7.9±1.7 cm (median ± standard deviation), respectively. The pain-reducing efficiency of all the treatments was compared using the Mann-Whitney U test (p=0.929). Rescue medication was needed for 25 patients in the proxicam group (p=0.014). Overall, 30 patients in the proxicam group and 41 patients in the proxicam group needed analgesics again in the 24-hour period after treatment (p=0.150). CONCLUSIONS At the end of our study, it was observed that there was no difference in the results of primary dysmenorrhea treatment with 20 mg piroxicam or 75 mg diclofenac sodium.


Assuntos
Diclofenaco/uso terapêutico , Dismenorreia/tratamento farmacológico , Piroxicam/uso terapêutico , Adulto , Anti-Inflamatórios não Esteroides/uso terapêutico , Método Duplo-Cego , Serviços Médicos de Emergência , Feminino , Humanos , Medição da Dor , Adulto Jovem
15.
Am J Emerg Med ; 37(12): 2136-2142, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-30744914

RESUMO

INTRODUCTION: Although acute musculoskeletal pain has a wide range of causes from tendinitis, muscle spasm, to bone and joint injuries, it is a frequent occurrence in emergency services. Paracetamol and non-steroidal anti-inflammatory analgesics (NSAID) are common used in the treatment of musculoskeletal pain. This study sets out to compare the effectiveness of intravenous dexketoprofen and paracetamol in musculoskeletal pain relief. METHODS: This prospective, randomized, double blind, controlled study was carried out in a university emergency room. The participating patients were randomized into two groups to receive either 50 mg of dexketoprofen or 1000 mg of paracetamol intravenously by rapid infusion in 150 ml of normal saline. Visual analogue scale (VAS), Numeric Rating Scala (NRS) was employed for pain measurement at baseline, after 15, after 30 and after 60 mins. RESULTS: 200 patients were included in the study, excluding 7342 of them. The mean age of the patients was calculated as 32,6. Paracetamol and dexketoprofen intervention decreases NRS pain scores over time. When compared to all pain locations, the NRS pain score of the patients was found to be statistically more effective in dexketoprofen than in paracetamol (p = 0.001). Paracetamol and dexketoprofen intervention reduces pain VAS scores over time. When the VAS pain score of the patients was compared to all pain locations, dexketoprofen was found to be statistically more effective than paracetamol (p = 0.001). CONCLUSION: Intravenous dexketoprofen seemed to achieve superior analgesia to intravenous paracetamol when compared with all pain locations in patients with non-traumatic musculoskeletal pain.


Assuntos
Acetaminofen/administração & dosagem , Analgésicos não Narcóticos/administração & dosagem , Anti-Inflamatórios não Esteroides/administração & dosagem , Cetoprofeno/análogos & derivados , Dor Musculoesquelética/tratamento farmacológico , Trometamina/administração & dosagem , Administração Intravenosa , Adulto , Método Duplo-Cego , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Humanos , Cetoprofeno/administração & dosagem , Masculino , Estudos Prospectivos , Resultado do Tratamento , Escala Visual Analógica
16.
Am J Emerg Med ; 37(10): 1891-1895, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-30638629

RESUMO

INTRODUCTION: Acute cocaine intoxication is one of the important causes of admission to emergency department, especially in western countries. We aimed to compare the efficacies of tetracycline, minocycline, doxycycline in the prevention of seizures and deaths in mice due to cocaine intoxication. METHODS: In the study, a total of 120 balb-c male mice weighing 25-30 g were randomized into 4 groups as tetracycline 255 mg/kg, minocycline 170 mg/kg, doxycycline 157 mg/kg, 0.5 ml saline (placebo). The doses of tetracycline, minocycline and doxycycline are the calculated ED50 values. The mice in the groups received 93 mg/kg cocaine intraperitoneally 10 min after drug administration. The dose of cocaine is 50% of the lethal dose. After cocaine injection, all mice were observed for 30 min in terms of cocaine toxicity findings. Mortality rates, death times, seizure activities, and seizure onset times of the mice were clinically evaluated in an observational way. RESULTS: There were significant differences among all the groups in terms of seizure and lethality (p < 0.001). The ratio of animals with seizures was significantly lower in the minocycline (73.3%), and doxycycline (73.3%) groups (all p = 0.040). The ratio of animals with lethality was significantly lower in the minocycline (23.3%) group compared with vehicle (p < 0.001). CONCLUSION: In our acute cocaine intoxication model, minocycline was effective in terms of lethality and preventing seizures, doxycycline was effective in preventing seizures.


Assuntos
Antibacterianos/uso terapêutico , Cocaína/toxicidade , Doxiciclina/uso terapêutico , Overdose de Drogas/tratamento farmacológico , Minociclina/uso terapêutico , Convulsões/prevenção & controle , Tetraciclina/uso terapêutico , Animais , Relação Dose-Resposta a Droga , Overdose de Drogas/complicações , Overdose de Drogas/mortalidade , Drogas Ilícitas/toxicidade , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Distribuição Aleatória , Convulsões/induzido quimicamente , Testes de Toxicidade , Resultado do Tratamento
17.
Am J Emerg Med ; 37(5): 902-908, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30100336

RESUMO

INTRODUCTION: Musculoskeletal system traumas are among the most common presentations in the emergency departments. In the treatment of traumatic musculoskeletal pain, paracetamol and non-steroidal anti-inflammatory analgesics (NSAID) are frequently used. Our aim in this study is to compare the efficacy of intravenous dexketoprofen and paracetamol in the treatment of traumatic musculoskeletal pain. METHODS: This prospective, randomised, double blind, controlled study was conducted in a tertiary care emergency unit. The participating patients were randomised into two groups to receive either 50 mg of dexketoprofen or 1000 mg of paracetamol intravenously by rapid infusion in 150 mL of normal saline. Visual analogue scale (VAS), Numeric Rating Scala (NRS) and Verbal Rating Scale (VRS) was employed for pain measurement at baseline, after 15, after 30 and after 60 mins. RESULTS: 200 patients were included in the final analysis. The median age of the paracetamol group was 34 (24-48), while that of the dexketoprofen group was 35 (23-50), and 63% (n = 126) of them consisted of men. Paracetamol and dexketoprofen administration reduced VAS pain scores over time (p = 0.0001). Median reduction in VAS score at 60 min was 55 (IQR 30-65) for the paracetamol group and 50(IQR 30.25-60) for the dexketoprofen group. There was no statistically significant difference between the paracetamol and dexketoprofen groups in terms of VAS reductions (p = 0.613). CONCLUSION: Intravenous paracetamol and dexketoprofen seem to produce equivalent pain relief for acute musculoskeletal trauma in the emergency department. CLINICALTRIALS. GOV NO: NCT03428503.


Assuntos
Acetaminofen/administração & dosagem , Analgésicos não Narcóticos/administração & dosagem , Anti-Inflamatórios não Esteroides/administração & dosagem , Cetoprofeno/análogos & derivados , Dor Musculoesquelética/tratamento farmacológico , Sistema Musculoesquelético/lesões , Trometamina/administração & dosagem , Administração Intravenosa , Adulto , Método Duplo-Cego , Serviço Hospitalar de Emergência , Feminino , Humanos , Cetoprofeno/administração & dosagem , Masculino , Pessoa de Meia-Idade , Medição da Dor/métodos , Estudos Prospectivos , Adulto Jovem
18.
J Pak Med Assoc ; 69(11): 1651-1656, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31740873

RESUMO

OBJECTIVE: To investigate laryngoscopic images, intubation time, intubation success, satisfaction and ease of use of a Macintosh laryngoscope and the Clarus optical stylet among inexperienced medical students. METHODS: The prospective, experimental study was conducted at Pamukkale University, Denizli, Turkey, from May to June 2017, and comprised medical school term VI students who had never before carried out endotracheal intubation. A standardised oral presentation and demonstration of the intubation technique with each device were given. Elements measured were success rate of orotracheal intubation, successful intubation time, number of intubation interventions, Cormack-Lehane classification, usefulness and satisfaction with the devices. SPSS 21 was used for data analysis. . RESULTS: Of the 94 subjects, 60(63.8%) were females. The overall mean age was 24.38±0.94 years. Compared to the direct laryngoscope, the optical stylet recorded a better success rate at first attempt (p<0.001), as well as with intubation time (p<0.001), pleasure (p<0.001) and usefulness (p<0.001). CONCLUSIONS: The use of an optical stylet increased endotracheal intubation success among inexperienced users.


Assuntos
Intubação Intratraqueal , Laringoscópios , Manequins , Adulto , Competência Clínica , Educação Médica/métodos , Desenho de Equipamento , Feminino , Humanos , Intubação Intratraqueal/instrumentação , Intubação Intratraqueal/métodos , Intubação Intratraqueal/normas , Intubação Intratraqueal/estatística & dados numéricos , Masculino , Estudos Prospectivos , Estudantes de Medicina , Turquia , Adulto Jovem
20.
Am J Emerg Med ; 32(7): 814.e1-2, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24462396

RESUMO

Venous thromboembolism (VTE) is serious medical condition, which might be caused by psychotropic medications. Previously, antipsychotic-induced VTE due to olanzapine, risperidone, clozapine, and amisulpiride was reported. In this report, we present 2 cases of paliperidone-induced VTE.


Assuntos
Antipsicóticos/efeitos adversos , Isoxazóis/efeitos adversos , Embolia Pulmonar/induzido quimicamente , Pirimidinas/efeitos adversos , Adulto , Humanos , Masculino , Palmitato de Paliperidona
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