ÖZET: Amaç: Acil servisler Türkiye nüfusunun üzerinde bir başvuru yükü altındadır. Bu sebeple acil servislerde hastalara verilen hizmet kalitesindeki düşüş toplumun ciddi bir kesimini etkileyecektir. Aynı zamanda yüksek başvuru sayıları ciddi bir mali bir yükü de beraberinde getirecektir. Ayrıca, çalışanlarda meydana gelen tükenmişlik ve sağlık personeline yönelik şiddet diğer önemli olaylardır. Bu ve benzer nedenler ele alındığında ‘Acil servis yoğunluğu’ ciddi bir halk sağlığı sorunu haline gelmiştir. Bu çalışmanın amacı acil tıp kliniğine başvuran ve acil müdahale ihtiyacı olmayan hastaların gözünden acil servislere bakış açılarını ve aciliyet algısını değerlendirmek, acil servislerin uygun olmayan kullanımı için analitik bir değerlendirme yapmaktır. Yöntem; 4 ay boyunca İzmir Katip Çelebi Üniversitesi Atatürk Eğitim ve Araştırma Hastanesine başvuran, acil müdahale ihtiyacı olmayan, 919 hasta çalışmaya dahil edilmiştir. Bulgular: Eğitim durumları incelendiğinde ise, katılımcıların %14,5’inin herhangi bir eğitim almadıkları görüldü. %7,5’u ilkokul, %7,9 ortaokul, %65,8’i lise, %4,2’siüniversite düzeyinde eğitim almıştı. Acil servilere başvuruları öncesi her hangi bir sağlık kuruluşuna başvurular sorgulandığında hastaların %28.3’ünün başka bir acil servisten hastanemiz acil servisine başvurdukları görüldü. Hastaların %17’si aile hekimleri tarafından, %28.4’ü polikliniklerden, %7’si medyadaki bilgilendirmeler sonrasında acil servislere başvurduklarını ifade ettiler. %15,6’sı herhangi bir değerlendirme gereksinimi duymadan acil müdahale ihtiyacının olduğunu düşünerek acil servise başvurduklarını söylediler. Sonuç: Hastaların aciliyet algısında yanıldıkları ve eğitim düzeyi ne olursa olsun acil servisleri amaçları dışında kullandıklarını gözlemledik.

/Objective: Ischemia is a leading cause of morbidity in Mechanical Intestinal Obstruction (MIO) in which the timing of decisions of whether to proceed to surgical or conservative treatment is critical in emergency departments (ED). While advanced technological options are available, patients may be negatively affected by the application of contrast agents or radiation. The use of ultrasound is limited because of the air in the intestines does not allow a good field of vision. While biomarkers can be considered as a good alternative option at this point. In the present study we examine the effect of hemogram and blood gas parameters on early surgical decision-making in MIO patients. Involved in this observational prospective study were 264 patients diagnosed with MIO who presented to the Department of Emergency Medicine, Ataturk Research and Training Hospital, Katip Celebi University between February 2018 and February 2019. Contrast-enhanced tomography (CECT) and laboratory results of the patients were recorded. Pathology reports of the patients who underwent surgery were collected. Laboratory data were analyzed by comparing CECT and pathology reports. In a ROC analysis of the laboratory values of the patients who were diagnosed with ileus, the sensitivity was calculated as 80% and the specificity was 57.7 in values above WBC>10.75 (109/L), 96.6%, and the specificity was 31.1% in N/L > 2.9. For intestinal ischemia, the cut-off values were WBC> 12.6 and N/L > 3.2, Lactate >2.8 mmol/L and B.E < -3.6 mmol/L. Diagnoses of ileus are based on the results examinations and imaging methods. More data are needed to support decisions on the timing of surgery in ED. WBC, N/L, Lactate and Base Excess indicate an ischemic segment. When the parameters are evaluated together, they strongly support early surgical decision-making regarding the treatment of intestinal ischemia.

Purpose: The purpose of this study is to describe long COVID-19 symptoms in patients receiving outpatient treatment. Materials and Methods: This prospective, observational, descriptive study was conducted in the COVID-19 clinic of a university hospital in February-May 2022. Patients who applied to the outpatient clinic and were diagnosed with COVID-19 were included in the study. Patients were follow up for prolonged COVID-19 symptoms for a 12-week period. It was investigated whether there was a relationship between long COVID-19 symptoms frequency and gender, age and blood type. Results: At least one long COVID symptom was observed in 23% of 7139 patients included in the study. Myalgia was the most common symptom detected in 4.33% of all patients. Cough and loss of taste/smell were the most common symptoms in women, and dizziness in men. The frequency of 26 of 29 symptoms varied with age. While the symptoms most affected by the Body Mass Index were peripheral neuropathy and tinnitus, the least affected symptoms were loss of taste/smell, anxiety and depression. Conclusion: Long COVID symptoms were widely detected in COVID-19 outpatients. Age, gender and BMI may be factors affecting long COVID symptoms.

Background and Objectives: Acute cardiorespiratory failure disrupts the delicate balance of energy supply, demand, and consumption, with elevated lactate levels and decreased blood pH serving as crucial indicators. Acute cardiogenic pulmonary edema (ACPO), a common cause of acute respiratory failure, poses a substantial mortality risk. Lactate, a byproduct of pyruvate reduction, is a pertinent marker in perfusion assessment. Lactate clearance (LC) has proven prognostic efficacy in various conditions but lacks consensus on its predictive power in acute cardiogenic pulmonary edema. Materials and Methods: This prospective observational study, conducted in a metropolitan area’s third-level emergency department, involved patients with cardiogenic pulmonary edema from May 2021 to August 2023. The inclusion criteria specified acute cardiogenic pulmonary edema, excluding patients with incomplete data or other respiratory conditions. Lactate clearance, calculated at presentation and after 6 h, served as the primary outcome predictor. Our data analysis employed logistic regression, the ROC curve, and statistical tests. Results: The cohort of 106 patients revealed that a lactate clearance below 14.29% was significantly associated with mortality. While 51.6% of survivors were discharged, LC’s predictive success for discharge was inconclusive. Logistic regression underscored the significance of lactate clearance, with a one-unit increase yielding a 5.55-fold probability of survival. The AUC for LC was 0.759. Conclusions: This study pioneers the exploration of lactate clearance in patients with acute cardiogenic pulmonary edema. LC below 14.29% signifies a poor prognosis, emphasizing its potential as an early treatment initiation marker. While acknowledging this study’s limitations, we advocate for further multicenter research to refine the understanding of lactate clearance in this context.