Background: Predicting mortality and morbidity poses a significant challenge to physicians, leading to the development of various scoring systems. Among these, the hemoglobin, albumin, lymphocyte and platelet (HALP) score evaluates a patient’s nutritional and immune status. The primary aim of this study was to determine the predictive effect of the HALP score on 30-day and 1-year mortality in elderly patients with proximal femoral fractures (PFFs). Materials and methods: Patient demographic, clinical, laboratory, and prognostic data were obtained. The patients were categorized into two groups: survival and nonsurvival at mortality endpoints. The HALP score was calculated and compared among the groups and with other mortality biomarkers such as C-reactive protein (CRP) and C-reactive protein to albumin ratio (CAR). The ability of the HALP score to predict mortality was compared between the groups. The mortality risk was also calculated at the optimal threshold. Results: The HALP score had a statistically significant predictive effect on mortality endpoints and was lower in the non-surviving group. The ability of the HALP score to predict 1-year mortality at the optimal cut-off value (17.975) was superb, with a sensitivity of 0.66 and specificity of 0.86 (AUC: 0.826, 95% CI: 0.784–0.868). In addition, the power of the HALP score to differentiate survivors and non-survivors was more significant than that of other indices (p < 0.001). Patients with a HALP score ≤ 17.975 had a 1-year mortality risk 11.794 times that of patients with a HALP score ≥ 17.975 (Odds ratio: 11.794, 95% CI [7.194–19.338], p < 0.001). Conclusion: The results indicate that the HALP score demonstrates efficacy and utility in predicting 30-day and 1-year mortality risk among elderly patients with PFFs.

Background: Carbon monoxide (CO) results from incomplete combustion of carbon-based materials, causing symptoms such as headaches, dizziness, nausea, chest pain, confusion, and, in severe cases, unconsciousness. Normobaric oxygen therapy (NBOT) is the standard therapy, whereas hyperbaric oxygen therapy (HBOT) is recommended in severe cases of organ damage. This study examined the early and late adverse outcomes in patients with severe CO poisoning. Materials and methods: This study analyzed severe cases of CO poisoning among patients admitted to the emergency department between January 2020 and May 2022. The demographic, clinical, and laboratory data of symptomatic individuals and those requiring HBOT were examined. The study recorded early outcomes, such as intubation and in-hospital mortality, and late outcomes, such as delayed neurological sequelae and 1-year mortality. Chi-square tests, Spearman’s rho correlation tests, and logistic regression analyses were performed to identify factors affecting these outcomes. Results: Patients who received HBOT showed a significant difference in delayed neurological sequelae (DNS) compared to those who received NBOT (p = 0.037). Significant differences were observed in the need for intubation, in-hospital mortality, and 1-year mortality between patients based on COHb levels, but no significant differences were found in DNS. The 1-year mortality probability was significantly influenced by COHb level (odds ratio = 1.159, 95% CI [1.056–1.273]). Patients receiving NBOT had a higher odds ratio for DNS risk than those receiving HBOT (odds ratio = 8.464, 95% [1.755–40.817], p = 0.008). Conclusion: The study showed no differences in intubation, in-hospital mortality, and 1-year mortality rates between the HBOT and NBOT groups. However, significant differences in DNS suggest that treatment modalities have different effects on neurological outcomes. High COHb levels are associated with an increased risk of intubation, and mortality underscores the significance of monitoring COHb levels in clinical evaluations.

Objective The present study evaluated the work-related anxiety scores of healthcare workers in emergency departments (ED) and aimed to determine the factors affecting these scores.Methods The data was obtained through a survey administered to the emergency staff. Beck’s Anxiety Inventory (BAI) and the Mini-International Neuropsychiatric Interview (MINI) work anxiety interview were used to predict and determine the type of anxiety experienced by the participants. The survey was administered to 147 volunteers, and questionnaires from 130 participants were included in the study.Results It was found that 43.8% of the participants had a BAI score greater than 7. The study results showed a negative correlation and a linear regression model between age and the BAI score. Additionally, the BAI score was significantly higher in female, singles, physicians, those who were dissatisfied with their jobs, and those who were dissatisfied with their salaries (p<0.05). The results also showed that having a history of anxiety disorder or depression, being a physician, and being dissatisfied with one’s job were 6.277, 5.583, and 4.005 times higher, respectively, in terms of suspicion of anxiety (p<0.001). In the MINI job anxiety interview, work-related posttraumatic stress disorder (38.6%) was predicted most frequently, and indiscriminative work-related social phobia (5.3%) was predicted least frequently in participants at risk for anxiety according to the BAI score.Conclusion This study suggests that teaching healthcare workers how to cope with workplace trauma and workplace-related situational phobias can be an effective solution to prevent anxiety disorders in healthcare workers working in ED.

Letrozole (LTZ), is an aromatase inhibitor, that has been widely used in a variety of diseases such as polycystic ovary syndrome, endometriosis, and breast cancer. LTZ is received via the oral route and metabolized in the liver. Therefore, LTZ may have toxic effects like other drugs metabolized in the liver. Based on this, our study aimed to investigate the effect of LTZ on liver function and biochemical parameters. For this purpose, 16 Wistar albino female rats were divided into two groups (n=8): Control and LTZ respectively. The rats in the letrozole group were administered with 2 mL/kg LTZ by oral gavage once a day for 21 days. The Control group received the vehicle once a day for 21 days. Blood samples were collected on the 22nd day of the experiment. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), lactate dehydrogenase (LDH), albumin (ALB), alkaline phosphatase (ALP), direct bilirubin and total bilirubin were measured. Biochemical analysis indicated that ALT, AST, LDH, ALP, and total bilirubin levels were significantly higher in the LTZ administrated group compared to the Control. ALB levels decreased in the LTZ group. In conclusion, it was determined that LTZ has toxic and detrimental effects on the liver. We suggested that long-term LTZ administrated patients should be under control against liver damage and may have liver supporting adjuvant therapies for robust liver functions.

Objective: Although the actual relationship between COVID -19 and the incidence of stroke has not yet been clearly defined, various potential mechanisms such as hypercoagulation or viral infecton burden have been reported as risk factors that can increase the risk of stroke. However, various anecdotal reports have emphasized the falling rate of new ischemic stroke diagnoses during period of COVID-19. This study was conducted to estimate the change in the number of new stroke diagnoses and evaluate the approximate causes of such situations during the early period of the COVID-19 outbreak.Methods: In this retrospective observational descriptive study, the patients were divided into two groups as January-February 2020 (Pre-COVID−19) and March-April 2020 (COVID-19 Period), based on when the first COVID-19 case was reported in Turkey in March 2020. Patients who were admitted to the emergency department (ED) between 01 January 2019 and 30 April 2019 and diagnosed with ischemic cerebrovascular disease were included as the control group to estimate the number of cases predicted for 2020. The data of the groups were retrospectively analyzed in terms of the number of stroke admissions and demographic features.Results: Among the 274 patients diagnosed with acute ischemic stroke during the 4-month study period, 112 (40.9%) were detected during the COVID-19 period. Considering the linear relationship between the number of patients diagnosed with ischemic stroke in January-February 2019 and March-April 2019 in the control group of the study, this number was expected to be 163 in March-April 2020, since the number of patients with ischemic stroke diagnosed in January-February 2020 was 162. While it was determined that a 25.35% decrease had occurred in January-February 2020 compared to the January-February 2019, it was determined that a 48.9% decrease had occurred in March-April 2020 compared to the same period of the previous year.Conclusion: This study showed that the number of patients admitted to the hospital with a diagnosis of ischemic stroke in the March-April 2020 decreased statistically significantly compared to the pre-pandemic period of the same year.

Acute myocardial infarction (AMI) in very young adults (≤ 35 years) represents a distinct clinical entity with limited evidence. This study aimed to characterize metabolic risk factors differentiating young AMI patients from clinic-based controls. This single-center retrospective case–control study included 62 consecutive young adults (aged 18–35 years) with confirmed AMI and 60 clinic-based controls selected from cardiology outpatient clinics during the same study period. Controls were selected using age (± 2 years) and sex restrictions to ensure group-level comparability with the AMI cohort. Metabolic parameters, including body mass index (BMI), LDL cholesterol, and blood glucose, were compared between groups. Effect sizes (Cohen’s d) were calculated to assess clinical significance. Multivariable logistic regression was performed to identify independent predictors of AMI. Correlation analyses (Pearson or Spearman, as appropriate) were performed to examine relationships between metabolic markers. Young AMI patients demonstrated a significantly more unfavorable metabolic profile than controls: median BMI (26.5 vs. 23.9 kg/m², p < 0.001), LDL cholesterol (136.5 vs. 108.0 mg/dL, p = 0.002), and blood glucose (120.0 vs. 95.0 mg/dL, p < 0.001). All three metabolic parameters showed large effect sizes (d > 1.0), indicating clinically substantial differences. In multivariable analysis, BMI (adjusted OR 1.28 per kg/m², 95% CI 1.08–1.52), LDL cholesterol (adjusted OR 1.14 per 10 mg/dL, 95% CI 1.01–1.29), and blood glucose (adjusted OR 1.16 per 10 mg/dL, 95% CI 1.05–1.29) remained independently associated with AMI risk. LDL cholesterol showed a statistically significant, albeit weak, positive association with peak troponin levels (ρ = 0.296, p = 0.020). Among AMI cases, STEMI patients exhibited higher acute glucose levels than NSTEMI patients (p = 0.004). Very young adults (≤ 35 years) with AMI exhibit markedly elevated BMI, LDL cholesterol, and glucose levels compared to age- and sex-comparable controls with large effect sizes supporting clinical significance. Multivariable analysis confirmed independent associations for all three metabolic parameters. These traditional modifiable risk factors continue to be strongly associated with early myocardial infarction, emphasizing the importance of aggressive metabolic screening and early prevention strategies in very young populations. The online version contains supplementary material available at 10.1186/s12872-026-05662-7.