Objective: To evaluate the diagnostic value of ultrasonography (US) and shear wave elastography (SWE) in detecting early renal parenchymal changes in patients with congestive heart failure (CHF) with preserved or mildly impaired renal function. Methods: This prospective study included 53 patients with CHF patients and 40 age- and demographic-matched healthy controls. Kidney length and cortical thickness were evaluated by US, and parenchymal stiffness was measured using SWE. Subgroup analyses were conducted based on ejection fraction (EF). Correlation and regression analyses assessed associations between imaging findings and laboratory parameters. Results: Kidney length and cortical thickness were significantly lower in CHF patients than controls (P < .05) but remained within normal limits. No significant differences were observed between patient subgroups (P > .05). Parenchymal stiffness was significantly higher in CHF patients (right: 6.5 ± 1.6 kPa; left: 6.4 ± 2.0 kPa) compared to controls (right: 4.8 ± 0.4 kPa; left: 4.9 ± 0.5 kPa; P < .001), with subgroup differences by EF (P < .01). ROC analysis identified optimal SWE thresholds of 5.05 kPa (right) and 5.03 kPa (left), with sensitivities of 78% and 80% and specificities of 69% and 70%. Regression analysis showed GFR (β = −.48, P < .001) and comorbidities (β = .397, P = .010) independently predicted stiffness, whereas EF, pro-BNP, and creatinine did not. Conclusions: SWE can detect subclinical renal changes in CHF before functional deterioration, offering a non-invasive biomarker for early diagnosis and personalized treatment strategies. Advances in knowledge: SWE may provide earlier detection of parenchymal alterations than conventional US.

En tr EVALUATION RESULTS OF THE CASES APPLIED TO THE EMERGENCY UNIT WITH CAUSE OF HEAD TRAUMA SUMMARY: Objective: Brain and spinal cord injuries causing permanent damage and death continue to present a significant health problem in developed societies. Accidents are the most important cause of injuries. Our aim in our work is to examine the frequency, causes and consequences of head trauma and to emphasize the importance of pathological findings. Materials and methods: Descriptive analyzes of 100 consecutive patients evaluated by the neurosurgery who applied for the cause of head trauma between the dates of 2015 and 2016 in the emergency department of Kırıkkale University Faculty of Medicine were performed. Of these patients, 69 were males and 31 were females. Patients' cranial CTs were analyzed with the Marshall score. Patients' age, sex, causes of head trauma, GCS and GOS were noted. Findings: The Marshall score of the patients was 94% 1, 4% 2, 1% 3, 2% 4. GCS at arrival was 92%, 15%, 6% 14, 2% 3. GOS 96% 5, 1% 3, 3% 1. The mean age of the cases was 34.2 + 22.2. (1-83 years) According to the gender group, the incidence of car accidents (6.5% vs. 13%) and fights (3.2% vs 11.6%) were more frequent in males than females. In contrast, female traffic accidents (45.2% vs. 23.2%) were observed more frequently in males than females. As a result of falling in females, the injury was slightly higher than males. The results show that the greatest cause of head trauma in all groups outside the age range of 16-30 years is falling. In the 16-30 age group, the traffic accidents was responsible. Conclusion: It is thought that the reason for the drop in each age group is the most frequent reason for being a region where the rural characteristics of the region and the agricultural economy are protected. Ergonomic working and living conditions will increase the economic level, which will contribute to the solution of this result. KEY WORDS: traffic accidents, emergency unıt, head trauma ACİL ÜNİTESİNE KAFA TRAVMASI NEDENİ İLE BAŞVURAN OLGULARIN DEĞERLENDİRME SONUÇLARI: ÖZET: Amaç: Kalıcı hasara ve ölüme neden olan beyin ve omurilik yaralanmaları gelişmiş toplumlarda önemli bir sağlık sorunu oluşturmaya devam etmektedir (1). Kazalar yaralanmaların en önemli nedenini oluşturmaktadır. Çalışmamızda amacımız kafa travmalarının sıklığını, nedenlerini ve sonuçlarını incelemek, oluşan patolojik bulguların önemini vurgulamaktır. Gereç ve yöntem: Kırıkkale Üniversitesi Tıp Fakültesi acil bölümüne 2015- 2016 tarihleri arasında kafa travması nedeni ile Beyin cerrahisi bölümünce değerlendirilen ardışık 100 olgunun tanımlayıcı analizleri gerçekleştirildi. Bu hastaların 69’u erkek, 31’i bayandı. Hastaların çekilen Kranial BT’leri Marshall skoru ile analiz edildi. Hastaların yaş, cins, kafa travma nedenleri, geliş GKS ve çıkış GOS’ları not edildi. Bulgular: Hastaların Marshall skoru %94 ünde 1 di. 4 olguda 2, 1 olguda 3, 2 olguda 4 idi. Geliş GKS %92 sinde 15, 6 olguda 14, 2 olguda 3 idi. GOS ise 96 olguda 5, 1 olguda 3, 3 olguda 1 idi. Olguların yaş ortalaması 34.2+22.2 idi. (1-83 yaş) Olguların cinsiyet grubuna göre kaza nedenlerine bakıldığında erkeklerde araç dışı trafik kazası (ADTK), (%13 ‘e karşılık % 6.5), darp (%11.6 ‘ya karşılık %3.2) bayanlara göre daha fazla gözlenmekteydi. Buna karşılık kadınlarda ise araç içi trafik kazası (AİTK) (%45.2 ‘ye karşılık %23.2 ) erkeklerden daha fazla gözlemlenmiştir. Kadınlarda düşme sonucunda yaralanma erkeklerden biraz daha yüksekti. Sonuçlara bakıldığında 16-30 yaş dışındaki tüm grublarda kafa travmasının en büyük nedeni düşme olarak saptandı. 16-30 yaş grubunda ise AİTK sorumluydu. Sonuç: Bölgenin kırsal özellikleri ve tarım ekonomisinin korunduğu bir bölge olması, her yaş grubunda düşmenin nedenle en sık neden olarak gözlendiği düşünülmüştür. Ergonomik çalışma ve yaşam koşullarının sağlanması ekonomik düzeyin yükseltilmesi bu sonucun çözümüne katkıda bulunacaktır. Anahtar kelime: acil ünitesi, kafa travması