Background: Traumatic brain injury (TBI) in children, including concussion, is one of the major causes of emergency department (ED) registration and a significant burden on the health system. Objectives: The primary goal of this study was to evaluate the outcomes of a telemedicine strategy for remotely monitoring the children with traumatic brain concussions, focusing on their neurological symptoms and signs. The secondary goal was to explore socioeconomic and educational differences among the participating families. Methods: This study was conducted in a prospective and observational fashion. It included children aged between 6 and 18 years who presented in the ED with head trauma and were subsequently diagnosed with a brain concussion. Enrolled patients split into telemedicine-only and telemedicine + readmission groups according to their concussion symptoms during video-call visits. Results: We recruited 29 children and performed 75 telehealth visits. Four children were called for readmission, and they comprised the telemedicine + readmission group. The telemedicine-only group included 25 children whose follow-ups were completed remotely. The median PECARN score was 1 (IQR = 0.75), and the most common reason for head trauma was simple falls from the same level (n = 18, 62%); 22 (76%) children were suffering from headaches; 55% of the families were in very low-income status. During the video-call visit sessions, three children stated worse headaches, and one child’s parents reported consistent sleepiness. Conclusion: This study demonstrates the potential effectiveness of telemedicine in monitoring children with concussions, especially in regions with diverse socioeconomic backgrounds and overcrowded metropolitan hospitals.

Amaç: Acil serviste hastalara uygulanan idrar sondası işleminin nedenleri analiz edildi. Bu şekilde uygunsuz endikasyonla takılan idrar sondalarının ve sondaya bağlı komplikasyonların oranlarını göstererek bu tıbbi uygulamanın gözden geçirilmesi hedeflendi. Gereç ve Yöntem: Bu çalışma 01/05/2022-01/11/2022 tarihleri arasında yetişkin acil serviste idrar sondası takılan hastaların dosyaları ve hastane sistemindeki bilgileri incelenerek retrospektif olarak gerçekleştrildi. Hastaların yaşı, cinsiyeti, kullandığı ilaçlar, bilinen hastalıklar, geçirilmiş operasyon öyküsü, idrar sondası takılma nedenleri, komplikasyonlar ile ilişkili olabilecek laboratuvar verileri, gelişen komplikasyonlar, acil servisten çıkış durumları kayıt edilerek analiz edildi. Bulgular: Olguların yaş ortalaması 65,04±19,85 yıl, ortanca yaş 68 olarak tespit edildi. Hipertansiyon %,50,3 (n=264) ile en sık görülen ek hastalıktı. Günlük aldığı çıkardığı takibi ile tanı ve tedavi amaçlı günlük diürez ölçümü %38,3 (n=201) ile en sık sonda takılma nedeni idi. Uygunsuz endikasyonla takılan sonda oranı %14,7 olarak bulundu. Olgular incelendiğinde tespit edilen komplikasyon gelişimi %8,6 olarak tespit edilmiştir. %5,3’ünde bakteriüri geliştiği görülmüştür. Hematürinin %2,7 ve üretral yaralanmanın %0,6 olguda yaşandığı izlendi Sonuç: Bu veriler sonda takma nedenlerini acil servise yönelik özelleşmesine ve analizine yardımcı olmuştur. Acil servis için daha gerçekçi bir veri oluşturmuş, acilde uygunsuz endikasyonla sonda takılmasının ve komplikasyonlarının belirlenmesini sağlamıştır. Bu istenmeyen durumlara karşı azaltıcı yönde acil hekimlerine ve sağlık personeline katkı sağlayacaktır.

Objectives: Thiol-disulfide measurements will assess obesity-related oxidative stress. Methods: A prospective observational study was done at two tertiary care centers. The participants were divided into three distinct categories based on their body mass index (BMI): The control group (Group 1) consisted of 116 individuals with a BMI ranging from 18 to 25 kg/m², while the overweight group (Group 2, n = 89) included those with a BMI between 25 and 30 kg/m². The obese group (Group 3, n = 39) comprised individuals with a BMI of 30 kg/m² or greater. This approach primarily utilizes the disulfide/native thiol ratio, disulfide/total thiol ratio, and native thiol/total thiol ratio as key metrics. All patients' demographics, waist circumference, hip circumference, height, weight, hemoglobin, hematocrit, white blood cell count, glucose, C-reactive protein, disulfide, native-thiol (NT), total-thiol (TT), lipid hydroperoxide radical (LOOH), and absolute ischemia-modified-albumin (ABSO) levels were recorded on calculations and records were made for disulfide to native and total thiol ratios. Results: Thiol-disulfide equilibrium differed between the three groups. NT concentrations averaged 368.87 mmol/L across all individuals and were significantly higher in the normal-weight cohort (BMI 18-25 kg/m2) at 380.60 mmol/L, compared to overweight and obese populations (p<0.001). TT concentrations were higher in normal-weight individuals, with an average of 426.36±54.48 mmol/L, compared to 405.41±52.14 and 391.07±46.45 in overweight and obese individuals, respectively (p<0.001). Conclusions: Reduced native and total thiol levels, along with altered disulfide concentrations in obese individuals, serve as indicators of oxidative stress.

Background/Objectives: Simple admission laboratory indices have been proposed for early risk stratification in acute pancreatitis (AP), but their relative performance and their value beyond established severity assessment are rarely examined directly. We performed an exploratory head-to-head comparison of eight admission inflammatory and immunonutritional indices, including the Global Immune-Nutrition-Inflammation Index (GINI), for a composite adverse in-hospital outcome. Methods: This single-center retrospective study (2020 to 2026) analyzed the index admission of each adult hospitalized with AP (one observation per patient). Eight indices were evaluated (NLR, CAR, PIV, PNI, HALP, CALLY, CCR, GINI). The primary endpoint was a composite of in-hospital death, intensive care unit (ICU) admission, or prolonged hospitalization (a length of stay of at least 7 days). We assessed discrimination (area under the curve, AUC, with DeLong intervals and Holm-corrected comparison), age-adjusted logistic regression, calibration, bootstrap validation, and incremental value over the Bedside Index for Severity in Acute Pancreatitis (BISAP), with a patient-clustered robustness analysis. Results: Of 238 patients, 73 (30.7%) met the composite outcome (prolonged stay 63, ICU 15, death 2). After age adjustment, all eight indices were associated with the outcome (all p < 0.001). The three numerically highest were NLR (age-adjusted AUC 0.737, 95% CI 0.667 to 0.808), CALLY (0.735), and GINI (0.734), with no significant pairwise difference after correction. Each added discrimination beyond BISAP (BISAP alone AUC 0.631 vs. BISAP plus CALLY 0.752; likelihood ratio p < 0.001). GINI was numerically higher but not significantly better than its components (CAR 0.710, PIV 0.708). Models were well calibrated (calibration slope 0.97 to 1.00). Conclusions: In AP, several admission indices, led by NLR, CALLY, and GINI, gave modest, broadly comparable discrimination for a composite adverse in-hospital outcome and added information beyond BISAP. No index was superior, and the composite was driven largely by prolonged hospitalization. These exploratory findings require prospective external validation before any clinical use.