This study aimed to investigate the potential prognostic role of the platelet-to-lymphocyte (PLR) ratio in patients presenting with suspected acute coronary syndromes (ACS). A systematic search of PubMed Central, Scopus, EMBASE, and the Cochrane Library from conception through 20 August 2023 was conducted. We used odds ratios (OR) as the effect measure with 95% confidence intervals (CIs) for dichotomous data and mean differences (MD) with a 95% CI for continuous data. If I2 was less than 50% or the p value of the Q tests was less than 0.05, a random synthesis analysis was conducted. Otherwise, a fixed pooled meta-analysis was performed. Nineteen studies fulfilled the eligibility criteria and were included in the meta-analysis. PLR was higher in MACE-positive (164.0 ± 68.6) than MACE-negative patients (115.3 ± 36.9; MD = 40.14; 95% CI: 22.76 to 57.52; p < 0.001). Pooled analysis showed that PLR was higher in AMI patients who died (183.3 ± 30.3), compared to survivors (126.2 ± 16.8; MD = 39.07; 95% CI: 13.30 to 64.84; p = 0.003). It was also higher in the ACS vs. control group (168.2 ± 81.1 vs. 131.9 ± 37.7; MD = 39.01; 95% CI: 2.81 to 75.21; p = 0.03), STEMI vs. NSTEMI cohort (165.5 ± 92.7 vs. 159.5 ± 87.8; MD = 5.98; 95% CI: −15.09 to 27.04; p = 0.58), and MI vs. UAP populations (162.4 ± 90.0 vs. 128.2 ± 64.9; MD = 18.28; 95% CI: −8.16 to 44.71; p = 0.18). Overall, our findings confirmed the potential prognostic role of the plate-let-to-lymphocyte (PLR) ratio in patients presenting with suspected acute coronary syndromes (ACS). Its use as a risk stratification tool should be examined prospectively to define its capability for evaluation in cardiovascular patients.

Our hypothesis is that glucose-potassium (GLU/K) ratio can be used to predict morbidity and mortality in the evaluation of patients with blunt abdominal trauma in emergency departments. The aim of the study is to demonstrate the effect of changes in serum GLU/K ratio on morbidity and mortality and to ensure that patient management is performed more quickly and effectively. The hemogram and biochemical parameters of 99 patients with isolated blunt abdominal trauma, applied to our hospital between January 2016 and January 2020, have been retrospectively reviewed. Patients were divided into two groups as non-survivors and survivors. The GLU/K ratio was calculated, and their ability to predict mortality and morbidity was statistically evaluated between the groups. In the non-survivor (mortal) group; blood urea nitrogen, serum creatinine, serum GLU and GLU/K ratio were statistically higher than the living group (p<0.005). Moreover, the sensitivity and specificity of the serum GLU/K ratio were found 72.7% and 84.1% respectively. We think that serum GLU/K ratio can have an important role in the follow-up and management of patients using it as a simple, quickly accessible, and easy predictor in evaluating patients with blunt abdominal trauma.

Over the last decade, YouTube has become one of the largest online resources for medical information. However, uploaded videos are published without any peer review or quality control, so incorrect and incomplete information can be easily disseminated via the virtual platform and can be perceived as correct. The YouTube website was searched for videos in English uploaded between 15 October 2015 and 21 October 2016 using the following keywords: “CPR,” “cardiopulmonary resuscitation,” and “basic life support.” This study had a cross-sectional analytical design. In the first evaluation, the accuracy of the videos was checked according to the information contained in the basic cardiac life support algorithm. In the second evaluation, we assessed whether advanced-level, innovative medical information was included in these videos; when included, the accuracy of such information was checked. Of 774 videos evaluated, 92 videos were included in the study after application of the exclusion criteria. The videos were scored on a scale ranging from 0 to 20 points. The mean total score, based on all criteria, was 4.79 ± 2.88. The highest mean total score was achieved by videos uploaded by official medical organizations (6.43 ± 3.57), followed by those uploaded by health professionals and organizations (4.25 ± 2.49), and those uploaded by unidentified sources. YouTube videos are insufficient in providing information about the basic life support algorithm and advanced-level information according to the 2015 AHA resuscitation guidelines for health professionals. The educational material published by health institutions that are constantly working in the area is a more reliable source of information on subjects that directly affect human life, such as cardiopulmonary resuscitation.

Background: The role of Cystatin C (CysC) in the diagnosis and prognosis of cardiovascular disease, particularly acute coronary syndrome (ACS), is increasingly significant. The goal of this meta-analysis was to assess the diagnostic and prognostic value of CysC in patients with ACS, as well as its association with major adverse cardiovascular events (MACE), defined as mortality, myocardial infarction, heart failure, and stroke. Methods: The present study is a systematic review and meta-analysis. Using PubMed, Web of Science, Cochrane Library, and Embase, a literature review of cohort and case control studies reporting MACE and using the terms ACS and Cystatin C was conducted, excluding studies published after August 1, 2024. the meta-analysis using a random effects model. Results: CysC concentrations were significantly higher in patients with ACS compared to controls [mean difference (MD) = 0.36, p < 0.001], and in acute myocardial infarction (AMI) vs. unstable angina (MD = 0.18, p < 0.001). No significant differences were observed between ST elevation myocardial infarction (STEMI) and Non-ST elevation myocardial infarction (NSTEMI). Patients with MACE had higher CysC levels than those without (MD = 0.25, p < 0.001). Hospital survivors had lower CysC levels compared to those who died (MD = −0.25, p < 0.001). Higher CysC concentrations were associated with increased risks of MACE, cardiac death, overall mortality, myocardial reinfarction, and stroke, both during hospitalization and beyond. Conclusions: CysC is a promising biomarker for both diagnosis and prognosis in patients with ACS, especially in the context of predicting MACE, mortality and heart failure risk. The use of CysC may improve risk stratification and support therapeutic decision-making in clinical practice. Keywords: cystatin C biomarker prognosis diagnosis ACS acute coronary syndrome meta-analysis

Background and Aim. The purpose of the study was to evaluate the relationship between COPD severity and the diaphragmatic function measured by point-of-care US in patients with stable COPD. Method. A total of 61 patients with COPD and 40 healthy subjects who had been admitted to Ufuk University Hospital between December 2018 and May 2019 were enrolled. Point-of-care US was performed, and lung silhouette and anterior, right, and left hemidiaphragm method in M-mode were used to evaluate the diaphragm. Results. The point-of-care US measurements, lung silhouette method right (Lung Sil R), lung silhouette method left (Lung Sil L), right hemidiaphragm US method in B-mode (Ant B-Mode R), and right hemidiaphragm US method in M-mode (Ant M-Mode R), were significantly different among groups (P<0.001 for each). FEV1 was strongly correlated with Lung Sil R, Lung Sil L, Ant B-Mode R, and Ant M-Mode R (r = 0.963, P<0.001; r = 0.956, P<0.001; r = 0.953, P<0.001; and r = 0.917, and P<0.001, respectively). Negative correlations were detected between the number of exacerbations per year and Lung Sil R and the number of exacerbations per year and Ant M-Mode R (r = −0.599, P<0.001 and r = −0.587, and P<0.001, respectively). Conclusion. In this study, FEV1 and annual number of exacerbations turned out to be strongly correlated US findings. The use of US in COPD patients could help to support clinical decision, but further clinical studies are necessary to confirm those findings.

Introduction. Airway management is one of key elements of resuscitation. Endotracheal intubation is still considered the gold standard for airway management during resuscitation. Aim. The aim of the study was to compare success rates and intubation time of different endotracheal intubation methods during emergency intubation with difficult airways in the conditions of cardiopulmonary resuscitation in a standardized manikin model. Methods. The study was designed as a prospective, randomized, cross-over simulation study. It involved 46 paramedics with at least 5 years of experience in Emergency Medical Service. The participants performed endotracheal intubation under difficult airway conditions during continuous chest compression, implemented with the LUCAS3 chest compression system. Three methods of tracheal intubation were applied: (1) standard Macintosh laryngoscope without a bougie stylet; (2) standard laryngoscope and a standard bougie stylet; (3) standard laryngoscope and a new bougie stylet. Results. The overall intubation success rate was 100% in the standard bougie and new bougie groups and lower (86.9%) when no bougie stylet was used (P=0.028). The intubation success rate with the 1st attempt equalled 91.3% for the new bougie group, 73.9% for standard bougie, and only 23.9% in the no-bougie group. The median intubation time was shortest in the new bougie group, where it amounted to 29 s (interquartile range [IQR]: 25–38); the time equalled 38s (IQR:31–44.5) in the standard bougie group and 47.5s (IQR:36–58) in the no-bougie group. The ease of use was lowest in the no-bougie group (85, IQR:63–88), average in the standard bougie group (44, IQR:30–51), and highest in the new bougie stylet group (32, IQR:19–41). Conclusion. In this manikin-based study, paramedics were able to perform endotracheal intubation with higher efficacy and in a shorter time using the new bougie stylet as compared with the standard bougie stylet.