Objective: To evaluate left and right ventricular functions using tissue Doppler echocardiography (TDE) and myocardial performance index (MPI) methods in patients with slow coronary flow (SCF) and to determine the relationship between these parameters and thrombolysis in myocardial infarction frame count in SCF patients. Subjects and Methods: Thirty-five patients (20 males and 15 females) with SCF who underwent coronary angiography and 35 age- and sex-matched controls (14 males and 21 females) without SCF who underwent elective coronary angiography were enrolled in the study. Left ventricular (LV) and right ventricular (RV) functions were examined using conventional echocardiography and TDE. Results: LV systolic myocardial velocity (Sm), early myocardial velocity (Em), late myocardial velocity (Am), and Em/Am ratio were similar in both the SCF and control groups; however, isovolumetric relaxation time (IRT) was higher in the SCF group compared to the control group (IRT: 99 ± 17 vs. 88 ± 20; p = 0.01). In patients with SCF, LV MPI was higher than in the control group, but this was not statistically significant (0.61 ± 0.11 vs. 0.56 ± 0.12; p = 0.07). The RV tricuspid annular velocities and MPI were similar in the SCF and control groups. Conclusion: This study showed that SCF affected LV functions echocardiographically and could cause partially reduced LV performance. In addition, SCF did not affect RV functions echocardiographically.

DeepSeek is a recently launched large language model (LLM), whereas GPT-4o is an advanced ChatGPT version whose electrocardiography (ECG) interpretation capabilities have been previously studied. However, DeepSeek's performance in this domain remains unexplored. This study aims to evaluate DeepSeek's accuracy in ECG interpretation and compare it with GPT-4o, emergency medicine specialists, and cardiologists. A secondary aim is to assess any performance changes in GPT-4o over one year. Between February 9 and March 1, 2025, 40 ECG images (20 daily routine, 20 more challenging) from the book 150 ECG Cases were evaluated by both GPT-4o and DeepSeek, each model tested 13 times. The accuracy of their responses was compared with previously collected answers from 12 cardiologists and 12 emergency medicine specialists. GPT-4o's 2025 performance was compared to its 2024 results on identical ECGs. GPT-4o outperformed DeepSeek with higher median correct answers on daily routine (14 vs. 12), more challenging (13 vs. 10), and total ECGs (27 vs. 22) with statistically significant differences (p=0.048, p<0.001, p<0.001). A moderate agreement was observed between the responses provided by GPT-4o (p<0.001, Fleiss Kappa=0.473), while a substantial agreement was observed in the responses provided by DeepSeek (p<0.001, Fleiss Kappa=0.712). No significant year-over-year improvement was observed in GPT-4o's performance. This first evaluation of DeepSeek in ECG interpretation reveals its performance is lower than that of GPT-4o and human experts. While GPT-4o demonstrates greater accuracy, both models fall short of expert-level performance, underscoring the need for caution and further validation before clinical integration.

Kounis syndrome is defined as a coronary artery distortion due to hypersensitivity to various reasons such as drugs, environmental exposure, nutrients, coronary stents, etc. Diffuse alveolar hemorrhage is a life-threatening condition that clinically presents with hypoxemic respiratory distress, low hematocrit level, hemoptysis, and extensive pulmonary infiltration. Drugs involving pinaverium bromide as an active ingredient is frequently used for relieving gastrointestinal complaints. In this report, we present a case of a young female patient with Kounis syndrome accompanying diffuse alveolar hemorrhage admitted to our emergency department due to allergic reaction following Pinaverium Bromide intake.

Blood gas analyzers (BGAs) offer rapid results and operational convenience in emergency settings, whereas laboratory auto analyzers (LAAs) remain the reference standard despite slower processing. This study compared BGA and LAA measurements of sodium (Na), potassium (K), hemoglobin (Hb), and hematocrit (Hct). A secondary aim was to evaluate their agreement across acid-base subgroups and in cases of severe acidosis. This study included ≥18 years patients from January 1 to June 30, 2024. BGA and LAA results were compared overall and across acid-base subgroups. Patients with pH <7.20 were analyzed separately as the severe acidosis group. Bland-Altman analysis showed the following mean differences and 95% limits of agreement: Na, 1.36 ± 2.33 mmol/L (-3.21 to 5.92); K, 0.221 ± 0.197 mmol/L (-0.166 to 0.607); Hb, 0.531 ± 0.649 g/dL (-0.742 to 1.804); and Hct, 1.68% ± 2.60 (-3.42 to 6.78). At clinical decision thresholds, BGA demonstrated varying diagnostic performance with sensitivities and specificities of 56.9% and 95.8% for hyponatremia, 67.5% and 98.7% for hypernatremia, 95.4% and 95.6% for hypokalemia, 48.7% and 99.8% for hyperkalemia, and 73.4% and 99.9% for transfusion decisions, respectively. In patients with severe acidosis, correlations remained strong, though agreement limits were notably wider. BGA-derived K values showed acceptable agreement with LAA and may be used interchangeably. Hb and Hct did not meet agreement criteria, while Na may be acceptable with clinical correlation. In severe acidosis, none of the parameters achieved acceptable agreement, indicating that BGA results should be interpreted with caution in this subgroup.

Aims: To our knowledge, the performances of Emergency Medicine (EM) journals have not been investigated in terms of contribution to scientific literature. This study, Aimed to reveal the characteristics of EM journals and compare them in terms of their qualitative and quantitative features. Material and Methods: Conducteda hand-searching on the websites of 8 EM journals. Also categorized the articles published in these journals into subgroups in terms of relevance to trauma and disaster medicine, cardiovascular and cardiology emergencies, pulmonary emergencies, toxicology, COVID-19, surgical emergencies, internal medicine/gastroenterological emergencies, medical treatment and marker studies, resuscitation and airway management, infectious diseases, sedation and analgesia, imaging, neurological emergencies, forensic medicine, epidemiological and statistical studies, hospital and emergency department management, intensive care and mechanical ventilation, prehospital care, experimental studies, elective surgery and surgical complications. The journals were also compared according to their contribution to COVID-19 literature. Results: Among 8 journals, only Ulus Travma Acil Cerrahi Derg is indexed in SCI-E. The top 3 journals according to the number of published articles and citations were as follows: Ulus Travma (1792 articles, 7834 citations), EAJEM (784 articles, 822 citations) and TJEM (646 articles, 3146 citations). Mean citation per article was the highest in TJEM (n=4.87) followed by Ulus Travma Acil Cerrahi Derg (n=4.37) and EAJEM (n=1,05). Ulus Travma Acil Cerrahi Derg has the highest H index (n=25). Conclusion: Academic development of EM is strongly linked to the performance of EM journals. The quality, amount and number of grant-supported research should increase in EM.