Objectives: Stroke is a condition with high morbidity and mortality. This study aims to investigate whether the effectiveness of Computed Tomography (CT) and diffusion-weighted Magnetic Resonance Imaging (MRI), the techniques that have a significant place in the diagnosis of ischemic stroke, the most common form of stroke, are affected by the physiological changes of advanced age. Methods: A total of 436 patients were included in the study. The study population was divided into two groups depending on age: those above 65 and those under 65. Medical files, both the emergency department and clinical ward files, of the patients who were admitted to the emergency department in nine months and admitted to the neurology clinic with the diagnosis of ischemic stroke were retrospectively analyzed. The time from admission to imaging was determined depending on patient files and the Hospital Management Information System (HBYS). The CT and MRI reports interpreted by radiologists were also reviewed. While recording the data, the presence of a lesion, its direction, and localization were also noted. Results: CT positivity was 21.3%, and the positivity of diffusion-weighted imaging was 82.1% in the study population. The time was shorter in the group of patients with positive CT results than in the group with negative CT results. In subjects under 65, the time between onset and imaging was shorter in the group with positive CT results than in the group with negative CT results. In subjects over 65, the time with positive CT results was not different from the group with negative CT results. It was determined that the mean time was shorter in the group with positive MRI results than in the group with negative results. In both the groups under the age of 65 and over the age of 65, the time interval was shorter in the patients with positive MRI results compared to those with negative MRI results. Conclusions: Regardless of the positivity or negativity of CT and MRI results, the mean time from symptom onset to imaging was shorter in the group under 65 years of age compared to the group over 65 years. Aging prolongs the time to admission and the neuroradiological response of geriatric patients.

Objectives: One of the most common reasons for admission to the emergency department is chest pain. The clinical presentation of chest pain is quite wide. The study aimed to compare the diagnoses of patients under and/or over the age of 65 admitted to the emergency department with non-traumatic chest pain.Methods: A thousand patients admitted to the emergency department with non-traumatic chest pain between 15.10.2014 and 15.07. 2015 were included in the study. Patients were divided into two groups according to age group as < 65 years old and ≥ 65 years old. Age, gender, the type of admission, comorbidities, accompanying symptoms, diagnosis, outcome and hospitalization were recorded.Results: Five hundred eighteen males and 482 females were included in the study. Eight hundred nineteen patients were between the ages of 18 to 64. The most common accompanying symptom was dyspnea in both age groups. Hypertension was the most common concomitant disease in the 18-64 year age group while coronary artery disease was the most common diseasein the 65 and over age group.Conclusions: Non-cardiac chest pain is more common in the young population admitted to the emergency department while life-threatening chest pain is more common in the population over the age of 65.

Objective: This study aims to assess the procedural aspects and content quality of forensic reports prepared for cases deemed judicial in the emergency department of Bursa Yüksek İhtisas Education and Research Hospital. Material and Methods: The study reviewed a total of 3,211 patients who presented to the emergency department between December 1, 2014, and February 28, 2015, and were classified as forensic cases. Of these, 2,029 patients were included in the analysis, while 1,182 were excluded. Data collection was followed by statistical analysis performed using SPSS version 22.0. Descriptive statistics were expressed as frequencies and percentages, and variance distribution was assessed with the Kolmogorov-Smirnov test. Concordance analysis was conducted using the Kappa test. Results: Of the 3,211 cases reviewed, 1,182 were excluded for the following reasons: 138 cases (11.67%) involved forensic chases, 827 cases (69.96%) were related to blow-coercion examinations, 30 cases (2.53%) were alcohol examinations, 46 cases (3.89%) had unreadable reports, 88 cases (7.44%) were improperly documented, and 52 cases (4.48%) were missing from the forensic case archive. Among the 2,029 cases included in the analysis, 113 cases involved life-threatening conditions. However, in 13 of these cases (0.6%), errors were identified in recognizing life-threatening conditions as defined by the Yeni Türk Ceza Kanunu Çerçevesinde Düzenlenecek Adli Raporlar İçin Kılavuz (Guide for Forensic Reports to Be Prepared Within the Framework of the New Turkish Penal Code). Among the 1,916 cases (94.4%) without life-threatening conditions, 82 cases (4.0%) demonstrated inconsistencies according to the same guideline. Conclusion: This study underscores significant errors in the identification and documentation of life-threatening conditions in forensic reports, with a notable 0.6% error rate among such cases and 4.0% inconsistencies in non-life-threatening cases. These findings reveal gaps in compliance with the Yeni Türk Ceza Kanunu Çerçevesinde Düzenlenecek Adli Raporlar İçin Kılavuz, highlighting the need for stricter adherence to established guidelines. To enhance the accuracy and reliability of forensic reports, targeted training programs, regular audits, and the implementation of standardized reporting procedures are recommended. Addressing these issues is crucial to improving the quality of forensic evaluations and fostering trust in judicial processes.

Objective: Pregnancy involves profound physiological adaptations, including significant hemodynamic changes. This study aimed to evaluate alterations in hepatic and portal vein flow patterns throughout gestation using Doppler ultrasonography and to define reference values that may help avoid misinterpretation and unnecessary interventions. Method: A total of 215 healthy pregnant women between 10 and 40 weeks of gestation, all with singleton pregnancies and no underlying conditions, were included. A control group of 22 healthy, non-pregnant women of reproductive age was also assessed. Doppler measurements were obtained from the middle hepatic vein and central portal vein using subcostal or intercostal approaches. Parameters recorded included hepatic vein waveform morphology, portal vein diameter, velocity, and calculated flow rate. Results: All control subjects exhibited triphasic hepatic vein flow. As gestation progressed, hepatic vein flow patterns in pregnant women shifted significantly from triphasic to biphasic and monophasic waveforms (p < 0.001). In late pregnancy, monophasic flow was observed in 72.6% of subjects, compared to 5.6% in early pregnancy. Portal vein flow velocity was significantly higher in all trimesters compared to the control group (p < 0.001), peaking between 15 and 25 weeks, then declining. Portal vein diameter increased steadily across gestation, showing a strong positive correlation with gestational age (R² = 0.346, p < 0.001). A statistically significant negative correlation was observed between portal vein velocity and gestational week (R² = 0.416, p < 0.001). Portal vein flow rate also rose throughout pregnancy but did not differ significantly between trimesters (p > 0.05). Conclusion: Hepatic and portal vein Doppler flow patterns undergo significant, progressive alterations during pregnancy. Recognizing these physiological changes—and referencing established normal values—is essential to avoid misdiagnosis of pathological conditions and to guide accurate clinical assessment.

Objective: Stroke remains a major cause of morbidity and mortality worldwide, with ischemic strokes accounting for approximately 80% of all cases. This study aimed to investigate the association between electrocardiographic (ECG) changes and elevated troponin levels with the anatomical localization of vascular occlusion causing cerebral ischemia. Materials and Methods: This retrospective study included 155 female and 145 male patients. Demographic data (age and sex), ECG findings assessed by emergency medicine specialists and residents, laboratory parameters, MRI lesion findings evaluated by radiologists, comorbidities, and clinical symptoms were recorded. Results: The mean patient age was 70 years. The most frequent presenting symptoms in the emergency department were motor-sensory deficits and aphasia or dysarthria. No significant relationship was found between lesion localization and serum levels of BUN, creatinine, sodium, potassium, calcium, or troponin. Similarly, no significant association was observed between comorbidities or ECG findings and the localization of ischemic lesions. Conclusion: Despite efforts to identify scoring systems and clinical correlations to expedite the diagnosis of ischemic stroke, neuroimaging remains the gold standard for diagnosis and treatment planning. Imaging plays a crucial role not only in diagnosis but also in excluding secondary causes and guiding clinical follow-up. In adult patients, the cranium functions as a closed compartment, and currently, the most effective tools for visualizing intracranial pathology are computed tomography (CT) and magnetic resonance imaging (MRI). These imaging modalities continue to be central to the rapid evaluation and management of stroke.