Objectives: Febrile neutropenia is a common oncologic emergency with significant morbidity and mortality. Although the MASCC (Multinational Association for Supportive Care in Cancer) score is widely used for risk stratification, its limited sensitivity and lack of laboratory parameters reduce its prognostic utility. This study aimed to evaluate whether incorporating serum lactate and CRP measurements into the MASCC score enhances its predictive performance for hospital admission and the 30-day mortality. Methods: This retrospective diagnostic accuracy study included adult patients diagnosed with febrile neutropenia in the emergency department of a tertiary care hospital between January 2021 and December 2024. The original MASCC score was calculated, and three modified models were derived: the MASCC-L (lactate/MASCC), MASCC-C (CRP/MASCC) and MASCC-LC models (CRP × lactate/MASCC). The predictive accuracy for hospital admission and the 30-day all-cause mortality was assessed using ROC analysis. Results: A total of 269 patients (mean age: 67.6 ± 12.4 years) were included; the 30-day mortality was 3.0%. The MASCC-LC model demonstrated the highest discriminative ability for mortality prediction (area under the curve (AUC): 0.995; sensitivity: 100%; specificity: 98%). For hospital admission prediction, the MASCC-C model had the highest specificity (81%), while the MASCC-LC model showed the best balance of sensitivity and specificity (both 73%). All the modified models outperformed the original MASCC score regarding both endpoints. Conclusions: Integrating lactate and CRP measurements into the MASCC score significantly improves its prognostic accuracy for both mortality and hospital admission in febrile neutropenic patients. The MASCC-LC model, relying on only three objective parameters, may serve as a practical and efficient tool for early risk stratification in emergency settings.

There is no consensus on whether cardiac troponins with high reliability values should be different diagnostic criteria for acute myocardial infarction in patients with and without renal dysfunction. Although it is often emphasized that the etiology of elevated troponin levels in chronic kidney disease (CKD) remains unclear, elevated cardiac troponin (cTnT) levels have been associated with increased subclinical cardiac damage in these patient groups. In this study, we investigated the value of cTnT value in diagnosing acute coronary syndrome in CKD patients with high clinical suspicion of acute coronary syndrome and without acute ST segment elevation on electrocardiogram. The aim was to prevent cardiac ischemia from being overlooked in CKD patients. Coronary angiography revealed vessel occlusion in 192 patients, and the mortality rate after treatment decisions was 6.7%. The first measured troponin results showed a significant difference in patients who did not survive, indicating the prognostic value of troponin levels. Troponin values were compared with cardiovascular pathologies obtained by angiography, and elevated troponin levels strongly correlated with pathologic angiography results. The conclusion highlighted that despite prognostic uncertainties, biomarkers used for acute myocardial infarction diagnosis in patients with renal insufficiency are reliable in those with renal dysfunction. Elevated cTnT levels in CKD patients are considered a clear marker of cardiac ischemia, emphasizing the need for careful consideration of troponin values in this population.

Purpose: This study evaluated patients diagnosed with acute pancreatitis in the emergency department by comparing the BUN/Albumin Ratio (BAR) and BISAP scores to indicate disease severity and prognosis. Materials and Methods: 457 patients diagnosed with acute pancreatitis between 2016 and 2021 were included in this observational study, which was planned retrospectively. The laboratory data of the patients and the calculated BISAP scores were recorded. Results: Patients were categorized according to the BISAP score; 385 (84.2%) patients were at low risk for acute pancreatitis, while 72 (15.8%) were at high risk. The AUC for BAR values was 0.757 (75.7%), and this was statistically significant for determining cutoff values, with a cutoff value of >4.60 (p<0.001). Regression analysis of the BAR value was performed for the BISAP categories. As the BAR value increased, the BISAP high-risk value increased 38,339 times. The sensitivity ratio between BAR and BISAP evaluation criteria was found to be 68.67% (0.60-0.75), and it was determined that the BAR value was as strongly correlated with the severity of the disease as the BISAP score. Conclusion: This study shows that BAR is as effective as BISAP scores in determining high-risk acute pancreatitis.

Background and Objectives: This study aimed to evaluate the pre- and post-treatment changes in ICEB and ICEBc score markers of cardiac electrical balance in patients presenting to the emergency department with hypertensive urgency and to investigate their relationship with short-term clinical outcomes. Materials and Methods: In this retrospective study, 50 patients who presented to a tertiary university hospital emergency department between 1 January 2021 and 31 December 2024 with a diagnosis of hypertensive urgency and had pre- and post-treatment 12-lead ECGs were analysed. ICEB (QT/QRS) and ICEBc (QTc/QRS) scores were calculated manually. Patients were categorized as discharged or hospitalized. Within-group and between-group comparisons of the scores were performed. Results: Of the patients, 66% were female, and the mean age was 60.4 ± 14.5 years. A statistically significant increase in ICEB scores was observed after treatment in discharged patients (p = 0.006), whereas ICEBc scores showed no significant change. In the hospitalized group, no significant difference was found in either ICEB or ICEBc scores. Additionally, between-group comparisons revealed no significant differences in ICEBc values. Conclusions: The ICEB score may serve as a dynamic marker reflecting the electrophysiological response to antihypertensive treatment. The observed increase in ICEB after treatment may indicate the restoration of electrical stability. In contrast, ICEBc appeared to have limited predictive value in this clinical context. Further prospective studies with larger populations are needed to determine the clinical utility of ICEB in the management of hypertensive crises.

Objective: Our study aimed to test whether a one-hour short training model for Focused Assessment with Sonography in Trauma (FAST) training would increase the visual skills of paramedics who had no previous training in this field. Material and Method: Our study was planned as a prospective, uncontrolled experimental study. A short training module was applied to 27 paramedics who were inexperienced in E-FAST Ultrasonography (USG). The first test was applied and the final test was applied after the training and their success in distinguishing normal and pathological case images was evaluated. Results: 55.6% of the participants were women, 74.1% were new graduates, and their average age was 21.58 ± 9.60 years. When the answers given by the participants to the first test and the last test were evaluated; While 31.9% of the participants answered "I did not understand" to many questions in the first test, after the training, it was seen that 82.9% could form ideas for all tests. When the correct response rates of the participants to the first test and the last test were examined, a statistically significant increase was observed (p