Background/Objectives: Atrial fibrillation (AF) is a prevalent cardiac arrhythmia associated with significant morbidity, including stroke, heart failure, and increased mortality, necessitating oral anticoagulant (OAC) therapy to reduce thromboembolic risk. However, OACs, including warfarin and non-vitamin K antagonist oral anticoagulants (NOACs), increase the risk of gastrointestinal (GI) bleeding, a serious complication requiring precise risk stratification in the emergency department (ED). Methods: This retrospective cohort study was conducted in the Emergency Department of Balikesir University Hospital in Turkey between 2019 and 2023 and evaluates systemic inflammatory markers as predictors of GI bleeding in AF patients receiving OACs. A total of 155 patients were divided into case (GI bleeding) and control (no GI bleeding) groups, comparing demographics, comorbidities, CHA₂DS₂-VASc and HAS-BLED scores, and inflammatory indices (uric acid/albumin ratio, neutrophil-to-lymphocyte ratio [NLR], platelet-to-lymphocyte ratio [PLR], systemic immune inflammation index [SII]). Results: For patients receiving NOACs, the case group exhibited significantly higher uric acid/albumin ratio, NLR, PLR, and SII (p < 0.05). For patients receiving warfarin, only the uric acid/albumin ratio was significantly elevated (p < 0.001). Hypolipidemia and elevated uric acid were associated with bleeding risk in patients receiving NOACs, while hypoalbuminemia and elevated urea predicted bleeding in patients receiving warfarin. HAS-BLED scores were significantly higher in bleeding groups, unlike CHA₂DS₂-VASc scores. Conclusions: These findings suggest that inflammatory indices, particularly in patients taking NOACs, are associated with GI bleeding risk stratification. Integrating these biomarkers into clinical practice could optimize personalized anticoagulation strategies, reducing morbidity and mortality in AF patients.

Background: Contrast-associated acute kidney injury (CA-AKI) is a clinically important complication following contrast-enhanced computed tomography (CT), particularly in emergency department (ED) populations. While several risk scores have been proposed, their comparative performance in ED-based imaging remains uncertain. Methods: This retrospective single-center study included 472 adult patients who underwent contrast-enhanced CT between November 2023 and November 2024. Patients with end-stage kidney disease, renal transplantation, baseline eGFR < 30 mL/min/1.73 m², or incomplete laboratory data were excluded. CA-AKI was defined as an increase in serum creatinine ≥ 0.3 mg/dL or ≥25% within 48–72 h after contrast exposure in the absence of alternative causes. The Mehran score, Pre-CT AKI score, and immunonutritional indices—including the Prognostic Nutritional Index (PNI), Osaka Prognostic Score (OPS), and Glasgow Prognostic Score (GPS)—were calculated. Predictive performance was evaluated using logistic regression and receiver operating characteristic (ROC) curve analyses. Results: The incidence of CA-AKI was 2.1% (n = 10). Patients who developed CA-AKI were older and had more comorbidities, particularly chronic kidney disease, diabetes, and cardiovascular disease. In univariate analysis, baseline eGFR, Pre-CT AKI score, and PNI were significantly associated with CA-AKI. Multivariate logistic regression identified baseline eGFR and PNI as independent predictors. The Pre-CT AKI score demonstrated the highest discriminative ability (AUC = 0.87), outperforming the Mehran score (AUC = 0.74). PNI provided complementary prognostic value (AUC = 0.71), whereas OPS and GPS did not reach statistical significance. Conclusions: In ED patients undergoing contrast-enhanced CT, the Pre-CT AKI score was the most accurate predictor of CA-AKI, while PNI offered additional prognostic information reflecting immunonutritional vulnerability. The Mehran score showed moderate usefulness, whereas OPS and GPS were less applicable. Incorporating multifactorial models that integrate clinical, hemodynamic, and immunonutritional factors may improve early risk stratification and guide preventive strategies for CA-AKI in emergency settings.

Background/Objectives: One of the most prevalent reasons for attending the emergency department (ED) is chest pain. There are many causes of its etiology. Recent studies indicate that coronary slow flow should be considered not only an angiographic phenomenon but also a clinical syndrome. In our study, we aimed to identify laboratory parameters indicative of coronary slow flow. Methods: Patients who presented to the Emergency Department of Balikesir University Hospital with chest pain and underwent coronary angiography between 2019 and 2023 were evaluated. A group of 107 patients with primary coronary slow flow was included as the patient group, while 108 patients without any pathology were included as the control group. Demographic, laboratory, clinical, and angiographic parameters were compared between the two groups to determine the predictors of coronary slow flow. Results: In our study, RCA dominance was detected in the control group, while Cx dominance was detected in our patient group (p < 0.001). CRP and the CRP/albumin ratio were observed to be higher in the patient group (p < 0.001). Conclusions: The inflammatory markers CRP and CRP/albumin ratio were found to be statistically significantly higher in the patient group. These parameters can be used to predict coronary slow flow in the emergency department.

Objective: Our aim was to assess the knowledge and skill levels of health workers in our hospital in relation to basic and advanced life support and to see if there was a difference before and after the training. Materials and Methods: The training was administered in the light of the updates in the Universal Basic and Advanced Life Support guidelines, and according to the AHA guidelines, with one day of theory and one day of practice. After the training, evaluation was done with the post-test. The demographic information of the participants, the distribution of tasks and the changes between the pre-test and the post-test according to their professional status were statistically evaluated. Results: We look at the training in both basic life support and advanced life support the level of knowledge of the participants increased. Conclusion: When we evaluate the changes in the knowledge levels of the participants after the course, we can say that the level of knowledge and awareness was limited before the training. We think that trainings should be repeated at certain intervals.

Travma, maruz kalan kişiyi etkileyebildiği gibi topluma dönük birçok sonuçları da içinde barındırmaktadır. Sonuçta akut bir durum olarak yaşanmasına rağmen, etkileri yıllarca sürebilmektedir. Üretken ve genç nüfus üzerindeki etkisi toplumun genelini ekonomik, sosyal, demografik anlamda derinden sarsmasına yol açmaktadır. Yapılan çalışmalarda tüm dünyada 45 yaş altı nüfusta ölüm nedeni arasında ilk sırada yer almakla birlikte, 45 yaş üzerindeki nüfusta ölüm nedenleri arasında halen üçüncü sırada yerini korumaktadır. Travma, hastane öncesi dönemden başlayarak, temel yaşam desteği, hastane içi değerlendirme ile ileri yaşam desteği uygulamalarını içermektedir. Bu sürecin iyi yönetilmesi, multidisipliner ve sistematik yaklaşım, mortalite ve morbidite azalmasına katkı sağlayabilmektedir. Bu kitap ile travma ve ilişkili konulara yer verilerek hızlı etkin yönetim, güncel verilen bilgilerle tanı ve tedaviye yaklaşım ile karar verme sürecinde kolaylık sağlanmaya çalışılmıştır. Kanıta dayalı tıp kuralları önde tutularak bilgiler yenilenmiştir. Emeği geçen meslektaşlarımıza, yazarlarımıza teşekkür ederiz. Okuyucularımıza, genç sağlık meslek üyelerimize, öğrencilerimize fark yaratması dileğiyle…Canan AkmanÖzgür Karcıoğlu