Medical sorting is aimed at assessment of disease severity and has to be carried out within a short time to determine the priorities for patient care and transportation to the most appropriate place for future treatment. The goal of this study was to provide an integrative review by analyzing the publications on the most common triage systems worldwide in order to select and implement the most reliable system at emergency departments. We searched for publications relevant to our comparative analysis in evidence-based medicine databases. A total of 1,740 literary sources were identified, of which 42 were selected for analysis. Comparative analysis of different triage systems may help implementing the most efficient system in Kazakhstan. The Emergency Severity Index is considered the most reliable and accurate tool used in international practice, and it could provide a basis for introduction of triage system at emergency departments in Kazakhstan.

Introduction: This study aimed to define the clinical features and laboratory findings that may be associated with

Introduction:Microhematuria is the presence of an abnormally high number of erythrocytes in the urine. This microscopic hematuria, not visible to the naked eye, can generally be detected through urine analysis. The causes of microscopic hematuria encompass a range of pathological conditions, from simple urinary tract infections to urolithiasis, trauma, urological cancers, and vascular diseases. Method: A single-center and retrospective research in an educational and research hospital's emergency department. Patients who presented to the emergency department between January 2020 and April 2023, were diagnosed with microhematuria based on laboratory tests, and underwent abdominal computed tomography were included in the study. Finding: Out of the 1499 patients with detected microhematuria in the emergency department and whose retrospective abdominal CT scans were evaluated, 780 (52%) were female, and the mean age of the patients was 43.9 ± 18.2 (min: 18; max: 95). Based on the patients' medical histories and the results of tomographic examinations, urinary tract stones were identified as the most common cause of microhematuria, followed by cystitis, pyelonephritis, kidney stones, and left retroaortic renal vein. Discussion: In the emergency department, investigating the etiology of microscopic hematuria detected during the evaluation of symptomatic or other presenting patients may be necessary. This is because, although the causes of microhematuria are often benign, it is essential to catch malign causes in the early stages. In addition to benign and malignant causes, there may be rare but significant congenital malformations that require monitoring Conclusions: A significant association between retroaortic left renal vein and microhematuria has been observed. After excluding the potential common causes of microhematuria, renal vascular anomalies should be considered as a possibility. Clinicians should consider retroaortic left renal vein as a differential diagnosis in patients with unexplained microhematuria and radiology experts should keep this anatomical variation in mind when evaluating abdominal CT scans. Введение: Микрогематурия – это наличие аномально высокого количества эритроцитов в моче. Эту патологию, невидимую невооруженным глазом, обычно можно обнаружить с помощью анализа мочи. Причины микроскопической гематурии охватывают широкий спектр патологических состояний: от простых инфекций мочевыводящих путей до мочекаменной болезни, травм, онкологических заболеваний урологического профиля и сосудистых заболеваний. Методы: Одноцентровое ретроспективное исследование в отделении неотложной помощи образовательно-исследовательского госпиталя. В исследование были включены пациенты, поступившие в отделение в период с января 2020 г. по апрель 2023 г., у которых на основании лабораторных исследований была диагностирована микрогематурия и которым была проведена компьютерная томография брюшной полости. Результаты: из 1499 пациентов с выявленной микрогематурией, поступивших в отделение неотложной помощи и которым были оценены ретроспективные КТ брюшной полости, 780 (52%) были женщинами, а средний возраст пациентов составил 43,9 ± 18,2 (мин: 18; макс: 95). На основании истории болезни пациентов и результатов томографических исследований наиболее частой причиной микрогематурии были выявлены камни мочевыводящих путей, за ними следовали цистит, пиелонефрит, камни в почках и левая ретроаортальная почечная вена. Обсуждение: В отделении неотложной помощи может возникнуть необходимость в выяснении этиологии микроскопической гематурии, обнаруженной при обследовании симптоматических или других пациентов. Это связано с тем, что, хотя причины микрогематурии часто бывают доброкачественными, важно выявить злокачественные причины на ранних стадиях. Помимо доброкачественных и злокачественных причин, могут встречаться редкие, но значительные врожденные пороки развития, требующие наблюдения. Заключение. Наблюдалась значительная связь между ретроаортальной левой почечной веной и микрогематурией. После исключения потенциальных частых причин микрогематурии следует рассматривать возможность аномалий почечных сосудов. Клиницисты должны учитывать ретроаортальную левую почечную...

Purpose: Maxillofacial trauma may be managed either conservatively or surgically. This study aimed to identify the clinical and radiologic factors associated with operative management in adult patients and to propose a practical, emergency department-based treatment approach. Methods: This retrospective cohort study included adult patients who presented with head and facial trauma between March 1, 2021, and March 1, 2026. Patients aged 18 years or older who had clinical findings suggestive of maxillofacial injury and who underwent maxillofacial computed tomography (CT) were included. Demographic data, trauma mechanism, Glasgow Coma Scale (GCS) score, forensic status, CT findings, consultation, hospitalization, mortality, and treatment were recorded. Patients were divided into operative and nonoperative groups. Descriptive statistics, between-group comparisons, and multivariable logistic regression were performed. Results: A total of 855 patients were included. The mean age was 59.06±22.38 years, and 499 patients (58.4%) were female. Falls were the most common mechanism of injury (74.15%). Surgery was performed in 32 patients (3.74%). Compared with nonoperatively managed patients, those who underwent surgery were younger, more frequently male, had lower GCS scores, and were more often forensic cases. A radiologically confirmed fracture was the strongest independent factor associated with surgery [odds ratio (OR)=11.29; P =0.001], together with forensic status and a lower GCS score. Among patients with radiologically confirmed facial fractures, mandibular, orbital, and nasal fractures were each independently associated with surgery (OR=44.70, 6.54, and 4.44, respectively; all P ≤0.004). Conclusion: Most adult patients with maxillofacial trauma were managed nonoperatively. A radiologically confirmed fracture, forensic status, a lower GCS score, and specific fracture locations—mandibular, orbital, and nasal—may help guide early surgical evaluation and support a simple, practical treatment algorithm.

Introduction:Emergency Medicine is a specialized field dedicated to providing immediate care to patients with acute, undifferentiated, and undiagnosed illnesses or injuries. Its focus lies in resuscitating and stabilizing patients, making them suitable for general care or identifying those who require more advanced treatment within an undifferentiated patient pool. This study centers on forensic cases, which encompass incidents resulting from human actions, such as assault, traffic accidents, firearm injuries, and other similar situations. Medical professionals in the emergency department not only have the responsibility to diagnose and provide medical interventions but also to assess whether the incident qualifies as a forensic case and report it to legal authorities. Method:The study was conducted at Başkent University's Emergency Medicine Clinic, Ankara, Türkiye, with ethical approval. Data were collected from February 1, 2023, to March 30, 2023, and included demographic information, comorbidities, laboratory results, imaging studies, hospitalization details, consultation records, morbidity, and mortality statistics. Statistical analyses were performed using SPSS version 25.0. Results: A total of 221 patients were included in the study, with an average age of 46.32 years, of which 55.2% were female. The most common reason for seeking emergency care was earthquake-related injuries (45.25%), followed by occupational accidents (13.12%), falls (11.76%), assault (8.6%), and burns (7.69%). Most patients (74.66%) sought medical attention during daytime hours. Consultations were obtained in 43.44% of cases, primarily in orthopedics (17.64%). A total of 7.69% of patients were hospitalized, with an average length of stay of 17.13 days. Mortality rates were higher among earthquake-related cases (76.47%) compared to other reasons. The study highlighted the prevalence of forensic cases during daytime hours, with more severe injuries presenting at night. Notably, earthquake-related incidents constituted a significant portion of cases, likely influenced by a recent major earthquake. The study also revealed that orthopedic and general surgery consultations were most common, possibly reflecting the industrial nature of the city. Mortality rates were highest among earthquake-related cases, emphasizing the importance of preparedness for disaster-related medical needs. Conclusion:This study sheds light on the patterns of forensic cases in an emergency department, with daytime hours seeing a higher volume of cases but nighttime admissions often indicating more severe injuries. The findings emphasize the need for readiness in responding to disaster-related incidents, as evidenced by the earthquake-related cases' higher mortality rates. Введение: Неотложная медицина — это специализированная область, посвященная оказанию неотложной помощи пациентам с острыми, недифференцированными и недиагностированными заболеваниями или травмами. Основное внимание уделяется реанимации и стабилизации пациентов, обеспечению общего ухода или выявлению тех, кто нуждается в более квалифицированном лечении среди всех пациентов. Это исследование сосредоточено на судебно-медицинских случаях, которые относятся к инцидентам, возникшим в результате действий человека, таких как нападения, дорожно-транспортные происшествия, травмы от огнестрельного оружия и другие подобные ситуации. Медицинские работники отделения неотложной помощи не только обязаны поставить диагноз и оказать медицинское вмешательство, но также оценить, квалифицируется ли инцидент как судебно-медицинское дело, и сообщить об этом в юридические органы. Материалы и методы: Исследование проводилось в Клинике неотложной медицинской помощи Университета Башкент, Анкара, Турция, с этическим одобрением. Данные были собраны с 1 февраля 2023 г. по 30 марта 2023 г. и включали демографическую информацию, сопутствующие заболевания, результаты лабораторных исследований, визуализационные исследования, подробности госпитализации, записи консультаций, статистику заболеваемости и смертности. Статистический анализ проводился с использованием SPSS версии 25.0. Результаты: В исследование был включен 221 пациент со средним возрастом 46,32 года, из которых 55,2% составляли женщины. Самой распространенной причиной обращения за неотложной помощью были травмы, связанные с землетрясением (45,25%), за ними следовали несчастные случаи на производстве (13,12%), падения (11,76%), нападения (8,6%) и ожоги (7,69%). Большинство пациентов (74,66%) обращались за медицинской...