OBJECTIVES: Publications and literature related to emergency medicine (EM) have been consistently increasing. There are 4048 studies in total in the EM journals published until the present day in Türkiye in the Web of Science (WoS) database. Our aim is to define the bibliometric features of scientific studies published in EM journals in Türkiye, to gain insights into the trends of the literature. METHODS: We retrospectively analyzed the bibliometric data of scientific studies published in EM journals in Türkiye until today on the WoS database related to the EM field. The bibliometrix package of R statistical software was used in the bibliometric analyses in the study. RESULTS: A total of 4048 scientific studies from Türkiye indexed on the WoS database from 10,263 authors in four different journals were analyzed. Among these, 3681 (90.9%) were articles, 188 (4.7%) were reviews, 97 (2.4%) were editorial material, 60 (1.5%) were letters, and 5 (0.1%) were corrections. Average number of citations per study was 3.6, with the most cited study having 2016 citations. The most frequent title’s words were emergency, patient, and acute. CONCLUSION: This study shows that there is an increasing trend in the number of EM publications and citations in Türkiye with the first most cited study having 2016 citations, and the top contributing countries were Türkiye, Iran, and India. The results of this study may be useful in understanding the historical and prospective development of EM, including the identification of general information about its publications, differentiation of the top-cited ones, and presentation of a bibliometric analysis of scientific activity to date.

OBJECTIVES: We aimed to evaluate the performance of a large language model (ChatGPT) in answering official sample questions from the Turkish Board of Emergency Medicine (TBEM). Two versions of the model, GPT-4 and GPT-4o, were assessed to explore consistency and accuracy across iterations. METHODS: A cross-sectional observational study was conducted using 25 standardized multiple-choice questions publicly released by TBEM. Each question was manually entered into GPT-4 and GPT-4o through the OpenAI interface. Both models were prompted to select the best single answer from the provided options without additional clarification or training context. Model responses were evaluated for accuracy, consistency upon repetition, and domain-specific error types. This study is compliant with the STROBE statement and the MedinAI reporting guidelines. RESULTS: GPT-4 correctly answered 20 out of 25 questions (80%) on the first attempt. On repetition, its score improved to 84%. GPT-4o also achieved a score of 88% (22/25) on its first attempt and showed consistent results upon a second evaluation, providing identical answers in both trials. Errors occurred in the domains of trauma during pregnancy, pediatric resuscitation, and adult resuscitation protocols. Both models demonstrated strong performance in fact-based domains and in questions involving image descriptions. CONCLUSION: GPT-4 and GPT-4o performed above the TBEM passing threshold, showing solid accuracy across a range of emergency medicine topics. Both excelled in fact-based and image-related questions. However, they showed limitations in clinical reasoning, particularly in scenarios requiring nuanced judgment. These tools may support examination preparation but should not replace the expertise of trained emergency physicians.

Arachnoid cysts (ACs) are benign congenital lesions that are often detected incidentally during imaging studies performed for various etiological reasons. These cysts are typically asymptomatic, and in most cases do not require surgical intervention. Although ACs are commonly encountered, they are rarely complicated by intracystic hemorrhage or subdural hematoma. In this report, we present a case of a nontraumatic rupture of an AC, which remained undiagnosed until the age of 52 years.

Determining the Factors Affecting the Satisfaction of Patient in Sedoanalgesia Due to Distal Radius Fracture in Emergency Department - Istanbul Medical Journal

Background: Tube thoracostomy is performed by several specialties in several hospital settings, but institution-wide data comparing who performs the procedure, where, how, and with what complications are limited. Methods: In this retrospective observational cohort study, all tube thoracostomies performed over a three-year period at a tertiary university hospital were identified through the hospital information system. Procedures were grouped by performing team (emergency medicine, thoracic surgery, and intensive care) and by setting (emergency department [ED], operating room/ward, and intensive care unit [ICU]) and compared with respect to demographics, indications, operator seniority, anesthesia practice, chest tube size, and complications. Effect sizes are reported with 95% confidence intervals (CIs), and predictors of complications were examined in a multivariable binomial logistic regression model. Results: In total, 487 procedures were analyzed (76.0% male; median age 56 years). The emergency medicine team performed 47.2% of procedures (all in the ED), the thoracic surgery team 46.8% (the only team active in all three settings), and the intensive care team 6.0%. Indication profiles diverged (p < 0.001): traumatic (34.8%) and spontaneous pneumothorax (31.7%) dominated the emergency medicine caseload, pleural effusion (40.4%) the thoracic surgery caseload, and iatrogenic pneumothorax (72.4%) the intensive care caseload. Overall, 95.9% of tubes were 28 F or 32 F; the thoracic surgery team favored 32 F (75.9%; p < 0.001). First-year residents performed 39.8% of procedures, two-thirds of them on the thoracic surgery team. Complications occurred in 70 procedures (14.4%), 90.0% of which were tube malpositions. Crude complication rates were 10.0% for emergency medicine, 16.2% for thoracic surgery, and 34.5% for intensive care (p = 0.001), but rates rose with the acuity of the setting (ED 10.9%, ICU 26.8%) and within-setting differences between teams were not significant (ED p = 0.363; ICU p = 0.301). In a multivariable model adjusting for team, setting, age, indication group and operator seniority, neither team (p = 0.164) nor setting (p = 0.223) was independently associated with complications. Complication rates did not differ by postgraduate year (16.5%, 9.8%, 14.3% and 20.8% for years 0–1 to 3–4; p = 0.157, test for trend p = 0.738), by tube size (≤28 F 12.0% versus ≥32 F 15.8%; p = 0.287) or by age (p = 0.276). Conclusions: This hospital-wide map of procedural labor shows that the three teams served largely distinct patient populations. Team, setting and indication are so tightly linked in this hospital that no independent effect of specialty could be demonstrated in either direction. Operator seniority and tube size were not associated with complications. Malposition accounted for nine of every ten complications, which supports routine verification of tube position after insertion. Which team drains which pathology, where, and at what level of training is determined locally rather than by specialty training standards, and that map is the principal contribution of this series.