Characteristics of the patients who admitted to the emergency department with seizures and the factors affecting the frequency of admission.

OBJECTIVES: To determine the features of patients applying to the emergency department (ED) with seizures and the factors affecting the frequency of admission. METHODS: This study was designed as a retrospective, cross-sectional study. The demographic and clinical characteristics, admission frequencies, diagnostic tests (laboratory and imaging methods) of the patients who were older than 18 years old and admitted to the ED between January 1, 2014 and January 1, 2017 with seizures were analyzed. RESULTS: The study included 867 patients with seizures. A comparison of the number of admissions by gender revealed a statistical significance (p=0.007). The number of admissions and the number of seizures until the time of admission were compared and found a statistical significance (p=0.002). In the logistic regression analysis of the factors affecting the frequency of admissions, seizure character [OR: 4.404 (%95 CI:1.761-11.015), p=0.002], comorbidity [OR: 2.021 (%95 CI:1.407-2.904), p<0.001], hospitalization [OR:1.893 (%95 CI: 1.259-2.847), p=0.002], concomitant injury [OR: 2.013 (%95 CI: 1.016-3.988), p=0.045], drug use (p<0.001), and possible etiology cerebrovascular disease (CVD) [OR: 2.763 (%95 CI: 1.327-5.752), p=0.007] were risk factors for frequent admission of patients applying to ED with seizures. CONCLUSION: Seizure character (first and known seizure), comorbidity status, hospitalization, concomitant injury, anti-epileptic drugs use, and possible etiology CVD are risk factors affecting the frequency of admission with seizure.

Emergency department presentation of hemoptysis due to nail gun injury.

Nail guns are cheap and easy-to-access devices that are common in the industry and personal use and are widely used by untrained people. Life-threatening injuries may occur after a self-accident due to the use of these devices. We report the case of a 47-year-old man who had hemoptysis due to a lung parenchymal injury after nail gun use. Computed tomography revealed focal alveolar hemorrhage. Hemodynamically stable, the patient underwent surgery. Nail guns penetrating the chest can cause life-threatening situations. In the emergency department, rapid diagnosis and treatment is vital in preventing fatal outcome.

MPV and other inflammatory markers in diagnosing acute appendicitis.

OBJECTIVE: To investigate whether mean platelet volume can be used as an inflammatory marker for the diagnosis of acute appendicitis, and to determine the role, if any, of white blood cell count, C-reactive protein and neutrophil count in this regard. METHODS: The retrospective study was conducted at Mersin University (MEU) Health Research and Application Center, Emergency Department, Mersin, Turkey, and included medical record of patients having gone appendectomy between April 2012 to July 2013. Based on pathology examination, the cases were grouped as uncomplicated, complicated, and non-appendicitis cases. Preoperative white blood cell, neutrophil, C-reactive protein and mean platelet volume were noted. SPSS 16 was used for statistical analysis. RESULTS: Records of 275 patients were studied. Overall, 90(32.7%) patients were uncomplicated, 120(43.7%) complicated, and 65(23.6%) were non-appendicitis cases. The first two groups had a significantly higher white blood cell (p=0.001) and neutrophil (p<0.001) counts than the third one. Mean platelet volume levels were not statistically different (p=0.478).The neutrophil count had a sensitivity of 76.19%, specificity of 56.92%, positive predictive value of 85.11%, and negative predictive value of 42.53%; white blod cell count had sensitivity 68.10%, specificity 61.54%, positive predictive value 85.12%, and negative predictive value 37.38%; mean platelet volume level had sensitivity 74.76%, specificity 35.38%, positive predictive value 78.89%, and negative predictive value 30.26%; and C-reactive protein level had sensitivity 84.29%, specificity 30.77%, positive predictive value 79.73%, and negative predictive value 37.74%. CONCLUSIONS: Elevated white blood cell and neutrophil counts may be used as diagnostic tests in cases of acute appendicitis, while C-reactive protein and mean platelet volume levels were not useful as diagnostic markers.