Analysis of Medical Responses in Mass Gatherings: The Commemoration Ceremonies for the 100th Anniversary of the Battle of Gallipoli.

IntroductionMass crowds outside the routine population create a burden of disease on Emergency Medical Services (EMS). The need for EMS in various mass-crowd events may vary. It is especially important to determine the EMS requirement that emerges during the historic commemoration ceremonies in Çanakkale (Turkey).Hypothesis/ProblemThis study aims to determine the unique challenges in the planning of EMS responses provided for people from various countries at the commemoration ceremony for a 100-year-old war and to identify the medical provision of those services. METHODS: This descriptive study examined the patient applications in the Çanakkale EMS at the commemoration ceremonies for the 100th anniversary of Gallipoli Wars (Çanakkale Amphibious Wars - Turkey) on April 24-25, 2015. RESULTS: A total of 221 cases were handled by 112 EMS in the ceremony area. Of those, 87.3% of the cases applied to a mobile operating room (MOR) stationed in the ceremony area while 12.7% of them applied directly to the health care team in a large area in the ceremony area. Overall, 13.1% of the cases were transferred to the hospital for further evaluation and treatment. Patient presentation rate (PPR) of the patients who were treated during the two days was 4.42, and transfer to hospital rate (TTHR) of the cases transferred to the hospital was calculated to be 0.58. CONCLUSION: Further studies may create models in regard to the estimations on mass and needs based on the data of previous organizations. KoçakH, ÇaliskanC, SönmezlerMS, EliuzK, KüçükdurmazF. Analysis of medical responses in mass gatherings: the commemoration ceremonies for the 100th anniversary of the Battle of Gallipoli. Prehosp Disaster Med. 2018;33(3):288-292.

The effect of low-dose external beam radiation on extraneural scarring after peripheral nerve surgery in rats.

OBJECTIVE: Scar tissue is an inevitable result of peripheral nerve surgery. A variety of substances have been used to prevent epineurial scarring. In this study, the effect of low-dose radiation therapy on epineurial scarring was investigated. METHODS: Seventy-eight male Sprague-Dawley rats were studied. A total of 60 rats were subjected to one of three types of surgical procedure on the sciatic nerve, as follows: Procedure 1, external neurolysis (n = 20); Procedure 2, abrasive injury (n = 20); and Procedure 3, anastomosis (n = 20). On the left sciatic nerves, 700 cGy external beam radiation was administered 24 hours after surgery, and the right sciatic nerves served as a control group (surgery only). Eighteen animals without surgical intervention were used to establish the fibrotic effect of radiotherapy on normal nerves. A neurological examination was performed weekly. Six weeks after surgery, the extent of extraneural scarring was examined by gross microdissection by means of a numerical grading scheme and histological analysis. Cellular density and surface measurements of scar tissue were also evaluated. RESULTS: The dissection around the nerve was easier in rats treated with low-dose radiation compared with the control group. Furthermore, grading scores in both nerve adherence and nerve separability were significantly lower in treated nerves than in the control group (P < or = 0.05). Low-dose radiotherapy decreased the scores of cellular density and surface measurement of scar tissue (P < or = 0.05). In normal nerves, radiotherapy did not produce any fibrotic effects and the density of fibroblasts/fibrocytes was also very low. CONCLUSION: In the case of surgery or local trauma to peripheral nerve, the use of low-dose radiation therapy may be a safe method of limiting postoperative epineurial scar formation.