Turkish Journal of Emergency Medicine最新文献_第4页

Effect of tranexamic acid in the treatment of angiotensin-converting enzyme inhibitor-induced angioedema: A systematic review and meta-analysis. 氨甲环酸治疗血管紧张素转换酶抑制剂诱导的血管性水肿的效果：一项系统综述和荟萃分析。

IF 2.3

Turkish Journal of Emergency Medicine Pub Date : 2026-01-01 DOI: 10.4103/tjem.tjem_170_25

Kanmani Indra Couppoussamy, Sasikumar Mahalingam, Gunaseelan Rajendran, Suruthi Purushothaman, Anitha Ramkumar, Yuvaraj Krishnamoorthy, Ezhilkugan Ganessane, Aswin Kumaran

{"title":"Effect of tranexamic acid in the treatment of angiotensin-converting enzyme inhibitor-induced angioedema: A systematic review and meta-analysis.","authors":"Kanmani Indra Couppoussamy, Sasikumar Mahalingam, Gunaseelan Rajendran, Suruthi Purushothaman, Anitha Ramkumar, Yuvaraj Krishnamoorthy, Ezhilkugan Ganessane, Aswin Kumaran","doi":"10.4103/tjem.tjem_170_25","DOIUrl":"10.4103/tjem.tjem_170_25","url":null,"abstract":"Objective: To assess the effectiveness of tranexamic acid (TXA) in the treatment of angiotensin-converting enzyme inhibitor-induced angioedema.Methods: A systematic review was conducted using PubMed, Scopus, Embase, and ProQuest databases from inception to January 2025, following PROSPERO registration (CRD42025524300). We included observational studies that evaluated the use of TXA in angiotensin-converting enzyme inhibitor-induced angioedema. Proportion meta-analyses were performed on the data obtained from the selected studies.Results: Only four retrospective studies met the inclusion criteria, including two cohort studies, one retrospective study, and one case series, encompassing a limited sample size of 133 patients. Meta-analysis showed that approximately 98% of patients treated with TXA did not require intubation, and 76% avoided intensive care unit admission. However, the absence of randomized controlled trials and the retrospective nature of the studies substantially limit the strength and generalizability of these results.Conclusion: TXA may be a potential treatment option for angiotensin-converting enzyme inhibitor-induced angioedema by lowering intensive care unit admission and intubation; however, current evidence is limited and primarily retrospective. Robust prospective, randomized controlled trials are needed to draw definitive conclusions.","PeriodicalId":46536,"journal":{"name":"Turkish Journal of Emergency Medicine","volume":"26 1","pages":"45-54"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12818780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ultrasonography-guided serratus anterior plane block for intercostal drain tube insertion pain. 超声引导下锯肌前平面阻滞治疗肋间引流管插入痛。

IF 2.3

Turkish Journal of Emergency Medicine Pub Date : 2026-01-01 DOI: 10.4103/tjem.tjem_151_25

Joshua Daniel Birru, Varsha Shinde

{"title":"Ultrasonography-guided serratus anterior plane block for intercostal drain tube insertion pain.","authors":"Joshua Daniel Birru, Varsha Shinde","doi":"10.4103/tjem.tjem_151_25","DOIUrl":"10.4103/tjem.tjem_151_25","url":null,"abstract":"Intercostal drainage (ICD) tube insertion is a life-saving procedure through which blood, fluid, or air is drained out of the pleural space surrounding the lungs. This treatment is essential to manage conditions such as hemothorax, pleural effusion, and pneumothorax. In addressing the severe pain accompanying these conditions and pain caused by ICD tube insertion, emergency physicians are increasingly turning to newer techniques for pain management. We are presenting one such technique, which is the serratus anterior plane block (SAPB) guided by ultrasonography. This emerging approach holds promise in improving pain management and patient comfort, making it a crucial consideration in individuals requiring an ICD. In this case series, we present cases that required an ICD tube insertion for which SAPB was administered to manage the pain caused by the ICD tube. The pain reduced significantly in all patients following SAPB administration, and they did not require any additional analgesics for an average of 6-8 h after the block. This case series shows a more efficient way of managing pain in patients requiring ICD tube insertion.","PeriodicalId":46536,"journal":{"name":"Turkish Journal of Emergency Medicine","volume":"26 1","pages":"78-81"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12818772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146019939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Correlation between venous excess ultrasound and acute kidney injury in patients with sepsis: A pilot study. 脓毒症患者静脉超声过量与急性肾损伤的相关性：一项初步研究。

IF 2.3

Turkish Journal of Emergency Medicine Pub Date : 2026-01-01 DOI: 10.4103/tjem.tjem_173_25

Muhamed Hanizar Hajanajumudin, Muhaimin Noor Azhar, Aida Bustam, Aliyah Zambri, Khadijah Poh

{"title":"Correlation between venous excess ultrasound and acute kidney injury in patients with sepsis: A pilot study.","authors":"Muhamed Hanizar Hajanajumudin, Muhaimin Noor Azhar, Aida Bustam, Aliyah Zambri, Khadijah Poh","doi":"10.4103/tjem.tjem_173_25","DOIUrl":"10.4103/tjem.tjem_173_25","url":null,"abstract":"Objectives: Venous congestion is increasingly recognized as a contributor to acute kidney injury (AKI) in critically ill patients. The venous excess ultrasound (VExUS) score has been proposed to assess systemic venous congestion, but its role in emergency department (ED) sepsis remains underexplored. This pilot study investigated the association between VExUS scores, development of AKI, and other outcomes in septic ED patients.Methods: This was a prospective observational pilot study conducted from July 2023 to December 2023 in a university-affiliated tertiary ED. Adult patients with sepsis and an inferior vena cava diameter ≥2 cm after initial resuscitation were enrolled. VExUS was assessed at enrolment. The primary outcome was AKI within 72 h based on the Kidney Disease Improving Global Outcomes criteria. Secondary outcomes included mortality, organ dysfunction scores, and other outcomes. Associations were analyzed using Kendall's tau-b correlation and group comparisons with Mann-Whitney U-test.Results: Thirty-one patients were included, mean age 64.2 years. VExUS scores were Grade 1 in 64.5%, Grade 2 in 25.8%, and Grade 3 in 9.7%. Median VExUS scores did not differ between patients with and without AKI (2.0 [2.0-3.0] vs. 2.0 [2.0-3.0], P = 0.729), died and survived at 28 days (2.0 [2.0-2.25] vs. 2.0 [2.0-3.0], P = 0.419) or 60 days (2.0 [2.0-3.0] vs. 2.0 [2.0-3.0], P = 0.693). VExUS showed moderate correlations with creatinine (τ = 0.392, P = 0.004), sequential organ failure assessment (τ =0.267, P = 0.041), and inotrope requirements (τ = 0.299, P = 0.041).Conclusion: In septic ED patients, VExUS was not associated with AKI or mortality but correlated with markers of organ dysfunction.","PeriodicalId":46536,"journal":{"name":"Turkish Journal of Emergency Medicine","volume":"26 1","pages":"37-44"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12818774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Midazolam or propofol added to ketamine: Which combination is better for the reduction of shoulder dislocation in the emergency department? 咪达唑仑或丙泊酚加氯胺酮：哪种组合对急诊科肩关节脱位治疗效果更好？

IF 2.3

Turkish Journal of Emergency Medicine Pub Date : 2026-01-01 DOI: 10.4103/tjem.tjem_211_25

Mert Pehlivan, Selen Acehan, Salim Satar, Muge Gulen, Sarper Sevdimbas, Ihsan Dengiz, Melike Kucukceylan, Mehmet Gorur

{"title":"Midazolam or propofol added to ketamine: Which combination is better for the reduction of shoulder dislocation in the emergency department?","authors":"Mert Pehlivan, Selen Acehan, Salim Satar, Muge Gulen, Sarper Sevdimbas, Ihsan Dengiz, Melike Kucukceylan, Mehmet Gorur","doi":"10.4103/tjem.tjem_211_25","DOIUrl":"10.4103/tjem.tjem_211_25","url":null,"abstract":"Objective: Glenohumeral dislocation is the most common type of shoulder dislocation and a leading cause of shoulder instability. Adequate muscle relaxation and pain control are essential for successful reduction. This study compared the effectiveness and safety of ketamine-midazolam (KM) versus ketamine-propofol (KP) for procedural sedation in anterior shoulder dislocations in the emergency department (ED). Effectiveness was evaluated using Ramsay sedation scale (RSS) scores, sedation onset, total procedure and recovery times, and reduction success. Safety was assessed by recording adverse events.Methods: This prospective, single-blind, randomized trial included patients ≥18 years presenting to a tertiary ED with anterior shoulder dislocation. Patients were randomized into two groups: KM (ketamine plus midazolam) and KP (ketamine plus propofol). Demographic and clinical characteristics, RSS scores, procedure and recovery times, adverse events, and additional sedation requirements were recorded.Results: Sixty-four patients were analyzed, 32 in each group. The overall mean RSS score was 4.5 ± 1.0, significantly higher in the KP group (P < 0.001). Adverse events were more common in the KM group, including higher rates of respiratory depression (P = 0.023) and tachycardia (P < 0.001). The mean procedure time was 5.7 ± 4.7 min, and recovery time was 36.3 ± 14.4 min, both significantly shorter in the KP group (P = 0.025 and P < 0.001, respectively).Conclusion: In the ED, the ketamine-propofol combination appears to be a safe and effective option for procedural sedation and analgesia, particularly in interventions such as shoulder reduction.","PeriodicalId":46536,"journal":{"name":"Turkish Journal of Emergency Medicine","volume":"26 1","pages":"62-70"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12818779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146019885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A rare case of purulent pericarditis arising from a hepato-pericardial fistula. 由肝-心包瘘引起的化脓性心包炎一例。

IF 2.3

Turkish Journal of Emergency Medicine Pub Date : 2026-01-01 DOI: 10.4103/tjem.tjem_256_24

Khaled Alaboud Alkheder, Omar Farooq Al-Nahhas, Yousif Basim Al-Khafaji, Ammar Alshirazi Alssabagh, Sudarshana Reddy Thiyyagura

{"title":"A rare case of purulent pericarditis arising from a hepato-pericardial fistula.","authors":"Khaled Alaboud Alkheder, Omar Farooq Al-Nahhas, Yousif Basim Al-Khafaji, Ammar Alshirazi Alssabagh, Sudarshana Reddy Thiyyagura","doi":"10.4103/tjem.tjem_256_24","DOIUrl":"10.4103/tjem.tjem_256_24","url":null,"abstract":"Purulent pericarditis is a rare but severe complication of bacterial pericarditis, often secondary to intrathoracic infections, and can cause a hepatic abscess that ruptures into the pericardium, which is an uncommon symptom with a high mortality rate if untreated. We report on a 52-year-old man with a poorly differentiated hepatocellular carcinoma who presented with chest pain and pericardial effusion caused by a hepato-pericardial fistula. Imaging revealed hepatic microabscesses extending into the pericardium. The patient underwent a pericardial window procedure with purulent fluid drainage and was treated with meropenem for Enterobacter cloacae. Postoperatively, the bilateral pleural effusions required chest drains. After 3 weeks of multidisciplinary care, the patient was discharged in a stable condition. This case highlights the importance of early diagnosis and a multidisciplinary approach in managing rare complications of purulent pericarditis caused by hepatic abscesses. Timely surgical intervention and appropriate antibiotic therapy are crucial for favorable outcomes.","PeriodicalId":46536,"journal":{"name":"Turkish Journal of Emergency Medicine","volume":"26 1","pages":"75-77"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12818777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evaluation of STONE, modified STONE, and CHOKAI scores for predicting ureteric stone disease in Indian emergency patients: A prospective observational study. 评估印度急诊患者输尿管结石疾病的STONE、改良STONE和CHOKAI评分：一项前瞻性观察研究

IF 2.3

Turkish Journal of Emergency Medicine Pub Date : 2026-01-01 DOI: 10.4103/tjem.tjem_277_25

Milan Manu, Naman Agrawal, Roshan Mathew, Saroj Kumar Pati, Amit Kumar Mishra, Debendra Kumar Tripathy

{"title":"Evaluation of STONE, modified STONE, and CHOKAI scores for predicting ureteric stone disease in Indian emergency patients: A prospective observational study.","authors":"Milan Manu, Naman Agrawal, Roshan Mathew, Saroj Kumar Pati, Amit Kumar Mishra, Debendra Kumar Tripathy","doi":"10.4103/tjem.tjem_277_25","DOIUrl":"10.4103/tjem.tjem_277_25","url":null,"abstract":"Objective: Acute flank pain is a common complaint in the emergency department (ED), with urolithiasis being a major cause. This prospective observational study evaluated the performance of the STONE, modified STONE, and CHOKAI scores in predicting ureteric stones in Indian ED patients with acute flank pain.Methods: The study included adult patients who underwent noncontrast computed tomography for suspected urolithiasis. Clinical scores were calculated independently, and their diagnostic accuracy was assessed using receiver operating characteristic (ROC) curve analysis.Results: Ureteric stones were diagnosed in 58.3% of the patients. The CHOKAI score demonstrated the highest accuracy (area under the curve [AUC] 0.89), followed by the modified STONE (AUC 0.84) and STONE (AUC 0.65) scores. Optimal cutoffs were identified using Youden's index. DeLong's test revealed that CHOKAI and modified STONE scores outperformed the STONE score, while the difference between CHOKAI and modified STONE was not significant. The Hosmer-Lemeshow test showed good calibration for the CHOKAI and modified STONE scores.Conclusions: The CHOKAI score demonstrated the highest diagnostic accuracy in our cohort and may be the preferred tool for predicting ureteric stones in this clinical setting. Further validation in larger multicenter studies is warranted.","PeriodicalId":46536,"journal":{"name":"Turkish Journal of Emergency Medicine","volume":"26 1","pages":"55-61"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12818773/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146019230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A review of mass casualty incident triage tools for hospital-based triage. 基于医院的大规模伤亡事件分类工具综述。

IF 2.3

Turkish Journal of Emergency Medicine Pub Date : 2025-10-01 DOI: 10.4103/tjem.tjem_77_25

Sarah S Abdul-Nabi, Eveline Hitti

{"title":"A review of mass casualty incident triage tools for hospital-based triage.","authors":"Sarah S Abdul-Nabi, Eveline Hitti","doi":"10.4103/tjem.tjem_77_25","DOIUrl":"10.4103/tjem.tjem_77_25","url":null,"abstract":"Mass casualty incidents (MCIs) pose significant challenges to the healthcare systems, particularly in low-and lower-middle-income countries where prehospital triage is often limited, and hospitals face sudden surges of casualties. While triage tools have been widely studied for field use, their effectiveness in hospital-based MCI response remains unclear. This review examines peer-reviewed studies on hospital-based triage tools used during mass casualties, focusing on their accuracy and applicability. A comprehensive search of MEDLINE identified six relevant studies, conducted across various income settings and utilizing different methodologies, including simulation-based research, retrospective analyses, and real-world debriefings. Several tools were assessed, including Simple Triage and Rapid Treatment, the Modified CareFlight system, and homegrown triage models developed in Berlin and Iran. While some tools showed potential in prioritizing critically ill patients and managing resource allocation, their application in the real-world hospital settings remains insufficiently studied. Existing research is limited by small sample sizes, reliance on simulations, and a lack of validation in live MCI scenarios. Given these gaps, further research is essential to evaluate triage models in real-time, high-volume, and resource-limited environments to ensure effective hospital-based mass-casualty response.","PeriodicalId":46536,"journal":{"name":"Turkish Journal of Emergency Medicine","volume":"25 4","pages":"251-255"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12527048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Floral phantosmia and bradycardia: A unique case of digoxin toxicity in an elderly patient. 花幻影和心动过缓：地高辛中毒在老年患者中的独特案例。

IF 2.3

Turkish Journal of Emergency Medicine Pub Date : 2025-10-01 DOI: 10.4103/tjem.tjem_275_24

Marsida Kasa, Brunilda Elezi, Eglantina Sinamati, Nereida Spahia, Merita Rroji

引用次数: 0

Evaluation of the relationship between the hemoglobin, albumin, lymphocyte, platelet score, and clinical prognosis in patients with acute pancreatitis in the emergency department. 急诊科急性胰腺炎患者血红蛋白、白蛋白、淋巴细胞、血小板评分与临床预后的关系

IF 2.3

Turkish Journal of Emergency Medicine Pub Date : 2025-10-01 DOI: 10.4103/tjem.tjem_167_25

Emine Sarcan, Ahmet Burak Erdem, Şeyda Gedikaslan, Ali Kablan, Yusuf Coşkun

{"title":"Evaluation of the relationship between the hemoglobin, albumin, lymphocyte, platelet score, and clinical prognosis in patients with acute pancreatitis in the emergency department.","authors":"Emine Sarcan, Ahmet Burak Erdem, Şeyda Gedikaslan, Ali Kablan, Yusuf Coşkun","doi":"10.4103/tjem.tjem_167_25","DOIUrl":"10.4103/tjem.tjem_167_25","url":null,"abstract":"Objectives: In acute pancreatitis (AP), the variable clinical course and high mortality have led to the use of complex and time-consuming scoring systems. This study aimed to evaluate the diagnostic performance of the hemoglobin, albumin, lymphocyte, and platelet (HALP) score in predicting mortality and intensive care unit (ICU) admission in patients with AP, and to compare it with the Atlanta classification and the Bedside Index for Severity in AP (BISAP).Methods: This single-center retrospective study included 455 patients diagnosed with AP. Demographic data, laboratory findings, and clinical course of the patients were recorded, and HALP, BISAP, and Atlanta classification scores were calculated.Results: The Atlanta classification showed the highest predictive accuracy for both mortality and ICU admission (mortality: sensitivity 91%, specificity 96%; ICU admission: sensitivity 77%, specificity 99%). The HALP score demonstrated a moderate predictive ability for both mortality (sensitivity = 0.64; specificity = 0.79) and ICU admission (sensitivity = 0.74; specificity = 0.67). The sensitivity of the HALP score was significantly higher than that of the BISAP score for both outcomes (P < 0.001).Conclusion: Although the HALP score has a lower overall predictive power compared to the Atlanta and BISAP scores, its higher sensitivity and easily calculable structure compared to the BISAP score suggest that it may serve as a supportive tool for early prognostic assessment of AP patients in emergency department settings.","PeriodicalId":46536,"journal":{"name":"Turkish Journal of Emergency Medicine","volume":"25 4","pages":"280-287"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12527053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Noninvasive mechanical ventilation in acute cardiogenic pulmonary edema in the emergency department: A limited sum of factors determining response. 急诊科急性心源性肺水肿的无创机械通气：决定反应的有限因素

IF 2.3

Turkish Journal of Emergency Medicine Pub Date : 2025-10-01 DOI: 10.4103/tjem.tjem_86_25

Hatice Aslan Sırakaya, Antonio M Esquinas

引用次数: 0