1,720,999 research outputs found
Mesenteric volvulus in children: Two autopsy cases and review of the literature.
No full textSmall bowel mesenteric volvulus when compared with mesocolonic volvulus, have not high incidence. Two autopsy cases of small bowel mesenteric volvulus in infants, highlighting the importance of a suspicion in early recognition of this rare but potentially fatal intra-abdominal emergency are reported. We also review the literature on possible aetiologies and mechanism of small bowel mesenteric volvulus, as well as its management
Emergency management of multiple trauma patients in a level i trauma center: "Time" as a quality assurance
No full textBackground: We aimed to find out the present level of trauma care in our ED by evaluating time to determine standards of our trauma care and compare these standards with advanced trauma centers.Methods: Between January 2002 and May 2002, 104 multiple trauma patients (age > 15) bearing criterias for trauma team activation in advanced trauma life support (ATLS) protocols were randomly included in the study. Time needed to perform the routine trauma x-rays (lateral cervical vertabra, AP chest, AP pelvis radiographies), abdominal ultrasonography (USG), laboratory tests, if indicated cranial computerized tomography (CCT) and the length of stay (LOS) in the ED were recorded.Results: Patients who needed emergency surgery were taken to the operation room within 30 minutes compatible with objective time of advanced trauma centers. The x-rays, abdominal USG, laboratory tests of all patients and CCT if required were performed within mean 47 +/- 20 minutes, 56 +/- 27 minutes, 91 +/- 23,5 minutes and 98 +/- 30 minutes, respectively. The average LOS in the ED was 162 +/- 87 minutes.Conclusion: As a result, total ED stay of a multiple trauma patient in our ED was found to be significantly longer when compared to that of advanced centers. In constant quality improvement, assessment of structural features and the methods used, on the basis of lost time is a parameter that is important but not sufficient
Comparison of the screening tools for the evaluation of prognostic factors in elderly patients who admit to emergency department
No full textGiriş ve Amaç: Bu çalışmadaki amacımız; acil servise (AS) başvuran 65 yaş üstü hastalar arasında AS`den hastaneye yatış ve mortalite; AS`den taburcu olduktan sonra tekrar AS`e başvuru, hastaneye yatış ve ölüm olasılığı gibi yüksek riskli prognostik faktörleri saptamada kullanılan ISAR (Identification of Seniors At Risk) ve SC (Silver Code) skorlama sistemlerini karşılaştırmaktır. Gereç ve Yöntem: Tek merkezli, prospektif, gözlemsel bir çalışma olup, Medipol Mega Hastanesi AS'ye 21.12.2015 - 10.09.2016 tarihleri arasında başvuran 65 yaş ve üstü tüm hastalar incelenmiştir. AS'e geldiğinde ex-duhul olan hastalar; çalışmaya katılmak istemeyen hastalar; bilgi alınamayan hastalar çalışmaya dahil edilmemiştir. Hastaların ISAR ve SC skorları hesaplanmıştır. ISAR ve SC skorlama sistemlerinin ilk AS'e başvurudaki hastaneye yatış ve mortalite ile 30. gün ve 6.aydaki AS'e tekrar başvuru, hastaneye yatış ve mortaliteyi öngörmedeki duyarlılık, özgüllük, pozitif prediktif değer (PPD) ve negatif prediktif değerlerini (NPD) göstermek için receiver operating characteristic (ROC) analizi yapılmıştır. Bulgular: Çalışmaya alınan 497 hastanın yaş ortanca değeri 73'tü (IQR: 68.5, 79.0). 268'i (%53.9) kadın, 229'u (%46.1) erkekti. AS başvurusundan 1 ay sonra SC risk grupları arasında mortalitede artış yokken ISAR pozitif grupta mortalite 6.6 kat artmıştır. AS başvurusundan 6 ay sonra mortalite risk gruplarına göre incelendiğinde SC yüksek riskli grupta 2 kat, ISAR pozitif grupta ise 35 kattan fazla artmıştır. Sonuç: İncelediğimiz tüm parametrelerde SC ve ISAR skorlamaları ile oldukça yakın ve anlamlı sonuçlar elde edilmiştir. Ancak ISAR mortaliteyi öngörmede SC'ye göre çok daha başarılı olmuştur. Yine kolay uygulanabilirliği nedeniyle ISAR'ın SC'ye göre daha kullanışlı olduğunu düşünmekteyiz.Introduction and Purpose: Our purpose in this study is to compare ISAR (Identification of Seniors At Risk) and SC (Silver Code) scoring systems to detect high-risk prognostic factors such as hospitalization and mortality in emergency service application; and re-admission to emergency department (ED), hospitalization and mortality after discharge from ED among patients older than 65 years. Materials and Methods: A single-centered, prospective, observational study was conducted in Medipol Mega Hospital ED. All patients aged 65 years and over who applied between 21.12.2015 - 10.09.2016 were examined. Patients who were dead on arrival, patients who do not want to participate in the study and patients who were inaccessible for information are not included in the study. ISAR and SC scores of patients were calculated. Sensitivity, specificity, positive and negative predictive values (PPV and NPV), and ROC (Receiver Operating Curve) analysis were done to show the predictive power of ISAR and SC scoring systems for hospitalization and mortality in first emergency service application and re-admission to ED, hospitalization and mortality at 30th day and 6th month after the first visit. Findings: The median age of the 497 patients included in the study was 73 (IQR: 68.5, 79.0). 268 (53.9%) were female and 229 (46.1%) were male. 1 month after the first ED visit, the mortality rate increased by 6.6 fold in the ISAR positive group but there was no increase in the risk groups of SC. When the mortality was examined by risk groups 6 months after the first application, the mortality increased 2 fold in the SC high risk group and more than 35 fold in the ISAR positive group. Results: SC and ISAR scorings were very close and meaningful in all the parameters examined. However, ISAR was far more successful than SC in predicting mortality. We also think that ISAR is more useful than SC because of its easy applicability
Investigation of the relationship between stroke and hematological parameters in the emergency department
No full textGiriş ve Amaç: Amacımız dünyada ölüm nedenleri arasında ön sıralarda yer alan iskemik inme ile kolay ulaşılabilir, ucuz ve hızlı bir test olan hematolojik parametrelerin ilişkisini araştırmaktır. Gereç ve Yöntem: Araştırma tek merkezli, retrospektif olup Medipol Mega Üniversitesi Hastanesi Acil Servisine başvuran 18 yaş ve üzeri akut iskemik inme ve GİA tanısı alan hastalar dahil edildi. Hastaların hematolojik parametreleri ile TOAST sınıflamasına göre inme alt grupları, acil serviste klinik sonlanma durumları ve yatış süreleri değerlendirildi. Hematolojik parametrelerin yoğun bakım ünitesine (YBÜ) yatış durumunu öngörmedeki etkinlikleri ROC (Receiver Operating Characteristic) eğrisi kullanılarak karşılaştırıldı. Bulgular: Toplam 152 hastanın 97'si (%63,8) erkek ve 55'i (%36,2) kadındı. Hastaların yaş ortalaması 64,38 ± 13,69 olarak saptandı. YBÜ'de takip edilen hastaların lökosit (WBC), nötrofil, monosit ve lökositin ortalama platelet hacmine oranı (WMR) servis hastalarına göre istatistiksel olarak yüksek bulundu. Ortalama eritrosit hacminin platelete oranı (MPR) YBÜ'de takip edilen hastalarda servis hastalarına göre daha düşük bulundu. WBC, nötrofil, monosit, ortalama eritrosit hacminin platelete oranı (MPR) ve WMR değerlerinin acil servisten yoğun bakıma yatışı öngörme başarısı istatistiksel olarak anlamlı bulunmuş olup WMR'nin öngörme gücü (AUC: 0,699 ± 0,056) en yüksek saptandı. Sonuç: Sonuç olarak GİA ve iskemik inmeli hastalarda WBC, nötrofil, monosit, WMR ve MPR, YBÜ'ye yatışı öngörmede kullanılabilir.Introductionand Aim: Our aim is to investigate the relationship between ischemic stroke, which is one of the leading causes of death in the world, and hematological parameters which are easily accessible, cheap and rapid tests. Materials and Methods: The study was a single-center, retrospective and patients aged 18 years and older with acute ischemic stroke and GİA who applied to Medipol Mega University Hospital Emergency Department were included in the study. Hematological parametres of patients were evaluated with stroke subgrups according to TOAST, clinical outcomes and duration of hospitalization. The predictive efficiency of the hematological parameters to the intensive care unit (ICU) admission status was compared using the ROC (Receiver Operating Characteristic). Results: Of the 152, 97 (63,8%) were male and 55 (36,2%) were female. The median age of the patients was 64,38 ± 13,69. Leukocyte (WBC), neutrophil, monocyte and leukocyte to mean platelet volume ratio (WMR) values in ICU patients were statistically higher than the service patients. Mean platelet volume to platelet ratio (MPR) value was lower in the intensive care unit (ICU) than in the service patients. WBC, neutrophil, monocyte, MPR and WMR 's predictive efficiencies to admision to ICU from emergency department were found statistically significant and the predictive power of WMR (AUC: 0.699 ± 0.056) was highest. Conclusion: As a result, WBC, neutrophil, monocyte, WMR and MPR can be used to predict ICU admission in patients with transient ischemic attack and ischemic stroke
Relation between hematological parameters and TIMI risk score in the evaluation of prognosis in NSTEMI patients
No full textGiriş ve Amaç: Çalışmamızda NSTEMI hastalarında prognozun öngörülmesinde hematolojik parametrelerin (lökosit sayısı (WBC), nötrofil sayısı, lenfosit sayısı, MPV, nötrofil/lenfosit oranı (NLR), platelet/lenfosit oranı (PLR), WBC/MPV oranı (WMR)) etkiliğini değerlendirmeyi, ayrıca hematolojik parametrelerin TIMI risk skoru ile olan uyumunu incelemeyi amaçladık. Gereç ve Yöntem: Bu çalışma tek merkezli, retrospektif ve gözlemsel bir kohort çalışması olup, NSTEMI tanısı alan, 18 yaş ve üzeri 259 hasta dahil edilmiştir. 1 senelik takip süresi içerisinde kararsız angina pektoris (USAP) nedeniyle hastaneye yatış, invaziv tedavi veya ilaç kullanımını gerektiren aritmiler, ölümcül olmayan MI veya kardiyak nedenli ölüm görülmesi majör istenmeyen kardiyak olay (MACE) olarak tanımlanmıştır. Hematolojik parametrelerin MACE'yi öngörmedeki etkinlikleri ROC eğrisi kullanılarak karşılaştırılmıştır. Bulgular: Çalışmaya dahil edilen 259 hastanın 188'i (%72,6) erkek olup hastaların yaş ortalaması 60,4 ± 11,9'dur. 1 yıllık takipte 60 hastada (%23,2) MACE görülmüştür. Başvuru anındaki yüksek WBC, nötrofil, NLR, PLR ve WMR değerleri uzun dönem prognozla, WBC, WMR ve NLR değerleri de TIMI skoruyla uyumlu bulunmuştur. Parametrelerin MACE öngörme gücü ROC analizi ile değerlendirildiğinde AUC değeri WBC, WMR ve NLR için sırasıyla 0,670 (%95 GA 0,590-0,750), 0,664(0,582-0,746), 0,689 (0,610-0,767) olarak saptanmıştır. Sonuç: Basit, hızlı ve ucuz bir tetkik olan hemogram parametrelerinden özellikle WBC, nötrofil, WMR, PLR ve NLR'nin NSTEMI hastalarında prognozu (MACE) öngörme gücü anlamlı bulunmuştur. Ayrıca WBC, WMR ve NLR değerleri TIMI skoruyla uyumlu saptanmıştır. Bunlar arasında NLR'nin prognozu öngörme gücü diğerlerinden daha yüksek saptanmıştır.Introduction and Aim: In our study, we aimed to evaluate the effectiveness of hematological parameters (WBC, neutrophil and lymphocyte count, MPV, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), WBC/MPV ratio (WMR)) on the prediction of 1-year prognosis in NSTEMI patients and to investigate the relationship between these hematological parameters and TIMI risk score. Materials and Methods: This single-center, retrospective and observational cohort study was performed with 259 patients aged 18 years or older who were diagnosed as NSTEMI. During the 1-year follow-up period, hospitalization due to unstable angina pectoris (USAP), any cardiac arrhythmias requiring invasive treatment or anti-arrhythmic drug use, non-fatal MI or cardiac death were defined as major adverse cardiac events (MACE). The efficacy of hematological parameters in predicting MACE was compared using ROC curve analysis. Results: Among the 259 patients included in this study, 188 (72.6%) were male and the mean age was 60.4 ± 11.9 years. MACE was observed in 60 patients (23.2%). Elevated baseline levels of WBC, neutrophil, NLR, PLR and WMR were correlated with long-term prognosis, whereas WBC, WMR and NLR were correlated with TIMI score. Predictive power of the parameters for MACE were evaluated by ROC analysis and the AUC values for WBC, WMR and NLR was 0.670 (95% CI 0.590-0.750), 0.666 (0.582-0.746), 0.689 (0.610-0.767) respectively. Conclusion: Simple, rapid and widely available hemogram parameters, especially WBC, neutrophil, WMR, PLR and NLR were found to be predictive of prognosis (MACE) in patients with NSTEMI. Among these, predictive power of the NLR was statistically better than the others
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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