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Lausanne, Switzerland

Aksel G.,Umraniye Training and Research Hospital | Guler S.,Ankara Nuclear Research And Training Center | Doan N.O.,Kocaeli University | Corbaciolu S.K.,Emergency Service
Human and Experimental Toxicology | Year: 2015

Objective: Appropriate treatment for scorpion-associated pain was not previously studied in detail in the literature. The aim of this study was to compare the efficacy of three treatment modalities in patients with painful scorpion stings using visual analog scale (VAS) scores. Materials and Methods: A randomized study was carried out during a 1-year period in patients with scorpion stings who did not have any systemic signs or symptoms. Patients were treated with intravenous paracetamol, topical lidocaine, or ice application. Pain intensity was evaluated using VAS score at the time of presentation to emergency department and at 30th, 60th, 120th, and 240th minutes. Changes in VAS scores from baseline were recorded. Results: A total of 130 patients were included in the statistical analysis. Significant reduction in pain intensity was observed with topical lidocaine group when compared with the ice application group (p < 0.001) and paracetamol group (p < 0.001) in all selected time intervals. The median reduction in scores at 30 min after therapeutic intervention was 25.0 mm for topical lidocaine, 14.5 mm for ice application, and 10.0 mm for intravenous paracetamol. No adverse events were reported. Discussion: Our results revealed that topical lidocaine is superior to both intravenous paracetamol and local ice application and its effect lasts several hours after envenomation. conclusion: Topical lidocaine is an effective and safe treatment in scorpion sting associated with pain in patients with nonsystemic signs and symptoms. © The Author(s) 2014.

Denoel P.,Emergency Service | Vanderstraeten J.,Free University of Colombia | Mols P.,Free University of Colombia | Pepersack T.,Free University of Colombia
Journal of Aging Research | Year: 2014

Several studies have reported underprescription of anticoagulants in atrial fibrillation (AF). We conducted an observational study on 142 out of a total of 995 consecutive ≥75 years old patients presenting AF (14%) when admitted in an emergency unit of a general hospital, in search of geriatric characteristics that might be associated with the underprescription of anticoagulation therapy (mostly antivitamin K at the time of the study). The following data was collected from patients presenting AF: medical history including treatment and comorbidities, CHADS2 score, ISAR scale (frailty), Lawton's scale (ADL), GDS scale (mood status), MUST (nutrition), and blood analysis (INR, kidney function, and albumin). Among those patients for who anticoagulation treatment was recommended (73%), only 61% were treated with it. In the group with anticoagulation therapy, the following characteristics were observed more often than in the group without such therapy: a recent (≤6 months) hospitalization and medical treatment including digoxin or based on >3 different drugs. Neither the value of the CHADS2 score, nor the geriatric characteristics could be correlated with the presence or the absence of an anticoagulation therapy. More research is thus required to identify and clarify the relative importance of patient-, physician-, and health care system-related hurdles for the prescription of oral anticoagulation therapy in older patients with AF. © 2014 Paule Denoël et al.

Arik F.,Selcuk University | Yaldiz T.,Emergency Service
Clean - Soil, Air, Water | Year: 2010

The investigation area is located to the east of Kütahya-Tavşanli and, covers an area about 150 km2. The units cropping out in the study area comprise of metamorphic, volcanic, and sedimentary rocks ranging from Upper Paleozoic to Quaternary. There are some polymetallic ore deposits represented by silver, zinc, lead, and antimony deposits and some enrichments related to them such as As, Cd, Tl, Cu, Mn, Ba, and Sr around the Aktepe at the southeast of the study area. In order to investigate the heavy metal contents and contamination in soil and plants, some leaves, branches, and fruits of trees (Salix, oak: Quercus sp., pine: Pinus sp., apple: Malus communis, walnut: Juglans regia, poplar: Populus sp., plane: Platanus orientalis, pear: Pyrus communis, oleaster: Elaeagnus angustifolia) and some herbaceous plants like prickle and meadow samples have been collected and subjected to geochemical analysis. Mean element concentrations of soil samples are 0.7 ppm Ag, 82.6 ppm Pb, 165.3 ppm Zn, and 8.5 ppm Sb. The concentration of As, Cd, Tl, Cu, Mn, Ba, and Sr are 203.3, 1.5, 1.7, 32.6, 1059.5, 718.4, and 289.6 ppm, respectively. With respect to plants the average heavy metal concentrations are 0.14 ppm Ag, 2.49 ppm Pb, 52.34 ppm Zn, and 1.05 ppm Sb and the average concentration of As, Cd, Tl, Cu, Mn, Ba, and Sr are 4.41, 0.64, 0.19, 6.54, 119.80, 39.46 versus 41.21 ppm, respectively. Element distributions of soil and plants depend on to the distance from the present Ag-Pb-Zn-Sb deposits. Element concentrations of plants differ depending on not only plant type like tree and herbaceous plants but also the types of samples such as leaves, branches, or fruits of trees. Especially leaves of trees and herbaceous plants have relatively higher element concentrations. Therefore, people who and animals which live in this area and benefit from these soil and plants have vital risks. © 2010 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Garrido-Chamorro R.,Emergency Service | Sirvent-Belando J.E.,University of Alicante | Gonzalez-Lorenzo M.,Intensive Care Unit | Blasco-Lafarga C.,University of Valencia | Roche E.,University Miguel Hernandez
International Journal of Morphology | Year: 2012

Skinfold determinations from different body parts are occasionally used in prediction equations to calculate fatness. This is a critical parameter that conditions optimal sport performance. Reference values of skinfolds in top athletes do not exist. Therefore, the main objective of this study is to present skinfold reference values from a large population of athletes. Triceps, subscapu lar, suprailiac, abdominal, thigh and medial calf skinfolds were measured according to ISAK (International Society for Advancement of Kinanthropometry) norms in 2500 athletes. Six skinfold sums as well as partial sums from different body segments (upper, trunk and lower) were applied. Data show that the highest skinfold values were observed for thigh calf and abdominal, being the subscapular the lowest. Women presented higher skinfold values than men. Concerning partial sums, trunk and lower body segments presented the highest scores. Subjects practicing hockey, handball, indoor soccer, rowing, scuba diving and table tennis displayed the highest fat percents. In conclusion, fatty mass calculation in athletes should consider the six skinfold sum. In addition, body fat tends to be localized in the trunk and lower body segments in athletes and varies according to gender and sport discipline.

Carron P.-N.,University of Lausanne | Taffe P.,University of Lausanne | Ribordy V.,Intensive Care Unit | Schoettker P.,University of Lausanne | And 2 more authors.
European Journal of Emergency Medicine | Year: 2011

OBJECTIVE: Accurate identification of major trauma patients in the prehospital setting positively affects survival and resource utilization. Triage algorithms using predictive criteria of injury severity have been identified in paramedic-based prehospital systems. Our rescue system is based on prehospital paramedics and emergency physicians. The aim of this study was to evaluate the accuracy of the prehospital triage performed by physicians and to identify the predictive factors leading to errors of triage. METHODS: Retrospective study of trauma patients triaged by physicians. Prehospital triage was analyzed using criteria defining major trauma victims (MTVs, Injury Severity Score >15, admission to ICU, need for immediate surgery and death within 48 h). Adequate triage was defined as MTVs oriented to the trauma centre or non-MTV (NMTV) oriented to regional hospitals. RESULTS: One thousand six hundred and eighti-five patients (blunt trauma 96%) were included (558 MTV and 1127 NMTV). Triage was adequate in 1455 patients (86.4%). Overtriage occurred in 171 cases (10.1%) and undertriage in 59 cases (3.5%). Sensitivity and specificity was 90 and 85%, respectively, whereas positive predictive value and negative predictive value were 75 and 94%, respectively. Using logistic regression analysis, significant (P<0.05) predictors of undertriage were head or thorax injuries (odds ratio >2.5). Predictors of overtriage were paediatric age group, pedestrian or 2 wheel-vehicle road traffic accidents (odds ratio >2.0). CONCLUSION: Physicians using clinical judgement provide effective prehospital triage of trauma patients. Only a few factors predicting errors in triage process were identified in this study. © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins.

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