Tinnitus can be defined as an imaginary sound perception in silence without any acoustic sound source in the external environment. Despite many years of human and experimental animal studies, its mechanism, pathophysiology and etiology are still debated. The perception of tinnitus differs between individuals in terms of intensity, frequency, temporal characteristics, and localization in the head or ear. Although it is easier to detect the presence and characterize tinnitus in humans in clinical practice and research, the use of experimental animal models is inevitable to determine the physiology of tinnitus, which significantly reduces the quality of life, and to study possible treatment methods. Although tinnitus can be induced in experimental animals by using salicylate or exposing them to noise, different techniques and methods have been used to determine the presence of tinnitus and its physiological characteristics. In this review article, it is aimed to present the tinnitus inducing methods in experimental animals used in the literature together with behavioral and electrophysiological methods used to determine the presence of tinnitus.

Objective: Acute myeloid leukemia (AML) is an uncommon illness in and of itself. Approximately 10% of AML cases have acute promyelocytic leukemia (APL), a particularly severe form of the disease. There is a dearth of information on Turkish patients with APL. Thus, our goal was to determine the clinical, laboratory, and survival characteristics of patients with APL diagnosed within the previous 5 years at our facility.
Methods: A retrospective analysis was performed on 15 individuals who received an APL diagnosis between 2017 and 2022. IBM SPSS Statistics 25.0 was used to conduct the statistical analysis. Kaplan-Meier analysis was used for survival analysis.
Results: With a median age of 61 years, the mean age was 56.5±15.7 years. The ratio of men to women was 1.5: 1. Hypergranular variation was seen in 73.3% of our cases. Based on the risk classification, 93.3% of cases were low-risk diseases. In 40% of patients, bleeding occurred, and in 13.3%, thrombosis occurred. In total, 5 patients (33.3%) passed away and 10 patients (66.6%) survived. There was a 20% early death rate. There was a 100% rate of total remission. The medians for overall survival (OS) and event-free survival were not met; instead, they were 34.1 and 37 months, respectively. The OS rate after 1 year was 66.7%.
Conclusion: The majority of patients in our group were elderly females with low-risk illnesses. According to our research, the biggest cause of treatment failure for this normally treatable type of leukemia is early mortality.

Objective: The autonomic nervous system is an issue that needs to be examined due to the symptoms that develop due to orthostatic intolerance when a person stands up. Nowadays, it is recommended to do sports regularly from childhood. In addition, there are many different ideas about which muscle groups work and how they work, and which sport is more beneficial. In our study, we aimed to examine the responses of the autonomic nervous systems to position changes in children who do regular and different sports.
Methods: The most commonly used head-up tilt test to detect orthostatic intolerance. Fifteen male wrestlers who dominantly do isometric sports, 15 male basketball players who dominantly do isotonic sports, and 15 children of similar age and gender who do not do regular sports participated in our study. After the children were placed on a tilt table and rested for 15 minutes, the table was turned to 70 degrees and their pulse and blood pressure were measured for 50 minutes, 65 minutes in total.
Results: In our study, basal cardiac pulse values were found to be lower in the athlete groups than in the control group, more clearly in the wrestler group doing isometric sports. There was an increase in cardiac pulses upon standing up in all groups. During the test, systolic blood pressure values were found to be higher in the wrestlers than in the control group, while basal diastolic blood pressure values were found to be significantly lower in the athlete groups.
Conclusion: The fact that there is a greater increase in diastolic blood pressure upon standing up in those who dominantly isometric sports compared to those who dominantly isotonic sports suggests the need to do dominantly isometric movements to prevent orthostatic intolerance which is the most common cause of vasovagal syncope.

Objective: According to the characteristics of the tasks in hospitals -cleaning works, laboratory services, polyclinic services- chemicals with high evaporation potential at room temperature and that named volatile organic compounds are used. Healthcare workers are defined as one of the worker groups that are most exposed to chemical risks in the literature. To protect the health of healthcare workers, it is necessary to evaluate the chemical risks in terms of possible negative health and safety effects for health workers and to measure their levels.
Methods: In this cross-sectional study, the measurement of chemical risks in hospitals will be discussed over two years of data from an accredited occupational hygiene laboratory to measure chemical risks.
Results: To 2.328 occupational hygiene measurements performed in 26 hospitals, 341 (14.6%) were related to chemical risks. Of the chemical risk measurement results, 19 (5.5%) exceeded the permissible limit value. Although different occupational risks were measured in 4 hospitals, chemical risks were not measured.
Conclusion: Although the activities and legal legislation offered through risk assessment in our country are sufficient in terms of quality, there are situations that need to be improved in quantity. It has been observed that national standards on the measurement of chemical risks do not adequately define the parameters to be measured, where and how they will be measured.

Objective: This study aimed to explore whether the coronary sinus (CS) diameter to the inferior vena cava (IVC) diameter (CS/IVC) ratio measured by computed tomography pulmonary angiography (CTPA) can be used to predict pulmonary embolism (PE) and its relationship with worse clinical outcomes.
Methods: Our study included 198 patients. Study patients were divided into groups according to the presence of PE. CS and IVC diameters were measured using CTPA. While PE was not detected in 132 patients, it was detected in 66 patients.
Results: The CS/IVC ratio (78.3±18.8% and 49.3±17.2%, p<0.001) was higher in the PE group. The CS/IVC ratio was established as a predictor of PE (odds ratio: 4.189, 95% confidence interval: 1.990-8.819, p<0.001). The cut-off value for the CS/IVC ratio value was ≥60.8 (sensitivity: 86.4%, specificity: 77.3%, positive predictive value: 66.67%, and negative predictive value: 94.44%) in PE. It was observed that clinical outcomes were higher in patients with CS/IVC ratio ≥60.8%.
Conclusion: The CS/IVC ratio was predictive of PE in patients diagnosed with acute PE. The CS/IVC ratio may be useful in estimating patients hospitalized for PE who require close monitoring.

Objective: Fresh frozen plasma (FFP) has limited indications despite its frequent use. This study aimed to investigate the clinical and laboratory findings of patients who received FFP transfusion. The suitability and effectiveness of transfusion were also examined.
Methods: We retrospectively reviewed the files of patients who underwent FFP transfusion for any reason below the age of 18 years. Transfusion suitability was determined based on the transfusion guidelines.
Results: Two hundred eight FFP transfusions to 134 patients were included in the study. In total, 429 units of FFP were transfused. Of the 208 transfusions, 156 (75%) were appropriate based on indication and 52 (25%) were considered inappropriate. In total, 87 out of the 429 units of the product (20.2%) were transfused inappropriately. None of the patients who received inappropriate transfusions exhibited signs of bleeding. Significant improvements in prothrombin time and activated partial thromboplastin time were observed in patients who received transfusions with appropriate indications.
Conclusion: In this study, the incidence of inappropriate FFP transfusion was lower compared to other centers. However, 3 out of 4 patients received prophylactic FFP for bleeding prevention. The cost of inappropriate transfusions in this study was estimated at $1640 annually. Since transfusion practices are mostly based on adult studies, our study will increase awareness regarding transfusion practices among children. Consequently, there is a need for educational programs that can reduce the rate of FFP transfusions.

Objective: To evaluate the efficacy of the necrotizing enterocolitis-treatment-aid (NEC-T-Aid) tool for diagnosing perforated NEC in preterm infants, particularly in cases in which pneumoperitoneum is absent.
Methods: This retrospective study included patients with surgically confirmed perforated NEC at a single-center from 2012 to 2022. Patients were assessed using the NEC-T-Aid assessment tool, which includes the clinical, abdominal signs, serological markers, and X-ray findings. Patients without pneumoperitoneum were specifically analyzed to determine the tool’s diagnostic accuracy.
Results: Among the 39 patients included in the study, 25% of those with perforated NEC without pneumoperitoneum could not be definitively diagnosed using the NEC-T-Aid tool. Patients in the pneumoperitoneum group also experienced longer delays from initial evaluation to surgery, more extensive bowel resections, and a higher incidence of pediatric intestinal failure compared with patients in the pneumoperitoneum group.
Conclusion: The NEC-T-Aid tool has limitations in diagnosing perforated NEC in patients lacking pneumoperitoneum, highlighting the need for enhanced diagnostic methods. Improving early detection and intervention strategies are crucial for better managing NEC and reducing complications, such as extensive bowel resection and pediatric intestinal failure.

Objective: The aim of this study was to determine the areas of use of artificial intelligence (AI) by family medicine assistants and to evaluate their knowledge and approaches to the use of AI in the field of health.
Methods: This study was designed as a descriptive research. The participants were family medicine residents in 4 university hospitals in İzmir province. Data were collected using an online questionnaire prepared by the researchers. The questionnaire included preliminary information about the participants’ use of AI as well as various sections aiming to evaluate their approaches towards AI in the field of health.
Results: A total of 204 participants, 108 (52.9%) female and 96 (47.1%) male, were included in the study. While 64.7% (n=132) of the participants defined themselves as having basic knowledge about AI, 69.1% (n=141) had knowledge about the use of AI in the field of medical imaging. While 85.3% (n=174) of the participants wanted to have AI applications courses in specialty education, only 35.3% (n=72) found AI reliable. 98.5% (n=201) of the participants thought that AI could keep records like a physician, 75% (n=153) thought that it could analyze disease prognosis, 97.1% (n=198) thought that the time taken for diagnosis would be shortened with the use of AI, and 80.9% (n=165) thought that treatment costs would be reduced.
Conclusion: AI is a development that will play a more active role in healthcare, especially in primary care, in the future. Many participants believed AI could perform certain health services like a physician, would have positive effects in various areas, and wanted AI included in health courses in specialty education. Therefore, increasing the knowledge level of family medicine assistants through AI training will contribute to the delivery of health services.

Objective: Pregnant refugees in Turkey are at high risk for infectious diseases due to limited access to healthcare services and suboptimal hygiene conditions. This study aims to assess the risks posed by infections, particularly toxoplasmosis, Rubella, hepatitis, human immunodeficiency virus (HIV), and cytomegalovirus (CMV), during pregnancy. These pathogens have adverse effects on maternal and fetal health during gestation, and early diagnosis and management are crucial.
Methods: This retrospective study analyzes serological test results from pregnant refugees who presented at University of Health Sciences Turkey, İzmir Tepecik Education and Research Hospital between March 1, 2018, and March 1, 2020. Tests evaluated included anti-Toxoplasma immunoglobulin (Ig)M, anti-Toxoplasma IgG, anti-hepatitis C virus (HCV), hepatitis B surface antigen (HBsAg), anti-HIV, anti-HBs, anti-Rubella IgM, anti-Rubella IgG, anti-CMV IgM, and anti-CMV IgG. Seroprevalence rates were analyzed annually.
Results: Of the pregnant participants, 94.7% were Syrian, and 5.3% were Afghan. Seroprevalence rates for Toxoplasma IgG, Rubella IgG, and CMV IgG were found to be 51.3%, 85.3%, and 57.6%, respectively. No significant variation in test results was observed over the years. The positive rates for anti-HCV, HBsAg, and anti-Rubella IgM were low; chi-square analysis was limited by low cell frequencies, affecting statistical power.
Conclusion: This study reveals a high prevalence of infections such as toxoplasmosis, Rubella, hepatitis B, and CMV among pregnant refugees in Turkey. Expanding screening and vaccination programs for refugee women is recommended to mitigate infection risks. Improving access to healthcare services and regular screenings is crucial to curbing the spread of these infections.

Objective: This study aims to conduct a bibliometric analysis of research on “emergency medicine in disasters” published between 2004 and 2023, highlighting the scientific developments, key themes, and research gaps in this growing field. With the increasing frequency of disasters due to factors like climate change, urbanization, and population growth, the importance of disaster emergency medicine has become more critical. While technological advancements have improved emergency medical responses, research shows that further development is needed. This analysis seeks to evaluate global trends and collaborations in disaster medicine research to provide a strategic roadmap for future studies and enhance the preparedness and effectiveness of health systems in responding to disasters.
Methods: A bibliometric review of 1,532 articles published between January 1, 2004 and December 31, 2023, was conducted using the Web of Science Core Collection database. The analysis focused on articles published in peer-reviewed journals, limited to the “emergency medicine” field, written in English, and meeting the defined timeframe. The selected articles were examined based on publication trends, citation counts, journal distribution, most-cited authors, and collaborative networks between institutions and countries. Tools such as keyword networks, bibliographic coupling, co-authorship analysis, and citation mapping were used to visualize research collaborations and thematic focus areas. VOSviewer software was employed to map research collaborations and identify the most influential studies in disaster medicine.
Results: The study’s findings reveal a significant increase in research output, particularly following global crises such as coronavirus disease-2019 (COVID-19). Countries like the United States of America (USA), Canada, the United Kingdom, and China lead in both publications and international collaborations, demonstrating strong partnerships in disaster medicine research. Institutions such as Harvard University and Johns Hopkins University stand out for their high productivity and impact, with highly cited articles focusing on disaster-related health impacts, triage, and the mental health of responders. Key research themes include disaster preparedness, emergency medical services, and global health crises, underscoring the growing importance of international collaboration in advancing disaster medicine.
Conclusion: The bibliometric analysis of research on “emergency medicine in disasters” from 2004 to 2023 demonstrates a substantial increase in scientific output, especially following the COVID-19 pandemic. Key findings highlight the central role of journals like Prehospital and Disaster Medicine and the influential contributions of institutions such as Harvard University and Johns Hopkins University. Frequently cited articles focus on disaster health impacts, triage, and mental health support for healthcare workers, reflecting the critical importance of preparedness and response strategies. International collaborations, particularly among countries like the USA, Sweden, Iran, and Turkey, have expanded, underlining the growing global significance of disaster medicine. These results underscore the vital role that disaster emergency medicine plays in strengthening global health systems and the increasing academic focus on this field.

Objective: Cardiac arrest, which is characterized by sudden cessation of circulation and cardiac activity, leads to irreversible fatal outcomes without resuscitative interventions. Although various biomarkers have been studied for the prognostic evaluation of cardiac arrest, data on the utility of eosinophil counts remain limited. The current study aimed to investigate the association between eosinophil count and emergency department (ED) mortality among patients experiencing cardiac arrest.
Methods: This retrospective study included patients with cardiac arrest who presented to the ED between 2022 and 2024. In total, 274 patients were analyzed. Data were retrospectively obtained from the hospital information system, including demographic characteristics (age, gender) and biochemical parameters (e.g., white blood cell count, eosinophil count). Outcomes such as ED mortality and hospital admission were also examined.
Results: The study was completed in 274 patients after applying the inclusion and exclusion criteria. The mean age of the patients was 68 years, and 65.3% of them experienced mortality in the ED. Among the blood parameters, eosinophil, lymphocyte, platelet, and albumin levels were significantly higher in patients who survived compared with those who did not (p<0.001, p=0.001, p=0.006, and p=0.008, respectively), while no significant differences were observed in other parameters (p>0.05). Multivariate logistic regression analysis revealed that a 0.1-unit decrease in eosinophil count increased the mortality rate by 1.482 times (p=0.006). The ROC analysis assessing the relationship between eosinophil count and mortality yielded an area under the curve of 0.629, with a cut-off value of 0.055 (p<0.001).
Conclusion: Our findings demonstrate that eosinophil levels are a significant biomarker of ED mortality in patients with cardiac arrest. The distinct response of eosinophils to post-cardiac arrest perfusion disturbances suggests their potential role as prognostic indicators in critical illness. Future large-scale, multicenter prospective studies are needed to further clarify the prognostic value of eosinophil levels and their broader clinical applications.

Objective: Point of care devices are fast and easy to use but their true potential is still waiting to come up. TensorTip MTX is a non-invasive medical device can measure various bioparameters, including hemoglobin. Purpose of this study is to measure the correlation between TensorTip MTX and our routine laboratuvary analysis of hemoglobin and to see that device is useable in emergency department settings for situations like gastroinstestinal bleeding and acute traumatic hemorrhages.
Methods: In the month after the ethical board approval, we conduct our study in 147 patients. Their hemoglobin levels were already measured while their course of emergency department visit. To gather accurate data of hemoglobin measurement of TensorTip MTX, device put on the ring finger of the patients and wait at least 45 seconds for measurement. All measurement documented and recorded by researcher. Measurements from blood samples and TensorTip MTX device are compared with intraclass correlation coefficient (ICC) and Pearson correlation coefficient.
Results: In 147 patients; 61.2% (n=90) were male, 38.8% (n=57) were female and ages are between 18 and 89. Mean age is 55.72±20.30 years; 23.1% (n=34) of them is under 35 years old, 76.9% (n=113) over 35 years. Statistically, the correlation between hemoglobin levels measured by the reference method and TensorTip was found to be 42.4%, which is statistically signficant (p=0.001; p<0.01) [ICC: 0.424; 95% confidence interval (CI): 0.281-0.548]. Correlation between hematocrit level measurements is 46.9% significantly compatible (p=0.001; p<0.01) (ICC: 0.429; 95% CI: 0.333-0.586).
Conclusion: Our study showed that correlation between reference measurement and TensorTip MTX device is fair (ICC: 0.424 for hemoglobin and 0.429 for hematocrit). Further studies needed to determine that this device is suitable or not to identify the need of blood transfusion and management of patients with acute hemorrhages in the emergency settings for now.

Aberrant right subclavian artery (ARSA) is a congenital anomaly with a reported frequency of 0.5-1% and generally shows an asymptomatic clinical course. Being rare and usually asymptomatic complicates diagnosis and treatment. Although respiratory symptoms are rare in ARSA, chronic cough may be a symptom for diagnosis. Cases with chronic cough that persists despite treatment should be evaluated using posteroanterior chest X-ray and, if necessary, thorax computed tomography. In our article, we presented a case of a patient who applied to our family medicine outpatient clinic with a complaint of chronic cough and was diagnosed with ARSA.