Objectives: To evaluate the relationship between clinical features evaluated at admission to the emergency department (ED) and the presence of infection on thoracic and abdominal tomography (CT) scans in patients with acute febrile illness without clinical clues. Methods: Patients aged 18 years and over who presented to ED with acute fever between January 1, 2020 and December 31, 2020 and underwent CT imaging (thoracic and abdomen) as a diagnostic test CT) were included in the study retrospectively. The patients were divided into two groups according to the presence and absence of a source of infection on CT. The clinical and demographic data of the patients were evaluated. The effect of clinical factors on the presence of infection in CT scans was determined using the logistic regression analysis. Results: Among the 173 patients included in the study, the CT scans were positive for the source of infection in 31.2% (n=54) and negative in 68.8% (n=119). In the multiple logistic regression analysis, age ≥ 65 years [odds ratio (OR):2.72, 95% confidence interval (CI):1.15-4.35, p<0.001), presence of comorbidity (OR:2.37, 95% CI:1.08-4.14, p=0.033), and procalcitonin positivity (PCT) (OR:2.54, 95% CI:1.29-4.95, p=0.006) were identified as risk factors for the presence of infection in CT. Conclusion: Age, presence of comorbidity, and PCT level should be considered when deciding on the use of CT in determining the source of infection in acute febrile patients without clinical clues.

Background: Despite significant advances in the treatment of heart failure, the prognosis of acute cardiogenic pulmonary edema (ACPE) continues to be a serious problem. The objective of this study is to determine the risk factors affecting in-hospital mortality in patients with ACPE. Methods: We enrolled 305 patients who were hospitalized with cardiogenic pulmonary edema as a diagnosis. Clinical, biochemical and echocardiographic variables were collected and analysed. The patients were divided into two groups according to the presence of mortality. Both groups were evaluated in terms of clinical features during admission to the emergency department (ED) and factors affecting in-hospital mortality. Results: Forty-two patients died and the mortality rate was 13.8%. To determine the factors affecting mortality, multiple logistic regression analysis was performed. In the regression analysis, it was seen that age at admission to the ED (OR:1.75, 95% CI 1.18-3.05, p:0.014), systolic blood pressure (OR:0.95, 95% CI 0.31-0.98, p:0.040), presence of acute myocardial infarction (OR:4.17, 95% CI 1.85-7.13, p:0.001), positive troponin (OR:5.47, 95% Cl 1.07-7.46, p:0.011), atrial fibrillation rhythm (OR;3.16, 95% CI 1.81-8.02, p:0.010), inotropic drug usage (OR;5.61, 95% CI 1.87-9.24, p:0.013) increased in-hospital mortality. Conclusion: Our findings might help clinicians in identifying patients with poor prognosis early in the presence of identified risk factors.

Background: There is growing interest in physical medicine treatment options for renal colic. In this study, we aimed to determine whether or not heat-patch treatment with no drug was effective in relieving renal colic. Methods: For this purpose, patients who were diagnosed with renal colic in the emergency department were randomized to have either heat-patch or sham treatment. The Visual Analog Scale (VAS) scores of renal colic, body temperature (Btemp), and sub-patch skin temperature (Stemp) values were measured at 0,15,30,45, and 60 min. In addition, the salvage treatment needs of the groups were compared. Results: The average age of the study group was30.5 ± 8.3 years and that of the sham group was 31.0 ± 8.2 years (p = 0.75). According to the baseline VAS score of the patients, 15, 30, 45, and 60min VAS scores significantly decreased in the heat-patch group (p<0.001). The Btemp values did not differ significantly between the heat-patch and sham groups. In addition, no statistically significant difference was found between the two groups in terms of Stemp values at 0 and 15 min (p = 0.39and p = 0.10, respectively). However, there was a significant difference in the heat-patch group in terms of Stemp values at30, 45, and 60 min compared to the sham group (p<0.001). The salvage treatment rates for the heat-patch and sham groups were 11.5% and 31.4%, respectively (p = 0.01). Conclusion: As non-pharmaceutical treatment, the heat-patch has been shown to be a possible candidate for pain relief in patients with urolithiasis. Further research should concentrate on multicenter and large-scale randomized studies.