Objectives: Poisoning is a significant global health concern, leading to higher mortality and morbidity rates. The present study aimed to assess demographic details, hospital admission patterns, laboratory findings, and applied pharmacological treatments for patients presenting to the Emergency Department with drug poisoning.Materials and Methods: From August 5, 2020, to August 5, 2021, a cross-sectional, retrospective analysis was conducted on patients who presented to the Emergency Department of a tertiary care hospital with a drug poisoning diagnosis. Information gathered included patient demographics, the identified poisoning agent, laboratory findings, and the implemented treatment strategies.Results: The mean age for the 584 drug poisoning cases was 30.0±10.9 years; the majority, 44.9%, were between 18-25 years old, with a female preponderance (63.0%). The most frequently implicated drug groups were anti-inflammatory/anti-rheumatic products and psychoanaleptics, each accounting for 13.7% of all identified drugs.Conclusion: These findings suggest the need for improved awareness, monitoring, and rational use of commonly accessible medications. Strengthening regulations on over-the-counter drug availability may also help reduce poisoning incidents.
Objective: To evaluate the clinical characteristics, subspecialty distribution, and legal outcomes of orthopedic malpractice claims adjudicated through individual applications to the Turkish Constitutional Court, and to identify patterns of rights-based judicial review in orthopedic litigation.Materials and Methods: A retrospective descriptive study was conducted using publicly accessible decisions retrieved from the official database of the Turkish Constitutional Court. A systematic search was performed using the keyword “ortopedi,” and results were further refined by applying legal filters related to medical negligence and healthcare-associated harm. A total of 111 decisions were initially identified. After applying malpractice-related filters, 15 decisions underwent full-text evaluation. Of these, 13 cases met the predefined inclusion criteria and were included in the final analysis. Decisions were assessed for clinical relevance to orthopedic practice and reviewed for clinical context, orthopedic subspecialty involvement, primary malpractice allegations, alleged constitutional rights violations, admissibility status, and final judicial outcomes. Data were extracted using a standardized framework and analyzed descriptively using frequencies and percentages.Results: Thirteen Constitutional Court decisions involving orthopedic care were included. Trauma-related management constituted the predominant clinical context, followed by postoperative complications and diagnostic delays. The most frequently involved subspecialties were trauma and fracture management, adult reconstructive surgery, and spine care. Constitutional violations were identified in 53.8% of cases (7/13), while the remaining 46.2% resulted either in findings of no violation or inadmissibility. Among cases reviewed on the merits, violations were primarily associated with procedural deficiencies in judicial evaluation, rather than direct determinations of medical fault.Conclusion: Orthopedic malpractice claims reaching the Turkish Constitutional Court are primarily derived from trauma-related care. These findings should be interpreted within the framework of constitutional judicial review, which evaluates procedural adequacy and protection of fundamental rights rather than directly determining medical negligence. These results underscore the distinction between clinical malpractice litigation and constitutional judicial review in orthopedic disputes.
Background: Autologous fat grafting has emerged as a promising technique to mitigate radiation-induced tissue damage during breast reconstruction. This study aimed to evaluate the effects of fat grafting timing on the irradiated skin in a rat model.Materials and Methods: Twenty female Wistar albino rats were divided into two groups: early grafting (EG) and delayed grafting (DG). All the rats received 20-Gy external beam irradiation of the anterior thoracic wall. In the EG group, fat grafting was performed one day post-irradiation, whereas in the DG group, it was performed 21 ds should be days. The contralateral side of each rat served as a control and received saline injection. Macroscopic evaluation of the skin quality and necrosis rates, microangiography, and histological analyses were performed.Results: Results showed that necrosis rates were significantly lower in grafted tissues than in control sites in both the EG and DG groups. Although the EG exhibited less fibrosis and higher vascularization, the differences were not statistically significant. Histological assessments revealed reduced inflammatory cell infiltration and better preservation of skin appendages in the grafted areas, particularly in the EG. Microangiography confirmed adequate neovascularization around the graft.Conclusion: Despite the limitations in sample size and grafting intervals, this study suggests that fat grafting, regardless of timing, can improve tissue integrity and vascularization in irradiated skin. Further research is needed to optimize protocols and enhance patient outcomes in breast reconstruction following radiotherapy.
Objective: To present a 10-year single-center experience with nasal dermoid cysts and to evaluate their clinical presentation, radiological characteristics, surgical management, and outcomes, in conjunction with a review of the literature. Materials and Methods: A retrospective analysis was conducted on eight patients diagnosed with nasal dermoid cysts between 2015 and 2025 at a tertiary referral center. Demographic data, presenting symptoms, imaging findings, lesion classification according to the Hartley system, surgical approaches, and follow-up outcomes were reviewed. Patients without histopathological confirmation or with incomplete clinical data were excluded. All patients underwent preoperative magnetic resonance imaging to assess lesion extent and possible intracranial involvement. Results: The study included eight patients (5 females, 3 males) with a mean age of 16.12 years. The most common presenting symptom was nasal dorsum swelling (75%). All lesions were cystic, and no sinus tract or fistula was observed. Imaging revealed fat-containing lesions in all cases, with varying degrees of soft tissue involvement and bone erosion. According to the Hartley classification, one patient was classified as Type I, six as Type II, and one as Type III. No intracranial intradural extension was identified. Surgical excision was performed using external, intranasal, or combined approaches depending on lesion extent. No postoperative complications were observed. The mean follow-up period was 5.37 years, and no recurrences were detected. Conclusion: Nasal dermoid cysts are rare congenital lesions requiring thorough preoperative evaluation, particularly to assess intracranial extension. Accurate radiological assessment and individualized surgical planning are essential for complete excision. In our series, appropriate surgical management resulted in favorable outcomes without recurrence.
Acute non-invasive ventilation (NIV) is a lifesaving treatment for acute hypercapnic respiratory failure, particularly during exacerbations of chronic obstructive pulmonary disease (COPD), and is also an established therapy that improves outcomes in acute cardiogenic pulmonary oedema. Decisions regarding NIV initiation are complex and require careful consideration of patient-specific factors. With an aging population, with increasing multimorbidity, understanding the evolving acute NIV patient characteristics is critical to optimize NIV delivery. We audited all adult acute NIV patients at a tertiary centre, pre-COVID (April 2019-March 2020) and post-COVID (April 2023-March 2024) and performed a retrospective observational cohort analysis. We compared the Charlson Comorbidity Index (CCI) scores and outcomes using Chi-squared or Mann-Whitney U. Three hundred and twelve patients received acute NIV, 171 pre-COVID and 141 post-COVID. Post-COVID patients had higher comorbidity burden vs pre-COVID (median CCI 5 vs 4, p=0.002), and ward-based NIV ceiling of care frequency (83% vs 66%, p=0.009). Across the entire cohort, higher CCI score associated with increased NIV failure (p=0.007) and in-hospital mortality (p<0.001). Our demonstration of increasing multimorbidity in a real-world cohort, and the association of multimorbidity with NIV failure, provides insights to guide optimization strategies for acute NIV services. Further understanding the evolving patient characteristics and their impact on outcome is essential to determine how best to incorporate comorbidity assessment into clinical decision making for improved NIV delivery.
