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A DEMOGRAPHIC ANALYSIS OF PATIENTS PRESENTING TO THE TERTIARY EMERGENCY DEPARTMENT BETWEEN THE FIRST RESTRICTION PERIOD AND THE FIRST NORMALIZATION PERIOD IN THE COVID-19 PANDEMIC
(2022) Ünlü, Kağan; Özsan, Sinan Oğuzhan; Cömertpay, Ertan; Deniz, Turgut
Objective: The COVID-19 virus has become a global threat by spreading all over the world. Countries are often unprepared for pandemics or other disasters, especially in the beginning, they experience organizational problems and the health system is adversely affected by this situation. The aim of this study is to analyze the patients who applied to the emergency department from the date of the first case in our country to the first day of the normalization process and to investigate the effects of different restraint decisions on the emergency patient characteristics. Material and Methods: This study was carried out retrospectively on patients who applied to the emergency department of Kırıkkale University Medical Faculty Hospital between 11.03.2020 and 01.06.2020. During this period, the dates of the critical restriction decisions regarding the pandemic were determined, and the patients were divided into four different periods according to the time of admission. Period-I: Between 11 March and 21 March, Period-II: Between 21 March and 3 April, Period-III: Between 3 April and 4 May, and Period-IV: Between 4 May and 1 June. Demographic data, application forms, units for which consultation was requested, diagnoses and hospitalization status of all patients were recorded. Obtained data were evaluated with SPSS 22.0 program and p<0.05 value was considered significant. Results: It was determined that 6507 patients applied to the emergency department during the study period. Period-I, n=1111; Period-II, n=723; Period-III consisted of n=2231 and Period-IV consisted of n=2442 patients. While the number of patient admissions was 78.39±28.46/day, 8.4% of them applied by ambulance. While 14.9% of all patients were infectious diseases emergencies, 17.3% were trauma. While simple traumas constituted 36.7% of the trauma patients, this was followed by falls and stab wounds. In Periods III and IV, the rate of stab wounds, blow and gunshot wounds increased. The highest number of consultations was requested from the Obstetrics and Gynecology clinic, followed by Internal Medicine and Cardiology. 14.8% of all patients were hospitalized and treated. The highest number of hospitalizations was in Internal Medicine, followed by Gynecology and Obstetrics and Cardiology. Conclusion: As the pandemic process progressed, the rate of admissions by ambulance increased, and the characteristics of trauma cases changed. The application of pregnant patients to the hospital continued even during the pandemic.
An investigation of cardiac effects in patients presenting to the pandemic clinic with suspected COVID-19
(2022) Karslı, Aysun; Özsan, Sinan Oğuzhan; Comertpay, Ertan; Başkürkçü, Ahmet Faruk; Eroğlu, Oğuz; Deniz, Turgut
Aim: COVID-19 is a virus capable of causing cardiovascular complications. This study investigates whether any cardiac effect is present in patients presenting with suspected COVID-19 in the light of Electrocardiography (ECG) findings. Material and Method: This prospective study involved patients with chest pain presenting to the pandemic clinic with suspected COVID-19. Patients were divided into two groups based on their PCR results, PCR-positive and -negative. All participants’ demographic characteristics, presentation symptoms and the duration thereof, physical examination findings, laboratory results, and ECG findings were recorded. Patients with positive PCR results were invited for checks on the 15th day, when repeat ECG was performed. Results: A-50 patients with positive PCR results and 50 with negative PCR results were included in the study. The mean age of the entire patient group was 52.30±16.02 years, and 56% were women. No difference was determined between the positive and negative PCR result patients in terms of age or sex (p=0.116; 0.687, respectively). Presentation high sensitive cardiac Troponin (hs-cTn) levels were significantly higher in the patients with positive PCR results than in the PCR-negative patients (p<0.001). Rates of detection of ST-T change at presentation ECG were 38% in the patients with positive PCR results and 16% in those with negative PCR results (p=0.023). ST-T alteration persisted at 15th day ECG in 36% of the patients with positive PCR results. P-wave amplitude and mean heart rate were significantly higher at presentation ECG in the patients with positive PCR results than at ECG on day fifteen (p=0.038; <0.001 respectively). Conclusion: A cardiac effect does occur in patients with COVID-19, and this can be shown by means of ECG findings. The increase in P-wave amplitude at presentation ECG in patients with positive PCR results may represent a marker of COVID-19-related cardiac overload. ECG should be performed both at presentation and in the following days on COVID-19 patients presenting with chest pain, and care should be taken against potential ischemic ST-T alterations.
Cama Yumruk Atan Hastaların Demografik Özellikleri Ve Hava Koşulları İle İlişkisi
(2017) Eroğlu, Oğuz; Koçak, Orhan Murat; Çoşkun, Figen; Deniz, Turgut
Giriş: Eski çağlardan beri hava koşullarının insan davranışları üzerinde etkisi olduğuna inanılmaktadır. Yapılan çalışmalarda elde edilen farklı sonuçlardan dolayı, bu etki halen popülerliğini koruyan bir tartışma konusudur. Cama yumruk atma eylemi, ani gelişen, dürtüsel bir kendine zarar verme davranışıdır; hava koşullarının yanında altta yatan birçok sebeple ilişkilendirilebilir. Bu çalışma cama yumruk atma sebebiyle acil servise başvuran hastaların demografik özelliklerini ve hava koşullarından etkilenip etkilenmediğini araştırmak amacıyla yapılmıştır. Gereç ve Yöntem: Çalışmamız 01.Ocak.2013 ile 31.Aralık.2014 tarihleri arasında "Cama yumruk atma" eylemi sonucu acil servise başvuran hastalar üzerinde retrospektif olarak yapılmıştır. Hava koşullarına ait veriler Türkiye Cumhuriyeti Orman ve Su İşleri Bakanlığı Meteoroloji Genel Müdürlüğü'nden alınmıştır.Bulgular: Çalışmaya 69 hasta dahil edildi. Çalışma grubunun %82.6'sı (n=57) erkek, % 81.2'si (n=56) bekar, % 27.5'si (n=19) üniversite öğrencisi, % 15.9'u (n=11) işsiz, %73.9'unda (n=51) yaralanma dominant elde, %37.7'sinin (n=26) kan alkol testi pozitif, %14.5'inde (n=10) ise önceden tanısı konmuş psikiyatrikhastalık mevcut idi. Cama yumruk atma sebebiyle başvuran hastaların olay günü veya olaydan bir gün önceki hava koşullarından etkilenmediği ancak etiyolojik faktörlerin bir kısmının hava koşulları ile ilişkisi olduğu saptandı. Sonuç: Cama yumruk atma eylemi pek çok sebeple ilişkilidir. Bu eylemin gelişimi, yalnızca hava koşullarındaki değişikliklerle açıklanamaz; ancak bazı olguların hava koşullarındaki değişikliklerden etkilendiği, özellikle hava sıcaklığı veya basınç gibi değişkenlerin bu eylemi tetiklediği söylenebilir.
Carbon monoxide poisoning cases presenting with non-specific symptoms
(Sage Publications Inc, 2017) Deniz, Turgut; Kandis, Hayati; Eroglu, Oguz; Gunes, Harun; Saygun, Meral; Kara, Ismail Hamdi
Carbon monoxide (CO) is a colourless and odourless gas appearing as a result of incomplete combustion of carbon-containing fuels. Many domestic or occupational poisonings are caused by CO exposure. Malfunctioning heating systems, improperly ventilated motor vehicles, generators, grills, stoves and residential fires may be listed in the common sources of CO exposure. The aim of this study was to emphasize the significance of early diagnosis of CO poisoning with non-invasive measurement of CO levels of the patients with nonspecific symptoms using a pulse oximeter device in the triage. Our study was a cross-sectional study. Patients who presented to the emergency department (ED)due to non-specific symptoms and had a Canadian Triage and Acuity scale level of 4 or 5 were included in the study; 106 (5.9%) of 1788 patients admitted during the study period were diagnosed with CO poisoning. Patients with CO poisoning and the other patients had statistically significant differences in terms of presenting symptoms, namely, headache, dizziness, nausea, and vomiting. More CO poisoning cases were admitted in the fall and winter compared to the spring and summer. The number of CO poisoning victims can be decreased if preventive measures like CO monitoring systems and well-designed ventilation systems are generalized at homes and workplaces. Measurement of carboxyhaemoglobin levels of patients presenting to ED due to non-specific symptoms like headache and dizziness during cold seasons and winter months using a pulse CO-oximeter should be a part of the routine of emergency medicine triage.
Demographic features of chest trauma patients
(Elsevier Science Bv, 2009) Kandis, Hayati; Deniz, Hayati; Gungor, Ahmet; Katirci, Yavuz; Deniz, Turgut
Objectives: The aim of this study was to define the demographic features of patients presented with chest trauma. Materials and Methods: This study was conducted in the emergency department of Kirikkale Yuksek ihtisas Hospital between 01.01.2003 and 31.12.2007. In the present study, patients were evaluated according to their age, gender, cause of trauma, thoracic injuries and accompanied system pathologies, time of accomplishing a therapy, the therapy modality and mortality. Results: A total of 382 patients were included into the study, 248 (65%) were male and 134 (35%) patients were female. The mean age of the study patients was 39.20 +/- 14 years (min-max: 1-85). Two hundred fifteen patients (56%) were presented with penetrating thoracic trauma and 167 patients (44%) with blunt thoracic trauma. Whereas implementation of conservative treatment ratio was 43%, and tube thoracostomy 37% and thoracotomy were implemented in 20% of the patients. Mortality rate was 6.2% (n=24). Conclusion: The thoracic trauma patients have usually multisystem injuries requires an experienced and multidisciplinary team with immediate therapeutic interventions.
Effect of chlorhexidine on oral airway biofilm formation of Staphylococcus epidermidis
(2015) Büyükkoçak, Ünase; Ağalar, Canan; Deniz, Turgut; Çeken, Sabahat; Ağalar, Fatih
Amaç: Airway yüzeyinde biofilm oluşması supraglottik kolonizasyona, bu da alt solunum yolu enfeksiyonlarına neden olabilir. Lokal dezenfektanların biofilm oluşumuna etkisini araştıran pek fazla çalışma bulunmamaktadır. Bu çalışmanın amacı airwayleri klorhekzidinle kaplamanın Staphylococcus epidermidis'in biofilm oluşturmasına etkisinin araştırılmasıdır.Yöntemler: Biofilm deneyi için kültür ve elektron mikroskobi yöntemleri kullanıldı. Airwayler, klorhekzidinin biofilm oluşumu ve bakteri sayısına etkisini araştırmak üzere, iki gruba ayrıldı. Grup 1 (Kontrol Grubu): Katkısız airway, Staphylococcus epidermidis, Grup 2: Klorhekzidinle kaplanmış airway, Staphylococcus epidermidis. Grup 1'e bir işlem yapılmazken, Grup 2'ye 4 saniye boyunca % 0,2 konsantrasyonda klorhekzidin sprey sıkıldı ve kurutuldu. Materyale tutunan bakteri sayısı mikrobiyolojik yöntemle incelendi, biofilm oluşumu elektron mikroskobik inceleme ile gösterildi. İstatistik analiz için Mann-Whitney U testi kullanıldı.Bulgular: Grup 2'de bakteri sayısı 1x102-8x102 cfu/ml iken Grup 1'de 3x103-1x104 cfu/ml idi. Klorhekzidinin airwaye tutunan bakteri sayısını istatistiksel olarak anlamlı oranda azalttığı görüldü (p0,04). Elektron microskobik incelemede de sonuç uyumluydu.Sonuç: Bu çalışmada, klorhekzidinin airway üzerinde biofilm oluşumu ve tutunan bakteri sayısını azaltmada etkili olduğu gösterildi
The effect of different types of honey on healing infected wounds
(Ma Healthcare Ltd, 2018) Eroglu, Oguz; Deniz, Turgut; Kisa, Ucler; Comu, Faruk Metin; Kaygusuz, Sedat; Kocak, Orhan Murat
Objective: To investigate the effects of treatments of 'mad honey', blossom honey and nitrofurazone on infected wound healing. Method: Male albino Wistar rats were randomly divided into four groups: 'mad honey' (MH), blossom honey (BH), nitrofurazone (N) and control (C). All rats were anaesthetised intraperitoneally. A circular skin incision was made to the back regions. Grafts containing slime-producing Staphylococcus epidermidis were placed on the incision area and then sutured to the skin. Infection in the wound area was confirmed after 48 hours. Wounds were dressed twice daily with the various treatment materials. Rats were randomly euthanised on days 7 or 14, and tissue samples taken. Tissue samples were assessed for hydroxyproline (HP), tensile strength (TS) and macroscopic measurement (area and intensity). Results: HP levels were higher in the treatment groups (MH, BH, N) at days 7 and 14 compared with the control group. 'Group x day' interaction was found in the HP levels (p=0.015). Increases in HP levels in the MH and N groups between days 7 and 14 were significantly higher than those in the other groups (p<0.05). Intensity was significantly lower in the control group and significantly higher in group MH compared with the other groups. Significant 'group x day' interaction was observed in intensity (p=0.006). TS was significantly lower on day 7 than on day 14 (p=0.022). No marked difference was observed between the groups, nor any 'group x day' interaction, in terms of TS. Conclusion: Honey administration successfully healed infected wounds. However, there was no significant difference between the effect of MH and that of N in terms of wound healing.
Effect of exposure to violence on the development of burnout syndrome in ambulance staff
(Tubitak Scientific & Technical Research Council Turkey, 2016) Deniz, Turgut; Saygun, Meral; Eroglu, Oguz; Ulger, Huseyin; Azapoglu, Burcu
Background/aim: The aim of this study is to determine the condition of ambulance staff (AS) who have been exposed to any kind of violence and to predict risk of development of burnout syndrome. Materials and methods: Our study was performed with 120 AS working for the Kirikkale Ambulance Services. During the research, questionnaires collecting descriptive information and the extent of violence to which the AS were exposed were administered; participants were asked to fill out the questionnaire themselves. Results: It was found that 81 (67.5%) participants had been subjected to at least one type of violence (verbal or physical). Sixty-two percent were exposed to verbal abuse and 55.8% to verbal threats. Rates of physical threats and attacks were higher among male staff (P = 0.036, P = 0.022), while the rate of personal accomplishment was determined to be significantly lower in males (P = 0.006). Emotional exhaustion and depersonalization scores were determined to be significantly higher in those who perceived less support from administrators (P = 0.014, P = 0.032). Conclusion: All kinds of negative situations exhaust an individual physically and mentally and lead to the development of burnout syndrome. AS are more prone to these kinds of situations.
Effect of exposure to violence on the development of burnoutsyndrome in ambulance staff
(2016) Deniz, Turgut; Saygun, Meral; Eroğlu, Oğuz; Ülger, Hüseyin; Azapoğlu, Burcu
Background/aim: The aim of this study is to determine the condition of ambulance staff (AS) who have been exposed to any kind of violence and to predict risk of development of burnout syndrome. Materials and methods: Our study was performed with 120 AS working for the Kırıkkale Ambulance Services. During the research, questionnaires collecting descriptive information and the extent of violence to which the AS were exposed were administered; participants were asked to fill out the questionnaire themselves. Results: It was found that 81 (67.5%) participants had been subjected to at least one type of violence (verbal or physical). Sixty-two percent were exposed to verbal abuse and 55.8% to verbal threats. Rates of physical threats and attacks were higher among male staff (P 0.036, P 0.022), while the rate of personal accomplishment was determined to be significantly lower in males (P 0.006). Emotional exhaustion and depersonalization scores were determined to be significantly higher in those who perceived less support from administrators (P 0.014, P 0.032). Conclusion: All kinds of negative situations exhaust an individual physically and mentally and lead to the development of burnout syndrome. AS are more prone to these kinds of situations.
Effect of hypothermia on apoptosis in traumatic brain injury and hemorrhagic shock model
(Elsevier Sci Ltd, 2017) Eroglua, Oguz; Deniz, Turgut; Kisa, Ucler; Atasoy, Pinar; Aydinuraz, Kuzey
Introduction: The neuroprotective mechanisms of therapeutic hypothermia against trauma-related injury have not been fully understood yet. In this study, we aimed to investigate the effects of therapeutic hypothermia on biochemical and histopathological markers of apoptosis using Traumatic brain injury (TBI) and hemorrhagic shock (HS) model. Methods: A total of 50 male albino-wistar rats were divided into five groups: Group isolated TBI, Group NT (HT + HS + normothermia), Group MH (HT + HS + mild hypothermia), Group MoH (HT + HS + moderate hypothermia) and Group C (control). Neurological deficit scores were assessed at baseline and at 24 h. The rats were, then, sacrificed to collect serum and brain tissue samples. Levels of Caspase-3,6,8, proteoglycan-4 (PG-4), malondialdehyde (MDA), and nitric oxide (NO) were measured in serum and brain tissue samples. Histopathological examination was performed in brain tissue. Results: There were significant differences in the serum levels of Caspase-3 between Group NT and Group C (p = 0.018). The serum levels of Caspase-6 in Group NT (0.70 +/- 0.58) were lower than Group MH (1.39 +/- 0.28), although the difference was not statistically significant (p = 0.068). There were significant differences in the brain tissue samples for Caspase-3 levels between Group NT and Group C (p = 0.049). A significant difference in the Caspase-8 brain tissue levels was also observed between Group NT and Group C (p = 0.022). Group NT had significantly higher scores of all the pathological variables (for edema p < 0.017; for gliosis p < 0.001; for congestion p < 0.003, for hemorrhage p < 0.011) than Group C. Conclusion: Our study results suggest that hypothermia may exert its neuroprotective effects by reducing markers of apoptotic pathway, particularly Caspase-3 on TBI and HS. (c) 2017 Elsevier Ltd. All rights reserved.
The Effect of Hypothermia on Splanchnic Flows and Lung in a Two-Hit Hemorrhagic Shock Model
(Academic Press Inc Elsevier Science, 2010) Deniz, Turgut; Agalar, Canan; Agalar, Fatih; Comu, Faruk M.; Caglayan, Osman; Alpay, Yesim; Saygun, Oral
Background. To evaluate the effect of hypothermia on bacterial translocation, splanchnic vascular flow, lung tissue weight, and levels of malondialdehyde (MDA) and nitric oxide (NO) in a two-hit model of hemorrhagic shock. Methods. Thirty rats were randomly allocated into three groups of 10 rats each. In the control group (group C), rats were treated without hemorrhage, and normothermia (37 degrees C) was maintained. In the mild hypothermia group (group MH), rats were subjected to volume-controlled hemorrhage (2 mL/100g) and a rectal temperature of 34 degrees C was maintained. In the normothermic group (group NT), rats were treated as in group MH, except for hypothermia. Seventy-two hours after hemorrhagic shock (first insult), Pseudomonas aeuruginosa was administered intratracheally as a second insult. Finally, mesenteric vascular flow patterns were recorded. Bacterial translocation was studied from tissue samples of spleen, liver, and mesenteric lymph nodes. Blood samples were obtained to evaluate the possible presence of bacteria in the bloodstream. Lung tissue weight ratio, MDA, and NO levels in lung tissue were assessed. Results. Renal, mesenteric, and portal venous flow rates were found to be lower in groups Mill and NT in comparison with group C. Blood flow profiles were lower in group NT than in group MH (P < 0.05). Bacterial translocation was not observed in group C, and it was detected more often in group NT than in group MH. Lung weight ratio was found to be higher in group NT compared with groups MH and C. Although it did not reach the level of statistical significance, MDA level in the control group was lower than that in the NT group (P = 0.085). Conclusion. Hypothermia corrected mesenteric blood flow and decreased the occurrence of bacterial translocation in the two-hit model of hemorrhagic shock and tracheal inoculaton of P. aeruginosa (C) 2010 Elsevier Inc. All rights reserved.
Electrocardiography abnormality in a suicide attempt with levetiracetam
(Asean Neurological Assoc, 2021) Comertpay, Ertan; Say, Bahar; Eroglu, Oguz; Deniz, Turgut; Coskun, Figen
We present a case of suicide attempt with levetiracetam (LEV) in an epilepsy patient. Multifocal ventricular contractions were observed together with bradycardia in this patient due to LEV overdose. Reported patient of LEV overdose in the literature rarely show electrocardiography findings. Although LEV is less toxic than other antiseizure medications, clinicians should be aware of its potential cardiac side effects.
Emergency Department Visits Secondary to Amusement Park Injury
(Emergency Medicine Physicians Assoc Turkey, 2010) Deniz, Turgut; Kandis, Hayati; Ulger, Huseyin; Agalar, Fatih
Funfairs are entertainment centers which draws mostly children's and also all other age groups' attention both in our country and in the world. Fun center equipments should be controlled regularly. Equipments that are not renewed in proper intervals and don't have appropriate security measures should be banned. Otherwise, funfair accidents that can cause really serious results can ocur. It is aimed in this study to present three cases who came to emergency room after a fall accident from the fun equipment that is called 'octopus'.
The evaluation of abstracts presented at the 5th Congress of National Trauma and Emergency Surgery
(Turkish Assoc Trauma Emergency Surgery, 2008) Deniz, Turgut; Saygun, Meral; Sahiner, Tayfun; Agalar, Fatih; Taviloglu, Korhan; Yorganci, Kaya; Ertekin, Cemalettin
BACKGROUND The aim of this study was to evaluate demographics, methodological data and writing style of abstracts presented at the 5th Congress of National Trauma and Emergency Surgery. METHODS Study design, institutions and number of authors, appropriateness of the title, use of a structured abstract, word count, fluency, accuracy of the statistical evaluation, and conclusion-abstract accordance were assessed in 451 abstracts. RESULTS Nearly 49% of abstracts were retrospective and 29% were case reports in design. 33%, 26%, and 24% of abstracts were related to isolated organ, single system and multi-system injuries, respectively. Approximately two-fifths of presentations were university-based. Approximately one-third of presentations were multidisciplinary in origin. The mean number of authors was 5.6 +/- 1.8, and a statistical significance was found between abstract contributions from university versus other hospitals (p=0.001). Three-fourths of the abstracts had an appropriate title and 91% were structured. Word count was 100-250 in 57% and 250-500 in 42% of abstracts. Statistical analysis was used in only 19% of abstracts. Most of the abstracts were fluent. Conclusion-abstract accordance was present in 71% of the abstracts. CONCLUSION Our results indicate there are some deficiencies in the abstract writing process. The use of a structured abstract may intensify fluency and compliance to abstract writing guidelines. Clinical studies regarding multi-traumatized patient groups and experimental studies should be encouraged.
The evaluation of academic emergency department design
(Turkish Assoc Trauma Emergency Surgery, 2007) Deniz, Turgut; Aydinuraz, Kuzey; Oktay, Cem; Saygun, Meral; Agalar, Fatih
BACKGROUND In our study which was based upon a questionnaire, the inner and outer architectural designs of emergency services of Emergency Medicine Departments were investigated. METHODS In this descriptive study, a standard questionnaire was sent to 26 Emergency Medicine Departments which were operating at that time. In the questionnnaire, the internal, external architectural and functional features were questioned. Answers of 22 Emergency Medicine Departments were analysed. Two Emergency Medicine Departments that were not operating at that time were not included in the study. RESULTS The analysis of the replies revealed that only 59% (n=13) of the Emergency Medicine Departments were designed as an emergency service prior to the construction. The ambulance parking areas were not suitable in 77% of the emergency units while only 54.5% (n=12) had protection against adverse weather conditions. In only 59% (n=13) of the emergency units, a triage unit was present and in only one of the in only one (4.5%), a decontamination room was available. It was understood that only 32% (n=8) of the emergency units were appropriate in enlarging their capacity taking the local risk factors into consideration. There was a toilette for disabled patients in only 18% (n=4) of the units as well. Considering a 12-year of history of the Emergency Medicine in Turkey, the presence of a lecture room is still 68% (n=15) in emergency departments which reflects that academical efforts in this field is emerging in challenging physical conditions. CONCLUSION The results of our study revelaed that emergency service architecture was neglected in Turkey and medical care given was precluded by the insufficient architecture. The design of emergency services has to be accomplished under guidance of scientific data and rules taking advices of architects who have knowledge and experience on this field.
Explosion at gunpowder factory Kirikkale Chemical Industry Machinery after emergency service management
(Elsevier Science Bv, 2010) Karakus, Ali; Kandis, Hayati; Deniz, Turgut; Sahan, Mustafa
Objective: Industrial accidents as a form of disaster, can result in numerous injuries and deaths. Appropriate management of this type of mass injuries in emergency room can prevent deaths and injuries. In this study, we aimed to investigate the patient profiles and clinical management provided at Kirikkale Yuksek Ihtisas Hospital ED, following the violent explosion in the nearby gunpowder plant of the Industry of Machinery-Chemistry (MKE) in Kirikkale on August 29, 2008. Methods: Medical records of injured employees that visited Kirikkale Yuksek Ihtisas Hospital ED after the explosion in gunpowder plant of Mechanical and Chemical Industry on August 29, 2008 were retrospectively reviewed. Results: Total of 23 patients admitted to our emergency room. Nine out of 23 patients were transferred with ambulance, while the remaining 14 patients arrived ED by other means. Only one patient had a Glasgow Coma Scale of 3, while all others scored 15. Skin laceration, fractures, swelling, scalp incision and soft tissue injuries were among the observed findings in physical examination. The mean length of stay in emergency room was 2.89 hour. Nineteen of the patients examined in emergency room were discharged after observation for 24 hours. One patient died of intracranial bleeding. Three patients were admitted to the orthopedic service and plastic surgery, and were discharged following their treatment. Conclusions: Although management and organization seemed to be not so difficult in this incident, EDs should always be prepared for more difficult situations. The elimination or reduction of losses in the event of disasters can be accomplished by effective management of disasters both inside and outside the EDs. For disaster management systems to be successful, all response actions should be conducted in a coordinated manner.
Göğüs travmalı olguların demografik özellikleri
(2009) Kandiş, Hayati; Deniz, Hayati; Güngör, Ahmet; Katırcı, Yavuz; Deniz, Turgut
G i r i ş : Bu çalışmanın amacı göğüs travması ile başvuran hastaların demografik özelliklerini tanımlamaktır. Gereç ve Yöntem: 01.01.2007-01.01.2008 tarihleri arasında Kırıkkale Yüksek ‹htisas Hastanesi Acil Servisine intihar girişimi nedeniyle başvuran olgular geriye dönük olarak incelendi. Sosyodemografik özellikleri, intihar girişim nedenleri ve şekli, daha öncesinde intihar girişimlerinin olup olmadığına dair bilgiler doldurulan acil servis formlardan ve psikiyatrik kayıtlardan elde edildi. Bulgular: Çalışmaya dahil edilen hastaların 248’i (%65) erkek, 134’ü (%35) kadın olup yaş aralığı 1-85 arasında, yaş ortalaması 39,2014 idi. Yaralanma mekanizması yönünden 215 olguda (%56) penetran toraks travması, 167 olgu- da (%44) künt toraks travması saptandı. Olguların %43’ünde konservatif tedavi ve %37’sinde tüp torakostomi yeter- li olurken, %20 olguda torakotomi uygulanmıştır. Mortalite 24 olgu ile %6,2 olarak saptanmıştır. S o n u ç: Toraks travmaları genellikle birden fazla sistemi ilgilendiren yaralanmalarla oluşabileceğinden, travma konusunda deneyimli ve multidisipliner bir ekip tarafından hastaların değerlendirilmesi ve tedaviye en kısa sürede başlanması uygun olan yaklaşım şeklidir.
Histamine 1 Receptor Antagonist in Symptomatic Treatment of Renal Colic Accompanied by Nausea: Two Birds With One Stone?
(Elsevier Science Inc, 2009) Yılmaz, Erdal; Batislam, Ertan; Deniz, Turgut; Yuvanç, Ercan
OBJECTIVES The pain-relieving efficacy of antagonists of histamine I (HI) receptors that are widely found in the ureter and that cause contractions in renal colic was presented in comparison with a placebo. METHODS Eighty-six patients who presented to the emergency service because of renal colic accompanied by nausea, and who had urinary system stones detected were included in the study. The patients were separated into 2 groups by double-blind, random assignment. The 45 patients in group 1 received 50 mg intramuscular (IM) dimenhydrinate. The 41 patients in group 2 received 2 mL IM saline solution as a placebo. The visual analogous scale (VAS) values were detected at referral of the patients and at 10, 20, and 30 minutes of therapy to detect the pain intensity. Verbal descriptive scale (VDS) was used for evaluation of nausea and vomiting before and after the therapy. RESULTS VAS values were statistically quite low in group 1 at 10, 20, and 30 minutes of therapy. VDS scores were also statistically significantly low in group 1 at 30 minutes of treatment. CONCLUSIONS Dimenhydrinate, which is an ethanolamine group H1 receptor blocker, appeared to be effective compared with the placebo in relieving renal colic pain and nausea and vomiting symptoms in patients. Comparative studies with other analgesics will be useful for determining how to use this agent for analgesic purposes in renal colic. UROLOGY 73: 32-36, 2009. (C) 2009 Elsevier Inc.
The impact of Pediatric Trauma Score on burden of trauma in emergency room care
(Turkish J Pediatrics, 2009) Soyer, Tutku; Deniz, Turgut; Akman, Hülya; Hançerlioğullari, Oymen; Türkmen, Feyza; Cesur, Özkan; Çakmak, Murat
Traumatic injuries are the leading cause of mortality and morbidity during childhood. A retrospective study was performed to evaluate the impact of Pediatric Trauma Score (PTS) on burden of trauma in emergency care. Children admitted to the emergency room were retrospectively evaluated for age, sex, mechanism of injury, physical examination findings, and PTS. The cost of trauma was obtained by medical records. A total of 146 patients (male/female: 93/53) were enrolled. The median age was 6 (interquartile range: 3-9.25). Mechanism of injury was falls (74%), motor vehicle crashes (9.6%), non-vehicular accidents (7.5%), struck by/against (6.2%), and cuts and gunshots (2.1%). The median PTS was 10. In the evaluation of trauma burden, radiologic investigations accounted for 41%, consultations for 23.5%, laboratory investigations for 15.6%, emergency surgical interventions for 12.1%, and medical interventions for 6.8% of total trauma cost in emergency care. PTS showed no impact on burden of trauma in emergency,care. (p>0.05). Total trauma. cost was increased 2.1-fold in male patients, 2.6-fold in head injuries and 4.4-fold in abdominal injuries (p<0.05). Pediatric Trauma Score had no effect on the burden of pediatric trauma in emergency care. The total cost of trauma was primarily affected by head injury and abdominal trauma. Higher costs may be related with routine radiological investigations in head and abdominal injuries.
ISOTRETINOIN INTOXICATION IN ATTEMPTED SUICIDE: A CASE REPORT
(Marmara Univ, Fac Medicine, 2008) Deniz, Turgut; Emeksiz, M. Can
We report a case of acute intoxication due to a massive overdose of isotretinoin. A 17 year-old male patient had ingested 16 capsules of isotretinoin (20 mg) with suicidal intentions. He presented with nausea, dizziness and myalgia on extremities. 2 hours after the attempt he was brought to our clinic. We administered gastric lavage and active charcoal treatment before taking him to the intensive care unit for observation. 24 hours later, cutaneous xerosis and desquamation of the face especially the nasolabial region occurred; cutaneous xerosis resolved spontaneously. The side-effects were only mild exacerbations of some common isotretinoin side-effects. There was a low toxicity of isotretinoin overdose. To date, few cases of isotretinoin overdosages have been reported. Being alert when using isotretinoin on a teenager may save life because this drug may exacerbate depression as a side effect.

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