Makale Koleksiyonu

Bu koleksiyon için kalıcı URI

https://hdl.handle.net/20.500.12587/17818

Listeleniyor 1 - 20 / 44

V. Ulusal Travma ve Acil Cerrahi Kongresi bildirilerinin değerlendirilmesi
(2008) Deniz, Turgut; Saygun, Meral; Şahiner, İbrahim Tayfun; Ağalar, Fatih; Taviloğlu, Korhan; Yorgancı, Kaya; Ertekin, Cemalettin
AMAÇ: V. Ulusal Travma ve Acil Cerrahi Kongresi’nde sunulan bildiri özetlerinin öz yazım kılavuzuna uygunluğu değerlendirildi; demografi, metodoloji ve yazım tekniği yönünden incelendi. GEREÇ-YÖNTEM: Kongre kitapçığındaki 451 bildiri değerlendirmeye alındı. Değerlendirilen parametreler; çalışmanın türü ve içeriği, çalışmanın yapıldığı kurumlar, yazar sayısı, başlık kullanımının uyumluluğu, yapısal öz kullanımı, sözcük sayısı, dilin akıcılığı, uygun istatistiksel değerlendirme ve sonuç-öz ilişkisiydi. BULGULAR: Çalışmaların %49’u retrospektif, %29’u olgu sunumuydu. Bildirilerin %33’ü izole organ yaralanması, %26’sı tek sistem yaralanması, %24’ü çoklu sistem yaralanmasına ilişkindi. Çalışmaların %43’ü üniversite, %38’i devlet hastanesi kökenliydi. Çalışmaların %40’ı genel cerrahiyle ilgiliydi, %29’u ise multidisiplinerdi. Çalışmalardaki ortalama yazar sayısı 5,6±1,8 idi; üniversite ve devlet hastaneleri arasında istatistiksel olarak anlamlı farklılık saptandı (p=0,001). Bildirilerin %91’inde yapısal öz vardı, %57’si 100-250, %42’si ise 250-500 sözcük içermekteydi. Çalışmaların %73’ü akıcı olarak değerlendirildi. Tüm bildirilerin %19’unda istatistiksel yöntem uygulandığı belirlendi. Bildirilerin çoğu akıcı idi. İstatistiksel analiz uygulama yönünden üniversite ve devlet hastaneleri arasında anlamlı fark saptandı (p=0,001). Sonuç-öz ilişkisi bildirilerin %71’inde yeterli olarak değerlendirildi. SONUÇ: Bildiri özeti yazma konusunda bazı sorunlarımızın olduğu saptanmıştır. Yapısal öz kullanımı, akıcılık ve yazım kurallarına uyumu artırmaktadır. Özellikle çoklu yaralanlamaları irdeleyen klinik çalışmalar ve deneysel çalışmalar özendirilmeli, bu yönde araştırmalar teşvik edilmelidir.
The evaluation of general knowledge of emergency care providers about child abuse and neglect
(2017) Özen, Mehmet; Ramadan, Hayri; Vural, Sevilay; Coşkun, Figen
Amaç: Çocuk istismarı ve ihmali, karmaşık nedenleri ve trajik sonuçları sebebiyle tıbbi, yasal, gelişimsel ve psikososyal bir halk sağlığı sorunudur. Toplum içindeki gerçek insidansı tam olarak bilinmemektedir. Çalışmamızda acil servislerde çalışan hekimler ve yardımcı sağlık personelinin çocuk istismarı ve ihmali hakkında bilgi düzeylerini ölçmeyi; elde edilen sonuçları sağlık çalışanı olmayan kontrol grubuyla karşılaştırmayı amaçladık.Gereç ve Yöntemler: Çalışmamıza Ankara İlindeki Eğitim Araştırma, Üniversite ve Devlet hastanelerinde çalışan acil doktorları, pediatri hekimleri ve diğer sağlık çalışanlarından oluşan 400 kişilik bir çalışma grubu ve 105 katılımcıdan oluşan kontrol grubu dahil edilerek yapılmıştır. Katılımcılara hem demografik sorulardan oluşan hem de çocuk istismarı ve ihmali konusunda genel olarak inanılan mitleri içeren birer anket uygulanmıştır.Bulgular: Demografik sorular ve mitler içeren ankette, doktorlar ve yardımcı sağlık çalışanlarının çalıştıkları kurumların mitlere bakış açısını etkilediği, deneyim süresinin sağlık çalışanları için bir değişken olduğu, çocuk istismarı konusunda eğitim almış olmanın belirleyici olduğu fakat çocuk sahibi olmanın cevaplardaki doğruluğu anlamlı şekilde etkilemediği tespit edilmiştir (p>0,05). Kontrol grubunun başarı oranları her mit için yardımcı sağlık personeli ile benzerlik göstermiştir (p> 0,05). Ancak kontrol grubunun 7, 18, 19, 22, 25, 27, 30 ve 35 numaralı mitlerde doktorlara göre düşük doğruluk oranları tespit edilmiştir.Sonuçlar: Acil servislerinde ve çoğunlukla çocuk yaş grubunun bakıldığı pediatrik acil servislerinde çalışan tüm sağlık çalışanlarının çocuk istismarı ve ihmaline dair belirti ve bulgularını bilmeleri gerekmektedir. Ayrıca yasal birimlere bildirmeye yönelik sorumlulukları mevcuttur. Bu konudaki mitleri çürütmeye yönelik düzenli eğitim programları hem sağlık sisteminde hem de toplum düzeyinde uygulanmalıdır
Acil Servise Epileptik Nöbetle Başvuran Hastalarda Nöbeti Tetikleyen Faktörler ve Bir Haftalık Takipte Nöbet Tekrarlama Sıklığı
(2019) Bilgin, Ali; Avcı, Sema; Ramadan, Hayri; Coşkun, Figen
Amaç: Bu çalışmada epileptik nöbet geçirme şikayetiyle acil servise başvuran hastalarda, epileptik nöbeti tetikleyen faktörler ve taburculuk sonrası bir haftalık dönemde nöbet tekrarlama durumunun araştırılması amaçlandı. Gereç ve Yöntem: Çalışma, prospektif olarak üçüncü basamak bir eğitim ve araştırma hastanesinin acil servisinde Ocak 2013- Temmuz 2013 tarihleri arasında yapıldı. Çalışmaya toplam 90 hasta dâhil edildi. Tüm hastaların verileri acil servise başvuru anında, standardize edilmiş bir çalışma formuna kaydedildi. Hastalar taburcu edildikten bir hafta sonra telefonla aranarak nöbet geçirme sıklıkları ve ilaç kullanma bilgileri sorgulandı. İstatistiksel analiz SPSS for Windows 18.0 (SPSS Inc., Chicago, USA) programında yapıldı. İstatistiksel olarak p<0.05 anlamlı kabul edildi. Bulgular: Hastalar nöbet sıklığını arttıran faktörler açısından değerlendirildiğinde; yaş, cinsiyet, nöbetten önceki son 24 saat içerisinde alkol alımı, kullanılan antiepileptik ilaçta doz atlanması ve kullanılan antiepileptik ilaç grubu açısından anlamlı fark saptanmadı. Düzenli ilaç kullananlarda, istatistiksel olarak anlamlı (p<0.05) nöbet sıklığında azalma saptandı. Nöbetten önceki son 24 saatte uykusuz kalanlar (p=0.026), stresli bir durumla karşılaşanlar (p=0.048) ve bekar olanlarda (p=0.001) istatistiksel olarak anlamlı nöbet sıklığında artma saptandı. Sonuç: Acil servise nöbet geçirme şikâyetiyle başvuran hastalarda nöbet sıklığını etkileyen faktörler arasında düzenli ilaç kullanımı, medeni durum, son 24 saatte uykusuz kalma veya stresli durum yaşama anlamlı bulunmuştur.
Ülkemizde Acil Tıp Anabilim Dalları’nda acil servislerin fonksiyonel mimari açısından değerlendirilmesi
(2007) Deniz, Turgut; Aydınuraz, Kuzey; Oktay, Cem; Saygun, Meral; Ağalar, Fatih
AMAÇ Ülkemizdeki Acil Tıp Anabilim Dalları’na (ATAD) bağlı acil servislerinin iç ve dış mimari yapıları araştırıldı. GEREÇ VE YÖNTEM Tanımlayıcı tipteki bu araştırmada, çalışmanın yapıldığı tarihte mevcut olan 26 ATAD’ye anket formları gönderildi. Bu anketle acil servislerin iç ve dış mimari yapıları ve fonksiyonel hizmet durumları sorgulandı. Anketi yanıtlayan 22 ATAD’nin verileri değerlendirmeye alındı. Henüz kurulma aşamasında olan ve hizmet vermeyen iki Anabilim Dalı çalışmaya dahil edilmedi. BULGULAR Geri bildirimlerin değerlendirilmesinde ATAD’den ancak %59’unun (n=13) hizmet verdikleri alanın acil servis alanı olarak planlandığı izlendi. Acil servislerin ambulans girişlerinin %77 oranında uygun olmadığı, %54,5 ATAD’de (n=12) acil servis girişinde ambulansların hasta bıraktığı alanın hava koşullarından korumalı olmadığı görüldü. Gelen yanıtlara bakıldığında ancak %59 ATAD’de (n=13) acil serviste triyaj ünitesinin bulunduğu, yine sadece bir ATAD’de (%4,5) acil serviste temizlenme (dekontaminasyon) odası bulunduğu bildirildi. Halen hizmet vermekte olan ATAD’lerine bağlı acil servislerin ancak %32’sinde (n=8) mevcut lokal risk faktörleri doğrultusunda genişleyebilme düzeyinin yeterli olabileceği belirlendi. ATAD’lerin sadece %18’inde (n=4) özürlü tuvaletinin var olması ülke genelinde özürlülere yönelik mimari değişikliklerin eksikliğinin acil servislerde de olduğunun göstergesidir. Acil tıbbın ülkemizde 12 yıllık geçmişi olduğu düşünüldüğünde ATAD’lerin ancak %68’inde (n=15) seminer odalarının var olması, akademik yapılanmaya fiziksel alt yapı yetersizliği olan yerlerde başlandığının göstergesidir. SONUÇ Ülkemizdeki acil tıp yapılanması içerisinde acil servis mimarisine gereken önemin verilmediğini, verilen hizmetteki bilimselliğin mimari yetersizliklerle gölgelendiğini göstermiştir. Acil servis mimari tasarımı, bilimsel veri ve kurallar çerçevesinde sağlanmalıdır. Bunun için hastane ve özellikle acil servis mimarisi hakkında bilgi ve tecrübesi olan mimar veya mimarlar yetkili kişiler ile hedefler üzerinde bir anlaşmaya varmalıdırlar.
Endothelial and Autonomic Functions in Patients with Migraine
(OXFORD UNIV PRESS, 2020) Dogru, Mehmet Tolga; Dilekoz, Ergin; Alpua, Murat; Eroglu, Oguz; Kandemir, Hilseyin; Alp, Caglar; Bolay, Hayrunnisa
Objective It has been shown that patients with migraine have endothelial dysfunction. Migraine patients with aura, especially, have more clinical manifestations of autonomic nervous system dysfunction. We aimed to evaluate the endothelial and autonomic functions in migraine patients during both migraine headache attack and headache-free periods. Design This was a cross-sectional, randomized study. Subjects and Methods A total of 130 participants (67 male and 63 female patients, minimum age = 19 years, maximum age = 71 years, mean age = 38.812.2years) were enrolled into the study. For the statistical evaluation of data, we classified the participants of the study as follows: group 1: headache (+) aura (+); group 2: headache (+) aura (-); group 3: headache (-) aura (+); group 4: headache (-) aura (-). Noninvasive evaluation of endothelial function was performed by flow-mediated dilation (FMD) and pulse wave analysis methods. Heart rate variability measurements were used for noninvasive evaluation of autonomic functions. Results Group 1 had a higher FMD ratio than the control group, group 3, or group 4 (P<0.001, P<0.001, and P=0.003, respectively). Group 4 had lower FMD ratio levels than the other migraine groups and or the control group (P<0.001). Group 3 had the highest high-frequency (HF) power levels among all migraine groups (P<0.001). Group 2 had higher low-frequency/HF ratio values than other migraineurs (P<0.001). Conclusions We concluded that endothelial dysfunction and headache are closely related. Additionally, higher parasympathetic tonus might be associated with the presence of aura.
The Effect of Extractum Cepae, Heparin Sodium, and Allantoin in Experimental Peritoneal Adhesion
(SPRINGER INDIA, 2020) Ozmen, Ismail; Gunal, Yasemin Dere; Atasoy, Pinar; Kisa, Ucler; Yorubulut, Serap; Aslan, Mustafa Kemal; Boybeyi-Turer, Ozlem
The purpose of the study is to investigate the effects of extractum cepae (EC), heparin sodium (HS), and allantoin (AA) on postoperative peritoneal adhesion (PPA) prevention. Forty-eight rats were allocated into six groups (n = 8). PPA was performed by Harris method. In group 1, no additional procedure was done. Abdominal cavity was washed with normal saline in group 2, EC in group 3, HS in group 4, AA in group 5, and EC-HS-AA mixture (EHA-m) in group 6. On the 21st postoperative day, PPA was scored with Nair adhesion score and examined for fibrosis histopathologically and hydroxy-proline levels (OHP) biochemically. Macroscopically, PPA was decreased in groups 2, 4, and 6 compared to groups 1, 3, and 5 (p < 0.05) and decreased in group 2 compared to other groups (p < 0.05). Histopathologically, fibrosis was decreased in groups 2, 4, and 6 compared to other groups and decreased in group 2 compared to other groups (p < 0.05). Tissue OHP level was decreased in groups 2, 3, 4, and 5 compared to groups 1 and 6 (p < 0.05). Tissue OHP level was decreased in group 6 compared to group 1, but the difference was not statistically significant. PPA formation decreases with normal saline, HS and EHA-m, whereas increases with EC and AA both macroscopically and microscopically. Although HS and EHA-m seem to have adhesion prevention effect, washing the intestines with saline seems to be more effective.
The Diagnostic Value of sTWEAK in Acute Ischemic Stroke
(GALENOS YAYINCILIK, 2020) Comertpay, Ertan; Vural, Sevilay; Eroglu, Oguz; Badem, Nermin Dindar; Bilgili, Yasemin Karadeniz; Coskun, Figen
Background: Considering the critical role of early diagnosis and management of acute ischemic stroke, biomarkers that can reliable assist in the diagnosis are still needed. These biomarkers should rapidly analyze, have high specificity for brain damage, and be available in the emergency settings for early diagnosis and exclusion of other conditions that mimic acute ischemic stroke. Soluble tumor necrosis factor-like weak inducer of apoptosis, a protein involved in the regulation of several biological functions, could be a potential acute ischemic stroke biomarker. Aims: To investigate the diagnostic value of soluble tumor necrosis factor-like weak inducer of apoptosis in patients with acute ischemic stroke and examine the relationship between ischemic area volume determined at diffusion-weighted magnetic resonance imaging and soluble tumor necrosis factor-like weak inducer of apoptosis. Study Design: A prospective, case-control study. Methods: This case-control prospective study included 36 patients with acute ischemic stroke and 36 healthy volunteers. Information on age, sex, presence of chronic disease, neurological examination findings, times of presentation to the emergency department after acute ischemic stroke, soluble tumor necrosis factor-like weak inducer of apoptosis levels, ischemic area volumes at diffusion-weighted magnetic resonance imaging, and 6-month mortality rates after stroke were recorded. The results were analyzed on SPSS 22.0 software (SPSS Inc., Chicago, IL, USA), and p<0.05 was considered statistically significant. Results: A soluble tumor necrosis factor-like weak inducer apoptosis cut-off value of 995.5 pg/mL exhibited a sensitivity of 80.5% and a positive predictive value of 82.5% with an area under the curve of 0.84 (95% confidence interval: 0.74-0.94; p<0.001). The mean soluble tumor necrosis factor-like weak inducer of apoptosis level - in the acute ischemic stroke group (1968.08=1441.99 mu g/L) were significantly higher than those in the control group (704.81 +/- 291.72 14,1) (p<0.001). No correlation was observed between soluble tumor necrosis factor-like weak inducer of apoptosis levels and ischemic area volume measured at diffusion-weighted magnetic resonance imaging (r=-0.008; p=0.07). The mean ischemic area volume was 505.68 +/- 381.10 and 60.96=80.89 mm(3) in the nonsurviving and surviving patients, respectively (p =.002). Conclusion: Soluble tumor necrosis factor-like weak inducer of apoptosis can be used in the diagnosis of acute ischemic stroke. However, it is inconclusive in estimating ischemic area volume and early mortality following acute ischemic stroke. Ischemic area volume measured at diffusion-weighted magnetic resonance imaging is a marker of poor prognosis and can be used in predicting early mortality.
Osborn wave in hypothermia and relation to mortality
(W B Saunders Co-Elsevier Inc, 2019) Eroğlu, Oğuz; Serbest, Sancar; Küfeciler, Tarkan; Kalkan, Asım
Background & aim: The aim of this study was to compare hypothermia patients with and without an Osborn wave (OW) in terms of physical examination findings, laboratory results, and clinical survival. Methods: The study was carried out retrospectively on hypothermic patients. The hypothermic patients were divided into two groups. Group 1 comprised patients with OW on electrocardiogram (ECG), and Group 2 comprised patients without OW on ECG. The Mann-Whitney U test was used to compare the two groups, and the relationships between the variables and the presence of OW and mortality were analyzed with ANOVA. A value of p < 0.05 was considered statistically significant. Results: OW was detected on ECG of 41.9% of the patients (Group 1). The mean body temperature was 30.8 +/- 4.1 degrees C in Group 1 and 33.3 +/- 1.6 degrees C in Group 2 (p = 0.106). The mean creatinine level was 1.01 +/- 0.6 mg/dl in Group 1 and 0.73 +/- 0.5 mg/dl in Group 2 (p = 0.046). The mean bicarbonate level was 15.9 +/- 3.8 mmol/l in Group 1 and 18.6 +/- 3.5 mmol/l in Group 2 (p = 0.038). A relationship was determined between the presence of OW and pH, bicarbonate, and creatinine levels (p = 0.026; 0.013; 0.042, respectively). The mortality rate was 69.2% in Group 1 and 77.8% in Group 2 (p = 0.689). Conclusion: Although there is a relationship between the decrease in bicarbonate levels, changes in kidney functions that cause acidosis, and the presence of OW, it has no effect on mortality. The presence of OW in hypothermic patients is insufficient to make a decision regarding mortality. (C) 2018 Elsevier Inc. All rights reserved.
On demand pancreatic stenting in chronic pancreatitis might provide good palliation of pain
(Univ Catholique Louvain-Ucl, 2019) Etik, D. O.; Parlak, E.; Oguz, D.; Oztas, E.; Kacar, S.; Onder, F. O.; Sahin, B.
Background and aim : Chronic pancreatitis (CP)-related pain is a considerable problem in gastroenterology practice that frequently requires several endoscopic interventions. We aimed to investigate the efficacy of pancreatic duct stenting performed on demand, instead of at defined intervals, for the management of the CP-related pain. Methods : This study is a retrospective evaluation of thirteen years of data. Sixty-seven patients with CP who suffered from intractable pain were enrolled in the study. Pancreatic stenting was performed mainly with single stents according to the diameter of the pancreatic duct and width of the stricture or, less frequently, with multiple stents to achieve stricture resolution. The subsequent endoscopic session was scheduled based on the patient's symptoms. Results : Overall, 65 of 67 patients underwent successful pancreatic cannulation (technical success rate 97%). Fifty-seven patients with a pancreatic stenting history were still undergoing follow-up. Of these patients, 26 patients still had pancreatic ductal stents; however, the stents were removed from 31 patients. Only 8 patients (25%) required furtherendoscopic or surgical intervention because of the re-emergence of pain after a median stent-free period of 17 months (3-127 months). One patient with a biliary stricture and one patient with a pancreatic mass underwent surgery. Pancreatic stents remained for a median length of 14 months (3-84 months). During the follow-up period, 55 of 65 patients became pain-free or had partial pain relief (clinical success rate 84%). Conclusions : On demand replacement of pancreatic stent is feasible in patients with CP and it might provide a good palliation of CP-related pain.
How much apoptosis does carbon monoxide poisoning cause? Primary clinical soluble TWEAK protein level study
(Sage Publications Ltd, 2019) Badem, N. Dindar; Comertpay, E.; Coskun, F.
Carbon monoxide (CO) is an important cause of deaths via poisoning. CO poisoning causes inhibition of O-2 transport and development of tissue hypoxia, which then causes cell apoptosis. A significant indicator of cell apoptosis, soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK) protein, is important for the stimulation of apoptosis. The primary purpose of this study is to determine whether apoptosis occurs during acute CO poisoning and to show that sTWEAK protein is an indicator of apoptosis that can be analyzed as a marker in the peripheral blood sample. The secondary aim is to determine the diagnostic and prognostic values of sTWEAK protein. The study was performed prospectively on 43 patients with CO poisoning and 30 healthy volunteer control individuals. The anamneses were taken from all patients, who also underwent physical examination. Complete blood count, biochemical markers, cardiac enzymes, and arterial blood gas measurements were analyzed. All the patients' sTWEAK protein levels were also analyzed. The sTWEAK protein level of patients with CO poisoning was 2278 pg/mL (1197-7234), while the level of the control group was 1609 pg/mL (310-3721). The patients' sTWEAK levels were significantly higher than the controls (area under the curve: 0.77 (0.66-0.89); p < 0.001), and the cutoff value was determined as 1895.50 pg/mL. The cutoff level had a sensitivity of 74.4%, a specificity of 76.7%, a positive predictive value of 82.0%, and a negative predictive value of 67.6%. sTWEAK is a significant indicator of apoptosis in CO poisoning that can be analyzed in the peripheral blood. However, further clinical trials are needed in terms of prognostic criteria.
The relation between scapula fracture and the severity of trauma in blunt thoracic trauma
(Tubitak Scientific & Technical Research Council Turkey, 2018) Algan Kaya, Hatice; Eroglu, Oguz; Gunal, Nesimi; Coskun, Figen; Deniz, Turgut
Background/aim: The aim of this study was to determine the level of presence of scapula fractures (SFs) in cases of blunt thoracic trauma and to identify other injuries accompanying SF. Materials and methods: Blunt thoracic trauma cases with SF determined on direct radiography or computerized tomography (CT) were categorized as Group 1. Group 2 was constituted by selecting cases with high injury severity score (ISS) with no SE The demographic characteristics and all injuries of the patients were evaluated. Results: SF was determined in 77 (11.3%) patients (Group 1), and Group 2 consisted of 607 patients. The ISS was significantly higher in Group 1(27.7 +/- 16.1) than Group 2 (15.9 +/- 9.5) (P < 0.001). The rate of SF with direct radiography was only 9.1%, and more than 90% of patients were evaluated using CT. The most common accompanying injury to SF was rib fracture (44.2%), and the odds ratio was 2.4 (95% CI: 1.51-3.72). Conclusion: The incidence of SF in cases of blunt trauma was higher than in previous studies. The use of CT in blunt trauma can determine SF that cannot be identified through physical examination or radiography, and the most commonly observed accompanying damage in these patients is rib fracture.
Medical students' knowledge of ultrasonography: effects of a simulation-based ultrasound training program
(African Field Epidemiology Network-Afenet, 2018) Eroğlu, Oğuz; Coşkun, Figen
Introduction: The use of simulation devices in medical education is becoming more prevalent with each passing day. The present study aimed to teach medical students to perform ultrasonography via a simulation-based ultrasound training program. Methods: The study was prospectively conducted on final year medical students who had not received previous ultrasound training and who came to the Emergency Department of the Kirikkale University Faculty of Medicine between July 2015 and July 2016. Ultrasound training was provided by two emergency department specialists who are qualified in this field. The training time was determined to be 20h (4h for theoretical lessons, 16h for hands-on). The students were evaluated by a theory test and practical application exam both before and after training. Results: Obtained were compared using the paired sample t-test, and p < 0.05 was considered to be significant. Results: Ninety-six final year medical students were included. Their mean age was 24.1 +/- 2.1 years. The mean test score obtained in the theoretical exam before training was 7.9 +/- 2.2, while that after training was 17.1 +/- 1.6 (p < 0.0001). The mean score obtained in the practical application exam before training was 1.1 +/- 0.9 points and that after training was 10.9 +/- 0.2 points (p < 0.0001). Conclusion: Medical students can learn to use an ultrasound device within a short period of time via simulation-based training programs. New studies must be conducted for the inclusion of ultrasound training programs in the medical education curriculum.
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.
The Effect of Gender Differences in Protracted Hiccups
(Wolters Kluwer Medknow Publications, 2018) Eroglu, O.
Background: Although little importance is attached to hiccups, they may be associated with several diseases. The purpose of this study was to investigate the effects of gender differences on types of hiccups and the relation with diseases involved in the etiology. Materials and Methods: Patients presenting to the Kirikkale University Medical Faculty Hospital with hiccups were investigated retrospectively. Patients' age, sex, duration of hiccups, additional diseases, advanced imaging results, laboratory tests, and clinical follow-up were recorded. Patients were divided into two groups; Group transient hiccup (TH) consisted of subjects with a duration of hiccups less than 48 h, and Group protracted hiccup (PH) of patients with a duration exceeding 48 h. The Chi-square test was used for comparisons, and P < 0.05 were regarded as significant. Results: Eighty-four patients were enrolled, 44.1% (n = 37) in Group TH, and 55.9% (n = 47) in Group PH. Male patients comprised 67.5% (n = 25) of Group TH and 89.4% (n = 42) of Group PH (P = 0.027). The conditions most associated with hiccups were gastrointestinal system (GIS) diseases. Correlation was determined between GIS diseases and male gender (P = 0.034), no relation between other system diseases and gender. Correlation was determined between GIS diseases and protracted hiccups (P = 0.037), but no relation between other system diseases and type of hiccups. Conclusion: Protracted hiccups are more common in males. This gender variation applies particularly to hiccups of GIS origin.
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.
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.
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.
Role of Procalcitonin in Evaluation of the Severity of Acute Cholecystitis
(Aves, 2016) Yuzbasioglu, Yucel; Duymaz, Hikmet; Tanrikulu, Ceren Sen; Halhalli, Huseyin Cahit; Koc, Mirac Ozturk; Tandogan, Meral; Coskun, Figen
Objective: The aim of this study is to investigate the relationship between procalcitonin (PCT) level and the severity of acute cholecystitis. Materials and Methods: This study included 200 patients diagnosed with acute cholecystitis. To diagnose and assess the severity of acute cholecystitis; physical examination and abdominal ultrasound findings were evaluated and blood samples were taken to determine white blood cell (WBC) count, erythrocyte sedimentation rate (ESR), and levels of coagulation factors, blood gas, C-reactive protein (CRP) and PCT. Patients were classified into three stages, namely, mild, moderate, and severe, according to the severity of acute cholecystitis using the Tokyo guidelines. The role of PCT level in the assessment of severity of acute cholecystitis and the correlation between the stages and PCT level were statistically analyzed. Results: Among patients with acute cholecystitis, 110 (55%) were classified as mild, 61 (30.5%) as moderate, and 29 (14.5%) as severe. Leukocytosis or leukopenia was positive in 48.5%, ESR elevation was found in 72.5%, CRP positivity in 55.5%, PCT elevation in 27%, and positive findings of ultrasonographic imaging in 54.5% of the patients. Serum WBC count, ESR, and CRP and PCT levels increased as the severity of disease increased (p<0.05). PCT could discriminate grade I from grade II-III with 95.45% sensitivity and 46.67% specificity at the best cut-off value of <= 0.52 (p<0.001). PCT could also discriminate grade III from grade I-II with 72.4% sensitivity and 90.06% specificity at the best cut-off value of >0.8 (p< 0.001). Conclusion: PCT level may be considered to be a parameter that could be added to the assessment of the severity of acute cholecystitis in the Tokyo guidelines, although further studies are needed to support our findings.
A study to develop clinical decision rules for the use of radiography in wrist trauma: Karadeniz wrist rules
(W B Saunders Co-Elsevier Inc, 2016) Karaca, Yunus; Turkmen, Suha; Cansu, Aysegul; Baki, Mehmet Emre; Eroglu, Oguz; Tatli, Ozgur; Turedi, Suleyman
Introduction: The aim of this study was to evaluate patients presenting to the emergency department (ED) with wrist trauma using physical examination findings and functional tests and to identify findings with high sensitivity and specificity among the parameters assessed in patients with fracture in the wrist. The ultimate objective was thus to establish a reliable and widely usable clinical decision rule for determining the necessity of radiography in wrist trauma. Methods: This prospective, multicenter study was performed in 8 hospitals. The relation between radiologically determined fracture and clinical findings consisting of physical examination findings and functional tests was assessed in terms of whether or not these were markers of radiography requirement, with the aim of identifying predictive values for fracture. Results: A total of 603 eligible trauma patients presented to the participating EDs during the study period. Fracture was identified in 24.5% of patients (n= 148). The 4-way combination with the highest sensitivity was identified as axial compression and the positive distal radioulnar drawer test, and pain with radial deviation and dorsal flexion. Sensitivity at distal ulna palpation was added as a fifth parameter, and sensitivity and negative predictive value thus increased to 100%. Conclusion: With their 100% sensitivity and 100% negative predictive values, the Karadeniz wrist rules may represent a clinical decision rule that can be used in practice in EDs. If all 5 findings are negative, there is no indication for wrist radiography. (C) 2016 Elsevier Inc. All rights reserved.
Warning: This may be as dangerous as firearm injuries;"grease-gun injury": A case report
(African Field Epidemiology Network-Afenet, 2015) Eroglu, Oguz; Sari, Elif; Vural, Sevilay; Coskun, Figen
High-pressure injection gun (Grease-gun) injuries mainly occur with industrial labourers. Injuries associated with high pressure grease guns are very rare and frequently involve the hand and chest. The non-dominant hand is generally injured since the grease gun is usually held in the dominant hand. Even if high-pressure injection injury causes only a small lesion in the skin, it is still characterized by severe damage to subcutaneous tissue. Since initial presentation may be deceptive, treatment is frequently delayed. The characteristics of the material injected need to be known as a priority, and systemic intoxication must be ruled out. The risk of amputation is 16-55%. With solvents it goes up to 50-80%. Surgical treatment must be performed immediately, under general anesthesia or plexus block. Foreign material and necrotic tissue must be early debrided with wide microsurgical exploration. Positive outcomes in reacquisition of hand functions can be obtained with long-term and early physiotherapy.

Güncel Gönderiler