Browsing by Author "Durukan, Polat"

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Approach to Patients with Syncope in Emergeny Department - An Evidence-Based Review
(2014) Ciftci, Orcun; Kavalci, Cemil; Durukan, Polat; https://orcid.org/0000-0001-8926-9142; https://orcid.org/0000-0003-2529-2946; W-5233-2018; AGG-1308-2022
Syncope is an important health problem, constituting 1%-5% of all emergency service admissions and up to 6% of all hospitalizations. Substantial experience with patient history and physical examination and time are required to diagnose syncope in patients presenting with transient loss of consciousness. In addition, only up to 50% of patients with syncope can be diagnosed with a final diagnosis, despite all efforts. Thus, management of syncope in emergency departments has shifted from reaching a final diagnosis and treatment to short-, moderate-, or long-term risk stratification systems, allowing decisions for outpatient management, including specialized branch care, or admission for further work-up. This review discusses the definition of syncope-related transient loss of consciousness, differential diagnosis of syncope, diagnostic methods and algorithms, and the main risk stratification studies. It also incorporates the recommendations of the American College of Emergency Physicians (ACEP) 2007 policy statement regarding patients with syncope.
Comparison of Different Suture Techniques
(2015) Kavalci, Cemil; Cevik, Yunsur; Durukan, Polat; Sayhan, Mustafa Burak
Aim: Traumas are frequent causes of presentation to emergency departments. Suturing is usually required in treatment of patients with scalp laceration. This study aimed to investigate different suture methods with respect of patient satisfaction, wound healing, and treatment cost in patients with scalp laceration. Material and Method: A total of 60 patients were included in the study. The patients were divided into 3 groups; traditional suturing (Group 1), stapling (Group 2), and the tissue adhesive (Group 3) groups. Chi-Square and Kruskal-Wallis tests were used for comparison of the groups. A p value less than 0.05 was considered statistically significant. Results: Two-thirds of the patients were male. The patient satisfaction was highest in the Group 3 (p<0.05). Tissue adhesive group had the lowest treatment cost (p<0.05). Discussion: In contrast to existing traditional belief, the alternative suture methods, i.e. tissue adhesives and staples are not expensive. The patient satisfaction was highest in the tissue adhesive group.
Comparison of Ischemia Modified Albumin Levels with Total Oxidant, Total Antioxidant Status, Oxidative Stress Index in Carbon Monoxide Poisoning
(2014) Durukan, Polat; Koyuncu, Murat; Salt, Omer; Kavalci, Cemil; Ozkan, Seda; Muhtaroglu, Sebahattin; Kavalci, Gulsum; Ozdemir, Caglar; Duzgun, Ali; Ikizceli, Ibrahim; https://orcid.org/0000-0003-2529-2946; AGG-1308-2022
Aim: The most common cause of death in CO poisoning is ventricular arrhythmias due to tissue hypoxia. In this study we aimed to investigate the relationship between severity of poisoning and Total Oxidant Status (TOS), total antioxidant status (TAS) and oxidative stress index (OSI) and also change in the levels of ischemia modified albumin (IMA) and neutrophil gelatinase-associated lipocalin (NGAL) over time in the patients with CO poisoning. Material and methods: This study was performed at Erciyes University Faculty of Medicine, Department of Emergency Medicine. Fifty patients between the ages of 18-65 who were diagnosed CO poisoning in the emergency department were included in the study. As a control group 30 adult individuals with no history of any disease were included in the study. Ischemia modified album, NGAL, OSI, TOS and TAS levels were studied. Mann-Whitney U test was using to compare of control and patient group. The Wilcoxon test was used to compare the change in TAS, TOS, OSI, IMA, NGAL, COHb and lactate. p<0.05 was considered as statistically significant. Results: When the 0th hour levels of Lactate, TOS, OSI, and IMA and TAS of the patient group were compared to the control group, there was a significant difference between these groups (p <0.05). There was no significant difference in terms of the NGAL level (p> 0.05). When 0th, 3rd, 6th, 12 and 24th hrs TAS, TOS, OSI, IMA, NGAL and lactate levels compared with each other, there was no difference between them (p>0.05). Conclusion: The levels of IMA, TOS, TAS and OSI were detected high in CO poisoning, but it is not meaningful in evaluating the effectiveness of treatment.
Comparison of the Canadian CT head rule and the new orleans criteria in patients with minor head injury
(2014) Kavalci, Cemil; Aksel, Gokhan; Salt, Omer; Yilmaz, M. Serkan; Demir, Ali; Kavalci, Gulsum; Ozel, Betul Akbuga; Altinbilek, Ertugrul; Durdu, Tamer; Yel, Cihat; Durukan, Polat; Isik, Bahattin
Aim: The aim of the study was to compare the New Orleans Criteria and the New Orleans Criteria according to their diagnostic performance in patients with mild head injury. Methods: The study was designed and conducted prospectively after obtaining ethics committee approval. Data was collected prospectively for patients presenting to the ED with Minor Head Injury. After clinical assessment, a standard CT scan of the head was performed in patients having at least one of the risk factors stated in one of the two clinical decision rules. Patients with positive traumatic head injury according to BT results defined as Group 1 and those who had no intracranial injury defined as Group 2. Statistical analysis was performed with SPSS 11.00 for Windows. ROC analyze was performed to determine the effectiveness of detecting intracranial injury with both decision rules. p < 0.05 was considered statistically significant. Results: 175 patients enrolled the study. Male to female ratio was 1.5. The mean age of the patients was 45 +/- 21,3 in group 1 and 49 +/- 20,6 in group 2. The most common mechanism of trauma was falling. The sensitivity and specificity of CCHR were respectively 76.4% and 41.7%, whereas sensitivity and specificity of NOC were 88.2% and 6.9%. Conclusion: The CCHR has higher specificity, PPV and NPV for important clinical outcomes than does the NOC.
Compliance to guidelines in in-hospital cardiopulmonary resuscitation interventions: single-center experience
(2019) Caliskan, Nail; Durukan, Polat; Baykan, Necmi; Kaymaz, Neslij Dogan; Elmali, Ferhan; Kavalci, Cemil
Purpose: The aim of this study was to investigate standard of knowledge about adult cardiopulmonary resuscitation according to current guidelines and affecting factors among clinicians working at the Hospital of Erciyes University, Medicine School. Materials and Methods: The study conducted on residences and subspecialty residences who accepted to participate and complete the survey. Overall 303 clinicians who accepted to participate and were accessible for completion of survey were recruited to the study. The survey included 2 sections. The first section included data regarding demographic characteristics and the second part included 20 multiple-choice items with one correct answer prepared based on 2010 American Heart Association Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.. Results: Age, total duration of medical practice and residency positively affected standard of knowledge. Higher number of cardiopulmonary resuscitation performed within prior 6 months and defibrillation performance during cardiopulmonary resuscitation positively affected standard of knowledge. Post-graduate theoretical and practical training positively affect standard of knowledge. Conclusion: Cardiopulmonary resuscitation trainings aiming clinicians should be standardized and updated as well as education during employment should be scheduled to provide access to such programs.
Emergency presentation of ophthalmic zona
(2018) Kavalci, Cemil; Durukan, Polat; Baykan, Necmi; Salt, Omer; Yakar, Sule; Tekin, Ismail; Ozkan, Seda
Importance of Neutrophil Gelatinase-Associated Lipocalin in Differential Diagnosis of Acute and Chronic Renal Failure
(2014) Ozkan, Seda; Durukan, Polat; Kavalci, Cemil; Duman, Ali; Sayhan, Mustafa Burak; Salt, Omer; Ipekci, Afsin; 24764742
Background: Neutrophil Gelatinase-associated Lipocalin (NGAL) protein is easily detected in the blood and urine soon after acute renal injury NGAL gains features of an early, sensitive and noninvasive biomarker for acute renal injury Recent evidences suggest that its expression is also increased in CRF reflecting the severity of disease. Objectives: In the present study, we aimed to investigate whether blood NGAL level plays a role in the differential diagnosis of acute and chronic renal failure. Patients and Methods: This was a prospective case-control study. Fifty patients presented to emergency department with acute renal failure (ARF), 30 with chronic renal failure (CRF) and 20 healthy individuals as control group were included in this study Blood pH, HCO3(-), BUN, creatinine and potassium values were evaluated in all patients. Blood NGAL values were evaluated in all groups. BUN, serum creatinine and NGAL values were statistically compared between patients and controls. Results: Median NGAL levels in patients was 304.50 (29), and 60 (0) in control, which was statistically significant between the two groups (Z = -6.477, P < 0.001). The median NGAL values were 261.50 +/- 291 in ARF group and 428.50 +/- 294 in CRF group. There was a significant difference in NGAL level between ARF and CRF groups (Z = -2.52, P = 0.012). Median BUN values were 153.46 +/- 82.47 in ARE group and 169.40 +/- 93.94 in CRF group. There was no significant difference in BUN value between ARF and CRF groups (P > 0.05). Median creatinine values were 2.84 +/- 2.95 in ARF group and 4.78 +/- 4.32 in CRF group. In serum creatinine values, a significant difference was found between ARF and CRE groups (P <0.05). Conclusions: Serum NGAL levels of ARE and CRF patients were significantly higher than healthy individuals. In addition, NGAL values of patients with CRF were significantly higher than those of ARE. Serum NGAL values can be used to detect renal injury and differentiate ARE and CRE
Intrahospital critical patient transport from the emergency department
(2020) Salt, Omer; Akpinar, Metin; Sayhan, Mustafa Burak; Ors, Fatma Betul; Durukan, Polat; Baykan, Necmi; Kavalci, Cemil; 32190144
Introduction: Although intrahospital transportation of critical patients from the emergency department (ED) is inevitable, it could also result in life-threatening situations. These situations, referred to as unwanted or unexpected events, mainly happen during the transportation of patients for diagnostic imaging or invasive procedures and result in a wide spectrum from vital condition changes, mental condition changes to cardiopulmonary arrest and death. Emergency departments have a high risk of facing such situations because these units are the first admission door of critical patients. Material and methods: This cross-sectional study was conducted prospectively, after interviewing the doctors who work in the ED actively, and by filling out the forms which were already prepared by the participants. Statistical analysis was performed according to the data received, and results were compared to the literature. Results: Three hundred and forty-seven doctors from 52 hospitals were included in the study. 59.4% (n = 206) of them were working at EDs which had more than 500 patients admitted. 51.9% (n = 180) of doctors stated that they performed 10 or more critical patients' transport every day from their ED. 86.7% (n = 301) of the participants stated that usage of control checklists would decrease the rate of unwanted situations and stated that they wanted to use them. Conclusions: Intrahospital transportation of critical patients from the emergency room is a subject that should require attention by emergency room doctors, and using educated personnel, proper equipment, standardized protocols and control checklists will decrease the frequency of unwanted situations effectively.
Isolated Triquetrum Fracture After Trauma
(2018) Durukan, Polat; Baykan, Necmi; Taslidere, Bahadir; Salt, Omer; Yakar, Sule; Ozkan, Seda; Kavalci, Cemil; https://orcid.org/0000-0003-2529-2946; AGG-1308-2022
Serum Neutrophil Gelatinase-Associated Lipocalin Levels In Early Detection Of Contrast-Induced Nephropathy
(2016) Muratoglu, Murat; Kavalci, Cemil; Kilicli, Elif; Findik, Meliha; Kayipmaz, Afsin Emre; Durukan, Polat; https://orcid.org/0000-0002-9586-7509; https://orcid.org/0000-0003-2529-2946; 27439687; AAK-2079-2021; AGG-1308-2022; AAC-2597-2020
Purpose: The purpose of this study was to investigate the role of serum neutrophil gelatinase-associated lipocalin (NGAL) levels in the early detection of contrast-induced nephropathy (CIN). Methods: This prospective study enrolled 74 patients undergoing abdominal tomography with contrast (1 November 2014 - 28 February 2015). Demographic properties (age and sex), symptoms and CT examination results were analysed. Sodium, potassium, urea, creatinine and NGAL levels were measured at 0th, 6th, and 72nd hours. P value < 0.05 was considered statistically significant. Results: CIN developed in 16.2% of the study patients. The mean age was significantly higher in the patients who developed CIN (p<0.05). No significant correlation existed between the occurrence of CIN and patient gender (p>0.05). Urea levels did not differ significantly between the groups at 0th and 6th hours (p>0.05) but was significantly higher in the patients with CIN at 72nd hour (p<0.05). Urea levels did not change significantly over time in the entire group (p>0.05). Creatinine level was not significantly different between the groups (p>0.05) but increased significantly over time (p>0.05). There were no significant differences between the groups with respect to NGAL levels at 0th and 72nd hours (p>0.05) whereas the group with CIN had a significantly higher NGAL level at 6th hour (p<0.05). A NGAL level of 668 mg/dL at 6th hour had a sensitivity of 100%, specificity of 95%, positive predictive value of 80% and negative predictive value of 100% for the detection of CIN. Conclusion: NGAL may be a useful marker for the early detection of CIN.