Browsing by Author "Yilmaz, Fevzi"

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An Analyses of Bicycle Accidents in Ankara: Analyses of 5 Years
(2016) Yilmaz, Muhittin Serkan; Durdu, Tamer; Kavalci, Cemil; Sonmez, Bedriye Muge; Yilmaz, Fevzi; Kavalci, Gulsum; Yel, Cihat; Hakbilir, Oktay
Aim: Bicycles are used for transportation, exercise and recreation. In this study we aimed to investigate the epidemiological, clinical and economic aspects of bicycle injuries. Material and Method: We included in the study who admitted to the Emergency Department with a bicycle accident between January 2008 and July 2012. Patient age and sex, accident pattern, presence of personal protective measures, injured body part, Glasgow Coma Scale (GCS) score, Revised Trauma Score (RTS), radiological findings, requested consultations, duration of hospital stay, season of injury, and average cost rates were recorded. The study population was divided into 2 age groups as 0-14 years and over 14 years. Results: A patients were 238 (81.2%) male and their mean age was 31.5 +/- 14.1 years. Fifty-five (18.8%) patients were female and their mean age was 34.5 +/- 15.9 years. Males had significantly higher rate of bicycle injury (p<0.001). The most common injuries occured to lower and upper extremities. Inspection of hospital bills revealed that median patient cost was $175. Discussion: In this study bicycle accidents were more common occured in males and during summer months. The most common injuries was in the lower extremities.
Analysis and injury paterns of walnut tree falls in central anatolia of turkey
(2014) Ersoy, Suleyman; Sonmez, Bedriye Muge; Yilmaz, Fevzi; Kavalci, Cemil; Ozturk, Derya; Altinbilek, Ertugrul; Alagoz, Fatih; Cesur, Fatma; Yildirim, Ali Erdem; Uckun, Ozhan Merzuk; Akin, Tezcan
Introduction: Falls are the second most common cause of injury-associated mortality worldwide. This study aimed to analysis the injuries caused by falls from walnut tree and assess their mortality and morbidity risk. Methods: This is a retrospective hospital-based study of patients presenting to emergency department (ED) of Ahi Evran Univercity between September and October 2012. For each casualty, we computed the ISS (defined as the sum of the squares of the highest Abbreviated Injury Scale (AIS) score in each of the three most severely injured body regions). Severe injury was defined as ISS >= 16. The duration of hospital stay and final outcome were recorded. Statistical comparisons were carried out with Chi-Square test for categorical data and non-parametric spearman correlation tests were used to test the association between variables. A p value less than 0.05 was considered to be statistically significant. Results: Fifty-four patients admitted to our emergency department with fall from walnut tree. Fifty (92.6%) patients were male. The mean age was 48 +/- 14 years. Spinal region (44.4%) and particularly lumbar area (25.9%) sustained the most of the injuries among all body parts. Wedge compression fractures ranked first among all spinal injuries. Extremities injuries were the second most common injury. None of the patients died. Morbidity rate was 9.25%. Conclussion: Falls from walnut trees are a significant health problem. Preventive measures including education of farmers and agricultural workers and using mechanized methods for harvesting walnut will lead to a dramatic decrease in mortality and morbidity caused by falls from walnut trees.
Assessment of maxillofacial trauma in emergency department
(2014) Arslan, Engin D.; Solakoglu, Alper G.; Komut, Erdal; Kavalci, Cemil; Yilmaz, Fevzi; Karakilic, Evvah; Durdu, Tamer; Sonmez, Muge
Introduction: The incidence and epidemiological causes of maxillofacial (MF) trauma varies widely. The objective of this study is to point out maxillofacial trauma patients' epidemiological properties and trauma patterns with simultaneous injuries in different areas of the body that may help emergency physicians to deliver more accurate diagnosis and decisions. Methods: In this study we analyze etiology and pattern of MF trauma and coexisting injuries if any, in patients whose maxillofacial CT scans was obtained in a three year period, retrospectively. Results: 754 patients included in the study consisting of 73.7% male and 26.3% female, and the male-to-female ratio was 2.8:1. Mean age was 40.3 +/- 17.2 years with a range of 18 to 97. 57.4% of the patients were between the ages of 18-39 years and predominantly male. Above 60 years of age, referrals were mostly woman. The most common cause of injuries were violence, accounting for 39.7% of the sample, followed by falls 27.9% and road traffic accidents 27.2%. The primary cause of injuries were violence between ages 20 and 49 and falls after 50. Bone fractures found in 56,0% of individuals. Of the total of 701 fractured bones in 422 patients the most frequent was maxillary bone 28,0% followed by nasal bone 25,3%, zygoma 20,2%, mandible 8,4%, frontal bone 8,1% and nasoethmoidoorbital bone 3,1%. Fractures to maxillary bone were uppermost in each age group. 8, 9% of the patients had brain injury and only frontal fractures is significantly associated to TBI (p < 0.05) if coexisting facial bone fracture occurred. Male gender has statistically stronger association for suffering TBI than female (p < 0, 05). Most common cause of TBI in MF trauma patients was violence (47, 8%). 158 of the 754 patients had consumed alcohol before trauma. No statistically significant data were revealed between alcohol consumption gender and presence of fracture. Violence is statistically significant (p < 0.05) in these patients. Conclusion: Studies subjected maxillofacial traumas yield various etiologic factors, demographic properties and fracture patterns probably due to social, cultural and governmental differences. Young males subjected to maxillofacial trauma more commonly as a result of interpersonal violence.
Bedside Heart Type Fatty Acid Binding Protein (H-FABP): Is an Early Predictive Marker of Cardiac Syncope
(2015) Sonmez, Bedriye Muge; Ozturk, Derya; Yilmaz, Fevzi; Altinbilek, Ertugrul; Kavalci, Cemil; Durdu, Tamer; Hakbilir, Oktay; Turhan, Turan; Ongar, Murat; 0000-0003-2529-2946; 26564283; AGG-1308-2022
Objective: To determine the value of bedside heart-type fatty acid binding protein in diagnosis of cardiac syncope in patients presenting with syncope or presyncope. Methods: The prospective study was conducted at Ankara Numune Training and Research Hospital, Ankara, Turkey, between September 1, 2010, and January 1, 2011, and comprised patients aged over 18 years who presented with syncope or presyncope. Patients presenting to emergency department within 4 hours of syncope or presyncope underwent a bedside heart-type fatty acid binding protein test measurement. SPSS 16 was used for statistical analysis, Results: Of the 100 patients evaluated, 22(22%) were diagnosed with cardiac syncope. Of them, 13(59.1%) patients had a positive and 9(40.9%) had a negative heart-type fatty acid binding protein result. Consequently, the test result was 12.64 times more positive in patients with cardiac syncope compared to those without. Conclusions: Bedside heart-type fatty acid binding protein, particularly at early phase of myocardial injury, reduces diagnostic and therapeutic uncertainity of cardiac origin in syncope patients.
Can We Use Red Cell Distribution as A Marker of Mortality in Acute Myocardial Infarcts?
(2015) Yilmaz, Muhittin Serkan; Isik, Bahattin; Kavalci, Cemil; Salt, Omer; Yel, Cihat; Demirci, Burak; Yilmaz, Fevzi; Durdu, Tamer; Ongar, Murat; Ozdemir, Metin; 0000-0003-2529-2946; AGG-1308-2022
Introduction: Red cell distribution width (RDW) is elevated in ischemic diseases and it is reported that this elevation is associated with mortality in this process. In this study, it is aimed to investigate the place of Red cell distribution width in the diagnosis of myocardial infarction and short-term effect on mortality in the patients presenting with chest pain. Materials and methods: The study was performed retrospectively between 1 July 2013 - 31 December 2013. Age, gender, Red cell distribution width, the affected cardiac region, and cardiac mortality levels of the patients with chest pain who were included in the study were examined. In the descriptive statistics of data; mean, standard deviation, and frequency ratio values were used. In the analysis of quantitative data, Mann-Whitney U test was used. Results were evaluated at 95% confidence interval, significance were evaluated at p <0.05. Results: The median age of patients with Acute myocardial infarction was 69 (Range = 65) and 230 of whom (68.9%) were male) in the study. Red Cell Distribution Width was significantly higher in the group with diagnosis of Acute myocardial infarction (p <0.05). The most frequently seen myocardial infarctus type was anterior myocardial infarction (23.8%) whereas hypertension has been found to be accompanied. Red Cell Distribution Width was significantly higher in the patients who died with a diagnosis of Acute myocardial infarction. Conclusion: As a result, the Red cell distribution width level, can be considered as statistically significant in patients with Acute myocardial infarction and is a parameter that may be associated with mortality.
Clinical Aspects and Emergent Management of Snake Bites Presented to Emergency Department
(2015) Sonmez, Bedriye Muge; Yilmaz, Fevzi; Yilmaz, Muhittin Serkan; Kavalci, Cemil; Gokhan, Servan; Akbulut, Ahmet Sami; Ozhansenekler, Ayhan; Alagöz, Fatih
Evaluating the epidemiologic characteristics and management of snake bites presenting to emergency departments. Material and Method: In this retrospective study 74 cases of snakebites admitted to Emergency Department of Diyarbakir Training and Research Hospital between 2008 and 2009 were retrospectively evaluated. Results: Fourty-six (62.2%) of patients were male and 28 (37.8%) were female. Mean age of the study population was 34.85 +/- 19.17 (min 7-max 80) years. Most of the snakebites occurred between 18.00 to 06.00 hours and at home (73%). 79.7% of snake bites occurred to upper extremities. %93 of cases had intravenous administration of antivenin (one dose). Neither none of the patients needed recurrent administration. Discussion: Snake bites are still a major public health problem especially in rural areas. Particularly emergency care physicians should be adequately capable and sophisticated in multidisciplinary management of snake bites.
Correlation of CAT Score With Peak Expiratory Flow in Acute Exacerbation of COPD Patients
(2016) Kavalci, Cemil; Yilmaz, Muhittin Serkan; Kayipmaz, Afsin Emre; Isik, Bahattin; Celikel, Elif; Kavalci, Gulsum; Yilmaz, Fevzi; Ozlem, Miray; Sonmez, Bedriye Muge; Celebi, Selman; https://orcid.org/0000-0003-2529-2946; 27692357; AGG-1308-2022; AAC-2597-2020
Introduction: Chronic obstructive pulmonary disease (COPD) leads to physical activity limitation and a significant reduction in quality of life. This study aimed to investigate the correlation between The COPD Assessment Test (CAT) score and peak expiratory flow (PEF), and the factors effecting hospital admission rates of patients with COPD. Methods: This observational study was conducted prospectively. CAT score was calculated and PEF measured at the time of emergency department admission. Descriptive statistics were expressed as number (n), percentage (%), and mean +/- standard deviation. Chi-Square and correlation tests were used for statistical analyses. A p value of less than 0.05 was considered statistically significant. Results: Of 123 patients included in the study, 85 (69.1%) were male and 38 (30.9%) were female. Pulse pressure, pH, blood urea nitrogen, oxygen saturation measured by pulse oximetry (SpO(2)), PO2, PCO2, and SpO(2) values on arterial blood gas analysis, and PEF value were significantly correlated to CAT score (p < 0.05). Conclusion: High CAT score and low PEF value can be used to make the decision of hospitalization from emergency department in acute exacerbations of COPD.
Evaluation of The Effect of Lipid Emulsıon Therapy on The Rat Model in Organophosphate Intoxication and Tissue Pathologies
(2014) Celikel, Elif; Arslan, Engin Deniz; Yilmaz, Fevzi; Turhan, Turan; Unal, Muge Tecder; Turhan, Turan; Turhan, Nesrin; Kavalci, Cemil; Karakilic, M. Evvah; Altunkaynak, Hande Ozge; Unal, Muge Tecder; Demir, Ali; AAH-5151-2020
Introduction and objective: Organophosphates are frequently used for agricultural spraying in an uncontrolled manner in our country. Humans are usually inadvertently exposed to these chemicals via respiratory, transdermal, or tranconjunctival routes whereas they may also be used for suicidal purposes: Having a high morbidity and mortality, this intoxication causes a high emergency department admission rate (1). Previous studies on lipid therapy in cardiac arrest associated with intoxication of lipophilic agents such as antidepressants, anticonvulsants, antihypertensives, and local anesthetics have reported a 55% increase in survival with these therapies (2). We also studied lipid emulsion therapy (LET) in poisoning with organophosphates that are lipophilic. Materials and method: This study used 30 male Wistar-albino rats of 12 months of age weighting 288 to 428 gr. The animals were randomly grouped into 5 groups: Group 1 Was the control group; Group 2 organophosphate+serum physiologic (SF) group; Group 3 organophosphate+LET group; Group 4 arganophosphate + Atropin(A)+ Pralidoxime (PAM) group; and Group 5 organophosphate+LET+A+PAM group. After an 8-hour clinical observation period the rats were sacrificed and Wad pseudocholitiesterase, cholesterol; and triglyceride levels were studied. Renal, hepatic, splenic, and cerebral tissues were sampled to be examined under light microscope. Results : There were significant differences between the groups with respect to cholesterol, triglyceride, but not pseudocholine-sterase level Dizziness was the first observed clinical symptom, followed by hindleg paralysis, foreleg paralysis, and general paralysis. After general paralysis salivation was usually observed together with gasping breathing. Rats with the above clinical course were sacrificed. The clinical picture progressed rapidly after foreleg paralysis. The toxic clinical course was observed in 100% of rats in Group 2 (organophosphate + SF) and Group 3 (Organophosphate +LET) and its mortality rate was high. No significant difference was observed between both groups with respect to time to symptom onset. This may be interpreted as that LET treatment alone was not effective. Conclusion: In the present study we did not observe any beneficial effect of LE treatment alone on mortality of organophosphate intoxication. According to our results, however, it may be beneficial when used in conjunction to Classical therapy. Considering its relatively low side effect profile and pros and cons, we believe that it can be used as a supportive therapy in organophosphate poisoning.
Role ofPoint-of-CareLung and Inferior Vena Cava Ultrasound in Clinical Decisions for Patients Presenting to the Emergency Department With Symptoms of Acute Decompensated Heart Failure
(2020) Hacialiogullari, Fakiye; Yilmaz, Fevzi; Yilmaz, Aykut; Sonmez, Bedriye Muge; Demir, Tayfun Anil; Karadas, Mehmet Akif; Duyan, Murat; Ayaz, Gizem; Ozdemir, Metin; 0000-0001-5841-2591; 0000-0002-4719-2535; 32865243; AAJ-3607-2021; AAJ-1600-2021
Objectives This prospective study was performed to evaluate the diagnostic role of point-of-care lung ultrasound (LUS) and inferior vena cava (IVC) ultrasound in patients with acute decompensated heart failure (ADHF). Methods A prospective cohort study was conducted between January 2018 and November 2018 on patients with a diagnosis of ADHF in the emergency department (ED). On admission, LUS findings, inspiratory and expiratory IVC diameters, and the inferior vena cava collapsibility index (IVCCI) were obtained. After therapeutic interventions, third-hour changes in LUS and the IVC index and the treatment response were assessed. Results Eighty patients were enrolled. Forty-six (58%) patients had an ejection fraction (EF) greater than 40%, and 34 (42%) had an EF of less than 40%. Significant differences were detected between the admission and third-hour inspiratory IVC diameter, expiratory IVC diameter, and IVCCI (P= .001). There was no correlation between the EF and inspiratory IVC diameter (r= -0.03;P= .976), expiratory IVC diameter (r= -109;P= .336), or IVCCI (r= -0.72;P= .523) and between the B-type natriuretic peptide level and inspiratory IVC diameter (r= -0.58;P= .610), expiratory IVC diameter (r= -0.33;P= .774), or IVCCI (r= -0.78;P= .493) either. A comparison of admission and third-hour numbers of B-lines on LUS imaging showed a significant decrease in the number of B-lines in all zones at the end of 3 hours (P= .001). A significant difference existed between the hospitalized and discharged patients with respect to IVC diameters and number of B-lines. Conclusions In the ED setting, an assessment of B-lines and measurement of IVC diameters are better markers than the B-type natriuretic peptide level, EF, or chest x-ray for diagnosis of ADHF and can be used to make decisions for hospitalization or discharge from the ED.
Subcutaneous emphysema, pneumo-orbita and pneumomediastinum following a facial trauma caused by a high-pressure car washer
(2014) Yilmaz, Fevzi; Ciftci, Orcun; Ozlem, Miray; Komut, Erdal; Altunbilek, Ertugrul
Pneumomediastinum is air leakage to mediastinal space from various potential sites, including lung, esophagus, trachea, and neck. It is a rare condition that develops either spontaneously with increased intraalveolar or intrabronchial pressure, or due to trauma. Although cases where face or neck trauma with subcutaneous emphysema that extended to mediastinal cavity via anatomical connections in face and neck have been reported, orbital traumas leading to pneumomediastinum are very rare occurrences that have seldom been reported. This paper documents a 17-year-old male who presented with diffuse subcutaneous emphysema involving paraorbital facial areas, which extended to neck and mediastinal cavity.
The value of Serum BNP for diagnosis of intracranial injury in minor head trauma
(2014) Demir, Ali; Kavalci, Cemil; Yilmaz, Muhittin Serkan; Yilmaz, Fevzi; Durdu, Tamer; Ceyhan, Mehmet Ali; Alagoz, Fatih; Yel, Cihat
Objective: Head injury is the main cause of death among individuals younger than 45 years old. Cranial Computerized tomography (CT) is commonly used for diagnosis of head injury. Brain Natriuretic Peptide (BNP) is a peptide originally isolated from brain ventricles. The main aim of this study is to investigate BNP as an indicator of head injury among patients presenting to emergency department (ED) with minor head trauma. Methods: This was a prospective study conducted at the emergency department of the Numune Training and Research Hospital. A total of 162 patients who presented to the ED with minor head injury were enrolled. The patients were categorized into 2 groups as the cranial CT-negative and positive groups. The normality of the data was tested using One Sample Kolmogorov Smirnov test. Mann-Whitney U test was used to compare 2 independent groups while the Kruskal-Wallis test was utilized for comparison of more than 2 groups. A p-value of <0.05 was considered to be significant. Results: Ninety-six (59.3%) patients were male and 66 (40.7%) were female. The cranial CT-negative group had a median BNP level of 14.5 pg/ml while the cranial CT-positive group had a median BNP level of 13 pg/ml. There was no statistically significant difference between these two groups for serum BNP levels (p > 0.05). Conclusion: This study suggested that serum BNP level wasn't used in defined of intracranial injury.