Tıp Fakültesi / Faculty of Medicine

Permanent URI for this collectionhttps://hdl.handle.net/11727/1403

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2014 - 20153

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Author: search.filters.author.Durukan, PolatSubject: search.filters.subject.Emergency

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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.
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    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.
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    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.