Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item 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-1308-2022Aim: 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.Item Effects of Drug Use on the Development of Diabetic Ketoacidosis(2015) Koyuncu, Murat; Ozturk, Derya; Altinbilek, Ertugrul; Yapar, Nikola; Karakisa, Halit; Kavalci, Cemil; Ikizceli, Ibrahim; 0000-0002-9825-4716; 0000-0003-2529-2946; 0000-0003-4201-8850; 0000-0001-7446-1641; D-1981-2019; AGG-1308-2022; AAB-1368-2019Introduction: Diabetic Ketoacidosis (DKA) is a condition in which the body must use adipose and protein deposits as intracellular energy sources due to a lack of insulin. In the current study, we aimed to investigate the effects of drug use on the development of DKA and on clinical parameters in patients who presented to the Emergency Department (ED) with the diagnosis of DKA. Materials and methods: This study was retrospectively conducted in Sisli Etfal Training and Research Hospital between October 1, 2011 and March 31, 2013. The following parameters were recorder for each patient: age, gender, complaints, history of drug use, cause of DKA, pH, HCO3 levels, time spent in the ED, treatment outcomes and hospitalization durations. Results: The mean age of the patients was 42.61 +/- 8.6 years, and 58% (n=43) of them were female. 20.3% (n=15) of the patients were drug free. 63.5% (n=47) of the patients were followed up with in the ward, 12 (16.5%) were followed up with in the ED and 20% (n=15) were followed up with in the intensive care unit (ICU). The mean duration of stay in the ED was 15 hours, and the mean hospitalization time was 10 days. The mortality rate was 2.7%(n=2). When the effects of the drug use on DKA were examined, there were no statistically significant differences between the patients in terms of acidosis condition, mortality, clinic of hospitalization and durations of follow-up and treatment (p>0.05). The most important factor causing ketoacidosis was the presence of infection (40.5%, n=30), while the most common symptom was nausea/vomiting (51.4%, n=38). Conclusion: We observed that in patients with DKA, drug use does not affect mortality and morbidity.Item A Comparison of Human Prothrombin Complex and Fresh Frozen Plasma for Reversal of Warfarin Anticoagulant Effect in The Emergency Department(2016) Altinbilek, Ertugrul; Ozturk, Derya; Ikizceli, Ibrahim; Kavalci, Cemil; https://orcid.org/0000-0003-2529-2946; AGG-1308-2022Introduction: Warfarin, the most commonly used oral anticoagulant worldwide. Bleeding represents the most significant complication of warfarin therapy. The aim of the present study was to compare the efficacies of Human Prothrombin Complex (PCC) and Fresh Frozen Plasma (FFP) for reversal of warfarin-induced anticoagulant effect in the emergency department. Materials and methods: This observational, retrospective study was retrospectively conducted at Sisli Hamidiye Etfal Training and Research Hospital. The study included 32 patients aged over 18 years who presented to the emergency department with warfarin-induced INR elevation and major bleeding. The patients were divided into PCC (Group 1) and FFP (Group 2) groups. The two groups were compared with each other with respect to age, gender distribution, duration of emergency department stay, warfarin dosing schedule (mg/day), bleeding site, amount of PCC (number*10 ml/IU) or FFP (number*200 ml) used for treatment, pre-treatment INR, aPTT levels, and INR, PT, and aPTT levels 15 minutes after FFP and 240 minutes after PCC administration. Results: The two groups were not significantly different with respect to age and gender distribution (p > 0.05). PCC group had an average duration of emergency department stay of 4.8 hours whereas FFP group had an average duration of emergency department stay of 12.25 hours (p<0.05). The number and cost of PCC was significantly greater than FFP (p<0.05). However, the volume of drug was significantly lower in the PCC group (p<0.05) Conclusion: PCC has a limited role in clinical practice due to its cost and limited availability. However, with the possible exceptions of blood transmissible diseases, volume loading, and loss of time, administration of a combination of FFP and vitamin K is not a medically inappropriate practice.Item Successful application of acute cardiopulmonary resuscitation(2015) Ozturk, Derya; Altinbilek, Ertugrul; Koyuncu, Murat; Sonmez, Bedriye Muge; Caltili, Cilem; Ikizceli, Ibrahim; Kavalci, Ibrahim; Kavalci, Cemil; Kavalci, GulsumObjective: To compare the quality and correct the deficiencies of cardiopulmonary resuscitation (CPR) procedures performed in patients who developed cardiopulmonary arrest before or after Emergency Department admission. Methods: This study was conducted on patients who were applied CPR at Sisli Etfal Training and Research and Research Hospital, Emergency Department between 01 January 2012 and 31 December 2012. Chi-square and Mann-Whitney U test were used to compare the patients' data. The study data were analyzed in SPSS 18.0 software package. A P value less than 0.05 was considered statistically significant. Results: A total of 155 patients who were applied CPR were included in the analysis. Among the study patients, seventy eight (50.3%) were brought to Emergency Department after developing cardiopulmonary arrest while 77 (49.7%) developed cardiopulmonary arrest at Emergency Department. The mean age of the study population was (66 +/- 16) years and 64% of the patients were male. The initial rhythms of the CPR-applied patients were different (P < 0.05). There were no significant differences between the groups with respect to the treatment protocols or CPR responses (P > 0.05). The CPR response time was longer in ED (P < 0.05). The survival rate was lower in the trauma patients who developed cardiopulmonary arrest at ED (P < 0.05). Conclusions: The scientific data obtained in this study suggest that an early response and therapy improves outcomes in CPR procedure.