Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item X-Ray Quiz: Ankle Sprain(2014) Kilicli, Elif; Findik, Meliha; Kavalci, Cemil; https://orcid.org/0000-0003-2529-2946; AGG-1308-2022Item 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-1308-2022Syncope 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.Item Calcified Hydatid Cyst: Original Image(2015) Kavalci, Cemil; Sezenler, Eylem; Sayhan, Mustafa Burak; 0000-0003-2529-2946; AGG-1308-2022Item 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-1308-2022Introduction: 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.Item The Association Between Blood Alcohol Levels and the Severity of Head Trauma in Patients with Minor Head Trauma(2015) Aksel, Gokhan; Ozel, Betul Akbuga; Guler, Sertac; Kavalci, Cemil; Dogan, Nurettin Ozgur; Corbacioglu, Seref KeremIntroduction: Alcohol intake is associated with a wide variety of traumatic hazards. Although most authors accept that head injuries are frequently sustained in the state of alcohol intoxication, contributing to major post-traumatic disability and mortality, the specific effects of alcohol exposure on injury severity and subsequent outcomes remain controversial. Materials and methods: This was a prospective cross-sectional study, which compared alcohol ingested and alcohol free patients presenting to the emergency department following minor head trauma according to their severity of head injury. Adult patients presenting to emergency department with minor head trauma, as defined by a GCS score of 15 and blunt trauma to the head are enrolled to the study consecutively. Patients with a blood alcohol level of >= 10mg/dL were defined as alcohol group and <10mg/dL were defined as non-alcohol group (control group). Cranial computed tomography results of two groups were compared. Results: A total number of 424 patients included in the study and 208 of them composed alcohol group and 216 non-alcohol group. There were 19 patients having (45%) positive findings in their cranial computed tomographies. 3 (0.7%) of them had clinically important intracranial injuries while 16 (3.8%) had clinically unimportant intracranial injuries. There was no statistically significant difference in two groups according to patients having intracranial injuries (p=0.273). 22 of the patients needed neurosurgical or non-neurosurgical interventions. Patients in alcohol group needed more operative interventions compared to non-alcohol group (p<0.001). Conclusion: Alcohol did not influence the severity of head trauma while it influenced the severity of whole body trauma. Although not reaching statistical significance, both patients with positive computed tomography results and patients who needed neurosurgical intervention were higher in alcohol-intoxicated patients. We believe that patients with alcohol intoxication need more elaborative evaluation than alcohol free patients in order to detect life-threatening complications in patients with mild head injury.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 Acute Dystonic Reaction Due To Dexketoprofen Trometamol(2015) Kayipmaz, Afsin Emre; Giray, Tufan Akin; Tasci, Suleyman Serdar; Kavalci, Cemil; Kocalar, Ummu Gulsum; 0000-0003-2529-2946; 0000-0003-4619-4034; 26564300; AGG-1308-2022; AGQ-5015-2022; AAC-2597-2020Dexketoprofentrometamol (DKP), is a tromethamine salt of the water-soluble S-enantiomer of ketoprofen. As with all other non-steroidal anti-inflammatory agents, the most common side effect of DKP is gastric complications. In this paper, we report a case of dystonic reaction after intravenous DKP use. A 24-year-old man was admitted to our hospital after suffering a leg burn from boiling oil. He had no drug hypersensitivity. An intravenous preparation containing the active ingredient DKP was injected for analgesia, after which the patient experienced an involuntary flexion response in both upper extremities. With a suspected diagnosis of dystonia, biperiden lactate 5 mg/ml was administered via the intramuscular route and the contractions abated within 30 seconds of the injection. As non-steroidal anti-inflammatory agents are commonly used and prescribed in emergency departments, it should be kept in mind that an acute dystonic reaction can develop against one of these agents, DKP.Item 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-1308-2022Objective: 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.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 Two Coronary Artery Bypass Graft Surgery Techniques with Respect to Acute Kidney Injury(2015) Beyazpinar, Deniz Sarp; Gultekin, Bahadir; Kayipmaz, Afsin Emre; Kayipmaz, Cagri; Sezgin, Atilla; Giray, Tufan Akin; Kavalci, Cemil; 0000-0003-2529-2946; 0000-0003-4619-4034; AAC-2597-2020; AGG-1308-2022; ABA-7388-2021; ABA-9675-2021; AGQ-5015-2022Background: This study aims to compare the conventional coronary artery bypass graft (CABG) surgery and on-pump beating heart bypass grafting (OPBHB) with respect to acute kidney injury and subsequent dialysis requirement. Methods: Between January 2012 and October 2013, medical records of 77 patients who underwent conventional CABG and 76 patients who underwent OPBHB for coronary artery disease in our clinic were retrospectively analyzed. Results: There was no significant difference in preoperative renal function test results between the groups. However, there was a significant difference in cardiopulmonary bypass time and length of intensive care unit stay (p<0.05). Seven (9.21%) of 76 patients in OPBHB group and 11 (14.28%) of 77 patients in CABG group developed acute kidney injury; however, it did not indicate a statistically significant difference between the groups (p>0.05). One patient in OPBHB group and four patients in CABG group also needed dialysis. Conclusion: Our study results suggest that OPBHB is superior to the conventional CABG in terms of acute kidney injury and, more importantly, development of acute renal failure in patients with a serum creatinine level of 1-1.3 mg/dL.