Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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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 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.Item 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-2597-2020Purpose: 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.Item Hair-Thread Tourniquet Syndrome Originating from A Haemangioma in an Adult Patient(2016) Okur, Osman Mahir; Coskun, Abuzer; Kayipmaz, Afsin Emre; Ozbay, Sedat; Kavalci, Cemil; Kocalar, Ummu Gulsum; https://orcid.org/0000-0003-2529-2946; 27427144; AAC-2597-2020; AGG-1308-2022Hair-thread tourniquet syndrome is an emergency condition rarely encountered since its first description, and it may be potentially dangerous unless treated. The potential hazard of the condition stems from hair strands wrapping around and strangulating various body processes such as fingers, penis, or clitoris. In this paper we aimed to report the first case of hair-thread tourniquet syndrome affecting a haemangioma of an adult patient. A 68-year-old woman presented to emergency department for pain in the mass on her back. On physical examination, a haemangioma with a size of about 3x3 cm was noted on the right scapula. When inspected closely, it appeared edematous and strangulated, and there were hair strands wrapped to the bottom of the wound. The hair strands were removed and the strangulated haemangioma was excised.Item Effect of Platelet-Lymphocyte Ratio and Lactate Levels Obtained on Mortality with Sepsis and Septic Shock(2018) Biyikli, Ebru; Kayipmaz, Afsin Emre; Kavalci, Cemil; 0000-0002-0520-0349; 0000-0003-2529-2946; 29225011; AAJ-7628-2021; AGX-8305-2022; AGG-1308-2022; AAC-2597-2020Background: Sepsis is a potentially fatal condition with high treatment costs, and is especially common among the elderly population. The emergency management of septic patients has gained importance. Objective: Herein, we investigated the effect of admission lactate levels and the platelet-lymphocyte ratio (PLR) on the 30-day mortality among patients older than 65 years who were diagnosed with sepsis and septic shock according to the qSOFA criteria at our hospital's emergency department. Methods: This observational study was conducted retrospectively. We obtained information regarding patients' demographic characteristics, comorbid conditions, hemodynamic parameters at admission, initial treatment needs at the emergency department. Results: 131 patients received a diagnosis of sepsis and septic shock at our emergency department in two years. Among these, 45% (n=59) of the patients died within 30 days of admission. Forty (30.5%) patients required mechanical ventilation. There was a significant difference between the survival and non-survival groups with regard to systolic and diastolic blood pressures (p = 0.013 and 0.045, respectively). There were significant differences between the two groups with respect to the Glasgow Coma Scale score (p < 0.001) and BUN levels (p < 0.001). The mortality status according to qSOFA scores was revealed a significant difference between the two groups (p < 0.001). Conclusion: Our results showed that the patients who died within 30 days of admission and those who did not had comparable PLR and lactate levels (p=0.821 and 0.120, respectively). We opine that serial lactate measurements would be more useful than a single admission lactate measurement for the prediction of mortality. (C) 2017 Published by Elsevier Inc.Item Predictors of Obstructive Coronary Artery Disease vs Non-obstructive Lesions on Coronary Angiography in Patients with Non-ST Elevation Myocardial Infarction. A Retrospective Analysis from a University Hospital(2017) Ciftci, Orcun; Kayipmaz, Afsin Emre; Karacaglar, Emir; Yilmaz, Kerem Can; Muderrisoglu, Ibrahim Haldun; 0000-0001-8926-9142; 0000-0002-2538-1642; AAC-2597-2020; AAJ-1331-2021; W-5233-2018; ABI-6723-2020Item Red Blood Cell Distribution Width Increases During Infection in Renal and Liver Graft Recipients(2017) Kayipmaz, Afsin Emre; Findik, Meliha; Kavalci, Cemil; Akdur, Aydincan; Moray, Gokhan; Haberal, Mehmet; 0000-0002-3462-7632; 0000-0003-2529-2946; 0000-0002-8726-3369; 0000-0003-2498-7287; 26767568; AAJ-8097-2021; AGG-1308-2022; AAA-3068-2021; AAC-2597-2020; AAE-1041-2021Objectives: Organ transplant is an effective treatment for patients with end- stage renal and hepatic failure. Increased use has introduced more emergency department admissions of infectious origin after transplant. Because infections usually manifest with simple complaints and fever, emer gency physicians need laboratory tests and radiologic imaging procedures to quickly detect the presence and source of infection. Our aim was to analyze fever-related emergency admissions of renal and hepatic graft recipients and determine whether admitted patients had increased red blood cell distribution width and mean platelet volume levels. Materials and Methods: We reviewed the medical records of renal and hepatic graft patients who presented to our emergency department with fever during a 4-year period. Our analyses included 150 patients in which complete blood count and C-reactive protein results were available and the source of infection was determined. We compared results with a control group of 150 transplant patients without any infectious findings. Results: In the 150 solid-organ graft recipients who presented to our emergency department with fever, significant differences were observed versus control patients with respect to white blood cell count, neutrophil-to-lymphocyte ratio, red blood cell distribution width, mean platelet volume, and C-reactive protein levels (P <.05). We determined that C-reactive protein levels, red blood cell distribution width, mean platelet volume, and lymphocyte count were independent indicators of infection on multiple logistic regression analyses. We also determined that red blood cell distribution width had a specificity of 94% and a sensitivity of 26%. Conclusions: We found a significantly higher red blood cell distribution width in emergency admissions of infectious origin of renal and hepatic graft recipients than in the control group (P <.001), suggesting that this measurement is a suitable marker of infection for the emergency setting by virtue of rapid availability of test results and lack of extra costs.Item Neutrophil to Lymphocyte Ratio As A Predictor of Severe Coronary Artery Disease and Left Ventricular Systolic Dysfunction of Any Degree in Geriatric Patients Presenting to Emergency Department with Acute Coronary Syndrome(2017) Ciftci, Orcun; Kayipmaz, Afsin Emre; Aydos, Tolga Resat; Muderrisoglu, Ibrahim Haldun; 0000-0002-1832-9336; 0000-0001-8926-9142; AAJ-7279-2020; AAC-2597-2020; W-5233-2018Introduction: We examined the role of the neutrophil-to-lymphocyte ratio (NLR) for predicting severe coronary artery disease and left ventricular systolic dysfunction of any degree in geriatric patients presenting to emergency department with non-ST-elevation acute coronary syndrome. Materials and Method: We retrospectively reviewed data for patients aged >= 65 years with non-ST-elevation acute coronary syndrome who underwent coronary angiography between April 2011 and January 2016. Patients were divided into Group 1 (101 patients; severe [>50%] lesions in one or more epicardial artery or branch) and Group 2 (65 patients; no severe lesions). The key clinical parameters, including NLR were compared among the groups and the power of NLR as a predictor of severe coronary artery disease and left ventricular systolic dysfunction of any degree was determined. Results: Group 1 included more patients who were male, older, or smoked; these had higher troponin I, mass CK-MB, NLR, but a lower left-ventricular ejection fraction. NLR was an independent predictor of severe coronary disease and left ventricular systolic dysfunction of any degree with good sensitivity and moderate specificity. Conclusion: Neutrophil-to-lymphocyte ratio is a simple, rapid, and cheap parameter that can predict severe coronary artery disease and left ventricular systolic dysfunction of any degree in geriatric patients with non-ST-elevation acute coronary syndrome.Item Differences Between Adolescent and Adult Cases of Suicidal Drug Intoxication(2016) Dogan, Halil; Adiguzel, Lokman; Uysal, Emin; Sarikaya, Sezgin; Ozucelik, Dogac Niyazi; Okuturlar, Yildiz; Giray, Tufan Akin; Kayipmaz, Afsin Emre; Yazicioglu, Mustafa; Sisek, Cem; https://orcid.org/0000-0003-4619-4034; AGQ-5015-2022; AAC-2597-2020Objective: Drug intoxications are among the major causes of emergency department admissions. There is a limited number of studies exploring the differences between adolescent and adult cases of intoxication. We aimed to compare adolescent and adult cases of drug intoxication to determine demographic and clinical properties of intoxications and necessary measures that have to be taken in both age groups. Material and Methods: Adolescent (9-19 years of age) and adult (19 years or older) cases of drug intoxication that presented to our Emergency Department between 1 June 2009 and 30 June 2010 were retrospectiely reviewed. Age, sex, purpose of drug intake, whether or not an antidote was used, single-or multidrug intake, the group of the offending drug, duration of hospital stay, and clinical outcomes were recorded. Results: This study included a total of 278 patients, of which 39.2% (n=109) were adolescent and 60.8% (n=169) were adult. Among adolescents, 15.6% (n=17) were male and 84.4% (n=92) were female while % 20.1 (n=34) of adults were male and 79.9% (n=139) were female. The mean age was 16.68 +/- 1.774 years in the adolescents and 27.87 +/- 7.264 in the adults. An antidote was used in 30% (n=3) of the adolescents and 70% (n=7) of the adults. Suicidal drug intake formed 39.2% (n=109) of the cases in the adolescents and 60.8% (n=169) in the adults. Multi-drug intake had a rate of 51.9% (n= 42) in the adolescents and 48.1% (n=39) in the adults. Paracetamol was the offending agent in 46.9% (n= 23) of the adolescents, while antidepressnats were responsible for 65.2% (n=30) of the drug intoxications in the adults. Duration of hospital stay was 1.19 +/- 0.775 hours in the adolescents and 1.15 +/- 0.617 hours in the adult cases. None of the patients in both groups died. Conclusion: Acute intoxications are an important medical problem for emergency departments. The most common suicide method is drug intake. Drug intoxications were more prevalent in women in both adolescent and adult age groups. Suicidal drug intoxications were more common in the adults compared to the adolescents. Paracetamol was the most commonly taken drug in the adolescents while antidepressants were the most common drugs in the adults. Multi-drug intake was more common in the adolescents than the adults. It is possible to reduce the number of drug intoxications by determining risk factors, taking necessary measures, and planning appropriate population-based educational activities.Item 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-2597-2020Introduction: 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.
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