Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item 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 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 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 Comparison of Two Intraosseous Devices in Adult Patients in The Emergency Setting: A Pilot Study(2016) Demir, Omer F.; Aydin, Kemal; Akay, Huriye; Erbil, Bulent; Karcioglu, Ozgur; Gulalp, Betul; https://orcid.org/0000-0002-2045-2771; 25075979; P-6931-2016Objective To compare two intraosseous (IO) insertion devices in terms of safety and ease of use in patients who need urgent vascular access in the emergency setting following failed attempts for intravenous lines. Methods This prospective, randomized clinical study compared two different IO access devices in adults (>= 16 years of age or weighing > 40 kg) admitted to our emergency department with difficult peripheral venous access and in need of urgent intervention. The findings were compared in terms of the rates of successful insertion of spring-loaded impact-driven adult BIG and the battery-driven EZ-IO devices on the first attempt, difficulty of use, time taken to complete the insertion, and complication rates. Results A total of 52 patients were enrolled and randomized for the study. IO access was performed in 26 patients using the BIG device and in 26 patients using the EZ-IO device. The rates of successful insertion of BIG and EZ-IO devices on the first attempt were 92.3 and 84.6%, respectively (P=0.668). The time taken to complete the procedure was significantly greater in the EZ-IO group (5.2 +/- 2.2 s) compared with the BIG group (2.8 +/- 1.2 s) (P < 0.001). Difficulty of use was scored using the visual analogue scale, which yielded the mean visual analogue scale for EZ-IO and BIG (25.4 +/- 12.6 and 8.6 +/- 6.4 mm, respectively) (P < 0.001). No mechanical problems or technique-related complications were encountered in any of the groups. Conclusion Both EZ-IO and BIG are shown to be reliable and safe methods for insertion of intravascular access in emergency conditions.Item The Role of Procalcitonin in Predicting Necessity of Antivenom Administration and Clinical Severity in Snake Bites(2022) Icme, Ferhat; Avci, Akkan; Yilmaz, Nurettin; Urfalioglu, Ahmet Burak; Avci, Begum Seyda; Yesiloglu, Onder; Tugcan, Mustafa Oguz; Sumbul, Hilmi Erdem; Yesilagac, Hasan; Sapmaz, Ekrem; 35491125One of the most important steps for preventing deaths due to snake bites is to administer snake antivenom to the eligible patients in a swift manner. In our study, we aimed to investigate whether procalcitonin is useful for predicting the clinical severity and the necessity of antivenom therapy at the early stages in patients presenting with snake bite. A total of 78 patients over the age of 18 who applied to the emergency department within the first 24 hours were included in this retrospective cross-sectional study. Age and sex of patients, severity of snake bites, total antivenom vials administered, observation periods and outcomes were recorded. Patients were graded according to their clinical severity after the snake bite. Procalcitonin, complete blood count and biochemical parameters of the patients were recorded. According to their clinical severity, the patients' grades were as follows: 21 (26.9%) patients were grade 0; 21 patients (26.9%) were grade 1; 16 patients (20.5%) were grade 2; and 20 patients (25.6%) were grade 3. Snake antivenom was administered to 57 (73.1%) patients. There was a statistically significant difference between procalcitonin levels of patients in respect to their grade (P < 0.001). Sensitivity and specificity of procalcitonin levels of 13.45 and above were 100% and 100% respectively, both for the need of antivenom administration and for the blister formation in the patients. According to our study, we believe that elevated procalcitonin levels should alert the clinicians for possible blister formation, higher clinical severity, and increased requirement for antivenom administration.Item Neutrophil/lymphocyte ratio and Red blood cell distribution width are independent risk factors for 30-day mortality in Gastrointestinal system bleeding patients(2019) Altinbilek, Ertugrul; Ozturk, Derya; Kavalci, CemilBackground. In this study, we aimed to examine demographic and endoscopic features of patients with GI bleeding to determine the factors affecting 30-day mortality. Method. Patient's demographic features, laboratory outcomes, comorbidities, drug use, endoscopy outcomes, Glasgow-Blatchford scores, and mortality status were examined. The factors affecting 30-day mortality were investigated. Results. The mean age of the patients was 58.2 +/- 17.4 years, and 72.1% were male patients. 30-day mortality rate was found to be 14.4%. The mean age of patients who died was high (p<0.05). The incidence of mortality was high in the presence of comorbidity, malignancy, and cirrhosis (p<0.05). Systolic blood pressure was low in the patients who died (p<0.05). No significant correlation was found between mortality and gender, symptoms, predisposing factors, lesion type and Forrest score, diastolic blood pressure and heart rate (p>0.05). Urea, neutrophils, red blood cell distribution width / platelet ratio, neutrophil / lymphocyte ratio and RDW levels were high, and hemoglobin level was significantly low in patients with a mortal progression (p<0.05). No significant correlation was found between mortality, and platelet and lymphocyte levels (p>0.05). Glasgow-Blatchford score was significantly higher in patients who died (p<0.05). Conclusion. Many factors affect 30-day mortality in GI bleeding. It should be remembered that follow-up of patients with an advanced age who have comorbidity and impaired hemodynamics should be kept for long, and that these patients are at a high risk for mortality. According to our results, NLR and RDW are independent factors that determine the 30-day mortality in upper GI bleeding.