Turkish Journal of Geriatrics-Turk Geriatri Dergisi, Apr 1, 2011
ABSTRACT RDELENMES‹ ÖZ Girifl: Dünyam›z h›zla yafllanmakta dolay›s›yla toplumumuzda da bu yafl po... more ABSTRACT RDELENMES‹ ÖZ Girifl: Dünyam›z h›zla yafllanmakta dolay›s›yla toplumumuzda da bu yafl popülasyonu giderek artmaktad›r. Bu yafl grubunda s›k görülen hastal›klar›n ve bu hastal›klara yol açan risk faktörleri-nin belirlenmesi hem disabiliteyi hem de tedavi maliyetlerini azaltacakt›r. Bu çal›flmada acil polik-lini¤e baflvuran 65 yafl ve üzeri olgularda nörolojik semptomlar›n s›kl›¤› ve olgular›n ald›klar› tan›-lar›n belirlenmesi amaçlanm›flt›r. Gereç ve Yöntem: Çal›flmaya 01.01.2006-1.12.2007 y›llar› aras›nda Çukurova Üniversitesi T›p Fakültesi Acil T›p poliklini¤ine baflvuran yafl ortalamas› 73.4±6.0 (65-102) olan 1945'si (%50.5) kad›n, 1907'si (%49.5) erkek toplam 3851 olgu al›nm›flt›r. Bulgular: 518 hastan›n (%13.4) nörolojik semptomlarla acile baflvurdu¤u belirlenmifltir.En s›k semptomun konuflma bozuklu¤u, kol ve bacak da uyuflma, a¤›z da e¤ilme oldu¤u, bunu bafla¤-r›s› ve bilinç bozuklu¤unun takip etti¤i görülmüfltür. Sonuç: Etyolojik nedenler gözden geçirildi¤inde en s›k nedenin iskemik inme oldu¤u belirlen-mifl, bunu vertebrobaziler yetmezlik ve metabolik ensefalopatiler takip etmifltir. ABSTRACT Introduction: Our world is aging rapidly, so this age population is on the increase also in our community. Designation of the frequent diseases and their risk factors in this age group may bring about a decrease in both disabilities and health expenditures. The aim of this study was to identify the frequency of neurological symptoms and the established diagnoses in patients admit-ted to the emergency department. Materials and Method: The study included 3851 cases, 1945 (50.5%) women and 1907 (49.5%) men, at a mean age of 73.4±6.0 years (65-102) admitted to Cukurova University Faculty of Medicine, department of emergeny during the period between 01.01.2006 and 01.12.2007. Results: Five hundred and eighteen (13.4%) patients were admitted to the emergency de-partment with neurological symptoms. The most frequent symptoms were speech disorders, pa-resthesia in limbs, nasolabial asymmetry, unconsciousness and headache. Conclusion: The most common etiological factors were stroke, vertebrobaziler deficiency and metabolic encephalopathy.
Akrep sokması ciddi ve hayatı tehdit eden acil bir durumdur. Akrep sokmalarında klinik olarak; ka... more Akrep sokması ciddi ve hayatı tehdit eden acil bir durumdur. Akrep sokmalarında klinik olarak; kardiyovasküler, nörolojik ve hematolojik anormallik (trombositopeni, nötropeni) görülebilir.Bu çalışmada; akrep sokması sonucu acil servisimize başvuran 60 yaşında bayan hastanın tanı ve tedavi metodları tartışıldı. Trombosit desteğine gerek kalmadan akrep antivenomu tedavisi ile trombosit seviyeleri düzeldi.
Given the importance of agriculture and widespread use of pesticides, intoxication due to organop... more Given the importance of agriculture and widespread use of pesticides, intoxication due to organophosphate insecticides is common in Turkey. Organophosphorus compounds may cause late-onset distal polyneuropathy occurring 2 or more weeks after the acute exposure. An 18-year-old woman and a 22-year-old man were admitted to the hospital with weakness, paresthesia, and gait disturbances at 35 and 22 days, respectively, after ingesting dimethyl-2,2-dichloro vinyl phosphate (DDVP). Neurological examination revealed weakness, vibration sense loss, bilateral dropped foot, brisk deep tendon reflexes, and bilaterally positive Babinski sign. Electroneurography demonstrated distal motor polyneuropathy with segmental demyelination associated with axonal degeneration prominent in the distal parts of both lower extremities.
Çukurova Üniversitesi Tıp Fakültesi dergisi, Mar 1, 2014
Kisisel koruyucu onlemler alinmadiginda mesleki zehirlenmeye neden olabilen organofosfatlar, Turk... more Kisisel koruyucu onlemler alinmadiginda mesleki zehirlenmeye neden olabilen organofosfatlar, Turkiye"nin guneyindeki tarim bolgelerinde sikca kullanilan insektisitlerdir. Bu nedenle, bu bolgenin saglik calisanlarinca taninmasi kolay olan bu kolinerjik zehirlenmenin klasik klinik bulgulari miyozis, sekresyonlarda artma, bradikardi ve fasikulasyonlardir. Alkolizme bagli hastalik ve durumlardan olan mental ve sosyal uyum problemleri, koma, zehirlenme, yoksunluk ve deliryum tremens, kronik alkolizmi olan hastalarin hastane ziyaretlerinin sik sebeplerindendir. Bu yazida, aslinda alkol yoksunlugu iken benzer semptomlar nedeniyle organofosfat zehirlenmesi tani ve tedavisi alip, deliryum tremense ilerleyen bir olgu sunulmustur.
Zehirlenme, organizman›n herhangi bir sistemi, fonksiyonunu olumsuz etkileyecek maddelere maruz k... more Zehirlenme, organizman›n herhangi bir sistemi, fonksiyonunu olumsuz etkileyecek maddelere maruz kald›¤›nda gerçekleflir. Zehirlenen hastalar acil servislerde s›kl›kla görülür. Bu hastalara uygun acil yaklafl›m ölüm oran›n› azalt›r. Mesleksel ve çevresel etkilenmelerle ya da ilaç doz afl›m› sonucu zehirlenme oluflabilir. Zehirleyici etmen solunum, sindirim, cilt ya da müköz mambranlar arac›l›¤›yla vücuda girebilir ve al›m yollar›na göre farkl› belirti ve bulgular görülebilir. Zehirlenme hastalar›nda tan› ve tedavi eflza-manl› olarak yap›l›r. Zehirlenmifl hastaya ilk yaklafl›mda havayolu aç›kl›¤› sa¤lanmal›, solunum ve dolafl›m deste¤i sa¤lanmal›, dekontaminasyon sa¤lanmal› ve uygun antidot uygulanmal›d›r. Havayolu ve solunum temininden sonra kan bas›nc› düzensizli¤i, na-b›z, rektal ›s›, oksijen satürasyonu ve hipoglisemi kontrol edilmeli ve düzeltilmelidir.
Akrep sokması ciddi ve hayatı tehdit eden acil bir durumdur. Akrep sokmalarında klinik olarak; ka... more Akrep sokması ciddi ve hayatı tehdit eden acil bir durumdur. Akrep sokmalarında klinik olarak; kardiyovasküler, nörolojik ve hematolojik anormallik (trombositopeni, nötropeni) görülebilir.Bu çalışmada; akrep sokması sonucu acil servisimize başvuran 60 yaşında bayan hastanın tanı ve tedavi metodları tartışıldı. Trombosit desteğine gerek kalmadan akrep antivenomu tedavisi ile trombosit seviyeleri düzeldi.
Akciğerin inflamatuar psödotümörü seyrek görülen, etiyolojisi bilinmeyen neoplastik olmayan bir t... more Akciğerin inflamatuar psödotümörü seyrek görülen, etiyolojisi bilinmeyen neoplastik olmayan bir tümördür. Tümör tipik olarak soliter, periferik yerleşimli, keskin kenarlı kitle şeklidedir. Birden fazla lezyonlar yaklaşık %5 olguda saptanır. Sıklıkla 40 yaş altı bireylerde spesifik olmayan semptomlarla seyreder. Baskın hücre tipine göre plazma hücreli granüloma, inflamatuvar myofibroblastik tumor, fibroksantoma, histiositoma veya psödoneoplastik pnömoni gibi farklı isimlendirmeler kullanılabilir.
PURPOSE: Old population of community is increasing fastly. Determining of frequently seen disease... more PURPOSE: Old population of community is increasing fastly. Determining of frequently seen diseases and risk factors causing these diseases will reduce the disability and cure costs. In this study, we aimed to determine patient's who is older than 65 years hospitalization ratio and which clinical services they threatened. METHOD: 3851 Patients age average of 73.4 +/-6.0 (65-102) and 1945 (% 50.5) women, 1906 (% 49.5) man who approach to Cukurova University Medical Faculty Department of Emergency Medicine between 01.01.2006-01.12.2007 is taken to this study. RESULT: 2350 cases (% 61) were hospitalized, 117 cases (% 3) refused the treatment and 36 cases (% 0.9) were died in emergency department,. Behindhand 1685 (%43.6) patients discharged from a hospital with necessary intervention and treatment. The most frequently hospitalization department were Internal medicine (n: 607), Neurology (n: 471), Coronary service (n: 405) and General surgery (n: 245) respectively. CONCLUSION: One of the two patients who approached to the emergency department has been hospitalized and great ratios of these patients were hospitalized in coronary, internal medicine, neurology and surgery intensive care unit. Our interesting observation is the problems required surgery in this age group are not so less to underestimate.
Objective: Our aim in this retrospective study was to determine the factors affecting poor progno... more Objective: Our aim in this retrospective study was to determine the factors affecting poor prognosis and mortality of organophosphate (OP) poisoning by reviewing patient data. We also reviewed present knowledge to make conclusions on certain longstanding debates in light of the literature. Methods: In this retrospective descriptive study, patients who were admitted to and hospitalized in the emergency department (ED) or intensive care unit (ICU) of a university hospital with the diagnosis of OP poisoning between December 2010 and December 2015 were evaluated. All the data were obtained from electronic and manual patient files. A total of 80 patients were included in the study. Results: The mean age of the study patients was 32.4±15.0 (13-94). Forty-nine (61.2%) patients were female. Twenty-two (27.5%) patients were seriously poisoned and needed mechanical ventilation (MV) support. Low pseudocholinesterase (PChE), high creatinine (Cr), low Glasgow Coma Scale (GCS) scores and long hospitalization durations were all found to be poor prognostics in MV patients. Low PChE and high Cr levels were found to be independent predictors of the hospitalization duration and high Cr was found to be an independent predictor of the intubation duration of MV patients in regression analyses. Ten (45.5%) of the MV patients were unresponsive to medical treatment and Therapeutic plasma exchange (TPE) was performed. Seven patients were discharged healthy. Three patients with low PChE levels and comorbidities died. Conclusions: Prolongation of respiratory depression necessitating MV support, comorbidities, long hospital stay, elevated creatinine, low GCS scores and low PcHE levels without regeneration in the first 48 hours of admission are all found to be poor prognostic factors for organophosphate (OP) poisoning.
Harran Üniversitesi Tıp Fakültesi Dergisi, Apr 1, 2014
Akrep sokması ciddi ve hayatı tehdit eden acil bir durumdur. Akrep sokmalarında klinik olarak; ka... more Akrep sokması ciddi ve hayatı tehdit eden acil bir durumdur. Akrep sokmalarında klinik olarak; kardiyovasküler, nörolojik ve hematolojik anormallik (trombositopeni, nötropeni) görülebilir.Bu çalışmada; akrep sokması sonucu acil servisimize başvuran 60 yaşında bayan hastanın tanı ve tedavi metodları tartışıldı. Trombosit desteğine gerek kalmadan akrep antivenomu tedavisi ile trombosit seviyeleri düzeldi.
individuals presenting in the ED who were $18 years of age with the clinical impression of a GIH ... more individuals presenting in the ED who were $18 years of age with the clinical impression of a GIH who had a lactate level obtained. The main outcome measure was in-hospital mortality with a secondary outcome comparing the predictive value of lactate in patients with and without hypotension. Results: Of the 269 patients in this analysis, 20 (7.4%) expired. The mean lactate of survivors was 2.5 (95% CI 2.3-2.7) and the mean lactate of expired patients was 5.6 (95% CI 3.6-7.6). In the subset of 245 normotensive patients, a lactate level < 2.5 had 1.9% mortality, a lactate 2.5-3.9 had 4.9% mortality, and a lactate $ 4 had 18.6% mortality (p<0.0001). Conclusions: Lactate is predictive of mortality in emergency department patients with GIH. This study highlights that elevated lactate levels were predictive of mortality when hypotension was absent. This indicates that lactate may be a useful predictor of mortality when used in conjunction with traditional variables.
Splenectomy is the frequently used surgical method for the treatment of traumatic splenic injurie... more Splenectomy is the frequently used surgical method for the treatment of traumatic splenic injuries. In this study, the patients who had traumatic splenic injuries were investigated and the results of surgical treatments were evaluated. There were 225 patients with traumatic splenic injuries, which contains 55 (24%) female and 170 (76%) male. The mean age was 29 (range 16-71) years. Severity of splenic injury was classified according to Moore organ injury scaling and there were 23 (10%) patients in grade 1, 96 (43%) in grade II, 75 (33%) in grade III, 24 (11%) in grade IV and 7 (3%) in grade V. Splenectomy was performed in 203 (90%) patients, splenoraphy in 18 (8%) and partial splenectomy in 4 (2%) patients. The overall mortality was 12%. A positive correlation was estimated between the combined trauma and the mortality (Fisher's Chi-Square test; chi 2 = 9,538, p < 0.002). In conclusion, non-operative treatment methods may prevent unnecessary splenectomies, especially in grade I and II blunt or penetrating splenic injuries. Combined injuries are the major factor increasing the mortality.
Objective: The research aim was to analyze the function of focused cardiac ultrasonography (FoCUS... more Objective: The research aim was to analyze the function of focused cardiac ultrasonography (FoCUS) in diagnosing a pulmonary embolism (PE) and contributing to the practice of emergency medicine and expediting the treatment of PE. Materials and Methods: In this prospective and observational study, Wells scores were calculated on those patients who presented to the emergency department over the last 2 years and were evaluated with a preliminary diagnosis of PE, as well as the biochemical values and imaging techniques. In all cases, FoCUS was used as the diagnostic tool. Results: A PE was detected in 38 (63.3%) of 60 patients. According to Wells score, it was determined that 5 (8.3%) patients had low-risk, 41 (68.3%) had medium-risk, and 14 (23.3%) had high-risk Wells score. There was a statistically significant correlation between the existence of PE and the findings of FoCUS in patients with right ventricular dilatation ( P < .001). According to Wells score, moderate-risk individu...
Turkish Journal of Geriatrics-Turk Geriatri Dergisi, Apr 1, 2011
ABSTRACT RDELENMES‹ ÖZ Girifl: Dünyam›z h›zla yafllanmakta dolay›s›yla toplumumuzda da bu yafl po... more ABSTRACT RDELENMES‹ ÖZ Girifl: Dünyam›z h›zla yafllanmakta dolay›s›yla toplumumuzda da bu yafl popülasyonu giderek artmaktad›r. Bu yafl grubunda s›k görülen hastal›klar›n ve bu hastal›klara yol açan risk faktörleri-nin belirlenmesi hem disabiliteyi hem de tedavi maliyetlerini azaltacakt›r. Bu çal›flmada acil polik-lini¤e baflvuran 65 yafl ve üzeri olgularda nörolojik semptomlar›n s›kl›¤› ve olgular›n ald›klar› tan›-lar›n belirlenmesi amaçlanm›flt›r. Gereç ve Yöntem: Çal›flmaya 01.01.2006-1.12.2007 y›llar› aras›nda Çukurova Üniversitesi T›p Fakültesi Acil T›p poliklini¤ine baflvuran yafl ortalamas› 73.4±6.0 (65-102) olan 1945&#39;si (%50.5) kad›n, 1907&#39;si (%49.5) erkek toplam 3851 olgu al›nm›flt›r. Bulgular: 518 hastan›n (%13.4) nörolojik semptomlarla acile baflvurdu¤u belirlenmifltir.En s›k semptomun konuflma bozuklu¤u, kol ve bacak da uyuflma, a¤›z da e¤ilme oldu¤u, bunu bafla¤-r›s› ve bilinç bozuklu¤unun takip etti¤i görülmüfltür. Sonuç: Etyolojik nedenler gözden geçirildi¤inde en s›k nedenin iskemik inme oldu¤u belirlen-mifl, bunu vertebrobaziler yetmezlik ve metabolik ensefalopatiler takip etmifltir. ABSTRACT Introduction: Our world is aging rapidly, so this age population is on the increase also in our community. Designation of the frequent diseases and their risk factors in this age group may bring about a decrease in both disabilities and health expenditures. The aim of this study was to identify the frequency of neurological symptoms and the established diagnoses in patients admit-ted to the emergency department. Materials and Method: The study included 3851 cases, 1945 (50.5%) women and 1907 (49.5%) men, at a mean age of 73.4±6.0 years (65-102) admitted to Cukurova University Faculty of Medicine, department of emergeny during the period between 01.01.2006 and 01.12.2007. Results: Five hundred and eighteen (13.4%) patients were admitted to the emergency de-partment with neurological symptoms. The most frequent symptoms were speech disorders, pa-resthesia in limbs, nasolabial asymmetry, unconsciousness and headache. Conclusion: The most common etiological factors were stroke, vertebrobaziler deficiency and metabolic encephalopathy.
Akrep sokması ciddi ve hayatı tehdit eden acil bir durumdur. Akrep sokmalarında klinik olarak; ka... more Akrep sokması ciddi ve hayatı tehdit eden acil bir durumdur. Akrep sokmalarında klinik olarak; kardiyovasküler, nörolojik ve hematolojik anormallik (trombositopeni, nötropeni) görülebilir.Bu çalışmada; akrep sokması sonucu acil servisimize başvuran 60 yaşında bayan hastanın tanı ve tedavi metodları tartışıldı. Trombosit desteğine gerek kalmadan akrep antivenomu tedavisi ile trombosit seviyeleri düzeldi.
Given the importance of agriculture and widespread use of pesticides, intoxication due to organop... more Given the importance of agriculture and widespread use of pesticides, intoxication due to organophosphate insecticides is common in Turkey. Organophosphorus compounds may cause late-onset distal polyneuropathy occurring 2 or more weeks after the acute exposure. An 18-year-old woman and a 22-year-old man were admitted to the hospital with weakness, paresthesia, and gait disturbances at 35 and 22 days, respectively, after ingesting dimethyl-2,2-dichloro vinyl phosphate (DDVP). Neurological examination revealed weakness, vibration sense loss, bilateral dropped foot, brisk deep tendon reflexes, and bilaterally positive Babinski sign. Electroneurography demonstrated distal motor polyneuropathy with segmental demyelination associated with axonal degeneration prominent in the distal parts of both lower extremities.
Çukurova Üniversitesi Tıp Fakültesi dergisi, Mar 1, 2014
Kisisel koruyucu onlemler alinmadiginda mesleki zehirlenmeye neden olabilen organofosfatlar, Turk... more Kisisel koruyucu onlemler alinmadiginda mesleki zehirlenmeye neden olabilen organofosfatlar, Turkiye"nin guneyindeki tarim bolgelerinde sikca kullanilan insektisitlerdir. Bu nedenle, bu bolgenin saglik calisanlarinca taninmasi kolay olan bu kolinerjik zehirlenmenin klasik klinik bulgulari miyozis, sekresyonlarda artma, bradikardi ve fasikulasyonlardir. Alkolizme bagli hastalik ve durumlardan olan mental ve sosyal uyum problemleri, koma, zehirlenme, yoksunluk ve deliryum tremens, kronik alkolizmi olan hastalarin hastane ziyaretlerinin sik sebeplerindendir. Bu yazida, aslinda alkol yoksunlugu iken benzer semptomlar nedeniyle organofosfat zehirlenmesi tani ve tedavisi alip, deliryum tremense ilerleyen bir olgu sunulmustur.
Zehirlenme, organizman›n herhangi bir sistemi, fonksiyonunu olumsuz etkileyecek maddelere maruz k... more Zehirlenme, organizman›n herhangi bir sistemi, fonksiyonunu olumsuz etkileyecek maddelere maruz kald›¤›nda gerçekleflir. Zehirlenen hastalar acil servislerde s›kl›kla görülür. Bu hastalara uygun acil yaklafl›m ölüm oran›n› azalt›r. Mesleksel ve çevresel etkilenmelerle ya da ilaç doz afl›m› sonucu zehirlenme oluflabilir. Zehirleyici etmen solunum, sindirim, cilt ya da müköz mambranlar arac›l›¤›yla vücuda girebilir ve al›m yollar›na göre farkl› belirti ve bulgular görülebilir. Zehirlenme hastalar›nda tan› ve tedavi eflza-manl› olarak yap›l›r. Zehirlenmifl hastaya ilk yaklafl›mda havayolu aç›kl›¤› sa¤lanmal›, solunum ve dolafl›m deste¤i sa¤lanmal›, dekontaminasyon sa¤lanmal› ve uygun antidot uygulanmal›d›r. Havayolu ve solunum temininden sonra kan bas›nc› düzensizli¤i, na-b›z, rektal ›s›, oksijen satürasyonu ve hipoglisemi kontrol edilmeli ve düzeltilmelidir.
Akrep sokması ciddi ve hayatı tehdit eden acil bir durumdur. Akrep sokmalarında klinik olarak; ka... more Akrep sokması ciddi ve hayatı tehdit eden acil bir durumdur. Akrep sokmalarında klinik olarak; kardiyovasküler, nörolojik ve hematolojik anormallik (trombositopeni, nötropeni) görülebilir.Bu çalışmada; akrep sokması sonucu acil servisimize başvuran 60 yaşında bayan hastanın tanı ve tedavi metodları tartışıldı. Trombosit desteğine gerek kalmadan akrep antivenomu tedavisi ile trombosit seviyeleri düzeldi.
Akciğerin inflamatuar psödotümörü seyrek görülen, etiyolojisi bilinmeyen neoplastik olmayan bir t... more Akciğerin inflamatuar psödotümörü seyrek görülen, etiyolojisi bilinmeyen neoplastik olmayan bir tümördür. Tümör tipik olarak soliter, periferik yerleşimli, keskin kenarlı kitle şeklidedir. Birden fazla lezyonlar yaklaşık %5 olguda saptanır. Sıklıkla 40 yaş altı bireylerde spesifik olmayan semptomlarla seyreder. Baskın hücre tipine göre plazma hücreli granüloma, inflamatuvar myofibroblastik tumor, fibroksantoma, histiositoma veya psödoneoplastik pnömoni gibi farklı isimlendirmeler kullanılabilir.
PURPOSE: Old population of community is increasing fastly. Determining of frequently seen disease... more PURPOSE: Old population of community is increasing fastly. Determining of frequently seen diseases and risk factors causing these diseases will reduce the disability and cure costs. In this study, we aimed to determine patient's who is older than 65 years hospitalization ratio and which clinical services they threatened. METHOD: 3851 Patients age average of 73.4 +/-6.0 (65-102) and 1945 (% 50.5) women, 1906 (% 49.5) man who approach to Cukurova University Medical Faculty Department of Emergency Medicine between 01.01.2006-01.12.2007 is taken to this study. RESULT: 2350 cases (% 61) were hospitalized, 117 cases (% 3) refused the treatment and 36 cases (% 0.9) were died in emergency department,. Behindhand 1685 (%43.6) patients discharged from a hospital with necessary intervention and treatment. The most frequently hospitalization department were Internal medicine (n: 607), Neurology (n: 471), Coronary service (n: 405) and General surgery (n: 245) respectively. CONCLUSION: One of the two patients who approached to the emergency department has been hospitalized and great ratios of these patients were hospitalized in coronary, internal medicine, neurology and surgery intensive care unit. Our interesting observation is the problems required surgery in this age group are not so less to underestimate.
Objective: Our aim in this retrospective study was to determine the factors affecting poor progno... more Objective: Our aim in this retrospective study was to determine the factors affecting poor prognosis and mortality of organophosphate (OP) poisoning by reviewing patient data. We also reviewed present knowledge to make conclusions on certain longstanding debates in light of the literature. Methods: In this retrospective descriptive study, patients who were admitted to and hospitalized in the emergency department (ED) or intensive care unit (ICU) of a university hospital with the diagnosis of OP poisoning between December 2010 and December 2015 were evaluated. All the data were obtained from electronic and manual patient files. A total of 80 patients were included in the study. Results: The mean age of the study patients was 32.4±15.0 (13-94). Forty-nine (61.2%) patients were female. Twenty-two (27.5%) patients were seriously poisoned and needed mechanical ventilation (MV) support. Low pseudocholinesterase (PChE), high creatinine (Cr), low Glasgow Coma Scale (GCS) scores and long hospitalization durations were all found to be poor prognostics in MV patients. Low PChE and high Cr levels were found to be independent predictors of the hospitalization duration and high Cr was found to be an independent predictor of the intubation duration of MV patients in regression analyses. Ten (45.5%) of the MV patients were unresponsive to medical treatment and Therapeutic plasma exchange (TPE) was performed. Seven patients were discharged healthy. Three patients with low PChE levels and comorbidities died. Conclusions: Prolongation of respiratory depression necessitating MV support, comorbidities, long hospital stay, elevated creatinine, low GCS scores and low PcHE levels without regeneration in the first 48 hours of admission are all found to be poor prognostic factors for organophosphate (OP) poisoning.
Harran Üniversitesi Tıp Fakültesi Dergisi, Apr 1, 2014
Akrep sokması ciddi ve hayatı tehdit eden acil bir durumdur. Akrep sokmalarında klinik olarak; ka... more Akrep sokması ciddi ve hayatı tehdit eden acil bir durumdur. Akrep sokmalarında klinik olarak; kardiyovasküler, nörolojik ve hematolojik anormallik (trombositopeni, nötropeni) görülebilir.Bu çalışmada; akrep sokması sonucu acil servisimize başvuran 60 yaşında bayan hastanın tanı ve tedavi metodları tartışıldı. Trombosit desteğine gerek kalmadan akrep antivenomu tedavisi ile trombosit seviyeleri düzeldi.
individuals presenting in the ED who were $18 years of age with the clinical impression of a GIH ... more individuals presenting in the ED who were $18 years of age with the clinical impression of a GIH who had a lactate level obtained. The main outcome measure was in-hospital mortality with a secondary outcome comparing the predictive value of lactate in patients with and without hypotension. Results: Of the 269 patients in this analysis, 20 (7.4%) expired. The mean lactate of survivors was 2.5 (95% CI 2.3-2.7) and the mean lactate of expired patients was 5.6 (95% CI 3.6-7.6). In the subset of 245 normotensive patients, a lactate level < 2.5 had 1.9% mortality, a lactate 2.5-3.9 had 4.9% mortality, and a lactate $ 4 had 18.6% mortality (p<0.0001). Conclusions: Lactate is predictive of mortality in emergency department patients with GIH. This study highlights that elevated lactate levels were predictive of mortality when hypotension was absent. This indicates that lactate may be a useful predictor of mortality when used in conjunction with traditional variables.
Splenectomy is the frequently used surgical method for the treatment of traumatic splenic injurie... more Splenectomy is the frequently used surgical method for the treatment of traumatic splenic injuries. In this study, the patients who had traumatic splenic injuries were investigated and the results of surgical treatments were evaluated. There were 225 patients with traumatic splenic injuries, which contains 55 (24%) female and 170 (76%) male. The mean age was 29 (range 16-71) years. Severity of splenic injury was classified according to Moore organ injury scaling and there were 23 (10%) patients in grade 1, 96 (43%) in grade II, 75 (33%) in grade III, 24 (11%) in grade IV and 7 (3%) in grade V. Splenectomy was performed in 203 (90%) patients, splenoraphy in 18 (8%) and partial splenectomy in 4 (2%) patients. The overall mortality was 12%. A positive correlation was estimated between the combined trauma and the mortality (Fisher's Chi-Square test; chi 2 = 9,538, p < 0.002). In conclusion, non-operative treatment methods may prevent unnecessary splenectomies, especially in grade I and II blunt or penetrating splenic injuries. Combined injuries are the major factor increasing the mortality.
Objective: The research aim was to analyze the function of focused cardiac ultrasonography (FoCUS... more Objective: The research aim was to analyze the function of focused cardiac ultrasonography (FoCUS) in diagnosing a pulmonary embolism (PE) and contributing to the practice of emergency medicine and expediting the treatment of PE. Materials and Methods: In this prospective and observational study, Wells scores were calculated on those patients who presented to the emergency department over the last 2 years and were evaluated with a preliminary diagnosis of PE, as well as the biochemical values and imaging techniques. In all cases, FoCUS was used as the diagnostic tool. Results: A PE was detected in 38 (63.3%) of 60 patients. According to Wells score, it was determined that 5 (8.3%) patients had low-risk, 41 (68.3%) had medium-risk, and 14 (23.3%) had high-risk Wells score. There was a statistically significant correlation between the existence of PE and the findings of FoCUS in patients with right ventricular dilatation ( P < .001). According to Wells score, moderate-risk individu...
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Papers by Zeynep Kekec