Browsing by Author "Esen, Mehmet"

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Acute arsenic self-poisoning for suicidal purpose in a dentist: A case report
(Sage Publications, 2009-01) Yılmaz, Yusuf; Armağan, Erol; Ölmez, Ömer Fatih; Esen, Mehmet; Alkış, Nihan; Dolar, Mahmut Enver; Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Acil Servis Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Gastroenteroloji Anabilim Dalı.; 0000-0003-4518-5283; AAH-8846-2021; K-6651-2012; AAG-9177-2021; 22936014300; 6506464232; 26435400000; 56567890200; 26533912000; 6602075084
Arsenic is a classical poison that has been historically used since ancient times for homicidal purposes. More recently, episodes of deliberate or unintentional arsenic self-poisoning have been increasingly reported. We describe here a case of a 77-year old male patient with a history of major depression, who attempted suicide by ingestion of 4 g of arsenic trioxide. The man, a dentist by profession, used arsenic preparations for pulp devitalization. The patient was admitted to our hospital 5 h after arsenic ingestion with nausea and vomiting. Plain radiograph of the abdomen showed radio-opaque material in the stomach and small intestine. Nasogastric lavage, activated charcoal, and chelators; were used to remove arsenic. On day 3, endoscopy disclosed the presence of gastritis and superficial ulcers. The patient developed significant anemia (Hb: 8.7 g/dL on day 7) without significant signs of hemolysis. He gradually recovered from anemia within 5 months. The patient did not suffer any adverse outcome in spite of having ingesting 4 g of arsenic, approximately 20 times the lethal dose.
Should the new injury severity score replace the injury severity score in the trauma and injury severity score?
(Ulusal Travma ve Acil Cerrahi Derneği, 2008-09) Aydın, Şule Akköse; Bulut, Mehtap; Özgüç, Halil; Ercan, İlker; Türkmen, Nursel; Eren, Bülent; Esen, Mehmet; Uludağ Üniversitesi/Tıp Fakültesi/Acil Tıp Ana Bilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Genel Cerrahi Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Adli Tıp Ana Bilim Dalı.; 0000-0002-2382-290X; 0000-0002-8296-5484; AAX-5571-2021; AAK-8096-2021
BACKGROUND This study was performed to compare the efficacies of Injury Severity Score (ISS) and New Injury Severity Score (NISS), and to investigate whether replacing ISS with NISS in Trauma and Injury Severity Score (TRISS) changes the predictive power for mortality. METHODS We retrospectively analyzed 550 patients aged over 16 years seen in our center over a period of four years who had injuries in at least two organ systems. The ISS, NISS and TRISS were calculated for each patient. TRISS was calculated in two ways: TRISS I with age, Revised Trauma Score (RTS) and ISS, and TRISS 2 with age, RTS and NISS. The cut-off values for TRISS 1, TRISS 2, ISS and NISS were determined by ROC analysis. RESULTS The ideal cut-off values for the prediction of mortality were 21.0 (AUC: 0.907) for ISS and 25.0 (AUC: 0.914) for NISS. There was no statistically significant difference between the ROC curves of ISS and NISS. The ideal cut-off values for predicting mortality were 90 (AUC: 0.934) for TRISS 1 and 86 (AUC: 0.935) for TRISS 2. There was no statistically significant difference between the ROC curves of TRISS I and TRISS 2. CONCLUSION Use of NISS instead of ISS in the TRISS model demonstrated no significant difference, and it can thus be recommended for use.
Snakebite cases admitted to uludag university faculty of medicine emergency department and current management of snake bite
(Aves, 2009-03-01) ÖZDEMİR, FATMA; Eren, Sebnem; Özdemir, Fatma; Köksal, Özlem; KÖKSAL, ÖZLEM; Durmuş, Oya; Esen, Mehmet; Akköse, Şule Aydın; AYDIN, ŞULE; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Acil Tıp Anabilim Dalı.; 0000-0003-2180-6946; HHN-5686-2022; AAK-8332-2020; AAX-5571-2021
Background: The purpose of this study is to analyse the characteristics of snakebite cases' epidemiology, clinic, treatment and prognosis and to investigate the current first aid and treatment methods.Methods: The snakebite cases admitted to our emergency department (ED) between 01.01.1995-31.12.2004 were investigated retrospectively. Demographic data, procedures and biochemical tests in the ED, prognosis of the hospitalized patients, the treatment given in the hospital and the complications were recorded.Results: The average age of the totally 48 (M/F: 27/21) patients was 40.4 year. 11 cases were discharged, 21 cases were transferred to other hospitals and 16 of them were hospitalized. Majority of the patients admitted in spring and summer. Among the 24 patients whom files had been obtained, 12 patients' snakebite was on the lower extremity, and 12 patients' was on the upper extremity. Antivenom was applied to 17 of these 24 patients. Systemic symptoms were seen in 6 patients. As an abnormal biochemical test only leucocytosis was seen in 7 patients. Faciotomy was applied to 25% of the patients with the diagnosis of compartment syndrome. The average hospitalization time was 4.2 day and there were no deaths and no extremity amputation among these patients.Conclusion: Most of the snakebites occur in the spring and summer season. Poisonous snakebites can cause severe systemic and local complications like compartment syndrome. ED approach includes close following of the vital signs, basic laboratory tests, tetanus prophylaxis, diagnosis of compartment syndrome and systemic complications. Patients should be examined in terms of antibiotherapy and antivenin.
Uludağ Üniversitesi Tıp Fakültesi Araştırma Hastanesi acil servisinde kan ve kan ürünleri transfüzyonu yapılan hastaların epidemiyolojik incelenmesi
(Uludağ Üniversitesi, 2011) Esen, Mehmet; Aydın, Şule Akköse; Uludağ Üniversitesi/Tıp Fakültesi/Acil Tıp Anabilim Dalı.
Bu çalışma, 01.06. 2009 31.12. 2009 tarihleri arasında Uludağ Üniversitesi Sağlık Uygulama ve Araştırma Hastanesi Acil Servisinde kan ve kan ürünü transfüzyonu yapılan hastaların demografik özelliklerini, transfüzyon endikasyonlarını, kullanılan kan ürünü miktar ve cinsi ile gelişen reaksiyonlarını dökümante etmek amacıyla prospektif olarak yapılmıştır.Transfüzyon yapılan hasta sayısının 434 olduğu görülmüştür. Hastaların %54.6'sını erkek, %46.4'ünü kadın hastalar oluşturmuştur. En fazla transfüzyon %35.5 ile 65 yaş üstü hastalara yapılmıştır. Transfüzyon yapılan hastaların %32'si 15-49 yaş, %30.9'u 49-65 yaş ve %1.6'sı 15 yaş altı hastalardan oluşmuştur.Transfüze edilen ürünlerin %56.5'inin eritrosit süspansiyonu (ES), %11.3'ünün taze donmuş plazma (TDP), %11.3'ünün trombosit süspansiyonu (TS), %9.2'sinin ES + TS, %6.9'unun ES + TDP, %2.1'inin Faktör VII ve Faktör VIII, %0.7'sinin TDP + TS, %0.9'unun ES + TDP + TS, %0.7'sinin ise TDP + Faktör olduğu saptanmıştır.Acil serviste transfüzyon yapılan hastaların %43'ünü hematolojik rahatsızlığı olan, %20.1'ni ise onkolojik rahatsızlığı olan hastalar oluşturmuştur. Transfüzyon yapılan hastalarda transfüzyon kararının %19.6'sı acil tıp asistanları tarafından, %80.4'ü ise konsültan hekim tarafından verilmiştir. Transfüzyon yapılan hastaların %62.7'sinin transfüzyon öyküsü olduğu saptanmıştır. Bu hastaların % 8.5'ine ise son bir hafta içinde transfüzyon yapıldığı belirlenmiştir.Hastalar vital parametreleri açısından değerlendirildiğinde, %83'ünde patoloji saptanmamış, %3.4'ünde hipotansiyon, %2.1'inde taşikardi %1.1'inde ateş, %9.7'sinde hipotansiyon + taşikardi ve %0.7'sinde ise hipotansiyon+ taşikardi + ateş olduğu görülmüştür.Transfüzyon yapılan hastalar hemoglobin miktarı açısından incelendiğinde %40.6'sının 7g/dl altında, %13.1'inin 7-8 g/dl arasında, %26.7'sinin 8-10 g/dl arasında ve %19.6'sının 10 g/dl üstünde olduğu belirlenmiştir. Eritrosit süspansiyonu en çok hemoglobin değerleri 7 g/dl altında olan hastalara, TS ise en çok trombosit sayısı 10-20x103/mm3 arasında olan hastalara verilmiştir. Taze donmuş plazma transfüzyonu yapılan hastaların %51'inde oral antikoagülan kullanımına bağlı kanama olduğu tespit edilmiştir.Çalışmamızda %1.2 hastaya acil 0 Rh negatif, %1.8 hastaya da coombs (+) kan transfüzyonu yapılmıştır.Transfüzyon yapılan hastaların %3.9'unda transfüzyonla ilişkili akut komplikasyonlar gelişmiştir. Bu komplikasyonlar incelendiğinde %1.2'sinin akut febril nonhemolitik reaksiyon (FNHR), %1.1'inin dolaşım yüklenmesi, %0.9'unun alerjik reksiyon, %0.7'sinin ise hem FNHR hem de alerjik reaksiyon olduğu gözlenmiştir.Transfüzyon yapılan hastaların %76.5'i acil servisten taburcu edilmiş, %19.4'ü hastaneye yatırılmış, %2.5'i başka bir sağlık kuruluşuna sevk edilmiş ve %1.6'sı da acil serviste ölmüştür.Çalışmamız süresince elde ettiğimiz tüm bu tespitler ışığında, acil serviste çok sayıda transfüzyon yapıldığını, endikasyon belirlemede belirli bir protokole bağlı kalınmadığını ve daha çok poliklinik takibinde olan hastalara ve destek niteliğinde transfüzyon yapıldığını söyleyebiliriz.Acil transfüzyon kararı; hangi amaçla ve ne için transfüzyon yapıldığının bilincinde olunarak, laboratuar düzelmeden çok klinik düzelmenin takibi yapılarak ve gerçek acil transfüzyon gerekliliği ortaya konularak verilmelidir.
Uludag University Medical Faculty research hospital emergency service an epidemiological investigation into blood and blood product transfusion
(Galenos Yayınevi, 2012-06-01) Esen, Mehmet; Aydın, Şule Akköse; Özdemir, Fatma; Köksal, Özlem; Öner, Nuran; AYDIN, ŞULE; ÖZDEMİR, FATMA; KÖKSAL, ÖZLEM; Öner, Nuran; Uludağ Üniversitesi/Tıp Fakültesi/Acil Tıp Anabilim Dalı.; 0000-0003-2180-6946; 0000-0002-4761-7863; AAK-8332-2020; JLX-9240-2023; ITH-9225-2023; DJG-5702-2022
Objective: This study was designed prospectively to investigate the demographic data of patients (n=434) who received blood and blood products at the Uludag University Medical Faculty Research Hospital Emergency Service between June 2009 and December 2009. The indications for the blood products used, the amount and the type of products used and the documentation of reactions were investigated and compared with data in the literature.Materials and Methods: 83.0% patients had normal vital parameters, 3.4% had hypotension, 2.1% had tachycardia, 1.1% had fever, 9.7% had hypotension and tachycardia and 0.7% had hypotension, tachycardia and fever. In terms of hemoglobin levels, 40.6% of patients had a level below 7 g/dL, 13.1% were between 7-8 g/dL, 26.7% were between 8-10 g/dL and 19.6% were above 10 g/dL. The patients who were transfused with an erythrocyte suspension were mostly the group who had a hemoglobin level below 7 g/dL. Platelets were transfused mostly for thrombocytopenia in patients with a platelet count between 10-20 x 10(3)/mm(3).Results: Of all transfused patients, 3.9% had an acute complication related to transfusion. 1.2% of these were acute febrile non-hemolytic reactions (FNHR), 1.1% were heart failure, 0.9% were allergic reactions and 0.7% were both FNHR and allergic reactions. 76.5% of all transfused patients were discharged from the emergency department, 19.4% were hospitalized, 2.5% were sent to other hospitals and 1.6% died in the emergency department.Conclusion: In light of our findings, it can be seen that many transfusions are performed in the emergency department, transfusion protocols are not normally followed and most transfusions are performed to support the outpatient clinic.