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A 4 year retrospective analysis of our patients with mushroom poisoning
(Sage, 2013-03) Köksal, Özlem; Armaǧan, Erol; İnal, Taylan; Ayyıldız, Talat; Öner, Nuran; Tıp Fakültesi; Acil Tıp Ana Bilim Dalı; 0000-0003-2271-5659; AAH-8846-2021; AAK-8332-2020; 23389880200; 6506464232; 55695563500; 6603155277; 55695552500
Objective: This study presented the demographic, clinical and laboratory data for the patients who presented to our emergency department (ED) with mushroom poisoning. Methods: We retrospectively examined the data for adult patients with mushroom poisoning that presented to the ED of Uludag University, Faculty of Medicine between 1 January 2007 and 31 December 2010. Results: A total of 53 patients were enrolled in the study. The mean age was 46.58 +/- 15.47. 52.8% of the patients were female, while 47.2% were male. These patients were typically admitted in the autumn. The most commonly seen symptoms were gastrointestinal such as nausea and vomiting. The time to symptom onset was <6 hours for 30.2% of the patients and >6 hours in 69.8% of the patients. While 73.5% of the patients received gastric lavage, activated charcoal and intravenous fluid therapy, 15.1% received penicillin, N-acetylcysteine and intravenous fluid therapy. For the remaining patients (11.4%) silibinin, dialysis and plasmapheresis were administered. While 35.8% of the patients were hospitalised, 64.2% were discharged from the ED. The median duration of stay in the ED was 6 hours (range: 1-27 hours); the median duration of stay among inpatients was 6 days (range: 1-36 days). Three of the hospitalised patients died, and two underwent hepatic transplantation. Conclusions: Mushroom poisoning remains an important issue that is encountered in rural areas during the rainy autumn season in our region. The condition may be fatal, but can be prevented by early and appropriate treatment.
A case report of ammonium sulfate inhalation
(Aves, 2011-12-01) Köksal, Özlem; KÖKSAL, ÖZLEM; Almacıoğlu, Meral Leman; ÖZDEMİR, FATMA; Aydın, Şule Akköse; AYDIN, ŞULE; Bulut, Mehtap; Tıp Fakültesi; Acil Tıp Ana Bilim Dalı; AAK-8332-2020; AAX-5571-2021; HHN-5686-2022
Ammonium sulfate is widely used in agriculture and the leather trade in many countries. Although it is reported to have potential effects on respiratory, gastrointestinal systems and the skin, there are a few case reports and toxicological studies about ammonium sulfate intoxication after ingestion and there is no case about ammonium sulfate inhalation. Thus, we report the clinical and laboratory findings of a patient who inhaled ammonium sulfate gas due to a work accident and was brought to our emergency department directly from the factory. When he arrived, loss of consciousness, cyanosis, tachypnea and metabolic acidosis were observed and convulsions were reported before arrival at the emergency department. After intubation and mechanical ventilator support in the emergency department, he was admitted to the intensive care unit, was given a T tube - mechanic ventilator support and was discharged in a healthy condition on the 8th day of admission. Ammonium sulfate intoxication should be suspected for the patients which brought from the leather industry or an agricultural environment, who inhaled bad or dense odored material, and had loss of consciousness, convulsions, acidosis and respiratory failure.
A preventable public health challenge in Southeastern Turkey: Rabies risk-contact cases
(Aves, 2011-03-01) Sayhan, Mustafa Burak; Gökdemir, Mehmet Tahir; Kara, Hanife Pınar; Söğüt, Özgür; Tıp Fakültesi; Acil Tıp Ana Bilim Dalı
Objective: It is projected that about 10 million persons are being treated worldwide every year due to contact with rabies-suspect animals. In this study, we aim to emphasize that rabies risk-contact cases are important public health problems for our region, and that the solution lies in an effective and accurate prophylaxis.Materials and Methods: Demographical data of 742 cases who presented to the emergency departments of three different hospitals in Sanliurfa between January 2007 and February 2009 due to animal bites and contacts were accessed from the "rabies risk- contact cases examination form" register, which were then entered into the previously prepared data forms.Results: A total of 501 (67%) cases were male, while 241 (33%) were female, with an average age of 22.78 +/- 0.63 years. The most commonly involved animals were dog (61.3%) and cat (33%) bites in our study. The majority (70%) of the cases entered into the prophylactic vaccination program were biting cases The remainder of the cases were included into the program due to scratching (28%) and suspicious indirect contact (2%). 3 doses of protectivevaccines were administered to 439 (59%) of the cases and 5 doses to 303 (41%) of the cases. Addtionally, 114 of the cases were treated with human rabies immune globulin. No rabies infections developed in the cases included into the vaccination program.Conclusion: It is indicated that there is an unsolved public health challenge in Sanliurfa and its vicinity due to the prevalence of cattle biting in addition to pet-related biting incidents.
Aci̇l servi̇ste i̇nme tanısı almış 65 yaş üzeri̇ hastaların retrospekti̇f kli̇ni̇k ve görüntüleme özelli̇kleri̇nin deǧerlendi̇ri̇lmesi̇
(Güneş Kitabevi, 2013) İnal, Taylan; Armaǧan, Erol; Köse, Ataman; Köksal, Özlem; Özdemír, Fatma; Akköse, Şule; Balcı, Arif Kadri; Demir, Aylin Bircan; Tıp Fakültesi; Nöroloji Ana Bilim Dalı; 0000-0003-2271-5659; AAH-8846-2021; AAK-8332-2020; L-7334-2015; AAM-7896-2020; 55695563500; 6506464232; 15755792500; 23389880200; 7006765911; 6603347542; 57225396135; 57217395786
Introduction: Elderly population in the World has been increasing gradually. In terms of emergency service, the elderly constitute a special group. We aimed to study the demographic, clinical, and imaging findings in patients who are 65 years and older presented to Emergency Department. Materials and Method: By obtaining the data of the patients with stroke diagnosis, who are 65 and older and who applied to Emergency Department between 01.01.2011 and 29.02.2012, demographic, clinical, and imaging findings were investigated and then compared among 65-74, 75-84 ve >85 age groups in this study. Results: According to the study results, among the age groups of 65-74, 75-84 and >= 85, significant difference was not found out between gender, complaints for application, duration of complaints, and comorbidities. Similarly, among physical examination findings such as consciousness, eye movements, visual fields, facial nerve examinations, lower and upper extremity motor functions, ataxia, negligence, aphasia, dysarthria, and NIHSS scores, statistically significant difference was not established. Besides, no significant difference was found among diagnoses, Cranial Computed Tomography and magnetic resonance imaging findings. Following the statistical analyses, the parameters revealing significant differences among age groups were conscious status, sense examinations, infarct in Cranial Computed Tomography, and bleeding sides. Conclusion: As a result of our study, we have seen that etiology of stroke may alter along with advancing age, however; in terms of clinical characteristics and patient results in hospitalization, discharge and mortality statistically significant differences were not observed.
Acute poisoning in adults in the years 1996-2001 treated in the Uludag University Hospital, Marmara region, Turkey
(Taylor & Francis, 2005) Akkose, Sule Aydin; Bulut, Mehmet Turker; Armagan, Emrah; Cebicci, Huseyin; Fedakar, Recep; Tıp Fakültesi; Acil Tıp Ana Bilim Dalı; 0000-0002-8987-6484; AAH-6287-2021
Background. Acute poisonings are frequent causes of admission to emergency departments and these cases may have hazardous outcomes. Methods. In the present study, medical records of 1818 poisoned patients admitted to Uludag University Medical School's Emergency Department between January 1996 and December 2001 were investigated. The age, sex, outcomes of the patients, and type of poisoning are described. Results. The mean age for females (63% of the patients) was 27 years, whilst the mean age of male patients was 31 years. The major types of poisonings were ingestions of medications (59.6%), mushrooms (3.3%), corrosives (2.5%), organophosphates (3.2%), and methyl alcohol (0.4%). Carbon monoxide accounted for 6.9% of intoxications. Approximately 65% of the patients survived, while the methyl alcohol and corrosive ingestions led to the highest fatality averages (100% and 14.8%, respectively). Conclusions. The demographic and diagnostic features of acute poisoning cases treated in our hospital are similar to those reported in the literature. Adults and women are in a high-risk group for acute poisonings and medicine poisoning, which is the most common type of poisoning.
Acute temporal lobe infarction in a young patient associated with marijuana abuse: An unusual cause of stroke
(Zhejiang Univ Sch Medicine, 2014-03-01) İnal, Taylan; Köse, Ataman; Özdemir, Fatma; KÖKSAL, ÖZLEM; Köksal, Özlem; Armağan, Erol; ARMAĞAN, EROL; Aydın, Şule A.; AYDIN, ŞULE; Tıp Fakültesi; Acil Tıp Ana Bilim Dalı; AAM-7896-2020; AAH-8846-2021; AAI-2164-2021; AAK-8332-2020; L-7334-2015
BACKGROUND: Cardiovascular or cerebrovascular events associated with drug abuse have been frequently reported, particularly in young patients. The drugs include generally cocaine, heroin, and amphetamines. Although marijuana is among the widely used narcotics in the world, stroke associated with the marijuana use is infrequently reported.METHODS: Stroke caused by the use of marijuana was investigated in a 23-year-old man and the importance of inquiry of drug abuse in case of stroke was emphasized.RESULTS: The patient was treated for 7 days in a follow-up, but he was not recovered. The patient was discharged in his existing condition and was directed for physiotherapy and rehabilitation.CONCLUSION: Ischemic stroke is associated with drug abuse and/or substance use, mainly cannabinoids and amphetamines, particularly in young patients.
Admission appropriateness and profile of the patients attended to a state hospital emergency department
(Aves Press Ltd, 2011-04-01) Köse, Beril; Öncü, M. Reşit; Tuğrul, Fuzuli; Köse, Ataman; Tıp Fakültesi; Acil Tıp Ana Bilim Dalı; L-7334-2015; AAM-7896-2020; GNH-4101-2022; A-1247-2018
The aim of this study was to determine the profile and appropriateness of the patients' indications admitted to the emergency department in a state hospital. Adult and pediatric trauma patients admitted to the emergency department of Van State Hospital between March 01 and March 31, 2010, in the course of one month period, were retrospectively analyzed. Data of the 32800 patients admitted to the emergency department during this period were evaluated. Male and female ratio of these patients was 54.8% and 45.2%, respectively, and the most intense group with 77% was the age group of 17-65. The majority of the applications with 60.5% occurred between 8 a.m. and 17 p.m. An examination was asked for 50% of the patients. It was determined that emergency examinations and therapies were applied to 9.9% of the patients, consultation rates were 4.5%, and the highest consultations were taken from orthopedic clinics (16.1%). It was established that 1.4% of the patients were hospitalized, with the highest admission to the general surgery clinic (13.8%). In hospitalized patients, the most common diagnoses were abdominal pain (9.6%), and 88.4% of the patients were discharged from the emergency department. It was observed that the majority of patients admitted to the emergency department need not have been in emergency, and should have applied to primary health care services and policlinics. The results of this study showed that non-emergency patients highly increase the workload of emergency departments, therefore, patients should be trained and awareness of patients should be increased; primary health care services should be made available; accurate, effective and enforceable policies for emergency medical services in the country must be established.
An investigation of the comt gene val158met polymorphism in patients admitted to the emergency department because of synthetic cannabinoid use
(Macedonian Acad Sciences Arts, 2020-06-01) Nennicioglu, Y.; Kaya, H.; Eraybar, S.; Atmaca, S.; Görükmez, O.; Armağan, Erol; ARMAĞAN, EROL; Tıp Fakültesi; Acil Tıp Ana Bilim Dalı; AAH-8846-2021
Catechol-O-methyl transferase (COMT) enzyme has a role in the inactivation of catecholamine neurotransmitters. Functional polymorphism in the COMT gene has been reported to play an important role in schizophrenia, bipolar affective disorder, aggressive and antisocial behavior, suicide attempts and the pathogenesis of Parkinson's disease. In this study, we aimed to investigate the effect of the Val158Met polymorphism of the COMT gene on substance use, and treatment history in patients with synthetic cannabinoid (SC) intoxication. The COMT enzyme Val158Met polymorphisms from DNA of 49 patients who were evaluated in the Emergency Department after SC use and 50 healthy control groups aged 18-45 years, were identified by polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) analyses as reported in the literature. Information regarding recurrent intake or hospitalization due to substance use was obtained from hospital records. Wild-type (WT) genotypes in 14 (28.6%) patients, heterozygous genotypes in 25 (51.0%) and homozygous genotypes in 10 (20.4%) patients were detected. Wild-type genotypes The homozygous genotype was found to be significantly higher in patients hospitalized due to drug addiction and substance use (p 0.008). The Val158 Met polymorphism of the COMT gene was not found to be significant in the first use after substance intake, while a significant relationship was found in terms of this polymorphism in patients with substance addiction diagnosis and treatment history.
Analysis of acute adult poisoning cases among patients admitted to the emergency department in Bursa, Turkey
(Galenos Yayınevi, 2009-01-01) Demircan, Celaleddin; Kahveci, Ferda; Engindeniz, Zülfi; Kıyıcı, Murat; Girgin, Nermin Kelebek; Ercan, İlker; Tekce, Hikmet; Özdemir, Fatma; Özyurt, Gurayten; DEMİRCAN, CELALEDDİN; KAHVECİ, FERDA ŞÖHRET; Engindeniz, Zülfi; KIYICI, MURAT; KELEBEK GİRGİN, NERMİN; ERCAN, İLKER; Tekce, Hikmet; ÖZDEMİR, FATMA; Özyurt, Gurayten; Tıp Fakültesi; Dahili Tıp Bilimleri Ana Bilim Dalı; 0000-0003-4820-2288; 0000-0003-1874-5097; 0000-0002-3208-6211; 0000-0002-2382-290X; HJZ-4470-2023; AAG-9356-2021; JBJ-5787-2023; AAI-4213-2021; AAH-7250-2019; ABF-2367-2020; JGP-4019-2023; JKS-7683-2023; JKO-9428-2023
Purpose: The aim of this study was to define the epidemiological features such as age, sex, toxic substance, suicide, and mortality rates of the adult poisoning cases among patients admitted to the Emergency Department (ED) of Uludag University Medical Faculty Hospital.Materials and Methods: Records of acute adult poisoning cases at the ED within a one-year period (June 1, 2002 - May 31, 2003) were evaluated retrospectively. Data were compared to those of similar studies from Turkey and around the world.Results: In total 430 (1.96%) of 21,934 patients admitted to the ED during the study period suffered acute poisoning. Of these patients 259 (60.2%) were women and 171 (39.8%) were men and the mean age of the patients was 29.9. Patients were exposed to different types of toxic substances: drugs (47.4%), pesticides (10.7%), toxic gases (10%), corrosives (6.5%), alcohol (3.5%), food (15.8%), toxic substances of animal origin (3.0%), and others (3.0%). In all, 29.8% of the patients were admitted to hospital, 22.3% were transferred to other hospitals, and 47.9% were discharged from the ED, and the overall mortality rate was 1.2%. In addition, 54.9% of the poisonings were suicide attempts and within this group the women to men ratio was 2.2 and the most common toxic substance was a drug (85.2%).Conclusion: Our results were similar to those of previous studies from this country as acute poisonings are more common in women and younger ages, most of them were suicide attempts, and the mortality rate was low. Our transfer rate was high and this may necessitate the organization of short-term observation of these patients.
Analysis of appropriate tetanus prophylaxis in an emergency department
(Türk Travma ve Acil Cerrahi Dergisi, 2013-07) Şimşek, Gözde; Armaǧan, Erol; Köksal, Özlem; Heper, Yasemin; Pozam, Suna Eraybar; Durak, Vahide Aslıhan; Tıp Fakültesi; Acil Tıp Ana Bilim Dalı; 0000-0003-4306-9262; 0000-0003-2271-5659; HIK-0672-2022; AAE-9483-2021; AAK-8332-2020; CAF-5149-2022; AAH-8846-2021; AAH-6506-2021; Y-3674-2018; 57225727701; 6506464232; 23389880200; 56191003300; 55791934000; 55792633100
BACKGROUND In this study, our aim was to identify the validity of the prophylaxis indications for patients who received tetanus prophylaxis, determine the ratio of high-risk wounds to the number of patients with immunity, and to evaluate the tetanus immunity of specific age groups. METHODS Patients who applied to the Emergency Department (ED) between September 2009 and May 2010 and who were considered for tetanus prophylaxis by his/her primary care physician were included in the study. RESULTS A total of 320 patients were evaluated. The average age of the patients was 40.87 +/- 15.83 years. A total of 73.1% of the patients were male and 26.8% were female. A total of 40.3% of the patients knew their vaccination history, while 59.7% had no recollection of their vaccination history. 14.7% of the patients had received their last dose within 5 years and 48.1% within 5-10 years; 37.2% of the patients declared that more 10 years had passed since their last vaccination. In 75% of the patients, the tetanus immunoglobulin (Ig)G level was identified as >= 0.1 IU/ml, while 25% of the patients had levels <0.1 IU/ml. The number of patients with protective levels was lower among those who were illiterate or who had only a primary school education, and this difference was statistically significant (p<0.001). CONCLUSION The vaccination histories can be misleading. Certain equipment can be used at the bedside to determine a patient's tetanus immunization status.
Analysis of the degree of accuracy and reliability of emergency medicine residents in interpreting computed tomography of the abdomen
(Galenos Publ House, 2022-06-01) Çetin, Murat; SARKI CANDER, SÜMEYYE TUĞBA; DURAK, VAHİDE ASLIHAN; AYDIN, ŞULE; Aydın, Şule Akköse; Durak, Vahide Aslıhan; SIĞIRLI, DENİZ; Sığırlı, Deniz; Tıp Fakültesi; Acil Tıp Ana Bilim Dalı; 0000-0003-0836-7862; 0000-0002-4161-5381; AAI-2164-2021
Aim: In this study, we aimed to investigate the accuracy and reliability of emergency medicine residents in the interpretation of radiological investigation of patients with trauma, who received abdominal computed tomography in the emergency department.Materials and Methods: We prospectively evaluated the reports of 200 patients who presented to the emergency medicine department of a university hospital with trauma, and who received abdominal computed tomography (CT) due to suspected abdominal pathology.Results: In this study, 33% (66/200) of the patients were female and 67% (134/200) were male. CT scans of these 200 patients were examined by emergency medicine residents and radiology specialists. The results of the study showed that emergency medicine residents performed well in interpreting abdominal CT scans of patients with trauma with an agreement rate of 90.5%. Evaluation of the results obtained in our study suggested that emergency medicine residents generally performed well in interpreting abdominal CT scans of patients with trauma with suspected abdominal pathology in the emergency room.Conclusion: The high rate of agreement may be associated with the fact that emergency medicine residents are usually the first physicians who meet and treat patients with trauma and thus have gained sufficient experience in this field.
Analysis of the necessity of routine tests in trauma patients in the emergency department
(Türk Travma ve Acil Cerrahi Derneği, 2012-01) Köksal, Özlem; Çevik, Şebnem Eren; Aydın, Şule Akköse; Özdemir, Fatma; Tıp Fakültesi; Acil Tıp Ana Bilim Dalı; 0000-0003-2271-5659; 0000-0001-7602-8104; AAK-8332-2020; 23389880200; 54894485300; 15757217900; 7006765911
BACKGROUND: The necessity of routine tests as regarded in the Advanced Trauma Life Support protocols has become controversial in recent years. The aim of this study was to analyze the necessity of routine tests in trauma patients. METHODS: This was a prospective study. A total of 103 blunt trauma patients aged between 15 and 65 years who presented to the emergency department with major trauma, Glasgow Coma Scale of 15 and Revised Trauma Score of 12 were admitted to the study. RESULTS: The average age of the patients (30.1% female, 69.9% male) was 35 +/- 12.97 years. A total of 72.8% of the patients presented for motor vehicle crashes, 12.6% for pedestrian injury and 14.6% for fall from a height. All of the routine tests were evaluated separately. With the exception of cervical examination-lateral cervical X-ray results and pelvic examination-complete blood count and urinalysis test results, significant relations were determined between the reason for requiring a test and the results of the other tests (complete blood count, lateral cervical X-ray and abdominal ultrasonography). CONCLUSION: According to our study, biochemical tests, anterior-posterior chest X-ray and anterior-posterior pelvic X-ray can be ordered as targeted tests. Conducting targeted tests will reduce costs and workload.
Analysis of the outcomes of cardiopulmonary resuscitation in an emergency department
(Taylor & Francis, 2005-12) Özcan, Vedat; Demircan, Celaleddin; Engindeniz, Zülfi; Turanoğlu, Gülay; Özdemir, Fatma; Ocak, Özgür; Cebicci, Hüseyin; Akgöz, Semra; Tıp Fakültesi; Acil Tıp Ana Bilim Dalı; 0000-0003-1874-5097; 0000-0002-8987-6484; AAN-2617-2021; 9939161400; 55399735400; 6507354145; 6505738648; 7006765911; 9940943800; 8203353000; 14061863400
Objective - The aim of this study is to analyse the factors affecting emergency department (ED) cardiopulmonary resuscitation (CPR) outcome. Methods - A standard CPR protocol was performed in all patients and certain pre and post-resuscitation parameters including age, sex, initial arrest rhythm, primary underlying disease, initiation time of advanced cardiac life support, duration of return of spontaneous circulation were recorded. Patients were followed up to determine rates of successful CPR, survival and one-year survival. Results - From December 1999 to May 2001, 80 consecutive adult patients in whom a standard CPR was performed in the ED were prospectively included in the study. The overall rate for successful CPR, survival and one-year survival were found to be 58.8% (47/80), 15% (12/80) and 10% (8/80), respectively. Survival and one-year survival rates were better in patients with an initial arrest rhythm of ventricular fibrillation or pulseless ventricular tachycardia (VF/pVT) than both pulseless electrical activity (pEA) and asystole; survival and one-year survival rates were better in patients with a primary underlying disease of cardiac origin than non-cardiac origin. Acute myocardial infarction had the best prognosis among conditions causing arrest. Presence of sudden death was found to have a better survival and one-year survival rate. Conclusion - Initial cardiac rhythm of VF/pVT, cardiac origin as the primary disease causing cardiopulmonary arrest and presence of sudden death were found to be good prognostic factors in CPR.
Aspirin resistance in patients presenting to the emergency department
(Carbone Editore, 2013) Köse, Ataman; Köksala, Özlem; Armağan, Erol; Sığırlı, Deniz; Özdemir, Fatma; Akköse, Sule; Tıp Fakültesi; Biyoistatistik Bölümü; 0000-0003-2271-5659; AAM-7896-2020; AAK-8332-2020; AAA-7472-2021; AAH-8846-2021; L-7334-2015; 55792812100; 55792424600; 55792577900; 55792509300; 57214275466; 55792876000
Introduction: The effect of aspirin is not the same for all patients and some patients can be resistant. Few emergency department (ED) studies have prospectively determined the rate of aspirin resistance in patients presenting to the ED and the most of them consider only specific group of patients. We aimed to evaluate the relation between clinical and laboratory parameters with aspirin resistance in patients presenting to the ED Methods: Using the bed-side point-of-care VerifyNow Aspirin assay (Accumetrics, San Diego, Calif), we sought to determine the rate of aspirin resistance in patients presenting to the ED with any complaint. Results: A total of 97 patients were included in this study. Aspirin resistance was found in 29 (29.9%) of them. There were not any significant differences in age, sex, drug usage, platelet count, ECG changes, heart rate, systolic, or diastolic blood pressure measures between the aspirin-resistant and aspirin-sensitive patients. In addition, patients' aspirin sensitivity and aspirin resistance did not differ significantly with regard to clinic results and diagnoses in the ED. However, patients with renal failure had significantly more aspirin resistance than other patients (p=0.007). Besides, the relationship between aspirin intake <30 time, pulse pressure and aspirin resistance were found out significant. Conclusion: To the best of our knowledge, this second current report of aspirin resistance in patients presenting to the ED pointed-out its presence in 29.9% of patients. In aspirin resistance, renal failure, pulse pressure and aspirin intake time were determined as important factors.
A case report of fatal oral ingestion of resorcinol
(Wiley-Blackwell, 2006-11) Bulut, Mehtap; Türkmen, Nursel; Fedakar, Recep; Aydın, Şule Akköse; Tıp Fakültesi; Adli Tıp Ana Bilim Dalı; AAH-6287-2021; 35783913800; 8715251700; 8725968900; 6603347542
Resorcinol is a pharmaceutical agent used topically in dermatological treatments for acne, eczema, psoriasis and related skin conditions. Although there are a few studies that indicate chronic toxic effects of resorcinol on humans after topical application, information on the effects of resorcinol in acute poisoning after oral ingestion is limited. Thus, we wish to report the clinical and laboratory findings of a patient who was admitted to our emergency department (ED) after inadvertent oral ingestion of resorcinol and later died, as well as the patient's autopsy findings. The major clinical and laboratory findings were unconsciousness, respiratory failure that required mechanical ventilation, generalized tonic-clonic seizures, leukocytosis and severe metabolic acidosis. In the blood sample taken at the autopsy, a high level of methemoglobin was found. In the serum, resorcinol was revealed by gas chromatography-mass spectrometry. It can be concluded that the basic approach to patients with resorcinol poisoning should include initial stabilization of the patient by supporting the airway, respiration and circulation, and treating complications such as seizures or metabolic acidosis in the ED, as soon as possible after oral ingestion.
Cathecol-O-methyl transferase Val158Met genotype is not a risk factor for conversion disorder
(Funpec-Editora, 2013) Almacıoğlu, M. L.; Armaǧan, Erol; Yakut, Tahsin; Köse, Ataman; Karkucak, Mutlu; Köksal, Özlem; Görükmez, Orhan; Tıp Fakültesi; Tıbbi Genetik Ana Bilim Dalı; 0000-0003-2271-5659; L-7334-2015; AAM-7896-2020; AAH-8846-2021; ABI-5648-2022; AAK-8332-2020; 6506464232; 6602802424; 15755792500; 35388323500; 23389880200; 56681045900
Alterations in catechol-O-methyltransferase (COMT) activity are involved in various types of neurological disorders. We examined a possible association between the COMT Val158Met polymorphism and conversion disorder in a study of 48 patients with conversion disorder and 48 control patients. In the conversion disorder group, 31 patients were Val/Met heterozygotes, 15 patients were Val/Val homozygotes and 2 patients were Met/Met homozygotes. In the control group, 32 patients were Val/Met heterozygotes and 16 patients were Val/Val homozygotes. There was no significant difference between the groups. We conclude that the COMT Val158Met genotype is quite common in Turkey and that it is not a risk factor for conversion disorder in the Turkish population.
Characteristics of patients transferred by air: A descriptive epidemiologic study
(TÜBİTAK, 2012-10) Köse, Beril; Akpınar, Ayca Açıkalın; Köse, Ataman; Köksal, Özlem; Aydın, Şule; Armağan, Erol; Tıp Fakültesi; Acil Tıp Ana Bilim Dalı; 0000-0003-2271-5659; AAK-8332-2020; AAH-8846-2021; L-7334-2015; AAM-7896-2020; 15755792500; 23389880200; 6603347542; 6506464232
Aim: To analyze the characteristics of patients transferred by air ambulance in the eastern Anatolia region of Turkey. Materials and methods: We retrospectively evaluated the records of patients transferred by air ambulance between January 2010 and December 2010. Demographics and medical data of the patients, geographic conditions, and flight duration data were all analyzed. Results: A total of 241 patients were included in the study, of whom 51% were men and 49% were women. The majority of the patients were between 0 and 1 year old (40.2%). In the adult patients, the most commonly seen diagnoses were trauma (31.6%), obstetric problems (24.7%), cerebrovascular events (12.4%), and myocardial infarction (9%). It was determined that in terms of medical disciplines the patients were most commonly transferred to the clinics of pediatrics (45.2%), neurosurgery (9.1%), gynecology (9.1%), cardiology (6.2%), neurology (5%), and general surgery (5%). The total flight time was 115.3 +/- 4.7 min and the patients were most commonly transferred to a university hospital. Conclusion: The decision to use an air ambulance may be made based on the distance, the length of the transfer and transportation, the resources of the health institutions located in the relevant region, and the environmental and climatic conditions. However, the association between the likelihood of survival, the therapeutic benefits of the patient, and the cost should be analyzed.
Childhood falls: Characteristics, outcome, and comparison of the injury severity score and new injury severity score
(BMJ Publishing Group, 2006) Bulut, Mehtap; Köksal, Özlem; Korkmaz, Ayhan; Turan, M.; Özgüc, Halil Bülent; Tıp Fakültesi; Genel Cerrahi Ana Bilim Dalı; 0000-0003-2271-5659; AAK-8332-2020
Objectives: The aim of this study was to determine the general characteristics of childhood falls, factors affecting on mortality, and to compare the Injury Severity Score (ISS) and the New Injury Severity Score (NISS) as predictors of mortality and length of hospital stay in childhood falls. Methods: We retrospectively analysed over a period of 8 years children aged younger than 14 years who had sustained falls and who were admitted to our emergency department. Data on the patients' age, sex, type of fall, height fallen, arrival type, type of injuries, scoring systems, and outcome were investigated retrospectively. The ISS and NISS were calculated for each patient. Comparisons between ISS and NISS for prediction of mortality were made by receiver operating characteristic (ROC) curve and Hosmer-Lemeshow (HL) goodness of fit statistics. Results: In total, there were 2061 paediatric trauma patients. Falls comprised 36 (n = 749) of these admissions. There were 479 male and 270 female patients. The mean (SD) age was 5.01 (3.48) years, and height fallen was 3.8 (3) metres. Over half (56.6%) of patients were referred by other centres. The most common type of fall was from balconies (38.5%), and head trauma was the most common injury (50%). The overall mortality rate was 3.6%. The cut off value for both the ISS and NISS in predicting mortality was 22 ( sensitivity 90.5%, specificity 95.4% for ISS; sensitivity 100%, specificity 88.7% for NISS) (p > 0.05). Significant factors affecting mortality in logistic regression analysis were Glasgow Coma Scale (GCS) < 9, ISS > 22, and NISS > 22. There were no significant differences in ROC between three scoring systems. The HL statistic showed poorer calibration (p = 0.02 v p = 0.37, respectively) of the NISS compared with the ISS. Conclusions: In our series, the head was the most frequent site of injury, and the most common type of fall was from balconies. Scores on the GCS, NISS, and ISS are significantly associated with mortality. The performance of the NISS and ISS in predicting mortality in childhood falls was similar.
Clinical value of D-dimer and other coagulation markers in differantial diagnosis of hemorrhagic and ischemic stroke
(Galenos Yayıncılık, 2009-12-01) Aydın, Şule Akköse; Köksal, Özlem; Bulut, Mehtap; Özuçelik, Doğaç Niyazi; Özdemir, Fatma; AYDIN, ŞULE; KÖKSAL, ÖZLEM; Bulut, Mehtap; ÖZDEMİR, FATMA; Tıp Fakültesi; Acil Tıp Ana Bilim Dalı; HHN-5686-2022; AAX-5571-2021; AAK-8332-2020; JCE-0651-2023; ITH-9225-2023
PURPOSE: This study aims to determine the clinical value of some laboratory markers(D-dimer, Fibrinogen, etc levels) as alternatives to expensive and sometimes unavailable advanced radiographic techniques, in differentiation and early diagnosis of hemorrhagic and ischemic stroke which require distinct diagnosis, monitoring and treatment methods.MATERIALS AND METHODS: The study includes 100 adult patients who applied to Emergency Department of Uludag University with clinical symptoms of stroke. At presentation on all of the patients and D-dimer, fibrinogen and other laboratory tests were studied. For differentiation of hemorrhagic and ischemic stroke, computerized tomography(CT) and magnetic resonance imaging(MRI) were taken. CT and MRI detections were assessed by radiology specialists blindly.FINDINGS: Of 100 patients included in the study, 53% were women and 47% were men. In 28% of the patients, ischemic stroke, in 21%, hemorrhagic stroke and in 48%, transient ischemic attack (TIA) was detected, while remaining 3% were assessed as normal. Average age of patients with ischemic stroke was found higher than that of patients with hemorrhagic stroke. No significant difference was observed when patients were grouped by sexes. Coagulation markers, D-dimer and aPTT were significantly different between hemorrhagic stroke and TIA groups while no significant difference was observed between ischemic and hemorrhagic stroke groups.RESULTS: Ischemic and hemorrhagic strokes cause homeostatic anomalies besides the brain damage accompanying. In our study, a difference between hemorrhagic stroke and TIA groups was observed, while no difference was found between ischemic and hemorrhagic stroke groups regarding coagulation markers.
Comparison of ice and lidocaine-prilocaine cream mixture in the reduction of pain during peripheral intravenous cannulation in emergency department patients
(Galenos Yayıncılık, 2013-03-01) Aygün, Hüseyin; Armağan, Erol; Özdemir, Fatma; Köse, Ataman; Selimoğlu, Kerem; Köksal, Özlem; Aydın, Şule Akköse; Aygün, Hüseyin; ARMAĞAN, EROL; ÖZDEMİR, FATMA; Köse, Ataman; Selimoğlu, Kerem; KÖKSAL, ÖZLEM; AYDIN, ŞULE; Tıp Fakültesi; Acil Tıp Ana Bilim Dalı; 0000-0003-3635-7282; AAK-8332-2020; AAI-2164-2021; AAH-8846-2021; AAM-7896-2020; JKT-3402-2023; JPE-0854-2023; CDS-3299-2022
Objective: We aimed to compare the efficacies of ice, lidocaine-prilocaine mixture cream and the classical method in reduction of the pain observed during intravenous cannulation, which is the most frequently performed procedure in emergency departments and to define the most effective method.Material and Methods: One hundred-twenty patients who applied to the emergency department of Uludag University Faculty of Medicine were included in this presented study. Cannulations were performed after one minute application of ice package in the ice group. Patients who applied to emergency only for blood transfusion were chosen for the lidocaine-prilocaine group and their cannulations were performed at the 60th minute of cream mixture application. Finally, no applications before cannulation were used for the control group. All cannulations were performed from antecubital region and 18 G cannula were used. Visual analog scale ( VAS) and patient satisfaction were scored.Results: VAS scores for ice, lidocaine-prilocaine and control groups are 2.8 +/- 1.7, 4.1 +/- 1.8, 4.4 +/- 1.9, respectively. VAS score in the ice group was significantly lower than both lidocaine-prilocaine and control groups. In addition, there was no statistically significant difference between lidocaine-prilocaine and control groups.Conclusion: Ice application method before intravenous cannulation, in addition to its advantages such as being inexpensive, easy to obtain and apply, is more effective than lidocaine-prilocaine cream.

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