Person: ARMAĞAN, EROL
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ARMAĞAN
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EROL
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Publication 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; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Acil Tıp Anabilim Dalı.; AAH-8846-2021Catechol-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.Publication Acid-base disorders in the emergency department: Incidence, etiologies and outcomes(Aves, 2014-03-01) Köse, Ataman; Armağan, Erol; Öner, Nuran; Köksal, Özlem; Mert, Dilek Kostak; Özdemir, Fatma; Aydın, Şule Akköse; ARMAĞAN, EROL; KÖKSAL, ÖZLEM; Mert, Dilek Kostak; ÖZDEMİR, FATMA; AYDIN, ŞULE; Uludağ Üniversitesi/Tıp Fakültesi/Acil Tıp Bölümü; AAK-8332-2020; AAH-8846-2021; AAI-2164-2021; L-7334-2015Objective: Acid-base disorders (ABDs) are usually correlated with high rates of morbidity and mortality. The objective of this study was to analyze the causes, outcomes, types and incidences of ABDs in patients presenting at the emergency department (ED).Material and Methods: We prospectively analyzed data from patients who presented between January 2011 and May 2011. Data on age, gender, chief complaint, and diagnosis in the ED were collected for ABD cases.Results: Of the 736 cases with an ABD, 173 patients (23.5%) had simple ABD and 563 patients (76.5%) had mixed ABD. The most common ABD was a mixed metabolic acidosis and respiratory alkalosis (MACRAL) (n=408, 55.4%). All ABD types were most commonly observed in patients over 65 years of age. Dyspnea was the most common complaint among ABD patients who presented at the ED (44.4%). In cases of ABD, pneumonia was the most common diagnosis (16.3%). Of the ABD cases, 379 patients (51.6%) were discharged, while 318 patients (43.2%) were hospitalized. Death was more commonly observed in cases with mixed metabolic and respiratory acidosis (MRAC) (n=6) and MACRAL (n=11).Conclusion: ABDs are quite common in patients presenting at the ED, especially among patients in a critical condition (71%). Mixed MACRAL was the most commonly noted ABD. Dyspnea and pneumonia were the most common diagnoses in ABD patients. Mortality was more common in cases with a mixed MRAC and MACRAL. This knowledge may provide important information concerning the diagnosis, treatment and early prognosis of patients.Publication 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; Uludağ Üniversitesi/Tıp Fakültesi/Acil Tıp Anabilim Dalı.; 0000-0003-3635-7282; AAK-8332-2020; AAI-2164-2021; AAH-8846-2021; AAM-7896-2020; JKT-3402-2023; JPE-0854-2023; CDS-3299-2022Objective: 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.Publication Is routine pregnancy test necessary in women of reproductive age admitted to the emergency department?(Zhejiang Univ Sch Medicine, 2013-09-01) Köksal, Özlem; KÖKSAL, ÖZLEM; Özdemir, Fatma; ÖZDEMİR, FATMA; Armağan, Erol; ARMAĞAN, EROL; Öner, Nuran; Sert, Pınar Çınar; Sığırlı, Deniz; SIĞIRLI, DENİZ; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Acil Tıp Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistk Anabilim Dalı.; AAH-8846-2021; AAK-8332-2020; AAA-7472-2021BACKGROUND: This study aimed to determine the necessity of pregnancy test in women of reproductive age admitted to emergency department (ED) in routine practice.METHODS: We retrospectively reviewed the records of patients who presented to the ED between January 1, 2006 and December 31, 2010 and received a pregnancy test.RESULTS: The median age of 1 586 patients enrolled into the study was 27 years. Of these patients, 19.55% had a positive result of pregnancy test. The most common complaint at admission was abdominal pain in 60.15% of the patients, and pregnancy test was prescribed. 15.83% of the patients with abdominal pain had a positive result of pregnancy test. Of the patients, 30.64% had nausea-vomiting at admission, and 11.52% had a positive result of pregnancy test. When other complaints were considered, the most commonly observed complaints were non-specific symptoms such as dizziness, malaise and respiratory problems. Of the patients, 70.93% were not remembering the date of last menstruation, and 9.51% showed a positive result of pregnancy test. Urinary tract infection (UTI) was commonly diagnosed with an incidence of 17.65%, which was followed by nonspecific abdominal pain (NSAP) (16.77%) and gastrointestinal disorders such as gastritis and peptic ulcer (6.87%). Of the patients, 88.40% were discharged from ED, and 11.60% were hospitalized.CONCLUSION: Pregnancy test should be given to women of reproductive age as a routine practice in ED in developing countries like Turkey.Publication 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; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Acil Tıp Anabilim Dalı.; AAM-7896-2020; AAH-8846-2021; AAI-2164-2021; AAK-8332-2020; L-7334-2015BACKGROUND: 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.Publication Comparison of fatal injuries resulting from tractor and high speed motorcycle accidents in Turkey: A multicenter study(Hindawi Ltd, 2019-01-01) Eraybar, Suna; Atmaca, Serhat; Nennicioğlu, Yasemin; Torun, Gökhan; Aydın, Okan; Varisli, Behçet; Sandal, Nuran; Büyükyılmaz, Tunç; Seyit, Murat; Yıldırım, Harun; Armağan, Erol; Torun, Gökhan; AYDİN, MEVLÜT OKAN; ARMAĞAN, EROL; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Acil Servis.; AAA-2367-2020; JWS-8589-2024; AAH-8846-2021Aim. Injuries are among the main causes of mortality and morbidity all over the world, and effective initial triage of these patients can determine the thin line between death and life. Tractor accidents and related injuries are significant problems particularly in rural areas. However, major trauma classification systems do not include tractor accidents as a criterion for trauma team activation or transportation of the patients to a trauma center. This study evaluated the general characteristics and outcomes of tractor accidents in comparison to motorcycle accidents, which are considered as a comparison criterion for major trauma. Materials and Methods. This is a multicenter study conducted in 6 emergency departments in 4 cities over a six month period. All cases over 18 years of age who were admitted to emergency service due to tractor or motorcycle accidents and meet the criteria were included in the study. The general characteristics and outcomes of both trauma types were compared to determine whether tractor accident should be considered as major traumas. Results. Eighty-eight patients had a tractor accident, and 339 patients had a motorcycle accident. The tractor accident victims were significantly younger (p<0.001), and the proportion of females was higher in this group (p=0.001). Glasgow coma score (p=0.062), revised trauma score (p=0.201), duration from incident to admission (p=0.481), and route of admission (p=0.810) were similar between both accident types. The rates of thoracic traumas (42% versus 23%, p<0.001) and spinal injuries (17% versus 5.9%, p=0.002) were significantly higher in tractor accidents. The hospitalization rates of the patients were significantly higher in tractor accidents (p=0.008). Conclusion. The findings of this study support the hypothesis that tractor accidents should be included in the criteria of ATLS major trauma classification system and trauma team activation procedures.Publication Discharge of emergency patients to the clinical wards or intensive care units: An assessment of complications and possible shortcomings(Elsevier, 2015-07-01) Durak, Vahide Aslıhan; Armağan, Erol; Özdemir, Fatma; Kahriman, Nezahat; DURAK, VAHİDE ASLIHAN; ARMAĞAN, EROL; ÖZDEMİR, FATMA; Kahriman, Nezahat; Uludağ Üniversitesi/Tıp Fakültesi/Acil Tıp Anabilim Dalı.; 0000-0003-0836-7862; AAE-9483-2021; Y-3674-2018; AAH-8846-2021; IOY-2055-2023; CXL-2354-2022Objective: We aimed to evaluate the most common complications and possible shortcomings in the emergency patients who were admitted to the clinical wards or intensive care units.Materials and methods: 1000 patients were included in this study. The patients's complication rates were compared with the clinical diagnosis, age groups, the section of the emergency department initially managed the patients, the time of the shift (daytime or night), the accompanying medical staff and specific type of patient populations. Also the interventions of the complications were recorded.Results: 37.5% of the patients who were included in the study were female and 62.5% were male. The median age of the patients was 54.2 year (min: 1 max:92). The vital signs that were recorded prior to transport of the patients did not interfere with the complication rates (p > 0.05). Complication rates in the night were found to be higher as more admissions took place during the night shift (p < 0.05). The complication rates were found higher in patients who were admitted to coronary care unit. The most frequent complication was the dislocation of the intravenous catheter. Replacing the dislocated intravenous catheter was the most frequently noted intervention. However, initiating inotropic agents to the hypotensive patients was done more frequently in the admitted clinical departments.Conclusion: The overall complication rate was low in this series of patients. The majority of them can be prevented by having in house guidelines. (C) 2015 Elsevier Ltd. All rights reserved.Publication Covid-19 pandemic and anxiety related factors in patients treated in the emergency department(Mre Press, 2020-10-01) Durak, Vahide Aslihan; DURAK, VAHİDE ASLIHAN; Günay, Seyda; GÜNAY POLATKAN, ŞEYDA; Sığırlı, Deniz; SIĞIRLI, DENİZ; Akova, Bedrettin; AKOVA, BEDRETTİN; Armağan, Erol; ARMAĞAN, EROL; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Acil Tıp Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Kardiyoloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi /Spor Hekimliği Anabilim Dalı; 0000-0003-0836-7862; 0000-0003-1044-8805; AAA-7472-2021; AAI-4550-2021; AAH-8846-2021; AAI-5350-2021Aims: A novel coronavirus, now known as SARS-CoV-2019, suddenly emerged in Wuhan, China and within threemonths of the initial outbreak, the virus had spread rapidly to neighboring countries causing a pandemic. After the first case was announced, emergency departments were immediately reorganized as pandemic clinics. Special areas with maximum precautions were designed to evaluate patients. The majority of studies on this pandemic have focused on the treatment of respiratory symptoms and comorbidities in intensive care units. In this study, we sought to determine those factors that contributed to the anxiety level during the COVID-19 pandemic using the 'State' subscale of State-Trait Anxiety Inventory (STAI-S). Methods: A survey was performed in the emergency department by using an online questionnaire which consisted of demographic variables, questions about the opinions and behaviors of patients during the pandemic, diagnostic test results for COVID-19, and treatment methods. Results: There was a statistically significant difference between employment status (p < 0.001), monthly income (p < 0.001), the food consumption changes during the pandemic period (p = 0.001) and the estimated end-date for the COVID-19 pandemic (p < 0.001) and total STAI-S points. Conclusions: Our study has identified factors which significantly increase anxiety during the COVID-19 pandemic and identified those individuals who may benefit from psychiatric and social support.Publication Management of fever; comparison of the effectiveness of metamizole and paracetamol in patients with suspected swine flu (h1n1)(Aves, 2011-12-01) Armağan, Erol; ARMAĞAN, EROL; Aydın, Sule Akkose; AYDIN, ŞULE; Köksal, Özlem; KÖKSAL, ÖZLEM; Kocabaş, Egemen; Küfeciler, Tarkan; Balcı, Arif Kadri; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Acil Tıp Anabilim Dalı.; AAH-8846-2021Objective: The study was performed to compare the effects of metamizol and paracetamol administered intravenously (IV), int adult patients with suspected swine flu (H1N1) presenting at the emergency department (ED) with feverMaterials and Methods: The study is a prospective randomized study made at the Uludag University Medical School ED between the dates of December 01-31.12.2009. 125 suspected H1N1 patients with fever were included in the study. Patients were randomized in turn and medications (1000 mg paracetamol/metamizole in 100 cc serum physiologic) were applied in the form of a 20-minute infusion by IV. Body temperatures are recorded before and after 15 and 30 minutes of drug applicationResults: The patients' mean age was 27.2 +/- 10.2. There were 63 patients in the metamizole and 62 patients in the paracetamol group. Body temperature decrease was significant with both drugs of application, however, in the group administered paracetamol the temperature decrease was more significant (p < 0.05).Conclusion: Although both paracetamol and metamizole are effective in fever management, in patients with suspected H1N1, paracetamol is the drug of choice.Publication The comparison of the relationship between haematuria severity and analgesia in renal colic patients(Galenos Yayınevi, 2013-12-01) Kocabaş, Egemen; Armağan, Erol; Kulaç, Semih; Çıldır, Ergün; Küfeciler, Tarkan; Pozam, Suna Eraybar; ARMAĞAN, EROL; Pozam, Suna Eraybar; Uludağ Üniversitesi/Tıp Fakültesi/Acil Servis Bölümü.; AAH-8846-2021; CAI-1624-2022Objective: Patients with Renal colic attack are usually admitted to hospital due to single-sided, sharp and sudden localised pain. 90% of patients have haematuria. Some analgesics might be used alone or in combination. This study was conducted to establish the relationship between haematuria severity determined in renal colic patients admitted to the ED and the efficacy of intramuscular (IM) non-steroid analgesic application.Material and Methods: The study was carried out prospectively in the Emergency Department. A total of 87 out of the possible 106 patients were included in the study. Pain severity was measured in accordance with the "Visual Analogue Scale" (VAS). Urine samples from patients were first evaluated macroscopically and then microscopically after being centrifuged to determine Erythrocyte count/hpf (high power field). VAS pain severity of patients who received 75 mg/3 mL Diclofenac sodium IM as an analgesic was measured and recorded at the time of admission; the measurements were repeated 20, 30 and 45 minutes after the analgesic was given.Results: When the score differences were examined between VAS values at the time of admission of patients and at 20, 30, and 45 mins after analgesia, a significantly positive correlation was found between haematuria severity and analgesic efficacy (p=0.003, r=0.311).Conclusion: If there is intensive or red colour anamnesis in patients presenting to the ED who are likely to be diagnosed as renal colic, the initial application of IM non-steroid analgesic may provide better pain palliation and increase patient comfort.