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Öğe Analysis of the patients admitted to emergency department due to urogenital trauma and investigation of factors that affect mortality(Elsevier Science Bv, 2017) Sozen, Semih; Celik, Simsek; Akpinar, Cafer; Guven, Fatma Mutlu Kukul; Yel, Cihat; Kavalci, Cemil; Salt, OmerObjective: To determine the general characteristics of urogenital trauma, and the factors that impact on mortality. Methods: Patients who were over 18 years of age admitted to the emergency service with urogenital injury between 1 January 2010 and 31 December 2014 were evaluated retrospectively. Age, gender, type of trauma, injured urogenital organs, vital parameters, additional organ injuries and mortality rate were investigated. Categorical variables were compared by using Chi-square test and comparing to groups data were performed with the Mann-Whitney and Kruskal-Wallis tests. P < 0.05 was considered statistically significant. Results: The median age of 174 patients was 35 years (interquartile range: 22), and 150 patients (86.2%) were males. It was determined that the incidence of urogenital trauma increased in August and September. The kidney was the most frequently injured organ (41.4%) and the most common cause of injury was traffic accidents (49.4%). Mean arterial pressure and revised trauma score were the lowest while pulse rate was the highest in renal trauma patients (P < 0.05). Mean arterial pressure, revised trauma score and respiratory rate were low in mortal group while pulse rate and Glasgow coma scale scores were significantly higher (P < 0.05). Conclusions: It is determined that the most common injured organs in trauma patients are kidneys and bladder and also no single factor is effective on mortality.Öğe Association Between Plasma Asprosin Levels and Gestational Diabetes Mellitus(Dove Medical Press Ltd, 2023) Boz, Ibrahim Bekir; Salt, Semra Ayturk; Salt, Omer; Sayin, Niyazi Cenk; Dibirdik, IlkerPurpose: This study sought to investigate whether asprosin can be used in the diagnosis of GDM or for diagnostic purposes in high-risk pregnancies, along with a review of other parameters that may be associated with serum asprosin levels. Patients and Methods: The study investigated the association between gestational diabetes mellitus (GDM) and asprosin levels. A total of 93 participants; 30 patients with GDM, 33 healthy pregnant women with normal glucose tolerance (NGT), and 30 healthy non-diabetic women (control group) at the Endocrinology and Metabolic Diseases outpatient clinic of a tertiary care university hospital were enrolled in the study. Patients with GDM and NGT were examined in terms of GDM between the 24th and 28th week of pregnancy (2nd trimester). Patient data were collected during routine examinations, and asprosin levels were measured using the ELISA method. All participants underwent testing for measurements of serum hemoglobin, insulin, C-peptide, fasting plasma glucose, and glycated hemoglobin (HbA1c) levels following a fasting period of at least eight hours. Results: Asprosin levels were higher in pregnant women with NGT and with GDM versus controls (Control-NGT asprosin, p = 0.001; Control-GDM asprosin, p = 0.001). Pregnant women with GDM had higher asprosin levels than those with NGT (p = 0.001). In detecting GDM in pregnant women, an asprosin cutoff value of >31.709 ng/mL yielded a sensitivity of 93.3%, specificity of 90.9%, positive predictive value of 90.3%, and negative predictive value of 93.75% (p < 0.001). Conclusion: Serum asprosin levels can potentially be used as a marker in the diagnosis of GDM.Öğe Atrial fibrillation associated with carbon monoxide intoxication(Cukurova Univ, Fac Medicine, 2018) Yakar, Sule; Baykan, Necmi; Durukan, Polat; Salt, Omer[Abstract Not Available]Öğe Avascular necrosis of lunate bone: Kienbock disease(W B Saunders Co-Elsevier Inc, 2016) Salt, Omer; Sayhan, Mustafa Burak[Abstract Not Available]Öğe Combined Effectiveness of Honey and Immunonutrition on Bacterial Translocation Secondary to Obstructive Jaundice in Rats: Experimental Study(Int Scientific Information, Inc, 2018) Oguz, Serhat; Salt, Omer; Ibis, Abdil C.; Gurcan, Saban; Albayrak, Dogan; Yalta, Tulin; Sagiroglu, TamerBackground: Obstructive jaundice is a serious, life-threatening condition that can lead to death as a result of sepsis and multiorgan failure due to bacterial translocation. Treatment should be started as soon as possible after diagnosis. Material/Methods: Forty 24-week-old male Sprague Dawley rats, with an average weight of 250 g to 300 g, were included in this study. The rats were randomly placed into five groups, each group consisted of eight rats. The sham group underwent only common bile duct (CBD) dissection and no ligation was performed. CBD ligation was applied to the other groups. After the operation, one CBD group was fed with rat chow only, the others were fed with rat chow supplemented with honey, or immunonutrients, or honey plus immunonutrients. After 10 to 12 days, all rats were sacrificed; blood and tissue samples were collected for biochemical, microbiological, and histopathological evaluation. Results: In the groups that were fed with honey and immunonutrients, alanine aminotransferase (ALT) levels were de- creased significantly compared to the other groups. Statistically significant differences were detected in terms of bacterial translocation (BT) rates among liver and spleen samples, and laboratory values of serum, except for MLNs of the BDL+HI group, when compared to other groups. We found mean mucosal thickness of ileum samples have been improved notably in the BDL+HI group compared to the other groups, especially compared to the C/BDL group. Conclusions: Immunonutrition applied with honey had immunostimulant effects, decreased BT due to an additive effect, and had positive effects on intestinal mucosa.Öğe Copeptin as a diagnostic PH marker in acute pulmonary embolism(Marmara Univ, Inst Health Sciences, 2022) Baykan, Necmi; Yakar, Sule; Ozkan, Seda; Sen, Ahmet; Salt, Omer; Durukan, PolatObjective: The present study aimed to investigate the effectiveness of copeptin levels in detecting increased pulmonary artery pressure and right ventricular dysfunction in patients with acute pulmonary embolism. Methods: A total of 116 patients who presented to the emergency department with chest pain or dyspnea and were diagnosed with acute pulmonary embolism and 30 healthy controls were included in the study. Plasma copeptin levels of patients and healthy control group were measured. Right ventricular functions and pulmonary artery pressures were evaluated in echocardiography of patients diagnosed with acute pulmonary embolism. Results: Copeptin levels were significantly higher in patients with right ventricular dysfunction than in those without right ventricular dysfunction [median 1.06(0.03-7.14) vs. 0.59(0.31-2.50), p= 0.01]. Conclusion: Copeptin can be used as a new biomarker in the diagnosis of acute pulmonary embolism and in predicting right ventricular dysfunction and increased pulmonary artery pressure in patients with acute pulmonary embolism.Öğe Emergency presentation of ophthalmic zona(Cukurova Univ, Fac Medicine, 2018) Durukan, Polat; Baykan, Necmi; Salt, Omer; Yakar, Sule; Tekin, Ismail; Kavalci, Cemil; Ozkan, Seda[Abstract Not Available]Öğe Evaluation of Intershift Handover in Emergency Department(Gazi Univ, Fac Med, 2018) Akpinar, Metin; Salt, Omer; Sayhan, Mustafa Burak; Mutlu, AlparslanObjective: Intershift handover (IH) in emergency departments can lead to serious distress in terms of both patient and doctor safety. In the study; it was aimed to determine how patients handed over between the shifts in the emergency services and the deficiencies, defects and errors occurred during this process. Methods: This study was conducted with 462 emergency doctors at 62 private, state, training research and university hospitals in Istanbul, Edirne, Kirklareli and Tekirdag cities where almost one fourth of Turkish population live, by interwiewing face-to-face between April 2016 and June 2016. Results: There were statistically significant difference between the groups who said that the transfer quality depends on the transferer doctor and lecturer and the other groups (respectively p<0.05). 98.1% (n = 453) of the physicians stated that they completely or partially agree with that; the deficiencies during handover the effect negatively the treatment of the patient (p<0.05). Conclusion: In conclusion, it is obvious that; the intershift handover in emergency department is vital. By reducing the number of mistakes made during this period, the quality of treatment of patients can be increased. In order to achieve this, we also think that it would be beneficial to give education to emergency service doctors about patient handover and to use a standardized intershift patient handover form.Öğe Evaluation of Patients with Ischemic Stroke Receiving iv t-PA in the Emergency Department(Aves, 2018) Salt, Omer; Baykan, Necmi; Kaymaz, Nesij Dogan; Yakar, Sule; Donmez, Halil; Koseoglu, Emel; Durukan, PolatAim: The aim of the present study was to determine the demographic characteristics, localization of emboli, imaging findings, National Institutes of Health Stroke Scale (NIHSS) scores, and complications of patients who received intravenous (iv) tissue plasminogen activator (t-PA) due to early period of ischemic cerebrovascular disease (CVD) during the 6-year period in a tertiary level emergency department of a university hospital. Materials and Methods: The study was retrospectively performed in 65 patients aged >= 18 years and who underwent iv t-PA with a diagnosis of ischemic CVD. Demographic data, such as age, gender, and smoking, were obtained by examining the medical records of the patients. The baseline Glasgow Coma Scale, NIHSS, start time of the event, time of admission to the hospital, and prognosis of the patients were recorded. Results: Intracranial hemorrhage was detected in 16.9% of the patients after treatment. On examination of the patients' outcome, a total of 32.3% (n=21) died after therapy. A significant correlation was observed between high NIHSS score and complications. Conclusion: In our study, a high NIHSS score at the time of admission has been found to increase both the risk of intracerebral hemorrhagic complication and mortality. We hypothesize that iv t-PA treatment gives successful results despite the complications, and emergency physicians should be more courageous in their application.Öğe Fat Embolism Syndrome after Lower Extremity Fracture(Aves, 2016) Sayhan, Mustafa Burak; Salt, Omer; Ozcan, Mert; Mumcu, Volkan; Filizay, BurcuIntroduction: Fat embolism syndrome (FES) is a potentially lethal complication of long bone fractures and is commonly seen after femur fractures. The clinical manifestations of FES are as follows: petechiae, pulmonary dysfunction, mental status changes, tachycardia, fever, thrombocytopenia, and anemia. FES can result in multiorgan dysfunction such as that of the brain, skin, and lungs. In this case report, we present a rare case of FES after traumatic fracture of the tibia and fibula. Case Report: A 32-year-old male patient was admitted to our emergency department 18 h after a traffic accident. He was previously healthy and had no medical history. At initial examination, a right shoulder fracture and dislocation and left tibia and fibula open fractures were detected. Almost 2 h after admission, he started to complain of difficulty in breathing. At the same time, petechiae appeared on his chest wall. With these clinical features, FES was diagnosed. Conclusion: With the presentation of this case report, we aim to improve the awareness and knowledge of Emergency Physicians regarding FES, such that they might keep in mind the diagnosis of FES in patients admitted to emergency departments with a long bone fracture and respiratory impairment.Öğe Importance of Neutrophil Gelatinase-Associated Lipocalin in Differential Diagnosis of Acute and Chronic Renal Failure(Kowsar Publ, 2014) Ozkan, Seda; Durukan, Polat; Kavalci, Cemil; Duman, Ali; Sayhan, Mustafa Burak; Salt, Omer; Ipekci, AfsinBackground: Neutrophil Gelatinase-associated Lipocalin (NGAL) protein is easily detected in the blood and urine soon after acute renal injury NGAL gains features of an early, sensitive and noninvasive biomarker for acute renal injury Recent evidences suggest that its expression is also increased in CRF reflecting the severity of disease. Objectives: In the present study, we aimed to investigate whether blood NGAL level plays a role in the differential diagnosis of acute and chronic renal failure. Patients and Methods: This was a prospective case-control study. Fifty patients presented to emergency department with acute renal failure (ARF), 30 with chronic renal failure (CRF) and 20 healthy individuals as control group were included in this study Blood pH, HCO3(-), BUN, creatinine and potassium values were evaluated in all patients. Blood NGAL values were evaluated in all groups. BUN, serum creatinine and NGAL values were statistically compared between patients and controls. Results: Median NGAL levels in patients was 304.50 (29), and 60 (0) in control, which was statistically significant between the two groups (Z = -6.477, P < 0.001). The median NGAL values were 261.50 +/- 291 in ARF group and 428.50 +/- 294 in CRF group. There was a significant difference in NGAL level between ARF and CRF groups (Z = -2.52, P = 0.012). Median BUN values were 153.46 +/- 82.47 in ARE group and 169.40 +/- 93.94 in CRF group. There was no significant difference in BUN value between ARF and CRF groups (P > 0.05). Median creatinine values were 2.84 +/- 2.95 in ARF group and 4.78 +/- 4.32 in CRF group. In serum creatinine values, a significant difference was found between ARF and CRE groups (P <0.05). Conclusions: Serum NGAL levels of ARE and CRF patients were significantly higher than healthy individuals. In addition, NGAL values of patients with CRF were significantly higher than those of ARE. Serum NGAL values can be used to detect renal injury and differentiate ARE and CREÖğe Intrahospital critical patient transport from the emergency department(Termedia Publishing House Ltd, 2020) Salt, Omer; Akpinar, Metin; Sayhan, Mustafa Burak; Ors, Fatma Betul; Durukan, Polat; Baykan, Necmi; Kavalci, CemilIntroduction: Although intrahospital transportation of critical patients from the emergency department (ED) is inevitable, it could also result in life-threatening situations. These situations, referred to as unwanted or unexpected events, mainly happen during the transportation of patients for diagnostic imaging or invasive procedures and result in a wide spectrum from vital condition changes, mental condition changes to cardiopulmonary arrest and death. Emergency departments have a high risk of facing such situations because these units are the first admission door of critical patients. Material and methods: This cross-sectional study was conducted prospectively, after interviewing the doctors who work in the ED actively, and by filling out the forms which were already prepared by the participants. Statistical analysis was performed according to the data received, and results were compared to the literature. Results: Three hundred and forty-seven doctors from 52 hospitals were included in the study. 59.4% (n = 206) of them were working at EDs which had more than 500 patients admitted. 51.9% (n = 180) of doctors stated that they performed 10 or more critical patients' transport every day from their ED. 86.7% (n = 301) of the participants stated that usage of control checklists would decrease the rate of unwanted situations and stated that they wanted to use them. Conclusions: Intrahospital transportation of critical patients from the emergency room is a subject that should require attention by emergency room doctors, and using educated personnel, proper equipment, standardized protocols and control checklists will decrease the frequency of unwanted situations effectively.Öğe Isolated superior mesenteric artery dissection in the emergency department: A rare cause of abdominal pain(Elsevier, 2018) Salt, Omer; Sayhan, Mustafa Burak; Duyar, ErenAcute onset abdominal pain constitutes a significant proportion of emergency department visits, but only a small fraction of these cases are attributable to vascular pathologies (Bauersfeld, 1947 [1]). In this case, report, we present an incidental diagnosis of Spontaneous Isolated Superior Mesenteric Artery Dissection (SISMAD). A 69-year-old man was admitted to the emergency department complaining of fever, loss of appetite, vague epigastric pain, dysuria, and a productive cough for several days. A lower extremity venous Doppler ultrasound was performed, and a deep venous thrombosis (DVT) was identified in the left main femoral vein and in the proximal segment of the superficial vein. The patient also had no blood flow in the distal part of left external iliac vein. A contrast-enhanced computerized tomography angiography of the thorax and abdomen was performed to detect pulmonary embolism and the etiology of the abdominal pain. No pulmonary embolism was found; however, multiple metastatic nodules were identified in both lungs, as well as infiltration on the posterobasal field of the right lung, metastases on the liver, focal dilatation, and an intimal flap on the middle-distal part of the superior mesenteric artery (SMA) at 2 cm, with a segment that was compatible with isolated dissection. There was a contrast passage on the distal part of SMA, and no sign of bowel ischemia. (C) 2018 Elsevier Inc. All rights reserved.Öğe Isolated triquetrum fracture after trauma(Cukurova Univ, Fac Medicine, 2018) Durukan, Polat; Baykan, Necmi; Taslidere, Bahadir; Salt, Omer; Yakar, Sule; Ozkan, Seda; Kavalci, Cemil[Abstract Not Available]Öğe A novel biomarker in acute cholecystitis: YKL-40(Elsevier Singapore Pte Ltd, 2023) Celikturk, Eray; Salt, Omer; Sayhan, Mustafa Burak; Dibirdik, IlkerBackground: The lack of a specific biomarker that can be used in the diagnosis of acute cholecystitis, a common cause of admission to the emergency department, delays physician efforts to diagnose and treat these patients. Therefore, the aim of this study was to measure plasma YKL-40 levels and investigate their diagnostic value in patients with acute cholecystitis (AC). Methods: This study was carried out between February 2020 and September 2020 in the adult emergency department of a tertiary university hospital. Permission was obtained from the Ethics Committee of Scientific Research on 03/02/2020 with Decision No. 03/16. The study included 80 patients who were diagnosed with acute cholecystitis and 80 healthy volunteers without known chronic diseases. Results: The median YKL-40 protein level was 798.66 pq/mL in the patient group and 392.45 pq/mL in the control group. A statistically significant difference in YKL-40 protein levels was found between the two groups. YKL-40 protein levels were significantly higher in patients diagnosed with acute cholecystitis than in healthy individuals (p < 0.001). A positive correlation was found between YKL-40 protein levels and ALT, AST, LDH, and GGT levels (r = 0.272, p = 0.015; r = 0.397, p < 0.001; r = 0.386, p < 0.001; and r = 0.264, p = 0.018; respectively). Conclusion: When evaluated together with physical examination, radiological imaging and other laboratory parameters, we think that plasma YKL-40 levels can be used effectively in the diagnosis of acute cholecystitis. (c) 2023 Asian Surgical Association and Taiwan Robotic Surgery Association. Publishing services by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/ by/4.0/).Öğe OCCUPATIONAL INJURIES AMONG THE ELDERLY ADMITTED TO THE EMERGENCY DEPARTMENT(Gunes Kitabevi Ltd Sti, 2019) Salt, Omer; Sayhan, Mustafa Burak; Kucukyagci, NejmiIntroduction: Occupational injuries are among the leading causes of morbidity and mortality worldwide. The rate of occupational injuries in the elderly is increasing daily and is directly proportional to the increase in the elderly population. This study aimed to examine occupational injuries in elderly patients (age, >65 years) admitted to the emergency department. Materials and Method: This cross-sectional study included 122 patients aged >65 year-old who were admitted to the third level emergency department with an occupational injury between January 2016 and January 2018. The demographic characteristics of the patients, type of work accident, type of injury, injured body parts, and comorbid conditions were recorded and statistically evaluated. Results: The mean patient age was 67.8 +/- 23 years (mean +/- SD); 85.5% (n:108) of the patients were men, and 85.2% (n:104) were retired. Hypertension was the most commonly observed comorbidity (35.2%, n:43). Falls from the same or a high level were the most commonly observed injury mechanisms (56.7%, n:74). The extremities were the most commonly injured body part (54.9%, n:67); sprains/strains were the most commonly observed injury type (47.5%, n:58). None of the injuries resulted in death. Conclusion: The proportion of elderly workers is increasing owing to the rising elderly population worldwide. Because of increased cognitive and motor disabilities, there is an increased risk of occupational injuries in this age group. Thus, occupational injuries in the elderly should be more carefully evaluated in the emergency department.Öğe Patient With Post Traumatic interhemispheric Subdural Hematoma: A Case Report(Gazi Univ, Fac Med, 2018) Baykan, Necmi; Durukan, Polat; Salt, Omer; Yakar, Sule; Kaymaz, Nesij Dogan; Kavalci, CemilTraumatic interhemispheric subdural hematoma is rarely seen important condition. It account about 6% of all patient with traumatic ISH. In our case we presented a trafic accident of 48 years old, male who was a brought to our ED. Norological examination there was neither patologic symptom nor increased intracranial pressure symptoms. In the cranial tomography at the level of anterior falx, about 13 mm width hyperdens area (subdural hemorrhage) was seen. without any patologic symptom in the norological examination of traumatic patient, even if there is no any risk to cause bleeding, intracranial bleeding can ocur. According to this reason we do suggest to do cranial scan for the patients with trauma history.Öğe Plasma copeptin levels in the patients with gastrointestinal bleeding(W B Saunders Co-Elsevier Inc, 2017) Salt, Omer; Durukan, Polat; Ozkan, S.; Saraymen, R.; Sen, A.; Yurci, M. A.Introduction: Gastrointestinal bleeding is a significant cause of morbidity andmortality worldwide. In addition, it constitutes an important part of health expenditures. In this study, we aimed to determine whether there is a relationship between plasma copeptin levels and the etiology, location and severity of gastrointestinal bleeding. Materials and methods: This study was performed prospectively in 104 consecutive patients who were admitted to anemergency department with complaints of bloody vomiting or bloody or black stool. To evaluate the level of biochemical parameters such as Full Blood Count (FBC), serumbiochemistry, bleeding parameters and copeptin, blood samples were obtained at admission. For the copeptin levels, 2 more blood samples were obtained at the 12th and 24th hours after admission. The values obtained were compared using statistical methods. Results: In terms of the etiology of bleeding, the copeptin levels in the patients with peptic ulcer were higher than the levels in patients with other gastrointestinal bleeding. However, the difference was not statistically significant. There were no significant differences among all groups' 0th, 12th and 24th hour levels of copeptin. Discussion: We conclude that copeptin cannot be effectively used as a biochemical parameter in an emergency department to determine the etiology and location of gastrointestinal bleeding. It can, however, be used to make decisions on endoscopy and the hospitalization of patients with suspected gastrointestinal bleeding. (C) 2017 Elsevier Inc. All rights reserved.Öğe Sesamin ameliorates mucosal tissue injury of mesenteric ischemia and reperfusion in an experimental rat model(Termedia Publishing House Ltd, 2019) Sayhan, Mustafa B.; Oguz, Serhat; Salt, Omer; Can, Nuray; Ozgurtas, Taner; Yalta, Tulin D.Introduction: Mesenteric ischemia/reperfusion (I/R) injury is a serious clinical condition. There were a lot of experimental studies performed in the treatment of I/R injury. To our knowledge, this is the first experimental study with effects of sesamin on I/R injury model. We aimed to investigate the protective effect of sesamin on mesenteric I/R injury model. Material and methods: A total of 32 male Sprague-Dawley rats were divided into four groups. Control group: superior mesenteric artery (SMA) exposed without clamping. I/R group: SMA was clamped for 60 min and then reperfused for 2 h. Sesamin group (S): 30 mg/kg sesamin were given for 5 days, and SMA exposed without clamping. I/R + S group: 30 mg/kg sesamin were given for 5 days, SMA was clamped for 60 min, and then reperfused for 2 h. Plasma and tissue oxidant parameters were investigated as well as histopathological evaluation. Results: Plasma and tissue total antioxidant status (TAS) levels were significantly higher in I/R + S group compared to the rest (p < 0.005). The plasma TAS levels in I/R group was significantly low. The highest tissue TAS levels were detected in I/R + S group. The high levels of plasma and tissue TOS were found in I/R + S group. Plasma and tissue OSI levels were significantly higher in I/R group. Histopathologic evaluation showed that the mean level of intestinal tissue injury score in I/R group was 2.75 and 1.38 in I/R + S group. Conclusions: Sesamin helps to protect the intestinal tissue at the cellular level by reducing the oxidative stress and inflammation at both the plasma and tissue levels in the experimental I/R model.Öğe Spontaneous Pneumomediastinum: Case report(Gazi Univ, Fac Med, 2017) Durukan, Polat; Tekin, Ismail; Yakar, Sule; Salt, Omer; Baykan, Necmi; Ozkan, SedaSpontaneous pneumomediastinum, without any triggering factor is described as presentation of air in the mediastinum and this is a benign, uncommon and generally self limiting condition. Admitted to the emergency department the feeling of congestion in the throat and dsypnea complaints, which present a case with the diagnosis of spontaneous pneumomediastinum. She was managed conservatively and recovered uneventfully. Careful physical examination and radiologic evaluation are very important in making the diagnosis of spontaneous pneumomediastinum. A close follow-up is needed to avoid from possible complications.
