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Öğe Acil Servise Başvuran Onkolojik Tanılı Hastaların Demografik İncelenmesi(2022) Erdem, Mustafa Numan; Çetin, Murat; Bıçakçı, Nurcan; Şahin, Hüseyin; Örün, Serhat; Yanıker, Rahime Merve; Bıçakçı, SercanAmaç: Hasta bakımındaki iyileşmeler sayesinde kanser hastalarının yaşam süresindeki uzamalar tüm dünyada kanserli hasta sayısının giderek artmasına neden olmaktadır. Bununla beraber acil servise başvuran onkolojik hastaların sayısı da gün geçtikçe artmaktadır. Bu çalışma ile kanserli hastaların acil servise başvuru nedenleri ve prognozu etkileyen faktörleri demografik olarak incelenmiştir. Gereç ve Yöntem: Çalışmaya Tekirdağ Namık Kemal Üniversitesi Hastanesi Acil Servisi’ne 1 Mart 2018 tarihi ile 31 Ağustos 2018 tarihi arasında başvuran ve klinik/patolojik/onkolojik tanısı olan 18 yaş ve üzeri hastalar dahil edildi. Çalışma prospektif olup, başlamadan önce etik kurul onayı alındı. Bulgular: Çalışmaya onkoloji tanısı patoloji raporları ile kesinleşmiş 265 hasta dahil edildi. Olguların yaş ortalaması 60±12 yıl olup, kadınlardaki yaş ortalamasının 58±13 yıl olduğu görüldü. En sık başvuru şikayeti %13,6 (n=36) ile “ağrı” oldu. Kliniklere ve yoğun bakım ünitelerine en sık yatış nedeninin %6,8 (n=18) ile gastrointestinal sistem patolojileri ve respiratuvar patolojiler olduğu görüldü. Yatışı yapılan 90 hastadan %63,3’ünün (n=57) hastaneden taburcu edildiği ve %33,3 (n=30) hastanın ise yatırıldığı kliniklerde vefat ettiği saptandı. Sonuç: Onkolojik hasta gruplarının yaş ortalaması yüksek olduğu için morbiditesi ve mortalitesi diğer hasta gruplarına göre daha yüksektir. Bu sebeple bu hasta grupları acil servise diğer hasta gruplarına göre farklı şikayetlerle gelebilmektedirler. Onkolojik hastaların tetkik ve tedavilerinin daha dikkatli düzenlenmesi gerekmektedir.Öğe B-lines in lung ultrasonography as prognostic markers for community-acquired pneumonia(E-Century Publishing Corp, 2020) Örün, Serhat; Şahin, Hüseyin; Erdem, Mustafa Numan; Bıçakçı, Sercan; Koçak, Abdullah Osman; Yanıker, Remziye Merve; Nahmadova, GünayObjective: Community-acquired pneumonia (CAP) is a type of pneumonia with high morbidity and mortality rates in high-risk groups. It is a common reason for referral to the emergency room. A prognostic marker that can be used quickly and easily at the bedside in the emergency room without a blood test and the need to transfer the patient to another department can contribute to quick determination of the best treatment and nursing protocol. Methods: This prospective study included patients with CAP who were referred to the emergency room. CURB-65 and the pneumonia severity index (PSI) were calculated for each patient and were used as reference scores that were compared to a B-line score (BLS) that we developed based on B-line artifacts from lung ultrasonography (LUSG). The CURB-65, PSI, and BLS values compared in terms of need for hospitalization and 30-day mortality. Results: A total of 72 patients were included in the study. Their mean age was 64.60 +/- 17.28 years. Of all the factors examined, the BLS showed statistically significant results in terms of mortality and differences between inpatients and outpatients. The AUC value of the BLS and 30-day mortality was 0.753 (95% CI: 0.594-0.911). The maximum likelihood ratio was 3.2. Conclusion: Although randomized, blind, controlled studies are required to evaluate the prognostic effectiveness of the scoring system that we developed based on B-lines in CAP patients' LUSG, we believe that LUSG images can provide valuable prognostic information and that B-line artifacts can be taken into consideration in this respect.Öğe Beneficial effects of sennoside B on pentylenetetrazole-induced seizures in rats(SAGE Publications Ltd, 2023) Şahin, Hüseyin; Erbaş, O.Background: Epilepsy is a common disorder affecting approximately 50 million people worldwide. Oxidative stress is known to play an important role in the pathophysiology of diseases, including epilepsy. In this study, we investigated the effects of sennoside B on PTZ-induced seizures in rats. Method: The rats were grouped into Group Electroencephalography and Group Behavioral. Both Groups were divided into eight subgroups, and these subgroups were compared in terms of the time of first myoclonic jerk, Racine’s Convulsion Scale, malondialdehyde levels, and brain superoxide dismutase activity. The experimental seizure model was performed with pentylenetetrazol. Results: The spike percentage was significantly lower in groups that received sennoside B, and this beneficial effect was shown to be associated with the dose of sennoside B received. The RCS score was lower and the FJM onset time was higher in the sennoside B-administered groups. Additionally, brain MDA and brain aquaporin-3 levels were lower and brain SOD activity was higher in the sennoside-administered groups. Conclusions: The present study shows the beneficial effects of sennoside B on PTZ-induced convulsion in rats. It is considered that sennoside B which is a natural and safe product would be a good candidate for strengthening the management of epilepsy without serious side effects. © The Author(s) 2023.Öğe Distribution of Forensic Cases in Admitted to the Emergency Department of a University Hospital in the Year of the Pandemic Onset and One Year Before(Türkiye Acil Tıp Derneği, 2024) Peköz, Mehmet Burak; Usluer, Halil Oktay; Şahin, Hüseyin; Yeşildaş, CumaAim: In light of the societal shifts brought about by the pandemic, alterations were noted in both the distribution and characteristics of forensic cases presenting at the emergency department. This study aimed to assess the changes in the features of forensic cases admitted to the emergency department before and during the COVID-19 pandemic. Material and Methods: An observational cross-sectional study was conducted at the Department of Emergency Medicine, Tekirdag Namik Kemal University, spanning from April 1, 2019, to March 31, 2021. The timeframe from April 1, 2019, to March 31, 2020, was designated as the "COVID-19 pre-pandemic period" (n = 1101), while the period from April 1, 2020, to March 31, 2021, was termed the "COVID-19 pandemic period" (n = 685). Patient records from the emergency department were retrospectively examined. Results: Among the 1786 forensic cases analyzed, 71.6% were male, with a mean age of 32.68 ± 15.67 years. Predominant case types included assault/battery (28.7%), road traffic accidents (25.1%), and occupational accidents (20.9%). While 61.6% of cases occurred during the pre-pandemic period, 38.4% were recorded during the pandemic. A significant increase was observed in the frequency of forensic cases among emergency department admissions during the pandemic compared to the pre-pandemic period (1.5% vs. 1.7%, p = 0.001). Moreover, during the pandemic period, there was a notable rise in the age of forensic cases, frequency of hospitalized cases, duration of hospitalization, and occurrences of occupational and motorcycle accidents, whereas incidents of assault/battery and traffic accidents decreased significantly (p < 0.05). Additionally, there was a statistically significant difference in the distribution of cases across different months during the pandemic compared to the pre-pandemic period (p < 0.001). Conclusion: Despite an overall decrease in the number of forensic cases during the pandemic, a heightened intensity of such cases was observed among hospital admissions. Notably, individuals admitted during the pandemic were older, experienced more frequent and prolonged hospitalizations, and were involved in fewer assault/battery and traffic accident cases but more occupational and motorcycle accidents.Öğe The Characteristics of Patients Transferred by Helicopter Ambulance in Erzurum(Galenos Yayincilik, 2017) Gür, Sultan Tuna Akgöl; Bayramoğlu, Atif; Şahin, HüseyinObjective: To analyze the characteristics of patients transferred by ambulance helicopter in Erzurum. Materials and Methods: We retrospectively evaluated the records of patients transferred by ambulance helicopter between 2009 and 2012. Medical, demographics, geographic and flight data of the patients were all analyzed. Results: A total of 347 (185 male, 162 female) patients were included in the study. 167 patients (48.4%) aged between 18 and 65 years. In the adult patients, the most common diagnoses were medical conditions in 82 (65.6%) men and 43 (34.4%) women. The number of male and female patients transferred during the summer was 64 (35%) and 50 (30.9%); in autumn, 54 (29.5%) and 34 (21%); in winter, 35 (19.1%) and 44 (27.1%); and in the spring, 30 (16.4%) and 34 (21%), respectively. Conclusion: Transferring patients living far from medical centers by air ambulance has become common. Plane and helicopter ambulances have become a part of emergency services. Since evidence was obtained on the outcomes of patients affected positively by helicopter transfer, air health transfer services and the number of air ambulances covered by insurance companies have increased recently.Öğe Varfarin Doz Aşımına Bağlı Kanamalarda Hızlı ve Etkin Bir Tedavi Yöntemi: Plazma Kompleks Konsantresi(Acil Tıp Uzmanları Derneği, 2020) Örün, Serhat; Şahin, Hüseyin; Erdem, Mustafa; Bıçakcı, Sercan; Başol, Batuhan; Yeniay, Elif; Demir, MehmetIntroduction: Warfarin is important anticoagulant that we need in indications despite. Bleeding duo to overdose of warfarin can be lifethreatening when we don’t intervene early and correctly.Case report: A 81 years old female presented with weakness, anorexia and black colored defecating. She uses warfarin for 5 years because of prosthetic heart valve. On clinical examination she had hypotension and melena. Blood tests revealed Hemoglobin: 5,14 g/dl and INR:12,08. Vitamin K, Prothrombin complex concentrate and Proton pomp inhibitor was given as treatment in emergency service. The patient hospitalised in intensive care unit for further examination and treatment. Next day blood tests revealed Hemoglobin: 8,84 g/dl and INR:3,83. The patient with no active bleeding focus on gastroscopy and with no decrease in hemoglobin tests discharged from hospital on 2nd day of hospitalization. Low-molecular-weight heparin treatment started.Discussion: Warfarin is a drug that still needed for treatment of atrial fibrillation, mechanical heart valves, protein c-s deficiency and antiphospholipid antibody disease. Common pathology of these diseases is predisposition to embolism and thrombus formation. In the emergency services, we need to make decisions according to the patient while treating patients who have warfarin overdose bleeding. On the one hand to stop the bleeding to ensure the patient's hemodynamics, on the other hand, the risk of thromboembolism caused by the use of warfarin should not be ignored. Therefore, it is necessary to reduce the current INR level to the targeted INR level as quickly and safely as possible.Conclusion: In conclusion, we suggest that a timely and protocol-based approach to treat coagulapathy in patients with trauma and drug-induced coagulapathy may improve patients’ prognosis.
