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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 Contribution of neutrophil/lymphocyte ratio to the diagnostic efficiency of computed tomography and polymerase chain reaction in COVID-19 patients(Sage Publications Inc, 2021) Örün, Serhat; Erdem, Mustafa NumanBackground: 6.5% of the country's population was diagnosed with COVID-19 disease. Computed tomography scanning and polymerase chain reaction tests are considered reliable methods for the detection of COVID-19. However, the specificity and reliability of polymerase chain reaction tests and ground-glass opacity (GGO) on thorax computed tomography images in diagnosing COVID-19 are still being disputed. Our aim was to compare the neutrophil/lymphocyte ratio, whose efficiency in differentiating between viral and bacterial infections has previously been studied, with computed tomography and polymerase chain reaction for COVID-19 diagnosis. Materials and methods: This was a retrospective study that included patients treated in a tertiary care hospital emergency service pandemic polyclinic between 14 March and 1 June 2020. The neutrophil/lymphocyte ratios of patients with polymerase chain reaction tests and ground-glass opacities on computed tomography were calculated. The neutrophil/lymphocyte ratios of polymerase chain reaction-negative patients with computed tomography images were compared with the neutrophil/lymphocyte ratios of polymerase chain reaction-positive patients with computed tomography images. Results: A total of 631 patients were included in this study. Thorax computed tomography scans were obtained from all patients. The mean neutrophil/lymphocyte ratio of patients with ground-glass opacities was 3.50 +/- 2.12, whereas that of patients without ground-glass opacities was 2.90 +/- 2.01. This difference was also statistically significant. Polymerase chain reaction swab samples were obtained from 282 patients (44.7%). The mean neutrophil/lymphocyte ratio of polymerase chain reaction-positive patients was 2.38 +/- 1.02, whereas that of polymerase chain reaction-negative patients was 3.97 +/- 2.25. The difference was statistically significant. Conclusion: Many studies are undoubtedly required to determine the efficiency of the neutrophil/lymphocyte ratio in COVID-19 diagnosis. However, we postulate that evaluating the neutrophil/lymphocyte ratio along with computed tomography and polymerase chain reaction can assist in the diagnosis of patients.Öğe EVALUATION OF GENDER DIFFERENCE IN PEDIATRIC TRAUMA PATIENTS ADMITTED TO THE EMERGENCY DEPARTMENT(Namık Kemal Üniversitesi, Tıp Fakültesi, 2017) Donma, Mustafa Metin; Tayfur, İsmail; Erdem, Mustafa Numan; Muhammed, Demirkol; Topçu, Birol; Donma, OrkideAim: A significant proportion of pediatric trauma patients admitted to the emergency department are injured by preventable causes. Accidental injuries are the most common causes of deaths in childhood. The purpose of this study was to analyze the demographic features of the parents and the gender difference of the cases in pediatric patients with trauma admitted to the emergency department (ED). Materials and Methods: Over a 1-year period (April 2015 through May 2016), a total of 502 consecutive paediatric patients who presented to our tertiary-care university hospital ED with symptoms of trauma of various causes (falling from a height, injury, burni traffic accident and physical abuse assault) were enrolled in this prospective clinical study. Results: In this study, the boy to girl gender ratio was found to be 1.52 (p = 0.868). The mean ages were 7.74 ± 4.97 in boys and 7.67 ± 5.25 in girls. 17.2% of the boys and 21.1% of the girls were detected fracture on direct radiographs (p=0.306). Upper extremity fractures were encountered more frequently than other fractures. The frequency of falling from a height was the first among all cases of trauma with the rate of 69.3%, 42.4% of which occurred in boys and 26.9% in girls (p=0.559). The rates of upper extremity injuries were 19.9% for boys and 15.7% for girls (p=0.126). The rates of head injuries were 22.5% for boys and 12% for girls (p=0.177). When the type of injury was evaluated, the rate of contusion was 60%, 36.3% of which occurred in boys and 23.7% in girls (p=0.952). When the parents of the pediatric trauma patients were classified according to their educational status, the largest group consisted of primary school graduated parents with rates of 41.4% for mothers (p=0.080) and 37.3% for fathers (p=0.008). 46.0% of the pediatric trauma patients were the first children of their families, 27.3% of which were boys and 18.7% were girls (p=0.657). Conclusion: We emphasized the importance of raising awareness about the issue at the individual and community-based level and the necessity of increasing the protective measures for indoor and outdoor accidents in order to be able to create a safe environment so that the pediatric trauma patients can be reduced in our country and in the world.Öğe The Importance and Its Relationship of Adropin Level in Prediting the Severity of Acute Pancreatitis(Galenos Publ House, 2023) Sahin, Huseyin; Nahmadova, Gunay; Bicakci, Sercan; Bicakci, Nurcan; Erdem, Mustafa Numan; Orun, Serhat; Basol, Batuhan IlbeyAim: We sought an alternative marker without serum amylase-lipase test for diagnosis in acute pancreatitis (AP), a disease with a wide range of severity. In this study, we wanted to see the benefit of serum adropin levels in improving the diagnosis time in the emergency department, predicting the severity of pancreatitis, and hospitalization. Materials and Methods: Our study is a single-center prospective study in which 39 patients with AP (>= 18 years old) participated. Thirty-six patients diagnosed with AP and 36 control group admitted to the Emergency Department of Tekirda & gbreve; Nam & imath;k Kemal University Hospital between March 2021 and November 2021 were included in the study. The blood samples of the patient and control groups at admission were studied by ELISA method. All patients diagnosed with AP were hospitalized and a package program called Statistical Package for the Social Sciences was used in the statistical analysis of the data obtained. Results: In our study results; There was no statistically significant difference in adropin levels compared to the patient/control group (p>0.05). When the ROC curves of the patient/control group were examined in terms of adropin levels; It was determined that the adropin level distinction was not statistically significant (p=0.336 >0.05). At the same time, no statistically significant difference was found in terms of adropin levels according to pancreatitis types and pancreatitis score classes of the patients (p>0.05). Conclusion: According to our study, adropin is not a significant biomarker in determining the diagnosis and severity of AP.
