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Öğe Analysis of 264 Patients with Stab and Gunshot Wounds in Abdominal and Thoracic Regions(DRUNPP-SARAJEVO, 2010) Korkmaz, Ilhan; Karadayi, Sule; Guven, Fatma Mutlu Kukul; Eren, Sevki Hakan; Sahin, Ekber; Nadir, Aydin; Beydilli, Inan; Kaptanoglu, MelihIntroduction: Penetrating traumas are life-threatening situations which can be encountered in emergency services. In this study, epidemiological data, treatment approaches and the results pertaining to penetrant abdominal and/or thoracic injuries, which occured due to gunshot or stab wounds, are evalauted retrospectively. Material-method: Two hundred and sixty four patients who admitted to emergency department with penetrating thoracic and/or abdominal trauma between 2002 and2009 were retrospectively analyzed. Patients were divided into 3 groups according to their shock indexes including Low risk (<= 0.5), medium risk (> 0.5-<= 1) and high risk (> 1) groups. Results: The study group included 244 male (92.4%) and 20(7.6%) female participants. Age distribution of the groups was as follows; 58 (22.0%) patients were in the 0-19 years group, 139 patients (52.6%) were in the 20-40 years group and 67 patients (25.4%) were over 40 years. Two hundred and fifteen injuries (81.4%) were caused by stab wounds and 49 (18.6%) were due to gunshots. When the patients were evaluated considering the injury site, isolated thoracic trauma was seen in 93 patients (35.3%) and isolated abdominal injuries were found in 74 patients (28.0%). The most common organ injuries among the patients who underwent laparotomy (n=73) were as follows; bowel injury in 28 patients (38.3%), stomach injuries in 20 patients (27.4%) and liver-spleen injuries in 17 patients (23.28 %). Of 189 patients with thoracic trauma, 17 patients (8.9 %) had hemothorax, 44 (23.28 %) had pneumothorax, 46 (24.33 %) had hemopneumothorax and 2 patients (1.05 %) had pulmonary contusion. Seven patients (2.65 %) died. Two patients were considered as exitus in the initial examination. Two of the 5 exitus cases had shock index ranging within the medium risk group and 3 were in the high-risk group. Conclusion: It must be considered that penetrating trauma patients with medium or high shock index have a higher mortality rate. Therefore, those patients must be closely monitored and the health services should be improved for immediately and appropriately transferring them.Öğe Analysis of patients with upper gastrointestinal bleeding: a study from Anatolian, Turkey Seasonal Distribution of Gastrointestinal Bleeding(DRUNPP-SARAJEVO, 2012) Korkmaz, Ilhan; Eren, Sevki Hakan; Guven, Fatma Mutlu Kukul; Beydilli, Inan; Yildirim, Birdal; Oguzturk, HakanThe aim of our study was to analyze if we have a seasonal or circadian distribution of acute upper gastrointestinal bleeding (AUGIB) patients, and to evaluate the laboratory and demographic risk factors on mortality rates. We scanned all of the files of the patients who had been diagnosed with AUGIB, for a ten year period. Datas' about seasonal distribution, circadian rhythm, admission hemoglobin, blood urea nitrogen and demographic variables were extracted from the charts. We didn't observed a seasonal distribution for AUGIB inspite of we excluded the drug effect by analyzing its seasonal distribution. Also our patients were admitted mostly nights which was compatible with the literature. Whereas our admission rate between 24 and 06 hour period was low. Admission low hemoglobin level, impaired blood urea nitrogen and creatinine level, and patients with advanced age has a higher mortality rate (p=0.03, p=0.003, p=0.02, p=0.001 respectively). Climatic factors effect on the seasonal distribution among AUGIB patients is not observed. Other risk factors (mental-physical) should also be evaluated. Low hemoglobin level, impaired renal functions and advanced age are bad risk factors for prognosis.Öğe Baseline characteristics and the association between hyponatraemia and pulmonary embolism prognosis(PAKISTAN MEDICAL ASSOC, 2013) Korkmaz, Ilhan; Guven, Fatma Mutlu Kukul; Eren, Sevki Hakan; Beydilli, Inan; Yildirim, Birdal; Aktas, Can; Alagozlu, HakanObjective: To evaluate the effect of hyponatraemia on pulmonary thromboembolism mortality rates. Methods: The retrospective study was conducted at the Cumhuriyet University Medicine Faculty's Emergency Department, and involved the analysis of records related to all patients who were diagnosed with acute pulmonary thromboembolism between January 2005 and June 2011. Diagnoses were confirmed by pulmonary angiography, multi-slice computed tomography or high-probablity ventilation/perfusion scintigraphy. All patients (n=260) were over 16 years of age. SPSS 14 was used for statistical analysis. Results: Plasma sodium level, platelet count and hospitalisation time were significiantly lower among those who died (n=16; 6.29) (p<0.005, p<0.035, p<0.035). Pearson correlation analysis found a negative correlation between plasma sodium level and C-reactive protein, white blood cells and pulmonary artery pressure (r=-0.238, p<0.001; r=-0.222, p<0.001; r=-0.444, p<0.018 respectively). A positive correlation was found between plasma sodium level and hospitalisation time (r=0.130; p<0.039). Conclusion: While mortality rates in hyponatraemic pulmonary thromboembolism patients increases, low plasma sodium is an easy parameter that should be kept in mind for the prognosis of pulmonary thromboembolism disease.Öğe Carbon Monoxide Intoxication Induced Atrial Fibrillation(Galenos Yayincilik, 2012) Korkmaz, Ilhan; Eren, Sevki Hakan; Guven, Fatma Mutlu Kukul; Turkdogan, Ahmet; Beydilli, Inan; Yildirim, BirdalCarbon monoxide (CO) is a colorless, odorless gas which is a leading cause of accidental deaths during winter months. Its toxic effect occurs by binding to hemoglobin or directly at cellular level. Electrocardiographic findings due to CO intoxication are STsegment changes, premature contractions, sinus tachycardia, bundle blocks and atrial fibrillation (AF). We report a 33-year-old man who presented with AF due to CO poisoning. The patient was treated with anti-ischemic drugs and oxygen therapy.Öğe Carbon monoxide intoxication induced atrial fibrillation(Galenos, 2012) Korkmaz, Ilhan; Eren, Şevki Hakan; Güven, Fatma Mutlu Kukul; Türkdo?an, Ahmet; Beydilli, Inan; Yildirm, BirdalCarbon monoxide (CO) is a colorless, odorless gas which is a leading cause of accidental deaths during winter months. Its toxic effect occurs by binding to hemoglobin or directly at cellular level. Electrocardiographic findings due to CO intoxication are STsegment changes, premature contractions, sinus tachycardia, bundle blocks and atrial fibrillation (AF). We report a 33-year-old man who presented with AF due to CO poisoning. The patient was treated with anti-ischemic drugs and oxygen therapy.Öğe Importance of high sensitive C-reactive protein, leukocyte levels and neutrophyl/lymphocyte rate in the patients with acute coronary syndrome(2010) Beydilli, Inan; Eren, Şevki Hakan; Korkmaz, Ilhan; Kukul Güven, Fatma Mutlu; O?uztürka, HakanObjective: Acute Coronary Syndrome (ACS) patients are a major group among the patients who admit to emergency department. Our aim in this study was to investigate the correlation of high sensitive C-reactive protein (hs-CRP) and leukocyte values and neutrophyl/lymphocyte rate in acute coronary syndromes and also the correlation between inflammation and atherosclerosis. Material and Methods: The study was performed on 85 cases; the patient group consisted of 50 patients (25 with ST elevated myocardial infarction, 19 with Unstable angina pectoris and 6 with Non-Q myocardial infarction) and 35 patient whose coronary angiography were normal constituted the control group. Results: The difference for hs-CRP and leukocyte values and neutrophyl/ lymphocyte rate were stastically significant between the control and patient groups (p< 0.05). There was a positive correlation between gensini score and hs-CRP (r= 0.49; p< 0.05), leukocyte values and neutrophyl/lymphocyte rate. Conclusion: According to the study results we found that the level of inflammation markers in patients with ACS and inflammation degree has a positive correlation with gensini score. In conclusion we can say that leucocyte, neutrophil/lymphocyte rate and hs-CRP increases in ACS and hs-CRP level has a correlation with atherosclerotic degree. Copyright © 2010 by Türkiye Klinikleri.Öğe Low Dose Duloxetine Induced Hyponatremia in an Elderly Patient: A Case Report(KURE ILETISIM GRUBU A S, 2012) Beydilli, Inan; Akguc, Leyla; Korkmaz, Ilhan; Gencoglan, Salih; Yilmaz, Fevzi; Uysal, ZehraLow dose duloxetine induced hyponatremia in an elderly patient: a case report Duloxetine is serotonin-norepinephrine reuptake inhibitor used for major depressive disorder, stress, urinary incontinence, pain associated with diabetic neuropathy and fibromyalgia. Nausea, dry mouth, fatigue, dizziness, decreased appetite, constipation and insomnia are the frequently reported advers effects. Duloxetine induced hyponatremia is a rare advers effect and is seen generally among the older female patients, like our case. Whereas our case was using duloxetine low dose (30mg/day).Öğe Pre-hospital airway management preferences of paramedics(Bayrakol Medical Publisher, 2020) Beydilli, Inan; Korkmaz, Ilhan; Yilmaz, Fevzi; Gungor, Faruk; Kirpat, Vedat; Kozaci, Nalan; Avci, MustafaAim: The success of paramedics in the pre-hospital airway management in traumatic and non-traumatic critically ill patients, especially in cardiac arrest, is very important in terms of mortality and morbidity. Materials and Methods: Patients who were admitted to the Emergency Department by pre-hospital emergency ambulance service were included in the study. The standard data registration form was created for the study. Demographic data, pre-hospital and in-hospital vital signs, GCS scores, cardiac rhythms, applied airway method, transport time and 48-hour mortality rates were recorded in the study form. Results: While the initial approach to airway management was a bag-valve mask in 80 patients (82%), advanced airway management was performed in 18 (18%) patients. The mean time period for the ambulance arriving at the patient was 6.52 +/- 3.06 min and the mean time period of transport to the hospital was 11.42 +/- 9.53 min in all patients. Although there was no difference between patients managed with BVM and patients managed with advanced airway interventions in terms of a time period needed to access patient (p=0.957), there were significant differences in terms of a time period needed to access emergency service (p=0.001) and total time period (p=0.001) Among patients with CPA, there was a significant difference between patients managed with and without advanced airway interventions in terms of 48-hour mortality (p=0.035). Discussion: Although the pre-hospital airway management still remains its mystery, we think that providing ventilation with BVM without losing time and transportation to the hospital would be more appropriate for patients in short distances and for patients with less risk of aspiration in terms of mortality and transportation time.Öğe The role of oxidative and antioxidative status in patients with suspected seizures in the emergency department(Bayrakol Medical Publisher, 2020) Ari, Asim; Beydilli, Inan; Yilmaz, Fevzi; Korkmaz, Ilhan; Ellidag, HamitAim: The aim of this study was to investigate the diagnostic value of Total oxidant level (TOS) and Total antioxidant level (TAS) in the differentiation of epileptic seizures and psychogenic nonepileptic seizures (PNES) in adult patients presenting to the emergency department (ED) with complaints of seizures. Material and Method: This prospective observational study was conducted at Antalya Training and Research Hospital. Patients were categorized into either a pseudoseizure group or a seizure group. Serum TAS and TOS levels were measured spectrophotometrically by colorimetric methods. Thirty and 60 minutes after the onset of symptoms, serum samples were collected for measuring serum albumin, ischemia modified albumin (IMA), TAS and TOS levels. Data were analyzed using SPSS 21. Results: A total of 110 participants were categorized into either a pseudoseizure group (n=48, 43.6%) or a seizure group (n=62,56.4%). Regarding 30-minute IMA and TOS, levels were significantly higher in the seizure group (p=0.001 and p<0.001). There was no statistically significant difference between seizure and pseudoseizure groups in terms of 30-minute TAS levels (p=0.16). Regarding 60-minute, IMA and TOS, levels were significantly higher in the seizure group (p<0.001 and p=0.002, p<0.05). There was no statistically significant difference between seizure and pseudoseizure groups in terms of TAS levels (p=0.19). Anion gap and lactate levels were significantly higher in the seizure group (p<0.001). Discussion: According to the results of our study, serum IMA, anion gap, lactate, and TOS levels increased significantly in patients with seizures compared to patients with pseudoseizures.
