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Öğe A Fifteen-Year Analysis of Rare Isolated Fallopian Tube Torsions in Adolescent Children: A Case Series(Mdpi, 2019) Guney, Cengiz; Coskun, AbuzerIsolated tubal torsions presenting to the emergency department are a very rare cause of pediatric acute abdominal pain. Since making the diagnosis early is of importance in terms of affecting tubal damage and fertility, we aimed to evaluate cases of isolated tubal torsions in light of the literature. This study included 10 patients under 18 years of age who presented to the emergency department with abdominal pain between January 2003 and December 2018. The mean age was 14.5 +/- 1.43 years (range: 12-17 years). The demographic characteristics, surgical findings and techniques, and concomitant pathology results of these patients were retrospectively evaluated. The reason for presenting to the emergency department for the 10 patients included in the study was abdominal pain. The mean duration of hospital admission with pain was 4.97 days. The onset of pain was less than 24 h in seven patients (70%) and more than 24 h in three patients (30%). Of the patients, nine (90%) had tenderness in the lower abdominal quadrant, five (5%) had defense, and three (30%) had rebound. Nausea, vomiting and leukocytosis were present in 50% of the cases. Right and left tubal involvement of the cases was equal. Seven (70%) of the isolated tubal torsions were accompanied by paraovarian cysts. Eight patients (80%) underwent open surgery and two (20%) underwent laparoscopic intervention. Detorsion was performed on five (50%) patients and salpingectomy was performed on five (50%) patients. Isolated tubal torsion should be considered in children presenting with acute abdominal pain in early adolescence. Early diagnosis is important for the preservation of fertility.Öğe Can Fetuin-A, CRP, and WBC Levels Be Predictive Values in the Diagnosis of Acute Appendicitis in Children with Abdominal Pain?(Mdpi, 2019) Guney, Cengiz; Coskun, AbuzerBackground: Acute appendicitis (AA) is the most common cause of emergency surgery. Therefore, perforation is common. Early diagnosis and new markers are needed. The aim of this study was to investigate the effects of plasma Fetuin-A (FA) levels in patients with an acute abdomen (AB). Material and Method: This prospective study included 107 patients younger than 16 years of age who were admitted to the emergency department for abdominal pain between January and December 2018. The patients who presented abdominal pain were divided into two groups as AA and other causes (OC) of AB. Patients with acute appendicitis; intraperitoneal, retrocolic/retrocecal, and appendicitis were divided into three groups. Additionally, the AA group was divided into two groups as perforated appendicitis and non-perforated appendicitis. Serum FA levels of the patients were evaluated in the emergency department. Results: In the AA group, C-reactive protein (CRP) and white blood cell (WBC) levels were higher, and FA levels were significantly lower than in the AB group. Intraperitoneal localization was 95.2% and perforation was frequent. When significant values in the univariate regression analysis for acute abdomen and perforation were compared in the multivariate regression analysis, CRP, WBC, and FA levels were found to be prognostic. Furthermore, decreased FA levels were associated with AA, while too greatly decreased FA levels were associated with the risk of perforation. Conclusion: Current diagnosis can be made by history, physical examination, laboratory, and imaging methods in appendicitis cases. While trying to diagnose AA in children, the FA, CRP, and WBC levels may be predictive values to identify risk factors.Öğe COHgb levels predict the long-term development of acute myocardial infarction in CO poisoning(W B SAUNDERS CO-ELSEVIER INC, 2016) Kaya, Hakki; Coskun, Abuzer; Beton, Osman; Zorlu, Ali; Kurt, Recep; Yucel, Hasan; Gunes, Hakan; Yilmaz, M. BirhanBackground: There are several studies evaluating the cardiac effects of carbon monoxide (CO) poisoning during the acute period; however, the number of studies evaluating the long-term cardiac effects is limited. Objective: The present study aimed to evaluate the effects of blood carboxyhemoglobin (COHb) levels, elevated due to CO poisoning on the long-term development of acute myocardial infarction (AMI). Methods: This cross-sectional cohort study included a total of 1013 consecutive patients who presented to the emergency department (ED) due to CO poisoning, between January 2005 and December 2007. The diagnosis of CO poisoning was made according to the medical history and a COHb level of greater than 5%. In terms of AMI development, the patients were followed up for an average of 56 months. Results: At the end of follow-up, 100 (10%) of 1013 patients experienced AMI. Carboxyhemoglobin levels at the time of poisoning were higher among those who were diagnosed with AMI compared to those who were not (55% +/- 6% vs 30% +/- 7%; P < .001). Using a multivariate Cox proportional hazards model with forward stepwise method, age, COHb level, CO exposure time, and smoking remained associated with an increased risk of AMI after adjustment for the variables found to be statistically significant in a univariate analysis. According to a receiver operating characteristic curve analysis, the optimal cutoff value of COHb used to predict the development of AMI was found to be greater than 45%, with 98% sensitivity and 94.1% specificity. Conclusion: In patients presenting to the ED with CO poisoning, COHb levels can be helpful for risk stratification in the long-term development of AMI. (C) 2016 Elsevier Inc. All rights reserved.Öğe Comparison of trauma scores for predicting mortality and morbidity on trauma patients(TURKISH ASSOC TRAUMA EMERGENCY SURGERY, 2014) Orhon, Reyhan; Eren, Sevki Hakan; Karadayi, Sule; Korkmaz, Ilhan; Coskun, Abuzer; Eren, Mehmet; Katrancioglu, NurkayBACKGROUND: In this study, we compared the anatomical, and physiological scoring systems trauma revised injury severity score (TRISS), revised trauma score (RTS), injury severity score (ISS), new injury severity score (NISS) to each other, to find out the most accurate and reliable trauma score for the risk classification of morbidity and mortality among the trauma patients. METHODS: This is a cross-sectional study, which included 633 patients who admitted to our University Hospital Emergency Department during an 8-month period due to trauma. All blunt and penetrating traumas (traffic accident, assault, etc.) patients above 16 years were included. RESULTS: Arrival time trauma scores (ISS, NISS, RTS, and TRISS) of the patients was calculated. Mean trauma score for the mortality prediction was calculated, and the p value was equal for all (p=0.001). Trauma scores were also analyzed for the hospitalization time in intensive care unit (ICU). While NISS, RTS, and TRISS values were significant (p=0.048, p=0.048, and p=0.017, respectively), ISS value was not significant (p=0.257) for predicting the ICU hospitalization time. Only TRISS was a good predictor for the mechanically ventilation time in ICU patients (p=0.01). CONCLUSION: In conclusion, we determined that the anatomical trauma scores (NISS, ISS) predicted the hospitalization and ICU necessities better, whereas TRISS, an anatomo-physiological trauma score, defined the ICU hospitalization and mechanically ventilation time better.Öğe Cost analysis of different venues for treating suicide cases presented to the Emergency Department(SCIENTIFIC PUBLISHERS INDIA, 2014) Guven, Fatma Mutlu Kukul; Turkdogan, Kenan Ahmet; Duman, Ali; Akpinar, Orhan; Kapci, Mucahit; Sonmez, Ertan; Coskun, Abuzer; Akpinar, Hatice; Sogut, Ozgur; Korkmaz, IlhanPatients presented with poisoning-related suicide attempts is one of the most problematic cases of the emergency services. The most important reason for this being the failure to decide the department of the hospital in which these patients should be admitted to, following consultation. The objective of this study is to emphasize the cost-lowering effect of treatment and follow-up of such suicide cases in Emergency Departments (ED) instead of intensive care units. A total of 791 adult patients with suicidal attempts were retrospectively examined and their clinical and demographic data were included. In addition, the costs of their treatment in the ED, Intensive Care Unit (ICU) and Psychiatric Clinic between 01/01/2007 and 31/12/2011were compared. When patients were classified by their month of birth it was found that patients who born in January had the maximum tendency to commit suicide (n:227, 28.7%), while those born in December were the least to do so (n: 30, 3.8%). Of all the patients, 122 (15.4%) were followed-up in Anesthesia Intensive Care (AIC), 639 (80.8%) in the Emergency Department Observation Unit and 30 (3.8%) in the Psychiatric Clinic. When costs of the patients who could receive the same medical treatment in case of necessity were compared; mean cost of the patients were found to be $ 665.44 for the patients treated in AIC, $ 204.09 for patients treated in EDs and $ 186.85 for those received treatments in the psychiatric clinic. We defined that it would be profitable if the intoxication cases were followed-up in the ED observation units and that ED's could be used more effectively than ICUs.Öğe Cyanide ingestion(MODESTUM LTD, 2017) Coskun, Abuzer; Ozkan, Fikret; Ozbay, Sedat; Okur, Osman Mahir; Kayipmaz, Afsin Emre; Gulunay, Behnan; Eren, Sevki Hakan; Ucar, Asuman; Kavalci, CemilCyanide is one of the oldest poisons. It has recently been introduced into industrial use in the gold enrichment process in gold mines. A 36-year-old man engaged in silver polishing business was brought to our emergency department by his colleagues with impaired consciousness and foamy saliva expectoration after accidentally drinking a sip of water mixed cyanide used for silver polishing. His general status was poor, and he was unconscious upon admission. The patient was administered the antidote three hours after his admission and extubated 11 hours after admission. His vital signs gradually returned to normal. On follow-up his urine color turned red; therefore, a second consultation was made with the poison information center, which recommended administering a second dose of antidote. After doing so, the patient gradually recovered, and he was discharged with normal liver enzymes, normal consciousness, and good overall status on 4th day of admission.Öğe Detection of neutrophil-lymphocyte ratio as a serum marker associated with inflammations by acute carbon monoxide poisoning(ELSEVIER SCIENCE BV, 2015) Karabacak, Mustafa; Turkdogan, Kenan Ahmet; Coskun, Abuzer; Akpinar, Orhan; Duman, Ali; Kapci, Mucahit; Eren, Sevki Hakan; Karabacak, PinarObjective: To investigate neutrophil-lymphocyte ratio (NLR), which is an indicator of systemic inflammation, in patients with carbon monoxide (CO) poisoning. Methods: We included 528 patients (275 women) who presented with a diagnosis of CO poisoning between June 2009 and March 2014. Control group was composed of 54 patients (24 women). Platelet count and mean platelet volume level were significantly higher in the CO poisoning group. Results: White blood cell level (9.8 +/- 3.3 vs. 8.6 +/- 2.9 x 10(3)/mL, respectively; P = 0.01), neutrophil count (6.00 +/- 2.29 vs. 4.43 +/- 2.04 x 10(3)/mL, respectively; P < 0.01) and NLR (3.01 +/- 2.34 vs. 2.23 +/- 1.27, respectively; P = 0.02) were significantly higher in CO poisoning group. Conclusions: The increase of NLR may indicate the progression of fatal complications due to CO poisoning.Öğe The epidemiological and prognostic importance of the aVR lead among patients with and without ST segment elevation(BAYCINAR MEDICAL PUBL-BAYCINAR TIBBI YAYINCILIK, 2011) Coskun, Abuzer; Eren, Sevki Hakan; Korkmaz, Ilhan; Guven, Fatma Mutlu KukulBackground: Patients with ST segment elevation in the aVR lead were divided into major and minor groups and compared with respect to blood lipid levels, admission glucose levels, angiography results and prognosis. Methods: The clinical data of the study was obtained by a retrospective review of the charts of 887 patients (550 males, 337 females) with aVR elevation, who were admitted to our emergency department between January 2004 and December 2008 with chest pain and hospitalized in the cardiology ward. The patients were divided into minor (group 1; 0.5-1 mm) and major (group 2; >1 mm) groups according to the ST segment elevation in aVR and compared with respect to age, gender, emergency room arrival time, blood glucose level, lipid profile, ejection fraction (EF), angiography results, Gensini score, and mortality rates. Results: Group 2 had a significant correlation with male gender, increased Gensini score, low EF, high blood glucose level, number of myocardial infarction patients with ST segment elevation, three-vessel disease and high mortality (p<0.05). Group 2 patients also had a worse prognosis. Conclusion: Early revascularization and/or medical treatment may be effective in the prognosis of patients with acute coronary syndrome diagnosis and a 1-mm or higher ST segment elevation in the aVR lead.Öğe Evaluation of Patients Presenting to the Emergency Service with Shoulder Dislocation(AVES, 2018) Coskun, Abuzer; Eren, Mehmet; Korkmaz, Ilhan; Al, Behcet; Zengin, Suat; Eren, Sevki HakanObjective: Glenohumeral joint dislocation is the most common major joint dislocation in the entire body. This study is an epidemiologic and demographic investigation of dislocated shoulder cases presenting to the emergency room of a public hospital. Methods: This study includes patients that presented to the emergency room of Sivas public hospital with a dislocated shoulder between the dates 01/02/2015-01/01/2018. Patients that were admitted to the emergency room and diagnosed with shoulder dislocation were informed about the study. Results: Five hundred and eighty one patients presenting to Sivas public hospital and diagnosed with shoulder dislocation were included in the study. The average age of patients was 43 +/- 18.59, with the youngest patient 19 years old and the oldest 88 years old. 537 (92.4%) patients had anterior, 32 (5.5%) patients had posterior and 12 (2.1%) patients had inferior dislocations. Conclusion: Shoulder dislocation cases are commonly seen in emergency rooms. It is more commonly seen in males and the most frequently seen type is anterior dislocation. This condition concerning individuals of all age groups develops mainly due to trauma. Despite the fact that shoulder dislocations can be diagnosed and treated easily in emergency rooms, prevention of shoulder dislocations can only be achieved by means of preventive measures and informative meetings.Öğe Evaluation of Pre-School (0-6) Age Group Trauma Patients Etiology(Aves, 2014) Atli, Bahri; Eren, Sevki Hakan; Coskun, Abuzer; Korkmaz, Ilhan; Eren, MehmetObjective: Trauma is one of the most important reasons of death in the pediatric age group. The aim of this study is to analyze the relation between the trauma type, trauma time, and the way of arrival to the hospital and to examine the causes of traumatic etiology and outcomes in the 0-6 age group (pre-primary) of trauma cases in our state. Material and Methods: Trauma cases in the 0-6 age group (pre-primary) who were admitted to the Cumhuriyet University Medical School Emergency Department between May 2009-May 2011 were evaluated. Results: In our study period, 799 children aged 0-6 were admitted to our emergency service; 55.8% of these patients were male. Most patients were mainly referred to the ER in July, August, and September, and the highest value was detected in July. Falls were first and motor vehicle accidents were second in frequency among the causes of injury. Conclusion: Consequently, traumas are showing an increase, especially in summer time, and it is observed that children are disregarded during farm works, and because of this, trauma numbers are being increased between the ages of 0-6 years.Öğe Evaluation of the child trauma cases applied to our university hospital department of emergency(AVES, 2011) Dogan, Zeki; Guven, Fatma Mutlu Kukul; Cankorkmaz, Levent; Korkmaz, Ilhan; Coskun, Abuzer; Doles, Kenan AhmetAim: Trauma is the major mortality cause in pediatric patients living in developed countries. The aim of this study was to evaluate the child trauma cases who were admitted to our emergency unit. Material and Method: Study data was obtained as a result of a retrospective review of the files of child trauma cases admitted to our emergency department between January 2006-December 2007. The child trauma cases were evaluated in terms of age, sex, application time, type of trauma, injury type, radiological findings and hospitalization rates. Results: Within age range 0-16 years, accessed records of 1293 trauma cases that admitted to the emergency deparment were 69% male, 31% female. Most of the applications were in August. Among the causes of injury, at the primary ordinal were falling down/crash into the flat. Out of vehicle traffic accidents were the fastest group who admitted to the emergency department. Within overall trauma types, rate of trauma exposure with 43.8% was the highest in 2-6 ages. In the exposed areas of injury, head zone with 42% took part in the first ordinal. Conclusions: In this study; we wanted to draw attention to the problem of trauma highlighting some features of pediatric injuries in our country. (Turk Arch Ped 2011; 46: 164-7)Öğe Factors Affecting Prognosis Based on Right Coronary Artery Pathologies(Galenos Publ House, 2019) Coskun, Abuzer; Korkmaz, Ilhan; Eren, Sevki HakanAim: Blood glucose levels, cardiac troponin (cTn) values within the first 12 hours, ejection fraction (EF), bundle branch block and Gensini scores of patients who were admitted to the emergency department for acute inferior myocardial infarction (AIMI) were compared based on the bundle branch of the occluded right coronary artery (RCA) with regard to prognosis. Materials and Methods: The data of the study were acquired through retrospective review of 212 patients with Al MI (48 women, 164 men; median age=64 years) who applied to the emergency department due to chest pain and who were hospitalized in cardiology clinic between January 2012 and December 2015. The patients were divided into five RCA groups based on the angiography results. The level of mortality and three-vessel disease (TVD) were compared based on age, gender, blood glucose, EF, Gensini score (GS), cTn, bundle branch block, type of myocardial infarction and percentage of the occluded vein. Results: Major percentage of the occluded vein, cTn, high-density lipoproteins, blood glucose, GS, and EF were statistically significant. The most frequent complication that occurred after acute myocardial infarction was ischemic heart failure (IHF) and it was mostly seen in RCA. Mortality, ventricular tachycardia (VT) and acute pulmonary edema (APE) were seen in acute ST-elevated MI that was close to circumflex artery (Cx) and lateral region. Cardiac tamponade or pericardial effusion was more frequent in mid-RCA. IHF, VT, atrioventricular complete block and APE were common in female patients. Male patients had only higher levels of cardiac tamponade and/or pericardial effusion (p<0.05). Mortality rate was 31.3% (n=15) in female patients and 11.6% (n=19) in male patients. Mortality and right bundle branch block were most common in acute inferoposterior myocardial infarction and IHF AIM!, as well as left bundle branch block was most common in inferolateral MI. TVD was more common in infarctions close to Cx, as well as most frequently in RCA when it was compared with the major occluded vein. Conclusion: Diagnosing an acute coronary syndrome and determining its characteristics based on RCA and the involved segment might be a predictive vision for rapidly predicting complications in TVD and mortality.Öğe Higher cancer antigen 125 level is associated with the presence of permanent atrial fibrillation in systolic heart failure patients(ACTA CARDIOLOGICA, 2016) Kaya, Hakki; Zorlu, Ali; Yucel, Hasan; Tatlisu, Mustafa Adem; Kivrak, Tarik; Coskun, Abuzer; Yilmaz, Mehmet BirhanIntroduction Atrial fibrillation (AF) is a common arrhythmia in heart failure (HF). Recent studies have shown that serum cancer antigen-125 (CA-125) levels are elevated in HF, and high levels of CA-125 in HF patients with sinus rhythm have been shown to be associated with the development of new onset AF. However, the relation between CA-125 levels and the presence of AF in HF is unknown. In this study we investigated whether plasma CA-125 levels in patients with systolic HF could predict the presence of AF. Methods The study was a retrospective cohort design including 205 stable systolic HF patients who were selected during outpatient clinic visits and who had CA-125 measurement and an electrocardiogram within the last one month before admittance to cardiology clinic. Patients were classified into two groups based on the presence of AF (n=67) or sinus rhythm (n=138). Results The mean age of the patients was 68 11 years. CA-125 levels were significantly higher in patients with AF than patients with SR [33 (3-273) vs 102 (7-296) U/ml, P < 0.001]. CA-125 level, presence of right ventricular dilatation, pericardial effusion, moderate to severe TR and MR, and left atrial diameter were found to be associated with the presence of AF in univariate analysis. In a multivariate logistic regression model, only the CA-125 level remained associated. Also, according to the ROC curve analysis, the optimal cut-off level of CA-125 for predicting AF was 91 U/mL with a specificity of 84% and a sensitivity of 54%. Conclusion We have shown that the CA-125 levels can be used to predict AF in patients with systolic HF.Öğe Management of thoracic trauma in emergency service: Analysis of 1139 cases(PROFESSIONAL MEDICAL PUBLICATIONS, 2013) Dongel, Isa; Coskun, Abuzer; Ozbay, Sedat; Bayram, Mehmet; Atli, BahriObjective: Thoracic trauma is a common cause of significant morbidity and mortality. This study presents a series of thoracic trauma with the aim to assess epidemiologic features, distribution of pathologies, additional systemic injuries, diagnosis, management and outcome. Methodology: Between January 2007 and December 2011, all patients with thorax trauma admitted to the emergency service of our hospital were retrospectively reviewed with respect to age, gender, etiological factors, distribution of pathologies, additional systemic injuries, diagnosis, treatment modalities, referral and outcome. Results: A total of 1139 patients with thorax trauma were included in the study. Of these, 698 (61.3%) were male and 441 (38.7%) were female, and the average age was 54.17 +/- 17.39 years. 1090 (95.7%) of the patients had blunt trauma, whereas 49 (4.3%) had penetrating trauma. Etiological factors were falls in 792 (69.5%), motor vehicle accidents in 259 (22.8%), animal related accidents in 39 (3.4%) and penetrating injuries in 49 (4.2%) patients. It was found that 229 (20%) patients had single, 101 (8.9%) had double, 5 (3%) had three or more, 10 (0.9%) had bilateral rib fractures and 19 (1.7%) had sternal fracture. Pneumothorax was diagnosed in 58 (5.1%) patients, whereas hemothorax, hemopneuomothorax and other system injuries were diagnosed in 36 (3.2%), 38(3.3%) and 292 (25.6%) respectively. In our series, thirteen patients (mortality rate 1.1%) died as result of hemorrhagic shock (n=8), respiratory distress (n=3) and severe multiple trauma (n=2). Conclusion: Although majority of the patients with thorax trauma receive treatment as outpatients; thoracic traumas may be a life threatening condition, and should be identified and treated immediately. Mortality varies based on etiological factors, additional systemic pathologies, capabilities of the hospital especially diagnostic and treatment facilities in emergency services. We believe that a multidisciplinary approach to the patients with severe thorax trauma, and the opportunities of emergency bedside thoracotomy in emergency services will significantly reduce the morbidity and mortality.Öğe METHANOL POISONING IN THREE CASES: DIAGNOSIS AND TREATMENT IN EMERGENCY DEPARTMENT(Istanbul Univ, Faculty Medicine, Publishing Office, 2012) Guven, Fatma Mutlu Kukul; Turkdogan, Kenan Ahmet; Eren, Sevki Hakan; Aydin, Huseyin; Korkmaz, Ilhan; Coskun, AbuzerMethanol is a very poisonous substance that is used as an industrial solvent and automotive antifreeze. Toxic dose is between 20-250 ml and causes neurological symptoms such as headache, cerebral edema and putamen necrosis within the first 12 to 14 hours. Central nervous system and visual cortex are the main areas which are damaged by methanol poisoning. Methyl alcohol is not toxic until its toxic metabolites turn into formic acid. Formic acid is especially responsible for the clinical findings. Serum half-life of methanol is 14 to 20 hours in mild and 24 to 30 hours in severe toxicity. Gastric lavage, fomepizole, ethanol and hemodialysis are used in the treatment. In this study, we aimed to review and discuss information from literature about the treatment and monitoring of methanol poisoning in three cases followed at emergency department.Öğe Predicting of neuropsychosis in carbon monoxide poisoning according to the plasma troponin, COHb, RDW and MPV levels Neuropsychoses in carbon monoxide poisoning(W B SAUNDERS CO-ELSEVIER INC, 2019) Coskun, Abuzer; Eren, Fatma Aysen; Eren, Sevki Hakan; Korkmaz, IlhanObjective: Carbon monoxide (CO) poisoning is very common worldwide. In this study, we aimed to evaluate the predictivity of neuro psychosis in carbon monoxide poisoning by the admission levels of red cell distribution (RDW), mean platelet volume (MPV) and troponin I levels which can be measured quickly and easily in the emergency department (ED). Patients and methods: This single center observational study included a total of 216 consecutive patients who presented to the ED due to CO poisoning between January 2009 and December 2013. The diagnosis of CO poisoning was made according to the medical history and carboxyhemoglobin (COHb) level of >5%. According to the carboxyhemoglobin levels, the patients were classified as mildly (COHb < 20%) and severely poisoned (COHb > 20%). In addition, patients were divided into 2 groups, i.e., those with positive (>0.05 ng/mL for our laboratory) and negative (<0.05 ng/mL for our laboratory) troponin levels. Results: Patients mean age was 52.58 +/- 10.58. 57.9% of the patients had high troponin levels and 51.9% were poisoned severely according to COHb levels. Patients with positive troponin and COHb had longer CO exposure time and higher neutrophil, lymphocyte, mean platelet volume (MPV), COHb and red cell distribution width (RDW) levels at the index admission following CO poisoning than patients with negative troponin (p < 0.05). Age, COHb level, CO exposure time, MPV and RDW (p = 0.001, p < 0.05) remained associated with an increased risk of troponin positivity following adjustment for the variables that were statistically significant. Conclusions: In patients presenting to the ED with CO poisoning, RDW and MPV can be helpful for risk stratification of neuropsychosis. (C) 2018 Elsevier Inc. All rights reserved.Öğe Ratio of neutrophil to lymphocyte Counts in Crimean Congo Hemorrhagic Fever(DERMAN MEDICAL PUBL, 2016) Turkdogan, Kenan Ahmet; Eren, Sevki Hakan; Coskun, Abuzer; Engin, Aynur; Sonmez, Ertan; Civelek, CemilThe implementation of new markers of bacterial and viral infection into clinical practice is hindered by their costs. In this study we assessed the potential use of the neutrophil to lymphocyte count ratio (NLCR) in crimean conga hemorraghic fever (CCHF). NLCR values were measured in total 104 patients with CCHF with 77 patients in whom bleeding was observed and 27 patients without bleeding observed and in 61 healthy adults. NLCR values of patients were measured in the first and 3rd days in which the patients admitted to the hospital. Median NLCR value was found as 4.02 in the patient group on the 1st day and 2.02 on the 3rd day, while this value was 4.10 in the healthy adults. NLCR values of the 3rd day were found as 1.16 (0.05-3.401 in the patients with bleeding and 2.32 (0.35-19.45) in the patients without bleeding (p<0.01). NLCR value seems to be a marker guiding in determination of the clinical course and treatment from the 3rd day of the contact with ticks.Öğe RED CELL DISTRIBUTION WIDTH IN CARBON MONOXIDE POISONING: RELATIONSHIP WITH MARKERS OF INEFFECTIVE ERYTHROPOIESIS, INFLAMMATION(CARBONE EDITORE, 2014) Turkdogan, Kenan Ahmet; Eren, Sevki Hakan; Sogut, Ozgur; Karabacak, Mustafa; Yigit, Mehmet; Gulen, Bedia; Coskun, Abuzer; Karabacak, PinarAims: Carbon monoxide (CO) poisoning is very common. Although it causes death in some cases, the pathophysiologic mechanisms that generate these fatal complications are still not fully understood. No study has directly focused on the indicators of severe complications resulting from CO poisoning; therefore, we investigated red cell distribution width (RDW), which is an indicator of systemic inflammation in patients with CO poisoning. Methods: A total of 429 patients (207 males and 222 females) who experienced CO poisoning between July 2009 and February 2013 were examined. Results: The control group comprised 23 males and 16 females (a total of 39 patients). The RDW level was significantly higher in the CO poisoning group; this increase may indicate the progression of anisocytosis due to CO poisoning. The white blood cell (WBC) level (9.9 +/- 3.4 vs 8.5 +/- 2.9 x 103/mL, respectively; p = 0.01), hemoglobin (13.7 +/- 1.7 vs 12.9 +/- 1.1 g/dl, respectively; p < 0.01) and MCHC (34.2 +/- 1.1 vs 35.1 +/- 1.6, respectively; p < 0.01) were critically higher in the group with CO poisoning. Conclusions: Our data suggest that the hypoxia in patients subjected to CO exposure resulted in significantly elevated red cell distribution width levels. The increasead red cell distribution width levels on admission may indicate the onset of complications due to CO exposure in patients without anemia.Öğe Red cell distribution width in carbon monoxide poisoning: Relationship with markers of ineffective erythropoiesis, inflammation(Acta Medica Mediterranea, 2014) Turkdogan, Kenan Ahmet; Eren, Sevki Hakan; Sogut, Ozgur; Karabacak, Mustafa; Yigit, Mehmet; Gülen, Bedia; Coskun, AbuzerAims: Carbon monoxide (CO) poisoning is very common. Although it causes death in some cases, the pathophysiologic mechanisms that generate these fatal complications are still not fully understood. No study has directly focused on the indicators of severe complications resulting from CO poisoning; therefore, we investigated red cell distribution width (RDW), which is an indicator of systemic inflammation in patients with CO poisoning. Methods: A total of 429 patients (207 males and 222 females) who experienced CO poisoning between July 2009 and February 2013 were examined. Results: The control group comprised 23 males and 16 females (a total of 39 patients). The RDW level was significantly higher in the CO poisoning group; this increase may indicate the progression of anisocytosis due to CO poisoning. The white blood cell (WBC) level (9.9 ± 3.4 vs 8.5 ± 2.9 ? 103/mL, respectively; p = 0.01), hemoglobin (13.7 ± 1.7 vs 12.9 ± 1.1 g/dl, respectively; p < 0.01) and MCHC (34.2 ± 1.1 vs 35.1 ± 1.6, respectively; p < 0.01) were critically higher in the group with CO poisoning. Conclusions: Our data suggest that the hypoxia in patients subjected to CO exposure resulted in significantly elevated red cell distribution width levels. The increasead red cell distribution width levels on admission may indicate the onset of complications due to CO exposure in patients without anemia.Öğe The Effect of Lactate Level on Early Mortality and Late Wound Healing in Children with Thoracoabdominal Trauma with Fluid Treatment Before Hospital(Mre Press, 2020) Guney, Cengiz; Coskun, AbuzerBackground: In this study, we aimed to evaluate the effect of serum lactate levels on early mortality and late wound healing in patients with childhood thoracoabdominal trauma, pre-hospital fluid replacement in patients admitted to the emergency department. Methods: This study included 479 patients under the age of 18 who applied to the emergency room for thoracoabdominal trauma between January 2014 and December 2018. Of these, 278(58%) were male, with a mean age of 8.34 years (range, 1-16 years). Demographic characteristics, fluid resuscitation, and serum lactate levels, trauma pattern, and mortality results of these patients were evaluated retrospectively. Results: 474 (98.9%) of the cases were blunt and 5 (1.1%) were penetrating trauma. 225 (47%) of the trauma cases were less than one meter falling, 162 (33.8%) were over one meter falling from the high, and 87 (18.2%) were car accidents inside and outside. Mortality was found most common in falling from height cases, which were related to prolonged hospitalization and high lactate level (p < 0.05). Wound healing times of patients undergoing pre-hospital fluid resuscitation and wound healing times of patients without pre-hospital fluid resuscitation were compared. Multivariate regression analysis, lactate level, and wound healing time were found to be predictive of the values found to be significant in the univariate regression analysis with fluid resuscitation and mortality (p < 0.05). Conclusion: Most thoracoabdominal traumas can be treated with conservative methods. Pre-hospital fluid treatment in severe trauma cases may lead to decreased lactate levels, reduced mortality, and shortened wound healing time.
