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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 Consequences of low energy falls in patients aged 65 years and over and those under 65 years(2010) Ekçi, Baki; Aktaş, Can; Eren, Şevki Hakan; Sarikaya, SezginIntroduction: Fractures due to low-energy falls are a major problem for the elderly population. In this study, we analyzed the pathologies of patients who applied to the emergency room because of low energy falls. Materials and Method: 220 patients who applied to the Emergency Services of Yeditepe University and Cumhuriyet University Faculty of Medicine between January 2009 and May 2009 after a low-energy fall were analyzed. Patients were evaluated in two groups: ?65 years (n =120) and <65 years (n =100). Results: Patients 65 years of age and older were found to have a higher rate of rib, pelvis and femur fractures and hospitalizations due to low-energy falls than the younger patients. Conclusion: Patients aged 65 years and over are exposed to more life-threatening fractures due to low-energy falls than younger patients. We believe that; educating this age group and their care givers for prevention of falls and taking necessary precautions may reduce the rate of low-energy falls.Öğe Depression in the elderly patients admitted to the emergency department: A multicenter study(2013) Aktaş, Can; Eren, Şevki Hakan; Korkmaz, Ilhan; Çalişkan, Haci Mehmet; Karcio?lu, Özgür; Sarikaya, SezginIntroduction: To investigate the prevalence and characteristics of depression in geriatric patients admitted to the emergency department (ED), and to determine the factors concerning depression. Materials and Method: This prospective study was carried out on 512 consecutive elderly patients over or equal to 65 years of age referred to EDs of three different centers during the six-month study period. The Geriatric Depression Scale (GDS) was used for the recognition of depression. Sociodemographic data and information needed to highlight depression status were collected via datasheets prepared for the study. Results: Scores obtained from GDS were assigned into groups regarding severity of illness: 35.3% of the patients (n=181) were found normal, 48.4% of the patients (n=248) were interpreted as mildly depressed and severe depression was considered in 16.2% of the patients (n=81). Mean GDS score determined in the normal patient group is 5.6±2.4 (range: 0 and 9). Mean scores of the mildly depressive patients were found to be 14.7±2.4 (range:10 and 26) while those of the severely depressed patients were found as 23.5±2.2 (range: 20 and 28). A significant relationship was determined between depression, and chronic disease, frequency of ED visit and psychiatric treatments. Conclusion: Depression in the elderly with underlying comorbid illnesses becomes more complex to recognize and treat. Depressive symptoms of patients are attributed to patients' current diseases and depression is often unnoticed.Öğe Effects of co-morbid disease and drug consumption on trauma patients 65 years of age and older: A university emergency department experience(Turkish Association of Trauma and Emergency Surgery, 2008) Aktaş, Can; Eren, Şevki Hakan; Eryilmaz, MehmetBACKGROUND: The objective of this study was to evaluate the causes and demographics of trauma patients 65 years of age and older, and also the effects of co-morbidities and drug use on trauma. METHODS: This study was performed in Medicine Faculty of Yeditepe University Hospital Department of Emergency Medicine Outpatients Clinic between January 2005 - February 2006. Ninety-one trauma patients (48 males [52.7%], 43 females [47.3%]; mean age 73±5.42; range 65 to 92 years) 65 years of age and older were included into the study. Age, gender, trauma causes, injury types, co-morbidities, drug consumption and injury severity scores were recorded onto the study form. RESULTS: Fifty-seven (62.6%) patients were admitted to the emergency department because of low-energy fall, 13 patients (14.3%) for high-energy falls, 6 patients (6.6%) for low-energy motor vehicle crush, and 14 patients (15.4%) for high-energy motor vehicle crush. Hypertension was significantly more frequent in falls than the other trauma mechanisms (p=0.003). There was a higher rate of femur fracture in low-energy falls than the others (p=0.026). However, the rate of vertebral fracture was higher in high-energy falls (p=0.037). Soft tissue injuries were seen most often in low-energy motor vehicle crush injuries (p=0.01) while rib fractures were seen most frequently in high-energy motor vehicle crush injury (p<0.01). CONCLUSION: Acute or chronic disease and drug side effects may facilitate the exposure of elderly people to trauma. Drug consumption, co-morbid diseases and trauma causes should be taken into consideration during the evaluation of elderly trauma patients.Öğe Hipertansif hastalarda kan homosistein düzeyleri ve DDL-K ile ilişkisi(Cumhuriyet Üniversitesi, 2004) Eren, Şevki Hakan; Yılmaz, KerimIV ÖZET Son yıllarda hipertansiyon (HT) etyolojisine yönelik birçok kapsamlı çalışma yapılmasına rağmen hala sistemik hipertansiyon nedenleri tam olarak anlaşılamamıştır. Bu çalışmada hipertansif hastalarda homosistein (Hey) düzeyleri ve bu düzeylerin düşük dansiteli lipoprotein kolesterol ( DDL-K) ile ilişkisi araştırıldı. Çalışmaya hipertansif normolipidemik 25 hasta (grup 1), hipertansif hiperlipidemik 25 hasta (grup 2) ve yaş ve cinsiyet uyumu sağlayan 21 sağlıklı kontrol grubu (grup 3) dahil edildi. Çalışmaya katılan tüm grupların Hey düzeyleri ölçüldü. Plazma Hey düzeyleri grup 1' de 14,42 ± 1,16 umol/1, grup T de 14,31 ± 0,98 umol/1, ve grup 3' de 9,00 ± 0,47 umol/1 olarak saptandı. Çalışmanın istatistiksel analizinde Mann- Whitney U, Kruskal Wallis ve Chi Kare testleri kullanıldı. Gruplar Hey düzeyleri açısından karşılaştırıldığında grup 1' deki bireylerin plazma Hey düzeyleri grup 3' deki bireylerin plazma Hey düzeylerine göre anlamlı olarak yüksek bulundu. Grup T deki bireylerin plazma Hey düzeyleri; grup 3' deki bireylerin plazma Hey düzeylerine göre anlamlı olarak yüksek bulunurken, grup 1 'deki bireylerin plazma Hey düzeyleri ile arasında anlamlı bir farklılık yoktu. Grupların plazma Hey düzeyleri ile DDL-K düzeyleri arası korelasyon istatistiksel açıdan anlamsız bulundu. Sonuç olarak hipertansif hastalarda plazma homosistein düzeyleri anlamlı olarak yüksek bulunurken, lipit yüksekliğinin homosistein düzeylerini etkilemediği tespit edildi. Anahtar kelimeler: Homosistein, hiperlipidemi, hipertansiyonÖğe 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 The Relationship Between Oxidative Stress, Paraoxanase and Injury Severity in Blunt Trauma Patients(2013) Korkmaz, İlhan; Aydın, Hüseyin; Eren, Şevki Hakan; Güven, Fatma Mutlu Kukul; Yıldırım, Birdal; Beydilli, İnan; Eren, MehmetAmaç: Travma hastalarının prognozunun takibinde şok indeksi ve glaskowkoma skalası (GKS) kullanılan parametrelerdir. Travma durumunda artan reaktif oksijen türlerine ve oksidatif strese bağlı olarak hücrelerde lipid peroksidasyonunda artma ve hücre duvar yapısındaki bozulmalara bağlı olarak hücre ve doku hasarı görülür. Bu çalışmada hastaların başvuru anındaki oksidatif stres düzeyleri ile antioksidan olan paraoksanazın prognozla ilişkisini araştırdık. Gereç ve Yöntem: Çalışmaya Temmuz-Eylül 2011 tarihlerinde başvuran 71 travma hastası dahil edildi. Hastalar GKSuna göre hafif(61), orta(6)ve ağır olarak(3) sınıflandırıldı. Paraoksanaz, oksidatif stres indeksi (OSİ), total antioksidan kapasite (TAS) ve toplam oksidatif stres (TOS) ile şok indeksive GKS ile karşılaştırıldı. Bulgular: Çalışma sonunda paraoksanaz, TAS, TOS,OSİ, ile GKS yönünden gruplar arası farklılık görülmedi (p>0.05). Şok indeksi ile paraoksanaz, TAS, TOS, OSİ arasında korelasyon analiz yapıldığında birkorelasyon gözlenmedi. Sonuç: Yaptığımız çalışma sonunda başvuru anındaki oksidatif stres parametreleri ile antioksidan olan paraoksanazın hastalarıntravma şiddeti ile korelasyonunun olmadığı sonucuna vardık.Öğe Vertigo: Is it really a neurological emergency?(2012) Beydilli, İnan; Topçuoğlu, Özgür Bilgin; Korkmaz, İlhan; Yılmaz, Fevzi; Eren, Şevki Hakan; Ayan, MuratAmaç: Acil serviste değerlendirilen vertigolu hastalarda nörolojik yönden acil olanların insidansını tespit etmek. Bulgular: Vertigo şikayeti nedeniyle başvu-ran 3558 hasta incelendi. Bunlardan 410 hasta nöroloji hekimince muayene edilmişti ve 86 hastaya beyin tomografisi çekildi. Yalnızca 11 hastada nörolo-jik yönden aciliyet gösteren bir lezyon bulundu. Gereç ve Yöntem: Acil servise vertigo nedeniyle başvuran ve nöroloji hekimince değerlendirilen hastalar çalışmaya alındı. Hastaların demografik, laboratuar ve beyin tomografileri ile hastanın son tanısı incelendi. Sonuç: Vertigo acil servislerde sık başvu-ru nedenlerinden biridir. Birçok nörolojik neden vertigonun etiyolojisinde rol almakla birlikte somatizasyon bozukluğu gibi çok basit nedenler de sebepler arasındadır. Acil servislerde gereksiz konsültasyonları, hasta yığılmalarını ve görüntüleme yöntemlerinin kullanımını önlemek için bu şikayetle başvuranlar-da iyi bir nörolojik muayene, arter kan gazı, kan şekeri ve tam kan sayımı ile hastanın değerlendirilmesi yeterlidir.
