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Öğe A Rare Cause of Acute Abdomen: Mesenteric Cyst Torsion(2018) Kurt, Feyzi; Korkmaz, İlhanMesenteric cysts are seen rarely and most of them are seen in the childhood period. The lack of characteristic clinicalfeatures and radiological signs may present great diagnostic difficulties. The cyst may present with diffuse abdominalswelling, abdominal pain or abdominal mass. Malignant cysts occur in less than 2% cases. Surgery is the treatment ofchoice.Öğe Akut koroner sendromlu hastalarda yüksek duyarlılıklı C-reaktif proteinin tanısal değeri ve diğer kardiyak belirteçlerle karşılaştırılması(Cumhuriyet Üniversitesi, 2005) Korkmaz, İlhan; Doğan, KasımIV ÖZET Koroner arterin kan akımında azalma veya bu arterin beslediği alandaki miyokardın perfüzyonundaki yetersizliğe bağlı olarak iskemiye yol açan bütün durumları içeren Akut Koroner Sendrom (AKS) acil servise başvuran hastalar arasındaki en sık sebeplerden birini oluşturmaktadır. İnflamasyonun koroner arter hastalığının (KAH) ilerlemesinde ve AKS'a dönüşümündeki öneminden dolayı bunun bir göstergesi olan yüksek duyarlılıklı C- reaktif proteini (hs-CRP) ele alarak diğer kardiyak belirteçlerle "kardiyak troponin I (cTn-I), kalbe özgül kreatin kinaz (CKMB) ve total kreatin kinaz (CKNAC)" ilişkisi araştırılmıştır. Çalışmaya acil servise başvuran 63 'ü hasta 57'si kontrol grubu olmak üzere 120 hasta dahil edilmiştir. Hasta grubu tanılarına göre sınırlandırıldığında 8 hastada (%12,7) q dalgasız miyokart enfarktüsü (Non Q ME), 35 hastada (%55,6) ST elevasyonlu miyokart enfarktüsü ve 20 hastada (%31,7) kararsız angina pektoris (KAP) tespit edilmiştir. Hasta grubunun hs-CRP ortalaması ile kontrol grubunun yüksekliği arasında istatistiksel olarak anlamlı bir fark bulunmuştur. Hasta grubunda tanılarına göre hs-CRP ortalaması açısından ise anlamlı farklılık yoktur. Braunwald'in KAP sınıflamasına göre sınıf-3b'deki hastaların hs-CRP ortalaması en yüksek olarak bulunmuştur. hs-CRP ve diğer kardiyak belirteçler arasında yaptığımız incelemede pozitif yönde bir korelasyon tespit edilmiştir. Çalışmamızdaki sonuçlara göre akut faz reaktanlarından biri olan hs-CRP' nin KAP'te miyokardiyal inflamasyonun, AMI'de de miyokart nekrozunun hassas bir göstergesi; miyokardiyal inflamasyonun ve nekrozun da güçlü bir hs-CRP uyarıcısı olduğu kesindir. Duyarlılığı yüksek fakat özgüllüğü düşük bir tanı kriteri olan hs-CRP'nin CK-MB ve cTn-I ile beraber yükselmesi tanıyı destekleyebilir. Ancak tek başına pozitif olması durumunda AKS'larda bir tanı kriteri olamaz. Negatif olduğu durumlarda ise, CK-MB ve cTn-P da yükselme yoksa, ayırıcı tanıda yardımcı olarak AKS' ların tanısını ekarte ettirebilir. Anahtar Kelimeler: Akut koroner sendrom, hs-CRP, acil servisÖğe Change of hand flora during the shift in emergency servise staff(2018) Yurtbay, Sefa; Tekin, Yusuf Kenan; Korkmaz, İlhan; Güven, Mutlu Kukul Fatma; Demirtaş, ErdalObjective: We aimed to reveal the change in microorganisms in the hand flora during the working period from hospitalpersonnels in the emergency department of Cumhuriyet University by taking hand cultures before and after the workingperiod.Method: Our study was planned to evaluate the change of the hand flora and pre-shift and post-shift hand cultures from10 physicians, 13 nurses, 10 transport personnel in the emergency department of Cumhuriyet University. Also the microorganisms of air samples from special intervention areas (resuscitation, red area) as well as general use areas wereanalyzed.Results: We compared the washing status between pre (4,%11.1) and post-contact16 (44.4%) hand washing rate. Thevolunteers generally had washed their hands after the contact with the patient and the difference was statistically wassignificantly higher (p <0.05). there wasn’t any difference between the microorganisms samples that were reproduced onthe pre-shift right and left hand samples and post-shift right and left hand. According to the total count of samples takenfrom the left and right hand before shift in terms of the microorganism seen the difference was significiant (t=7,48;p=0,001).Conclusions: Although our participants knew the hand hygiene indications of emergency service workers, their harmonywas found to be low, consistent with many studies in the literature. It has been observed that the habit of using gloves andhand disinfectant was low also. Efficient strategies may be developed; improving institutional healthcare conditions,conducting educations at certain intervals, observing the practitioner and collecting feedback. However, it should be notedthat the most significant issue is that the significance in hand washing is ensured with changes in habits.Öğe Comparison of alvarado and ripasa scores in patients with acute appendicitis(Sivas Cumhuriyet University, 2020) Gökçe, Mine Esmer; Korkmaz, İlhan; Tekin, Yusuf; Yurtbay, Sefa; Demirtaş, Erdal; Özsoy, Orhan; Özbay, SedatObjective: Acute appendicitis management delays results in perforation and increases the morbidity and mortality. Studies have reported a 20% perforation rate, and 2-30% negative laparotomy whose diagnoses are made by symptoms and physical examination. By using anamnesis, clinical signs-symptoms and inflammatory parameters to reduce the diagnosis time, complications, and morbidity-mortality of AA, various scoring methods have been developed. The first scoring system defined for this purpose is Alvarado scoring system. The RIPASA scoring system was developed for patients in Asia. In this study, we aimed to determine which scoring is more suitable for our population by comparing Alvarado and RIPASA scoring methods in patients who underwent an appendectomy.Method: The Alvarado and RIPASA scores of each patient were calculated by the scoring system parameters after the 182 patient files were analyzed retrospectively. At cut-off value of 7.5 for RIPASA score and 7 for Alvarado score, patients were divided into high and low-risk groups. The positive predictive value, negative predictive value, sensitivity, and specificity were calculated and the two scoring systems' effectivity were compared with Chi-square and area under curve analysis.Results: According to the histological examination 42(23%) patients were not considered as acute appendicitis. RİPASA scoring systems high-risk group classification was better by predicting the acute appendicitis patients (p = 0.001, p <0.05). The area under the curve for RIPASA score calculated as 0.738 and this is statistically significant (p = 0.001; p <0.05). The result was better then the Alvarado AUC score (0,633). Alvarado scoring systems' negative predictive value was higher than the RİPASA score, respectively (58,14%, 32.56%).Conclusions: It is beneficial to use the RIPASA scoring system for patients in our region to reduce the rate of negative laparotomy and unnecessary surgical procedures in patients admitted to emergency services with the suspicion of acute appendicitis.Öğe Concomitant substance use increases the toxic effect of synthetic cannabinoid (Bonsai): A prospective study(Mattioli 1885, 2021) Beydilli, İnan; Duyan, Murat; Yılmaz, Fevzi; Arslan, Engin Deniz; Korkmaz, İlhan; Akçimen, Mehmet; Keşaplı, MustafaObjective: In this study, we aimed to contribute to the literature by evaluating synthetic cannabinoid (bonsai) and additional drugs. Materials and Methods: This prospective study was conducted on 217 patients who admitted to the emergency department (ED) with bonsai intake between December 20, 2014 and Janu-ary 1, 2016, according to the patient history obtained from the patients. One hundred sixty-eight patients with negative urinary metabolites results were excluded from the study, 49 patients with positive urinary metabolites were included in the study. Patients were divided into two groups. The first group consisted of patients with only bonsai intake and the second group consisted of patients with bonsai and concomitant drug intake. The groups were compared in terms of symptoms, findings, blood gas values, duration of the symp-toms, discharge time, hospitalization, and mortality rate. Data were analyzed using the Chi-square, the Fish-er’s exact test, the Student t-test, and the Mann-Whitney U test. Data were evaluated at the 95% confidence interval. P<0.05 was considered statistically significant. Results: The mean age of 49 patients included in the study was 26.7±8.9 years and 91.8% (n=45) of the patients were male. Concomitant drug intake was identified in 69.4% of the patients. Concomitant drug use was as follows: cocaine (20.4%, n=10), amphetamines (14.3%, n=7), methamphetamines (8,2%, n=4,) tetrahydrocannabinol (32.7%, n=16), opiates (18.4%, n=9) and alcohol (30.6%, n=15). On admission, the Glasgow Coma Score (GCS) in the bonsai group with an additional substance was significantly higher (p=0,003). The most common symptom was palpitations (tachycardia) (75.5%, n=37). There were no patients hospitalized in the Only Bonsai group (p=0,020). The median time to remission of symptoms and median follow-up time of the patients in the emergency room were 3 hours and 6 hours, respectively. Remission time of the symptoms and hospitalization rates were higher in patients taking concomitant drug (p <0.05). Conclusion: While the bonsai intake alone is not considered mortal to the patients and most of them can be discharged from the ED after signs and symptoms disappear, concomitant drug use can increase the toxic effects of bonsai intake. That is why the follow-up of patients taking concomitant drugs, and the treatment process should be carried out more carefully. (www.actabiomedica.it). © Mattioli 1885.Öğe Correlation Between Serum Glucose/Potassium Ratio and The Severity of Mushroom Poisoning at The Time of Admission to The Emergency Departments(Sivas Cumhuriyet University, 2022) Tekin, Yusuf; Demirtaş, Erdal; Korkmaz, İlhan; Demirel, Yeltekin; Tekin, Gülaçan; Nur, NaimExposure to wild mushrooms can lead to serious toxicity and death. It is accepted that patients who ingest potentially lethal mushrooms typically develop toxicity signs after six hours. However, clinical manifestations of poisoning that occur less than six hours after ingestion do not exclude the potential for life-threatening toxicity, especially when more than one type of mushroom has been eaten. Whereas there are not any clinical parameters that help to establish the severity of mushroom poisoning. In this study, we aimed to determine the relationship of serum glucose/potassium ratio and the clinical severity of mushroom poisoning cases.This is a retrospective study which includes the mushroom poisoning 510 cases between the years 2007 - 2018. Data consisted of age, gender, clinical history of mushroom poisoning including time from consumption to first symptoms, date of presentation, discharge time and laboratory results including complete blood cell count, biochemistry tests for liver and renal function, and coagulation profile. Patients included in this study were classified as mild-moderate and severe mushroom poisoning groups according to laboratory and clinical characteristics. Glucose, BUN, Creatinine, ALT, AST mean values and glucose/potassium ratio were significantly higher in the clinically severe group patients (p=0.008, p=0.01, p=0.039, p=0.037, p=0.046 and p=0.036 respectively). The sensitivity, specificity and area under curve for glucose/potassium ratio were as follows; 0.68, 0.57 (AUC %95CI) was 0.0647. Glucose/potassium ratio can predict the severity in mushroom poisonings according to our results which can helpful by management in mushroom poisonings as a laboratory result.Öğe CUMHURİYET ÜNİVERSİTESİ TIP FAKÜLTESİ HASTANESİNE BAŞVURAN ADLİ OLGULARIN DEĞERLENDİRİLMESİ(Aydın Adnan Menderes Üniversitesi, 2009) Güven, Fatma Mutlu Kukul; Bütün, Celal; Beyaztas, Fatma Yücel; Eren, Sevki Hakan; Korkmaz, İlhanAMAÇ:Bu çalışmada; adli olguların demografik özellikleri ile adli olgu profilinin ortaya çıkarılması yanı sıra;hekimlerin adli rapor düzenleme aşamasında standardizasyonunun sağlanmasının adli tıp uygulamaları veyargılama aşamasındaki öneminin vurgulanması amaçlandı.GEREÇ ve YÖNTEM:Bu çalışma; 01.01.2006-31.12.2006 tarihleri arasında Cumhuriyet Üniversitesi TıpFakültesiAdli TıpAnabilim Dalı'na adli rapor düzenlenmesi için adli makamlardan gönderilen olguların hastanedosyaları ile adli raporlarının retrospektif olarak incelenmesiyle yapılmıştır. Olguların tıbbi ve adli kayıtları;cinsiyet, yaş, olay türü, olay tarihi, olay yeri, gönderilen makam, yaralanan vücut bölgesi, tedavi olduğu servis,zehirlenme ve cinsel saldırı yönünden, ayrıca adli rapordaki sonuç raporları yönünden değerlendirilerek benzerçalışmalarla karşılaştırıldı.BULGULAR:belirlendi. Adli olguların özellikle ağustos ayında (%10.9) daha yoğun olduğu ve çoğunlukla acil serviste(%29.9) tanı ve tedavi sonrası taburcu edildikleri saptandı. Yaşamsal tehlikeye neden olacak yaralanma oranı ise%17.4 olarak tespit edildi. Yaralanmaların en sık (%44.6) baş-boyun bölgesinde olduğu, %30.8 ile trafikkazalarının adli olguların önemli bir kısmını oluşturduğu gözlendi.SONUÇ:Hekim güvenliği ve hasta mağduriyetinin önlenmesi açısından adli olguların özellikle raporlamaaşamasının daha özenli yapılması için mezuniyet sonrası adli tıp eğitimi ve adli tıp uzmanları ile koordineliçalışma gereklidirÖğe Dissemine İntravasküler koagulasyonun tanı ve yönetimi(Sivas Cumhuriyet Üniversitesi, 2024) Korkmaz, İlhanBu derlemedeki öncelikli olarak amacımız birçok travmatik veya nontravmatik hastalıklara eşlik eden ve mortaliteyi arttıran dissemine intravasküler koagulasyonu tanımlayarak patofizyolojisi hakkında bilgi verip, erken dönemde tanınmasını sağlamak. Trombotik veya kanamalar ile seyreden dissemine intravasküler koagulasyonun erken dönemde tanınması antikoagulan veya kan ürünleri ve kriyopresipitat tedavisinin erken başlanması prognozu olumlu etkilemektedir.Öğe Efficacy of lipid, NT-proBNP and D-dimer biomarkers in the differential diagnosis of patients presenting to the emergency department with syncope(2023) Çelik, Şimşek; Güven, Fatma Mutlu Kukul; Korkmaz, İlhanAims: Syncope is defined as a temporary loss of consciousness in any disorder characterized by a self-limited loss of consciousness, whatever the mechanism. It accounts for 1% of emergency room admissions. NT-proBNP, D-dimer and lipids are important parameters in the diagnosis and differential diagnosis of patients with syncope. This study aims to determine the levels of these biomarkers during and after treatment in patients admitted to the emergency department(ED) due to syncope. Methods: Forty-nine patients admitted to the emergency department due to syncope were included in this study. Forty-nine age- and sex-matched individuals without a history of syncope were taken as the control group. Blood samples were taken from the patient group three times, at the time of admission to the emergency department, 24 hours after admission, and on the day they were discharged from the hospital, and only once from the control group. The patient and control groups were compared in terms of NT-proBNP, D-dimer and lipids. Results: The mean HDL level at discharge was 33.63±9.62 mg/dl, which was significantly lower than the mean HDL level in the control group (38.77±10.33 mg/dl) (t=2.14, p=0.012). Although the mean LDL levels at discharge (108.02±48.03 mg/dl) were higher than the control group (92.53±37.39 mg/dl), this increase was not statistically significant (t=1.78, p=0.078). However, the mean LDL levels during hospitalization and after 24 hours (126.08±51.88 mg/dl, 116.26±48.21 mg/dl, respectively) compared to the control group (92.53±7.39 mg/dl) were statistically significantly higher (t=3.67, p=0.001, t=2.73, p=0.008). NT proBNP and D-dimer median values at the time of admission to the emergency department (844.00 pg/ml, 616.50 mcg/L, respectively), after 24 hours (1985.00 pg/ml, 662.00 mcg/L, respectively) and at discharge (748.00 pg/ml, 702.50 mcg/L respectively) compared to the control group (85.00 pg/ml, 176.00 mcg/L, respectively), a statistically significant increase was detected (p=0.001). Conclusion: In the patients admitted to the ED with a diagnosis of syncope, early treatment can be achieved getting the differential diagnosis of syncope in a short time with NT-pro BNP, D-dimer and lipid blood levels that can be worked easily. In addition, the need for serious interventional procedures and further investigations in the diagnostic process will be reduced.Öğe Factors affecting drowning-related mortality of elderly foreigners according to autopsy results(Geriatrics Society, 2016) Beydilli, İnan; Cin, Özgür; Kozaci, Nalan; Yilmaz, Fevzi; Sönmez, Bedriye Müge; Tepe, Güler; Korkmaz, İlhanIntroduction: We aimed to determine age-related factors associated with fatal drowning by analyzing the demographic data of drowning victims. In addition, we discuss possible measures to reduce drowning-associated deaths. Materials and Method: We retrospectively reviewed autopsy reports of foreign tourists, who died due to drowning, and then, whose autopsy and pathological sampling were carried out in Antalya Forensic Medicine Institution. The included cases were divided into two groups; Group I comprised cases who were a65 years at the time of death, and Group II comprised cases ?65 years. The groups were compared with respect to demographic data, water source from which they were taken out, season, narcotics, alcohol level and presence of coronary artery diseases. Results: 48 of 89 cases that we included in the study account for Group I while the rest, 41 cases, account for Group II. Statistically significant difference was determined between the groups with respect to nationality, season, water source from which they were taken out, alcohol levels and coronary artery diseases (p<0.05). No statistically significant difference was determined between the groups with respect to gender, narcotics and BMI (p>0.05). Conclusion: We therefore recommend that people, particularly those with CAD, choose mornings and afternoons for swimming, thereby avoiding the midday hours in which temperature and humidity are high. Furthermore, they should not strain their effort capacity and should avoid imbibing alcoholic drinks before swimming. © 2016, Geriatrics Society. All rights reserved.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.
