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    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, Cemil
    Cyanide 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.
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    Management of thoracic trauma in emergency service: Analysis of 1139 cases
    (PROFESSIONAL MEDICAL PUBLICATIONS, 2013) Dongel, Isa; Coskun, Abuzer; Ozbay, Sedat; Bayram, Mehmet; Atli, Bahri
    Objective: 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.
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    Urea Cycle and Arginine Metabolic Changes in COVID-19 Patients
    (Galenos Publ House, 2023) Ozbay, Sedat; Aydin, Hueseyin; Korkmaz, Ilhan; Tekin, Yusuf Kenan; Tekin, Guelacan; Yurtbay, Sefa; Sargin, Ata Berkay
    Aim: Metabolic changes begin after the invasion of an infectious microorganism and continue to develop as a series of interrelated events. Arginine is important in infectious diseases due to lymphocyte proliferation, nitricoxide production by macrophages, and the use of polyamides in the immune response. In this study, we aimed to examine the possible causes and consequences of urea cycle amino acid metabolism changes by comparing plasma arginine and urea cycle amino acid levels in Coronavirus disease-2019 (COVID-19) patients. Materials and Methods: In this cross-sectional study, we evaluated the urea cycle and arginine metabolic changes and compared the plasma aminoacid levels of 35 COVID-19 patients and a healthy control group (n=35). The patient was diagnosed by reverse transcriptase-polymerase chain reaction of oropharyngeal-nasofaringeal swab specimens. For statistical analyzes, Mann-Whitney U and chi-square tests were used. Results: The aminoacid plasma levels of argininosuccinate (1.03 mu mol/L, p=3.3x10-3), arginine (53.64 mu mol/L, p=1.1x10-3), aspartic acid (3.83 mu mol/L, p=5.5x10-9), citrulline (27.79 mu mol/L, p=3.3x10-5), glutamine (489.6 mu mol/L, p=9.0x10-17), lysine (206.4 mu mol/L, p=5.8x10-8), ornithine (129.5 mu mol/L, p=0.012), plasma levels and glutamine/glutamate (p=3.4x10-11), arg/ornithine (p=0.033), asp/argininosuccinate (p=0.011) ratios were decreased in the COVID-19 patient group compared to the healthy group. Conclusion: Arginine is significant in endothelial control, the urea cycle, and immune activation. Arginine deficiency in COVID-19 patients may cause disturbances in this biological process and its pathways. As indicated by many clinical trials, we believe that preventing a decrease in plasma arginine levels will prevent a poor prognosis of patients and metabolic pathway disturbances in the urea cycle.