Dilber Üçöz Kocaşaban - Academia.edu (original) (raw)

Papers by Dilber Üçöz Kocaşaban

Archives of iranian medicine, Mar 1, 2024

Eurasian journal of critical care, Apr 2, 2024

World journal of emergency medicine, 2024

Қазақстанның клиникалық медицинасы, Aug 28, 2023

Notfall & Rettungsmedizin, Dec 11, 2019

Hong Kong Journal of Emergency Medicine, 2012

Turkish Journal of Emergency Medicine, 2012

Objectives The GH/IGF axis (GH: growth hormone; IGF: insulin-like growth factor) includes IGF-1 a... more Objectives The GH/IGF axis (GH: growth hormone; IGF: insulin-like growth factor) includes IGF-1 and-2, specific receptors, and at least six insulin-like growth factor binding proteins (IGFBP). Human and animal studies have shown that the IGF axis, particularly IGF-1, is related to stroke risk. In the present study, we aimed to determine the relationship between IGF-1, GH, IGFBP3, and stroke and comorbid diseases. Methods This prospective study was conducted between August 2010 and December 2010 at the Emergency Department of Ankara Training and Research Hospital after approval by the local ethics committee. Patients diagnosed with ischemic stroke within 24 hours of symptom onset were included in the study. Gender, age, waist circumference, diabetes mellitus, hypertension, history of stroke, systolic and diastolic blood pressure, lipid profile, and GH, IGF-1, and IGFBP-3 levels were recorded. Results Fifty patients with ischemic stroke and 30 control patients were included. GH levels were significantly higher in stroke patients than in the control group (0.57 versus 0.06, respectively; p<0.001), as were IGFB3 levels (3234.6±1135.3 versus 2264.1±451.5, respectively; p<0.001). However, IGF-1 levels were significantly lower in stroke patients (93.5 versus 142, respectively; p<0.001). Logistic regression analysis revealed that GH (odds ratio: 24.972; 95% confidence interval: 2.362-263.974) and IGFBP3 (odds ratio: 1.002; 95% confidence interval: 1.0003-1.003) are significant markers for ischemic stroke, but IGF-1 is not a significant marker. Conclusions According to the results of this study, IGF-1 is not related to ischemic stroke, but high levels of GH and IGFBP3 are related to ischemic stroke. Further studies are needed to determine the diagnostic or prognostic usage of these markers in ischemic stroke patients.

Therapeutic hypothermia and temperature management, Apr 12, 2024

Acta Facultatis Medicae Naissensis, 2023

Introduction: Moxifloxacin is an antibiotic used orally or parenterally in the emergency departme... more Introduction: Moxifloxacin is an antibiotic used orally or parenterally in the emergency department (ED) for the treatment of various infections, especially acute exacerbation of chronic bronchitis and communityacquired pneumonia. The side effects of the drug are mainly on the gastrointestinal system, while the central nervous system side effects are rare. Case report: Herein, we present an elderly patient who had altered mental status associated with the use of moxifloxacin. Upon discontinuation of the drug, the patient quickly returned to baseline neurologic status. In the evaluation of altered mental status in elderly patients in the ED, much of the effort should be spent primarily on ruling out more complex diagnoses. However, this approach requires more invasive and advanced testing. Conclusion: Considering drug side effects among these more complicated diagnoses may increase noninvasive and radiation-free options for the patient and physician.

Turkish journal of emergency medicine, 2010

Nonsteroid antiinflamatuvar ilaçlar (NSAİİ) tüm dünyada ve ülkemizde yaygın olarak kullanılmaktad... more Nonsteroid antiinflamatuvar ilaçlar (NSAİİ) tüm dünyada ve ülkemizde yaygın olarak kullanılmaktadır. Biz özkıyım amaçlı ilaç alımı (naproksen sodyum) olan ve klinik izleminde akut pankreatit gelişen 32 yaşında kadın hastamızı sunuyoruz. NSAİİ'lerin aşırı alımına bağlı akut panreatit çok nadir görülen bir komplikasyon olmasına rağmen özellikle genç hastalarda diğer etmenlerin yokluğunda gelişen pankreatitin ilaca bağlı oluşabileceği unutulmamalıdır.

DergiPark (Istanbul University), Jul 17, 2019

Ticagrelor is one of the new generation antiplatelet agents, which acts by reversibly binding to ... more Ticagrelor is one of the new generation antiplatelet agents, which acts by reversibly binding to P2Y12 platelet receptors. Literature-related data on overdose intake of ticagrelor is quite limited. Here, we report a 23-year old male patient, who presented to our emergency clinic with the complaint of suicidal intake of 15 tablets of 90 mg ticagrelor (Brilinta® 90 mg tablet, Astra Zeneca Pharmaceuticals, Istanbul). Ticagrelor is one of the new generation antiplatelet agents that is currently being used in the treatment of acute coronary syndrome in our country. The overdose use of the drug for suicidal purpose or accidentally, is a relatively new issue for emergency physicians. According to our knowledge, suicidal ticagrelor overdose intake is a case that has not been reported in the literature previously. In this article, we shared the asymptomatic process of a case with 1350 mg ticagrelor toxicity. With the increased use and prevalence of the drug in our country, we think that the emergency physicians may encounter ticagrelor poisoning at higher rates. Therefore, in ticagrelor poisoning, emergency physicians need to be aware and familiar with the drug

Hamidiye Medical Journal, Feb 16, 2023

Background: We aim to analyze the patients hospitalized during 2016-2018 in the "emergency critic... more Background: We aim to analyze the patients hospitalized during 2016-2018 in the "emergency critical care unit" (ECCU) of our institution, which has emerged in recent years in our country and is primarily run by emergency medicine specialists operating within the department of emergency medicine and representation of a new understanding in these aspects. Materials and Methods: Our study was carried out retrospectively on 1.658 patients hospitalized in the secondary step ECCU operating within the department of emergency medicine between 01.01.2016 and 31.12.2018. The epidemiological and medical data of the patients were obtained from the hospital registration system records. Factors affecting mortality and discharge were investigated. Results: A total of 1.658 inpatients in the ECCU were included in our study. The median age of the patients was 71 years, and 43.8% were male. It was determined that 46.8% of the patients were discharged from ECCU, 34.3% were transferred to other services or intensive care units, and 18.9% exitus. There was no correlation between the outcome of the patients and age and gender (p>0.05). The highest rate of discharge was in patients hospitalized due to drug intoxication (p<0.05), while the highest rate of deceased patients was gastrointestinal system bleeding (p<0.05). Following the literature, the Apache-II score was highest in deceased patients and lowest in discharged patients (p<0.05). In our study, it was determined that 37% of the patients underwent various interventional procedures. A higher rate of death was found in patients who had many attempts and underwent tracheostomy and central catheterization (p<0.05). Conclusion: ECCUs are managed by emergency medicine specialists who provide intensive care support, especially for critically ill patients. As we concluded in our study, many patients received the critical care they needed without waiting for the intensive care unit in the emergency room, and about half of them were discharged.

Clinical and experimental emergency medicine, Nov 22, 2022

In emergency departments, many drugs, fluids, and materials for medical examinations and treatmen... more In emergency departments, many drugs, fluids, and materials for medical examinations and treatment are typically administered to patients intravenously. One of the most common complications of the intravenous bolus or infusion of drugs is extravasation injuries. These injuries may cause certain morbidities for the patient, increase the cost of treatment, and prolong hospital stays. At the same time, these injuries also carry medicolegal risks for health personnel. Furosemide is a potent diuretic that is commonly used in emergency departments for volume overload conditions. To the best of our knowledge, there have been no cases reported in the literature of furosemide-induced extravasation injury with subsequent compartment syndrome that has required surgical intervention. Presented herein is the case of a 70-year-old female patient who was administered intravenous furosemide from the dorsum of the left hand and whose extravasation injury progressed to compartment syndrome requiring an emergency fasciotomy.

Eurasian journal of emergency medicine, Dec 1, 2021

Aim: The diagnosis and initial therapy of supraventricular tachycardia are always made in emergen... more Aim: The diagnosis and initial therapy of supraventricular tachycardia are always made in emergency departments. Vagal maneuvers are recommended as the first-line treatment for the termination of SVT. We aimed to compare the efficacy of standard and modified Valsalva maneuvers in treating patients with SVT.

Journal of emergency medicine case reports, Jun 23, 2022

Darifenacin is a medication that has anticholinergic and antimuscarinic effects and is used in th... more Darifenacin is a medication that has anticholinergic and antimuscarinic effects and is used in the treatment of overactive bladder. Adverse and overdose effects of the medication such as dry mouth and eyes, headache, nausea, constipation, urinary retention, and dyspepsia have been reported. An overdose effect on acute kidney injury (AKI) has not been reported in the literature, and no dose adjustment is recommended in patients with renal impairment. A 24-year-old male patient applied to the emergency department with a declaration of taking 25 drugs containing darifenacin active ingredient for suicidal purposes. The patient had complaints of nausea and difficulty urinating. The patient's physical examination was normal. In laboratory, creatinine was 2.09mg/dL, and hemoglobin (+++) and protein (++) were found in urine test. Renal ultrasonography revealed a grade 1-2 increase in echogenicity of both kidneys. The patient was followed up with intravenous fluid replacement therapy, and the patient whose creatinine levels regressed was discharged with the recommendation of nephrology outpatient control. Any molecule taken in overdose can cause AKI via acute tubular necrosis should not be ignored by emergency physicians. The fact that such a side effect or undesirable situation has not been reported with Darifenacin so far doesn't mean that the molecule is safe for this situation. An overdose of Darifenacin may cause AKI in patients.

DergiPark (Istanbul University), Sep 3, 2019

Introduction: Poisoning is an important health problem in Turkey and all over the world. We belie... more Introduction: Poisoning is an important health problem in Turkey and all over the world. We believe that the creation of ideal scoring systems for patients with poisoning is essential for the determination of intensive care hospitalization necessity, duration of follow-up, mortality and morbidity. Materials-Method: In our study, we included over-18-year-old 292 patients with poisoning who were urgently hospitalized into the intensive care unit between January 2016 to December 2017. We have identified some criteria which are named as Ankara Poisoning Criterion. Glasgow Coma Score (GCS) (<15); hypotension (systolic blood pressure< 90 mm Hg); bradycardia (<60 beats/min) or tachycardia (> 100 beats/min); lactate level (2.0); and the pH value (< 7.35 or >7.45). OR The main decisive factor in the selection of these five criteria (Glaskow coma score <15, systolic blood pressure <90 mm Hg, bradycardia (<60 beats / min) or tachycardia (> 100 beats / min), acidosis (pH < 7,359 or alkalosis (pH> 7,45) and serum lactate level> 2.0 mmol / L), We anticipated that a patient who meets at least one of these criteria is in need of intensive care hospitalization, and that if s/he does not, there is no need for intensive care hospitalization. The patient's scores of Acute Physiology and Chronic Health Evaluation II (ApacheII), Sequential Organ Failure Assessment Score (SOFA), Quick Sequential Organ Failure Assessment (QSOFA), Modified Early Warning Score (MEWS), and Systemic Inflammatory Response Syndrome (SIRS), and length of hospital stay (LOS), inotrop, dialysis, mechanical ventilation, special treatment, and antidote needs were recorded and these parameters were compared with the Ankara Poisoning Criteria. Results: Of the 292 patients included in the Ankara Poisoning Criteria, 45.5% (n = 133) had zero scores; therefore they did not need to remain in intensive care. We statistically revealed that patients with the LOS ≥2, and need of inotrop, dialysis, mechanical ventilation, special treatment, and antidote, meet at least one of the Ankara Toxicity Criteria (p <0.005). Meanwhile, we statistically observed correlations between the Apache II, SOFA, QSOFA, MEWS, and SIRS scores and revealed criteria (p <0.005). Conclusion: We concluded that the Ankara Poisoning Criteria, which consists of 5 criteria that can be easily and quickly obtained in the emergency services, can prevent unnecessary intensive care hospitalizations and they will be beneficial for the prognosis and mortality-morbidity of patients.

Ak ku ut t K Ko ol le es si is st ti it t-K Ko ol le el li it ti ia az zi is s A Ay yı ır rı ıc c... more Ak ku ut t K Ko ol le es si is st ti it t-K Ko ol le el li it ti ia az zi is s A Ay yı ır rı ıc cı ı T Ta an nı ıs sı ın nd da a N Nö öt tr ro of fi il l/ /L Le en nf fo os si it t O Or ra an nı ın nı ın n K Kl li in ni ik k Ö Ön ne em mi i C Cl li in ni ic ca al l I Im mp po or rt ta an nc ce e o of f N Ne eu ut tr ro op ph hi il l/ /L Ly ym mp ph ho oc cy yt te e R Ra at ti io o i in n D Di if ff fe er re en nt ti ia al l D Di ia ag gn no os si is s o of f A Ac cu ut te e C Ch ho ol le ec cy ys st ti it ti is s a an nd d C Ch ho ol le el li it th hi ia as si is s

Journal of Emergency Medicine Case Reports

Introduction:Darifenacin is a medication that has anticholinergic and antimuscarinic effects and ... more Introduction:Darifenacin is a medication that has anticholinergic and antimuscarinic effects and is used in the treatment of overactive bladder.Adverse and overdose effects of the medication such as dry mouth and eyes,headache,nausea, constipation, urinary retention, and dyspepsia have been reported .An overdose effect on AKI has not been reported in the literature, and no dose adjustment is recommended in patients with renal impairment Case:A 24-year-old male patient applied to the emergency department with a declaration of taking 25 drugs containing darifenacin active ingredient for suicidal purposes.The patient had complaints of nausea and difficulty urinating.The patient's physical examination was normal.In laboratory, creatinine was 2.09mg/dL, and hemoglobi (+++) and protein(++) were found in urine test.Renal USG revealed a grade 1-2 increase in echogenicity of both kidneys.The patient was followed up with intravenous fluid replacement therapy, and the patient whose creatin...

Hamidiye Medical Journal

Artuklu International Journal of Health Sciences

Objective: This study aims to determine the frequency of adult patients presenting to the emergen... more Objective: This study aims to determine the frequency of adult patients presenting to the emergency department with skin lesions, and the main diagnoses made in the ED. We aimed to investigate the reasons of patients choose the emergency department rather than dermatology outpatient clinics in non-emergency situations. Material and Method: This is a prospective study conducted on patients with dermatological conditions diagnosed in the emergency department of a tertiary hospital during a 6-month period. Basic epidemiological and clinical characteristics, and whether the situation is a "real emergency" from the perspectives of the patients and clinicians were recorded. Results: A total of 262 patients were included. The three most common diagnoses in the ED were acute urticaria (41.6%), maculopapular drug eruptions (17.2%) and pruritus (7.6%). Dermatology consultation was requested for 26 (9.9%) of all patients. When evaluating the necessity of emergency ED examination from...