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Papers by Nurdan Acar

Research paper thumbnail of Hemorajik Ve İskemik Serebrovasküler Hastalık Tanısı Alan Hastalarda Kan Laktat Düzeyinin Prognoz Üzerine Etkisi

OSMANGAZİ JOURNAL OF MEDICINE, 2020

Çalışmamızın amacı iskemik ve hemorajik inme tanısı alan hastalarda, venöz kan laktat değerinin p... more Çalışmamızın amacı iskemik ve hemorajik inme tanısı alan hastalarda, venöz kan laktat değerinin prognoz üzerine etkisinin araştırılmasıdır. Çalışmamıza, (Eskişehir Osmangazi Üniversitesi Tıp Fakültesi cil servisine başvuran ve 12 saatten kısa süreli iskemik veya hemorajik inme tanısı alan 18 yaş üstü hastalar dahil edildi. Hastaların demografik bilgileri, ilk başvuru ve 24. saat venöz kan laktat düzeyleri ve) National Institutes of Health Stroke Scale (NIHSS), bilgisayarlı tomografi (BT) bulguları ve 3. ay modifiye Ranson skalası (mRs) kayıt edildi ve aralarındaki ilişki değerlendirildi. Çalışmaya 51'i (%58) erkek, 72'si (%81,8) iskemik, inme tanısı alan toplam 88 hasta dahil edildi. İskemik inme tanısı alan 7 (%8) hastada infarkt alanı 2/3' den büyük olduğu çekilen BT' de görüldü. Başvuru ve 24. saat venöz kan laktat düzeyleri medyan değerleri sırasıyla: 1,6 mmol/L, 1,4 mmol/l ve azalma istatistiksel olarak anlamlı idi (0-24 Saat p=0,019, p<0,001).İskemik inmeli hastalarda ilk venöz kan laktat düzeyi, infarkt alanı büyüklüğü MCA sulama alanının 2/3'ünden büyük olanların, küçük olanlara göre daha yüksek idi (p=0,013). Hemorajik inmelerde ise ilk başvuru venöz kan laktat düzeylerinin iskemik inmeye göre daha yüksek idi (2.05 e karşı 1,55 mmol/l, p=0,043). Başvuru ve 24. saat laktat düzeyleri ile NIHSS ve mRs arasında anlamlı ilişki tespit edilemedi. İnme hastalarında venöz kan laktat düzeyi ölçümü, kanama tipi ve iskemik infarkt alanı büyüklüğünün belirlenmesinde ve inme yönetiminde acil tıp hekimlerine yardımcı olabilir.

Research paper thumbnail of Outcomes of Cardiopulmonary Resuscitation of Oncologic Patients in Emergency Department

JCPSP. Journal of the College of Physicians & Surgeons Pakistan, May 1, 2022

Objective: To evaluate the outcomes of cardiopulmonary resuscitation (CPR) of oncological cases v... more Objective: To evaluate the outcomes of cardiopulmonary resuscitation (CPR) of oncological cases versus non-oncological admitted to the emergency department as out-of-hospital cardiac arrest (OHCA) or in-hospital cardiac arrest (IHCA).

Research paper thumbnail of Fokal Nörolojik Defisitli Hasta: Bir Karbonmonoksit Zehirlenmesi Olgusu The Patient with Focal Neurological Deficit: A Case of Carbonmonoxide Poisoning

Research paper thumbnail of Frequency of psychiatric disorders in nonemergent admissions to emergency department

Nigerian Journal of Clinical Practice, 2019

Objectives: Repeated admissions of patients with undiagnosed psychiatric problems in emergency de... more Objectives: Repeated admissions of patients with undiagnosed psychiatric problems in emergency departments (ED) is a major contributor to patient unsatisfaction and overcrowding in EDs. We evaluated the presence of psychiatric disorders in non-emergent admissions in the ED of a tertiary care hospital. Materials and Methods: This cross-sectional study was carried out in Eskisehir Osmangazi University Hospital between December 2015 and March 2016. The study group consists of 4320 non-emergent patients (31% of all admissions to non-emergent ED). Psychiatric assessments of patients were done using the Primary Care Evaluation of Mental Disorders (PRIME-MD) scale prior to their discharge from the ED. The Mann-Whitney U, Kruskal-Wallis and Chi-square tests, as well as multivariate logistic regression, were performed for statistical analysis. Results: The mean age was 30 ± 11.7 years years ranging from 18 to 78 years. Among non-emergent cases, 44% had at least one psychiatric disorder. The ...

Research paper thumbnail of Analysis of gender-related differences among the patients with suicidal drug intoxication

Research paper thumbnail of Acute Drug Poisonings in Eskisehir, Turkey: A Retrospective Study

Turkish Journal of Pharmaceutical Sciences, 2013

The aim of this study w as to characterize acute drug-poisoning cases admitted to the Adult Emerg... more The aim of this study w as to characterize acute drug-poisoning cases admitted to the Adult Emergency Service of ESOGU Medicine Faculty Hospital, Turkey. All acute drug-poisoning cases admitted to the emergency service from January 2003 to December 2009 were evaluated retrospectively. For this purpose; age, gender, admission date, vital signs, symptoms, the types of drugs used, purpose of drug intake, alcohol co-ingestion, treatment procedures and patient outcomes were recorded. According to the results, 68.6 % of cases was female and 31.4 % was male. The mean age of all cases was 28.16±11.74, being 27.26±10.48 in women and 32.16±13.53 in men. The purposes of drug intake were found as; 84.90 % for suicidal attempts, 9.70 % for treatment purposes, 4.30 % for accidental drug poisonings and 1.20 % for drug abuse. Psychoactive drugs were the most common drugs causing acute drug-poisoning events while analgesics were the secondary causative drug group. Central nervous system symptoms wer...

Research paper thumbnail of The evaluation of intracranial pressure evaluation by optic nerve sheath diameter measurement on bedside ultrasonography after ischemic stroke

Clinical Neurology and Neurosurgery, 2021

INTRODUCTION We aimed to predict intracranial pressure(ICP)after cerebral ischemic stroke by meas... more INTRODUCTION We aimed to predict intracranial pressure(ICP)after cerebral ischemic stroke by measuring diameter of the optic nerve sheath(ONSD)with bedside ultrasonography(US). In order to see the ICP changes,it was planned to record delta ICP changes at the 3rd and 5th day follow-up of the patients METHOTS: Patients aged 18 years or older who were admitted to the emergency department(ED)with stroke symptoms for one year were included.Demographic data,time elapsed since the onset of symptoms,neurogical status assesment scales,ONSD values measured by US in three time periods(the day the patient was admitted to the ED,the 3rd and 5th days of hospitalization),MDCT findings when the patient was admitted,ONSD values in MDCT,whether they received tissue plasminogen activator(tPA)and whether they underwent decompression surgery were recorded. RESULTS The average age of the 82 patients was 67.5(range 33-89)years.Forty-two patients(51.2%)were male.On both the right and left sides,ONSD on the 3rd day was larger(>5 mm)than on first day(p < 0.05). ONSD on the 5th day was larger than on the first day(p > 0.05). All ONSD results measured using both US and MDCT showed a positive correlation between the same eye and contralateral eye measurements(p < 0.05). DISCUSSION CT is the most critical radiological method for stroke patients.Transport to radyology unit in unstable patients carries risk and is not recommended.Optic nerve US can be used in the early diagnosis of ICP increase and provides early treatment.The ease of use and safety in unstable patients have increased its popularity. CONCLUSION We believe that measuring ONSD using US is an appropriate choice on ICP management in stroke patients.

Research paper thumbnail of Computed Tomographic Findings of Injuries After Mechanical and Manual Resuscitation: A Retrospective Study

Cureus, 2021

Introduction Cardiopulmonary resuscitation (CPR)-related injuries are complications of chest comp... more Introduction Cardiopulmonary resuscitation (CPR)-related injuries are complications of chest compressions during CPR. This study aimed to investigate the differences and complications between mechanical and manual CPR techniques by using computed tomography (CT). Methods Patients in whom return of spontaneous circulation was achieved after CPR and thorax CT imaging were performed for diagnostic purposes were included in the study. Results A total of 178 non-traumatic cardiac arrest patients were successfully resuscitated and had CT scans in the emergency department. The complications of CPR are sternum fracture, rib fracture, pleural effusion/hemothorax, and pneumothorax. There were no statistically significant differences in terms of age, first complaint, cardiac arrest rhythm, CPR duration, and complications between mechanical and manual CPR. The number of exitus in the emergency department was similar (p=0.638). The discharge from hospital rate was higher in the mechanical CPR group but there was no statistically significant difference (p=0.196). The duration of CPR was associated with the number of rib fractures and lung contusion, but it did not affect other CPR-related chest injuries. Conclusion There was no significant difference observed in terms of increased complications in patients who received mechanical compression as compared with those who received manual compression. According to our results, mechanical compression does not cause serious complications, and the discharge from hospital rate was higher than for manual CPR; therefore, its use should be encouraged.

Research paper thumbnail of Comparison of Endotracheal Intubation Skills With Video Laryngoscopy and Direct Laryngoscopy in Providing Airway Patency in a Moving Ambulance

The Journal of Emergency Medicine

Research paper thumbnail of Acil servise künt toraks travması ile başvuran hastalarda pnömotoraksın görüntüleme yöntemleriyle değerlendirilmesi

Turkish journal of trauma & emergency surgery, 2015

Research paper thumbnail of The Usefulness of Pleural Lactate Measurement for Differentiating Transudate and Exudate

Our study aimed to evaluate pleural lactate levels, to identify the reliability and validity of d... more Our study aimed to evaluate pleural lactate levels, to identify the reliability and validity of determining pleural fluid quality in patients with pleural effusion.This is a prospective, observational study conducted on patients who were admitted to a university hospital between July 1, 2017, and January 31, 2018, and diagnosed with pleural effusion. Pleural fluid classification into transudates and exudates was made according to Light’s criteria. The study group consisted of a total of 169 patients with pleural effusion, [99 (58.6%) male and aging 18-93 years (mean ± SD, 64.6 ± 16.1 years)]. Forty-four (26%) of the patients were evaluated as exudate and 125 (74%) as transudate. The median value of lactate was 3.20 mmol/L (min-max: 0.90-14.3) in exudate patients and 1.85 mmol/L (min-max: 0.90-4.70) in transudate patients, and a significant difference was detected in the comparison of both (z: 5.894; p<0.001). There was a positive correlation between pleural lactate levels and ple...

Research paper thumbnail of Acil servise künt toraks travması ile başvuran hastalarda pnömotoraksın görüntüleme yöntemleriyle değerlendirilmesi

Turkish journal of trauma & emergency surgery, 2015

Research paper thumbnail of Assessment of Electrocardiography Knowledge Among Doctors Working in Emergency Department

Eskisehir Medical Journal, Eskisehir City Hospital

Giris: Elektrokardiyografi (EKG) acil servislerde hizli ve guvenilir kardiyak degerlendirme icin ... more Giris: Elektrokardiyografi (EKG) acil servislerde hizli ve guvenilir kardiyak degerlendirme icin vazgecilmez bir yontemdir. Dogru hasta yonetimi icin doktorlar uygun EKG bilgisine sahip olmalidir. Bu calismanin amaci acil tip hekimlerinin EKG bilgilerini degerlendirmektir. Yontemler: Pratisyen hekimler (PH), acil tip asistanlari (ATA), acil tip uzmani (ATU) ve kardiyoloji uzmanlari; kardiyak olmayan patolojiler, aritmiler, ileti defektleri ve miyokard enfarktuslerinde toplam 40 EKG ornegini yorumladilar. Bulgular: Calismaya toplam 178 hekim katildi – katilimcilarin % 27,5'i ATA, % 24,7'si PH, % 24,2'si ATU ve % 23,6'si kardiyologdu. Pratisyen hekimler EKG yorumlamasinda en dusuk basariya sahipti. Kardiyologlar, aritmi (A) ve ileti gecikmelerinin (IG) EKG yorumlamasinda PH, ATA ve ATU’lara daha basariliydi (sirasiyla pA <0,001, pIG <0,001; pA <0,001, pIG <0,001; pA <0,001, pIG = 0,006) . Miyokard enfarktus EKG'lerinde kardiyologlar ve ATU’lar, pratisyen hekimler ve ATA’lara gore daha basarili iken kendi aralarinda istatistiksel olarak anlamli bir fark yoktu (sirasiyla p <0,001, p = 0,001 ve p = 1.000). Non-kardiyak durumlara yonelik EKG'lerde ATA, ATU ve kardiyologlar arasinda onemli bir fark yoktu. Sonuc: Acil serviste calisan pratisyen hekimlerin EKG bilgi duzeyleri yetersiz bulundu. Hekimlerin EKG bilgileri tip fakultesinden baslayarak gelistirilmeli ve acil servislerde mesleki kariyerleri boyunca hizmet ici egitimlerle surekli guncellenmelidir.

Research paper thumbnail of Hemodynamic Instability in Emergency Department: Giant Rectus Sheath Hematoma and Point-of-Care Ultrasonography

Cureus, 2021

Iatrogenic rectus sheath hematoma (RSH) developed after paracentesis is a rare but life-threateni... more Iatrogenic rectus sheath hematoma (RSH) developed after paracentesis is a rare but life-threatening complication. Mortality rates of patients may increase due to delays in treatment and comorbid conditions. In this article, we present the case of a patient who was unstable in the emergency department and was diagnosed with RSH using point-of-care ultrasonography (POCUS). The importance of POCUS has increased as hematoma manifestations of patients with severe ascites tend to be obscured. POCUS has varied uses in the emergency department, and in this article we emphasize the use of POCUS in a life-threatening case of RSH.

Research paper thumbnail of The relationship between blood alcohol concentration and injury severity in patients admitted to the hospital emergency department after a motor vehicle accident

Eurasian Journal of Emergency Medicine, 2016

Aim: The aim of our study is to establish the point at which a high blood alcohol concentration (... more Aim: The aim of our study is to establish the point at which a high blood alcohol concentration (BAC) in patients admitted to a hospital’s emergency department (ED) after an automobile accident can increase the severity of the injury and influence the survival and death rates. Materials and Methods: Our study is a prospective performed on patients ≥18 years of age admitted to the ED for in-car road accidents (ICRA) between September 15, 2011 and September 14, 201214-09-2012. Information such as demographic features, trauma score systems, BACs, hospital charges, discharge, hospitalization, and death of the patients was recorded. Results: The BACs of 52 out of a total of 324 patients were determined to be above normal limits (50 mg/dL). The clinical condition of patients with a BAC above normal limits was relatively worse (42.9%) than those with a BAC within normal limits (p<0.05). The BAC was above normal limits for 30.0% of the hospitalized patients, for 50% of surgical patients,...

Research paper thumbnail of The Effect of Blood Lactate Level on Prognosis in Patients with Hemorrhagic and Ischemic Cerebrovascular Disease

Cite this article as: Uskudar Teke H, Andic N, Davutoglu NO, Gunduz E, Bal C, Bone Marrow Examina... more Cite this article as: Uskudar Teke H, Andic N, Davutoglu NO, Gunduz E, Bal C, Bone Marrow Examinations in 85 Years or Older Geriatric Patients: Indications, Morbidity and Diagnosis, Osmangazi Journal of Medicine, 2021;43(3):273-282, Doi: 10.20515/otd.852348 As a result of the population aging, the incidence of both hematologic and non-hematologic diseases of elderly gets higher, requiring bone marrow (BM) aspirations and biopsies be implemented also in the geriatric patients. Our aim in this study is to address BM examination in the geriatric patients aged 85 and over, describing its indications and morbidity and discussing the established diagnoses and outcomes of applied therapies based on BM examinations in comparison to the available literature which is actually limited in number particularly in this patient group. We have retrospectively reviewed the BM aspiration/biopsy results of 114 patients aged ≥ 85 years who were followed-up by hematology department of a university hospit...

Research paper thumbnail of Acute Drug Poisonings in Eskisehir , Turkey : A Retrospective Study

The aim of this study was to characterize acute drug-poisoning cases admitted to the Adult Emerge... more The aim of this study was to characterize acute drug-poisoning cases admitted to the Adult Emergency Service of ESOGU Medicine Faculty Hospital, Turkey. All acute drug-poisoning cases admitted to the emergency service from January 2003 to December 2009 were evaluated retrospectively. For this purpose; age, gender, admission date, vital signs, symptoms, the types of drugs used, purpose of drug intake, alcohol co-ingestion, treatment procedures and patient outcomes were recorded. According to the results, 68.6 % of cases was female and 31.4 % was male. The mean age of all cases was 28.16±11.74, being 27.26±10.48 in women and 32.16±13.53 in men. The purposes of drug intake were found as; 84.90 % for suicidal attempts, 9.70 % for treatment purposes, 4.30 % for accidental drug poisonings and 1.20 % for drug abuse. Psychoactive drugs were the most common drugs causing acute drug-poisoning events while analgesics were the secondary causative drug group. Central nervous system symptoms were...

Research paper thumbnail of The Flatness Index of Inferior Vena Cava can be an Accurate Predictor for Hypovolemia in Multi-Trauma Patients

Introduction: Shock is the leading cause of death in multi-trauma patients and must be detected a... more Introduction: Shock is the leading cause of death in multi-trauma patients and must be detected at an early stage to improve prognosis. Many parameters are used to predict clinical condition and outcome in trauma. Computed tomography (CT) signs of hypovolemic shock in trauma patients are not clear yet, requiring further research. The flatness index of inferior vena cava (IVC) is a helpful method for this purpose. Methods: This is a prospective, cross-sectional study which included adult multi-trauma patients (>18 years) who were admitted to the emergency department (ED) and underwent a thoraco-abdominal CT from 2017 through 2018. The main objective of this study was to investigate whether the flatness index of IVC can be used to determine the hypovolemic shock at an early stage in multi-trauma patients, and to establish its relations with shock parameters. The patients’ demographic features, trauma mechanisms, vitals, laboratory values, shock parameters, and clinical outcome with...

Research paper thumbnail of Novel criteria for dyspnea patients

Research paper thumbnail of An assessment of initial symptoms in patients admitted to the ER of a tertiary healthcare institution and diagnosed with acute myocardial infarction

Aim: The aim of this study is to identify the initial symptoms in patients that are admitted to t... more Aim: The aim of this study is to identify the initial symptoms in patients that are admitted to the emergency room (ER) and diagnosed with acute myocardial infarction. Material and Method: This study was conducted retrospectively based on the medical records of patients aged 18 and over, who were admitted between 1 January and 31 December 2014 to the ER. For the purpose of this study, the researchers recorded the age, gender, initial symptom/symptoms as well as laboratory results including CK-MB, myoglobin and troponin t values of the patients aged 18 and over admitted to the ER and diagnosed with acute myocardial infarction. Results: This study was conducted with a total of 285 patients whose distribution by gender was as follows: 59 (20.70%) women and 226 (79.30%) men. The average age of patients was 64.03 ± 12.05 years. The most common symptom in patients was chest pain (58.90%). Among 285 patients, the number of patients diagnosed with non-ST segment elevation myocardial infarct...

Research paper thumbnail of Hemorajik Ve İskemik Serebrovasküler Hastalık Tanısı Alan Hastalarda Kan Laktat Düzeyinin Prognoz Üzerine Etkisi

OSMANGAZİ JOURNAL OF MEDICINE, 2020

Çalışmamızın amacı iskemik ve hemorajik inme tanısı alan hastalarda, venöz kan laktat değerinin p... more Çalışmamızın amacı iskemik ve hemorajik inme tanısı alan hastalarda, venöz kan laktat değerinin prognoz üzerine etkisinin araştırılmasıdır. Çalışmamıza, (Eskişehir Osmangazi Üniversitesi Tıp Fakültesi cil servisine başvuran ve 12 saatten kısa süreli iskemik veya hemorajik inme tanısı alan 18 yaş üstü hastalar dahil edildi. Hastaların demografik bilgileri, ilk başvuru ve 24. saat venöz kan laktat düzeyleri ve) National Institutes of Health Stroke Scale (NIHSS), bilgisayarlı tomografi (BT) bulguları ve 3. ay modifiye Ranson skalası (mRs) kayıt edildi ve aralarındaki ilişki değerlendirildi. Çalışmaya 51'i (%58) erkek, 72'si (%81,8) iskemik, inme tanısı alan toplam 88 hasta dahil edildi. İskemik inme tanısı alan 7 (%8) hastada infarkt alanı 2/3' den büyük olduğu çekilen BT' de görüldü. Başvuru ve 24. saat venöz kan laktat düzeyleri medyan değerleri sırasıyla: 1,6 mmol/L, 1,4 mmol/l ve azalma istatistiksel olarak anlamlı idi (0-24 Saat p=0,019, p<0,001).İskemik inmeli hastalarda ilk venöz kan laktat düzeyi, infarkt alanı büyüklüğü MCA sulama alanının 2/3'ünden büyük olanların, küçük olanlara göre daha yüksek idi (p=0,013). Hemorajik inmelerde ise ilk başvuru venöz kan laktat düzeylerinin iskemik inmeye göre daha yüksek idi (2.05 e karşı 1,55 mmol/l, p=0,043). Başvuru ve 24. saat laktat düzeyleri ile NIHSS ve mRs arasında anlamlı ilişki tespit edilemedi. İnme hastalarında venöz kan laktat düzeyi ölçümü, kanama tipi ve iskemik infarkt alanı büyüklüğünün belirlenmesinde ve inme yönetiminde acil tıp hekimlerine yardımcı olabilir.

Research paper thumbnail of Outcomes of Cardiopulmonary Resuscitation of Oncologic Patients in Emergency Department

JCPSP. Journal of the College of Physicians & Surgeons Pakistan, May 1, 2022

Objective: To evaluate the outcomes of cardiopulmonary resuscitation (CPR) of oncological cases v... more Objective: To evaluate the outcomes of cardiopulmonary resuscitation (CPR) of oncological cases versus non-oncological admitted to the emergency department as out-of-hospital cardiac arrest (OHCA) or in-hospital cardiac arrest (IHCA).

Research paper thumbnail of Fokal Nörolojik Defisitli Hasta: Bir Karbonmonoksit Zehirlenmesi Olgusu The Patient with Focal Neurological Deficit: A Case of Carbonmonoxide Poisoning

Research paper thumbnail of Frequency of psychiatric disorders in nonemergent admissions to emergency department

Nigerian Journal of Clinical Practice, 2019

Objectives: Repeated admissions of patients with undiagnosed psychiatric problems in emergency de... more Objectives: Repeated admissions of patients with undiagnosed psychiatric problems in emergency departments (ED) is a major contributor to patient unsatisfaction and overcrowding in EDs. We evaluated the presence of psychiatric disorders in non-emergent admissions in the ED of a tertiary care hospital. Materials and Methods: This cross-sectional study was carried out in Eskisehir Osmangazi University Hospital between December 2015 and March 2016. The study group consists of 4320 non-emergent patients (31% of all admissions to non-emergent ED). Psychiatric assessments of patients were done using the Primary Care Evaluation of Mental Disorders (PRIME-MD) scale prior to their discharge from the ED. The Mann-Whitney U, Kruskal-Wallis and Chi-square tests, as well as multivariate logistic regression, were performed for statistical analysis. Results: The mean age was 30 ± 11.7 years years ranging from 18 to 78 years. Among non-emergent cases, 44% had at least one psychiatric disorder. The ...

Research paper thumbnail of Analysis of gender-related differences among the patients with suicidal drug intoxication

Research paper thumbnail of Acute Drug Poisonings in Eskisehir, Turkey: A Retrospective Study

Turkish Journal of Pharmaceutical Sciences, 2013

The aim of this study w as to characterize acute drug-poisoning cases admitted to the Adult Emerg... more The aim of this study w as to characterize acute drug-poisoning cases admitted to the Adult Emergency Service of ESOGU Medicine Faculty Hospital, Turkey. All acute drug-poisoning cases admitted to the emergency service from January 2003 to December 2009 were evaluated retrospectively. For this purpose; age, gender, admission date, vital signs, symptoms, the types of drugs used, purpose of drug intake, alcohol co-ingestion, treatment procedures and patient outcomes were recorded. According to the results, 68.6 % of cases was female and 31.4 % was male. The mean age of all cases was 28.16±11.74, being 27.26±10.48 in women and 32.16±13.53 in men. The purposes of drug intake were found as; 84.90 % for suicidal attempts, 9.70 % for treatment purposes, 4.30 % for accidental drug poisonings and 1.20 % for drug abuse. Psychoactive drugs were the most common drugs causing acute drug-poisoning events while analgesics were the secondary causative drug group. Central nervous system symptoms wer...

Research paper thumbnail of The evaluation of intracranial pressure evaluation by optic nerve sheath diameter measurement on bedside ultrasonography after ischemic stroke

Clinical Neurology and Neurosurgery, 2021

INTRODUCTION We aimed to predict intracranial pressure(ICP)after cerebral ischemic stroke by meas... more INTRODUCTION We aimed to predict intracranial pressure(ICP)after cerebral ischemic stroke by measuring diameter of the optic nerve sheath(ONSD)with bedside ultrasonography(US). In order to see the ICP changes,it was planned to record delta ICP changes at the 3rd and 5th day follow-up of the patients METHOTS: Patients aged 18 years or older who were admitted to the emergency department(ED)with stroke symptoms for one year were included.Demographic data,time elapsed since the onset of symptoms,neurogical status assesment scales,ONSD values measured by US in three time periods(the day the patient was admitted to the ED,the 3rd and 5th days of hospitalization),MDCT findings when the patient was admitted,ONSD values in MDCT,whether they received tissue plasminogen activator(tPA)and whether they underwent decompression surgery were recorded. RESULTS The average age of the 82 patients was 67.5(range 33-89)years.Forty-two patients(51.2%)were male.On both the right and left sides,ONSD on the 3rd day was larger(>5 mm)than on first day(p < 0.05). ONSD on the 5th day was larger than on the first day(p > 0.05). All ONSD results measured using both US and MDCT showed a positive correlation between the same eye and contralateral eye measurements(p < 0.05). DISCUSSION CT is the most critical radiological method for stroke patients.Transport to radyology unit in unstable patients carries risk and is not recommended.Optic nerve US can be used in the early diagnosis of ICP increase and provides early treatment.The ease of use and safety in unstable patients have increased its popularity. CONCLUSION We believe that measuring ONSD using US is an appropriate choice on ICP management in stroke patients.

Research paper thumbnail of Computed Tomographic Findings of Injuries After Mechanical and Manual Resuscitation: A Retrospective Study

Cureus, 2021

Introduction Cardiopulmonary resuscitation (CPR)-related injuries are complications of chest comp... more Introduction Cardiopulmonary resuscitation (CPR)-related injuries are complications of chest compressions during CPR. This study aimed to investigate the differences and complications between mechanical and manual CPR techniques by using computed tomography (CT). Methods Patients in whom return of spontaneous circulation was achieved after CPR and thorax CT imaging were performed for diagnostic purposes were included in the study. Results A total of 178 non-traumatic cardiac arrest patients were successfully resuscitated and had CT scans in the emergency department. The complications of CPR are sternum fracture, rib fracture, pleural effusion/hemothorax, and pneumothorax. There were no statistically significant differences in terms of age, first complaint, cardiac arrest rhythm, CPR duration, and complications between mechanical and manual CPR. The number of exitus in the emergency department was similar (p=0.638). The discharge from hospital rate was higher in the mechanical CPR group but there was no statistically significant difference (p=0.196). The duration of CPR was associated with the number of rib fractures and lung contusion, but it did not affect other CPR-related chest injuries. Conclusion There was no significant difference observed in terms of increased complications in patients who received mechanical compression as compared with those who received manual compression. According to our results, mechanical compression does not cause serious complications, and the discharge from hospital rate was higher than for manual CPR; therefore, its use should be encouraged.

Research paper thumbnail of Comparison of Endotracheal Intubation Skills With Video Laryngoscopy and Direct Laryngoscopy in Providing Airway Patency in a Moving Ambulance

The Journal of Emergency Medicine

Research paper thumbnail of Acil servise künt toraks travması ile başvuran hastalarda pnömotoraksın görüntüleme yöntemleriyle değerlendirilmesi

Turkish journal of trauma & emergency surgery, 2015

Research paper thumbnail of The Usefulness of Pleural Lactate Measurement for Differentiating Transudate and Exudate

Our study aimed to evaluate pleural lactate levels, to identify the reliability and validity of d... more Our study aimed to evaluate pleural lactate levels, to identify the reliability and validity of determining pleural fluid quality in patients with pleural effusion.This is a prospective, observational study conducted on patients who were admitted to a university hospital between July 1, 2017, and January 31, 2018, and diagnosed with pleural effusion. Pleural fluid classification into transudates and exudates was made according to Light’s criteria. The study group consisted of a total of 169 patients with pleural effusion, [99 (58.6%) male and aging 18-93 years (mean ± SD, 64.6 ± 16.1 years)]. Forty-four (26%) of the patients were evaluated as exudate and 125 (74%) as transudate. The median value of lactate was 3.20 mmol/L (min-max: 0.90-14.3) in exudate patients and 1.85 mmol/L (min-max: 0.90-4.70) in transudate patients, and a significant difference was detected in the comparison of both (z: 5.894; p<0.001). There was a positive correlation between pleural lactate levels and ple...

Research paper thumbnail of Acil servise künt toraks travması ile başvuran hastalarda pnömotoraksın görüntüleme yöntemleriyle değerlendirilmesi

Turkish journal of trauma & emergency surgery, 2015

Research paper thumbnail of Assessment of Electrocardiography Knowledge Among Doctors Working in Emergency Department

Eskisehir Medical Journal, Eskisehir City Hospital

Giris: Elektrokardiyografi (EKG) acil servislerde hizli ve guvenilir kardiyak degerlendirme icin ... more Giris: Elektrokardiyografi (EKG) acil servislerde hizli ve guvenilir kardiyak degerlendirme icin vazgecilmez bir yontemdir. Dogru hasta yonetimi icin doktorlar uygun EKG bilgisine sahip olmalidir. Bu calismanin amaci acil tip hekimlerinin EKG bilgilerini degerlendirmektir. Yontemler: Pratisyen hekimler (PH), acil tip asistanlari (ATA), acil tip uzmani (ATU) ve kardiyoloji uzmanlari; kardiyak olmayan patolojiler, aritmiler, ileti defektleri ve miyokard enfarktuslerinde toplam 40 EKG ornegini yorumladilar. Bulgular: Calismaya toplam 178 hekim katildi – katilimcilarin % 27,5'i ATA, % 24,7'si PH, % 24,2'si ATU ve % 23,6'si kardiyologdu. Pratisyen hekimler EKG yorumlamasinda en dusuk basariya sahipti. Kardiyologlar, aritmi (A) ve ileti gecikmelerinin (IG) EKG yorumlamasinda PH, ATA ve ATU’lara daha basariliydi (sirasiyla pA <0,001, pIG <0,001; pA <0,001, pIG <0,001; pA <0,001, pIG = 0,006) . Miyokard enfarktus EKG'lerinde kardiyologlar ve ATU’lar, pratisyen hekimler ve ATA’lara gore daha basarili iken kendi aralarinda istatistiksel olarak anlamli bir fark yoktu (sirasiyla p <0,001, p = 0,001 ve p = 1.000). Non-kardiyak durumlara yonelik EKG'lerde ATA, ATU ve kardiyologlar arasinda onemli bir fark yoktu. Sonuc: Acil serviste calisan pratisyen hekimlerin EKG bilgi duzeyleri yetersiz bulundu. Hekimlerin EKG bilgileri tip fakultesinden baslayarak gelistirilmeli ve acil servislerde mesleki kariyerleri boyunca hizmet ici egitimlerle surekli guncellenmelidir.

Research paper thumbnail of Hemodynamic Instability in Emergency Department: Giant Rectus Sheath Hematoma and Point-of-Care Ultrasonography

Cureus, 2021

Iatrogenic rectus sheath hematoma (RSH) developed after paracentesis is a rare but life-threateni... more Iatrogenic rectus sheath hematoma (RSH) developed after paracentesis is a rare but life-threatening complication. Mortality rates of patients may increase due to delays in treatment and comorbid conditions. In this article, we present the case of a patient who was unstable in the emergency department and was diagnosed with RSH using point-of-care ultrasonography (POCUS). The importance of POCUS has increased as hematoma manifestations of patients with severe ascites tend to be obscured. POCUS has varied uses in the emergency department, and in this article we emphasize the use of POCUS in a life-threatening case of RSH.

Research paper thumbnail of The relationship between blood alcohol concentration and injury severity in patients admitted to the hospital emergency department after a motor vehicle accident

Eurasian Journal of Emergency Medicine, 2016

Aim: The aim of our study is to establish the point at which a high blood alcohol concentration (... more Aim: The aim of our study is to establish the point at which a high blood alcohol concentration (BAC) in patients admitted to a hospital’s emergency department (ED) after an automobile accident can increase the severity of the injury and influence the survival and death rates. Materials and Methods: Our study is a prospective performed on patients ≥18 years of age admitted to the ED for in-car road accidents (ICRA) between September 15, 2011 and September 14, 201214-09-2012. Information such as demographic features, trauma score systems, BACs, hospital charges, discharge, hospitalization, and death of the patients was recorded. Results: The BACs of 52 out of a total of 324 patients were determined to be above normal limits (50 mg/dL). The clinical condition of patients with a BAC above normal limits was relatively worse (42.9%) than those with a BAC within normal limits (p<0.05). The BAC was above normal limits for 30.0% of the hospitalized patients, for 50% of surgical patients,...

Research paper thumbnail of The Effect of Blood Lactate Level on Prognosis in Patients with Hemorrhagic and Ischemic Cerebrovascular Disease

Cite this article as: Uskudar Teke H, Andic N, Davutoglu NO, Gunduz E, Bal C, Bone Marrow Examina... more Cite this article as: Uskudar Teke H, Andic N, Davutoglu NO, Gunduz E, Bal C, Bone Marrow Examinations in 85 Years or Older Geriatric Patients: Indications, Morbidity and Diagnosis, Osmangazi Journal of Medicine, 2021;43(3):273-282, Doi: 10.20515/otd.852348 As a result of the population aging, the incidence of both hematologic and non-hematologic diseases of elderly gets higher, requiring bone marrow (BM) aspirations and biopsies be implemented also in the geriatric patients. Our aim in this study is to address BM examination in the geriatric patients aged 85 and over, describing its indications and morbidity and discussing the established diagnoses and outcomes of applied therapies based on BM examinations in comparison to the available literature which is actually limited in number particularly in this patient group. We have retrospectively reviewed the BM aspiration/biopsy results of 114 patients aged ≥ 85 years who were followed-up by hematology department of a university hospit...

Research paper thumbnail of Acute Drug Poisonings in Eskisehir , Turkey : A Retrospective Study

The aim of this study was to characterize acute drug-poisoning cases admitted to the Adult Emerge... more The aim of this study was to characterize acute drug-poisoning cases admitted to the Adult Emergency Service of ESOGU Medicine Faculty Hospital, Turkey. All acute drug-poisoning cases admitted to the emergency service from January 2003 to December 2009 were evaluated retrospectively. For this purpose; age, gender, admission date, vital signs, symptoms, the types of drugs used, purpose of drug intake, alcohol co-ingestion, treatment procedures and patient outcomes were recorded. According to the results, 68.6 % of cases was female and 31.4 % was male. The mean age of all cases was 28.16±11.74, being 27.26±10.48 in women and 32.16±13.53 in men. The purposes of drug intake were found as; 84.90 % for suicidal attempts, 9.70 % for treatment purposes, 4.30 % for accidental drug poisonings and 1.20 % for drug abuse. Psychoactive drugs were the most common drugs causing acute drug-poisoning events while analgesics were the secondary causative drug group. Central nervous system symptoms were...

Research paper thumbnail of The Flatness Index of Inferior Vena Cava can be an Accurate Predictor for Hypovolemia in Multi-Trauma Patients

Introduction: Shock is the leading cause of death in multi-trauma patients and must be detected a... more Introduction: Shock is the leading cause of death in multi-trauma patients and must be detected at an early stage to improve prognosis. Many parameters are used to predict clinical condition and outcome in trauma. Computed tomography (CT) signs of hypovolemic shock in trauma patients are not clear yet, requiring further research. The flatness index of inferior vena cava (IVC) is a helpful method for this purpose. Methods: This is a prospective, cross-sectional study which included adult multi-trauma patients (>18 years) who were admitted to the emergency department (ED) and underwent a thoraco-abdominal CT from 2017 through 2018. The main objective of this study was to investigate whether the flatness index of IVC can be used to determine the hypovolemic shock at an early stage in multi-trauma patients, and to establish its relations with shock parameters. The patients’ demographic features, trauma mechanisms, vitals, laboratory values, shock parameters, and clinical outcome with...

Research paper thumbnail of Novel criteria for dyspnea patients

Research paper thumbnail of An assessment of initial symptoms in patients admitted to the ER of a tertiary healthcare institution and diagnosed with acute myocardial infarction

Aim: The aim of this study is to identify the initial symptoms in patients that are admitted to t... more Aim: The aim of this study is to identify the initial symptoms in patients that are admitted to the emergency room (ER) and diagnosed with acute myocardial infarction. Material and Method: This study was conducted retrospectively based on the medical records of patients aged 18 and over, who were admitted between 1 January and 31 December 2014 to the ER. For the purpose of this study, the researchers recorded the age, gender, initial symptom/symptoms as well as laboratory results including CK-MB, myoglobin and troponin t values of the patients aged 18 and over admitted to the ER and diagnosed with acute myocardial infarction. Results: This study was conducted with a total of 285 patients whose distribution by gender was as follows: 59 (20.70%) women and 226 (79.30%) men. The average age of patients was 64.03 ± 12.05 years. The most common symptom in patients was chest pain (58.90%). Among 285 patients, the number of patients diagnosed with non-ST segment elevation myocardial infarct...