Onur Polat - Academia.edu (original) (raw)

Papers by Onur Polat

Acta Chirurgica Belgica, 2009

Herbert screws particularly suitable for this type of injury: it allows good inter-fragmentary co... more Herbert screws particularly suitable for this type of injury: it allows good inter-fragmentary compression due to the sub-articular positioning that avoids the risk of damaging the articular surface. Mobilisation should start early to prevent joint stiffness and long-term disability.

Anatolian journal of emergency medicine, Mar 31, 2019

Introduction: The use of backboard is a widely-accepted practice for the stabilization of major t... more Introduction: The use of backboard is a widely-accepted practice for the stabilization of major trauma cases. Discomfort and pressure pain due to the use of backboard are common complications. In this study, we aimed to reduce the discomfort and pressure pain due to the use of backboard. Materials and methods: The study was carried out with 20 healthy volunteers. In the first stage, the volunteers were placed in the supine position for 5 minutes on the standard backboard(STB) and on the supported backboard(SUB). The pressures in the occipital, scapular, and sacral regions were measured while lying on an STB and an SUB. In the second stage, the volunteers were placed in the supine position on an STB or an SUB as two episodes of 60 minutes. Visual Analog Scale(VAS) was used for evaluation of the pain at 10,15,30,45 and 60th minutes. Results: When the VAS scores while lying on an STB and an SUB were compared in the volunteers, general pain and pain in the occipital, scapular, and sacral regions were found to be statistically significantly decreased at all minutes while lying on an SUB. When the pressures while lying on an STB and an SUB were compared in the volunteers, there was no statistically significant difference between the areas exposed to the pressure above the capillary filling pressure in the occipital and scapular regions. However, as a positive result, the area exposed to the pressure below the capillary filling pressure in the sacral region while lying on an SUB was found to be high at a statistically significant level. Conclusion: Although it is needed to be slightly improved in terms of the pressure due to lengthened transport time and lengthened waiting time on a backboard, the SUB, which we used to reduce pressure pain, was demonstrated to provide significant benefits.

Turkish journal of emergency medicine, 2022

Konuralp Tıp Dergisi

Objective: Patients using anticoagulant and/or antiplatelet (AC/AP) medications are at an increas... more Objective: Patients using anticoagulant and/or antiplatelet (AC/AP) medications are at an increased risk of intracranial hemorrhage (ICH) subsequent to head trauma and current guidelines recommend a head computed tomography (CT) scan for these patients. There is a lack of consensus about management recommendations for mild head trauma patients on AC/AP treatment who had an initially normal head CT. The aim of this study was to determine the rate of delayed ICH after a 24-hour observation in patients with mild head trauma using AC/AP who had an initially normal head CT. Method: Patients aged 18 and older, using AC/AP drugs with mild head trauma were included prospectively. Patients underwent head CT for suspected bleeding. A repeat CT scan was performed after a 24-hours observation period for the patients who had an initially normal head CT for detecting delayed intracranial hemorrhage. Result: A total of 101 patients were included and, 57.4% (n=58) of the patients were female. Delay...

Disaster Medicine and Public Health Preparedness

Objective: Triage is a tool used to determine patients’ severity of illness or injury within minu... more Objective: Triage is a tool used to determine patients’ severity of illness or injury within minutes of arrival. This study aims to assess the reliability and validity of a new computer-based triage decision support tool, ANKUTRIAGE, prospectively. Methods: ANKUTRIAGE, a 5-level triage tool was established considering 2 major factors, patient’s vital signs and characteristics of the admission complaint. Adult patients admitted to the ED between July and October, 2019 were consecutively and independently double triaged by 2 assessors using ANKUTRIAGE system. To measure inter-rater reliability, quadratic-weighted kappa coefficients (Kw) were calculated. For the validity, associations among urgency levels, resource use, and clinical outcomes were evaluated. Results: The inter-rater reliability between users of ANKUTRIAGE was excellent with an agreement coefficient (Kw) greater than 0.8 in all compared groups. In the validity phase, hospitalization rate, intensive care unit admission an...

Idrar yolu enfeksiyonu acil servislerde karsilasilan sik enfeksiyonlardan birisidir. Idrar yolu e... more Idrar yolu enfeksiyonu acil servislerde karsilasilan sik enfeksiyonlardan birisidir. Idrar yolu enfeksiyonunun erken tanisi onemlidir, cunku yanlis veya gecikmis tani idrar yolu enfeksiyonu tedavisinin yetersiz olmasina neden olacaktir. Gunluk pratikte idrar yolu enfeksiyonu tanisi idrar analizi ile konmaktadir ve tedaviye karar verilmektedir. Idrar analizinde bakilan piuri, pozitif lokosit esteraz ve nitrit testlerinin idrar yolu enfeksiyonunu tanimlamada bazi kisitliliklari vardir. Idrar kulturunun, idrar yolu enfeksiyonu tanisi icin altin standart olmasina ragmen pozitif kultur sonucunda bakterinin tanimlanmasi icin 2-3 gun zaman gerekmektedir. Ayrica acil servislerde idrar orneklerinin toplanmasindaki zorluk, toplanan orneklerin yetersiz olmasi yanlis tani konmasina neden olabilmektedir. Idrar orneginin kontamine olmasi bir diger problemdir ve yalanci pozitif tani konmasina ve gereksiz tedavi yapilmasina neden olur.Bu nedenlerden dolayi, acil servislerde idrar yolu enfeksiyonlar...

Archives of Iranian medicine, 2019

Methanol is a clear liquid with high toxicity. Methanol intoxication may result from accidental e... more Methanol is a clear liquid with high toxicity. Methanol intoxication may result from accidental exposure, overconsumption of compounds containing methanol with suicidal intent, or following consumption of distilled and contaminated alcoholic beverages. This report describes a case of transdermal methanol intoxication, which is a rare condition. A 58-year-old woman presented with nausea, vomiting, weakness, diplopia and dizziness. On neurological examination, she only had diplopia. On physical examination, a hyperemic lesion with clear borders was found over the right knee. The patient's recent medical history revealed that four days prior to the onset of symptoms, she had covered her knee with a methanol-soaked bandage in an attempt to alleviate her knee pain. She had a high osmolar gap as well as high anion-gap metabolic acidosis (HAGMA). Methanol intoxication was suspected due to HAGMA and high osmolar gap. Serum methanol levels were subsequently measured and found to be 37.9 ...

Ankara Üniversitesi Tıp Fakültesi Mecmuası, 2017

Bu çalıșmanın amacı acil serviste sık karșılașılan el/el bileği yaralanmalı hastaların retrospekt... more Bu çalıșmanın amacı acil serviste sık karșılașılan el/el bileği yaralanmalı hastaların retrospektif olarak değerlendirilmesi ve bu hasta grubunda tedavi maliyeti üzerine etkisi olan faktörlerin incelenmesidir.

Journal of Ankara University Faculty of Medicine, 2021

Acil serviste (AS) hasta fiili işlem süresinde kaynak ve iş gücü kullanımının belirlenerek triyaj... more Acil serviste (AS) hasta fiili işlem süresinde kaynak ve iş gücü kullanımının belirlenerek triyaj seviyelerine göre toplam maliyetlerin ve toplam maliyete etki eden faktörlerin saptanmasıdır. Gereç ve Yöntem: Çalışma, üçüncü basamak bir hastanenin AS'sine başvuran 45.443 hasta arasından, beşli triyaj sisteminde başvuru sıklığına göre belirlenen tanılara sahip 1,171 hastanın katılımıyla gerçekleştirilen prospektif kesitsel gözlemsel bir araştırmadır. Klinik kararın verilme zamanına kadar geçen süre fiili işlem süresi olarak belirlenmiştir. Bu sürede hasta için kullanılan işçilik dahil tüm kaynaklar ve bu kaynaklara ait giderler kaydedilerek fiili maliyet ölçülmüş ve her bir triyaj seviyesi için ortalama kişi başı maliyet hesaplanmıştır. Bulgular: AS'ye gelen hastalar triyaj seviyelerine göre gruplandırıldığında, bu gruplar için toplam hasta maliyetinin faturalandırılan fiyatları arasında istatistiksel olarak anlamlı fark saptandı. Toplam maliyetlere etki eden faktörler incelendiğinde triyaj seviyeleri arasında toplam maliyetlerin anlamlı derecede farklı olduğu gözlendi. Yaş ile toplam maliyet arasında yapılan korelasyon analizinde yaş arttıkça toplam maliyet miktarının arttığı gözlendi. Sonuç: Çok değişkenli analizlerde cinsiyet, yaş, triyaj seviyesi ve geliş tipinin toplam maliyet ile ilişkili olduğu gözlendi. Çok ciddi gelir gider döngüsü olan AS'lerde maliyet sisteminin oturmuş olması ve etkin maliyet yönetiminin uygulanması, hastanelerde gerek yönetimin başarısı gerekse kurumun veya birimin sürekliliği açısından büyük öneme sahiptir. Bu çalışmada, ortaya konulan bulgular neticesinde, faaliyet tabanlı maliyetlendirme yöntemi kullanılarak daha doğru/güvenilir sonuçlara ulaşılacağı gösterilmiştir.

The American Journal of Emergency Medicine, 2020

OBJECTIVE This study aimed to examine the use of point-of-care ultrasonography (POCUS) in detecti... more OBJECTIVE This study aimed to examine the use of point-of-care ultrasonography (POCUS) in detecting diaphragmatic dysfunction (DD) and evaluate its ability to predict noninvasive mechanical ventilation (NIV) failure in patients presented to the emergency department with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). METHODS In this prospective cohort study, the diaphragm was examined using POCUS in patients with AECOPD. DD was defined as a diaphragm thickening fraction of less than 20% during spontaneous breathing. NIV failure was the primary outcome of the study, and duration of hospital stay and in-hospital mortality were the secondary outcomes. Specificity, sensitivity, positive predictive value, and negative predictive value were estimated for predicting NIV failure in DD and evaluating the diagnostic performance of POCUS. RESULTS 60 patients were enrolled the study. NIV failure was found in 11 (73.3%) of 15 patients with DD and in 2 (4.4%) of 45 patients without DD. In predicting NIV failure, DD had a sensitivity of 84.6% (95% confidence interval [CI]:54.6-98.1), specificity of 91.5% (95% CI:79.6-97.6), positive predictive value of 73.3% (95% CI:51.2-87.8), and negative predictive value of 95.6% (95% CI:85.7-98.7). The duration of hospital stay was not different between groups (p = .065). No in-hospital mortality was seen in patients without DD. CONCLUSIONS DD has high sensitivity and specificity in predicting NIV failure in patients admitted to the emergency department with AECOPD. DD can be assessed by an experienced clinician noninvasively using POCUS in emergency departments.

Ultrasound in Medicine & Biology, 2020

Bedside lung ultrasonography (LUS) is a reliable method for the diagnosis of pneumonia. No common... more Bedside lung ultrasonography (LUS) is a reliable method for the diagnosis of pneumonia. No common consensus exists in the literature regarding the effectiveness of LUS findings, except consolidation, for the diagnosis of pneumonia. The primary objective of this study was to investigate the effectiveness of LUS for the diagnosis of pneumonia, and the secondary objective was to investigate the use of LUS findings, except consolidation, for the diagnosis of pneumonia. A total of 127 patients with clinically suspected pneumonia were evaluated in the study. The sensitivity and specificity of LUS were 98.0% and 95.8%, respectively. In the cases where consolidation was not determined in LUS but B-3 line positivity or a diffuse interstitial pattern was present, the sensitivity and specificity were 93.3% and 88.2%, respectively. When consolidation was not observed in LUS, the presence of B-3 line positivity or diffuse interstitial pattern could be used for the diagnosis of pneumonia.

Journal of Ankara University Faculty of Medicine, 2018

Triyaj acil tıbbi bakımı bekleyebilecek olanlar ile bekleyemeyecek olanların ayrılması için yapıl... more Triyaj acil tıbbi bakımı bekleyebilecek olanlar ile bekleyemeyecek olanların ayrılması için yapılan uygulamadır. Mortaliteyi öngörmek için fizyolojik parametreler de dahil olmak üzere skorlama sistemleri tanımlanmıştır, ancak acil servislerde kullanılan çoğu triyaj yönteminde, vital bulgular veya laboratuvar parametreler standart değerlendirmeler olarak dahil edilmemiştir. Bu çalışmanın amacı, acil servise başvuran hastaların triyaj kararını farklı sağlık çalışanları arasındaki uyuşmalarını ölçmektir. Ayrıca, farklı parametrelerle modlar oluşturarak hangi vital bulguların ve parametrelerin triyaj kararını etkilediğini belirlemeyi amaçladık. Gereç ve Yöntem: Bu prospektif çalışma, bir akademik acil servise başvuran 550 hasta üzerinde gerçekleştirildi. Hastaların triyaj düzeyleri hemşireler, stajyer doktorlar, asistanlar ve acil tıp uzmanları tarafından belirlendi. Farklı parametreler içeren 11 mod belirlenmiştir ve her mod için 50 hasta tanımlanmıştır. Uygulayıcıların triyaj kararları arasındaki anlaşmayı değerlendirmek için, kappa uyumluluk testi kullanılmıştır. Bulgular: Çalışmaya dahil edilen 550 hasta için, kappa uyumluluk değeri hemşireler için 0,374, intörn doktorların; 257, asistanlar için 0,311 bulunmuştur. Sonuç: Acil tıpta, acil servise kabul edilen hastaları tanımlamak için hassas araçlara güçlü bir ihtiyaç vardır. Sonuçlarımıza göre triyaj kararını etkileyen en önemli parametreler oksijen satürasyonu ve Glasgow Koma skalası olduğu tespit edilmiştir.

Medical Science Monitor, 2014

Departmental sources Background: Febrile neutropenia (FN) is a life-threatening condition that re... more Departmental sources Background: Febrile neutropenia (FN) is a life-threatening condition that requires urgent management in the emergency department (ED). Recent progress in the treatment of neutropenic fever has underscored the importance of risk stratification. In this study, we aimed to determine independent factors for prediction of poor outcomes in patients with FN. Material/Methods: We retrospectively evaluated 200 chemotherapy-induced febrile neutropenic patients who visited the ED. Upon arrival at the ED, clinical data, including sex, age, vital signs, underlying systemic diseases, laboratory test results, estimated GFR, blood cultures, CRP, radiologic examinations, and Multinational Association of Supportive Care in Cancer (MASCC) score of all febrile neutropenic patients were obtained. Outcomes were categorized as "poor" if serious complications during hospitalization, including death, occurred. Results: The platelet count <50 000 cells/mm 3 (OR 3.90, 95% CI 1.62-9.43), pulmonary infiltration (OR 3.45, 95% CI 1.48-8.07), hypoproteinemia <6 g/dl (OR 3.30, 95% CI 1.27-8.56), respiratory rate >24/min (OR 8.75, 95% CI 2.18-35.13), and MASCC score <21 (OR 9.20, 95% CI 3.98-21.26) were determined as independent risk factors for the prediction of death. The platelet count <50 000 cells/mm3 (OR 3.93, 95% CI 1.42-10.92), serum CRP >50 mg/dl (OR 3.80, 95% CI 1.68-8.61), hypoproteinemia (OR 7.81, 95% CI 3.43-17.78), eGFR £90 ML/min/1.73 m 2 (OR 3.06, 95% CI 1.13-8.26), and MASCC score <21 (OR 3.45, 95% CI 1.53-7.79) were determined as independent risk factors for the prediction of poor clinical outcomes of FN patients. Platelet count, protein level, respiratory rate, pulmonary infiltration, CRP, MASCC score, and eGFR were shown to have a significant association with outcome. Conclusions: The results of our study may help emergency medicine physicians to prevent serious complications with proper use of simple independent risk factors besides MASCC score.

European Journal of Trauma and Emergency Surgery, 2009

Background: Fracture healing is a significant process in orthopedics. In this controlled animal s... more Background: Fracture healing is a significant process in orthopedics. In this controlled animal study, our aim is to expose the healing effects of cord blood umbilico-placental mononuclear cells (UPMNCs) on bone fractures. Materials and Methods: Caesarean sections were performed on five pregnant New Zealand rabbits at term. Placentas and cords were collected. Standard closed transverse shaft fractures were created on both tibial bones of 15 baby rabbits. The right tibias were given UPMNCs; the left tibias were the control group. Histological examinations, osteoblast and osteoclast cell counts, and mechanical stabilities were compared. Anchorage of the donor cells was shown by the fluorescence in situ hybridization (FISH) technique. Results: In the group injected with UPMNCs, histopathological fracture healing was faster, osteoblast and osteoclast counts were significantly increased, and the maximum load capacity was higher. The presence of XX and XY chromatins on the same slide revealed the anchorage of female donor cells on male tissues. Conclusion: The effects of umbilico-placental mononuclear cells on bone healing are histopathological healing priority, increased osteoblastic and osteoclastic activities (bone turnover), and better mechanical stability.

Advances in Therapy, 2007

Glutamine is considered a nonessential amino acid, but it may be conditionally essential in patie... more Glutamine is considered a nonessential amino acid, but it may be conditionally essential in patients with catabolic conditions. For centuries, researchers have looked for ways to promote and accelerate fracture healing. This controlled animal study examines the effects of glutamine on fracture healing. The left tibias of 10 standardized albino rats were broken at the distal third to produce a closed fracture. L-glutamine/L-alanyl solution (2.0 mL/kg) was administered through the tail veins of half the rats for the first 7 d, and physiologic serum alone was given to the control group. On the 21st day, all rats were euthanized and their left legs removed; after histologic observation, the tibias were examined under light microscopy. In the glutamine-injected group, development of primary callus was quicker and more regular than in the control group. The control group produced insufficient fibrous callus, and the glutamine group attained formed cartilaginous callus. Glutamine was noted to have positive effects on healing of traumatically fractured bone through attainment of positive nitrogen balance. This effect was minimal in enhancing the quality of fracture healing under conditions of stress, but some effect was noted on the speed of healing. Further research is needed in this area.

$Research paper thumbnail of Safe percutaneous pinning for subcapital fifth Metacarpal fractures: An anatomical study$

2EMHFW×YHV :KHQ WUHDWLQJ FORVHG IUDFWXUHV RI WKH QHFN RI WKH little finger metacarpal (boxer frac... more 2EMHFW×YHV :KHQ WUHDWLQJ FORVHG IUDFWXUHV RI WKH QHFN RI WKH little finger metacarpal (boxer fractures) with percutaneous transverse K-wire fixation and other procedures, there may be iatrogenic injury to the dorsal digital branch to the little finger (DDBLF) of the dorsal branch of the ulnar nerve (DBUN). In this study we aimed to describe the relationship of the DDBLF of the DBUN and the insertion points on the external side of the fifth metacarpal during percutaneous transverse K-wire fixation of subcapital fractures. Methods: Dissections and measurements regarding this branch were performed after percutaneous transverse pinning to distal part of fifth metacarpal bones in ten cadaver hands formalin fixed. Results: The results of this study confirm the close proximity of the trajectory of the with this branch and demonstrate its potential iatrogenic injury during K-wire fixation of the fifth metacarpal. Conclusions: To avoid penetration of this nerve and limit the chances of iatrogenic injury it is important to know its course. The authors describe the anatomical insertion points and believe that using the anatomical knowledge, subcapital fifth metacarpal fractures can be treated without risk of sensory deficits.

Journal of Ankara University Faculty of Medicine

Akut komplike olmayan alt üriner sistem enfeksiyonları acil servislerde sıklıkla karşılaşılan ve ... more Akut komplike olmayan alt üriner sistem enfeksiyonları acil servislerde sıklıkla karşılaşılan ve ampirik antibiyotik reçete edilen hastalıklardandır. Bu çalışmada nötrofil jelatinaz ilişkili lipokalin (NGAL) molekülünün serum düzeylerinin akut komplike olmayan idrar yolu enfeksiyonlarının tanı ve takibinde öneminin olup olmadığının ortaya konması amaçlandı. Gereç ve Yöntem: Bu çalışma prospektif kesitsel bir çalışma olup 15 Eylül 2013-15 Nisan 2014 tarihinde yapıldı. Bu çalışmaya akut komplike olmayan alt üriner sistem enfeksiyonu semptomları olan, tam idrar tetkikinde piyüri saptanan ve ampirik antibiyotik tedavisi acil serviste planlanan 18-65 yaş arası 80 hasta ve kontrol grubu olarak sağlıklı 40 kişi dahil edildi. Tüm hastalardan tedavi öncesinde ve sonrasında lökosit, nötrofil, C-reaktif protein (CRP), eritrosit sedimentasyon hızı ve NGAL ölçümü yapıldı ve aralarındaki korelasyon araştırıldı. Bulgular: Hasta grubunda, plazma lökosit, nötrofil ve CRP'ye ait tedavi öncesi değerlerin tedavi sonrası değerlerine oranla daha yüksek olduğu görüldü (p<0,001). Tedavi öncesinde ölçülen serum NGAL değeri ile tedavi sonrasında ölçülen serum NGAL değeri arasında anlamlı olarak bir fark bulunmadı (p=0,091). Sonuç: Plazma lökosit, nötrofil ve CRP değerlerinin ölçümü ile idrar yolu enfeksiyonunun tanısı desteklenebileceği gibi takiplerinin yapılması ile de hastalığın prognozu hakkında bilgi edinilebilir. Ancak plazma NGAL düzeyi komplike olmayan idrar yolu enfeksiyonunun tanısında kullanılabilecek bir parametre değildir.

Emergency Medicine International

Introduction. Acute cholecystitis is one of the most common reasons of acute abdominal pain for o... more Introduction. Acute cholecystitis is one of the most common reasons of acute abdominal pain for older patients to present to the emergency department (ED). Presentation may differ from that of the younger patient and is often complicated by coexistent disease due to elderliness. In this study, we aimed to evaluate the clinical presentation of acute cholecystitis, with special focus on comparision between elderly and young patients. Materials and Methods. This study included 318 patients who were admitted to the emergency department with right upper quadrant pain during a period of determined 8 months. After retrospective data collection, patients were groupped in accordance with their age, <65 and ≥65 years. Those who had ultrasonographic signs such as wall thickening and fluid collection were diagnosed as acute cholecystitis. Results. The young group (Group I) consisted of 225 patients, 132 females and 93 males. In Group I, 39 patients were diagnosed as acute cholecystitis of wh...