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Papers by sedat akkan

Eurasian Journal of Critical Care, Dec 15, 2020

Renal colic is a frequent cause of application to the emergency room. Although it is a condition ... more Renal colic is a frequent cause of application to the emergency room. Although it is a condition that requires conservative treatment, it can often be confused with clinical conditions that may require surgical intervention and complications such as urinary tract infection and acute kidney failure mayor cur. In this case, were viewed 49 year old male patient who has lower abdominal pain due to ureteral stone and did not know that he had a pelvic kidney. Because of leukocytosis and vomiting, acute appendicitis was considered as prediagnosis, but abdominal CT imaging of patient showed a left pelvic kidney and 5 mm calcule in the middle part of the ureter.

Journal of Cardiovascular Medicine, 2021

BACKGROUND Atrial fibrillation is one of the most common arrhythmias after ST-segment elevation m... more BACKGROUND Atrial fibrillation is one of the most common arrhythmias after ST-segment elevation myocardial infarction (STEMI). In recent years, a strong correlation was found between epicardial adipose tissue (EAT) and the development of atrial fibrillation. In addition, EAT has been reported to be a predictor of new-onset atrial fibrillation development in different clinical situations. In this study, we aimed to determine the relationship between EAT thickness in patients with STEMI who underwent primary percutaneous coronary intervention (pPCI) and the development of new-onset atrial fibrillation during hospital follow-up. MATERIAL AND METHODS Four hundred and thirteen consecutive patients [284 men (69%) and 129 women (31%)] with a mean age of 59 ± 11 years diagnosed with STEMI were included in this study. Atrial fibrillation developed in 52 (12.5%) patients during in-hospital follow-up and the remaining 361 patients were determined as the control group. There was no difference between the two groups in terms of age and sex. EAT thickness was measured using transthoracic echocardiography. Multiple regression analysis was performed to determine the independent predictors of atrial fibrillation. RESULTS EAT thickness was higher in the group with atrial fibrillation than in the control group (P < 0.001). The SYNTAX risk score was higher in the atrial fibrillation group (P < 0.001). A positive correlation was observed between EAT thickness and SYNTAX score (r = 0.523, P < 0.001). In the logistic regression analysis, EAT was detected to be an independent predictor for the development of atrial fibrillation (odds ratio: 4.135, 95% confidence interval 1.245-8.176, P < 0.001). CONCLUSION EAT thickness is an important marker of atrial fibrillation development in STEMI patients in the post-pPCI period. We think that EAT thickness can be used as a cardioembolic risk factor in STEMI patients.

Annals of Emergency Medicine, 2019

Study objective: The primary objective of this study is to compare the effectiveness of 3 treatme... more Study objective: The primary objective of this study is to compare the effectiveness of 3 treatment protocols to stop anterior epistaxis: classic compression, nasal packing, and local application of tranexamic acid. It also aims to determine the frequency of rebleeding after each of these protocols. Methods: This single-center, prospective, randomized controlled study was conducted with patients who had spontaneous anterior epistaxis. The study compared the effect of 3 treatment options, tranexamic acid with compression but without nasal packing, nasal packing (Merocel), and simple nasal external compression, on the primary outcome of stopping anterior epistaxis bleeding within 15 minutes. Results: Among the 135 patients enrolled, the median age was 60 years (interquartile range 25% to 75%: 48 to 72 years) and 70 patients (51.9%) were women. The success rate in the compression with tranexamic acid group was 91.1% (41 of 45 patients); in the nasal packing group, 93.3% (42 of 45 patients); and in the compression with saline solution group, 71.1% (32 of 45 patients). There was an overall statistically significant difference among the 3 treatment groups but no significant difference in pairwise comparison between the compression with tranexamic acid and nasal packing groups. In regard to rebleeding within 24 hours, the study found rates of 86.7% in the tranexamic acid group, 74% in the nasal packing group, and 60% in the compression with saline solution group. Conclusion: Applying external compression after administering tranexamic acid through the nostrils by atomizer stops bleeding as effectively as anterior nasal packing using Merocel. In addition, the tranexamic acid approach is superior to Merocel in terms of decreasing rebleeding rates. [

Eurasian Journal of Emergency Medicine, 2018

Aim: The primary aim of the present study was to detect whether blood gases analyzer (BGA) is rel... more Aim: The primary aim of the present study was to detect whether blood gases analyzer (BGA) is reliable or not in daily practice by comparing sodium (Na +), potassium (K +), hemoglobin (Hgb), and hematocrit (Htc) levels measured by BGA and laboratory auto-analyzer (LAA). The secondary aim was whether BGA is reliable or not in daily practice by comparing Na + , K + , Hgb, and Htc levels measured by BGA and LAA in different pH stages. Materials and methods: The study screened the electronic data and file records of all patients who were admitted to the emergency department with any complaint during the study period retrospectively. Patients who had results of venous blood gases and routine laboratory obtained at the same time were included the study. For each parameter, agreements and correlations between the results of BGA and LAA were evaluated by Bland-Altman test and Spearman's correlation test, respectively. An r-value >0.80 was considered a strong correlation. Results: The laboratory results of 1374 patients were evaluated for statistical analyses. When evaluating the correlations between the results of BGA and LAA, it was found that there was only a strong correlation for K + (p<0.001, r=0.83). When assessing the agreements between the results of BGA and LAA, the mean differences were found to be 0.02±6.1 for Na + , 0.3±0.44 for K + ,-0.5±1.6 for Hgb, and-0.6±5 for Htc. Conclusion: Although there are strong correlation and relatively good acceptable agreement for K + measurement, there are no strong correlation and good agreement for other measurements, including Na + , Hgb, and Htc. In addition, we found that these results did not change according to the different pH stages.

The American journal of emergency medicine, Jan 22, 2017

The study aimed to detect whether modified Valsalva maneuver (VM) is more effective than the stan... more The study aimed to detect whether modified Valsalva maneuver (VM) is more effective than the standard VM in terminating paroxysmal supraventricular tachycardia (PSVT). This randomized controlled trial was conducted in the emergency department of a training and research hospital between Dec. 1, 2015 and Dec. 31, 2016. Participants were divided into two groups, randomly assigned standard VM or modified VM, as the first treatment with two-dimensional permutation blocks; in the order of arrival of the patients. In both groups; the determined procedure for standard or modified VM was repeated up to three times in patients whose PSVT did not convert to sinus rhythm. In both groups; if the maneuver was unsuccessful after three attempts, anti-arrhythmic medication was administered. The primary outcome was defined to compare the success rate of achieving sinus rhythm after standard VM or modified VM. Fifty-six patients were randomized to modified or standard VM with 28 patients in each treat...

Angioedema (AE) is a life-threatening condition that can be seen in hereditary or non-hereditary ... more Angioedema (AE) is a life-threatening condition that can be seen in hereditary or non-hereditary form, usually manifests in subcutaneous tissue and progressed with edema in the face, lips, tongue, larynx and gastrointestinal system. Captopril is the first generated angiotensin-converting enzyme (ACE) inhibitor. Since the inhibition of ACE and consequently the angiotensin II level in plasma and tissues is reduced and quinine degradation is also inhibited by ACE, the level of bradykinin increases in plasma and tissues. It is thought to that the bradykinin causes edema due to vasodilation and increased vascular permaability. In this case report, we reviewed a 63-year-old patient, who hospitalized in the general surgery ward with the preliminary diagnosis of acute cholecystitis, developed AE after treated with 25 mg captopril for high blood pressure.

Eurasian Journal of Critical Care, Dec 15, 2020

Renal colic is a frequent cause of application to the emergency room. Although it is a condition ... more Renal colic is a frequent cause of application to the emergency room. Although it is a condition that requires conservative treatment, it can often be confused with clinical conditions that may require surgical intervention and complications such as urinary tract infection and acute kidney failure mayor cur. In this case, were viewed 49 year old male patient who has lower abdominal pain due to ureteral stone and did not know that he had a pelvic kidney. Because of leukocytosis and vomiting, acute appendicitis was considered as prediagnosis, but abdominal CT imaging of patient showed a left pelvic kidney and 5 mm calcule in the middle part of the ureter.

Journal of Cardiovascular Medicine, 2021

BACKGROUND Atrial fibrillation is one of the most common arrhythmias after ST-segment elevation m... more BACKGROUND Atrial fibrillation is one of the most common arrhythmias after ST-segment elevation myocardial infarction (STEMI). In recent years, a strong correlation was found between epicardial adipose tissue (EAT) and the development of atrial fibrillation. In addition, EAT has been reported to be a predictor of new-onset atrial fibrillation development in different clinical situations. In this study, we aimed to determine the relationship between EAT thickness in patients with STEMI who underwent primary percutaneous coronary intervention (pPCI) and the development of new-onset atrial fibrillation during hospital follow-up. MATERIAL AND METHODS Four hundred and thirteen consecutive patients [284 men (69%) and 129 women (31%)] with a mean age of 59 ± 11 years diagnosed with STEMI were included in this study. Atrial fibrillation developed in 52 (12.5%) patients during in-hospital follow-up and the remaining 361 patients were determined as the control group. There was no difference between the two groups in terms of age and sex. EAT thickness was measured using transthoracic echocardiography. Multiple regression analysis was performed to determine the independent predictors of atrial fibrillation. RESULTS EAT thickness was higher in the group with atrial fibrillation than in the control group (P < 0.001). The SYNTAX risk score was higher in the atrial fibrillation group (P < 0.001). A positive correlation was observed between EAT thickness and SYNTAX score (r = 0.523, P < 0.001). In the logistic regression analysis, EAT was detected to be an independent predictor for the development of atrial fibrillation (odds ratio: 4.135, 95% confidence interval 1.245-8.176, P < 0.001). CONCLUSION EAT thickness is an important marker of atrial fibrillation development in STEMI patients in the post-pPCI period. We think that EAT thickness can be used as a cardioembolic risk factor in STEMI patients.

Annals of Emergency Medicine, 2019

Study objective: The primary objective of this study is to compare the effectiveness of 3 treatme... more Study objective: The primary objective of this study is to compare the effectiveness of 3 treatment protocols to stop anterior epistaxis: classic compression, nasal packing, and local application of tranexamic acid. It also aims to determine the frequency of rebleeding after each of these protocols. Methods: This single-center, prospective, randomized controlled study was conducted with patients who had spontaneous anterior epistaxis. The study compared the effect of 3 treatment options, tranexamic acid with compression but without nasal packing, nasal packing (Merocel), and simple nasal external compression, on the primary outcome of stopping anterior epistaxis bleeding within 15 minutes. Results: Among the 135 patients enrolled, the median age was 60 years (interquartile range 25% to 75%: 48 to 72 years) and 70 patients (51.9%) were women. The success rate in the compression with tranexamic acid group was 91.1% (41 of 45 patients); in the nasal packing group, 93.3% (42 of 45 patients); and in the compression with saline solution group, 71.1% (32 of 45 patients). There was an overall statistically significant difference among the 3 treatment groups but no significant difference in pairwise comparison between the compression with tranexamic acid and nasal packing groups. In regard to rebleeding within 24 hours, the study found rates of 86.7% in the tranexamic acid group, 74% in the nasal packing group, and 60% in the compression with saline solution group. Conclusion: Applying external compression after administering tranexamic acid through the nostrils by atomizer stops bleeding as effectively as anterior nasal packing using Merocel. In addition, the tranexamic acid approach is superior to Merocel in terms of decreasing rebleeding rates. [

Eurasian Journal of Emergency Medicine, 2018

Aim: The primary aim of the present study was to detect whether blood gases analyzer (BGA) is rel... more Aim: The primary aim of the present study was to detect whether blood gases analyzer (BGA) is reliable or not in daily practice by comparing sodium (Na +), potassium (K +), hemoglobin (Hgb), and hematocrit (Htc) levels measured by BGA and laboratory auto-analyzer (LAA). The secondary aim was whether BGA is reliable or not in daily practice by comparing Na + , K + , Hgb, and Htc levels measured by BGA and LAA in different pH stages. Materials and methods: The study screened the electronic data and file records of all patients who were admitted to the emergency department with any complaint during the study period retrospectively. Patients who had results of venous blood gases and routine laboratory obtained at the same time were included the study. For each parameter, agreements and correlations between the results of BGA and LAA were evaluated by Bland-Altman test and Spearman's correlation test, respectively. An r-value >0.80 was considered a strong correlation. Results: The laboratory results of 1374 patients were evaluated for statistical analyses. When evaluating the correlations between the results of BGA and LAA, it was found that there was only a strong correlation for K + (p<0.001, r=0.83). When assessing the agreements between the results of BGA and LAA, the mean differences were found to be 0.02±6.1 for Na + , 0.3±0.44 for K + ,-0.5±1.6 for Hgb, and-0.6±5 for Htc. Conclusion: Although there are strong correlation and relatively good acceptable agreement for K + measurement, there are no strong correlation and good agreement for other measurements, including Na + , Hgb, and Htc. In addition, we found that these results did not change according to the different pH stages.

The American journal of emergency medicine, Jan 22, 2017

The study aimed to detect whether modified Valsalva maneuver (VM) is more effective than the stan... more The study aimed to detect whether modified Valsalva maneuver (VM) is more effective than the standard VM in terminating paroxysmal supraventricular tachycardia (PSVT). This randomized controlled trial was conducted in the emergency department of a training and research hospital between Dec. 1, 2015 and Dec. 31, 2016. Participants were divided into two groups, randomly assigned standard VM or modified VM, as the first treatment with two-dimensional permutation blocks; in the order of arrival of the patients. In both groups; the determined procedure for standard or modified VM was repeated up to three times in patients whose PSVT did not convert to sinus rhythm. In both groups; if the maneuver was unsuccessful after three attempts, anti-arrhythmic medication was administered. The primary outcome was defined to compare the success rate of achieving sinus rhythm after standard VM or modified VM. Fifty-six patients were randomized to modified or standard VM with 28 patients in each treat...

Angioedema (AE) is a life-threatening condition that can be seen in hereditary or non-hereditary ... more Angioedema (AE) is a life-threatening condition that can be seen in hereditary or non-hereditary form, usually manifests in subcutaneous tissue and progressed with edema in the face, lips, tongue, larynx and gastrointestinal system. Captopril is the first generated angiotensin-converting enzyme (ACE) inhibitor. Since the inhibition of ACE and consequently the angiotensin II level in plasma and tissues is reduced and quinine degradation is also inhibited by ACE, the level of bradykinin increases in plasma and tissues. It is thought to that the bradykinin causes edema due to vasodilation and increased vascular permaability. In this case report, we reviewed a 63-year-old patient, who hospitalized in the general surgery ward with the preliminary diagnosis of acute cholecystitis, developed AE after treated with 25 mg captopril for high blood pressure.