ERTUĞRUL ALTINBİLEK | Sağlık Bilimleri Üniversitesi (original) (raw)

Papers by ERTUĞRUL ALTINBİLEK

Research Square (Research Square), Jul 17, 2023

Introduction/aims: Cardiopulmonary arrest can occur with different rhythms in in-hospital and out... more Introduction/aims: Cardiopulmonary arrest can occur with different rhythms in in-hospital and out-of-hospital cases. Early and effective cardiopulmonary resuscitation (CPR) is the most important practice affecting survival in these patients. It was aimed to determine the relation of fetuin-A level, which is a new protein, with the collapse rhythm, prognosis, and mortality in patients who underwent CPR. Methods: One hundred four patients who had cardiopulmonary arrest as witnesses in the emergency department were included in prospective study. The patients were divided into four groups according to their collapse rhythm: asystole, pulseless electrical activity, pulseless ventricular tachycardia, and ventricular brillation. According to the mortality status, they were divided into three groups as alive, exitus at the emergency department (EXED), and exitus at intensive care unit (EXIC). Results: The average age of the patients included in the study was 63.38±12.38 years, 42 (40%) of them were women. Fetuin-A was 0.183±0.18 ng/ml in the EXED group, 0.183±0.22 ng/ml in the EXIC group, and 0.201±0.16 ng/ml in the survival group (p=0.001). The fetuin-A level was the highest in the pulseless electrical activity group with 0.206±0.10 ng/ml and the lowest in the ventricular brillation group with a value of 0.183±0.20 ng/ml (p=0.002). There was a strong negative correlation between fetuin-A and rhythm (p=0.001). Conclusion: In cardiopulmonary resuscitated patients, the fetuin-A level may be a helpful value in de ning prognosis and mortality.

Bagcılar medical bulletin, Jun 15, 2023

Indian journal of respiratory care, Dec 1, 2022

in contrast with seasonal influenza epidemics, the negative effects of COVID-19 in COPD patients ... more in contrast with seasonal influenza epidemics, the negative effects of COVID-19 in COPD patients seem to be lower than expected. 8 We aimed to explore the impact of airflow limitation severity, exacerbation history, and laboratory findings of COPD patients who are hospitalized due to COVID-19 pneumonia. Materials a n d Methods The study was conducted in a single-center tertiary hospital from March 2020 to February 2021 after the approval of the Ethics Committee. The study was carried out in compliance with the criteria of the Declaration of Helsinki. All the participants provided

Journal of health sciences and medicine, Mar 27, 2023

Aim: Early repolarization (ER) is a frequent indication, and it is important to correctly evaluat... more Aim: Early repolarization (ER) is a frequent indication, and it is important to correctly evaluate the effects of its benign and malignant forms in terms of prognosis. It was aimed to compare ER cases with the normal population in terms of multi-vessel disease, bypass and mortality. Material and Method: This study comprised 776 patients aged 18 and older who admitted the emergency department between January 2015 and December 2020. 377 of these patients had ER in the electrocardiogram (ECG), 409 patients had normal ECGs and were added to the study as the control group. Age, gender, multi-vessel disease, bypass and mortality relations of the patients were evaluated with angiographic findings. Results: The mean age of 786 patients was 50.49±6.82 years, 372 (47.3%) were female, and the age range was 23-66 years (p<0.001). Of the cases, 110 (14%) were in the horizontal ER, 267 (34%) were in the ascending ER, and 409 (52%) were in the normal group. Multi-vessel disease was observed in 58 (7.4%) of all cases (p<0.001), while 19 (2.4%) had a bypass attempt because angiography could not be cured (p=0.001). Of the cases with early repolarization, 176 (22.4%) were inferior, 112 (14.2%) were inferolateral, 77 (9.8%) were anterior, and a small number of them were 12 (1.5%) common ER types (p<0.001). Angiography was normal in 575 (73.2%) cases, left anterior descending artery was occluded in 65 (8.3%), circumflex artery was occluded in 73 (9.3%) and right coronary artery was occluded in 73 (9.3%) cases (p<0.001). Eighteen (2.3%) patients resulted in mortality in the 60-month follow-up of all cases. Of these, 9 (8.2%) were horizontal, 2 (0.7%) were asending, and 7 (1.7%) were in the normal population (p<0.001). Conclusion: Electrocardiography can be a helpful method to evaluate interventional angiography, prognosis and mortality in both early repolarization cases and normal cases.

Frontiers in Medical Case Reports, 2022

Musculoskeletal disorders are a common reason for emergency department admissions. In addition to... more Musculoskeletal disorders are a common reason for emergency department admissions. In addition to providing pain control to these patients, it is crucial to differentiate between musculoskeletal, spinal cord, abdominal, and retroperitoneal diseases. A 37-year-old female with multiple sclerosis complained of pain extending from the left groin and leg to the left knee. The patient had severe non-traumatic pain, posture and gait disturbances. In addition, paresthesia in the left thigh of the lower extremity, difficulty in flexion, and the reverse laseque test were positive. On magnetic resonance imaging, a far lateral lumbar disc herniation was found at the L3-L4 vertebral level. Twelve days after being hospitalized to the neurosurgery clinic, the patient was discharged. A patient who presented to the emergency department with multiple sclerosis and distal lateral lumbar disc herniation was evaluated in light of the relevant literature.

DergiPark (Istanbul University), Mar 1, 2015

Secondary spontaneous pneumothorax occurs in people with a wide variety of pulmonary pathology es... more Secondary spontaneous pneumothorax occurs in people with a wide variety of pulmonary pathology especially in chronic obstructive pulmonary disease, bullous emphysema, bronchial asthma, congenital cysts, malignancies, interstitial fibrosis, pneumonia and cystic fibrosis. Secondary spontaneous pneumothorax is a lifethreatening condition due to underlying chronic pulmonary pathology and commonly seen in elderly patients. In this case we want to remind possibility of underlying pulmonary malignancy with pneumothorax in an elderly patient.

The annals of clinical and analytical medicine, 2021

Aim: During the 2019 coronavirus disease (COVID-19) pandemic, healthcare workers experience inten... more Aim: During the 2019 coronavirus disease (COVID-19) pandemic, healthcare workers experience intense levels of workload and pressure. The exact psychological and mental impacts of this pandemic on healthcare workers and relevant factors remain to be elucidated. Therefore, this study aimed to investigate the stress and anxiety of healthcare workers due to COVID-19. Material and Methods: This prospective multi-centered survey-based study was conducted on 205 participants working in the emergency room (ER) of two hospitals between May 15 and May 22, 2020. Besides demographic data such as age, gender, working history in ER, marital status and presence of children, the Perceived Stress Scale (PSS) and the Beck Anxiety Inventory (BAI) were used in the questionnaire. Data were analyzed by either the Kruskal-Wallis test and Mann-Whitney U test, Chi-square test or Fisher's exact test. Results: Most of the participants were nurses (35.5%), and 53.2% of all participants were male. The rate of COVID-19 infection among physicians and nurses was significantly higher than among personnel in other occupations. The rate of the willingness of physicians and nurses to receive psychiatric support was significantly higher than that of other personnel (p < 0.05). Physicians and nurses had higher BAI and PSS scores than other staff, and scores of nurses were significantly higher than physicians (p < 0.05). Discussion: During the pandemic, the adverse psychological and mental impacts of COVID-19 were prevalent among the healthcare workers. Adequate measures at both organizational and national levels are required to improve the psychological state of frontline healthcare workers during the COVID-19 pandemic.

The annals of clinical and analytical medicine, 2020

Laboratory results and chest CT findings in COVID-19 patients Comparison of laboratory results an... more Laboratory results and chest CT findings in COVID-19 patients Comparison of laboratory results and chest CT findings in COVID-19 patients

DergiPark (Istanbul University), Apr 26, 2020

The aim of this study was to investigate the demographic and clinical characteristics of fatal tr... more The aim of this study was to investigate the demographic and clinical characteristics of fatal trauma cases presenting to the Emergency Department of XXX Training and Research Hospital in Turkey. Methods: In this retrospective study, the forensic cases of fatal trauma patients admitted to the emergency department between 15.06.2017 and 15.06.2019 were obtained from the hospital's automation system, and the patient files and hospital police records were evaluated. Results: The most common cause of forensic trauma cases was pedestrian accidents (n=18; 25%), and the least common cause was crush injuries by a heavy object (n=2; 2.8%). The most common site of trauma was the cranial region (n=45; 62.5%). Forty-six patients died (63.9%) in the emergency room and 26 (36.1%) at various clinics. The average duration of active dying was 3.7 ± 17.9 hours. Fifty-four cases (75%) were found to be ethanol-negative and 18 (25%) were ethanol-positive. Conclusion: The most common forensic trauma cases are pedestrian accidents and seen in male patients. Most of these patients die in the emergency room, where they are first admitted. The most important factor in reducing mortality is preventing the occurrence of trauma. In addition to giving the person adequate and appropriate treatment, physicians also have the responsibility of writing clear and intelligible forensic reports in accordance with the laws and hospital rules.

Urinary calculi disease is considered as endemic in our countr y and has an incidence of approxim... more Urinary calculi disease is considered as endemic in our countr y and has an incidence of approximately 15%. Cystolithiasis constitutes only 5% of the whole urinary tract calculuses. It is commonly seen in elderly men. Prostatic hyperplasia, infection, neurogenic bladder, foreign bodies and anti-incontinence surgery in women may be a predisposing factor for cystolithiasis. Most of the patients with cystolithiasis admit to the hospital with pain, bleeding, infection and recurrent lower urinary tract symptoms. In this case report, we aimed to pr esent a patient who admitted to the emergency department with complaints of anuria and at whose direct graphy a lot of opacity detected compatible with calculi.

Biomedical Research-tokyo, 2017

Objective: Spinal trauma and the ensuing neurological problems transform a person's social life a... more Objective: Spinal trauma and the ensuing neurological problems transform a person's social life and result in significant economic and non-economic burden. We compared the diagnostic performances of the National Emergency X-Radiography Utilization Study (NEXUS) Low-Risk Criteria (NLC) with the Canadian C-Spine Rule (CCSR) criteria in identifying lesions. Methods: This retrospective study was conducted on 724 patients after obtaining approval from the ethical board of the hospital. The demographic characteristics of the patients (age, gender), their medical histories, season, trauma occurrence mechanism, hospital arrival time following the development of spinal trauma, their Glasgow Coma Score at the time of admission, their complaints at the time of admission (such as pain, paresthesia, and loss of muscle strength), their spinal trauma lesion levels, and compatibility of the applied viewing methods with the NEXUS and CCSR criteria were collected from the patients' files. Results: A total of 2,442 cases were diagnosed with spinal trauma. For patients with a spinal fracture, the sensitivity and specificity of CCSR were 99.7% and 17.9%, respectively, while the sensitivity and specificity of NEXUS were 97.6% and 27.2%, respectively. Positive predictive value (PPV) and negative predictive value (NPV) of CCSR were, respectively, 16.3% and 99.7%, while the PPV and NPV of NEXUS were 17.7% and 98.6%, respectively. Conclusions: This study showed that the CCSR criteria are more sensitive than the Nexus criteria.

Journal of Clinical and Analytical Medicine, Sep 1, 2016

Hemofagositik sendrom sistemik inflamatuvar bozukluklara eşlik eden T-lenfosit ve makrofajların a... more Hemofagositik sendrom sistemik inflamatuvar bozukluklara eşlik eden T-lenfosit ve makrofajların aşırı aktivasyon ve proliferasyonu sonucu oluşan masif hipersitokinemi seyreden ciddi bir tablodur. Bu olgu sunumunda yüksek ateş ve halsizlikle başvuran hemofagositik sendromlu bir vakanın sunulması amaçlandı. Tedaviye rağmen mortalite yüksek olabilir. Erken tanının önemli olduğu tanıda gecikildiğinde prognozu son derece kötü olan hemofagositik sendromun tanısı mümkün olan en kısa sürede konulmalı, tedavisi ise altta yatan etiyolojiye göre yapılmalıdır

Journal of Experimental & Clinical Medicine, 2015

We aimed to define point of view of the Emergency Medicine Physicians (EMPs) working in emergency... more We aimed to define point of view of the Emergency Medicine Physicians (EMPs) working in emergency services in Turkey about the duration of cardiopulmonary resuscitation (CPR) and to determine whether a standardization could be developed for CPR duration in the light of this information. After approval of the ethics committee, a survey form was prepared using Google Document and internet access address was sent to 1.404 EMPs via mail. A total of 428 persons responded the survey and 426 appropriate responses were assessed. Of the EMPs, 64.2% suggested that the persons who perform and/or manage CPR must make the decision for the duration. The participants stated that CPR time should be longer at younger ages and shorten with aging and that duration of CPR must be shorter in patients with the end-stage. The decision for ‘Do Not Attempt Resuscitation (DNAR)’ can not be made in our country. Legal studies must be conducted for law, regulations and notification in order to made decision for DNAR only in terminal stage patients. Therefore there must not be a law, regulation or CPR guide including exact duration for CPR.

Irish Journal of Medical Science, Jan 10, 2022

Background CoronaVac, an inactivated whole-virion vaccine against COVID-19, has been shown to be ... more Background CoronaVac, an inactivated whole-virion vaccine against COVID-19, has been shown to be safe with acceptable antibody responses by various clinical trials. Aims The objective was to investigate the post-vaccination antibody levels of both symptomatic and asymptomatic healthcare workers with or without the diagnosis of COVID-19 in an emergency department (ED) of a hospital serving as a pandemic hospital. Methods This single-centred, prospective study was conducted on 86 participants who were working as nurse or doctor in the ED. The volunteers were older than 18 years and either positive or negative for either computed tomography (CT), realtime reverse transcription polymerase chain reaction (qRT-PCR), or both. Thirty days after the second dose of CoronaVac (3 µg), the antibody levels were chemiluminescent microparticle immunoassay. Results Mean age of all participants were 33.1 ± 9.1 years. The antibody levels in the qRT-PCR(+) and CT(+) groups were significantly higher than the qRT-PCR(−) and CT(−) groups, respectively (p < 0.05). In the CT(+)/qRT-PCR(+) group, the antibody level was significantly higher than the CT(−)/qRT-PCR(−) and CT(−)/qRT-PCR(+) or CT(+)/qRT-PCR(−) group (p < 0.05). On the other hand, antibody levels in the hospitalized group were significantly higher than in the non-hospitalized group (p < 0.05). A significant positive correlation was observed between the time elapsed after vaccination and antibody levels of the participants (r = 0.343; p = 0.000). Conclusion In conclusion, antibody responses of recovered patients COVID-19 diagnosed by both CT and qRT-PCR were much robust than the patients diagnosed by either one of the techniques or undiagnosed/disease-free participants suggesting that severity of the disease likely contributes to the antibody responses after vaccination with CoronaVac.

PubMed, Aug 10, 2020

Background and aim: In this study, it was aimed to review patients who presented to a Turkish eme... more Background and aim: In this study, it was aimed to review patients who presented to a Turkish emergency department (ED) with fever and at least one symptom and finding of acute respiratory infection (cough, shortness of breath) in Sisli Hamidiye Etfal Education and Research Hospital Tertiary Medical Care Center during COVID-19 pandemic. Methods: This retrospective, descriptive, observational study included patients presented between March 10, 2020 and April 25, 2020. The patients were classified into two groups according to RT-PCR test result: RT-PCR (+) and RT-PCR (-). The demographic characteristics and clinical endpoint-related factors were analyzed in the patients. Results: The study included 840 patients; 461 men (54.9%) and 379 women (45.1%). RT-PCR test was positive in 345 patients (41.0%). The most common comorbidity was hypertension (HT) in 119 patients (34.5%); followed by diabetes mellitus (DM) in 61 patients (18.3%). At time of ED presentation, there was mild clinical manifestation in 72.2%, whereas moderate in 21.7% and severe in 6.1% of patients with positive RT-PCR testing. Of the patients with positive RT-PCR testing, 64 patients (18.6%) were discharged from ED while 255 patients (73.9%) were admitted to COVID clinic and 26 were admitted to COVID intensive care unit (ICU). Of the patients admitted, 299 patients (86.7%) were discharged while 46 patients (13.3%) died due to multi-organ failure (MOF) (50%), acute respiratory distress syndrome (ARDS) (32.6%), acute pulmonary embolism (APE) (10.9%) and acute coronary syndrome (ACS) (6.5%). Conclusions: The RT-PCR positivity rate seemed lower in our study when compared to literature. In addition, mortality rate was lower in our study when compared to other countries.

$Research paper thumbnail of Relation of a novel fibrosis marker and post-myocardial infarction left ventricular ejection fraction in revascularized patients$

Biomarkers in Medicine, Dec 1, 2021

Aim: To investigate the relationship between post-myocardial infarction (MI) left ventricular eje... more Aim: To investigate the relationship between post-myocardial infarction (MI) left ventricular ejection fraction (LVEF) and fibrosis marker HE-4 in primarily revascularized patients with ST-segment elevation MI (STEMI). Patients & methods: In 94 consecutive STEMI patients (median age 57 [IQR: 50–69] years; 77.7% male), HE-4 values were measured at hospital admission and 4 days after STEMI. Transthoracic echocardiography was performed 4 days after STEMI (median 5 days [interquartile range: 4–6]). Results: HE-4 levels 4 days after STEMI were significantly higher in the low ejection fraction group (30.1 [26.0–46.5] pmol/l vs 48.5 [32.5–85.9] pmol/l, p = 0.004). In the multivariable analysis, HE-4 values (odds ratio: 1.029, 95% CI: 1.012–1.046, p = 0.001), troponin I levels, anterior MI and diabetes mellitus were independent predictors of low LVEF after STEMI. A negative correlation existed between ΔHE-4 levels and LVEF (r: -0.337, p = 0.001). Receiver operating characteristic analysis indicated 34.01 pmol/l HE-4 at 4 days after STEMI identified patients with low LVEF (AUC = 0.707; 95% CI: 0.601–0.813; p = 0.001). Conclusion: In revascularized STEMI patients, high HE-4 levels are associated with decreased LVEF. HE-4 may represent a diagnostic marker and treatment target for patients with heart failure or left ventricular systolic dysfunction after STEMI.

World Journal of Emergency Surgery, Jul 25, 2013

Aim: Scalp lacerations are commonly encountered in patients presenting to emergency department wi... more Aim: Scalp lacerations are commonly encountered in patients presenting to emergency department with trauma. Lacerations are repaired with suturing, stapling, adhesive tapes, and tissue adhesives. In this study, we aimed to compare the effectiveness of suturing, stapling, and hair apposition techniques used in repair of scalp lacerations in patients who presented to emergency department with scalp laceration. Materials and method: After obtaining approval of local ethics committee, we examined the effects of the three technique used to repair scalp lacerations on wound healing, complication rate, and patient satisfaction by recording data. Categorical variables were expressed as n and %. X 2 test was used for statistical analysis. A p value less than 0.05 was accepted statistically significant. Results: Our study included a total of 134 patients of whom were treated 37 (27.6%) with hair apposition technique 49, 48 (35.8%) with suturing, and (36.6%) with stapling. There was a significant difference between the scalp repair technique and 7th and 15th day patient satisfaction rates in favor of the hair apposition technique (p < 0.05). There was a significant difference between the scalp repair technique and cosmetic problems after 15 days (p < 0.05). Cosmetic problems 15 days after the procedure were significantly lower in the hair apposition technique. Conclusion: In patients presenting to emergency departments with linear scalp laceration suturing, stapling, and hair apposition techniques can be safely applied. However, hair apposition technique has the advantages of being more satisfying, and having lower cosmetic problem and complication rates compared with other techniques.

International Journal of General Medicine, Apr 1, 2023

Indian Journal of Respiratory Care

Background: Coronavirus disease 2019 (COVID-19) has been a challenging viral respiratory tract in... more Background: Coronavirus disease 2019 (COVID-19) has been a challenging viral respiratory tract infection since 2019 and may contribute to higher mortality in patients with chronic obstructive pulmonary disease (COPD). Methods: We analyzed the clinical data of 98 patients hospitalized with a diagnosis of COVID-19 and who had a previous diagnosis of COPD. They are grouped regarding GOLD ABCD stages, reported as follows whether in pandemic wards or intensive care units (ICU). The clinical outcomes were noted as a live hospital discharge or inhospital mortality. Results: A total of 76 patients (77.6%) were in the pandemic wards, 22 (22.4%) were in the ICU. Around 81 (82.7%) patients survived, 17 (17.3%) were deceased. We grouped them as GOLD A and GOLD B and GLOD C, and GOLD D. Procalcitonin (PCT) level was higher and arterial oxygen partial pressure (PaO2 in mm Hg) to fractional inspired oxygen (PaO2/FiO2) level was lower in the group of GOLD C and GOLD D than in GOLD A and GOLD B (p &...