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Öğe A comparison of computerized tomography and flair-SWI MRI results of patients with head injury attending the emergency department(Verduci Publisher, 2022) Durak, M. A.; Gurbuez, S.; Derya, S.; Yildirim, I. o.; Ekmekyapar, M.; Tetik, B.; Colak, C.- OBJECTIVE: Detection of trau-matic brain injury (TBI) is of vital importance in patients who apply to the emergency depart-ment with a history of trauma. The aim of initial imaging in patients with suspected TBI is to de-tect trauma-related injury quickly and accurate-ly. In this study, the effectiveness of prospec-tively cranial computed tomography (CT) and fluid attenuation inversion recovery (FLAIR) and susceptibility weighted imaging (SWI) sequence magnetic resonance imaging (MRI) examination results of patients diagnosed with TBI in the emergency department in terms of bleeding de-tection was investigated in the light of the liter-ature. PATIENTS AND METHODS: Patients with traumatic brain injury who applied to the emer-gency department between 2016 and 2020 were included in this prospective study. Crani-al CT and MRI images containing SWI-FLAIR se-quence were taken on the same day, immediate-ly after cranial CT, for a total of 500 patients. RESULTS: In our study, TBI was detected in 242 males (70.8%) and 100 females (29.2%), for a total of 342 patients. The mean age was 41.45, the mean GCS was 13.35. There was a history of trauma such as falling in 155 patients (45.3%), traffic accidents in 171 patients (50%), and trau-ma in 16 patients (4.7%). In the comparative eval-uation of CT and FLAIR-SWI MRI examinations no bleeding was detected in the FLAIR-SWI sec-tions of 239 patients who did not have bleed-ing on CT; however, bleeding was detected in FLAIR-SWI sections in 14 patients who did not have bleeding on CT. CONCLUSIONS: FLAIR-SWI MR, which is a more reliable examination method, should be per-formed before control CT, especially in patients with incompatible clinical and admission CT.Öğe The effects of iron deficiency on blood transfusion requirements in traumatic brain injury(Scientific Publishers India, 2016) Durak, M. A.; Aydogan, M. S.; Gurbuz, S.Introduction: Traumatic brain injury (TBI) is the leading cause of preventable death in trauma patients. TBI often need blood transfusion, iron deficiency (ID) is known as the first cause of anemia worldwide, but no known predictors of transfusion requirements are available at intensive care unit (ICU). The aims of this study were to investigate ID relationship with blood transfusion requirements in TBI patients at ICU. Methods: One hundred forty-two patients with severe TBI, as defined by Glasgow Coma Scale (GCS) scores < 8 with an expected ICU length of stay >= 48 hours were admitted to the general ICU were enrolled in the prospective observational study between April 1, 2013, and December 31, 2015. Patients were divided into 2 groups according to their baseline iron status: iron-deficient (ID) and non-ID (normal iron profile) cohorts. Demographic features, laboratory values, blood transfusions, and length of ICU stay were recorded. Results: A total of 134 patients were included in this analysis. The mean Glasgow coma score at baseline was 6 +/- 5 and Injury Severity Score (ISS) 18.5 +/- 4.5. ID with TBI patients, which was diagnosed in 65 patients (48.5%), compared with non-ID patients, with higher ISS but no difference in admission GCS score or APACHE II scores. ID was associated with a greater use of blood transfusions (5 and 2 U/patient, respectively; p=.0001). The median length of ICU stay after TBI was longer among the ID versus the non-ID group (25 and 17 days per patient, respectively; p=.0001). Conclusion: We found that ID was highly prevalent at ICU admission patients with TBI and that it was associated with higher blood transfusion requirements. Therefore, ID may be a prognostic factor for the blood transfusion requirements in TBI at ICU.Öğe Efficacy of Intravenous Paracetamol and Ibuprofen on Postoperative Pain and Morphine Consumption in Lumbar Disc Surgery: Prospective, Randomized, Double-Blind, Placebo-Controlled Clinical Trial(Masson Editeur, 2021) Akbas, S.; Ozkan, A. S.; Durak, M. A.; Yologlu, S.Objectives. - Effective postoperative pain management after lumbar disc surgery reduces complications and improves postoperative care. The purpose of this prospective, randomized, double-blind, placebo-controlled clinical study is to evaluate the effects of IV paracetamol and ibuprofen on postoperative pain, morphine consumption and side effects of morphine in patients who underwent lumbar disc surgery. Materials and methods. - Seventy-five patients aged 18-85 years scheduled for lumbar disk surgery with a single level laminectomy included in this study. All patients received morphine with an IV patient-controlled analgesia device during the first postoperative 24 hour. The patients were divided randomly and double-blinded into three groups (control, paracetamol and ibuprofen). The demographic characteristics and procedure data, VAS score, cumulative morphine consumption, opioid-related side effects were recorded. Results. - There was no significant difference regarding to demographic characteristics, comorbidities, and durations of anesthesia and surgery. There was a significant difference between all groups regarding to total morphine consumption (P< 0.001). IV ibuprofen significantly reduced the total morphine consumption in comparison with control and paracetamol (P< 0.001). Repeated measures ANOVA showed in all periods of the study that VAS score was significantly lower in ibuprofen (P < 0.001), but not in paracetamol (P= 0.394) in comparison with control. There was no difference between groups regarding postoperative heart rate, mean arterial pressure, nausea-vomiting, pruritus and urinary retention. Conclusions. - This study showed that pain scores and morphine consumption, but not the side effects of patient-controlled analgesia during 24 hours after the lumbar disk surgery, were significantly reduced by IV ibuprofen as a supplemental analgesic when compared with controls and paracetamols. (C) 2021 Elsevier Masson SAS. All rights reserved.Öğe Nutritional evaluation of non-traumatic patients admitted to the hospital from Emergency Department(Verduci Publisher, 2022) Gurbuz, S.; Ekmekyapar, M.; Durak, M. A.; Oguzturk, H.; Turtay, M. G.; Yucel, N.; Demir, T. O.OBJECTIVE: Malnutrition is a common condition, especially among hospitalized patients which are overlooked by many clinicians. Malnutrition was found to be associated with increased hospitalization duration, increased admission frequency. increase in infection frequency and severity, bad wound healing, gait disturbances, fallings. and fractures. In this study, we aimed to determine malnutrition frequency in patients who were admitted to the emergency department for non-trauma causes and hospitalized. PATIENTS AND METHODS: 245 patients were admitted to the Emergency Department for non-trauma causes and hospitalized and 245 control group patients were included in this study. Hospitalized patients were assessed with NRS-2002 (Nutritional Risk Screening) and Mini Nutritional Assessment (MNA). Age, gender. height. weight, body mass index (BMI), malnutrition status. and wards of the patients were screened. RESULTS: 140 (57.1%) of the hospitalized patients had malnutrition according to NRS-2002 and MNA. There was a statistically significant difference between the control group and the hospitalized patients who were malnourished (Pearson chi-square test: p<0,001). There was a significant relation between hospitalized departments and malnutrition (p<0.05). There was a significant difference in age and height between hospitalized patients and the control group (p<0.0001) whereas no significant difference was found between the height and BMI (p>0.05). There was a significant relationship in terms of hospitalization and malnutrition. CONCLUSIONS: The nutritional state of the patients admitted to the emergency department for non-trauma conditions is an important factor and should not be overlooked.Öğe Protective and therapeutic effects of molsidomine on radiation induced neural injury in rats(Taylor & Francis Inc, 2017) Durak, M. A.; Parlakpinar, H.; Polat, A.; Vardi, N.; Ekici, K.; Ucar, M.; Ozhan, O.We investigated the protective and therapeutic effects of molsidomine (MOL) in a rat model of whole brain radiotherapy (RT). Forty female rats were divided into five groups of eight: group 1, control; group 2, 15 Gy single dose RT (RT); group 3, 4 mg/kg MOL treated for 5 days (MOL); group 4, 4 mg/kg MOL for 5 days, 10 days after RT treatment (RT + MOL); group 5, 4 mg/kg MOL treatment for 5 days before RT treatment and for 5 days after RT treatment (MOL + RT). All rats were sacrificed on day 16. Neurodegenerative changes in the brain and tissue levels of oxidants and antioxidants were evaluated. The oxidative parameters were increased and antioxidant status was decreased in group RT compared to groups MOL + RT and RT + MOL. Histopathological examination showed that treatment with MOL after RT application and treatment with MOL before RT treatment decreased neuronal degeneration. No difference in neuronal appearance was found between groups RT + MOL and MOL + RT. MOL treatment protected the nervous system of rats and may be a treatment option for preventing RT induced neural injury.Öğe Protective effect of short-term thymoquinone administration on the central nervous system in cisplatin-induced neurotoxicity(Verduci Publisher, 2022) Durak, M. A.; Ozhan, O.; Yildiz, A.; Durhan, M.; Vardi, N.; Cigremis, Y.; Parlakpinar, H.OBJECTIVE: This study was performed to investigate the potential benefi- cial effects of thymoquinone (TQ) on brain tis-sue based on biochemical and histopathologi-cal analyses in cisplatin (CIS) treated rats with central nervous system (CNS) neurotoxicity. MATERIALS AND METHODS: The rats were randomly divided into 4 groups with 8 rats in each group (n:8). Group 1: (Control), saline was administered for 3 days at a volume of 0.5 ml per day intraperitoneal (i.p.). Group 2: (CIS Group), one dose of CIS was administered (7 mg/kg i.p.). Group 3: (TQ Group), TQ was giv-en at a dose of 5 mg/kg per day for 3 days (i.p.). Group 4: (CIS+TQ Group), one dose of 7 mg/ kg was initiated half an hour before adminis-tration of CIS and one dose of 5 mg/kg per day was administered TQ i.p. for 3 days. RESULTS: Malondialdehyde levels were found to be statistically significantly higher in the CIS group compared to the control group. Degenerative changes observed in the CIS+TQ group were found to be milder than in the CIS group. In the CIS+TQ group, a statistically sig-nificant decrease in the severity of caspase-3 immunoreactivity was found when compared to the CIS group. It was found that the sever-ity of neurofilament immunoreactivity moni- tored in neuronal extensions was similar in all groups. In the CIS+TQ group, the severity of tau protein's immunoreactivity was similar to that of the CIS-group.CONCLUSIONS: According to the results obtained in our study, beneficial effects were obtained in reducing neurotoxicity with short-term TQ application in rats treated with CIS treatment.
