Yazar "Ekmekyapar, Tuba" seçeneğine göre listele
Listeleniyor 1 - 6 / 6
Sayfa Başına Sonuç
Sıralama seçenekleri
Öğe Carotid Artery Dissection: A Case Report(Emergency Medicine Physicians Assoc Turkey, 2020) Ekmekyapar, Muhammed; Oguzturk, Hakan; Ekmekyapar, Tuba; Derya, Serdar; Gurbuz, SukruCarotid artery dissection, firstly described by Pratt-Thomas and Berger in 1947, typically begins in inner layer of artery wall, proceeds to the middle layer, and intramurally extends along length of the artery as a result of the pressure produced by blood stream. This study aims to report a case in which internal carotid artery dissection was diagnosed as secondary to trauma. A 24-year-old male patient was brought to the emergency room by 112 emergency service team after a motorcycle accident. Physical examination of the patient revealed a painful dermabrasion in his right neck region and other system examinations were normal. Carotid-vertebral color Doppler ultrasonography was performed on the patient because he had a right neck pain. Accordingly, an intimal flap appearance compatible with dissection was observed on the right internal carotid artery (ICA) proximal segment. Then, brain+cervical CT angiography was performed on the patient, and an appearance compatible with dissection was observed in the right ICA. Therefore, the patient was referred to neurology and neurosurgery consultation and accordingly admitted to neurosurgery intensive care unit. As a result, carotid artery dissection in addition to other intracranial pathologies should be considered among differential diagnoses for patients with head and/or neck pain complaints regardless of whether or not they have a trauma history.Öğe Clinical and radiological observation of stroke cases in the emergency department of a university hospital(2021) Ekmekyapar, Tuba; Ekmekyapar, Muhammed; Sahin, Levent; Solgun, Omer Faruk; Gurbuz, SukruStroke is an important cause of mortality and morbidity. In our study, the accuracy relationship of the radiological imaging methods within themselves, together with the existing risk factors of stroke patients diagnosed in the emergency department, and their mortality status were examined. This study was conducted with 252 patients. The patients' ages and sexes, clinical features, arterial blood pressure and laboratory findings, history of diseases, vascular imaging methods, thrombolytic therapy applications, length of stay, and mortality rates were examined retrospectively. There was no statistical difference between stroke types and age and sex (p=0.73, p=0.53). While 65 patients had a recurrent stroke, male patients were dominant in this group (p=0.00). Hypertension was the most common comorbid disease with a frequency of 64.4%. Hemiparesis, speech disorder, headache, and hypoesthesia symptoms were prominent symptoms in patients with ischemic stroke, while changes in consciousness were the most prominent symptom in patients with hemorrhagic stroke (p=0.00). In 90.9% of the 59 patients who underwent both doppler ultrasonography (USG) and angiography examinations, doppler USG determined cases without 70% and higher stenosis as significant. The length of intensive care unit stay for hemorrhagic stroke was significantly longer (p=0.03), and the mortality rates of patients with 70% and higher stenosis and undergoing digital subtraction angiography (DSA) were found to be significantly higher (p=0.01). We observed that doppler USG was not an adequate method in detecting significant stenoses (70% and higher), but it was an important examination method for showing cases without significant stenosis. Furthermore, the longer length of intensive care unit stay in patients with hemorrhagic stroke and the higher mortality rate in patients with 70% and higher stenosisand undergoing interventional angiography are other important resultsÖğe Iliac Artery Dissection: A Case Report(Emergency Medicine Physicians Assoc Turkey, 2020) Ekmekyapar, Mohammed; Oguzturk, Hakan; Ekmekyapar, Tuba; Gurbuz, Sukru; Derya, SerdarIntroduction: Iliac artery aneurisms are generally observed associated with abdominal aortic aneurisms. Iliac artery dissection happens to be one of the rarely encountered cases and very few cases have been reported in literature. We aimed to present a patient with both iliac artery aneurisms associated with left iliac artery dissection in this study. Case: A male, 34-years old patient applied to emergency service with complaints of abdominal pain and paresthesia in his left leg. There was no pain or loss of strength in the left leg of the patient, but there existed a numbness described by himself. The brain computed tomography (CT) of the patient was considered as normal but his abdominal ultrasonography was reported as an aneurismal dilatation in both iliac artery at bifurcation level on a nearly 3 cm-segment, reaching up to 3 cm at the widest section and a mural thrombus reaching up to 70 % stenosis within the vein lumen were observed. Thereon, the patient went through a CT-angiogram and as a result dissection was observed in the left iliac artery together with aneurismal dilatation and mural thrombus in both iliac arteries The patient was hospitalized in the intensive care unit of cardiovascular surgery clinic. Conclusion: In regards to the patients who apply to emergency services with complaints of abdominal pain, numbness in extremities, acute abdomen or neurologic symptoms atypically seen like loss of strength; we should also keep in mind aortic dissection and/or iliac artery dissection among our preliminary diagnoses.Öğe Importance of vertigo classification in the emergency department and its effects on economic burden(2023) Ekmekyapar, Muhammed; Ekmekyapar, Tuba; Gürbüz, ŞükrüAim: Patients with vertigo present to the emergency department with their clinical status and social comfort significantly impaired. More importantly, diseases that can pose a life-threatening risk may also underlying vertigo. In our study, we aimed to detect life- threatening conditions in vertigo patients early, and to alleviate the economic burden by preventing unnecessary radiological imaging in emergency services. Materials and Methods: Three hundred eighteen patients were included in the study. The patients were divided into two groups as peripheral and central vertigo. Patients’ age, sex, temperature, pulse, and arterial blood pressure values were examined. The complaints at admission were grouped as dizziness, dizziness+nausea-vomiting, and dizzi- ness+neurological complaint. Furthermore, patients’ examination findings, history of diseases, and laboratory data were recorded. Radiological imaging methods used in the emergency department, the requested consultations, peripheral-central vertigo, and hospitalization-discharge status were examined. Results: Of all patients, 287 (90.3%) and 31 (9.7%) had peripheral and central vertigo, respectively. The mean age of patients with peripheral vertigo was 52.34±17.38 years, while the mean age of patients with central vertigo was 68.06±19.56 years. There was a statistically significant difference between peripheral-central vertigo and age. A statis- tically significant difference was revealed between peripheral-central vertigo and systolic and diastolic blood pressure. In laboratory data, we found a significant difference between peripheral-central vertigo and glucose and CRP. Hypertension was the most common dis- ease in the history. Conclusion: The etiology of vertigo should be clarified quickly and reliably in emergency departments. To this end, the patient’s complaints and the findings obtained as a result of the examination along with auxiliary radiological imaging methods are vital. Thus, the diagnosis and treatment of patients with severe vertigo will be performed earlier, and unnecessary radiological imaging will be prevented. As a result, the economic burden will also decrease with the decrease in the examinations performed.Öğe RELATIONSHIPS BETWEEN PARKINSON'S DISEASE DEMENTIA AND 25-HYDROXY VITAMIN D AND BRAIN-DERIVED NEUROTROPHIC FACTOR LEVELS(Gunes Kitabevi Ltd Sti, 2021) Ekmekyapar, Tuba; Turkoz, Yusuf; Erdemli, Zeynep; Demirtas, Yasemin; Altinayar, SibelIntroduction: Parkinson's disease dementia is an important condition that worsens the quality of life in approximately 30% of parkinson disease patients. Vitamin D deficiency and brain-derived neurotrophic factor have been implicated in the pathogenesis of alzheimer type dementia, parkinson's disease, and many neurodegenerative diseases. The aim of this study was to investigate the relationship between cognitive impairment and 25-hydroxy vitamin D and brain-derived neurotrophic factor levels in parkinson's disease dementia patients. Materials and Method: 25-hydroxy vitamin D and brain-derived neurotrophic factor serum levels were evaluated in patients with parkinson's disease dementia (n = 63) and healthy controls (n = 33). Brain-derived neurotrophic factor and vitamin D levels were examined using one sample t-tests, and multiple comparisons among independent groups were done using ANOVA post hoc Tukey's test analysis. Wechsler Memory Scale and Mini-Mental State Examination were used to evaluate the cognitive functions of the groups. The disease levels of the patients were determined using the Hoehn and Yahr scale and the Unified Parkinson's Disease Rating Scale. Results: There was a significant negative correlation between the worsening of dementia and vitamin D levels (p = 0.009). However, there were significant negative correlations between the unified parkinson's disease rating scale daily living activity and Hoehn and Yahr scales and vitamin D levels. No significant relationship was found between brain-derived neurotrophic factor and parkinson's disease dementia (p = 0.983). Conclusions: Vitamin D deficiency plays a role in cognitive loss in parkinson's disease dementia. Vitamin D replacement can be used in dementia support treatment.Öğe Unexpected Acute Aorta Dissection with Ischemic Stroke: A Case Report(Emergency Medicine Physicians Assoc Turkey, 2020) Ekmekyapar, Tuba; Ekmekyapar, Muhammed; Gurbuz, Sukru; Oguzurk, HakanIntroduction: Both acute aorta dissection and ruptured aorta aneurism are prominent causes of death in cardiovascular diseases. The frequency of developing neurological complications in aortic dissections is reported to be between 2 to 8%. Stroke is more common in dissections involving the proximal aorta, but paraparesis is more common in distal aortic dissections due to circulatory impairment in the spinal arteries. Case: The 70-year-old male patient was referred to our emergency service from an external center with diagnosis of acute ischemic stroke. The patient had experienced loss of strength on his left side and had syncope one hour before. After his physical examination, the patient received computerized brain tomography and diffusion MR imaging with the pre-diagnosis of acute stroke. For the patient who had an appearance of acute diffusion restriction in the right parietal region in the diffusion MRI and had a chance of thrombolytic treatment, thrombolytic treatment was planned. However, the general status of the patient was worsened in this checkup examination, and his GCS score regressed down to 7. The poor current condition of the patient could not be explained by the acute ischemic stroke in the right parietal region. Aorta dissection, which may progress with clinical signs of stroke, was considered for the patient, and as an advanced test, dynamic thorax CT angiography was taken. In the dynamic thorax CT angiography of the patient, aneurism in the ascending aorta, dissection and fluid around the pericardium and left lung (hemorrhage?) were observed. The echocardiography of the patient revealed that the fluid around the pericardium caused tamponade. Discussion: Cardiovascular system diseases are the most common cause of natural sudden deaths and are mostly seen in middle and older ages. Acute myocardial infarction and coronary artery disease are the most common cardiovascular diseases, however, sudden deaths due to aortic dissection and rupture have been reported less frequently. The most typical symptom is the sudden start of severe chest or back pain. Patients typically visit with complaints of tearing chest and back pain, while they may visit with atypical clinical pictures wementioned in our cases such as abdominal pain, syncope, stroke. Sensory loss may also be seen in patients, and this is a neurological symptom which may extend from falling as leep to deep coma. Conclusion: Patients who visit emergency services with symptoms that are not expected for aorta dissection such as syncope, altered consciousness, hypotension, atypical abdominal pain and loss of strength in the extremities.
