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Öğe Beneficial effects of hesperidin following cis diamminedichloroplatinum induced damage in heart of rats(Niger J Clin Pract., 2016) Oğuztürk, Hakan; Çiftçi, Osman; Çetin, Aslı; Kaya, Kürşat; Dişli, Om; Turtay, Muhammet Gökhan; Gürbüz, Şükrü; Başak, NeşeBackground: Increased oxidative stress and histopathological damage have been implicated in the cardiotoxicity that limits the clinical therapy of cisplatin (CP) as an anti-cancer drug. Objectives: This study aimed to investigate the protective effect of hesperidin (HP) against CP-induced cardiotoxicity in rats. Materials and Methods: Rats were divided into four groups (n = 7/group), and the first group served as the control group. Animals in Group CP and Group CP + HP received a single dose of CP (CP - 7 mg/kg); animals in Group HP and Group CP + HP received 50 mg/kg/day HP with gavage for 14 days. At the end of day 14, cardiac tissue samples were histologically and biochemically examined. Results: In this experimental study, thiobarbituric acid reactive substances levels in the cardiac tissue were significantly higher in the CP group, whereas glutathione (GSH), superoxide dismutase (SOD), and CAT levels were significantly lower in this group. On the other hand, GSH and SOD levels in the CP + HP group were similar to the control group. There was no significant difference in cardiac CAT levels between Group CP and Group CP + HP. Conclusion: Hesperetin treatment leads to a decrease in oxidative stress, and associated histological damage. The findings of the current study suggest that HP has a protective effect against CP‑induced cardiotoxicity.Öğe Bilateral Knee Osteonecrosis After Intraarticular Concomitant Local Anesthetic and Corticosteroid Injection: A Case Report(2015) Görmeli, Gökay; Görmeli, Ayşe Cemile; Uçar, Muharrem; Sevimli, Reşit; Gürbüz, ŞükrüAbstract: Osteoartrit maluliyetin en önemli etkenlerinden biri olarak karşılaşabileceğimiz, en sık eklem hastalıkları formudur. Osteoartrit, eklem kıkırdağının dejenerasyonu, osteofit formasyonu ve subkondral kistler ile karakterizedir. Eklem kıkırdağının geniş olmadığı durumlarda konservatif tedavi tercih edilebilir. Klinisyenler tarafından tercih edilen konservatif tedavi yöntemlerden biri de lokal anestezik, kortikosteroid veya bunların her ikisinin birlikte kullanıldığı eklem içi enjeksiyonlardır. Mevcut literatür ve bizim deneyimlerimiz, eklem içi enjeksiyonların hasta memnuniyeti için olumlu etkilere sahip olduğunu göstermektedir. Eklem içi steroid uygulanımı osteoartritli hastalarda kısa dönemli ağrıyı giderir. Bu ilaçların ağrı ve maluliyeti azaltıcı etkisi olmasına rağmen kondrosit hasarına bağlı erken osteoartrit veya avasküler nekroz gibi yan etkileri de olmaktadır. Biz kortikosteroid ve lokal anestezik maddenin eklem içi enjeksiyonu sonrasında kısa dönem içerisine her iki dizde avasküler nekroz gözlenen bir olguyu sunmayı amaçladık.Öğe Bilateral Peripheral Facial Paralysis in a Pregnant Patient Admitted to Emergency Service: A case of Guillain-Barre Syndrome(2016) Gürbüz, Şükrü; Güven, Taner; Kamışlı, Suat; Turtay, Muhammet Gökhan; Oğuztürk, HakanUnilateral facial paralysis is frequently seen in emergency services but bilateral facialparalysis (BFP) is rare. The most common causes of bilateral facial paralysis are GullianBarre syndrome, lyme disease, Bell paralysis, skull fracture, moebius, multiple sclerosis,and infectious mononucleosis. Gullian Barre Syndrome is a demyelinatingpolyneuropathy which is associated with acute infection. The majority of cases presentwith symmetric muscle weakness and areflexia. Gullian Barre Syndrome can bediagnosed by clinical findings together with lumbar puncture and/or electrodiagnosticresults. It is a rare disease in pregnancy. Plasma exchange or gamma globulin treatmentis the preferred treatment. In this report, we present the case of a 20-week pregnantwoman who presented with bilateral facial paralysis and was eventually diagnosed withGullian Barre syndrome.Öğe Bilateral Peripheral Facial Paralysis in a Pregnant Patient Admitted to Emergency Service: A case of Guillain-Barre Syndrome(2016) Gürbüz, Şükrü; Güven, Taner; Kamışlı, Suat; Turtay, Muhammet Gökhan; Oğuztürk, HakanAcil Serviste tek taraflı periferik fasiyal sinir paralizisi sık görülmektedir, fakat bilateral fasiyal sinir paralizisi (BFP) nadir görülür. Bilateral fasiyal sinir paralizisinin en yaygın nedenleri; Guillain Barre sendromu, lyme hastalığı, Bell paralizisi, kafatası fraktürü, moebius, multipl skleroz, enfeksiyoz mononükleozdur. Guillain Barre sendromu akut enfeksiyonla ilişkili demiyelizan bir polinöropatidir. Hastaların büyük çoğunluğu simetrik kas güçsüzlüğü ve arefleksi ile başvururlar. Klinik bulgular, lumbal ponksiyon ve/veya elektrotanısal testler ile desteklenerek Guillain Barre sendromu tanısı konur. Gebelikte nadir görülen bir hastalıktır. Tedavide gama globulin ya da plasma exchange uygulanır. Bu yazıda, bilateral periferik fasiyal sinir paralizi ile başvuran ve Guillain Barre tanısı konulan, 20 haftalık gebe vakası sunulmuştur.Öğe Böbrek travmalarına güncel yaklaşımlar(2016) Çelik, Hüseyin; Çamtosun, Ahmet; Ediz, Caner; Gürbüz, Şükrü; Altıntaş, RamazanÖz: Üriner sistem yaralanmaları, tüm karın travma hastalarının yaklaşık %8-10'unda meydana gelir. Künt ve delici yaralanmalar ile üriner sistemde en çok böbrek yaralanır ve uygun bir şekilde tedavi edilmediği taktirde ciddi mortalite ve morbiditeye neden olabilir. Renal travma değerlendirilmesi için en önemli laboratuvar testleri idrar tahlili, hematokrit ve kreatinin. Hematüri genellikle mikroskopik veya makroskopik görülür, ancak majör ve minör yaralanmaları ayırt etmek için yeterli değildir. Renal travmalı hastaya yaklaşım hep tartışmalı olmuştur ve tedavide konservatif (izlem) ve agresif (cerrahi) tedaviler önerilmektedir. Konservatif yaklaşım ilk olarak 1900'lü yılların ilk yarısında önerildi. O zamandan buyana nefrektomi oranları, komplikasyon ve hastanede kalış süreleri giderek azaldığı bildirilmiştir. Delici yaralanmalarda ise bu yaklaşım 1980'lerden sonra ivme kazanmıştır. Son yıllarda grade 4 ve 5 travma bile olsa konservatif yaklaşım daha ön plana çıkmıştır. Bir çok çalışmada konservatif yaklaşım başarılı olarak görülmüş ve cerrahi tedavi sadece grade 5 renal travmalı uygun hastalarda uygulanmıştır. Bu yazımızda 2000 ve 2014 arasında yayınlanmış makaleler ve klavuzlar geriye dönük olarak incelendi. Biz bu çalışmada litaratürü gözden geçirerek böbrek travmasında konservatif ve cerrahi yönetim ile ilgili genel tavsiyelerde yapmayı hedefledik.Öğe A case of myocardial infarction together with acute appendicitis in Emergency Clinic of Turgut Ozal Medical Center(2017) Sarıhan, Mehmet Ediz; Gürbüz, Şükrü; Gür, AliAbstract: In this study, a case of myocardial infarction (MI) developed in a 55-year old patient who applied to emergency clinic with acute appendicitis was presented. The patient who already had diabetes and hypertension applied to emergency clinic of our hospital due to abdominal pain, and he was diagnosed as having acute appendicitis associated with MI in routine evaluation and analyses. Treatment preference was used for MI for the patient, and the coronary occlusion was opened with using percutaneous transluminal coronary angiography. In the follow up of the patient, the clinical symptoms of the acute appendicitis disappeared, and the patient was discharged with cure without requiring any surgical intervention for the appendicitis. High mortality clinical situations, such as MI, which is stimulated due to various stress factors should be considered in the patients who applied to emergency clinicÖğe Clinical analysis of the cancer patients who admitted to the emergency room(BIOMEDICAL RESEARCH-INDIA, 2016) Gürbüz, Şükrü; Turtay, Gökhan; Ögüztürk, Hakan; Güven, Taner; Gür, Ali; Çolak, Cemil; Durak, Mehmet AkifObjective: Patients with cancer diagnosis often admit to emergency room with complaints that are directly or indirectly related to their current condition. We aimed to analyze what complaints the cancer patients admit with most, how long the cancer patients who are treated with antitumor treatment admit to the emergency room after the antitumor treatment, which departments were consulted with these patients most and the outcomes of these patients in the emergency room. Method: In this study, 1946 male and female patients older than 18 years old with oncological diseases who admitted to the emergency room for any complaints were analyzed retrospectively. Results: 879 (45.2%) of the patients were females and 1067 (54.8%) of them were males. The mean age was 59.1. The most common complaint was abdominal pain with 344 (17.7%) patients. The most common malignancy was lung cancer with 335 (17.3%) patients. 610 (31.3%) of the patients in the study were still receiving chemotherapy whereas 1052 (54%) of the patients never had chemotherapy. 285 (14.6%) patients were not receiving chemotherapy although they previously had. It was found that the patients admitted to the emergency room a mean of 69.9 days after the chemotherapy. 651 (33.5%) of the patients were not consulted with any departments whereas other patients were consulted with other departments, with medical oncology being the most consulted department. 1017 (52.2%) patients were discharged from the emergency room and 895 (46%) patients were hospitalized. 33 patients (1.7%) died in the emergency room. Conclusions: Patients with lung cancer admitted to the emergency rooms more often. Cancer patients admitted to the emergency department with abdominal pain and shortness of breath most. Emergency physicians have increased responsibility for tests, treatment and hospitalization of these patients as the patients are generally older and have multiple conditions. Keywords Cancer, Emergency room, Oncology. Introduction Death caused by cancer is the second most common reason after cardiovascular causes in our country, Turkey. With the increase in older population, an increase in new cancer cases and side effects of cancer treatment are expected [1]. This increase affects emergency rooms as well as oncology departments in terms of volume and work force. Cancer patients can admit to emergency rooms for complaints caused by their condition like pain, bleeding and respiratory distress as well as the metabolic, infectious and endocrine problems caused by their condition. In addition to this, these patients can admit for febrile neutropenia or hypersensitivity reactions caused by antitumor medication administered for their treatment, or malnutrition or lack of care caused by inadequacy of social conditions. They also can admit to the hospital for trauma, cardiovascular diseases, pulmonary diseases and other conditions that are not caused by cancer [2,3]. Usually, the benefits of emergency rooms to the cancer patients are more than expected. We aimed to analyze what complaints the cancer patients admit with most, how long the cancer patients who are treated with antitumor treatment admit to the emergency room after the antitumor treatment, which departments were consulted with these patients most and the outcomes of these patients in the emergency room in a period of one year.Öğe Clinical analysis of the cancer patients who admitted to the emergency room(Biomedical research-India, 2016) Gürbüz, Şükrü; Turtay, Muhammet Gökhan; Oğuztürk, Hakan; Güven, Taner; Gür, Ali; Çolak, Cemil; Durak, Mehmet AkifObjective: Patients with cancer diagnosis often admit to emergency room with complaints that are directly or indirectly related to their current condition. We aimed to analyze what complaints the cancer patients admit with most, how long the cancer patients who are treated with antitumor treatment admit to the emergency room after the antitumor treatment, which departments were consulted with these patients most and the outcomes of these patients in the emergency room. Method: In this study, 1946 male and female patients older than 18 years old with oncological diseases who admitted to the emergency room for any complaints were analyzed retrospectively. Results: 879 (45.2%) of the patients were females and 1067 (54.8%) of them were males. The mean age was 59.1. The most common complaint was abdominal pain with 344 (17.7%) patients. The most common malignancy was lung cancer with 335 (17.3%) patients. 610 (31.3%) of the patients in the study were still receiving chemotherapy whereas 1052 (54%) of the patients never had chemotherapy. 285 (14.6%) patients were not receiving chemotherapy although they previously had. It was found that the patients admitted to the emergency room a mean of 69.9 days after the chemotherapy. 651 (33.5%) of the patients were not consulted with any departments whereas other patients were consulted with other departments, with medical oncology being the most consulted department. 1017 (52.2%) patients were discharged from the emergency room and 895 (46%) patients were hospitalized. 33 patients (1.7%) died in the emergency room. Conclusions: Patients with lung cancer admitted to the emergency rooms more often. Cancer patients admitted to the emergency department with abdominal pain and shortness of breath most. Emergency physicians have increased responsibility for tests, treatment and hospitalization of these patients as the patients are generally older and have multiple conditions.Öğe Comparison of Auxiliary Diagnostic Methods in Pulmonary Embolism(2021) Ekmekyapar, Muhammed; Gürbüz, Şükrü; Şahin, LeventAim: We investigated the importance of auxiliary diagnostic methods in cases when computed tomography pulmonary angiography (CTPA) cannot be used in pulmonary embolism (PE) with a high mortality rate. Materials and Methods: Patients were selected after the exclusion criteria were applied in a sample created from a single center. A total of 86 patients included in our study were examined in terms of clinical features, auxiliary diagnostic methods, anticoagulant use, and hospitalization and discharge status according to the massive or segmental involvement of PE in CTPA. Results: The mean age of the patients was 52.29±14.14 years. According to the CTPA results, there were 46 (53.5%) patients with massive involvement and 40 (46.5%) patients with segmental involvement. While there were 38 (82.6%) patients with massive involvement whose right chambers of the heart were dilated in echocardiography (ECHO) results, there were 19 (47.5%) patients with segmental involvement. There was a statistical significance between the massive involvement of CTPA and ECHO result (p=0.001). Conclusion: ECHO may be preferred as an auxiliary radiological method in the diagnosis of PE in emergency departments (ED), especially in massive embolisms.Öğe Does Money Spent on Measuring Blood Levels of Acetaminophen Reduce the Cost of Treatment of Acetaminophen Poisoning?(2015) Çebiçci, Hüseyin; Kilci, Ali İhsan; Gürbüz, Şükrü; Vural, Abdussamed; Karaca, Bahadır; Çakır, IşılAbstract: Objective: Acetaminophen has been used as a safe analgesic and antipyretic. Acute ingestion of 10 g or more than 200 mg/kg as a single ingestion is accepted as toxic for adults. To show that money spent on measuring blood levels of acetaminophen reduces the cost of treatment of acetaminophen poisoning. Materials and Methods: The files of patients who were admitted to Kayseri Training and Research Hospital with pre-diagnosis of acetaminophen intoxication were examined over 6 months. One of the costs is based on the patients' own estimation of the toxic level of acetaminophen and the other is according to the measure of the toxic blood level of acetaminophen. The cost of the two groups was compared. Results: A total of 558 patients were diagnosed to have drug overdose during 6 months. Of these patients, 55 patients were evaluated as having acetaminophen overdose. According to the claims of 19 patients, acetaminophen level was calculated as toxic. However, only five patients' blood acetaminophen level was measured as toxic. Conclusion: Measuring blood acetaminophen level would be more accurate and advantageous in terms of both treatment planning and the cost of therapy in developing countries as in developed countries that have advanced healthcare system.Öğe Efficiency of mechanical thrombectomy in acute ischemic stroke patients(2020) Kolu, Mehmet; Yıldırım, İsmail Okan; Turan Kaya, Ahmet; Kamışlı, Suat; Kaplan, Yüksel; Durak, Mehmet Akif; Gürbüz, Şükrü; Saraç, KayaAbstract: The aim of this single-center study is to assess the outcomes in patients with acute ischemic stroke underwent endovascular mechanical thrombectomy. The data and outcome of patients who were admitted due to acute ischemic stroke caused by a large vessel occlusion in the anterior or posterior circulation and treated with endovascular stent retriever mechanical thrombectomy between 2014 and 2018 were retrospectively evaluated. Recanalization success was assessed based on Thrombolysis in Cerebral Infarction (TICI) scores, and the TICI grades 2b and 3 were considered as ‘successful’. Functional outcomes of the patients were assessed by modified Rankin Scale (mRS) at the 3rd month follow up and a score of ?2 points was considered as ‘good clinical outcome’. Successful recanalization was achieved in 34 patients (69%). At the 3rd month follow-up, 23 patients (46,9%) had mRS scores of ?2 points. The overall mortality rate at the 90th day was %30 (n=15). After endovascular thrombectomy, symptomatic intracranial hemorrhage was seen in 9 patients, groin hematoma due to vascular access in 5 patients, which did not require additional treatment, and pseudoaneurysm in 3 patients. Stent retriever mechanical thrombectomy is an effective and safe procedure in patients admitted due to acute ischemic stroke caused by large vessel occlusion.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 Investigation of RDW and MPV levels in patients with upper gastrointestinal bleeding admitted to the emergency department(2021) Yildirim, Aslihan Mete; Gürbüz, ŞükrüComparison of red cell distribution width (RDW) and mean platelet volume (MPV) levels of patients with upper gastrointestinal bleeding and non-bleeding patients regis- tered in the emergency department. After the approval of the ethics committee, adult patients aged 16 years and over who were detected upper gastrointestinal bleeding at Emergency Service between 01.01.2010 and 31.12.2015 were retrospectively investigated. 102 patients with upper gastrointestinal haemorrhage (UGIH) and 110 healthy individuals were included in the study. There wasn’t any statistically significant negative or positive correlation of mpv with any complete blood count parameter. There was a statistically significant difference between the patient and control groups in terms of RDW and MPV values (p <0.0001, p <0.0001, respectively). RDW levels observed higher and MPV levels observed lower in patients with upper gastrointestinal bleeding who were registered to the emergency department. Considering MPV and RDW levels in patients detected upper gastrointestinal bleeding may be useful in predicting the mortality and morbidity. It should also be considered that MPV levels may vary in patients with gastrointestinal bleeding.Öğe İskemik İnmede Risk Faktörleri ve Etkileri(2015) Karaman, Esra; Turtay, Muhammet Gökhan; Çolak, Cemil; Oğuztürk, Hakan; Gürbüz, Şükrü; Kamışlı, Suat; Çelik, EmrahAmaç: İnme, ölüm nedenleri arasında üçüncü sırada olup uzun dönem sakatlığında en önemli nedenlerindendir. Çalışmamızda iskemik inmeye neden olan risk faktörlerinin tespit edilmesi ve birden fazla risk faktörü varlığında inme geçirme riskinin belirlenmesi amaçlanmıştır. Gereç ve Yöntemler: Çalışmamızda, acil serviste iskemik inme tanısı konulan 120 hasta ve kontrol grubu olarak da 140 hasta incelendi. Hastaların daha önce geçirilmiş serebrovasküler hastalık (SVH), koroner arter hastalığı (KAH), diabetes mellitus (DM), hipertansiyon (HT), atriyal fibrilasyon (AF), sigara kullanımını içeren anamnez ve fizik muayene bilgileri elde edildi. Tüm hastaların high density lipoprotein (HDL), international normalized ratio (INR), C-reaktif protein (CRP), protein C, protein S ve antithrombin III (AT3) düzeyleri saptandı. Ayrıca elektrokardiyografileri (EKG), beyin tomografileri ve karotisdoppler ultrasonografileri (USG) yapıldı. Bulgular: Çalışmamızda KAH'ın (p<0.001), DM (p<0.001), geçirilmiş SVH öyküsünün (p<0.001), sigara kullanımının (p=0.004), karotiste plak veya plak ve/veya stenoz (>=%50) varlığının (p<0001), HDL düzeyinin düşüklüğü (p=0.014) istatistiksel olarak anlamlı olduğu tespit edildi. Risk faktörlerinin tek değişkenli lojistik regresyon analizinde iskemik inme için en yüksek riske sahip faktörün karotiste plak ve >=%50 stenoz varlığı [(OddsRatio/Oranı (OR) = 32.08)] olduğu tespit edildi. İkili risk faktörlerinden DM ile sigara birlikteliğine ait OR=18 olup tek başlarına neden oldukları riskten çok daha fazla risk oluşturdukları görüldü. Sonuç: Bu çalışma iskemik inme risk faktörlerini ve bu faktörlerin riski artırma oranlarını ayrıca iskemik inme geçirme olasılığının, ikili risk faktörü varlığında daha fazla olduğunu ortaya koymuştur. Bu sonuçlar, iskemik inme risk faktörlerinin erken dönemde tespitinin özellikle bu risk faktörlerinin birlikteliğinde, gerekli önlemlerin ve önleyici tedavilerin erken dönemde planlanmasının önemini göstermiştirÖğe Lokal anestezik ve kortikosteroidin eklemiçi birlikte enjeksiyonu sonrası gelişen bilateral diz osteonekrozu: olgu sunumu(İnönü Üniversitesi Tıp Fakültesi Dergisi, 2015) Görmeli, Gökay; Görmeli, Cemile Ayşe; Ucar, Muharrem; Sevimli, Reşit; Gürbüz, ŞükrüOsteoartrit maluliyetin en önemli etkenlerinden biri olarak karşılaşabileceğimiz, en sık eklem hastalıkları formudur. Osteoartrit, eklem kıkırdağının dejenerasyonu, osteofit formasyonu ve subkondral kistler ile karakterizedir. Eklem kıkırdağının geniş olmadığı durumlarda konservatif tedavi tercih edilebilir. Klinisyenler tarafından tercih edilen konservatif tedavi yöntemlerden biri de lokal anestezik, kortikosteroid veya bunların her ikisinin birlikte kullanıldığı eklem içi enjeksiyonlardır. Mevcut literatür ve bizim deneyimlerimiz, eklem içi enjeksiyonların hasta memnuniyeti için olumlu etkilere sahip olduğunu göstermektedir. Eklem içi steroid uygulanımı osteoartritli hastalarda kısa dönemli ağrıyı giderir. Bu ilaçların ağrı ve maluliyeti azaltıcı etkisi olmasına rağmen kondrosit hasarına bağlı erken osteoartrit veya avasküler nekroz gibi yan etkileri de olmaktadır. Biz kortikosteroid ve lokal anestezik maddenin eklem içi enjeksiyonu sonrasında kısa dönem içerisine her iki dizde avasküler nekroz gözlenen bir olguyu sunmayı amaçladık.Öğe Long term analysis of patients admitted to the emergency room as a result of occupational accidents(Biomedical Research, 2016) Gürbüz, Şükrü; Aydoğan, Mustafa Said; Çolak, Cemil; Turtay, Muhammet Gökhan; Oğuztürk, Hakan; Gür, Ali; Ekmekyapar, Muhammed; Ercan, AbdullahObjective: We aimed to describe the demographic and clinical features and healthcare costs associated with occupation related injuries between 2010 and 2015. Method: The patients of occupational accidents were evaluated according to age, gender, accident type, trauma localization, duration of hospitalization in the emergency department, prognosis, imperfection types causing to accidents and outcomes and cost spent. Results: 449 patients diagnosed with occupational accidents from January 2010 to December 2014 were included in the analysis. Of injury referring distribution the most common cause of occupational accidents (type of accidents) was extremities injury 141 (31.4%). About 50.1% of all estimated construction occupational accidents treated in the emergency department affected upper extremities. Remaining injuries primarily affected the head, lower extremities and thorax (45%). The mean cost of an inpatient admission following occupational accidents was $232, and the overall costs of patient care for the study sample during this time frame exceeded $26.142 annually. Conclusions: Occupational injuries, illnesses, and fatalities remain a major public health and economic concern around the world. The findings from this study may be beneficial in the development, implementation, and evaluation of injury prevention policies and prevention programs.Öğe Renal trauma management and current approaches(Turgut Özal Tıp Merkezi Dergisi, 2016) Çelik, Hüseyin; Camtosun, Ahmet; Ediz, Caner; Gürbüz, Şükrü; Altıntaş, RamazanAbstract Urinary tract injuries happen in approximately 8-10% of all abdominal trauma patients. Kidney is the most frequently injured organ in the urinary tract with penetrating or blunt trauma, and, if not suitable care is carried out, it may lead to morbidity and mortality. The most important laboratory tests are urinalysis, haematocrit and creatinine for evaluating renal trauma. Hematuria is often seen as microscopic or gross, but it is not enough to differentiate the condition between minor and major injuries. The management of kidney trauma has always been and will always be controversial. Conservative (follow-up) and aggressive (surgical) approach both have their proponents. The conservative management of blunt kidney trauma was first suggested in the first half of the 1900s. Since then, it has been reported that the utilities of this approach have become gradually decreased in terms of rate of nephrectomy, complications, and hospital stay. This approach has gained popularity in penetrating kidney trauma cases especially after the 1980s. Nowadays, conservative management is usually favoured, even in the case of grade IV / V traumas. In addition to this, while many studies have shown the conservative approach to be successful, surgical treatment is used only in appropriate cases in grade V injuries. In this survey, relevant articles and guidelines published between 2000 and 2014 have been reviewed, retrospectively. We aim to review the literature and suggest advices regarding conservative and surgical management of renal trauma. Keywords: Kidney Injury; Renal Trauma; Management; Renal Surgery.Öğe The risk factors and their effects in ıschemic stroke(İnönü Üniversitesi Tıp Fakültesi Dergisi, 2015) Karaman, Esra; Turtay, Muhammet Gökhan; Çolak, Cemil; Oğuztürk, Hakan; Gürbüz, Şükrü; Kamışlı, Suat; Çelik, EmrahAmaç: İnme, ölüm nedenleri arasında üçüncü sırada olup uzun dönem sakatlığında en önemli nedenlerindendir. Çalışmamızda iskemik inmeye neden olan risk faktörlerinin tespit edilmesi ve birden fazla risk faktörü varlığında inme geçirme riskinin belirlenmesi amaçlanmıştır. Gereç ve Yöntemler: Çalışmamızda, acil serviste iskemik inme tanısı konulan 120 hasta ve kontrol grubu olarak da 140 hasta incelendi. Hastaların daha önce geçirilmiş serebrovasküler hastalık (SVH), koroner arter hastalığı (KAH), diabetes mellitus (DM), hipertansiyon (HT), atriyal fibrilasyon (AF), sigara kullanımını içeren anamnez ve fizik muayene bilgileri elde edildi. Tüm hastaların high density lipoprotein (HDL), international normalized ratio (INR), C-reaktif protein (CRP), protein C, protein S ve antithrombin III (AT3) düzeyleri saptandı. Ayrıca elektrokardiyografileri (EKG), beyin tomografileri ve karotisdoppler ultrasonografileri (USG) yapıldı. Bulgular: Çalışmamızda KAH’ın (p<0.001), DM (p<0.001), geçirilmiş SVH öyküsünün (p<0.001), sigara kullanımının (p=0.004), karotiste plak veya plak ve/veya stenoz (≥%50) varlığının (p<0001), HDL düzeyinin düşüklüğü (p=0.014) istatistiksel olarak anlamlı olduğu tespit edildi. Risk faktörlerinin tek değişkenli lojistik regresyon analizinde iskemik inme için en yüksek riske sahip faktörün karotiste plak ve ≥%50 stenoz varlığı [(OddsRatio/Oranı (OR) = 32.08)] olduğu tespit edildi. İkili risk faktörlerinden DM ile sigara birlikteliğine ait OR=18 olup tek başlarına neden oldukları riskten çok daha fazla risk oluşturdukları görüldü. Sonuç: Bu çalışma iskemik inme risk faktörlerini ve bu faktörlerin riski artırma oranlarını ayrıca iskemik inme geçirme olasılığının, ikili risk faktörü varlığında daha fazla olduğunu ortaya koymuştur. Bu sonuçlar, iskemik inme risk faktörlerinin erken dönemde tespitinin özellikle bu risk faktörlerinin birlikteliğinde, gerekli önlemlerin ve önleyici tedavilerin erken dönemde planlanmasının önemini göstermiştir.Öğe Rupture of testicle accompanying multiple traumas: A case report(2020) Ekmekyapar, Muhammed; Turtay, Muhammed Gökhan; Gürbüz, Şükrü; Derya, Serdar; Gökçe, Hasan; Solgun, Ömer FarukIn this case report, we aimed to present an 18-year-old male patient who had ruptured testicle after severe testicular trauma that developed due to a motorcycle accident. An eighteen-year-old male patient was brought to the emergency service after a motorcycle accident. There were open fractures in the left arm and left leg. The scrotum was ruptured, both testicles were outside, and the right testicle was ruptured. The patient was underwent emergency surgery for intraabdominal hemorrhage and liver laceration by general surgery. Also urology joined the operation. Urology carried out right orchiectomy and left testicular fixation on the patient. Although rupture of testicles is a rare condition, it may accompany the diagnosis in patients with multiple traumas. Early urology consultation should be sought to be able to save testicles and minimize complications.Öğe Secret Carbon Monoxide Intoxication Assessments of the Patients Who Presented to Emergency(2022) Derya, Serdar; Gürbüz, Şükrü; Oğuztürk, Hakan; Yücel, Neslihan; Turtay, Muhammet Gökhan; Ekmekyapar, Muhammed; Uyanık, ÖmürAim: The primary aim of this study is to evaluate patients who present to the emergency department with atypical symptoms in terms of occult Carbon monoxide (CO) poisoning, and the secondary aim is to compare the invasive and non-invasive values of Carboxyhemglobin (COHb) levels in patients with high CO levels. Material and Method: This prospective and descriptive study was conducted on 2775 adult patients who visited the Emergency Department (ED) between January 1 and March 31, 2015. The COHb levels of the individuals who applied to the emergency department with non-specific complaints were measured with a non-invasive multiwave pulse oximeter device and the date of application, age, gender, complaint, smoking history, pregnancy status, pulse COHb, blood COHb and blood metHb parameters were recorded in the preformed form. Values under 10% in smokers and under 6.6% in non-smokers were recorded as secret COHb intoxication. Results: 52.8% of the patients were male and 34.4% were smokers. The rate of pregnant women among female patients was 13.4%. The first three complaints were shortness of breath, chest pain and stomach ache. It was determined that the mean COHb of the patients was 1.44±1.65 in arterial blood gas and 1.75±1.63 in finger measurement. A highly significant positive correlation was found between the two averages. The COHb value measured by both techniques was higher in male patients and in smokers and non-pregnant patients. The rate of latent COHb intoxication was determined as 1% in smokers and 0.1% in non-smokers. Conclusion: We came to the conclusion that non-invasive COHb measurement can make positive contributions to the diagnosis of secret carbonmonoxyde intoxications.
