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Öğe Apricot tree falls: a study from Malatya, Turkey(Allied Acad, 2016) Oguzturk, Hakan; Turgut, Kasim; Turtay, Muhammet Gokhan; Sarihan, M. Ediz; Gur, Ali; Beydilli, Inan; Gurbuz, SukruIntroduction: Falls from trees constitute an important and fatal form of injury. The present study aimed to assess the demographic and clinical features of apricot tree falls. Materials and methods: The patients who were admitted to the emergency department with a fall from an apricot tree between June 2015 and September 2015 were recorded prospectively. The age, gender, fall height, fall time, emergency department admission time, vital signs, injury types, treatments and outcomes, Glasgow coma score, and injury severity score, were studied for each patient. Results: There were 30 falls from apricot trees and all of them were male. The mean age was 29 +/- 18.9 years, and 33% of the patients were in the pediatric age group. The patients suffered from extremity (46.7%), spinal system (30%), chest (13.3%), abdomino-pelvic (6.7%), and head (3.3%) injuries. Arm and forearm fractures were ranked first among all the fractures. The majority of the patients (70%) were managed and discharged from emergency department. None of the patients died, and all of them recovered fully. Conclusion: Falls from apricot trees usually lead to only minor injuries. The emergency department has the most important role in the management of these injuries. A considerable amount of patients are children, therefore, clear and feasible rules regarding child workers will reduce falls from apricot trees.Öğe Bilateral Ureteral Stones Causing Anuria: A Case Report(Aves, 2015) Gur, Ali; Turtay, Muhammet Gokhan; Gurbuz, Sukru; Oguztruk, Hakan; Sarihan, M. Ediz; Oguz, Fatih; Derya, SerdarIntroduction: Bilateral ureteral stone is not known to frequently result in anuria during emergency. Case Report: An 18-year-old male patient was admitted to an emergency department with the complaint of sudden inability to urinate. He did not mention any additional complaints. On conducting a physical examination, we could not detect any pathological findings. From the patient's blood tests, potassium and creatinine levels were found to be 6.4 mmol/L and 9.81 mg/dL, respectively. Subsequently, we found bilateral ureteral stones on ultrasonography and non-contrast spiral computed tomography. Urology consultation was requested. The patient undergoing emergency surgery had ureterorenoscopy, bilateral endoscopic retrograde basket, and DJ stents procedures done by urology. During the follow-up, the patient was able to urinate, and his creatinine and potassium levels decreased. The patient was discharged. Conclusion: For patients admitted with complaint of anuria, we should keep in mind that the patient could have bilateral ureteral stones; therefore, he or she may have acute kidney failure and may subsequently require emergency surgery.Öğe Clinical analysis of the cancer patients who admitted to the emergency room(Scientific Publishers India, 2016) Gurbuz, Sukru; Turtay, Muhammet Gokhan; Oguzturk, Hakan; Guven, Taner; Gur, Ali; Colak, 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 PULMONARY FUNCTION TESTING AMONG NON-SMOKERS, HAND-ROLLED CIGARETTE SMOKERS AND FACTORY MADE CIGARETTE SMOKERS(Southeast Asian Ministers Educ Organization, 2018) Turgut, Kasim; Turtay, Muhammet Gokhan; Kilic, Talat; Oguzturk, Hakan; Gulacti, Umut; Gur, Ali; Guven, TanerTobacco use causes significant health problems. The aim of this study was to compare the following factors among factory-made cigarette (FMC) smokers, hand-rolled cigarette (HRC) smokers and non-smokers (NS): demographic characteristics, pulmonary function testing (PFT) and carboxyhemoglobin (COHb) levels. PFT included checking: forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1/FVC, forced expiratory flow from 25-75% of the vital capacity (FEF25-75) and peak expiratory flow (PEF). We wanted to determine the impact of smoking on pulmonary function testing and to determine any differences in PFTs and COHb levels between FMC and HRC smokers. A total of 182 participants (all males) were included in the study. The subjects in the study were randomly chosen from emergency service admissions which had complaints other than respiratory system. The mean age of study subjects was 40.8 (range: 22-92) years. Mean age of starting smoking among HRC smokers was not significantly different from FMC smokers (95% CI: -0.55-2.37, p=0.220). HRC smokers had significantly lower economic and education levels than FMC smokers (95% CI: 9.0-45.2, p<0.01). NS had highest economic and educational levels (95% CI: 35.9-66.6, p<0.01) of the 3 study groups. The mean [+/- standard deviation(SD)] FEV1/FVC was 76.66 (+/- 7.45) among FMC smokers (95% CI: 74.82-78.51), 77.36 (+/- 8.14) among HRC smokers (95% CI: 75.36-79.36) and 83.13 (+/- 5.08) among NS (95% CI: 81.70-84.56, p<0.01). The mean (+/- SD) FEV1 was 84.50 (+/- 17.80) among FMC smokers (95% CI: 80.12-88.92 ), 89.4 (+/- 15.8) among HRC smokers (95% CI: 85.56-93.32) and 95.30 (+/- 13.3) among NS (95% CI: 91.59-99.07, p<0.01). The mean (+/- SD) PEF was 81.90 (+/- 19.30) among HRC smokers (95% CI: 77.19-86.69), 78.10 (+/- 18.70) among FMC smokers (95% CI: 73.47-82.74) and 86.20 (+/- 16.0) among NS (95% CI: 81.70-90.69, p=0.06). The mean FVC, FEV1, FEV1/FVC, FEF25-75%, and PEF values among NS were significantly (p<0.05) higher for each variable than the mean of these values among FMC and HRC smokers. The mean COHb level among NS was significantly (p<0.05) lower than the mean COHb levels in the two smoking groups. There were no significant differences in PFT results or COHb levels between the two smoking groups (p>0.05). Cigarette smoking cause impairment of pulmonary function equally independent of the cigarette type (FMC, HRC) smoked.Öğe Comparıson of pulmonary functıon testıng among non-smokers, hand-rolledcıgarette smokers and factory made cıgarette smokers(Southeast asıan mınısters educ organızatıon, seameo-tropmed, 420-6 rajvıthı rd,, bangkok 10400, thaıland, 2018) Turgut, Kasim; Turtay, Muhammet Gokhan; Kilic, Talat; Oguzturk, Hakan; Gulacti, Umut; Gur, Ali; Guven, Taner; Colak, CemilTobacco use causes significant health problems. The aim of this study was to compare the following factors among factory-made cigarette (FMC) smokers, hand-rolled cigarette (HRC) smokers and non-smokers (NS): demographic characteristics, pulmonary function testing (PFT) and carboxyhemoglobin (COHb) levels. PFT included checking: forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1/FVC, forced expiratory flow from 25-75% of the vital capacity (FEF25-75) and peak expiratory flow (PEF). We wanted to determine the impact of smoking on pulmonary function testing and to determine any differences in PFTs and COHb levels between FMC and HRC smokers. A total of 182 participants (all males) were included in the study. The subjects in the study were randomly chosen from emergency service admissions which had complaints other than respiratory system. The mean age of study subjects was 40.8 (range: 22-92) years. Mean age of starting smoking among HRC smokers was not significantly different from FMC smokers (95% CI: -0.55-2.37, p=0.220). HRC smokers had significantly lower economic and education levels than FMC smokers (95% CI: 9.0-45.2, p<0.01). NS had highest economic and educational levels (95% CI: 35.9-66.6, p<0.01) of the 3 study groups. The mean [+/- standard deviation(SD)] FEV1/FVC was 76.66 (+/- 7.45) among FMC smokers (95% CI: 74.82-78.51), 77.36 (+/- 8.14) among HRC smokers (95% CI: 75.36-79.36) and 83.13 (+/- 5.08) among NS (95% CI: 81.70-84.56, p<0.01). The mean (+/- SD) FEV1 was 84.50 (+/- 17.80) among FMC smokers (95% CI: 80.12-88.92 ), 89.4 (+/- 15.8) among HRC smokers (95% CI: 85.56-93.32) and 95.30 (+/- 13.3) among NS (95% CI: 91.59-99.07, p<0.01). The mean (+/- SD) PEF was 81.90 (+/- 19.30) among HRC smokers (95% CI: 77.19-86.69), 78.10 (+/- 18.70) among FMC smokers (95% CI: 73.47-82.74) and 86.20 (+/- 16.0) among NS (95% CI: 81.70-90.69, p=0.06). The mean FVC, FEV1, FEV1/FVC, FEF25-75%, and PEF values among NS were significantly (p<0.05) higher for each variable than the mean of these values among FMC and HRC smokers. The mean COHb level among NS was significantly (p<0.05) lower than the mean COHb levels in the two smoking groups. There were no significant differences in PFT results or COHb levels between the two smoking groups (p>0.05). Cigarette smoking cause impairment of pulmonary function equally independent of the cigarette type (FMC, HRC) smoked.Öğe The effect of lactate levels on prognosis in patients with ST-segment elevation myocardial infarction(2020) Gur, Ali; Ulutas, Zeynep; Turgut, Kasim; Guven, Taner; Yucel, Neslihan; Ermis, NecipAim: The prognostic role of lactate for early mortality in patients with ST-segment elevation myocardial infarction (STEMI) submitted to primary percutaneous transluminal coronary angiography (PTCA) is not elucidated clearly. This study was conducted with patients that presented to the emergency department (ED) with STEMI and underwent PTCA to investigate whether the changes in lactate values from ED admission to 24 hours after PTCA affected mortality.Material and Methods: This prospective observational study on 143 patients with STEMI was conducted at emergency service and tertiary-level cardiology clinic in a public university hospital. The documentation for each patient included detailed information on demographics, type of myocardial infarction according to electrocardiography and PTCA results, duration of hospital stay, vital signs, laboratory findings on admission, lactate levels 24 hours after PTCA, and outcome (hospital discharge or death). Results: The lactate values are higher in non-surviving groups measured 24 hours after PTCA (P 0.001). The differences in the lactate levels from the time of admission to 24 hours after PTCA were significantly lower in the non-surviving group (P 0.001). Conclusion: Among patients presenting to the ED with STEMI, a high lactate level is associated with mortality. Also, the difference between lactate values of the patients after PTCA is associated with the risk of mortality. Therefore, we consider that first lactate levels in ED and last lactate levels after PTCA in patients with STEMI can provide physicians with an insight into the possibility of mortality.Öğe Evaluation of Factors Related to Mortality Caused by Firearm Injury: A Retrospective Analysis from Malatya, Turkey(Acad Medical Sciences I R Iran, 2019) Turgut, Kasim; Gur, Ali; Guven, Taner; Oguzturk, HakanBackground: Firearm related injuries continue to increase throughout the world and they become the first or second cause of mortality in worldwide. The present study aimed to determine the factors that affect mortality in firearm injuries. Methods: The patients which were admitted to emergency service between January 2011 and December 2015 due to firearm injuries, were reviewed from hospital records. The patients were evaluated in terms of their age, sex, event time, admission time, Glasgow Coma Scale (GCS), Injury Severity Score (ISS), the reason of event, type of weapon, the region of the body that injured, department in which they were hospitalized, hospitalization duration and the relation between these parameters and mortality. Results: A total of 174 patients (86.8% male, 13.2% female) were identified. The mean age of patients was 35.2 years and 30 patients (17.2%) died. Among the cases, 137 were attempted homicide (78.7%), 23 were accidents and the remaining 14 were suicides. The suicidal cases had significantly higher mortality rate than other causes (P = 0.003). The most frequently used weapon was pistols (73.6%) and the events took place between 18.00 and 24.00 (36.2%) hours mainly. The injuries were mostly on extremities, however many of deaths were seen after head-neck injuries and the mortality rate of head and neck injuries was significantly higher than other regions (P < 0.001). The mean of hospitalization duration was 9.1 days and it was 10.2 +/- 11.7 days for survivors, 4 +/- 7.3 days for died subjects. The hospitalization duration of died patients was significantly shorter than survivors (P = 0.042). The GCS of died patients (4.4 +/- 1.7) was significantly lower than those of survivors (13.3 +/- 2.8) (P < 0.001). The ISS score of died patients (49.7 +/- 24.1) was significantly higher than those of survivors (13.6 +/- 10.6) (P < 0.001). Conclusion: It was determined that GCS, ISS, length of hospitalization, injuries due to suicide attempt, the department of hospitalization, injuries to head-neck regions affected mortality significantly.Öğe Falls from height: A retrospective analysis(Zhejiang Univ Sch Medicine, 2018) Turgut, Kasim; Sarihan, Mehmet Ediz; Colak, Cemil; Guven, Taner; Gur, Ali; Gurbuz, SukruBACKGROUND: Emergency services manage trauma patients frequently and falls from height comprise the main cause of emergency service admissions. In this study, we aimed to analyse the demographic characteristics of falls from height and their relationship to the mortality. METHODS: A total of 460 patients, who admitted to the Emergency Department of Inonu University between November 2011 and November 2014 with a history of fall from height, were examined retrospectively. Demographic parameters, fall characteristics and their effect to mortality were evaluated statistically. RESULTS: The study comprised of 292 (63.5%) men and 168 (36.5%) women patients. The mean age of all patients was 27 +/- 24.99 years. Twenty-six (5.6%) patients died and the majority of them were in >= 62 years old group. The highest percentage of falls was at 0-5 years age group (28.3%). People fell mainly from 1.1-4 metres(m) level (46.1%). The causes of falls were ordered as unintentional (92.2%), workplace (8.1%) and suicidal (1.7%). Skin and soft tissue injuries (37.4%) were the main traumatic lesions. CONCLUSION: Age, fall height, fall place, lineer skull fracture, subarachnoidal hemorrhage, cervical fracture, thoracic vertebra fracture and trauma scores had statistically significant effect on mortality. The casualties died because of subarachnoid hemorrhage mostly.Öğe Impact of pulmonary rehabilitation program with cycle ergometry in chronic obstructive pulmonary disease(2021) Altindag, Ozlem; Uyar, Meral; Akaltun, Mazlum Serdar; Gursoy, Savas; Gur, AliAim: To evaluate impact of pulmonary rehabilitation (PR) on quality of life (QoL) and respiratory variables in Chronic Obstructive Pulmonary Disease (COPD).Materials and methods: PR program for 3 times per week for 8 weeks were performed in patients with COPD. Breathing, upper extremity strengthening and cycle ergometry exercises were performed. PFTs, MMRC dyspnoea scale, BODE Index and 6-minute walking test (6-MWT) were evaluated baseline and after treatment in all patients with COPD. Beck Depression Inventory and State-Trait Anxiety Inventory (STAI I and II) were used for evaluating depression and anxiety and QoL was evaluated with SF-36 scale. Patients having any other cardiac or pulmonary co-morbiditites, inability for attending rehabilitation program (due to physical, physicologic or neurologic problems) were excluded. Results: A total of 50 patients were included (45 male and 5 female patients). Mean age was 59.4±8.8 (56-62). Improvement was detected in exercise capacity, dyspnea severity, QoL, anxiety, and depression levels. Improvement in PFT results were obtained after exercise program. Conclusion: PR program with cycle ergometry is effective in patients with COPD.Öğe Long-term analysis of patients admitted to the emergency room as a result of occupational accidents(Allied Acad, 2016) Gurbuz, Sukru; Aydogan, Mustafa Said; Colak, Cemil; Turtay, Muhammet Gokhan; Oguzturk, Hakan; Gur, Ali; Ekmekyapar, MuhammedObjective: 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 Prognostic Value of Procalcitonin, CRP, Serum Amyloid A, Lactate and IL-6 Markers in Liver Transplant Patients Admitted to ED with Suspected Infection(Int Inst Anticancer Research, 2017) Gur, Ali; Oguzturk, Hakan; Kose, Adem; Turtay, M. Gokhan; Ersan, Veysel; Bayindir, Yasar; Ince, VolkanBackground/Aim: Infections are one of the most important causes of mortality and morbidity after liver transplantation as in all transplantations. Infectious complications are known to be among the preventable causes with appropriate diagnosis and treatment. So early prediction of the risk of infections will provide an effective approach to determine the local antimicrobial resistance and prevention of specific risk factors. The aim of this study was to deterimne whether specific markers are useful or not to deterimne a suspected infection in patients that have undergone liver transplantation. Patients and Methods: The study included 65 patients with liver transplantation admitted to emergency room with suspicion of infection. These patient's CRP, procalsitonin (PCT), lactate, SAA and IL-6 levels were initially measured in the emergency department. The patients were classified to three categories according to culture results; culture-negative, culture-positive and control group. Studying parameters were investigated according to whether the culture was positive or negative in these patients. Results: CRP, PCT, lactate, SAA and IL-6 levels were significanlty high in patients with suspected infeciton when compared to the control group (p<0.05). CRP, PCT and IL-6 levels were higher in the culture-positive group than in the culture-negative group and there was a significant variation (p<0.05). When suspecting an infection evaluating the parameters CRP, PCT and IL-6 was very meaningfull (p<0.05). Conclusion: We can use CRP, PCT, lactate, SAA and IL-6 parameters to identify presence of infection at the liver transplantation patients admitted to the emergency department with suspected infection. If CRP, PCT and IL-6 levels are significantly high we can guess the patient's positive culture.Öğe Prognostic Value of Routine Biochemistry Profile of Liver Transplant Patients Admitted to the Emergency Department with a Suspected Infection(Tehran Univ Medical Sciences, 2021) Gur, Ali; Kose, Adem; Oguzturk, HakanIntroduction: Since patients who have undergone liver transplantation should take immunosuppressants for life, the prevalence of systemic infections after this procedure is very high. These infections are associated with increased mortality and morbidity. Objective: This study aimed to investigate the prognostic value of routine biochemistry profile and its relationship with mortality in liver transplant patients admitted to the emergency department (ED) with a suspected infection. Methods: Patients who had undergone liver transplantation were included in the study. The patients were divided into three groups of culture-negative, culture-positive and control. White blood cell (WBC) count, hemoglobin (Hb), platelet (Plt), international normalized ratio (INR), creatinine (Cr), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) values as well as vital sign findings were comparatively evaluated in terms of their ability to show the presence of any infection and their correlation with mortality. Results: Totally, 142 patients were enrolled and were divided into the following three groups: 41 cases in culture-negative group, 30 cases in culture-positive group, and 71 cases in control group. There was not any significant difference between study groups in terms of age and sex ratio (p>0.05). The Hb and Plt values of the culture-positive patients were significantly lower, and their INR was significantly higher compared to those in control group (p<0.05). Fever, Hb, Plt, INR, AST and ALT values were factors that had a significant correlation with mortality in patients with an infection whethere culture-positive or culture-negative ones (p<0.05). Conclusions: In patients admitted to the ED with a history of liver transplantation, we recommend the evaluation of vital signs and Hb, PLt, and INR values to determine whether there is an infection or not. We can also state that mortality risk is higher in cases with low Hb and Plt levels and high INR, ALT, and AST values.Öğe Psychological status is associated with health related quality of life in patients with rheumatoid arthritis(Ios Press, 2011) Nas, Kemal; Sarac, Aysegul Jale; Gur, Ali; Cevik, Remzi; Altay, Zuhal; Erdal, Akin; Ersoy, YukselObjective: Rheumatoid arthritis (RA) is a chronic and disabling disease frequently effects physical and psychological well being. The aim of the present study was to determine the impact of psychological status on health related quality of life in patients with RA and also to assess which quality of life (QoL) instrument - disease specific and generic - is more prone to this effect. Methods: A total of 421 patients with RA recruited from joint database of five tertiary centers. Depression and anxiety risks were assessed by the Hospital Anxiety and Depression Scale (HADS); and quality of life assessed by Rheumatoid Arthritis Quality of Life (RAQoL), Nottingham Health Profile (NHP) and The Short Form 36 (SF 36) questionnaire. Results: Patients with higher risk for depression or anxiety had poorer quality of life compared to the patients without risk for depression or anxiety. Depression and anxiety scores significantly correlated with quality of life questionnaires. There was significant association between anxiety and depression with worsening in both disease specific and generic health related quality of life. However, RAQoL showed more association with depression and anxiety levels. Conclusion: Higher depression and anxiety risks showed increased deterioration in quality of life. Compared to generic QoL scales, RAQoL scale, a disease specific QoL instrument, is much more influenced by depression and anxiety.
