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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 MUSHROOMS: THE VELVETY POISON(Carbone Editore, 2015) Gurbuz, Sukru; Oguzturk, Hakan; Turgut, Kasim; Turtay, Muhammet Gokhan; Guven, TanerIntroduction: Mushroom poisoning, a frequent health condition worldwide, documented since ancient times, can occur when an amateur mushroom hunter misidentifies a mushroom due to the close resemblance between toxic and edible species. In the majority of cases, mistakenly ingested mushrooms cause only gastrointestinal irritation, but certain toxic species, such as Amanita phalloides, can cause multiorgan failure and death. This study investigated the demographic and clinical characteristics of 79 mushroom poisoning cases, together with the treatments applied and their outcomes. Materials and methods: A total of 79 adult patients who were admitted to the emergency ward of the medical faculty of Inonu University between 2011 and 2014 were evaluated retrospectively. Results: The 79 patients ranged in age from 18 to 85 years; 44 (55.7%) were female and 35 (44.3%) were male. A total of 62 (78.4%) of the poisoning cases occurred during the spring and autumn seasons, which in Turkey are characterized by the highest levels of rainfall. At admission, nausea was observed in 76 (96.2%) cases, vomiting in 63 (79.7%), abdominal pain in 18 (22.8%), and diarrhea in 3 (3.8%). In 35 (44.3%) cases, toxicity symptoms onset within 6 hours of ingestion and later in 45 (64.5%) patients. A total of 73 patients recovered fully following medical treatment and were therefore discharged; three others received a liver transplant, one of whom survived. The remaining three patients, in whom no transplantations were performed, died; therefore a total of five patients did not survive. Conclusion: Mushroom poisoning can cause serious, potentially fatal illness. Rapid toxin analysis, prompt treatment and liver transplantation decrease the likelihood of mortality.Öğe ST Segment Elevation Caused by Pericarditis: A Case Report(Galenos Yayincilik, 2017) Aydin, Seval Demir; Turtay, Muhammet Gokhan; Gurbuz, Sukru; Pekdemir, Hasan; Oguzturk, Hakan; Guven, TanerChest pain is one of the common reasons for admission to the emergency department and an important symptom that can be a precursor of a fatal condition. A simple muscle pain can be a sign of illnesses until myocardial infarction or even aortic dissection, which is more lethal. In this respect, electrocardiogram ( ECG) which is of critical importance in the evaluation of patients is a guide for us. However, starting treatments such as thrombolytic therapy that is solely considered according to ECG may be a wrong decision. Therefore, detailed investigations should be made for establishing a diagnosis and treatment plans should be made accordingly. In this paper, we present a 19-year-old male patient who was admitted to our emergency department with chest pain, having ST segment elevation of D2, D3 and aVF in ECG along with troponin elevation and was diagnosed with acute pericarditis.
