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Öğe Acil Serviste Gerçekleşen Kardiyak Arrestler ve Kardiyopulmoner Resüsitasyon Deneyimlerimiz(Kafkas Tıp Bilimleri Dergisi, 2011) Oğuztürk, Hakan; Turtay, Muhammet Gökhan; Tekin, Yusuf Kenan; Sarıhan, EdizÖz: AMAÇ: Bu çalışmada acil serviste kardiyak arrest gelişen hastalarda var olan hastalık gruplarını, arrest ritimlerinin türlerini, kardiyopulmoner resüsitasyon (KPR) süresi ile mortalite oranlarını araştırmayı amaçladık YÖNTEM: Bir yıllık süre içinde hastane içinde arrest olan 70 hastanın dosyası geriye dönük incelendi. Yaş, cinsiyet, etiyoloji, arrest sırasındaki kardiyak ritim, kardiyopulmoner resüsitasyon süresi ve sonuçları araştırılan parametrelerdi. Kardiyopulmoner resüsitasyon kalp atımı ve kan basıncının devamlılığı sağladığında girişim başarılı kabul edildi. Grup içi karşılaştırmalarda ?2 testi ve kardiyak arrest sırasındaki ritim farklılıklarına göre cinsiyetlerin karşılaştırılmasında Kruskal Wallis testi kullanıldı. BULGULAR: Yaş ortalaması 63,4±17,3 olan 70 hastaya ileri yaşam desteği verildi. Hastaların 41'i (%58,6) erkek ve 29'u (%41,4) kadındı. Arrestin başlangıcındaki kardiyak ritimler incelendiğinde en sık ventriküler fibrilasyon 32(%45,7) ve asistoli 28(%40) izlendi. Kardiyopulmoner resüsitasyon yapılan 11 (%11,7) hastada resüsitasyona yanıt alınamadı. Arresti takiben uygulanan kardiyopulmoner resüsitasyon süresi ortalama 17,64±14,30 dakikaydı. Kardiyopulmoner resüsitasyona yanıt alınan hastaların 18'i (%25,7) iyileşti ve taburcu edildi. SONUÇ: Kardiyak arrestlerin önemli bir kısmı kardiyak hastalıkların sonucudur ve arrest sırasında en sık ventriküler fibrilasyon görülür. Buna ek olarak ventriküler fibrilasyonla başlayan arrest hastalarında hem spontane dolaşımın sağlanması hem de hastaneden taburculuk şansı daha fazladır Başlık (İngilizce): Cardiac Arrests in the Emergency Ward and Our Experiences on the Cardiopulmonary Resuscitation Öz (İngilizce): AIM: We aimed to analyse the patients diagnosed with cardiac arrest in the emergency ward in accordance to their chronic illnesses, cardiac rhythm at the beginning of the cardiac arrest, the duration of the cardiopulmonary resuscitation and the mortality rates.METHODS: The records of 70 patients diagnosed with in-hospital cardiac arrest in one year period were analysed retrospectively. Age, sex, etiology, cardiac rhythm at the time of cardiac arrest, the duration and the results of the cardiopulmonary resuscitation were the searched parameters. Cardiopulmonary resuscitation was considered successful following the establishment of spontaneous heart beats and a steady blood pressure. ?2 test was used for intra group analysis and Kruskal Wallis test used to compare the genders of the patients according to the cardiac rhythm at the time of the cardiac arrest.RESULTS: Seventy patients with a mean age of 63.4±17.3 received advanced life support. There were 41 (58.6%) male and 29 (41.4%) female patients. In the analysis of the cardiac rhythms at the beginning of the arrests, ventricular fibrillation in 32 (45.7%) and asystole in 28 (40%) patients were the most frequent ones. Eleven (11.7%) patients were unresponsive to cardiopulmonary resuscitation. The mean cardiopulmonary resuscitation time was 17.64±14.30 minutes. Eighteen (25.7%) of the patients recovered and were discharged.CONCLUSION: Most of the cardiac arrests are the results of cardiac diseases and ventricular fibrillation is the most frequent cardiac rhythm at the time of the arrest. In addition, in patients with ventricular fibrillation at the time of the cardiac arrest, the chance of establishment of a spontaneous circulation and hospital discharge is higherÖğe Akut apandisit tanısındaki güçlükler: İki olgu sunumu(Cumhuriyet Tıp Dergisi (ELEKTRONİK), 2009) Oğuztürk, Hakan; Ertan, Cem; Tekin, Yusuf Kenan; Eren, Şevki HakanÖz: Akut karın nedenleri arasında önemli bir yere sahip olan akut apandisitin tanısının geciktirilmesi veya karıştırılması istenmeyen komplikasyonlara yol açabilmektedir. Gebelikte ve bazı hastalıklarla akut apandisitin birlikteliği bu hastalığın akla getirilmesini zorlaştırabilmekte veya tanıda karışıklık ve gecikmeye yol açmaktadır. Bu olgu sunumunda gastroenterit ve gebelik birlikteliğinde olan akut apandisit klinik tabloları sunularak eksiksiz öykü, fizik muayene ve ayırıcı tanının önemi vurgulandı. Başlık (İngilizce): Complexities of the acute appendicitis diagnosis: Two case reports Öz (İngilizce): Acute appendicitis has an important place among causes of acute abdominal pain. Acute appendicitis can lead to unwanted complications if its diagnosis is confused or delayed. If acute appendicitis has occurred with pregnancy and other diseases such as gastroenteritis, diagnosis of acute appendicitis can be difficult as a result of confusion or delayed in its diagnosis. In the present study, we wanted to present and emphasize how definitive story, physical examination, and differential diagnosis are important in the diagnosis of acute appendicitis presented with pregnancy and gastroenteritis.Öğe Cerebral Venous Sinus Thrombosis After Spinal Anesthesia: Case Report(Elsevier Science Bv, 2011) Yucel, Neslihan; Akgun, Feride Sinem; Tekin, Yusuf Kenan; Altinayar, Sibel; Alkan, AlpayCerebral venous sinus thrombosis is a rare clinical disorder which frequently shows up as prolonged headache unresponsive to standard therapies following spinal anesthesia. In this study, a 24 years old male presenting to our emergency department (ED) after many visits to other ED with headache which started following spinal anesthesia underwent fifteen days ago and being diagnosed with cerebral sinus venous thrombosis upon the evaluations is reported.Öğe Electrical Injuries: The Demographical and Clinical Features(Galenos Yayincilik, 2010) Oguzturk, Hakan; Turtay, Muhammet Gokhan; Ertan, Cem; Akgun, Feride Sinem; Tekin, Yusuf KenanAim: Electrical injuries are an important health problem in our country, as well as worldwide. The aim of this study was to explore the demographic characteristics, complications and mortality associated with electrical injuries. Methods: In this study, 38 patients who had been exposed to electrical injuries and treated at the Emergency Department of, Faculty of Medicine, Inonu University between October 2008 and October 2010 were reviewed. Data pertaining to the patients were analysed retrospectively. Results: Out of 38 patients, 28 (73.7%) were male and 10 (26.3%) female. Electrical injuries were most frequently encountered in the 17-29 year age group, constituting 39.5% of cases. Eight (21.1%) patients were exposed to high voltage and 30 (78.9%) to low voltage. Among the circumstances leading to electrical injury, household accidents (63.2%) prevailed over the occupational accidents (36.8%). Two patients died due to sepsis. The overall mortality rate was 5.3 % and the mean hospital stay was 4.1 +/- 5.2 days. Conclusion: The results obtained from this research with respect to the demographic and clinical features can help the development of a particular strategy for electirical injuries.Öğe Elektrik yaralanmaları: Demografik ve klinik özellikler(2010) Oğuztürk, Hakan; Turtay, Muhammet Gökhan; Ertan, Cem; Akgün, Feride Sinem; Tekin, Yusuf KenanÖz: Amaç: Elektrik yaralanmaları tüm dünyada oldu¤u gibi ülkemizde de önemli bir sağlık sorunu olup, bu yaralanmalarla ilgili ülkemiz için yeterli veri bulunmamaktadır. Çalışmamızın amacı elektrik yaralanmalarının demografik özellikleri, komplikasyonları ve bu yaralanmalara bağlı gelişen mortalitenin araştırılmasıdır. Yöntemler: Bu çalışmada Ekim 2008-Ekim 2010 tarihleri arasında İnönü Üniversitesi Tıp Fakültesi Acil Tıp Anabilim dalına elektrik yaralanması ile getirilen ve tedavi edilen 38 hasta araştırıldı. Hastalarla ilgili bilgiler retrospektif olarak incelendi Bulgular: Olguların 28’i (%73,7) erkek, 10’u (%26,3) kadındı. Elektrik yaralanmalarının en sık 17-29 yaş aralı¤ında olduğu saptandı. Olguların 30’u (%78,9) düşük voltaj, 8’i (%21,1) ise yüksek voltajlı elektrik yaralanmasıydı. Elektrik yaralanmasına yol açan koşullar arasında ev kazaları (%63,2) iş kazalarından (36,8%) daha çok görülmekteydi. İki hastada ölüm nedeni sepsisti. Mortalite oranı %5,3, ortalama hastanede kalış süresi ise 4,1±5,2 gündü. Sonuç: Bu araştırmadan elde edilen bulgular demografik ve klinik özellikleri göz önüne alarak elektrik yaralanmasını önlemeye yönelik farklı bir strateji oluşturmasına hizmet edebilir. (Haseki Tıp Bülteni 2010; 48: 139-41)Öğe Erişkin ve pediatrik yaş grupları arasında çoklu yaralanmaların koagülasyon parametreleri üzerindeki etkisi(İnönü Üniversitesi, 2011) Tekin, Yusuf KenanTürkiye’de, travma hem erişkinlerde hemde çocuklarda önemli mortalite ve morbidite nedenidir. Hemoraji, önlenebilir ölümün en sık sebebidir ve multiple travmatik hastalarda posttravmatik koagülopatinin iyi yönetimi hayat kurtarıcıdır. Bundan dolayı, multiple travmalı erişkin ve çocuk hastalarda koagülasyon parametrelerindeki değişkliği ve normal kişilerle karşılaştırmayı amaçladık............Erken travma döneminde koagülasyon sisteminin travmaya cevabı çocukta ve erişkinde birbirine benzerdi. aPTT, INR ve fibrinojen düzeyleri istatistiksel olarak anlamlı iken D-dimer, doku faktörü, faktör VII ve faktör X düzeylerinde istatistiksel olarak anlamlı fark yoktu. Çalışmamızda, travmanın erken döneminde travmaya ilk yanıt doku faktörü olduğundan yüksek bulundu. Travmanın erken döneminde faktör VII ve faktör X düzeylerinde değişiklik saptanmadı.Öğe The Evaluation of Electrocardiogram Findings in Acute Abdominal Pain Patients Admitted to the Emergency Department(Sage Publications Inc, 2011) Oguzturk, Hakan; Turtay, Muhammet Gokhan; Tekin, Yusuf Kenan; Tekin, GulacanThe aim of this study was to determine the diagnostic value of electrocardiogram in differential diagnosis of patients with nonspecific abdominal pain. This prospective observational study was conducted in a university emergency department over 2 weeks. One hundred twenty patients with complaints of abdominal pain were admitted to the emergency department. During the study period, a total of 120 cases were evaluated. The final emergency department disposition status of the 120 patients was 1 (0.8%) died in the emergency department, 28 (23.3%) were admitted to the general ward, 27 (22.5%) were admitted to other services, and 10 (8.3%) were admitted to the cardiology service and coronary care unit. The examination indicated that 38 (31.7%) patients with abdominal pain showed cardiac pathologies on their electrocardiograms; 3 (2.5%) patients with abdominal pain admitted to cardiology service had ST elevation, and 2 (1.6%) had electrocardiogram depression on their electrocardiograms. According to the results, the authors claim that the electrocardiogram played an important role in the treatment and diagnosis of patients presenting with abdominal pain in emergency medicine. For this reason, it was thought that emergency medicine specialists should understand the basis of the perception of abdominal pain and develop a focused approach to the initial evaluation of these patients.Öğe Evaluation of Intestinal Parasites in Diarrheic Patients Refer to the Emergency Medicine Department of the Inonu University School of Medicine(Duzce Univ, 2010) Oguzturk, Hakan; Turtay, Muhammet Gokhan; Ertan, Cem; Kaya, Ozlem Makbule; Atambay, Metin; Tekin, Yusuf KenanPurpose: The infections caused by intestinal parasites are one of the leading health issues both by means of individuals and society, especially in developing countries. We analyzed stool samples of 54 patients aged 18 to 67, who presented at our emergency department during June 2009 - October 2009 period, for parasitological agents. Methods: Stool samples were examined using native-lugol, trichrome staining and Kinyoun acide fast methods. Entamoeba species (Entamoeba histolytica and/or dispar) were found to be the most common parasites. Results: Of 54 patients' samples 12 (22,2%) were found to be positive for parasites by microscopy, six (11,1%) by Thrichrome painted samples and one by Kinyoun acid fast painted samples. Most common detected parasites were Entemoeba species (Entamoeba histolytica and/or dispar) found in seven samples (12,9%). Seven of the patients found positive by microscopy were female (12,9%), male five (41,7%). The complaints and of all 54 patients were recorded. Malaise and nausea were found to be the most common symptoms in groups both with and without parasites. Conclusion: Parasitological agents have to be recalled in patients presenting to emergency departments with diarrhea as well as bacterial, viral and fungal pathogens.Öğe Gebelikte akut karın tanı zorluğu: Olgu sunumu(2012) Tekin, Yusuf Kenan; Oğuztürk, Hakan; Turtay, Muhammet Gökhan; Beytur, Ali; Çelik, EmrahÖz: Akut karın tablosu ile başvuran gebelerde hasta- lığın tanısı zordur. Gebelikte oluşan anatomik ve fizyolojik değişiklikler, belki de cerrahi girişim ge- rektirecek klinik tablonun değişmesine yol açacak- tır. Bu olgu sunumunda gebe bir hastada hem üro- litiasis hem de akut apandisit birlikteliğinde olan klinik tablolar sunularak eksiksiz öykü, fizik muaye- ne ve ayırıcı tanının önemi vurgulandı. Doğru tanı ve uygun tedavi için dikkatli ve eksiksiz muayene yapılmalıdır. Bildirilen bu olgunun klinik tablosu acil tıp pratiğinde dikkat edilmesi gereken öğeler taşımaktadır.Öğe Pattern of coagulation in pediatric and adult multiple trauma patients(2019) Tekin, Yusuf Kenan; Yucel, NeslihanAim: Aim of this study was evaluated changes in coagulation parameters in adult and pediatric multiple trauma patients.Material and Methods: A prospective observational study was conducted of adult and pediatric patients with blunt multiple trauma. The platelet count, prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (aPTT), fibrinogen, D-dimer, tissue factor (TF), factor VII and factor X were evaluated.Results: For our pediatric trauma patients, platelet count, factor VII and factor X were inversely related to the APACHE II score, whereas aPTT, D-dimer and INR and APACHE II scores were positively correlated. Furthermore, we found that aPTT, D-dimer, INR and TF in adults positively correlated with the APACHE II score. We also found that factor X, aPTT, and platelet count were strongly associated with adverse outcomes in pediatric trauma patients, and remained independently associated in the multivariate analysis. Conclusion: TF and INR are strongly associated with adverse outcomes after multiple traumas in adults. However, in pediatric patients, platelet count, aPTT, TF and factor X are associated with adverse outcomes. Therefore, early assessment of TF and INR in adult trauma patients, and platelet count, aPTT, TF and factor X in pediatric trauma patients, may significantly improve the accuracy of assessments of the severity of traumatic injuries.Öğe Pattern of coagulation in pediatric and adult multiple trauma patients(2019) Tekin, Yusuf Kenan; Yücel, NeslihanAbstract: Aim: Aim of this study was evaluated changes in coagulation parameters in adult and pediatric multiple trauma patients. Material and Methods: A prospective observational study was conducted of adult and pediatric patients with blunt multiple trauma. The platelet count, prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (aPTT), fibrinogen, D-dimer, tissue factor (TF), factor VII and factor X were evaluated. Results: For our pediatric trauma patients, platelet count, factor VII and factor X were inversely related to the APACHE II score, whereas aPTT, D-dimer and INR and APACHE II scores were positively correlated. Furthermore, we found that aPTT, D-dimer, INR and TF in adults positively correlated with the APACHE II score. We also found that factor X, aPTT, and platelet count were strongly associated with adverse outcomes in pediatric trauma patients, and remained independently associated in the multivariate analysis. Conclusion: TF and INR are strongly associated with adverse outcomes after multiple traumas in adults. However, in pediatric patients, platelet count, aPTT, TF and factor X are associated with adverse outcomes. Therefore, early assessment of TF and INR in adult trauma patients, and platelet count, aPTT, TF and factor X in pediatric trauma patients, may significantly improve the accuracy of assessments of the severity of traumatic injuries.Öğe Spinal Anestezi Sonrası Gelişen Serebral Ven Sinüs Trombozu: Olgu Sunumu(Türkiye Acil Tıp Dergisi, 2011) Yücel, Neslihan; Akgün, Feride Sinem; Tekin, Yusuf Kenan; Altınayar, Sibel; Alkan, AlpayÖz: Serebral sinüs ven trombozu spinal anestezi sonrasında nadir görülen bir klinik durumdur. Sıklıkla, spinal anestezi sonrası uzamış ve standart tedavilere yanıtsız baş ağrısı ile kendisini gösterir. Acil servisimize başvurusundan 15 gün önce spinal anestezi geçiren, sonrasında baş ağrısı nedeniyle birçok kez farklı acil servislere başvuran ve sonunda kliniğimizde serebral sinüs trombozu tanısı alan 24 yaşındaki erkek hastayı sunuyoruzÖğe Spontan spinal epidural hematom: Olgu sunumu(2010) Yücel, Neslihan; Akgün, Feride Sinem; Tekin, Yusuf Kenan; Önal, Selami Çağatay; Alkan, AlpayÖz: Spontan spinal epidural hematom nadir görülen, erken tanınıp, tedavi edilmediğinde kalıcı nörolojik defisit ve ölüm ile sonuçlanabilen bir acildir. Bu yazıda, acil servise sırt ağrısı ve parapleji ile başvuran, incelemeler sonrasında spontan spinal epidural hematom tanısı alan 34 yaşındaki erkek hastayı sunuldu.Öğe Spontaneous spinal epidural hematoma: a case report(Elsevier Science Bv, 2010) Yucel, Neslihan; Akgun, Sinem Feride; Tekin, Yusuf Kenan; Onal, Selami Cagatay; Alkan, AlpaySpontaneous spinal epidural hematoma is a rare clinical disorder that might result in permanant neurological deficit and death when left untreated. We present a 34 year old male admitted to our emergency department with back pain and paraplegia, and being diagnosed with spontaneous spinal epidural hematoma.
