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Öğe Protective effects of alpha-lipoic acid on methotrexate-ınduced oxidative lung ınjury in rats(TAYLOR & FRANCIS INC, 530 WALNUT STREET, STE 850, PHILADELPHIA, PA 19106 USA, 2018) Gül, Mehmet; Yiğitcan, BirgülObjective: Oxidative stress is one of the major causes of methotrexate induced lung injury (MILI). Alpha-lipoic acid (ALA), which occurs naturally in human food, has antioxidative and anti-inflammatory activities. The aim of this study was to research the potential protective role of ALA on MILI in rats. Methods: Twenty one rats were randomly subdivided into three groups: control (group I), methotrexate (MTX) treated (group II), and MTX+ALA treated (group III). Lung injury was performed with a single dose of MTX (20mg/kg) to groups 2 and 3. On the sixth day, animals in all groups were sacrificed by decapitation and lung tissue and blood samples were removed for histological examination and also measurement the levels of interleukin-1-beta (IL-1), malondialdehyde (MDA), glutathione (GSH), tumour necrosis factor-alpha (TNF-), myeloperoxidase (MPO), and sodium potassium-adenosine triphosphatase (Na+/K+ATPase). Results: In MTX group tissue GSH, Na+/K+ATPase activities were lower, tissue MDA, MPO and plasma IL-1?, TNF-? were significantly higher than the other groups. Histopathological examination showed that lung injury was less severe in group 2 according to group 3. Conclusions: Oxidative damage of MTX in rat lung is partially reduced when combined with ALA.Öğe The prognastic efficiencies of modified early warning score and mainzemergency evaluation score for emergency department patients(Wolters kluwer medknow publıcatıons, wolters kluwer ındıa pvt ltd , a-202, 2nd flr, qube, c t s no 1498a-2 vıllage marol, andherı east, mumbaı, 400059, ındıa, 2018) Akgun, F. S.; Ertan, C.; Yucel, N.Background: Recently, there is an increasing interest for scoring systems to evaluate the critically ill patients by means of the severeness of their disease and their availibility for discharge in the emergency departments and intensive care units. Our aim in this study is to evaluate the efficiency of the mEWS and MEES scoring systems in assessing the severeness of the disease and predicting the mid term prognosis of the patients hospitalized following their emergency care in our emergency room. Material and Method: Patients, who attended to Inonu University Department of Emergency Medicine and hospitalized following their emergency care were included to our study. The effects of age, sex, triage categories, mEWS and MEES scores on the site of hospitalization and mortality was evaluated. Statistical analyses were performed by SPSS for Windows version 16.0. The data was summarized as means, standart deviation and percents. Univariate and multiavriate analyses were performed for risk factor calculations. Results: The mean age of the patients was 5819 and 584 (56%) were male. Triage group 1 patients accounted for 21 of all (2%), while 646 (61%) were in group 2 and 384 (37%) were in triage group 3. Of all patients, 341 (32%) were hospitalized to ICU. While discharged patients accounted for 89% (935 patients) of the study group, 116 patients (11%) died at the hospital. The GCS, AVPU and mEWS values were statistically significant by means of patient mortality (P < 0.0001), but the delta MEES value was not (P < 0.127). Conclusion: The results of our stuy suggests that mEWS evaluation is an effective and reliable tool for predicting outcome and hospitalization areas of ED patients. Our results also displayed that the easily available GCS and AVPU scales are reliable guides in patient management. MEES values, on the other hand, are not convenient for ED use.Öğe Pulmonary physician consultancy in emergency services in Turkey (PUPCEST) - a prospective multicenter study(EUROPEAN RESPIRATORY SOC JOURNALS LTD, 442 GLOSSOP RD, SHEFFIELD S10 2PX, ENGLAND, 2018) Kılıç, TalatÖğe Media-based clinical research on selfie-related injuries and deaths(TURKISH ASSOC TRAUMA EMERGENCY SURGERY, KOPRULU MEHMET PASA SOC, DENIZ ABDAL MAH, DADASOGLU AP, 25-1 SEHREMINI, ISTANBUL, 00000, TURKEY, 2018) Karadağ, MehmetBACKGROUND: The incidence of taking selfies and sharing them on social media as well as selfie-related behaviors is increasing, particularly among young people, possible leading to selfie-related trauma. Therefore, we performed this clinical study to draw attention to selfie-related injuries and deaths. METHODS: We analyzed 159 selfie victims from 111 events or accidents, which were reported in the media sources. We evaluated vital results, demography, rhythmicity, preferences, event or accident types, selfie-related risk factors, affected body regions of victims with causes of injury, and death. RESULTS: We found that the majority of selfie victims were students. Selfie-related injuries and deaths were reported most frequently in India, the US, and Russia. The most preferred site of taking selfies was the edge of the cliff. The most frequently reported event or accident type was falling from a height. Mostly multiple body parts were affected in selfie-related injuries and deaths. The most frequent causes of selfie-related deaths were multitrauma and drowning. CONCLUSION: Selfie-related injuries and deaths have increased in the past years. Particularly, teenagers and young adults are at high risk for selfie-related traumas and deaths; therefore, drastic measures should be taken to reduce their incidence.Öğe Efficacy of negative pressure wound therapy in the management of acute burns(TURKISH ASSOC TRAUMA EMERGENCY SURGERY, KOPRULU MEHMET PASA SOC, DENIZ ABDAL MAH, DADASOGLU AP, 25-1 SEHREMINI, ISTANBUL, 00000, TURKEY, 2018) Başkıran, AdilBACKGROUND: The aim of the present study was to evaluate the outcomes and efficacy of negative pressure wound therapy in the management of acute burns. METHODS: Patients with acute burns who have received negative pressure wound therapy at the Dr. Lutfi Kirdar Kartal Research and Training Hospital Tertiary Burn Care Center between January 2014 and December 2015 were included in the study. Patient data were retrospectively reviewed by analyzing data from our prospective patient database. RESULTS: A total of 38 patients were evaluated for the study. Three patients were excluded due to mortality prior to the completion of the treatment course. There were 32 (91.6%) male and 3 (8.4%) female patients. The mean age of the patients was 49.5 +/- 16 years. The etiological factors included electrical burn injury in 19 (54.3%), chemical burn injury in 7 (20%), flame burn injury in 6 (17.2%), and hot water burns in 3 (8.4%) patients. The severity of the burns was grade 3 or 4 in all of the patients included in the study. The mean duration of negative pressure wound therapy was 10.1 +/- 3.9 days. There were no procedure-related complications throughout the duration of the study. During the standard application of the device, one patient experienced local pain; therefore, low pressure (75 mmHg) was applied during therapy, and pressure was steadily increased. As a result of the application of this therapy, a decrease in the surface area, edema, and secretion of the wound and an increase in the granulation tissue and perfusion of the wound were observed in all treated patients. Wound cultures revealed no bacterial growth in any of the patients. The mean duration of surgical wound closure was 11.2 +/- 3.7 days. No complication was observed related to wound closure. The mean duration of hospital discharge in the postoperative period was 6.7 +/- 2.1 days. CONCLUSION: Well-designed, randomized control studies showing the efficacy of negative pressure wound therapy in patients with burns are lacking. The results of the present study showed that negative pressure wound therapy may reduce the number of wound debridement sessions, time of wound closure, and hospitalization in major burn injuries exposing the underlying tendons and bones.Öğe Histopathological efficiency of amifostine in radiation-induced heart disease in rats(Comenıus unıv, sch medıcıne, spıtalska 24, bratıslava ı, sk-813 72, slovakıa, 2018) Gurses, I; Ozeren, M; Serin, M.; Yücel, N; Erkal, HSOBJECTIVE: Amifositine is a phosphorylated thiol that holds its radioprotective actions by several indirect mechanisms. The purpose of this study was to evaluate histopathologically whether amifositine administration prior to irradiation would have a long-term protective effect on heart tissue in an experimental rat model. METHODS: Single dose of 18 Gy radiation and sham radiation exposure were used in related groups. A dose of 200 mg/kg of amifostine was injected intraperitoneally 30 min prior to radiation exposure. Analyses were performed 6 months after irradiation. RESULTS: Vascular damage and vasculitis were significantly decreased in amifositine treatment group. At the same time, significant thickening of the medial layer was accompanied by vascular damage in irradiated groups. The number and severity of myocyte necrosis were diminished with amifostine. Nevertheless, it could not prevent epicardial and myocardial fibrosis. Severe myocardial fibrosis was observed prominently in three regions, particularly on the apex, tips of papillary muscles and in sites adjacent to the atrioventricular valves. The anti-inflammatory effect of amifostine was not seen. CONCLUSION: The development of vascular damage and vasculitis were prevented by the use of amifostine. There was a correlation between vascular damage and fibrosis development. According to histopathological results, amifostine could be used as a protective agent against the side effects of radiotherapy (Tab. 4, Fig. 2, Ref. 22).Öğe Hoeing machine accident: a case report(Australıan rural health educ network, po box 242, deakın west, act 2600, australıa, 2018) Turgut, Kasim; Gurbuz, SukruContext: Agricultural accidents are a prominent cause of mortality and morbidity in the literature despite few studies. The machines and equipments used in this sector frequently cause agricultural accidents. One of these, the hoeing machine, can cause tragic and severe injuries. Issue: We present a case of subtotal leg amputation that occurred after a hoeing machine accident in 2015 in Malatya, eastern Turkey. We monitored the patient and started initial therapies according to advanced trauma life support in the emergency service. However, his right leg was severely injured and had to be amputated. Lessons learned: Hoeing machine accidents lead to physical disabilities due to extreme injury and amputation.Öğe Falls from height: a retrospective analysis(Zhejıang unıv sch medıcıne, second affılıated hospıtal, 88 jıefang rd, hangzhou, 310009, peoples r chına, 2018) Turgut, Kasim; Sarihan, Mehmet Ediz; Colak, Cemil; Guven, T; Gur, A; Gurbuz, SBACKGROUND: 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 Chilaiditi syndrome: a rare cause of shortness of breath and abdominal pain(Aves, buyukdere cad 105-9, mecıdıyekoy, sıslı, ıstanbul 34394, turkey, 2018) Ekmekyapar, Muhammed; Turtay, Muhammet Gokhan; Yucel, Neslihan; Oguzturk, Hakan; Gurbuz, Sukru; Derya, SerdarIntroduction: Chilaiditi syndrome is a rare condition in which a segment of the small or large intestine is interposed in between the diaphragm and the liver. This case report presents a patient who was admitted to the Department of Emergency Medicine, Turgut Ozal Medical Center with complaints of respiratory distress and abdominal pain and then diagnosed with Chilaiditi syndrome. Case Report: An 81-year-old female patient was admitted to the emergency department with complaints of difficulty in breathing and abdominal pain. The patient's anamnesis indicated that difficulty of breathing increased when she had abdominal pain. There was no defense or rebound, but sensitivity was observed on abdominal examination. Other system examinations were normal. Abdominal ultrasonography performed on the patient was also normal. A dynamic thorax-abdominal tomography was obtained in terms of differential diagnosis of the patient who had abdominal pain. In the dynamic thorax-abdominal tomography of the patient, loops of the colon were visualized in the vicinity of the liver anterior segment, and these images indicated with Chiliaditi syndrome. Conclusion: As a result, when the causes of shortness of breath and abdominal pain are investigated, Chiliaditi syndrome should be considered as a differential diagnosis.Öğe Atrial fibrillation due to blunt cardiac ınjury: Case report(AVES, BUYUKDERE CAD 105-9, MECIDIYEKOY, SISLI, ISTANBUL 34394, TURKEY, 2018) Yücel, Neslihan; Oğuztürk, Hakan; Ulutaş, Zeynep; Afşin, AbdulmecitIntroduction: Blunt cardiac injury secondary to chest trauma is an important cause of emergency department admissions. It can range from asymptomatic myocardial contusion to significant dysrhythmia, acute heart failure, valvular injury, or cardiac rupture. Case Report A 38-years-old patient was admitted to the emergency department with atrial fibrillation (AF) that occurred after a car accident. The patient had chest trauma caused by striking the steering wheel during the accident. The AF rhythm of the patient reverted to the normal sinus rhythm at the 3rd hour after trauma. Conclusion: Emergency medicine professionals should keep in mind arrhythmias due to blunt chest trauma and take electrocardiograms of patients to be able to provide treatment in time.
