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    The clinical features of olanzapine overdose in emergency department; a three years experience
    (Cumhuriyet Univ Tip Fak Psikiyatri Anabilim Dali, 2010) Uestuendag, Mehmet; Gueloglu, Cahfer; Orak, Murat; Altunci, Yusuf Ali; Dogan, Halil; Tamam, Yusuf
    Objective: Since using of olanzapine becomes widespread in the world, clinical features of olanzapine intoxication become important for emergency departments. In our study, we evaluated the patients with Olanzapine intoxication retrospectively. Methods: Olanzapine overdose patients who were admitted to an emergency department between February 2004 and April 2007 were included in the study. The Poisoning Severity Score of the European Association of Poison Centers and Clinical Toxicologists was used to assess intoxication severity. Results: In our study we include fifteen olanzapine overdose patients. Female and male ratio was two (10/5). The average age was 27.33 +/- 9.27 years (range: 17-48 years). The ingested olanzapine doses ranged from 50 to 600 mg whereas the mean of admission time was 3.96 +/- 2.38 (range: 1.5-10) hours after ingestion. For a subgroup of patients ingesting olanzapine alone, The Poisoning Severity Score was 'minor' in four (44.4%), 'moderate' in four (44.4%), and 'severe' in one (11.2%) patients. While minor intoxication symptoms occurred in a broad range of ingested doses (50-75 mg), moderate intoxications were observed at a minimal ingested reported dose of 140 mg. Finally 13 patients were discharged after full recovery and two patients died. Conclusion: Our findings showed that olanzapine overdose is relatively well tolerated especially when it is not accompanied by any co-ingestant. However, it can be life threaten when it is high doses are ingested or in association with other ingestants. There is correlation between dose and clinical features or prognosis. (Anatolian Journal of Psychiatry 2010; 11:145-150)
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    Factors that effect on complication development while inserting central venous catheter
    (Elsevier Science Bv, 2006) Orak, Murat; Ustundag, Mehmet; Guloglu, Cahfer; Aldemir, Mustafa; Dogan, Halil
    Objectives: Knowledge of factors that effect the development of complications while inserting a central venous catheter can lead to interventions which can lead to decreased rates of complications. In this study we evaluate the factors that effect the development of complications during central venous catheter insertion. Materials and Methods: 325 patients (179 males (% 55.1), 146 females (% 44.9)) who had central venous catheters inserted in Dicle University hospital emergency department between June 2005 and May 2006 were enrolled in this study. The effect of age, gender, reason for central venous catheter insertion, diameter of the catheter, the initial insertion site, the number of attempts for inserting the catheter, the time of day when the catheterwas inserted and the level of training of the physician on development of complications was studies. Chisquare test was used for categorical variables and the t test for continuous variables in statistical analysis. Results: Complications developed in 12% (n=39) patients. Of patients with complications, 56.4% (n=22) were male and 43.6% (n=17) female. No significant statistical relationship was detected between complication development and age, gender, reason of central venous catheter insertion, diameter of the catheter, the insertionsite, the time of day when the catheter was inserted, or the level of training of the physician (p>0.05). Patients in whom the initial insertion site was infraclavicular (42.6%) had a statistically significant higher rate of complications (p=0.036). Patients who had three or more attempts for catheterization (26.5%) also had statistically significant increase in the rate of complications (p<0.0001). Conclusion: The infraclavicular approach and three or more attempts at CVP catheter insertion arerelated to complicationst.
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    Mortal postpartum neuroleptic malignant syndrome
    (Elsevier Science Bv, 2006) Ustundag, Mehmet; Orak, Murat; Guloglu, Cahfer; Dogan, Halil; Uysal, Emin
    Neuroleptic malignant syndrome is a serious side effect caused by antipsychotic medications. Neuroleptic malignant syndrome is believed to be triggered by neuroleptic blockade of dopaminergic receptors located in the hypothalamus and basal ganglia. The incidence of neuroleptic malignant syndrome with conventional antipsychotic agents has been reported to vary from 0.02-2.44%. Manifestations of this syndrome include severe muscle rigidity and high temperature with any of the following symptoms: dysphagia, tremor, incontinence, changes in the level of consciousness, ranging from confusion to coma, mutism, tachycardia, elevated or labile blood pressure, leukocytosis and laboratory evidence of muscle injury characterized by elevated creatinine-phosphokinase (CPK). In this study, we present a case of postpartum neuroleptic malignant syndrome which ended in the death of the patient, and review the literature.