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Öğe Affecting factors on early mortality in elderly patients diagnosed with pulmonary embolism in emergency department(Geriatrics Society, 2015) Zengin Y.; Gündüz E.; Dursun R.; İçer M.; Durgun H.M.; Taylan M.; Güloğlu C.Introduction: The ratio of elderly people in Turkey is rapidly growing. It is known that pulmonary embolism and venous thrombolysis incidence increases with age. Despite the major advances in pulmonary embolism diagnosis and treatment, pulmonary embolism leads to higher mortality rates in the elderly. In the present study, evaluation of socio-demographic and clinical characteristics of elderly patients diagnosed with pulmonary embolism in the emergency department and determination of factors that affect early mortality have been targeted in order to decrease mortality. Materials and Method: Between January 1, 2009, and September 30, 2014, patients who were 65 years of age and older who had been admitted through the emergency department with suspected pulmonary embolism and whose pulmonary embolism diagnosis was finalized via computerized tomographic pulmonary angiography. Results: In the study, 87 (61.8%) were female and 52 (38.2%) were male. Thirteen patients (9.4%) died during the follow-up period. The analysis of the relationship between pulmonary embolism in elderly patients and early mortality revealed that there is a statistical correlation among immobility, syncope, tachycardia, hypotension, elevated Troponin-T, coronary arterial disease, cerebrovascular disease, pulmonary embolism with massive dimension, bilateral pulmonary embolism, Wells-likely pulmonary embolism, and modified Geneva-likely pulmonary embolism were statistically related factors(p values, respectively, were 0.002; 0.033; 0.000; 0.000; 0.000; 0.037; 0.011; 0.000; 0.030; 0.023; 0.018). Conclusion: Immobility, syncope, tachycardia, hypotension, elevated Troponin T, coronary arterial disease, cerebrovascular disease, pulmonary embolism with massive dimension, bilateral pulmonary embolism, Wells-likely pulmonary embolism, and modified Geneva-likely pulmonary embolism were determined as effective risk factors affecting the early mortality of elderly patients with pulmonary embolism. © 2015, Geriatrics Society. All rights reserved.Öğe Demographic properties and clinical outcomes of acute pancreatitis in pregnancy: Our experience of 33 patients(Acta Medica Mediterranea, 2014) Gündüz E.; Zengin Y.; Ülger B.; Içer M.; Dursun R.; Güllü M.N.Objective: In this study we aimed to examine the clinical, demographic properties, and outcomes of acute pancreatitis in pregnancy. Materials and method: Our study included 33 patients with acute pancreatitis in pregnancy (APP) who were followed at the departments of Obstetrics and Gynecology and Internal Medicine at Dicle University Faculty of Medicine between January 2004 and June 2013. Patient information were obtained from the hospital records. Age, gestational age, etiology, complications, laboratory results, diagnostic tests, treatment modalities, mode of delivery (normal vaginal delivery or caesarean section (C/S)), duration of hospital stay, and maternal mortality and morbidity rates were recorded.Hypertriglyceridemia was recorded as the etiological factor when triglyceride level was more than 11.3 mmol/L (1000 mg/dl) and biliary pathology was recorded when there were biliary stones or bile mud. Patients who did not have a history of alcohol abuse or any condition responsible from pancreatitis were classified as idiopathic pancreatitis and grouped accordingly. Results: This study included a total of 33 patients with APP among a total of 85542 deliveries. Mean age of the study population was 34.8±7.15 (23-46) years and mean gestational age was 25.75±7.49 weeks. The etiology of acute pancreatitis was a biliary pathology in 18 (54.5%) patients, hypertriglyceridemia in 11 (33.3%), and idiopathic APP in 4 (12.2%). Four (12.1%) maternal deaths occurred. Sixteen (48.5%) patients suffered from a maternal complication while 10 (33.3%) patients died.Twenty-nine patients were discharged with cure. All maternal deaths and 50% of maternal complications occurred in second trimester. Conclusion: In our study APP was most commonly observed in second trimester and it had a more complicated and fatal course during this period.Biliary pathologies were the most fatal etiological group.Öğe Effects of Carvacrol on Experimental Testicular Torsion-Detorsion Model(Science Printers and Publishers Inc., 2020) Dursun R.; Şen A.; Yaman M.; Durgun H.M.; Aşır F.OBJECTIVE: To investigate the protective effects of carvacrol on an experimental testicular torsion-detorsion rat model. STUDY DESIGN: Wistar male rats (n=48) weighing 230–250 g were assigned to 4 groups (8 per group): control, torsion, torsion-detorsion, and torsion-detorsion+ carvacrol–treated groups. Control group animals did not undergo any surgical operation. For the torsion group, the scrotum was opened (under general anesthesia) and the left testis twisted 720° clockwise and in the last 30 minutes of 3-hour ischemia; i.p. saline was injected. In the torsion-detorsion group, after ischemia the left testis was reperfused for 2 hours. The torsion/ detorsion+carvacrol group protocol was similar to that of the torsion-detorsion group but in the last 30 minutes of 3-hour ischemia, i.p. 20 mg/kg carvacrol was administered. RESULTS: Malondialdehyde (MDA) was highest in the torsion-detorsion group (p<0.01). The lowest catalase (CAT) value was found in the torsion-detorsion group. Decrease in glutathione (GSH) levels of the torsion and torsion-detorsion groups as compared to those of control and carvacrol groups was significant (p<0.01). The highest superoxide dismutase (SOD) value was in the control and carvacrol groups. Increased apoptosis and degeneration of spermatogenic cells with hyperplasic nuclei were mainly observed in the torsion and torsion-detorsion groups. The torsion-detorsion+ carvacrol group mostly showed regular histology, but Leydig cells were degenerated. ET-1 expression was increased in endothelial cells in the torsion and detorsion groups but negative in the carvacrol group. Bax expression was positive in luminal spermatogenic cells in the torsion group but negative in interstitial cells in both torsion and torsion-detorsion groups. In the carvacrol-treated group some luminal spermatogenic cells in seminiferous tubules showed positive Bax expression but weak in basal membrane cells and Leydig cells. CONCLUSION: Carvacrol influences spermatogenic cells with strong mitotic activity in basal membranes of seminiferous tubules and may prevent apoptotic development and signaling of these cells. © Science Printers and Publishers, Inc.Öğe Factors affecting mortality in geriatric patients with head trauma(Geriatrics Society, 2016) İçer M.; Şen A.; Zengin Y.; Dursun R.; Durgun H.M.; Üstündağ M.; Orak M.Introduction: With aging, the anatomy and physiology of the body undergo changes. This leads to a change in the body’s capabilities in response to trauma, resulting in increased traumainduced morbidity and mortality. We aimed to investigate the factors influencing the prognosis and mortality of geriatric patients with head trauma. Materials and Method: A total of 1060 patients aged 65 and above who presented with head trauma within a three-year period were studied. The patients’ collected data included gender, age, trauma presentation, Glasgow Coma Scale, Revised Trauma Score, cranial physical examination findings, localisation of the fracture in the cranial regions, cranial pathology, additional organ injury and survival/death status. Results: Of the 1060 geriatric patients enrolled in the study, 500 (47%) were male and 560 (53%) were female. Of these patients, 1005 (94.8%) survived and 55 (5.20%) died. Among the deceased patients, 37 (37.3%) were male and 18 (32.7%) were female. The most common presentation was observed in the young old group (aged 65–75) with 513 patients. According to the causes of trauma, the most common cause was due to falling. The male gender was found to be at risk of mortality in all patients aged 65 and above. According to the computed tomography findings; intracranial haemorrhage, contusion, subarachnoid haemorrhage, epidural hematoma, subdural hematoma and intracranial edema were factors associated with increased mortality. Conclusion: Males and cranial pathologies are associated with a higher mortality in geriatric patients with head trauma. © 2016, Geriatrics Society. All rights reserved.Öğe Health professionals of emergency service: An evaluation of disaster medicine and ethical values(Yozmot Heiliger Ltd, 2015) Sevimli Ş.; Dursun R.; Karadas S.Aim: To obtain the opinions of health professionals’ who work in emergency medical services on the application of basic attitudes like triage, ethics, legal rules; to popularize problems they have encountered or may experience while giving health services after natural disasters; and to develop further suggestions. Material and method: In order to evaluate health service problems, laws, triage and ethics applications, a questionnaire tool was formulated. The poll that was taken included 133 emergency service workers, with and without earthquake experiences. Data were analyzed using descriptive statistics with statistical significance set at p<0.001. The frequency distributions taken into account and chi square test were applied to understand the difference between the employees who experienced an earthquake and the employees who did not. Findings: 57.7% of participants in the survey were males and 42.3% females. Their average age was 29.8 %. 16.8% of them worked in the university hospital, 77.4 % in a state hospital and 5.8% in private hospitals. 51.1% of the participants were doctors, 43.1% nurses and 5.8% emergency medical technicians. 48.2% of the participants had experienced earthquakes, 52.6% had not. 27% of them were consulted on triage, 37.2% on both triage and legal rules, 31.4% on triage, laws and ethics and 4.4% on triage and ethical principles. Conclusion: Results show that while ethical principles are less considered in medical services after natural disasters, triage and legal regulations play an essential role in resource allocation and medical service presentation. The results show that the inclusion of ethical training in natural disaster medicine education and its enhancement through regular rehearsals is essential. © 2015, Yozmot Heiliger Ltd. All rights Reserved.Öğe A Paraganglioma presenting with a giant mediastinal mass: A case report(Ondokuz Mayis Universitesi, 2014) Gündüz E.; Dursun R.; Erbey A.; Içera M.; Zengin Y.; Gülo?lua C.Paragangliomas are considerably rare and usually benign chromaffin cell tumors originating from sympathetic ganglia outside adrenal medulla. They are usually asymptomatic and detected incidentally. Tumor spread is through both lymphatic and hematogenous route. However, they may cause symptoms when excessively grown. They can be successfully treated with surgery even if they reach a gigantic size when they are diagnosed at an early period and lack metastases. From this perspective, early diagnosis and treatment of them is of great importance. In this study we present a patient presenting to emergency department with dyspnea and diagnosed with a giant paraganglioma in the anterior mediastinum. © 2014 OMU.Öğe Protective effect of sildenafil on the heart in hepatic ischemia/reperfusion injury(Science Printers and Publishers Inc., 2021) Ekinci A.; Oguz A.; Aşır F.; Ekinci C.; Dursun R.OBJECTIVE: To investigate the effect of sildenafil on reducing the impact of hepatic ischemia/reperfusion (HIR) injury established by Pringle maneuver on the heart of rats. STUDY DESIGN: Forty Wistar albino rats were divided into 4 groups: Sham (laparotomy only), Control (laparotomy following sildenafil application), IR (ischemia/reperfusion injured by HIR), and IR+SIL (injured by HIR following sildenafil application). Ischemia was developed by clamping the hepatoduodenal ligament for 30 minutes; then reperfusion was applied for 30 minutes. Sildenafil (single dose of 50 mg/kg) was administered by oral gavage for 15 minutes before ischemia. Blood samples of rats were collected from Sham and Control groups at 60 minutes and from IR and IR+SIL groups at 30 minutes after initiation of reperfusion for biochemical analysis. Meanwhile, heart tissues were sampled for biochemical analysis. Malondialdehyde (MDA) and total antioxidant capacity (TAC) in serum samples and TAC, total oxidative capacity (TOC), and oxidative stress index in heart tissues were examined biochemically. RESULTS: Serum MDA levels were elevated significantly in the IR and IR+SIL groups as compared to the sham group. Sildenafil treatment inhibited MDA increase considerably in the IR+SIL group as compared to the IR group. Serum TAC levels were elevated significantly in the sildenafil and control groups (compared with sham groups) and in the IR+SIL group (compared with the IR group). TAC levels detected in heart tissue increased significantly in the IR group as compared to the sham group; however, sildenafil treatment had no effect on this increase. CONCLUSION: Heart tissue was affected by HIR. It was revealed that sildenafil treatment may prevent the oxidative stress via increasing serum TAC levels in both control and IR+SIL groups. © Science Printers and Publishers, Inc.Öğe Specific and non-spesicific dermatoses of pregnancy in the emergency department(Yuzuncu Yil Universitesi Tip Fakultesi, 2019) Bilgili M.A.; Bilvanisi S.K.; Bilgili S.G.; Okyay A.G.; Dursun R.; Karadag A.S.Dermatological changes both specific to pregnancy and nonspecific to it may be observed during gestation. In this study, specific and nonspecific dermatoses of pregnancy were investigated in patients admitted with dermatologic complaints to the emergency department. This information will be useful in identifying common and important dermatoses of pregnancy that need to be recognized at the point of primary care, so that the proper initial treatment and referrals can be instituted. Pregnant patients admitted with dermatological complaints to the emergency service were enrolled in the study. We retrospectively collected clinical and laboratory findings, diagnoses, administered treatments and admission rates. Of the 4,280 pregnant patients admitted to the emergency service, 99 pregnant patients had dermatological complaints. While pregnancy-specific dermatoses were detected in 22 % of the patients, dermatoses nonspecific to the pregnancy were found in 78 % of them. Listed in descending order, specific dermatoses of pregnancy were atopic eruption of pregnancy (12%), polymorphic eruption of pregnancy (6%), intrahepatic cholestasis of pregnancy (2%), and pemphigoid gestationis (2%). Urticaria and angioedema were the most frequently diagnosed diseases among the dermatoses nonspecific to the pregnancy. There are many dermatoses are seen in the pregnancy, while urticaria and angioedema are the most common. Atopic eruption of pregnancy and the polymorphic eruption of pregnancy are the most common specific dermatoses. It was seen that the frequency of dermatological causes was quite low among the pregnant patients applying to the emergency service. However, some of these dermatoses may necessitate early diagnosis and immediate treatment. © 2019, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
