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Öğe Acil Serviste Kardiyopulmoner Resüsitasyon Yapılan Hastaların Değerlendirilmesi; Retrospektif Çalışma(Bolu Abant İzzet Baysal Üniversitesi, 2021) Araç, Songül; Zengin, Yılmaz; İçer, Mustafa; Gündüz, Ercan; Dursun, Recep; Durgun, Hasan; Üstündağ, MehmetGİRİŞ ve AMAÇ: Kardiyak arrest tedavisinde yapılacak işlemlerin tamamı Kardiyopulmoner resüsitasyon (KPR) olarak adlandırılmaktadır. Tüm ölümlerin yaklaşık %20’si ani kardiyak arrest nedeniyle olmaktadır. Çalışmamızda hastane içi ve dışı kardiyak arestlerin özelliklerini tanımlamak ve sonuçlarımızı literatür ile karşılaştırmak amaçlandı. YÖNTEM ve GEREÇLER: Bu çalışmada 01.01.2013 ile 31.05.2015 tarihleri arasında acil servise başvuran tüm yaş gruplarında etyolojiden bağımsız olarak Kardiyopulmoner Resüsitasyon uygulanan hastalar retrospektif olarak incelendi. Tüm olgular yaş, cinsiyet, başvuru saati, komorbidite varlığı, biyokimyasal parametreler, kullanılan ilaçlar, hasta sonlanımı, yoğun bakım ihtiyacı, yatış sonrası hastanede kalış süreleri ve mortalite gibi sosyodemografik ve klinik özellikleri bakımından araştırıldı. TARTIŞMA ve SONUÇ: Tüm hastalarda HT varlığı sağ kalım lehine anlamlı iken, erkek cinsiyeti ve saat 06:01-12:00 arası başvuru mortalite lehine anlamlı bulundu. Hastane içi kardiyak arestte 21 dakika ve üzeri uygulanan KPR artmış mortalite ile ilşkili bulunmuştur. Kardiyopulmoner Resüsitasyonun kalitesini arttırmak amaçlı kayıt sistemlerinin ve standardizasyonun oluşturulması gerekliliği görülmektedir.Öğe AFFECTING FACTORS ON EARLY MORTALITY IN ELDERLY PATIENTS DIAGNOSED WITH PULMONARY EMBOLISM IN EMERGENCY DEPARTMENT(2015) Zengin, Yılmaz; Gülolu, Cahfer; Dursun, Recep; İçer, Mustafa; Gündüz, Ercan; Taylan, Mahşuk; Durgun, Hasan MansurGiriş: Tüm dünyada olduğu gibi Türkiye'de de yaşlı nüfus oranı hızla artmaktadır. Pulmoneremboli ve venöz tromboli insidansının yaşla birlikte arttığı bilinmektedir. Pulmoner emboli tanı vetedavisindeki büyük ilerlemelere rağmen pulmoner emboli yaşlılarda daha yüksek oranda mortalite ile sonuçlanmaktadır. Bu çalışmada, acil serviste pulmoner emboli tanısı alan yaşlı hastalarınsosyodemografik ve klinik özelliklerini değerlendirmek ve mortalitenin azaltılabilmesi için erkenmortalite üzerindeki etkili faktörlerin belirlenmesi amaçlanmıştır. Gereç ve Yöntem: Bu çalışma 01.01.2009 tarihi ile 30.09.2014 tarihleri arasında acil servise başvuran 65 yaş ve üzeri olan ve pulmoner emboli şüphesi ile çekilen kompüterize tomografikpulmoner anjiografilerinde pulmoner emboli tanısı kesinleşen 139 hasta hastane bilgisayar kayıtsisteminden retrospektif olarak incelendi. Bulgular: Bu çalışmada hastaların 87'si (%61,8) kadın, 52'si (%38,2)'si erkekti. Hastaların takibinde 13 kişi (9,4%) yaşamını kaybetti. Çalışmada pulmoner embolili yaşlı hastalarının acil başvuru anındaki özellikleri ile erken mortalite arasındaki faktörlerin araştırıldığı analizde immobilite,bayılma, taşikardi, hipotansiyon, Troponin T yükselmesi, koroner arter hastalığı, serebrovaskülerhastalık, masif boyutlu pulmoner emboli olması, bilateral pulmoner emboli olması, Wells skorlamasında muhtemel pulmoner emboli olması ve Modifiye Genava skorlamasında muhtemel pulmoner emboli olmasının istatistiksel olarak ilişkili faktörler olduğu tespit edildi( p değerleri sırasıyla 0,002; 0,033; 0,000; 0,000; 0,006; 0,037; 0,011; 0,000; 0,030; 0,023; 0,018).Sonuç: İmmobilite, senkop, taşikardi, hipotansiyon, Troponin T yükselmesi, koroner arterhastalığı, serebrovasküler hastalık, masif boyutlu pulmoner emboli olması, bilateral pulmoner emboli olması, Wells skorlamasında muhtemel pulmoner emboli olması ve Modifiye Genava skorlamasında muhtemel pulmoner emboli olması yaşlı pulmoner embolili hastalarda erken mortaliteüzerine etkili faktörler olarak bulunmuşturÖğe Assessment of adult patients with hypernatremia: A single center experience(Dicle Üniversitesi Tıp Fakültesi, 2015) Gündüz, Ercan; Zengin, Yılmaz; İçer, Mustafa; Durgun, Hasan Mansur; Dursun, Recep; Gündüzalp, Ahmet; İpek, Mustafa; Güloğlu, CahferObjective: In the present study, determination of symptoms, clinical characteristics, prevalence and recovery rates was aimed in patients who applied to the emergency service and diagnosed with hypernatremia. Methods: Patients who applied to Dicle University Medical School Emergency Service during January 2013-December 2014 and whose serum Na>148 mEq/L were included in the study. The study was conducted retrospectively. Results: Hypernatremia prevalence was determined as 0.21% in the cases who applied to the emergency service. The average age in all patients was 69±22 and the median age was 72 years. The average hospitalization period was 13.3±10.9 days. The mortality rate was 75.7% and male gender domination (56%) was determined in patients who developed mortality. When mortality and recovery groups were compared statistically; significant difference was determined (p<0.05) in terms of hospitalization period, glucose, urea, creatinine and calcium averages. The complaints of our patients who applied to the emergency service were changes in consciousness (92.7%), oral intake disorder (83.4%) and fever (48.6%) based on frequency order. The accompanying comorbid states were cerebrovascular illness (36.9%), Dementia/ Alzheimer (32.4%) and hypertension (28.9%) based on frequency order. Conclusion: Consequently, hypernatremia is a fluidelectrolyte disorder progressing with high mortality and could be observed in older patients and in patients whose oral intake is defective and who have cerebrovascular illness and dementiaÖğe Effectiveness of boric acid in preventing acrylamide-conducted brain damage in rats(Merthan Tunay, 2023) Yıldızhan, Eda; Ülger, Burak Veli; Gündüz, Ercan; Akkuş, Murat; Bilge, HüseyinAim: Acrylamide (ACR) is a water-soluble neurotoxic substance that has been widely researched in recent years. Boric acid (BA) is a component that does not have a toxic effect when taken at low concentrations and has a cystotoxic activity. Studies have reported that BA has antioxidant effects. In this study, we aimed to examine the protective efficacy of BA against the toxic damage that ACR may cause in the brain tissue. Methods: In this study, 28 Wistar Albino male rats with an average weight of 320-400 grams were used. In our study, ACR was administered intraperitoneally (i.p.) at a dose of 50 mg/kg for 14 days, while BA was administered orally (p.o.) with a dose of 200 mg/kg for 14 days. Group 1 (n=7): It is the control group and no medication was administered for 14 days. Group 2 (n=7): ACR group, Group 3 (n=7): BA group and Group 4 (n=7): ACR + BA group. Results: The comparison between the groups in terms of serum Total Oxidant Status (TOS) and Malondialdehyde (MDA) analysis revealed that the highest MDA level was in the ACR group. The MDA and TOS levels of the ACR+BA group were significantly lower than the ACR group (p<0.05). Conclusions: Our study revealed that BA has a protective effect in the prevention of neurotoxicity due to oxidative stress after ACR applicationÖğe Efficacy of taxifolin in the prevention of renal injury due to liver ischemia and reperfusion(2023) Ülger, Burak Veli; Durgun, Hasan Mansur; Aşır, Fırat; Varlı, Metin; Gündüz, ErcanAim: During surgical procedures such as liver resection and transplantation, ischemia/reperfusion (I/R) injury and related complications may occur at a rate of approximately 10%. Our study, we planned to investigate histologically and biochemically the efficacy of Taxifolin in the prevention of renal tissue damage in liver ischemia reperfusion. Methods: A total of 28 Wistar Albino rats with an average age of 8-10 weeks and weights of 250-300 grams were used in our study. Group 1 (n=7): control group, Group 2 (n=7): Taxifolin group; Taxifolin was administered orally at a dose of 50 mg/kg for 3 weeks, Group 3 (n=7): Liver I/R group, 30 minutes ischemia and 120 minutes reperfusion was performed. Group 4 (n=7): Taxifolin+Liver I/R group. Results: Kidney tissues of the liver I/R group showed atrophy, degeneration of tubule epithelium and increased TNF-? expression. In addition, deterioration in renal function tests was also monitored in this group. In the Taxifolin+Liver I/R group, a significant difference was observed on both histologic and biochemical basis compared to the Liver I/R group and a positive effect was observed (p<0.05). Outcome: As a consequence of hepatic ischemia and reperfusion, impairment in the function and histological appearance of renal tissues was observed and Taxifolin was monitored to be effective in eliminating these adverse effects.Öğe Erişkin Still Hastalığı: Olgu Sunumu(Acil Tıp Uzmanları Derneği, 2014) Gündüz, Ercan; Güllü, Mehmet Nezir; Zengin, Yılmaz; Dursun, Recep; İçer, Mustafa; Özhasenekler, Ayhan; Karakoç, YenalIntroduction: Adult-onset Still’s disease (ASD) is a systemic inflammatory disease of unknown etiology and pathogenesis. ASD, one of the most important causes of fever of unknown origin, is diagnosed after ruling out infection, malignancy, and rheumatologic diseases. It may also present with fever alone, without typical skin rash and articular manifestations. Case Report: There are no pathognomonic laboratory findings in ASD. In this paper, we report a case that presented to the emergency department with fever, malaise, and joint pain for 5 days and was subsequently diagnosed with ASD. Conclusion: In patients with prolonged fever combined with musculoskeletal symptoms and macular rash, the differential diagnosis should include ASD. Timely diagnosis and treatment of the disease can prevent complications and lead to a favorable prognosisÖğe Etiologic Factors of Nonalcoholic Hepatosteathosis in Malatya(2014) Gündüz, Ercan; Bentil, Receğ; Berber, İlhami; Ukutaş, Özkan; Karıncaoğlu, Melih; Kurt, Mehmet AliAmaç: Non alkolik karaciğer yağlanmasına neden olan faktörler tam olarak ortaya anlaşılamamıştır. Bu çalışmada Malatya ve çevresinde nonalkolik yağlı karaciğer hastalığı olan hastalarda etiyolojik faktörleri araştırmayı amaçladık. Gereç ve Yöntemler: Çalışmada İnönü Üniversitesi Tıp Fakültesi, Gastroenteroloji Polikliniğine başvuran ve hepatobilier ultrasonografide karaciğer yağlanması tespit edilen hastalar retrospektif olarak incelendi. Alkole bağlı karaciğer yağlanmasının dışlamak amacıyla kadınlarda 20 gram/gün, erkeklerde 30 gram/gün üzerindeki dozlar alkol alımı olarak kabul edildi ve çalışmanın dışında bırakıldı. Karaciğer enzim düzeyleri normal hastalar hepatosteatoz, enzim düzeyi normalin iki katı veya daha yüksek olanlar steatohepatit olarak değerlendirildi. Bulgular: Toplam 112 hastanın 58'i (51,8%) kadın, 54'ü erkek (48,2%) ve tüm hastaların yaş ortalaması 43,8±11,3 yıl idi. Erkeklerin yaş ortalaması 41,8±11,3 yıl, kadınların ise 45,4±11,3 yıldı. Toplam 112 olgunun 97'sinde (%86,6) hiperlipidemi, 53'ünde (%47,3) obezite, 47'sinde (%42) insülin direnci, 16'sında (%14,2) hiperlipidemi ile birlikte insülin direnci, 27'sinde (%24,1) hiperlipidemi ile birlikte obezite, 35'inde (%31,3) obezite ile birlikte insülin direnci, 11 hastada (%9,8) latent diyabetes mellitus tesbit edildi. Sonuç: Hiperlipidemi, obezite, insülin direnci gibi risk faktörlerine sahip bireylerin karaciğer sirozuna kadar ilerleyebilen nonalkolik karaciğer yağlanması açısından değerlendirilmesi önem arzetmektedir. Nonalkolik karaciğer yağlanması hastalığı olan hastalar latent diabet açısından araştırılmalıdırÖğe Etiological risk factors in children with cerebral palsy(Lippincott Williams and Wilkins, 2023) Başaran, Alev; Kılınç, Zehra; Sarı, Hıdır; Gündüz, ErcanTo evaluate the etiological risk factors of cerebral palsy, especially the preventable ones. The study was carried out with the mothers of 210 children with cerebral palsy (CP) registered in Mardin Guidance and Research Center between February and May 2022. The data form prepared by the researchers was applied to the mothers by face-to-face interview technique. The data form consisted of 29 questions including sociodemographic characteristics of the child and mother, risk factors for CP, and secondary medical problems of the child. Of the 210 patients included in the study, 43.3% (91) were female and 56.7% (119) were male. The mean age of the children was 67.4 (SD = 50.6) weeks, and 73.3% of children were premature. The number of children with a birth weight below 2500 g was 48.1% (101). The mean birth weight was 2472.5 (SD = 871.8) g. The children with another disabled sibling consisted 6.2% of the population. Among the mothers, 41.9% stated that they were illiterate and 73.3% stated that their income status was low. The rate of the parents that were related to each other was 51%. In our study, it was noteworthy that most of the children were premature, had low birth weight, more than half of them had parents who were relatives, the education level of the mothers was low, the socioeconomic status of most of the families was low, and most of these risk factors were preventable.Öğe Evaluation of pregnant patients admitted to the emergency department with suicide attempt(Modestum Publishing Ltd., 2015) Zengin, Yılmaz; Gündüz, Ercan; Dursun, Recep; İçer, Mustafa; Durgun, Hasan Mansur; Kara, Ertuğrul; Gündüzalp, Ahmet; Güloğlu, CahferObjective: In the pregnancy period, the incidence of suicide attempt is lower compared to other life-periods. However, according to the recent studies, suicide attempts may lead life-threatening consequences in high-risk pregnant women. The aim of this study is to compare pregnant patients admitted to the emergency department for suicide attempt in terms of their sociodemographic and clinical properties and suicide attempt methods. Methods: In this study, 56 patients admitted to the emergency department of university for suicide attempt between January 1, 2009, and December 31, 2014, were included and they were classified according to suicide attempt methods into 2 groups as violent ones. Group 1 included violent methods as hanging, jumping, shooting and Group 2 included non-violent method as drugs. The study was a retrospective cross-sectional study. The sociodemographic, psychiatric and clinical properties of the patients were identified by patient registry system and patient files, and inter-group differences were compared. Results: In this study, 15 (26.7%) patients in the violent suicide attempt group, and 41 (73.3%) patients in the non-violent suicide attempt group, totally 56 patients were included. In the non-violent suicide attempt group, cigarette smoking, suicide attempt due to boredom, and live birth was significantly higher as compared to violent group; hospitalization period and fetal death was lower (p=0.04; p=0.006; p=0.004; p=0.004, respectively). Conclusion: Most of our pregnant suicide attempt patients are in the non-violent group, however, violent suicide attempt increased hospitalization period and fetal mortality significantly. J Clin Exp Invest 2015; 6 (2): 115- 120.Öğe Gallstone obstruction in anastomotic stricture: A very rare case(Modestum Ltd., 2014) Ülger, Burak Veli; Uslukaya, Ömer; Oğuz, Abdullah; Gündüz, Ercan; Teke, Memik; Baç, BilselGallstone ileus is a rare but serious complication of cholelithiasis. It is a rare cause of small bowel obstruction but it accounts up to 25% of non-strangulated small bowel obstructions in elderly. Obstruction usually occurs in the terminal ileum. Although the most frequent mechanism of gallstone ileus is migration of the gallstone through a gallbladder-duodenal fistula, there have been cases of bowel obstruction caused by gallstones without any findings of bilio-enteric fistula during the operation. The diagnosis is usually delayed due to nonspecific clinical signs and symptoms. Abdominal computerized tomography (CT) scan is the optimal way to diagnose the gallstone ileus. It can identify the site and nature of the obstruction. The optimal surgical approach is a matter of debate. Enterolithotomy is the most performed operation. One stage operation should be performed in selected low risk patients. In this study, we report a 55 years old male patient who underwent surgical intervention due to gallstone ileus. During the operation, we observed that two individual gallstones lead to obstruction in anastomotic stricture which was due to the patient's prior small bowel resection. Also, no fistula was found during the operation between the gall bladder and the gastrointestinal tract of patient. The gallstones were removed by enterolithotomy. Because there was no gallstone in the gallbladder, we did not perform cholecystectomy. J Clin Exp Invest 2015; 6 (1): 72-74.Öğe Glutamine provides effective protection against deltamethrin-induced acute hepatotoxicity in rats but not against nephrotoxicity(International Scientific Literature Inc., 2015) Gündüz, Ercan; Ülger, Burak Veli; İbiloğlu, İbrahim; Ekinci, Aysun; Dursun, Recep; Zengin, Yılmaz; İçer, Mustafa; Uslukaya, Ömer; Ekinci, Cenap; Güloğlu, CahferBackground: The aim of this study was to investigate the protective effects of L-glutamine (GLN) against liver and kidney injury caused by acute toxicity of deltamethrin (DLM). Material/Methods: Thirty-two rats were indiscriminately separated into 4 groups with 8 rats each: control group (distilled water; 10 ml/kg, perorally[p.o.]), DLM group (35 mg/kg p.o. one dose.), GLN group (1.5 gr/kg, p.o. single dose.) and DLM (35 mg/kg p.o. one dose.) + GLN group (1.5 gr/kg, p.o. one dose after 4 hours.). Testing for total antioxidant status (TAS), total oxidant status (TOS), interleukin-1 beta (IL-1?), tumor necrosis factor-alpha (TNF-?), and interleukin-6 (IL-6) analyses were performed on tissue samples, and alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), urea, and creatinine were analyzed on serum samples. Liver and kidney samples were histopathologically analyzed. Results: The TOS level in liver was significantly higher in the DLM group than in the control group, and the level in DLM+GLN group was considerably lower than in the DLM group. The TAS level in the DLM+GLN group was considerably higher than in the control and DLM groups. The TAS level in kidney tissues was considerably lower in the DLM group than in controls, but was similar to other groups. Histopathological analyses of liver tissues established a significant difference between DLM and DLM+GLN groups in terms of grade 2 hepatic injury. However, no significant difference was found between DLM and DLM+GLN groups in terms of kidney injury. Conclusions: Glutamine leads to significant improvement in deltamethrin-induced acute hepatotoxicity in terms of histopathologic results, tissue oxidative stress parameters, and serum liver function marker enzymes.Öğe Investigation of the protective effect of boric acid against hepatotoxic and nephrotoxic injury induced by acrylamide in rats(Universidad de la Frontera, 2023) Gündüz, Ercan; Yıldızhan, Eda; Yaman, Mahmut; Şen, Abdullah; Akkuş, MuratTo investigate if the administration of boric acid (BA) would exert any protective effect against possible nephrotoxicity and hepatotoxicity induced by the exposure to acrylamide (ACR) in rats. In our study, we used a total of 28 rats that were divided into four equal groups. Group 1: the control group which was not treated with any procedure. Group 2: the ACR group that was administered ACR 50 mg/kg/day via intraperitoneal (i.p) route for 14 days. Group 3: the BA group that was administered BA 200 mg/kg/ day via gavage via peroral (p.o) route for 14 days. Group 4: the ACR+BA group that was administered BA simultaneously with ACR. Total antioxidant and oxidant (TAS/TOS) capacities were measured in all groups at the end of the experiment. In addition, the specimens obtained were evaluated with histopathological examination. Studies showed that the ACR and ACr+BA groups were not significantly different in terms of hepatic TAS level while the TOS level was higher in the ACR group than the ACR+BA group. The groups did not show any significant difference regarding renal TAS and TOS levels. In the histopathological examination of the hepatic tissue, the histopathological injury score of the ACR group was significantly higher than those of the other groups whereas it was significantly lower in the ACR+BA group than the ACR group. Our study concluded that Boric acid had a protective effect against acrylamide-induced hepatotoxicity, but not against nephrotoxicity.Öğe Protective effectiveness of anise against testicular ischemia and reperfusion injury: An experimental study in rats(Polska Akademia Nauk, 2023) Yıldızhan, Eda; Akkuş, Murat; Ülger, Burak Veli; Aşır, Fırat; Söker, Sevda; Gündüz, Ercan; Rençber, M.; Barçin, MahsumTesticular torsion is a frequently encountered clinical condition that requires urgent treatment. The aim of this study is to investigate the efficacy of Anise (Pimpinella anisum L.) in treating the pathological condition due to ischemia and reperfusion injury by using biochemical, histopathological and immunohistochemical methods. A total of 6 groups were formed with 8 male Wistar Albino rats in each group. Group 1 (n=8): control group, Group 2 (n=8): Anise aqueous solution was given orally 5 ml/kg by gavage for 30 days. Group 3 (n=8): Ischemia and Reperfusion (I/R) group, bilateral testicles were rotated 270° and reperfused after 30 minutes of ischemia. Group 4 (n=8): I/R+ Anise group, Group 5 (n=8): Anise+ I/R group and Group 6 (n=8): Anise+ I/R+ Anise group. The results of the Anise group and the Control group were similar. However, the damage in the I/R group was considerably more severe than in any of the other study groups. While it was observed that spermatogenic cells started to regenerate in the I/R+Anise group, edema and congestion were observed in the Anise+I/R group. In the Anise+I/R+Anise group, all histological findings and biochemical parameters were similar to those of the control group. It was observed that anise had protective effects in ischemia and reperfusion injury in rat testicles.Öğe Socio-demographic and clinical factors related to mortality among the geriatric suicide attempters admitted to the emergency department(Dicle Üniversitesi Tıp Fakültesi, 2015) Zengin, Yılmaz; Gündüz, Ercan; İçer, Mustafa; Dursun, Recep; Durgun, Hasan Mansur; Gürbüz, Hüseyin; Demir, Süleyman; Kuyumcu, MahirObjective: The ratio of elderly people in Turkey is rapidly growing. Accordingly, psychiatric problems and suicidality among elderly people are growing concerns. In this study, we aimed to investigate the socio-demographic characteristics of older people who attempted suicide by drug and to identify risk factors affecting mortality. Methods: Patients who were over 65 years old and admitted to the emergency department of a university hospital due to drug-related suicide attempt between January 1, 2004 and December 30, 2014, were included into this retrospective cross-sectional study. Relationship between suicide attempt and mortality was investigated in regard to socio-demographic and clinical factors. Patients were divided into two groups according to whether they survived or died. Results: Of the 107 patients included in the study, 68.2% were female and 31.8% were male; 34 6% were married. Common reasons for suicide attempt were depression (34.6%) and domestic violence (30.8%). Analgesics (33.6%) were the most common drugs used in suicide attempts. The analysis of the factors related to suicide attempt and mortality revealed that significant factors were loneliness, being widowed, being retired, having adjustment disorder and anxiety disorder. Conclusion: Loneliness, being widowed, being retired, adjustment disorder, and anxiety disorder were found as the risk factors affecting mortality in geriatric suicide attempts.Öğe Telkâri sanatı alanında öğrenci yeterliklerinin öğrenci görüşlerine göre temel tasarım ilke ve öğeleri açısından değerlendirilmesi(2018) Gündüz, Ercan; Alakuş, Ali OsmanAraştırmanın genel amacı, telkâri sanatı alanında öğrenci yeterliklerinin inovatif tasarımlar ile temel tasarım ilke ve öğeleri açısından değerlendirilmesidir. Araştırmada nitel araştırma modeli kullanılmıştır. Araştırmanın evrenini Mardin, örneklemini ise Mardin ili Midyat ilçesinde bulunan Artuklu Üniversitesi Meslek Yüksek Okulunda öğrenim gören toplam 33 öğrenci oluşturmaktadır. Araştırma iki aşamalı olup 8 haftaya yayılmıştır. Araştırmanın ilk dört haftasında teorik dersler işlenmiştir. Teorik ders aşamasında öğrencilere temel tasarım ilke ve öğeleri konuları anlatılmış, bu konular çerçevesinde çizimlerin nasıl değerlendirileceği aktarılmıştır. Araştırmanın ikinci aşaması olan dört haftalık dönemde şu uygulamalar yapılmıştır. Uygulamalar her bir haftada; görüşme, gözlem, uygulama ve değerlendirmeden ibarettir. Araştırmada, nitel araştırma modeline göre hazırlanmış görüşme formu, gözlem formu ve kişisel bilgiler formu kullanılmıştır. Araştırmanın verileri değerlendirildiğinde; Araştırmaya katılan öğrencilerin telkâri eğitiminin yaratıcılıklarını geliştirdiğini ve yaratıcılıklarının üzerinde etkili olduğunu vurgulamışlardır. Ayrıca bireyler telkâri eğitiminin gümüşe şekil verme süreci olduğu, üç boyutlu çalışmalar yapıldığı, zevk alındığı, eğlenceli olduğu, el becerisini geliştirdiği, mutlu olmalarını sağladığı, sabırlı olmayı öğrettiği, kişisel doyuma ulaştırdığını belirtmişlerdir. Öğrenciler telkâri sanatı uygulamalarının iyi vakit geçirmelerini sağladığı ve telkâri eğitimine yönelik öz yeterliklerini geliştirdiğini belirtmişlerdir. Ayrıca öğrenciler tarafından telkâri çalışmalarının aşamalarını bilmelerini sağladığı, el becerilerini geliştirdiği, huzur ve mutluluk verdiği, derse yönelik olumlu tutum geliştirdiği, üç boyutlu çalışmaların nasıl yapıldığını öğrettiği ve yaratıcılıklarını geliştirdiği belirtilmiştir. Sonuç olarak; bireylerin eğitimi üzerinde ailenin olumlu ya da olumsuz tutumunun etkili olduğu ve bu tutumun bireyin telkâri sanatına bakışını etkilediği tespit edilmiştir. Dolayısıyla bu tutumların telkâri sanatı alanında öğrenci yeterliliklerini bu anlamda etkilemiş olduğu söylenebilir. İnovatif tasarımlar üzerinde bireyin yaşı ve ailenin ekonomik düzeyi konusunda anlamlı bir fark bulunamamıştır. Bireylerin demografik özellikleri tasarım sürecini etkilemediği anlaşılmıştır. Araştırmaya bakıldığında toplumsal beklentilerinde birey üzerinde etkili olduğu görülmüştür. Araştırmaya katılan öğrencilerin görüşme formlarına verdikleri cevaplar değerlendirildiğinde, telkâri çalışmalarından mutluluk duyduğu, bu çalışmaların onları iyi hissettirdiği ve onlara sabırlı olmayı öğrettiği ve estetik haz aldıkları sonucuna varmak mümkündür. Araştırma sonuçlarına dayalı olarak; inovatif tasarım konularını içeren ders saatlerinin artırılması, bu dersin lisans düzeyinde verilmesi, uygun fiziki şartları içeren atölyelerin oluşturulması ve bu sanatın tanıtılması amacıyla sanatsal ve bilimsel tanıtım faaliyetlerinde bulunulmasında yarar olduğu düşünülmektedir. Anahtar Kelimeler: Sanat Eğitimi, Telkâri, Gümüş işlemeciliği, İnovatif Motifler, Temel Tasarım.Öğe The Impact of Lactate Clearance, Bilirubin, and Albumin on Mortality in Elderly COPD Patients: Insights from Emergency Department Data(Türkiye Acil Tıp Derneği, 2024) Yaman, Mahmut; Şen, Abdullah; Durgun, Hasan Mansur; Belek, Sema; Orak, Murat; Tekin, Veysi; Gündüz, ErcanAim: Chronic obstructive pulmonary disease (COPD) is a common respiratory condition characterized by symptoms such as cough, dyspnea, and airflow limitation. The prevalence and health risks of COPD increase with age, making emergency interventions crucial for elderly patients. This study investigated the influence of bilirubin, lactate clearance, and albumin levels on mortality rates among elderly COPD patients in emergency settings to inform treatment strategies and improve clinical outcomes. Material and Methods: Elderly patients diagnosed with COPD were included in this retrospective cohort study. Data on demographics, clinical presentations, laboratory results, comorbidities, and outcomes were collected. Biochemical measurements were performed via biochemical analyses and arterial blood gas analyses. Results: Among the 139 patients studied, 89 (64%) were male with a mean age of 75 years. The mortality rate was 7.92%. No significant differences were observed in age, sex distribution, or comorbidities between deceased and surviving patients. Lactate clearance and bilirubin levels did not significantly affect mortality. However, albumin levels were notably lower in deceased patients (pÖğe Toxic epidermal necrolysis secondary to ceftriaxone use: A case report(Dicle Üniversitesi Tıp Fakültesi, 2015) İçer, Mustafa; Zengin, Yılmaz; Gündüz, Ercan; Durgun, Hasan Mansur; Orak, Murat; Üstündağ, Mehmet; Güloğlu, CahferToxic epidermal necrolysis (TEN) is a rare, life-threatening condition that is usually associated with medication use and characterized by separation of epidermis and dermis and a scalded skin appearance. A 71-year-old man presented to emergency department with fever, malaise, and hyperemic skin eruptions and bullae. Skin lesions covered more than 70% of total body surface area. Nikolsky sign was positive. He had been begun ceftriaxone for pneumonia before. TEN was considered as the initial diagnosis; the medication he used was stopped, appropriate supportive treatment was begun, and the patient was admitted to intensive care unit. He was discharged on 8th day after skin epithelization occurred. Toxic epidermal necrolysis is a highly fatal syndrome, in which early diagnosis, stopping the offensive drug, and administering appropriate supportive treatment are important components of the management.Öğe Vital indicators in predicting burn mortality: A comparison of shock indices and burn shock indices(Turkiye Klinikleri, 2023) İçer, Mustafa; Gündüz, Ercan; Güloğlu, Cahfer; Erbatur, Serkan; Polat, Dicle; Özkan, Halime; Bayrak, Tuğçe; Ülgüt, Şilan GögerBackground/aim: In many studies, shock indices have proven to be good tools for predicting mortality. In the present study, burn shock index (BSI), percentage of total body surface area burned (TBSA%) multiplied by shock index; burn modified shock index (BMSI), TBSA% multiplied by modified shock index; burn age shock index (BASI), TBSA% multiplied by age shock index; burn rivers shock index (BrSI), TBSA% multiplied by rivers shock index; burn rivers shock index multiplied by Glasgow Coma Scale score (BrSIG) were examined in burn patients. We defined these burn shock indices for the first time. This study aimed to evaluate the effectiveness of shock indices and burn shock indices in predicting mortality in burn patients. Materials and methods: This study examines retrospectively of burn patients admitted to the emergency department of Dicle University Hospital between January 2010 and December 2022. The patients’ vital signs were obtained at the time of presentation to the emergency department, and shock indices were calculated. The effectiveness of shock indices in predicting mortality was compared. Results: A total of 2445 patients were included in the study. Of the patients, 1793 were pediatric, and 652 were adults. BSI (AUC: 0.872, 95% confidence interval (CI): 0.812–0.931, p ˂ 0.001) had the highest area under the curve (AUC) value in predicting mortality in children. The optimal cut-off value for BSI in children was 21.79 and its was sensitivity 83.05%, specificity 79.64%, positive predictive value (PPV) 12.19%, negative predictive value (NPV) 99.28%. In adults, BASI had the highest value of AUC (AUC: 0.936, 95% CI: 0.887–0.984, p ˂ 0.001). The optimal cut-off value for BASI in adults was 62.5 and its sensitivity was 86.49%, specificity was 91.71%, PPV was 38.55%, and NPV was 99.12%. Conclusion: Shock indices are easy to calculate and effective in predicting mortality in burn patients admitted to the emergency department. Among the shock indices in the study, BSI was the best in predicting mortality in children, and BASI was the best in adults.
