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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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    Isolated thoracic duct injury in penetrating neck trauma
    (Turkish Assoc Trauma Emergency Surgery, 2007) Eren, Sevval; Cakir, Oemer; Gueloglu, Cahfer; Eren, M. Nesimi
    A 39-year-old man was admitted with a stab wound to left lower neck. Chest X-ray revealed a left hydropneumothorax. Thoracentesis was performed and analysis of the fluid revealed chyle. Patient was treated conservatively by closed chest drainage and total parenteral nutrition. On the basis of this clinical report and review of the literature, it is concluded that thoracic duct injury should be kept in mind in penetrating neck trauma and conservative treatment should be the first line therapy.
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    PLASMA D-DIMER LEVELS IN ACUTE ISCHEMIC STROKE: ASSOCIATION WITH MORTALITY, STROKE TYPE AND PROGNOSIS
    (Nobel Ilac, 2010) Uestuendag, Mehmet; Orak, Murat; Gueloglu, Cahfer; Tamam, Yusuf; Sayhan, Mustafa Burak
    Objective: The purpose of this study is to examine the correlation between mortality, stroke sub-types, neurological disability and D-Dimer values measured before a specific treatment is given to patients in the emergency department. Material and Method: In the first 24 hours after stroke symptoms started and before anticoagulant treatment started, the serum D-Dimer levels of every patient were examined. The stroke sub-type of every patient was determined according to TOAST criteria and clinical classification was made according to the Oxfordshire Community Stroke Project (OCSP). The Rankin scale was used to determine the neurological disability of the surviving patients. Results: Ninety one patients were included in the study. There was a significant difference between the D-Dimer levels of patients who died and who survived (4.50+2.80 and 1.39+1.36 ng/ml respectively, p=0.003). According to the TOAST criteria, average D-dimer levels of cardioembolic and atherothrombotic stroke patients were higher than the control group. (4.35 +/- 3.03/ 3.11 +/- 1.69 and 0.43 +/- 0.26 respectively, p=0.000). According to OCSP classification, average D-dimer levels of patients with total anterior circulation infract (TOCI) and partial anterior circulation infract (PACI) were higher than the control group, (3.67 +/- 2.14, 4 +/- 3.03 and 0.43 +/- 0.26, respectively, p=0.000). The evaluation of surviving stroke patients in terms of neurological disability revealed that average D-dimer levels of patients with serious neurological disability (Rankin score=3-5) were higher than patients with slight neurological disability (Rankin score=0 and Rankin score=12), (2.85 +/- 1.69; 0.79 +/- 0.56; 0.81 +/- 0.44 respectively, p=0.000). Conclusion: We reached the conclusion that D-dimer levels in the acute period can be a leading factor for clinicians in predicting the direct results of cerebral infarct and deciding the type of treatment.