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Öğe Acil Servise Başvuran İnme Olgularında Laktat ve Laktat KlirensininMortalite Üzerine Etkileri(2021) Orak, Murat; Üstündağ, Mehmet; Güloğlu, Cahfer; Yaman, Mahmut; Aluçlu, Mehmet Ufuk; İpek, MustafaAmaç: İskemik ve hemorajik serebrovasküler hastalıklar, önemli bir morbidite ve mortalite nedenidir. Laktat klirensinin kritik hasta grubunda tüm mortaliteler ile ilişkili olduğu gösterilmiş. Biz bu çalışmada kritik hasta grubu içinde olabilecekinme ön tanılı hastalarda laktat ve laktat klirensinin prognozu tayin etmede yerini araştırmayı amaçladık.Yöntemler: 01.01.2018-31.12.2018 tarihleri arasında Dicle Üniversitesi acil servisine inme ön tanısıyla başvuran yaklaşık 300 hasta retrospektif olarak incelendi. Çalışma kriterlerine uyan 50 hastanın geliş anı laktat değeri, 24. saat laktat değeri ve 24. saat laktat klirensi değerlerine bakıldı. Çıkan sonuçların mortalite üzerine etkileri incelendi.Bulgular: Çalışmaya 50 hasta dahil edildi. Bu hastaların 23’ü erkek, 27’si kadındı. Hastaların yaş ortalaması 64,18±17.80 yıl olarak hesaplandı. Ölen hastaların 6’sı erkek, 13’ü kadın olup yaş ortalaması 66.11±19.95 yıl idi. Sağ kalan ve ölen hastalarımızın laktat düzeyleri ve laktat klirenslerine göre değerlendirildiğinde ölen hastalarımızda 24’üncü saatteki laktat düzeyi anlamlı derecede yüksektirSonuç: İnme ön tanısıyla acile başvuran hastalarda laktat klirensinin prognoz tayini açısından iyi bir marker olamayacağı, 24. Saat laktat değerinin daha anlamlı olduğu ortaya çıktı.Öğe Cardiac Evaluation of Children Presenting with Trauma(2024) Yaman, Mahmut; Türe, Mehmet; Akın, Alper; Uç, Duygu; Sürücü, Mehmet; Şen, Abdullah; Güloğlu, CahferBackground: Trauma is a critical public health issue, particularly impacting the young and caus-ing significant financial and moral losses. Approximately one-third of trauma-related hospitaliza-tions and 20-25% of trauma-related deaths are caused by serious chest injuries. We aimed to determine the prognostic value of changing pediatric global troponin levels in the emergency department after trauma. Materials and Methods: Patients who applied to the emergency department with complaints of trauma between January 1, 2015 and January 31, 2022 were evaluated. Records of pediatric patients between the ages of 0 and 18 were reviewed. The cause and severity of the trauma, electrocardiography and echocardiography results, and laboratory data (biochemical, hemogram, C-reactive protein, pro-BNP, CK-MB, troponin, etc.) of the patients were evaluated. This study is an observational and retrospective. Results: Falling from height was the most prevalent cause of injury, accounting for 43% of cases. Chest trauma was observed in 55 patients (56%). All patients with chest trauma exhibited ele-vated troponin levels. Troponin levels were found to be significantly higher in patients with chest trauma (p=0.011). Conclusions: Our findings highlighted the prognostic importance of cardiac troponins, especially in pediatric patients presenting with trauma.Öğe Dicle University Hospital's hospital disaster plan and emergency service management: Kahramanmaras earthquake experience(Oxford Univ Press, 2024) Yaman, Mahmut; Ulgut, Silan Goger; Sen, Abdullah; Ulgut, Ali Firat; Belek, Sema; Durgun, Hasan MansurBackground: Hospitals, being establishments with varying functions and capacities, must have disaster plans that reduce vulnerability, ensure the continuity, and possibly increase the capacity of healthcare services; these measures are crucial for reducing mortality and facilitating the normalization of life after a disaster. In this study, the aim was to analyze the operational process of the disaster management plan at Dicle University Faculty of Medicine Hospital following the earthquake in Kahramanmara & scedil; on 6 February 2023. Methods: This is a retrospective observational study. The study focused on determining the role of the hospital's disaster plan in crisis situations, specifically examining the emergency service task distribution and management. Results: The study included patients aged 1 to 85 years (median 34, mean 36.9 +/- 19.0), with 52.5% being female. The median injury severity score was 17 (mean 20.1 +/- 19.2). Hospital admission was 65.7%, with nephrology and orthopedics being the most common departments. Higher injury severity scores were significantly associated with mortality (P < .05), and dialysis and surgery rates were significantly higher in deceased patients (P < .05). No significant differences were found in age, gender, or comorbidities between groups. Conclusion: The earthquake highlighted the importance of disaster preparedness in hospitals for effective patient care, collaboration among disciplines, and resource management. Detailed data on the hospital's disaster plan and its operational process during the earthquake were provided to underscore its critical role in managing the crisis. Lessons learned will shape future disaster response protocols, stressing continual evaluation and improvement in healthcare disaster readiness.Öğe Effects of Carvacrol on Experimental Testicular Torsion-Detorsion Model Investigation by Immunohistochemistry(Sci Printers & Publ Inc, 2020) Dursun, Recep; Sen, Abdullah; Yaman, Mahmut; Durgun, Hasan Mansur; Asir, FiratOBJECTIVE: 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 degrees 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.Öğe El ve el bilek yaralanmaları ile acil servise başvuran hastaların klinik ve demografik özellikleri(2015) Yaman, Mahmut; Dursun, RecepAcil servise başvuran travma olgularında üst ekstremite travmaları yaygın olarak görülür ve özellikle el ve el bileğinin sıklıkla etkilenmesi söz konusudur. Bu tür yaralanmalar acil servise başvuruların %10-30’undan sorumludur. Acil servise genellikle 15-30 yaş arası erkek hastalar başvurur ve yaralanmadan sonra hastaların günlük yaşam kaliteleri çok etkilenir. Bu vakalara nadir de olsa diğer sistem travmaları da eşlik edebilmektedir. Bu çalışmada 1 Ocak 2014 – 31 Aralık 2014 tarihleri arasında Dicle Üniversitesi Tıp Fakültesi Hastanesi Acil Servis birimine el ve el bileği travması nedeniyle başvuran olguların acil servis kayıtları, Ortopedi ve Travmatoloji servisi ile Plastik ve Rekonstrüktif Cerrahi servisine yatırılarak tedavi edilen hastaların dosyaları tarandı. Olguların klinik ve demografik özellikleri ayrıca operasyon gereksinimleri ve sonuçlar retrospektif olarak incelendi. Öncelikle acil poliklinik defteri taranarak el ve el bileği yaralanması nedeniyle başvuran hastaların isimleri ve acil servis poliklinik protokolleri çıkarıldı. Bu isim ve protokol numaraları kullanılarak arşivden acil servis hasta muayene kartları çıkarıldı ve uygun hastalar çalışmaya dahil edildi. Hasta verileri "El ve El Bilek Travması Formu" kullanılarak toplanmıştır. Çalışmaya 12 aylık dönemde toplam 600 hasta alınmıştır. İlave el dışı organ yaralanması olanlar, major travmalı hastalar çalışma dışı bırakılmıştır. İzole el ve el bilek travmalı 474 vaka incelenmiştir. Çalışmaya 346’sı erkek 128’i kadın toplam 474 hasta dahil edildi. Hastalarımızın yaş ortalaması 21.8±17.8 idi. Erkeklerin yaş ortalaması 22.6±16.6 iken kadınların yaş ortalaması 19.5±20.5 idi Sonuç olarak acil servise el travması ile başvuran hastaların büyük bir kısmını çalışan, genç erkek hastalar oluşturmaktadır. İncelenen hastalardaki yaralanmaların çoğu dikkatsizlik ve eğitimsizlikten kaynaklanmakta olup gerekli basit tedbirlerin alınması ve mesleki eğitim programlarının yaygınlaştırılması ile bu yaralanmaların önüne geçilebilir. Bu alandaki çalışmaların son yıllarda belirgin olarak artmasına rağmen el ve el bileği yaralanmalarının oluşmasına katkıda bulunan biyomekanik, davranışsal ve çevresel faktörlerin karmaşıklığı nedeniyle daha büyük çapta ve uzun vadeli çalışmalara gerek vardır. Anahtar Kelimeler: El travması, Acil servis, Demografik özellik, İş kazası.Öğe Evaluating the McMahon score for predicting mortality in earthquake-induced rhabdomyolysis: a retrospective study(Oxford Univ Press, 2024) Yaman, Mahmut; Sen, Abdullah; Durgun, Hasan Mansur; Eynel, Eren; Belek, Sema; Ulgut, Silan Goger; Orak, MuratBackground: In natural disasters like earthquakes, building collapses can trap individuals, causing crush syndrome and rhabdomyolysis. This life-threatening condition often leads to acute kidney injury. We aimed to determine the effectiveness of the McMahon score in predicting mortality due to rhabdomyolysis in patients affected by the earthquake. Methods: This is a retrospective observational study. In this study, the clinical and laboratory data of patients who presented to the emergency department due to the earthquake were analyzed. The McMahon score was calculated by evaluating factors such as creatine kinase, serum creatinine levels, age, and gender. Results: The study included 151 patients, of whom 74 (49.0%) were male and 77 (51.0%) were female. In the univariate model, significant (P < .05) effectiveness was observed in differentiating between patients with and without mortality for McMahon score and the risk of acute kidney injury. At a McMahon score cutoff of 6, significant effectiveness was also observed, with an area under the curve of 0.723. At this cutoff value, the sensitivity was 80.0% and the specificity was 64.5%. Conclusions: The use of the McMahon score in emergency medicine and disaster management plays a crucial role in rapid decision-making processes due to its effectiveness in predicting mortality. Key messages What is already known on this topic center dot Rhabdomyolysis, often associated with crush syndrome and acute renal failure, leads to elevated serum creatinine levels due to muscle breakdown, frequently seen in trauma and earthquake victims. What this study adds center dot The McMahon score helps predict mortality and acute kidney injury in rhabdomyolysis patients, particularly after earthquakes, by evaluating key clinical and demographic factors. How this study might affect research, practice, or policy center dot This study highlights the McMahon score's reliability in predicting mortality in rhabdomyolysis patients, potentially guiding future research on early intervention strategies and trauma management, informing clinical practices for rapid assessment and treatment.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 The prognostic value of HALP score and sPESI in predicting in-hospital mortality in patients with pulmonary thromboembolism(Oxford Univ Press, 2024) Yaman, Mahmut; Orak, Murat; Durgun, Hasan Mansur; Tekin, Veysi; Ulgut, Silan Goger; Belek, Sema; Gunel, Bercem TugayBackground Pulmonary thromboembolism (PTE), often arising from deep vein thrombosis, remains a high-mortality condition despite diagnostic advancements. Prognostic models like Pulmonary Embolism Severity Index (PESI) and sPESI identify low-risk groups effectively. The Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) score, reflecting nutritional status and systemic inflammation, shows prognostic value in cancers and cardiovascular diseases. This study examines the relationship between in-hospital mortality HALP score and simplified PESI (sPESI) in PTE patients. Methods This retrospective observational study included patients diagnosed with PTE in the emergency department of a tertiary medical faculty from 2018 to 2023. PTE diagnosis was confirmed via computed tomography pulmonary angiography. Data on transthoracic echocardiography, D-dimer levels, demographics, laboratory results, PESI, sPESI, and HALP scores, and in-hospital mortality were collected. Results In this study, clinical characteristics of 171 patients with PTE were analysed. The average age was 61.88 +/- 19.94 years, and 53.2% were female. Mortality was observed in 19.3% of patients. PESI and sPESI scores were significant predictors of mortality, with area under the curve values of 0.938 and 0.879, respectively. PESI score > 175.50 indicated a significantly higher mortality risk (HR = 18.208; P < .001), while sPESI >2.50 was also a strong predictor (HR = 11.840; P < .001). No significant cut-off value for HALP in predicting mortality was identified. Conclusions Our study supports the reliability of sPESI and PESI scores in predicting in-hospital mortality in PTE patients. However, the prognostic value of the HALP score requires further investigation. Our findings highlight the need for developing risk stratification models.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 Travma ile Başvuran Çocuklarda Kardiyak Değerlendirme(Harran Üniversitesi, 2024) Yaman, Mahmut; Türe, Mehmet; Akın, Alper; Uç, Duygu; Sürücü, Mehmet; Şen, Abdullah; Güloğlu, CahferAmaç: Travma, özellikle gençleri etkileyen, önemli finansal ve manevi kayıplara yol açan kritik bir halk sağlığı sorunudur. Travma ile ilgili hastane yatışlarının yaklaşık üçte biri ve travma kaynaklı ölümlerin %20-25'ine ciddi göğüs yaralanmaları neden olmaktadır. Travma sonrası acil servise başvuran pediatrik hastalarda troponin düzeylerinin prognostik değerini belirlemeyi amaçladık Materyal ve Metod: 1 Ocak 2015 ile 31 Ocak 2022 tarihleri arasında acil servise travma şikayetiyle başvuran hastalar değerlendirildi. 0 ile18 yaş arası çocuk hastaların kayıtları incelendi. Hastaların travma nedeni ve şiddeti, elektrokardiyografi ve ekokardiyografi sonuçları, laboratuvar verileri (biyokimyasal, hemogram, C-reaktif protein, pro-BNP, CK-MB, troponin vb.) değer-lendirildi. Bu araştırma gözlemsel ve retrospektiftir. Bulgular: Yüksekten düşme en yaygın yaralanma nedeni olarak bulundu (%43). 55 (%56) hastada göğüs travması saptandı. Göğüs travması olan tüm hastalarda troponin yüksekliği mevcuttu. Göğüs travması olan hastalarda troponin seviyeleri anlamlı olarak yüksek bulundu (p=0.011). Sonuç: Bulgularımız, özellikle travma ile başvuran pediatrik hastalarda kardiyak troponinlerin prognostik önemini vurguladı.
