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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 sleep quality, income level and comorbid conditions on quality of life in a Turkish elderly population: A multicentre study(Geriatrics Society, 2015) Gündüz E.; Eskin F.; Gündüz M.; Bentli R.; Selçuk E.B.; Zengin Y.; İcer M.Introduction: Our aim is to investigate the effects of sleep quality, income level and comorbid conditions on Quality of Life in a Turkish elderly population. Materials and Method: This multicentric study was performed in seven districts. A total of 1030 patients older than 65 years of age who applied to the internal medicine and geriatrics outpatient clinics of study centres between January and December 2014 were included. All patients underwent the Pittsburgh Sleep Quality Index and Quality of Life Assessment (Short Form 36) tests viaface to face interview method. The demographic properties of patients were also recorded during this interview. Results: The mean Quality of Life subscale scores, except for vitality, were significantly lower (p<0.001) in patients with poor sleep quality. When analysing the relationship between Quality of Life and multiple chronic diseases, it was observed that patients having multiple chronic diseases had significantly lowered scores in three subscales (physical functioning, mental health and bodily pain; p=0.04, p=0.04, p=0.01, respectively). There were significant differences between patients with high versus low income level with respect to the mean physical functioning, mental health and bodily pain subscales (p=0.01). Conclusion: Our study demonstrated an adverse effect of low sleep quality, multiple chronic disorders and low income level on Quality of Life. © 2015, Geriatrics Society. All rights reserved.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 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.
