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Öğe Acil Tıpta Şiddet İle İlgili Adli Olgular Trafik Kazalarının Önüne Mi Geçiyor?(2015) İbrahim, Abdullah; Çolak, Şahin; Ayhan, Harun; Afacan, Mustafa Ahmet; Sarıtaş, Ayhan; Kandiş, HayatiAmaç: Her yıl bir milyondan fazla insan kendine zarar verme, başkası ta- rafından uygulanan şiddet ya da toplu şiddet uygulamalarıyla ha- yatlarını kaybetmekte veya sakat kalmaktadır. Daha önce acil ser- vislerde yapılan çalışmaların tü- münde, motorlu taşıt kazalarının (MTK) en büyük adli vaka grubunu oluşturduğu gösterilmişti. Bu ça- lışmada acil servislerdeki şiddet ile ilgili adli vakaların, MTK vaka- larından daha fazla olduğunu ve acil servislerde daha fazla iş yü- küne neden olduğunu göstermek amaçlanmıştır. Yöntemler: Bu çalışma 1 Ocak 2011 - 31 Ara- lık 2012 tarihleri arasında hasta- nemiz acil servisindeki kayıtlar incelenerek retrospektif olarak yapıldı. Eş zamanlı olarak litera- türü analiz edildi ve Türkiyenin farklı bölgelerinde toplam 54000 olgu içeren 7 ayrı çalışmanın ve- rileri karşılaştırıldı. Adli vakalar Motorlu taşıt kazaları, Şiddet vakaları ve Diğer olarak üç grup altında incelendi. Hastaneye başvuran tüm adli vakalar çalış- maya dahil edildi. Veriler topla- nırken hastane ve polis resmi ka- yıtları kullanıldı. Bulgular: Toplam 3838 adli olgu incelen- di. Vakaların %70,3ü erkek, %29,7si kadındı. Ortalama yaş 32,515,52 (min. 0, max. 94) bulundu. Vakaların çoğunu genç erkekler oluşturuyordu. Şiddet %45,6 ile ilk sırada yer alırken (darp %29, bıçaklan- ma %7, ilaç zehirlenmesi %8, ateşli silah %1, cinsel saldırı %0,1), motorlu taşıt kazaları % 37,9 ile ikinci sırada ve diğer grup %16,5 ile üçüncü sıra- daydı. Sonuç: Şiddet, 15-44 yaş arasındaki in- sanlar için dünyada en önde ge- len ölüm sebeplerindendir. Acil servislere başvuran adli vaka- larda motorlu taşıt kazaları daha çok mortalite ve morbiditeye sahip olmasına rağmen, şiddet ve şiddetten kaynaklanan adli vakalar daha sık görülmektedir. Bunun yanında şiddete bağlı adli vakaların acil servislerde çok daha fazla iş yüküne ve ekono- mik kayba sebep olduğu gerçeği de dikkatleri çekmelidir.Öğe Acute Kidney Failure Associated with Anaphylactic Shock Caused by Diclofenac Sodium(Coll Physicians & Surgeons Pakistan, 2015) Çolak, Şahin; Kutlucan, Leyla; Erdoğan, Mehmet Özgür; Afacan, Mustafa Ahmet; Sarıtaş, Ayhan; Kandiş, Hayati…Öğe Anaphylaxis after intramuscular injection of diclofenac sodium(W B Saunders Co-Elsevier Inc, 2014) Çolak, Şahin; Güneş, Harun; Afacan, Mustafa Ahmet; Kandiş, Hayati; Erdoğan, Mehmet Özgür; Ayrancı, Mehmet; Sarıtaş, AyhanDiclofenac sodium is a 2-arylacetic acid, nonsteroidal anti-inflammatory drug. It is widely used in pain management. Side effects such as urticaria, asthmatic attack, vasospastic angina, ischemic stroke, and Kounis syndrome may be seen after the use of diclofenac sodium. However, anaphylactic shock is rare. Anaphylactic shock secondary to injection of diclofenac sodium can be treated successfully with intramuscular injection of adrenaline. Because diclofenac sodium is commonly used in analgesic treatment in emergency departments, we present this case report to emphasize that anaphylactic shock may be seen after the use of that drug.Öğe Assessment of patients who presented to the emergency department with mushroom poisoning(Sage Publications Ltd, 2015) Çolak, Şahin; Kandiş, Hayati; Afacan, Mustafa Ahmet; Erdoğan, Mehmet Özgür; Güneş, Harun; Kaya, Ertuğrul; Sarıtaş, AyhanObjective: This study aimed to assess the demographic characteristics, emergency department (ED) complaints, laboratory findings, and latent phase periods of patients who presented to the ED due to mushroom poisoning (MP) as well as the efficacy of conventional and hemofiltration therapies. Method: The study was conducted on patients who presented to the ED with MP between 2010 and 2012. The patient's demographic characteristics, complaints at the ED, latent phases, laboratory findings, and treatments of MP cases were evaluated. Results: The mean age of patients was 38.03 15.96, where 63.8% of them were female and 36.2% were male. Visits occurred most frequently in the autumn (32.6%). When presenting to the ED, the most frequent complaint was nausea-vomiting. The aspartate aminotransferase (AST), alanine aminotransferase (ALT), international normalised ratio (INR), and blood urea nitrogen values of patients with a latent phase between 0 h and 5 h were significantly lower than the values of patients with a latent phase between 6 h and 24 h. In this study, 62% of the patients (n = 36) had stomach lavage and received activated charcoal. Altogether, 55.2% of the patients had received conventional therapy, 37.9% of them received hemofiltration, and all of them received supportive treatment. The AST, ALT, and INR values of those who had received hemofiltration and conventional therapies were significantly higher than of those who received only supportive treatment (p < 0.01). Conclusion: Hemofiltration, in combination with conventional therapy, seems to be an effective treatment for reducing mortality in suspected MP cases involving late acting toxins.Öğe Carbonmonoxide Post-interval Syndrome(Coll Physicians & Surgeons Pakistan, 2015) Sağlam, Sadullah; Cortuk, Mustafa; Güneş, Harun; Çolak, Şahin; Kandiş, Hayati; Sarıtaş, Ayhan; Dikici, Süber…Öğe External Pulmonary Artery Stenosis Mimicking Pulmonary Thromboembolism(Düzce Üniversitesi, 2014) Ayhan, Harun; Çolak, Şahin; Gençyavuz, Burcu; Kandiş, Hayati; Erdoğan, Mehmet ÖzgürAcquired pulmonary stenosis is very rare in adults and diagnosis requires a high index ofsuspicion. Malignant mediastinal masses may compress cardiac structures and great vessels.45year-old female patient was admitted to the emergency department with dyspnea and chest pain.Arterial blood gas analysis revealed hypoxia and respiratory alkalosis (pH 7,51, pCO2 65mmHg, pO2 65, HCO3 26 mEq/L, lactate 6 mmol/L).patient had decreased breath sounds inthe right hemithorax, 2-3/6 apical systolic ejection murmur, pretibial edema, jugular venouspressure. Electrocardiogram revealed right axis deviation and sinus tachycardia. D-dimer valuewas 300 ng/ml. Thorax computed tomography angiography revealed no thrombus or dissection.CT revealed soft tissue mass compressing right pulmonary artery and right pleural effusion.External compression of pulmonary artery may clinically mimic pulmonary thromboembolism.Low D-dimer levels may rule out pulmonary thromboembolism. External pulmonary arterycompressions may not increase D-dimer levels.Tomographic imaging should be preferred inpatients with unexplained dyspneaÖğe THE RETROSPECTIVE EVALUATION OF CASES WITH HIGH BLOOD PARACETAMOL LEVELS(Carbone Editore, 2015) Kandiş, Hayati; Bilir, Özlem; Çolak, Şahin; Sarıtaş, Ayhan; Şenel, Ahmet; Koşargelir, Mehmet; Kara, İsmail HamdiIntroduction: The aim of the study is to compare laboratory parameters and clinical outcomes of the patients taking paracetamol only and those of the patients using other medications in addition to paracetamol. Material and method: 471 cases whose ages were 15 or over, and who had a history of paracetamol intake as a single drug or in addition to other medications, and had high serum paracetamol levels, admitted to our emergency department (ED) in a 24-month period. Patients were divided into 3 groups according to Modified Rumack-Matthew nomogram and whether they took paracetamol only or together with other drugs: Paracetamol levels higher than toxic level (Group 1), lower than toxic level and using only paracetamol (Group 2), lower than toxic level and using other medications in addition to paracetamol (Group 3). In all cases, alanine amino transferase, aspartate aminotransferase, platelet counts and INR values were retrospectively recorded. Cases were evaluated in terms of the rates of discharge from the ED, hospitalization and mortality. Results: Eighty two of 471 patients were in the Group 1, 264 cases were in the Group 2, and 125 cases were in the Group 3. Forty nine of patients admitted to the ED within-2 hours after drug ingestion. Gastric lavage was performed and activated charcoal was administered in 94% (n=443) of patients presenting to ED in the following 4 hours after ingestion of paracetamol. Only the cases in the Group 1 had a statistically significant difference in ALT, AST, PLT and INR values measured on admission and at the 12th hour 377 cases were discharged after ED observation, and 94 patients were hospitalized. All patients were discharged with full recovery. Conclusion: Determining the treatment protocol by measuring serum paracetamol level shortens the duration of hospital stay, decreases treatment costs and helps avoid unnecessary N-acetylcysteine applications.Öğe An unusual complication of cardiopulmonary resuscitation: Stomach perforation(W B Saunders Co-Elsevier Inc, 2014) Afacan, Mustafa Ahmet; Çolak, Şahin; Güneş, Harun; Kandiş, Hayati; Sarıtaş, Ayhan; Çörtük, Mustafa; Özaydın, İsmetStomach perforation is an unusual complication of cardiopulmonary resuscitation. It generally occurs while providing an advanced airway. Stomach perforation may develop as a consequence of chest compressions in a patient with stomach distention caused by long periods of bag-valve mask ventilation. We presented this case to emphasize that stomach perforation may develop during cardiopulmonary resuscitation, and early diagnosis and surgical treatment may be lifesaving.
