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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 Can argyrophilic nucleolar organizing region-associated protein amount be used for the detection of cardiac damage?(Sage Publications Ltd, 2016) Kandiş, Hayati; Afacan, Mustafa Ahmet; Eröz, Recep; Çolakoğlu, Serdar; Bayramoğlu, Ayşegül; Oktay, MuratIntroduction: Carbon monoxide (CO) is a colorless, tasteless, odorless, nonirritant gas and CO poisoning affects all organ systems. Aim: We aimed to detect any possible effects of CO exposure on the argyrophilic nucleolar organizing region (AgNOR)-associated protein synthesis of heart cells and whether there is any relationship between AgNOR protein amount and both carboxyhemoglobin (COHb) level and histopathological evaluation methods used for the detection of damage in heart tissue after CO exposure. Materials and Methods: The rats were divided into four groups (control, 1000, 3000, and 5000 ppm), each containing six rats. After CO intoxication, COHb levels were measured and the animals were killed on the 7th day. AgNOR staining was performed in the heart tissue. One hundred nuclei per rat were evaluated, and total AgNOR area/nuclear area and mean AgNOR number were analyzed for each nucleus. The CO exposure groups had significantly higher AgNOR values than the control group (p < 0.0001). According to cardiomyopathy (CMY) scoring methods, the differences between groups 3 and 4 and groups 1 and 2 were significant (p < 0.05). A significant positive correlation between AgNOR values and both CMY and COHb levels were detected. Conclusion: The detection of AgNOR protein amount may give information about the CMY levels and be used to detect the CO intoxication levels instead of COHb in later periods.Öğe Does determination of drug level in intoxicated patients offer an advantage in diagnosis, treatment, and reducing complications?(Pakistan Medical Assoc, 2020) Tayfur, Ismail; Senel, Ahmet; Colak, Sahin; Ibrahim, Abdullah; Afacan, Mustafa Ahmet; Saritas, AyhanObjective: To investigate the effect of determining the drug type and level on emergency management in patients presenting with intoxication, and to identify the factors behind associated mortality. Methods: The retrospective, observational, cross-sectional and single -centre study was conducted at a large tertiary care teaching hospital in Istanbul, Turkey, between September and November 2016 using the hospital's toxicology registry. Data was extracted for patients who had presented to the emergency department from January 1, 2011, to February 28, 2013, and were found to have toxic doses of single active ingredients in the plasma. The patients were evaluated in terms of age, gender, demographic characteristics, time from ingestion to presentation, reason for drug ingestion, type of drug ingested, time elapsed before the emergency service was called, treatment given, drug level, hospitalisation and mortality. Data was analysed using SPSS 11.5. Results: Of the 224 patients, 145(64.8%) were women. The overall mean age was 30.8 +/- 15.4 years. Drug ingestion was more common in women aged 18-30 years (p<0.0001). Besides, 215(96%) patients had ingested drugs with the intent to commit suicide. The minimum education level of 163(72.8%) patients was high school. The most frequently ingested drug was paracetamol 90(40.2%). Overall mortality was 4(1.8%) and all of them were brought to the emergency department after a delay of more than five hours (p<0.0001). Conclusion: Drug type and quantity were found to be of great importance in taking timely decisions while attending to patients with intoxication in an emergency setting. Delay in presentation was associated with mortality.Öğe Kounis syndrome as a result of anaphylactic reaction to diclofenac sodium: A case report(Fatih BAŞAK, 2018) İbrahim, Abdullah; Çolak, Şahin; Erdoğan, Mehmet Özgür; Afacan, Mustafa Ahmet; Sarıtaş, Ayhan; Kandiş, HayatiKounis syndrome refers to acute coronary syndromes of varying degrees (myocardial ischaemia to infarction) induced by mast cell activation as a result of allergic and anaphylactic reactions. Following subclinical, acute or chronic allergic reactions, it has a clinical spectrum ranging from chest pain to ST segment elevated myocardial infarction. The trigger of the allergic reaction can be drugs, food, environmental factors (insect bite, bee sting, pollen, latex contact). We present a case of a patient who developed Kounis syndrome as a result of anaphylactic reaction to Voltaren (Diclofenac sodium) which is one of the drugs widely used in the emergency departments as intramuscular pain killer.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.
