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Öğe Acil Pandemi Polikliniğine Başvuran ve COVID-19 Şüphesiyle Değerlendirilen Hastaların Retrospektif Analizi(2021) Altınsoy, Hasan Baki; Naldemir, İbrahim Feyyaz; Çalışkan, Emel; Şahin, İbrahim Ethem; Karadağ, Mehmet; Boğan, MustafaAmaç: SARS-CoV-2 olarak adlandırılan yeni tip korona virüsün neden olduğu COVID-19 pandemisi halen tüm dünyada etkisini sürdürmektedir. COVID-19 etkeninin neden olduğu semptomlar diğer solunum yolu etkenlerine benzese de toplumsal etkileri oldukça şiddetli ve farklı seyretmektedir. Bu çalışma hastanemizin acil servis girişinde oluşturulan acil pandemi polikliniğine başvuran ve COVID-19 ön tanısıyla tetkik edilen hastaların analizinin yapılması amacıyla planlanmıştır.Gereç ve Yöntemler: Acil pandemi polikliniğine başvurmuş 16 yaş ve üzeri hastalardan, ateş, öksürük, nefes darlığı şikayetleri olup COVID-19 şüphesiyle polimeraz zincir reaksiyonu (PZR) testi için üst solunum yolundan sürüntü örneği alınmış ve Toraks bilgisayarlı tomografisi (TBT) yapılmış olanlar dahil edilmiştir. Bulgular: PZR testi pozitif ve negatif olan hastaların geliş şikayetleri karşılaştırıldığında, iki grubun da benzer şikayetlere sahip olduğu görülmüştür. PZR testi pozitif hastaların WBC sayıları (5748,39 ± 1547,01), nötrofil sayıları (3650,32 ± 1355,58), lenfosit sayıları (1467,74 ± 472,3) ve platelet sayıları (224,65 ± 76,01); PZR testi negatif olan hastalardan daha düşük bulunmuştur.Sonuç: COVID-19 PZR testi pozitif hastalarda daha düşük WBC, nötrofil ve lenfosit sayısı tespit edilmiştir. Toraks bilgisayarlı tomografi bulguları olan PZR pozitif vakalarda platelet sayısı daha düşük ve CRP değeri daha yüksek izlenmiştir. Bu verilerin özellikle ileri tanı testlerinin olmadığı veya geç sonuçlandığı sağlık kuruluşları için hastalıktan şüphelenme ve erken izolasyon için yol gösterici olabileceğini düşünmekteyiz.Öğe Acil Servise Travma Nedeniyle Getirilen ve Kraniyal Bilgisayarlı Tomografi Çekilen Hastalarda İzlenen Travmatik Olmayan İnsidental Bulguların Analizi(Van Yüzüncü Yıl Üniversitesi, 2021) Gümüşboğa, Hasan; Boğan, Mustafa; Oktay, Murat; Sabak, Mustafa; Özdemir, Nurcan SağlamÖzet Amaç: Bu çalışmada, travma nedeniyle acil servise getirilen ve çekilen KBT’de tespit edilen rastlantısal (insidental) bulguların neler olduğunu, yaygınlığını ve klinik önemini değerlendirmek; bu bulguların tespiti sonrasında acil hekimlerinin izlemesi gereken yolu tartışmak amaçlanmıştır. Materyal-Metot: Acil Serviste KBT çekilen 2399 hastanın travmatik etiyolojiye sahip olan 1100’ünün epikrizleri ve PACS kayıtları retrospektif olarak incelendi. Bulgular: Hastaların 755 (%68,6)’i erkektir. Ortalama yaş 21,69±19,58 (0-101) olup, yaş gruplarında en yüksek payın 422 (%38,4) hasta ile 10 yaş altı olduğu gözlenmiştir. Başvuru nedenleri düşme (%50,1), trafik kazası (%19,0), kafa travması (%18,9), darp edilme (%10,4) ve iş kazası (%1,6) olarak bulunmuştur. Hastaların %22,3 (245 kişi)’ünde en az bir insidental bulgu görülmüş olup bu hastaların 29’unda ikinci ve 4’ünde üçüncü bir insidental bulgu olduğu tespit edilmiştir. Grup-1 bulgular içinde en sık sinüzit (115; %10,4), nazofaringeal adenoid hipertrofi (35; %3,1), sinüs retansiyon kisti (32; %2,9) ve üst solunum yolu anatomik bozukluğu (27; %2,4) tespit edilmiştir. Grup-2 bulgularda ise en sık araknoid kist (10; %0,9), mastoidit (5; %0,4), menenjiom (3; %0,2) ve hipofizer makroadenom (2; %0,1) tespit edilmiştir. Sonuç: İnsidental bulguların büyük kısmı benign özellikte olsa da az bir kısmı ciddi ve araştırma gerektirecek özellikler göstermektedir. Hekim insidental bulgu tespit ettiği hastaların doğru yönetimini sağlamalı, malpraktis davaları açısından hastaları insidental bulgular konusunda yeteri kadar bilgilendirmeli ve yaptığı bilgilendirme ile yönlendirmelerini eksiksiz biçimde hasta dosyasına kayıt etmelidir. Anahtar kelimeler: Kafa Travması, İnsidental Bulgular, Bilgisayarlı Tomografi, Acil Servis, MalpraktisÖğe Acil serviste tespit edilen çocukluk çağı kafa tası kırıklarının mortalite ve morbiditesinin incelenmesi(Van Yüzüncü Yıl Üniversitesi, 2021) Boğan, Mustafa; Altınsoy, Hasan Baki; Oktay, MuratAmaç: Kafatası kırıkları çocukluk çağında sık görülen yaralanmalardandır, basit travmalarla oluşan izole lineer kırıklardan yüksek enerjili travmalara oluşan intrakraniyal kanamayı da içeren çökme kırıklarına kadar değişen derecelerde görülebilmektedir. Bu çalışmanın amacı kafa travması sonrası acil servise başvuran, 16 yaş ve altı çocuklarda tespit edilen kafatası kırıklarının mortalite ve morbiditesini araştırmaktır. Materyal ve Metot: Kafatası kırığı nedeniyle travma ünitesine alınan 16 yaş ve altı çocuk hastalar çalışmaya dahil edilmiştir. Bulgular: Hastaların (toplam 113 vaka) yaş ortalaması 4,16?3,71 (0-15), %64,6’sı erkek ve geliş nedenleri en sık yüksekten düşmeydi (%69). Kafatası kırığı en sık sağ tarafta (%54), en sık frontal kemikte (%31) ve en sık lineer kırık (%78,8) izlenmiştir. Hastaların %68,1’inde kırığa eşlik eden intrakraniyal kanama izlenmemiştir. Travma ünitesinde takibe alınan hastaların ortalama yatış süreleri 3,42?4,52 (0-25) gündüz, 53 hastaya (%46,9) kontrol bilgisayarlı beyin tomografisi (BBT) çekilmiş, bunlardan 24(%45,3)’ünde kontrol BBT’de yeni gelişen intrakraniyal patoloji (6 hastada yeni gelişen kanama, 10 hastadan mevcut kanamda artış, 3 hastada yeni gelişen ödem, 4 hastada mevcut ödemde artış, bir hastada orta hat yapılarında yeni gelişen şift) izlenmiştir. 4 hasta nöroşirürjik operasyona alınırken, mortalite izlenmemiştir. Sonuç: Çocukluk çağı kafa travmalarında radyolojik görüntülemede fraktür izlense dahi mortalite ve cerrahi oranları düşüktür. Ancak düşük GKS, deplase fraktür (çökme kırığı gibi) ve kırıkla birlikte olan kanamalar cerrahiye gidişi artırabilmektedir.Öğe Analysis of 12-lead electrocardiograms shared on Twitter(Rabia YILMAZ, 2022) Sultanoğlu, Hasan; Boğan, Mustafa; Demir, Mehmet Cihat; Sultanoğlu, Tuba ErdemIntroduction: A large number of electrocardiograms (ECG) are shared on Twitter every day. Some of them aim to provide information to the readers, and some of them aim to provide training with a mini quiz. This study aimed to discuss the evaluability of ECG images shared on Twitter. Methods: The study sample consisted of 12-lead ECG images shared on Twitter. ECG images shared on 08/01/2020 - 01/31/2021 were manually scanned. Results: A total of 286 tweets matching the criteria were included in the study on the specified dates. The majority of them (n = 231. 80.5%) asked the reader about the ECG. The average number of the tweets' interactions was 70.42 ± 112.17, and the interaction was mainly in the form of "likes" (50.49 ± 80.64). 83.5% of ECGs had a rhythm strip. Total interaction numbers and other parameters were compared. ECGs from which small squares could be selected collected more interactions (p = 0.015). ECGs explained the case or whose diagnosis was clearly stated collected more interactions (p <0.001). Also, it was observed that ECGs without a rhythm strip contained more interaction (p <0.001). Conclusions: We concluded that 12-derivation ECGs shared on Twitter are highly evaluable. There was also a moderate correlation between the number of followers and the number of interactions. For this reason, it is important for accounts with a high number of followers to following that are experts in their field to prevent information pollution.Öğe Analysis of publications related to Triage in the Web of Science database(2022) Karadağ, Mehmet; Boğan, MustafaObjective The aim of this study is to make a bibliometric analysis of the publications made about the increasing triage in recent years. Materials and Methods The review of the articles to be included in this study was conducted on June 8, 2021 using the database of Web of Science Core Collection. Triage was written in the subject section and a search was made in the form. “Web of Science Categories: (All); Document Types: (All); Languages: (English); Timespan: (All); Indexes: (All)”. During the search, no restrictions were entered regarding the dates of the publications. The data were transferred to VOSviewer software and analyzed systematically. Results A total of 22653 publications were descripted between 1980 and 2021. It was found that the most publications were made in the field of emergency medicine (EM) (n=3798; 16,76%). It has been observed that the most publications have been made from the United States. (n=10049; 44,36%). When Turkey's place in all fields and EM is examined; it was seen that it was in the 26th rank (n=225; 0,99%) in the all fields, and 18th in the EM field (n=50; 1,32%). Conclusion Studies and publications on triage have been conducted most often in the field of emergency medicine. However, Turkey's place in the current literature is far behind compared to the risks it poses. It is recommended to increase the work on this area in our country.Öğe The Analysis of Thoracic Computed Tomography before and after COVID-19 Pandemic(2020) Altınsoy, Hasan Baki; Boğan, MustafaAim: The aim of this study is to describe the changes in the number of Thoracic Computed Tomographs (TCT) takenfrom the emergency department (ED) and the general characteristics of the patients concerned.Material and Methods: The patients were examined in two periods as before and after March 10 (Period 1: January 1,2020 - March 9, 2020; Period 2: March 10-31, 2020), the date COVID-19 first occurred in our country. Furthermore, ifCOVID-19 findings were present, the severity of the findings, the side involved (right lung, left lung, bilateral), thenumber of lobes involved, the type of the finding observed, the localization of the lesions were identified.Results: The daily number of TCT scans increased by approximately two-folds after March 10. A total of 400 TCTscans were performed in Period 1. In a total of 69 days, the average daily TCT number was 5.8, and the number of casesconsistent with viral pneumonia was 21 (5.25% of the TCT scans on these dates). A total of 243 TCT scans wereperformed in Period 2. In a total of 22 days, the daily number of TCT scans was 11.04, and the number of patientsconsistent with viral pneumonia (COVID-19 included) was 44 (18.1% of the TCT scans on these dates).Conclusion: During this period, while it is still being debated whether COVID-19 is a biological attack or not, thesignificant increase in exposure to ionizing radiation with known risks is a matter worthy of discussion.Öğe Assessment of Patients Transferred from the Emergency Department to Home by Ambulance(Emergency Medicine Physicians Assoc Turkey, 2021) Sultanoğlu, Hasan; Boğan, Mustafa; Akpınar, Güleser; Demir, Mehmet CihatAim: Our research aimed to examine patients' sociodemographic characteristics transferred from the emergency department to home by ambulance and the factors that cause ambulance transport. To our knowledge, there is no study presenting a perspective on patients who were discharged from the emergency department but were transferred home by ambulance. Although the literature on patients using prehospital ambulance services is full, it lacks patients in need of post-hospital ambulance services. Since it is the first study on this subject, it aims to guide future studies. Materials and Methods: This retrospective study was conducted at an academic tertiary care emergency department in Turkey between March 2019 and March 2020. Results: Of the 1059 patients included in the study, 56.1% were women, 43.9% were male, and their average age was 74.21 years. The most influential factors in transporting patients from the emergency department to home by ambulance were bedridden (%47,4), social reasons(%37,7) and oxygen need (%14,9). Conclusion: The high average age of patients transferred from the emergency department to the home and the reasons for their transportation demands show that the increasing elderly population creates new requirements in health. Providing ambulance service to special groups for home transport after emergency room discharge should be seen as an emergency treatment. Standardization should be developed by carrying out studies on this subject.Öğe Assessment of the homophobic attitudes of the emergency department professionals: descriptive survey study(Via Medica, 2021) Oktay, Mehmet Murat; Boğan, Mustafa; Sabak, Mustafa; Sultanoğlu, Hasan; Narcı, HüseyinINTRODUCTION: Homophobia can be defined as fear, hatred, discrimination, and even violent feelings and behaviors developed towards individuals with sexual orientations different to other individuals of the same sex. Our study was conducted to assess the levels of homophobia among emergency medicine specialists, practitioners, nurses, and other health care professionals working in the emergency department (ED). MATERIAL AND METHODS: This study was carried out as a descriptive survey study in Gaziantep, Turkey, between July 7, 2018 and August 30, 2018. The data was collected using a Google survey form link sent to volunteers via mobile phone. RESULTS: The mean age of the patients was 30.85 ± 7 (20-53) years. While 77.5% (n = 117) of the volunteers who participated in the study worked in state hospitals, 11.3% (n = 17) worked in a private hospital. The Cronbach's Alpha value was calculated as 92.3 and the scale average score as 85.42 ± 12.33 as a result of the evaluation of the Likert-type scale. While 69 (45.7%) people were lower in homophobia, 82 (54.3%) were higher in homophobia. A difference in attitudes towards homosexuals was only observed between those who had a homosexual friend or acquaintance and those who did not (p = 0.009). Accordingly, those with homosexual friends were determined to be less homophobic. On the other hand, it was observed that those with a homosexual acquaintance and those with no homosexual acquaintances were more homophobic. CONCLUSION: In our study, it was shown that emergency medicine specialists and other health professionals working in the ED exhibit high levels of homophobic attitudes and behaviors. Including lesbian, gay, bisexual, transgender, intersex (LGBT-I) health problems in in-service trainings may contribute to the improvement of homophobic attitudes. Copyright © 2021 Via MedicaÖğe Bibliometric Analysis of Studies on Mean Platelet Volume (MPV) in the Web of Science Database(Acil Tıp Uzmanları Derneği, 2022) Gümüşboğa, Hasan; Karaduman, Muhammet Esat; Karakeçili, Ceren; Boğan, MustafaBackground: Mean platelet volume (MPV) was investigated by many medical disciplines for different disease groups. But, the use of MPV values in clinical practice is limited. In this study, it is aimed to make a bibliometric analysis of studies on MPV over the Web of Science database and also to reveal Turkey's contribution to this issue. Materials and methods: This bibliometric analysis was performed in June 2021 as a result of a search for mean platelet volume (MPV) in all indexes in the Web of Science (WOS) database. Results: The most of the MPV studies in the world were conducted on hematology (1256, 18.9%), general internal medicine (746, 11.2%), peripheral vascular diseases (579, 8.7%), cardiology/cardiovascular system diseases (537, 8%), experimental medicine research departments (376, 5.6%), and surgical sciences (342, 5.1%) in the fields of science/subject. The rank of emergency medicine is 64 (0.9%) in the world and 41 (2.1%) in Turkey. 17 of the 25 authors who published the most were Turkish. Conclusion: In many studies, when the standard deviations are taken into account, the difference between the groups cannot be seen mathematically, even if they are statistically different. Therefore, the use of MPVÖğe Comparison of GAM and DLNM Methods for Disease Modeling in Environmental Epidemiology(2021) Al, Behçet; Kul, Seval; Yoloğlu, Saim; Boğan, Mustafa; Karadağ, MehmetABSTRACT Objective: In this study, it was aimed to compare the performance results of the methods modeled by using generalized additive models (GAM) and distributed lag non-linear models (DLNM) methods from real data of three different outcome variables of three separate diseases related to air pollution. Material and Methods: The data were retrospectively obtained from three hospitals under the General Secretariat of Gaziantep province public hospitals for a total of 1,916 days between 01 January 2009 and 31 March 2014. Response variables were number of the emergency unit admission, hospitalization and mortality due to asthma, chronic obstructive pulmonary disease (COPD) and pneumonia. The response variables were estimated by GAM and DLNM methods by building four different models and the performances of the models were compared. Results: When the estimation performances of GAM and DLNM methods are compared for each of the dependent variables in the prediction of hospitalizations due to asthma, GAM model IV [Akaike Information Criteria (AIC) (4,280.63)] values were found to perform the best. It was observed that DLNM method performed better than GAM in models established for the prediction of almost all other dependent variables. For when compare the odds ratio (OR) plot estimated on particulate matter (PM10); it was seen that GAM method made predictions with lower standard error compared to DLNM methods. Conclusion: When the models created with each dependent variable were compared; it was generally observed that superior performance was obtained from the DLNM method. However, the lowest standard error in the OR charts were observed in the models using the GAM method.Öğe COVID-19 Pandemisi Öncesi ve Sonrası Alt Ekstremite Venöz Doppler Ultrasonografi Sonuçlarının Değerlendirilmesi; Retrospektif Bir Çalışma(Duzce University, 2024) Boğan, Mustafa; Bal, Melih; Gürdal, Tarık; Selki, Kudret; Kaya, Abdulkadir; Kömürcü, Özkan; Altınsoy, Hasan BakiAmaç: COVID-19 testi pozitifliği asemptomatik bireyler arasında bildirilmiştir ve asemptomatik kişilerin de tromboembolik olaylar için risk altında olduğu düşünülmektedir. Bu çalışmanın amacı, COVID-19 testinden bağımsız olarak, pandemi öncesi ve sonrasında derin ven trombozu (DVT) ön tanısıyla alt ekstremite Doppler ultrasonografisi (DUS) yapılan hastaların sonuçlarını karşılaştırmaktır. Yöntem: Toplam 35 aylık süre boyunca (01/08/2018 - 01/07/2021) Radyoloji Bölümünde RDUS yapılan hastalar analiz edildi. Çalışma dönemi boyunca toplam 599 hastaya RDUS yapılmıştır. Bulgular: Pandemi sonrasında daha fazla pozitif DVT bulgusu gözlenmiştir (n=43, %18,3, p=0,005) (bu hastaların yalnızca ikisinde pozitif COVID-19 sonucu vardı). Son üç ay içinde hastaneye yatış öyküsü, D-dimer, platelet (PLT), ortalama platelet hacmi (MPV), (lökosit sayısı) WBC, nötrofil sayısı, lenfosit sayısı, nötrofil/ lenfosit oranı (NLR) değerleri, komorbidite ve antiagregan kullanımı farklı değildi (p>0.05). Sonuç: Pandemi sırasında virüse maruz kalan ancak semptom göstermeyen bireyler (özellikle yaşlı bireyler) bile DVT riski altındadır.Öğe Effect of desert dust storms and meteorological factors on respiratory diseases(Wiley, 2022) Boğan, Mustafa; Kul, Seval; Al, Behçet; Oktay, Mehmet Murat; Akpinar Elci, Muge; Pinkerton, Kent E.; Bayram, Hasan[Bastract Not Available]Öğe The Effect of Epinephrine Administration on Return of Spontaneous Circulation and One-Month Mortality with Cardiopulmonary Arrest Patients(2020) Sabak, Mustafa; Al, Behçet; Oktay, Mehmet Murat; Zengin, Suat; Boğan, Mustafa; Gümüşboğa, Hasan; Kazaz, Tanyeli GüneyligilObjective: The objective of this study is to determine the effect of epinephrine administration on the return of spontaneous circulation (ROSC) and one-month mortality in patients with cardiopulmonary arrest.Methods: We conducted this study between August 1, 2016 and May 31, 2017. Importantly, we included the witnessed cases (?18years) of in-emergency department cardiopulmonary arrest (IEDCA) and out-of-hospital cardiopulmonary arrest (OHCA) in thestudy. We divided the patients into two groups: the adrenaline group (Group 1) and the non-adrenaline group (Group 2). Thereafter, we investigated ROSC and one-month mortality in them.Results: We included 183 patients (50.3% of males and 49.7% of females with a mean age of 64.2±16.8 years) in the study. Thepercentages of IEDCA and OHCA cases were 25.1% and 74.9%, respectively. Epinephrine was administered to 100 (54.6%) patients(Group 1). Among these patients, 15.9% (n=29) of the patients had shockable rhythms (ventricular fibrillation, pulseless ventriculartachycardia) and 84.1% (n=154) of them had non-shockable rhythms (asystole, pulseless electrical activity) as the initial rhythm.ROSC and one-month mortality rate of these patients were 24% (n=44) and 72.8% (n=36), respectively. The one-month mortalityrates of Group 1 (30% of patients had IEDCA and 70% of patients had OHCA) and Group 2 were 43.8% and 56.2%, respectively(p=0.0231). The ROSC and one-month mortality rates of Group 1 and Group 2 cases, whose initial rhythm was a shockable rhythm,were 26.6% and 50% vs. 42.8% and 66.6%, respectively.Conclusion: In this study, we found no significant difference in terms of obtaining ROSC between the shockable rhythm and ROSCin the IEDCA and OHCA cases (p=0.963 and p=0.141, respectively). The effect of epinephrine administration on patients with IEDCA and OHCA whose ROSC was obtained on one-month mortality was not statistically significant (p>0.05).Öğe Effect of the Seasonal Changes on Renal Function in Patients with Acute Ischemic Stroke(2020) Akpinar, Gulseren; Boğan, Mustafa; Yusufoğlu, Kaan; Korkmaz, Miray; Baldane, Emine Gül; Çevik, ErdemObjective: This study aimed to define seasonality trends of acute renal dysfunction in the patients with ischemic stroke.Method: This study was conducted retrospectively. Data were obtained from digital records of Şişli Hamidiye Etfal Training and Research Emergency Medicine Clinical Statistic Office.Results: One hundred ninety-nine patients with ischemic stroke were included in the study. Patients were divided into two groups according to their renal functions. Group 1 (patients with abnormal renal function) included 70 patients. In this group, the mean urea value was 67.3±26.9 mg/dL, the mean creatinine value was 1.4±1.1 mg/dL, the mean age was 77.0±6.5 years, 34 patients were male (48.6%). Group 2 (patients with normal renal function) included 129 patients. In this group, the mean urea value was 37.9±9.9 mg/dL, the mean creatinine value was 0.9±0.2 mg/dL, the mean age was 76.6±7.3 years, 74 patients were male (57.4%). Season distribution, age and gender distribution, affected area of the brain, and platelet count did not show significant differences between the groups (p>0.05).Conclusion: There is not a significant relationship between seasonal changes and renal dysfunction in the patients with ischemic stroke.Öğe The Evaluation of Core Needle Breast Biopsy Analyzes Performed with 14 and 18 Gauge Needles: A Single Center Experience for Eight Years(2021) Altınsoy, Hasan Baki; Güçlü, Derya; Coşkun, Sinem Kantarcıoğlu; Boğan, MustafaAim: Percutaneous imaging-guided core needle breast biopsy has become widely used as analternative to incisional biopsy in the diagnosis of breast lesions. In this study, it was aimed toevaluate and report our core needle breast biopsy experiences performed with 14- and 18-gauge needles.Material and Methods: Patients who underwent core needle breast biopsy between March2012 and December 2019 in our radiology department and whose biopsy specimens wereevaluated in the pathology department, of all age groups and both sexes, were included in thisstudy. A total of 628 (615 female and 13 male) patients with breast masses were examined.Results: The mean age of the patients was 52.20±13.94 (median= 51, range, 13-96) years,90.4% (n=568) of the lesions were masses and the majority of lesions (53.2%, n=334) were11-20 mm in size. The most of cases (47.2%, n=268) were BI-RADS 5. There was nosignificant difference between the two needles in terms of gender distribution, age, type ofsurgery, and core needle breast biopsy results. In 86.5% (n=141) of the patients, there wasdiagnostic accuracy between the surgical specimen and the core needle breast biopsy result.Conclusion: We demonstrated that the 14-gauge and 18-gauge needles have similarperformance of results. Smaller needles should be used for ultrasound-guided breast biopsies,which is less invasive, less painful, and creates less risk of hemorrhage. Moreover, no patientadmitted to the emergency department because of the core needle breast biopsy acutecomplications such as hematoma, bleeding, etc. during this time.Öğe Evaluation of the Prevalence of Incidental HBV, HCV and HIV Infection Among Patients Presenting to the Emergency Department: A Prospective Cross-sectional Study(2020) Oktay, Mehmet Murat; Al, Behçet; Zer, Yasemin; Kılıçoğlu, Cuma; Boğan, Mustafa; Sabak, Mustafa; Gümüşboğa, HasanAim: In this study, we randomized the patients without known hepatitis-B, hepatitis C and HIV infection who presented to the emergency department (ED). We measured the serum levels of HBsAg, Anti-HCV and Anti-HIV antibodies besides biochemical tests regarding the diagnostic process of the main complaint resulting in presentation to the ED. In this way, we aimed to determine the prevalence of occult chronic viral diseases among patients presenting to the ED and the risk of ED employees was evaluated.Materials and Methods: The study included 800 patients who had presented to the ED for any reason over two month and who had no history of infectious viral disease. Results: Four hundred and thirthy-four (54.2%) of the patients were male, 366 (45.8%) were female, and the mean age was 32.7 (±16.9) years. The rate of presence of a person with an infectious viral disease at the patient’s home was 1%, 0.5% and 0.0% for HBV, HCV, and HIV, respectively. The overall history of HBV vaccination was 15.5% in our study sample. HBsAg, anti-HCV and HIV-positivity were 2%, 0.8% and 0.0%, respectively.Conclusion: The prevalence of HBV- and HCV-positivity in patients admitted to the ED who did not have any known chronic viral disease was consistent with the general population prevalence. No significant change in the prevalence of HCV compared to previous years can be explained by the absence of a protective vaccine. The absence of HIV-positivity can be explained by the low rate of HIV-positivity in our country.Öğe Examination of Emergency Ophthalmologic Consultations in Terms of Urgency, Ophthalmic Pathology, and the Weekend Effect(2021) Demir, Mehmet Cihat; Boğan, Mustafa; Akçam, Hanife Tuba; Sultanoğlu, Hasan; Özdamar, Yasemin; Ağaçkıran, İlterObjective: To evaluate the urgency of ophthalmologyconsultations in the emergency department (ED) and thepresence of ophthalmic pathology. This study also aimedto determine whether the weekend phenomenon affectedemergency ophthalmologic consultation requests.Materials and Methods: Ophthalmology consultationsrequested by the emergency physician for patients whovisited the ED of a tertiary care hospital in Turkey fromJanuary to December 2019 were retrospectively investigated. Consultation requests were grouped as possibleemergent, unlikely to be emergent, and undetermined.Results: A total of 256 eligible patients were included.The top three reasons for ophthalmologic consultationswere blunt trauma (29.7%), foreign body (24.2%), andconjunctivitis (13.3%). 70.3% of the consultations werecategorized as a possible emergent, 18.4% as unlikely tobe emergent, and 11.3% undetermined. Most of the possible emergent consultations had ophthalmic pathology(p=0.001).Conclusion: Traumatic injuries are the most commoncause of ophthalmology consultation in the ED. Approximately one-fifth of patients are unlikely to be emergent.Early ophthalmology evaluation is required in possibleemergent category patients. The weekend effect does notinfluence ophthalmology consultations. Establishing eyeemergency services or having an available ophthalmologist is crucial in the emergency diagnosis and treatment ofpatients who require special practice skills.Öğe Experiences of Turkey's First National E-Congress of Emergency Medicine(Galenos Publ House, 2022) Sabak, Mustafa; Boğan, Mustafa; Evrin, Togay; Katipoglu, BurakAim: In our study, by analyzing the first national emergency medicine e-congress organized during the pandemic process, it was investigated what differences it made to the emergency medicine field. Materials and Methods: The study was arranged by taking data from www.acilakademi.net website, which was published under the title of 1st National Emergency Medicine E-Congress of the Emergency Medicine Physicians Association of Turkey (ATUDER) between June 11 and June 13, 2020. Results: A total of 120 speakers and 545 listeners attended. 66.7% of the speakers were male, 45% verbally (oral presentation) presented, and 45.8% participated with the title of attending physicians. 13.3% of the topics presented by the speakers were critical care. The clothes 69.2% of them wore were in the style of daily clothes. The average speaking time of the invited speakers is 18.71 +/- 4.91 (13.3-31.19) minutes. While the average number of people watching the invited speakers was 46.65 +/- 43.86 (16-252), the number of those who watched the presentations until the end was calculated as 14.73 +/- 8.43 people. It was observed that the male gender was in a significant majority with oral presentations, invited speakers, and moderators (p=0.020). Conclusion: Organizing online congresses is advantageous for the participants as an alternative to the traditional congress and it can be made more effective with some arrangements.Öğe The effect of white blood cell and platelet values on mortality in patients with abdominal aortic aneurysm(Acil Tıp Uzmanları Derneği, 2023) Demirel, Mustafa Enes; Kormaz, Ufuk Turan Kürşat; Çetin, Ömer; Güldal, Hatice; Boğan, MustafaObjective: In this study, we aimed to investigate the relationship between preoperative inflammatory markers, length of hospital stay, and mortality in patients with abdominal aortic aneurysm (AAA) who underwent surgical repair. Methods: A total of 83 patients diagnosed with AAA were included in the study. A complete blood count (CBC) was performed on the first visit (pre-op 0-1 hour) in all patients. Non-ruptured cases (AAA) and ruptured cases (AAA-R) were compared. Results: 14.5% (n=12) of the patients died. Higher White blood cells and neutrophils were obtained in patients who died than in surviving patients (respectively, p=0.0002, p=0.001). Higher WBC and NALP in AAA-R patients were determined. Conclusion: WBC and Neu's values were higher in AAA patients who died post-operatively and who were detected rupture pre-operatively but PLT and HB values were similar. Normal or near-normal HB and PLT values that will be seen in the first examination of AAA cases in the emergency department may mislead clinicians or cause them to display a more optimistic attitude.Öğe The pandemic’s effect on discharge against medical advice from the emergency department(Selçuk BAŞAK, 2021) Demir, Mehmet Cihat; Ağaçkıran, İlter; Özdamar, Yasemin; Boğan, MustafaBackground/Aim: Reasons for discharge against medical advice (DAMA) may vary according to countries' conditions and environmental or individual factors. Patients who choose to leave the hospital against the doctors’ recommendations are at risk of inadequate treatment and increased rehospitalization risk. The COVID-19 disease has come to the fore with a pandemic and the atmosphere of fear and panic it creates. We aimed to investigate the effect of fear of the pandemic on DAMA. Methods: This study was conducted in the emergency department (ED) of a tertiary hospital in Turkey. The characteristics of all patients who were discharged against medical advice and their reasons over six months at the beginning of the pandemic were examined prospectively. Results: A total of 263 patients left the ED on various excuses against medical advice between February 6-August 31, 2020 (DAMA rate: 2.4‰). The most common complaint of patients discharged against medical advice was abdominal pain (27%). The top 3 most common causes of DAMA were the fear of being infected by COVID-19 (36.5%), the thought of being neglected (12.2%), and the month of Ramadan (11.4%). Conclusion: The pandemic is an important reason for DAMA. Patients leave the hospital against medical advice with an avoidance-avoidance conflict during the COVID-19 pandemic. Defining dirty and clean areas within the emergency services with sharp boundaries and informing patients may prevent DAMA due to the fear of being infected with COVID-19. Physicians do not ignore the risk of progression to worse clinical outcomes in patients who discontinue treatment due to the pandemic.
