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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 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 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 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 Trends in Geriatric Trauma Emergency Department Admissions During COVID-19(Lippincott Williams & Wilkins, 2022) Sultanoğlu, Hasan; Demir, Mehmet Cihat; Boğan, MustafaBACKGROUND: The impact of coronavirus disease-2019 (COVID-19) on geriatric trauma presenting to the emergency department is unknown. OBJECTIVE: To examine geriatric trauma emergency department admission trends during the COVID-19 pandemic. METHODS: This retrospective, observational, comparison study was conducted in an academic emergency department in Turkey. Trauma patients 65 years and older who presented to the emergency department within 1 year of March 12, 2020, were included. Patients admitted in the same date range in the previous year were included as the control group. The characteristics of the patients, injured area, and injury mechanisms were compared. RESULTS: Geriatric trauma admissions decreased (relative risk = 0.71, odds ratio [OR] = 0.69 [95% confidence interval, CI: 0.62, 0.77], p < .001). According to the type of injury, there was no significant difference in admissions to the emergency department (p = .318). During the pandemic, there was an increase in falls and a decrease in stab wounds and gunshot wounds (p = .001). Multiple trauma (OR = 5.56 [95% CI: 3.75, 8.23], p < .001), fall (OR = 2.41 [95% CI: 1.6, 3.73], p < .001), and-assault related injuries (OR = 4.43 [95% CI: 2.06, 9.56], p < .001) were determined as factors that increased the admissions to the emergency department compared with the prepandemic. CONCLUSION: Although geriatric trauma emergency department admissions decreased during the pandemic, those due to falls and assaults increased. Although curfews and social isolation resulted in a decrease in penetrating injuries, assault-related trauma has increased.
