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A Scientometric Analysis of Mechanical Cardiopulmonary Resuscitiation Device Publications
(Düzce Üniversitesi, 2024) Ağaçkıran, İlter; Günay, Serkan; Ağaçkıran, Merve; Demir, Mehmet Cihat; Yürekli, Ümit Can; Komut, Seval; Öztürk, Ahmet
Aim: Today, the use of automatic chest compression devices is increasing. The aim of this study is to identify popular publications about chest compression devices, save time for researchers, and summarize the important points of chest compression devices using the scientometric analysis method.Material and Methods: All data were collected using the Web of Science Core Collection between July 1-8, 2023. Articles related to the topic were selected using the keywords "automated chest compression device" or "mechanical chest compression device". All articles in the database were manually scanned and analyzed. The distribution of relevant articles in the database was analysed according to scientific journals. Global research productivity, international collaborations, and research themes were analyzed using the scientometric method.Results: A total of 589 articles were identified in the WoS. Out of these, 439 (74.407%) were original articles, followed by 63 (10.678%) review articles and 30 (5.085%) editorial materials. When examining the distribution of research articles by country, the United States (US) topped the list with 171 articles, followed by Germany (n=77). Although the UK ranked third in terms of the number of publications with 53 articles, it ranked first in terms of the number of citations. (n=3465). An assessment of the top 20 publishing journals revealed that the Resuscitation Journal led in terms of publication count (n=133), citation count (n=5906), and average citations per publication (n=44.41). Conclusion: Our bibliometric study analyzed 589 articles on mechanical cardiopulmonary resuscitation. This can help researchers identify trending topics and areas of interest more quickly. More research is needed to fully understand the effectiveness and best tools for saving lives in emergency situations.
Acil Servis Hastalarında Serum Ürik Asit Düzeyi ve İnme İlişkisinin Değerlendirilmesi
(Düzce Üniversitesi, 2024) Şengüldür, Erdinç; Demir, Mehmet Cihat
Amaç: İnme, sakatlık ve ölümlerin önde gelen nedenlerinden biridir. İnme yönetiminde klinik ve görüntüleme yöntemleri yaygın olarak kullanılırken, serum ürik asit (SUA) düzeyi gibi biyokimyasal parametreler büyük ölçüde göz ardı edilmektedir. Bu çalışmada, yüksek veya düşük SUA düzeyleri ile hem iskemik hem de hemorajik inme arasındaki ilişkinin incelenmesi amaçlanmıştır.Gereç ve Yöntemler: Bu çalışma retrospektif, tek merkezli gözlemsel bir çalışmadır. Çalışmaya 1 Ocak 2023 ile 31 Aralık 2023 tarihleri arasında acil servisten nöroloji ve/veya beyin cerrahisine konsülte edilen tüm ardışık hastalar dahil edilmiştir. Hastaların verileri hastane bilgisayar sisteminden ve acil servis kayıtlarından elde edilmiştir. ?2,8 mg/dL olan SUA düzeyleri hipoürisemiyi gösterirken, ?7 mg/dL olması hiperürisemi olarak kabul edildi.Bulgular: Çalışmaya toplam 1186 yetişkin hasta dahil edildi. Bunların 484'ünün inme tanısı aldığı, 394'ünün iskemik inme, 90'ının ise hemorajik inme olduğu görüldü. İnme hastalarının medyan SUA düzeyleri daha yüksekti (p
Acil Serviste Kan Ürünü İstemlerinin Değerlendirilmesi: Prospektif Gözlemsel Bir Çalışma
(2024) Özdamar, Yasemin; Demir, Mehmet Cihat; Ağaçkıran, İlter; Aksu, Nalan Metin
Amaç: Acil servis kan ürünü istemleri artıyor, ancak aşırı olup olmadığı belirsizdir. Acil hekimleri tarafından yapılan kan ürünü istemlerini ve kullanım oranlarını inceleyerek kan ürünleri istemlerinin aşırı olup olmadığını tespit etmeyi amaçladık. Gereç ve Yöntem: Bu prospektif, gözlemsel ve tek merkezli çalışma, beş ay içinde üçüncü basamak bir yetişkin acil servisine başvuran 18 yaş ve üzeri hastaların demografik verilerini, kan transfüzyonu endikasyonlarını ve transfüzyon oranlarını incelemiştir. Bulgular: Bin dört yüz yetmiş beş kan ürünü istemi (hasta başına ortalama 6,92 ünite) incelendi. Bu istemlerin %63,1’i kullanılmadı. Transfüzyon oranları eritrosit süspansiyonu için %40,89, trombosit süspansiyonu için %25,61 ve taze donmuş plazma için %44,34 idi. Kan ürünleri istemenin ana endikasyonları gastrointestinal kanama ve anemiydi. Gastrointestinal kanaması olan hastalarda spesifik olarak eritrosit süspansiyonlarının %30,04’ü, trombosit süspansiyonlarının %31,9’u ve taze donmuş plazmaların %60,56’sı kullanıldı. Travma hastalarında istenen eritrosit süspansiyonlarının %12,75’i, trombosit süspansiyonlarının %0,083’ü ve taze donmuş plazmaların %13,89’u kullanıldı. Sonuç: Acil serviste kan ürünlerine yönelik aşırı istemler, kaynakların yanlış kullanılmasına neden olabilir. Transfüzyon komitesi, gereksiz istekleri azaltmak ve kaynak kullanımını optimize etmek için özel stratejiler geliştirmeli ve hekim farkındalığını arttırmalıdır.
Acil Serviste Küçük Bir Mülteciyim: Mülteci Çocuklarda Travma Maruziyeti ve Sonuçları
(Duzce University, 2025) Demir, Mehmet Cihat; Şengüldür, Erdinç
Amaç: Bu çalışmada, acil servise fiziksel travma nedeniyle başvuran mülteci çocukların travma mekanizmaları, klinik özellikleri ve sonuçlarının değerlendirilmesi amaçlanmıştır.
Acute Systemic Toxicity Associated with Ingestion of Juniper Tar
(Emergency Medicine Physicians Assoc Turkey, 2023) Ozdamar, Yasemin; Demir, Mehmet Cihat
Juniper Tar has been utilized in traditional folk medicine to treat various ailments. Despite its historical use, documented cases are scarce regarding the potential complications associated with Juniper Tar, some of which have been fatal. A 62-year-old male patient with no previous medical history presented to the emergency department complaining of confusion and respiratory distress after drinking a glass of Juniper Tar approximately four hours ago. The patient, who experienced multiple seizures and cardiac arrest at the emergency department, was discharged after an 11-day intensive care unit monitoring period. We present this case to raise awareness among emergency physicians about Juniper Tar, which is widely used for various purposes in folk medicine and cosmetics but can cause poisoning due to its content of essential oils, triterpenes, and phenols. This is a case of cardiac arrest and status epilepticus associated with juniper tar poisoning.
Analysis of 12-lead electrocardiograms shared on Twitter
(Rabia YILMAZ, 2022) Sultanoğlu, Hasan; Boğan, Mustafa; Demir, Mehmet Cihat; Sultanoğlu, Tuba Erdem
Introduction: 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.
An Aortic Abscess Associated with Psoas Abscess: A Case Report
(Emergency Medicine Physicians Assoc Turkey, 2023) Selki, Kudret; Demir, Mehmet Cihat; Bogan, Mustafa
In this article, we report a case in which a psoas abscess opened into the aneurysmatic abdominal aorta, and abscess formation was observed in the aortic lumen containing a stent. A 57-year-old male patient presented to the emergency department with a complaint of abdominal pain. During the abdominal examination of the patient, tenderness and defense were detected in the right lower quadrant. Contrast-enhanced computed tomography (CT) angiography of the abdominal aorta was ordered because the patient had a history of previous stenting and right lower quadrant deficiency. In the right iliopsoas muscle, there was an increase in size suggestive of abscess formation with air densities. The diameter of the ascending aorta was 44 mm. At the level of the descending thoracic aortic bifurcation, an aneurysmatic appearance was noted in a segment of approximately 140 mm extending to the proximities of both main iliac arteries, and USG showed air in the wall in the aneurysmatic section and mural wall thickening with thrombus. In this case, although the abscess eroded the aneurysmatic aortic wall, acute bleeding did not develop due to the presence of a stent. We wanted to share the rare image on computed tomography (massive air-fluid level around the stent in the aortic lumen), especially in our case with the medical literature.
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 Cihat
Aim: 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.
Can end-tidal CO2 measurement replace arterial partial CO2 in emergency department respiratory distress management?
(Elsevier Espana Slu, 2024) Selki, Kudret; Demir, Mehmet Cihat; Senguldur, Erdinc; Erdem, Emre; Guldal, Hatice; Tasdemir, Murat; Kiciroglu, Alp Kaan Furkan
Objective: To assess the feasibility of using end-tidal carbon dioxide (EtCO2) as a non-invasive substitute for partial pressure of arterial carbon dioxide (PaCO2) in emergency department (ED) triage and follow-up, and to explore the potential of partial pressure of venous carbon dioxide (PvCO(2)) as an alternative to PaCO2. Design: Prospective cross-sectional study. Setting: Tertiary university hospital. Patients or participants: 97 patients presenting with acute respiratory distress to the ED. Interventions: EtCO2, arterial blood gases, and venous blood gases measured at admission (0 min), 60 min, and 120 min. Main variables of interest: CO2 levels. Results: Among 97 patients (mean age: 70.93 +/- 9.6 years; 60.8% male), EtCO2 > 45 mmHg at admission showed strong positive correlations with PaCO2 and PvCO(2) (r = 0.844, r = 0.803; p < 0.001, respectively). Significant positive correlation was observed between 60-min EtCO2 and PaCO2 (r = 0.729; p < 0.001). Strong correlation between PaCO2 and PvCO(2) at 120 min when EtCO2 > 45 mmHg (r = 0.870; p < 0.001). EtCO2 was higher in hospitalized patients compared to discharged ones. Conclusions: EtCO2 appears promising as a substitute for PaCO2 in ED patients with acute respiratory distress within the initial two hours of treatment. Venous blood gas sampling offers a less invasive alternative to arterial sampling, facilitating simultaneous blood tests. (c) 2024 Elsevier Espana, S.L.U. and SEMICYUC. All rights are reserved, including those for text and data mining, AI training, and similar technologies.
Characteristics of patients leaving the emergency department without being seen by a doctor: The first report from Türkiye
(Lippincott Williams & Wilkins, 2024) Senguldur, Erdinc; Demir, Mehmet Cihat; Selki, Kudret; Erdem, Emre; Guldal, Hatice
The presence of patients who leave without being seen (LWBS) by a physician in the emergency department (ED) is an essential indicator of the accessibility and quality of healthcare delivery. A high LWBS rate implies low patient satisfaction. This study aims to analyze the prevalence and characteristics of LWBS patients in T & uuml;rkiye and their ED readmission rate within 3 days. This retrospective, single-center, observational study was conducted in the ED of a Turkish tertiary university hospital. It looked at patients who left without being evaluated by a physician admitted to the ED between June 01, 2021, and June 01, 2023. Data on age, gender, residential area, health insurance status, ED readmission within 3 days, complaints, and hospitalization were obtained through the hospital's electronic record system. The prevalence of LWBS patients was 0.43%. Only 0.6% (n = 5) of LWBS patients had no health insurance. About 12.8% (n = 99) of them were 65 years and older. About 10.2% (n = 79) of LWBS patients were readmitted to the ED within 72 hours. The most common reason for readmission was musculoskeletal system complaints. Statistically, ED readmission was significantly more common in older adults (P = .05). Older LWBS patients are more likely hospitalized upon return visits to the ED (P = .014). LWBS patients are both a result and a consequence of ED crowding. A zero LWBS rate is crucial for older adults' health as they may fall victim to an invisible accident while avoiding ED traffic. Prioritizing older adults and reorganizing waiting areas can reduce ED crowding and cost burden due to delayed treatments.
Clozapine related Ogilvie syndrome with fatal outcome
(Pensiero Scientifico Editor, 2020) Akkas, Meltem; Demir, Mehmet Cihat
Background. Clozapine, an antipsychotic medication, can ordinarily cause gastrointestinal hypomotility, but clozapine-related Ogilvie Syndrome (colonic pseudo-obstruction) has been reported rarely. Case Report. A 29-year-old male was admitted to the emergency department (ED) with complaints of vomiting, abdominal pain, and distension lasting for a day. He was on clozapine therapy due to schizophrenia. An abdominal-CT scan revealed dilation from the cecum to the ileum and he was diagnosed with Ogilvie syndrome. During the observation period in the ED, respiratory distress, hypotension, and alteration in consciousness were observed, and the patient was intubated electively. Arterial blood gas showed primary metabolic acidosis, with a normal anion gap with full respiratory compensation. In the control CT scan there was no visible perforation but distension persisted; the cecum diameter was 93 mm and the colonic wall was thickened. After the CT scan, the patient went into cardiac arrest and died 13 hours after his admission. In this case, excessive colonic dilatation, high WBC, and lactate levels and increased thickness of the colon wall suggest sepsis due to intestinal ischemia. Conclusions. Clozapine-related gastrointestinal hypomotility (CRGH) is not a trivial symptom. It can cause Ogilvie syndrome, which can be fatal due to complications. In the current clozapine prescription content, information on CRGH is insufficient. Higher levels of suspicion, lower diagnostic thresholds in the case of mental and psychiatric patients may prevent delays in diagnosis and treatment and result in lower mortality.
Deep Vein Thrombosis as a Harbinger of Malignancy in the Emergency Department
(Coll Physicians & Surgeons Pakistan, 2024) Demir, Mehmet Cihat; Selki, Kudret; Demir, Mehmet Cihat
Objective: To determine whether malignancy was discovered within one year of follow-up in patients with deep vein thrombosis (DVT) in the emergency department (ED). Study Design: Descriptive study. Place and Duration of the Study: Department of Emergency Medicine, School of Medicine, Duzce University, Duzce, Turkiye, from November 2019 to November 2022. Methodology: All patients diagnosed with lower limb DVT on venous Doppler ultrasound were included in this study. Patients with a confirmed diagnosis or suspicion of malignancy were excluded. The study outcome was the discovery of malignancy within a year. DVT patients subsequently diagnosed with malignancy were grouped as secondary or idiopathic. Results: A total of 224 DVT patients without malignancy were studied. The median age of patients diagnosed with DVT was 65.5 years (47-77), of which, 51.8% were females. Malignancy was detected in 5.4% (12/224) of the patients within one year. Malignancy discovery was significantly higher in the secondary DVT group (OR = 4.52, 95% CI = 1.31-11.55; p = 0.021). Ten of 12 patients (83.3%) diagnosed with malignancy were from the genitourinary or gastrointestinal systems. Conclusion: In patients without known malignancy who were diagnosed with DVT in the ED, the rate of malignancy discovery in a one-year follow-up was 5.4%. EDs, where DVT is frequently diagnosed, are a hub of opportunities for early detection of malignancy. Arranging primary care follow-up of patients with DVT will contribute to better early diagnosis and survival rates, especially for genitourinary and gastrointestinal malignancies.
Emergency Department Neurosurgical Consultations in a Tertiary Care Hospital
(Duzce Univ, Fac Medicine, 2023) Senguldur, Erdinc; Selki, Kudret; Tuncer, Cengiz; Demir, Mehmet Cihat
Objective: To reveal the characteristics of patients in need of neurosurgery by examining neurosurgery consultations within the emergency department (ED) admissions of a tertiary academic hospital.Methods: This is a retrospective, single-centre observational study. Patients admitted to the ED between 01.01.2022 -31.12.2022 and consulted to the neurosurgery department were identified through the hospital computer system and included in the study. The demographic information of the patients, mode of admission to the ED, the reasons for admission, the time of admission, the number of brain computed tomography (CT) scans, whether they underwent surgery or not, and the mortality results were recorded.Results: A total of 441 neurosurgery consultations were examined. Fall 35.6% (n=157) and traffic accident 16.6% (n=73) were the most common reasons for consultation. It was observed that 92.5% (n=408) of the patients had a brain CT scan, and 19.5% (n=86) had two or more brain CTs. It was determined that 12.7% (n=56) of the patients consulted to neurosurgery were operated on, and 4.1% (n=18) of the patients' hospital admissions resulted in death. Only 53.7% (n=237) of the patients who underwent neurosurgery consultation were discharged from the ED. It was determined that significantly more Neurosurgery consultations were requested during working hours (p = 0.013).Conclusions: Most consultation calls from the ED to neurosurgery are for trauma patients. Brain CT examination is frequently used in neurosurgical patient evaluation. As a result of the consultations, almost half of the patients are hospitalized. Emergency physicians can select patients who need neurosurgery well.
Emergency Medicine Physicians' Approaches to Coping with Stress in COVID-19 Pandemic
(Emergency Medicine Physicians Assoc Turkey, 2021) Demir, Mehmet Cihat; Ataman, Ali Kaan
Aim: This study aimed to investigate the stress experienced by emergency medicine physicians working in emergency departments during the coronavirus disease-2019 (COVID-19) pandemic, the factors they stated to be effective against stress, and their coping approaches to stressful situations. Materials and Methods: The study was designed in a general screening model, and 200 emergency medicine physicians participated via e-mail who work in emergency departments in Turkey. The sources of stress related to the pandemic, the factors that they find effective in combating stress, and their strategies to cope with stress were investigated with relation to their gender, marital status, after-shift accommodation, manner of working in a shift, smoking behavior, having a chronic disease, having children, and spouse's job as a healthcare professional. Results: While the primary source of stress of emergency medicine physicians during the pandemic was the risk of transmitting the virus to their families, the most influential factor in combating stress was leisure activities. Emergency physicians' approaches to coping with stress were significantly predicted by the variables of using full personal protective equipment while working, having an adequate sleep and resting opportunities, obtaining additional economic income, and not knowing the pandemic's end date. Conclusion: Emergency medicine physicians used active problem-oriented approaches, and among these, they used the social support seeking approach the most during the pandemic. It is necessary to provide social support, take precautions to care for healthcare workers' families and arrange emergency physicians' shifts to allocate their time to their leisure activities appropriately to reduce stress.
Evaluation of patients with decreased general condition and comparing HOTEL, WPS, and REMS for mortality prediction
(Nature Portfolio, 2025) Aykol, Emine; Demir, Mehmet Cihat; Selki, Kudret; Sultanoglu, Hasan
The emergency department (ED) plays a crucial role in evaluating patients with decreased general condition (DGC). Prompt diagnosis and precise risk stratification enhances clinical care outcomes. This study aimed to reveal which scoring system is better for predicting mortality in patients with DGC. This single-center prospective study was conducted between 1 March 2021 and 1 June 2021 in a tertiary university hospital's ED. All patients presented with DGC were included. The scores assessed upon ED admission for patients include the Hypotension, Oxygen saturation, low Temperature, ECG changes, and Loss of independence, abbreviated as HOTEL score, Rapid Emergency Medicine Score (REMS), and the Worthing Physiological Scoring (WPS). The study aimed to compare the scoring systems to identify which is the best mortality predictor. Independent risk factors for 30-day mortality were analyzed using binary logistic regression and ROC curves to assess the effectiveness of HOTEL, REMS, and WPS scores in predicting mortality. The study was conducted with 137 DGC patients. The median age of patients presented to the ED with DGC was 77 (66.5-87), and 50.4% were male. 52.6% of patients died within one month. Analysis of mortality risk factors revealed that gender, age, day of admission, visit type, home oxygen, urinary catheter use, and speech status were not independent risk factors. For one-month mortality prediction, AUCs were: HOTEL 0.644 (cut-off 1), REMS 0.635 (cut-off 8), WPS 0.547 (cut-off 5). For mechanical ventilation: HOTEL 0.689 (10), REMS 0.790 (10), WPS 0.777 (4). For ICU admission: HOTEL 0.697 (2), REMS 0.770 (9), WPS 0.728 (4). Both the HOTEL and REMS scoring systems have moderate prognostic value in predicting mortality in patients with a DGC. The REMS, and WPS scores are also more helpful in determining the need for intensive care unit admission and mechanical ventilation.
Evaluation of trailer attached-two wheel tractor (Pat- pat) accident - related pediatric injuries in Turkey's western black sea region
(2021) Akpinar, Gulseren; Demir, Mehmet Cihat
Traumatic injuries related to agricultural production can lead to serious illness, disability, and even death. Pediatric injuries due to trailer attached-two wheel tractor (Patpat)accidents occupy a scarce place in the literature. To contribute to the literature, we aimed to evaluate the demographic characteristics and analysis of pediatric injuriesdue to a Pat-pat accident admitted to our emergency department in the last decade. The study data were obtained by retrospectively examining patients younger than 18years of age admitted to the Emergency Medicine Clinic between 01/01/2010 and 31/12/2019 with injuries due to Pat-pat accident. Demographic characteristics, injurysites, injury types, hospitalization status, length of hospital stay, injury severity score (ISS), and mortality status were recorded. Due to the Pat-pat accident, 32 childrenapplied to the hospital. The male/Female ratio was 25/7. The median age of pediatric patients ranging from 9 to 18 years was 17 years. When evaluated according to theinjury areas, extremity injuries were the most common. Admissions were most frequently in the summer season (n=21, 65.6%) and in July (n=13, 40.6%). These caseswere admitted mostly on Tuesday (n=8, 25.0%) and between 16:00 and 23:59 (n=22, 68.8%). According to the ISS, 20 of the patients had a mild injury (ISS?3), 3 had amoderate injury (4? ISS ?8), and 9 had a severe injury (ISS?9). To prevent accidents, the public should be made aware of this issue, and the authorities should be morecareful in making the necessary administrative decisions and in implementation. For young agricultural workers, it should be an obligation to ensure proper education andjob security. Pat-pat, which is not well known but often used in rural agricultural areas of the Western Black Sea region, can have dangerous consequences for children.Children should be kept away from such unsafe vehicles.
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, İlter
Objective: 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.
An extremely rare phenomenon: Angina bullosa hemorrhagica
(SAGE Publications Ltd, 2023) Demir, Mehmet Cihat; Ağaçkıran, İlter
Introduction: Angina bullosa hemorrhagica is a disease without a concomitant hematological or vesiculobullous disorder characterized by painless hemorrhagic bullae in the oral mucosa; it is rarely seen and has a good course. Case presentation: A 45-year-old female patient was admitted to the emergency department with a painless hemorrhagic bulla that suddenly appeared on the soft palate. A blister, 2 cm in diameter and dark red in color, was seen extending from the hard palate’s posterior to the soft palate. Nasolaryngoscopic evaluation was performed, and no additional hemorrhagic bulla was detected. She was discharged with the recommendation of oral mouthwash. Discussion: Solitary hemorrhagic bulla, suddenly occurring on the soft palate, is diagnostic for angina bullosa hemorrhagica. Some authors have reported that blisters in the posterior pharynx may progress to acute upper airway obstruction. Conclusion: Early nasolaryngoscopic evaluation in angina bullosa hemorrhagica is an excellent option to be considered by the emergency physician to prevent life-threatening situations. © 2023 Elsevier B.V., All rights reserved.
Investigation of the Effect of Leaky Gut on COVID-19 Clinic
(2022) İnce, Nevin; Kayabaşı, Eda; Demir, Mehmet Cihat; Cangür, Şengül; Keskin, Banu Hümeyra; Öztürk, C. Elif; Kaya, Sare
Aim: In the course of the COVID-19 pandemic, in millions of cases were observed those of some patients do not exhibit any symptoms whereas some others are hospitalized with having fatal outcomes. One of the most significant findings is that patients with existing comorbidities are extremely exposed to severe clinical conditions developed due to excessive inflammatory response. That is to say, the indicative cause of chronic inflammation may be bacterial translocation derived from the impaired intestinal mucosal barriers. This study is aimed to investigate the probable relations between the impaired intestinal barrier integrity and which would be associated with severity of COVID-19 clinical conditions. Material and Methods: According to the clinical and laboratory findings, the patients were classified into three groups as mild, moderate, and severe clinical conditions. All patients’ blood samples were collected on the first admission to the hospital. Serum concentrations of lipopolysaccharide-binding protein (LBP), were analyzed to evaluate the intestinal barrier function and bacterial translocation. Results: The proportions of those with high LBP levels among all the groups were significantly different (p<0.001). The proportion of the patients with high LBP levels in the mild patient group (65.4%) was significantly lower than those with moderate (100%) and with severe clinical conditions (95.2%) (p<0.05 for each). Conclusion: In recent years, it has been clearly demonstrated that the functions of the intestines are much more than the digestive function, and that the intestinal microbiota and mucosal barrier integrity have a great impact on the immune system. These results would indicate that the impaired intestinal barrier integrity and bacterial translocation might be effective in severe COVID-19 development.
Investigation of Vitamin B12 Deficiency in Patients with Acute Coronary Syndrome and its Relationship with Gensini Score
(Clin Lab Publ, 2022) Polat, Esra; Demir, Mehmet Cihat; Küçükdemirci, Ömer
Background: Vitamin B12 deficiency is not an independent risk factor for cardiovascular disease. However, anemia due to vitamin B12 deficiency and also hyperhomocysteinemia are among the cardiovascular risk factors. The study aimed to determine the frequency of vitamin B12 deficiency in patients with acute coronary syndrome. We also aimed to ascertain whether there is a significant difference between obstructive coronary artery disease presence and its severity in patients with and without vitamin B12 deficiency using the Gensini score. Methods: Patients who underwent coronary angiography due to acute coronary syndrome between June 1, 2018, and November 30, 2019, and whose vitamin B12 levels were measured were retrospectively analyzed. Coronary angiography results of the patients were evaluated with the Gensini scoring system. Results: Anemia was observed in 32.6% (n = 135) of the patients who underwent coronary angiography with a diagnosis of acute coronary syndrome, and vitamin B12 deficiency was observed in 14.7% (n = 61). The median age was 69 years in anemic patients and 68 years in those with Vitamin B12 deficiency and was significantly higher than patients without anemia and vitamin B12 deficiency (p < 0.001 and p = 0.038, respectively). There was no statistically significant differences between the patients' Gensini scores with or without Vitamin B12 deficiency (p = 0.554). Conclusions: We concluded that anemia and vitamin B12 deficiency were higher in elderly patients with acute coronary syndrome. We found no significant difference when the Gensini score was used to evaluate obstructive coronary artery disease presence and its severity according to anemia and vitamin B12 deficiency. Investigating vitamin B12 levels in elderly patients with acute coronary syndrome should not be ignored.

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