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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 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 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 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.
