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Öğe Adverse effects of energy drinks(W B Saunders Co-Elsevier Inc, 2015) Sarıtaş, Ayhan; Dikici, Süber; Güneş, Harun…Öğe Ailesel Hipokalemik periyodik paralizi: olgu sunumu(2010) Korkut, Semih; Kandiş, Hayati; Güneş, Harun; Korkut, EsinAilesel hipokalemik periyodik paralizi, yılda birkaç kez veya her gün ortaya çıkabilen ve birkaç saat veya birkaç gün sürebilen geçici kas güçsüzlüğü atakları ile karakterize otozomal dominant geçişli konjenital bir hastalıktır. Ataklar sırasında potasyumun kas hücrelerine geçmesine bağlı olarak serum potasyum düzeyi düşer ve ataklar arasında normal sınırlardadır. Bu makalede belirgin bir tetikleyici faktör olmaksızın geçirdiği hipokalemik paralizi atağı sırasında acil servise başvuran 21 yaşında bir erkek hasta sunulmaktadır.Öğe Anaphylaxis after intramuscular injection of diclofenac sodium(W B Saunders Co-Elsevier Inc, 2014) Çolak, Şahin; Güneş, Harun; Afacan, Mustafa Ahmet; Kandiş, Hayati; Erdoğan, Mehmet Özgür; Ayrancı, Mehmet; Sarıtaş, AyhanDiclofenac sodium is a 2-arylacetic acid, nonsteroidal anti-inflammatory drug. It is widely used in pain management. Side effects such as urticaria, asthmatic attack, vasospastic angina, ischemic stroke, and Kounis syndrome may be seen after the use of diclofenac sodium. However, anaphylactic shock is rare. Anaphylactic shock secondary to injection of diclofenac sodium can be treated successfully with intramuscular injection of adrenaline. Because diclofenac sodium is commonly used in analgesic treatment in emergency departments, we present this case report to emphasize that anaphylactic shock may be seen after the use of that drug.Öğe Are there any effects of chronic carbon monoxide exposure on argyrophilic nucleolar-organizing region-associated protein synthesis in rat myocardium?(Sage Publications Ltd, 2016) Sarıtaş, A.; Güneş, Harun; Çolakoğlu, Serdar; Eröz, Recep; Aköz, Ayhan; Oktay, Murat; Özkan, A.The aims of the study are to detect whether there are any possible effects of chronic carbon monoxide (CO) exposure on the argyrophilic nucleolar-organizing region (AgNOR)-associated protein synthesis and evaluate any possible relationship between the amount of AgNOR protein and the level of myocardial injury also and between AgNOR and histopathological evaluation methods. Adult male albino Wistar rats (n = 18) were randomly divided into three groups (groups A, B, and C). Group A served as control, while groups B and C were rats exposed to CO gas chrbnically (1000 and 3000 ppm CO concentration with a flow rate of 4 L/min for 30 min/day for 7 days, respectively). Total AgNOR area/nuclear area (TAA/NA) and the mean AgNOR numbers for each myocyte nucleus were determined. There were significant differences among all groups for TAA/NA ratio. These differences were not significant for mean AgNOR numbers. According to the histopathological evaluation scores, there were significant differences between the groups. The differences were significant among the groups for loss of sarcomere pattern. A strong positive correlation between histopathological injury scores and TAA/NA ratio was found (R-sq = 0.48; p = 0.002), however, the correlation was not significant for mean AgNOR numbers (R-sq = 0.08; p = 0.25). In conclusion, TAA/NA ratio can be used as an indicator for obtaining information about the level of myocardial damage instead of histopathological evaluation scores.Öğe Assessment of Electrocardiographic and Echocardiographic Features in Patients Admitting with Syncope(Duzce Univ, 2017) Güneysu, Fatih; Sarıtaş, Ayhan; Güneş, Harun; Sönmez, Feruza Turan; Güneysu, SemihObjective: This study aims to investigate the ECG and ECO parameters in patients admitting to the emergency department with syncope and to evaluate relationship between ECG and ECHO findings and the cause and feature of syncope. Methods: A total of 90 patients admitted to our emergency department due to syncope between January 2016 and December 2016 were included in the study. This research is designed as a prospective cross-sectional case study. Electrocardiographic and echocardiographic parameters were measured and recorded. The type-1 error level was determined as 0.05 for statistical significance. Results: Forty (44.4%) of the patients were female, and 50 (55.6%) were male. The mean age of the patients was 63,5 years of age. Most of the cases (% 57,8) discharged with a follow-up decision, and 36 patients were hospitalized, and 2.2% of patients died. When the relationship between the syncope duration of the patients and the duration of PR, QRS, and QT at the time of referral and 6th hour were examined, the only relation between QRS duration and duration of syncope was found statistically significant. Tricuspid insufficiency (41.1%), mitral regurgitation (37.8%), aortic insufficiency (18.9), mitral stenosis (6.7%) and aortic stenosis (5.6%) were found to be the most common cardiac valve diseases in the patients. The mean ejection fraction values of the patients were 50.3% and mean pulmonary artery pressure 30.8 mmHg. Conclusion: The use of ECG and ECHO in all patients who are referred for syncope is very useful in distinguishing cardiac syncope patients, diagnosing syncope, and identifying patients at risk.Öğe Assessment of patients who presented to the emergency department with mushroom poisoning(Sage Publications Ltd, 2015) Çolak, Şahin; Kandiş, Hayati; Afacan, Mustafa Ahmet; Erdoğan, Mehmet Özgür; Güneş, Harun; Kaya, Ertuğrul; Sarıtaş, AyhanObjective: This study aimed to assess the demographic characteristics, emergency department (ED) complaints, laboratory findings, and latent phase periods of patients who presented to the ED due to mushroom poisoning (MP) as well as the efficacy of conventional and hemofiltration therapies. Method: The study was conducted on patients who presented to the ED with MP between 2010 and 2012. The patient's demographic characteristics, complaints at the ED, latent phases, laboratory findings, and treatments of MP cases were evaluated. Results: The mean age of patients was 38.03 15.96, where 63.8% of them were female and 36.2% were male. Visits occurred most frequently in the autumn (32.6%). When presenting to the ED, the most frequent complaint was nausea-vomiting. The aspartate aminotransferase (AST), alanine aminotransferase (ALT), international normalised ratio (INR), and blood urea nitrogen values of patients with a latent phase between 0 h and 5 h were significantly lower than the values of patients with a latent phase between 6 h and 24 h. In this study, 62% of the patients (n = 36) had stomach lavage and received activated charcoal. Altogether, 55.2% of the patients had received conventional therapy, 37.9% of them received hemofiltration, and all of them received supportive treatment. The AST, ALT, and INR values of those who had received hemofiltration and conventional therapies were significantly higher than of those who received only supportive treatment (p < 0.01). Conclusion: Hemofiltration, in combination with conventional therapy, seems to be an effective treatment for reducing mortality in suspected MP cases involving late acting toxins.Öğe Asystole after the first dose of lansoprazole(W B Saunders Co-Elsevier Inc, 2014) Candar, Melik; Güneş, Harun; Boz, Behiç Volkan; Kandiş, Hayati; Kutlucan, Leyla; Sarıtaş, AyhanAllergic reactions due to drug intake are responsible from an important amount of emergency admissions. Patients mostly complain of urticarial lesions. But clinical picture may sometimes include a large scale of signs and symptoms ranging from a simple confusion to serious conditions like coma and even cardiopulmonary arrest. In this article, a case of anaphylactic shock and respiratory arrest after lansoprazole intake is presented. Delays in reaching basic and advanced life support decrease chance of positive results of life support in anaphylactic shock victims. It is important to remember that any medication we usually prescribe in our daily practice for treatment of any disease has a potential to kill the patient.Öğe Carbon monoxide poisoning cases presenting with non-specific symptoms(Sage Publications Inc, 2017) Deniz, Turgut; Kandiş, Hayati; Eroğlu, Oğuz; Güneş, Harun; Saygun, Meral; Kara, İsmail HamdiCarbon monoxide (CO) is a colourless and odourless gas appearing as a result of incomplete combustion of carbon-containing fuels. Many domestic or occupational poisonings are caused by CO exposure. Malfunctioning heating systems, improperly ventilated motor vehicles, generators, grills, stoves and residential fires may be listed in the common sources of CO exposure. The aim of this study was to emphasize the significance of early diagnosis of CO poisoning with non-invasive measurement of CO levels of the patients with nonspecific symptoms using a pulse oximeter device in the triage. Our study was a cross-sectional study. Patients who presented to the emergency department (ED)due to non-specific symptoms and had a Canadian Triage and Acuity scale level of 4 or 5 were included in the study; 106 (5.9%) of 1788 patients admitted during the study period were diagnosed with CO poisoning. Patients with CO poisoning and the other patients had statistically significant differences in terms of presenting symptoms, namely, headache, dizziness, nausea, and vomiting. More CO poisoning cases were admitted in the fall and winter compared to the spring and summer. The number of CO poisoning victims can be decreased if preventive measures like CO monitoring systems and well-designed ventilation systems are generalized at homes and workplaces. Measurement of carboxyhaemoglobin levels of patients presenting to ED due to non-specific symptoms like headache and dizziness during cold seasons and winter months using a pulse CO-oximeter should be a part of the routine of emergency medicine triage.Öğe Carbon Monoxide Poisoning: Clinical Manifestations, Consequences, Monitoring, Diagnosis and Treatment of Toxicity(Duzce Univ, 2015) Sönmez, Feruza Turan; Güneş, Harun; Sarıtaş, Ayhan; Kandiş, HayatiCarbon monoxide poisoning is a multisystem condition that may present with a wide range of symptoms and can cause a confusing constellation of clinical features. Diagnosis may be easily missed if physician is not alert about. Carbon monoxide intoxication is more frequent than it is reported. It has a simple treatment if diagnosed, and has many long-term sequela if under-treated.Öğe Carbonmonoxide Post-interval Syndrome(Coll Physicians & Surgeons Pakistan, 2015) Sağlam, Sadullah; Cortuk, Mustafa; Güneş, Harun; Çolak, Şahin; Kandiş, Hayati; Sarıtaş, Ayhan; Dikici, Süber…Öğe Comparison of ESC and ACCF/AHA Guidelines for Oral Antiplatelet Treatment in the Management of Patients with Acute Coronary Syndrome(Emergency Medicine Physicians Assoc Turkey, 2016) Sarıtaş, Ayhan; Güneş, HarunBasically, acute coronary syndrome (ACS) is caused by the partial or total occlusion of coronary arteries because of platelet activation and aggregation. Hence, one of the major components of ACS treatment is the inhibition of platelet activation and aggregation. New studies performed in recent years have led to the update of guidelines for the usage of antiplatelet agents (APA) in the treatment of ACSs. This paper aims to compare the European Society of Cardiology (ESC) and American Heart Association (ACCF/AHA) guidelines, by summarizing the key points, regarding the usage of oral APA in patients admitted to emergency departments due to ACS.Öğe Comparison of the effects of N-acetyl cysteine and erdosteine in rats with renal injury caused by paracetamol intoxication(Sage Publications Ltd, 2011) Kandiş, Hayati; Erkan, Melih Engin; Yıldırım, Ümran; Güneş, Harun; Erbaş, Mesut; Yıldırım, Hayriye A.K.; Kara, İsmail HamdiAim: The aim of the present study was to investigate the therapeutic and preventive effects of N-acetyl cysteine and erdosteine on renal injury associated with paracetamol (acetaminophen) intoxication. Materials and methods: Female albino Wistar rats were divided into six groups: control; paracetamol (1 g/kg, oral); paracetamol (1 g/kg, oral) + erdosteine (150 mg/kg/day, oral); paracetamol (1 g/kg, oral) + N-acetyl cysteine (140 mg/kg bolus, followed by 70 mg/kg, oral); N-acetyl cysteine control (140 mg/kg bolus, followed by 70 mg/kg, oral); and erdosteine control (150 mg/kg/day, oral). Potential renal injury was assessed using biochemical analyses, radionuclide imaging, and histopathological parameters. Results: In the paracetamol group, blood urea nitrogen and creatinine levels were significantly increased compared with controls. Histopathological examination showed tubular vacuolization, tubular necrosis, and remarkable interstitial inflammation. The excretion function was observed to be insufficient on radionuclide imaging. However, in the groups treated with erdosteine or N-acetyl cysteine after paracetamol, biochemical analyses, radionuclide imaging, and histopathological parameters showed significantly less evidence of renal toxicity than that observed in the group receiving paracetamol alone. Less renal toxicity was detected in rats receiving N-acetyl cysteine than in those receiving erdosteine. Conclusion: Renal injury may develop after paracetamol overdose. Erdosteine and N-acetyl cysteine are both effective in the prevention of renal injury when given in the early phase of paracetamol nephrotoxicity. N-acetyl cysteine is more protective than erdosteine.Öğe Complete Blood Count Parameters for Prediction of non-ST Segment Elevation Myocardial Infarction(Coll Physicians & Surgeons Pakistan, 2019) Güneş, Harun; Sarıtaş, Ayhan; Cangür, Şengül; Kayapınar, OsmanObjective: To evaluate whether the complete blood count parameters can be used to predict patients who will have positive troponin levels during emergency department observation, and to establish whether any single parameter or combination of parameters has sufficiently good diagnostic test criteria results to be recommended for use in daily clinical practice. Study Design: An observational study. Place and Duration of Study: Department of Emergency Medicine, Duzce University School of Medicine, Duzce, Turkey, from October 2015 to October 2016. Methodology: Study group had patients with positive troponin levels during observation in the emergency department. The control group had normal troponin levels. Their complete blood count parameters were compared individually and in combination. Results: Total white blood cell count, neutrophil count, red cell distribution width, neutrophil-to-lymphocyte ratio, and some combinations of these parameters were found to be predictive of troponin elevation. The best one was combination of white blood cell count, red cell distribution width and neutrophil-to-lymphocyte ratio. Conclusion: Some of the complete blood count parameters may provide some clues when predicting troponin elevation in patients with chest pain. However, none of these parameters or no combination of them have sufficiently good diagnostic test criteria results to safely predict non-ST segment elevation myocardial infarction.Öğe CT versus grayscale rib series for the detection of rib fracture(W B Saunders Co-Elsevier Inc, 2015) Güneş, Harun; Ünlü, Elif Nisa; Sarıtaş, Ayhan…Öğe Demographic and Epidemiologic Features of Tick Bite Cases Who Have Applied to Emergency Service in an Endemic Region(Düzce Üniversitesi, 2010) Katırcı, Yavuz; Uzun, Hakan; Güneş, Harun; Kara, İsmail Hamdi; Geyik, Mehmet Faruk; Kandiş, HayatiAim: In this study, demographic and epidemiologic features of patients seen in emergencydepartment due to tick bites that can cause Crimean-Congo Haemorrhagic Fever were discussedwith literature data.Material and Methods: Patients seen in Yozgat State Hospital Emergency Department due totick bites between 03.01.2007 and 09.31.2007 have been included. These cases have beeninvestigated according to age, gender, job, biting part of body by the tick, settlement of patientand month in which patient came to hospital, and RNA positivity in polymerase chain reaction(PCR) or IgM antibody with ELISA were investigated. Results: 641 patients who came to emergency department due to tick bite have been includedin this study. Mean age of the cases was 41.3 ±18.3. Lower extremity bites (25.3%) were themost common type when patients investigated according to site that is bitten by the tick. 44.3%of tick bite cases were young-adults and tick bites were most commonly being seen in monthsMay, June and July. 52.1% of patients were farmer. RNA positivity in PCR and IgM antibodypositivity with ELISA were 29 cases and two cases, respectively.Conclusion: Patients who come to hospital due to tick bite should be examined carefully.Patients without any symptoms should be informed about Crimean-Congo Haemorrhagic Feverand followed until the end of incubation periodÖğe Does an energy drink cause a transient ischemic attack?(W B Saunders Co-Elsevier Inc, 2015) Dikici, Süber; Sarıtaş, Ayhan; Kılınç, Şeyma; Güneysu, Semih; Güneş, HarunEnergy drinks have become a popular beverage especially among young individuals. The growing literature sheds light on acute health problems associated with these products, although they have not yet been in existence long enough to build a solid, evidence-based appreciation of potential long-term effects. Perhaps the greatest concern about energy drinks is the amount of caffeine they contain, which generally far exceeds that in other beverages. A transient ischemic attack (TIA) has been traditionally defined as an episode of neurologic dysfunction caused by focal cerebral ischemia with complete recovery within 24 hours. We report a patient who had a TIA after intake of an energy drink without alcohol. To the best of our knowledge, the following case is the first report of TIA after intake of an energy drink.Öğe Elongation and aberrant articulation of cervical transverse processes mimicking osteochondroma(Elsevier Science Inc, 2015) Ünlü, Elif Nisa; Büyükkaya, Ayla; Ünlü, İlhan; Boran, Mertay; Güneş, Harun…Öğe Endemik bir bölgede kene ısırığı nedeniyle acil servise başvuran olguların demografik ve epidemiyolojik özellikleri(2010) Kandiş, Hayati; Katırcı, Yavuz; Uzun, Hakan; Güneş, Harun; Kara, İsmail Hamdi; Geyik, Mehmet FarukAmaç: Bu çalışmada Kırım-Kongo Kanamalı Ateşine (KKKA) de neden olabilen kene ısırığı sonucu, acil servise başvuran hastaların demografik ve epidemiyolojik özellikleri, kene ısırıkları ve KKKA ile ilgili bilgiler literatür eşliğinde tartışıldı. Yöntem: Yozgat Devlet Hastane’si acil servisine 01.03.2007 ile 31.09.2007 tarihleri arasında kene ısırması nedeniyle başvuran olgular alındı. Bu olgular yaş, cinsiyet, kenenin ısırdığı bölge, geldiği yer, geldiği ay, meslekleri, polimeraz zincir reaksiyonunda RNA pozitifliği veya ELISA yöntemi ile IgM araştırıldı. Bulgular: Kene ısırması şikayeti ile acil servise başvuran 641 kene ısırığı olgusu çalışmaya alındı. Yaş ortalaması 41.318.3’tü. Kene ısırıkları lokalizasyonuna göre değerlendirildiğinde alt ekstremite ısırıkları %25.3 en sık görüldü. Kene ısırması olguları değerlendirildiğinde %44.3’ünün genç-erişkin olduğu ve en sık Mayıs, Haziran, Temmuz aylarında görüldüğü tespit edildi. Olguların %52.1 mesleği tarım ve hayvancılıktı. Bu olgulardan 29’unda PCR ile RNA pozitif, ikisinde ELISA yöntemi ile IGM pozitif idi. Sonuç: Kene ısırması şikayeti ile hastanelere başvuran olgular detaylı bir şekilde muayene edilmelidir. Semptomsuz olan olgular kene ısırması sonucu gelişebilecek KKKA hakkında bilgilendirilmeli ve takipleri inkubasyon süresi boyunca yapılmalıdır.Öğe Familial Hypokalemic Periodic Paralysis: A Case Report(Düzce Üniversitesi, 2010) Korkut, Semih; Güneş, Harun; Korkut, Esin; Kandiş, HayatiFamilial hypokalemic periodic paralysis is an autosomal dominantly inherited congenital diseasecharacterized by intermittent attacks of muscle weakness lasting for a few hours to a few daysand occurring a few times a year or once a day. Due to the shift of potassium into muscle cells,serum potassium level is decreased during attacks and it is in the normal range between twoattacks. A 21 year old male patient seen in the emergency department due to a hypokalemicparalysis attack occurring without any obvious triggering factor was presented in this articleÖğe Floating Forearm: Perilunar and Elbow Dislocation Without a Fracture(Coll Physicians & Surgeons Pakistan, 2010) Kandiş, Hayati; Yücel, İstemi; Sarıtaş, Ayhan; Güneş, HarunTraumatic perilunar and elbow dislocation is rarely seen together. There are only a few reported cases in the literature. Limitation of joint movement, deformity and pain are generally the presenting symptoms. A case of perilunar and elbow dislocation without fracture admitted to the emergency department due to a traffic accident and treated with closed reduction after sedoanalgesia and benefited from closed reduction
