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Öğe 2 Yaş Altı Çocuklarda Kafa Travmasının Değerlendirilmesinde Bilgisayarlı Tomografinin Rolü(Duzce Univ, 2018) Sönmez, Feruza Turan; Kılıçaslan, Önder; Yalçın, GülşenAmaç: Kafa travması çocukların acil servise sık başvuru nedenlerindendir. Travma nedeniyle iki yaş altı çocukların bilgisayarlı tomografi gerekliliği açısından değerlendirilmesi oldukça zordur. Bu çalışmanın amacı 2 yaş altı çocukların değerlendirilmesinde gereksiz kranial bilgisayarlı tomografi çekimine dikkat çekmektir. Gereç ve Yöntem: Acil Servise, yaşları 0-24 ay arası olan ve Ocak 2011 ile Aralık 2015 tarihleri arasında gelen kafa travmalı 183 olgunun kayıtları geriye dönük olarak incelenmiştir. Bulgular: Çalışmaya dahil edilen 183 olgunun, 93’ü erkek (%50,8), 90’ı kız (%49,2) ve hastaların yaşları ortalama 13.08±6.30 (en küçük 1, en büyük 24) ay idi. Kazaların 139’u (%76) düşme, 24’ü (%13,1) araç dışı trafik kazası, 20’si (%10,9) araç içi trafik kazası sonucu gerçekleşmişti. Olguların %12’sine kranial bilgisayarlı tomografi çekilmezken, %80’ine çekilmişti. Kranial bilgisayarlı tomografi çekilen hastaların 7’sinde (%3,8) frontal kemikte, 1’inde (%0,5) temporal kemikte, 5’inde (%2,7) oksipital kemikte, 5’inde (%2,7) parietal kemikte kırık saptandı. Hastaların yatış süresi 0.54±2,90 ( en küçük 0, en büyük 27) gün idi. Olguların hiçbirinde operasyon gereksinimi olmadı. Sonuç: İki yaş altı çocuklarda, kafa travmalarında bilgisayarlı tomografi çekilme oranındaki yükseklik dikkat çekici bulundu. Bu çalışma ile özellikle hafif kafa travmalı olgularda bilgisayarlı tomografi istenmesi için doğru endikasyon konulması, daha ayrıntılı ve objektif kriterleri belirleyen çalışmalar ile istemin azaltılması gerekliliği vurgulanmıştır.Öğe Alpha-lipoic acid intoxication in an adolescent girl(2021) Al-Mendalawi, Mahmood D.; Polat, Sinem; Kılıçaslan, Önder; Sönmez, Feruza Turan[Bastract Not Available]Öğe Alpha-lipoic acid intoxication in an adolescent girl: Case report and review of the literature(2020) Polat, Sinem; Kılıçaslan, Önder; Sönmez, Feruza TuranAlpha-lipoic acid is a widely used medication that does not need a prescription. Although it is safely used in adults, hitherto no safe dose for children has been reported, and there is no known antidote. The medical literature provides four reports of alpha-lipoic acid intoxication in the pediatric population to date. This case-report is the lowest known dose of alpha-lipoic acid intake leading to poisoning in a teenager.Öğe Alpha-lipoic acid intoxication in an adolescent girl:Case report and review of the literature(2020) Kılıçaslan, Önder; Polat, Sinem; Sönmez, Feruza TuranAlpha-lipoic acid is a widely used medication that does not need a prescription. Although it is safely used in adults, hitherto no safe dose for children has been reported, and there is no known antidote. The medical literature provides four reports of alpha-lipoic acid intoxication in the pediatric population to date. This case-report is the lowest known dose of alpha-lipoic acid intake leading to poisoning in a teenager.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 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 An interesting combination of anterior and posterior arch defects of atlas(Elsevier Science Inc, 2016) Ünlü, Elif Nisa; Aydın, Leyla Yılmaz; Ünlü, İlhan; Sönmez, Feruza Turan…Öğe Kounis Syndrome Induced by Oral Intake of Diclofenac Potassium(Iranian Scientific Society Medical Entomology, 2017) Güneş, Harun; Sönmez, Feruza Turan; Sarıtaş, Ayhan; Köksal, YasinAn acute coronary syndrome (ACS) occurring during the course of an allergic reaction is called Kounis syndrome (KS). The second case of KS induced by diclofenac potassium (DP) is presented in this report. A 67-year-old man was brought to our emergency department with the possible diagnosis of anaphylactic shock by the ambulance staff. It emerged that widespread erythema and pruritus developed after taking DP. Then, he lost consciousness. Diffuse urticarial lesions were detected on physical examination at the emergency department. He complained of chest pain during his observation, and progressive ST segment elevation was seen in the inferior leads on serial electrocardiograms. His coronary angiography showed 100% occlusion of the right coronary artery. Then, KS was diagnosed. The patient was discharged on the second day, and he was doing well on the control visit 2 weeks later. All allergic reactions may trigger an ACS so physicians should be aware of KS and always keep that unique clinical entity in mind to recognize it promptly and direct the therapy at suppressing the allergic reaction and improving the coronary circulation simultaneously when encountering a patient with symptoms suggesting an allergic reaction and a concomitant ACS.Öğe Prilocaine-induced Methemoglobinemia(Coll Physicians & Surgeons Pakistan, 2017) Güneş, Harun; Sönmez, Feruza Turan; Güneysu, Fatih; Kandiş, Hayati; Sarıtaş, Ayhan…Öğe The role of argyrophilic nucleolar organizing region-associated proteins in clinical exacerbation of chronic obstructive pulmonary disease(Sage Publications Ltd, 2018) Sönmez, Feruza Turan; Eröz, RecepObjective To investigate whether argyrophilic nucleolar organizing region-associated protein (AgNOR) parameters can be used as a biomarker that could potentially help with the management and clinical prognosis of chronic obstructive pulmonary disease (COPD) exacerbation. Methods This case-control study enrolled patients with COPD who were admitted to the Emergency Department and healthy sex- and age-matched control subjects. Peripheral blood samples were collected at hospital admission and the peripheral lymphocytes were silver-stained to investigate the quantity and distribution of AgNOR proteins. Fifty nuclei per patient were viewed and the total AgNOR area/total nuclear area (TAA/TNA) ratio and the mean AgNOR number for each patient were calculated. Results A total of 20 patients with COPD exacerbation and 17 healthy control subjects were recruited to the study. The TAA/TNA ratio and the mean AgNOR number were significantly higher in the patients with COPD exacerbation compared with the healthy control subjects. The mean AgNOR number showed a positive correlation with the pCO(2) levels on admission. Conclusion AgNOR protein levels were elevated during a COPD exacerbation compared with healthy control subjects and there was a positive correlation between pCO(2) levels and mean AgNOR number.Öğe Senkop ile Gelen Olgularda Elektrokardiyografik veEkokardiyografik Özelliklerin Değerlendirilmesi(2017) Güneysu, Fatih; Güneş, Harun; Sönmez, Feruza Turan; Güneysu, Semih; Sarıtaş, AyhanAmaç: Bu çalışmanın amacı senkop ile acil servise gelen hastalarda, EKG ve EKO bulguları ile senkop nedenini ve senkop özelliklerini ortaya koymak, EKG ve EKO parametrelerle ilişkisini araştırmaktır. Gereç ve Yöntem: Acil servisimize Ocak 2016 ile Aralık 2016 tarihleri arasında senkop nedeniyle başvuran toplam 90 hasta çalışmaya dâhil edildi. Prospektif kesitsel bir vaka çalışması olarak tasarlandı. Elektrokardiyografik ve ekokardiyografik parametreleri ölçülerek kaydedildi. İstatistiksel anlamlılık için tip-1 hata düzeyi 0,05 olarak belirlendi. Bulgular: Hastaların 40'ı (%44,4) kadın, 50'si (%55,6) erkek idi. Hastaların genel yaş ortalaması 63,5?18,0 olarak saptanmıştır. Olguların büyük çoğunluğu (%57,8) ayaktan takip kararı ile taburcu edilmiş, 36 hasta hastaneye yatırılmış ve %2,2'si ölümle sonuçlanmıştır. Hastaların senkop süreleri ile başvuru esnasındaki ve 6. saatteki PR, QRS ve QT süreleri arasındaki ilişki incelendiğinde sadece QRS süreleri ile senkop süresi arasında istatistiksel olarak anlamlı ilişki saptanmıştır. Hastalara ait kalp kapak hastalıkları incelendiğinde sıklık sırasına göre trikuspit yetmezlik (%41.1), mitral yetmezlik (%37.8), aort yetmezliği (18.9), mitral darlık (%6.7) ve aort stenozu (%5.6) tespit edilmiştir. Hastaların ejeksiyon fraksiyonu değerlerinin ortalaması %50,3, ortalama pulmoner arter basıncı ise 30,8 mmHg görülmüştür. Sonuç: Senkop nedeniyle başvuran tüm hastalara EKG ve EKO uygulanması kardiyak kökenli senkop hastalarını ayırt etmek, senkopa neden olan hastalığın tanısını koymak ve riskli hasta grubunu saptamakta oldukça faydalıdır.Öğe Short Term Unscheduled Revisits to Paediatric Emergency Department - A Six Year Data(Premchand Shantidevi Research Foundation, 2017) Kılıçaslan, Önder; Sönmez, Feruza Turan; Güneş, Harun; Temizkan, Ramazan Cahit; Kocabay, Kenan; Sarıtaş, AyhanIntroduction: Reviewing the reasons for return visits within 24 hours is a very important method of determining possible problems of emergency health care. Several causes stay behind unscheduled emergency return visits. Therefore, identifying these factors is crucial to set strategies in order to decrease the number of unnecessary visits. Aim: To define the characteristics of the patients returning to the Paediatric Emergency Department (PED) within 24 hours via determining rate, number and demographic data of patients. Materials and Methods: The present study design involves retrospective data collection of patients who returned to PED within 24 hours after being discharged. Data was included over six year period and was collected from July 1, 2010 to June 30, 2016. The data was analysed with SPSS17.0 statistical package for windows. Results: A total of 1994 patients returned to PED within 24 hours from July 1, 2010 to June 30, 2016. The most common group of revisiting patients were toddlers (aged 0-2-year old), n=1168 (58.5%), and the least number represented young adolescents (aged 15-18-year old), n=82 (4.1%). Number of patients returning to PED in 24 hours has significantly increased within years from approximately 90 patients to 720 (p<0.05). This increase in number was observed in all and each age group (from 0-18 years of age) without any exception. Seasonal distribution of the patients showed no significant difference (p>0.05) for each age, but again, presented definite negative correlation with age (the older is the patient group, the less is the number of revisits). The most common time for revisits was 17-24 hours after first discharge from PED, n=1277 (64.04%). Conclusion: The number of return visits is increasing over the years. The younger the patient is, more likely is the risk of unscheduled revisit to PED. Most of the patients returned to PED in 17 to 24 hours after discharge.Öğe Tick infestation: A 200-patients’ series(Obafemi Awolowo University, 2017) Güven, Oya; Satılmış, Dilay; Sönmez, Feruza Turan; Demir, Bilgehan; Erdoğan, ÖzgürBackground: A great number of zoonotic diseases with high mortality rate are transmitted by ticks. We performed this study in order to investigate patients admitted to emergency department following a tick bite. We examined the patients and get knowledge about the infestation and we followed up them for possible tick-conducted disease symptoms and laboratory findings both clinically and serologically. Materials and Methods: The study presented was hold for one year, between 01.01.2012 and 31.12.2012. 200 tick infested cases, admitted to Emergency Department of Haydarpasa Numune Training and Research Hospital, were subjected in the study. Demographic patterns of the patients and the region they come from, infested area on body, admission time and blood analyzing results were detected. Results: Rate of adult patients to pediatric was 2:1; gender distribution was similar to each other. The most common body areas that ticks were removed from were lower extremity. The highest tick bite incidence was in summer and on weekends. No tick bite incident of Istanbul surrounding from the year 2012 progressed to a zoonotic disease. Conclusions: Although non-of the patients of our study has been diagnosed with Crimean-Congo hemorrhagic fever we informed all of them for the incubation period and call for observation during the time. Tick borne infections may present with vary of symptoms, the most sever of which is hemorrhagic diathesis and patients should be informed for the risks. Knowledge of local area fauna risks may guide physicians so studies on this topic are essential. © 2017, Obafemi Awolowo University. All rights reserved.Öğe Turkey and Europe data comparison in terms of the course of the COVID-19 pandemic and health expenses(2022) Sönmez, Cemil Işık; Sönmez, Feruza TuranIntroduction: The COVID-19 pandemic has affected the entire world and has been a challenge to the health prospects of the nations infected. The elderly population of the nations and parameters like the countries' health system and the allocation of budget to health are critical factors for explaining the epidemic's development with different mortality rates in various countries. The purpose of the study was to assess the characteristics of the Turkish population, COVID cases, the progression of diseases, and health expenditures compared to those in Europe. Methods: For this study, we used the following databases: the Worldometer digital database, the database of the Organization for Economic Cooperation and Development, and the Turkish National Databases on Economic and Finance references, such as the Turkish National Strategy and Budget Presidency and the database of the Turkish Statistical Institute. The data was for the date 15.12.2021 and the general annual for 2020. Results: By the investigation date as of 15/12/2021, the total number of COVID-19 cases was 9209740 in Turkey and 81556853 in the European Union countries. The incidence of the disease was 107.500 in Turkey and 135.525 in Europe. While the total change/ increase in last-week-new cases was -5% and 8% in Turkey and Europe, respectively, the real change/ increase in last-week-deaths was -1% to -8% in Turkey and Europe. The number of COVID screening tests per one million population was higher in Europe (1.343.256 to 8.790.27 in Turkey and Europe, respectively). The GDP and health expenditure per capita were distinctly higher in Europe. Conclusion: The fact that there is a higher percentage of elderly residents in European countries than in Turkey, that the number of new cases detected every week is higher, and that the death rate and the gradual decline in cases are linked to the large share of health expenditures distributed by nations for the fight against the disease.Öğe An unexpected presentation of sick sinus syndrome: Isolated ventricular asystole(W B Saunders Co-Elsevier Inc, 2017) Güneş, Harun; Sönmez, Feruza Turan; Canga, Halit Berk; Sarıtaş, AyhanSick sinus syndrome is a disorder of sinus node function characterized by various dysrhythmias such as sinus bradycardia or pause, paroxysmal regular or irregular atrial tachycardia, tachycardiabradycardia attacks or atrial fibrillation with slow ventricular response. Ventricular asystole with preserved atrial electrical activity is a rarely seen presenting rhythm in the ED and an extremely rare cause of syncope. A 67-year-old male having a syncope attack was admitted to the emergency department. His Glasgow coma scale score was 15 on admission. He became unconscious during his observation in the emergency department, and cardiopulmonary resuscitation was initiated because he was seen to be apneic; his arterial pulse was impalpable, and ventricular asystole with preserved atrial electrical activity was seen on the monitor. He regained consciousness and normal sinus rhythm was seen on the monitor after 2 min of cardiopulmonary resuscitation. Then, an alternating rhythm with short periods of bradycardia and tachycardia suggesting sick sinus syndrome was developed. A dualchamber pacemaker was placed, and he was discharged after 2 days of in patient follow-up. His symptoms have not recurred after placement of the pacemaker device. When sudden changes in vital parameters and/ or consciousness develop during observation of a patient with sick sinus syndrome, although it is not a common circumstance, accompanying high degree atrioventricular block and simultaneous ventricular asystole should be considered, and cardiopulmonary resuscitation should be initiated immediately because cardiopulmonary arrest is inevitable when ventricular asystole develops even if the atrial electrical activity is maintained. (C) 2017 Elsevier Inc. All rights reserved.
