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Öğe Acil Servise Bir Yılda Başvuran Hastalarda Mükerrer Başvuruların İncelenmesi ve Çözüm Önerileri(2021) Sultanoğlu, Hasan; Gamsızkan, Zerrin; Cangür, ŞengülAmaç: Çalışmamızda acil servise bir yılda başvuran hastalarda mükerrer başvuruların incelenmesi ve çözümönerilerinin sunulması amaçlanmıştır.Gereç ve Yöntemler: Acil Servise Ekim 2018-Ekim 2019 tarihleri arasında başvuran hastalara ait veriler retrospektifolarak incelendi. Hastaların sosyodemografik özellikleri, başvuru tanıları, yatış ve konsültasyon bilgileri yanı sıra ilkbaşvurudan sonraki bir ay içinde tekrar başvuru oranları, yatış durumu, sevk edilme durumu, reçete verilme durumu vetanıları incelendi.Bulgular: Bir yıl içinde acil servise 75622 hasta başvurmuş olup %54,5'i kadın ve %45,5’i erkekti; hastaların yaşortalaması 40,3±20,2 (0-108) idi. Acil servise gelen hastaların %17,2’si bir ay içinde bir kez gelen hastalardı. Bir aydabirden fazla kez gelen hastaların ortalama gelme sayısı 2,54±1,6’dır. Bir yıl içinde acil hastaların %8,4’üne yatış işlemiyapılırken, %0,4'ü sevk edilmiştir. Bir ay içinde tekrar başvuruların %16,4 yatış yapılmıştır. Bir yıl içinde acil servisbirimine gelen hastaların %53,7’sine reçete yazılmıştır. En sık başvuru tanısı ağrı ve üst solunum yolu enfeksiyonlarıolarak bulunmuştur.Sonuç: Sağlık kuruluşlarının en önemli vizyon göstergelerinden biri olan acil sağlık hizmetlerinin verildiği acilservislere tekrar başvuru sayılarını azaltmak için eğitim ile arttırıp sağlık okur yazarlık seviyesini arttırmamız, birincibasamak sistemini etkin kullandırmak, sevk zincirini aktifleştirmek ve acil servis benzeri 7/24 çalışan genel polikliniksistemi üzerinde çalışmak çözüm önerileri olabilir.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 Ciddi Acil Tanılarıyla Karışan Nadir Bir Durum: Kist Hidatik Rüptürü, Bir Olgu Sunumu(2020) Sultanoğlu, HasanKist hidatik hastalığı, Echinococcus granulosus etkenine bağlı paraziter bir enfeksiyondur. En sık karaciğer veakciğerde görülür. Kistlerin çoğu asemptomatiktir ve spontan olarak gerileyebilir. Klinik tablo paraziter enfeksiyonunetkilediği organa, kistin büyüklüğüne ve kistin kom?u organlar ile etkile?imine bağlı olarak deği?kenlik gösterebilir;ancak nadiren rüptüre olan kistin periton bo?luğuna yayılmasıyla ciddi anafilaktik ?ok tablosu ortaya çıkabilmektedir.Bu olgu sunumunda acil servise anafilaktik ?ok tablosu ile ba?vuran hastalarda, acil tıbbi müdahale gerektiren akutkoroner sendrom, aort diseksiyonu, akut pankreatit ve bağırsak perforasyonu ayırıcı tanıda dü?ünülürken asemptomatikolan kist hidatiğin rüptürüne bağlı anaflaktik ?ok tanılarla karı?abildiği için kist hidatiğin unutulmaması gerektiğivurgulandı.Öğe Clinical and Magnetic Resonance Imaging Findings of Patients with Acute Carbon Monoxide Poisoning(2020) Kavaka, Nezih; Sultanoğlu, Hasan; Kavak, Rasime Pelin; Özdemir, MeltemObjective: We aim to evaluate the demographic and clinical characteristics of patients withacute carbon monoxide (CO) poisoning, who had a Glasgow Coma Score (GCS) below 15,and who had cerebral lesions detected in magnetic resonance imaging (MRI).Methods: The age, gender, causes of CO intoxication, clinical signs, neurological findings,GCS, blood carboxyhemoglobin level (COHb), serum pH, lactate, creatine kinase (CK),creatinine kinase-myocardial band MB (CK-MB), troponin-I level, brain MRI (T1-weighted, T2-weighted, FLAIR and diffusion-weighted imaging), treatment, and mortalitystatus of 327 patients were evaluated retrospectively.Results: The median age of patients was 31.5 years (IQR=19.5 years), 72.2% of the patientswere women. Neurological findings were detected in 34 (10.4%) of the patients. Thefrequency of dyspnea was significantly higher in patients with neurological findings(p<0.05). The COHb and lactate levels of patients with neurological findings were found tobe significantly high, the pH level was significantly lower (p<0.05). There was nosignificant relationship between the presence of neurological findings and CK, CK-MB, andtroponin-I levels (p>0.05). Patients with neurological findings were found to have asignificantly longer follow-up period, more frequently received hyperbaric oxygen therapy(p<0.05). The rate of hospitalization was 10.7%, the mortality rate was 0.9%.Hospitalization and mortality rates were significantly high in patients with neurologicalfindings (p <0.05). Pathological findings were detected in 13 (40.6%) of 32 of patients(except for 2 patients who did not respond to the resuscitation) who had an MRI.Conclusions: It was determined that acute CO poisoning may lead to acute brain damage,40.6% would be detected in brain MRIs taken in patients during the acute phase.Öğe Comparison and Short Term Effect of Extracorporeal Shock Wave Therapy and Kinesiotaping in Treatment of Lateral Epicondylitis(2020) Sultanoğlu, Tuba; Sultanoğlu, HasanIntroduction: To compare the effects of extracorporeal shock wave therapy and kinesiotaping, performed as the first-step treatments added to physiotherapy, on pain, functionality, and quality of life among newly diagnosed lateral epicondylitis patients. Patients and Methods: Our study was retrospectively performed. The medical records of 62 patients whose treatment was designed for clinically-diagnosed unilateral lateral epicondylitis were reviewed, they were categorized into two groups each containing 31 patients. The demographic properties, profession, body mass index, dominant hand, symptom duration, and the side of the affected elbow were recorded. Patients were assessed twice; prior to treatment onset and at 1stmonth after the treatment. Pain intensity was recorded with Visual Analog Scale at rest, at night, during activity (repeated elbow motions). Patients completed quick disabilities of the arm, shoulder, and hand questionnaire for a functional evaluation. Quality of life was assessed by Short Form-36. Results: There was no statistically significant difference between the two groups in terms of demographic characteristics. When the patients were evaluated at the fourth week after the treatment; the visual analogue scale showing pain severity at rest, at night and during activity, the Q-DASH, and all sub-parameters of Short Form 36 was found significantly difference. There was no statistically significant difference between the two groups in terms of evaluation parameters. Conclusions: We reported that treatment effect of kinesiotaping to lateral epicondylitis is similar to that of ESWT. Both treatments significantly improved pain score, functional status and patient satisfaction.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 Femoroasetabular sıkışma sendromlu hastalarda pelvik bölgenin radyolojik anormallikleri ve klinik sonuçlar(2021) Sultanoğlu, Tuba; Ataoğlu, Sarfinaz; Altınsoy, Hasan Baki; Sultanoğlu, HasanAmaç: Çalışmamızda femoroasetabular sıkışma sendromlu hastalarda klinik sonuçların ve eşlik edebilen pelvik bölgedeki radyolojik değişikliklerin incelenmesi; kalça ağrılarının etyolojisinde femoroasetabular sıkışmanın ve konservatif tedavinin öneminin vurgulanması amaçlanmıştır.Yöntem: Ağustos 2016-Ağustos 2020 tarihleri arasında femoroasetabular sıkışma sendromu tanısı olan 104 hastanın dosya kayıtları ile sosyodemografik ve klinik özellikleri, abdominal ve pelvik bilgisayarlı tomografi taramaları, pelvik bölgenin magnetik rezonans görüntülemeleri retrospektif olarak incelendi. Bulgular: Hastaların %41.3’ü kadın, %58.7’si erkek ve yaş ortalaması 52.78±13.18 idi. Hastaların %37.5’u ev hanımı; %29.8’i çalışmayan; %28.8’i çalışan ve %3.8‘i öğrenciydi. Kalça ağrısı olan hastaların oranı %76 idi. %31.7’sinde sağ kalça; %22.1 sol kalça ve %22.1’inde her iki kalça bölgesinde ağrı şikayeti mevcuttu. Hastaların %17.3’üne aktivite modifikasyonu ve medikal tedavi; %32.7’sinde medikal tedavi ve ev egzersiz programı; %26.0’ünde fizyoterapi uygulanmış; %24.0'ünde herhangi bir tedavi uygulanmamıştı. Hastaların %54.8’ine tomografi; %45.2’sine magnetik rezonans görüntüleme ile tanı konmuştu. Radyografik bulgulara göre %80.8’inde cam tip; %5.8’inde pincer tip ve 13.5’inde mikst tip femoroasetabular sıkışma vardı. Asemptomatik hastaların %53.7’sinde; ağrı şikayeti olan hastaların %61.8’inde pelvik bölgede ek radyolojik değişiklikler vardı. Her iki grupta pelvik bölgede eşlik eden radyolojik değişiklikler en fazla subkortikal kist ve sklerozdu. Sonuç: Kalça osteoartriti gelişiminde önemli faktörlerden birisi olan femoroasetabular sıkışma sendromu kalça ağrısı nedenleri araştırılırken düşünülmelidir. Erken tanı ve etkin tedaviyle kalça ekleminin korunması, hastanın yaşam kalitesinin arttırılması hedeflenmelidir. Bu amaçlarla fizyoterapi semptomatik femoroasetabular sıkışma sendromlu hastalarda tedavi seçeneği olarak düşünülebilir.Öğe Sultan Mahmud II's diseases and cause of death from the perspective of medical doctor’s and current medical literature(2023) Sultanoğlu, Hasan; Topçu, İbrahim; Gündoğdu, Raşit; Salman, ZeynepThe illness of Sultan Mahmud II, the 30th Sultan of the Ottoman Empire and the 109th Islamic Caliph, started to be discussed after his death. In this study, the possible illnesses of Sultan Mahmud II, his illness process and death were analysed by comparing the claims and explanations made by his physicians during his illness and death. The research includes: the incomplete document of Abdülhak Molla, the chief physician of the period; the book titled Deux Annees de l’Histoire d’Orient 1839-1840 (Two Years in the East 1839-1840) written by Edmond De Cadalvene and Emile Barrault; the book titled Relation Officielle de la Maladie et de la Mort du Sultan Mahmud II (Sultan Mahmud II’s Illness and Death) by Mac Carthy and Konstantin Kara Todori. The Illness and Death of Sultan Mahmud II), published in 1841; and, three reports sent by Karl Ambros Bernard to the Austrian government on different dates based on Jakob Neuner. In the light of current medical knowledge, the above-mentioned information and documents about the sultan’s illness suggest that Sultan Mahmud II suffered from “lung cancer” and “alcohol withdrawal syndrome”. It was concluded that his death was due to sepsis developing as a result of the infection caused by the disease and the deterioration of metabolite balances in the body.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.Öğe Ultrasound versus computed tomography scan findings in pediatric blunt abdominal traumas(Tehran Univ Medical Sciences, 2022) Sultanoğlu, Hasan; Başaran, Ayşe; Hekimoğlu, Azad; Arslan, Engin Deniz; Özkan, SedaObjective: We aimed to evaluate the performance of ultrasonography (US) versus computed tomography (CT) scan in detecting intra-abdominal injury among pediatric patients with blunt abdominal trauma. Methods: Pediatric patients aged<18, who were admitted to the emergency department (ED) due to blunt abdominal trauma and underwent both US and CT scan were evaluated retrospectively. Results: A total of 732 pediatric patients were included in this study. Pathology was detected on US of 418 (57.1%) cases, whereas, intra-abdominal pathology was detected in CT scan of 359 (48.7%) cases. The sensitivity of US in detecting pathology (fluid and/or organ injury) was 95.3%, and its specificity was 79.6%. The sensitivity of US in detecting free fluid was 94.9%, and its specificity was 80.5%. In hemodynamically unstable and stable patients, the sensitivities of US in detection of pathology (fluid and/or organ injury) were 97.6% and 91.6%, and its specificities were 74.3% and 80.9%, respectively. Conclusion: In our study, the sensitivity of US in terms of detecting pathology in pediatrics with blunt abdominal trauma was high, whereas the specificity of US was low.
