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Öğe AWARENESS AND APPROACHES OF FAMILY PHYSICIANS ABOUT CHRONIC PAIN(Dokuz Eylul Univ Inst Health Sciences, 2021) Sultanoglu, Tuba Erdem; Gamsizkan, Zerrin; Ataoglu, Safinaz; Sultanoglu, HasanPurpose: We aimed to investigate family physicians' awareness and approaches to chronic pain in its management. Methods: This study was planned as a descriptive, crosssectional study to investigate family physicians' awareness and approaches to chronic pain between September and November 2020.A questionnaire were used as data collection tools.The physicians sociodemographic characteristics, the number of registered patients, the percentage of patients with chronic pain, the status of participation in training activities on pain management, the most common cause of chronic pain, initial approach to chronic pain management were recorded. They were also questioned about the medical treatment option that they preferred for the treatment of patients with chronic pain, the most commonly demanded medication group by their patients and their practice of prescribing those medications, their views on traditional and complementary medicine, and the most effective treatment option for chronic pain. Results: 81 family physicians participated in the study. The mean age was 34.2 +/- 7.3.58% of the participants are women;42% of them were male.Half of the family physicians participating reported that low back pain was the most common cause of chronic pain. In our country, the responses given to the question about the most common causes of chronic pain were psychiatric problems and low back pain. Initial approach to a patient presenting with chronic pain, the most the physicians responsed 'I treat the patient'.66.7% of the physicians agreed with multidisciplinary approach. Conclusion: Developing algorithms for chronic pain management, structuring specialist training and planning continuous training after graduation will contribute significantly to increasing awareness of chronic pain.Öğe Comparison of Clinical, Laboratory and Demographic Characteristics of Patients Diagnosed with COVID-19 as Symptomatic and Atypical Symptoms(Clin Lab Publ, 2021) Akpinar, Guleser; Demir, Mehmet C.; Sultanoglu, Hasan; Unlu, Elif N.; Oksuz, SukruBackground: Clinical findings of COVID-19 have been observed with a wide spectrum ranging from asymptomatic disease and mild upper respiratory tract infection to severe viral pneumonia resulting in mortality. While clinical symptoms present in some COVID-19 patients, others have been incidentally identified. The objective of this study was to examine the clinical and laboratory features of patients diagnosed with COVID-19 who were symptomatic or had atypical symptoms and to make a contribution to the literature. Methods: Patients with the likelihood of having COVID-19 pneumonia were evaluated with RT-PCR samples, other laboratory tests, and chest computed tomography. Results: There were significant differences between these groups in terms of age, dyspnea, saturation, and comor-bidities including hypertension [HT] in 19 patients, cerebrovascular events [CVE] that were classified as other diseases in two patients (intracranial mass in one patient and Alzheimer's disease in one patient), and CRP and platelet counts (PLT) among the laboratory parameters (for all p < 0.05). Conclusions: Atypical symptoms have increased due to the progression of the outbreak. Infected people with atypical symptoms can act as sources of the infection. Therefore, the epidemiological history of these patients should be sought in detail, and individuals with atypical symptoms in society should be identified as soon as possible in order to control the spreading of the disease.Öğe The Demographic Analysis of the Probable COVID-19 Cases in Terms of RT-PCR Results and Age(Clin Lab Publ, 2021) Akpinar, Guleser; Demir, Mehmet C.; Sultanoglu, Hasan; Sonmez, Feruza T.; Karaman, Kivanc; Keskin, Banu H.; Guclu, DeryaBackground: Despite global prevention and quarantine efforts, the incidence of COVID-19 disease continues to increase. As a possible cause, our aim was to investigate which parameters increase the sensitivity or protection against COVID-19 between RT-PCR positive and RT-PCR negative cases in patients admitted to the emergency department. Methods: In the pandemic process, patients admitted to the hospital with suspicion of COVID-19 were evaluated retrospectively. RT-PCR test was divided into + (for Group 1) and - (Group 2). The gender, age, clinical information, application symptoms, and comorbidity data of the patients were evaluated. Results: One hundred and sixty-seven cases were evaluated in the study. Group 1: 88 cases, M/F ratio: 46/42 and average age 48 +/- 17.3 years, Group 2: 79 cases, M/F ratio was approximately 3/2, and the average age was 48.3 +/- 19.4 years. When the groups were compared in terms of symptoms, fever, cough, weakness, and headache were prominent in Group 1, whereas the contact was significantly higher in Group 2 (p < 0.05). Among the comorbid diseases, only COPD showed a significant difference between the groups, and it was found significantly higher in Group 2 (p < 0.05). Conclusions: Cough, headache, and fever were found valuable in the detection of cases. Attention should be paid to contact isolation to circumvent the pandemic process with less damage. Having chronic diseases, especially COPD, increases the risk of infection with SARS-CoV-2. Close monitoring and control of chronic diseases can positively change the course of COVID-19.Öğe Diagnostic Comparison Of Troponin and Scube 1 Levels In Patients Diagnosed with Stemi and Nstemi In The Emergency Department(Duzce Univ, 2021) Ozmen, Fatma Nihal; Sultanoglu, Hasan; Cavus, Umut Yucel; Ozturk, AlpaslanObjective: In the present study we aimed to compare the levels of troponin and SCUBE 1 markers to determine the diagnostic role of SCUBE 1 in patients with STEMI-NSTEMI. Methods: This study was prospectively conducted with 119 patients diagnosed with acute myocardial infarction at the emergency department of DiskapiYildirimBeyazit Training and Research Hospital and 30 control subjects between 01.10.2016 and 01.02.2017. The relationship between age, sex, acute myocardial infarction (AMI) type, white blood cell (WBC), lymphocyte, neutrophil, neutrophil/lymphocyte ratio, red cell distribution width (RDW), thrombocyte count, aspartate aminotransferase (AST), alanine aminotransferase (ALT), CK, CK-MB, troponin, and SCUBE 1 level was examined. Age, sex, and SCUBE 1 level were compared between the patient and control groups. Results: The patients had a mean age of 61.5 +/- 14.5 years, and 68.9% of them were male. The patients had a SCUBE 1 level of 79.7 ng/mL and the control group 53.2 ng/ml. SCUBE 1 level was comparable between the patients with acute myocardial infarction and the control group (p>0.05). A correlation was found between SCUBE 1 level and age (p>0.05).Women in the patient group had a significantly higher SCUBE 1 level (p<0.05). There was a positive correlation between the WBC, CKMB, and troponin levels, and SCUBE 1 level in the patient group.cor No correlation was found between SCUBE 1 level and neutrophil, lymphocyte, neutrophil/lymphocyte ratio, RDW, platelet, AST, ALT, and CK levels (p>0.05). There was no significant correlation between infarction type and SCUBE 1 level (p>0.05). Conclusions: SCUBE 1 level did not significantly rise in patients with acute myocardial infarction. As the test had lower sensitivity and specificity compared to the other markers, we believe that it is not suitable for practical use.Öğe Duzce University Faculty of Medicine, Department of Emergency Medicine and Pandemic Process(Duzce Univ, 2020) Sultanoglu, HasanThe epidemic, screening and preventive measures seen in our country, as in the world, are one of the extraordinary periods that must be taken quickly. We think that sharing health policies carried out in hospitals and experiences in this challenging process will contribute to the upcoming period. It has been planned from the first day of the pandemic to the working conditions of the Emergency department and to prevent the contamination of healthcare workers and to determine the prediagnosis of possible COVID patients in accordance with the algorithm. In this review, the pandemic process in our clinic was explained.Öğe Endogenous Carboxyhemoglobin Concentrations in Predicting Prognosis of Patients with COVID-19 Pneumonia(Clin Lab Publ, 2021) Demir, Mehmet C.; Akpinar, Guleser; Sultanoglu, Hasan; Yildiz-Gulhan, Pinar; Caliskan, Emel; Guclu, Derya; Ince, NevinBackground: The coronavirus disease 2019 (COVID-19) outbreak has caused great difficulties in providing healthcare services worldwide. Accurate and useful indicators are needed for the effective use of resources. Carbon monoxide (CO) is also produced endogenously without exogenous exposure. Studies confirm that endogenous CO increases in conditions such as pneumonia, sepsis, and trauma. This study aimed to compare patients diagnosed with COVID-19 pneumonia and healthy people to reveal whether endogenous carboxyhemoglobin (COHb) levels differ. It was also to determine whether it could be a helpful indicator for the clinician in predicting disease severity in combating the COVID-19 pandemic. Methods: The study included 72 patients admitted to the hospital during the COVID-19 pandemic and diagnosed with COVID-19 pneumonia and a control group of 75 healthy people. The research data was collected retrospectively in a tertiary emergency department. The patients' demographic data, pneumonia severity index (PSI) score, CURB-65 score, 30-day mortality, hospitalization, need for mechanical ventilation (MV), and COHb levels were recorded. Results: While the COHb level was 0.9% (min-max, 0.1 - 4.0) in patients with COVID-19 pneumonia, it was 1% (min-max, 0.1 - 2.6) in the control group. No significant difference was found between the patients and the control group in terms of COHb levels (p = 0.341). Also, there was no correlation between COHb levels and PSI and CURB-65 scores. No significant difference was detected between COHb levels and patients diagnosed with COVID-19 pneumonia in terms of mortality, need for MV, or hospitalization (p > 0.05). Conclusions: We concluded that COHb levels alone could not be used to diagnose COVID-19 pneumonia or predict disease severity. Besides, in COVID-19 pneumonia, the COHb level was not a useful indicator of mortality, need for MV, or hospitalization decision. Further studies are needed to find useful indicators to assist clinicians in their decision-making process in tackling the COVID-19 pandemic.Öğe Evaluation of elderly patients in adult suicide cases admitted to the emergency department(Elsevier Sci Ltd, 2021) Sultanoglu, Hasan; Sultanoglu, Tuba ErdemThe proportion of elderly people in the general population has been increasing in our country. The suicide rate increases by a person's age, and old age appears as one of the life periods with a high suicide incidence. We aimed at investigating the causes and risk factors of suicide attempts and to analyze the sociodemographic and clinical features of the elderly individuals presenting to the emergency department after suicide attempt. Crosssectional retrospective study was performed.1403 patients were enrolled. The patients were categorized into two age groups of 18-64 years and 65 years or older. The male gender had a greater proportion in both groups. The young group contained more subjects having an educational level of primary school while the illiterate ones in the older group had a greater suicide tendency. The married subjects had a greater suicide tendency in the younger group while widowed/divorced subjects had a greater suicide tendency in the older group. Subjects without any comorbidity or medication use had a greater suicide tendency in the younger group whereas those who had comorbidities or medication use greater suicide tendency. Mood disorders were the most common psychiatric disorder in both groups. Medication intake was the most common method of suicide in both groups; suicide attempts were more common in summer and between 16:00-24:00. Domestic problems as the cause of suicide were more common in the younger group, while communication problems were more common in the older group. Male gender, divorced/widowed, low education and sociocultural level, presence of depression, communication problems have been identified as risk factors for older group.Öğe Evaluation of patients with rheumatic diseases admitted at emergency department: 5-year analysis in a single centre(Wiley, 2021) Sultanoglu, Tuba Erdem; Sultanoglu, HasanBackground Chronic inflammatory diseases can lead to emergency admissions with various acute complications. Unfortunately, there is limited data on emergency admissions because of rheumatological diseases. Objectives To evaluate the patients with rheumatic diseases presenting to the emergency department (ED). Methods A total of 1788 patients with a diagnosis of inflammatory rheumatic disease admitted to the ED of a tertiary university hospital between March 2016 and March 2021 were included. The patients' socio-demographic and clinical characteristics, diagnosis and treatments in the ED were recorded. Patients' complaints were classified as rheumatological or non-rheumatological. Results Over 5 years, 1788 patients with an inflammatory rheumatic disease presented to the ED. The mean duration of rheumatological disease was 7 +/- 3.4 years, and the mean number of emergency admissions was 4.4 +/- 5. The four most common groups attending the ED were patients with rheumatoid arthritis, ankylosing spondylitis, familial Mediterranean fever and vasculitis. Of the complaints of the 1788 ED visitors, 1106 (61.9%) were rheumatological, 681 (38.1%) were non-rheumatological and other acute or chronic conditions. Twenty-three patients (1.3%) had the rheumatic disease and died after admission to the ED. When the univariable model results are examined, the risk of hospitalisation increases 1.024 times with increasing age. The risk of hospitalisation is 2.318 times higher in those with ankylosing spondylitis and 2.722 times in those with rheumatoid arthritis compared with those with a diagnosis of vasculitis. The risk of hospitalisation in patients with comorbid diseases is 1.807 times higher than those without. When the results of the multivariable model are examined, the risk of hospitalisation is 2.227 times higher in those with ankylosing spondylitis and 2.615 times in those with rheumatoid arthritis compared to those with vasculitis. Other risk factors were not statistically significant (P > .050). Conclusion Patients with the rheumatic disease most frequently presented to the ED with musculoskeletal complaints and were discharged from the ED. True rheumatological emergencies are rare, but ED physicians should be aware of serious and life-threatening conditions.Öğe Pagophagia-Induced Hyponatremia: An Unusual Case(Knowledge E, 2023) Akbaba, Aydanur; Bogan, Mustafa; Karakecili, Ceren; Bogan, Fatma; Sultanoglu, HasanHyponatremia occurs when the serum sodium level is below 135 mmol/L. The symptoms include nausea, vomiting, confusion, headache, cardiorespiratory symptoms, profound somnolence or coma, and seizures are observed. Iron deficiency anemia can also cause pagophagia, a Pica subspecies. Although it has been emphasized that electrolyte disturbance may develop due to pagophagia, only a dearth of cases was reported. A 59-year-old male patient was brought to the emergency department with complaints of incoherent speech that started at night, disorientated movements (such as fluttering and climbing), insomnia, restlessness, and confusion. In 2017, he experienced hyponatremia due to pagophagia and a salt-free diet. At the index episode of hyponatremia, he experienced confusion, drowsiness, and sleepiness. It was learned that the patient enjoyed these symptoms.For this purpose, the patient made a habit of eating a completely salt-free diet and consumed plenty of water. Although pagophagia is considered to cause hyponatremia because it causes excessive water intake, there are not enough cases reported. It is to be noted that people develop habits or addiction to things they like.
