Person: ÖZPOLAT, ÇİĞDEM
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ÖZPOLAT
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ÇİĞDEM
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Publication Open Access Comparing the effects of different amounts of fluid treatments in addition to analgesia in patients admitted to the emergency department with renal colic: A randomized study(2022-01-01) ÖZPOLAT, ÇİĞDEM; SANRI, ERKMAN; AKOĞLU, HALDUN; DENİZBAŞI ALTINOK, ARZU; Celebi L., ÖZPOLAT Ç., Onur O., AKOĞLU H., SANRI E., DENİZBAŞI ALTINOK A.Objective: There are a limited number of studies examining the effect of fluid administration for acute pain relief in patients with renal colic. We aim to evaluate whether intravenous fluid of different amounts will make a difference regarding pain, in patients who presented to the emergency department (ED) with flank pain. Patients and Methods: This single-center, prospective, randomized clinical trial was performed at the ED of a university hospital. Subjects were randomly assigned to three groups. All received an intramuscular (IM) injection of 75 mg diclofenac sodium and 3 mg intravenous (IV) morphine. While group 1 did not receive extra treatment, group 2 received 100 cc /hr physiological serum (PS), and group 3 received 500 cc /hr PS. Pain was assessed by using the visual analogue scale (VAS) ruler for 6 hours. Results: A total of 201 patients were included. Mean age was 36.16 ± 9.85. At 60 min mean VAS scores were 3.55 ± 1.24 in the first group, 4.42 ± 1.87 in the second group and 5.02 ± 1.92 in the third group. In the group fluid not given, pain decrease was faster than others. At 240 min mean VAS scores were similar in all groups. Conclusion: This study indicates that IV fluids given to patients with renal colic pain was not effective in pain relief. Keywords: Renal colic, Analgesia, Intravenous fluid, Urolithiasis, VASPublication Open Access Comparison of predicting the severity of disease by clinical and radiological scoring systems in acute pancreatitis(2022-01-01) ÖZPOLAT, ÇİĞDEM; AKOĞLU, HALDUN; DENİZBAŞI ALTINOK, ARZU; Aktaş İ., Özpolat Ç., Demir H., Akoğlu E., Akoğlu H., Denizbaşı Altınok A.Aim: Acute pancreatitis (AP) is a frequent reason for patient presentation in emergency department. It is hard to assess objectively the grade of the disease due to a wide range of clinical signs in terms of determination the need for intensive care or surgical intervention. At this stage there is not a unique, unified scoring system that determines the severity of the disease. In this study we aimed to compare clinically used AP scoring systems; Ranson, BISAP and Balthazar (CTSI), SIRS to predict disease severity. Material and Methods: In this study, AP patients that were diagnosed by Atlanta criteria were analyzed retrospectively. The clinical, laboratory and radiological images and results of the patients were analyzed by using the "first 24 hours Ranson", "BISAP" and SIRS scores. The Balthazar scores were calculated from the CT reports retrospectively. Results: Age, respiratory rate and BUN values of the patients with mortality were significantly higher than the patients who survived, whereas diastolic blood pressure, systolic BP blood pressure, SO2 and amylase values of the patients with mortality were found to be significantly lower than the patients who survived. When the 6 month mortality prediction of prognostic scoring systems was examined, it was found that the BISAP score could catch 94% of mortality (95% CI: 0.88-0.97), and the SIRS score could predict mortality by 74.7% (95% CI: 0,66-0,82). Conclusion: Regarding the APs severity prediction, BISAP and SIRS scores were more sensitive and specific in terms of monthly and overall mortality in patientsPublication Open Access The Cardiopulmonary Effects of Medical Masks and Filtering Facepiece Respirators on Healthy Health Care Workers in the Emergency Department: A Prospective Cohort Study(Elsevier Inc., 2022-01) DENİZBAŞI ALTINOK, ARZU; Sanri E., Karacabey S., Unal E., Kudu E., Cetin M., Ozpolat C., Denizbasi A.Background: International COVID-19 guidelines recommend that health care workers (HCWs) wear filtering facepiece (FFP) respirators to reduce exposure risk. However, there are concerns about FFP respirators causing hypercapnia via rebreathing carbon dioxide (CO2). Most previous studies measured the physiological effects of FFP respirators on treadmills or while resting, and such measurements may not reflect the physiological changes of HCWs working in the emergency department (ED). Objective: Our aim was to evaluate the physiological and clinical impacts of FFP type II (FFP2) respirators on HCWs during 2 h of their day shift in the ED. Methods: We included emergency HCWs in this prospective cohort study. We measured end-tidal CO2 (ETCO2), mean arterial pressure (MAP), respiratory rate (RR), and heart rate values and dyspnea scores of subjects at two time points. The first measurements were carried out with medical masks while resting. Subjects then began their day shift in the ED with medical mask plus FFP2 respirator. We called subjects after 2 h for the second measurement. Results: The median age of 153 healthy volunteers was 24.0 years (interquartile range 24.0–25.0 years). Subjects’ MAP, RR, and ETCO2 values and dyspnea scores were significantly higher after 2 h. Median ETCO2 values increased from 36.4 to 38.8 mm Hg. None of the subjects had hypercapnia symptoms, hypoxia, or other adverse effects. Conclusion: We did not observe any clinical reflection of these changes in physiological values. Thus, we evaluated these changes to be clinically insignificant. We found that it is safe for healthy HCWs to wear medical masks plus FFP2 respirators during a 2-h working shift in the ED. © 2021Publication Metadata only An unusual complication following unconventional use of high pressure injector(SAGE PUBLICATIONS LTD, 2013) DENİZBAŞI ALTINOK, ARZU; Eroglu, S. E.; Tezel, S.; Salcin, E.; Denizbasi, A.; Onur, O.; Ozpolat, C.; Demir, H.High pressure injection injuries most commonly occur in industrial accidents. In accident due to high pressure gun injuries, the nature of injected materials, the degree of toxicity, and the amount injected will affect the clinical outcome. Early vigorous treatment is essential to reduce morbidity. We reported a case of hand injuries due to inadvertent use of a high pressure injector device for haemostasis. 46-year-old male technician tried to stop bleeding from his injured hand by directing air jet from a high pressure injector to the wound resulting in significant subcutaneous emphysema. Adequate training and knowledge on occupational safety should be reinforced to avoid similar accidents.Publication Open Access Determination of Pro-BNP and Troponin I Levels for ShortTerm Mortality Prediction in Ischemic Stroke Patients who did not Undergo Revascularization(2022-01-01) ÖZPOLAT, ÇİĞDEM; ONUR, ÖZGE ECMEL; DENİZBAŞI ALTINOK, ARZU; AKOĞLU, HALDUN; Aydın N., Özpolat Ç., Onur Ö. E. , Akoğlu H., Denizbaşı Altınok A.Introduction: Emergency departments (EDs) are the first place to start treatment for most stroke patients. Prognozing patients for planning and proper management of the therapies have an important place in approaching stroke patients. Many studies have been carried out with serum biomarkers especially in terms of prognosis stroke. Our objective, in this study, is to research short-term (14th day) mortality prediction of serum Troponin I (TnI) and pro-brain natriuretic peptide (BNP) levels. Methods: This was a prospective and observational prognostic test study. All consecutive patients admitted to the ED with the onset of symptoms in the past 24 h and diagnosed with the first episode of acute ischemic stroke were included in the study. A total of 121 subjects were included in the study. On admission, pro-BNP and TnI were collected from all subjects. On the 14th day of admission, patients were checked for mortality. Results: Of 121 patients, 14 (11.5%) had a mortal outcome at the end of the 14th day. The overall median pro-BNP level of all patients was 799.00 pg/ml (IQR: 220.00–2818.25). The median pro-BNP level of the non-survivor group was significantly higher than that of the survivor group (p:0.030). However, there was no significant difference between the TnI levels of the mortality groups. The optimal cutoff value of serum pro-BNP levels as an indicator of mortality on the 14th day was estimated to be 509 pg/ml (sensitivity: 85.7%, specificity: 49.5%, and AUC: 0.68 [95% CI, 0.59–0.769]). Discussion and Conclusion: Various biomarkers are investigated for prediction of mortality in ischemic stroke patient. According to our study, elevated pro-BNP values are associated with mortality. Further study with larger patient cohorts can be studied regarding the relationship between these threshold, in terms of predicting the mortality, in a more comprehensive study, as well as using subgroup and underlying conditions.Publication Metadata only Diagnostic utility of the Covichem score in predicting COVID-19 disease(2022-10-01) ÖZPOLAT, ÇİĞDEM; ALTUNBAŞ, ERHAN; ÖZPOLAT Ç., Altunbas E.© 2022 Elsevier Inc.Background: Identifying which patients with COVİD-19 have a high risk of severe illness is essential to optimizing management and resource utilization strategies. Objectives: The aim of this study was to externally validate the diagnostic utility of the Covichem score for predicting COVID-19 disease severity, and secondarily to evaluate its utility in predicting intensive care unit (ICU) admission, and in-hospital mortality. Methods: All consecutive COVID-19 patients who presented to the emergency department (ED) were included, and patients\" demographic data, comorbidities, vital signs, oxygen requirement, and laboratory results were recorded. We calculated patients\" Covichem scores and estimates (using a threshold of 0.5) and evaluated the utility of the Covichem score for predicting disease severity, ICU admission, and mortality. Results: The median Covichem score was significantly higher for patients with severe illness (Covichem score: 0.170, IQR: 0.298, n = 300 vs. Covichem score: 0.026, IQR: 0.065, n: 191; p < 0.001). Based on their Covichem scores, 12.4% (61/491) of the patients were predicted to experience severe illness (threshold: 0.5), the accuracy of the Covichem score was poor, as the area under curve (AUC) was 48.5% (18.1% sensitivity and 93.8% specificity). When we calculated a new ideal threshold, the AUC reached 82%, but the sensitivity was 79.9% and the specificity was 71.2%. Conclusion: In this external validation of the Covichem score, we found that it performed worse than in the original derivation and validation study, even with the assistance of a new cutoff.Publication Metadata only INITIAL AND SUSTAINED RESPONSE EFFECTS OF 3 VAGAL MANEUVERS IN SUPRAVENTRICULAR TACHYCARDIA: A RANDOMIZED, CLINICAL TRIAL(ELSEVIER SCIENCE INC, 2019) DENİZBAŞI ALTINOK, ARZU; Ceylan, Ezgi; Ozpolat, Cigdem; Onur, Ozge; Akoglu, Haldun; Denizbasi, ArzuBackground: For acute termination of supraventricular tachycardia (SVT), vagal maneuvers, including the standard Valsalva maneuver (sVM), modified Valsalva (mVM) maneuver, and carotid sinus massage (CSM), are first-line interventions. There is no criterion standard technique. Objective: This prospective, randomized study was aimed at analyzing the success rates of these 3 vagal maneuvers as measured by sustaining sinus rhythm at the fifth minute and SVT termination. Methods: We conducted this prospective, randomized controlled study in an emergency department (ED). We enrolled all the patients who were admitted to the ED and diagnosed with SVT. We randomly assigned them to 3 groups receiving sVM, mVM, and CSM and recorded the patients' responses to the vagal maneuvers and SVT recurrence after vagal maneuvers. Results: The study was completed with 98 patients. A total of 25 (25.5%) instances of SVT were initially treated successfully with vagal maneuvers. The success rate was 43.7% (14/32 cases) from mVM, 24.2% (8/33) for sVM, and 9.1 % (3/33) for CSM (p < 0.05). At the end of the fifth minute, only 12.2% (12/98) of all patients had sinus rhythm. Sinus rhythm persisted in 28.1% (9/32) of patients in the mVM group, 6.1% (2/33) of patients in the sVM group, and 3% (1/33) in the CSM group at the fifth minute (p < 0.05). Conclusion: mVM is superior to the CSM maneuver in terminating SVT and maintaining rhythm. We conclude that it is beneficial to use mVM, which is more effective and lacks side effects. (C) 2019 Elsevier Inc. All rights reserved.Publication Metadata only The effects of adrenomedullin in traumatic brain injury(ELSEVIER SCIENCE INC, 2013) DENİZBAŞI ALTINOK, ARZU; Demir, Hasan; Onur, Ozge E.; Denizbasi, Arzu; Akoglu, Haldun; Eroglu, Serkan E.; Ozpolat, Cigdem; Akoglu, EbruTraumatic brain injury (TBI) is a common cause of death and disability throughout the world. A multifunctional peptide adrenomedullin (AM) has protective effects in the central nervous system. We evaluated AM in an animal model as a therapeutic agent that reduces brain damage after traumatic brain injury. A total of 36 rats was divided into 3 groups as sham, head trauma plus intraperitoneal (ip) saline, and head trauma plus adrenomedullin ip. The diffuse brain injury model of Marmarou et al. was used. Blood samples were taken from all groups at the 1st, 6th and 24th hours for analysis of TNF-alpha (tumor necrosis factor-alpha), IL-1 beta (interleukin-1 beta) and IL-6 (interleukin-6) levels. At the end of the study (at the 24th hour) a neurological examination was performed and half of the rats were decapitated to obtain blood and tissue samples, the other half were perfused transcardiacally for studying the histopathology of the brain tissue. There were no statistically significant changes in plasma levels of IL-1 beta, IL-6 and TNF-alpha relative to the sham group. Also, changes in tissue levels of malonedialdehyde, myeloperoxidase and glutathione were not statistically significant. However, neurological scores and histopathological examinations revealed healing. AM individually exerts neuroprotective effects in animal models of acute brain injury. But the mechanisms of action remain to be assessed. (C) 2013 Elsevier Inc. All rights reserved.Publication Metadata only The utility of adding 1 l intravenous normal saline to standard 75 mg intramuscular diclofenac potassium injection in patients presented to the emergency department with an acute migraine attack: a randomizedcontrolled trial(2021-11-28) KARACABEY, SİNAN; AKOĞLU, HALDUN; SANRI, ERKMAN; ÖZPOLAT, ÇİĞDEM; DENİZBAŞI ALTINOK, ARZU; ONUR, ÖZGE ECMEL; Turan Y., AKOĞLU H., SANRI E., KARACABEY S., ÖZPOLAT Ç., ONUR Ö. E., DENİZBAŞI ALTINOK A.Publication Open Access Major health concerns of refugees in an emergency department: A single-center experience in the country hosting greatest number of refugees(2022-01-01) ÖZPOLAT, ÇİĞDEM; ÖZPOLAT Ç.Objective: Turkey hosts a large number of refugees. The extensive use of the emergency services (ED) created a high burden on the health care system. This study was conducted to determine ED utilization by refugees at a tertiary care center. Patients and Methods: Pediatric patients presenting with trauma and all adult patients were included in the study. Demographic information, country of origin, date of admission and triage category, complaint on admission, hospital resource utilization frequency, final diagnosis, and outcome of patients were recorded. Results: A total number of 762 patients (1266 cases) were included. The median age was 30 (range 23-39) and 317 (41.6%) were male. 627 (82.3%) of the patients were from Syria. Considering hospital resource utilization of 1266 cases, radiologic imaging was performed on 28.1% and laboratory testings were performed on 50.2% of cases. 1128 (89.1 %) of all cases were discharged, while 119/1266 (9.4 %) cases were admitted to wards and 19/1266 (1.5 %) cases to intensive care units. Conclusion: There is not enough data regarding in which health care areas refugees need care. Access to primary care specific to refugees may reduce ED utilization. Especially, routine gynecologic primary care and follow-up centers are needed for refugees in Turkey.