Person: ONUR, ÖZGE ECMEL
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ONUR
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ÖZGE ECMEL
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Publication Metadata only Effects of Recombinant Human Granulocyte Colony-Stimulating Factor (Filgrastim) on ECG Parameters in Neutropenic Patients A Single-Centre, Prospective Study(ADIS INT LTD, 2009) DENİZBAŞI ALTINOK, ARZU; Guneysel, Ozlem; Onur, Ozge Ecmel; Denizbasi, ArzuBackground and objective: Human granulocyte colony-stimulating factor (G-CSF) is a haematopoietic hormone that promotes the growth, proliferation, differentiation and maturation of neutrophil precursors. Filgrastim is a recombinant human G-CSF. Myocardial infarction, atrial fibrillation and arrhythmia have been reported in several patients with malignancy receiving filgrastim, but a causal relationship with the drug has not been established. The purpose of this study was to investigate the changes in ECG parameters in neutropenic patients during treatment with filgrastim. Methods: This was a single-centre, prospective study carried out in a hospital emergency room. Patients with neutropenia and malignancy who were required to receive filgrastim were eligible for the study. After a reference ECG had been obtained, filgrastim was administered to all patients at a dose of 5 mu g/kg/day subcutaneously for 2 days. Follow-up ECGs were then obtained at 12-hourly intervals. Continuous telemetric monitoring was conducted throughout hospitalization. Results: Serial ECG parameters were compared in 102 patients. There were no statistically significant differences between baseline and follow-up ECG measurements of rhythm, P-wave duration, PR interval, QRS-wave duration, corrected QT (QTc) interval, ECG axis, premature supraventricular events, ventricular arrhythmia, R-wave progression, right bundle branch block or left bundle branch block. There was a significant reduction in mean heart rate in subsequent ECGs compared with baseline (p < 0.05). Conclusion: This study did not demonstrate any ECG changes other than a significant reduction in mean heart rate in this selected population of neutropenic patients given 2 days' treatment with subcutaneous 5 mu g/kg/day of filgrastim.Publication Open Access Electrocardiographic clue for a mid-LAD lesion(2016-03-17) ONUR, ÖZGE ECMEL; Ak, Rohat; Doganay, Fatih; Onur, Ozge Ozberk; Akoglu, Ebru UnalPublication Open Access Initial inferior vena cava and aorta diameter parameters measured by ultrasonography or computed tomography does not correlate with vital signs, hemorrhage or shock markers in trauma patients(TURKISH ASSOC TRAUMA EMERGENCY SURGERY, 2017) DENİZBAŞI ALTINOK, ARZU; Celik, Omer Faruk; Akoglu, Haldun; Celik, Ali; Asadov, Ruslan; Onur, Ozge Ecmel; Denizbasi, ArzuBACKGROUND: Ultrasonography (US) is noninvasive, readily available, and cheap. The diameter of inferior vena cava (dIVC) and its respiratory variation were proposed as a good surrogate of the hemodynamic state. However, recent studies have shown conflicting results, and the value of IVC-derived parameters in the estimation of fluid status and hemorrhage remains unclear. METHODS: This was an observational study of trauma patients who presented to emergency department. dIVC and aorta diameter (dAorta) were measured at the initial US and CT in all patients. The correlation of these measurements and all parameters derived from those measurements along with the initial vital signs and laboratory values of hemorrhage (hemoglobin, hematocrit) and shock (lactate, base excess) were assessed. US and CT values were also compared for accuracy using Bland-Altman analysis. RESULTS: The final study population was 140, with a mean age of 38 years and 79.3% were male. dIVC and dAorta did not have any clinically significant correlation with any of the vital signs or laboratory values of hemorrhage or shock when measured by US or CT. A good and significant correlation was observed between dIVC and dAorta measured by US and CT. CONCLUSION: The value of an initial and single measurement of IVC and aorta parameters in the evaluation of trauma patients should be questioned. However, the change in the measured parameters may be of value and should be investigated in further studies.Publication Open Access Predictive value of scoring systems for the diagnosis of acute appendicitis in emergency department patients: Is there an accurate one?(SAGE PUBLICATIONS LTD, 2020-09) AKOĞLU, HALDUN; Rohat, Ak; Doganay, Fatih; Akoglu, Ebru Unal; Akoglu, Haldun; Ucar, Asli Bahar; Kurt, Erdem; Turan, Cansu Arslan; Onur, OzgeBackground: Acute appendicitis is one of the challenging surgical conditions presented in the emergency departments. Clinical scoring systems were developed to reduce the negative appendectomy rate and also to avoid unnecessary diagnostic evaluation. Objectives: The primary aim was to compare the clinical adequacy of the Alvarado, Acute Inflammatory Response, and the Raja Isteri Pengiran Anak Saleha Appendicitis scores in patients with right lower quadrant pain for the diagnosis of acute appendicitis. Methods: This was a prospective and observational study. All patients over the age of 18 years who presented with a complaint of right lower quadrant pain were enrolled. The Alvarado, Acute Inflammatory Response, and Raja Isteri Pengiran Anak Saleha Appendicitis scoring systems were compared. The patients were either admitted or followed-up as out-patient. Face-to-face or telephone follow-up visits were arranged for the patients who did not have surgery and who were not admitted. Results: 232 patients were included and 14 patients were excluded from the study. Of the 218 patients, 114 patients underwent surgery. Of the 114 patients, 107 patients were pathologically diagnosed with acute appendicitis. It was determined that Raja Isteri Pengiran Anak Saleha Appendicitis score was the most valuable score with 0.88 accuracy, followed by Acute Inflammatory Response (area under the curve = 0.79) and Alvarado (area under the curve = 0.71) scores. Conclusion: The accuracy of Raja Isteri Pengiran Anak Saleha Appendicitis scoring system was higher for the diagnosis of acute appendicitis than the other scores. The cut-off of the Raja Isteri Pengiran Anak Saleha Appendicitis score from a 7.5-point threshold provides a practical, non-invasive, rapid diagnostic method that increases acute appendicitis discriminative power in patients presenting with right lower quadrant pain.Publication Metadata only Adrenomedullin reduces the severity of cerulein-induced acute pancreatitis(ELSEVIER SCIENCE INC, 2007) DENİZBAŞI ALTINOK, ARZU; Onur, Ozge Ecmel; Guneysel, Ozlem; Akoglu, Haldun; Denizbasi, Arzu; Onur, EnderWe investigated the effect of Adrenomedullin (AM) on cerulein-induced acute pancreatitis in rats. AM treatment (100 ng/kg per rat, subcutaneous) after one hour of cerulein injection reduced the plasma amylase levels, pancreatic weight, pancreatic malondialdehyde (MDA) levels, and the severity of the lesions microscopically. These data suggest that AM has a protective effect on cerulein-induced acute pancreatitis. These could be due to anti-inflammatory properties of AM, inhibition of proinflammatory cytokine secretion, reducing the endothelial permeability increased by reactive oxygen species, endotoxins or cytokines. (C) 2007 Elsevier Inc. All rights reserved.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 Open Access Diagnostic Accuracy of the Electrocardiography Criteria for Left Ventricular Hypertrophy (Cornell Voltage Criteria, Sokolow-Lyon Index, Romhilt-Estes, and Peguero-Lo Presti Criteria) Compared to Transthoracic Echocardiography(CUREUS INC, 2021-03-14) DENİZBAŞI ALTINOK, ARZU; Bayram, Nurseli; Akoglu, Haldun; Sanri, Erkman; Karacabey, Sinan; Efeoglu, Melis; Onur, Ozge; Denizbasi, ArzuObjective/Aim: We aimed to evaluate the diagnostic utility of the widely used left ventricular hypertrophy (LVH) electrocardiography (ECG) criteria (Cornell Voltage Criteria [CVC], Sokolow-Lyon Index [SLI], Romhilt-Estes [REC], and Peguero-Lo Presti [PLP] Criteria) compared with the left ventricular mass measured by echocardiography. Methods: In this prospective diagnostic accuracy study, we screened all consecutive adults (18 to 65 years) who presented to our academic emergency department (ED) with increased blood pressure (>= 130/85 mmHg) between January 2016 and January 2017, and we enrolled a convenience sample of 165 patients in our study. The attending emergency physician managed all patients as per their primary complaint. The consulting cardiologist performed a transthoracic echocardiogram (TTE) of the patient and calculated the left ventricular mass (LVM) according to the American Society of Echocardiography (ASE) formula. After completing the patient recruitment phase, researchers evaluated all ECGs and calculated scores for SLI, CVC, REC, and PLP. We used contingency tables to calculate the diagnostic utility metrics of all ECG criteria. Results: The prevalence of LVH by TTE was 31.5%. CVC, SLI, REC, and PLP criteria correctly identified (true positive rate) abnormal LVM in only 3.9%, 1.9%, 9.6%, and 19.2% of the patients, respectively. CVC, SLI, REC score and PLP criteria performed poorly with extremely low sensitivities (3.9%, 1.9%, 10%, 19.2%) and poor accuracies (67.3%, 64.9%, 57.7%, 69.7%). Conclusion: ECG voltage criteria's clinical utility in estimating LVM and LVH is low, and it should not be used for this purpose.Publication Open Access Diagnostic accuracy of the ECG criteria for left ventricular hypertrophy (cornell voltage criteria, sokolow-lyon index, romhilt-estes, and peguero-lo presti criteria) compared to transthoracic echocardiography(2021-03-01) AKOĞLU, HALDUN; ONUR, ÖZGE ECMEL; KARACABEY, SİNAN; EFEOĞLU, MELİS; DENİZBAŞI ALTINOK, ARZU; Akoğlu H., Onur Ö. E., Karacabey S., Efeoğlu Saçak M., Denizbaşı Altınok A.Objective/Aim: We aimed to evaluate the diagnostic utility of the widely used left ventricular hypertrophy (LVH) electrocardiography (ECG) criteria (Cornell Voltage Criteria [CVC], Sokolow-Lyon Index [SLI], RomhiltEstes [REC], and Peguero-Lo Presti [PLP] Criteria) compared with the left ventricular mass measured by echocardiography. Methods: In this prospective diagnostic accuracy study, we screened all consecutive adults (18 to 65 years) who presented to our academic emergency department (ED) with increased blood pressure (≥130/85 mmHg) between January 2016 and January 2017, and we enrolled a convenience sample of 165 patients in our study. The attending emergency physician managed all patients as per their primary complaint. The consulting cardiologist performed a transthoracic echocardiogram (TTE) of the patient and calculated the left ventricular mass (LVM) according to the American Society of Echocardiography (ASE) formula. After completing the patient recruitment phase, researchers evaluated all ECGs and calculated scores for SLI, CVC, REC, and PLP. We used contingency tables to calculate the diagnostic utility metrics of all ECG criteria. Results: The prevalence of LVH by TTE was 31.5%. CVC, SLI, REC, and PLP criteria correctly identified (true positive rate) abnormal LVM in only 3.9%, 1.9%, 9.6%, and 19.2% of the patients, respectively. CVC, SLI, REC score and PLP criteria performed poorly with extremely low sensitivities (3.9%, 1.9%, 10%, 19.2%) and poor accuracies (67.3%, 64.9%, 57.7%, 69.7%). Conclusion: ECG voltage criteria's clinical utility in estimating LVM and LVH is low, and it should not be used for this purpose.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 Covid-19 ilişkili izole korpus kallosum splenium enfarktı(2021-11-28) SANRI, ERKMAN; DENİZBAŞI ALTINOK, ARZU; AKOĞLU, HALDUN; ONUR, ÖZGE ECMEL; KARACABEY, SİNAN; Ünlü B., Altun M., ALTUNBAS E., ADANÇ M., SANRI E., KARACABEY S., AKOĞLU H., ONUR Ö. E., DENİZBAŞI ALTINOK A.