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 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 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 Open Access Grayanotoxin (Mad Honey) - Ongoing Consumption After Poisoning(AVES YAYINCILIK, 2013-09-10) DENİZBAŞI ALTINOK, ARZU; Eroglu, Serkan Emre; Urgan, Oguz; Onur, Ozge Ecmel; Denizbasi, Arzu; Akoglu, HaldunBackground: Some honey types in certain geographical regions may cause toxic effects on people. This type of honey is known as mad honey in Turkey. The toxic ingredient of this honey is called Grayanotoxin I. The consumption of mad honey can cause severe bradycardia, hypotension, dizziness, nausea and vomiting. Aims: Our study is aimed at analysing patients diagnosed with mad honey poisoning and their behaviour towards the consumption of this honey after diagnosis. Study Design: Cross sectional study. Methods: This cross-sectional study was based on complaints and findings of mad honey poisoning. Patient information and findings at the time of admission were compared with those at one month after discharge through telephone interviews. They were asked if either they or their relatives had continued consuming the same honey. Frequency data such as gender, purpose of honey consumption, first complaints and continuance of honey consumption are shown as number (n) and percentage (%). A Chi Square test was conducted to determine the difference between groups. Results: 38 patients were participated in this study; 18 of the patients had to be followed up in a coronary intensive care unit. We were able to reach 34 patients by phone after discharge. It was found that 12 of 16 patients discharged after emergency unit observation or their close relatives were continuing to consume mad honey, whereas 16 (88.9%) of the 18 patients under coronary intensive care had discontinued consuming mad honey. The difference in the continuation of mad honey consumption between patient groups followed-up in the intensive care unit and those discharged after emergency observation was statistically significant. Conclusion: Hazards associated with and serious consequences following the consumption of mad honey must be clearly explained to patients who are found to be consuming mad honey.Publication Open Access The Effects of Intravenous Lipid Emulsion Therapy in the Prevention of Depressive Effects of Propofol on Cardiovascular and Respiratory Systems: An Experimental Animal Study(MDPI, 2018-12-25) ONUR, ÖZGE ECMEL; Doganay, Fatih; Ak, Rohat; Aliskan, Halil; Abut, Serdar; Sumer, Engin; Onur, OzgeBackground and objectives: Although there are several hypotheses about the mechanism of action, intravenous lipid emulsion (ILE) therapy has been shown to be effective in the treatment of toxicities due to local anaesthetics and many lipophilic drugs. In this study, we had hypothesized that ILE therapy might also be effective in preventing mortality and cardiorespiratory depressant effects due to propofol intoxication. Materials and methods: Twenty-eight Sprague-Dawley adult rats were randomly divided into four groups. Saline was administered to the subjects in the control group. The second group was administered propofol (PP group); the third group was administered ILE (ILE group), and the fourth group was administered propofol and ILE therapy together (ILE+PP group). Systolic blood pressure (SBP), diastolic blood pressure (DBP), respiratory rate (RR), heart rate (HR), and mortality were recorded at 10 time-points during a period of 60 min. A repeated measures linear mixed-effect model with unstructured covariance was used to compare the groups. Results: In the PP group; SBP, DBP, RR, and HR levels declined steadily; and all rats in this group died after the 60-min period. In the ILE+PP group, the initially reduced SBP, DBP, RR, and HR scores increased close to the levels observed in the control group. The SBP, DBP, RR, and HR values in the PP group were significantly lower compared to the other groups (p < 0.01). The mortality rate was 100% (with survival duration of 60 min) for the PP group; however, it was 0% for the remaining three groups. Conclusions: Our results suggest that the untoward effects of propofol including hypotension, bradycardia, and respiratory depression might be prevented with ILE therapy.Publication Metadata only Predictors of false negative diffusion-weighted MRI in clinically suspected central cause of vertigo(W B SAUNDERS CO-ELSEVIER INC, 2018) DENİZBAŞI ALTINOK, ARZU; Akoglu, Ebru Unal; Akoglu, Haldun; Ozturk, Tuba Cimilli; Onur, Bahaeddin; Eroglu, Serkan Emre; Onur, Ozge; Denizbasi, ArzuIntroduction: Vertigo is classified as peripheral and central. Differentiation of stroke mimics is the most important diagnostic challenge. There is no clinical guidance for the indications of neuroimaging in isolated vertigo patients. The primary aim of this study is to test the diagnostic value of a DWI-MRI protocol to rule-out a central cause in patients with acute isolated vertigo in the ED. Methods: We prospectively enrolled 144 patients who were presented with isolated vertigo to the ED. A detailed neurological examination and maneuvers were performed for differential diagnosis. All patients underwent CT and/or DW-MRI either during ED visit or at the follow-up, if necessary. Out-patient follow-up exams and evaluations were repeated until all patients had a definitive diagnosis. Results: In the study, 137 of the 144 patients completed the follow-up period, and 34 of 137 patients were diagnosed with central vertigo. Six of 34 central vertigo patients had normal DW-MRI findings. One was diagnosed with migraine headache and five with vertebra-basilar insufficiency during the out-patient follow-up. One of the 28 patients with a pathological MRI was diagnosed with mass and the rest was stroke. The utility of DW-MRI in vertigo patients was moderately high (sensitivity: 82%, specificity: 100%). We found that age, history of HT, history of CAD and vertigo unresponsive to ED treatment were significantly associated with a central cause of vertigo. Conclusion: We suggest that unresponsiveness to ED treatment, especially in patients with a history of HT and CAD, should alert physicians for central causes and warrant DW-MRI imaging. (C) 2017 Elsevier Inc. All rights reserved.Publication Open Access Spinal Trauma is Never without Sin: A Tetraplegia Patient Presented Without any Symptoms(2014-12) DENİZBAŞI ALTINOK, ARZU; Efeoglu, Melis; Akoglu, Haldun; Akoglu, Tayfun; Eroglu, Serkan Emre; Onur, Ozge Ecmel; Denizbasi, ArzuPublication Open Access Diagnostic value of Tei index for acute myocardial infarction in patients presenting to emergency department with ischemic chest pain and correlation with Hs-troponin(SAGE PUBLICATIONS LTD, 2019-07) ONUR, ÖZGE ECMEL; Ucar, Asli Bahar; Akoglu, Ebru Unal; Ozturk, Tuba Cimilli; Eyinc, Yalman; Ak, Rohat; Demir, Hasan; Ilgezdi, Zeynep Demet; Onur, OzgeBackground: Acute myocardial infarction is one of the most common causes of mortality in developed countries, and high-sensitive troponin test usually becomes positive within 3 h from the onset of symptoms. Myocardial perfusion index (Tei index) is a parameter measured during the echocardiographic examination. Objectives: The aim of this study is to investigate the diagnostic value of the Tei index for early diagnosis of acute myocardial infarction in the emergency department and to evaluate the correlation between the Tei index and Hs-Troponin value. Materials and Methods: A total of 129 cases were evaluated, and patients were divided into two groups according to their final diagnosis as acute myocardial infarction (non-ST segment elevation myocardial infarction) and non-acute myocardial infarction groups. Baseline and third-hour Hs-Troponin levels and Tei index values were determined, and their correlation was analyzed. Results: A total of 84 cases were diagnosed with acute myocardial infarction (non-ST segment elevation myocardial infarction), 84.5% had positive Tei index results at the time of admission while the remaining 45 patients were diagnosed as non-acute myocardial infarction and only 48.9% of them had positive Tei index. The diagnostic value of the Tei index and Hs-troponin were calculated as 79.8% and 60%; 67.9% and 60%, respectively. Also, we found that a 0.02 or more increase in the Tei index value has a 97.6 sensitivity and 97.5 specificity for the diagnosis of non-ST segment elevation myocardial infarction. A weak correlation was found between the Tei index and Hs-Troponin values in the acute myocardial infarction group (r = 0.425) and a negative correlation in non-acute myocardial infarction patients at presentation. Conclusion: It is suggested that the use of Tei index might be used as a supportive measure for the early diagnosis of acute myocardial infarction, and the deterioration of Tei index seems to be more significant than Hs-Troponin especially in ruling out acute myocardial infarction.