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 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 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.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 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 Metadata only Normal values of cervical vertebral measurements according to age and sex in CT(W B SAUNDERS CO-ELSEVIER INC, 2017) DENİZBAŞI ALTINOK, ARZU; Omercikoglu, Serhad; Altunbas, Erhan; Akoglu, Haldun; Onur, Ozge; Denizbasi, ArzuIntroduction: Atlantodental interval (ADI), basion-dental interval (BDI) and the thickness of prevertebral soft tissue (TOPST) measured in lateral cervical radiographs were reported to be useful indicators and indirect signs of underlying cervical spine injuries. However, cervical computed tomography (MDCT) is the firstmethod of imaging used in all trauma patients and upper normal limits (UNLs) of cervical distances according to age and sex are undetermined. Therefore, we aimed to calculate these metrics. Methods: 500 adult trauma patients with cervical MDCT at the time of admission were retrospectively selected. ADI, BDI, and TOPSTs were measured by two blinded researchers. Results: 488 cervical spine CT scans were reported to be normal and 12 has pathological findings. Mean ADI, BDI and TOPST of C1, C2, C6 and C7 were statistically significantly wider in males. In females, ADI and BDI were significantly narrower with the increase in age. In males, only ADI was significantly narrower, and TOPST of C6 and C7 vertebra were significantly wider with the increase in age. We found the optimal UNLs as follows: ADI 2.5mm, BDI 8.5mm, C1 6.5mm, C2 5.7mm, C3 6.3mm(6mmfor C1-3 for practical purposes), C4 11.7 and C5-7 17mm. Discussion: We believe that the increase in distances with age may be affected by the height losses of discs and vertebral bodies, formation of anterior osteophytes and regional kyphosis by age. Those results were compatible with the previous reports. (C) 2016 Elsevier Inc. All rights reserved.Publication Metadata only Gastric perforation post cardiopulmonary resuscitation in a non-cardiac arrest patient: A case report(2021-11-28) SANRI, ERKMAN; AKOĞLU, HALDUN; DENİZBAŞI ALTINOK, ARZU; ŞEN, TUNAHAN; ONUR, ÖZGE ECMEL; KUDU E., Görman Ö., ŞEN T., YAKIN F., ÜNAL E., SANRI E., AKOĞLU H., ONUR Ö. E., DENİZBAŞI ALTINOK A.Publication Metadata only Determination of the chest wall thicknesses and needle thoracostomy success rates at second and fifth intercostal spaces: a cadaver-based study(W B SAUNDERS CO-ELSEVIER INC, 2016) DENİZBAŞI ALTINOK, ARZU; Ozen, Can; Akoglu, Haldun; Ozdemirel, Rifat Ozgur; Omeroglu, Elif; Ozpolat, Cigdem Ulubay; Onur, Ozge; Buyuk, Yalcin; Denizbasi, ArzuIntroduction: The purposes of this study were to measure the chest wall thicknesses (CWTs) at second intercostal space (ICS) mid-clavicular line (MCL) and fifth ICS MAL directly, and compare the actual success rates of needle thoracostomies (NTs) by inserting a 5-cm-long syringe needle. Predictive values of weight, body mass index (BMI) and CWT were also analyzed. Materials and Methods: This study included 199 measurements of 50 adult fresh cadavers from both hemithoraces. Five-centimeter-long syringe needles were inserted and secured. Penetration into the pleural cavity was assessed, and CWTs at 4 locations were measured. Achieved power of this study for the primary aim of CWT comparison from 2nd and 5th ICSs was .94. Results: Overall mean CWTs at 2nd ICS MCL and 5th ICS MAL were measured as 2.46 +/- 0.78 and 2.89 +/- 1.09, respectively, and 5th ICSMAL was found to be statistically thicker (P - .002). The success rate of NT at 2nd ICS MCL was 87% (95% CI, 80-94), and that at 5th ICSMAL was 78% (95% CI, 70-86; P = .3570). Only 6 (17.1%) of 35 failed NTs had a CWT greater than 5-cm. Needle thoracostomy has failed in 29 (14.9%) of 194 locations, despite a CWT less than 5-cm. Below a weight of 72 kg, BMI of 23 kg/m(2), or CWT of 2.4 cm, all NTs were successful. Discussion and Conclusions: In this report, we present the largest cadaver-based cohort to date to the best of our knowledge, and we observed a statistically nonsignificant 9% more NT success rate at 2nd ICS at a power of 88% and statistically significant more success rate in males at 5th ICS was (47.7%). We also observed thinner CWTs and higher success rates than previous imaging-based studies. A BMI of 23 kg/m(2) or less and weight of 72 kg or less seem to accurately rule-out NT failure in cadavers, and they seem to be better predictors at the bedside. (C) 2016 Elsevier Inc. All rights reserved.Publication Metadata only Diagnostic accuracy of the Extended Focused Abdominal Sonography for Trauma (E-FAST) performed by emergency physicians compared to CT(W B SAUNDERS CO-ELSEVIER INC, 2018) DENİZBAŞI ALTINOK, ARZU; Akoglu, Haldun; Celik, Omer Faruk; Celik, Ali; Ergelen, Rabia; Onur, Ozge; Denizbasi, ArzuIntroduction: The diagnostic accuracy of the FAST exam performed by EM residents were shown to be similar to radiology residents. However, in the last 2 decades, an extended-FAST (E-FAST) protocol including thoracic examination to exclude pneumo- and hemothorax was introduced. The accuracy of emergency physicians (EPs) while performing E-FAST is a less studied area especially in Europe. The aim of this study was to compare the diagnostic accuracy of the E-FAST exam performed by EM residents with the results of CT scan as a gold standard. Methods: This was a prospective, observational, diagnostic accuracy study conducted at the ED of a Level 1 Trauma Center. All consecutive adult multiple trauma patients were eligible, and any patient in whom thoraco-abdominal CT was ordered were recruited. Unstable and unavailable patients were excluded. E-FAST examination was performed by EPs as the index test, and CT examinations reported by a blinded academic radiology faculty was the gold standard. Results: A total of 140 patients were recruited from eligible 144 patients. The final study population was 132 for abdominal and 130 for thorax examinations. In this study, AUC of E-FAST was 0.71 for abdominal free fluid, 0.87 for pneumothorax and 1.00 for pleural effusion. The sensitivity was 42.9% and specificity was 98.4%. The + LR for abdominal free fluid was 26.8 and -LR was 0.58. Conclusion: E FAST examination has an excellent specificity. However, the sensitivity of the test is not high enough to rule out thoraco abdominal injuries in trauma patients when performed by EPs. (C) 2017 Published by Elsevier Inc.