Person: SANRI, ERKMAN
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SANRI
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ERKMAN
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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 Metadata only THE IMPACT OF HEAD OF BED ELEVATION ON OPTIC NERVE SHEATH DIAMETER IN CERVICAL COLLAR APPLIED HEALTHY VOLUNTEERS(ELSEVIER SCIENCE INC, 2019) SANRI, ERKMAN; Sanri, Erkman; Karacabey, SinanBackground: Guidelines recommend placing a cervical collar (c-collar) until spinal injury is excluded. Previous studies have shown that c-collar placement increases intracranial pressure (ICP), which can worsen outcomes for trauma patients who are at risk of increased ICP. Head of bed elevation (HBE) has been found to decrease ICP. However, there is no consensus in the literature for the optimal degree of HBE to decrease ICP. Objective: We aimed to find an optimal HBE degree to decrease ICP to its baseline values in healthy volunteers with increased ICP caused by c-collar. Methods: This is a randomized controlled and blinded study performed in healthy volunteers. Two sonographers measured the optic nerve sheath diameter (ONSD) of each subject's eyes separately for different time points. Then, we calculated a mean ONSD value for five time points: before c-collar placement (T-0), 5 and 20 min in supine position after c-collar placement (T-5 and T-20), and 5 and 20 min after HBE (T-25 and T-40). We randomized the subjects into three groups of HBE: 15, 30, and 45 degrees, and compared the mean ONSD values among groups. Results: All groups were similar with regard to baseline demographics and ONSD measurements before HBE. We found significant increases in mean ONSD values at T-5 and at T-20 caused by the c-collar. Thirty and forty-five degrees of HBE for 20 min decreased ONSD to its baseline values. The inter-rater reliability of the sonographers was > 0.9. Conclusions: Our results show that c-collar increases ONSD in healthy volunteers. Elevating the head of the bed 30 and 45 degrees for 20 min decreased ONSD to baseline values. (C) 2018 Elsevier Inc. All rights reserved.Publication Metadata only ULTRASOUND APPRAISAL OF OPTIC NERVE SHEATH DIAMETER IN CERVICAL COLLAR APPLIED HEALTHY VOLUNTEERS REPLY(ELSEVIER SCIENCE INC, 2020) SANRI, ERKMAN; Sanri, Erkman; Karacabey, SinanPublication Metadata only Aortic rupture secondary to blunt trauma(2021-11-28) SANRI, ERKMAN; DENİZBAŞI ALTINOK, ARZU; ÖZVARİNLİ H. M., Altun M., YAKIN F., TIRIŞ C., KURULAY İ., ÜNAL E., Demir H., SANRI E., DENİZBAŞI ALTINOK A.Publication Metadata only Disosiyatif anestezikler, narkotiklerin farmakolojisi ve endikasyon doz örnekleri(Türkiye Klinikleri Yayınları, 2022-01-01) SANRI, ERKMAN; KARACABEY, SİNAN; SANRI E., KARACABEY S.Publication 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 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 Methemoglobinemia treated with hyperbaric oxygen therapy: A case report(ELSEVIER SCIENCE BV, 2018-12) DENİZBAŞI ALTINOK, ARZU; Altintop, Ismail; Sanri, Erkman; Tatli, Mehmet; Akcin, Mehmet Emin; Denizbasi, ArzuMethemoglobinemia is a rare but clinically important condition that should be considered among differential diagnosis in cyanosis. The conventional treatments of methemoglobinemia are high flow oxygen and methylene blue therapies. We present a 52-year-old male patient who admitted to emergency room with severe cyanosis and dyspnea after he was exposed to paint thinner and zinc phosphate solution. The patient was diagnosed with methemoglobinemia with a MetHb level of 49.1mm/Hg in his arterial blood gas test. Patient's symptoms and increased MetHb levels were resistant to high flow oxygen and methylene blue therapies so hyperbaric oxygen therapy (HBO) as an alternative treatment was initiated and the patient was cured promptly. In this case presentation, we aim to discuss the alternative treatment modalities in methemoglobinemia patients with persistent hypoxia and cyanosis, who are unresponsive to standard methylene blue treatment. Copyright (C) 2018 The Emergency Medicine Association of Turkey.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 EVALUATION AND COMPARISON OF SCREENING TOOLS USED TO PREDICT THE ADVERSE OUTCOMES OF ELDERLY PATIENTS IN THE EMERGENCY DEPARTMENT(CARBONE EDITORE, 2021) SANRI, ERKMAN; Bahadirli, Suphi; Kurt, Erdem; Ak, Rohat; Kurt, Sebnem Zeynep Eke; Sanri, Erkman; Bulut, MehtapIntroduction: The proportion of the geriatric population, who visited the emergency departments (EDs) more frequently and with more complicated problems, is increasing every passing day. The use of screening tools to identify high-risk patients among elderly patients gains importance as it facilitates the selection of appropriate treatment and follow-up. In this study, we evaluate and compare the predictive ability of the Identification of Seniors at Risk (ISAR) and the Silver Code (SC) screening tools in Turkey. Materials and methods: Patients aged 65-year and over who visited our ED over a ten-month period were enrolled. ISAR and SC tools were applied to participants following the initial medical assessment. Receiver operating characteristic (ROC) analysis was used to evaluate the predictive ability of the tools in short and long-term adverse outcomes such as ED re-visit, hospitalization, and mortality. These evaluations were performed following the initial ED visit, 1 and 6-month after the initial ED visit. Results: The median (IQR) age of 497 participants was 73.0 (68.5, 79.0), and %53.9 were women. ISAR was slightly better than SC in predicting all adverse outcomes, except hospitalization following the initial visit, with poor-fair results [area under the ROC curves (AUCs) between 0.62-0.78]. SC was excellent in predicting hospitalization following the initial visit (AUC: 0.90) and poor in all other outcomes (AUCs between 0.58-0.71). Conclusion: Although the results of our study underline that SC was excellent at predicting hospitalization following the initial ED visit, both tools were insufficient to make decisions for other adverse outcomes. Of course, this does not mean that the tools have no clinical value; but indicates that they are not suitable for clinical decision-making on their own and need improvements.
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