Person: AKOĞLU, HALDUN
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AKOĞLU
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HALDUN
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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 Neoadjuvan kemoterapi uygulanan meme kanserli olgularda güvenli tümör-meme ucu mesafesini meme MR öngörebilir mi?(2022-02-24) UĞURLU, MUSTAFA ÜMİT; AKMERCAN, AHMET; BUĞDAYCI, ONUR; KAYA, HANDAN; AKOĞLU, HALDUN; GÜLLÜOĞLU, MAHMUT BAHADIR; UĞURLU M. Ü., AKMERCAN A., BUĞDAYCI O., KAYA H., AKIN TELLİ T., AKOĞLU H., GÜLLÜOĞLU M. B.Publication Open Access A national Internet survey on rapid sequence intubation patterns from Turkey(2008) DENİZBAŞI ALTINOK, ARZU; Guneysel, Ozlem; Onur, Ozge Ecmel; Akoglu, Haldun; Eroglu, Serkan; Denizbasi, ArzuAIM: To determine which specialty was performing rapid sequence intubation (RSI) in the emergency departments and to determine drug preferences of emergency physicians during RSI in Turkey. METHOD: All emergency departments were contacted via e-mail, and the chiefs of the departments were requested to answer a survey consisting of six questions. Hospitals within the specified regions were selected with the only inclusion criteria being that the hospital had an emergency medicine department. We determined that there were 32 university and 9 state hospital emergency medicine residency programs. RESULTS: Thirty-five emergency departments responded. In 31 (73%) departments emergency medicine physicians, in 4 (10%) departments anesthetists, and in 7 (17%) departments physicians of either specialty were routinely performing RSI. The most commonly preferred drugs were fentanyl for premedication, vecuronium for defasciculation, etomidate for induction, and succinylcholine for neuromuscular blocking. CONCLUSION: In the majority of the emergency departments in Turkey, emergency medicine physicians perform the RSI; the anesthetists perform it in only a few departments.Publication Metadata only Earliest electrocardiogram is golden for the diagnosis of Brugada Syndrome(W B SAUNDERS CO-ELSEVIER INC, 2013) DENİZBAŞI ALTINOK, ARZU; Celik, Omer Faruk; Akoglu, Haldun; Eroglu, Serkan; Onur, Ozge; Denizbasi, ArzuCardiac syncope can be classified as being either structural or dysrhythmogenic in origin, and it may be the only warning symptom of sudden cardiac death. One of the causes of dysrhythmic sudden cardiac death in young adults with structurally normal hearts is Brugada syndrome. Electrocardiogram (ECG) of Brugada syndrome is characterized by an ST-segment elevation in the right precordial leads. A 23-year-old man was presented to our emergency department (ED) with a history of syncope which has occurred 30 minutes before arrival and lasted for 10 minutes. Both physical and neurological examinations were unremarkable. Family history revealed coronary artery disease of his father and sudden death at 45. Initial ECG performed 3 minutes after his arrival showed a type 2 repolarization variant of Brugada syndrome. This pattern was reverted back to normal 5 minutes later and never showed up again on his future ECGs. In our case, it was only the earliest ECG that made the diagnosis possible since all future ECGs showed a perfectly normal pattern throughout the follow-up period. In all syncope patients, initial ECGs should be kept and filed to be reviewed again in case the primary physician is not competent enough for the evaluation of ECG.Publication 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 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 Do Prehospital Resuscitations Performed by Medical Emergency Services Make a Difference? A Report on Resuscitations Performed in an University Hospital(2015) DENİZBAŞI ALTINOK, ARZU; Salçin, Emre; Eroğlu, Serkan Emre; Özen, Can; Akoğlu, Haldun; Onur, Özge; Deni̇Zbaşi, Arzu; Ci̇Mi̇Lli̇ Öztürk, Tuba