Person: AKOĞLU, HALDUN
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AKOĞLU
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HALDUN
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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 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 effects of adrenomedullin in traumatic brain injury(ELSEVIER SCIENCE INC, 2013) DENİZBAŞI ALTINOK, ARZU; Demir, Hasan; Onur, Ozge E.; Denizbasi, Arzu; Akoglu, Haldun; Eroglu, Serkan E.; Ozpolat, Cigdem; Akoglu, EbruTraumatic brain injury (TBI) is a common cause of death and disability throughout the world. A multifunctional peptide adrenomedullin (AM) has protective effects in the central nervous system. We evaluated AM in an animal model as a therapeutic agent that reduces brain damage after traumatic brain injury. A total of 36 rats was divided into 3 groups as sham, head trauma plus intraperitoneal (ip) saline, and head trauma plus adrenomedullin ip. The diffuse brain injury model of Marmarou et al. was used. Blood samples were taken from all groups at the 1st, 6th and 24th hours for analysis of TNF-alpha (tumor necrosis factor-alpha), IL-1 beta (interleukin-1 beta) and IL-6 (interleukin-6) levels. At the end of the study (at the 24th hour) a neurological examination was performed and half of the rats were decapitated to obtain blood and tissue samples, the other half were perfused transcardiacally for studying the histopathology of the brain tissue. There were no statistically significant changes in plasma levels of IL-1 beta, IL-6 and TNF-alpha relative to the sham group. Also, changes in tissue levels of malonedialdehyde, myeloperoxidase and glutathione were not statistically significant. However, neurological scores and histopathological examinations revealed healing. AM individually exerts neuroprotective effects in animal models of acute brain injury. But the mechanisms of action remain to be assessed. (C) 2013 Elsevier Inc. All rights reserved.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 Unknown 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 Unknown Diagnostic utilities of tracheal ultrasound and USB-endoscope for the confirmation of endotracheal tube placement: A cadaver study(W B SAUNDERS CO-ELSEVIER INC, 2018) DENİZBAŞI ALTINOK, ARZU; Sanri, Erkman; Akoglu, Ebru Unal; Karacabey, Sinan; Verimli, Ural; Akoglu, Haldun; Sehirli, Umit; Denizbasi, ArzuObjectives: Confirmation of the endotracheal tube placement (CoETP) has the utmost importance in the management of an airway. Visualization of tracheal rings or carina with a fiber-optical bronchoscope (FOB) has considered to be a reliable method for the CoETP. However, FOB is expensive, time-consuming, and not always practical. Inexpensive endoscopic USB-cameras were shown to aid intubation successfully and reliably. On the other hand, there have been no studies investigating their use for the CoETP. Tracheal ultrasonography (TUS) is also a new, inexpensive and widely available alternative. A cadaver study has planned to evaluate the diagnostic utility of TUS and a USB-camera. Methods: This study was conducted in the Anatomy Lab of a University on a fresh frozen female cadaver. Three senior Emergency Physicians have intubated the cadaver, and performed TUS or USB-endoscopy. We have prepared a randomized intubation list (n = 96) in three blocks (3 times 32) as to include equal number of esophageal and tracheal intubations (48 for each). Each EP is performed all three interventions (intubation, TUS and USB-endoscopy) in consecutive blocks of 32 intubations, in turn. The position of the tube has been verified from a 2 cm wide ostium on the proximal trachea. Results: In this study, all intubations (n = 96, 100%) were correctly identified as tracheal or esophageal with both TUS and USB-camera. Both the sensitivity and specificity of TUS and USB-endoscopy for the CoETP were 100.0%. Conclusion: The perfect accuracy of TUS and USB-endoscopy, have placed those techniques in a unique position as an alternative in resource-poor situations. (C) 2018 Elsevier Inc. All rights reserved.Publication Unknown 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.