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    Abdominal necrotizing fasciitis associated with severe clinical table
    (Mrs Deepika Charan, 2014) Şit, Mustafa; Ocak, Tarık; Duran, Arif; Karabekmez, Furkan E.; Çetin, Ayşe
    Necrotizing fasciitis is characterized by progressive tissue necrosis and a life-threatening severe soft-tissue infection of skin, subcutaneous tissue and fascia. The etiology includes trauma, surgery and injection. In this report, we aimed to present a morbid obese female patient diagnosed with incarcerated umbilical hernia and subsequent severe necrotizing fasciitis during follow-up and discuss with the literature.
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    Acil servisden akut koroner sendrom nedeniyle yatırılan hastaların birinci derece yakınlarının kalp hastalığı bilirlilik düzeyleri: Anket çalışması
    (2013) Ocak, Tarık; Duran, Arif; Öztürk, Serkan; Tekelioğlu, Ümit Yaşar; Erdem, Alim; Ayhan, Selim S.
    Amaç: Çalışmamızda, sağlık sektörü dışındaki genel popüla syonun miyokart enfarktüsü (MI) geçiren hastaların tanınması ve yapılması gereken ilk müdahale konusunda bilgi düzeyi ve yaklaşımlarını incelemeyi amaçladık. Yöntem: Araştırmacılar tarafından, MI geçiren kişilerdeki klinik bulgular ile ilk müdahalede yapılması gerekenleri sorgulayan bir anket oluşturuldu ve 250 gönüllü kişi tarafı ndan doldurulması sağlandı. Gönüllüler özellikle sağlık sektörü dışından seçildi. Bulgular : Katılımcılara sorulan "Sizce hastalıklara bağlı en sık ölüm nedir " sorusuna kadınların %45.1’i kalp krizi, %47.2’si kanser derken aynı soruya erkeklerin ise % 63.9’u kalp krizi, %22.2’si kanser cevabı verdiler. Katılımcıl a ra sorulan "Yalnız başınıza çevrenizde MI geçirdiğini düşü n düğünüz biri ile karşılaşırsanız ne yaparsınız? " sorusuna %92.4’ü acil servisi arayacağını (ka dınlarda %57, erkeklerde %40.7), %31,2’si hastanın bulu n duğu odayı havalandıracağını (kadınlarda %31.7, erkeklerde %30.6), %20.4’ü hastaya aspirin vereceğ ini (kadınlarda %21.8, erkeklerde %18.5), %7.6’sı ise ne yap acağı konusunda bilgisi olmadığını ifade etti (kadınlarda %7.2, erkeklerde %4.3). Sonuç : Bu çalışmanın sonucunda MI yaygınlığı ve mortalitesi konusunda özellikle kadınlarda farkındalığın daha az olduğu görülmüştür. MI’daki tipik bulgular konusunda göğüs ağrısı dışında diğer bulguların yeterince bilinmediği kanısına varılmıştır. MI ile karşılaşılacak bir durumda ise popülasyonun acil servisi arama dışında yapılması gerekenler konusunda yeterli bilgi seviyesine sahip olmadığı anlaşılmıştır. MI’ne müdahalede en önemli kısmı oluşturan tanı ve ilk müdahale konusunda toplum çapında yaygın eğitim programlarının uygulanması gerekli olduğunu düşünmekteyiz.
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    Acute parathyroid storm secondary to parathyroid adenoma: a case report
    (Mrs Deepika Charan, 2014) Duran, Arif; Dikbaş, Oğuz; Ocak, Tarık; Tekçe, Hikmet; Şengül, Neriman
    Hypercalcemic hyperparathyroid crisis is an infrequent but life threatening complication of main hyperparathyroidism. It is an infrequent manifestation for primary hyperparathyroidism by reason of parathyroid adenoma presenting with parathyroid storm. Acute hypercalcemic hyperparathyroid crisis is a rapidly developing syndrome characterized by severe hypercalcemia associated with life threatening disturbances in cardiac, renal, cerebral functions. This state should be doubted in acutely ill cases with gastrointestinal appearances, profound dehydration, changed mental state, urinary signs or cardiac arrhythmias. We offer this patients to give emphasis to the significance management of an acute hypercalcemic syndrome and early diagnosis as a result of primary hyperparathyroidism as a cause of an undefined adenoma of the parathyroid gland. We present this patients to give emphasis on early and rigorous treatment of hypercalcemic crisis as a result of parathyroid storm otherwise it could be fatal.
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    Cardiac Tamponade with Primary Certain Non-Malignancy in Clinic: Case Report
    (Duzce Univ, 2014) Duran, Arif; Ocak, Tarik; Usyeturk, Ummugul; Erdem, Alim; Onder, Husnu; Maltas, Mehmet Sakir
    Cardiac tamponade is a major life threatening condition characterized with accumulation of fluid in pericardial cavity which prevents heart contractions. Etiology includes trauma, renal failure, myocardial infarction, cardiovascular surgery, coronary angiography, and malignancies. Clinical signs vary depending on the development rate of tamponade. Malignancy related tamponade is caused by different factors that associated with the type and the extension of malignancy. We present a patient who admitted to our emergency department with cardiac tamponade caused by a malignancy of an unknown primary
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    Consciousness disturbance associated with severe hyponatremia : a case report
    (Ondokuz Mayıs Üniversitesi, 2013) Duran, Arif; Ocak, Tarık; Tekelioğlu, Ümit Yaşar; Tekçe, Hikmet; Akkaya, Akcan; Demirhan, Abdullah; Aktaş, Gülali
    Hyponatremia; a serious electrolyte disorder, frequently develops in the elderly and hospitalized patients with heart failure. Hyponatremia in patients with heart failure is usually in hypervolemic form characterized by increased total body sodium and water. However, rarely, hypovolemic hyponatremia associated with actual sodium loss may occur in the clinical course. We present an extremely hypovolemic hyponatremia case in a patient with severe heart failure. Serum sodium value of the patient was 101mEq/L; which is exceptionally compatible with life. © 2013 OMU.
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    The Demographic Characteristics of Patients Admitted to the Emergency due to Low Back Pain
    (2015) Boyraz, İsmail; Duran, Arif; Koç, Bünyamin; Erkuran, Mansur Kürşad; Sarman, Hakan; Yazıcı, Selma
    Amaç: 2007-2015 yılları arasında bel şikayetiyle acile başvuran hastaların demografik özelliklerini incelemek istedik Gereç-Yöntem: Abant İzzet Baysal Üniversitesi Tıp Fakültesi Hastanesi ve Kamu Hastaneler birliğine bağlı acil servislere 2007- 2015 yılları arasında bel şikayetiyle acile başvuran hastalar retrospektif olarak kayıtlardan incelendi. Hastaların demografik özellikleri ve hasta bilgileri kayıtlardan elde edildi. Acile başvurduğunda ilk teşhisi bel olan hastalar çalışmaya dahil edildi. Travma veya kaza geçiren, akut kırık teşhisi konulmuş olan hastalar incelemeye dahil edilmedi. Hastaların yaş, cinsiyet, başvuru zamanının hangi saat, gün, ay, yıl ve mevsimde olduğu, acilde ne kadar kaldığı ve başka servise sevk edilmişse hangi bölüme sevk edildiği ve orda kaç gün yattığı incelendi. Cerrahi servislerden birine sevk edilmişse cerrahi yapılıp yapılmadığı kaydedildi. Bulgular: Bel ağrısı teşhisiyle acile başvurmuş ve tedavi almış toplam hasta sayısı 43233 idi. Bunlardan 22372 hasta yaklaşık % 51.7’si erkek, 20861 hasta yaklaşık %48.3’ü kadındı.11 hasta Genel cerrahiye nakledilmiş, 14 hasta Ortopedi ve Travmatoloji servisine, 3 hasta Kadın Hastalıkları ve Doğum servisine, 1 hasta üroloji servisine, 1 hasta Göğüs Cerrahisi servisine, 699 hasta Beyin Cerrahi servisine yatırılmış. 5 hasta Algoloji, 3 hasta Çocuk Hastalıkları, 20 hasta Enfeksiyon Hastalıkları, 89 hasta Fizik Tedavi ve Rehabilitasyon, 9 hasta Dahiliye, 5 hasta Kardiyoloji, 11 hasta Nöroloji, 1 hasta Yoğun Bakım servisine yatırılmıştır. Sonuç: Hastanın anemnezi ve fizik muayenesi çok iyi yapılırsa gereksiz tetkik ve tedavilerin önüne geçilmiş olur. Yapılacak geniş çaplı çalışmalar sayesinde acil hekimlerinin karşılaşabilecekleri bel ağrılı hastadaki teşhis ve tedavi stratejisinin belirlenmesi konusunda izleyecekleri bir paradigma oluşturulabilir.
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    The diagnostic significance of NT-proBNP and troponin I in emergency department patients presenting with palpitations
    (Hospital Clinicas, Univ Sao Paulo, 2013) Ocak, Tarık; Erdem, Alim; Duran, Arif; Tekelioğlu, Ümit Yaşar; Öztürk, Serkan; Ayhan, Suzi Selim; Özlü, Mehmet Fatih; Tosun, Mehmet; Koçoğlu, Hasan; Yazıcı, Mehmet
    OBJECTIVE: This prospective study investigated the diagnostic significance of the N-terminal pro-brain natriuretic (NT-proBNP) and troponin I peptides in emergency department patients presenting with palpitations. METHODS: Two groups of patients with palpitations but without documented supraventricular tachycardia were compared: a group with supraventricular tachycardia (n = 49) and a control group (n = 47). Both groups were diagnosed using electrophysiological studies during the study period. Blood samples were obtained from all of the patients to determine the NT-proBNP and troponin I levels within the first hour following arrival in the emergency department. RESULT: The mean NT-proBNP levels were 207.74 +/- 197.11 in supraventricular tachyarrhythmia group and 39.99 +/- 32.83 pg/mL in control group (p<0.001). To predict supraventricular tachycardia, the optimum NT-proBNP threshold was 61.15 pg/mL, as defined by the receiver operating characteristic (ROC) curve, with a non-significant area under the ROC curve of 0.920 (95% CI, 0.86-0.97, p<0.001). The NT-proBNP cut-off for diagnosing supraventricular tachycardia had 81.6% sensitivity and 91.5% specificity. Supraventricular tachycardia was significantly more frequent in the patients with NT-proBNP levels >= 61.15 pg/mL (n = 44, 90.9%, p>0.001). The mean troponin I levels were 0.17 +/- 0.56 and 0.01 +/- 0.06 pg/mL for the patients with and without supraventricular tachycardia, respectively (p<0.05). Of the 96 patients, 21 (21.87%) had troponin I levels >= 0.01:2 (4.25%) in the control group and 19 (38.77%) in the supraventricular tachycardia group (p<0.001). CONCLUSION: Troponin I and, in particular, NT-proBNP peptide were helpful for differentiating supraventricular tachycardia from non-supraventricular tachycardia palpitations. Further randomized, large, multicenter trials are needed to define the benefit and diagnostic role of NT-proBNP and troponin I in the management algorithm of patients presenting with palpitations in emergency departments.
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    Effect of montelukast on acute lung injury induced by intestinal ischemia and reperfusion in rats
    (Carbone Editore, 2014) Terzi, Elçin Hakan; Duran, Arif; Fırat, Tülin; Ocak, Tarık; Kükner, Aysel
    Aims: Lungs are the most affected remote organs after intestinal ischemia/reperfusion. The aim of our study is to investigate the effects of montelukast on intestinal ischemia/reperfusion-induced acute pulmonary injury, mast cells, and apoptosis. Materials and methods': Wistar Albino rats were used in the study. Control, intestinal ischemia/reperfusion (IIR), and IRR+montelukast groups, each comprising six rats, were constructed. Ischemia was induced by ligating the superior mesenteric artery for 60 min, followed by 60 min of reperfusion. Montelukast at a dose of 7 mg/kg was administered intraperitoneally 10 min before reperfusion. Lung tissues were fixed in neutral formalin. Paraffin sections were stained with hematoxylin-eosin and toluidine blue to assess mast cells. Pulmonary damage was graded, and mast cells were counted. Apoptotic cells were examined by terminal deoxynucleotidyl transferase dUTP nick-end labelling (TUNEL) staining. Results: Thickening of the inter-alveolar wall, capillary congestion, haemorrhage, edema, and accumulation of numerous inflammatory cells around the vessels were observed in the lung specimens of the IIR group. Wall thickness, edema, haemorrhage, and inflammatory cell infiltration were less severe in the montelukast-treated group. The number of mast cells and apoptotic cells with positive TUNEL staining was found to be increased in the IRR group and decreased in the montelukast-treated group. Conclusion: Montelukast alleviated tissue damage and reduced the number of mast cells and apoptotic epithelial cells caused by IIR-induced acute pulmonary injury. These results suggest a new approach for the prevention or treatment of secondary lung injury.
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    The effect of stretcher type on safety and ease of treatment in an emergency department
    (Tubitak Scientific & Technical Research Council Turkey, 2013) Duran, Arif; Öztürk, Hayrettin; Tekelioğlu, Ümit Yaşar; Ocak, Tarık; Emet, Mücahit
    Aim: Stretchers are frequently used to transport patients in the emergency department. Safety and comfort of the stretcher are important factors for the staff and patients. The present study investigated the effect of stretcher type on patient safety and treatment in an emergency department. Materials and methods: Doctors, nurses, interns, emergency medical technicians, and patient caregivers at the Abant Izzet Baysal University Medical Faculty Hospital emergency department completed a questionnaire on stretcher safety and comfort. Six stretchers were classical (group A), 6 had new technological specifications (group B), and 6 stretchers in group C were similar to those in group B in terms of technological specifications but were more expensive. Results: A total of 139 questionnaires were completed between 15 January and 29 February 2012 (group A: 42; group B: 66; group C: 31). We found statistically significant differences in ratings between group A and groups B and C (P < 0.05); however, no significant difference was found between groups B and C (P > 0.05). Conclusion: The safety and comfort of stretchers with satisfactory ergonomics and moderate cost are similar to those of higher-priced stretchers.
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    Efficacy of aprotinin treatment on bilateral blunt chest trauma created in rab
    (2013) Kaya, Halil; Kafali, Mehmet Ertugrul; Aydin, Kemal; Kocak, Sedat; Sahin, Mustafa; Duran, Arif; Gul, Mehmet
    Objectives: To investigate the effects of aprotinin, on blood gasses, oxidant-antioxidant status, and lung histopathology in an experimental bilateral blunt chest trauma model. Methods: Conducted at the Experimental Animal Laboratory of Meram Medical School at Selcuk University, Konya, Turkey, the study comprised 21 New Zealand female albino rabbits who were divided into three groups. Trauma was applied on the sham and aprotinin groups, which was administered intravenous Aprotinin 20.000 U/kg. Arterial blood samples were obtained from all rabbits at hours 0, 3, 24, and 96. At hour 96 after trauma, all rabbits were sacrificed using the decapitation method, and then blood and lung tissue samples were obtained. Blood nitric oxide, malondialdehyde and blood gas measurements were made. Histopathological changes in the lung were examined with a light microscope. Results: While no positive effect of aprotinin was observed on nitric oxide malondialdehyde and partial pressure of carbon dioxide values, it was seen to have an increasing effect on partial oxygen pressure level. Aprotinin had a partial effect on lung histopathology. Conclusion: Aprotinin was determined to have a positive effect on PO2 levels. We could not find any positive effects especially on alveolar haemorrhage.
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    Efficacy of aprotinin treatment on bilateral blunt chest trauma created in rabbits
    (Pakistan Medical Assoc, 2013) Kaya, Halil; Kafalı, Mehmet Ertuğrul; Aydın, Kemal; Koçak, Sedat; Şahin, Mustafa; Duran, Arif; Gül, Mehmet; Cander, Başar; Top, Hatice; Erdem, Sami
    Objectives: To investigate the effects of aprotinin, on blood gasses, oxidant-antioxidant status, and lung histopathology in an experimental bilateral blunt chest trauma model. Methods: Conducted at the Experimental Animal Laboratory of Meram Medical School at Selcuk University, Konya, Turkey, the study comprised 21 New Zealand female albino rabbits who were divided into three groups. Trauma was applied on the sham and aprotinin groups, which was administered intravenous Aprotinin 20.000 U/kg. Arterial blood samples were obtained from all rabbits at hours 0, 3, 24, and 96. At hour 96 after trauma, all rabbits were sacrificed using the decapitation method, and then blood and lung tissue samples were obtained. Blood nitric oxide, malondialdehyde and blood gas measurements were made. Histopathological changes in the lung were examined with a light microscope. Results: While no positive effect of aprotinin was observed on nitric oxide malondialdehyde and partial pressure of carbon dioxide values, it was seen to have an increasing effect on partial oxygen pressure level. Aprotinin had a partial effect on lung histopathology. Conclusion: Aprotinin was determined to have a positive effect on PO2 levels. We could not find any positive effects especially on alveolar haemorrhage.
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    Emergency upper gastrointestinal endoscopy at the emergency department of İzzet Baysal hospital: analysis of 269 patients
    (Medical Association of Zenica-Doboj Canton, 2013) Duran, Arif; Ocak, Tarık; Öztürk, Hayrettin
    To evaluate the epidemiological characteristics, etiology, and therapeutic outcome of gastrointestinal disorders in 269 patients who underwent emergency upper gastrointestinal (EUGI) endoscopy at the Emergency Department. Abdominal pain was the most common clinical indication, in 90 (33.5%) patients. The clinical reasons for emergency admission were signiicantly related to endoscopic diagnostic yield. Non-erosive gastritis was the most common diagnosis, in 76 (28.3%) of EUGIE patients. Erosive duodenitis and gastric ulcer were found to be the other most common clinical indications, in 69 (25.7%) and 31 (11.5%) of EUGIE patients, respectively. The majority of patients who presented with abdominal pain and loss of appetite were between the age of 41 and 60 years, while a signiicant number of patients presenting with the same symptoms did so during the winter season. Emergency endoscopy is a procedure of choice for the investigation of upper gastrointestinal complaints. Emergency endoscopy is not only a diagnostic tool but also a therapeutic modality.
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    Evaluation of patients with Crimean-Congo hemorrhagic fever in Bolu, Turkey
    (Makerere Univ, Fac Med, 2013) Duran, Arif; Küçükbayrak, Abdülkadir; Ocak, Tarık; Hakyemez, Necati İsmail; Taş, Tekin; Karadağ, Mustafa; Mengeloğlu, Zafer Fırat
    Background: Crimean-Congo hemorrhagic fever (CCHF), which is associated with a high mortality rate in the Black Sea region of Turkey, has received increasing attention. Objective: In this study, the epidemiological features, clinical and laboratory findings, treatments, and outcomes of patients diagnosed with CCHF between 2006 and 2012 based on data obtained from the Bolu Provincial Directorate of Health (BPDH) were evaluated. Methods: BPDH data were reviewed for the period between 1 January 2006 and 31 July 2012. The locations where the tick had attached to the patient, the site of the tick bite on the patient's body, the dates of tick bite and removal, and the demographic characteristics of each patient were recorded. BPDH data on the total number of tick bites, patients with confirmed CCHF, and deaths due to CCHF in Bolu Province during the study period were also evaluated. Results: A total of 46 patients with CCHF and 38 patients without CCHF but who had been bitten by ticks were admitted to the BPDH. Of the patients with CCHF, 54.3% were female. The mean age of the patients was 46.88 +/- 2.05 years (range, 1-79 years). The mortality rate was 8.82%. Patients were predominantly observed in June and July. When the patients were distributed according to their occupations, the majority was houswife (48.6%), followed by animal husbandry worker (27.0%), farmer (10.8%), health worker (5.4%), and other (8.1%). The symptoms of the patients with CCHF included fatigue (60.9%), fever (60.9%), and myalgia (60.9%). Of those patients with CCHF, 41.3% were determined to have a high fever. Conclusions: The probability of developing CCHF decreased as the duration of tick attachment increased. Moreover, although the clinical presentation is important, it is not diagnostic. Physical examination and laboratory findings become more specific in later stages.
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    Evaluation of patients with Tularemia in Bolu province in northwestern Anatolia, Turkey
    (J Infection Developing Countries, 2014) Mengeloğlu, Zafer; Duran, Arif; Hakyemez, İsmail Necati; Ocak, Tarık; Küçükbayrak, Abdülkadir; Akdeniz, Hayrettin; Taş, Tekin
    Introduction: Tularemia is a zoonotic disease caused by Francisella tularensis. Here we present an epidemic occurring in Bolu province, located in northwestern Anatolia in Turkey, and some features of the cases. Methodology: The data was provided by the Bolu Provincial Health Directorate. All of the antibody response tests were studied in the National Health Institute (formerly named Refik Saydam Hygiene Department), the reference laboratory of the Ministry of Health of the Turkish Republic. A total of 393 individuals were tested by microagglutination test (MAT) for tularemia between 2006 and 2011. A total of 218 patients whose demographical data were available were included in the study; 83 were accepted as the patient group and 135 were the controls. Of the patients, 31 (37.3%) were male and 52 (62.7%) were female. Results: Fever (p < 0.001), URTI symptoms (p = 0.047), conjunctivitis (p = 0.004), and rash (p = 0.026) were significantly higher in the patient group. A positive association was found between MAT and fever (r = 0.324; p < 0.001), and a negative association was found between MAT and both lymphoadenopathy (r = -0.25; p = 0.013) and chills (r = -0.218; p = 0.035). Higher MAT titers were detected in oropharyngeal tularemia (r = 0.306; p = 0.003). Conclusions: In conclusion, tularemia must be considered in differential diagnosis in patients presenting with fever and LAP in non-endemic regions. Furthermore, water sources and contact with rodents must be investigated.
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    Femoral diyaliz kateterine bağlı ölümcül retroperitoneal hematom
    (2013) Duran, Arif; Şit, Mustafa; Ocak, Tarık; Tekelioğlu, Ümit Yaşar; Akkaya, Akcan
    [No Abstract Available]
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    Frequency of MEFV mutation and genotype-phenotype correlation in cases with dysmenorrhea
    (Wiley-Blackwell, 2013) Ocak, Zeynep; Ocak, Tarık; Duran, Arif; Özlü, Tülay; Kocaman, Ertuğrul Mevlüt
    AimWe aimed to investigate the relation between mutations and polymorphisms playing roles in the onset of clinical findings of Familial Mediterranean Fever (FMF) and clinical phenotypic reflections manifesting with painful episodes, such as dysmenorrhea. Material and MethodsA total of 1000 female patients who had not responded well to non-steroidal anti-inflammatory drugs in the menstrual period, and who had presented to the emergency room with the complaint of recurrent pain episodes were included in the study. All the patients were Turkish women living in Istanbul. In this study, the mutations most frequently seen in the Mediterranean Fever Gene (MEFV), namely M694V, E148Q, M680I(G/C), V726A, P369S, R761H, A744S, M694I, K695R, F479L, M680I(G/A), and I692del were examined using the DNA sequence analysis following DNA isolation. ResultsThe number of individuals who had a mutation in at least one allele for FMF was 511 out of 1000 patients. Of these 511 patients, homozygous mutations were found in 21% (n=109), compound heterozygous mutations were found in 27% (n=136), and heterozygous mutations were found in 52% (n=266). The most frequent homozygous genotype seen in our study population was M694V/M694V. The most common compound heterozygote genotypes were M694V/M680I, M694V/V726A, M694V/E148Q, and M680I/V726A; and 11.7% (n=60) of the families in whom mutations were found had consanguinity. ConclusionWomen who present to the emergency room with the complaint of dysmenorrhea that is irresponsive to non-steroidal anti-inflammatory drugs may have several types of MEFV mutations that are responsible for FMF.
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    Hepatorenal syndrome associated with the use of reishi fungus
    (Aves, 2016) Ocak, Tarık; Duran, Arif; Katırcı, Yavuz; Erkuran, Mansur Kürşad; Kurt, Bekir Barış
    Introduction: Ganoderma lucidum, also known as red reishi mushroom, lingzhi, mannentake, and immortality mushroom, is the oldest known mushroom species used in Chinese and Japanese medicine for more than 2000 years. Case Report: In our presentation, we aim to discuss the case of a 64-year-old male with acute hepatorenal failure associated with the use of reishi mushroom. He was brought to our hospital with complaints of palpitation and anuria since two days and altered mental status since one day. Conclusion: Reishi mushroom may lead to hepatorenal failure. Just because of reasons mentioned above, legal sanctions and public education programs shall be organized to prevent this patient group from using herbal treatment as a result of overemphasized advertisements.
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    High antimicrobial resistance and isolated pathogens in outpatient elderly population with urinary tract symptom
    (Drunpp-Sarajevo, 2012) Küçükbayrak, Abdulkadir; Hakyemez, İsmail Necati; Taş, Tekin; Alçelik, Aytekin; Kemahlı, Eray; Duran, Arif; Aydemir, Bilge; Kocaoğlu, Esra
    Background: In this study, antibiotic sensitivities and uropathogens isolated from elderly outpatients to have least one urinary tract symptom were evaluated. Methods: The yielded bacteria of 344 urine samples were evaluated. Isolated pathogens were identified with classical methods and authomatized systems. Antibiotic susceptibilities were done by disc diffusion method. If need, authomatize system was used. Results: The ages of the patients were from 60 to 92, and mean age was 73.02. The male/female ratio was 147/197. The most common isolated 3 pathogens were Escherichia coli (80.52 %), Coagulase negative staphylococcus, and Enterococcus spp. In this study, the sensitivities to the antibiotics of E. coli were 59.92 %, 70.30 %, 64.98, 63.78, 86.44 % and 90.48 % for amoxicillin-clavulanate, cefuroxime-axetil, trimethoprim-sulphamethoxazole, ciprofloxa-cine, ceftizoxime and nitrofrontein, respectively. The sensitivities of amoxicillin-clavulanate, cefuroxime-axetil, trimethoprim-sulphamethoxazole, ciprofloxa-cine, ceftizoxime and nitrofrontein for male and female were 55.17-66.12,54.08-78.12, 50.00-73.29, 55.04-69.70, 76.00-91.56 and 80.00-91.71, respectively. The susceptibility rates of amikacin, gentamycin and ceftriaxone were 90.16 %, 78.94 % and 81.99 % as 89.21, 70.64 and 66.67 in male patients and 90.30, 70.64 and 88.52 in female patients. Conclusion: In the elderly outpatients, E. coli was the most common pathogen in the urine. The resistant rates in our region are higher from reported in literature. Nitrofrontein and amikacine can be started empirically for both gender. However, cefuroxime, ceftriaxone, ceftizoxime, cephazoline, and gentamycine for the female patients can be used empirically. We think that the male elderly patients should be treated with hospitalized.
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    Hyperbaric Oxygen Treatment for Visual Loss Due to Carbon Monoxide Intoxication: A Case Report
    (Emergency Medicine Physicians Assoc Turkey, 2013) Ocak, Tarik; Bastuerk, Mustafa; Aydin, Salih; Kemahli, Ozer; Abanoz, Mehmet Emre; Duran, Arif
    High oxygen (O-2) consuming organs such as the brain and the heart are easily affected by carbon monoxide (CO) intoxication. The most frequent changes are bilateral ischemic lesions and necrosis in the grey substance of brain tissue, particularly in the globus pallidus. Depending on the severity of intoxication, cerebral and cardiac findings may occur as well as visual impairment, although rare. Visual disorders may develop in patients recovering from coma. In this case report, we present a case with severe loss of vision consequent to CO intoxication, who demonstrated a complete response to long-term hyperbaric oxygen treatment.
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    The impact of the duration of admission to the emergency room on the mortality of intensive care patients
    (Medknow Publications & Media Pvt Ltd, 2014) Erkuran, Mansur Kürşat; Duran, Arif; Ocak, Tarık; Çıtışlı, Veli; Kaya, Halil
    Objective: There are many factors affecting the mortality of patients admitted to the intensive care unit (ICU). Among these are the patients age, diagnosis, and concomitant pathology. The aim of this retrospective study was to investigate whether there is an adverse effect of the time between admission to the Emergency Room (ER) and admission to the ICU on the mortality of these patients. Materials and Methods: The medical records of the patients who were admitted to the Emergency Department (ED) of the Bolu Izzet Baysal State Hospital and subsequently were admitted to the ICU between December 2009 and August 2011 were analyzed in terms of the time of admission, the season of admission, and the waiting and the stand-by times in the ER. Results: A total of 2380 patients, who were admitted to the ED of the Bolu Izzet Baysal State Hospital and subsequently to the ICU, were included in the study. The median waiting time in the ER was 1.23 h (10 min to 10.02 h). After completion of the admission procedures, the median hospitalization time in the ER was 0.16 h (3 min to 2.58 h). There was no statistically significant difference between the patients who died after admission to the ICU and the ones who survived, in terms of the waiting and the stand-by times in the ER ( P > 0.05). Conclusion: The waiting times at the ED did not affect the mortality of the ICU patients.