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Öğe Aggression and violence towards health care providers - A problem in Turkey?(2007) Erkol, Hayri; Gökdoǧan, Mira Rana; Erkol, Zerrin; Boz, BoraHealth care providers are increasingly concerned about the escalating incidence of verbal and physical abuse to healthcare staff. Factors, such as long wait in hospital areas, which lead to client frustration over an inability to obtain needed services promptly, are influencing these situations. Nonetheless, incidents of this nature can cause immense psychological harm as well as physical damage among medical employees. The current study aimed to ascertain from staff members aggressive experiences in the workplace, and the effects on the individual. The results of this study mirrored those of similar surveys in Turkey. Non-reporting was revealed as a major problem. Respondents believed they were treated less seriously than similar incidents involving private citizens. Accordingly, staff criticized hospital managers, the police, and the courts for their attitude about assaults towards hospital employees. They reported feeling vulnerable to abuse and there was a general desire for training in preventing and protection. These include teaching staff breakaway techniques, increasing the number of trained security officers on duty, issuing personal alarms, and encouraging staff to officially report all incidents. © 2007 Elsevier Ltd and FFLM.Öğe Allele distribution data for 16 short tandem repeat loci in Bolu(2010) Tuğ, Ayşim; Erkol, Zerrin; Çetinyürek, Aysun; Alakoç, Yeşim Doğan; Elma, Cüneyt; Büken, Bora; Erkol, HayriAim: To examine the short tandem repeat (STR) data of Bolu population and compare the data with previously published population studies and with the data of a neighboring province, Düzce (a former district of Bolu), which became a province after the earthquake in 1999. Materials and methods: Blood samples were taken from 175 unrelated individuals. DNA was isolated using a DNA Kit and the amplification was performed using an AmpFℓSTR Identifier kit. Genotyping was carried out by an ABI Prism 310 genetic analyzer by using a reference ladder. Several parameters, such as allele frequencies, Hardy-Weinberg equilibrium, power of exclusion, power of discrimination, pairwise comparison, were calculated and correction test was used to confirm significant differences found in the comparative analysis. Results: According to their power of exclusion and power of discrimination values, the most discriminating loci were D18S51 and D2S1338 whereas TPOX appears to be the least. The most discriminating loci and paternity index were found to be different in Bolu and its former district, Düzce, which is an interesting result. Conclusion: The results indicate the importance of local population studies, because in regions where migration occurs and marriages between members of different ethnic groups are not socially acceptable, genetic data are affected.Öğe Analysis of trauma patients in a rural hospital in Turkey(Turkish Assoc Trauma Emergency Surgery, 2011) Kahramansoy, Nurettin; Erkol, Hayri; Kurt, Feyzi; Gürbüz, Necla; Bozgeyik, Murat; Kıyan, AysuBACKGROUND There is a grey zone about the epidemiology of trauma in eastern Turkey. The present study was aimed at obtaining data on this subject. METHODS Trauma patients who applied to the emergency department (ED) between January 2006 and December 2007 were analyzed. RESULTS There were 6183 patients, of whom 87% were male. The mean age was 26.2 +/- 13.6 years. Assault was the most common cause (63.2%). Motor vehicle injury (MVI) and fall were encountered at frequencies of 21.2% and 6.5%, respectively. The most frequently injured body regions were head-neck and extremities. The majority of patients were managed and discharged from the ED (89.8%) with no consultation (81.8%). Interestingly, the discharge rate of assault cases was 98.7%. Patients were hospitalized (4.2%) mostly for MVI (32.6%) and fall (19%); however, hospitalization rates for firearm and piercing/cutting injury (36.1% and 16.7%) were significantly high. Among the transported patients (5.3%), the rates of MVI and fall were high (41.5% and 24.3%, respectively). In groups, for burn and firearm injuries, these were 42.1% and 24.1%, respectively. Forty-eight patients (0.8%) died, mostly from MVI by number, but by self-infliction and firearm by rate (8.3% and 6%). CONCLUSION Assault cases caused an excessive trauma patient density in the ED, as 98.7% were discharged from the ED. Further studies are needed regarding the high rate of assault cases.Öğe Could red cell distribution width be a marker of thyroid cancer?(Coll Physicians & Surgeons Pakistan, 2017) Aktaş, Gülali; Şit, Mustafa; Karagöz, İbrahim; Erkuş, Edip; Özer, Bahri; Koçak, Mehmet Zahid; Yaman, Semih; Keyif, Fatih; Altınordu, Rabia; Erkol, Hayri; Şavlı, HalukObjective: To study red cell distribution width (RDW) values, a novel inflammatory marker in routine hemogram, of patients with benign or malignant thyroid nodules and to compare with healthy population. Study Design: Descriptive study. Place and Duration of Study: Abant Izzet Baysal University Hospital, Bolu, Turkey, from November 2015 and February 2017. Methodology: The hemogram values of patients undergone thyroid surgery for thyroid nodule between November 2015 and February 2017 were retrospectively analyzed, and compared to those in healthy subjects. Subjects with infectious or inflammatory diseases were excluded. Patients' characteristics and laboratory data were obtained from institutional computerized database. Preoperative hemogram values of thyroid nodule patients were recorded. One-way ANOVA and Kruskal-Wallis tests were performed to compare variables with significance at p<0.05. Results: Median RDW of malignant nodule group was 15.8 (12.9-19.5) and was significantly higher than both of those in benign nodule (15) and control groups (14), (p<0.001). Conclusion: Elevated RDW in patients with thyroid nodules in preoperative period should alert the physician for possible malignancy and this cost-effective marker also can help support other modalities (ultrasound scan, and fine needle aspiration biopsy) to distinguish malignant from benign nodules.Öğe Death caused by malignant hyperthermia: Two case reports(2012) Erkol, Zerrin; Ertan, Ayşegül; Öz, Hüseyin; Erkol, Hayri; Şeker, AliBu yazıda, malign hipertermi nedeniyle gelişen iki ölüm olgusu sunuldu ve olguların nitelikleri literatür verileri ışığında tartışıldı. Olgu 1: 24 yaşında erkek hasta lomber disk hernisi nedeniyle ameliyat salonuna alınmıştı. Operasyonun 30. dakikasında taşikardi (120/dk), takiben bradikardi ve ameliyatın 45. dakikasında kardiak arrest gelişmişti. Resusitasyon sonrasında 39.5°C (103.1°F) ölçülen ateş, kısa sürede 40°C (104°F)’ye yükselmiş, CPK-MB yüksek bulunmuştu. Olgu operasyonun yedinci günü kaybedilmişti. Olgu 2: 27 yaşında erkek hasta rinoplasti uygulanmak üzere ameliyata alınmıştı. Birkaç dakika sonra, nabzın 50/dk’ya düşmesi nedeniyle yapılan atropini takiben nabız ve kan basıncı yükselen, SpO2 değeri %96’dan %90’a düşen olgunun ateşi 41°C (105.8°F) ölçülmüş, CPK-MB değeri yüksek bulunmuştu. Olgu anestezinin başlangıcından yedi saat sonra kaybedilmişti. Olguların tıbbi ve adli belgeleri Adli Tıp Kurumu Birinci ve Üçüncü Adli Tıp İhtisas Kurulu’nda incelendi. Her iki olguda da ölümün malign hipertermiye bağlı olarak meydana geldiği kararına varıldı.Öğe The effects of low thyroid hormone levels on the formation of stress gastritis: An experimental study on the rats(2008) Maralcan, Göktürk; Erkol, Hayri; Erkol, Zerrin; Yanar, Fatih; Plevin, RebeccaBACKGROUND The aim of this study was to investigate the effect of low circulating thyroid hormone levels on the development of acute stress gastritis in rats. METHODS Sixty adult Sprague-Dawley rats were divided into six groups: Control group, surgically thyroidectomized group, stressed group, surgically thyroidectomized + stressed group, surgically thyroidectomized + T4 + stressed group, and surgically thyroidectomized + T3 + stressed group. Damage to the gastric mucosa was studied using millimetric acetate papers on photographs enlarged 3.5 times and the number and the size of the lesions was recorded. RESULTS Acute stress gastritis was significantly increased in stress + surgically thyroidectomized rats as compared to rats that were only put under stress (group III) (stress gastritis scores; group IV: 44, group III: 16, p<0.001). The stress gastritis score in group VI was significantly decreased compared to rats in group IV ( stres gastritis scores; group VI: 10, group IV: 44, p<0.001). CONCLUSION Low circulating thyroid hormone levels in rats increased the development of stress gastritis. This effect could be prevented by thyroid hormone replacement therapy.Öğe Effects of lycopene in intestinal ischemia reperfusion injury via intestinal immunoglobulin A(ACADEMIC PRESS INC ELSEVIER SCIENCE, 2021) İkiz, Özgür; Kahramansoy, Nurettin; Erkol, Hayri; Koçoğlu, Esra; Fırat, TülinBackground: Intestinal ischemia causes an inflammatory response that may become intense by reperfusion and result in bacterial translocation. Intestinal immunoglobulin A is known to be a barrier against bacterial translocation. Lycopene is a compound with antioxidant and anti-inflammatory properties. We hypothesized that lycopene has positive effects in ischemia-reperfusion of the intestine through the intestinal IgA. Material and methods: Twenty-eight Wistar albino rats were separated into four groups: sham, control, lycopene-administered-before-ischemia (L-pre), and lycopene-administered-after-reperfusion groups. Histopathologic changes, intestinal immunoglobulin A levels, and bacterial translocation were evaluated after the ischemia-reperfusion period of 0.5-12 h. Results: Histopathologic changes, intestinal immunoglobulin A, and bacterial translocation levels in the L-pre group were similar to those in the sham group. Administration of the lycopene after reperfusion showed just a slight protective effect. However, the L-pre group had significantly fewer histopathologic changes when compared with changes in the control (P = 0.011). Intestinal immunoglobulin A level in the L-pre group was found to be higher than that in the control group (P = 0.014). Bacterial translocation levels in the blood and mesenteric lymph nodes, in the L-pre group, were lower than those in the control group (P = 0.0027 and P = 0.0097, respectively). Conclusions: Lycopene limited intestinal damage, reduced loss of intestinal immunoglobulin A and decreased bacterial translocation when administered before the ischemia-reperfusion injury.Öğe Elevated neutrophil-to-lymphocyte ratio in the diagnosis of Hashimoto's thyroiditis(Assoc Medica Brasileira, 2017) Aktaş, Gülali; Şit, Mustafa; Dikbaş, Oğuz; Erkol, Hayri; Altınordu, Rabia; Erkuş, Edip; Şavlı, HalukObjective: Hashimoto's thyroiditis (HT) is an autoimmune inflammatory disorder. The purpose of this study was to determine the neutrophil-to-lymphocyte ratio (NLR), a novel marker of inflammation, in patients with HT and to compare these values with those from healthy subjects. Method: A total of 154 participants were included in the study, 90 HT patients and 64 healthy volunteers. Retrospectively, demographic and laboratory data of the subjects were obtained from our institution's database. Patients with active infection, diabetes mellitus, malignancy, other chronic inflammatory diseases, hematologic disorders and patients on aspirin or steroid treatment were excluded from the study. Values for complete blood count (CBC) and serum laboratory parameters of HT patients were the baseline values obtained at the time of HT diagnosis. Control subjects consisted of healthy volunteers who visited our institution for a routine check-up. Results: Age, gender and CBC parameters were not different between the HT group and the control group; however, the NLR of HT group (2.1 [1.3-5.8]) was significantly higher than the control group (1.9 [0.6-3.3]), p=0.04. Conclusion: Increased NLR may be useful as an indicator of the presence of HT, especially in complicated cases. NLR is inexpensive and easy to determine. Larger, prospective studies are required to determine its usefulness in assessing diagnostic potential and treatment outcomes in HT patients.Öğe Erişkin bir hastada gastrik volvulusa yol açan mobil dalak: Olgu sunumu(2012) Büyükaşık, Oktay; Hasdemir, Ahmet Oğuz; Kahramansoy, Nurettin; Çöl, Cavit; Erkol, HayriGezici dalağa bağlı gastrik volvulus erişkin yaşta çok nadir görülmektedir. Literatürde şu ana kadar sadece iki olgu bildirilmiştir. 82 yaşında erkek hasta bir haftadır bulantı, kusma, gaita yapamama yakınmalarıyla acil polikliniğimize başvurdu. Fizik muayenede ve bilgisayarlı tomografide sol alt kadranda düzgün konturlu solid kitle saptandı. Eksplorasyonda karın sol alt kadranını dolduran, üzerinde iki adet kitle olan, 13x13x15 cm ebadında kısmen iskemi alanları olan mobil dalak saptandı. Dalağın uzun pedikülünün mide antrum-korpus bileşkesi civarındaki bantlarla birlikte mideyi kardiyopilorik hat boyunca rotasyona uğrattığı ve gastrik pasajı engellediği saptandı. Splenektomi ve anterior gastropeksi yapıldı. Hasta postoperatif 6. günde sağlıklı bir şekilde taburcu edildi.Öğe Gastric Volvulus Associated with Wandering Spleen in Adult: Case Report(Derman Medical Publ, 2012) Buyukasik, Oktay; Hasdemir, Ahmet Oguz; Kahramansoy, Nurettin; Col, Cavit; Erkol, HayriGastric volvulus associated with wandering spleen is a rare diagnosis in adult ages. So far, only two cases have been reported in the literature. 82 year old male patients admitted to emergency department with complaint of nausea, vomiting and constipation. Physical examination and computerize tomography detected a big solid mass with regular contour which is full filling abdominal left lower quadrant. Exploratory laparotomy revealed a wandering spleen in sizes of 13x13x15 cm in the mentioned region. The spleen which had two masses on was partially ischemic. The stomach had rotated through cardiopyloric axis due to long pedicle of the spleen and adhesions neighborhood to corpoantral junction. Thus gastric passage was partialy obstructed. Splenectomy and anterior gastropexy were applied. The patient was discharged in health at 6th day postoperatively.Öğe Intra-abdominal lymphangiomyomatosis(Aves, 2006) Turkeli, Vildan; Sengul, Neriman; Senocak, Efsun; Erkol, HayriLymphangiomyomatosis (LAM) is a rare idiopathic disease characterized by hamartomatous smooth muscle proliferation of the lymph nodes, lymphatics, blood vessels as well as airways within the lung, mediastinum and abdomen. Extrapulmonary LAM is quite rare. We represent a case of retroperitoneal lymhangioma in a young man as the only radiological finding of LAM.Öğe İntraabdominal lenfanjiomyiyomatoz(2006) Türkeli, Vildan; Şengül, Neriman; Şenocak, Efsun; Erkol, HayriLenfanjiomyomatozis lenf nodülü, lenfatik ve kan damarlarında hamartamatöz karakterde düz kas hücre proliferasyonu ile giden akciğer, mediasten ve abdomende görülebilen nadir bir hastalıktır (1). Üreme çağındaki genç kadınların hastalığı olarak bilinir. Ekstrapulmoner yayılım oldukça nadir olup en sık renal anjiomyiyomlar görülür. Bu çalışmada genç erkek hastada intraabdominal yerleşimli lenfanjiomyiyomatoz olgusu sunulmuştur.Öğe Investigation of antiproliferative effect of Tarantula Cubensis extract against Hepatocellular Carcinoma(Wiley-Blackwell, 2015) Bayram, Recep; Karğı, Ertuğrul; Şit, Mustafa; Erkol, Hayri; Yavuz, Muhsine Zeynep; Bayram, Şaban; Şakar, Hakan; Benek, Bedri Selim; Gümüştekin, KenanÖğe Karsinomayı taklit eden ve kolo-kolik invajinasyona neden olan lipom(2006) Şengül, Neriman; Dinler, Kahraman; Boran, Çetin; Kalfaoğlu, Melike E.; Erkol, HayriKolonik lipomlar, oldukça ender görülmelerine rağmen kolonda non-epiteliyal tümörler arasında en sık rastlanılan selim yağ dokusu tümörleridir. Genellikle asemptomatiktirler ve görüntüleme çalışmalarında, kolonoskopi sırasında veya başka bir nedenle ameliyat edilen hastalarda insidental olarak saptanır. Nadir olarak konstipasyon, diayare, karın ağrısı, hematokezya, obstruksiyon gibi belirtiler görülebilir. Bu sunumda kolokolonik invajinasyona neden olmuş, klinik ve endoskopik olarak kolon karsinomuna benzer bulgular sergileyen, ancak bilgisayarlı tomografi bulgularıyla tanısı konulan ve histopatolojik olarak da kolonik submukozal lipom tanısı doğrulanan olgu sunulmaktadır.Öğe Lipoma causing a colo-colic intussusception and mimicking carcinoma(Aves, 2006) Sengul, Neriman; Dinler, Kahraman; Boran, Cetin; Kalfaoglu, Melike E.; Erkol, HayriColonic lipomas are relatively uncommon, although they are among the most common nonepithelial benign tumors of the colon. They are usually asymptomatic and often discovered incidentally on imaging studies, during colonoscopy, or in patients operated for other reasons. Rarely, appearing symptoms as if constipation, diarrhea, abdominal pain, bleeding, obstruction. We are presenting a case of colonic lipoma causing colo-colonic intussusception, in which clinical presentation mimicking carcinoma but diagnosed with computed tomography examination and verified with histopathology as lipoma in the left colon.Öğe Masif intraabdominal kanamaya yol açan metastatik matür teratom: Olgu sunumu(2011) Büyükaşık, Oktay; Hasdemir, A. Oğuz; Kahramansoy, Nurettin; Kılıçgün, H.Ali; Korkmaz, Tanzer; Çöl, Cavit; Erkol, Hayri; Yanık, SerdarTeratomlar nadir karşılaşılan olgulardır. Onyedi yaşında bir erkek hasta akut batın ve hipovolemik şok tablosu nedeniyle acil servise getirildi. Yapılan laparatomide batın içinde masif kanama, karaciğerde multipl metastatik lezyonlar ve retroperitonda aktif kanayan 5x3x3 cm boyutlarında kitle saptandı. Total eksizyon yapıldı. Patolojik tanısı metastatik matür teratom olarak rapor edildi. Skrotal ultrasonografide sağ testiste 2x1 cm boyutunda kitle saptandı. Hasta, tetkikleri henüz devam edilmekte iken, eksploratris laparatomiden sonraki 24. günde oluşan yeni bir kanama nedeniyle kaybedildi. Bu olgu nadir bir olguyu hatırlatmak ve tartışmaya açmak amacıyla sunulmuştur. -Abstract-Öğe Postcoital transvaginal evisceration after hysterectomy: A case report(2012) Büyükaşık, Oktay; Koç, Önder; Hasdemir, Ahmet Oğuz; Çöl, Cavit; Erkol, HayriTransvajinal evisserasyon(TVE) çoğunlukla postmenapozal ve vajinal cerrahi geçiren olgularda görülmektedir. Premenapozal olgularda ise histerektomi sonrası postkoital oluşmaktadır, iki ay önce total abdominal histerektomi geçiren 47 yaşındaki hasta koitus sonrası vajeninden barsak heniasyonu nedeni ile hastanemiz acil servisimize başvurdu ve acil operasyona alındı. Vajinal kuf transvajinal olarak sütüre edildi. Ardından laparoskopik eksplorasyon ve irrigasyon yapıldı.TVE oluşumu nedeni net değildir. Vajinal kafin kötü bir teknikle kapatılması, enfeksiyon, erken koitus, enterosel, radyoterapi ve kronik steroid kullanımı suçlanmaktadır. Tedavi yaklaşımı laparoskopik, açık, vajinal veya kombine yaklaşımlar şeklindedir. Vajinal yaklaşımla kaf sütürasyonu tedavi için yeterli olsa da abdomenin exploras-yonu ve vajinal flora kökenli peritonit oluşumunun engellenmesi için peritoneal irrigasyon ve drenaj uygulanması uygun bir yaklaşım olacaktır.Öğe The role of monocyte to lymphocyt ratio in predictingmetastasis in rectal cancer(2021) Çatal, Oğuz; Özer, Bahri; Şit, Mustafa; Aktaş, Gülali; Erkol, HayriAim: A lot of studies are being carried out to predict recurrence and metastasis in rectal cancer, which is a common type of cancerin general surgery practice. It is thought that MLR (monocyte to lymphocyte ratio) , an indice developed by division of monocytecount by lymphocyte count, may be a good marker to reflect the degree of tumor progression and predict prognosis. In our study, weinvestigated the role of MLR in predicting metastasis in rectal cancer. Materials and Methods: Fifty-seven patients diagnosed with rectal cancer in the Abant Izzet Baysal University general surgeryclinic between 2012 and 2016 were retrospectively investigated. Albumin, CRP(C reactive protein), Platelet, Neutrophil, Lymphocyte,Monocyte values were obtained as the inflammatory markers in the blood count test of the patients before neoadjuvant treatment. Results: In this study, 25 patients who underwent neoadjuvant chemoradiotherapy and underwent full postoperative follow-up wereevaluated. Eight of these 25 patients had metastasis until June 2019. There was a significant difference in monocyte and MLRvalues between groups with and without metastasis. Conclusion: This study is presented as a preliminary study. In our study, we showed that MLR value which measured beforeneoadjuvant therapy in rectum cancer patients may be useful in predicting metastasis development.Öğe Subtotal self-amputation of the penis and bilateral self-orchiectomy followed by suicide by hanging: Case report(Ortadogu Ad Pres & Publ Co, 2012) Erkol, Zerrin; Şirin, Gözde; Erkol, Hayri; Yılmaz, Rıza; İnce, Haluk; Konuk, NeşeWe presented a case that had self-amputated his penis partly, performed bilateral self-orchiectomy and then committed suicide. The case was a-80-year-old male with a urinary catheter for the last year for an urologic problem, who was using alprazolam for a psychiatric disorder. He had history of attempted suicide, one year ago. The victim was found by his wife hanged to the balcony railing. Distal 1/2 part of his penis was amputated and the penis amputate was found beside the body, as well as both of his testicles. In the autopsy examination, macroscopic examination of the amputated items revealed penile ecchymosis around the cut side of the skin and benign prostate hypertrophy and chronic prostatitis was diagnosed with microscopic examination of the prostate gland. The paper discussed the characteristics of the victim and the manner of the presented case; a genital self-amputation case followed by suicide or a failed suicide case completed by hanging method (a complex suicide case).Öğe Time related admissions and outcomes of trauma patient at an emergency department(2012) Kahramansoy, Nurettin; Erkol, Hayri; Gürbüz, Necla; Kurt, Feyzi; Korkmaz, Tanzer; İkiz, ÖzgürAcil servise (AS) hastaların başvuru zamanı değişiklik gösterebilmektedir. Belirli zamanlarda hasta yoğunluğu artışı, hastaların morbiditesi ve mortalitesi üzerine olumsuz etki yapabilir. Bu çalışmanın amacı, hastaların travma özelliklerinin ve çıkışlarının zamanla ilişkili olarak dağılımının araştırılmasıdır. Gereç ve Yöntem: Bu retrospektif, kesitsel bir çalışmadır. Ocak 2006 – Aralık 2007 arasındaki dönemde, Türkiye’nin doğusundaki bir AS’e başvuran tüm travma hastalarını kapsamaktadır. Bulgular: Tüm hastaların dağılımı, doktor başına günlük 230 hasta idi. İncelenen travma hasta sayısı 6185 idi. Aylık hasta sayısı ve vücut bölgelerine göre yaralanma oranları yaz aylarına doğru artış gösterdi. En çok Ağustos ayında %31.9 ile baş boyun yaralanması görüldü. Günlük dağılım açısından darp ve trafik kazası sırayla Perşembe (%68) ve Cuma (%25.5) günleri en sık idi. Yaralanma bölgesi olarak sadece torakodorsal yaralanmalar pazar gününde (%9.2) belirgin yüksek idi. AS çıkışlarının günlük dağılımı farklı değildi. AS’e başvuru sayısı, saat 05:00-07:59 arasında (?1.3%) düşüktü ve 08:00’dan itibaren artarak saat 17:00’da pik yaptı (8.6%) ve günün ilerleyen saatlerinde tekrar azaldı. Travma mekanizmalarının günlük dağılımı da benzer eğriye sahipti. Yatışı yapılan ve sevk edilen hastaların oranları, saat 00:00-06:59 arasında belirgin düşüktü. Ölümlerin dağılımı gün içinde dengeli olmakla birlikte %42.6’sı saat 13:00- 18:59 arasında gerçekleşti. Sonuç: AS’te hasta yükü fazladır. Bu durum yaz mevsiminde ve akşama doğru en yüksekteydi. Ayrıca bu zamanlarda yatış ve sevk sayısı da yüksekti. AS’in özellikle yoğun olduğu zamanlarda her çeşit personel ve teknik donanımla desteklenmesi gerekli gözükmektedir.
