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Öğe EFFECTS OF DRUG USE ON THE DEVELOPMENT OF DIABETIC KETOACIDOSIS(Carbone Editore, 2015) Koyuncu, Murat; Ozturk, Derya; Altinbilek, Ertugrul; Yapar, Nikola; Karakisa, Halit; Kavalci, Cemil; Ikizceli, IbrahimIntroduction: Diabetic Ketoacidosis (DKA) is a condition in which the body must use adipose and protein deposits as intracellular energy sources due to a lack of insulin. In the current study, we aimed to investigate the effects of drug use on the development of DKA and on clinical parameters in patients who presented to the Emergency Department (ED) with the diagnosis of DKA. Materials and methods: This study was retrospectively conducted in Sisli Etfal Training and Research Hospital between October 1, 2011 and March 31, 2013. The following parameters were recorder for each patient: age, gender, complaints, history of drug use, cause of DKA, pH, HCO3 levels, time spent in the ED, treatment outcomes and hospitalization durations. Results: The mean age of the patients was 42.61 +/- 8.6 years, and 58% (n=43) of them were female. 20.3% (n=15) of the patients were drug free. 63.5% (n=47) of the patients were followed up with in the ward, 12 (16.5%) were followed up with in the ED and 20% (n=15) were followed up with in the intensive care unit (ICU). The mean duration of stay in the ED was 15 hours, and the mean hospitalization time was 10 days. The mortality rate was 2.7%(n=2). When the effects of the drug use on DKA were examined, there were no statistically significant differences between the patients in terms of acidosis condition, mortality, clinic of hospitalization and durations of follow-up and treatment (p>0.05). The most important factor causing ketoacidosis was the presence of infection (40.5%, n=30), while the most common symptom was nausea/vomiting (51.4%, n=38). Conclusion: We observed that in patients with DKA, drug use does not affect mortality and morbidity.Öğe Mushroom Poisoning in a Metropolitan Hospital(Emergency Medicine Physicians Assoc Turkey, 2014) Koyuncu, Murat; Ozturk, Derya; Benli, Ali Ramazan; Altinbilek, Ertugrul; Sahin, Harun; Serin, Mehmet; Ikizceli, IbrahimObjective: We aimed to investigate suspected cases of mushroom poisoning that were admitted to the emergency department of a metropolitan education and research hospital. Material and Methods: Suspicious cases of mushroom poisoning and determined mushroom poisoning patients were investigated in the medical records of patients who were older than 18 years old in 1 year. We examined patient's demographic information, admission date, complaints, time of complaint starting, and clinical and laboratory findings. Treatments and results were evaluated. Results: We analyzed 74 patients who were diagnosed with mushroom poisoning. The most common complaints of the patients were nausea and vomiting. Increases in the number of admission were observed in November and December. A total of 25 patients were externed from emergency medicine, and 39 patients were hospitalized. 5 patients treatment with hemodialysis and both of them died. Conclusion: Mushroom poisoning is known to vary according to seasonal distribution, type of mushroom, geographic shape, and climate of the region. Therefore, emergency physicians should investigate the characteristics and ecology of the region and the geographic shape, so that provision services can facility the emergency departments principles working and organizated. The importance of regional characteristics is lost in a metropolitan hospital.Öğe Splenic Infarction as a Rare Cause of Chest Pain(Aves, 2015) Koyuncu, Murat; Kostekci, Senol Kadir; Ozturk, Derya; Altinbilek, Ertugrul; Okay, Meryem; Ekinci, NihatThis report reviews literature on splenic infarction. It also describes the case of a 27-year-old female who was bedridden because of a muscular disease and who was admitted to the emergency department with chest pain. She experienced continuous squeezing and compressing pain, which originated from the lower left hemithorax and radiated to the left axilla. A splenic infarct was detected after 24 h follow-up in the emergency room. Emergency physicians should keep in mind that chest pain originating from the lower left thorax and radiating to the left shoulder can be a sign of splenic infarction.Öğe Successful application of acute cardiopulmonary resuscitation(Wolters Kluwer Medknow Publications, 2015) Ozturk, Derya; Altinbilek, Ertugrul; Koyuncu, Murat; Sonmez, Bedriye Muge; Caltili, Cilem; Ikizceli, Ibrahim; Kavalci, CemilObjective: To compare the quality and correct the deficiencies of cardiopulmonary resuscitation (CPR) procedures performed in patients who developed cardiopulmonary arrest before or after Emergency Department admission. Methods: This study was conducted on patients who were applied CPR at Sisli Etfal Training and Research and Research Hospital, Emergency Department between 01 January 2012 and 31 December 2012. Chi-square and Mann-Whitney U test were used to compare the patients' data. The study data were analyzed in SPSS 18.0 software package. A P value less than 0.05 was considered statistically significant. Results: A total of 155 patients who were applied CPR were included in the analysis. Among the study patients, seventy eight (50.3%) were brought to Emergency Department after developing cardiopulmonary arrest while 77 (49.7%) developed cardiopulmonary arrest at Emergency Department. The mean age of the study population was (66 +/- 16) years and 64% of the patients were male. The initial rhythms of the CPR-applied patients were different (P < 0.05). There were no significant differences between the groups with respect to the treatment protocols or CPR responses (P > 0.05). The CPR response time was longer in ED (P < 0.05). The survival rate was lower in the trauma patients who developed cardiopulmonary arrest at ED (P < 0.05). Conclusions: The scientific data obtained in this study suggest that an early response and therapy improves outcomes in CPR procedure.
