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Öğe Effectiveness of the Full Outline of UnResponsiveness Score in Patients With Acute Ischemic Stroke(Springernature, 2022) Atis, Seref Emre; Bozan, Oner; Ferhatlar, Mehmet Esat; Kalkan, AsimBackground Predicting the mortality and prognosis of patients with stroke is one of the commonly studied topics. Various scoring systems have been used in this regard. One of them is the Full Outline of UnResponsiveness (FOUR) score. In this study, we aimed to investigate the utility of the FOUR scores in terms of their ability to predict hospital stay duration and mortality in patients who were diagnosed with ischemic stroke upon their admission to the emergency department. Methods Our study is a prospective observational study. Patients who were admitted to the emergency department of a tertiary hospital and diagnosed with ischemic stroke between August 1, 2020, and August 1, 2021, were included in the study. The inclusion criteria were as follows: being over the age of 18, being diagnosed with ischemic stroke, having symptoms that started within the last 48 hours, and patient consent approved by the patients themselves or their relatives. The patients were divided into two groups according to the FOUR scores (FOUR score = 16 and FOUR score < 16). Patients' demographic information, vital parameters, symptoms, time to admission, comorbidities, laboratory parameters, length of hospitalization, mortality, and Glasgow Coma Scale (GCS), FOUR, and National Institutes of Health Stroke Scale (NIHSS) scores were recorded. Results A total of 79 patients were included in the current study, of which 47 (59.5%) were male. The patients included in the present study had a mean age of 66 +/- 13 years. When the two groups of patients with a FOUR score of 16 and a FOUR score of below 16 were compared, the mean platelet count was found to be 248 +/- 70 x 103/L in the former group and 170 +/- 84 x 103/L in the latter (p = 0.004). Sixty-five (91.5%) of the patients in the group with a FOUR score of 16 and three (37.5%) of the patients in the group with a FOUR score of less than 16 stayed for more than six hours in the hospital (p < 0.001). When the patients were evaluated for intensive care unit (ICU) admission rates, five (62.5%) patients with a FOUR score of <16 were admitted to the ICU. This rate was 2.8% (n = 2) in the group of patients with a FOUR score of 16 and was found to be significantly lower (p < 0.001). Conclusion The FOUR score was found to be useful in predicting the ICU admission rate of patients with ischemic stroke. It has also been shown that the admission time was shorter in patients with a lower FOUR score, and platelet counts were also lower in this group.Öğe Evaluation of brain oxygenation by near infrared spectroscopy in healthcare professionals using surgical and ffp2/n95 masks(2022) Bozan, Öner; Atıs, Seref Emre; Çekmen, Bora; Karakısa, Halit; Karaaslan, Edip Burak; Ferhatlar, Mehmet Esat; İslam, Mehmet MuzafferAim: The present study aimed to detect changes in brain oxygenation associated with the use of surgical and FFP2/N95 masks using the near infrared spectroscopy (NIRS) method. Material and Methods: Volunteers wearing surgical masks were asked to sit upright for 30 minutes. Cerebral oxygen saturation values were measured at the 1st, 5th, and 30th minutes (group 1). The mask wearers were requested to return at the same time on the day following this procedure. In group 2, serial cerebral oxygen saturation values (SpO2) were obtained at the same time intervals as in group 1, but while the subjects were wearing FFP2/N95 masks. Results: A statistically significant difference was found between the groups in the comparison of the values measured using NIRS at the 1st, 5th, and 30th minutes in group 1. According to the post-hoc analysis, this difference was due to discrepancies in NIRS measurements at the 1st minute and 30th minute and at the 5th minute and 30th minute. No statistically significant difference was found between the groups in the comparison of the values measured using NIRS at the 1st, 5th, and 30th minutes in group 2. Conclusion: Neither surgical nor FFP2/N95 masks caused a clinically significant negative difference in brain oxygenation.Öğe A new biomarker in the differential diagnosis of epileptic seizure: Neurogranin(W B Saunders Co-Elsevier Inc, 2022) Kalkan, Asim; Demirel, Ahmet; Atis, Seref Emre; Karaaslan, Edip Burak; Ferhatlar, Mehmet Esat; Senturk, MucahitAim: The aim of this study was to determine the level of serum NGRN in epilepsy patients presenting at the Emergency Department with complaints of an epileptic seizure, and to thus evaluate the utility of this biomarker in the differentiation of epilepsy and PNES patients from each other. Material methods: The study included patients aged >18 years who had experienced an epileptic seizure or were experiencing an epileptic seizure proven with EEG. All patients with brain disease of structural or infectious cause were excluded from the study (dementia, stroke, intracranial mass, meningitis, encephalitis, Creutzfeldt-Jacobs disease, abscess, etc). Patients were also excluded if they had traumatic brain injury or a severe systemic disease such as sepsis, which was thought to impair brain blood flow. The control group was formed of completely healthy volunteers. Results: Evaluation was made of a total of 49 patients, comprising 19 (38.78%) males and 30 (61.22%) females, and a control group of 53 healthy volunteers comprising 28 (52.83%) males and 25 (47.17%) females. The serum neurogranin value was median 184.16 ng/dl (range: 110.1-1172.98) in the patient group and 97.90 ng/dl (range: 73.71-282. 11) in the control group. The serum neurogranin value was determined to be statistically significantly higher in the patient group than in the control group (p < 0.005). Conclusion: The differential diagnosis of ES from PNES remains a challenging situation for emergency service physicians. Based on the findings of this study, it can be said that the serum NRGN level is high in patients who have experienced an epileptic seizure. Therefore, this new biomarker can be considered for use in the differential diagnosis of epileptic seizure and PNES. (c) 2022 Elsevier Inc. All rights reserved.
