Browsing by Author "Şaşmaz M.İ."

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    Evaluation and comparison of patients poisoned with acetaminophen and nonsteroidal anti-inflammatory drugs
    (Yuzuncu Yil Universitesi Tip Fakultesi, 2019) Çelik A.; Şaşmaz M.İ.
    We aimed to determine and compare the clinical and demographical features, treatments, follow-up, poisoning scores and outcome of cases with the acetaminophen and NSAIDs intoxication. Data of the patients who were at the age of 18 and older and applied to the Emergency Department with the acetaminophen or NSAIDs intoxication were retrospectively examined. The cases were divided into 2 groups as the acetaminophen and NSAIDs group. The cases‟ age, gender, drug dose, hospitalization status and periods, poisoning scores (PSS, APACHE-II) and last conditions in discharging from the hospital were compared. The döşe was taken by 99 (55%) patients in the acetaminophen group was calculated as toxic, and intravenous acetylcysteine was administered to 70 (38.9%) patients as an antidote. When the APACHE-II scores of the patients hospitalized in the intensive care unit were examined, the mean APACHE-II score of 54 patients in the acetaminophen group was 3.15±3.70, the mean APACHE-II score of 34 patients in the NSAIDs group was 4.15±3.13 and it was statistically higher (p=0.031). All the patients followed-up in both groups were discharged with healing except only 1 (0.6%) patient who developed acute liver failure. Conclusion: The mean APACHE-II score was low in both groups. Therefore, following-up the patients in a unit such as a toxicology unit instead of the intensive care unit can be beneficial in terms of both reducing the place and labor force loads and cost. Moreover, the acetylcysteine treatments in the early period of the acetaminophen toxicity are very effective in decreasing the mortality and morbidity. © 2019, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
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    Kinesiotaping for isolated rib fractures in emergency department
    (W.B. Saunders, 2020) Akça A.H.; Şaşmaz M.İ.; Kaplan
    Introduction: Rib fractures, which are among the most common injuries in blunt thoracic trauma, are usually encountered in Emergency Departments. Kinesiotape (KT) is a drug-free elastic therapeutic tape used for treating various musculoskeletal problems such as injury, dysfunction and pain. We aimed to investigate whether kinesotaping should be used safely and effectively in rib fractures in emergency setting. Materials and methods: This was a prospective, randomized controlled study conducted in an Emergency Department of a University Hospital. Patients diagnosed with isolated rib fractures were included in the study. Pain severity of patients assessed with 0–10 cm visual analog scale (VAS), then patients assigned into 2 treatment groups. One of them received treatment with flurbiprofen 200 mg/day and the other group received kinesiotaping in addition to the same oral therapy. On the 4th day of the procedure, both groups were assessed with VAS in the followup visit. Results: Total of 82 patients presented with rib fractures, 52 of them were excluded. Remaining 30 constituted the study group and randomly allocated to kinesiotaping (n = 16) or control group (n = 14). In both groups, pain intensity on the 4th day was significantly reduced when compared with baseline (p for both<0.01). Additionally, considering the reducing the pain intensity on 4th day, kinesiotaping was significantly superior than the control group (p < 0.01). Conclusion: This study investigated the use of kinesiotaping in emergency departments. When compared to NSAID therapy alone, combined kinesiotaping and NSAID therapy appears to be more effective in terms of pain reduction in rib fractures. © 2019 Elsevier Inc.
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    Aspartate-aminotransferase to platelet ratio index score for predicting HELLP syndrome
    (W.B. Saunders, 2020) Şaşmaz M.İ.; Ayvaz M.A.; Dülger A.C.; Kuday Kaykısız E.K.; Güven R.
    Introduction: HELLP (hemolysis, elevated liver enzyme levels, low platelet counts)-syndrome is a rare but dramatic pregnancy-related illness. The difficult part of this syndrome is the lack of standardised diagnostic criterias and tests to be used to predict it. The aim of this study is determining the role of APRI score in the diagnosis of HELLP syndrome. Material and methods: In this cross sectional, retrospective study, patients with HELLP syndrome as case group and age-matched healthy pregnants at the similar pregnancy trimester as control group were included between January 12,017 and May 31, 2018. Data including sex, age, laboratory values, prognosis were recorded from the computerized system of the hospital. The p-value <0.05 was considered statistically significant. Results: 40 patients with HELLP syndrome and 124 age-matched healthy pregnants included in the study. There was a statistically significant difference between control group and HELLP patients in terms of the mean urinary protein, platelet count, ALT, AST, creatinin, D dimer levels and also the mean APRI score. In the multivariate regression analysis, APRI score was found a better predictor than AST and both were in a good significant in predicting HELLP. On the ROC curve in order to distinguish the patients with HELLP from the control group for AST and APRI score, the sensitivity was found to be 71.7% and 82.6%, specificity to be 91.2% and 87.6% respectively. Maternal mortality rate of HELLP syndrome was 10%. Conclusion: We concluded that the APRI score was robustly predicted HELLP syndrome than AST alone in this study. Further studies are needed to support our data with prospective, multicentre, larger patient groups. © 2019 Elsevier Inc.
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    Prognostic value of lactate to hematocrit ratio score in patients with severe thoracoabdominal trauma; [Ciddi torakoabdominal travma hastalarında laktat-hematokrit oranının prognostik değeri]
    (Turkish Association of Trauma and Emergency Surgery, 2022) Demir B.; Şaşmaz M.İ.; Saglam Gurmen E.; Bilge A.
    BACKGROUND: Significant portion of trauma-related deaths occur in the 1st h; therefore, rapid diagnosis and adequate resuscitation in trauma patients are essential preventing mortality. In this study, we aimed to evaluate the role of lactate-to-hematocrite ratio (LHR) score for predicting mortality in patients with severe thoracoabdominal trauma. METHODS: In this retrospective, cross-sectional study, we evaluated patients who applied to the emergency room between January 1, 2016, and December 31, 2019, due to multiple trauma. We measured the blood gas analysis values and LHR score of patients with severe thoracoabdominal trauma included in the study and investigated the effectiveness of the LHR score in predicting mortality. RESULTS: 106 patients with severe thoracoabdominal trauma were included in the study. The 30-day mortality rate of the patients was 42.5% (n=45). Considering the 30-day mortality rates, the initial hematocrit, lactate, base deficit, and LHR score were statistically different between patients who died and survived. When the cutoff value for the LHR score was taken as 0.187 on the ROC curve to distinguish mortality, the sensitivity was found to be 77.8%, specificity to be 90.2%. CONCLUSION: LHR score is an effective parameter with high sensitivity and specificity in predicting mortality in patients with severe thoracoabdominal trauma. © 2022 Turkish Association of Trauma and Emergency Surgery.
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    Prognostic Value of Serum Neuron Specific Enolase and Pentraxin-3 In Acute Pulmonary Embolism
    (Yuzuncu Yil Universitesi Tip Fakultesi, 2023) Şaşmaz M.İ.; Tulay C.M.; Gurmen E.S.; Angin A.; Ulman C.
    The aim of this study is to investigate whether serum neuron-specific enolase (NSE) and pentraxin-3 (PTX-3) values are effective in the diagnosis and prognosis of acute pulmonary embolism. In addition, in the light of significant results, we aimed to determine a cut-off value for NSE and PTX-3 in acute pulmonary embolism and to try to determine the sensitivity-specificity in the diagnosis of pulmonary embolism according to these values. In this prospective study, patients who applied to the Emergency Department of Manisa Celal Bayar University School of Medicine between September 2019 and January 2021 and were diagnosed with acute pulmonary embolism constituted the study group and healthy volunteers without any chronic disease or drug use constituted the control group. Serum NSE and PTX-3 values of the patient and control groups were compared. In addition, demographic data, vital signs, laboratory findings, PESI (pulmonary embolism severity index) scores and prognoses of the patients were investigated. In this study 70 patients diagnosed with pulmonary embolism were included to the patient group. 36 (51.4%) of them were women and the mean age was 67.01 ± 14. 74 healthy volunteers were included to the control group; 45 of them (60.8%) were women and the mean age was 44.99 ± 12.85. In patient group the mean PTX-3 value of the was 1.753±1.91 ng/ml, the mean NSE value was 182.13±14.99 ng/ml. In control group, the mean PTX-3 value was 0.429±0.035 ng/ml, the mean NSE value was 166.51±5.14 ng/ml. While there was a statistical difference between two groups in terms of pentraxin-3 value, there was no difference in terms of NSE value. When the cut-off value of 1.115 ng/ml for serum pentraxin-3 in the ROC analysis in order to distunguish the patients with pulmonary embolism from the control group, sensitivity was found to be 58.6% and specificity to be 96%. In our study, we found that serum PTX-3 level is a powerful biomarker with high specificity in the diagnosis of acute pulmonary embolism and is positively associated with the severity and prognosis of the disease. Therefore, we believe that serum PTX-3 may be a guiding biomarker in the diagnosis and prognosis of acute pulmonary embolism in clinical practice. © 2023, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
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    Reply to Letter to the Editor: "Management of Ventricular Pseudoaneurysms"
    (Turkish Society of Cardiology, 2024) Şaşmaz M.İ.; Demir B.; Uçar M.; Avci A.
    [No abstract available]
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    Evaluation of Vertebral Fractures and Associated Injuries in Multiple Trauma Patients
    (Yuzuncu Yil Universitesi Tip Fakultesi, 2024) Cigerci Ç.; Şaşmaz M.İ.; Cigerci N.E.
    In this study, it was aimed to determine the accompanying organ injuries and their frequencies in trauma patients diagnosed with vertebral fracture in the emergency department. In this study, trauma patients aged 18 years and older and with at least one vertebral corpus fracture who applied to the Emergency Department of Hafsa Sultan Hospital of Manisa Celal Bayar University Faculty of Medicine between Januar y 2016 and December 2020 were retrospectively analyzed. In addition to vertebral fractures, the mechanism of trauma, accompanying organ injuries, the intervention and the prognosis of the patients were examined. Of the patients, %72 were male and the mean age was 46,07. The two most common trauma mechanisms causing vertebral fracture were falling from height and traffic accident. The vertebral region most affected by trauma was the thoracolumbar (28.7%) region. Compression fracture was detected in 52% of the patients, and burst fracture was detected in 19,3% of the patients. Neurological deficit was observed in 8% of the patients, and death in 3,4%. Thoracic injuries were detected in 41.3% of the patients, and extremity injuries in 26%, and these were the mo st common injuries accompanying vertebral fractures. In our study, concomitant cranial and maxillofacial injuries in cervical vertebral fractures and concomitant thoracic injuries in thoracic vertebral fractures were found to be significantly higher. Traffic accidents and falling from a height were determined as the two most common causes of vertebral fracture and were thought to be preventable causes. In addition, although distant traumas accompanied the affected vertebral region in vertebral fractures, it was observed that traumas of nearby structures were more common in general. © 2024, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.