Browsing by Author "Akbulut, G"

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    Data Analysis of 1811 Major Trauma Patients Admitted to the Emergency Departments of Thirteen Hospitals
    Yaldiz, D; Akbulut, G; Anil, M; Öztan, MO; Yaldiz, S
    Objective: Our objective was to determine metrics and measure the trauma-related emergency care quality. Methods: Patients with majortrauma admitted to emergency departments of 13 hospitals in the north region of Izmir between January 01, 2014, and December 31, 2014, were included in this study. For the definition of major trauma, guideline of Centers for Disease Control (CDC) for field triage of injured patients version 2011 was used. Age, time passed in emergency, first order timing, number of consultations and amount of time taken by the consultations, number of deaths in emergency departments and intensive care units, number of radiological tests applied to patients, total score of interventional applications, and total billing were recorded. Results: In one-year period, 2,415,361 patients applied to selected hospitals' emergency departments, and 1811 patients (0.07%) were accepted as major trauma. The mean age of the patients was 29.4 years. The meantime passed in emergency was 28.3 h. The mean number of consultations and amount of time taken by consultations were 1.6 and 26.2 h, respectively. The number and mean X-ray, ultrasound, computerized tomography, and magnetic resonance imaging numbers were 3910 and 2.16; 518 and 0.29; 2805 and 1.55; 114 and 0.06, respectively. The total mortality rate was 1.04% (19 patients). Conclusion: This is a preliminary study presenting the data obtained from different level hospitals in the region, and indicators in such a high number of patient group were evaluated for the first time. We believe that as national emergency care is built and strengthened with data, management of care for patients with trauma will improve.
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    Biochemical changes representing oxidative stress on brain tissue due to intraabdominal hypertension in a rat model
    Karabekir, HS; Guzey, FK; Balci, C; Guvenc, Y; Onur, E; Akbulut, G; Serteser, M
    Introduction: Intraabdominal hypertension affects the central nervous system in addition to respiratory, renal and cardiovascular systems. This effect that, investigated in detail by clinical and experimental studies, is due to the increase of intracranial pressure and decrease of cerebral perfusion pressure caused by the increase of intrathoracic pressure and increase of pressure of great veins. However, no study has been found on biochemical changes on central nervous tissue due to intraabdomial hypertension. Material and methods: Thirty rats were divided into three groups containing 10 animals: sham group, study group I and study group II. In group 1, intraabdominal pressure was elevated to 20 mmHg, and in group 11, it was elevated to 30 mmHg for 60 minutes. Intracranial pressures (ICP) in all animals were monitored. Values of biochemical parameters including thiobarbituric acid, nitrite oxide, xanthine oxidase, protein carbonyls and protein sulfhydryl in cortical, subcortical, cerebellar and spinal cord tissues were compared with the corresponding values in sham rats. Results: Thiobarbituric acid (0.58 +/- 0.8 and 0.76 +/- 0.04 vs. 0.23 +/- 0.03, p < 0.05 and p < 0.001), nitrite oxide (3.11 +/- 0.10 and 8.4 +/- 0.54 vs. 1.52 +/- 0.18, p < 0.05 and p < 0.001), xantine oxiclase (1.55 +/- 0.11 and 3.01 +/- 0.25 vs. 0.32 +/- 0.09, p < 0.001) and carbonyl levels (1.41 +/- 0.01 and 1.69 +/- 0.01 vs. 1.22 +/- 0.03, p < 0.001) of the various central nervous system regions and ICP were increased. SH levels (92.60 +/- 2.50 and 74.60 +/- 3.80 vs. 139.20 +/- 4.72, p < 0.001) were decreased after intraabdominal hypertension, and higher IAP generally caused more detrimental effects on these parameters. The levels of spinal cord and cerebellum samples were significantly worse in the study groups for most of the markers. Conclusions: Intraabdominal hypertension may cause biochemical changes representing oxidative stress on various regions of central nervous system even 60 minutes after increase of intraabdominal pressure, and higher IAH causes more detrimental effects. Most prominent effects were seen in spinal cord and cerebellar tissue suggesting that compression of lumbar vertebral venous pressure might have a rote in addition to increase of ICP due to increase of pressure of great veins caused by increase of intrathoracic pressure.