Browsing by Author "Gölcük Y."

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    Effect of renal failure on N-terminal pro-brain natriuretic peptide in patients admitted to emergency department with acute dyspnea
    (AVES Ibrahim Kara, 2014) Çolak A.; Çuhadar S.; Gölcük B.; Gölcük Y.; Özdoğan Ö.; Çoker B.
    Objective: Preexisting renal failure diminishes the excretion of N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP), therefore limits the diagnostic value of this peptide for concomitant heart failure. The aim of this study was to evaluate the association between NT-proBNP and the stages of renal dysfunction in a typical population attended to emergency department with acute dyspnea.; Methods: In this cross-sectional study, all consecutive patients with acute dyspnea underwent clinical evaluation, laboratory assessment of NT-proBNP, and echocardiographic examinations. Among subjects, 54.5% were diagnosed as heart failure. Grouping variables according to renal function capacity and ejection fraction, independent variables were compared with Kruskal-Wallis or ANOVA with posthoc tests. Correlation and linear regression analysis were done to analyze the variables associated with NT-proBNP. The diagnostic performance of NT-proBNP was evaluated by receiver-operating characteristic (ROC) curve. ; Results: Serum median NT-proBNP level in patients with severe renal impairment was significantly higher than moderate and mildly decreased renal functions (p=0.001). In patients with moderate and severe left ventricular failure, NT-proBNP was significantly higher compared with normal subjects (LVEF>50%) (p=0.040, and 0.017, respectively). Renal dysfunction was associated in 56% of patients with heart failure. The area under the ROC curve of NT-proBNP for identifying left ventricular failure in patients with renal failure (eGFR<90 mL/min/1.73 m2) was 0.649 and reached significant difference (95% CI:0.548-0.749, p=0.005).; Conclusion: In addition to NT-proBNP measurement in clinical judgement of heart failure, renal functions have to be taken into consideration to avoid misdiagnosis. ©Copyright 2014 by Turkish Society of Cardiology.
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    Epidemiological characteristics of geriatric patients in emergency departments: Results of a multicenter study; [Acil servislerdeki geriatrik hastalarin epidemiyolojik özellikleri: Çok merkezli çalişma sonuçlari]
    (Geriatrics Society, 2015) Ergin M.; Karamercan M.A.; Ayranci M.; Yavuz Y.; Yavaşi Ö.; Serinken M.; Acar T.; Avcil M.; Al B.; Bayramoğlu A.; Durgun H.M.; Gölcük Y.; Arziman İ.; Dündar Z.D.
    Introduction: The increasing proportion of elderly individuals in the population due to increased life expectancy has necessitated greater provision of health care. Here we aimed to determine patient characteristics, reasons for referral, and outcomes of emergency department visits and hospitalization in patients aged ?65 years with referrals to emergency departments. Materials and Method: This prospective, multicenter observational study was conducted over one week at the emergency departments of 13 Turkey hospitals. All patients aged ?65 years who were referred to emergency departments with acute medical or surgical issues during the study period were included. Patients aged <65 years or those referred for trauma were excluded. Results: In total, 1299 patients with a mean age of 74.8±7.3 years were included. Of these 51.9% (n=674) were aged 65–74 years, 67.5% (n=877) were discharged from the hospital and 5.8% (n=75) died during admission. The most frequently diagnosed disorders in the emergency departments were cardiovascular, gastrointestinal, and pulmonary diseases. A significant difference in age was observed between the survival and non-survival groups (p=0.001), with no significant differences in gender distribution (p=0.259), length of stay in intensive care units (p=0.605), or length of stay in hospital (p=0.055). Conclusion: With an increased proportion of elderly individuals in the general population the number of elderly patients referred to emergency departments continues to increase. This study presents the demographic features and clinical course of elderly patients referred to study centers. © 2015, Geriatrics Society. All rights reserved.
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    Multislice computed tomographic measurements of optic nerve sheath diameter in brain injury patients; [Beyin hasarı olan hastalarda çok kesitli bilgisayarlı tomografide optik sinir kılıfı ölçümleri]
    (Turkish Association of Trauma and Emergency Surgery, 2018) Özsaraç M.; Düzgün F.; Gölcük Y.; Pabuşcu Y.; Bilge A.; İrik M.; Yılmaz H.
    BACKGROUND: Currently, the measurement of optic nerve sheath diameter (ONSD) has been offered as a possible indicator of intracranial pressure (ICP). Increased ICP is observed during intracranial injury. The objective of this study was to evaluate the relationship between increased ONSD and positive intracranial findings from multislice computed tomography (CT) of the brain. METHODS: In total, CT scans of 161 patients were retrospectively reviewed. The image that showed the largest ONSD was magnified five times. RESULTS: The CT scan revealed intracranial lesions in 54 patients and no intracranial lesions in 107 patients. A significant relationship was observed between positive CT findings and increased ONSD: 5.60±0.75 mm vs. 5.35±0.75 mm (p=0.038). The area under the receiver operating characteristic curve was 0.600 (95% confidence interval, 0.508–0.692; p<0.039). A cut-off value of ≥5.0 mm had a sensitivity and specificity of 80% and 36%, respectively. CONCLUSION: This study demonstrated a significant yet poor relationship between intracranial injury and increased ONSD from the multislice CT scan. Severe structural changes in the brain and trauma that causes bleeding have only limited effects on the extension of the optic nerve. © 2018 Turkish Association of Trauma and Emergency Surgery.
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    Topical ketoprofen versus placebo in children presenting with ankle sprain to the Emergency Department: A randomized controlled study
    (Lippincott Williams and Wilkins, 2020) Serinken M.; Eken C.; Tünay K.; Gölcük Y.
    Objective Despite the favorable data concerning topical agents use in outpatient clinics, they are not commonly in emergency departments (EDs). The present study aimed to compare the effect of 2.5% topical ketoprofen (gel form) to placebo in children presenting with ankle sprain to the ED. Study Design Children between 7 and 18 years old presenting with ankle sprain composed the study population. Study patients were randomized into 2 study arms: 2.5% ketoprofen gel and placebo administered in a 5-cm area locally. Pain improvements at 15 and 30 minutes were measured by visual analog scale. Results Median pain reductions at 15 minutes for ketoprofen and placebo groups were 27.5 (16-39) and 5 (4-10), respectively. Median changes in pain intensity at 30 minutes for ketoprofen and placebo gel groups were 48 (43-52) and 9 (6-16), respectively. When compared 2 arms for the pain improvement at 15 and 30 minutes, the differences between 2 study drugs were 20 (13-28) and 35 (29-41), respectively. There were 7 (12.7%) rescue drug needs in the placebo group and 1 (1.7%) in the ketoprofen group (difference, 10.9%; 95% confidence interval, -6% to 7%; P = 0.83). There were no adverse effects in either group. Conclusions Ketoprofen gel is superior to placebo in ceasing pain in children presenting with ankle sprain to the ED with a high safety profile. © Wolters Kluwer Health, Inc. All rights reserved.