Browsing by Author "Tulay C.M."
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Item Outcomes of coronary artery bypass surgery in syrian refugees(E-Century Publishing Corporation, 2016) Demir D.; Abanoz M.; Tulay C.M.; Aydın M.S.; Kasapoğlu B.Ö.; Merdanoğlu M.; Altıparmak İ.H.; Gücü A.Background: In recent years, an increasing number of individuals have become refugees as a result of wars and domestic disturbance in their countries. The struggle for life of refugees under difficult conditions, increasing health problems, and insufficient Access to health services result in the loss of human lives. The aim of the present study was to present the outcomes of coronary artery bypass surgery in Syrian refugees. Methods: We performed emergency or elective bypass surgery to 53 Syrian refugees who ran away from civil war in Syria, between 2012 and 2014. The preoperative, intraoperative, and postoperative data of the patients were evaluated. Results: Of the patients, 18.9% sustained myocardial infarction, 34% had diabetes, 28.3% had COPD, and 52.8% were smokers. Two patients had emergency surgery and 51 patients had elective surgery. In the postoperative period, five patients (9.4%) were found to have atrial fibrillation. Cerebrovascular disease was observed at three patients (5.7%) in the postoperative period, and one patient had wound infection. A total of three patients (5.7%) died. Conclusion: The authors believe that under appropriate conditions, refugee patients should also receive therapy for chronic disorders in addition to emergency interventions. © 2016, E-Century Publishing Corporation. All rights reserved.Item A thymic neuroendocrine carcinoma presenting with upper gastrointestinal bleeding: A case report(Baycinar Medical Publishing, 2017) Yaldiz S.; Yaldiz D.; Tulay C.M.; Işisağ A.Neuroendocrine carcinomas of the thymus are rare clinical entities, which can be complicated by endocrine abnormalities. These tumors are frequently associated with ectopic adrenocorticotropic hormone production giving rise to Cushing's syndrome. Herein, we describe a 23-year-old male case with upper gastrointestinal bleeding as the initial presentation of a thymic neuroendocrine carcinoma. This case was reported due to its extremely exceptional occurrence. © 2017 All right reserved by the Turkish Society of Cardiovascular Surgery.Item Do we really know the duration of pain after rib fracture?(Termedia Publishing House Ltd., 2018) Tulay C.M.; Yaldiz S.; Bilge A.Introduction: The duration of pain after rib fracture is the question physicians are most frequently asked. The duration of pain following a traumatic rib fracture without any comorbidity is not widely published. Aim: We report our experience to investigate the duration of pain following isolated traumatic rib fractures without any traumatic comorbidity. Material and methods: We examined 182 patients with isolated rib fracture without any trauma to other body parts. The numeric rating scale (NRS) for pain was used to rate the level of pain. The NRS pain scores were evaluated in the emergency department at presentation, on the 15th day, and at the 3rd and 6th months of trauma. The Mann-Whitney U test was performed for the statistical analysis. Results: The pain level of young patients on the 15th day and at the third month and sixth month was lower than that in the old group, and the difference was statistically significant. While patients with two rib fractures had a higher pain level in the emergency room than those with one rib fracture, there was no statistically significant difference at other time points. In patients with anterior fractures, the pain level was significantly lower than in the lateral and posterior regions, whereas in the lateral fractures, the pain score was significantly higher than others at all time points except at the 6th month. The pain score of displaced fractures was significantly higher than that of non-displaced ones at all time points except the 6-month follow-up. Conclusions: Rib fractures cause significant pain and need appropriate medication. The time of the 6th month could be an important milestone. © 2018 Termedia Publishing House Ltd. All rights reserved.Item Oblique chest X-ray: An alternative way to detect pneumothorax(Japanese Association for Coronary Artery Surgery, 2018) Tulay C.M.; Yaldız S.; Bilge A.Purpose: To identify occult pneumothorax with oblique chest X-ray (OCXR) in clinically suspected patients. Methods: In this retrospective study, we examined 1082 adult multitrauma patients who were admitted to our emergency service between January 2016 and January 2017. Clinical findings that suggest occult pneumothorax were rib fracture, flail chest, chest pain, subcutaneous emphysema, abrasion or ecchymosis and moderate to severe hypoxia in clinical parameters. All of these patients underwent anteroposterior chest X-ray (APCXR), but no pneumothorax could be detected. Upon this, OCXR was performed using mobile X-ray equipment. Results: Traumatic pneumothorax was observed in 421 (38.9%) of 1082 patients. We applied OCXR to 26 multitrauma patients. Occult pneumothorax was evaluated at 22 patients (2.03%) in 1082 multitrauma patients. The 22 patients who had multitrauma occult pneumothorax on OCXR were internated at intensive care unit (ICU) and follow-up was done using OCXR and APCXR. Conclusions: OCXR can be an alternative imaging technique to identify occult pneumo-thorax in some trauma patients at emergency room and also follow period at ICU. © 2018 The Editorial Committee of Annals of Thoracic and Cardiovascular Surgery.Item Langerhans cell histiocytosis: A rare cause of pathological rib fracture(Baycinar Medical Publishing, 2021) Yolcu A.; Tulay C.M.; Temiz P.; Aydoğdu İ.Langerhans cell histiocytosis, formerly known as histiocytosis X, represents clonal proliferations of the antigen-presenting dendritic cells, which are normally found in many organs. It is a rare disease which tends to affect children and adolescents. In particular, adult-onset type is very rare. Herein, we present a female adult diagnosed with Langerhans cell histiocytosis of the rib without any systemic involvement which was successfully treated with surgery. © 2021. All right reserved by the Turkish Society of Cardiovascular Surgery.Item Comparative analysis of two different turkish hospital reports on polytrauma patients with thoracic trauma; [Türkiye’deki iki farklı hastanenin toraks travmalı politravma olgularındaki verilerinin karşılaştırmalı analizi](Turkish Association of Trauma and Emergency Surgery, 2021) Yaldız S.; Tulay C.M.; Yaldız D.; Arpat A.H.; Bayülgen A.; Pirzirenli M.G.; Balta C.BACKGROUND: The present study aims to assess whether there are any differences in the management and outcome of polytrau-ma patients with thoracic trauma in trauma units of two different hospitals in the same country; one hospital is near the Syrian border. METHODS: A retrospective analysis (January 2012 to January 2014) of 348 polytrauma casualties with thoracic trauma from Manisa Celal Bayar University Hospital (MH) were compared according to age, gender, mechanism of injury, associated injuries, abbreviated injury scale (AIS), injury severity score (ISS), treatment modalities, and mortality with 917 patients of Şanlıurfa Training and Research Hospital (SH) registry (near the Syrian border). RESULTS: Of the 348 patients in the MH, 230 (66%) and of the 917 patients in the SH, 697 (76%) were males (p<0.001). Mean age was 45.6±18.3 yrs in the MH group and 26.4±22.4 yrs in the SH group (p<0.001). The SH patients had a larger proportion of stab wounds (MH; 9% vs. SH; 17%, p<0.05), gunshot injuries (MH; 5% vs. SH; 18%, p<0.05), higher mean ISS (MH; 30.2±8.4 vs. SH; 42.8±10.2, p<0.001), and increased mortality (MH; 2.6% vs. SH; 11.1%, p<0.001). AISabdomen was the highest component in the SH registry (AISabdomen = 4.8±0.7), whereas AIS extremities were the highest component in the MH registry (AISextremities = 3.6±0.2). CONCLUSION: Significantly different demographic features, mechanisms of injury, worse outcomes and higher mortality rates in SH demonstrate and reflect the surgical challenges depending on the combat environment. Two hospitals in Turkey, one seemingly adjacent to a war zone and another with the more standard civilian experience highlight the impact of the Syrian conflict on the Turkish healthcare system. © 2021, Turkish Association of Trauma and Emergency Surgery. All rights reserved.Item Video-Assisted Thoracoscopic Surgery for the First Episode of Primary Spontaneous Pneumothorax(Springer, 2021) Tulay C.M.; Yaldiz S.The aim of this study was to evaluate the use of a videothoracoscopic surgical (VATS) approach as the “first-line” treatment for primary spontaneous pneumothorax (PSP). One hundred sixteen patients who were diagnosed with pneumothorax and underwent surgery with VATS technique between January 2016 and January 2018 were included in the study. We observed 60 patients with a first episode of PSP and 56 patients with recurrent PSP who had undergone prior chest tube application. Surgery was done in the first 24 h after hospital admission. Duration of hospital stay and pneumothorax recurrence rate were recorded. Pain level was assessed on the fifteenth day after surgery using the numerical rating scale (NRS). Recurrent pneumothorax patients who were treated with chest tube application after their first episode were asked to evaluate their preference for surgery over chest tube via a questionnaire. Intraoperative bleb/bullous structures were detected in 102 (87.93%) of 116 patients. In the questionnaire of 56 patients with recurrent pneumothorax who had previously undergone chest tube, 44 (78.6%) stated that they would immediately accept operation instead of the chest tube, if recommended. The length of hospitalization was significantly less in patients who underwent surgery in the first episode. There was no statistical difference between pain scores. Employing VATS as the first-line treatment for PSP provides benefits of early return to normal daily life, better clinical satisfaction, and psychosocial outcomes. © 2020, Association of Surgeons of India.Item The role of the perfusion index in patients with thoracic trauma(Second Affiliated Hospital, Zhejiang University School of Medicine, 2022) Uzkuç İ.; Gurmen E.S.; Tulay C.M.Traumatic injuries range from simple to complicated multiple injuries. The identification of patients with critical injuries and disrupted organ perfusion is essential to prevent tissue hypoxia. A study estimated that a fast and accurate response to thoracic trauma should reduce the mortality by 30%.[1] The tissue perfusion value is an essential indicator of mortality and morbidity for patients admitted to the hospital with thoracic trauma. Thus, this study aimed to show the role of the perfusion index (PI) in predicting the prognosis of patients admitted to the emergency department for thoracic trauma. © 2017 22 World Journal of Emergency Medicine.Item Attention: Cardiac contusion; [Dikkat: Kardiyak kontüzyon](Turkish Association of Trauma and Emergency Surgery, 2022) Gürmen E.S.; Tulay C.M.BACKGROUND: The objective of the study is to investigate diagnostic and clinical processes performed for cardiac contusion in patients with blunt thoracic trauma. METHODS: This study was conducted retrospectively on 65 patients admitted with isolated blunt thoracic trauma to the Emergency Medicine Department. The CT images, the cardiac enzyme levels, the periodic 4-h follow-up electrocardiography (ECGs) in the emergency department, and the results of echocardiography, performed at admission and when required according to the clinical status, were investigated. The 1-h and 4-h high-sensitivity troponin I levels were studied, and values above 0.04 ng/ml were considered as positive. RESULTS: Sixty-five patients with isolated thoracic trauma were included in the study, 23 (35.38%) had pulmonary and cardiac contusions both. In 23 (35.38%) patients, pulmonary contusion had been present, and cardiac contusion had not been identified at the initial evaluation. However, during clinical follow-up, troponin became positive, dysrhythmia developed, and the trauma affected the heart in four of these patients. In six (9.24%) patients, cardiac contusion was identified without pulmonary contusion. In 13 (20%) patients, no cardiac or pulmonary contusion was identified. troponin elevation was detected in 10 patients without a diagnosis of cardiac contusion who had a pulmonary contusion, hemothorax, and/or pneumothorax at the time of hospital admission and then with normal troponin levels at 4-h control. We found that there was a statistical agreement between cardiac contusion and troponin-ECG results at 4th h. CONCLUSION: We advise that all blunt thoracic trauma patients should be screened for cardiac contusion by continuous ECG monitoring and troponin levels. @ 2022 Turkish Association of Trauma and Emergency Surgery.Item Dyspnea: perfusion index and triage status(Springer Science and Business Media B.V., 2023) Tulay C.M.; Gurmen E.S.Purpose: To determine the relationship between perfusion index and the emergency triage classification in patients admitted to the emergency department with dyspnea. Methods: Adult patients who presented with dyspnea and whose perfusion index values were measured with Masimo Radical-7 device at the time of admission, at the first hour and the second hour of admission were included in the study. The PI and oxygen saturation measured by finger probes were compared and the superiority of their effects on the emergency triage classification was compared. Results: For the 0.9 cut- off value of the arrival PI level according to the triage status; sensitivity 79.25%; specificity 78.12%; positive predictive value is 66.7 and negative predictive value is 87.2. A statistically significant correlation was found between the triage status and the 0.9 cut- off value of the admission PI level. We can say that the ODDS rate of red triage is 13.63 times (95% CI: 5.99–31.01) times higher in cases with a PI level of 0.9 and below. In the ROC analysis, the cut-off value of 1.1 and above the admission PI level was determined as the most appropriate point for discharge. Conclusion: The perfusion index can help to determine the triage classification in emergency departments for dyspnea. © 2023, The Author(s), under exclusive licence to Springer Nature B.V.Item Correction to: Dyspnea: perfusion index and triage status (Journal of Clinical Monitoring and Computing, (2023), 37, 4, (1103-1108), 10.1007/s10877-023-00995-6)(Springer Science and Business Media B.V., 2023) Tulay C.M.; Gurmen E.S.In the original article, the title was incorrectly published, hence the correct title has been updated which is Dyspnea: perfusion index and triage status. The original article has been corrected © 2023, Springer Nature B.V.Item Lung cancer from suspicion to treatment: An indicator of healthcare access in Turkey(Elsevier Ltd, 2023) Kızılırmak D.; Yılmaz Kaya Z.; Gökçimen G.; Havlucu Y.; Cengiz Özyurt B.; Gündoğuş B.; Esendağlı D.; Serez Kaya B.; Yılmam İ.; Aydemir Y.; Çolak M.; Afşin E.; Çetin N.; İdikut A.; Değirmenci C.; Oral Tapan Ö.; Gündüz Gürkan C.; Kocatürk C.İ.; Ömeroğlu Şimşek G.; Kalafat C.E.; Özgün Niksarlıoğlu E.Y.; Ergün Serdaroğlu M.; Karcıoğlu O.; Özyurt S.; Karahacıoğlu Madran E.; Yaprak Bayrak B.; Alasgarova Z.; Baydar Toprak O.; Yılmazel Uçar E.; Topal B.N.; Argun Barış S.; Guliyev E.; Güzel E.; Küçük S.; Ocaklı B.; Baran Ketencioğlu B.; Selçuk N.T.; Sarı Akyüz M.; Sercan Özgür E.; Yetkin N.A.; Çetinkaya P.D.; Deniz P.P.; Atlı S.; Çetindoğan H.; Karakaş F.G.; Yılmaz E.S.; Ergün D.; Ergün R.; Tulay C.M.; Ünsal M.; Demirkaya İ.; Marım F.; Kaya İ.; Demirdöğen E.; Görek Dilektaşlı A.; Ursavaş A.; Çelik P.Background: Lung cancer is the leading cause of cancer-related deaths worldwide. Before beginning lung cancer treatment, it is necessary to complete procedures such as suspecting lung cancer, obtaining a pathologic diagnosis, and staging. This study aimed to investigate the processes from suspicion of lung cancer to diagnosis, staging, and treatment initiation. Methods: The study was designed as a multicenter and cross-sectional study. Patients with lung cancer from various health institutions located in all geographic regions of Turkey were included in the study. The sociodemographic and clinical characteristics of the patients, the characteristics of the health institutions and geographic regions, and other variables of the lung cancer process were recorded. The time from suspicion of lung cancer to pathologic diagnosis, radiologic staging, and treatment initiation, as well as influencing factors, were investigated. Results: The study included 1410 patients from 29 different medical centers. The mean time from the initial suspicion of lung cancer to the pathologic diagnosis was 48.0 ± 52.6 days, 39.0 ± 52.7 days for radiologic staging, and 74.9 ± 65.5 days for treatment initiation. The residential areas with the most suspected lung cancer cases were highly developed socioeconomic zones. Primary healthcare services accounted for only 0.4% of patients with suspected lung cancer. The time to pathologic diagnosis was longer in the Marmara region, and the wait time for staging and treatment initiation was longer in Eastern and Southeastern Anatolia. Patients who presented to chest disease referral hospitals with peripheral lesions, those with early-stage disease, and those who were diagnosed surgically had significantly longer wait times. Conclusion: The time between pathologic diagnosis, staging, and treatment initiation in lung cancer was longer than expected. Increasing the role of primary healthcare services and distributing socioeconomic resources more equally will contribute to shortening the time to diagnosis and improve treatment processes for lung cancer. © 2023 Elsevier LtdItem 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.