Publications with Fulltext
Permanent URI for this collectionhttps://hdl.handle.net/20.500.14288/6
Browse
14 results
Search Results
Publication Open Access Effects of short-term hyperoxic ventilation on lung, kidney, heart, and liver in a rat model: a biochemical evaluation(Kare Yayıncılık, 2021) Aksu, Uğur; Ulugöl, Halim; Sungur, Mukadder Orhan; Vardar, Kübra; Şentürk, Mert; Toraman, Fevzi; Şentürk, Evren; Faculty Member; School of Medicine; 48359Background: despite studies on the adverse effects of hyperoxia, its use is still recommended by the World Health Organization. The aim of this study was to test the possible harmful effects of hyperoxia on the lung, kidney, heart, and liver in a rat mechanical ventilation model. Methods: male Wistar rats were randomly assigned into two groups (n=6/group): Normoxic (FiO(2): 0.3) or hyperoxic (FiO(2): 1.0) ventilation for 4 h. The injury was evaluated in bronchoalveolar lavage (BAL), blood, lung, liver, kidney, and heart was evaluated in terms of cell surface integrity, extracellular matrix (sialic acid, syndecan-1), osmotic stress (free hemoglobin), and redox homeostasis-lipid peroxidaation (malondialdehyde). BAL and wet/dry weight ratio were also evaluated for cellular permeability. Results: four hours of hyperoxic ventilation did not lead to significant changes in (1) sialic acid, syndecan-1, (2) malondialdehyde levels and wet/dry weight ratio in liver, kidney, heart, and lung compared to normoxic ventilation. Conclusion: mechanical ventilation with hyperoxia seems to have almost similar effects compared to ventilation with normoxia. However, the long term effect of hyperoxia should be evaluated. / Amaç: hiperoksinin olumsuz etkileri üzerine yapılan çalışmalara rağmen, Dünya Sağlık Örgütü (WHO) hiperoksinin kullanımını önermektedir. Bu çalışmanın amacı sıçan mekanik ventilasyon modelinde hiperoksinin akciğer, böbrek, kalp ve karaciğer üzerindeki olası olumsuz etkilerini test etmektedir. Gereç ve yöntem: erkek Wistar sıçanlar dört saat boyunca normoksik (FiO2: 0.3) veya hiperoksik (FiO2: 1.0) ventile edilerek iki gruba (n=6/grup) ayrıldı. Hasar hücre yüzey bütünlüğü, ekstraselüler matriks (sialik asit, sindekan-1), ozmotik stres (serbest hemoglobin) ve redoks homeostazisi-lipit peroksidasyonu (malondialdehit) açısından bronkoalveolar lavaj, kan, akciğer, böbrek, kalp ve karaciğer örneklerinde değerlendirildi. Ayrıca bronkoalveolar lavaj ve ıslak/kuru ağırlık oranı ile hücre geçirgenliği değerlendirildi. Bulgular: dört saatlik hiperoksik ventilasyon sialik asit, sindekan-1, malondialdehit düzeylerinde ve organların ıslak kuru ağırlıklarında anlamlı bir değişikliğe neden olmadı. Tartışma: hiperoksik ventilasyonun normoksik ventilasyona benzer bir etki gösterdiği görülmektedir. Ancak, hiperoksinin uzun vadeli etkileri değerlendirilmelidir.Publication Open Access Environment, global climate change, and cardiopulmonary health(American Thoracic Society (ATS), 2017) Bauer, Alison K.; Abdalati, Waleed; Carlsten, Christopher; Pinkerton, Kent E.; Thurston, George D.; Balmes, John R.; Takaro, Tim K.; N/A; Bayram, Hasan; Faculty Member; School of Medicine; 4890Publication Open Access Endoscopic and surgical management of iatrogenic biliary tract injuries(Kare Yayıncılık, 2020) Acar, Turan; Acar, Nihan; Güngör, Feyyaz; Gür, Özlem; Çamyar, Hakan; Haıyanlı, Mehmet; Dilek, Osman Nuri; Alper, Emrah; Faculty Member; School of MedicineBackground: Iatrogenic biliary tract injury (BTI) is a rare complication but has high risks of morbidity and mortality when it is not early noticed. Although the treatment varies depending on the size of injury and the time until the injury is noticed, endoscopic and percutaneous interventions are usually sufficient. However, it should be remembered that these interventions may cause major complications in the following years, such as biliary stricture, recurrent episodes of cholangitis and even cirrhosis. In this paper, we aimed to present our approach to BTI following cholecystectomy and our treatment management in the light of the literature. Methods: the medical records of 105 patients who were treated for BTI between January 2015 and July 2019 were evaluated retrospectively. The majority of the patients consisted of the patients who underwent cholecystectomy at an external medical center and were referred to our clinic due to biliary leakage (BL). Patients were grouped according to Strasberg classification determined by the place of leakage. Results: among 105 patients included in this study, 55 were male, and 50 were female. Mean age was 55.2 ±16.26 years (range, 21– 93 years). According to Strasberg classification, type A, B, C, D and E injuries were detected in 57, 1, 3, 29 and 15 patients, respectively. Eighty-five patients were successfully treated with endoscopic and percutaneous interventions, while 20 patients underwent surgery. Conclusion: in all patients with suspected BTI, a detailed screening and appropriate treatment provide a significant decline in morbidity and mortality. Therefore, early diagnosis is very important for both early and late outcomes. / Amaç: iyatrojenik safra yolu yaralanmalarını, nadir görülen bir komplikasyon olup erken tanınmadığında yüksek morbidite ve mortaliteye neden olur. Tedavisi, yaralanma boyutu ve yaralanmanın fark edilmesine dek geçen süreye göre değişmekle birlikte, çoğunlukla endoskopik ve perkütan girişimler yeterli olmaktadır. Fakat bu tedaviler sonrasında ilerleyen yıllarda biliyer striktür, tekrarlayan kolanjit atakları ve hatta siroz gibi majör komplikasyonlara neden olabileceği unutulmamalıdır. Bu yazımızda postkolesistektomi biliyer kaçaklara yaklaşımımızı ve literatür eşliğinde tedavi yönetimini sunmayı amaçladık. Gereç ve yöntem: Ocak 2015–Temmuz 2019 tarihleri arasında biliyer kaçak nedeniyle tedavi ettiğimiz 105 hastanın dosyası geriye dönük olarak değerlendirildi. Hastaların çoğunluğunu, dış merkezde kolesistektomi geçirip, biliyer kaçak saptanması üzerine kliniğimize sevk edilenler oluşturmakta idi. Hastalar kaçak yeri ve miktarına göre belirlenen Strasberg sınıflandırmasına göre gruplandırıldı. Bulgular: çalışmaya alınan 105 hastanın 55’i erkek, 50’si kadın olup ortalama yaş 55.2±16.26 yıl (21–93 yıl) idi. Strasberg sınıflamasına göre; 57 hastada tip A, 1 hastada tip B, 3 hastada tip C, 29 hastada tip D ve 15 hastada tip E yaralanma mevcut idi. Seksen beş hasta endoskopik ve girişimsel radyolojik yöntemlerle başarı ile tedavi edilirken, 20 hastaya cerrahi girişim yapıldı.Tartışma: biliyer kaçaktan şüphelenilen her hastada, ayrıntılı tarama ve uygun tedavi morbidite ve mortalitede önemli bir düşüş sağlar. Bu sebeple, erken tanı hem erken hem de geç dönem sonuçlar açısından çok önemlidir.Publication Open Access Acil serviste Akdeniz benekli ateşi(Aves, 2015) Dikme, Özgür; Topaçoğlu, Hakan; Dikme, Özlem; Faculty Member; Koç University HospitalIntroduction: Mediterranean spotted fever (MSF) is one of the tick-borne rickettsial infections caused by Rickettsia conorii. In this case, we describe a patient who was admitted to the Emergency Department (ED) with persistent fever caused by MSF. Case Report: A 36-year-old male patient was admitted to the ED with persistent fever. Six days ago, antibacterial therapy had been started by his family practitioner; however, his fever continued. Upon admission on the seventh day of fever, the patient appeared ill. He had complaints such as malaise, myalgias, and nausea/vomiting. His fever was 38.6 degrees C, and other vital signs were normal. On physical examination, a single, crusted, ulcerated papule with a red halo resembling a cigarette burn was observed on the left leg. According to the diagnostic criteria for MSF, his score was 33, and he was admitted to the infectious disease department. Antibodies against Rickettsia were positive with the immunofluorescence assay. Fever after continuing for 24 hours reduced when a dose of 200 mg/daily doxycycline treatment was started. Conclusion: The aim of this presentation is to point out that MSF should be considered in the ED for the differential diagnosis of patient with a history of tick bite, persistent fever, maculopapular rash, headache, myalgia, arthralgia, and particularly with black eschar/tache noire.Publication Open Access Nosocomial infections and associated risk factors in geriatric patients in the intensive care unit(Aves, 2016) İnci, Ayşe; Karabay, Ayşegül; Demiraran, Yavuz; N/A; Erus, Suat; Faculty Member; School of MedicineAim: The elderly population increases worldwide. The purpose of this study was to evaluate nosocomial infections (NI) detected in geriatric patients and to determine the risk factors leading to their development. Materials and Methods: Patients monitored in our hospital's Intensive Care Unit (ICU) were evaluated daily by intensive care and infectious disease specialists, including surveillance by our Infection Control Committee. We included the patients aged >= 65 years who were monitored in the adult ICU between January and December 2014, using the methods of retrospective file screening and computer record review. Patients were classified into two groups: patients with and without NI. Results: In total, 222 (38.07%) patients were >= 65 years old. 44 NI events were detected in 27 patients. Groups were compared with respect to age; sex; presence of mechanic ventilation (MV), central venous catheterization (CVC), cerebrovascular disease, chronic obstructive disease, diabetes mellitus; and mortality. The presence of MV, CVC, and mortality were seen to be significantly higher in patients with NI compared with those without. The most common NIs found were sepsis and pneumonia. The most common infectious agent was Acinetobacter. Conclusion: NIs observed in hospital ICUs are common, but largely preventable, conditions. A systematic approach and well-disciplined empiric therapy are very important. Our study revealed that the mortality rate is high in elderly patients who develop NI, and NI is more commonly seen in patients who undergo invasive interventions. We believe that using invasive interventions as little as possible in this group may improve their treatment success and outcome.Publication Open Access Diagnostic value of signal peptide, CUB (Complement C1r/C1s, Uegf, and Bmp1), EGF (Epidermal Growth Factor)-like domain-containing Protein 1 (SCUBE1) and Chemerin in experimental testicular torsion(Aves, 2017) Yeniocak, Selman; Saraç, Fatma; Olgaç, Vakur; Kalkan, Asım; Düz, Muhammed Emin; Koldaş, Macit; Department of Emergency; Department of Emergency; Karadana, Gökçe Akgül; Faculty Member; School of MedicineAim: The purpose of this experimental study was to investigate the potential diagnostic value of the platelet activation marker SCUBE1 [signal peptide, CUB (complement C1r/C1s, Uegf, and Bmp1), and EGF (epidermal growth factor)-like domain-containing protein 1] and the adipocytokine chemerin in a prepubertal rat model of testicular torsion (TT). Materials and Methods: Twenty-eight male rats were used for this study. They were randomly assigned into one of the four groups, each containing seven rats. No additional procedure other than a sham operation was performed on the control group (group IV). The other subjects comprised the torsion ischemia groups (groups I, II, and III). Blood specimens were collected after 30 min (group I), 2 h (group II), or 4 h (group III) using the intracardiac method. For group IV, which was the sham operation group, blood specimens were collected after 4 h, and testis tissue specimens were extracted by orchiectomy for histopathological examination. Results: No statistically significant change was determined in SCUBE1 levels of rats exposed to torsion. Also, no significant difference was observed between SCUBE1 levels of rats exposed to torsion and those of the control group. Statistically significant change was determined in chemerin levels during observation in rats exposed to torsion. This change was statistically significant between groups I and III. There was no statistically significant difference between chemerin levels of rats exposed to torsion (groups I, II, and III) and those of the control group (group IV). Conclusion: We observed no statistically significant differences when plasma SCUBE1 and chemerin levels of rats subjected to TT were compared with a control group in this study.Publication Open Access Thyrotoxic hypokalemic periodic paralysis: case report(Emergency Medicine Physicians Association of Turkey (EPAT), 2022) Akın, Seydahmet; Aladağ, Nazire; Keskin, Özcan; Altıntaş, Alara; Undergraduate Student; School of MedicineThyrotoxic Hypokalemic Periodic Paralysis (THPP) is a rare hereditary disorder which is characterized by thyroid hormone elevation, low blood potassium level and recurrent acute muscle weakness. Basic pathology is thought to be the increase in activity in the sodium-potassium pump (Na+/K+ATPase). Here we report the case of a 31-year-old male that presented with weakness in his legs, and inability to walk. The patient had elevated thyroid hormone levels (FT3 and FT4) and lower TSH levels, lower serum potassium levels, and recurrent acute muscle weakness. The diagnosis was made to be Thyrotoxic Hypokalemic Periodic Paralysis precipitated after intense physical activity. THPP is a reversible medical emergency. Early diagnosis, and rapid treatment is lifesaving. Although rare, THPP must be considered as a differential diagnosis in patients presenting with hypokalemia and paralysis.Publication Open Access The diagnostic value of irisin in patients with acute abdominal pain: a preliminary study(Kare Yayıncılık, 2018) Yeniocak, Selman; Karcıoğlu, Özgür; Kalkan, Asım; Saraç, Fatma; Keklikkıran, Zehra Zeynep; Gümüş, Alper; Koldaş, Macit; Korkut, Semih; N/A; Karadana, Gökçe Akgül; Doctor; School of MedicineBackground: the aim of this study was to investigate the prognostic value of irisin by examining the serum level of this smooth muscle protein in patients presenting at the emergency department (ED) with acute abdominal pain. Methods: this research was performed as a single-center, prospective, cross-sectional study. In all, 213 adult patients presenting at the ED with acute abdominal pain and 140 healthy controls were enrolled. The serum irisin level was correlated with the leukocyte, C-reactive protein, amylase, and creatine kinase values. The irisin level was compared between groups of those who were admitted or discharged, and those who received surgical or medical treatment. Results: the mean irisin level of the 213 patients and the 140 controls was 6.81 +/- 3.17 mcg/mL vs. 5.69 +/- 2.08 mcg/mL. The mean irisin value of the hospitalized patients (7.98 +/- 3.1 1 mcg/mL) was significantly higher than that of the discharged patient group (6.38 +/- 3.09 mcg/mL) and the controls (control vs. discharged: p=0.202; control vs. hospitalized: p<0.001; discharged vs. hospitalized: p=0.001). When compared with that of the control group, the irisin level was significantly higher in patients with gall bladder diseases, urolithiasis, and acute appendicitis (p=0.001, p=0.007, p=0.007). Conclusion: the serum irisin level in patients with abdominal pain may serve as a guide in diagnostic decision-making and determining the prognosis for cases of acute abdominal pain involving luminal obstruction in tubular intra-abdominal organs.Publication Open Access The predictive value of procalcitonin in the prognosis of patients with acute coronary syndrome(Galenos Yayınevi, 2019) Coşkun, Abuzer; Eren, Şevki Hakan; Aktaş, Can; Faculty Member; School of Medicine; 24297Aim: the study aimed to investigate the prognostic value of serum procalcitonin (PCT) levels in patients with acute coronary syndrome (ACS). Materials and Methods: two hundred patients with ACS who applied to the emergency department due to chest pain and were hospitalized into the cardiology clinic of our hospital between January 2014 and December 2016 were included in this cross-sectional cohort study. The patients were divided into four groups based on their diagnosis. The first group was inferior myocardial infarction (MI), the second group was anterior MI, the third group was non-ST-elevation MI (NSTEMI), and the fourth group was high-risk unstable angina (UA). These groups were compared according to PCT, age, gender, left ventricular ejection fraction, cardiac troponin (cTn) I, three-vessel disease (TVD), and mortality rate. Results: there were statistically significant differences between ACS groups concerning PCT values. PCT level was significantly higher in inferior MI than in anterior MI, NSTEMI, and UA groups. There were statistically significant differences between cTn positivity checked at 0th, 6th, and 12th hours and ischemic heart failure after MI as well as between mortality and TVD. TVD and mortality were found to be significantly higher in the inferior MI group than the other subgroups. Ischemic heart failure was found to be statistically higher in anterior subgroup than the other subgroups. Conclusion: increased PCT level may be a marker that can be used in indicating ACS and its prognosis.Publication Open Access Bisikletten düşme sonrası izole künt submandibular gland yaralanması(Aves, 2015) Erten, Abdulkerim; Aktaş, Can; Ekinci, Salih; Demirtaş, Yoldaş; Faculty Member; Koç University Hospital; 24297; N/A; N/AIntroduction: Injury to deep neck structures should be considered during emergency room (ER) admissions in patients with a chief complaint of swelling in the neck, particularly when there is a history of trauma to the neck. Life-threatening conditions should be assessed, diagnosis should be made using appropriate imaging modalities, and treatment should be planned accordingly. Case Report: A 30-year-old male presented to the ER with the chief complaint of a swollen neck 2 h after he fell off a bicycle. Based on the ultrasound and computed tomography analysis, he was diagnosed with isolated submandibular injury. Conclusion: Isolated submandibular injury following a blunt trauma is a rare condition. Obtaining appropriate imaging modalities is helpful in confirming the diagnosis. Patients with blunt trauma should also be carefully assessed for other, nonapparent injuries.