Researcher:
Aktaş, Can

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Can

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Aktaş

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Aktaş, Can

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2015 - 201962020 - 20232

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    Conventional vs invert-grayscale X-ray for diagnosis of pneumothorax in the emergency setting
    (W B Saunders Co-Elsevier Inc, 2017) Unek, Orkun; Eren, Hakan Sevki; N/A; Musalar, Ekrem; Ekinci, Salih; Arş, Eda; Gürses, Bengi; Aktaş, Can; Doctor; Doctor; Doctor; Faculty Member; Faculty Member; N/A; N/A; N/A; School of Medicine; School of Medicine; Koç University Hospital; Koç University Hospital; Koç University Hospital; N/A; N/A; N/A; N/A; N/A; 113169; 24297
    Introduction: Pneumothorax is a pathologic condition in which air is accumulated between the visceral and parietal pleura. After clinical suspicion, in order to diagnose the severity of the condition, imaging is necessary. By using the help of Picture Archiving and Communication Systems (PACS) direct conventional X-rays are converted to gray-scale and this has become a preferred method among many physicians. Methods: Our study design was a case-control study with cross-over design study. Posterior-anterior chest Xrays of patients were evaluated for pneumothorax by 10 expert physicians with at least 3 years of experience and who have used inverted gray-scale posterior anterior chest X-ray for diagnosing pneumothorax. Results: The study included posterior anterior chest X-ray images of 268 patients of which 106 were diagnosed with spontaneous pneumothorax and 162 patients used as a control group. The sensitivity of Digital-conventional X-rays was found to be higher than that of inverted gray-scale images (95% CI (2,08-5,04), p < 0,01). There was no statistically significant difference between the gold standard and digital-conventional images (95% CI (0,45-2,17), p = 0,20), while the evaluations of the gray-scale images were found to be less sensitive for diagnosis (95% CI (3,16-5,67) p < 0,01). Conclusion: Inverted gray-scale imaging is not a superior imaging modality over digital-conventional X-ray for the diagnosis of pneumothorax. Prospective studies should be performed where diagnostic potency of inverted gray-scale radiograms is tested against gold standard chest CT. Further research should compare inverted gray-scale to lung ultrasound to assess them as alternatives prior to CT.
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    Valsalva maneuver techniques for supraventricular tachycardias: Which and how?
    (Sage Publications Ltd, 2017) N/A; N/A; Ekinci, Salih; Karadana, Gökçe Akgül; Arş, Eda; Musalar, Ekrem; Aktaş, Can; Doctor; Doctor; Doctor; Doctor; Doctor; Faculty Member; N/A; N/A; N/A, N/A; N/A; School of Medicine; Koç University Hospital; Koç University Hospital; Koç University Hospital; Koç University Hospital; Koç University Hospital; Koç University Hospital; N/A; N/A; N/A; N/A; N/A; 24297
    Study objective: While some research has been done on Valsalva maneuvers in treating supraventricular tachycardia, there is no standardized algorithm on which technique has been the most effective for the termination of supraventricular tachycardias. In this study, we compare different Valsalva maneuver techniques in order to determine the exact technique needed for maximal vagal response. Methods: This was a repeated measures clinical study, which enlisted a sample of healthy adult volunteers. Participants performed four different Valsalva maneuver techniques (40 mm Hg10 s, 40 mm Hg15 s, 50 mm Hg10 s, and 50 mm Hg15 s) while lying in a supine position. The maneuvers were repeated three times. An electrocardiography printout was obtained during each trial, and heart rate differences between pre-maneuver and post-maneuver were measured. Results: Among the 97 volunteers who participated in the study, 7 were excluded because the target Valsalva maneuver pressures were not reached, and 1 volunteer was excluded due to T-wave inversion that developed after Valsalva maneuver. We enrolled 89 participants. There was no significant difference in the heart rate decrease among the four techniques. In addition, there was no difference between the vagal responses in terms of age, gender, and body mass index. Conclusion: This study shows that the four different Valsalva maneuver techniques were not superior to one another in terms of decreased heart rate.
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    The thin border between life and death
    (Galenos Yayınevi, 2015) N/A; N/A; Değirmenci, Elif; Aktaş, Can; Doctor; Faculty Member; School of Medicine; N/A; Koç University Hospital; N/A; 24297
    N/A
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    Necrotizing fasciitis as complication of combined use of bevacizumab with chemotherapy
    (Galenos Yayınevi, 2023) N/A; Emir, Cantürk; Aktaş, Can; Aydın, Alp Giray; Doctor; Faculty Member; Doctor; N/A; School of Medicine; N/A; Koç University Hospital; Koç University Hospital; Koç University Hospital; N/A; 24297; N/A
    Necrotizing fasciitis (NF) is an uncommon, severe, life-threatening soft tissue infection involving the subcutaneous tissue. Immunocompromised and patients with diabetes are at a higher risk of developing NF. One of the pathophysiologic mechanisms of NF is subcutaneous arterie thrombosis and tissue ischemia. Bevacizumab, a agent used in cancer treatment, blocks the activity of the vascular endothelial growth factor receptor. Recently, it is used along with paclitaxel and carboplatin due to an increased survival rate. The frequent use of this combination caused patients to applied to the emergency department (ED) with some side effects. NF is one of the rare side effects of this combination. Here, we present a patient with ovarian cancer who was admitted to the ED with severe leg pain, whose initial examination and tests were normal, and then NF developed within hours and then arrested.
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    PublicationOpen Access
    Phytocontact dermatitis: A case study
    (Aves, 2015) Duman, Neşe; Mat, Afife; Bavunoğlu, Işıl; İkizceli, İbrahim; Department of Emergency; Değirmenci, Elif; Aktaş, Can; Doctor; Faculty Member; Department of Emergency; School of Medicine; N/A; 24297
    Introduction: Herbal medicines are used for different purposes by applying them directly to the skin. Case Report: A 57-year-old female patient presented with erythema and swelling of the left knee. On examination, erythematous and bullous lesions were observed. In the story of 'Ranunculus Scleratus' plants 12 hours knee closed contact of the learned. Diagnosis; Fitokontakt thought of as Dermatitis patients to wet dressing is recommended. 1 month after hyperemia outside of a clinical finding out. Conclusion: Treatment with plants in our community are used as often as incorrect use can lead to harmful effects.
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    PublicationOpen 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; 24297
    Aim: 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.
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    PublicationOpen 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/A
    Introduction: 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.
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    PublicationOpen Access
    Acil serviste hekimler fonksiyonel nörolojik belirti bozukluğu ve somatik belirti bozukluğunu nasıl yönetiyor? Bir vinyet çalışması
    (Türk Nöropsikiyatri Derneği, 2021) Kılıç, Özge; Altunöz, Umut; Eser, Hale Yapıcı; Necef, Işıl; Çakmak, Özgür Öztop; Aktaş, Can; Faculty Member; Faculty Member; Faculty Member; School of Medicine; Koç University Hospital; 134359; N/A; 299358; N/A
    Introduction: we aimed to explore how physicians from different specialties approach the management of functional neurological symptom (conversion) and somatic symptom disorders in the emergency department compared with pulmonary embolism and how physicians’ professional and personal characteristics influence their diagnostic preferences. Methods: using a vignette methodology, and cross-sectional design, three emergency department case vignettes of possible functional neurological symptom, somatic symptom disorder, and pulmonary embolism were presented to physicians from internal medicine, emergency medicine, and psychiatry. A structured survey including questions on diagnosis and management of these cases, and physicians’ professional and personal characteristics (childhood trauma, attachment style) was conducted. Results: physicians from internal medicine and emergency medicine tended to consider functional neurological symptom disorder as ‘malingering’ while psychiatrists tended to diagnose the pulmonary embolism case as a psychiatric condition. Emergency medicine physicians preferred to manage functional neurological symptom disorder themselves, while other doctors endorsed recommending a psychiatric consultation. In the univariable model, being a physician from psychiatry, emergency medicine, or internal medicine; being a specialist, history of childhood sexual abuse, dismissive, and fearful attachment styles of doctors were significant predictors of diagnosing functional neurological symptom disorder as malingering. Being a psychiatrist stayed as the only significant predictor in the multivariable model. Conclusion: objectively-aberrant functional neurological symptoms and subjective somatic symptoms may be creating different reactions in physicians. In the emergency department, physicians’ diagnostic and treatment preferences of conversion disorder may be influenced by lack of training in conversion disorder, rather than their personal characteristics. / Amaç: farklı uzmanlık dallarından hekimlerin acil serviste fonksiyonel nörolojik (konversiyon) belirti bozukluğu ve bedensel belirti bozukluğunu yönetimini, pulmoner embolinin yönetimi ile karşılaştırarak incelemeyi ve hekimlerin mesleki ve kişisel özelliklerinin tanı tercihlerini nasıl etkilediğini araştırmayı amaçladık. Yöntem: vinyet yöntemi ve kesitsel tasarım kullanıldı. Olası fonksiyonel nörolojik belirti bozukluğu, bedensel belirti bozukluğu ve pulmoner emboli tanısı ile acil servise başvuran üç olgu, iç hastalıkları, acil tıp ve psikiyatri hekimlerine sunuldu. Bu olguların tanı ve tedavisine, ve hekimlerin mesleki ve kişisel özellikleri (çocukluk çağı travması, bağlanma biçimi) ne yönelik sorular içeren yapılandırılmış anket uygulandı. Bulgular: dahiliye ve acil tıp hekimleri, fonksiyonel nörolojik belirti bozukluğunu “temaruz” olarak görme eğilimindeyken, psikiyatristler pulmoner emboli vakasını psikiyatrik bir durum olarak görme eğilimindeydiler. Acil tıp hekimleri, fonksiyonel nörolojik belirti bozukluğunu kendileri yönetmeyi tercih ederken, diğer doktorlar psikiyatri konsültasyonu önerdi. Tek değişkenli modelde psikiyatri, acil tıp veya dahiliye hekimi olmak; uzman olmak, çocukluk çağı cinsel istismarı, kayıtsız ve korkulu bağlanma biçimleri, fonksiyonel nörolojik belirti bozukluğunu temaruz olarak tanımlamayı yordamaktaydı. Çok değişkenli modelde tek anlamlı yordayıcı psikiyatri uzmanlık dalıydı. Sonuç: nesnel olarak gözlenen anormal fonksiyonel nörolojik belirtiler ve öznel bedensel belirtiler hekimlerde farklı tepkilere yol açıyor olabilir. Acil serviste hekimlerin konversiyon bozukluğu tanı ve tedavi tercihleri, kişisel özelliklerinden ziyade konversiyon bozukluğu konusundaki eğitim eksikliğinden etkileniyor olabilir.