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Öğe The Bibliometric Qualities of Original Research Published in the Eurasian Journal of Emergency Medicine between the Years 2010-2014(2016) Emet, Mücahit; Akbaş, İlker; Koçak, Abdullah Osman; Cander, Başar; Aslan, ŞahinAim: Bibliographic work in the Turkish emergency medicine community is very scarce. We aim to improve upon the shortcomings in this area.Materials and Methods: Original research published in the Eurasian Journal of Emergency Medicine (EAJEM) (formerly known as the Academic Journal of Emergency Medicine) within the 5-year period between 2010 and 2014 was retrospectively reviewed.Results: While retrospective publications stood out the most (n81, 54.7%), they were followed by prospective (n38, 25.7%) and sectional (n29, 93.9%) works. A vast majority of the work was concentric (n139, 93.9%). Here 6.1% publications were sourced overseas. The most commonly studied subjects in the articles published in the EAJEM were medical emergencies (26.35%), trauma (20.27%), and emergency service (19.59%). Further, 52.7% (n78) texts were written in English and 47.3% (n70) were written in Turkish. In 15.5% (n23) articles, an emergency medicine resident and/or emergency medicine specialist was not among the authors. The original research most commonly had 3 keywords (n73, 49.3%). There were 12 (8.1%) articles in which no tables were used and 70 (47.3%) articles in which there were no figures. According to our findings, a total of 2981 references were used in the 148 articles that were reviewed, and the median reference value per article was 17 (min: 6; max: 50). In our study, 38 references were self-references (12.85) and 727 (24.4%) references were references to texts published in journals in the Turkish index. Within all the references, there were 43 (14.4%) references to the Turkish Journal of Emergency Medicine (TJEM), 41 (13.8%) references to the EAJEM, and only 3 (1.1%) references to Journal of Emergency Medicine Case Reports (JEMCR). The median value of references made to texts in the journals in the Turkish index per article was 2 (min: 0; max: 32). The number of references to the TJEM per article was 43/148 (29.1%), that to the EAJEM was 41/148 (27.7%), and that to JEMCR was 3/148 (2%). While the acceptance period ranged between 1 and 350 days, the average period was 49 days.Conclusion: We believe that preference should be given to the printing of prospective and multi-centric publications and those with more keywords.Öğe Cranial Subdural Hematoma Following Spinal Anesthesia: Case Report(2017) Gül, Mehmet; Ayrancı, Mustafa Kürşat; Güner, Hakan; Medni, Mohamed Refik; Cander, BaşarAlthough post dural puncture headache is the most common complication of spinalanesthesia, subdural hematoma is a rare complication. The mortality would be high if untreated. Inthis case, a patient of 28 years old presented to our emergency department with headache after cesarean section performed with spinal anesthesia 20 days prior. She had received analgesic drugtreatment for post dural puncture headache. Despite treatment, she presented to our emergency department for unresolved headache. A subdural hematoma was detected using a brain computed tomography (CT) because of complaint of double vision accompanied by headache. For headacheoccurring after spinal anesthesia without response to medical therapy, subdural hematoma shouldbe considered.Öğe Datura Stramonium Poisoning: Two Case Reports(2017) Günaydın, Yahya Kemal; Cander, Başar; Işıkoğlu, Vahdet; Kokulu, Kamil; Muraçar, Nurser; Akıllı, Nazire Belgin; Yıldız, Can Gökay; Köylü, RamazanIntroduction: Datura stramonium is a wild plant, which grows in almost every region of Turkey and is found in the native flora. D. stramonium is used as a herbal medicine for asthma, bronchitis, eczema, and hemorrhoid treatment. Because of D. stramonium’s hallucinative and euphoric effects, it can be abused, particularly by drug addicts. Excessive oral intake may cause anticholinergic toxicity. In the case of a very high dose intake, it may result in coma. In this study, we have discussed two patients who presented to the emergency department of our hospital with anticholinergic findings and were diagnosed with D. stramonium intoxication.Case Report: Two patients presented to the emergency department of our hospital with signs and symptoms of anticholinergic poisoning. Two cases were also fell complaints with symptomatic treatment. Both the patients were admitted to the toxicology department and were followed-up for 2 days. The complaints regressed the next day, and the both the patients were discharged with complete recovery.Conclusion: Our study reporting the present cases shows that D. stramonium, which is used for therapeutic purposes, also causes severe intoxication. Therefore, wild plant poisoning should be considered for every patient presenting to the emergency department with unexplained anticholinergic symptoms and complaints.Öğe Diagnostic and Prognostic Significance of Neutrophil Gelatinase- Associated Lipocalin and Pentraxin-3 in Acute Coronary Syndrome(2017) Özer, Muhammet Raşit; Ergin, Mehmet; Kılınç, İbrahim; Dündar, Zerrin Defne; Özer, Nejla; Önal, Mehmet Akif; Girişgin, Abdullah Sadık; Koçak, Sedat; Gül, Mehmet; Cander, BaşarAim: The aim was to evaluate the levels of serum pentraxin-3 (PTX-3) and neutrophil gelatinase-associated lipocalin (NGAL) and the efficiency of making a diagnosis and to estimate the prognosis in patients with chest pain.Materials and Methods: The study was conducted in the Necmettin Erbakan University Meram Medicine School Emergency Department. Patients who had chest pain and met the inclusion criteria were accepted. They were divided into the following groups: acute coronary syndrome (ACS), a diagnosis other than ACS (non-ACS), and control. The patients in theACS and non-ACS groups were divided into five sub-group -groups: ST Elevated Myocardial Infarction (STEMI) Non- ST Elevated Myocardial Infarction (NSTEMI), Unstable Angina Pectoris (USAP), stable angina, and pulmonary embolus. For all patients, serum PTX-3, serum NGAL, troponin I, and creatine kinase-MB fraction (CK-MB) levels were measured.Results: There were 199 patients in the ACS and non-ACS groups and 30 patientsin the control group. There was no significant difference among the study groups in terms of age and PTX-3 and NGAL levels. When comparing survival and non-survival in terms of in-hospital death, CK-MB and troponin I levels were significantly higher in the ACS and non-ACS groups than in the control groups, whereas there was no significant difference in terms of PTX-3 and NGAL levels.Conclusion: The results of our study demonstrated that PTX-3 and NGAL are not effective biomarkers in the differential diagnosis and the determination of in-hospital mortality in ACS. However, the limitations of the study should be considered. The results confirmed that CK-MB and Troponin I can be safely used in the differential diagnosis and the prediction of mortality.Öğe The Importance of Electrocardiographic Screening in Cardiac Contusion after Blunt Chest Trauma: Case Reports(2013) Uçar Karabulut, Keziban; Narcı, Hüseyin; Cander, Başar; Gül, Mehmet; Duman, ÇetinKünt göğüs travması geçiren hastaların takip ve monitorizasyonu önemlidir.İzole künt göğüs travmasına bağlı kardiyak kontüzyon takiben akut koroner sendrom gelişebileceği unutulmamalıdır. Künt göğüs travması sonucu akut koroner sndrom gelişen iki hasta tanımlamaya çalıştık.Hastarın EKG lerinde inferior derivasyonlarda ST elevasyonu tespit ettik,hastalar medikal tedavi ve koroner anjiografi yapıldı. koroner anjiografi sonucu koroner arterlerde herhangi bir patoloji saptanmadı.Onların durumu, travma ve stres nedeniyle kardiyak kontüzyona bağlandı.Kardiyak kontüzyon izole künt göğüs travmalarında oluşabilir, bununla birlikte hertürlü travma ve stres sonucu akut koroner sendromu gelişebileceği unutulmamalıdır.Öğe Investigation of Electrocardiography Changes and, Specifically, Changes in the TpTe Interval and TpTe/QT Ratio in Patients Presenting with Electrical Injuries(2016) Günaydın, Yahya Kemal; Yıldız, Can Gökay; Çağlar, Ahmet; Akıllı, Nazire Belgin; Köylü, Ramazan; Cander, BaşarAim: The purpose of this study was to examine changes in cardiac monitoring, electrocardiography (ECG), or cardiac enzymes and, specifically, changes in the TpTe interval and TpTe/QT ratio in patients who presented with electrical injuries. Materials and Methods: All patients aged over 18 years who had visited the Emergency Medicine Clinic between January 2011 and January 2014 because of electrical injuries and who were monitored for more than 24 h were included. Results: Seventy patients were included in the trial. ECG changes were present in 19 patients (27.1%) at various time points (0th, 6th, 12th, and 24th hour). The TpTe intervals of the patients at the time points were 64.5 (IQR: 21.25), 65 (IQR: 21.5), 64 (IQR: 20), and 64 (IQR: 20) ms, respectively, which were within the normal range. Although a statistical difference was present (p0.033), superior analyses showed no significant difference among the groups. The TpTe/QT ratios of the patients were 0.18 (0.07), 0.18 (0.05), 0.18 (0.06), 0.18 (0.05), respectively, which were within the normal range (p0.105). We compared the TpTe intervals and TpTe/QT ratios of patients with and without ECG changes and found that no statistically significant difference was present at all time points. Besides this, no difference in the TpTe intervals and TpTe/QT ratios was identified between the groups with elevated and non-elevated troponin levels. Conclusion: The use of TpTe intervals and TpTe/QT ratios may not be the correct approach for predicting potential rhythm disorders in electrical injuries. In addition, there is no association of the TpTe interval or the TpTe/QT ratio with ECG changes or troponin elevation caused by electrical injuries.Öğe Is There a Difference Between the Readabilities of Informed Consent Forms Used for Procedures in the Emergency Services of State and University Hospitals in Turkey?(2018) Öztürk Sönmez, Leyla; Sönmez, Mehmet Giray; Mustafa Kürşat, Ayrancı; Evrin, Togay; Katipoğlu, Burak; Cander, BaşarAim: The aim of the present study was to evaluate the readability levels of informed consent forms (ICFs) used for procedures in the emergency services of state and university hospitals by comparing through readability formulas.Materials and Methods: ICFs used in emergency medicine clinics in different university and state hospitals in Turkey were collected, and forms that were the same were included in the evaluation only once. A total of 32 ICFs, with 15 from university hospitals and 17 from state hospitals, were evaluated. Average word number, syllable number, and words with syllable number of four and above were calculated. Different formulas were used to determine readability levels.Results: Although the readability of ICFs used in university hospitals was found to be better than those in state hospitals, the readability levels of the ICFs for both groups were detected to have medium difficulty according to the Atesman formula, very difficult according to the Flesch-Kincaid formula, difficult according to the Gunning-Fog formula, and at high school level according to the Bezirci-Yilmaz formula.Conclusion: In conclusion, the readability rates of emergency procedure ICFs in both state hospitals and university hospitals were detected to be rather low according to the present study. The education level of our country and the local environment should be considered while preparing these ICFs.Öğe 'Lichtenberg Figure' as a Result of Lightning Shock(2014) Ergin, Mehmet; Önal, Mehmet Akif; Dikmetaş, Cesarettin; Cander, BaşarA 30 year-old-male was found unconscious while working outdoors. After completion of the initial evaluation, the Primary Health Care Center referred him to our emergency department. He couldn’t remember what had happened to him and he was complaining of chest and back pain. His vital signs were in the normal ranges, and his physical examination values were normal except for the skin findings. The findings in his ECG, complete blood count, other laboratory results and braincomputed tomography were in the normal ranges. Mainly six types of cutaneous findings occur as a result of being struck by lightning. They include linear burns, punctate burns, Lichtenberg figures (LF), contact burns from overlying metal objects, superficial erythema and their combinations. Moreover, entry and outlet holes of lightning strikes are rarely seen. The painless, hyperemic, spreading and ferning patern figure on the skin is called Lichtenberg figure (LF). It matches no anatomical, vascular, or neural patterns. Contrary to thermal and electrical burns, it is harmless to epidermis and deeper tissues. Although the exact mechanism is unknown, it is thought that they represent red blood cells extravasated into the superficial layers of the skin from capillaries secondary to the dielectric breakdown of the skin and subsequent massive electron shower. Our patient was admitted to the observation unit. The patient, who was on observation status for 48 hours, discharged from the hospital and recommended to attend the outpatient clinic. If a victim found unconscious outdoors, strike of lightning should be considered in the differential diagnosis. Pathognomonic skin findings should not be overlooked.Öğe Liporotein-Associated Phospholipase-A2 Can Be A Diagnostic Marker İnthe Early Stage Diagnosis Of Acute Mesenteric İschemia(2016) Acar, Tarık; Koçak, Sedat; Cander, Başar; Ergin, Mehmet; Dikmetaş, CesareddinBackground/aim: The purpose of this experimental study was to investigate the role of lipoprotein-associated phospholipase-A2 (LpPLA2 ) in the diagnosis of acute mesenteric ischemia (AMI) in the early stage. Materials and methods: Twenty-seven New Zealand rabbits were randomly divided into 3 groups in this study. Blood specimens were obtained from the groups at hours 0, 1, 3, and 6. Using the blood samples drawn from all groups, Lp-PLA2 and C-reactive protein (CRP) parameters were investigated. Results: There was a significant rise in the levels of both Lp-PLA2 and CRP starting at hour 1 (P > 0.05) (hour 1; Lp-PLA2 , P 0.003) in the ischemia group. In the sham group, the levels of Lp-PLA2 and CRP started to rise at hour 3 (P > 0.05) (hour 3; Lp-PLA2 , P 0.011). At hour 6 of ischemia, the area under the ROC curve was 100%, and the cut-off value of 63.91 ng/mL revealed a sensitivity of 88% and a specificity of 100% for Lp-PLA2 . Conclusion: These findings showed the role of serum Lp-PLA2 and CRP levels in the early diagnosis of AMI. Thus, further studies are needed to describe the role of Lp-PLA2 in the early diagnosis of AMI.Öğe Melena Associated with Ganoderma Lucidum: A Case Report(2015) Acar, Demet; Gülpembe, Mustafa; Akıllı, Nazire Belgin; Göknil Çalık, Saniye; Köylü, Ramazan; Günaydın, Yahya Kemal; Cander, BaşarMelena acil servis hastaları arasında görülen hayatı tehdit edebilecek bir bulgudur. Olgu Sunumu: Biz burada, önceden bilinen herhangi bir mide şikayeti olmayan genç bir erkek hastada Ganoderma Lucidum kullanımı ile indüklenen bir melena olgusu sunacağız. Sonuç: G. lucidum'un bazı toksik etkileri bildirilmiştir ancak bildiğimiz kadarıyla, bu vaka bildirilen G. lucidum ile ilişkili ilk üst gastrointestinal sistem kanamasıdır.Öğe N Terminal prohormone brain natriuretic peptit level in patients with arhythmia(2016) Uçar Karabulut, Keziban; Cander, BaşarObjective: Brain natriuretic peptides are the marker protein structures released in response to wall tension from ventricular myocytes, and have been increasingly used in recent years. The use of N-Terminal Prohormone Brain Natriuretic Peptide is getting more expanded in acute heart failure, left ventricular diseases and acute dyspnea. Here, we aimed at investigating the level of N-Terminal Prohormone Brain Natriuretic Peptide in patients diagnosed with arrhythmias. Materials and Methods: Patients admitted to the emergency department and with any rhythm disorder were included into this study. Bedside echocardiography was performed for each patient. Patients were classified into two groups with and without heart failure. Blood samples of 1 cc were drawn from patients and put into ethylene diamine tetraacetic acid (EDTA)-containing tubes, and N-Terminal Prohormone Brain Natriuretic was investigated. Collected data were recorded into the prepared forms. Statistical analyses were performed with SPSS for Windows 13.0 software package. While average N-Terminal Prohormone Brain Natriuretic level was 25100±10955 pg/Ml in patients with heart failure, average level of NTerminal Prohormone Brain Natriuretic was seen as 5767.61±6225 pg/mL in those with any rhythm disorder but no heart failure.Brain Natrıuretıc Peptıt And Arhythmia Conclusion: N Terminal Prohormon Brain Natriuretik Peptid are important markers in the diagnosis of acute heart failure. In recent years, studies on their association with other diseases have become widespread. In our study, we also found BNP levels more than normal ranges in patients with arrhythmia but no cardiac failure, as well as finding N-Terminal Prohormone Brain Natriuretic levels at higher rates in heart failure patients with dysrhythmia.Öğe Prognostic Value of Red Cell Distribution Width in Critically Ill Patients and Comparison with Intensive Care Unit Scoring Systems(2017) Gül, Mehmet; Dündar, Zerrin Defne; Girişgin, Abdullah Sadık; Vişneci, Emin Fatih; Cander, Başar; Dur, AliAim: This study aimed to investigate the prognostic value of lactate and red cell distribution width (RDW) parameters of patients admitted to emergency service and critical care unit (CCU). Materials and Methods: A total of 147 patients hospitalized in the CCU of Necmettin Erbakan University, Meram Faculty of Medicine, Department of Emergency Medicine, were included in the study. Vital signs, laboratory results, lactate, and RDW values of the patients were recorded. Acute Physiology and Chronic Health Evaluation II (APACHE II) and sequential organ failure assessment (SOFA) scores were calculated. Duration of hospitalization and intensive care unit stay and mortalities were recorded. Chi-square, Fisher's exact chi-square, and Student t tests were used for statistical analyzes, and Mann-Whitney U test was used for comparing nonparametric data that were not compatible with a normal distribution. P>0.05 were accepted as statistically significant. Spearman correlation analysis was used to assess whether a linear correlation existed between the parameters. Results: A statistically significant correlation was found between the duration of stay in the CCU for >7 days and total duration of hospitalization (p>0.001). Also, statistically significant correlations were observed between mortalities of 28 days and 3 months, APACHE II and SOFA scores, and mean lactate (for 24 h and during hospitalization) and RDW values (p>0.001, p>0.001, p>0.001, and p>0.05, respectively). Moreover, correlations were noted between APACHE II scores, lactate value during the first admission, and SOFA scores (p>0.001). Correlations were also observed between 48-h SOFA scores and RDW and lactate values (p>0.001). Conclusion: SOFA and APACHE II are the scoring systems used in practice. Efficiencies for mortality assessment of critical patients were confirmed. This study showed that lactate and RDW values, which were compatible with the scoring systems, could be used for assessing prognosis. Wider and more comprehensive studies that can assess scoring systems and lactate and RDW values together for prognostic identification are required to validate the findings.Öğe Prognostic Value of Red Cell Distribution Width in Patients with Organophosphate Poisoning(2015) Dündar, Zerrin Defne; Ergin, Mehmet; Köylü, Ramazan; Günaydın, Yahya Kemal; Özer, Raşit; Cander, BaşarThe aim of this retrospective study was to investigate the prognostic value of red cell distribution width (RDW) and other hematological parameters measured on admission to the emergency department in patients with organophosphate poisoning.Materials and Methods_ All patients aged ? 15 years who were admitted to the emergency department from 2008 to 2013 on account of organophosphate poisoning were included in the study. The written and electronic medical charts of the patients were reviewed. Hematological parameters were recorded. Mechanical ventilation requirement was used as the primary endpoint. Results: A total of 72 patients were included in the study for evaluation. Mechanically ventilated patients had significantly higher leukocyte counts and RDW levels than non-ventilated patients (p0.004 and p0.001, respectively). The area under the receiver-operating characteristic curve of RDW levels for predicting mechanical ventilation requirement was 0.716 (95% CI: 0.581-0.852, p0.010). RDW had a sensitivity of 73%, specificity of 70%, and negative predictive value of 91% with a cut-off value of 14.5% in predicting mechanical ventilation requirement in patients with organophosphate poisoning. Conclusion: RDW can be a valuable and easy-to-use parameter in estimating prognosis in the follow-up of patients with organophosphate poisoning. Conclusion: RDW can be a valuable and easy-to-use parameter in estimating prognosis in the follow-up of patients with organophosphate poisoning.Öğe Relationship between the neutrophil-to-lymphocyte ratio in acute pancreatitis and the severity and systemic complications of the disease(2018) Kokulu, Kamil; Günaydın, Yahya Kemal; Akıllı, Nazire Belgin; Köylü, Ramazan; Sert, Ekrem Taha; Köylü, Öznur; Cander, BaşarBackground/Aims: In 80% of the patients, Acute pancreatitis (AP) occurs as a self-limiting disease that does not require any specifictreatment; however, in 20% of the cases it occurs in its clinically severe form that may lead to local or systemic complications. The aimof this prospective study was to examine the relationship between the neutrophil to lymphocyte ratio (NLR) and the systemic complications and severity of AP.Materials and Methods: This prospective study included 100 patients with AP. Age, sex, NLR, Ranson scores and the revised Atlantaclassification of the patients were recorded. The patients were divided into two groups according to the Ranson scores as mild andsevere AP. According to the Revised Atlanta classification, the patients were divided into two groups as mild and moderatesevere AP.Results: According to the Ranson score, NLR at the time of admission and at the 48th hour in the severe group was found to be statistically higher than the mild AP group (p0.01). The receiver operating characteristic (ROC) curve analysis was performed to determinethe cut-off value of NLR at the emergency department in order for it to be used for distinguishing AP patients with and without systemiccomplications. The area under the ROC curve was 0.81. Sensitivity and specificity were 87.50% and 69.05%, respectively, when the NLRcut-off value was 7.13.Conclusion: Neutrophil to lymphocyte ratio is associated with severe AP. We also regard NLR as a valuable parameter for predicting thedevelopment of systemic complications in patients with AP.Öğe The reno-protective effects of atorvastatin in crush syndrome and rhabdomyolysis:is there a dilemma?(2017) Acar, Demet; Gülpembe, Mustafa; Yıldız, Can Gökay; Özdamar, Emine Nur; Açıkgöz, Kerem; Çağlar, Ahmet; Cander, BaşarBackground/aim: We aim to determine the effects of low-dose atorvastatin treatment together with crush fluid resuscitation on renal functions and muscle enzyme levels in a rat model of crush syndrome. Materials and methods: The study involved female Wistar Albino rats weighing 250300 g that were housed with free access to food and water. The crush model was obtained by compression. Rats were randomly divided into four groups: control (C) group, atorvastatin crush fluid (ACF) group, crush fluid (CF) group, and hypertonic saline (%3) mannitol sodium bicarbonate (SM) group. Blood was obtained at 24, 48, and 72 h, and serum creatinine kinase, myoglobin, urea, creatinine, and lactate dehydrogenase levels were studied. Results: All parameters were statistically significantly higher in the control group than in the treatment groups at all hours. However, there was no statistically significant difference among treatment groups regarding any of the parameters. Conclusion: This is the first study determining the role of atorvastatin in the treatment of renal ischemia/reperfusion injury in a crush syndrome and rhabdomyolysis model setting. Larger studies with different atorvastatin doses are required to define the role of this drug in the treatment of renal ischemia/reperfusion injury during crush syndrome.Öğe Rhabdomyolysis Associated with Opiate Abuse: A Case Report(2015) Gülpembe, Mustafa; Acar, Demet; Akıllı, Nazire Belgin; Göknil Çalık, Saniye; Günaydın, Yahya Kemal; Köylü, Ramazan; Cander, BaşarOpioid kötüye kullanımı ile ilişkili pek çok komplikasyon bildirilmiştir. Bunların arasında solunum depresyonu, bilinç bulanıklığı, aspirasyon ğnömonisi, pulmoner ödem, miyokardit, rabdomiyoliz ve kompartman sendromu sayılabilir. Bu komplikasyonların bazıları hayatı tehdit eder.Olgu Sunumu: Burada genç bir erkek hastada opioid kötüye kullanımına bağlı gelişen rabdomiyoliz vakası sunacağız. Sonuç: Rabdomiyoliz intravenöz opioid kötüye kullanımına bağlı nadir görülen bir komplikasyondur. Rabdomiyoliz hayatı tehdit edebilecek sonuçlar doğurabileceği için erken tanı ve tedavisi çok önemlidir. Bu nedenle klinisyenler opioid kullanıcılarında bu komplikasyona karşı uyanık olmalılardır.Öğe Rhabdomyolysis Induced by Agaricus Bisporus(2014) Akilli, Nazire Belgin; Dündar, Zerrin Defne; Köylü, Ramazan; Günaydin, Yahya Kemal; Cander, BaşarMushroom poisoning may present with a variety of clinical conditions, extending from simple food poisoning to life-threatening liver and renal failure. Rhabdomyolysis is a recently described syndrome that is observed within the clinical spectrum associated with mushroom poisoning. In this report, we present two patients-one presenting with a state of rhabdomyolysis and the other case with simple symptoms only-following consumption of cultivated mushroom together in the same meal.Öğe The role of oxidative stress in ?-amanitin-induced hepatotoxicity in an experimental mouse model(2017) Dündar, Zerrin Defne; Ergin, Mehmet; Kılınç, İbrahim; Çolak, Tamer; Oltulu, Pembe; Cander, BaşarBackground/aim: This study aimed to evaluate oxidative stress markers of liver tissue in a mouse α-amanitin poisoning model with three different toxin levels. Materials and methods: The mice were randomly divided into Group 1 (control), Group 2 (0.2 mg/kg), Group 3 (0.6 mg/kg), and Group 4 (1.0 mg/kg). The toxin was injected intraperitoneally and 48 h of follow-up was performed before sacrifice. Results: Median superoxide dismutase activities of liver tissue in Groups 3 and 4 were significantly higher than in Group 1 (for both, P 0.001). The catalase activity in Group 2 was significantly higher, but in Groups 3 and 4 it was significantly lower than in Group 1 (for all, P 0.001). The glutathione peroxidase activities in Groups 2, 3, and 4 were significantly higher than in Group 1 (P 0.006, P 0.001, and P 0.001, respectively). The malondialdehyde levels of Groups 3 and 4 were significantly higher than Group 1 (P 0.015 and P 0.003, respectively). The catalase activity had significant correlations with total antioxidant status and total oxidant status levels (r 0.935 and r 0.789, respectively; for both, P > 0.001). Conclusion: Our findings support a significant role for increased oxidative stress in α-amanitin-induced hepatotoxicity.Öğe The role of soluble urokinase plasminogen activator receptor (SuPAR) as an indicator of the severity of acute pancreatitis(2018) Küçükceran, Kadir; Ergin, Mehmet; Kılınç, İbrahim; Karaibrahimoğlu, Adnan; Çolak, Tamer; Tuncar, Alpay; Dündar, Zerrin Defne; Koçak, Sedat; Girişgin, Abdullah Sadık; Gül, Mehmet; Cander, BaşarBackground/aim: Soluble urokinase plasminogen activator receptor (suPAR) has been reported to have a positive correlation with theactivation degree of the immune system. This study’s aim is to investigate the efficiency of SuPAR serum levels in acute pancreatitis (AP)patients in determining the severity of disease.Materials and methods: This prospective research involves patients who arrived at the emergency service, were over 18 years old, hadnontraumatic abdominal pain and diagnosis of AP, and agreed to join the study. Demographic characteristics, contact information,laboratory and imaging test parameters, Ranson’s criteria, the Balthazar Severity Index, the Rapid Acute Physiologic Score (RAPS), andthe modified Glasgow (Imrie) score of all patients were recorded. Two study groups were created as score of 3 (mild, Group I) and 3(severe, Group II) for pancreatitis according to Ranson’s criteria.Results: During the study period, 59 sequential patients with AP were included in the study. It was seen that 79.7% of the study group(n 47) were in Group I. Etiologically 67.8% (n 40) cases were biliary and 32.3% (n 19) were nonbiliary diseases. According to theresults, suPAR level was effective in distinguishing the severity of AP (AUC 0.902, P 0.001 (95% CI: 0.821–0.984)). With regardto determining severe disease, suPAR had an optimum cutoff value of 6.815 ng/mL, sensitivity of 91.66%, specificity of 82.97%, andnegative predictive value of 97.5%.Conclusion: Our study was performed the determine the efficiency of suPAR level in predicting severe disease in AP patients. We foundit significant in indicating the severity of disease according to the study results.Öğe Thrombolysis in STEMI at Prehospital Settings(2014) Ergin, Mehmet; Dündar, Zerrin Defne; Cander, BaşarThrombolysis is a rapidly available but semi-effective treatment, whereas percutaneous coronary intervention is a potentially delayed but highly effective therapy. What about thrombolysis in the prehospital setting for ST-elevated myocardial infarction? Does scientific evidence support or oppose? Which patient group is more eligible for prehospital thrombolysis? Is there any skirmish between emergency medicine and cardiovascular professionals? You can find a history of prehospital thrombolysis on the basis of scientific evidence in this writing