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    Acute Deep Venous Thrombosis Associated with Acute Brucellosis: A Case Report
    (Aves, 2012) Kocak, Sedat; Dikmetas, Cesarettin; Dundar, Zerrin D.; Erdemir, Esma; Kesli, Recep
    Brucellosis continues to be one of the most widespread zoonoses worldwide. Human brucellosis is a multisystem disease that may present with a broad spectrum of clinical manifestations, but it may also be asymptomatic with only serological evidence of infection. In this paper, a case report is presented of deep venous thrombosis (DVT) developing after a diagnosis of acute brucellosis in a young slaughterhouse worker. A 26-year-old man was diagnosed with DVT which had presented with the complaints of weakness and fever and a one-week history of pain and swelling in the right leg. Ultrasound revealed that the right femoral and popliteal veins were occluded with thrombi. Brucella was diagnosed using Rose-Bengal, tube agglutination, the Brucellacapt test and an enzyme-linked immunoassay using anti-Brucella abortus IgM/G antibody detection at another institution. Although rare, some infectious agents may cause vascular pathologies. These conditions may be life-threatening. Thus, it should be kept in mind that vascular complications may occur during infectious disease and patients should be monitored. Additionally, patients presenting with symptoms of DVT or similar vascular pathologies should be assessed for infectious agents, particularly Brucella and Salmonella, as well as other risk factors.
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    Association of Severity of Coronary Lesion with Markers of Acute Infection and Inflammation in Patients with Acute Coronary Syndrome
    (2016) Koçak, Sedat; Dündar, Zerrin Defne; Harmankaya, Atıf; Erdemir, Esma; Keşli, Recep; Alibasic, Hayrudin
    Aim: Inflammation and some infectious agents play a key role in acute coronary syndrome (ACS) caused by atherosclerosis. The purpose of this study was to assess the effects of inflammatory markers and the positivity of Chlamydia pneumoniae (CP), Helicobacter pylori (HP), and Cytomegalovirus (CMV) on the level of atherosclerosis in patients with ACS. Materials and Methods: Patients (57) that were referred to the emergency unit with classic angina symptoms or angina equivalent symptoms and were determined to have critical lesions in the coronary angiography (<70% stenosis, coronary artery disease (CAD) severity assessed by the Gensini score) were compared with 27 ACS patients who had no critical lesions in terms of procalcitonin (PCT), tumor necrosis factor-alpha (TNF-?), interleukin-2 receptor (IL2r), interleukin-6 (IL-6), and interleukin-10 (IL-10) levels and positivity of CP, HP, and CMV. Also, the two groups of ACS patients were compared in terms of cytokine levels measured at hours 0 and 48. Results: No significant association was found between the degree of the coronary lesion and the inflammatory and infectious agents. However, in patients with critical coronary lesions, as markers of inflammatory agents, the levels of IL-6 were significantly lower and levels of IL-10 were significantly higher (p>0.001 and p0.030, respectively) at hour 48 than originally found at hour 0. Conclusion: There is no association between the severity of coronary lesions and cytokine levels and positivity of infectious agents in ACS since the levels of proinflammatory cytokines in ACS are higher than those in atherosclerosis. The changes in cytokine levels at hour 48 were found to be significant.
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    Demography and Clinical Consequences of Trauma-Related Amputations in the Emergency Department Short
    (Aves, 2013) Kocak, Sedat; Ertekin, Birsen; Erdemir, Esma; Girisgin, Abdullah Sadik; Cander, Basar
    Objective: Total or subtotal traumatic extremity amputations constitute a considerable portion of trauma-related emergency department admissions. In this study, we aimed to establish the patients' age group, educational level and occupational group in which trauma-related extremity amputations are more frequently performed. Material and Methods: Cases presenting to our Emergency Department between August 2006 and August 2008, in whom traumatic extremity amputations were performed were prospectively studied. The data that were recorded on a study form, which included age, sex, educational level, occupation, mechanism of the trauma and hospitalization duration, underwent evaluation. Results: The data of 309 subjects were evaluated in this study. The mean age of the patients was 29 +/- 17.9, with 18.1% of the subjects being female and 81.9% being of male gender. 41.1% of the cases were laborers, 23.6% were self-employed in various fields, and 9.4% were farmers. With respect to the method of trauma in the majority of the amputations, industrial injuries accounted for 65.7%, finger jamming (door-related) accounted for 17.2%, and home injuries accounted for 8.7%. Finger amputation was identified in 93.4%, toe amputation in 4.4%, and others in 2.2%. Conclusion: Traumatic amputation concerns particularly children, youths, and people of low educational level with an active work life. The most frequently affected body parts are the fingers.
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    Efficacy of Use of Red Cell Distribution Width as a Diagnostic Marker in Acute Appendicitis
    (2017) Ertekin, Birsen; Kara, Hasan; Erdemir, Esma; Doğan, Emine; Acar, Tarık; Demir, Lütfi Saltuk
    Aim: We aimed to investigate the increase in values of red cell distribution width (RDW) and also the dependence of RDW on leukocyte count (WBC) and C-reactive protein (CRP) values in acute appendicitis (AA).Materials and Methods: This study includes data collected from 407 patients who were admitted between January 2012 and July 2014 to the emergency service and underwent an operation owing to a diagnosis of AA confirmed by a pathology report. These patients were divided into two groups, namely, non-complicated and complicated appendicitis, according to the results of the operation. The control group consisted of 100 adult patients with similar complaints not having acute abdominal conditions. The age, gender, and WBC, RDW, and CRP levels of the patients on admission were recorded retrospectively.Results: A total of 350 (86%) of the patient group were diagnosed with non-complicated appendicitis, 34 (8.4%) with plastron appendicitis, and 23 (5.6%) with perforated appendicitis. No significant difference was observed with respect to WBC, RDW, and CRP levels between the AA groups (p<0.05). The WBC, RDW, and CRP values were found to be significantly different in the AA groups from the control group (p>0.05). The sensitivity and specificity of the WBC, RDW, and CRP values in the AA group were 70% and 60%, 41% and 30%, and 51% and 40%, respectively. No dependence of RDW values on WBC or CRP levels was found.Conclusion: RDW values were found to be significantly higher in the AA group than in the control group. The low sensitivity and specificity values of the RDW test reduce the possibility that it might become a hematologic marker to be used in the definitive diagnosis of AA.