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    Carbon Monoxide Poisoning and Mechanical Ventilation: Case Report Literature Review
    (Aves, 2010) Cander, Basar; Dundar, Z. Defne; Yaylali, Cetin; Bayir, Aysegul; Girisgin, Sadik
    Carbon monoxide poisoning is one of the most common lethal poisonings. Neurological or psychiatric sequelae occur in approximately 50-75% of survivors. Carbon monoxide poisoning can be treated with 100% oxygen or hyperbaric oxygen. The Glasgow Coma Scale (GKS) of the male patient who was admitted to our emergency department with CO intoxication due to a heater was 4. The patient's transport to a hyperbaric oxygen treatment center was considered but the conditions were not suitable for transport, so 100% oxygen treatment with mechanical ventilator was initiated. The patient was weaned from the mechanical ventilator at day 5 and he was extubated when his spontaneous breathing was adequate. He was discharged from hospital at the end of the follow-up period, day 14. His general condition was quite good and his GKS was 15 at discharge. Although most of the studies suggested that hyperbaric oxygen treatment was more effi cacious in carbon monoxide poisoning, other studies stated that there was no diff erence between hyperbaric oxygen and 100% oxygen treatment. There is a general opinion that the supportive treatment is very important for survival.
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    A Diagnosis ofTotal Abdominal Aortic Occlusion in a Patient Who Entered the Emergency Department by Walking
    (Aves, 2014) Dundar, Zerrin Defne; Guven, Merve; Ergin, Mehmet; Cander, Basar; Girisgin, Sadik
    Introduction: The risk of thrombosis is increased in hypercoagulability. Hypercoagulability can be inherited or acquired. Here, we want to present a patient with inherited hypercoagulability who came to the emergency department by walking and was diagnosed with total abdominal aortic thrombosis and acute renal artery thrombosis. Case Report: A 48-year-old female patient presented to our emergency medicine department with a history of right flank pain for 30 minutes. The pain had started abruptly and was continuous. She came to the emergency medicine department by walking. The contrast-enhanced abdominal computed tomography showed right renal infarction, right artery occlusion, and abdominal aortic thrombus at the level of the iliac bifurcation. Conclusion: Abdominal aortic thrombus is a relatively rare complication of hypercoagulability. Total occlusion of the aorta is generally presented with pain, pallor, weakness, and numbness of the lower limbs. In our case, there was none of these signs due to the blood flow supplied by collaterals. It is a challenge to diagnose total aortic occlusion in a patient that comes to the emergency department by walking.
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    Diagnostic value of ischemia-modified albumin in acute coronary syndrome and acute ischemic stroke
    (Professional Medical Publications, 2013) Ertekin, Birsen; Kocak, Sedat; Dundar, Zerrin Defne; Girisgin, Sadik; Cander, Basar; Gul, Mehmet; Doseyici, Sibel
    Objective: To investigate diagnostic value of ischemia-modified albumin (IMA) levels in patients applying to emergency with symptoms of acute coronary syndrome (ACS) and acute ischemic stroke (AIS). Methods: Two patient groups (ACS and AIS) and a control group were constituted. The study was discontinued upon reaching 30 patients in each group. Following patient approval at the initial visit, a total of 10 ml venous blood sample was obtained from all patients with a high clinical suspicion of ACS and AIS. The Troponin I and the IMA levels were determined in the blood samples. Results: Statistically significant higher IMA values were determined in the patient groups compared to the control group (p < 0.001 for both groups). No statistically significant correlation was found between the IMA and the Troponin I values in the ACS and the AIS groups (p>0.05 for both groups). The sensitivity of IMA was 83% and 87% for ACS and AIS, respectively. The specificity of IMA was 90% and 87% for ACS and AIS, respectively. Conclusion: The sensitivity and specificity values, determined according to the optimal cut-off values in the groups demonstrated that IMA could be a useful diagnostic marker in ACS and AIS patients.
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    Diagnostic value of ischemia-modified albumin in acute coronary syndrome and acute ischemic stroke
    (Professional Medical Publications, 2013) Ertekin, Birsen; Kocak, Sedat; Dundar, Zerrin Defne; Girisgin, Sadik; Cander, Basar; Gul, Mehmet; Doseyici, Sibel
    Objective: To investigate diagnostic value of ischemia-modified albumin (IMA) levels in patients applying to emergency with symptoms of acute coronary syndrome (ACS) and acute ischemic stroke (AIS). Methods: Two patient groups (ACS and AIS) and a control group were constituted. The study was discontinued upon reaching 30 patients in each group. Following patient approval at the initial visit, a total of 10 ml venous blood sample was obtained from all patients with a high clinical suspicion of ACS and AIS. The Troponin I and the IMA levels were determined in the blood samples. Results: Statistically significant higher IMA values were determined in the patient groups compared to the control group (p < 0.001 for both groups). No statistically significant correlation was found between the IMA and the Troponin I values in the ACS and the AIS groups (p>0.05 for both groups). The sensitivity of IMA was 83% and 87% for ACS and AIS, respectively. The specificity of IMA was 90% and 87% for ACS and AIS, respectively. Conclusion: The sensitivity and specificity values, determined according to the optimal cut-off values in the groups demonstrated that IMA could be a useful diagnostic marker in ACS and AIS patients.
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    How successful is pleural sound sign in the identification of pneumothorax?
    (Kare Publ, 2019) Calik, Saniye Goknil; Calik, Mustafa; Girisgin, Sadik; Karaoglan, Osman; Dundar, Zerrin Defne; Ergin, Mehmet
    OBJECTIVE: In the present study, in thorax ultrasonography (USG) Doppler images obtained from cases with occult pneumothorax, we investigated the status of pulsatile pleural sounds over the pleural line and called these as the pleural sound sign (PSS). The purpose of the present study was to identify the efficacy of the proposed PSS in diagnosing pneumothorax and to compare it with the other USG findings including the sliding lung sign (SLS) and seashore sign (SSS). METHODS: The present study included 66 consecutive patients who were referred to the emergency unit with a blunt trauma from October 2009 to January 2010 at a tertiary university hospital. RESULTS: Of the 66 patients, 34 were in the patient group, and 32 were in the control group. Males accounted for 66.7% (n=44) of the study population. In predicting pneumothorax, the areas under receiver operating characteristic (ROC) curves of PSSmax and PSSdifference were 0.989 and 0.990, respectively. While the sensitivity of the SLS was 88% and the sensitivity of the SSS was 56%, the specificities of the SLS and SSS were 100%. Based on our findings, accuracy ranking was as follows: PSSmax = PSSdifference > SLS > SSS. CONCLUSION: New applications of thorax USG are rapidly growing. Our findings have to be confirmed in a large patient series. PSS is not a novel method, but it enhanced the importance of USG in the diagnosis of pneumothorax. We can stipulate that it can replace thorax computed tomography imaging particularly for the diagnosis of occult pneumothoraxes.
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    How successful is pleural sound sign in the identification of pneumothorax?
    (Kare Publ, 2019) Calik, Saniye Goknil; Calik, Mustafa; Girisgin, Sadik; Karaoglan, Osman; Dundar, Zerrin Defne; Ergin, Mehmet
    OBJECTIVE: In the present study, in thorax ultrasonography (USG) Doppler images obtained from cases with occult pneumothorax, we investigated the status of pulsatile pleural sounds over the pleural line and called these as the pleural sound sign (PSS). The purpose of the present study was to identify the efficacy of the proposed PSS in diagnosing pneumothorax and to compare it with the other USG findings including the sliding lung sign (SLS) and seashore sign (SSS). METHODS: The present study included 66 consecutive patients who were referred to the emergency unit with a blunt trauma from October 2009 to January 2010 at a tertiary university hospital. RESULTS: Of the 66 patients, 34 were in the patient group, and 32 were in the control group. Males accounted for 66.7% (n=44) of the study population. In predicting pneumothorax, the areas under receiver operating characteristic (ROC) curves of PSSmax and PSSdifference were 0.989 and 0.990, respectively. While the sensitivity of the SLS was 88% and the sensitivity of the SSS was 56%, the specificities of the SLS and SSS were 100%. Based on our findings, accuracy ranking was as follows: PSSmax = PSSdifference > SLS > SSS. CONCLUSION: New applications of thorax USG are rapidly growing. Our findings have to be confirmed in a large patient series. PSS is not a novel method, but it enhanced the importance of USG in the diagnosis of pneumothorax. We can stipulate that it can replace thorax computed tomography imaging particularly for the diagnosis of occult pneumothoraxes.
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    The Relationship Between Acute Ischemic Stroke and Acute Phase Reactants
    (Emergency Medicine Physicians Assoc Turkey, 2011) Gul, Mehmet; Cander, Basar; Girisgin, Sadik; Tokgoz, Serhat; Kocak, Sedat; Bircan, Metin; Kaya, Halil
    Objective: The role played by inflammation in the etiopathogenesis of stroke has been intensively investigated in recent years. In this clinical study, the relationship between acute phase reactants (APR) and acute ischemic stroke (AIS) was investigated. Material and Methods: 126 patients with AIS and 104 volunteer individuals as controls were included in the study. White blood count (WBC), C-reactive protein (CRP), fibrinogen, lipoprotein (a) (Lp a) and complementary fragments (C-3 and C-4) levels were investigated both in patients with AIS and the controls. Results: In patients with AIS, WBC and fibrinogen values were significantly higher than the controls (p < 0.001, p < 0.001, p < 0.001, respectively). There was no significant difference between Lp(a), C-3 and C-4 values in patients with AIS and controls (p=0.727, p=0.163, p=0.497, respectively). Conclusion: The most important goal in the prevention of primary stroke is that the risk factors leading to stroke are defined and changed.