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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 Deneysel kombine kafa travması ve hemorajik şok modelinde sıvı resusitasyonu ve antioksidan tedavinin beyin doku laktik asidozu ve lipid peroksidasyonu üzerine etkileri(2006) Köylü, Ramazan; Gökalp, AdilBu çalışmada, ratlarda deneysel olarak oluşturulan kafa travması ve hemorajik şokmodelinde sıvı resusitasyonu ve DMSO'nun doku laktik asidozu ve lipid peroksidasyonuüzerine etkisi araştırıldı.Denekler 5 ayrı gruba ayrıldı. İlk 2 grup (n=8) sham ve kontrol grubunu, son 3 grup(n=7) ise tedavi verilen grubu oluşturdu. Deneklere Marmarou metoduyla kafa travması veayrıca hemorajik şok oluşturuldu. 3.grupda OAB 60 mmHg, 4.grupta OAB 80 mmHg olacaksekilde sadece sıvı replasman tedavisi, 5. grupta ise OAB 80 mmHg olacak şekilde sıvıreplasmanına ek olarak antioksidan tedavi amacıyla DMSO verildi. Laktik asidoz ve lipidperoksidasyon derecesi, beyin dokusunda laktat ve MDA seviyelerinin ölçülmesi iledeğerlendirildi. Beyin dokusu MDA değerleri, 2., 3. ve 4. gruplarda, sham grubuna görebelirgin olarak artmış olarak tespit edilmesine rağmen (P< 0,05), antioksidan tedavi verilen 5.grupta bu oranda bir artış tespit edilmedi. Doku laktat düzeyleri ise tedavi verilmeyen 2.grupve OAB'ın 60 mmHg civarında tutulduğu 3. grupta, sham grubuna göre belirgin (P< 0,05)olarak artmışken, OAB'ın 80 mmHg civarında tutulduğu 4. ve 5. grupta istatistiksel olarakanlamlı bir artış saptanmadıSonuç olarak; ratlarda deneysel kombine kafa travması ve hemorajik şok modelindeerken dönemde uygun sıvı tedavisi ile birlikte verilen DMSO'nun daha yüksek ortalamaarteryel basınç değerlerinde doku laktik asidozu ve lipid peroksidasyonu üzerine etkili olduğubulundu.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 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 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 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.