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    Does Neutrophil Lymphocyte Ratio Have a Clinical Value to Determine the Severity of the Patients with Acute Appendicitis?
    (Emergency Medicine Physicians Assoc Turkey, 2020) Ozaydin, Vehbi; Dogruyol, Sinem; Bagdigen, Seda Nur; Katipoglu, Burak; Gul, Mehmet
    Aim: The aim of our study is to investigate the predictive value of the neutrophil lymphocyte ratio (NLR) assessed in the emergency department to distinguish complicated and uncomplicated patients with acute appendicitis (AA). Materials and Methods: In our study, the files of the patients with AA who visited our emergency clinic between 01.06.2015 and 01.01.2016 and then were operated in our hospital were reviewed retrospectively. The age, gender, the imaging method performed in the emergency clinic with an AA preliminary diagnosis, the result of the radiologic report in terms of AA and histopathological examination results were recorded according to the patients' records. The patients were divided into two groups: Complicated AA ( group 1) and uncomplicated AA (group 2) based on their histopathological analysis results. The laboratory parameters of the patients, which were seen within the first 30 minutes after they visited the emergency clinic, were examined. Results: One hundred and twenty one of the 154 patients who were involved in the study were in group 1 and 33 of the patients were in group 2. A statistically significant difference was found between two groups in terms of the number of white blood cells and NLR (p=0.000). The cut-off value for NLR in the complicated AA distinction was detected as 7.3 (75.8% sensitivity, 81.8% specifity). Conclusion: As an easy and effective analysis method, we think that NLR might be a good guide to diagnose complicated patients with AA quickly.
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    Evaluating Stable Chronic Obstructive Pulmonary Disease by Ultrasound
    (Hindawi Ltd, 2019) Evrin, Togay; Korkut, Semih; Sonmez, Leyla Ozturk; Szarpak, Lukasz; Katipoglu, Burak; Smereka, Jacek; Guven, Ramazan
    Background and Aim. The purpose of the study was to evaluate the relationship between COPD severity and the diaphragmatic function measured by point-of-care US in patients with stable COPD. Method. A total of 61 patients with COPD and 40 healthy subjects who had been admitted to Ufuk University Hospital between December 2018 and May 2019 were enrolled. Point-of-care US was performed, and lung silhouette and anterior, right, and left hemidiaphragm method in M-mode were used to evaluate the diaphragm. Results. The point-of-care US measurements, lung silhouette method right (Lung Sil R), lung silhouette method left (Lung Sil L), right hemidiaphragm US method in B-mode (Ant B-Mode R), and right hemidiaphragm US method in M-mode (Ant M-Mode R), were significantly different among groups (P < 0.001 for each). FEV1 was strongly correlated with Lung Sil R, Lung Sil L, Ant B-Mode R, and Ant M-Mode R (r = 0.963, P < 0.001; r = 0.956, P < 0.001; r = 0.953, P < 0.001; and r = 0.917, and P < 0.001, respectively). Negative correlations were detected between the number of exacerbations per year and Lung Sil R and the number of exacerbations per year and Ant M-Mode R (r = -0.599, P < 0.001 and r = -0.587, and P < 0.001, respectively). Conclusion. In this study, FEV1 and annual number of exacerbations turned out to be strongly correlated US findings. The use of US in COPD patients could help to support clinical decision, but further clinical studies are necessary to confirm those findings.
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    The Impact of Lung Ultrasound on Coronavirus Disease 2019 Pneumonia Suspected Patients Admitted to Emergency Departments
    (Lippincott Williams & Wilkins, 2021) Sonmez, Leyla Ozturk; Katipoglu, Burak; Vatansev, Hulya; Kaykisiz, Eylem Kuday; Yuce, Nalan; Szarpak, Lukasz; Evrin, Togay
    Objective The aim of this study was to identify the sensitivity and specificity of lung ultrasound (LUS) and show its place in diagnosing patients with known coronavirus disease 2019 (COVID-19) pneumonia, according to chest computed tomography and the COVID-19 reporting and data system (CO-RADS). Methods Nineteen patients who admitted to a single university hospital emergency department between March 5, 2020, and April 27, 2020, describing dyspnea were included in the study and underwent LUS by a single emergency specialist. The patient population was divided into 2 groups, COVID-19 positive and negative, and the sensitivity and specificity of LUS according to chest computed tomography were calculated for COVID-19 pneumonia diagnosis. In the subgroup analysis, the patient group was divided into real-time reverse transcription-polymerase chain reaction positive (n = 7) and negative (n = 12), and sensitivity and specificity were calculated according to the CO-RADS. Results According to the CO-RADS, significant differences were detected between the LUS positive and negative groups in terms of COVID-19 pneumonia presence. Only 1 patient was evaluated as CO-RADS 2 in the LUS positive group, and 2 patients were evaluated as CO-RADS 4 in the LUS negative group (P = 0.04). The sensitivity of LUS according to the CO-RADS for COVID-19 pneumonia diagnosis was measured to be 77.78% (95% confidence interval [CI], 39.9%-97.1%), specificity was 90% (95% CI, 55.5%-99.75%), positive predictive value was 87.5% (95% CI, 51.35%-97.8%), and accuracy was 84.21% (95% CI, 60.4%-96.62%; P = 0.004). Conclusions In conclusion, LUS is easily used in the diagnosis of COVID-19 pneumonia because it has bedside application and is fast, easy to apply, reproducible, radiation free, safe for pregnant women, and cheap.