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Öğe The effects of mannitol and melatonin on MRI findings in an animal model of traumatic brain edema(SPRINGER HEIDELBERG, 2008) Bayir, Ayseguel; Kiresi, Demet Aydogdu; Kara, Hasan; Cengiz, Sahika Liva; Kocak, Sedat; Oezdinc, Serife; Ak, AhmetObjectives: The aim of this study was to compare the effects of mannitol and melatonin on brain edema secondary to trauma using magnetic resonance imaging (MRI). Methods : A mild traumatic brain injury with the Feeney method was performed upon twelve New Zealand rabbits. Three hours after the trauma was inflicted, MRI images were obtained, then the subjects were divided into two groups : a mannitol group and a melatonin group. The mannitol group (n = 6) was given 2 gr/kg of 20% mannitol IV over 10 minutes and the melatonin group (n = 6) received 100 mg/kg of melatonin IV over 30 minutes. Thirty-three hours after the first MRI, MRI was repeated. The 3-hour and 36-hour post-trauma MRI images in both groups were scored regarding signs of edema and extent of brain tissue protrusion in a blinded fashion by a staff radiologist. Intragroup and intergroup comparisons were made using the Fisher exact test and chi square test. Comparison of brain tissue protrusion measurements was done using the Mann Whitney U test. Results : Signs of raised intraventricular pressure, contusion and parenchymal edema were more prevelant, and parenchymal protrusion was more prominent on the 36-hour MRI in both mannitol and melatonin groups. No significant difference was,found between the melatonin and mannitol groups in any parameter in the MRI images performed 3 and 36 hours after the head trauma. Conclusions : In this animal model, melatonin and mannitol had similar effects on brain edema, as demonstrated on MRI 3 and 36 hours after head trauma.Öğe Magnesium Sulfate in Emergency Department Patients with Hypertension(HUMANA PRESS INC, 2009) Bayir, Ayseguel; Kara, Hasan; Cander, Ahmet Ak. Basar; Kara, FatihTo compare the effect of IV magnesium with other antihypertensives in emergency department (ED) patients with hypertension. ED patients with a systolic BP > 135 mmHg or diastolic BP > 85 were approached for entry into the study. Those granting consent were randomly placed into one of three treatment groups: (1) 1.5 gm IV MgSO(4) (n = 42), (2) a parenteral or oral antihypertensive agent (n = 41), (3) both IV MgSO(4) and an antihypertensive agent (n = 44). Systolic and diastolic blood pressures were measured at entry into the study and at 15, 30, 45, and 60 min after magnesium or other antihypertensive medications were given. The main outcome measure was blood pressure at 60 min, and results were compared using one-way analysis of variance with the post hoc Tukey HSD test. Compared to systolic and diastolic blood pressures at time 0, both were lower at 15, 30, 45, and 60 min in all groups (p < 0.05). No significant difference in systolic or diastolic BP at any time point was observed when response to treatment was compared between the three groups. Intravenous MgSO(4) is as effective as antihypertensives at lowering BP in emergency department patients.Öğe Serum and Cerebrospinal Fluid Magnesium Levels, Glasgow Coma Scores, and In-Hospital Mortality in Patients with Acute Stroke(HUMANA PRESS INC, 2009) Bayir, Ayseguel; Ak, Ahmet; Kara, Hasan; Sahin, Tahir KemalThe aim of this study was to determine the relationship between serum and cerebrospinal fluid (CSF) magnesium (Mg(+2)) levels, Glasgow Coma Scores (GCS), and 7-day mortality in acute stroke patients. Patients with acute ischemic or hemorrhagic stroke arriving within the first 3 h of symptoms were included in the study. The control group consisted of healthy volunteers. GCS was determined, and blood and CSF samples were taken in order to establish serum and CSF glucose, Mg(+2), sodium, potassium, calcium, and chlorine levels. Mortality was recorded at 7 days after admission. CSF Mg(+2) in the ischemic infarct group was significantly lower than in the control group (p = 0.006). CSF Mg(+2) in the ischemic infarct patients with a GCS a parts per thousand currency signaEuro parts per thousand 8 were significantly lower (p = 0.002) than controls and in ischemic infarct patients with a GCS a parts per thousand yen9. In the ischemic stroke patients, CSF Mg(+2) and GCS were significantly correlated (r = 55, p = 0.031). CSF Mg(+2) levels in ischemic stroke patients who died within 7 days were significantly lower than controls, ischemic stroke patients who survived, and hemorrhagic stroke patients who died (p = 0.002, p = 0.042, and p = 0.005, respectively). Low CSF Mg(+2) levels in patients with acute ischemic stoke at admission predicted a higher 1-week mortality.Öğe Succesful treatment of prolonged sulfonylurea-induced hypoglycemia with octreotide in a patient with chronic renal failure: Case report(ORTADOGU AD PRES & PUBL CO, 2008) Guel, Mehmet; Cander, Basar; Ahmet, A. K.; Girisgin, A. Sadik; Bayir, Ayseguel; Kocak, SedatPatients who present to the emergency department after ingestion of excessive amounts of suflonylurea medications have hypoglycemia refractory to dextrose administration. Recently, the use of octreotide was described as an alternative treatment in such patients. A diabetic patient with chronic renal failure who ingested excessive amounts of sulfonylurea medications causing refractory hypoglycemia resistant to treatment with large doses of intravenous dextrose was presented here. Octreotide administration rapidly reversed hypoglycemia allowing the patient's stabilization and eventual discharge without any significant adverse events. We believe that octreotide may be an effective therapy in refractory sulfonylurea-induced hypoglycemia.Öğe Total right coronary artery obstruction related to penetrating injuries of the thorax caused by gunshot(ACTA CARDIOLOGICA, 2007) Bayir, Ayseguel; Soylu, Ahmet; Kara, HasanA 51-year-old male patient with penetrating injury to the thorax caused by gunshot was admitted to the emergency room. He suffered from typical chest pain and ECG showed acute inferior myocardial infarction. Coronary angiography of the patient revealed missile embolization in the right coronary artery and total occlusion related to thrombus.The patient was treated conservatively and discharged from the hospital on the 17(th) day of treatment.
