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Öğe Acil servise gastrointestinal kanama ile başvuran hastalarda hastane yatış süresini etkileyen faktörler(2011) Cander, Başar; Ertekin, Birsen; Kara, Hasan; Gül, Mehmet; Dündar, Defne; Koçak, Sedat; Girişgin, Sadıkçalışmamızda GİS kanaması ile acil servisimize başvuran hastaların başvuru anındaki CRP, lökosit değerleri, endoskopi bulguları ve sosyodemografik özelliklerinin yatış süresine etkisi incelemeyi amaçladık. Gereç ve Yöntem: Eylül 2008-Aralık 2008 tarihleri arasında Selçuk Üniversitesi Meram Tıp Fakültesi Acil servisine başvuran ve üst gis kanamalı hastalar çalışmaya alındı. Hastalar; yaş, cinsiyet, yatış süresi, başvuru anındaki CRP, lökosit değerleri ile endoskopi bulguları yönünden değerlendirildi. Bulgular: Toplam 30 hasta çalışmaya alındı. Alt gastrointestinal sistem ve özafagus varis kanamaları olan hastalar çalışma dışı tutuldu. Gastrointestinal kanama ile başvuran hastaların %33’ü kadın, %67’si erkekti. Hastaların ortalama lökosit değerleri 11,064,06 k/uL ve ortalama CRP değerleri 35,7726,56 mg/L idi. Bu hastaların hastanede ortalama yatış süreleri 6,406,17 gün olarak tespit edildi. En sık görünen endoskopik bulgular %70.0 evre 3, %3.3 evre 2b, %6.7 evre 2a, %13.3 evre1b ve %6.7 oranında evre 1a olarak tespit edildi. Sonuç: Çalışmamızda hastaların hastane yatış süresi ile endoskopi sonuçları, lökosit ve CRP değerleri arasında anlamlı bir ilişki bulunmamıştır.Öğe AUTHOR'S REPLY: CEREBROVASCULAR ISCHAEMIA AFTER CARBON MONOXIDE INTOXICATION(SINGAPORE MEDICAL ASSOC, 2015) Kara, Hasan[Abstract not Available]Öğe A case of rhabdomyolysis related with low intensity body building exercise(Ondokuz Mayis Universitesi, 2015) Kara, Hasan; Bayır, Ayşegül; Ak, Ahmet; Doğru, Ali; Değirmenci, Selim; Akıncı, MuratRhabdomyolysis is a clinical and biochemical syndrome resulting from the acute necrosis of muscle fibers and the leak of cellular elements into circulation. It can usually develop after trauma and severe exercises. However, it may also occur following low intensity exercises. In our case, a 24-year-old man was admitted to our emergency department because of severe abdominal pain after low intensity bodybuilding exercise. The development of an acute exertional rhabdomyolysis was confirmed by the increased serum enzyme levels. The patient was treated with intravenous sodium chloride, and sodium bicarbonate. In patients admitted to the emergency room after trauma or intensive exercise who are suspected of having rhabdomyolysis, the serum creatine phosphokinase, creatinine and potassium levels should be evaluated and if found to be high, fluid treatment should be started early to avoid any potential complications. © 2015 OMU.Öğe Causes of poisoning in patients evaluated in a hospital emergency department in Konya, Turkey(PAKISTAN MEDICAL ASSOC, 2014) Kara, Hasan; Bayır, Ayşegül; Değirmenci, Selim; Kayış, Seyit Ali; Akıncı, Murat; Ak, Ahmet; Ağaçayak, AhmetObjectives: To evaluate demographic and clinical characteristics of patients with poisoning at a community hospital. Methods: The retrospective study comprised records of patients who were admitted to the emergency department of Konya Numune Hospital, Turkey, because of poisoning between January 1, 2009, and December 31, 2011. Data was evaluated for age, gender, educational status, occupation, arrival time, mechanism of intoxication, body temperature, pulse, respiratory rate, Glasgow Coma Scale score, treatment applied, duration of hospital stay, duration of follow-up, test results, final diagnosis, clinical disposition, and outcome. Agents causing the poisoning were also determined. Results: Records of 1036 patients were evaluated. Of them, 764(74%) were female and 272(26%) were male. The predominant age range was 15-24 years in 617(60%) patients. The median time from substance exposure to admission to the emergency department was 2 hours. The most common cause of poisoning was attempted suicide in 955 [92%] patients and drug intoxication was the agent involved in 932 (90%). In the 15-24 year age range, there were 469(76%) female patients. Of the total female population in the study, 716(94%) attempted suicide. The median hospital stay was 24 hours. There were 908(88%) patients who were advised to seek further evaluation at the psychiatry clinic, and 9 (0.9%) patients were admitted to the psychiatry inpatient units after medical treatment. In patients who were hospitalized and followed up, 1 (0.1%) died because of multiple drug poisoning. Conclusion: Most admissions to the emergency department for poisoning related to young women had used drugs during a suicide attempt.Öğe Cerebrovascular ischaemia after carbon monoxide intoxication(SINGAPORE MEDICAL ASSOC, 2015) Kara, Hasan; Bayir, Aysegul; Ak, Ahmet; Degirmenci, SelimCarbon monoxide intoxication is the most prevalent cause of death from carbon monoxide poisoning. We herein report the case of a 56-year-old man who was found unconscious and smelled of smoke after exposure to carbon monoxide from a heater. He scored 5 on the Glasgow Coma Scale, and had respiratory insufficiency and elevated troponin I, creatine kinase-MB fraction and carboxyhaemoglobin levels. He was treated by mechanical ventilation. After regaining consciousness, brain magnetic resonance imaging showed diffusion restriction in the left occipital lobe; there was a loss of vision (right temporal hemianopsia), which improved by the follow-up session. Carbon monoxide intoxication may cause neurologic and cardiac sequelae, and the initial treatment includes oxygen therapy. Acute carbon monoxide poisoning can cause serious injury to the brain, heart and other organs; the most severe damages that could be inflicted to the brain include cerebral ischaemia and hypoxia, oedema, and neural cell degeneration and necrosis.Öğe D-dimer and D-dimer/fibrinogen ratio in predicting pulmonary embolism in patients evaluated in a hospital emergency department(MANEY PUBLISHING, 2014) Kara, Hasan; Bayır, Ayşegül; Değirmenci, Selim; Kayış, Seyit Ali; Akıncı, Murat; Ak, Ahmet; Çelik, Bülent; Doğru, Ali; Öztürk, B.Objectives: The D-dimer level, fibrinogen level, and D-dimer/fibrinogen ratio are used in the diagnosis of pulmonary embolism, but results vary. We evaluated these parameters in the diagnosis of pulmonary embolism in emergency clinic patients. Methods: In this prospective study, 200 patients (pulmonary embolism, 100 patients; no pulmonary embolism, 100 patients) had D-dimer and fibrinogen levels measured before intervention. Pulmonary embolism was diagnosed with computed tomography angiography or ventilation-perfusion scintigraphy. Results: Compared with patients who did not have pulmonary embolism, patients who had pulmonary embolism had significantly greater mean D-dimer level (pulmonary embolism, 6 +/- 7 mu g/ml; no pulmonary embolism, 1 +/- 1 mu g/ml; P <= 0.001) and D-dimer/fibrinogen ratio (pulmonary embolism, 3 +/- 3; no pulmonary embolism, 0.4 +/- 0.4; P <= 0.001), but similar mean fibrinogen levels (pulmonary embolism, 337 +/- 184 mg/dl; no pulmonary embolism, 384 +/- 200 mg/dl; not significant). In patients who had pulmonary embolism, mean D-dimer level and D-dimer/fibrinogen ratio were greater in high-risk than non-high-risk patients. With D-dimer cutoff 0.35 mu g/ml, sensitivity was high (100%) and specificity was low (27%) for pulmonary embolism. With D-dimer/fibrinogen ratio cutoff 0.13, sensitivity was high (100%) and specificity was low (37%) for pulmonary embolism. Conclusion: A D-dimer level <0.35 mu g/ml may exclude the diagnosis of pulmonary embolism. At a D-dimer cutoff 0.5 mu g/ml and D-dimer/fibrinogen ratio cutoff 1.0, the D-dimer/fibrinogen ratio may have better specificity than D-dimer level in the diagnosis of pulmonary embolism, but the D-dimer/fibrinogen ratio may lack sufficient specificity in screening.Öğe Deneysel akut organik fosfor toksisitesi tedavisine eklenen e vitaminin olumlu etkileri(2011) Bayır, Ayşegül; Yıldız, Mesut; Kara, Hasan; Köylü, Öznur; Kocabaş, Rahim; Ak, AhmetAmaçPestisit zehirlenmelerinde reaktif oksijen türevlerinin artmış üretimine bağlı olarak oksidatif stres geliştiği bildirilmiştir. Doku ROS seviyeleri doku hasarının en önemli göstergelerindendir. Bu çalışmada, akut organofosfat (OF) zehirlenmesinde ek olarak kullanılacak E vitamininin tedavisinin kandaki ve karaciğer dokusundaki kolin esteraz (KE) ve malondialdehit (MDA) düzeyleri üzerine etkilerini araştırmak ve sadece antidot tedavisi verilen grup ile karşılaştırarak OF zehirlenmesi tedavisinde kullanılıp kullanılamayacağını belirlemektir.Gereç ve YöntemÇalışmada 20 Yeni Zelanda cinsi tavşan randomize olarak sham (n8), pralidoksim (PAM)atropin (n6) ve E vitamini (n6) olarak 3 gruba ayrıldı. Her denekten toksisite öncesi plazma KE, serum ve eritrosit MDA değerlerini ölçmek için kan örnekleri alındıktan sonra orogastrik yoldan 50 mg/kg 2.2-diklorvinil dimetil fosfat verildi. PAMatropin grubundaki deneklere 30 mg/kg IV bolus, ardından 15 mg/kg PAM ve 0.05 mg/kg atropin her 4 saatte İV verildi. E vitamini grubundaki deneklere benzer atropin ve PAM tedavisine ilaveten 250 mg/kg E vitamini tek doz İM uygulandı. Deneklerden tedavi başlatıldıktan sonra 12. ve 24. saatlerde kan örnekleri alındı. Tüm deneklerden aynı parametreleri değerlendirmek üzere karaciğer dokusu örnekleri alındı. Denekler yüksek dozda İV anestezik verilerek sakrifiye edildiler. BulgularE vitamini grubunun eritrosit MDA’sı PAMatropin grubundan anlamlı düşük (p0.003) tespit edildi. E vitamini grubunun karaciğer dokusundaki KE düzeyi PAMatropin grubundan anlamlı olarak yüksekti (p0.001). E vitamini grubundaki tavşanların karaciğer doku MDA’sı PAM-atropin grubundan anlamlı olarak düşüktü (p0.001). SonuçAkut OF zehirlenmesinde antidot tedavisine eklenen E vitamininin hem eritrosit ve karaciğer dokusu lipid peroksidasyonu üzerine hem de karaciğer dokusu KE aktivitesi üzerine iyileştirici etkisi vardır.Öğe Diagnostic value of neutrophil-to-lymphocyte ratio in emergency department patients diagnosed with acute pancreatitis(CUKUROVA UNIV, FAC MEDICINE, 2016) Kara, Hasan; Dogru, Ali; Degirmenci, Selim; Bayir, Aysegul; Ak, Ahmet; Kafali, Mehmet Ertugrul; Nazik, Emet EbruPurpose: Decreased lymphocyte count and increased neutrophil count may be associated with severe sepsis, bacteremia, and surgical stress. The neutrophil-to-lymphocyte ratio (NLR) may be used to assess inflammatory conditions and surgery. We evaluated whether NLR may be useful in the differentiation between biliary and nonbiliary acute pancreatitis. Material and Methods: Data from patients aged >18 years who were diagnosed with acute pancreatitis between January 2011 and July 2014 were evaluated retrospectively. Patients were grouped as having biliary or nonbiliary pancreatitis. The white blood cell, neutrophil, and lymphocyte counts and NLR were evaluated and compared between the 2 groups. Results: In the 225 patients with acute pancreatitis (mean age, 59+/-18 y; 81 male patients [36%]), most patients had biliary pancreatitis (biliary, 144 patients [64%]; nonbiliary, 81 patients [36%]). Frequency of hypertension and mean arterial pressure were lower in patients who had biliary than nonbiliary pancreatitis. The mean white blood cell, neutrophil, and platelet counts were greater in patients who had nonbiliary than biliary pancreatitis. Conclusions: Although the NLR was increased in acute pancreatitis, there were no differences in NLR between patients who had biliary or nonbiliary acute pancreatitis. Therefore, the NLR is not useful in differentiating biliary from nonbiliary acute pancreatitis.Öğe Dyspnoea and chest pain as the presenting symptoms of pneumomediastinum: two cases and a review of the literature(CLINICS CARDIVE PUBL PTY LTD, 2015) Kara, Hasan; Uyar, Hasan Gazi; Degirmenci, Selim; Bayir, Aysegul; Oncel, Murat; Ak, AhmetPneumomediastinum is the presence of air in the mediastinum. It may occur as spontaneous, traumatic, or iatrogenic pneumomediastinum. Although spontaneous pneumomediastinum is usually observed in healthy young men, traumatic pneumomediastinum may be caused by blunt or penetrating trauma to the chest and neck. Pneumomediastinum is a clinical condition with potential complications that cause high morbidity and mortality rates. Pneumomediastinum also may develop without tracheal or oesophageal injury after spontaneous or blunt chest, neck and facial injuries, and it may be accompanied by pneumothorax. We treated two patients who had pneumomediastinum. Case 1 was a 20-year-old man who had pain and dyspnoea around the sternum for one hour, as a result of a blow from an elbow during a football match. Case 2 was a 23-year-old man who had a two-day history of dyspnoea and chest pain with no history of trauma. In both patients, diagnosis of pneumomediastinum was confirmed with thoracic computed tomography scans, and the condition resolved within five days of in-patient observation. In conclusion, the diagnosis of pneumomediastinum should be considered for all patients who present to the emergency department with chest pain and dyspnoea.Öğe The effects of antioxidants on blood Gas Parameters in the acute organic phosphorus toxicity of rabbits(ELSEVIER IRELAND LTD, 2008) Bayir, Aysegul; Kara, Hasan; Yildiz, Mesut; Ak, Ahmet; Kara, Fatih[Abstract not Available]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 The effects of melatonin on oxidative stress markers in an animal model of radiocontrast-induced nephropathy(ALLIED ACAD, 2011) Bayir, Aysegul; Kara, Hasan; Kiyici, Aysel; Kiyici, Halil; Ak, AhmetWe investigated the effects of melatonin on erythrocyte and renal tissue superoxide dismutase (SOD) and malondialdehyde (MDA) levels in rabbits after the administration of a radiocontrast agent. Twenty-four New Zealand rabbits were divided into four groups, six rabbits in each: control, sham, hydration, and hydration plus melatonin. Rabbits in the control group were sacrificed after the extraction of renal tissue. All other rabbits received a single dose of IV diatrizoat sodium (10 mL/kg). In the hydration group, saline (10 mL/kg IV) was infused at 6 hour intervals. In the hydration plus melatonin group, melatonin (10 mg/kg IV) and saline (10 ml/kg IV) were administered at 6 hour intervals. Venous blood samples were obtained from the rabbits before, and 48 and 72 hours after diatrizoat sodium administration to measure serum urea, creatinine, sodium, potassium, calcium, and erythrocyte MDA levels and SOD activities. Renal tissues were removed at the end of 72 hours, and tissue MDA levels and SOD activities were determined. At 72 hours, erythrocyte MDA concentrations of the hydration plus melatonin animals were significantly lower than those of the sham and hydration groups. However, erythrocyte and renal tissue SOD activities were significantly higher in the hydration plus melatonin group than the other groups. Renal tissue MDA levels of the hydration plus melatonin group were significantly lower than those of the sham and hydration groups. Melatonin has favorable effects on lipid peroxidation and antioxidant status in this animal model of radiocontrast nephropathy.Öğe Efficacy of Use of Red Cell Distribution Width as a Diagnostic Marker in Acute Appendicitis(AVES, 2017) Ertekin, Birsen; Kara, Hasan; Erdemir, Esma; Doğan, Emine; Acar, Tarık; Demir, Lütfi SaltukAim: 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.Öğe Examining the Seroprevalance and Antiviral Prophylaxis Rate of Hepatitis B and C Virus in Rheumatic Patients Treated with Biological and Targeted Synthetic Disease Modifying Anti-rheumatic Drugs: Results from a Tertiary Center in Central Anatolia(Selçuk Üniversitesi, 2024 Şubat) Kaplan, Hüseyin; Cengiz, Gizem; Şaş, Senem; Kara, HasanABSTRACT Objective: To evaluate the epidemiological characteristics of hepatitis B virus (HBV) and hepatitis C virus (HCV) in rheumatic patients treated with biological and targeted synthetic disease modifying anti-rheumatic drugs (DMARDs). Methods: This cross-sectional study was carried out between September 2021 and April 2022 at the Rheumatology Outpatient Clinic of Erciyes University Faculty of Medicine, and it included 200 patients [113 with axial spondyloarthritis (axSpA), 18 with psoriatic arthritis (PsA) and 69 with rheumatoid arthritis (RA)]. The demographic and clinical characteristics, treatment details and viral hepatitis serology of the patients were recorded. Those not receiving biological and/or targeted synthetic DMARDs (b/tsDMARDs) were excluded. Results: The median age of the patients was 47 (39-58) years, and the median disease duration was 10 (7-15) years. Of the patients, 117 (58.5%) were female and 83 (41.5%) were male. The median duration of treatment with b/tsDMARDs was 6 (2-9) years. In the viral serological examinations, 1.5% of the patients were positive for HBsAg, 64.5% for anti-HBs, 23.5% for anti-HBc IgG, and 0.5% for anti-HCV. The anti-HBc IgG positivity rate was significantly higher in RA (34.8%) than axSpA patients (16.8%) and was similar to PsA patients (22.2%) (p = 0.023). Yet HBsAg, anti-HBs, and antiHCV serologies were similar across patient subgroups (p > 0.05). A total of 44 (22%) patients were undergoing oral antiviral prophylaxis. Three (1.5%) patients who were anti-HBc positive and HBV DNA negative were followed without antiviral treatment. There was no viral reactivation in any patient. Conclusion: Approximately one in four patients in our cohort showed anti-Hbc positivity, and almost all of them were using antiviral prophylaxis. Anti-HCV prevalence was much lower. Studies addressing viral hepatitis in rheumatic patients and/or patient subgroups, both at the national and local level, will enable rheumatologists to be more effective in managing HBV and HCV.Öğe Fahr hastalığı: İki olgu sunumu(2009) Koçak, Sedat; Erdemir, Esma; Bayrak, Ayşe; Kara, Hasan; Gül, MehmetBilateral Striopallidodentat Kalsinozis olarak da isimlendirilen Fahr Hastalığı (FH); bazal ganglion, talamus, serebellar dentat nükleus ve serebral beyaz cevherde simetrik kalsifikasyonlar ile karakterize nadir görülen bir durumdur. Kalsifikasyonlar genellikle başka nedenlerle çekilen bilgisayarlı beyin tomografisinde dikkat çeker. Hastalığın klinik özellikleri değişken olmasına rağmen; ilerleyici mental hasar, tremor, kore, ataksi, disartri, konvülzyon, parkinson benzeri klinik tablo, nöro-psikiyatrik davranış değişiklikleri ve zihinsel işlev bozuklukları FH’nda sıklıkla görülen klinik bulgulardır. FH’nın anoksi, radyasyon, sistemik hastalıklar, toksinler, kalsiyum metabolizma bozuklukları ve ensefalitler ile bağlantılı olduğu ileri sürülmüştür. Burada sırasıyla şiddetli baş ağrısı ve şuur kaybı ile gelen ve FH teşhisi konulan iki vaka literatür bilgileri ışığında değerlendirilmiştir.Öğe Hemolysis associated with pneumatic tube system transport for blood samples(PROFESSIONAL MEDICAL PUBLICATIONS, 2014) Kara, Hasan; Bayır, Ayşegül; Ak, Ahmet; Değirmenci, Selim; Akıncı, Murat; Ağaçayak, Ahmet; Marçıl, EmineObjective: The frequency of hemolysis of blood samples may be increased by transport in a pneumatic tube system. The purpose of this study was to evaluate the effect of pneumatic tube system transport on hemolysis of blood samples. Methods: Blood samples were transported from the emergency department to the hospital laboratory manually by hospital staff (49 patients) or with a pneumatic tube system (53 patients). The hemolysis index and serum chemistry studies were performed on the blood samples and compared between the different methods of transport. Results: The blood samples that were transported by the pneumatic tube system had a greater frequency of hemolysis and greater mean serum potassium and median creatinine, aspartate aminotransferase, and lactate dehydrogenase levels than samples transported manually. Conclusion: Blood samples transported from the emergency department to the hospital laboratory by a pneumatic tube system may have a greater frequency of hemolysis than samples transported manually. This may necessitate repeat phlebotomy and cause a delay in completing the laboratory analysis.Öğe High-sensitivity C-reactive protein, lipoprotein-related phospholipase A(2), and acute ischemic stroke(DOVE MEDICAL PRESS LTD, 2014) Kara, Hasan; Akinci, Murat; Degirmenci, Selim; Bayir, Aysegul; Ak, Ahmet; Nayman, Alaaddin; Unlu, AliBackground: Serum biomarkers may be useful for early diagnosis of acute ischemic stroke, exclusion of other diseases that may mimic stroke, and prediction of infarct volume. We evaluated serum high-sensitivity C-reactive protein (hs-CRP) and lipoprotein-related phospholipase A(2) (Lp-PLA2) in patients who had acute ischemic stroke. Methods: In 200 patients who presented to an emergency service (acute ischemic stroke, 102 patients; control with no stroke, 98 patients), stroke patients were evaluated with the Canadian neurological scale and diffusion-weighted magnetic resonance imaging, and all patients were evaluated with the Glasgow coma scale and their serum hs-CRP level and Lp-PLA2 activity were assessed. The volume of stroke lesions was calculated from magnetic resonance images. Results: Patients who had stroke had higher mean serum hs-CRP level (stroke, 7 +/- 6 mg/dL; control, mean +/- standard deviation 1 +/- 1 mg/dL; P <= 0.001) and Lp-PLA2 activity (stroke, mean +/- standard deviation 113 +/- 86 nmol/min/mL; control, mean +/- standard deviation 103 +/- 50 nmol/min/mL; P <= 0.001) than control patients who did not have stroke. The mean hs-CRP level and Lp-PLA2 activity were higher in patients who had greater stroke severity (lower Canadian neurological scale score) and were higher in patients who had larger volume strokes. Conclusion: Higher hs-CRP level and Lp-PLA2 activity are significantly associated with more severe neurologic impairment and larger infarct size in patients who have acute ischemic stroke. These biomarkers may be useful for rapid diagnosis and prediction of ischemic tissue volume in the early stage of ischemic stroke. These findings may be important for health care facilities that have limited access to emergency computed tomography scanning for the diagnosis of stroke.Öğe Kontrolsüz Warfarin Kullanımına Bağlı Ciltte Kanama: Olgu sunumu(2015) Kara, Hasan; Bayır, Ayşegül; Ak, Ahmet; Değirmenci, Selim; Serin, HavvaAntikoagülan tedavi, klinik tablo açıdan geniş bir spektrum oluşturan tromboembolik hastalıkların profilaksi ve tedavisinde yaşamsal önem taşıyan bir tedavi yöntemidir. Antikoagülan tedavinin bazen hasta hayatını tehdit edebilen en önemli komplikasyonu kanamadır. Bu nedenle antikoagülan tedavinin tromboz veya kanamaya yol açmayacak şekilde planlanması, klinik ve laboratuvar takibinin titizlikle yapılması yaşamsal önem taşımaktadır. Oral antikoagülanlara bağlı cilt kanamaları çok nadir görülmektedir. Tedavide K vitamini, protrombin kompleks konsantresi (PCC) ve taze donmuş plazma (TDP) ile antikoagülasyonun bir an önce tersine çevrilmesi önerilmektedir. Bu makalede, atrial fibrilasyon ve aort valv replasmanı (AVR) nedeniyle profilaktik olarak warfarin alımına bağlı ciltte kanama gelişen bir olgu sunulmuştur.Öğe Levels of Selenium, Zinc, Copper, and Cardiac Troponin I in Serum of Patients with Acute Coronary Syndrome(HUMANA PRESS INC, 2013) Bayır, Ayşegül; Kara, Hasan; Kıyıcı, Aysel; Öztürk, Bahadır; Akyürek, FikretThe aim of this study was to assess the levels of selenium (Se), zinc (Zn), copper (Cu), and troponin I (TnI) in patients with acute coronary syndrome (ACS) on admission to our emergency department in comparison to healthy control subjects. Patients with diagnosed ACS (n = 100) were included in the study group. Control subjects (n = 100) were selected from healthy volunteers in the same age range. Venous blood samples were obtained to evaluate the levels of Se, Zn, Cu, and TnI (on admission for the ACS group). Serum Se, Zn, and Cu levels were significantly less in the ACS group compared to the control group (p < 0.001, p < 0.01, and p < 0.001, respectively). The serum TnI level was significantly greater in the ACS group compared to the control group (p < 0.05). The serum Se level in the ACS group correlated significantly with the TnI level (r = -0.211, p = 0.035). These results indicate that Se, Zn, and Cu deficiencies may be risk factors for ACS, and a decreased serum Se level in patients with ACS might reflect the degree of myocardial necrosis.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.
