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Yurtsever G, Yamanoglu A, Bora ES, Topal FE. A rare complication of cardiopulmonary resuscitation applied during transportation by ambulance: A case report of flail chest. Turk J Emerg Med 2022; 22:159-162. [PMID: 35936949 PMCID: PMC9355074 DOI: 10.4103/2452-2473.348437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/29/2022] [Accepted: 02/09/2022] [Indexed: 11/28/2022] Open
Abstract
Cardiopulmonary resuscitation (CPR) to be applied during patient transfer by ambulance differs from CPR applied in the field or in the hospital in terms of physical condition. Especially the deeper and faster chest compressions recommended in the latest CPR guidelines, when administered during ambulance transport, may result in a further increase in traumatic CPR complications. However, in the current CPR guidelines, there are no clear recommendations regarding additional measures that can be taken to reduce the complications and increase the efficiency of CPR during patient transport. In this study, a case of flail chest that developed after short-term CPR application during ambulance transport is presented. The aim of this study was to evaluate the flail chest complication and solution suggestions that may occur due to chest compressions applied during transportation.
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Affiliation(s)
- Güner Yurtsever
- Department of Emergency Medicine, Izmir Kâtip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
| | - Adnan Yamanoglu
- Department of Emergency Medicine, Izmir Kâtip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
| | - Ejder Saylav Bora
- Department of Emergency Medicine, Izmir Kâtip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
| | - Fatih Esad Topal
- Department of Emergency Medicine, Izmir Kâtip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
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2
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Bilgin S, Kayali A, Yamanoğlu A, Acar H, Karakaya Z, Topal F, Yüksel ES, Topal FE. The value of conventional manometry in the identification of normal esophageal manometry. Medicine (Baltimore) 2021; 100:e28395. [PMID: 34967374 PMCID: PMC8718173 DOI: 10.1097/md.0000000000028395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 11/23/2021] [Indexed: 01/05/2023] Open
Abstract
In the last decade, high-resolution esophageal manometry (HREM) is the main device for the management of dysphagia replacing conventional manometry (CM). Conventional manometry still seems to have some space to diagnose major motility disorders and differentiate normal from abnormal esophageal motility. The long term outcomes of patients with normal CM were analyzed in our study.Participants (patients with dysphagia and normal CM) took a questionnaire via a phone call in February 2021. Impact Dysphagia Questionnaire (IDQ) was used as an assessment tool.Only 55% (83/151) the individuals with previous normal manometric findings were reached via telephone. The group who have completed the survey was representative of the cohort. 66.2% of the participants were female (P = .40). The mean age was 57.21, mean weight was 70.69 kg, mean height was 163.74 cm and mean body mass index was 26.41. More than 40% of patients were completely asymptomatic at follow up, reflected by an IDQ score of 0. Only 28 out of 83 (33.7%) patients reported significant symptoms as reflected by an IDQ score greater than or equal to 7. The rest of responders admitted as having moderate to mild symptoms.HREM is a valid technique with comparable precision to CM. HREM measurements differ considerably to CM. The identification of normal motor function in CM is not likely a positive prognostic indicator and must be interpreted precautiously.
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Affiliation(s)
- Serkan Bilgin
- Department of Emergency, Izmir Katip Çelebi University, İzmir, Turkey
| | - Ahmet Kayali
- Department of Emergency, Izmir Katip Çelebi University, İzmir, Turkey
| | - Adnan Yamanoğlu
- Department of Emergency, Izmir Katip Çelebi University, İzmir, Turkey
| | - Hüseyin Acar
- Department of Emergency, Izmir Katip Çelebi University, İzmir, Turkey
| | - Zeynep Karakaya
- Department of Emergency, Izmir Katip Çelebi University, İzmir, Turkey
| | - Firdevs Topal
- Department of Gastroenterology, İzmir Katip Çelebi University, İzmir, Turkey
| | - Elif Saritaş Yüksel
- Department of Gastroenterology, İzmir Katip Çelebi University, İzmir, Turkey
| | - Fatih Esad Topal
- Department of Emergency, Izmir Katip Çelebi University, İzmir, Turkey
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3
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Akyol PY, Acar H, Çakır A, Saraçoğlu G, Topal FE. Determining the level and causes of anxiety related to pandemic of healthcare professionals working in the emergency department. Am J Emerg Med 2021; 56:333-335. [PMID: 34565631 PMCID: PMC8425744 DOI: 10.1016/j.ajem.2021.09.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 09/04/2021] [Accepted: 09/04/2021] [Indexed: 01/25/2023] Open
Affiliation(s)
- Pınar Yeşim Akyol
- Department of Emergency Medicine, Izmir Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey.
| | - Hüseyin Acar
- Department of Emergency Medicine, Izmir Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey
| | - Adem Çakır
- Department of Emergency Medicine, The Ministry of Health Basaksehir City Hospital, Istanbul, Turkey
| | - Gülçim Saraçoğlu
- Muğla Sıtkı Koçman University Research and Training Hospital, Emergency Department, Muğla, Turkey
| | - Fatih Esad Topal
- Department of Emergency Medicine, Izmir Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey
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4
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Tosun Ö, Solmaz D, Karaca G, Özmen M, Tosun A, Topal FE, Akar S. Prevalence of pistol-grip deformity in patients with axial spondyloarthritis. Eur J Rheumatol 2021; 8:139-143. [PMID: 34059185 PMCID: PMC9770409 DOI: 10.5152/eurjrheum.2021.19181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE To our knowledge, the prevalence of pistol-grip deformity (PGD) has not previously been studied in patients with axial spondyloarthritis (axSpA). This study aimed to evaluate PGD prevalence in patients with axSpA and to assess its relationship with the clinical and demographic factors. METHODS A total of 158 patients with axSpA in whom diagnosis was established according to the Assessment of SpondyloArthritis International Society criteria in rheumatology department and 193 age- and sex-matched controls admitted to the emergency room and had anteroposterior (AP) pelvic X-rays were included in the study. PGD was identified by determining the non-spherical shape of the femoral head on AP hip or pelvic X-rays. RESULTS Prevalence of PGD was significantly higher in patients with axSpA than in controls (20.3% vs. 8.8%, respectively, p=0.002). PGD was also found to be more frequent in patients with radiographic axSpA than in those with non-radiographic axSpA (26/106 [24.5%] vs. 6/52 [11.5%]); however, this difference did not reach statistical significance (p=0.056). The presence of PGD was significantly associated with the presence of hip arthritis (odds ratio [OR], 3.1; 95% confidence interval [CI], 1.2-8.7; p=0.023), ever smoking (OR, 4.5; 95% CI, 1.4-13.6; p=0.008), and male sex (OR, 38.7; 95% CI, 5.1-292.7; p<0.001) in univariate analyses. In multivariate model, ever smoking (OR, 2.9; 95% CI, 1.10-10.05; p=0.03) and male sex (OR, 27.0; 95% CI, 3.5-208.4; p=0.002) were associated with PGD. CONCLUSION PGD was significantly more common in patients with axSpA. Presence of PGD correlated significantly with hip arthritis, smoking, and sex. We assume that new bone formation could be the possible reason for increased PGD prevalence. Femoroacetabular impingement should be considered as a secondary cause of hip pain in patients with axSpA.
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Affiliation(s)
- Özgür Tosun
- Department of Radiology, İzmir Katip Çelebi University School of Medicine, İzmir,
Turkey
| | - Dilek Solmaz
- Division of Rheumatology, Department of Internal Medicine, İzmir Katip Çelebi University School of Medicine, İzmir,
Turkey
| | - Gökay Karaca
- Department of Radiology, İzmir Katip Çelebi University School of Medicine, İzmir,
Turkey
| | - Mustafa Özmen
- Division of Rheumatology, Department of Internal Medicine, İzmir Katip Çelebi University School of Medicine, İzmir,
Turkey
| | - Aliye Tosun
- Department of Physical Medicine and Rehabilitation, İzmir Katip Çelebi University School of Medicine, İzmir,
Turkey
| | - Fatih Esad Topal
- Department of Emergency Medicine, İzmir Katip Çelebi University School of Medicine, İzmir,
Turkey
| | - Servet Akar
- Division of Rheumatology, Department of Internal Medicine, İzmir Katip Çelebi University School of Medicine, İzmir,
Turkey
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Karaali R, Payza U, Kayalı A, Topal F, Topal FE. EVALUATION OF QTC INTERVAL IN CIRRHOSIS PATIENTS WITH VARICEAL HEMORRHAGE. J Istanb Fac Med 2021. [DOI: 10.26650/iuitfd.2020.0055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Yamanoğlu A, Bilgin S, Celebi Yamanoğlu NG, Topal FE. A rare complication of continuous positive airway pressure treatment - rectus sheath hematoma: a case report. Braz J Anesthesiol 2021; 71:461-463. [PMID: 33766684 PMCID: PMC9373644 DOI: 10.1016/j.bjane.2021.02.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 02/06/2021] [Accepted: 02/27/2021] [Indexed: 11/25/2022] Open
Abstract
Noninvasive mechanical ventilation (NIMV) has a relevant role in the treatment of critically ill patients displaying severe dyspnea. Continuous positive airway pressure (CPAP), a method of NIMV, is also widely used in the management of acute heart failure, chronic obstructive pulmonary disease (COPD) exacerbation, and symptomatic sleep apnea. However, numerous traumatic complications of CPAP treatment in the face region, head, and thorax have been reported and may be related to the application of a continuous positive high pressure to the airway. Conversely, we have observed no complications due to CPAP-related increased intra-abdominal pressure. In this article, we describe a clinical case of a patient with an acute rectus sheath hematoma during CPAP treatment. This previously unreported complication demonstrates that CPAP should be carefully used in patients with exacerbated COPD with difficulty in expiration
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Affiliation(s)
- Adnan Yamanoğlu
- Ataturk Training and Research Hospital, Izmir Katip Celebi University, Department of Emergency Medicine, Izmir, Turkey.
| | - Serkan Bilgin
- Ataturk Training and Research Hospital, Izmir Katip Celebi University, Department of Emergency Medicine, Izmir, Turkey
| | | | - Fatih Esad Topal
- Ataturk Training and Research Hospital, Izmir Katip Celebi University, Department of Emergency Medicine, Izmir, Turkey
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7
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Payza U, Kayali A, Bilgin S, Karakaya Z, Esad Topal F. When is the right time to take an emergency surgery decision in Mechanical Intestinal Obstruction? Asian J Surg 2021; 44:854-859. [PMID: 33712329 DOI: 10.1016/j.asjsur.2021.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 01/27/2021] [Accepted: 02/21/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND /Objective: Ischemia is a leading cause of morbidity in Mechanical Intestinal Obstruction (MIO) in which the timing of decisions of whether to proceed to surgical or conservative treatment is critical in emergency departments (ED). While advanced technological options are available, patients may be negatively affected by the application of contrast agents or radiation. The use of ultrasound is limited because of the air in the intestines does not allow a good field of vision. While biomarkers can be considered as a good alternative option at this point. In the present study we examine the effect of hemogram and blood gas parameters on early surgical decision-making in MIO patients. METHOD Involved in this observational prospective study were 264 patients diagnosed with MIO who presented to the Department of Emergency Medicine, Ataturk Research and Training Hospital, Katip Celebi University between February 2018 and February 2019. Contrast-enhanced tomography (CECT) and laboratory results of the patients were recorded. Pathology reports of the patients who underwent surgery were collected. Laboratory data were analyzed by comparing CECT and pathology reports. RESULTS In a ROC analysis of the laboratory values of the patients who were diagnosed with ileus, the sensitivity was calculated as 80% and the specificity was 57.7 in values above WBC>10.75 (109/L), 96.6%, and the specificity was 31.1% in N/L > 2.9. For intestinal ischemia, the cut-off values were WBC> 12.6 and N/L > 3.2, Lactate >2.8 mmol/L and B.E < -3.6 mmol/L. CONCLUSION Diagnoses of ileus are based on the results examinations and imaging methods. More data are needed to support decisions on the timing of surgery in ED. WBC, N/L, Lactate and Base Excess indicate an ischemic segment. When the parameters are evaluated together, they strongly support early surgical decision-making regarding the treatment of intestinal ischemia.
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Affiliation(s)
- Umut Payza
- Department of Emergency Medicine, Ataturk Research and Training Hospital, Katip Celebi University, İzmir, Turkey.
| | - Ahmet Kayali
- Department of Emergency Medicine, Ataturk Research and Training Hospital, Katip Celebi University, İzmir, Turkey.
| | - Serkan Bilgin
- Department of Emergency Medicine, Ataturk Research and Training Hospital, Katip Celebi University, İzmir, Turkey.
| | - Zeynep Karakaya
- Department of Emergency Medicine, Ataturk Research and Training Hospital, Katip Celebi University, İzmir, Turkey.
| | - Fatih Esad Topal
- Department of Emergency Medicine, Ataturk Research and Training Hospital, Katip Celebi University, İzmir, Turkey.
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8
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Yamanoğlu A, Bilgin S, Çelebi Yamanoğlu NG, Topal FE. A Rare Ultrasonographic Finding of Emphysematous Cholecystitis: The Champagne Sign. J Emerg Med 2021; 60:e151-e153. [PMID: 33640216 DOI: 10.1016/j.jemermed.2021.01.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/15/2021] [Accepted: 01/23/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Emphysematous cholecystitis (EC) is a form of cholecystitis with high mortality rates more commonly seen in patients with medical histories such as diabetes, hypertension, and peripheral vascular disease. The common features of these medical diseases are impaired pain perception, particularly abdominal pain, due to advanced age and peripheral neuropathies. Accurate evaluation of characteristics observed at ultrasonography, the method of first choice in the diagnosis of EC, is therefore highly important in these patients. CASE REPORT This study reports a case of the champagne sign, rarely seen in EC, together with other EC findings. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: The champagne sign is a little-known sonographic finding that is evidence of the presence of gas in the gallbladder. The champagne sign that will be detected while evaluating the hepatobiliary system on bedside ultrasound is one of the valuable findings in the diagnosis of emphysematous cholecystitis with high mortality.
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Affiliation(s)
- Adnan Yamanoğlu
- Department of Emergency Medicine, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
| | - Serkan Bilgin
- Department of Emergency Medicine, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
| | | | - Fatih Esad Topal
- Department of Emergency Medicine, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
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9
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Yamanoglu A, Akyol PY, Acar H, Celebi Yamanoglu NG, Topal FE, Kayalı A. How would you like your COVID-19? From a host with mild course disease, or from a severe one? Am J Emerg Med 2020; 38:2487.e7-2487.e12. [PMID: 32536478 PMCID: PMC7834627 DOI: 10.1016/j.ajem.2020.05.091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 05/29/2020] [Indexed: 12/15/2022] Open
Abstract
The clinical course of COVID-19 presents a broad spectrum, being asymptomatic in some individuals while following a severe course and resulting in mortality in others. It is known that such factors as age and chronic diseases can result in a different clinical courses in individuals, however, variable clinical courses among the similar individuals in terms of age and chronic diseases are also seen. Other possible factors affecting the course of the disease that are mostly speculative or under investigation are genetic factors and the origin of transmission or possible subtype of novel coronavirus. Whether the source of transmission is important in the clinical course of the disease is unknown. A case series composed of seven individuals in a similar age group, with different lines of descent and different genetic structures, but who were infected from the same source is presented here. The similar and different clinical, laboratory and radiological findings of the cases residing in the same nursing home, who presented to the hospital altogether, were evaluated. The aim of the study was to analyze whether the source of transmission is influential in the clinical course of the disease.
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Affiliation(s)
- Adnan Yamanoglu
- Department of Emergency Medicine, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey.
| | - Pinar Yeşim Akyol
- Department of Emergency Medicine, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
| | - Hüseyin Acar
- Department of Emergency Medicine, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
| | | | - Fatih Esad Topal
- Department of Emergency Medicine, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
| | - Ahmet Kayalı
- Department of Emergency Medicine, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
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10
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Karaagac E, Besir Y, Kurus M, Gokalp O, Iscan S, Gokkurt Y, Kandemir C, Topal FE, Keselik E, Eygi B, Gurbuz A. The effect of bovine serum albumin-glutaraldehyde and polyethylene glycol polymer on neointimal hyperplasia in rabbit carotid artery anastomosis. J Biomater Appl 2020; 36:152-164. [PMID: 33050834 DOI: 10.1177/0885328220964913] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Since the systemic drugs have been used to reduce the hyperplasic response in the tunica intima, the periadventitial local drug applications to the vascular wall have gained more popularity. In this study, we investigated the effect of bovine serum albumin-glutaraldehyde and polyethylene glycol polymer on neointimal hyperplasia in rabbit carotid artery anastomosis to explore the effects of these two different agents. METHODS 21 New Zealand male rabbits were randomly divided into three groups. The carotid artery transection and anastomosis was performed onthe control group. The bovine serum albumin-glutaraldehyde and the polyethylene glycol polymer were applied locally on the other two groups seperatley after transection and anastomosis of the carotid arteries. At the end of 28-day follow-up, the histological and the immunohistochemical results related to neointimal hyperplasia were compared. RESULTS The glue residues were detected in the BSA-glutaraldehyde group, but in the PEG polymer group there was no glue residue. The intima thickness and the intima/media thickness ratio in the control group was significantly higher (p<0.05) than the other groups. These values did not differ significantly between the BSA-glutaraldehyde group and the PEG polymer group (p>0.05). The lumen diameter and the area in the control group were significantly higher (p < 0.05) than the BSA-glutaraldehyde group. These values between the control group and the PEG polymer group did not differ significantly (p>0.05). aSMA-positive staining score in the Control group was found to be significantly lower (p < 0.05) than the BSA-glutaraldehyde and PEG polymer group and the VEGF-positive staining score in the control group was found to be significantly higher (p < 0.05) than the BSA-glutaraldehyde and the PEG polymer group. CONCLUSIONS Although the both agents have positive results on neointimal hyperplasia, it would be favorable to use polyethylene glycol polymer, since it does not seem to affect the lumen area and the lumen diameter of the vessel.
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Affiliation(s)
- Erturk Karaagac
- Department of Cardiovascular Surgery, Muş State Hospital, Muş, Turkey
| | - Yuksel Besir
- Department of Cardiovascular Surgery, Izmir KatipÇelebi University, Atatürk Training and Research Hospital, Izmir, Turkey
| | - Meltem Kurus
- Department of Histology and Embryology, Faculty of Medicine, Izmir KatipÇelebi University, Izmir, Turkey
| | - Orhan Gokalp
- Department of Cardiovascular Surgery, Izmir KatipÇelebi University, Atatürk Training and Research Hospital, Izmir, Turkey
| | - Sahin Iscan
- Department of Cardiovascular Surgery, Izmir KatipÇelebi University, Atatürk Training and Research Hospital, Izmir, Turkey
| | - Yasar Gokkurt
- Department of Cardiovascular Surgery, Izmir KatipÇelebi University, Atatürk Training and Research Hospital, Izmir, Turkey
| | - Cagri Kandemir
- Department of Cardiovascular Surgery, Izmir KatipÇelebi University, Atatürk Training and Research Hospital, Izmir, Turkey
| | - Fatih Esad Topal
- Department of Emergency Medicine, Izmir KatipÇelebi University, Atatürk Training and Research Hospital, Izmir, Turkey
| | - Erdi Keselik
- Department of Histology and Embryology, Faculty of Medicine, Izmir KatipÇelebi University, Izmir, Turkey
| | - Bortecin Eygi
- Department of Cardiovascular Surgery, Izmir KatipÇelebi University, Atatürk Training and Research Hospital, Izmir, Turkey
| | - Ali Gurbuz
- Department of Cardiovascular Surgery, Izmir KatipÇelebi University, Atatürk Training and Research Hospital, Izmir, Turkey
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Ozkaya E, Topal FE, Bulut T, Gursoy M, Ozuysal M, Karakaya Z. Evaluation of an artificial intelligence system for diagnosing scaphoid fracture on direct radiography. Eur J Trauma Emerg Surg 2020; 48:585-592. [DOI: 10.1007/s00068-020-01468-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 08/21/2020] [Indexed: 11/30/2022]
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12
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Topal FE, Bilgin S, Yamanoglu A, Karakaya Z, Payza U, Akyol PY, Aslan C, Aksun M. The Feasibility of the Ultrasound-Guided Femoral Nerve Block Procedure with Low-Dose Local Anesthetic in Intracapsular and Extracapsular Hip Fractures. J Emerg Med 2020; 58:553-561. [PMID: 32070647 DOI: 10.1016/j.jemermed.2019.12.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 12/25/2019] [Accepted: 12/25/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND The local anesthetic dosages used in the current literature in regional applications of local anesthetics are frequently high for surgical purposes, and there are no sufficient dosage studies for emergency department (ED) management. OBJECTIVES The aim of this study was to determine the success of lower local anesthetic dosages capable of reducing costs and excessive exposure to drugs in pain control in patients with femoral neck fractures (FNFs) in the ED. METHODS Patients ≥65 years of age with FNFs and reporting Wong-Baker Pain Rating Scales scores ≥8 were included in this prospective, interventional study. Patients underwent ultrasound-guided regional femoral block with 5 mL 2% prilocaine. Pain scores before the procedure and at 30 min and 2 h postprocedure were compared with the Friedman test and Wilcoxon test with Bonferroni correction. RESULTS Forty patients, 20 with intracapsular and 20 with extracapsular FNFs, were enrolled. The initial pain scores of patients with both intra- and extracapsular fractures were 8 (range 8-10). A statistically significant 50% decrease in pain scores was observed in both groups 30 min after the regional block procedure (p < 0.001). A statistically significant 75% decrease in pain scores was observed in both groups 2 h after the regional block procedure (p < 0.001). No statistically significant difference was determined in the change in 30-min and 2-h pain scores between the groups. CONCLUSIONS The administration of 5 mL 2% prilocaine for pain control in FNFs in elderly patients in the ED can reduce systemic analgesic requirements by establishing effective analgesia in both intracapsular and extracapsular fractures.
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Affiliation(s)
- Fatih Esad Topal
- Department of Emergency Medicine, Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
| | - Serkan Bilgin
- Department of Emergency Medicine, Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
| | - Adnan Yamanoglu
- Department of Emergency Medicine, Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
| | - Zeynep Karakaya
- Department of Emergency Medicine, Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
| | - Umut Payza
- Department of Emergency Medicine, Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
| | - Pınar Yesim Akyol
- Department of Emergency Medicine, Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
| | - Cihan Aslan
- Department of Orthopaedics and Traumatology, Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
| | - Murat Aksun
- Department of Anesthesiology, Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
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13
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Bilgin S, Topal FE, Yamanoğlu A, Payza U, Karakaya Z, Akyol PY, Tahtaci R, Topal F. Effect of Changes in Intravascular Volume on Inferior Vena Cava and Aorta Diameters and the Caval/Aorta Index in Healthy Volunteers. J Ultrasound Med 2020; 39:231-238. [PMID: 31283047 DOI: 10.1002/jum.15093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Accepted: 06/17/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVES Although inferior vena cava diameter (IVCD) measurement can be useful as a noninvasive method for monitoring the volume status, the benefit of abdominal aorta diameter (AAD) measurement is unclear. The purpose of this study was to determine the value of the combined use of the IVCD and AAD in blood loss monitoring. METHODS This prospective observational study was conducted at the blood donor center of a training and research hospital. Standard blood donation criteria were followed during volunteer enrollment. Vital signs and ultrasound IVCD and AAD measurements were obtained before and after blood donation and after fluid resuscitation with 500 mL of 0.9% sodium chloride. Measurements before and after blood donation and after fluid resuscitation were compared by the paired t and Wilcoxon matched-pair tests. RESULTS Thirty-nine volunteers were included in the study. With 500 mL of blood loss, percent changes in the shock index (SI; mean ± SD, 7% ± 6%), IVCD (6% ± 2%), and caval/aorta index (IVCD/AAD; 6.1% ± 3%) were similar and were higher (P < .001 for all parameters) than the changes in the pulse rate (3% ± 4%), AAD (0.5% ± 1.5%), systolic blood pressure (3% ± 4%), and diastolic blood pressure (2% ± 7%). Although IVCD and SI values changed significantly (P < .001 for both) after 500 mL of 0.9% sodium chloride resuscitation, no significant change was observed in the IVCD/AAD (P = .059). CONCLUSIONS The IVCD/AAD, SI, and IVCD may have similar success rates in diagnosing early blood loss. Additionally, the SI and IVCD may be superior to the IVCD/AAD in bleeding patients requiring simultaneous fluid resuscitation.
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Affiliation(s)
- Serkan Bilgin
- Departments of Emergency Medicine, Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
| | - Fatih Esad Topal
- Departments of Emergency Medicine, Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
| | - Adnan Yamanoğlu
- Departments of Emergency Medicine, Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
| | - Umut Payza
- Departments of Emergency Medicine, Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
| | - Zeynep Karakaya
- Departments of Emergency Medicine, Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
| | - Pınar Yesim Akyol
- Departments of Emergency Medicine, Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
| | - Rezan Tahtaci
- Departments of Emergency Medicine, Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
| | - Firdes Topal
- Departments of Gastroenterology, Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
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Topal FE, Karakaya Z, Akyol PY, Payza U, Çalışkan M, Topal F, Aksun S, Erdoğan S, Neşelioğlu S. ST elevasyonlu akut koroner sendromlu hastalarda artmış tiyol/disülfid oranı. Cukurova Medical Journal 2019. [DOI: 10.17826/cumj.527542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Karakaya Z, Saritas A, Yeşim Akyol P, Esad Topal F, Payza U, Bilgin S. Evaluation of Chronic Subdural Hematoma Volume Calculated via Cavalieri’s Principle. Konuralp Tıp Dergisi 2019. [DOI: 10.18521/ktd.469173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Akyol PY, Karakaya Z, Topal FE, Payza U, Kuday Kaykısız E. Simplified Pulmonary Embolism Severity Index in Predicting Mortality in ED. Konuralp Tıp Dergisi 2019. [DOI: 10.18521/ktd.511525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Yamanoglu A, Celebi Yamanoglu NG, Sogut O, Yigit M, Tas D, Saclı N, Topal FE. A comparison of noninvasive methods for early detection of hemorrhage: Inferior vena cava ultrasonography and spectrophotometric hemoglobin levels. J Clin Ultrasound 2019; 47:278-284. [PMID: 30873632 DOI: 10.1002/jcu.22709] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Revised: 12/04/2018] [Accepted: 01/24/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVES Blood hemoglobin concentration measurements using a spectrophotometric method (SpHb), and inferior vena cava ultrasonography (IVC-US) are noninvasive methods used to follow-up hemorrhages. We compared their efficacy using voluntary blood donation as a model of moderate (approx. 500 mL) blood loss. METHODS In this prospective observational study enrolling blood-donor volunteers (BD) and matched controls, we recorded SpHb, IVC diameters, and vital signs. Changes in variables from baseline were compared between BD and controls using the paired t test and Wilcoxon signed rank test. RESULTS We included 118 subjects in the BD group and 95 healthy subjects in the control group. Changes in IVC maximum diameter, IVC minimum diameter, pulse rate, mean arterial pressure, pulse pressure, and shock index, but not in other variables, were significantly different in the BD and the control group (P < 0.05). IVCmax ≥1.1 mm yielded a 74% sensitivity and 77% specificity (PPV 79.8%, NPV 70.2%) in detecting early hemorrhage. With these cutoff values, IVCmax or PR reached a 90% sensitivity, while IVCmin and PR reached 98% specificity. CONCLUSIONS IVC ultrasound may be superior to SpHb in predicting blood loss and may be useful in addition to vital signs for its follow-up.
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Affiliation(s)
- Adnan Yamanoglu
- Department of Emergency Medicine, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
| | | | - Ozgur Sogut
- Department of Emergency Medicine, University of Health Sciences, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Yigit
- Department of Emergency Medicine, University of Health Sciences, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Demet Tas
- Department of Emergency Medicine, University of Health Sciences, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Neslihan Saclı
- Department of Emergency Medicine, University of Health Sciences, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Fatih Esad Topal
- Department of Emergency Medicine, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
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Urnal R, Akyol PY, Karakaya Z, Payza U, Topal FE, Kaykisiz EK. The effect of neutrophil/lymphocyte ratio on 1-year mortality in pulmonary embolism diagnosed patients. Biomed Res 2018. [DOI: 10.4066/biomedicalresearch.29-18-137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Ugur Goktas M, Akyol PY, Karakaya Z, Payza U, Topal FE. Evaluation of white blood cell and neutrophil/lymphocyte ratio in acute coronary syndrome patients admitted to emergency department. Biomed Res 2018. [DOI: 10.4066/biomedicalresearch.29-18-136] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Alp MB, Karakaya Z, Yavaş GC, Akyol PY, Topal FE, Payza U, Bilgin S. Analysis of Patients Who Applied to Our Clinic with Aortic Dissection: A Five-year Experience. meandros 2017. [DOI: 10.4274/meandros.08379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Caltekin İ, Akyol PY, Topal FE, Karagöz A, Ünlüer EE. Contrast-induced nephropathy and allergic reaction in patients who were given intravenous contrast material in emergency department. J Emerg Trauma Shock 2017; 10:48-49. [PMID: 28243014 PMCID: PMC5316798 DOI: 10.4103/0974-2700.199523] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- İbrahim Caltekin
- Department of Emergency Medicine, Malatya State Hospital, Malatya, Turkey E-mail:
| | - Pıxnar Yeşim Akyol
- Department of Emergency Medicine, İzmir Katip Çelebi University Atatürk Research and Training Hospital, İzmir, Turkey
| | - Fatih Esad Topal
- Department of Emergency Medicine, İzmir Katip Çelebi University Atatürk Research and Training Hospital, İzmir, Turkey
| | - Arif Karagöz
- Department of Emergency Medicine, Karşıyaka State Hospital, İzmir, Turkey
| | - Erden Erol Ünlüer
- Department of Emergency Medicine, İzmir Katip Çelebi University Atatürk Research and Training Hospital, İzmir, Turkey
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Affiliation(s)
- Erden Erol Ünlüer
- Emergency Department, Izmir Katip Çelebi University Atatürk Research and Training Hospital, İzmir, Turkey
| | - Umut Payza
- Emergency Department, Izmir Katip Çelebi University Atatürk Research and Training Hospital, İzmir, Turkey
| | - Serdar Bayata
- Department of Cardiology, Izmir Katip Çelebi University Atatürk Research and Training Hospital, İzmir, Turkey E-mail:
| | - Fatih Esad Topal
- Emergency Department, Izmir Katip Çelebi University Atatürk Research and Training Hospital, İzmir, Turkey
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Abstract
The differential diagnosis of dyspnea in Emergency Department (ED) patients is broad and atelectasis is one of the differentials among these. We present a 29-year-old women presented to our ED for evaluation of shortness of breath. On her chest examination, air entry and breath sounds were diminished on the left side but normal on the right. A posteroanterior chest radiograph showed radioluscent area in the upper zone of the left lung, around the aortic arch and also hyperdens area neighbouring this, like covered by a veil. Luftsichel sign together with this hiperdensity were consistent with the diagnose of left lung upper lobe collapse. The Luftsichel sign represents the hyperexpanded superior segment of the left lower lobe interposed between the atelectatic left upper lobe and aortic arch. Patient was discharged to home with chest physiotherapy and breathing exercises together with analgesic prescreption.
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Affiliation(s)
- Erden Erol Ünlüer
- Department of Emergency, Izmir Katip Çelebi University Atatürk Research and Training Hospital, Izmir, Turkey
| | - Behzat Özkan
- Izmir South Area Public Hospitals Association, Izmir, Turkey
| | - Fatih Esad Topal
- Department of Emergency, Izmir Katip Çelebi University Atatürk Research and Training Hospital, Izmir, Turkey
| | - Nuri Nazif Altiner
- Department of Internal Medicine, Izmir Katip Çelebi University Atatürk Research and Training Hospital, Izmir, Turkey
| | - Arif Karagöz
- Department of Emergency, Karşıyaka State Hospital, Izmir, Turkey
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Unlüer EE, Karagöz A, Topal FE, Akyol PY. Bedside ultrasound diagnosis of intracardiac paperclip. J Emerg Trauma Shock 2014; 7:236-8. [PMID: 25114437 PMCID: PMC4126127 DOI: 10.4103/0974-2700.136873] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Accepted: 03/01/2014] [Indexed: 12/03/2022] Open
Abstract
Penetrating cardiac injuries are rarely reported in the literature. Foreign bodies are rarely seen in the heart and most patients with penetrating cardiac injuries die from hemorragic or pericardial tamponade before arriving at the hospital. Bedside ultrasonography is a highly valuable and readily learned tool that has expanded rapidly since its introduction more than 20 years ago. Our case was a 23-year-old convict brought to the emergency department (ED) with a history of continuous chest pain in the upper area of the left side of the chest for one week. Focused Cardiac Sonography (FOCUS) which was performed by emergency physician showed a strong echogenic linear structure with comet tail artifact, free floating in the mid-segment of the left ventricule. Exact localizations of the paperclips within the chest was obtained with multidetector computed tomography and one of them was seen in the left ventricular cavity. FOCUS plays a crucial role in these patients by diagnosing the injury and detecting the complications in emergency department.
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Affiliation(s)
- Erden Erol Unlüer
- Department of Emergency Medicine, İzmir Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey
| | - Arif Karagöz
- Department of Emergency Medicine, İzmir Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey
| | - Fatih Esad Topal
- Department of Emergency Medicine, İzmir Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey
| | - Pinar Yeşim Akyol
- Department of Emergency Medicine, İzmir Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey
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Akyol PY, Unlüer EE, Elibol P, Karagöz A, Topal FE. A rare cause of dyspnea in emergency medicine: transfusion-related acute lung injury. Am J Emerg Med 2013; 31:1626.e1-2. [PMID: 24070980 DOI: 10.1016/j.ajem.2013.06.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2013] [Accepted: 06/17/2013] [Indexed: 11/27/2022] Open
Abstract
The earliest definition of transfusion-related acute lung injury (TRALI) included all patients who developed acute respiratory distress, moderate to severe hypoxemia, rapid onset of pulmonary edema, mild to moderate hypotension, and fever within 6 hours of receiving a plasma containing blood transfusion. The definition excluded patients if they had underlying cardiac or respiratory disease. The mechanism is not known exactly but it causes morbidity and mortality. Incidence of TRALI changes between 0.08% and 15% of patients receiving a blood transfusion. A 78 year old female patient with history of myelodysplastic syndrome, coronary artey disease and hypertansion, was admitted to the hospital because of dyspnea after the blood transfusion. She was managed as TRALI after diagnostic workup and transported to the intensive care unit. In the following days her clinical status changed dramatically with complete recovery.
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Affiliation(s)
- Pınar Yeşim Akyol
- Emergency Department, İzmir Katip Çelebi University Atatürk Research and Training Hospital, Izmir, Turkey.
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Akbulut S, Gür G, Topal F, Senel E, Topal FE, Alli N, Saritas U. Coeliac disease-associated antibodies in psoriasis. Ann Dermatol 2013; 25:298-303. [PMID: 24003271 PMCID: PMC3756193 DOI: 10.5021/ad.2013.25.3.298] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2012] [Revised: 05/16/2012] [Accepted: 06/14/2012] [Indexed: 12/12/2022] Open
Abstract
Background The possible relationship between psoriasis and coeliac disease (CD) has been attributed to the common pathogenic mechanisms of the two diseases and the presence of antigliadin antibodies in patients has been reported to increase the incidence of CD. Objective The aim of this report was to study CD-associated antibodies serum antigliadin antibody immunoglobulin (Ig)A, IgG, anti-endomysial antibody IgA and anti-transglutaminase antibody IgA and to demonstrate whether there is an increase in the frequency of those markers of CD in patients with psoriasis. Methods Serum antigliadin antibody IgG and IgA, antiendomysial antibody IgA and anti-transglutaminase antibody IgA were studied in 37 (19 males) patients with psoriasis and 50 (23 males) healthy controls. Upper gastrointestinal endoscopy and duodenal biopsies were performed in patients with at least one positive marker. Results Antigliadin IgA was statistically higher in the psoriasis group than in the controls (p<0.05). Serological markers were found positive in 6 patients with psoriasis and 1 person from the control group. Upper gastrointestinal endoscopy was performed in all these persons, with biopsies collected from the duodenum. The diagnosis of CD was reported in only one patient with psoriasis following the pathological examination of the biopsies. Whereas one person of the control group was found to be positive for antigliadin antibody IgA, pathological examination of the duodenal biopsies obtain from this patient were found to be normal. Conclusion Antigliadin IgA prominently increases in patients diagnosed with psoriasis. Patients with psoriasis should be investigated for latent CD and should be followed up.
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Affiliation(s)
- Sabiye Akbulut
- Department of Gastroenterology, Kartal Kosuyolu High Speciality Education and Research Hospital, Istanbul, Turkey
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Abstract
OBJECTIVE Red cell distribution width (RDW) which is reported as part of complete blood count in routine clinical practice, is a measure of variability in size of the erythrocytes in the circulation. It is a novel predictor of mortality both in unselected populations and in some selected group of patients. We aimed to search whether RDW values differ between the healthy population and the patients with pre-hypertension and hypertension who are otherwise healthy, considering the widely accepted role of RDW as a prognostic marker especially for mortality. PATIENTS AND METHODS Patients who were diagnosed with prehypertension or hypertension for the first time according to the Joint National Committee (JNC) 7 criteria and otherwise healthy were enrolled to the study. One-hundred and twenty-eight patients with hypertension, 74 patients with prehypertension and 36 healthy controls participated in the study. Complete blood count, biochemistry and erythrocyte sedimentation rates were measured by standard methods. Hemoglobin, white blood cell count, mean corpuscular volume, platelet count and RDW were recorded. RESULTS After adjustment for age, hemoglobin level, presence of anemia, serum uric acid level, erythrocyte sedimentation rate and mean corpuscular volume, mean RDW values were 15.26 ± 0.82, 16.54 ± 0.91 and 13.87 ± 0.94 in prehypertensive, hypertensive and control groups, respectively (p < 0.05). Systolic and diastolic blood pressures were strongly correlated with RDW (r = 0.848 and r = 0.748, respectively; p < 0.01). CONCLUSION RDW is higher in prehypertensive and hypertensive patients compared with healthy controls independently of age, inflammatory status and anemia. Higher RDW values are strongly correlated with higher systolic and diastolic blood pressures.
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Affiliation(s)
- Asli Tanindi
- Department of Cardiology, Cankiri State Hospital, Aksu mahallesi, Ogretmenler, Sokak, Cankiri, Turkey.
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Abstract
Familial Mediterranean fever (FMF) is an autoimmune disease inherited as an autosomal recessive trait and is characterized by recurrent attacks of fever and sterile polyserositis. This study examined electrocardiographic ventricular repolarization parameters (QT interval and QT dispersion) in 38 FMF patients and 35 healthy controls. The QT interval was measured manually from the onset of QRS to the end of the T wave (return to the TP baseline). QT dispersion was defined as the difference between the maximum and minimum QT values, and corrected QT was calculated according to the Bazett formula. There were no significant differences between FMF patients and healthy control subjects in any parameter of ventricular repolarization; hence QT dispersion was not affected by FMF. Electrocardiographic assessment of QT interval and QT dispersion are, therefore, of little value for the evaluation of cardiac impairment and risk of arrhythmia in FMF patients.
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Affiliation(s)
- F Topal
- Department of Gastroenterology, Cankiri State Hospital, Cankiri, Turkey
| | - A Tanindi
- Department of Cardiology, Cankiri State Hospital, Cankiri, Turkey
| | - HG Kurtoglu
- Department of Cardiology, Cankiri State Hospital, Cankiri, Turkey
| | - S Akbulut
- Department of Gastroenterology, Kartal Kosuyolu Yuksek Ihtisas Education and Research Hospital, Istanbul, Turkey
| | - M Kucukazman
- Department of Gastroenterology, Kecioren Education and Research Hospital, Ankara, Turkey
| | - FE Topal
- Department of Emergency Medicine, Cankiri State Hospital, Cankiri, Turkey
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