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Mutlucan UO, Bedel C, Selvi F, Zortuk Ö, Türk CÇ, Korkut M. The effect of indicators of CALLY index on survival in glioblastoma. Ir J Med Sci 2024:10.1007/s11845-024-03666-w. [PMID: 38561591 DOI: 10.1007/s11845-024-03666-w] [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: 02/23/2024] [Accepted: 03/09/2024] [Indexed: 04/04/2024]
Abstract
INTRODUCTION Glioblastoma is the most common primary brain tumor in adults. Recently, research has been published on the potential prognostic indicators associated with different types of cancer. Due to the limited availability of data investigating the relationship between the CALLY index and glioblastoma patients, we aimed to conduct this study. MATERIALS AND METHODS Between January 2017 and December 2023, we conducted a study on patients diagnosed with glioblastoma. We collected demographic data and routine laboratory tests at the time of admission. To calculate the CALLY index, we used the formula (albumin value × lymphocyte count) / CRP value × 104. Parameters were compared for in-hospital mortality across different groups. RESULTS The study analyzed 202 patients who met the inclusion criteria. Of these, 165 (81.7%) were classified as "survivors" and 37 (18.3%) as "deceased." A comparison of hematologic parameters between the two groups showed a significantly lower CALLY index in the "deceased" group (3.05 (4.92)) compared to the "survivor" group (10.13 (13.69)) (p < 0.001). The study compared the parameters between groups with regard to in-hospital mortality. CONCLUSIONS Based on the results of the study, we conclude that the CALLY index can be considered an easily applicable indicator for the mortality of glioblastoma patients.
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Affiliation(s)
- Umut Ogün Mutlucan
- Department of Neurosurgery, Health Science University Antalya Training and Research Hospital, Antalya, Turkey
| | - Cihan Bedel
- Department of Emergency Medicine, Health Science University Antalya Training and Research Hospital, Muratpaşa, Antalya, Turkey.
| | - Fatih Selvi
- Department of Emergency Medicine, Health Science University Antalya Training and Research Hospital, Muratpaşa, Antalya, Turkey
| | - Ökkeş Zortuk
- Department of Emergency Medicine, Health Science University Antalya Training and Research Hospital, Muratpaşa, Antalya, Turkey
| | - Cezmi Çağrı Türk
- Department of Neurosurgery, Health Science University Antalya Training and Research Hospital, Antalya, Turkey
| | - Mustafa Korkut
- Department of Emergency Medicine, Health Science University Antalya Training and Research Hospital, Muratpaşa, Antalya, Turkey
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Selvi F, Korkut M, Bedel C, Kuş G, Zortuk Ö. Evaluation of Tpeak-end interval, Tpeak-end/QT, and Tpeak-end/Qtc ratio during acute migraine attack in the emergency department. Acta Neurol Belg 2024:10.1007/s13760-024-02497-x. [PMID: 38472697 DOI: 10.1007/s13760-024-02497-x] [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: 11/17/2022] [Accepted: 02/08/2024] [Indexed: 03/14/2024]
Abstract
INTRODUCTION During an acute migraine attack, changes in ventricular repolarisation parameters may occur due to an imbalance in the autonomic nervous system. Tpeak-tend (Tp-e) interval, Tp-e/QT ratio, and Tp-e/corrected QT (QTc) ratio are novel parameters of arrhythmogenesis and can be easily calculated in electrocardiography (ECG). The objective of this study is to demonstrate that novel ventricular repolarisation parameters can anticipate the risk of ventricular dysrhythmia in the migraine attack period. METHODS This research was a prospective case-control study, which recruited a total of 144 participants, including 74 migraine patients and 70 healthy volunteers in the control group (CG) who met the criteria for migraine with or without aura. All participants underwent 12-lead ECG recordings, and the study compared the Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio with those of the CG. RESULTS The average age of patients experiencing migraine attacks was 38.14 ± 10.82, with 58 (76%) of these patients being female. The Tp-e interval mean was higher in the migraine attack group than the CG, with a statistically significant difference discovered (74.22 ± 20.20 ms [ms] compared to 65.39 ± 11.33 ms, p = 0.001). However, there were higher mean Tp-e/QT and Tp-e/QTc ratios in the migraine attack group compared to the CG, and this difference was found to be statistically significant (0.20 ± 0.05 vs. 0.17 ± 0.03, p = 0.001, 0.18 ± 0.52 vs 0.16 ± 0.29, p = 0.003, respectively). CONCLUSION Prolonged Tp-e interval and elevated Tp-e/QT and Tp-e/QTc ratios were observed in migraine patients who presented to the emergency department, indicating a potential risk of ventricular dysrhythmia.
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Affiliation(s)
- Fatih Selvi
- Antalya Training and Research Hospital: Antalya Egitim ve Arastirma Hastanesi, Antalya, Turkey.
| | - Mustafa Korkut
- Antalya Training and Research Hospital: Antalya Egitim ve Arastirma Hastanesi, Antalya, Turkey
| | - Cihan Bedel
- Antalya Training and Research Hospital: Antalya Egitim ve Arastirma Hastanesi, Antalya, Turkey
| | - Görkem Kuş
- Antalya Training and Research Hospital: Antalya Egitim ve Arastirma Hastanesi, Antalya, Turkey
| | - Ökkeş Zortuk
- Antalya Training and Research Hospital: Antalya Egitim ve Arastirma Hastanesi, Antalya, Turkey
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Selvi F, Bedel C, Baltacıoglu B, Yıldız G. A Case of Ticagrelor-induced Seizure. Heart Views 2023; 24:210-211. [PMID: 38188707 PMCID: PMC10766155 DOI: 10.4103/heartviews.heartviews_20_23] [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: 03/05/2023] [Accepted: 08/27/2023] [Indexed: 01/09/2024] Open
Abstract
Ticagrelor is available as an oral antiplatelet agent that can bind reversibly to the adenosine diphosphate receptor P2Y12 on platelets without first having to be activated. Main side effects such as dizziness, bleeding gums, nausea in common, difficulty in speaking, fever, and change in mental status are rare. Herein, we report a patient who had seizures after the usage of ticagrelor.
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Affiliation(s)
- Fatih Selvi
- Department of Emergency Medicine, Health Science University, Antalya Training and Research Hospital, Antalya, Turkey
| | - Cihan Bedel
- Department of Emergency Medicine, Health Science University, Antalya Training and Research Hospital, Antalya, Turkey
| | - Bora Baltacıoglu
- Department of Emergency Medicine, Health Science University, Antalya Training and Research Hospital, Antalya, Turkey
| | - Günay Yıldız
- Department of Emergency Medicine, Health Science University, Antalya Training and Research Hospital, Antalya, Turkey
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Bedel C, Selvi F, Yıldız G, Uysal AŞ. Comment on: "Risk Factors of Thrombocytopenia After Cardiac Surgery with Cardiopulmonary Bypass". Braz J Cardiovasc Surg 2023; 38:e20230010. [PMID: 37540800 PMCID: PMC10401836 DOI: 10.21470/1678-9741-2023-0010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/06/2023] Open
Affiliation(s)
- Cihan Bedel
- Department of Emergency Medicine, Health Science University, Antalya Training and Research Hospital, Antalya, Turkey. E-mail:
| | - Fatih Selvi
- Department of Emergency Medicine, Health Science University, Antalya Training and Research Hospital, Antalya, Turkey
| | - Günay Yıldız
- Department of Emergency Medicine, Health Science University, Antalya Training and Research Hospital, Antalya, Turkey
| | - Ayşe Şeyma Uysal
- Department of Emergency Medicine, Health Science University, Antalya Training and Research Hospital, Antalya, Turkey
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Öztürk G, Selvi F, Yıldız G, Atay S, Baltacıoğlu B, Bedel C. Comparison of Two-Point Compression Ultrasonography Performed by Emergency Medicine Doctors and Radiologists in Detection of Deep Vein Thrombosis. Ibnosina Journal of Medicine and Biomedical Sciences 2023. [DOI: 10.1055/s-0043-1762938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
AbstractVenous thromboembolism (VTE) is a serious coagulation disorder that includes deep vein thrombosis (DVT) and pulmonary embolism and is an important cause of hospitalization and death. This study aimed to evaluate the compliance of the emergency doctor and radiologist in diagnosing DVT in the emergency department using the two-point compression ultrasonography (USG) method.
Patients and Methods This prospective cross-sectional study was performed between February and July 2022 in the Emergency Medicine Clinic of a tertiary university hospital with patients who were thought to have DVT and had lower extremity venous USG indication. Demographic information of patients, clinical markers used in the Wells score, and USG results of the emergency doctors and radiologists were recorded in the study form.
Results A total of 400 patients were included in the study. The mean age of the study patients was 59.8 ± 18.0 years, and 54.4% (n = 217) of the patients were male. There was a significant difference in the incidence of DVT between those with a Wells score of 2 or less and those above 2 (n = 67, 21.8% vs. n = 41, 47.1%; p < 0.001). Regarding interobserver agreement in the evaluation of DVT by emergency medicine doctor and radiologist, kappa values were 0.81 (95% confidence interval [CI]: 0.71–0.91) for the right femoral vein, 0.89 (95% CI: 0.81–0.97) for the left femoral vein. It was found to be 0.81 (95% CI: 0.76–0.86) for all lower extremity vein USGs.
Conclusions There is a very good level of agreement between the emergency department and the radiologist in diagnosing DVT with USG.
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Affiliation(s)
- Göknur Öztürk
- Department of Emergency Medicine, Health Science University, Antalya Training and Research Hospital, Antalya, Turkey
| | - Fatih Selvi
- Department of Emergency Medicine, Health Science University, Antalya Training and Research Hospital, Antalya, Turkey
| | - Günay Yıldız
- Department of Emergency Medicine, Health Science University, Antalya Training and Research Hospital, Antalya, Turkey
| | - Süleyman Atay
- Department of Emergency Medicine, Health Science University, Antalya Training and Research Hospital, Antalya, Turkey
| | - Bora Baltacıoğlu
- Department of Emergency Medicine, Health Science University, Antalya Training and Research Hospital, Antalya, Turkey
| | - Cihan Bedel
- Department of Emergency Medicine, Health Science University, Antalya Training and Research Hospital, Antalya, Turkey
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Bedel C, Yildiz G, Selvi F, Zortuk Ö. Systemic inflammation response index and systemic immune-inflammation index for predicting complications of acute appendicitis: A retrospective study. J Acute Dis 2023. [DOI: 10.4103/2221-6189.369075] [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: 02/10/2023] Open
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Sivil R, Selvi F, Bedel C, Korkut M. Spontaneous pneumomediastinum in COVID‐19 patients: two cases. Egypt J Bronchol 2022. [PMCID: PMC9261154 DOI: 10.1186/s43168-022-00144-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) has become a massive epidemic affecting millions of people worldwide. The common radiological findings of COVID-19 are peripheral ground glass or consolidative opacities, but pneumomediastinum is a very rare finding of COVID-19, especially in patients not receiving mechanical ventilation support. Our aim was to present cases of spontaneous pneumomediastinum in two patients with COVID-19 and to discuss the potential mechanism underlying it.
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Gönüllü G, Selvi F, Bedel C. Clinical Score Application for Abdominopelvic Computed Tomography Used in the Diagnosis of Renal Colic Patients. Ibnosina Journal of Medicine and Biomedical Sciences 2022. [DOI: 10.1055/s-0042-1755540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Abstract
Background To develop risk scoring for the use of computed tomography (CT) imaging using the visual analog scale (VAS), physical examination, and laboratory findings of renal colic patients admitted to the emergency department (ED).
Materials and Methods This is prospective observational study. Among the patients who presented to the ED with abdominal or flank pain, patients who were scheduled for CT imaging for urolithiasis were included in the study. The mean VAS pain scores, physical examination findings, laboratory parameters, and macroscopic and microscopic values in urinalysis were compared between the two groups with and without stones on CT.
Results Of the 196 urolithiasis patients included in the study, 165 had ureteral stones, 76 had renal stones, and 45 had renal and ureteral stones. While the difference between the urine erythrocyte averages of the two groups was borderline significant (p = 0.04), there was a high difference between the urinary hemoglobin amounts (p < 0.001). In patients with urinary system stone disease, hydronephrosis, and ureteral dilatation, hemoglobin ++ and above were more significant (p < 0.001). For ureteral stones, pain intensity increased as the size increased (r = 0.34 p < 0.001). White blood cells > 10,000 103/mL, and C-reactive protein (CRP) ≤ 5 mg/L were more significant in patients with acute renal colic.
Conclusions Although we cannot develop a clinical scoring system for renal colic patients, the meaningful results we found for urinary stone disease can be used in a newly developed scoring system. It can be used in new scoring systems in the ED using a high VAS score, presence and amount of urine hemoglobin, CRP) ≤ 5 mg/L, and creatinine value.
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Affiliation(s)
- Gizem Gönüllü
- Department of Emergency Medicine, Bilecik Training and Research Hospital, Bilecik, Turkey
| | - Fatih Selvi
- Department of Emergency Medicine, Health Science University, Antalya Training and Research Hospital, Antalya, Turkey
| | - Cihan Bedel
- Department of Emergency Medicine, Health Science University, Antalya Training and Research Hospital, Antalya, Turkey
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Korkut M, Bedel C. Abducens paralysis-a rare complication of spinal anesthesia at an emergency department: a case report. Acute Crit Care 2022:acc.2021.01697. [PMID: 35791653 DOI: 10.4266/acc.2021.01697] [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: 12/04/2021] [Accepted: 01/28/2022] [Indexed: 11/30/2022] Open
Abstract
The sixth cranial nerve (CN VI) is a rare site of complication associated with spinal anesthesia and can produce secondary symptoms of ocular muscle palsy. A 38-year-old man was admitted to the emergency department with complaint of diplopia and limited lateral gaze in the first week after endoscopic urological surgery under spinal anesthesia. Isolated unilateral CN VI palsy was considered after excluding differential diagnoses. Ocular palsy and diplopia regressed with conservative treatment during follow-up, and the patient was discharged. This article aims to show that CN VI palsy is a rare complication of spinal anesthesia, which can be observed in the emergency department.
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Affiliation(s)
- Mustafa Korkut
- Department of Emergency Medicine, Health Science University Antalya Training and Research Hospital, Antalya, Turkey
| | - Cihan Bedel
- Department of Emergency Medicine, Health Science University Antalya Training and Research Hospital, Antalya, Turkey
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Bedel C, Selvi F, Akçimen M. Vapocoolant Spray for Pain Control in Intramuscular Injection Applications: A Prospective, Randomized Controlled Trial. Ibnosina Journal of Medicine and Biomedical Sciences 2022. [DOI: 10.1055/s-0042-1748778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Abstract
Background Many pharmacological and nonpharmacological methods have been investigated along with advances in pain treatment. One of these nonpharmacological methods is the use of vapocoolant spray.
Objective This study aimedto demonstrate the effectiveness of vapocoolant spray to reduce pain during intramuscular (IM) injection.
Patients and Methods The study included ≥18 years old patients admitted to the emergency department who were asked to undergo IM injection. Patients were randomly divided into two groups as vapocoolant spray and control group. Demographic data, injection side, and visual analog scale (VAS) of the patients were recorded.
Results Mean VAS values during IM injection were significantly lower in patients treated with vapocoolant spray compared with the control group. The severity of pain during IM injection was lower in the vapocoolant spray group as both moderate pain (VAS > 3 cm) and severe pain (VAS > 5.4 cm) compared with the control group.
Conclusion Vapocoolant spray to be applied before IM injection is effective in reducing pain caused by the injection.
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Affiliation(s)
- Cihan Bedel
- Department of Emergency Medicine, Health Science University, Antalya Training and Research Hospital, Antalya, Turkey
| | - Fatih Selvi
- Department of Emergency Medicine, Health Science University, Antalya Training and Research Hospital, Antalya, Turkey
| | - Mehmet Akçimen
- Department of Emergency Medicine, Health Science University, Antalya Training and Research Hospital, Antalya, Turkey
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Korkut M, Selvi F, Bedel C. Echocardiographic epicardial fat thickness and immature granulocyte are novel inflammatory predictors of acute ischemic stroke: a prospective study. SAO PAULO MED J 2022; 140:384-389. [PMID: 35508005 PMCID: PMC9671256 DOI: 10.1590/1516-3180.2021.0461.r1.16082021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 08/16/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Acute ischemic stroke (AIS) is the most common type of stroke. Inflammation is the primary factor in the pathogenesis of atherosclerosis. Use of immature granulocytes (IGs) has been recommended as a new indicator of systemic inflammation. However, data on the association between echocardiographic epicardial fat tissue thickness (EFT) and IGs in patients with AIS are limited. OBJECTIVE To evaluate the association between the presences of IGs, epicardial fat tissue and AIS. DESIGN AND SETTING Prospective study in a tertiary-care university hospital in Antalya, Turkey. METHODS Our study included 53 AIS patients and 41 healthy controls with age and gender compatibility. Blood samples and transthoracic echocardiography of all participants were compared. RESULTS IG levels were significantly higher in patients with AIS than in controls (0.62 ± 0.36 versus 0.28 ± 0.02, P < 0.001). The mean EFT was 3.74 ± 0.61 mm in the control group and 6.33 ± 1.47 mm in the AIS patient group. EFT was significantly greater in AIS patients than in controls (P < 0.001). For the optimum cut-off value for IG (0.95), the area under the curve (AUC) was determined to be 0.840; sensitivity was determined to be 81.1% and specificity, 92.5%. For the optimum cut-off value for EFT (4.95 mm), the AUC was determined to be 0.953; sensitivity was determined to be 90.6% and specificity, 90%. CONCLUSIONS IG and echocardiographic EFT are clinical markers that can be used to predict AIS risk.
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Affiliation(s)
- Mustafa Korkut
- MD. Emergency Physician, Department of Emergency Medicine, Health Science University, Antalya Training and Research Hospital, Antalya, Turkey
| | - Fatih Selvi
- MD. Emergency Physician and Assistant Professor, Department of Emergency Medicine, Health Science University, Antalya Training and Research Hospital, Antalya, Turkey.
| | - Cihan Bedel
- MD. Emergency Physician, Department of Emergency Medicine, Health Science University, Antalya Training and Research Hospital, Antalya, Turkey.
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Korkut M, Bedel C, Selvi F, Zortuk Ö. Can Peripheral Perfusion Index (PPI) Predict Disease Severity in COVID-19 Patients in the Emergency Department? Ibnosina Journal of Medicine and Biomedical Sciences 2022. [DOI: 10.1055/s-0042-1748776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Abstract
Background Coronavirus disease 2019 (COVID-19) causes significant mortality and morbidity in severe patients.
Objective In this study, we aimed to examine the relationship between COVID-19 disease severity and peripheral perfusion index (PPI).
Patients and Methods This prospective observational study included COVID-19 patients admitted to the tertiary hospital emergency department. Basal clinical and demographic data of the patients and PPI values at the time of admission were recorded. The patients were categorized to severe and nonsevere groups according to clinical severity. The relationship between COVID-19 severity and PPI was examined in comparison with the control group.
Results A total of 324 patients who met the inclusion criteria were analyzed. COVID-19 (+) was detected in 180 of these patients. Ninety-two of the COVID-19 (+) patients were in the severe group, and 88 of them were in the non severe group. Note that 164 COVID-19 (–) patients were in the control group. PPI average was found to be 1.44 ± 1.12 in the severe group, and 3.69 ± 2.51 in the nonsevere group. PPI average was found to be significantly lower in the severe group than the nonsevere group (p< 0.01) As for the nonsevere group and control group, PPI averages were found to be 3.69 ± 2.51 and3.54 ± 2.32, respectively, and a significant difference was determined between the two groups (p< 0.05). PPI COVID-19 severity predicting activity was calculated as area under the curve: 0.833, sensitivity:70.4%, andspecificity:71%(p = 0.025) at 2.2 cutoff value.
Conclusion The results of our study showed that PPI is an easy-to-apply and useful parameter in the emergency department in determining the severity of COVID-19 patients.
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Affiliation(s)
- Mustafa Korkut
- Department of Emergency Medicine, Health Science University, Antalya Training and Research Hospital, Antalya, Turkey
| | - Cihan Bedel
- Department of Emergency Medicine, Health Science University, Antalya Training and Research Hospital, Antalya, Turkey
| | - Fatih Selvi
- Department of Emergency Medicine, Health Science University, Antalya Training and Research Hospital, Antalya, Turkey
| | - Ökkeş Zortuk
- Department of Emergency Medicine, Health Science University, Antalya Training and Research Hospital, Antalya, Turkey
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Bedel C, Balci E, Korkut M. Angioedema after the Administration of tPA for Ischemic Stroke in Patients Taking Angiotensin Converting Enzyme Inhibitors. Neurol India 2022; 70:799-800. [PMID: 35532667 DOI: 10.4103/0028-3886.344668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Cihan Bedel
- Health Science University Antalya Training And Research Hospital, Department of Emergency Medicine, Antalya, Turkey
| | - Erdinc Balci
- Health Science University Antalya Training And Research Hospital, Department of Emergency Medicine, Antalya, Turkey
| | - Mustafa Korkut
- Health Science University Antalya Training And Research Hospital, Department of Emergency Medicine, Antalya, Turkey
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Bedel C, Selvi F, Korkut M. Immature granulocytes: A novel biomarker of acute pericarditis. Indian J Med Spec 2022. [DOI: 10.4103/injms.injms_60_21] [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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Korkut M, Bedel C, Sivil R, Arslan MA, Selvi F, Kuş G, Zortuk Ö. Usefulness of Immature Granulocytes as A Prognostic Factor in ST-Elevation Myocardial Infarction. Braz J Cardiovasc Surg 2022; 37:893-899. [DOI: 10.21470/1678-9741-2021-0088] [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] Open
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Selvi F, Yilmaz F, Bedel C, Karakoyun O, Caliskan G, Gulcan G. Analysis of inmate patients admitted to emergency department of a tertiary education and research hospital: A retrospective cohort study. Med-Science 2022. [DOI: 10.5455/medscience.2021.08.261] [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: 11/03/2022] Open
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Pages N, Picard F, Barritault F, Amara W, Lafitte S, Maribas P, Abassade P, Labarre JP, Boulestreau R, Chaouky H, Abdennadher M, Lemieux H, Lasserre R, Bedel C, Betito L, Nisse-Durgeat S, Diebold B. Remote patient monitoring for chronic heart failure in France: When an innovative funding program (ETAPES) meets an innovative solution (Satelia® Cardio). Digit Health 2022; 8:20552076221116774. [PMID: 36034602 PMCID: PMC9403459 DOI: 10.1177/20552076221116774] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 07/13/2022] [Indexed: 11/15/2022] Open
Abstract
Introduction Remote patient monitoring (RPM) is a telehealth activity to collect and analyze patient health or medical data. Its use has expanded in the past decade and has improved medical outcomes and care management of non-communicable chronic diseases. However, implementation of RPM into routine clinical activities has been limited. The objective of this study was to describe the French funding program for RPM (known as ETAPES) and one of the RPM solution providers (Satelia®) dedicated to chronic heart failure (CHF). Methods A descriptive assessment of both the ETAPES funding program and Satelia® RPM solution was conducted. Data were collected from official legal documents and information that was publicly available online from the French Ministry of Health. Results and Discussion ETAPES was formally created in 2016 based on previous legislation pertaining to the national health insurance funding strategy. However, it only started to operate in 2018. Patients with CHF were only eligible if they were at medium or high risk of re-hospitalization with a New York Heart Association (NYHA) score superior or equal to two and a BNP>100 pg/ml or NT pro BNP>1000 pg/ml. Medical monitoring was supported through the therapeutic education of a patient on the RPM model of care with a minimum of three training sessions during the first six months. The use of Satelia® Cardio is noteworthy since it relies only on symptomatic monitoring through which the patient manually reports their information by answering a simple questionnaire on a regular basis and does not rely on any connected devices. Conclusion Innovative funding programs and solutions for RPM need real-world evaluation in the future.
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Affiliation(s)
- N Pages
- Cardiology Department, Hôpital Haut Leveque, Pessac, France
| | - F Picard
- Cardiology Department, Hôpital Haut Leveque, Pessac, France
| | - F Barritault
- Cardiology Department, GCS Cardiologie, Hôpital de Bayonne, Bayonne, France
| | - W Amara
- Cardiology Department, Centre Hospitalier Intercommunal Le Raincy-Montfermeil, Le Raincy-Montfermeil, France
| | - S Lafitte
- Cardiology Department, Hôpital Haut Leveque, Pessac, France
| | - P Maribas
- Cardiology Department, Hôpital privé de Parly 2, Le Chesnay, France
| | - P Abassade
- Cardiology Department, Hôpital Saint Joseph, Paris, France
| | - J Ph Labarre
- Cardiology Department, Clinique du Pont de Chaume, Montauban,
France
| | - R Boulestreau
- Cardiology Department, Centre Hospitalier de Pau, Pau, France
| | - H Chaouky
- Cardiology Department, Centre Hospitalier de Pau, Pau, France
| | - M Abdennadher
- Cardiology Department, Centre Hospitalier de Bigorre, Tarbes,
France
| | - H Lemieux
- Cardiology Department, Clinique Esquirol St Hilaire, Agen, France
| | - R Lasserre
- Cardiology Department, Centre Hospitalier de Bigorre, Tarbes,
France
| | - C Bedel
- NP Medical, Bordeaux, France
| | | | | | - B Diebold
- Cardiology Department, Hôpital Cochin, Paris, France
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Korkut M, Bedel C, Zortuk Ö, Selvi F. Can immature granulocytes indicate mortality in patients with acute ischemic stroke? NeuroAsia 2021. [DOI: 10.54029/2021fjn] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/09/2023]
Abstract
Background & Objective: Stroke is the most common cause of permanent disability and the most important cause of mortality. Acute ischemic stroke (AIS) reveals inflammation in the ischemic brain tissue. Ischemic tissue causes proinflammatory cytokine release and aggregation of immune cells. Therefore in this study, we aimed to investigate the role of immature granulocyte (IG) in showing 30-day mortality in patients with AİS.
Methods: This study was designed as a single-centered, retrospective cohort study. Patients aged >18 years who were diagnosed with AIS in the tertiary emergency department were included in this study. Patients were divided into two groups as low (<0.6%) and high (≥0.6%) by IG values. Demographic and laboratory parameters were compared between the groups at admission to the emergency department.
Results: Our study consisted of 172 patients diagnosed with AIS, who met the inclusion criteria. The average age of the study group was 69.19 ± 14.34 years, and 94 (54.7%) of the patients were male. 98 (56.9%) patients were in the low IG group, and 74 (43.1%) of them were in the poor outcome group. IG at the cut-off value of 1.3 was shown to predict mortality in patients with AIS with 80.5% sensitivity and 93.2% specificity (area under the curve: 0.715 95% CI: 0.623-0.807, p <0.001)
Conclusion: The results of our study showed that IG is a new and simple predictor to predict 30-day prognosis in patients with AIS.
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Affiliation(s)
- Cihan Bedel
- Department of Emergency Medicine Health Science University Antalya Training And Research Hospital Antalya, Turkey
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Bedel C, Korkut M, Armağan HH. Can NLR, PLR and LMR be used as prognostic indicators in patients with pulmonary embolism? A commentary. Bosn J Basic Med Sci 2021; 21:501. [PMID: 33159434 PMCID: PMC8292860 DOI: 10.17305/bjbms.2020.5236] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 11/06/2020] [Indexed: 11/16/2022] Open
Affiliation(s)
- Cihan Bedel
- Department of Emergency Medicine, Health Science University Antalya Training and Research Hospital, Antalya, Turkey
| | - Mustafa Korkut
- Department of Emergency Medicine, Health Science University Antalya Training and Research Hospital, Antalya, Turkey
| | - Hamit Hakan Armağan
- Department of Emergency Medicine, Suleyman Demirel University Faculty of Medicine, Isparta, Turkey
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Bedel C, Korkut M, Armağan HH. Comment on ''Can the neutrophil/lymphocyte ratio (NLR) have a role in the diagnosis of coronavirus 2019 disease (COVID-19)?''. ACTA ACUST UNITED AC 2021; 67Suppl 1:168-169. [PMID: 34259771 DOI: 10.1590/1806-9282.67.suppl1.20200812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 10/21/2020] [Indexed: 11/22/2022]
Affiliation(s)
- Cihan Bedel
- Unıversıty of Health Scıences, Antalya Training and Research Hospital Physician, Department of Emergency Medicine - Antalya, Turkey
| | - Mustafa Korkut
- Unıversıty of Health Scıences, Antalya Training and Research Hospital Physician, Department of Emergency Medicine - Antalya, Turkey
| | - Hamit Hakan Armağan
- Suleyman Demirel University, Faculty of Medicine, Department of Emergency Medicine - Isparta, Turkey
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Abstract
Introduction: Scoring systems are still valuable and valid for differential diagnosis of acute appendicitis (AA). Bedel Score is a new diagnostic tool with 7 parameters that can be easily applied. The aim of this study is to determine the diagnostic performance of the Bedel score in AA and compare it with the Alvarado score. Methods: Our study consisted of 95 patients as a prospective cohort who were admitted to our emergency department due to abdominal pain and were hospitalized with a preliminary diagnosis of AA. Bedel and Alvarado scores were calculated. The patients were categorized into two groups (positive and negative appendectomy) according to their histopathological diagnosis. Results: The study population consisted of 65 (68.4%) male and 30 (31.6%) female patients. The mean age of the patients was 34 (18-87) years. 81 (85.3%) of the patients had histopathologically confirmed AA. Median Alvarado score was significantly higher in patients with positive AA than those with negative AA (7 (range: 3-10) vs. 5 (range 3-7), p<0.001, respectively). Median Bedel score of positive AA patients were also significantly higher than those with negative AA (9 (range: 6-10) vs. 5 (range 2-8) p<0.001, respectively) In separating acute appendicitis from negative exploration, the threshold of the Alvarado score is 63% sensitivity for ?7, 85.7% specificity; The Bedel score had 80.2% sensitivity and 92.9% specificity for the threshold value ?7. Conclusion: Bedel score is fast, simple, easy to learn and apply, as well as an effective and practical scoring system with only 7 parameters.
Keywords: Acute appendicitis, Alvarado score, New score, Negative appendectomy
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Bedel C, Korkut M, Armağan HH. Red blood cell distribution width and mortality in traumatic brain injury. Acta Neurol Belg 2021; 121:791-792. [PMID: 33136274 DOI: 10.1007/s13760-020-01539-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 10/21/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Cihan Bedel
- Department of Emergency Medicine, Health Science University Antalya Training and Research Hospital, Kazım Karabekir Street, 07100, Muratpaşa, Antalya, Turkey.
| | - Mustafa Korkut
- Department of Emergency Medicine, Health Science University Antalya Training and Research Hospital, Kazım Karabekir Street, 07100, Muratpaşa, Antalya, Turkey
| | - Hamit Hakan Armağan
- Department of Emergency Medicine, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey
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Bedel C, Korkut M. Red Cell Distribution Width and Hip Fracture. J Bone Miner Res 2021; 36:1202. [PMID: 33170965 DOI: 10.1002/jbmr.4201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 10/20/2020] [Indexed: 11/09/2022]
Affiliation(s)
- Cihan Bedel
- Department of Emergency Medicine, Health Science University Antalya Training and Research Hospital, Antalya, Turkey
| | - Mustafa Korkut
- Department of Emergency Medicine, Health Science University Antalya Training and Research Hospital, Antalya, Turkey
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Uzunay H, Selvi F, Bedel C, Karakoyun OF. Comparison of ETCO2 Value and Blood Gas PCO2 Value of Patients Receiving Non-invasive Mechanical Ventilation Treatment in Emergency Department. ACTA ACUST UNITED AC 2021; 3:1717-1721. [PMID: 33937634 PMCID: PMC8078828 DOI: 10.1007/s42399-021-00935-y] [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] [Accepted: 04/22/2021] [Indexed: 11/01/2022]
Abstract
Capnography is the non-invasive measurement and graphic representation of the partial pressure of CO2 in expiration. Although there are many studies in the literature comparing the partial pressure of carbon dioxide (pCO2) and end-tidal CO2 (ETCO2) values in patients who underwent IMV (invasive mechanical ventilation), there are no studies showing their interchangeable applicability in patients who received NIMV (non-IMV). We aimed to evaluate whether the use of ETCO2 in the treatment process can replace pCO2 use in patients scheduled for NIMV treatment in the emergency department. Patients who applied to the emergency department with respiratory distress between March 2019 and January 2020, who were diagnosed with acute cardiogenic edema or acute chronic obstructive pulmonary disease (COPD) exacerbation, and who needed NIMV were included in the study. General characteristics of the patients and the pCO2 and ETCO2 values were measured in the blood gas 1 h after the NIMV application was started. 64.2% (99 patients) of the patients included in the study were male, and 35.8% (55 patients) were female. The mean age of the patients included in the study was 69.1 ± 12.2 years. The mean pCO2 values were measured as 52.6 ± 13.2. The mean of ETCO2 values measured simultaneously was 33.6 ± 10.1. There was a significant difference between the controlled pCO2 values and ETCO2 values at the first hour of NIMV treatment (Z: - 10.640, p < 0.001). The ETCO2 level was found to be different in our patients who received NIMV treatment, which could not be used instead of the pCO2 level.
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Affiliation(s)
- Hüseyin Uzunay
- Department of Emergency Medicine, Kas State Hospital, Antalya, Turkey
| | - Fatih Selvi
- Department of Emergency Medicine, Health Science University, Antalya Training and Research Hospital, Antalya, Turkey
| | - Cihan Bedel
- Department of Emergency Medicine, Health Science University, Antalya Training and Research Hospital, Antalya, Turkey
| | - Omer Faruk Karakoyun
- Department of Emergency Medicine, Mugla Sitki Kocman University Training Research Hospital, Mugla, Turkey
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Bedel C, Korkut M, Selvi F. New markers in predicting the severity of acute pancreatitis in the emergency department: Immature granulocyte count and percentage. J Postgrad Med 2021; 67:7-11. [PMID: 33533745 PMCID: PMC8098866 DOI: 10.4103/jpgm.jpgm_784_20] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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] [Indexed: 12/11/2022] Open
Abstract
Background: Acute pancreatitis (AP) may vary in severity, from mild, self-limiting pancreatic inflammation to rapidly progressive life-threatening clinical course. If the severity of AP can be predicted early and treated quickly, it may lead to a decrease in morbidity and mortality rates. There?fore, we aimed to investigate the clinical utility of immature granulocyte count (IGC) and IGC percentage (IG%) in showing the severity of AP in this study. Methods: Two hundred and twenty-seven patients who were admitted to our emergency department and diagnosed with AP between March 1 and September 30, 2019, were included in the study. The patients were divided into two groups as mild and severe AP (MAP and SAP) according to the severity of the disease. Demographic characteristics of the patients, disease etiology, disease severity, and inflammation markers [white blood cell count (WBC), IGC, IG%, neutrophil–lymphocyte ratio (NLR), and C-reactive protein (CRP)] were recorded. Differences between the groups were statistically analyzed. Results: Of the patients included in the study, 183 (80.7%) were in the MAP group and 44 (19.3%) were in the SAP group. The mean WBC, NLR, CRP, IGC, and IG% levels were significantly higher in the SAP group compared to the MAP group. The power of IGC and IG% in predicting SAP was higher than other inflammation markers (WBC, NLR, and CRP) [(AUC for IGC: 0.902; sensitivity: 78.2%; specificity: 92.8%); (AUC for IG%: 0.843; sensitivity: 72.7%; specificity: 84.6%)]. Conclusion: IGC and IG% show the severity of AP more effectively than WBC, NLR, and CRP, which are traditional inflammation markers.
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Affiliation(s)
- C Bedel
- Health Science University Antalya Training and Research Hospital, Department of Emergency Medicine, Antalya, Turkey
| | - M Korkut
- Health Science University Antalya Training and Research Hospital, Department of Emergency Medicine, Antalya, Turkey
| | - F Selvi
- Health Science University Antalya Training and Research Hospital, Department of Emergency Medicine, Antalya, Turkey
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Mutlu H, Korkut M, Soyuncu S, Bedel C. Initial Versus Final Diagnosis in Patients Who Presented to the Emergency Department Without Trauma: A Prospective Cohort Study. Eurasian J Emerg Med 2021. [DOI: 10.4274/eajem.galenos.2020.95866] [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] Open
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28
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Bedel C, Korkut M. Mean platelet volume combined red cell distribution width is affected by many conditions. Clin Respir J 2021; 15:702. [PMID: 33624423 DOI: 10.1111/crj.13343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 02/19/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Cihan Bedel
- Department of Emergency Medicine, Health Science University Antalya Training and Research Hospital, Antalya, Turkey
| | - Mustafa Korkut
- Department of Emergency Medicine, Health Science University Antalya Training and Research Hospital, Antalya, Turkey
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Bedel C, Korkut M, Selvi F, Zortuk Ö. The Immature Granulocyte Count Is a New Predictor of the 30-Day Mortality in Intracerebral Haemorrhage Patients: Preliminary Study. Indian Journal of Neurosurgery 2021. [DOI: 10.1055/s-0040-1721627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Abstract
Objectives Spontaneous intracerebral hemorrhage (ICH) accounts for 10 to 20% of all types of stroke and is associated with high mortality and morbidity rates. Neuroinflammation caused by intracerebral blood includes resident microglia activation, infiltration of systemic immune cells, and production of cytokines, chemokines, extracellular proteases, and reactive oxygen species. Despite several findings demonstrating that an immature granulocyte (IG) count can be a prognostic indicator as an inflammatory parameter in many diseases, no studies conducted on ICH patients are available in the literature. Therefore, in this study, we aimed to investigate the relationship between the 30-day mortality rate and the IG count obtained at the time of admission in ICH patients.
Methods Demographic characteristics and laboratory test results of patients, who were diagnosed with ICH and hospitalized accordingly upon arrival at the emergency ward in our tertiary care hospital in the period from January 2019 and December 2019, were recorded. The endpoint of the study was the examination of the relationship between the short-term mortality (within 30 days after hospitalization) and the IG count at admission.
Results Seventy patients, who met the inclusion criteria, were included in the study. Of these patients, 40 (57.1%) were males and the mean age was 68.04 ± 13.08 years. Patients with poor prognosis had higher IG counts (p = 0.001). The 30-day mortality rate was 33.3% (11/33) in the high IG count (≥0.6) group and 5.4% (2/37) in the low IG count (< 0.6) group (p = 0.004). In the regression analysis, we found out a significant relationship of the IG count to the 30-day mortality, with an odds ratio of 5.157(95% CI = 0.914–29.087, p = 0.029).
Conclusion An IG count can be obtained from a simple full blood count, is easy to apply, does not result in extra costs, and is used as a marker to predict the 30-day prognosis.
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Affiliation(s)
- Cihan Bedel
- Department of Emergency Medicine, Health Science University, Antalya Training and Research Hospital, Antalya, Turkey
| | - Mustafa Korkut
- Department of Emergency Medicine, Health Science University, Antalya Training and Research Hospital, Antalya, Turkey
| | - Fatih Selvi
- Department of Emergency Medicine, Health Science University, Antalya Training and Research Hospital, Antalya, Turkey
| | - Ökkeş Zortuk
- Department of Emergency Medicine, Health Science University, Antalya Training and Research Hospital, Antalya, Turkey
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Bedel C, Korkut M. Thrombocytopenia due to escitalopram use – A rare case report at the emergency department. Iraqi J Hematol 2021. [DOI: 10.4103/ijh.ijh_47_20] [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] Open
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Bedel C, Korkut M, Selvi F, Karanci Y. Can the neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and lymphocyte-monocyte ratio predict active bleeding in patients with upper gastrointestinal bleeding? J Acute Dis 2021. [DOI: 10.4103/2221-6189.307389] [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] Open
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Bedel C, Selvi F, Korkut M. Can the immature granulocyte count have a role in the diagnosis of coronavirus 2019 disease? Ibnosina J Med Biomed Sci 2021. [DOI: 10.4103/ijmbs.ijmbs_43_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Abstract
We have read the article by Yang et al, entitled “The diagnostic and predictive role of NLR, d-NLR and PLR in COVID-19 patients” with great interest. The authors emphasized that the NLR (Neutrophil to lymphocyte ratio) is an independent prognostic biomarker for COVID-19 patients. First of all, we congratulate the authors for their valuable contribution to the literature in these difficult conditions. However, we would like to add on a few cases that need more attention.
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Affiliation(s)
- Cihan Bedel
- Department of Emergency Medicine, Health Science University Antalya Training and Research Hospital, Antalya, Turkey.
| | - Mustafa Korkut
- Department of Emergency Medicine, Health Science University Antalya Training and Research Hospital, Antalya, Turkey
| | - Hamit Hakan Armağan
- Department of Emergency Medicine, Suleyman Demirel University Faculty of Medicine, Isparta, Turkey
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Bedel C, Korkut M, Avcı A, Uzun A. Immature Granulocyte Count and Percentage as New Predictors of Mortality in Patients with Upper Gastrointestinal Bleeding. Indian J Crit Care Med 2020; 24:794-798. [PMID: 33132562 PMCID: PMC7584826 DOI: 10.5005/jp-journals-10071-23563] [Citation(s) in RCA: 4] [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] [Indexed: 01/05/2023] Open
Abstract
Aims Early identification of patients at risk of adverse outcomes may increase the survival rates in patients with upper gastrointestinal bleeding (UGIB), but this can be difficult to predict in emergencies. The aim of the study is to evaluate immature granulocyte (IG), which can be obtained from simple hemogram tests in patients with UGIB, in terms of clinical use and as a mortality marker. Materials and methods The patients diagnosed with UGIB between March 1, 2019, and September 30, 2019, were evaluated retrospectively. Demographic characteristics, causes of hemorrhage, clinical presentations, hemogram, and biochemistry values at ED admission and 30-day mortality status of the patients were examined. We divided the patients into groups according to their mortality status, and the groups were compared among themselves in terms of parameters. Results A total of 213 patients who met the inclusion criteria were included in the study. Of these patients, 139 (65.3%) were male and the mean age was 65.05 ± 16.7 years. Fifteen (7%) of them were in the nonsurvival group, while 198 (93%) were in the survival group. The efficacy of both the IG count (IGC) and IG% in predicting mortality was statistically significant (p = 0.002, p = 0.008, respectively). The sensitivity and specificity for the IGC were found as 60% and 84.4; for the IG%, they were found as 66.7% and 75.7%, respectively. Conclusion IGC and IG% are independent risk factors for the 30-day mortality status. These measurements are obtained from simple hemogram tests and may be useful for the evaluation of mortality in patients with UGIB. How to cite this article Bedel C, Korkut M, Avcı A, Uzun A. Immature Granulocyte Count and Percentage as New Predictors of Mortality in Patients with Upper Gastrointestinal Bleeding. Indian J Crit Care Med 2020;24(9):794-798.
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Affiliation(s)
- Cihan Bedel
- Department of Emergency Medicine, Health Science University Antalya Training and Research Hospital, Antalya, Turkey
| | - Mustafa Korkut
- Department of Emergency Medicine, Health Science University Antalya Training and Research Hospital, Antalya, Turkey
| | - Ali Avcı
- Department of Emergency Medicine, Karaman State Hospital, Karaman, Turkey
| | - Ahmet Uzun
- Department of Emergency Medicine, Karabük University Training and Research Hospital, Karabük, Turkey
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Bedel C, Korkut M, Aksoy F, Kuş G. Usefulness of Immature Granulocytes to Predict High Coronary SYNTAX Score in Acute Coronary Syndrome; a Cross-sectional Study. Arch Acad Emerg Med 2020; 8:e73. [PMID: 33134969 PMCID: PMC7587994] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Immature granulocytes (IG) in peripheral blood indicate increased bone marrow activation and inflammation, and SYNTAX score (SS) is an anatomical scoring system based on coronary angiogram. This study, aimed to evaluate the relationship between IG and SS, as a new inflammatory marker in patients with acute coronary syndrome (ACS). METHODS Patients aged >18 years who were diagnosed with ACS in the emergency department were included in this study, which was planned as a cross-sectional study. Patients were divided into two groups of patients with high and low SSs according to coronary angiography results. Demographic and laboratory parameters were compared between the groups. RESULTS Our study consisted of 78 patients diagnosed with ACS, who met the inclusion criteria. The average age of the study group was 59 years, and 67.9% of the patients were male. 21 patients (26.9%) had high SSs and 57 patients (73.1%) had low SSs. Mean IG% was significantly higher in high SS group compared to low SS group (0.71±0.25 vs 0.44±0.21 mg/dl, p<0.001). IG% can present a high SS with 76.2% sensitivity and 75.4% specificity at a cut-off value of 0.7. CONCLUSION IG was significantly higher in ACS patients with high SSs. It seems that IG can be used as a parameter, which is quickly accessible and cheap, in order to predict high SS in ACS patients in daily clinical practice.
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Affiliation(s)
- Cihan Bedel
- Department of Emergency Medicine, Health Science University Antalya Training and Research Hospital, Antalya,Turkey.
| | - Mustafa Korkut
- Department of Emergency Medicine, Health Science University Antalya Training and Research Hospital, Antalya,Turkey.
| | - Fatih Aksoy
- Department of Cardiology, Suleyman Demirel University Faculty of Medicine, Isparta, Turkey.
| | - Görkem Kuş
- Department of Cardiology, Health Science University Antalya Training and Research Hospital, Antalya,Turkey.
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Bedel C, Korkut M, Karancı Y, Duyan M. Can We Estimate the Recurrence of Epistaxis with Simple Blood Tests? J Clin Exp Invest 2020. [DOI: 10.5799/jcei/7839] [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: 11/23/2022] Open
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Korkut M, Bedel C, Karancı Y, Avcı A, Duyan M. Accuracy of Alvarado, Eskelinen, Ohmann, RIPASA and Tzanakis Scores in Diagnosis of Acute Appendicitis; a Cross-sectional Study. Arch Acad Emerg Med 2020; 8:e20. [PMID: 32259117 PMCID: PMC7130437] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Many scoring systems have been developed to assist in diagnosis of acute appendicitis (AA). This study aimed to compare the screening performance characteristics of Alvarado, Eskelinen, Ohmann, Raja Isteri Pengiran Anak Saleha (RIPASA), and Tzanakis scores in predicting the need for appendectomy in AA patients. METHODS Our study prospectively evaluated AA patients that were treated in a tertiary hospital's emergency department. The obtained data were used to calculate Alvarado, Tzanakis, RIPASA, Eskelinen and Ohmann scores. Patients were categorized into two groups according to their histopathological results: positive (PA) and negative appendectomy (NA). The accuracy of different scoring systems in diagnosing AA was investigated. RESULTS 74 patients suspected to AA with the mean age of 36.68 ± 11.97 years were studied (56.8% male). The diagnosis was histopathologically confirmed in 65 cases (87.8%). Median Alvarado, Tzanakis, RIPASA, Eskelinen and Ohmann scores were significantly higher in patients with positive appendectomy. The area under the curve (AUC), sensitivity, and specificity of Tzanakis score in the cut-off value of 8 were 0.965, 84.4%, and 100%, respectively. For Ohmann and Alvarado scores, these measures were 0.941; 71.9%, 89.9% and 0.938, 60.9%, 89.9%, respectively. Tzanakis scoring system had the best screening performance in detection of cases with AA. CONCLUSION Tzanakis score is more sensitive and specific than Alvarado, RIPASA, Eskelinen and Ohmann scores in identifying AA patients needing appendectomy.
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Affiliation(s)
- Mustafa Korkut
- Department of Emergency Medicine, Health Science University Antalya Training and Research Hospital, Antalya, Turkey
| | - Cihan Bedel
- Department of Emergency Medicine, Health Science University Antalya Training and Research Hospital, Antalya, Turkey.,Corresponding author: Cihan Bedel; Health Science University Antalya Training And Research Hospital, Kazım Karabekir Street postal zip code: 07100, Muratpaşa, Antalya, Turkey. Phone: +905075641254, Fax: +902422494487, E-mail:
| | - Yusuf Karancı
- Department of Emergency Medicine, Health Science University Antalya Training and Research Hospital, Antalya, Turkey
| | - Ali Avcı
- Department of Emergency Medicine, Karaman State Hospital, Karaman, Turkey
| | - Murat Duyan
- Department of Emergency Medicine, Health Science University Antalya Training and Research Hospital, Antalya, Turkey
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Coskun G, Beceren NG, Bedel C. The Role of Allopregnanolone Levels in Traumatic Brain Injury in Children and Adults and the Correlation of Its Levels with Computerized Tomography Images of the Brain. Indian Journal of Neurosurgery 2020. [DOI: 10.1055/s-0040-1701323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Abstract
Aim Allopregnanolone (AP) is a steroid of progesterone origin and it can readily pass through the blood–brain barrier. The aim of this study was to determine the AP levels occurring after head trauma in children and adults and to compare these results to the findings observed in the computed tomography (CT) of the respective individuals.
Materials and Methods This study was conducted in the period from April 2018 to December 2018 on 92 patients admitted with isolated head trauma and on 80 healthy individuals in similar gender and age groups. The age, gender, and Glasgow Coma Scores of the patients; the cause of the head trauma; and the findings from CT imaging were recorded.
Results The levels of AP were significantly lower in the head trauma patients both in the adult and pediatric groups compared with the healthy control groups of respective ages (p < 0.001). Furthermore, the levels of AP were significantly lower in both the pediatric and adult patients with identified pathologies in the CT images compared with their counterpart control groups (p < 0.001). In predicting an existing pathology in the CT, an AP level of > 138.5 was found to be 85.7% sensitive and 85.3% specific in the pediatric patients, and an AP level of >118.3 was 75% sensitive and 83.5% specific in the adult patients.
Conclusion The levels of AP in head trauma patients were reduced in both the pediatric and adult patients and these low levels increase the likelihood of detecting pathology in CT images.
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Affiliation(s)
- Göker Coskun
- Department of Emergency Medicine, Cigli Regional Training and Research Hospital, Izmir, Turkey
| | - Nesrin Gökben Beceren
- Department of Emergency Medicine, Suleyman Demirel University Faculty of Medicine, Isparta, Turkey
| | - Cihan Bedel
- Department of Emergency Medicine, Health Science University Antalya Training and Research Hospital, Antalya, Turkey
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Keskin Y, Bedel C, Gökben Beceren N. Investigation of histopathological and radiological effects of surfactant treatment in an experimental female rat model of lung contusion. Iran J Basic Med Sci 2020; 22:1153-1157. [PMID: 31998456 PMCID: PMC6885389 DOI: 10.22038/ijbms.2019.32357.8258] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Objective(s): Pulmonary contusion (PC) is a clinical entity that often accompanies blunt traumas. We aimed to investigate the radiological and histopathological effects of surfactant treatment in an experimental rat model in which lung contusion was formed by blunt thoracic trauma. Materials and Methods: 50 female Sprague-Dawley rats were used. Five groups were formed randomly. In groups 2, 4, and 5 lung contusion was made by the drop-weight method after anesthesia. Intratracheal surfactant was administered in the 4th hr in groups 3 and 4 and in the 24th hr in groups 4 and 5. All rats were sacrificed and their lungs removed at 48 hr after contusion. Alveolar edema, congestion, hemorrhage, destruction, leukocyte infiltration, immune staining were examined histopathologically. Results: When the first thoracic CT scans were evaluated, we observed two rats with rib fractures and four rats with pneumothorax. 4 and 48 hr thoracic CT evaluation contusion and atelectasis showed no statistically significant decrease (P>0.05). After sacrifice of group 2, in macroscopic evaluation, there was a heterogeneous contusion and hemorrhagic appearance in the lungs of rats and less hemorrhagic appearance was observed in Groups 4 and 5 than in Group 2. In comparison of Immunohistopathological findings, surfactant treatment showed a statistically significant decrease in leukocyte infiltration scores (P=0.046). Immunohistopathologically, surfactant group had more staining but only statistically significant when compared to groups 4 and sham. (P=0.036). Conclusion: Surfactant treatment may be of significant benefit in lung contusion secondary to blunt chest trauma, and further prospective evidence of its efficacy in such disorders is needed.
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Affiliation(s)
- Yasin Keskin
- Beyhekim State Hospital, Department of Emergency Medicine, Konya, Turkey
| | - Cihan Bedel
- Health Science University Antalya Training and Research Hospital, Department of Emergency Medicine, Antalya, Turkey
| | - Nesrin Gökben Beceren
- Süleyman Demirel University Faculty of Medicine, Department of Emergency Medicine, Isparta, Turkey
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Bedel C, Uzun A, Korkut M, Kartal M. Evaluation of modified STONE score in patients presenting to the emergency department with flank pain. Urol Sci 2020. [DOI: 10.4103/uros.uros_32_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Bedel C, Korkut M. The relationship of clinical and laboratory factors with acute isolated vertigo and cerebellar infarction. Indian J Med Spec 2020. [DOI: 10.4103/injms.injms_14_20] [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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Bedel C, Korkut M, Selvi F. Are immature granulocytes and derivatives early predictors of acute appendicitis and acute complicated appendicitis in adults? Formos J Surg 2020. [DOI: 10.4103/fjs.fjs_111_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Bedel C, Korkut M. Evaluation of the neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and monocyte lymphocyte ratio for diagnosis of testicular torsion. J Acute Dis 2020. [DOI: 10.4103/2221-6189.291286] [Citation(s) in RCA: 2] [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: 11/04/2022] Open
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Bedel C, Selvi F. Association of Platelet to Lymphocyte and Neutrophil to Lymphocyte Ratios with In-Hospital Mortality in Patients with Type A Acute Aortic Dissection. Braz J Cardiovasc Surg 2019. [PMID: 31545575 DOI: 10.19538/j.ek2019080618] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVE To evaluate the relationship between neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) with in-hospital mortality in type A acute aortic dissection (AAD). METHODS A total of 96 patients who presented to the emergency department between January 2013 and June 2018 with a diagnosis of type A AAD were enrolled in this study. White blood cell count subtypes such as NLR and PLR were calculated at the time of admission. The end point was in-hospital mortality. RESULTS Of the 96 type A AAD patients included in this analysis, 17 patients (17.7%) died during hospitalization. NLR and PLR were significantly elevated in patients with type A AAD (P<0.001 and <0.001, respectively). Based on the receiver operating characteristic curve, the best NLR cut-off value to predict in-hospital mortality was 9.74, with 70.6% sensitivity and 76.8% specificity, whereas the best PLR cut-off value was 195.8, with 76.5% sensitivity and 78.1% specificity. CONCLUSION Admission NLR and PLR levels were important risk factors and independently associated with in-hospital mortality of type A AAD patients.
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Affiliation(s)
- Cihan Bedel
- University of Health Sciences Antalya Training and Research Hospital Department of Emergency Medicine Antalya Turkey University of Health Sciences, Antalya Training and Research Hospital, Department of Emergency Medicine, Antalya, Turkey
| | - Fatih Selvi
- University of Health Sciences Antalya Training and Research Hospital Department of Emergency Medicine Antalya Turkey University of Health Sciences, Antalya Training and Research Hospital, Department of Emergency Medicine, Antalya, Turkey
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Bedel C, Selvi F. Association of Platelet to Lymphocyte and Neutrophil to Lymphocyte Ratios with In-Hospital Mortality in Patients with Type A Acute Aortic Dissection. Braz J Cardiovasc Surg 2019; 34:694-698. [PMID: 31545575 PMCID: PMC6894039 DOI: 10.21470/1678-9741-2018-0343] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [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] [Indexed: 11/18/2022] Open
Abstract
Objective To evaluate the relationship between neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) with in-hospital mortality in type A acute aortic dissection (AAD). Methods A total of 96 patients who presented to the emergency department between January 2013 and June 2018 with a diagnosis of type A AAD were enrolled in this study. White blood cell count subtypes such as NLR and PLR were calculated at the time of admission. The end point was in-hospital mortality. Results Of the 96 type A AAD patients included in this analysis, 17 patients (17.7%) died during hospitalization. NLR and PLR were significantly elevated in patients with type A AAD (P<0.001 and <0.001, respectively). Based on the receiver operating characteristic curve, the best NLR cut-off value to predict in-hospital mortality was 9.74, with 70.6% sensitivity and 76.8% specificity, whereas the best PLR cut-off value was 195.8, with 76.5% sensitivity and 78.1% specificity. Conclusion Admission NLR and PLR levels were important risk factors and independently associated with in-hospital mortality of type A AAD patients.
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Affiliation(s)
- Cihan Bedel
- University of Health Sciences Antalya Training and Research Hospital Department of Emergency Medicine Antalya Turkey University of Health Sciences, Antalya Training and Research Hospital, Department of Emergency Medicine, Antalya, Turkey
| | - Fatih Selvi
- University of Health Sciences Antalya Training and Research Hospital Department of Emergency Medicine Antalya Turkey University of Health Sciences, Antalya Training and Research Hospital, Department of Emergency Medicine, Antalya, Turkey
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Akcimen M, Bedel C. Comparison between new modified external rotation method and external rotation method for reduction of ASD. Am J Emerg Med 2019; 38:874-878. [PMID: 31280941 DOI: 10.1016/j.ajem.2019.07.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 05/07/2019] [Revised: 07/01/2019] [Accepted: 07/01/2019] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Dislocation of the shoulder joint is common and is mainly anterior. Several reduction methods have been described and the external reduction method (ERM) is one of the newest. We modified the ERM by making some additions in hopes to develop a less painful, quick and simple method. The aim of this study was to compare the new modified external rotation reduction method (MERM) with ERM in acute anterior shoulder dislocations (ASD). METHODS A total of 62 patients with ASD were classified randomly into 2 groups. The reduction was performed with MERM in one group and with ERM in the other group and the results were compared. Patients' pain scores, reduction time, success rate of the reduction methods, age, sex, dislocation side, dislocation time, previous dislocations history, injury mechanism, any complications, reduction time and neurovascular examination were collected. Parametric and nonparametric analyses were used to compare MERM and ERM. RESULTS The study cohort consisted of 62 patients (52 males, 10 females; mean age, 35 years; age range, 18-73 years) who were randomly assigned to treatment with the MERM (n = 32) or the ERM (n = 30). There was a statistically significant difference between the two methods in terms of time, and the MERM can be applied much faster than ERM (1.34 ± 1.41 min vs 3.05 ± 1.93 min; p < 0.001). The intra-reduction VAS pain score was not significantly in patients who were treated with MERM (85.31 ± 10.39 vs. 78.33 ± 16.54; p = 0.122). CONCLUSION MERM can be an alternate method compared to the ERM for the reduction of ASD.
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Affiliation(s)
- Mehmet Akcimen
- Health Science University Antalya Training and Research Hospital, Department of Emergency Medicine, Antalya, Turkey
| | - Cihan Bedel
- Health Science University Antalya Training and Research Hospital, Department of Emergency Medicine, Antalya, Turkey.
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Bedel C, Şalkacı A. A Rare Cause of Acute Abdomen: Ruptured Splenic Artery Aneurysm. Haseki 2019. [DOI: 10.4274/haseki.galenos.2018.4075] [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] Open
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Bedel C, Özkaya M. Diagnosis and prognosis of traumatic pulmonary pseudocysts. Indian J Thorac Cardiovasc Surg 2019; 35:186-189. [PMID: 33061003 DOI: 10.1007/s12055-018-0762-8] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 10/10/2018] [Accepted: 10/11/2018] [Indexed: 10/28/2022] Open
Abstract
Purpose Traumatic pulmonary pseudocysts (TPP) are rarely talked about, developing in less than 3% of patients with pulmonary parenchymal injuries. Resolution usually occurs within a few weeks to a few months. Methods A retrospective study was undertaken in 30 cases treated in Antalya Training and Research Hospital, Turkey, from January 2014 to December 2017. Results The 30 patients with TPP were 28 males (93.3%) and 2 females (6.7%) aged 14-64 years (mean age 31.9 years). Most of them are located in the right lower lobe (50%). The mean size of TPP was 2.07 cm. The overall resolution time for TPP was found to range from 8 to 124 days with a mean of 45.1 ± 32.9 days. Conclusions Computed tomography (CT) is a more beneficial than chest radiograph for early diagnosis. Physicians should control follow-up chest radiograph or CT scans until the pseudocyst resolves. Conservative treatment is acceptable in most cases, but intervention may be necessary if complications show up.
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Affiliation(s)
- Cihan Bedel
- Health Science University Antalya Training and Research Hospital Emergency Medicine Department, Antalya, Turkey
| | - Muharrem Özkaya
- Department of Thorasic Surgery, Health Science University Antalya Training and Research Hospital, Antalya, Turkey
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Korkut M, Bedel C. Can the quick Sequential Organ Failure Assessment (qSOFA) score, combined with plasma lactate concentration, predict the mortality for patients with infections in the emergency department? ARCHIVES OF CLINICAL AND EXPERIMENTAL MEDICINE 2019. [DOI: 10.25000/acem.468057] [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: 11/23/2022] Open
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Bedel C, Ararat E. Anicteric Leptospirosis: A Frequently Forgotten Disease. Erciyes Med J 2018. [DOI: 10.5152/etd.2018.0004] [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: 11/22/2022] Open
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