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    An extremely rare phenomenon: Angina bullosa hemorrhagica
    (Sage Publications Ltd, 2020) Demir, Mehmet Cihat; Ağaçkıran, İlter
    Introduction: Angina bullosa hemorrhagica is a disease without a concomitant hematological or vesiculobullous disorder characterized by painless hemorrhagic bullae in the oral mucosa; it is rarely seen and has a good course. Case presentation: A 45-year-old female patient was admitted to the emergency department with a painless hemorrhagic bulla that suddenly appeared on the soft palate. A blister, 2 cm in diameter and dark red in color, was seen extending from the hard palate's posterior to the soft palate. Nasolaryngoscopic evaluation was performed, and no additional hemorrhagic bulla was detected. She was discharged with the recommendation of oral mouthwash. Discussion: Solitary hemorrhagic bulla, suddenly occurring on the soft palate, is diagnostic for angina bullosa hemorrhagica. Some authors have reported that blisters in the posterior pharynx may progress to acute upper airway obstruction. Conclusion: Early nasolaryngoscopic evaluation in angina bullosa hemorrhagica is an excellent option to be considered by the emergency physician to prevent life-threatening situations.
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    Examination of Emergency Ophthalmologic Consultations in Terms of Urgency, Ophthalmic Pathology, and the Weekend Effect
    (2021) Demir, Mehmet Cihat; Boğan, Mustafa; Akçam, Hanife Tuba; Sultanoğlu, Hasan; Özdamar, Yasemin; Ağaçkıran, İlter
    Objective: To evaluate the urgency of ophthalmology consultations in the emergency department (ED) and the presence of ophthalmic pathology. This study also aimed to determine whether the weekend phenomenon affected emergency ophthalmologic consultation requests. Materials and Methods: Ophthalmology consultations requested by the emergency physician for patients who visited the ED of a tertiary care hospital in Turkey from January to December 2019 were retrospectively investigated. Consultation requests were grouped as possible emergent, unlikely to be emergent, and undetermined. Results: A total of 256 eligible patients were included. The top three reasons for ophthalmologic consultations were blunt trauma (29.7%), foreign body (24.2%), and conjunctivitis (13.3%). 70.3% of the consultations were categorized as a possible emergent, 18.4% as unlikely to be emergent, and 11.3% undetermined. Most of the possible emergent consultations had ophthalmic pathology (p=0.001). Conclusion: Traumatic injuries are the most common cause of ophthalmology consultation in the ED. Approximately one-fifth of patients are unlikely to be emergent. Early ophthalmology evaluation is required in possible emergent category patients. The weekend effect does not influence ophthalmology consultations. Establishing eye emergency services or having an available ophthalmologist is crucial in the emergency diagnosis and treatment of patients who require special practice skills.
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    Medical problems of athletes attending Summer Deaflympics 2017 and comparison by gender
    (Edizioni Minerva Medica, 2018) Baydın, Ahmet; Pişkin, Ahmet; Erenler, Ali Kemal; Şengüldür, Erdinç; Duran, Latif; Güzel, Murat F.; Demir, Mehmet Cihat; Katı, Celal; Akdemir, Hızır Ufuk; Yardan, Türker; Öz, Hatice; Aksoy, İskender
    BACKGROUND: The aim of this paper is to share our experience of the Summer Deaflympics 2017 from the point of view of healthcare, and to describe the athletes’ health issues. METHODS: Besides demographical features, also types of trauma or illness of the athletes who partecipated to the 23rd Summer Deaflympics Games were determined. Then, the patients were grouped according to gender and compared with each other. RESULTS: Turkey and China were the countries that most commonly presented to a hospital. Of 135 athletes presented to a hospital due to injuries or illnesses, the majority of them practised football or athletics sports. The most common reason for trauma-related injury was falls, while the most common illness was gastroenteritis. There was no significant difference in illnesses or injuries between male and female athletes. CONCLUSIONS: For a better success in healthcare in such big sports events, with cooperation between health institutions, healthcare providers must be aware of trauma and illness types to which most frequently athletes are exposed to. COPYRIGHT © 2018 EDIZIONI MINERVA MEDICA
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    The Role of Lactate and Troponin-I Levels in Predicting Length of Hospital Stay in Patients with Carbon Monoxide Poisoning
    (Clin Lab Publ, 2019) Güzel, Murat; Atay, Erdi; Terzi, Özlem; Demir, Mehmet Cihat; Erenler, Ali Kemal; Demir, Mehmet T.
    Background: Carbon monoxide (CO) is one of the most common causes of unintentional poisonings resulting in death. Patients with more severe findings such as loss of consciousness and persistent neurological or cardiovascular dysfunction require hospitalization. Although there are clinical findings which determine hospitalization criteria in patients presenting with CO poisoning, there is some ambiguity regarding laboratory biomarkers which determine length of hospital stay (LOS) in these patients. In this study, we aimed to identify the effectiveness of initial blood gases and biochemical parameters in predicting LOS in patients presenting to the emergency department with CO poisoning by retrospective analysis of medical records. Methods: This study was conducted in the Emergency Department (ED) of Samsun Training and Research Hospital by analyzing from medical records retrospectively of 275 patients who were admitted to the hospital following acute CO poisoning between January 2014 and July 2017. The patients were divided into 3 groups according to LOS: Group I, patients with LOS < 24 hours; group II, those with LOS > 24 hours and < 3 days; and group III, those with LOS > 3 days. Results: In comparisons regarding lactate and troponin-I, it was found that there were significant differences in both parameters among the three groups (p = 0.000) and that both lactate and troponin-I levels were higher in group III than groups I and II, with group I being lowest (group III > group II > group I). While there was a moderate positive statistically significant correlation between LOS and lactate (r: 0.43, p = 0.001) and troponin (r: 0.31, p = 0.001), a weak positive correlation was determined with CK (r: 0.19, p = 0.04). In this study, it was found that lactate and troponin-I values were more effective in predicting LOS when compared to carboxyhemoglobin levels and other biochemical parameters. Conclusions: The results of this study may guide clinicians to predict LOS in patients who present with CO poisoning and have high troponin-I and lactate levels at the time of admission to EDs.