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Öğe Bacterial and protozoal pathogens found in ticks collected from humans in Corum province of Turkey(Public Library of Science, 2018) Karasartova, Djursun; Güreser, Ayşe Semra; Gökçe, Tuncay; Çelebi, Bekir; Yapar, Derya; Keskin, Adem; Çelik, Selim; Ece, Yasemin; Erenler, Ali Kemal; Usluca, Selma; Mumcuoğlu, Kosta Yani; Taylan Özkan, Hikmet AyşegülBackground: Tick-borne diseases are increasing all over the word, including Turkey. The aim of this study was to determine the bacterial and protozoan vector-borne pathogens in ticks infesting humans in the Corum province of Turkey. Methodology/Principal findings: From March to November 2014 a total of 322 ticks were collected from patients who attended the local hospitals with tick bites. Ticks were screened by real time-PCR and PCR, and obtained amplicons were sequenced. The dedected tick was belonging to the genus Hyalomma, Haemaphysalis, Rhipicephalus, Dermacentor and Ixodes. A total of 17 microorganism species were identified in ticks. The most prevalent Rickettsia spp. were: R. aeschlimannii (19.5%), R. slovaca (4.5%), R. raoultii (2.2%), R. hoogstraalii (1.9%), R. sibirica subsp. mongolitimonae (1.2%), R. monacensis (0.31%), and Rickettsia spp. (1.2%). In addition, the following pathogens were identified: Borrelia afzelii (0.31%), Anaplasma spp. (0.31%), Ehrlichia spp. (0.93%), Babesia microti (0.93%), Babesia ovis (0.31%), Babesia occultans (3.4%), Theileria spp. (1.6%), Hepatozoon felis (0.31%), Hepatozoon canis (0.31%), and Hemolivia mauritanica (2.1%). All samples were negative for Francisella tularensis, Coxiella burnetii, Bartonella spp., Toxoplasma gondii and Leishmania spp. Conclusions/Significance: Ticks in Corum carry a large variety of human and zoonotic pathogens that were detected not only in known vectors, but showed a wider vector diversity. There is an increase in the prevalence of ticks infected with the spotted fever group and lymphangitis-associated rickettsiosis, while Ehrlichia spp. and Anaplasma spp. were reported for the first time from this region. B. microti was detected for the first time in Hyalomma marginatum infesting humans. The detection of B. occultans, B. ovis, Hepatozoon spp., Theileria spp. and Hemolivia mauritanica indicate the importance of these ticks as vectors of pathogens of veterinary importance, therefore patients with a tick infestation should be followed for a variety of pathogens with medical importance. © 2018 Karasartova et al.Öğe Evaluation of characteristics and clinical outcomes of patients with cardiac arrest(Emergency Medicine Physicians’ Association of Turkey, 2017) Ece, Yasemin; Ünlüer, Erden Erol; Erenler, Ali Kemal; Şener, AslıAim: Cardiopulmonary resuscitation (CPR) is an important and common intervention in emergency settings. In this article, we aimed to determine the characteristics and outcomes of the patients on whom CPR was performed in the emergency department (ED).Materials and Methods: We retrospectively investigated the medical records of 295 patients with cardiopulmonary arrest over a two-year period. The patient's, age, sex, arrival time, route of arrival, reasons for admission, medical history, whether CPR was performed before arrival, whether intubation was performed, whether CPR was performed after arrival, whether defibrillation was performed, whether rapid sequence intubation (RSI) was performed, outcome (death, admission to an intensive care unit, an angiography unit, or a ward), and period of hospitalization were recorded. Results: Most of the patients were brought by ambulance, and asystoly was the most common initial rhythm. In 182 patients, CPR was initiated before admission to the ED. All 26 patients with malignity died. Of the patients with a medical history of multiple diseases, 91.4% (n=32) died. RSI was performed in 19 patients (6.4%), and defibrillation was performed in 49 patients (16.6%). It was determined that 253 patients (85.8%) died after CPR. Conclusion: In our study, asystoly was found to be the most common initial rhythm in patients with cardiopulmonary arrest. Our study also revealed that patients with co-morbidity and patients requiring RSI had lower rates of survivalÖğe Investigation of toxic effects of mushroom poisoning on the cardiovascular system(Blackwell Publishing Ltd, 2016) Erenler, Ali Kemal; Doğan, Tolga; Koçak, Cem; Ece, YaseminMushroom poisoning (MP) is a public health problem in many countries. It is well known that consumption of wild mushrooms may cause serious toxicity on renal, hepatic and brain functions. In the literature, however, studies investigating cardiotoxic effects of MP are rare. In this study, we evaluated laboratory and ECG findings of patients and sought for possible toxic effects of MP on the cardiovascular system. During a 2-year period, 175 patients with MP were included in the study. The majority of the poisonings occurred in early summertime. The most common complaint was found to be nausea and vomiting followed by mental status alterations. Methods of treatment were mainly based on gastric lavage, activated charcoal and supportive therapy. The most common ECG abnormalities in the patients with MP were sinus tachycardia, sinus arrhythmia, ST/T inversion, 1st degree AV block and QT prolongation, respectively. Cardiac markers of the patients were found to be normal. Then, patients were divided into two subgroups according to symptom onset after consumption (less than 6 hr and more than 6 hr). When the two groups were compared, prevalence of tachycardia was significantly higher in Group II. Additionally, the interval between mushroom consumption and onset of symptoms was strongly correlated with blood pressure (BP). As this interval prolonged, BP of the patients tended to increase. In conclusion, according to our results, although mechanisms need to be clarified, MP causes hypertension and ECG alterations, particularly tachycardia in patients with late-onset symptoms. © 2016 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society)Öğe Kounis Syndrome following metamizole infusion(Sakarya Üniversitesi, 2016) Ece, Yasemin; Erenler, Ali Kemal; Doğan, TolgaObjective Kounis Syndrome (KS) is described as temporary vasospasm of coronary arteries after exposure to an allergen. It may present as severe chest pain, ST elevated or non-ST elevated myocardial infarction. Among factors causing KS are bee stings, all kinds of medications and food. Case A 25-year-old female patient developed dyspnea and syncope following metamizole infusion. During follow-up in Emergency department, she developed severe chest pain and blood results revealed Troponin I elevation. She underwent coronary angiogram and any narrowing in coronary arteries was not determined. After hospitalization in the Intensive Care Unit with supportive therapy, levels of Troponin I decreased and the patient was discharged with a total recovery. Conclusion Emergency physicians must be aware of this rare entity in order to prevent mortality and morbidity. ( Sakarya Med J 2016, 6(3):170-174 )Öğe Predicting tularemia with clinical, laboratory and demographical findings in the ED(W.B. Saunders, 2016) Yapar, Derya; Erenler, Ali Kemal; Terzi, Özlem; Akdoğan, Özlem; Ece, Yasemin; Baykam, NurcanIntroduction We aimed to determine clinical, laboratory and demographical characteristics of tularemia on admission to Emergency Department (ED). Material and Methods Medical data of 317 patients admitted to ED and subsequently hospitalized with suspected tularemia between January 1, 2011, and May 31, 2015, were collected. Patients were divided into 2 groups according to microagglutination test results, as tularemia (+) and tularemia (-). Results Of the 317 patients involved, 49 were found to be tularemia (+) and 268 were tularemia (-). Mean age of the tularemia (+) patients was found to be higher than that of tularemia (-) patients. When compared to tularemia (-) patients, a significant portion of patients in tularemia (+) patients were elderly, living in rural areas and had contact with rodents. When clinical and laboratory findings of the 2 groups were compared, any statistical significance could not be determined. Conclusion Tularemia is a disease of elderly people living in rural areas. Contact with rodents also increases risk of tularemia in suspected patients. © 2015 Elsevier Inc.Öğe Re: Outcomes of Patients with Cardiac Arrest and Effect of Blood Glucose Concentration(2018) Ece, Yasemin; Ünlüer, Erden Erol; Erenler, Ali Kemal; Şener, Aslı[Abstract Not Available]Öğe Re: Outcomes of Patients with Cardiac Arrest and Effect of Blood Glucose Concentration Reply(Aves, 2018) Ece, Yasemin; Unluer, Erden Erol; Erenler, Ali Kemal; Sener, Asli[Abstract Not Available]Öğe Traumatic isolated aortic dissection(Logos Medical Publishing, 2015) Erenler, Ali Kemal; Oruçoğlu, Aysun; Ece, Yasemin; Karabulut, Mine; Çiftçi, EşrefAcute traumatic aortic injuries are rare conditions usually caused by direct or indirect forces to the abdomen induced by high-energy trauma often associated with rapid deceleration. In this report, we present an isolated traumatic aortic injury in a male patient. A 34-year-old male patient was brought to our Emergency department because of a car accident. His only complaint was moderate chest pain. After further investigation, it was determined that the patient had aortic transection due to trauma without any concomitant injuries. In case of suspicion from aortic injuries, patients must be investigated with contrasted Computerized Tomography, even though they do not have any concomitant injuries. © 2015, Logos Medical Publishing. All rights reserved.
