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Analysis of road traffic accidents in Turkey between 2013 and 2017
(MDPI, 2019) Erenler, Ali Kemal; Gümüş, Burak
Abstract: Background and objectives: Road traffic accident (RTAs) is one of the top ten leading causes of death worldwide and its incidence is higher in developing countries. In this study, our aim was to determine the characteristics of RTAs in Turkey and make recommendations to reduce mortality and morbidity related to RTAs. Material and Methods: We obtained our data, which cover the years 2013 to 2017, from the database accessible at the official website of the Turkish Statistical Institute, which permits the use of its data for research purposes. The chi-square test was used for statistical analysis, and the percentage distribution and odds ratios were calculated. Results: In the study period, a total of 697,957 RTAs occurred in Turkey. A total of 1,168,121 individuals have been wounded and 3534 of them have lost their lives. The majority of RTAs occurred on weekends and in summer months. Male individuals are more likely to be exposed to death and injuries related to accidents. When the vehicle type is considered, motorcycle drivers are under more risk for RTAs. RTAs are more likely to occur in rural areas. Conclusion: Male individuals and motorcyclists are under a great risk for RTAs. Strict laws are mandatory in order to reduce morbidity and mortality related to RTAs. Additionally, educational efforts must focus on two-wheelers and tractor drivers, particularly in developing countries
Analysis of Top Cited 100 Articles About Covid-19
(Carbone Editore, 2021) Erenler, Ali Kemal; Ay, Mehmet Oğuzhan
Introduction: Following a series of pneumonia cases of unknown origin in Wuhan, China on December, 2019, the World Health Organization (WHO) announced the disease caused by SARS-CoV-2 as COVID-19 on 11, February. A month later, the WHO declared the pandemic status. Since then, literature on COVID-19 has grown rapidly. In this article, our aim was to provide a scientometric analysis of the most popular publications on COVID-19. Materials and Methods: We analysed the top 100 most cited articles by entering the term COVID-19 to Web of Science (c) database. The top 100 articles were extracted and investigated according to citation times, number of citations per publication, countries, journals and study fields. Also, top 10 articles are summarized. Results: All top 100 articles were written in English and published in 2020. Majority of the articles were published in May (n= 26). China was the most productive country with 51 publications and a total of 40,973 citations (61.1%). New England Journal of Medicine and the Journal of the American Medical Association (JAMA) were the most popular journals with a total of 24 articles and 20,463 citations. Lancet had the highest rate with a mean of 1276.7 citations per 7 publications. The most commonly studied field was related to the complications of the disease (n= 18, a total of 8472 citations, 470.6 citations per publications). However, the most cited field was clinical findings of the disease (n= 14, a total of 18255 citations). Publications regarding clinical findings of the disease also had the highest number of citations per publications (citations per publications= 1303.9). Conclusion: China ranked in the first place according to number of both publications and citations. New England Journal of Medicine and JAMA shared the first place in popularity. Researchers commonly focused on Complications of the disease, treatment methods and clinical findings.
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 Ayşegül
Background: 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.
Butyrylcholinesterase as an additional marker in the diagnostic network of acute myocardial infarction
(Walter De Gruyter Gmbh, 2016) Kocabaş, Ramazan; Erenler, Ali Kemal; Yetim, Mücahit; Doğan, Tolga; Erdemli, Hacı Kemal
Background: Acute coronary syndrome defines a broad spectrum of complaints from angina to irreversible myocardial damage. There is an ongoing need for a biomarker to predict and diagnose acute myocardial infarction (AMI) in the early stage. In this study, our aim was to reveal early diagnostic value of butyrylcholinesterase (BChE) in discrimination of healthy subjects and patients with AMI. Methods: Eighty-five patients admitted to our hospital due to AMI and 45 healthy subjects were involved in the study. Patients and controls were compared according to BChE, lipid profiles and biochemical parameters. Results: The serum BChE activity was significantly lower in patients with AMI than in the controls (p < 0.001). After correlation analysis, while a negative correlation was determined between the serum BChE concentrations and AMI presence (r = -0.363, p < 0.001); a positive correlation was determined between the serum BChE and cholesterol (r = 0.443, p < 0.001), HDL (r = 0.243, p = 0.006) and LDL (r = 0.369, p < 0.001) levels. The data indicate that BChE is associated with AMI and a subsequent receiver operating characteristic curve (ROC) analysis revealed that BChE, as an independent indicator, may differentiate AMI patients from controls. A cut-off point set at = 7.15 kIU/L, BChE showed a sensitivity of 51.2% and a specificity of 84.4% (AUC = 0.719, p < 0.001). Conclusions: Low BChE level was significantly associated with AMI when compared to healthy subjects. Even though it has low sensitivity, plasma levels of BChE might represent an additional marker in the diagnostic network of AMI.
Challenges in COVID-19 diagnosis
(Comenius Univ, 2020) Erenler, Ali Kemal; Baydın, Ahmet
OBJECTIVE: In this narrative review, our aim was to clarify the roles of diagnostic methods used in COVID-19 disease. BACKGROUND: Coronavirus disease 2019 (COVID-19) caused by coronavirusis emerged as the major healthcare challenge globally. The mainstay approach to limit this virus spread is an early and accurate diagnosis of the viral infection and appropriate quarantine of patients with coronavirus infection. RESULTS: Real time polymerase chain reaction (PCR) offers a quick detection of the disease in either symptomatic or asymptomatic patients. In literature, there are numerous studies that underline the importance of CT as the first-step diagnostic tool in COVID-19 diagnosis. Even in asymptomatic patients, COVID-19 pneumonia may manifest with chest CT imaging abnormalities. CONCLUSION: There is a need for an algorithm, which involves a combination of PCR and CT in diagnosis of COVID-19 (Ref. 85). Text in PDF www.elis.sk
Characteristics of patients admitted to the emergency department due to tick bite
(2014) Erenler, Ali Kemal; Kulaksız, Fuat; Ülger, Hüseyin; Erdem, Murat; Koçak, Cem; Söylemez, Fatih; Öztürk, Özkan; Baydın, Ahmet
Crimean-Congo haemorrhagic fever (CCHF) is a tick-borne disease endemic in Turkey since 2002. Çorum is one of the leading five cities in Turkey in which CCHF disease is seen most. We studied characteristics of the patients with tick bites in our emergency department (ED) and determined the fatality rate of the disease in city of Çorum for the first time. We retrospectively analysed the characteristics of the patients admitted to our ED from the medical files of 21,680 patients in a 5-year period. The number of patients with definite diagnosis and who have died was determined. Our results demonstrated that the fatality rate of CCHF in Çorum is 6.78%. Among 21,680 patients, blood samples of 970 patients were sent to an advanced centre in Ankara for polymerase chain reaction (PCR) testing. Results of 560 patients were reported to be PCR (+) and 38 of them have died. © 2014, SAGE Publications. All rights reserved.
Characteristics of refugee patients admitted to the emergency department
(W.B. Saunders, 2018) Sarıaydın, Tuba; Erenler, Ali Kemal; Ay, Mehmet Oğuzhan
In 1991, thousands of Iraqi civilians passed the border to seek refuge in Turkey [1]. After the –so called– Arab Spring uprising, a civil war emerged in Syria in 2011. Millions of Syrians were internally displaced and millions of them sought refuge outside of Syria [2]. Physical, mental and social health disorders are known to be associated with migration
Chronic Licorice Consumption as a Rare Cause of Hypocalcemia
(Emergency Medicine Physicians Assoc Turkey, 2020) Kan, Eda; Sarıaydın, Tuba; Doğan, Murat; Erenler, Ali Kemal
Introduction: Licorice ingestion is well-described with its hypokalemic and hypertensive effects in the literature. To our knowledge, up to now, hypocalcemia due to licorice ingestion has not been described. Our aim is to create awareness for hypocalecemia concomittant with hypokalemia in patients with chronic licorice ingestion. Case Report: A 51-year old male patient presented to our Emergency Department (ED) with complaint of numbness on his whole body. On anamnesis, it was determined that he has been consuming licorice to regulate his hypertension for 3 months. Laboratory analysis revealed hypokalemia and hypocalcemia. After replacement therapy, the patient was discharged from the hospital with full recovery. Conclusion: Focusing on hypokalemia may lead to misdiagnosis of hypocalcemia in patients with chronic licorice ingestion. Physicians must be aware of other electrolyte disturbances not described in the literature yet.
Clinical utility of thiol/disulfide homeostasis
(Verlag Klinisches Labor GmbH, 2017) Erenler, Ali Kemal; Yardan, Türker
Background: Recently, the usefulness of thiol/disulfide homeostasis (TDH) in various diseases is being widely investigated. In this mini-review, our aim is to clarify the role of TDH in clinical practice in the light of current literature. Methods: We performed a systematic review of the existing literature describing the clinical utility of TDH in the clinical setting. MEDLINE, EMBASE, and CINAHL were used as data sources. Two reviewers conducted independent screening and data extraction. Use of TDH in each system was investigated separately. Results: A total of 35 studies were detected in this mini-review. Our results revealed the protective role of TDH and its utility as a diagnostic marker in many common diseases in clinical practice. Conclusions: Maintenance of TDH as a crucial part of antioxidant defense system is critical in diagnosis and prognosis of potentially lethal diseases. © Copyright.
Comparison of pentraxin-3 and ischemia-modified albumin with troponin in early diagnosis of acute coronary syndrome
(Comenius University, 2018) Demir, Muhammed Taha; Baydın, Ahmet; Amanvermez, Ramazan; Erenler, Ali Kemal; Güzel, Murat; Yücel, Osman
INTRODUCTION: In this study, our aim was to evaluate clinical utilities of Pentraxin 3 (PTX3) and Ischemiamodified Albumin (IMA) in diagnosis of acute coronary syndrome (ACS) and compare these two biomarkers with a conventional diagnostic marker, cardiac troponin I (cTnI). MATERIALS AND METHODS: Sixty adult patients with ACS diagnosis were involved into this prospective study. Addi tionally, 20 healthy subjects were determined as control group (Group IV). Patients were divided into 3 groups as follows: Patients with Acute Myocardial Infarction (STEMI Group, n=20, Group I), patients without ST elevation but with elevated cTnI levels (NSTEMI Group, n=20, Group II), and patients with unstable angina pectoris (USAP Group, n=20, Group III). Blood measurements were obtained for each marker at admission and in the 4th hour. RESULTS: Troponin level was significantly different between groups I and II at both admission and in the 4th hour. Additionally, PTX 3 level was significantly different at admission and 4th hour between groups II and III. CONCLUSION: This study revealed that cTnI is the most sensitive test in ACS diagnosis at the admission to Emergency Department. Our results also revealed that PTX 3 may be a useful diagnostic tool for ACS at admission, however, IMA alone cannot be used for diagnosis of ACS. Similarly, in the 4th hour, cTnI was found to be the most useful marker in ACS diagnosis, however, PTX 3 and IMA were found to be inadequate for diagnosis of ACS. © 2018, Comenius University.
Comparison of performances of top emergency medicine journals in terms of COVID-19 publications in 2020
(W B Saunders Co-Elsevier Inc, 2021) Erenler, Ali Kemal; Baydın, Ahmet
Introduction: The aim of this study is to evaluate the qualitative and quantitative contribution of Emergency Medicine (EM) journals to scientific literature on COVID-19 and compare the journals in terms of publications. Material and methods: We performed a comparison of top EM journals by hand-search in terms of COVID-19 publications and citations between January 1st and December 31st, 2020. Publications were also categorized according to research field, country and article types. Data were given as numbers and percentages. Results: Among 18 EM journals, Resuscitation ranked in the first place and American Journal of Emergency Medicine ranked in the last place according to Impact Factor. In these journals, 512 (12.2%) articles related to COVID19 were published. The American Journal of Emergency Medicine and Internal and Emergency Medicine published the greatest amount of publications related to COVID-19 (n = 71). The American Journal of Emergency Medicine was also the leading journal in terms of Total Citations to COVID-19 Articles (n = 1192). Western Journal of Emergency Medicine published the greatest proportion of COVID-19 articles (Total COVID-19 Articles/Total Articles = 0.3). World Journal of Emergency Surgery ranked in the first place in terms of citations per COVID-19 articles (n = 33.2). The most common studied field was Effects of COVID-19 on the Health System (n = 222). The US was the most productive country with 188 COVID-19 publications and 1411 citations to these publications, followed by Italy. Conclusion: The contribution of EM journals to COVID-19 literature is controversial. Effects of COVID-19 on the Health System is the most studied field. Clinical Properties, Ethical Issues and Treatment Methods are neglected fields in EM journals. (c) 2021 Elsevier Inc. All rights reserved.
Comparison of procalcitonin and c-reactive protein in differential diagnosis of sepsis and severe sepsis in emergency department
(Dicle Üniversitesi Tıp Fakültesi, 2017) Erenler, Ali Kemal; Yapar, Derya; Terzi, Özlem
Objective: Sepsis and severe sepsis (sepsis accompanied by acute organ dysfunction) are leading causes of death worldwide. In this study, our aim was to investigate utility of biomarkers commonly used in diagnosis of sepsis in discriminating these two entities. Methods: Two-hundred and three patients involved were divided into 2 subgroups as sepsis and severe sepsis according to Surviving Sepsis Campaign: International Guidelines for Management of Severe Sepsis and Septic Shock: 2012. Then groups were compared according to clinical and laboratory (including C-reactive protein (CRP) and procalcitonin (PCT) levels) characteristics. Results: Of 203 patients included into the study, 124 (61.1%) were male and 79 (38.9%) were female. The most common reason for sepsis was urinary tract infection (n=64, 31.5%), followed by catheter infection (n=16, 7.9%) and pneumonia (n=14, 6.9%). Escherichia coli was the most common agent in both blood and urinary cultures. Majority of the patients were treated with ceftriaxone (n=33, 16.3%), followed by meronem/dapson (n=25, 12.3%). In both groups, CRP and PCT levels were high, even higher in severe sepsis group. However, any statistical significance could not be determined between groups. Mortality rate in sepsis patients was 6.4%. Conclusion: Plasma levels of both markers elevate in sepsis and severe sepsis. It was determined that CRP and PCT is higher in severe sepsis than in sepsis. However, the difference is not statistically significant. Plasma levels of CRP and PCT are not useful in differential diagnosis of sepsis and severe sepsis
Diagnostic value of copeptin in acute myocardial infarction
(2017) Ay, Mehmet Oğuzhan; Erenler, Ali Kemal; Doğan, Tolga; Yetim, Mücahit
PATIENTS AND METHODS: A total of 160 cases were enrolled in the study. All were over 18 years of age, and consisted of 54 non-ST elevation MI (NSTEMI), 54 ST segment elevation MI (STEMI), and 52 healthy subjects (controls). Serum troponin-I, CK-MB mass, copeptin and CRP levels were measured in each of the cases, and were compared between the three groups for statistical differences.RESULTS: The copeptin levels in the STEMI (p < 0.001) and NSTEMI (p = 0.042) groups were found to be significantly higher than the control group. Spearman's correlation analysis showed a significant positive correlation between the level of copeptin and the presence of AMI (r = 0.285, p < 0.001), CK-MB mass (r = 0.246, p = 0.002), and troponin-I (r = 0.199, p = 0.012). Sensitivity, specificity, and AUC values of the tests, according to ROC analysis performed for the diagnosis of AMI were; troponin-I > 0.1 ng/mL (71.0%, 100.0%, and 0.855); CK-MB mass > 3.59 ng/mL (77.8%, 92.3%, and 0.911); CRP > 6.37 mg/L (53.7%, 88.5%, and 0.769); and copeptin > 2.47 ng/mL (66.7%, 75.0%, and 0.676), respectively (p < 0.001).CONCLUSIONS: Cardiac troponin remains the gold standard biomarker for the diagnostic evaluation of AMI. Copeptin can be used as a diagnostic marker in patients with suspected AMI in combination with other biomarkers, but, copeptin alone should not be considered as a single diagnostic marker in patients with suspected AMI.OBJECTIVE: The aim of this study was to investigate the effectiveness of copeptin in the early diagnosis of acute myocardial infarction (AMI), and to compare the diagnostic efficacy of copeptin with other cardiac markers.
Diagnostic values of proenkephalin and S100B protein in traumatic brain injury
(Walter de Gruyter GmbH, 2017) Yalçın, Anıl; Baydın, Ahmet; Tuncel, Özgür Korhan; Erenler, Ali Kemal; Çokluk, Cengiz; Güzel, Murat; Tomak, Leman
Background: The primary aim of this study was to investigate the diagnostic values of serum S100 calciumbinding protein B (S100B) and proenkephalin (P-ENK) levels in brain damage caused by traumatic brain injury (TBI). Methods: We prospectively collected serum blood samples of 58 adult patients admitted to our emergency department due to TBI. Serum S100B and P-ENK levels were measured and compared according to clinical findings and outcomes of the patients. Results: When patients with brain injury were compared to controls, statistical significance was determined in both S100B and P-ENK levels. According to the receiver operating characteristic (ROC) analysis, cut-off values for serum S100B and P-ENK levels for the differential diagnosis of patients with and without brain damage were found to be 785.944 ng/mL and 2.445 ng/mL, respectively. There was a statistical significance in both S100B and P-ENK levels when patients who were discharged and those who died were compared. Conclusions: Serum S100B and P-ENK levels are found to be elevated in patients with TBI when compared to controls. Additionally, serum levels of both markers are found to be elevated in patients with multiple lesions when compared to patients with a single lesion. Serum S100B and P-ENK levels may also be used as predictors of mortality in patients with TBI. © 2017 Walter de Gruyter GmbH, Berlin/Boston.
Early biochemical predictors of sepsis in patients with burn injury: current status and future perspectives
(Lippincott Williams & Wilkins, 2020) Erenler, Ali Kemal; Baydın, Ahmet; Ay, Mehmet Oğuzhan; Doğan, Güvenç; Yastı, Ahmet Çınar
Sepsis is the leading cause of morbidity and mortality in patients with burn injury and emerges as a clinical challenge for both emergency specialists and critical care staff. Since early diagnosis and appropriate treatment are known to be the milestones of sepsis management, use of biomarkers in diagnosis is highly recommended in the initial stage of sepsis. Although currently used Procalcitonin, as a traditional marker, may accurately indicate the presence of a systemic inflammation in burn patients, there is a need for more accurate markers of sepsis in burn patients. For now, use of a combination of markers may be suggested for a more accurate diagnosis. In the near future, gene therapy may make not only early prediction, but also appropriate treatment of sepsis in burn patients possible. In this article, we aimed to clarify roles of current biomarkers in early diagnosis of sepsis in burn patients and make future reflections in this growing field. Copyright (C) 2020 Wolters Kluwer Health, Inc. All rights reserved.
Efficiency of helmet and protective clothing use on outcomes of patients with motorcycle accidents
(Derman Medical Publishing, 2017) Ay, Mehmet Oğuzhan; Erenler, Ali Kemal; Koçak, Cem; Baydın, Ahmet
Aim: Motor vehicle accidents are a growing public health problem, particularly in developing countries. In this study, we aimed to clarify the role of helmet and protective clothing in prevention from injuries to the head, trunk, and extremities in motorcycle accidents. Material and Method: Patients over 18 years old of both genders who were admitted to the Emergency Department (ED) of Hitit University Corum Training and Research Hospital due to a motorcycle accident between January 1, 2010 and July 1, 2015 were included in this retrospective study. We used their medical records to identify the location of injury, radiographic findings, use of helmet and protective clothing, and whether the patient was consulted, hospitalized, or underwent surgery. Then, patients were divided into two subgroups. Group I: Patients without helmet and protective clothing. Group II: Patients with helmet and protective clothing. The groups were compared statistically. Results: One hundred and twenty patients admitted to our ED due to a motorcycle accident were included in the study. It was determined that 73 (60.8%) of the patients had not used a helmet or protective clothing, whereas 47 (38.2%) had used a helmet or protective clothing. Neurosurgery was found to be the most frequently consulted speciality. When the groups were compared, it was found that 7 of 8 patients with traumatic brain injury were in Group I. This finding was statistically significant. The rate of alcohol intake before the accident of Group 1 (15.1%) was statistically significantly higher than in Group II (6.4%). When the groups were compared according to age, gender, spinal injuries, long bone fractures, and intraabdominal organ injuries, there was not any statistical significance. Discussion: Helmet use is found to be useful to prevent head injuries in motorcycle accidents. However, protective clothing does not contribute to prevention from injuries to the trunk and extremities. Strict laws for helmet use, intake of alcohol prior to driving a motorcycle, and education of motorcyclists may help reduce morbidity and mortality in motorcycle accidents. © 2017, Derman Medical Publishing. All rights reserved.
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, Aslı
Aim: 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 survival
Heart-type fatty acid-binding protein as a potential biomarker of acute carbon monoxide poisoning
(2013) Erenler, Ali Kemal; Yardan, Türker; Baydın, Ahmet; Günay, Murat; Amanvermez, Ramazan
Background The aim of this study was to investigate the role of serum heart-type fatty acid-binding protein (H-FABP) in the evaluation of patients with carbon monoxide (CO) poisoning. Methods Forty patients with acute CO poisoning admitted to the emergency department and 15 healthy adults as the control group were included in the study. Serum H-FABP levels of patients were studied on admission and at the 6th, 12th, and 18th hours. Patients were divided into 3 groups according to clinical severity as mild, moderate, and severe. Patients were also divided into 2 groups according to treatment with hyperbaric oxygen (HBO) or normobaric oxygen. Results Serum H-FABP levels of the patients were higher than those of the control group. There was a negative correlation between H-FABP levels and Glasgow Coma Scale score on admission. Heart-type fatty acid-binding protein levels were significantly higher in patients in the severe compared with mild group. Heart-type fatty acid-binding protein levels in patients treated with HBO were significantly higher than in those treated with normobaric oxygen. The cutoff value of serum H-FABP as an indicator for HBO treatment was determined as 1.5 ng/mL or higher, with a sensitivity of 85.7% and specificity of 69.7%. Serial measurement revealed that H-FABP level peaked at the sixth hour and reduced over time but remained higher than in the control group at the 18th hour. Conclusion Heart-type fatty acid-binding protein may be a promising novel biomarker in the evaluation of clinical severity and in the selection of patients for HBO therapy in acute CO poisoning. © 2013 Elsevier Inc.
How prepared are we for possible bioterrorist attacks: An approach from emergency medicine perspective
(Hindawi Limited, 2018) Erenler, Ali Kemal; Güzel, Murat; Baydın, Ahmet
Preparedness for bioterrorist attacks and early recognition of specific agents are essential for public health. Emergency departments may play an important role in this field. The large spectrum of bioterrorism involves not only disastrous terrorism with mass casualties, but also microevents using low technology but producing civil unrest, disruption, disease, disabilities, and death. It aims not only to cause mortality and morbidity, but also to lead to social and political disruption. Preparedness appears to be the most potent defense against possible bioterrorist events. In this article, we aim to create awareness against biological agents and underline the importance of emergency departments in this public health problem. © 2018 Ali Kemal Erenler et al.
Interleukin-33 (IL-33) as a Diagnostic and Prognostic Factor in Traumatic Brain Injury
(Hindawi Ltd, 2020) Erenler, Ali Kemal; Baydın, Ahmet
Interleukin-33 (IL-33) is a cytokine involved in interleukin-1 family. Role of IL-33 in immune system activation is well described in the literature. IL-33 has been identified as an endogenous alarm signal (alarmin) to alert various types of immune cells to trauma. In this narrative review, we aimed to underline the diagnostic and prognostic importance of IL-33 in trauma, particularly in brain trauma.

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