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Öğe Acil Servise Düşük Tehdidi Nedeniyle Başvuran Hastalarda Sistemik Inflamatuar Belirteçlerin Gebelik Sonuçlarını Öngörmede Etkisi(2019) Kan, EdaAmaç: Erken gebelikte vajinal kanama acil servise en sık başvuru sebepleri arasındadır. Bu olgularda inflamasyonun önemli bir rol oynadığı ve ilerleyen dönemde oluşabilecek düşüklerin habercisi olabileceği düşünülmektedir. Çalışmanın amacı, abortus imminens (AI) tanısı ile acil servise başvurup hospitalize edilen hastalarda nötrofil?lenfosit oranı (NLO) ve platelet?lenfosit oranlarının (PLO) incelenmesi ve bu belirteçlerin gebelik sonuçlarını öngörmedeki etkinliklerinin değerlendirilmesidir. Materyal ve Metot: Üniversite hastanesi acil servisine, gebeliğinin ilk 14 haftası içerisinde vajinal kanama şikâyeti ile başvurup AI tanısı alan toplam 121 hasta çalışmaya dahil edilmiştir. Bu hastalar; gebeliklerini abortus nedeniyle kaybedenler (n=73; %60,33) ve 24. hafta sonrasında gebeliği devam edenler (n=48; %39,66) olarak iki gruba ayrılmış olup, demografik veriler, inflamatuar belirteçler ve diğer hematolojik parametreler açısından karşılaştırılmıştır. Bulgular: Gruplar arasındaki demografik veriler benzer olarak saptanmıştır. Abortus grubunda NLO anlamlı şekilde yüksek bulunmuştur (3,92±2,01 ve 2,94±1,20; p<0,001). PLO açısından gruplar arasında anlamlı fark izlenmemiştir (p=0,071). Receiver operating characteristics (ROC) analiz ile değerlendirildiğinde NLO için %77 duyarlılık ve %63 özgüllük ile eşik değer 2,93 olarak belirlenmiştir. Sonuç: AI patogenezinde inflamasyon önemli rol oynamaktadır. NLO kullanımı, acil servislerde gebelik sonuçlarını öngörmede faydalı olabilir. Kolay ulaşılabilir ve maliyet etkin olmaları sebebiyle inflamatuar belirteçlerin kullanıldığı daha büyük populasyon çalışmaları ile abortus olguları açısından önemli bilgiler edinilebilir.Öğe Chronic Licorice Consumption as a Rare Cause of Hypocalcemia(Emergency Medicine Physicians Assoc Turkey, 2020) Kan, Eda; Sarıaydın, Tuba; Doğan, Murat; Erenler, Ali KemalIntroduction: 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.Öğe Comparison of social supports for geriatric patients admitted to emergency department for trauma and medical reasons(Emergency Medicine Association of Turkey, 2019) Şafak, Tuba; Emektar, Emine; Şafak, Yasir; Kan, Eda; Çorbacıoğlu, Şeref Kerem; Çevik, YunsurObjectives: Developments in medical technology have increased life expectancy around the world thereby, the population of elderly patients increases. While diagnosing the elderly patients, besides factors like physiological changes, comorbidities, multiple medications and admittance to the Emergency Department (ED)for serious causes, a lack of information and experience complicate the work of emergency physicians. Elderly people are admitted to ED with medical or traumatic complaints; nevertheless, independent of the reason for admittance to the ED their presenting condition should be simultaneously assessed for comorbidities. In this study, we aimed to compare social support and stress levels in geriatric patients admitted to the ED for trauma and medical reasons. Methods: This was a single-center, prospective, descriptive, epidemiologic trial conducted in the ED of a training and research hospital between October 1st, 2015, and April 1st, 2016. Participants consisted 197 patients who were older than 65 years and presented to ED with medical reasons or trauma whose Emergency Severity Index (ESI)was ?3. A socio-demographic and clinical data form, and the DUKE Social Support and Stress Scale (DUSOCS)were completed for each patient. Results: Patients presenting with medical problems had higher family support levels than patients presenting with traumatic incidents, and this difference was statistically significant (p = 0.028). Concurrently, when both groups’ family stress and social stress levels are viewed, patients presenting with trauma had higher levels of stress, and this difference was also statistically significant (p < 0.001). Conclusion: This study revealed that the patients admitted to the ED for trauma have lower social support levels than patients admitted for medical reasons. Moreover, social stress levels were also higher in these patients. © 2019 Emergency Medicine Association of TurkeyÖğe Evaluation of relationship between inflammatory markers and hyperemesis gravidarumin patients admitted to emergency department(W B Saunders Co-Elsevier Inc, 2020) Kan, Eda; Emektar, Emine; Corbacioglu, Kerem; Safak, Tuba; Sariaydin, Tuba; Cevik, YunsurBackground: Hyperemesis gravidarum (HG) is defined as severe nausea and vomiting in pregnancy and considered as one of the most frequent causes to emergency department (ED) admissions. Previous research has shown that HG is associated with systemic inflammation, but there have been no prospective studies to explore this link. The objective of this study was to assess the impact of inflammation in HG pathophysiology and to investigate the association between severity of HG and neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and CRP in patients who were admitted to ED with nausea and vomiting. Methods: This prospective study has been conducted in a tertiary clinic between 2015 and 2016. A total of 162 patients with b16 weeks gestation with singleton pregnancies and without any chronic diseases enrolled in the study. The study group consisted of 113 patients with HG and the control group included 49 healthy subjects. PUQE Index and VAS were used to evaluate the severity of symptoms. Results: Demographical data were similar between both groups. The study group demonstrated significantly higher NLR, PLR and CRP levels (NLR 3.39 vs 2.5, p = 0.001; PLR 134.3 vs 111.2, p = 0.005; CRP 0.85 mg/dL vs 0.19 mg/dL, p = 0.001). While NLR and PLR levels were not correlated with severity of HG, CRP levels were associated with severity of disease (p=0.001) regarding to PUQE index. Conclusion: NLR and PLR are easily obtained and routinely used diagnostic tools for various inflammatory diseases. Measurement of this markers might provide useful information in HG pathogenesis and diagnosis. (C) 2019 Elsevier Inc. All rights reserved.
