Person: AYDIN, ŞULE
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AYDIN
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ŞULE
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Publication Paraquat intoxication: A case report(Aves Press Ltd, 2011-07-01) Eraybar, Suna; Köse, Ataman; Aydın, Şule Akköse; AYDIN, ŞULE; Özdemir, Fatma; ÖZDEMİR, FATMA; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Acil Tıp Anabilim Dalı.; 0000-0003-4306-9262; HIK-0672-2022; AAM-7896-2020; L-7334-2015Paraquat, a widely used herbicide, causes high morbidity and mortality in people when taken accidentally or for suicidal intent. In this study our aim is to present the treatment and follow up of a 23 years old young lady after a history of suicide attempt in the emergency department after taking large amount of paraquat. The patient was initially asymptomatic and in follow up care gastrointestinal, renal and liver toxicity developed. Patients with severe paraquat poisoning may be asymptomatic after ingestion, but may deteriorate rapidly within a few hours. Therefore, in the case of taking high dose paraquat, the patient needs long term follow up for liver, kidney and lung effects even if he is asymptomatic.Publication Acid-base disorders in the emergency department: Incidence, etiologies and outcomes(Aves, 2014-03-01) Köse, Ataman; Armağan, Erol; Öner, Nuran; Köksal, Özlem; Mert, Dilek Kostak; Özdemir, Fatma; Aydın, Şule Akköse; ARMAĞAN, EROL; KÖKSAL, ÖZLEM; Mert, Dilek Kostak; ÖZDEMİR, FATMA; AYDIN, ŞULE; Uludağ Üniversitesi/Tıp Fakültesi/Acil Tıp Bölümü; AAK-8332-2020; AAH-8846-2021; AAI-2164-2021; L-7334-2015Objective: Acid-base disorders (ABDs) are usually correlated with high rates of morbidity and mortality. The objective of this study was to analyze the causes, outcomes, types and incidences of ABDs in patients presenting at the emergency department (ED).Material and Methods: We prospectively analyzed data from patients who presented between January 2011 and May 2011. Data on age, gender, chief complaint, and diagnosis in the ED were collected for ABD cases.Results: Of the 736 cases with an ABD, 173 patients (23.5%) had simple ABD and 563 patients (76.5%) had mixed ABD. The most common ABD was a mixed metabolic acidosis and respiratory alkalosis (MACRAL) (n=408, 55.4%). All ABD types were most commonly observed in patients over 65 years of age. Dyspnea was the most common complaint among ABD patients who presented at the ED (44.4%). In cases of ABD, pneumonia was the most common diagnosis (16.3%). Of the ABD cases, 379 patients (51.6%) were discharged, while 318 patients (43.2%) were hospitalized. Death was more commonly observed in cases with mixed metabolic and respiratory acidosis (MRAC) (n=6) and MACRAL (n=11).Conclusion: ABDs are quite common in patients presenting at the ED, especially among patients in a critical condition (71%). Mixed MACRAL was the most commonly noted ABD. Dyspnea and pneumonia were the most common diagnoses in ABD patients. Mortality was more common in cases with a mixed MRAC and MACRAL. This knowledge may provide important information concerning the diagnosis, treatment and early prognosis of patients.Publication Patients over the age of 15 years admitted for attempted suicide to the emergency department and the psychosocial support unit(Emergency Medicine Physicians Assoc Turkey, 2012-12-01) Köse, Beril; KÖKSAL, ÖZLEM; ARMAĞAN, EROL; Köse, Ataman; Eraybar, Suna; AYDIN, ŞULE; Aydın, Şule Akköse; Armağan, Erol; ÖZDEMİR, FATMA; Özdemir, Fatma; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Acil Tıp Anabilim Dalı.; 0000-0003-4306-9262; CAF-5149-2022; HIK-0672-2022; L-7334-2015; AAM-7896-2020; AAH-8846-2021Objective: This study aimed to evaluate the demographic characteristics, methods of suicide and its causes in patients over the age of 15 years admitted to the emergency service for attempted suicide. The importance of the psychosocial support unit that has recently become active in the emergency department is emphasized.Material and Methods: In our study, we retrospectively evaluated the "Suicide Attempt Feedback Forms" of patients over the age of 15 years who were admitted to the emergency service of the Van Education and Research Hospital for suicide attempts between February and November 2009.Results: A total of 112 cases were enrolled in the study, of whom 92 were female ( 82.2%) and 20 were male ( 17.8%). The most prominent age range for suicide attempts was between 15-24 years of age ( 71.4%). In both sexes, the most common suicide attempt method was drug use, and family problems were the most common cause of suicide. Nearly all patients had made suicide attempts with the use of drugs/toxic substances. Suicide attempts were most commonly seen in March, April and October.Conclusion: Considering the number of patients in the emergency department, a team working as a psychosocial support and crisis intervention unit with experience in suicide attempts and enough time to address this issue is important for patients to receive adequate and appropriate service. Implementation of this mechanism in an uninterrupted manner in the emergency department can contribute to the prevention of recurrent suicide attempts.Publication Is there a relationship between the diameter of the inferior vena cava and hemodynamic parameters in critically ill patients?(Medknow Publications, 2015-11-01) Aydın, Şule A.; Özdemir, Fatma; Taşkın, G.; Ocakoğlu, Gökhan; Yıldırım, H.; Köksal, Özlem; AYDIN, ŞULE; ÖZDEMİR, FATMA; Taşkın, G.; OCAKOĞLU, GÖKHAN; KÖKSAL, ÖZLEM; Uludağ Üniversitesi/Tıp Fakültesi/Acil Servis Bölümü; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı; 0000-0002-1114-6051; AAH-5180-2021; AAK-8332-2020; HLG-6346-2023; AAI-2164-2021; IOY-2055-2023; GHW-4797-2022Introduction: The early detection of critically ill patients together with the rapid initiation of effective treatment in emergency departments(ED) increase the survival rates.Aim: This study investigated whether a correlation exists between haemodynamic parameters of critically ill patients and the diameter of the inferior vena cava (IVC).Materials and Methods: A cross-sectional study was performed included patients aged >= 18 years with an unstable haemodynamic and/or respiratory status who were referred to the ED for non-traumatic issues. IVC diameters were measured by ultrasound (US) and then central venous pressures (CVP) were measured. Anteroposterior (AP) and mediolateral (ML) diameters of the IVC, both in the inspirium (IAP, IML) and expirium (EAP, EML), were measured by US.Results: 102 patients were evaluated with a median age of 59. The relationship between the diameters of IVC and CVP was evaluated and significant correlation was found in IAP, EAP according to CVP values (p<0.001). ROC analyses were performed and significant relationship was found between the EAP diameter with haemoglobin (Hmg), haemotocrit (Hct), and central venous oxygen saturation (ScvO2) and also significant correlation was detected between the IAP diameter and white blood cell (WBC).Discussion: We detected significant correlation between the CVP and the IVC diameter in our study compatible with recent studies besides, significant correlation was found between the diameter of the IVC and CVP values as well as between the EAP diameter and Hmg, Hct, ScvO2 levels.Conclusion: Measurement of IVC diameters, especially EAP may be useful at the monitoring of critically ill patients in ED.Publication Comparison of ice and lidocaine-prilocaine cream mixture in the reduction of pain during peripheral intravenous cannulation in emergency department patients(Galenos Yayıncılık, 2013-03-01) Aygün, Hüseyin; Armağan, Erol; Özdemir, Fatma; Köse, Ataman; Selimoğlu, Kerem; Köksal, Özlem; Aydın, Şule Akköse; Aygün, Hüseyin; ARMAĞAN, EROL; ÖZDEMİR, FATMA; Köse, Ataman; Selimoğlu, Kerem; KÖKSAL, ÖZLEM; AYDIN, ŞULE; Uludağ Üniversitesi/Tıp Fakültesi/Acil Tıp Anabilim Dalı.; 0000-0003-3635-7282; AAK-8332-2020; AAI-2164-2021; AAH-8846-2021; AAM-7896-2020; JKT-3402-2023; JPE-0854-2023; CDS-3299-2022Objective: We aimed to compare the efficacies of ice, lidocaine-prilocaine mixture cream and the classical method in reduction of the pain observed during intravenous cannulation, which is the most frequently performed procedure in emergency departments and to define the most effective method.Material and Methods: One hundred-twenty patients who applied to the emergency department of Uludag University Faculty of Medicine were included in this presented study. Cannulations were performed after one minute application of ice package in the ice group. Patients who applied to emergency only for blood transfusion were chosen for the lidocaine-prilocaine group and their cannulations were performed at the 60th minute of cream mixture application. Finally, no applications before cannulation were used for the control group. All cannulations were performed from antecubital region and 18 G cannula were used. Visual analog scale ( VAS) and patient satisfaction were scored.Results: VAS scores for ice, lidocaine-prilocaine and control groups are 2.8 +/- 1.7, 4.1 +/- 1.8, 4.4 +/- 1.9, respectively. VAS score in the ice group was significantly lower than both lidocaine-prilocaine and control groups. In addition, there was no statistically significant difference between lidocaine-prilocaine and control groups.Conclusion: Ice application method before intravenous cannulation, in addition to its advantages such as being inexpensive, easy to obtain and apply, is more effective than lidocaine-prilocaine cream.Publication Clinical probability and risk analysis of patients with suspected pulmonary embolism(Zhejiang Univ Press, 2014-12-01) Yetgin, Gülden Özeren; Aydın, Şule Akköse; Köksal, Özlem; Özdemir, Fatma; Mert, Dilek Kostak; Torun, Gökhan; AYDIN, ŞULE; KÖKSAL, ÖZLEM; ÖZDEMİR, FATMA; Mert, Dilek Kostak; Torun, Gökhan; AAI-2164-2021; AAA-2367-2020; AAK-8332-2020BACKGROUND: Pulmonary embolism (PE) is one of the most frequent diseases that could be missed in overcrowded emergency departments as in Turkey. Early and accurate diagnosis could decrease the mortality rate and this standard algorithm should be defined. This study is to find the accurate, fast, non-invasive, cost-effective, easy-to-access diagnostic tests, clinical scoring systems and the patients who should be tested for clinical diagnosis of PE in emergency department.METHODS: One hundred and forty patients admitted to the emergency department with the final diagnosis of PE regarding to anamnesis, physical examination and risk factors, were included in this prospective, cross-sectional study. The patients with a diagnosis of pulmonary embolism, acute coronary syndrome or infection and chronic obstructive pulmonary disease (COPD) were excluded from the study. The demographics, risk factors, radiological findings, vital signs, symptoms, physicallaboratory findings, diagnostic tests and clinical scoring systems of patients (Wells and Geneva) were noted. The diagnostic criteria for pulmonary emboli were: filling defect in the pulmonary artery lumen on spiral computed tomographic angiography and perfusion defect on perfusion scintigraphy.RESULTS: Totally, 90 (64%) of the patients had PE. Age, hypotension, having deep vein thrombosis were the risk factors, and oxygen saturation, shock index, BNP, troponin and fibrinogen levels as for the biochemical parameters were significantly different between the PE (+) and PE (-) groups (P<0.05). The Wells scoring system was more successful than the other scoring systems.CONCLUSION: Biochemical parameters, clinical findings, and scoring systems, when used altogether, can contribute to the diagnosis of PE.Publication Snakebite cases admitted to uludag university faculty of medicine emergency department and current management of snake bite(Aves, 2009-03-01) ÖZDEMİR, FATMA; Eren, Sebnem; Özdemir, Fatma; Köksal, Özlem; KÖKSAL, ÖZLEM; Durmuş, Oya; Esen, Mehmet; Akköse, Şule Aydın; AYDIN, ŞULE; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Acil Tıp Anabilim Dalı.; 0000-0003-2180-6946; HHN-5686-2022; AAK-8332-2020; AAX-5571-2021Background: The purpose of this study is to analyse the characteristics of snakebite cases' epidemiology, clinic, treatment and prognosis and to investigate the current first aid and treatment methods.Methods: The snakebite cases admitted to our emergency department (ED) between 01.01.1995-31.12.2004 were investigated retrospectively. Demographic data, procedures and biochemical tests in the ED, prognosis of the hospitalized patients, the treatment given in the hospital and the complications were recorded.Results: The average age of the totally 48 (M/F: 27/21) patients was 40.4 year. 11 cases were discharged, 21 cases were transferred to other hospitals and 16 of them were hospitalized. Majority of the patients admitted in spring and summer. Among the 24 patients whom files had been obtained, 12 patients' snakebite was on the lower extremity, and 12 patients' was on the upper extremity. Antivenom was applied to 17 of these 24 patients. Systemic symptoms were seen in 6 patients. As an abnormal biochemical test only leucocytosis was seen in 7 patients. Faciotomy was applied to 25% of the patients with the diagnosis of compartment syndrome. The average hospitalization time was 4.2 day and there were no deaths and no extremity amputation among these patients.Conclusion: Most of the snakebites occur in the spring and summer season. Poisonous snakebites can cause severe systemic and local complications like compartment syndrome. ED approach includes close following of the vital signs, basic laboratory tests, tetanus prophylaxis, diagnosis of compartment syndrome and systemic complications. Patients should be examined in terms of antibiotherapy and antivenin.Publication Acute temporal lobe infarction in a young patient associated with marijuana abuse: An unusual cause of stroke(Zhejiang Univ Sch Medicine, 2014-03-01) İnal, Taylan; Köse, Ataman; Özdemir, Fatma; KÖKSAL, ÖZLEM; Köksal, Özlem; Armağan, Erol; ARMAĞAN, EROL; Aydın, Şule A.; AYDIN, ŞULE; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Acil Tıp Anabilim Dalı.; AAM-7896-2020; AAH-8846-2021; AAI-2164-2021; AAK-8332-2020; L-7334-2015BACKGROUND: Cardiovascular or cerebrovascular events associated with drug abuse have been frequently reported, particularly in young patients. The drugs include generally cocaine, heroin, and amphetamines. Although marijuana is among the widely used narcotics in the world, stroke associated with the marijuana use is infrequently reported.METHODS: Stroke caused by the use of marijuana was investigated in a 23-year-old man and the importance of inquiry of drug abuse in case of stroke was emphasized.RESULTS: The patient was treated for 7 days in a follow-up, but he was not recovered. The patient was discharged in his existing condition and was directed for physiotherapy and rehabilitation.CONCLUSION: Ischemic stroke is associated with drug abuse and/or substance use, mainly cannabinoids and amphetamines, particularly in young patients.Publication A case report of ammonium sulfate inhalation(Aves, 2011-12-01) Köksal, Özlem; KÖKSAL, ÖZLEM; Almacıoğlu, Meral Leman; ÖZDEMİR, FATMA; Aydın, Şule Akköse; AYDIN, ŞULE; Bulut, Mehtap; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Acil Tıp Anabilim Dalı.; AAK-8332-2020; AAX-5571-2021; HHN-5686-2022Ammonium sulfate is widely used in agriculture and the leather trade in many countries. Although it is reported to have potential effects on respiratory, gastrointestinal systems and the skin, there are a few case reports and toxicological studies about ammonium sulfate intoxication after ingestion and there is no case about ammonium sulfate inhalation. Thus, we report the clinical and laboratory findings of a patient who inhaled ammonium sulfate gas due to a work accident and was brought to our emergency department directly from the factory. When he arrived, loss of consciousness, cyanosis, tachypnea and metabolic acidosis were observed and convulsions were reported before arrival at the emergency department. After intubation and mechanical ventilator support in the emergency department, he was admitted to the intensive care unit, was given a T tube - mechanic ventilator support and was discharged in a healthy condition on the 8th day of admission. Ammonium sulfate intoxication should be suspected for the patients which brought from the leather industry or an agricultural environment, who inhaled bad or dense odored material, and had loss of consciousness, convulsions, acidosis and respiratory failure.Publication Bedside sonography in emergency departments in turkey(Sage Publications, 2008-05-01) Girişgin, Sadık A.; Cander, Başar; Yürümez, Yusuf; Coşkun, Figen; İkizceli, İbrahim; Akköse, Şule; AYDIN, ŞULE; Uludağ Üniversitesi/Tıp Fakültesi/Acil Tıp Bölümü; JRG-1971-2023Emergency departments in Turkey have been steadily improving their services since emergency medicine began as a specialty over 12 years ago, but bedside ultrasound (US) has not been implemented widely. In order to learn the extent of ultrasound usage and training opportunities, a 27-question survey was distributed to emergency medicine-trained physicians working in emergency departments at ten university hospitals (the busiest one in each geographical region, plus three others), which are referral centres covering over half of the country's population.Eight of the ten EM departments had an ultrasound machine in their ED (for a mean of 3.7 years), but the machines were used and controlled by the Department of EM in only four of the centres. While EM physicians knew how to perform US in seven centres, they routinely performed US themselves in only five. Of the 173 EM staff in the centres surveyed, 57 performed bedside US, and 28 possessed an US course certificate. All respondents wanted their EM residents to have formal US training, but such a rotation was present in only five centres. Bedside US was being performed in the following clinical situations: trauma (n=7), abdominal pain (n=7), renal colic (n=5), chest pain (n=3), assist to invasive procedures (n=3), locating subcutaneous foreign bodies (n=3), and dyspnea (n=1). Five departments had no form or system for documenting their US findings, and if finding anything suspicious, always sent the patients to radiology to have the US repeated. The mean duration from request-to-radiology-for-US to report-in-EM-physician's-hands was 47 minutes.Bedside US is performed by EM physicians in only half of the academic centers we surveyed. Documentation is absent in many, thus the quality or impact of this practice would be difficult, if not impossible, to determine. Formal educational programs are desired by all, but have yet to be implemented in half of the centres. Given the many benefits to patients of bedside US, diligent efforts still need to be made to improve this service in academic emergency departments in Turkey.