Person: ÖZDEMİR, FATMA
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ÖZDEMİR
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FATMA
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Publication Rhinocerebral mucormycosis case in the emergency room(Acil Tıp Hekimleri Derneği Türkiye, 2021-12-01) Aslan, Şahin; Omar, Issa; Durak, Vahide Aslıhan; Cıkrıklar, Halil İbrahim; Özdemir, Fatma; ASLAN, ŞAHİN; OMAR, ISSA MALONGO; DURAK, VAHİDE ASLIHAN; ÇIKRIKLAR, HALİL İBRAHİM; ÖZDEMİR, FATMA; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Acil Tıp Anabilim Dalı; 0000-0003-0836-7862; 0000-0002-6665-7166; EMD-3139-2022; GXT-8042-2022; AAE-9483-2021; AAH-8714-2021; JRF-5591-2023Introduction: Rhinocerebral mucormycosis is a rare disease, which causes serious and life-threatening fungal infections.The disease usually develops in immunocompromised individuals and usually begins by mimicking cellulite, especially in the face area, and shows a very rapid course.Case Report: A 75-year-old male patient previously admitted to an external center with 3-4 days complaints of headache, numbness in the right half of his face and closure of his left eye was brought to our emergency department for further investigation.The cranial magnetic resonance imaging (MRI) revealed suspected opportunistic fungal infection or malignancy in the ethmoidal and sphenoidal sinuses.The patient was hospitalized with the diagnosis of opportunistic fungal infection after consultations to relevant clinics. Biopsy revealed polypes and mucocele like cystic tissues. The patient, followed-up and treated with rhinocerebral mucormicosis, was transferred to intensive care unit after deterioration of his general condition.After approximately 45 days of follow-up and treatment, the patient was lost due to multiple organ failure.Conclusion: Rhinocerebral mucormycosis is an emergency that requires a multidisciplinary approach. Presence of one or more of the non-traumatic orbital apex syndrome findings should alert emergency physicians. In this and similar infections with high mortality rates, early diagnosis and treatment may lead to good results.Publication Discharge of emergency patients to the clinical wards or intensive care units: An assessment of complications and possible shortcomings(Elsevier, 2015-07-01) Durak, Vahide Aslıhan; Armağan, Erol; Özdemir, Fatma; Kahriman, Nezahat; DURAK, VAHİDE ASLIHAN; ARMAĞAN, EROL; ÖZDEMİR, FATMA; Kahriman, Nezahat; Uludağ Üniversitesi/Tıp Fakültesi/Acil Tıp Anabilim Dalı.; 0000-0003-0836-7862; AAE-9483-2021; Y-3674-2018; AAH-8846-2021; IOY-2055-2023; CXL-2354-2022Objective: We aimed to evaluate the most common complications and possible shortcomings in the emergency patients who were admitted to the clinical wards or intensive care units.Materials and methods: 1000 patients were included in this study. The patients's complication rates were compared with the clinical diagnosis, age groups, the section of the emergency department initially managed the patients, the time of the shift (daytime or night), the accompanying medical staff and specific type of patient populations. Also the interventions of the complications were recorded.Results: 37.5% of the patients who were included in the study were female and 62.5% were male. The median age of the patients was 54.2 year (min: 1 max:92). The vital signs that were recorded prior to transport of the patients did not interfere with the complication rates (p > 0.05). Complication rates in the night were found to be higher as more admissions took place during the night shift (p < 0.05). The complication rates were found higher in patients who were admitted to coronary care unit. The most frequent complication was the dislocation of the intravenous catheter. Replacing the dislocated intravenous catheter was the most frequently noted intervention. However, initiating inotropic agents to the hypotensive patients was done more frequently in the admitted clinical departments.Conclusion: The overall complication rate was low in this series of patients. The majority of them can be prevented by having in house guidelines. (C) 2015 Elsevier Ltd. All rights reserved.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 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 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 Uludag University Medical Faculty research hospital emergency service an epidemiological investigation into blood and blood product transfusion(Galenos Yayınevi, 2012-06-01) Esen, Mehmet; Aydın, Şule Akköse; Özdemir, Fatma; Köksal, Özlem; Öner, Nuran; AYDIN, ŞULE; ÖZDEMİR, FATMA; KÖKSAL, ÖZLEM; Öner, Nuran; Uludağ Üniversitesi/Tıp Fakültesi/Acil Tıp Anabilim Dalı.; 0000-0003-2180-6946; 0000-0002-4761-7863; AAK-8332-2020; JLX-9240-2023; ITH-9225-2023; DJG-5702-2022Objective: This study was designed prospectively to investigate the demographic data of patients (n=434) who received blood and blood products at the Uludag University Medical Faculty Research Hospital Emergency Service between June 2009 and December 2009. The indications for the blood products used, the amount and the type of products used and the documentation of reactions were investigated and compared with data in the literature.Materials and Methods: 83.0% patients had normal vital parameters, 3.4% had hypotension, 2.1% had tachycardia, 1.1% had fever, 9.7% had hypotension and tachycardia and 0.7% had hypotension, tachycardia and fever. In terms of hemoglobin levels, 40.6% of patients had a level below 7 g/dL, 13.1% were between 7-8 g/dL, 26.7% were between 8-10 g/dL and 19.6% were above 10 g/dL. The patients who were transfused with an erythrocyte suspension were mostly the group who had a hemoglobin level below 7 g/dL. Platelets were transfused mostly for thrombocytopenia in patients with a platelet count between 10-20 x 10(3)/mm(3).Results: Of all transfused patients, 3.9% had an acute complication related to transfusion. 1.2% of these were acute febrile non-hemolytic reactions (FNHR), 1.1% were heart failure, 0.9% were allergic reactions and 0.7% were both FNHR and allergic reactions. 76.5% of all transfused patients were discharged from the emergency department, 19.4% were hospitalized, 2.5% were sent to other hospitals and 1.6% died in the emergency department.Conclusion: In light of our findings, it can be seen that many transfusions are performed in the emergency department, transfusion protocols are not normally followed and most transfusions are performed to support the outpatient clinic.