Person: ÖZDEMİR, FATMA
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ÖZDEMİR
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FATMA
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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 General characteristics of patients with electrolyte imbalance admitted to emergency department(Zhejiang Univ Sch Medicine, 2013-06-01) Balcı, Arif Kadri; ARMAĞAN, EROL; Köksal, Özlem; KÖKSAL, ÖZLEM; Köse, Ataman; ÖZDEMİR, FATMA; Özdemir, Fatma; Öner, Nuran; İnal, Taylan; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Acil Tıp Anabilim Dalı.; AAH-8846-2021; ABD-7228-2021; AAK-8332-2020; L-7334-2015; AAM-7896-2020BACKGROUND: Fluid and electrolyte balance is a key concept to understand for maintaining homeostasis, and for a successful treatment of many metabolic disorders. There are various regulating mechanisms for the equilibrium of electrolytes in organisms. Disorders of these mechanisms result in electrolyte imbalances that may be life-threatening clinical conditions. In this study we defined the electrolyte imbalance characteristics of patients admitted to our emergency department.METHODS: This study was conducted in the Emergency Department (ED) of Uludag University Faculty of Medicine, and included 996 patients over 18 years of age. All patients had electrolyte imbalance, with various etiologies other than traumatic origin. Demographic and clinical parameters were collected after obtaining informed consent from the patients. The ethical committee of the university approved this study.RESULTS: The mean age of the patients was 59.28 16.79, and 55% of the patients were male. The common symptoms of the patients were dyspnea (14.7%), fever (13.7%), and systemic deterioration (11.9%); but the most and least frequent electrolyte imbalances were hyponatremia and hypermagnesemia, respectively. Most frequent findings in physical examination were confusion (14%), edema (10%) and rates (9%); and most frequent pathological findings in ECG were tachycardia in 24%, and atrial fibrillation in 7% of the patients. Most frequent comorbidity was malignancy (39%). Most frequent diagnoses in the patients were sepsis (11%), pneumonia (9%), and acute renal failure (7%).CONCLUSIONS: Electrolyte imbalances are of particular importance in the treatment of ED patients. Therefore, ED physicians must be acknowledged of their fluid-electrolyte balance dynamics and general characteristics.Publication Evaluation of trauma patients admitted to emergency department according to triage categories(Galenos Yayıncılık, 2015-06-01) Pozam, Suna Eraybar; Özdemir, Fatma; Sert, Pınar Çınar; Mert, Dilek Kostak; Öner, Nuran; Beğenen, Magruf; Önen, Gizem; ÖZDEMİR, FATMA; Sert, Pınar Çınar; Mert, Dilek Kostak; Beğenen, Magruf; Önen, Gizem; Uludağ Üniversitesi/Tıp Fakültesi/Acil Tıp Anabilim Dalı.; JKS-7683-2023; FZV-9566-2022; DGZ-3639-2022; EMD-6092-2022; DJQ-1494-2022Aim: In our study, we aimed to evaluate the trauma patients who were admitted to Department of Emergency Medicine, Uludag University Hospital for demographic characteristics, triage categories, and necessity of a third-level emergency service.Materials and Methods: Data of the trauma patients admitted between November 1, 2012 and November 1, 2013 were selected by a retrospective systematic sampling. The patient age, sex, admission date, trauma mechanism, body part affected by trauma, and triage categories have been recorded.Results: In all, 3251 patients were included. Most cases were men (66%); the age of trauma exposure was 18-64 years age. Most patients were admitted between April and June, and the most frequent mechanism of trauma was sprain and crush. The hospital admission rate is higher in triages 1 and 2, and discharge rates were higher in triages 4 and 5.Conclusion: To determine the severity of the trauma patients that comprised a special group in the emergency department, triage categories can be effectively used. Considering emergency admissions, 80.4% were not found to be emergent patients group, and these patients should be referred to outpatient clinics.Publication Is routine pregnancy test necessary in women of reproductive age admitted to the emergency department?(Zhejiang Univ Sch Medicine, 2013-09-01) Köksal, Özlem; KÖKSAL, ÖZLEM; Özdemir, Fatma; ÖZDEMİR, FATMA; Armağan, Erol; ARMAĞAN, EROL; Öner, Nuran; Sert, Pınar Çınar; Sığırlı, Deniz; SIĞIRLI, DENİZ; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Acil Tıp Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistk Anabilim Dalı.; AAH-8846-2021; AAK-8332-2020; AAA-7472-2021BACKGROUND: This study aimed to determine the necessity of pregnancy test in women of reproductive age admitted to emergency department (ED) in routine practice.METHODS: We retrospectively reviewed the records of patients who presented to the ED between January 1, 2006 and December 31, 2010 and received a pregnancy test.RESULTS: The median age of 1 586 patients enrolled into the study was 27 years. Of these patients, 19.55% had a positive result of pregnancy test. The most common complaint at admission was abdominal pain in 60.15% of the patients, and pregnancy test was prescribed. 15.83% of the patients with abdominal pain had a positive result of pregnancy test. Of the patients, 30.64% had nausea-vomiting at admission, and 11.52% had a positive result of pregnancy test. When other complaints were considered, the most commonly observed complaints were non-specific symptoms such as dizziness, malaise and respiratory problems. Of the patients, 70.93% were not remembering the date of last menstruation, and 9.51% showed a positive result of pregnancy test. Urinary tract infection (UTI) was commonly diagnosed with an incidence of 17.65%, which was followed by nonspecific abdominal pain (NSAP) (16.77%) and gastrointestinal disorders such as gastritis and peptic ulcer (6.87%). Of the patients, 88.40% were discharged from ED, and 11.60% were hospitalized.CONCLUSION: Pregnancy test should be given to women of reproductive age as a routine practice in ED in developing countries like Turkey.Publication Analysis of acute adult poisoning cases among patients admitted to the emergency department in Bursa, Turkey(Galenos Yayınevi, 2009-01-01) Demircan, Celaleddin; Kahveci, Ferda; Engindeniz, Zülfi; Kıyıcı, Murat; Girgin, Nermin Kelebek; Ercan, İlker; Tekce, Hikmet; Özdemir, Fatma; Özyurt, Gurayten; DEMİRCAN, CELALEDDİN; KAHVECİ, FERDA ŞÖHRET; Engindeniz, Zülfi; KIYICI, MURAT; KELEBEK GİRGİN, NERMİN; ERCAN, İLKER; Tekce, Hikmet; ÖZDEMİR, FATMA; Özyurt, Gurayten; Uludağ Üniversitesi/Tıp Fakültesi/Dahili Tıp Bilimleri Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Anesteziyoloji ve Reanimasyon Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Acil Tıp Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Gastroenteroloji ve Hepatoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; 0000-0003-4820-2288; 0000-0003-1874-5097; 0000-0002-3208-6211; 0000-0002-2382-290X; HJZ-4470-2023; AAG-9356-2021; JBJ-5787-2023; AAI-4213-2021; AAH-7250-2019; ABF-2367-2020; JGP-4019-2023; JKS-7683-2023; JKO-9428-2023Purpose: The aim of this study was to define the epidemiological features such as age, sex, toxic substance, suicide, and mortality rates of the adult poisoning cases among patients admitted to the Emergency Department (ED) of Uludag University Medical Faculty Hospital.Materials and Methods: Records of acute adult poisoning cases at the ED within a one-year period (June 1, 2002 - May 31, 2003) were evaluated retrospectively. Data were compared to those of similar studies from Turkey and around the world.Results: In total 430 (1.96%) of 21,934 patients admitted to the ED during the study period suffered acute poisoning. Of these patients 259 (60.2%) were women and 171 (39.8%) were men and the mean age of the patients was 29.9. Patients were exposed to different types of toxic substances: drugs (47.4%), pesticides (10.7%), toxic gases (10%), corrosives (6.5%), alcohol (3.5%), food (15.8%), toxic substances of animal origin (3.0%), and others (3.0%). In all, 29.8% of the patients were admitted to hospital, 22.3% were transferred to other hospitals, and 47.9% were discharged from the ED, and the overall mortality rate was 1.2%. In addition, 54.9% of the poisonings were suicide attempts and within this group the women to men ratio was 2.2 and the most common toxic substance was a drug (85.2%).Conclusion: Our results were similar to those of previous studies from this country as acute poisonings are more common in women and younger ages, most of them were suicide attempts, and the mortality rate was low. Our transfer rate was high and this may necessitate the organization of short-term observation of these patients.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.