Şevki Hakan Eren

Quail consumption can be harmful.

BACKGROUND Intoxication due to quail consumption is rarely seen. Such a toxicological syndrome (also called coturnism) occurs during the migration of quails from north to south, when they consume hemlock seeds. The clinical symptoms and laboratory results are indicative of acute rhabdomyolysis. OBJECTIVES Acute rhabdomyolysis has a wide range of etiologies. Coturnism is a rare cause of acute rhabdomyolysis that can be lethal due to renal failure and shock. To avoid severe complications, coturnism may be considered if the history is appropriate. CASE REPORT We report four cases of coturnism from quail consumption; the patients were admitted with some combination of symptoms including muscle tenderness, extremity pain, nausea, and vomiting. They were treated with vigorous isotonic crystalloid hydration and urine alkalinization. Consequently, the laboratory results returned to normal ranges and the clinical symptoms disappeared. CONCLUSION Although coturnism is a rarely seen toxicological syndrome that causes rhabdomyolysis, we present this case to increase awareness that it may present with symptoms of muscle tenderness, extremity pain, nausea, and vomiting after quail consumption.

Bir Devlet hastanesi acil servisi demografik özellikleri: 2011 yılı meta analizi

Objective: The examination and treatment modalities should be measurable for improve the service quality of emergency service. This may be possible with the data collection system which is comprehensive and world-wide known. The aim of this study is to investigate the demographical features of patients who admitted to our service by computer based patient recording system and create a better service quality in the view of these data. Methods: Registered 115,185 patients were included whom admitted to our service between January 2011 and December 2011. The demographic characteristics, symptoms, triage distributions, the average length of stay, consultation rates, hospital admission forms, hospitalization and discharge rates were classified according to the Inter national Classification of Diseases-10 (ICD-10). Results: The mean age of patients was 38.70±19.92 years and 44.8% of the patients were male. Triage categories of the patients in category red, yellow and green 5.5%, 53.1%, 41.4%, respectively. Patients older than 65 years old were 14,643 (12.7%). Most common presentation day was Monday and the time period was between 20 p.m. and 24 p.m. The mean length of emergency service stay was 47 minutes, consultation and admission rates were 8.5% and 3.2%, respectively. 1,876 patients of older than 65 years old were admitted to the services. Conclusions: Emergency service admission registrations should be stored and analyzed by using the digital and sharable systems to serving a better qualified service in emergency services which provides continued service step to health care. This will allow the national standardization and determine the international location. J Clin Exp Invest 2013; 4 (3): 274-278

The Relationship Between Oxidative Stress, Paraoxanase and Injury Severity in Blunt Trauma Patients

1 İlhan Korkmaz1, Hüseyin Aydın2, Şevki Hakan Eren3, Fatma Mutlu Kukul Güven4, Birdal Yıldırım5, İnan Beydilli6, Mehmet Eren7, 1Cumhuriyet Üniversitesi Tıp Fakültesi Acil Tıp A.D., 2Cumhuriyet Üniversitesi Tıp Fakültesi Klinik Biyokimya Laboratuarı, 3Cumhuriyet Üniversitesi Tıp Fakültesi Acil Tıp A.D., 4Cumhuriyet Üniversitesi Tıp Fakültesi Acil Tıp A.D., Sivas, 5Muğla Devlet Hastanesi Acil Servis, Muğla, 6Antalya Eğitim Araştırma Hastanesi Acil Servis, Antalya, 7Atatürk Eğitim Araştırma Hastanesi Ortopedi ve Travmatoloji, Ankara, Türkiye Travma Hastalarında Paraoksanaz / Paraoxanase Levels in Trauma Patients The Relationship Between Oxidative Stress, Paraoxanase and Injury Severity in Blunt Trauma Patients

Predicting of neuropsychosis in carbon monoxide poisoning according to the plasma troponin, COHb, RDW and MPV levels

OBJECTIVE Carbon monoxide (CO) poisoning is very common worldwide. In this study, we aimed to evaluate the predictivity of neuro psychosis in carbon monoxide poisoning by the admission levels of red cell distribution (RDW), mean platelet volume (MPV) and troponin I levels which can be measured quickly and easily in the emergency department (ED). PATIENTS AND METHODS This single center observational study included a total of 216 consecutive patients who presented to the ED due to CO poisoning between January 2009 and December 2013. The diagnosis of CO poisoning was made according to the medical history and carboxyhemoglobin (COHb) level of >5%. According to the carboxyhemoglobin levels, the patients were classified as mildly (COHb < 20%) and severely poisoned (COHb > 20%). In addition, patients were divided into 2 groups, i.e., those with positive (>0.05 ng/mL for our laboratory) and negative (<0.05 ng/mL for our laboratory) troponin levels. RESULTS Patients mean age was 52.58 ± 10.58. 57.9% of the patients had high troponin levels and 51.9% were poisoned severely according to COHb levels. Patients with positive troponin and COHb had longer CO exposure time and higher neutrophil, lymphocyte, mean platelet volume (MPV), COHb and red cell distribution width (RDW) levels at the index admission following CO poisoning than patients with negative troponin (p < 0.05). Age, COHb level, CO exposure time, MPV and RDW (p = 0.001, p < 0.05) remained associated with an increased risk of troponin positivity following adjustment for the variables that were statistically significant. CONCLUSIONS In patients presenting to the ED with CO poisoning, RDW and MPV can be helpful for risk stratification of neuropsychosis.

THE ANALYSIS OF CARBON MONOXIDE POISONING CASES PRESENTED TO THE EMERGENCY DEPARTMENT OF A UNIVERSITY HOSPITAL

Introduction : Carbon monoxide poisoning is one of the most leading poisoning causing death through worldwide, although its exact incidence is yet to be determined. Carbon monoxide is a colorless and odorless gas that binds to hemoglobin and cellular oxidative enzymes with a higher affinity than oxygen, causing tissue hypoxia. Hypoxia of heart and nervous system cells leads to neuropsychiatric and cardiological signs and symptoms. In this study, we aimed to investigate the demographic characteristics of the carbon monoxide poisonings occurring in patients presenting to the emergency department. We also aimed to determine the clinical characteristics, and the factors affecting the mortality. Material and Methods : We retrospectively reviewed the demographic and clinical characteristics of 1013 patients who admitted to our adult emergency department and were diagnosed with carbon monoxide poisoning for a period of two years. We recorded and analyzed age, gender, season of presentation, hospital admission rate, sources of poisoning, symptoms at admission, mortality rate, and carboxyhemoglobin and cardiac Troponin-I levels. Results : The mean age of the study population was 36.2±16.2 years. 70.5% of the patients were admitted in winter seasons. 66.1% of the patients’ poisoning source was water heater and stove. The most frequent symptoms were nausea, headache, and dizziness. On multilogistic regression analysis the death rate was significantly correlated with age and cardiac Troponin I level. Conclusion : Our results indicate that accidental carbon monoxide poisonings continue to be an important public health problem in regions with cold winter seasons. We believe that intensifying efforts for public education and efficient control of resources of poisoning are the key steps to prevent carbon monoxide poisonings.

Femoral diyaliz kateteri takılması hayatı tehdit edici komplikasyona yol açabilir mi

Venous catheter (VC) insertion may be necessary for the patients with renal failure facing vascular access problem. Femoral VCs are commonly used for their lower complication rates especially in emergency clinics. The incidence of bleeding associated with VC is reported 0.51.6%, however, life threatening hemorrhage and complications requiring surgical intervention are very rare. In this manuscript, we aimed to present a case with hemolytic uremic syndrome complicated with retroperitoneal hematoma after femoral VC insertion. J Clin Exp Invest 2014; 5 (3): 472-474 OZET Vaskuler girisim yolu problemi yasayan bobrek yetmezlikli

METHANOL POISONING IN THREE CASES: DIAGNOSIS AND TREATMENT IN EMERGENCY DEPARTMENT

ABSTRACT Methanol is a very poisonous substance that is used as an industrial solvent and automotive antifreeze. Toxic dose is between 20-250 ml and causes neurological symptoms such as headache, cerebral edema and putamen necrosis within the first 12 to 14 hours. Central nervous system and visual cortex are the main areas which are damaged by methanol poisoning. Methyl alcohol is not toxic until its toxic metabolites turn into formic acid. Formic acid is especially responsible for the clinical findings. Serum half-life of methanol is 14 to 20 hours in mild and 24 to 30 hours in severe toxicity. Gastric lavage, fomepizole, ethanol and hemodialysis are used in the treatment. In this study, we aimed to review and discuss information from literature about the treatment and monitoring of methanol poisoning in three cases followed at emergency department. Key words: Methanol poisoning, emergency, blurred vision, hemodialysis

Analyses of The Risc Factors for Atrial Fibrillation Among the Patients Who were Admitted to Emergency Service

1 Ethem Arisoy1, İlhan Korkmaz2, Şevki Hakan Eren3, Fatma Mutlu Kukul Güven4, Mehmet Birhan Yilmaz5, İnan Beydilli6, Birdal Yıldırım7 1Zonguldak Devlet Hastanesi Acil Servis, Zonguldak, 2Cumhuriyet ÜniversitesiTıp Fakültesi Acil Servis, Sivas, 3Cumhuriyet Üniversitesi Tıp Fakültesi Acil Servis, Sivas, 4Cumhuriyet Üniversitesi Tıp Fakültesi Acil Servis, Sivas, 5Cumhuriyet Üniversitesi Tıp Fakültesi Kardiyoloji A.D, Sivas, 6Kayseri Eğitim Araştırma Hastanesi Kayseri, 7Muğla Devlet Hastanesi Muğla, Türkiye Atrial Fibrillation / Atrial Fibrilasyon Analyses of the Risc Factors for Atrial Fibrillation Among the Patients Who were Admitted to Emergency Service

Kronik obstruktif akciğer hastalığı akut alevlenmeli hastalarda prokalsitonin ve diğer akut faz belirteçleri

Objectives: The aim of this study was to investigate the correlation between procalcitonin and other acute phase reactants, and also analyze their relationship with clinical situation in chronic obstructive pulmonary disease (COPD) acute exacerbations. Materials and methods: The study was made with 122 acute COPD exacerbated patients, who were admitted to emergency service. Patients with below 0.25 ng/ml PCT value included Group 1, and the patients with PCT values ≥ 0.25 ng/ml Group 2. Serum procalcitonin levels, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) values and white blood cell (WBC) counts were measured. Also, patients hospitalization time and mortality rates were recorded and compared with PCT. Results: Patients were divided in 3 groups according to their clinical diagnosis; Pneumonia (n=27), MycoplasmaChlamydia pneumonia (n=11) and the patients with only COPD exacerbation(n=84). Mean PCT values according to the groups were 9.47 ± 8.1 ng/ml, 0.41 ± 0.2 ng/ ml, and 0.21 ± 0.05 ng/ml respectively. The relationship between PCT with CRP and white blood cell has been found between significiant (p=0.001, p=0.005 respec tively), whereas the relationship between PCT and ESR was nonsignificant (p=0.55). Procalcitonin and CRP had a positive correlation with the hospitalization time (p=0.034, p=0.022 respectively). The mean ± standard error of PCT for the patients who died was 28.3 ± 27.5 ng/ml, and the difference between patients who died or were discharged was statistically significant (p= 0.012). Conclusion: PCT can be a useful indicator for morbidity and prognosis in COPD patients.