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Öğe Comparison of intravenous ibuprofen and paracetamol in the treatment of fever: A randomized double-blind study(W B Saunders Co-Elsevier Inc, 2021) Can, Ozge; Kiyan, Guclu Selahattin; Yalcinli, SercanObjective: Fever is one of the frequent reasons for admission to the emergency department. Studies comparing oral forms of non-steroidal anti-inflammatory drugs (NSAIDs) and paracetamol with intravenous (IV) forms for fever are common in the literature. Our study is the first emergency department study comparing IV forms of ibuprofen and paracetamol in the treatment of febrile patients. Methods: A randomized, double-blind study was conducted in a tertiary university emergency department for a six-month period. Patients aged 18-65 years who had a fever of >= 38.0 degrees C were included. Patients were administered 400 mg of IV ibuprofen and 1000 mg of IV paracetamol. The primary aim of the study was to determine whether there was a difference in the effect of the two drugs on fever. The secondary aim was to investigate whether there was a difference in terms of numeric rating scale (NRS) measurements and the need for additional antipyretic therapy. Results: A total of 200 people, 100 of whom were female, were included in the study. The mean age was 30.77 +/- 10.61 years. The mean initial temperature for ibuprofen and paracetamol was 38.79 +/- 0.470 degrees C and 38.70 +/- 0.520 degrees C, respectively, with no difference noted between the groups (p = 0.380). It was found that both drugs significantly provided fever control in the first 30 min (p < 0.001), with no difference between them in terms of fever reduction (p = 0.980). Both drugs significantly improved in accompanying symptoms, although both drugs did not show superiority to each other (p = 0.0226). When evaluated in terms of a need for rescue medication, no significant difference was found between the two drugs (p = 0.404). No side effects were encountered during the study. Conclusion: In adult age group patients admitted to the emergency department with high fever, the IV forms of 1000 mg paracetamol and 400 mg ibuprofen effectively and equally reduce complaints, such as fever and accompanying pain. They can be effectively used as each other's rescue medicine and as an alternative to each other in patients with comorbid diseases. (c) 2021 Elsevier Inc. All rights reserved.Öğe Comparison of qSOFA, SIRS, and NEWS scoring systems for diagnosis, mortality, and morbidity of sepsis in emergency department(W B Saunders Co-Elsevier Inc, 2021) Oduncu, Ali Fuat; Kiyan, Guclu Selahattin; Yalcinli, SercanPurpose: This study was aimed to compare the quick Sequential Organ Failure Assessment (qSOFA), Systemic Inflammatory Response Syndrome (SIRS), and National Early Warning Score (NEWS) scoring systems for diagnosing sepsis and predicting mortality and morbidity. Patients and methods: A prospective study was designed. qSOFA, SIRS, and NEWS scores were calculated at the admission. The diagnosis of sepsis was made with SOFA scoring initially. The morbidity and mortality of the patients were identified during follow-up. Also, the sensitivity, specificity, negative predictive value, and positive predictive value of three scoring systems were calculated. The scoring systems were compared with ROC analysis. Results: A total of 463 patients were evaluated. There were 287 (62.0%) patients diagnosed with sepsis, and septic shock occurred in 64 (13.8%) of patients. Seven-day mortality rate was 8.4% (n = 39), 30-day mortality rate was 18.1% (n = 84). The sensitivity for qSOFA, SIRS, and NEWS for diagnosis of sepsis was 23%, 77%, 58%, and specificity was 99%, 35%, 81% respectively. The sensitivity of the qSOFA, SIRS and NEWS scoring systems for mortality was 39%, 82%, 77% and specificity 91%, 29%, and 64%, respectively. AUROC values for mortality detected as NEWS = 0.772, qSOFA = 0.758, SIRS = 0.542. According to the ROC analysis, the SIRS system was significantly less useful than the qSOFA and NEWS system in the diagnosis of sepsis and mortality (p < 0.0001). Conclusion: NEWS and qSOFA scoring systems have similar prognosis in both diagnosing sepsis and predicting mortality and both are superior to SIRS. (c) 2021 Elsevier Inc. All rights reserved.Öğe Flow-safe disposable CPAP efficiency in cardiogenic pulmonary oedema(W B Saunders Co-Elsevier Inc, 2020) Uz, Ilhan; Kiyan, Guclu Selahattin; Ozcete, Enver; Yalcinli, Sercan; Korgan, Mehmet Birkan; Altunci, Yusuf Ali; Yavuzgil, Oguz[No abstract available]Öğe Is the flow-safe disposable continuous positive airway pressure (CPAP) system as effective as non-invasivemechanical ventilation (NIMV) in the treatment of acute cardiogenic pulmonary Oedema?(W B Saunders Co-Elsevier Inc, 2021) Uz, Ilhan; Kiyan, Guclu Selahattin; Ozcete, Enver; Yalcinli, Sercan; Korgan, Mehmet Birkan; Altunci, Yusuf Ali; Yavuzgil, Oguz[No Abstract Available]Öğe Mechanical Thrombectomy With Solitaire Stent in Acute Ischemic Stroke Patients: Our First Experiences(Journal Neurological Sciences, 2014) Guler, Ayse; Cinar, Celal; Oran, Ismail; Sirin, Hadiye; Celebisoy, Nese; Akarca, Funda Karbek; Kiyan, Guclu SelahattinIntroduction: Intravenous thrombolysis or endovascular treatment for occluded vessel in acute ischemic stroke patients reduces mortality and effects prognosis. Mechanical thrombectomy shows better results than intravenous thrombolytic treatment on proximal vessel occlusions. In this study, we aimed to evaluate efficiency of Solitaire stent based mechanical thrombectomy for acute ischemic stroke patients who has proximal vessel occlusion, and its impact on prognosis of these patients. Material and Method: Data of eleven patients, who applied to Ege University Medical School Emergency Department between March 2012 -May 2013 with acute ischemic stroke diagnosis due to proximal vessel occlusion and treated with mechanical thrombectomy collected retrospectively. Inclusion criterias were: 1) Age between 18-80, 2) NIHSS >= 10 at admission, 3) ICA or ASM occlusion found on cranial and neck CT angio, 4) symptom duration <= 6 hours, 5) no contrindication for reperfusion theraphy. Results: Eleven patients treated with mechanical thrombectomy(8female/3male), and mean age of these patients were 59(min34, max 75). The mean symptom to door time was 98 minutes(30-180 minutes). Demographic data, application time, time to treatment, additional treatments, complications, NIHSS at 0 and 24 hour and mRS at discharge were evaluated. Conclusion: The main aim of acute stroke treatment is revascularizaion of occluded vessel as quickly as possible. Intravenous thrombolytic treatment is the standard treatment procedure for acute ischemic stroke. Intraarterial treatment options must be inside of our treatment strategies for the patients with acute ischemic stroke diagnosis and who had proximal vessel occlusion.Öğe The predictive value of biochemical parameters in evaluating patients with abdominal trauma: The new scoring system(Kare Publ, 2017) Musalar, Ekrem; Ersel, Murat; Akarca, Funda Karbek; Kiyan, Guclu Selahattin; Can, OzgeAim: The aim of this study was to investigate the contribution of non-invasively and rapidly obtained biochemical parameter results to the diagnosis and follow-up of intraabdominal injuries in multitrauma patients. Material and Methods: A total of 2604 multitrauma patients who were treated following their referral to our emergency department between January 2009 and January 2012 were retrospectively reviewed. A logistic regression analysis was used in the risk assessment. Results: Statistically significant associations between intraabdominal injury and certain biochemical variables measured at the time of the referral were determined. These variables were hemoglobin <= 9.99 g/dL [odds ratio (OR): 6.25, 95% CI: 2.86-13.52, p < 0.0001], serum alanine amino transferase (ALT) >= 100 IU/L (OR: 34.45, 95% CI: 21.76-54.54, p < 0.0001), and serum lipase >= 61 U/L (OR: 10.44, 95% CI: 6.56-16.49, p < 0.0001). The pretest probability score was determined for each patient by adding the scores that were obtained from each factor. ROC curve analysis was performed to determine the diagnostic value of the pretest probability score for detecting intra-abdominal injury (area = 0.88; p < 0.0001). Conclusion: The results of our study demonstrated that biochemical parameters may contribute to the diagnosis and follow-up of intraabdominal injuries in multitrauma patients. In particular, ALT, AST, CK and myoglobin were found to have higher ORs than low hemoglobin. After these parameters are tested in larger scale studies in conjunction with the gold standard multislice abdominal CT, they may be used for establishing scores to evaluate the severity of abdominal injuries. Copyright (C) 2016 The Emergency Medicine Association of Turkey. Production and hosting by Elsevier B.V. on behalf of the Owner. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).Öğe REPRINT OF: REMEMBER ATROPINE FOR "KILLER B'S" RESPONSE(Elsevier Science Inc, 2020) Yalcinli, Sercan; Kiyan, Guclu Selahattin[No abstract available]Öğe TPH1 A218 allele is associated with suicidal behavior in Turkish population(Elsevier Ireland Ltd, 2016) Beden, Onur; Senol, Ender; Atay, Sevcan; Ak, Handan; Altintoprak, Ayse Ender; Kiyan, Guclu Selahattin; Petin, Buket; Yaman, Utku; Aydin, Hikmet HakanBackground: Serotonergic dysfunction is implicated in depression, psychiatric disorders and suicidal behaviors. The first and rate-limiting step in the synthesis of serotonin is catalyzed by tryptophan hydroxylase (TPH) which is encoded by TPH1 and THP2 genes. Genetic association studies have revealed contradictory results about the effect of the TPH1 A218C (rs1800532) polymorphism on suicidal behavior in different populations. Material and method: In this study, we investigated A218C polymorphism in 109 suicide attempters and 98 healthy controls. Socio-demographic characteristics of participants were obtained through questionnaire. DNA was extracted from peripheral blood and genotyping was performed by Real Time PCR. Fisher's exact test was used to evaluate the significance of the difference among the independent variables. Hardy-Weinberg equilibrium was tested using Pearson's goodness-of-fit chi-squared test. Results: The frequency of A allele was significantly higher in suicide attempters than controls (46.33% vs. 35.71%, p = 0.0357). However, there were no differences in genotype frequencies of this locus between participants having attempted suicide and controls (p > 0.05). Among males, frequencies of CC genotype and C allele were found to be significantly higher in controls (p = 0.0125, p = 0.0298). With regard to the female subjects and female controls, no significant association was detected between suicidal behavior and genotype/allele frequencies (p > 0.05). Conclusion: Our results provide evidence that A allele of TPH1 A218C polymorphism may be associated with suicidal behavior in Turkish population. (C) 2016 Elsevier Ireland Ltd. All rights reserved.
