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Öğe The effect of cannula material on the pain of peripheral intravenous cannulation in the emergency department: A prospective, randomized controlled study(2012) Özsaraç M.; Dolek M.; Sarsilmaz M.; Sever M.; Sener S.; Kiyan S.; Yürüktümen A.; Yilmaz G.Objectives: The present study was undertaken to compare the pain of peripheral IV cannulation (IVC) using a 20-G peripheral biomaterial PEU-Vialon cannula or the 20-G compound FEP-Teflon cannula widely used in clinical practice. Methods: A prospective, randomized, single-blinded, controlled trial was undertaken at the ED of University Hospital. Eighty-nine noncritically ill adult patients who were receiving an IV line as part of their care were enrolled. In each case cannulas were applicated to the antecubital area. Participants rated their pain on a visual analog scale (VAS). The primary outcome was patients pain score, and the secondary outcome was the provider's perception of safety and satisfaction. Results: The two treatment groups did not differ in age, gender or cannulation indication (p>0.05). Mean VAS was 2.80 for PEU and 3.56 for FEP (p=0.061). Mean provider safety scores were 4.84 (4 to 5) in the PEU group and 4.00 (2 to 5) in the FEP group (p=0.0001). Mean provider satisfaction of application scores were 4.65 in the PEU group and 4.56 in the FEP group (p>0.05). Conclusions: Althogh provider safety perception is high, perception of pain has not reduced when inserting PEU-Vialon cannula compared with compound of FEP.Öğe Endobronchial solitary papilloma [Endobronşial soliter papillom](2011) Yildiz F.; Sever M.; Kömüs N.; Uçan E.S.; Sivrikoz O.A sixty-four year old male patient came to the emergency service with a haemoptysis complaint for which his postero-anterior chest X-Ray and computerized thorax tomography had no pathological findings. To find the origin of the haemoptysis, indirect laryngoscopy and endoscopy inspections were made. However, there was no pathology found on these inspections. At fiberoptic bronchoscopy a lobulated, white lesion approximately 0.5 cm in diameter was found at the entrance of left lower lobe anterior segment. The lesion was removed by forceps biopsy resection. The pathological inspection of this lesion resulted in a diagnosis of endobronchial papilloma. Examination of this biopsy with HPV DNA gave negative result. To plan his treatment, we examined the patient 2 weeks and 6 months later. He had no complaint and his bronchoscopic inspection had no pathological findings. We decided to examine him periodically. The endobronchial solitary papilloma is a rare benign tumor of the bronchus but we must be careful about smokers since this benign lesion may become malignanat.Öğe An evaluation of the pediatric medico-legal admissions to a tertiary hospital emergency department [Bir üçüncü basamak hastane acil servisine başvuran adli nitelikli çocuk hastalari{dotless}n degerlendirilmesi](2010) Sever M.; Saz E.U.; Koşargelir M.BACKGROUND: This study aimed to determine the demographic and epidemiological characteristics and to investigate the outcomes of pediatric medico-legal cases who admitted to the emergency department. It was also aimed to contribute to the national survey. METHODS: Medico-legal charts of the pediatric cases were reviewed retrospectively. Patients were allocated into two groups as traumatic (Group 1) and non-traumatic (Group 2). Age, sex, presenting complaint and frequencies, local or multiple trauma frequencies, and localizations (based on the Abbreviated Injury Scale) and also admission, discharge and mortality rates were ascertained. Data were evaluated by descriptive methods, Kolmogorov-Smirnov and chi-square tests. Values of p<0.05 were accepted as significant. RESULTS: There were a total of 486 eligible patients. The mean age was 8.91±5.08 years (95% confidence interval [CI]). The majority (66.3%) were male. The group aged 5-9 years was larger (33.3%) than the others (in Kolmogorov-Smirnov test, p=0.000). Summer was the most common season for admissions. There were 153 patients in Group 1, and the most common complaint was accidental drug intake (13.8%). In Group 2, the most common reason for admission was motor vehicle accident (32.5%).CONCLUSION: Motor vehicle and home accidents in childhood are preventable health problems. To ensure a safe environment, continuous health education programs on injury and prevention for parents and children and legal controls will be effective in injury control.Öğe Familial mediterranean fever with pulmonary manifestations alone; early diagnosis with genetic analysis [Yalni{dotless}z pulmoner bulgulari{dotless} olan ailesel Akdeniz ateşi; genetik analizle erken tani{dotless}](Ankara University, 2012) Sever F.; Sever M.; Sanal S.; Yalçin M.; Berdeli A.Painful pleural effusion and fever are the only presenting clinical features in 5-10% of patients with familial Mediterranean fever (FMF). We report the results of genetic analysis that have confirmed the diagnosis of FMF in six patients who presented with fever and pleuritic pain alone. At time of presentation, all six patients received antibiotic treatment for suspected infectious etiology following routine laboratory and microbiologic evaluation. Gene analysis was performed when other diagnostic studies had failed to uncover the etiology and patients did not respond to conventional treatment. Mutation analysis for MEFV gene performed from genomic DNA by the direct DNA sequence method. Half of the patients were male. Five were older than 50, one was 33 years old. All of the patients had fever and pleuritic pain; none had the typical abdominal symptoms. Erythrocyte sedimentation rates and C-reactive protein levels were high. Pericardial effusion was discovered in three patients. Genetic analysis confirmed; R202Q/R202R, E148V/E148E, R314R, E474E, Q476Q, D510D, E148Q/E148E heterozygote polymorphisms with and M694V/M694V mutations were determined on the MEFV gene. In five patients an improvement has been observed with colchicine therapy. In one patient steroid treatment was needed because of no response to colchicine and clinical deterioration. Rapid improvement was observed in this case with steroid therapy. But after cessation of steroid therapy new flare developed that responded to new colchicine therapy. In patients who present with pleuritic chest pain and fever without an identifiable etiology, genetic analysis help making the diagnosis of FMF, especially in certain ethnic populations where FMF is relevant. This should help patients receive specific treatment without unnecessary delay. Thus, by making early diagnosis and timely delivery of treatment, disease progression is delayed and development of secondary amyloidosis avoided.Öğe Fears of fever and fever management in Turkish families [Türk ailelerinin ateş yönetimi i·le i·lgili bilinç düzeyi ve korkulari](2009) Saz E.U.; Koturoglu G.; Duyu M.; Ozananar Y.; Kurugöl Z.; Sever M.Objective: Fever is one of the most common reasons for parents to bring their children to the emergency departments. Most parents believe that fever is not a sign of illness, they have numerous misconceptions about it as well as its management.The objectives of this study were to explore knowledge and management of childhood fever and to evaluate factors associated with correctly identifying a temperature which is within the normal range and one which is a fever. Methods: Between January and July 2008, a crosssectional 30-item questionnaire was distributed to caregivers whose children were enrolled in an urban hospital-based pediatric clinic in Ege University Hosoital, Izmir. This questionnaire was conducted in a division of the emergency and ambulatory pediatrics department of Ege University School of Medicine. We included all parents who approached for examination regardless of the chief complaint. All parents were asked about definition of fever, concerns about fever, and fever management. Additional information including home fever reduction techniques, frequency of temperature monitoring was also sought. Results: A total of 200 parents agreed to join the study and were interviewed. Approximately half of the participitants had completed highschool and college. Of the parents surveyed, 85%stated that they owned a thermometer and 70%preferred the axillarymethod of temperature measurement. Forty precent of caregivers believed their children had a fever if the temperature was between 30-37 C and half of them would give medicines for management. According to 73%of responders, if the fever remained untreated febrile seizure, %18 brain damage could occur. For 45%of caregivers the 1st choice of medicine was acetaminophen, and ibuprofen for 40%. Conclusion: This study demonstrates that numerous misconceptions exist regarding fever and its role in illness among well educated caregivers. Providing parents with a thermometer and educating them about its proper use may lead to an increase in appropriate monitoring and medical treatment of the febrile child.Öğe Macleod syndrome accompanied by right middle lobe agenesis [Sag orta lob agenezisi ile birlikte olan Macleod sendromu](2010) Yildiz F.; Sever M.; Kömüs N.; Öncel D.; Yalçin M.; Özyurt Ö.A 70-year-old female patient was admitted to the hospital with complaints of dyspnea on exertion, fatigue, weight loss and palpitation lasting for one year but accentuated in the previous month. The radiological examinations revealed right middle lobe agenesis along with Macleod syndrome localized at the right inferior lobe. Macleod syndrome is a rare disease but the localization at the right inferior lobe accompanying a right middle lobe agenesis is even rarer. We present this case with an overview of the literature.Öğe Massive carbamazepine overdose: Any role of hemodialysis?: Case report [İleri derecedeki karbamazepin doz aşi{dotless}mlari{dotless}nda hemodiyaliz uygulanmali{dotless} mi{dotless}?](Turkiye Klinikleri, 2011) Özsaraç M.; Sever M.; Gökova S.; Ersel M.; Seziş M.Massive carbamazepine (CBZ) overdose is associated with life-threatening hemody- namic complications that present challenges for clinicians. We describe the highest-reported dose of CBZ intoxication in a patient who survived and discuss early hemodialysis option in a CBZ-poisoned patient. Although hemodialysis is reported to increase the elimination of CBZ despite its partiall effectiveness due to the poor water-solubility of CBZ, massive CBZ overdose can induce an acute renal failure and renal function should be monitored closely, and the data obtained from this case that standard low-flux HD might be used and is effective in the management of acute CBZ overdose in patients with associated electrolyte disorders and acute renal failure. © 2011 by Türkiye Klinikleri.
