42 results on '"Karbek Akarca, Funda"'
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2. Comparison of non-COVID-19 critically ill patients between pre-pandemic and pandemic period admitted from emergency department to internal medicine intensive care unit
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KILINÇER BOZGÜL, Şükriye Miray, primary, KURTULMUŞ, İlkçe Akgün, additional, YARGUCU, Figen, additional, YİLMAZ, Mümtaz, additional, KARBEK AKARCA, Funda, additional, AYDOGAN, Deniz Can, additional, ÖZKILIÇ, Barış, additional, İSLAMOĞLU, Karya, additional, AK, Güneş, additional, ÇİLLİ, Fatma Feriha, additional, and BOZKURT, Devrim, additional
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- 2024
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3. EMS’DE HEMORAJİK TRAVMA OLGULARINDA ŞOK İNDEXİNİN SIVI TEDAVİSİNDE BELİRLEYİCİ ROLÜ: RETROSPEKTİF BİR ÇALIŞMA
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EKŞİ, Ali, primary, GÜMÜŞSOY, Süreyya, additional, ALTUNCI, Yusuf Ali, additional, and KARBEK AKARCA, Funda, additional
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- 2023
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4. Impact of the Empirical Therapy Timing On The Clinical Progress of Septic Shock Patients
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Akyol, Deniz, primary, Çankayalı, İlkin, additional, Ersel, Murat, additional, Demirağ, Kubilay, additional, Uyar, Mehmet, additional, Can, Özge, additional, Özçete, Enver, additional, Karbek-Akarca, Funda, additional, Yağdı, Tahir, additional, Engin, Çağatay, additional, Özgiray, Erkin, additional, Yurtseven, Taşkın, additional, Yağmur, Burcu, additional, Nalbantgil, Sanem, additional, Ekren, Pervin, additional, Bozkurt, Devrim, additional, Şirin, Hadiye, additional, Çilli, Feriha, additional, Sezer, Ebru Demirel, additional, Taşbakan, Meltem, additional, Yamazhan, Tansu, additional, Pullukçu, Hüsnü, additional, Sipahi, Hilal, additional, Arda, Bilgin, additional, Ulusoy, Sercan, additional, and Sipahi, Oğuz Reşat, additional
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- 2023
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5. Evaluation of the Retrospective LACE Index in Predicting the Risk of Readmission in Patients with Hereditary Angioedema in an Emergency Department
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Songur Kodik, Meltem, primary, Inci, Ozlem, additional, Çetin, Zeynep Dila, additional, Mete Gokmen, Emine Nihal, additional, and Karbek Akarca, Funda, additional
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- 2023
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6. COMPARISON OF CLINICAL FRAILTY SCALE AND EDMONTON FRAIL SCALE IN OLDER ADULTS PRESENTING TO THE EMERGENCY DEPARTMENT.
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YÜCEL, Mustafa, ALTUNCI, Yusuf Ali, ÖZÇETE, Enver, KILAVUZ, Asli, and KARBEK AKARCA, Funda
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HOSPITAL emergency services ,FRAILTY ,INTENSIVE care units ,ADULTS ,PROGNOSIS - Abstract
Introduction: This study aimed to compare the prognostic values of Edmonton Frail Scale and Clinical Frailty Scale in the emergency department and determine their suitability for patient management. Materials and Method: This study was conducted as a single-center prospective observational study. Patients aged 65 and older who presented to the emergency department were included. Clinical Frailty Scale and Edmonton Frail Scale scores, the emergency department outcomes, length of stay in the emergency department, 30-day mortality, and 30-day readmission data of the patients were recorded. ROC analysis was performed to examine the predictive values on outcomes. DeLong Test was used to compare the predictive values. Results: This study included 400 patients. Intensive care unit admission was significantly more frequent in the frail group according to both Edmonton Frail Scale and Clinical Frailty Scale. The length of stay in the emergency department was significantly longer in the frail group in both classifications. The mortality rate was significantly higher in the frail group in both classifications. The optimal cut off value for predicting mortality was found to be 9 for Edmonton Frail Scale and 7 for Clinical Frailty Scale. There was no significant difference between the predictive values of two scales. Conclusion: We found that two frail scales have good predictive values for adverse outcomes, such as mortality and the need for Intensive care unit admission in the emergency department. We believe that both scores would be valuable in guiding decisions for the emergency department usage due to their similar predictive values. [ABSTRACT FROM AUTHOR]
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- 2024
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7. The diagnostic accuracy of ultrasonography in determining the reduction success of distal radius fractures
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Bozkurt, Ozgur, Ersel, Murat, Karbek Akarca, Funda, Yalcinli, Sercan, Midik, Sadiye, and Kucuk, Levent
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- 2018
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8. Emergency Medicine Association of Turkey Disaster Committee Summary of Field Observations of February 6th Kahramanmaraş Earthquakes
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Yılmaz, Sarper, primary, Karakayali, Onur, additional, Yilmaz, Serkan, additional, Çetin, Murat, additional, Eroglu, Serkan Emre, additional, Dikme, Ozgur, additional, Özhasenekler, Ayhan, additional, Orak, Murat, additional, Yavaşi, Özcan, additional, Karbek Akarca, Funda, additional, Günalp Eneyli, Müge, additional, Erbil, Bülent, additional, and Akoğlu, Haldun, additional
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- 2023
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9. COVID-19 Pandemi Döneminde Yetişkin Hastada İleri Kardiyak Yaşam Desteği Uygulamalarındaki Değişiklikler
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ÇELİKTÜRK, Nihal, primary, DEMİR KORKMAZ, Fatma, additional, and KARBEK AKARCA, Funda, additional
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- 2023
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10. Innovatif Approaches to Medicine, Nursing and Health Sciences Dynamics and Changes
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Karbek Akarca , Funda; Ege Üniversitesi, Konakçı, Gülbin; İzmir Demokrasi Üniversitesi, Karbek Akarca , Funda; Ege Üniversitesi, and Konakçı, Gülbin; İzmir Demokrasi Üniversitesi
- Abstract
Although globalization causes the rapid development of technology and the increase in knowledge transfer worldwide, developments in the field of health are also important in terms of contributing to improving the quality of life by reducing both survival and disability, especially in emergencies. The care management models to be used in the new health understanding, in which holistic care and preventive health services are prioritized, have also taken their place as the areas that interact the most with technological developments. This book aims to contribute to the updating of our knowledge by bringing together recent research, compilations, reviews, criticisms and innovations in the field of health sciences. I would like to thank all the authors who contributed to the preparation of this book., Küreselleşme teknolojinin hızla gelişmesine ve dünya genelinde bilgi transferinin artışına neden olmakla birlikte, sağlık alanındaki gelişmeler, özellikle acil gelişen durumlarda hem yaşatma hem de sakatlığın azaltılması ile yaşamın kalitesini artırmaya katkısı açısından ayrıca önemlidir. Holistik bakım ve koruyucu sağlık hizmetlerinin ön planda tutulduğu yeni sağlık anlayışında kullanılacak bakım yönetim modelleri de teknolojik gelişmelerle en fazla etkileşimde bulunan alanlar olarak yerini almıştır. Bu kitap, son dönemlerde sağlık bilimleri alanında yapılan araştırmaları, derlemeleri, incelemeleri, eleştirileri ve yenilikleri bir araya getirerek, bilgilerimizin güncellenmesine katkı sağlamayı amaçlamaktadır. Bu kitabın hazırlanmasında emeği geçen tüm yazarlara teşekkür ediyorum.
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- 2023
11. Evaluation of optic nerve sheath diameter in the management of patients with traumatic brain injury in emergency department
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CAN, Özge, primary, ERSEL, Murat, additional, YALÇINLI, Sercan, additional, and KARBEK AKARCA, Funda, additional
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- 2023
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12. Treatment of Amlodipine Intoxication with Intravenous Lipid Emulsion Therapy: A Case Report and Review of the Literature
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Karbek Akarca, Funda, Akceylan, Ece, and Kıyan, Selahattin
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- 2017
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13. Retrospective Analyses of the Utility of Glasgow-Blatchford and Rockall and Pre-Rockall Scoring Systems in Patients Admitted to the Emergency Department with Upper Gastrointestinal System Bleeding
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GÖKÇEK, Kemal, primary, ERSEL, Murat, additional, ALTUNCI, Yusuf Ali, additional, KARBEK AKARCA, Funda, additional, and KIYAN, Selahattin, additional
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- 2022
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14. Tüm Yönleriyle Acil Tıp
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Atilla, Rıdvan, additional, Özel, Gürkan, additional, Tanır, Ferdi, additional, Ersel, Murat, additional, Karcıoğlu, Özgür, additional, Aslan, Şahin, additional, Yaylacı, Serpil, additional, Gökcan Çakır, Zeynep, additional, Kıyan, Selahattin, additional, Avşaroğulları, Levent, additional, Şener, Serkan, additional, Ünverir, Pınar, additional, Yalınız, Hafize, additional, Serinken, Mustafa, additional, Bozkurt, Seyran, additional, Ayrık, Cüneyt, additional, Kuleci, Sedat, additional, Ersoy, Gürkan, additional, Kavalcı, Cemil, additional, Uyanık, Bünyamin, additional, Solak, Yalçın, additional, Emet, Mücahit, additional, Arslan, Engin Deniz, additional, Yılmaz, Fevzi, additional, Durdu, Tamer, additional, Türkyılmaz, Atilla, additional, Toprak, Nihal, additional, Kahveci, F. Ozan, additional, Paydaş, Saime, additional, Yılmaz, Mustafa, additional, Kekeç, Zeynep, additional, Kozacı, Nalan, additional, Paydaş, Semra, additional, Uzun, Belkan, additional, Gürkan, Emel, additional, Yavuz, Sinan, additional, Taşova, Yeşim, additional, Yücel, Murat, additional, Çebiçci, Hüseyin, additional, Günay, Nurullah, additional, Okumuş, Mehmet, additional, Kurtaran, Behice, additional, Candevir, Aslıhan, additional, Vural, Sevilay, additional, Coşkun, Figen, additional, Pekdemir, Murat, additional, Topaçoğlu, Hakan, additional, Kaplan, Onur, additional, Özlü, Ferda, additional, Yapıcıoğlu Yıldızdaş, Hacer, additional, Yılmaz, Hayri Levent, additional, Karaböcüoğlu, Metin, additional, Güzel, Ahmet, additional, Özdemir, Durgül, additional, Duman, Murat, additional, Kalkan, Gökhan, additional, Koturoğlu, Güldane, additional, Derinöz, Okşan, additional, Asilsoy, Suna, additional, Yıldızdaş, Dinçer, additional, Yılmaz, Resul, additional, User, Neşe Nur, additional, Akköse Aydın, Şule, additional, Bulut, Mehtap, additional, Denizbaşı, Arzu, additional, Parlak, İsmet, additional, Parlak, Mine, additional, Duru, Mehmet, additional, Bozdemir, Nuri, additional, Çolak Oray, Neşe, additional, Hocaoğlu Aksay, Nil, additional, Kalkan, Şule, additional, Arıcı, Aylin, additional, Baydın, Ahmet, additional, Erenler, Ali Kemal, additional, Onur, Özge, additional, E. Onur, Özge, additional, Gündüz, Abdulkadir, additional, Duman Atilla, Özge, additional, Yavuz, Yücel, additional, Yıldırım, Cuma, additional, Karakuş, Ali, additional, Özkan, Seda, additional, Akdur, Okhan, additional, Türedi, Süleyman, additional, Sarpel, Tuncay, additional, Hilal, Ahmet, additional, Koç, Filiz, additional, Yerdelen, Deniz, additional, Öner, Ayşe, additional, Keleş, Ayfer, additional, Ertan, Cem, additional, Kapçı, Mücahit, additional, Şadıllıoğlu, Sıla, additional, Ünlüler, Erol, additional, Şentürk, Güldehan, additional, Karbek Akarca, Funda, additional, Çevik, Arif Alper, additional, Gülalp, Betül, additional, Özdemir, Atilla Özcan, additional, Koç, Zafer, additional, Çakır Peköz, Burak, additional, Büyükdereli, Gülgün, additional, Uğur, Murat, additional, Değerli, Vermi, additional, Aksay, Ersin, additional, and Türkmen, Süha, additional
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- 2022
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15. Retrospective Evaluation of Patients with Angioedema Treated with C1 Inhibitors in an Emergency Department
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Yalçınlı, Sercan, primary, Kıyan, Selahattin, additional, and Karbek Akarca, Funda, additional
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- 2022
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16. Increased Mortality with Co-existence of Crimean Congo Hemorrhagic Fever and COVID-19
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Elik, Dilşah Başkol, primary, Oruç, Nevin, additional, Güler, Ezgi, additional, Erdem, Hüseyin Aytaç, additional, Karbek Akarca, Funda, additional, Sipahi, Oğuz Reşat, additional, Özütemiz, Ahmet Ömer, additional, Pullukçu, Hüsnü, additional, Taşbakan, Meltem, additional, Çiçek, Candan, additional, and Yamazhan, Tansu, additional
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- 2022
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17. Retrospective Evaluation of the Frequency of Acute Pancreatitis in Adult Hospitalized Patients with COVID-19 Infection
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Başkol Elik, Dilşah, primary, Oruç, Nevin, additional, Güler, Ezgi, additional, Erdem, Hüseyin Aytaç, additional, Karbek Akarca, Funda, additional, Sipahi, Oğuz Reşat, additional, Özütemiz, Ahmet Ömer, additional, Pullukçu, Hüsnü, additional, Taşbakan, Meltem, additional, Çiçek, Candan, additional, and Yamazhan, Tansu, additional
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- 2022
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18. Acil Serviste Pulmoner Emboli Tanısı Alan Hastalarda Laktat ve Laktat Klerensinin Mortalite Üzerine Etkisinin Retrospektif Değerlendirilmesi
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ÖZÇETE, Enver, primary, UZ, İlhan, additional, ALTUNTAŞ, Simge, additional, KARAN, Damla, additional, and KARBEK AKARCA, Funda, additional
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- 2022
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19. Acil serviste tıbbi sosyal hizmet müdahalesi gereksinimi olan hastaların retrospektif değerlendirilmesi
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YALÇINLI, Sercan, primary, KARBEK AKARCA, Funda, additional, and YERDELEN, Berna, additional
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- 2021
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20. Comparison of Standard Technique, Ultrasonography, and Near-Infrared Light in Difficult Peripheral Vascular Access: A Randomized Controlled Trial
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Yalçınlı, Sercan, primary, Karbek Akarca, Funda, additional, Can, Özge, additional, Uz, İlhan, additional, and Konakçı, Gülbin, additional
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- 2021
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21. Bir Üniversite Hastanesinde COVID-19 Pandemisinin İlk Yılında Laboratuvarda Doğrulanmış Pozitif Olguların Özellikleri
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Çiçek, Candan, primary, Soylu, Mehmet, additional, Özarslan, Muhammed Alper, additional, Mert, Merve, additional, Başkır, Mükerrem Bahar, additional, Sertöz, Şaziya Rüçhan, additional, Zeytinoğlu, Ayşin, additional, Karbek Akarca, Funda, additional, Ersel, Murat, additional, Ulaş Saz, Eylem, additional, Taşbakan, Meltem, additional, Pullukçu, Hüsnü, additional, Taşbakan, Mehmet Sezai, additional, Ersayoğlu, İrem, additional, Çankayalı, İlkin, additional, Aydoğan, Tansu Gülbahar, additional, Polat, Furkan, additional, Aydın Uysal, Ayça, additional, Akkul, Betül, additional, Akkuş, Gözde, additional, Şahin, İrem Nur, additional, and Noyan, Ayşe, additional
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- 2021
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22. COVID-19 enfeksiyonu ilişkili pandemi döneminde Ege Üniversitesi Tıp Fakültesi Hastanesi Acil Servisi’ne başvuran hastane dışı kardiyak arrest vakalarının retrospektif değerlendirilmesi
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YALÇINLI, Sercan, primary, ERSEL, Murat, additional, KIYAN, Güçlü Selahattin, additional, KARBEK AKARCA, Funda, additional, ALTUNC, Yusuf Ali I, additional, UZ, İlhan, additional, ÖZÇETE, Enver, additional, SONGÜR KODİK, Meltem, additional, and CAN, Özge, additional
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- 2021
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23. Diagnostic Accuracy of Early Systolic Notching in Pulmonary Embolism
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Aslaner, Mehmet Ali, primary, Karbek Akarca, Funda, additional, Aksu, Şakir Hakan, additional, Yazla, Merve, additional, Can, Özge, additional, Kuş, Görkem, additional, Çelik, Ali, additional, Özkan, Selçuk, additional, İbze, Süleyman, additional, Yamanoğlu, Adnan, additional, Yazıcı, Mümin Murat, additional, Yürüktümen Ünal, Aslıhan, additional, and Demircan, Ahmet, additional
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- 2021
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24. Diagnostic Accuracy of Early Systolic Notching in Pulmonary Embolism.
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Aslaner, Mehmet Ali, Karbek Akarca, Funda, Aksu, Şakir Hakan, Yazla, Merve, Can, Özge, Kuş, Görkem, Çelik, Ali, Özkan, Selçuk, İbze, Süleyman, Yamanoğlu, Adnan, Yazıcı, Mümin Murat, Yürüktümen Ünal, Aslıhan, and Demircan, Ahmet
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PULMONARY embolism ,EMERGENCY physicians ,DOPPLER echocardiography ,COMPUTED tomography ,ECHOCARDIOGRAPHY ,DIAGNOSIS methods ,HOSPITAL emergency services - Abstract
Objective: Recently, a cardiac sonography finding, early systolic notching (ESN), was reported with high sensitivity and specificity for the diagnosis of pulmonary embolism (PE) in a limited population. The aim of this study was to determine the diagnostic accuracy of ESN finding for PE in emergency department (ED) patients. Method: This prospective multicenter study was conducted in 4 academic EDs. All patients who underwent computed tomography angiography for suspected PE were included in the study. After inclusion, cardiac ultrasound including the right ventricular outflow tract Doppler signal was performed. The diagnostic tests of ESN finding were used for PE and its subgroups. Results: In the study, 183 of 201 patients met the study criteria. Of all patients, 52.5% had PE (n = 96), and 19.7% (n = 36) had ESN finding. In all ED patients, the sensitivity of ESN for PE was 34% (95% CI 25–45), and the specificity was 97% (95% CI 90–99). In the subgroup analysis, the sensitivity of ESN for PE with high or intermediate‐high risk was 69% (95% CI 49–85), and the specificity was 90% (95% CI 84–94). Inter‐rater reliability for ESN finding between the cardiologist and emergency physician was strong with a kappa statistic of 0.87. Conclusion: The pulmonary Doppler flow of ESN was moderate to high specific but low sensitive for PE in all ED patients. In the subgroup analysis, this finding was moderate specific and low sensitive. [ABSTRACT FROM AUTHOR]
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- 2022
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25. Comparison of Standard Technique, Ultrasonography, and Near-Infrared Light in Difficult Peripheral Vascular Access: A Randomized Controlled Trial.
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Yalçınlı, Sercan, Karbek Akarca, Funda, Can, Özge, Uz, İlhan, and Konakçı, Gülbin
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NEAR infrared radiation ,RANDOMIZED controlled trials ,ULTRASONIC imaging ,ARTERIAL catheterization - Abstract
Objectives: Successful placement of a peripheral intravenous catheter (PIVC) on the first attempt is an important outcome for difficult vascular access (DVA) patients. This study compared standard technique, ultrasonography (USG), and near-infrared light (NIR) in terms of success in the first attempt in patients with DVA. Methods: This was a prospective, randomized controlled study. The study was conducted in a tertiary care hospital. Emergency department patients who describe DVA history, have no visible or palpable veins, and were assessed by the nurse to have a difficult PIVC were included to study. The PIVC procedure was performed on patients by standard, USG, or NIR device techniques. For all approaches, the success of the first attempt was the primary aim. Total procedure time, the total number of attempts, and the need for rescue intervention were secondary aims. Results: This study evaluated 270 patients. The first attempt success rates for USG, standard, and NIR methods were 78.9%, 62.2%, and 58.9%, respectively. The rate of first attempt success was higher in patients who underwent USG (USG versus standard, P =.014; USG versus NIR, P =.004; standard versus NIR, P =.648). The total median (IQR) procedure time for USG, standard, and NIR methods was 107 (69-228), 72 (47-134), and 82 (61-163) seconds, respectively. The total procedure time was longer in patients undergoing USG (standard versus USG, P <.001; NIR versus USG, P =.035; standard versus NIR, P =.055). The total median (IQR) number of attempts of USG, standard, and NIR methods were 1 (1-1), 1 (1-2), and 1 (1-2), respectively. A difference was found among the groups regarding the total number of attempts (USG versus NIR, P =.015; USG versus standard P =.108; standard versus NIR, P =.307). No difference was found among groups in terms of the need for rescue methods. Conclusion: It was found that USG increases the success of the first attempt compared with the standard method and NIR in patients with DVA. [ABSTRACT FROM AUTHOR]
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- 2022
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26. Point-of-Care Emergency Ultrasonography in Non-Traumatic Cardiac Arrest and Near-Arrest Emergency Patients; A Pilot Trial
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Gulalp, Betul, primary, Evrin, Togay, additional, Karbek Akarca, Funda, additional, Yuruktumen Unal, Aslıhan, additional, Sabak, Mustafa, additional, Akbuga Ozel, Betul, additional, Canakcı, Mustafa Emin, additional, Acar Ergun, Nurdan, additional, Karagun, Ozlem, additional, Tasın, Veyis, additional, and Yesilagac, Hasan, additional
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- 2020
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27. Acil Servis Stajı Sırasında İntörn Doktorların Temel ve İleri Yaşam Desteği Becerilerinin Değerlendirilmesi
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ÖZÇETE, Enver, UZ, İlhan, and KARBEK AKARCA, Funda
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Basic life support,Advanced Cardiac Life Support,Emergency Department ,education ,Temel Yaşam Desteği,İleri Yaşam Desteği,Acil Servis - Abstract
AmaçTıp fakültesi eğitiminde öğrencilerin CPR eğitimi sırasında, kardiyak arresti etkili bir şekilde tedavi etmeye hazırlamak için CPR öğrenme deneyimini optimize etmek önemlidir. Çalışmamızın amacı intörn doktorlarda CPR eğitimimizinetkinliğini değerlendirmek ve kalitesini arttırmaktır.Gereç ve YöntemProspektif olarak 2017 - 2018 tarihleri arasında Acil Servis Stajında CPR eğitimi alan, Pre-Post testi cevaplayan intörn doktorların test skorları karşılaştırıldı. İntörn doktorlara Acil stajına başladıkları ilk gün bilgilendirme toplantısı sırasında önceden hazırlanmış sorularla pre-test ve eğitim sonrası aynı sorularla post-test yapılarak, eğitim kalitesi ve CPR bilgi düzeyleri ve değişimi değerlendirildi.BulgularÇalışma süresince 185 intörn pre-test, 128 intörn post-test ile değerlendirildi. 57 intörn doktor derse katılmadıkları ya da post testi cevaplamadıkları için değerlendirilmeye alınmadı. Eğitim sonrası başarı oranı temel-ileri yaşam desteği, taşikardi-bradikardi ve toplam değerlendirmede belirgin olarak arttı. Bu bölümler içinde en fazla başarı değişimi ileri yaşam desteği sorularında en az başarı değişimi taşikardi-bradikardi sorularında idi.Sonuçİntörn doktorlarda temel ve ileri yaşam desteği konusunda 3 saat didaktik ve 1 saat simüle senaryo manken eşliğinde eğitimimiz etkindir., AimIt is important to optimize CPR training so that medical students become capable of treating cardiac arrest effectively. CPR training program and to improve the quality of CPR training among 6th-year medical students.Material and MethodsIn this study, the pre-and post-test scores of 6th-year medical students who received CPR training during emergency medicine clerkship between the years 2017 and 2018 were compared prospectively. The students completed the pre-test during the information meeting held on the first day of the clerkship. At the end of the training course, the students took the post-test which was identical to the pre-test. The pre-test and post-test results were compared to evaluate the improvement in the CPR skills of the students and the quality of the CPR trainingResultsDuring the study, 185 participants took the pre-test and 128 participants took the post-test. Fifty-seven participants who failed to attend the course or the post-test were excluded. After the course, the success rates increased significantly in the Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS), and arrhythmia management sections and in the overall evaluation. Among these, the most significant increase in success was in the ACLS section and the least significant increase was in the arrhythmia management section.ConclusionThe BLS-ACLS course we provided to 6th-year medical students, which consisted of 3-hours of didactic training and 1- hour of scenario-based simulation training, was shown to be effective.
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- 2019
28. Pediatric cardiac arrest in the emergency department: Outcome is related to the time of admission
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Yurtseven, Ali, primary, Turan, Caner, primary, Karbek Akarca, Funda, primary, and Saz, Eylem Ulaş, primary
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- 2019
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29. Clinical and video head impulse test in the diagnosis of posterior circulation stroke presenting as acute vestibular syndrome in the emergency department
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Guler, Ayse, primary, Karbek Akarca, Funda, additional, Eraslan, Cenk, additional, Tarhan, Ceyda, additional, Bilgen, Cem, additional, Kirazli, Tayfun, additional, and Celebisoy, Nese, additional
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- 2017
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30. Effects of Silk Sericin on Incision Wound Healing in a Dorsal Skin Flap Wound Healing Rat Model
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Ersel, Murat, primary, Uyanikgil, Yigit, additional, Karbek Akarca, Funda, additional, Ozcete, Enver, additional, Altunci, Yusuf Ali, additional, Karabey, Fatih, additional, Cavucoglu, Turker, additional, Meral, Ayfer, additional, Yigitturk, Gurkan, additional, and Oyku Cetin, Emel, additional
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- 2016
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31. CAN BARTHEL INDEX PREDICT MORTALITY IN GERIATRIC PATIENTS ADMITTED TO THE EMERGENCY DEPARTMENT WITH A HIGH FEVER?
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YALÇINLI, Sercan, ERSEL, Murat, KARBEK AKARCA, Funda, CAN, Özge, and MİDİK, Sadiye
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OLDER patients ,EMERGENCY medical services ,BARTHEL Index ,FEVER ,PROGNOSIS ,MEDICAL care - Abstract
Copyright of Turkish Journal of Geriatrics / Türk Geriatri Dergisi is the property of Turkish Geriatrics Society and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2015
32. Analgesic treatment in patients with acute extremity trauma and effect of training
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Karbek Akarca, Funda, primary, Karcioglu, Ozgur, additional, Korkmaz, Tanzer, additional, Erbil, Bulent, additional, and Demir, Omer Faruk, additional
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- 2012
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33. Disseminated Leptomeningeal Carcinomatosis; Presenting With Cauda Equina-conus Syndrome
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Sarsilmaz, Aysegul, primary, Apaydin, Melda, additional, Varer, Makbule, additional, Uluc, Engin, additional, Degerli, Vermi, additional, and Karbek Akarca, Funda, additional
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- 2009
- Full Text
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34. The Impacts of Using Cardiac Ultrasonography in the Emergency Department (ED) for Clinical Decision-Making: Two Case Reports.
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Yürüktümen, Aslýhan, Karbek Akarca, Funda, Uz, Ýlhan, Kýyan, Selahattin, and Musalar, Ekrem
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- *
HEART diseases , *ULTRASONIC imaging , *EMERGENCY medical services , *DISEASES in older people , *VASCULAR surgery - Abstract
Bedside cardiac ultrasonography in emergency departments (ED) is used frequently, with the name of Focused Cardiac Ultra-sound (FOCUS) for certain indications. A 72 year old man with congestive heart failure, coronary artery disease and atrial fibrillation presented to the ED with the chief complaint of dyspnoea. Pulmonary hyertension and a left ventricular ejection fraction of 35-40% was determined by echocardiography one month previously. The emergency physician applied bedside FOCUS to the patient who was diagnosed to have pulmonary oedema after examination and chest x-ray. The patient was hospitalised as global hypokinaesia and a new atrial thrombus was determined. A 55 year old patient presented to the ED with soft tissue sarcoma in his left arm and leg. He had left hemiparaesis and pulses were not palpable in the right upper extremity. The head computerised tomography (CT) was normal. In the bedside ultrasonography, an aortic thrombus was determined. In the latter examination by computed tomographic pulmonary angiography and formal doppler evaluation, complete thrombus at the right subclavian artery and at the arteries of right upper extremity were detected with signs that were indicative of thrombus in the intracranial part of right internal carotid artery. The patient was hospitalised within the plan of peripheral vascular surgery. Dyspnoea is a well known indication for FOCUS. However, the use of bedside cardiac ultrasonography with patient-based decision can contribute to safe and fast service delivery in ED as in the second case. Thus, the wider use of FOCUS can be indicated in the future. [ABSTRACT FROM AUTHOR]
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- 2013
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35. Akut iskemik İnmeli Olgularda Solitaire Stent ile Mekanik Trombektomi: İlk Deneyimlerimiz.
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Güler, Ayşe, Çınar, Celal, Oran, İsmail, Şirin, Hadiye, Çelebisoy, Neşe, Karbek Akarca, Funda, and Selahattin Kıyan, Güçlü
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- *
STROKE treatment , *SURGICAL stents , *THROMBOLYTIC therapy , *INTRAVENOUS therapy , *MORTALITY , *REVASCULARIZATION (Surgery) - Abstract
Introduction: 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. İnclusion 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. [ABSTRACT FROM AUTHOR]
- Published
- 2014
36. Acil servise kalp yetmezliği bulguları ile gelen hastaların tanı ve tedavisinde düzeltilmiş karotis akım zamanı ve vena kava indeksin etkinliği
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Efe, Mehmet, Karbek Akarca, Funda, and Acil Tıp Anabilim Dalı
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İlk ve Acil Yardım ,Heart failure ,Emergency and First Aid - Abstract
Amaç: Kalp yetmezliği(KY) ile acil servise başvuran hastaların volüm durumunun ve tedavi yanıtlarının değerlendirilmesinde İnferior vena kava kolapsibilite indeksinin (İVKKİ) ve düzeltilmiş karotis akım zamanının (FTc) karşılaştırılmasıdır. Burada elde edilecek veriler daha kolay uygulanabilen yeni bir yöntemin KY hastalarının tanı ve takip sürecinde de kullanılmasını sağlayabilir. Gereç ve Yöntem: Bu araştırma prospektif, gözlemsel, analitik çalışma olarak tasarlandı. Çalışma için Ege Üniversitesi Girişimsel Olmayan Araştırmalar Etik Kurulundan alınan izin ile Eylül 2018 – Şubat 2019 tarihleri arasında Ege Üniversitesi, Acil Servis Kliniğine Dekompanze KY ön tanısı ile başvuran 125 hasta çalışmaya alınmıştır.Hastalara ait yaş, cinsiyet, acil servise başvuru şikayetleri, eşlik eden komorbid hastalıklar, kullandığı kardiyak ilaçlar, vitalller kaydedildikten sonra acil servis hekimi tarafından fizik muayeneleri (ral,PTÖ,JVD) ve yatak başı ultrasonografi (USG) ile inferior vena kava (İVK) çapları, İVKKİ, karotis akımı, akciğer ve kardiyak değerlendirmeleri yapıldı. Sonrasında hastaların acil servis tanı, tetkik ve tedavi sürecine müdahale edilmedi. Acil serviste tedavisi sonuçlanan hastalarda USG ile İVK çapları, İVKKİ ve karotis akımları tekrar değerlendirildi ve kaydedildi. Kaydedilen veriler doğrultusunda istatistiksel analizler yapıldı.Bulgular: Kalp yetmezliği hastalarında Ejeksiyon fraksiyonlarına (EF) göre gruplandırılarak düzeltilmiş karotis akım zamanı ile arasındaki ilişkiler incelendi. EF değeri 40 altında olan grup ile 40-50 arsında ki grup arasında istatistiksel bir ilişki varken(p=0,01) diğer gruplar arasında bir ilişki görülmedi.KY hastalarında hem İVKKİ hem de İVK çaplarının sağ ve sol EF ile arasında ilişki olduğu görüldü. Hastalar EF'ye göre gruplandığında %40 altında kalan grup ile üstündeki grup arasında belirgin fark vardı. İVKKİ %40 üstündeki grupta daha etkin olarak değişti.İVKKİ'ndeki değişim ile FTc'deki değişim(%) karşılaştırıldığında aralarında negatif yönde bir ilişki görüldü. Fakat bu istatistiksel olarak anlamlı değildi. (Rho=-0,027) Sonuç: Acil servise başvuran KY hastalarının tanı ve takip sürecinde yatak başı USG etkilidir. İVKKİ kalp yetmezliği hastalarının tanı ve tedavi süreçlerinde kullanılabilir. İVKKİ EF değeri 40 üstündeki hastalar için daha kullanışlı bir yöntemdir. FTc ise KY hastaların tanı ve tedavi sürecinde çoklu etkileşim sebebiyle kullanımı uygun değildir. Purpose: Aim of this study is the comparison of vena cava inferior collapsibility index(VCCI) and corrected carotis flow time (FTc) for assement of volume status and treatment response of patients who admitted to emergency department wih congestive heart failure(HF).Data acquiered from this study may provide the use of a new more applicable method for diagnosis and treatment of heart failiure patients.Material and Methods: this study was designed as a prospective, observational, analytical study. 125 patients who were admitted to the Emergency Department of Ege University between September 2018 and February 2019 with the preliminary diagnosis of Decompansated Heart Failure were included in the study with the permission of Ege University Non-Interventional Research Ethics Committee.Patient's age, sex, complaints to the emergency department, comorbid diseases, cardiac medications and vitals were recorded.Physical examination (Rales, PTE, JVD) and inferior vena cava (IVC) diameter , IVCCI, carotis flow rate , lung and cardiac ultrasonography evaluated by bedside ultrasonography by the emergency physician. . Afterwards, the patients were not intervened in the process of diagnosis, examination and treatment in emergency department.In patients who were treated in the emergency department, IVC diameters, IVCCI and carotid flow were reevaluated and recorded by USG. Statistical analyzes were performed according to the recorded data.Findings : In heart failiure patients ,relationship between Corrected carotis flow time and classified Ejection fractions were analysed. There was a statistically significant relationship between the group with EF value below 40 and the group between 40-50 (p = 0.01).However this relationship did not observed with other groups.In patients with HF, both IVCCI and IVC diameters were correlated with right and left ventricle EF. When the patients were grouped according to EF, there was a significant difference between the group below 40% EF and the group above %40 EF . IVCCI changed more effectively in the group above 40% EF.There was a negative correlation between change in IVCCI and change in FTc (%). But this was not statistically significant (Rho = -0.027).Conclusion: Bedside USG is effective in the diagnosis and follow-up of HF patients admitted to the emergency department. IVCCI can be used in the diagnosis and treatment of heart failure patients. IVCCI is a more useful method for patients with EF above 40%. FTc is not suitable for ithe diagnosis and treatment of HF patients because of multiple interactions. 72
- Published
- 2019
37. Patients admitted to the emergency room with seizures of demographic data, evaluation of laboratory and treatment process, A prospective investigation of second seizure frequency during follow-up in the emergency department
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Altinsoy, Gizem, Karbek Akarca, Funda, and Acil Tıp Anabilim Dalı
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Nöroloji ,Epilepsy ,Neurology ,Seizures ,Recurrence ,İlk ve Acil Yardım ,Prospective studies ,Emergency and First Aid ,Emergency service-hospital ,Demography - Abstract
AMAÇ: Acil servise epileptik nöbet ile başvuran hastaların demografik özelliklerinin tanımlanması, hastaların nöbet özelliğinin belirlenmesi (epileptik, akut semptomatik, uzak semptomatik), laboratuvar ve görüntüleme sonuçları değerlendirilip bu parametrelerin hastane takibinde rekürren nöbet geçirme oranları ile ilişkisi araştırılarak bu ilişkinin hastaların acil servis yönetimine katkısı olup olmadığının saptanması amaçlanmıştır.YÖNTEM: Prospektif analitik araştırma olarak tasarlanan çalışmaya EÜTF Hastanesi Acil Servisine Mart 2014 - Şubat 2016 tarihleri arasında epileptik nöbet geçirme sebebiyle başvuran on sekiz yaş üstü hastalar alınmıştır. İlgili tarihler arasında acil servise nöbetle başvuran hastalardan travma sonrası ilk kez nöbet geçirenler ve acil servis takibinde arrest olanlar çalışmaya dâhil edilmemiştir. Söz konusu dışlama kriterlerine sahip olmayan hastalardan gönüllü olur formunu onaylayan 450 olgu çalışmaya dâhil edilmiştir. Bu 450 olgu arasında nöbet şikâyeti ile acil servise mükerrer başvurusu olan hastalar da mevcuttur. Mükerrer başvurusu olan olguların çalışmaya alındıktan sonraki otuz günlük süredeki ikinci başvuruları çalışmaya dâhil edilmemiş; ancak iki başvuru arasındaki süre otuz günden fazla ise olgu çalışmaya dâhil edilmiştir. Veri kaydı için standart bir olgu rapor formu oluşturulmuştur. İstatistiksel değerlendirme için veriler SPSS 20.0 programına girilerek veri tabanı oluşturulmuş ve gerekli analizler yapılmıştır. BULGULAR: Çalışmamızda 439 hasta değerlendirmeye alındı. Hastaların yaş ortalaması 46±20 yaş (18-94) olarak saptandı. Hastaların nöbet başlama yaşlarına göre dağılımı incelendiğinde %28,4 (n=125) ile en kalabalık grup 1-20 yaş arası olduğu, bu grubu %13,7 ile (n=60) 31-40 yaş aralığındaki hastaların oluşturduğu saptandı. Cinsiyete göre nöbet başlama yaşına bakıldığında erkeklerde ortanca nöbet başlama yaşı 37,5± 23,8 (1-94); kadınlarda ise 39,0 ± 25,1 (1-93) olarak saptandı. Hastaların %35,1'sinde (n=154) hayatında ilk kez epileptik nöbet geçirme şikâyeti olduğu saptandı. Hastaların %48.5'inin (n=213) nöbet özelliğine göre epileptik nöbet, %51.5'inin (n:266) semptomatik nöbet olduğu saptandı. Semptomatik nöbet olarak değerlendirilen hastaların %20.8'i (n=47) akut semptomatik, %79,2'si (n=179) uzak semptomatik nöbet olarak değerlendirildi. Hastaların nöbet özelliklerinin yaşa göre dağılımı incelendiğinde 18-35 yaş grubunun ağırlıklı olarak epileptik nöbet geçirdiği, yaş arttıkça semptomatik nöbet sıklığının da arttığı saptandı. Akut semptomatik nöbet hastalarının yaş ortancası 34,0±15,8 olup, etiyolojik sebebe göre kendi içinde sınıflandırıldığında; en sık sebep olarak %24,5'inde (n=11) akut serebral iskemi saptandı. Uzak semptomatik nöbet hastaları yaş ortancaları 59,0±19,8 olup (18-94), etiyolojisine göre sınıflandırıldığında nöbeti tetikleyen en sık sebep %49,7'inde (n=90) intrakraniyal yer kaplayan kitle, metastaz veya kafa içi basınç artışı yapan durum (ödem, hidrosefali gibi), ikinci sırada %37,0' ında (n=67) kronik iskemik/ hemorajik stroke olduğu saptandı.Çalışmaya alınan hastaların %31,9'u (n=140) acil servis takibi boyunca en az bir kez nöbet geçirdi. Hastaların takipte ilk nöbet geçirme saatinin dağılım aralığına bakıldığında ortanca değeri 2,0 (1- 40) çeyrekler arası aralık 1,0- 4,0 olarak saptandı. Gözlemde nöbet geçiren hastaların %39,3'ü (n=55) status epilepticus olarak değerlendirildi. Çalışmaya alınan hastaların ortanca acil serviste kalış saatleri 17,28±18,8 (1- 152) olarak saptandı.Acil servis gözleminde nöbet geçirme ile hastaların yaş aralıkları arasındaki ilişki incelendiğinde hastaların yaşı arttıkça hastane izleminde nöbet geçirme oranının daha yüksek olduğu gözlendi (p=0,016). Acil servis takibinde nöbet geçiren hastaların nöbet başlama yaşının >80 olduğu grubun takipte nöbet geçirme oranının en yüksek olduğu istatistiksel olarak anlamlı saptandı (p=0,016). Ambulansla acil servise gelen hastaların hem acil servis takibinde hem de taburculuk sonrası bir ay içinde nöbet geçirme sıklığının daha yüksek olduğu; yine bu hastalarda SE görülme oranlarının da daha yüksek olduğu istatistiksel olarak anlamlı saptandı. Bazal nöbet basit parsiyel olan hastaların acil servis takibinde nöbet geçirme sıklığının daha yüksek olduğu istatistiksel olarak anlamlı saptandı (p=0,047). Semptomatik nöbetlerin epileptiklere göre acil servis gözleminde daha sık nöbet geçirdiği istatistiksel olarak anlamlı saptanırken (p=0,025); akut/ uzak semptomatiklerin arasında anlamlı istatistiksel fark saptanmadı (p=0,230).Daha önce status epileptikus geçiren hastaların acil serviste nöbet geçirme oranının istatistiksel olarak anlamlı düzeyde yüksek olduğu saptandı (p=0,039). Tanılı epilepsisi olan hastaların kullandığı ilaç sayısı arttıkça acil serviste nöbet geçirme oranlarının daha yüksek olduğu istatistiksel olarak anlamlı saptandı (p=0,004).İlk nöbetler ayrı olarak değerlendirildiğinde semptomatik nöbetlerin epileptiklere göre takipte nöbet geçirme oranının daha yüksek olduğu saptandı (p=0,013). Yine ilk nöbet hastalarının geliş GKS ile takipte nöbet geçirme oranlarının ters orantılı olduğu (p=0,001); fokal nörolojik defisiti olan hastaların da takipte daha sık nöbet geçirdiği istatistiksel olarak anlamlı saptandı (p=0,031). İlk nöbet hastalarınde BBT'de patolojik bulgu saptanan hastaların, patolojinin ne olduğundan bağımsız olarak, takipte daha yüksek oranda nöbet geçirdiği saptandı (p=0,012).Tüm gruplar ele alındığında semptomatik nöbet hastalarının acil servis takibinde birinci basamak tedavi ile nöbet kontrolünün sağlanabilme oranının daha düşük olduğu saptandı (p=0,025). Hastaların geliş GKS ile takipte SE gözlenme sıklığının ters orantılı olduğu saptandı (p80, seizure rates during emergency room care were the highest; these high rates were statistically significant (p=0.016). For patients who arrived at the emergency department via ambulance, seizure frequency, either under emergency room care or after discharge, was statistically higher; in addition, SE (status epilepticus) prevalence in these patients was also higher. Patients who have simple partial seizures as basal seizures had statistically higher seizure rates under emergency room care (p=0.047). Symptomatic seizures during emergency room care were statistically higher than epileptic seizures (p=0.025), whereas no statistically significant difference was found between acute and remote symptomatic seizures (p=0.230). Seizure rates under emergency room care were statistically higher in patients with an SE history (p=0.039). Statistically higher seizure rates under emergency room care were observed for patients who were diagnosed with epilepsy and used a higher number of drugs (p=0.004). When the first seizures are considered separately, compared with epileptic seizures, patients with symptomatic seizures were determined to have more frequent seizures (p=0.013) under emergency room care. For patients with first-seizure complaints, GCS (Glasgow Coma Scale) scores on admission were inversely proportional to seizure rates during emergency room care (p=0.001); the frequency of seizures under emergency room care was statistically higher in patients with focal neurological deficits (p=0.031). Regardless of the pathology, seizures were more frequent in first-seizure patients diagnosed with pathological findings on their brain revealed by computed tomography (CT) scans (p=0.012). 135
- Published
- 2016
38. Pulmoner embolide plazma laktat seviyesinin 30 günlük mortalitede prognostik değeri
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Temel, Ali Haydar, Karbek Akarca, Funda, and Acil Tıp Anabilim Dalı
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Risk factors ,Pulmonary embolism ,Lactates ,İlk ve Acil Yardım ,Mortality ,Prognosis ,Emergency and First Aid - Abstract
Giriş ve Amaç: PTE saptanan hastalarda erken dönem risk sınıflaması yapılarak, prognoz ve tedavi protokolleri belirlenmektedir. Başvuru sırasında özellikle normotansif olan hastaların prognozları, klinik takip ile birlikte uygulanacak tedavinin etkinliğine bağlıdır. PTE saptanan hastalarda artmış laktat değerleri hastane içi ve 30 günlük ölümlerle ilişkili bulunmuştur (1). Amacımız acil servise PTE tanısı ile takip edilen hastaların plazma laktat düzeylerinin 30 günlük mortalite ile ilişkisini ve erken dönem risk sınıflandırmasında kullanılabilirliğini araştırmaktır.Gereç ve Yöntem: Prospektif kesitsel olarak tasarlanan bu çalışma 01 Şubat 2014 – 01 Ağustos 2014 tarihleri arasında, Ege Üniversitesi Tıp Fakültesi Hastanesi Acil Servisinde yapıldı. Acil servise nefes darlığı, göğüs ağrısı ve buna benzer şikayetler ile başvuran hastalardan pulmoner emboli ön tanısı ile toraks anjio BT çekilenler çalışmaya alındı. Hastaların Risk faktörleri, vital bulguları, Laktat (geliş, 6 ve 12. saatte) düzeyleri, kardiyak belirteçleri, toraks BT anjiyografi görüntüleri, ekokardiyografik görüntülemeleri incelendi. Derin ven trombozuna yönelik, tüm hastalara alt ekstremite venöz KUS yapıldı. Hastalar, hastane yatışları ve taburculukları sonrası da takip edildi ve 30 günlük sağ kalım oranları incelendi.Bulgular: PTE ön tanısı ile toraks anjio BT çekilen 236 hastadan pulmoner emboli tanısı konulan 88 hasta çalışmaya alındı. Olguların, 45'inin (% 51.1) kadın hastaların oluşturduğu, ortalama yaşı ise 68.1± 1.12 (21-100 yaş arası) olarak saptandı. Laktat seviyesi 2 mmol/L'un altında olan 64 olgudan 15'i (% 23.4), laktat seviyesi 2 mmol/L'un üstünde olan 24 olgundan 12'si (% 50) ölmüştür. `Cut-off` değeri 2 mmol/L olarak alındığında % 44.4 duyarlılık, % 80.3 özgüllük göstermiştir. Bununla birlikte pozitif prediktif değeri % 50, negatif prediktif değeri % 76 bulunmuştur. Plazma laktat seviyesinin yükselmesiyle birlikte, 30 günlük mortalite de progresif bir artış gözlemlendi. Hastaların 0. saat, 6. saat ve 12. saat laktat değerleri takip edildiğinde; eğer laktat düzeyi progresyon gösteriyorsa mortalitenin arttığı tespit edildi.Tartışma ve Sonuç: Acil serviste PE tanısı konan hastalar da yüksek plazma laktat düzeylerinin kısa dönem mortalite ile ilişkisi vardır. Troponin yakın dönem prognoz öngörüsü için yüksek sensitiviteye sahip bir bulgudur. Laktat ile birlikte kombine kullanımı daha etkili bir prognoz göstergesi olarak değerlendirilmiştir.Anahtar kelimeler: pulmoner Emboli, plazma Laktat düzeyi, mortalite Background and Purpose: An early risk assessment tool is used to determine prognosis and treatment protocol in patients with PTE diagnosis. The prognosis of normotensive PTE patients depends on the efficiency of the treatment and clinical follow-up. Elevated lactate levels are correlated with 30-day mortality in PTE patients. Our purpose is to evaluate the relation between plasma lactate levels and 30 day mortality in patients diagnosed in the emergency service and to evaluate the availability of application of these risk factors for early risk classification.Materials and Method: This study that was designed as a prospective cross sectional research and held in Ege University Medicine Faculty Emergency Service between 01 February 2014 and 01 August 2014. Patients complaining of shortness of breath, chest pains, etc. and who have done thorax CT angiography scanning for PE differential diagnosis were included in the study. The Risk factors, vital findings, blood lactate levels (admittance, 6th and 12th hours), cardiac markers, thorax CT angiography images, echocardiographic screenings of the patients were examined. Lower extremities venous doppler USG examination was used for deep vein thrombosis diagnosis. The patients were monitored after discharge and 30 day follow up was used to report mortality. Findings: 236 patients had thorax CT angiography scanning for PE differential diagnosis and 88 patients with pulmonary embolisim diagnosis were included in the study. 45 (51.1%) patients were female and average age was 68.1± 1.12 (between ages 21-100). 64 patients had lactate levels below 2 mmol/L and 15 of them died (23.4%). 24 cases had blood lactate levels higher than 2 mmol/L and 12 of them died (50%). When the 'cut-off' blood lactate level is selected as 2 mmol/L, sensitivity was 44.4% and specificity was 80.3%. However, the positive predictive value was found %50 and the negative predictive value was %76. It was observed that plasma lactate levels were correlated with 30 day mortality. Blood lactate levels at 0th, 6th and 12th hour showed that, mortality increased if the lactate level was showing progression.Discussion and Conclusion: Among patients diagnosed with PE at emergency department, the high lactate levels were correlated with short term mortality. Blood troponin levels showed high sensitivity for short term prognosis in PE diagnosed patients and could have more prognostic value with blood lactate level measurement.Keywords: pulmonary embolism, plasma lactate level, mortality 151
- Published
- 2015
39. Distal radius fraktürlerinde ultrason eşliğinde redüksiyon başarısının değerlendirilmesi
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Umdu, Ercüment, Karbek Akarca, Funda, and Acil Tıp Anabilim Dalı
- Subjects
Radius ,Radius fractures ,Wrist joint ,İlk ve Acil Yardım ,Wrist ,Hand ,Emergency and First Aid ,Ultrasonography - Abstract
AMAÇ: Çalışmanın esas amacı, distal radius fraktürlerinin ultrason eşliğinde redüksiyon başarısının artırılmasıdır. İkincil amacı tekrarlayan prosedürel sedasyon ve redüksiyon ihtiyacının azaltılmasıdır.YÖNTEM: Randomize kontrollü prospektif kesitsel nitelikteki çalışmamızda deplase distal radius fraktürü olan ve redüksiyon gereken 18 yaş üstü 119 hasta alındı.Olgu grubuna acil tıp asistanı tarafından dorsal, lateral ve horizontal olmak üzere üç planda ultrason yapılarak preredüksiyon fraktür görüntüleri elde edildi. Prosedürel sedasyon uygulanan hastalara ortopedi asistanı tarafından traksiyon ve kapalı redüksiyon işlemi uygulandı. Hastalarda redüksiyon işlemi sonrası alçıya almadan hemen önce acil tıp asistanı tarafından ultrasonla kırık redüksiyonunun başarısı kontrol edildi. Ultrason sonucu redüksiyonun gerçekleşmediği düşünülen hastalara, ortopedi hekimi tarafından tekrar redüksiyon amaçlı manipülasyon uygulandı. Kontrol grubu hastalara ultrason yapılmadı ve ortopedi hekimi tarafından standart redüksiyon işlemi uygulandı. Çalışmaya alınan hastaların postredüksiyon grafileri ortopedi uzmanı tarafından ve ultrason görüntüleri de acil tıp uzmanı tarafından redüksiyon başarısı açısından değerlendirildi. BULGULAR: Olgu grubunda redüksiyon başarısı ultrasonda %76,7 (n=46), grafide ise %75,0 (n=45) olarak bulundu. Ultrasonun redüksiyon başarısını değerlendirmedeki duyarlılığı %95,7 , özgüllüğü %92,9 , pozitif prediktiv değeri %97,78 , negatif prediktiv değeri % 86,67 saptandı. Olgu grubunun %75,0 (n=45) 'ında tek redüksiyonda tek manipülasyonda başarı sağlanırken, kontrol grubunda başarı %54,2 (n=32)'de kaldı. Olgu grubunda başarısız olan %25 (n=15) hastanın %46,7 (n=7) 'sinde ultrason eşliğinde tekrar manipülasyonlarla redüksiyon başarısı artırıldı.TARTIŞMA: Literatürle uyumlu olarak, çalışmamızda distal radius fraktürlerinin ultrason rehberliğinde redüksiyon başarısı artırıldı. Distal radius fraktürlerinde redüksiyon öncesi ultrasonda radial kısalık, multiple fragman ve distal fragmanda 40o üstünde dorsale açılanma tespit edildiğinde redüksiyon başarısının düşük olabileceği öngörülebilir ve cerrahi önerilebilir. AIM: The main purpose of this study is increasing the reduction success of DRF.The secondary aim is decreasing the recurrent procedural sedation and reduction needs.METHOD: This is a randomized control, prospective cross-sectional study.119 patients with deplaced DRF injury, over 18 years old are included in case group.Prereduction fracture Ultrasonography(USG) were performed by observer.Prereduction fracture USG were performed by observer(emergency medicine resident) as dorsal, lateral and horizantal plan.Traction and closed reduction process were obtained by orthopedy residents.Reduction success was controlled by observer before casting.Patients detected as inappropriate reduction referred to orthopedy for revolution.In control group only standart reduction processes were performed without using USG.Post-reduction X-ray films were evaluated by orthopedy whereas USG by observer. FINDINGS: In this study, reduction success of USG-guided process is 76.7%(n=40) whereas by X-ray this rate is 75%(n=45) sensitivity of USG for evaluation of reduction success is 95,7 % and spesifitivity is 92,9 %.Positive predicted value is 97,78 %.Negative predicted value is 86,67 %.In case group 75 % (n:45) of patients fractures were reducted in the first time whereas in control group this rate is only %54,2 (n:32)25 % of case group (n:15) are failed to reducted are remanupulated and 46% of these (n:7) were reducted successfully which means increasing reduction success.DISCUSSION: Reduction success of DRF by using USG was increased parallel to litherature.In DRF by useing USG, prereductional detection of conditions which brings low reduction success(radius shortness, multiple fragment fractures, above 40o dorsal angulation of distal fragment) may be usefull for direct surgery referral. 80
- Published
- 2015
40. Acil servise başvuran kafa travması olgularında optik sinir kılıf çapının tekrarlayan yatak başı ultrasonografik ölçümünün tanıdaki ve hasta takibindeki yeri
- Author
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Dağtekin, Özge, Karbek Akarca, Funda, and Acil Tıp Anabilim Dalı
- Subjects
Optic nerve ,Wounds and injuries ,İlk ve Acil Yardım ,Emergency medicine ,Head injuries ,Brain injury ,Eye ,Glaskow coma scale ,Emergency and First Aid ,Emergency service-hospital ,Ultrasonography - Abstract
Travmatik beyin hasarına (TBH) bağlı kafa içi basınç artışı, tüm dünyada genç nüfusta mortalite ve morbiditenin en önemli nedenlerinden biridir. Erken tanı ve tedavi ile olumsuz sonuçların önüne geçebilmek mümkündür.Günümüzde travmatik beyin hasarının tanısında ve takibinde kraniyal bilgisayarlı tomografi (BT) ilk tercih olarak kullanılmaktadır, ancak vital durumu stabil olmayan hastalarda kullanışlı değildir ve çekilen her tomografi ile radyasyon maruziyeti artmaktadır. Ultrasonografi (USG) ile optik sinir kılıf çapının (OSKÇ) ölçümü, kafa içi basınç artışının (KİBA) saptanmasında yeni bir yöntem olarak araştırılmaktadır.Çalışmamızda USG ile OSKÇ ölçümünü kraniyal BT'de lezyon varlığı ile kıyaslayarak TBH'de USG'nin tanıda kullanılabilirliğini araştırdık. Ayrıca TBH saptanıp acil serviste kontrol kraniyal BT ile izlenen hastalarda, eş zamanlı OSKÇ ölçümleri yapılarak USG'nin hasta takibindeki yeri de araştırılmıştır. Hastalar Glasgow koma skoruna (GKS) göre gruplandırılıp, ROC analizi sonucu OSKÇ sınır değeri 5.1 mm olarak belirlenerek istatistiksel analizler yapılmıştır. Ayrıca 5.8 mm sınır değeri ile de istatistikler tekrarlanmıştır. OSKÇ ile GKS arasında orta derecede (r=-0.384) ancak çok anlamlı (p
- Published
- 2015
41. Emergency department management after the 2020 Aegean Sea - Izmir earthquake.
- Author
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Uz İ, Çetin M, Songur Kodik M, Güvenç E, Karbek Akarca F, and Ersel M
- Subjects
- Adolescent, Adult, Aged, 80 and over, Cross-Sectional Studies, Emergency Service, Hospital, Female, Humans, Infant, Male, Middle Aged, Retrospective Studies, Young Adult, Earthquakes, Rhabdomyolysis
- Abstract
Background: This article aims to provide an up-to-date resource on disaster management by reporting about the destructive fea-tures of the earthquake that occurred on October 30, 2020, and about the hospital and emergency service organization during a pandemic., Methods: This study was carried out with a multicentered, cross-sectional retrospective design on the victims of the 2020 Aegean Sea - Izmir earthquake. Local ethics committee approval was obtained. The data obtained by obtaining permission from two hospitals and ambulance services (transport data) located in the region where earthquake-related destruction was most prominent were evalu-ated. Patient data including demographic data, time of arrival to the emergency department, duration of stay under the debris, triage codes (green: not urgent, slightly injured; yellow: may be delayed, injured; red: critically injured; and black: dead), type of injuries, dura-tion of stay in the emergency department, crush syndrome, rhabdomyolysis, need for invasive procedures (e.g., surgery and dialysis), intensive care admission, hospital admission, and discharge were evaluated., Results: In total, 313 patients (60.4% females) were included in the study according to the inclusion criteria. The mean age of the participants was 38.0±21.0 years, with the youngest being a 6-month-old baby and the oldest a 91-year-old individual. Approximately 41.5% of the earthquake victims presented to the emergency department within the first 3 h of the earthquake, and patients with yellow triage code were the most common in the 1st h. Further, 35.2% of the patients who were rescued from under the debris were discharged alive. Four patients were discharged alive after being rescued from under the debris 24 h following the earthquake, of whom three were rescued after >48 h (longest duration, 91 h). Further, 32 (15.9%) patients who survived upon presentation to the emergency department had rhabdomyolysis, 4 (1.9%) underwent hemodialysis in the emergency department due to acute renal failure, and 8 (3.8%) underwent other emergency operations such as fasciotomy and amputation. In total, 122 patients died and 191 patients were discharged from the hospitals. Furthermore, 139 patients were discharged from the emergency department, 15 were admitted to the intensive care unit, 41 were hospitalized in the relevant clinics, and 112 were directly transferred to the morgue following preliminary evaluation., Conclusion: Emergency services should be ready in terms of accurate registration, correct data entry, correct triage assignment, sufficient resources, adequate team, sufficient equipment, and adequate treatment areas for disasters such as earthquakes. Further, ade-quate disaster trainings should be provided, feasible disaster relief plans should be prepared, and regular exercises should be conducted.
- Published
- 2022
- Full Text
- View/download PDF
42. Evaluation of patients diagnosed with acute blunt aortic injury and their bedside plain chest radiography in the emergency department: A retrospective study.
- Author
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Karbek Akarca F, Korkmaz T, Çınar C, Çakal ED, and Ersel M
- Subjects
- Accidents, Traffic, Adult, Aged, Cross-Sectional Studies, Decision Support Techniques, Emergency Medical Services, Female, Humans, Injury Severity Score, Male, Middle Aged, Physical Examination, Retrospective Studies, Rib Fractures diagnosis, Rib Fractures diagnostic imaging, Thoracic Injuries diagnosis, Tomography, X-Ray Computed, Turkey, Vascular System Injuries diagnosis, Vascular System Injuries diagnostic imaging, Wounds, Nonpenetrating diagnosis, Young Adult, Aorta, Thoracic injuries, Thoracic Injuries diagnostic imaging, Wounds, Nonpenetrating diagnostic imaging
- Abstract
Background: The purpose of our study was to retrospectively evaluate traumatic aortic transection patients and their bedside plain chest radiographs for signs of aortic injury., Methods: Emergency department (ED) patients from a 5-year period with traumatic aortic transection who were over 18 years of age were included in the study. Demographic characteristics, mechanism of trauma, Revised Trauma Score, Glasgow Coma Score, vital signs, physical exam findings, laboratory parameters, length of stay in the ED, and patient outcomes were documented. Bedside plain chest radiograph images were interpreted by 2 emergency medicine specialists and 1 radiologist., Results: Thirty patients, mean age 45.87±16.14 years (70% male), were enrolled. Most common trauma mechanism was motor vehicle accident (53.3%). Agreement rates between emergency medicine specialists and radiologist were found to be "excellent" and "substantial" in identifying mediastinal widening and multiple left sided rib fractures; and "fair" in identifying widened paraspinal line, and transthoracic vertebral fractures., Conclusion: Though not completely reliable, bedside plain chest radiographs and physical examination findings may be useful in detecting aortic injury during primary survey when the patient is unstable and cannot be sent for chest computerized tomography. Appropriate further imaging studies should be carried out as appropriate based on patient's hemodynamic status.
- Published
- 2016
- Full Text
- View/download PDF
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