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    A fatal rabies case and experiences of a mass post exposure prophylaxis among healthcare workers
    (Akademiai Kiado ZRt., 2021) Şener, Alper; Akman, Canan; Akça, Anıl; Varışlı, Behcet
    We aimed to monitor the adverse effects (AE) and efficacy of post exposure prophylaxis (PEP) in health care workers (HCWs) exposed to a rabies patient. In this study 109 HCWs and eight household contacts were PEP candidates. Contact persons without infection control precautions were in Group I (high risk-82 cases). HCWs indirectly exposed to environmental surfaces were classified in Group II (low risk-35 cases). PEP schedule was rabies vaccine (RBV) + equine rabies immunoglobulin (eRIG) in Group I and only RBV in Group II. Local and systemic AE were observed in all cases. Efficacy of post exposure prophylaxis (PEP) was determined by rabies development in a six month follow-up. 585 doses of RBV have been used in 117 cases and eRIG has been used in 82 cases. 32 Nurses (39%); 22 emergency medicine technicians (26.8%); 12 doctors (14%); six laboratory technicians (0.07%); six radiology technicians (0.07%); four cleaners (0.05%) were in Group I (82 cases), respectively. One doctor, laboratory technician, nurse and radiology technician (0.02%); two emergency medicine technicians (0.04%) and nine cleaners (25.7%) were in Group II (35 cases), respectively. Routes of transmission were blood in five (0.06%); saliva in 14 (17%); sweat in 50 (61%); CSF/serum in five (0.06%); sexual intercourse in one (0.01%); personal equipment in seven (0.09%) in Group I, respectively. Indirect contact was the only route in Group II. The most common local and systemic AE were seen in Group I; pain at injection side (19 cases) and fever (13 cases). Both of them showed statistically significant difference (P<0.05). Allergic rash has been seen at only one case. PEP failed in one case where the possible exposure way was sexual intercourse. PEP is the safest way to prevent rabies. Infection control precautions were still not enough applied. eRIGs are also safe and have rare AE.
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    A Killer in Disguise: Button Battery Ingestions in Acute Care
    (Bentham Science Publ Ltd, 2025) Akman, Canan; Karcioglu, Ozgur; Ozturk, Goksu Afacan; Ucar, Asli Bahar
    Ingestion of button batteries (BB) represents a substantial health hazard, causing more common and severe complications than most other ingested objects. While the primary mechanism of injury is alkaline caustic injury (mediated by hydroxide ions produced through electrolysis at the site of the button battery), additional pathophysiological processes include pressure-induced necrosis, accumulation of hydroxide compounds at the battery's negative pole, direct caustic tissue injury, and potential heavy metal toxicity. Full-thickness burns, esophageal perforation, tracheoesophageal and aortoesophageal fistulas are encountered shortly after exposure. Vocal cord paralysis due to BB ingestion appears to be an early sign to predict the severity of the condition. Besides expedient removal, mitigation strategies are the key to the management. Pre-BB removal using honey or sucralfate and post-removal sterile acetic acid irrigation in the operation room can alleviate complication rates. This review is intended to cover and summarize all aspects of these incidents to provide information to clinicians and healthcare personnel.
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    A Pharmacological Update and Safety Analysis of Medications for Smoking Cessation: Which Ones to Use?
    (Bentham Science Publ Ltd, 2025) Akman, Canan; Akgun, Feride Sinem; Ozel, Betul Akbuga; Ozkaya, Bilgen; Ozturk, Goksu Afacan; Karcioglu, Ozgur
    Interventions to reduce smoking prevalence aim to help patients quit smoking to cut down its hazards and related impairments in human beings. Pharmacological treatments are recommended for those with high levels of addiction because of severe physical and psychological dependence. Use of pharmacotherapy can double the odds of successful quitting. Nicotine replacement therapy (NRT), drug treatment regimens including nicotinic receptor agonists (varenicline), dopamine and norepinephrine reuptake inhibitors (bupropion), cytisinicline (cytisine), and combination therapy (NRT + medication) can be employed on a case-by-case basis. Furthermore, varenicline has been found to be more effective than the other agents in most studies. The most common adverse effects of pharmacological agents include depression, nausea, anxiety, abnormal dreams, and insomnia. On the other hand, electronic cigarettes offer another alternative to aid in smoking cessation (SC). Endurance of SC is mostly related to the employment of combined approaches, such as counselling and pharmacotherapy. This study is designed to provide an up-to-date overview of the contemporary approach to interventions aimed at helping patients in SC.
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    A prediction model for lung involvement using circulating angiotensin converting enzyme-2 and renin levels in COVID-19 patients
    (J Infection Developing Countries, 2025) Akkan, Cansu; Das, Murat; Bardakci, Okan; Sehitoglu, Muserref Hilal; Akdur, Gokhan; Akman, Canan; Akdur, Okhan
    Introduction: The potential role of the renin-angiotensin-aldosterone system (RAAS) in the pathogenesis of coronavirus disease 2019 (COVID-19) is controversial, with concerns mainly about the part RAAS peptides play in the prediction of progression to more severe disease. Given the importance of COVID-19 prognostication at early disease stages, we established and validated a multivariable risk stratification tool for COVID-19 associated lung involvement by utilizing a combination of RAAS peptides. Methodology: In this prospective study, circulating renin and angiotensin converting enzyme-2 (ACE-2) levels were measured in 116 COVID-19 patients who were admitted to our hospital from March 30, 2021 to January 24, 2022 and underwent a lung computed tomography (CT) scan. Clinical severity was measured with a national early warning score (NEWS). Associations among RAAS peptides, inflammation-dependent biomarkers, demographic variables, and clinical outcomes were studied using logistic regression and Cox proportional-hazards models. Results: We assessed 116 COVID-19 patients (mean age 45.1 f 12.6 years; 51.7% male), of whom 66 (56.9%) had COVID-19 associated pneumonia. Baseline circulating ACE-2 (2.63 f 0.12 ng/mL) and renin levels (85.04 f 6.8 ng/L) were lower in patients with COVID-19 related pneumonia compared to patients without pneumonia (6.4 f 0.7 ng/mL and 211.6 f 21.9 ng/L, respectively) (p < 0.001 for both). Both RAAS components were found to be significantly related to adverse outcomes, including COVID-19 associated pneumonia and intensive care unit (ICU) admission, in both crude and adjusted multivariable logistic regression analyses. Conclusions: Circulating ACE-2 and renin levels can predict lung involvement in COVID-19 patients, and they display good correlation and agreement with NEWS.
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    A RETROSPECTIVE ANALYSIS OF THE CAUSES OF SEVERE HYPONATREMIA IN THE PATIENTS AGED OVER 65 ADMITTED TO THE EMERGENCY DEPARTMENT
    (Gunes Kitabevi Ltd Sti, 2022) Akman, Canan; Cetin, Murat
    Introduction: This study aimed to retrospectively analyze the data of patients older than 65 years and diagnosed with severe hyponatremia in the emergency department. Method: Patients >= 65 years and with severe hyponatremia (serum sodium levels <= 125 mEq/L) were included in the analyses. Results: Fifty-five patients were hypovolemic, 22 were normovolemic, and 23 were hypervolemic. 65.5% (n = 36), 59.1% (n = 13) and 60.9% (n = 14) of the groups were females (p > 0.05), and regarding comorbidities, 27.3%, 9.1%, and 4.3% of the groups were diagnosed with a malignancy, respectively (p = 0.031). Conclusions: Early diagnosis and treatment in the emergency department are critical considering the severity and prognosis of hyponatremia.
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    Acil Servise Başvuran Hipertansif Hastalarda Serum Ürik Asit Düzeyleri
    (Kahramanmaraş Sütçü İmam Üniversitesi, 2022) Akman, Canan; Bakirdogen, Serkan
    Amaç: Hipertansif acil hastalarda serum ürik asit düzeylerinin önemi konusunda yapılan literatürde yeterli bilgi yoktur. Çalışmamız, yüksek tansiyon nedeniyle acil servise başvuran hastalarda serum ürik asit düzeylerinin rolünü araştırmayı amaçlamaktadır. Gereç ve yöntemler: Kan basıncı 180/110 mmHg ve üzerinde akut hedef organ hasarı olan hipertansif acil (grup I), kan basıncı 180/110 mmHg ve üzerinde olan akut hedef organ hasarı olmayan hipertansif acil hastalar (grup II) ve 140-180 mmHg arasında sistolik kan basıncı ve 90-110 mmHg arasında diyastolik kan basıncı olan kontrolsüz hipertansiyonu olan hastalar (grup III). Bulgular: Yüz yirmi dört hipertansif hasta (80 kadın, 44 erkek) dahil edildi. Grup I'de 33 (% 26.6), grup II'de 19 (% 15.3) ve grup III'te 72 (% 58.1) hasta yer aldı. Serum ürik asit düzeyi açısından karşılaştırıldığında gruplar arasında istatistiksel olarak anlamlı fark olduğu bulundu (p = 0,001). Grup I'deki hastaların ortalama serum ürik asit düzeyi diğer gruplara göre yüksekti (p <0.05). Sonuç: Acil servise yüksek tansiyon ile başvuran hastalarda serum ürik asit düzeyleri hipertansif acil durumu ayırt etmede önemli olabilir
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    Acil Servise Başvuran Hipertansiyon Hastalarının Klinik Özellikleri ve Acil Servise Başvuru Sıklığını Etkileyen Faktörlerin İncelenmesi
    (2020) Akman, Canan; Akşit, Ercan
    Giriş ve Amaç: Acil servis doktorları yüksek kan basıncı nedeniyle acil servise başvuran hastalar ile sık olarakkarşılaşmaktadır. Bu çalışmanın amacı, acil servise başvuran hipertansiyon hastalarının klinik özelliklerini ve acilservise başvuru sıklığını etkileyen faktörleri incelemektir.Gereç ve Yöntemler: Bu çalışmaya hastanemiz acil servisine başvuran daha önce hipertansiyon tanısı olan 100gönüllü hasta alınmıştır. Araştırmanın veri toplama aşamasında yüz yüze görüşülerek anket uygulanmıştır.Bulgular: Hastaların %52’sinde 10 yıldan fazladır hipertansiyon mevcuttu. Hastaların %81’ine yaşam tarzı değişikliğihakkında bilgilendirme yapılmıştır. Hastaların sadece %32’sine acil durumda kullanması için ilaç reçete edilmiştir.Takipte olduğu doktor tarafından, hipertansiyonun uç organlarına zarar verebileceği hastaların yalnız %40’ınaanlatılmıştır. Son bir yıl içinde hipertansiyon nedeni ile iki veya daha fazla sayıda acil servise başvuran hasta oranı%57’dir.Sonuç: Bu çalışma hipertansiyon tanısı ile bir yıl içinde iki veya üstü sayı ile acil servise başvurunun olduğunugöstermektedir. Hipertansiyon hastalarına hastalıkları hakkında ayrıntılı bilgilendirme yapmak hastaların acil servisebaşvuru sıklıklarını azaltabilir.
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    Acil Servise Özkıyım Girişimi Nedeniyle Başvuran Vakaların Retrospektif İncelenmesi
    (Türkiye Acil Tıp Derneği, 2024) Akman, Canan; Ataç Öksüz, Merve
    Amaç: Dünyada ve ülkemizde önemli bir psikososyal sorun olan özkıyım girişimleri, acilen önlem alınması gereken bir sorun olarak karşımıza çıkmaktadır. Bu nedenle çalışmada, Çanakkale ilinde bulunan bir hastanenin acil servisine özkıyım girişimi nedeni ile başvuran hastaların sosyodemografik ve bazı klinik özelliklerinin incelenmesi amaçlanmıştır. Gereç ve Yöntemler: Bu çalışma, tek merkezli, gözlemsel ve retrospektif bir çalışmadır. Çalışmamızda 01.01.2013-31.12.2023 yılları arasında Çanakkale bulunan bir hastanenin yetişkin acil servis birimine özkıyım olgusuyla başvuran yetişkinlere ait veriler hastane otomasyon sistemi üzerinden taranarak geriye dönük olarak incelenmiştir. Bulgular: Acil servise 2013-2023 yılları arasında başvuran özkıyım girişiminde bulunan hastaların yaş ortalamasının 33.65 olduğu, %58.8’inin erkek, %52.4’ünün ise bekar olduğu görülmektedir. Başvuruda bulunan hastaların 69.4’üne konsültasyon istendiği, bu istemlerin ise en yüksek oranı %40.6 ile ruh sağlığı ve hastalıkları bölümüne ait olduğu belirlenmiştir. Başvuran hastaların %42.9’unun acil servise geliş saatinin 24:00-06:00 aralığında olduğu, %35.3’ü acil servise yaz ayları içerisinde başvurduğu görülmüştür. Acil servise özkıyım girişimi nedeniyle başvuran hastaların %24.7’si Keskin cisimle kendine zarar verme, %17.6’sı Kimyasallar ve zararlı maddelere maruz kalma ve kendine zarar verme tanısı ile başvurmuşlardır. Ayrıca hastaların geliş tanıları ile cinsiyetleri arasında anlamlı farklılık olduğu belirlenmiştir. Sonuç: Çalışmada özkıyım girişiminde bulunan hastalar arasında erkek cinsiyet oranı ve bekar olma oranın daha yüksek olduğu görülmüştür. Ayrıca çalışmada hastaların geliş tanıları ile cinsiyetleri arasında anlamlı farklılık olduğu belirlenmiştir.
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    Acil Serviste Spontan Pnömotoraks Tanısı Alan Hastaların Demografik Verilerinin Retrospektif Olarak Değerlendirilmesi
    (2021) Akman, Canan; Çetin, Murat
    Amaç: Pnömotoraks, plevral boşlukta hava bulunmasıdır. Pnömotoraks tanılarının yarıdan fazlası herhangi bir travma durumu söz konusu olmadan ortaya çıkmaktadır. Bu durum spontan pnömotoraks (SP) adını almaktadır. Aynı zamanda pnömotoraks vakaları ile acil serviste sıkça karşılaşılmaktadır. Tanı ve tedavisinin anında hızlı olarak yapılması gereken ve önem taşıyan bir plevra hastalığı olarak karşımıza çıkmaktadır. Bu çalışmada acil servise başvuran SP hastalarının demografik özellikleri, risk faktörleri, klinik özellikleri, tanı ve tedavi yaklaşımlarının farkındalığının ortaya konulması amaçlanmıştır. Gereç ve Yöntemler: Ocak 2018-Haziran 2020 tarihleri arasında Çanakkale Onsekiz Mart Üniversitesi Tıp Fakültesi acil servisine başvuran SP tanısı alan hastalar retrospektif olarak tek merkezli incelenmiştir. Hastalarda yaş, cinsiyet, acil servise geliş şekilleri, şikayetleri, alta yatan hastalık durumları, sigara öyküsü, daha önce pnömotoraks şikayeti varlığı, nüks ve sayısı, fizik muayene bulguları, eşlik eden durumlar, tansiyon pnömotoraks varlığı, tüp torakostomi tedavisi ve tedavinin sonuçları belirlenmiştir. Bulgular: Acil servise başvurup SP tanısı alan 53 hasta çalışmaya dahil edildi. Hastaların %92,5 (n=49) erkektir. %92,5’ine (n=49) tüp torakostomi işlemi uygulanmıştır. Bu hastaların %84,9’u (n=45) göğüs cerrahi servisine, %11,3’ü (n=6) yoğun bakıma ve %2’si (n=3,8) dış merkeze sevk edilmiştir. Tedavinin sonuçlarına bakıldığında ise %88,7’si (n=47) spontan pnömotoraks hastası şifa ile taburcu edilmiştir. Sonuç: Spontan pnömotoraks zamanında müdahale edilmediğinde hayati tehlike oluşturabilecek bir klinik durumudur.
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    Acil Tip Stajını Alan Önhekimlerin Staj Öncesi ve Sonrası Meslekî Kaygılarının İncelenmesi (Çanakkale Onsekiz Mart Üniversitesi Örneği)
    (Tıp Eğitimini Geliştirme Derneği, 2021) Akman, Canan; Koşan, Ayşen Melek Aytuğ; Toraman, Çetin; Akdur, Gökhan; Akdur, Okhan
    Amaç: Bu araştırmanın amacı acil tıp stajını alan önhekimlerin, bu stajı almadan ve aldıktan sonraki mesleki kaygılarını karşılaştırarak, acil tıp staj eğitiminin önhekimlerin mesleki kaygılarında değişiklik yaratıp yaratmadığına dair fikir edinmektir.Gereç ve Yöntem: Araştırma izlem temelli bir araştırmadır. Araştırma, Türkiye’deki bir tıp fakültesinde öğrenim gören 83 önhekim ile yürütülmüştür. Önhekimlerin mesleki kaygıları “Acil Müdahale Hizmeti Sunan Personel Mesleki Kaygı Ölçeği” ile elde edilmiştir. Veriler, ilişkili örneklemler için t-test ile analiz edilmiştir.Bulgular: Önhekimlerin acil tıp stajını almadan önce en az kaygı yaşadıkları durumlar; “yaşım ilerledikçe fiziksel aktivitelerden dolayı mesleğimi verimli biçimde yapamamak”, “hizmet sunarken sakat kalma riski”, “sakat kalıp gelirimin düşmesi”, “çalışma arkadaşımın bilgi ve beceri yetersizliği”, “hasta nakil sırasında yaşanacak engeller (dar koridor vb.)” ve “müdahale ve nakil ekipmanlarının ergonomik olmaması”dır. Bu kaygılar staj sonunda da yaşanan en düşük kaygılar olarak belirlenmiştir. Önhekimlerin acil tıp stajını almadan önce en fazla kaygı yaşadıkları durumlar; “hizmet sunarken fiziksel şiddet görme olasılığı”, “hizmet sunarken sözel şiddet görme olasılığı”, “personel yetersizliği”, “hizmet sırasında karşılaştığım etik dışı davranışlar” ve “hasta ve hasta yakınlarının bize karşı önyargısı”dır. Araştırmanın sunduğu kayda değer bir bulgu, bu kaygıların acil tıp stajı alındıktan sonra da düşme eğilimi göstermemiş olmasıdır. Sonuç: Araştırmada önhekimlerin aldıkları acil tıp stajının onların yaşadıkları kaygılarda herhangi bir değişiklik yaratmadığı belirlenmiştir. Başka üniversitelerde önhekimlere uygulanan acil tıp stajı ile araştırmada geçen üniversitenin acil tıp stajının öğrencilerin yaşadığı kaygılara etkisi karşılaştırmalı olarak incelenmesi, uygulanan acil tıp staj programının gözden geçirilip, etkililiğinin incelenmesi, önhekimlerin acil vakalara müdahale konusunda yaşadıkları kaygıların nitel araştırmalar ile derinlemesine araştırılması önerilir
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    Akut böbrek hasarı olan hastalarda serum düzeltilmiş ve iyonize kalsiyum seviyelerinin karşılaştırılması
    (2021) Akman, Canan; Bakirdogen, Serkan; Daş, Murat; Balcı, Serdal; Aykan, Okyanus Necdet
    Giriş: Hastaneye yatırılan hastalarda akut böbrek hasarı (ABH) sık olarak görülmektedir (%1,92). ABH’lı hastalarda serum düzeltilmiş ve iyonize kalsiyum düzeylerinin acil hemodiyalizi öngörmedeki etkisi bilinmemektedir. Bu çalışmada acil serviste ABH tanısı alan hastalarda serum düzeltilmiş ve iyonize kalsiyum düzeylerini karşılaştırmayı amaçladık. Yöntem: Çalışmamız retrospektif olarak planlandı. Grup 1: En az bir kez acil hemodiyaliz seansı alan ABH hastaları. Grup 2: Hemodiyalize girmeyen AKIN evre 1-3 olan hastalar. Hastaların başvuru anında serum düzeltilmiş ve iyonize kalsiyum, kreatinin ve albümin değerleri incelendi. Çalışmanın tüm verileri SPSS 19.0 ile kaydedildi. İstatistiksel anlamlılık için p <0,050 kabul edildi. Bulgular: Serum düzeltilmiş kalsiyum düzeylerinin ortalaması grup 1'de grup 2'ye göre daha düşüktü ve fark istatistiksel olarak anlamlıydı (p <0,001). Kan gazındaki ortalama iyonize kalsiyum seviyeleri grup 1'de grup 2'ye göre daha düşüktü ve fark istatistiksel olarak anlamlıydı (p = 0,002).
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    Analysis of Emergency Department Presentations due to Injuries From Motor Vehicle Crashes and Pedestrian Strikes
    (Springernature, 2020) Akman, Canan; Kuru, Tolgahan
    Objective The objective of this study was to analyze the causes and outcomes of presentations to the emergency department (ED) due to injuries from motor vehicle crashes and pedestrian strikes along several parameters. Methods Data from 798 patients who were injured due to motor vehicle crashes or pedestrian strikes that occurred in Canakkale Province were retrospectively analyzed. Patient demographic data such as age and gender, emergency service outcomes, and the consulted clinics were also recorded. Distributions of the crashes by weekdays or weekends, national and religious holidays, official holidays, and Ramadan month were comparatively analyzed. Results A total of 253 people injured in motor vehicle crashes and 395 people injured in pedestrian strikes were directly brought to the ED from the crash or strike scene. While 656 patients were discharged from the ED, 142 patients were referred to other clinics for surgery. A total of 538 crashes occurred on weekdays and 206 on weekends, and 54 crashes occurred during official and religious holidays. Most crashes occurred in summer, and the second most occurred in autumn. The rate of pedestrian strikes that occurred in summer and autumn was statistically significantly higher than the rate of injuries from motor vehicle crashes observed in the same seasons. The majority of the weekend crashes were caused by persons who had not consumed alcohol. Conclusion Traffic crashes occur more commonly among young men and in the summer season, while national, official, and religious holidays do not seem to play a role in the frequency of traffic crashes.
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    Approach to the transplanted patient in acute care: a comprehensive update
    (Mre Press, 2025) Akman, Canan; Karcioglu, Ozgur
    Organ transplant patients present to emergency departments (EDs) for conditions often associated with transplantation due to changing anatomy, denervated allograft and immunosuppression. Infections and rejection are among the most feared problems in these patients. It is necessary to maintain a high index of suspicion. The process should be carried out in a multidisciplinary fashion with the transplantation team including specialists in infectious diseases. When evaluating these patients, conditions that are easily managed in other patients should be carefully investigated. Emergency care providers should recognize infections and other complications, obtain diagnostic work up, initiate empirical treatment and consider specialty consultation and inpatient admission. Even if these patients are referred to hospitals for reasons unrelated to transplantation, healthcare providers need to know their differences, the expected effects of the drugs to be administered, and to be aware of probable drug interactions while their treatment is being planned.
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    Assessment of Awareness Levels About Anticoagulants in Patients With Atrial Fibrillation Presenting to Emergency Department
    (Springer, 2021) Akman, Canan; Kırılmaz, Bahadır; Balcı, Serdal; Akşit, Ercan; Yurtseven, Ersan; Duygu, Ali
    Atrial fibrillation (AF) is a rhythm disorder observed mostly amongst adults. AF has been regarded as one of the most important medical problems because it leads to thromboembolism and paralysis risks. Although warfarin has been used in the past to cope with this health problem, new oral anticoagulant medicines have replaced it in the last few years. The new oral anticoagulants, namely, dabigatran etexilate, rivaroxaban, and apixaban, are currently being used in daily clinical practice and treatment guidelines. Since AF patients are supposed to receive long-term oral anticoagulant therapy, it is extremely important to provide them with accurate information and appropriate training regarding the treatment to decrease oncoming complications. This is a prospective study involving 168 patients who were admitted to the emergency department with AF and who were using oral anticoagulants. Findings indicate a lack of awareness in the patients regarding the effects and side effects of the drugs they take despite having been informed by the prescribing physician. We believe that informed action by patients with regard to the oral anticoagulants and their side effects will have an impact on the reduction in hospitalization observed. It will also make a substantial contribution to the quality of life of AF patients and to their use of medical services.
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    Black Widow Spider Envenomation with Elevated Troponin I Levels
    (Aves, 2018) Das, Murat; Akdur, Okhan; Akman, Canan; Cetinkaya, Yasemin
    Introduction: The black widow spider is found worldwide. Alpha-latrotoxin is responsible for the toxic effects related to the spider bite. We report the case of a patient who presented at the emergency department after being bitten by a black widow spider that later developed increased cardiac enzymes. Case Report: The patient was a 24-year-old male who had been bitten by a black spider inside his shoe while he was working in the garden. The patient was referred to the emergency department of department of emergency medicine Canakkale Onsekiz Mart University Faculty of Training and Research Hospital with nausea, vomiting, and severe rigidity in the abdomen for the differential diagnosis of acute abdomen. With severe sweating, the patient had rales in the lower lung zones, and abdominal examination revealed diffuse abdominal guarding. Blood biochemistry revealed creatine kinase (CK): 1838 U/L, CKMb: 71.6 U/L, and troponin I: 0.14 ng/mL. In follow-ups, the troponin I levels increased to 3.01 ng/mL. Electrocardiography revealed normal sinus rhythm. He was followed with a bedside monitor for 3 days in the emergency department. When the patient's troponin I and CK levels decreased, at the end of the third day he was discharged.. Conclusion: Black widow envenomation should be followed for cardiac toxicity other than symptoms, such as muscle spasms, sweating, anxiety, and headache.
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    Clinical, Demographic and Prognostic Evaluation of Patients Admitted the Emergency Department with Mushroom Poisoning
    (Gümüşhane Üniversitesi, 2023) Varışlı, Behçet; Yıldırım, Sinan; Akman, Canan; Ataç, Kenan; Çakır, Okan
    Fungal intoxications can lead to a variety of conditions ranging from simple gastroenteritis to severe neurological manifestations, and even fatal liver and kidney failure. In this study, we aimed to evaluate the diagnosis, treatment, prognosis and demographic data of patients admitted to the emergency department due to fungal intoxication. The aim of this study was to conduct a retrospective evaluation of examination findings, laboratory investigations, duration of treatments, hospitalization rates, and mortality rates in patients admitted to our emergency department due to fungal intoxication between October 01, 2017 and October 01, 2018. Of the 40 patients included in the study, 25 (62.5%) were female, with a mean age of 44.83 ± 17.00 years and a range of 18 to 82 years. Nausea and vomiting had the highest frequency (28 patients) among the presenting complaints of the patients. Only 11 (27.5%) patients underwent gastric lavage and decontamination with activated charcoal, whereas 29 (72.5%) patients had no gastric decontamination. The highest frequency of admissions was recorded in November. The highest frequency of patient admissions was between 01:00 and 02:00. It was concluded that there was a low rate of the administration of gastric decontamination in patients admitted to the emergency department, especially those admitted to the ward. In our study, the majority of patients with fungal intoxication had early-onset mild symptoms. Particular attention should be paid to early diagnosis and adherence to appropriate treatment algorithms in emergency departments, particularly in patients presenting with late-onset symptoms that may result in mortality.
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    DEVELOPMENT OF PRE-HOSPITAL EMERGENCY HEALTH SERVICES APPROACH SCALE TO TRAUMA PATIENTS
    (Paramedik Eğitiminde Standardizasyon ve Akreditasyon Derneği, 2022) Çebi, Gamze Ekrem; Akman, Canan
    Objective: It is the development of a measurement tool that measures the level of approach of pre-hospital emergency health care workers to trauma patients in a valid and reliable way.Materials and Methods: The research was structured in a descriptive approach. The research group is pre-hospital emergency health care workers. Since participation in the research is on a voluntary basis, the sample in the research can be evaluated in the context of purposeful sampling. In order to collect data, a candidate measurement tool form with 27 questions was created. SPSS 26.0 and AMOS statistical software were used in the analysis of the data. Explanatory factor analysis, reliability analysis and confirmatory factor analysis were performed. A sample application was made with the developed scale and comparison analyzes were made between the scale scores of the participants and their demographic variables.Results: As a result of the analyzes, it was determined that the scale was a single factored 11-item scale. This structure was confirmed by confirmatory factor analysis. The reliability value of the scale was determined as 0.923. In the sample application, the awareness of trauma was found to be higher in the employees who received training on trauma and followed the developments and new publications.Conclusion: It was concluded that the developed scale measures the approaches of emergency health care workers to trauma cases in a valid and reliable way. For a better trauma approach, module trainings should be given to employees as soon as possible and updates should be made periodically
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    Diagnostic and Prognostic Roles of Procalcitonin and Other Tools in Community-Acquired Pneumonia: A Narrative Review
    (Multidisciplinary Digital Publishing Institute (MDPI), 2023) Özbay, Sedat; Ayan, Mustafa; Özsoy, Orhan; Akman, Canan; Karcıoğlu, Özgür
    Community-acquired pneumonia (CAP) is among the most common causes of death and one of the leading healthcare concerns worldwide. It can evolve into sepsis and septic shock, which have a high mortality rate, especially in critical patients and comorbidities. The definitions of sepsis were revised in the last decade as “life-threatening organ dysfunction caused by a dysregulated host response to infection”. Procalcitonin (PCT), C-reactive protein (CRP), and complete blood count, including white blood cells, are among the most commonly analyzed sepsis-specific biomarkers also used in pneumonia in a broad range of studies. It appears to be a reliable diagnostic tool to expedite care of these patients with severe infections in the acute setting. PCT was found to be superior to most other acute phase reactants and indicators, including CRP as a predictor of pneumonia, bacteremia, sepsis, and poor outcome, although conflicting results exist. In addition, PCT use is beneficial to judge timing for the cessation of antibiotic treatment in most severe infectious states. The clinicians should be aware of strengths and weaknesses of known and potential biomarkers in expedient recognition and management of severe infections. This manuscript is intended to present an overview of the definitions, complications, and outcomes of CAP and sepsis in adults, with special regard to PCT and other important markers.
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    Diagnostic utility of microhematuria in renal colic patients in emergency medicine: correlation with findings from multidetector computed tomography
    (2019) Daş, Murat; Bardakçı, Okan; Yurtseven, Ersan; Akman, Canan; Beyazit, Yavuz; Akdur, Okhan
    Although urine analysis is a simple and inexpensive method for the initial evaluation of renal colic patients presenting in emergency departments, it is regarded as unreliable for an exact diagnosis of urinary system stones. The aim of the present study is to assess the association between clinical demographics, and stone size and location, with the combined utility of urinalysis and unenhanced multidetector computed tomography (MDCT) in the emergency department. After gaining local Ethics Committee approval, a retrospective study was conducted with data from 186 patients who presented at our emergency service with flank pain and documented urolithiasis. Stone location and size was determined by MDCT, and the presence of microhematuria confirmed by urinalysis. The presence of hydronephrosis and clinical complaints were also recorded. A total of 186 patients were included in the present study, in which an absence of microhematuria was recorded in 24.7% patients. Urine density was found to be elevated in the microhematuria group (p=0.001). Upper urinary tract stones and hydronephrosis were found to be associated with the presence of microhematuria. Although statistically insignificant, an increased trend of microhematuria was observed with stones over 5 mm in size. Urinary stone size and location are directly associated with the incidence of microhematuria. Absence of microhematuria does not preclude MDCT imaging, however, especially in cases where stones are suspected in patients with renal colic.
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    Effect of luer-lock access device on hemolysis during blood collection via intravenous catheters in the emergency department
    (Walter De Gruyter Gmbh, 2025) Cinpolat, Havva Yasemin; Akman, Canan; Sahin, Eda
    Objectives: Emergency departments are the units where hemolysis is most frequently observed, and blood collection from intravenous catheters increases the hemolysis rate. This study aimed to compare the effects of two different blood collection methods from an intravenous catheter (an adapter and a syringe) on serum indices, complete blood count, and routine clinical chemistry tests in an emergency department. Methods: The study encompassed 104 patients from the yellow and green zones of the Emergency Department at Canakkale Onsekiz Mart University Hospital. Blood samples were obtained from an intravenous catheter with a standard syringe and an adapter into serum separator tubes and dipotassium ethylenediaminetetraacetic acid (K(2)EDTA) tubes. Serum index, aspartate aminotransferase (AST), creatine kinase (CK), lactate dehydrogenase (LDH), potassium, high-sensitivity (hs) Troponin T, and complete blood count were evaluated. Passing-Bablok regression analysis was performed, and the mean percentage difference was calculated and compared to target values via a Bland-Altman plot. Results: A statistically higher hemolysis rate was observed when blood was collected with a syringe, compared to collecting blood with an adapter (p<0.001). When the results were categorized according to the parameter-specific hemolysis index, AST, CK, potassium, LDH, and hs Troponin T results were more affected by hemolysis when blood was collected with a syringe (p<0.001). The mean percentage difference for AST and LDH exceeded the minimum target values based on biological variation. Conclusions: Using a catheter-compatible adapter in emergency departments may reduce the rate of hemolysis and provide reliable results for tests frequently affected by hemolysis.