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    Öğe
    Biceps Tendon Rupture Diagnosed by Physical Examination and Bedside Ultrasonography in the Emergency Department
    (2015) Yıldırım, Ahmet; Akdur, Okhan; Balcı, Serdal; Beggi, Halil
    Giriş: Biceps proksimal uzun tendon (PBUT) rüptürü direk ve indirek travma sonrası görülen nadir bir klinik tablodur. Bu yazıda acil serviste fizik muayene ve yatak başı ultrasonografi (USG) ile tanı koyulan bir PBUT rüptürü olgusu sunuldu.Olgu Sunumu: 55 yaşında sağ elini kullanan bir erkek hasta acil servise sağ omuzda ağrı ve dirseği bükmede güçsüzlük şikayeti ile başvurdu. Öyküsünde 2 gün önce yerden yaklaşık 5 kg'lık bir ağırlığı kaldırırken sağ omuzda ani ağrı, yanma hissi ve çarpma sesi meydana geldiği öğrenildi. Fizik muayenede palpasyonla sağ omuz anteriorda ağrı ve hassasiyet dirsek fleksiyonunda distal yerleşimli biseps kası kitlesi tespit edildi. Acil servis hekimi tarafından 7.5-12 MHz linear prob ile yapılan yatak başı USG'de sağ omuz bicipital olukta tendon liflerinin olmadığı bir hipoekoik alan görüntülendi. Fizik muayene ve USG bulguları ile hastaya PBUT rüptür tanısı konuldu. Sonuç: Acil servislerde PBUT total rüptür tanısında yatak başı USG hızlı, yeterli ve ucuz bir tanı yöntemidir
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    Öğe
    Biceps Tendon Rupture Diagnosed by Physical Examination and Bedside Ultrasonography in the Emergency Department
    (Aves, 2015) Yildirim, Ahmet; Akdur, Okhan; Balci, Serdal; Beggi, Halil
    Introduction: A complete tear of the proximal long head of biceps tendon is a rare clinical condition that is caused by direct or indirect trauma. We report the case of a patient with a proximal long-head biceps (PLHB) rupture diagnosed by bedside ultrasonography (BUS) and physical examination in the emergency department (ED). Case Report: A-55-year-old, right-handed man presented to ED with pain in the right shoulder and weakness in the elbow. Two days before, while he was lifting a 5-kg object from the ground, he felt a sudden pain, a burning sensation, and an audible pop in his right shoulder. On physical examination, there was a severe pain and tenderness over the anterior aspect of the shoulder, proximal part of the biceps muscle, and distally located biceps muscle mass. An emergency medicine physician performed BUS with a 7.5- to 12-MHz linear transducer. In BUS, there was a hypoechoic area in the right shoulder bicipital groove, but there were no tendon fibers. The evaluation of both the physical examination and sonographic findings revealed a PLHB rupture. Conclusion: BUS is a fast and cost-effective imaging method for the diagnosis of PLHB total rupture in ED.
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    Öğe
    Hemodiyaliz hastalarında akut volüm kaybında periferal perfüzyon indeksi değişiminin araştırılması
    (Çanakkale Onsekiz Mart Üniversitesi, 2017) Beggi, Halil; Daş, Murat
    ÖZET Amaç: Kritik hastalarda ve akut volüm kayıplarında, sempatik sistem aktivite artışına sekonder periferal doku perfüzyonunun azaldığı çeşitli yöntemler kullanılarak gösterilmiştir. Hemodiyaliz hastalarında, saatler içinde litrelerce sıvı intravasküler alandan çekilmekte ve bu durum, hastaların volüm durumunda değişime neden olmaktadır. Bu süreç makrovasküler hemodinamik parametrelerle takip edilmiş ancak, ultrafiltrasyona bağlı oluşan bu volüm değişiminin periferal doku perfüzyonuna etkisi net değildir. Bizim amacımız hemodiyaliz hastalarındaki volüm değişiminin periferal doku perfüzyonuna etkisini, periferal perfüzyon indeksi ölçüm yöntemini kullanarak incelemektir. Yöntem: Dışlama kriterlerini taşımayan ve kronik aralıklı hemodiyaliz tedavisi alan 94 adet son böbrek yetmezliği hastası çalışmaya dahil edilmiştir. Gönüllülerden hemodiyaliz öncesi, hedef ultrafiltrasyon değerinin % 50 sine ulaşılınca ve hemodiyaliz sonrası olmak üzere üç kez periferal perfüzyon indeksi değeri ve diğer vital değişkenler ölçülmüştür. Periferal perfüzyon indeksi'nin değişimi, tekrarlayan ölçümlerde varyans analizi yöntemi ile değerlendirilip, p<0,05 anlamlı kabul edilmiştir. Bulgular: 94 gönüllünün 38'i kadın (%40,43), 56'sı erkektir (%59,57). Gönüllülerin ortanca yaşı 63 (54-70) yıl, hemodializ tedavi süreleri ortanca değeri 36 (12-96) aydır. Hemodiyaliz etyolojisi olarak en sık iki neden hipertansiyon(n=42) ve diyabet'tir (n=23) Ultrafiltrasyon boyunca PPİ değeri düşme eğilimi göstermektedir. PPİ'inin ortalama değeri işlemin ilk yarısında 3,47 (±1,97) den, 2,35 (±2,21)'e düşmüş daha sonra işlemin ikinci yarısında da düşme eğilimi devam etmiş ve üçüncü ölçümde ortalama değer 1,39 (±2,45) olarak ölçülmüştür. Bu değişim istatiksel olarak anlamlıdır. (p<0,001) Sonuç: Hemodiyaliz işlemi süresince ultrafiltrasyona bağlı olarak periferal doku perfüzyonu azalmaktadır ve bu durum periferal perfüzyon indeksi ölçüm yöntemi kullanılarak gösterilmiştir. Anahtar kelimeler; perfüzyon indeksi, hemodiyaliz, ultrafiltrasyon, periferal doku perfüzyonu.
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    Should computed tomography be the first choice in blunt chest trauma?
    (Nobelmedicus, 2018) Bardakçı, Okan; Akdur, Okhan; Karatağ, Ozan; Akdur, Gökhan; Alar, Timuçin; Beggi, Halil
    Objective: We aimed to determine whether thorax tomography, which can be chosen as the first imaging method in blunt thoracic injuries early for and accurate diagnosis, has superiority to chest radiography. Material and Method: Patients who referred to Emergency Service between January 1st, 2011 and December 31st, 2013 with blunt chest trauma were evaluated. The examination was performed retrospectively. Results: 131 (75.3%) of blunt chest trauma patients were male. The mean age of the cases was 44.7±19.1. When trauma mechanisms leading to chest trauma were discussed, the most common cause of trauma in-vehicle was traffic accidents in 63 (36.2%) cases. There were 40 patients (28.5%) with normal radiography and pathologic findings in chest computed tomography. It was seen that costa fractures were the pathologies which escaped the attention most commonly in radiography and detected in computed tomography imaging in 27 (67%) of 40 cases. Pathologies not seen in radiography were pneumothorax in 12 cases (30%), hemothorax in 9 cases (22.5%) and sternum fracture in 3 cases (7.5%). Discussion: In conclusion, it would be useful to use thorax tomography as the primary imaging, especially in blunt chest trauma in emergency care, to be able to intervene quickly. © 2018, Nobelmedicus. All rights reserved.
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    SHOULD COMPUTED TOMOGRAPHY BE THE FIRST CHOICE IN BLUNT CHEST TRAUMA?
    (Nobel Ilac, 2018) Bardakci, Okan; Akdur, Okhan; Karatag, Ozan; Akdur, Gokhan; Alar, Timucin; Beggi, Halil
    U Objective: We aimed to determine whether thorax tomography, which can be chosen as the first imaging method in blunt thoracic injuries early for and accurate diagnosis, has superiority to chest radiography. Material and Method: Patients who referred to Emergency Service between January 1st, 2011 and December 31st, 2013 with blunt chest trauma were evaluated. The examination was performed retrospectively. Results: 131 (75.3%) of blunt chest trauma patients were male. The mean age of the cases was 44.7 +/- 19.1. When trauma mechanisms leading to chest trauma were discussed, the most common cause of trauma in-vehicle was traffic accidents in 63 (36.2%) cases. There were 40 patients (28.5%) with normal radiography and pathologic findings in chest computed tomography. It was seen that costa fractures were the pathologies which escaped the attention most commonly in radiography and detected in computed tomography imaging in 27 (67%) of 40 cases. Pathologies not seen in radiography were pneumothorax in 12 cases (30%), hemothorax in 9 cases (22.5%) and sternum fracture in 3 cases (7.5%). Discussion: In conclusion, it would be useful to use thorax tomography as the primary imaging, especially in blunt chest trauma in emergency care, to be able to intervene quickly.
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    Öğe
    The relationship between high-sensitive troponin T, neutrophil lymphocyte ratio and SYNTAX Score
    (Informa Healthcare, 2014) Altun, Burak; Turkon, Hakan; Tasolar, Hakan; Beggi, Halil; Altun, Mehzat; Temiz, Ahmet; Gazi, Emine
    Aim. Cardiac troponins are the most preferred biomarkers in the evaluation of acute coronary syndromes (ACS). The aim of our study was to examine the association between high sensitive troponin T (hs-TnT), and neutrophil to lymphocyte ratio (NLR) and the complexity of ACS assessed by SYNTAX Score. Methods and results. 287 patients who underwent coronary angiography were studied (215 male, mean age 62.0 +/- 12.7 years). 133 patients were ST elevation myocardial infarction (STEMI), 154 patients were non-ST elevation (NSTE) ACS. The patients are divided to tertiles according to SYNTAX Score; SYNTAX Score <22 (n = 122) 22 < SYNTAX Score < 32 (n = 120), and SYNTAX Score >32 (n = 45). NLR was significantly correlated with SYNTAX Score in both STEMI and NSTE-ACS groups (r = 0.254, p = 0.003, r = 0.419 p < 0.001). Multiple linear regression analysis showed NLR predicted the angiographic severity of ACS assessed by SYNTAX Score in two groups (beta = 0.231, p = 0.004; beta = 0.232, p = 0.003). Hs-TnT was significantly correlated with SYNTAX Score in two groups (r = 0.327, p < 0.001; r = 0.430, p < 0.001). Multiple linear regression analysis showed hs-TnT was independent predictor of SYNTAX Score in STEMI and NSTE-ACS patients (beta = 0.292, p < 0.001; beta = 0.317, p < 0.001). Conclusion. Hs-TnT and NLR were significantly correlated with angiographic severity of ACS assessed by SYNTAX Score.