Yazar "Kalkan, Esin Akgul" seçeneğine göre listele

Listeleniyor 1 - 4 / 4
  • [ X ]
    Öğe
    Opinions of Chest Physicians About the Do-Not-Resuscitate (DNR) Orders: Respect for Patient's Autonomy or Medical Futility?
    (Aves, 2018) Kalkan, Esin Akgul; Mirici, Arzu
    Objective: In this study, we aimed to investigate physicians' knowledge, attitude, and behavior related to cardiopulmonary resuscitation (CPR) and the do-not-resuscitate (DNR) order, and the factors associated with decisions to abide by patients' DNR orders were also evaluated. Material and Methods: An e-survey designed by the research team, based on the European Resuscitation Council Guidelines (2015), American Heart Association Guidelines (2015) for resuscitation, and the relevant literature and legal regulations, was administered to resident and specialist doctors in chest diseases. Descriptive data of the number, percentage, and the mean and standard deviation are presented. The chi-squared test was used in the analysis of categorical data. Statistical significance was accepted as p<0.05. Results: The e-survey questions were answered by 376 physicians voluntarily. Of responders, 59.6% (n=224) were female, and the mean age was 40.2 +/- 9.0 years. Approximately 57% of physicians reported that if a doctor has decided medical futility, not performing CPR does not constitute an ethical debate. Responses indicated that 47.7% of physicians would abide by the DNR order. A statistically significant difference was identified between physicians' decision not to perform CPR and abiding by the patient's DNR orders (p<0.05). There was also a statistically significant difference between perceiving the DNR orders as euthanasia and thinking abiding by this decision was a crime and abiding by patient's DNR orders (p<0.05). Conclusion: In this study, we observed that two main factors are foreground in the implementation of the DNR order. The first of these is the physician's opinion about medical futility of CPR, and the other is the lack of specific laws regarding DNR in Turkey. Defining specific legal regulations related to end-of-life decisions like DNR will aid in ensuring patient autonomy.
  • [ X ]
    Öğe
    Quantitative Clinical Diagnostic Analysis of Acetone in Human Blood by HPLC: A Metabolomic Search for Acetone as Indicator
    (Hindawi Ltd, 2016) Kalkan, Esin Akgul; Sahiner, Mehtap; Cakir, Dilek Ulker; Alpaslan, Duygu; Yilmaz, Selehattin
    Using high-performance liquid chromatography (HPLC) and 2,4-dinitrophenylhydrazine (2,4-DNPH) as a derivatizing reagent, an analytical method was developed for the quantitative determination of acetone in human blood. The determination was carried out at 365 nm using an ultraviolet-visible (UV-Vis) diode array detector (DAD). For acetone as its 2,4-dinitrophenylhydrazone derivative, a good separation was achieved with a ThermoAcclaim C-18 column (15 cm x 4.6mm x 3 mu m) at retention time (t(R)) 12.10 min and flowrate of 1mL min(-1) using a (methanol/acetonitrile) water elution gradient. The methodology is simple, rapid, sensitive, and of low cost, exhibits good reproducibility, and allows the analysis of acetone in biological fluids. A calibration curve was obtained for acetone using its standard solutions in acetonitrile. Quantitative analysis of acetone in human blood was successfully carried out using this calibration graph. The applied method was validated in parameters of linearity, limit of detection and quantification, accuracy, and precision. We also present acetone as a useful tool for the HPLC-based metabolomic investigation of endogenous metabolism and quantitative clinical diagnostic analysis.
  • [ X ]
    Öğe
    Role of pleural fluid attenuation values on CT for hemothorax diagnosis in trauma patients
    (E-Century Publishing Corp, 2018) Kalkan, Esin Akgul; Aylanc, Nilufer
    Background and aim: Hemothorax is a critical issue in patients with chest trauma. It should be diagnosed quickly and accurately. The study's aim was to define the potential role of pleural fluid (PF) attenuation value determined on computerized tomography (CT) for the diagnosis of traumatic hemothorax. Methods: From 01.07.2011 to 01.07.2016, patients with PF detected on CT with tube thoracostomy were reviewed. On CT sections, PF attenuation values taken from levels where pleural fluid had the most intense appearance were measured as Hounsfield Units (HU). The relationship between HU values and chest traumatic findings, macroscopic discharge diagnosis, peripheral blood Hb and Htc levels and CT protocol were investigated. Results: Thirty eight cases were reviewed in the study group. All PF HU values were determined to be more than 20.0 HU. PF attenuation values were more than 35 HU in 71.1% (n:27) of the cases and between 20.0 and 34.9 for 28.9% (n:11). In the subgroup with hemorrhagic fluid drained from the thoracic cavity, HU values were often higher than 35. For the sub-groups with and without coexisting traumatic findings, there was no statistically significant difference in terms of PF density being below or above 35 HU. No statistically significant correlation was detected between PF HU values and age, peripheral blood Hb and Htc values. Conclusion: For thorax trauma cases, PF attenuation values were between 20.0 to 34.9 HU, and more than 35 HU. Patients with acute trauma who have PF with attenuation value below 35 HU should be considered as hemothorax primarily, even with no coexisting traumatic findings on CT scans.
  • [ X ]
    Öğe
    Trauma and Intentional Injury Characteristics of Pediatric Forensic Cases Applying to Emergency Room
    (Derman Medical Publ, 2016) Kalkan, Esin Akgul; Yildirim, Ahmet; Akdur, Okhan
    Aim: In this study, we aim to reveal the characteristics of intentional injuries and the trauma profiles in order to prevent injuries in pediatric forensic cases. Material and Method: Forensic cases of patients aged 18 or younger who were admitted into emergency service were analyzed retrospectively in terms of age, gender, type of injury, and etiology of trauma between January 1, 2014 and December 31. 2014. Results: Of the 148 cases, 62(41.995) were female and 86(58.1%) male; the mean age was 11.260.4. The most common cause of injury was traffic accident (46.695). The second most common type of injury was intentional injuries (21.686). The distribution of intentional injury is: beating in 20 cases (13.586), stab wounds in 7 cases (4.795), gunshot wounds in 1 case (0.79'o), sexual abuse in 1 case (0.765), and attempted suicide in 3 cases (286). Eleven (7.486) cases had life -threatening injuries. Discussion: Most injuries are preventable because they are due to traffic accidents. Intentional injuries were more frequent during school age and adolescence. Understanding these findings is very important in developing child safety programs to reduce injuries.