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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, HalilIntroduction: 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.Öğe Comparison of Macintosh, McCoy and C-MAC D-Blade video laryngoscope intubation by prehospital emergency health workers: a simulation study(Springer-Verlag Italia Srl, 2017) Yildirim, Ahmet; Kiraz, Hasan A.; Agaoglu, Ibrahim; Akdur, OkhanThe aim of the this study is to evaluate the intubation success rates of emergency medical technicians using a Macintosh laryngoscope (ML), McCoy laryngoscope (MCL), and C MAC D-Blade (CMDB) video laryngoscope on manikin models with immobilized cervical spines. This randomized crossover study included 40 EMTs with at least 2 years' active service in ambulances. All participating technicians completed intubations in three scenarios-a normal airway model, a rigid cervical collar model, and a manual in-line cervical stabilization model-with three different laryngoscopes. The scenario and laryngoscope model were determined randomly. We recorded the scenario, laryngoscope method, intubation time in seconds, tooth pressure, and intubation on a previously prepared study form. We performed Friedman tests to determine whether there is a significant change in the intubation success rate, duration of tracheal intubation, tooth pressure, and visual analog scale scores due to violations of parametric test assumptions. We performed the Wilcoxon test to determine the significance of pairwise differences for multiple comparisons. An overall 5 % type I error level was used to infer statistical significance. We considered a p value of less than 0.05 statistically significant. The CMDB and MCL success rates were significantly higher than the ML rates in all scenario models (p < 0.05). The CMDB intubation duration was significantly shorter when compared with ML and MCL in all models. CMDB and MCL may provide an easier, faster intubation by prehospital emergency health care workers in patients with immobilized cervical spines.Öğe Correlation of ischemia-modified albumin levels and histopathologic findings in experimental ovarian torsion(Kare Publ, 2016) Yildirim, Ahmet; Yildirim, Sule; Topaloglu, Naci; Tekin, Mustafa; Kucuk, Adem; Erdem, Havva; Erbas, MesutObjectives: Ischemia modified albumin (IMA) levels significantly increased and may be used as a diagnostic marker in ovarian torsion. The aim of this study is to investigate whether there was any correlation between IMA levels and histopathologic changes in experimental ovarian torsion. Material and methods: Fourteen Sprague-Dawley rats, each weighing 220-250 g were divided randomly into 2 groups; in Group 1, the control group (n = 7), only laparotomy was performed and in Group 2, the experimental group (n = 7), ovarian torsion was performed. Ischemia was performed for 3 h; following the ischemia period, the torsion was relieved by detwisting the adnexa and then the ovarian I/R protocol was applied for 3 h. Blood samples were taken from all of the rats to measure the IMA levels and the ovaries were surgically removed for histologic examination. A blinded pathologist examined and scored the samples. Results: The median (minimum-maximum) IMA values were 921.00 (870.00-966.00) ABSUs in the ovarian torsion group and 853.00 (782.00-869.00) ABSUs in the control group. The difference was statistically significant. In the correlation analysis, a significant and strong correlationwas found between IMA levels and histopathologic changes (Spearman's rho = vertical bar 0.987, p < 0.001). Conclusion: Positive correlation was found between the IMA levels and the histopathologic severity of the disease. This finding is important for both diagnosis of the disease and patient follow-up. As a new marker in ovarian torsion, IMA may also indicate the severity of the ovarian histopathology. Copyright (C) 2016 The Emergency Medicine Association of Turkey. Production and hosting by Elsevier B.V. on behalf of the Owner.Öğe Myelin basic protein and ischemia modified albumin levels in acute ischemic stroke cases(Professional Medical Publications, 2015) Can, Serdar; Akdur, Okhan; Yildirim, Ahmet; Adam, Gurhan; Cakir, Dilek Ulker; Karaman, Handan Isin OzisikObjective: To investigate early diagnostic effects of serum myelin basic protein (MBP) and ischemic modified albumin (IMA) levels in patients with ischemic stroke. Methods: Fifty patients who presented to an emergency service with acute ischemic stroke between June 2013 to March 2014 were evaluated with the National Institute of Health Stroke Scale (NIHSS) and diffusion-weighted magnetic resonance imaging (MRI). Thirty four healthy cases were included as control group. All patients' serum IMA and MBP level were assessed. Results: Mean IMA value was 0.52 +/- 0.25 cases with acute ischemic stroke and serum IMA levels were significantly higher than the control group (p<0.01). No statistical significance was observed between acute ischemic stroke group and control group related to the MBP serum levels (P>0.05). Statistically significant correlation was detected between the volumes of diffusion restriction on MRI and NIHSS score (P=0.002,r=0.43) and IMA (P=0.015,r=0.344) levels. Conclusions: We have found that serum IMA levels are elevated in acute ischemic stroke cases and these levels are correlated with the ischemic tissue volume. MBP levels do not increase in early period of stroke cases.Öğe New equations for kinetic analysis of non-isothermal thermogravimetry(Asian Journal Of Chemistry, 2008) Dogan, Fatih; Yildirim, Ahmet; Yuerekli, MehmetNew equations have been proposed for the evaluation of the kinetic parameters from non-isothermal thermogravimetry. The Arrhenius temperature integral. In p(x), values were computed from the recently proposed series and approximations. The validity of the new equations has been confirmed by the analysis of theoretical and experimental thermogravimetric curves. The kinetic parameters computed using the proposed equations show better agreement for theoretical TG curves than the well-known methods.Öğe Protective role of Proanthocyanidin in experimental ovarian torsion(Tehran University of Medical Sciences, 2015) Yildirim, Şule; Topaloğlu, Naci; Tekin, Mustafa; Küçük, Adem; Erdem, Havva; Erbaş, Mesut; Yildirim, AhmetBackground: Proanthocyanidin is a potent bioactive antioxidant naturally occurring in grape seed and acts as reactive oxygen species (ROS) scavenger. The aim of this study was to investigate the effects of proanthocyanidinin in experimental ovarian torsion injury. Methods: Twenty four rats were randomly divided into three groups (n=8). Group 1: the laparotomy group, group 2: ovarian torsion group, and group 3: intervention group administered proanthocyanidinin of 50 mg/kg before bilateral ovarian ischemia and reperfusion. Histologic examination and scoring was done at the end of the experiment. Statistical analyses were performed using the SPSS v. 19. Results: Ovarian histopathologic findings of all three groups were significantly different in terms of hemorrhage (p<0.001), edema (p=0.001) and vascular dilatation (p<0.001). Pathologic changes induced by I/R were reduced in ovaries of rats administered proanthocyanidin, in particular, hemorrhage, edema and vascular dilatation. Conclusion: Proanthocyanidin, known as free radical scavenger and antioxidant, is protective against tissue damage induced by ischemia and/or ischemia/reperfusion in rat ovaries.Öğe Trauma and Intentional Injury Characteristics of Pediatric Forensic Cases Applying to Emergency Room(Derman Medical Publ, 2016) Kalkan, Esin Akgul; Yildirim, Ahmet; Akdur, OkhanAim: 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.
