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    Evaluation of Risk Factors and Clinical Characteristics of Elderly Patients with Acute Upper Gastrointestinal Hemorrhage
    (Elsevier Science Bv, 2012) Sayhan, Mustafa Burak; Oguz, Serhat; Umit, Hasan; Sayhan, Esin Secgin; Eralp, Mustafa Onur; Akdur, Gokhan; Kavalci, Cemil
    Objectives Acute upper gastrointestinal hemorrhage (AUGIH) is a life-threatening emergency problem in the elderly population. In this study, we aimed to determine the sociodemographic characteristics, clinical features and the risk factors of the elderly patients presenting to the Emergency Department (ED) with AUGIH. Methods A cross-sectional study was conducted in a university-based hospital. One hundred and ninety-four patients were divided into two groups: Group A (n=128); elderly group (65-79 years) and Group B (n=66); very elderly group (>79 years). Results The mean age was 76.34 +/- 7.91 years. The most frequently presenting symptom was melena (87.1%). Fourteen patients (7.2%) were in shock at the time of bleeding. One hundred and thirty-three patients (68.5%) had a history of rebleeding. Underlying comorbidities were detected in 171 patients (88.1%). There was a significant difference in terms of alcohol abuse and coronary artery disease between the two groups (p=0.038 and p=0.049 respectively). The most frequent endoscopic lesions were peptic ulcer and gastroduodenal erosions in both groups. Conservative medical treatments were applied in most of the patients in both groups, but there were no statistically significant differences in terms of response to conservative medical treatment between the two groups (p=0.892). The overall mortality rate was 11.7% in group A and 19.7% in group B. There were no statistically significant differences in mortality between the two groups (p=0.134). Conclusions Evaluation of risk factors and clinical characteristics of elderly patients with upper gastrointestinal hemorrhage is extremely important. Comorbid diseases and multiple drug use are commonly observed in the elderly patients.
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    Isolated Transverse Sacrum Fracture: A Case Report
    (Hindawi Ltd, 2011) Kavalci, Cemil; Akdur, Gokhan; Sayhan, Mustafa Burak; Sogut, Ozgur; Gokdemir, Mehmet Tahir
    Sacral fracture commonly results from high-energy trauma. Most insufficiency fractures of the sacrum are seen in women after the age of 70. Fractures of the sacrum are rare and generally combined with a concomitant pelvic fracture. Transverse sacral fractures are even less frequent which constitute only 3-5% of all sacral fractures. This type of fractures provide a diagnostic challenge. We report a unique case of isolated transverse fracture of sacrum in a young man sustained low-energy trauma. The patient presented to our emergency department after several hours of injury, and diagnosed by clinical features and roentgenogram findings.
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    The Value of Serum BNP for the Diagnosis of Intracranial Injury in Head Trauma
    (Elsevier Science Bv, 2012) Kavalci, Cemil; Akdur, Gokhan; Yemenici, Serap; Sayhan, Mustafa Burak
    Objectives Head injuries are the leading cause of death in persons less than 45 years old. In order to diagnose these patients, cranial computed tomography (CT) is used. Brain natriuretic peptide (BNP) was isolated first from the cerebral ventricles. The aim of this study was to research whether bedside BNP measurement has a place in determining intracranial injury in patients admitted to the emergency department (ED) with head trauma. Methods The study was done prospectively in the ED of the Trakya University Hospital. Patients admitted to the ED because of head injury (100 patients), and a control group (20 healthy volunteers) were enrolled in the study. Mann-Whitney U test was used to compare the binary groups, and Kruskal-Wallis test was used to make multi-group comparison. A p-value of <0.05 was considered to be significant. Results Demographic features of the subjets showed that eighty-one patients (81%) were male, and 19 (19%) were female. The median serum BNP level was 5.00 pg/ml in a total 86 patients in the cranial CT (-) group. The mean serum BNP level in 14 patients of the cranial CT (+) group was 6.15 pg/ml. There was no statistically significant difference between these two groups from the point of serum BNP levels (p>0.05). Conclusions The study showed that serum BNP examination to reveal any intracranial injury in patients with head trauma was poor.