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    112 Acil Sağlık Personelinin Elektrokardiyografi Hakkındaki Bilgi Tutum ve Davranışlarının Saptanması
    (2020) Özışık, Ozan; Sayhan, Mustafa Burak; Salt, Ömer
    Amaç: Acil kardiyak hastalıkların tedavisinde en önemli faktörlerden biri erken tanıdır. Bu kapsamda, acil sağlık perso-nelinin tanıdaki en önemli yardımcısı ise elektrokardiyografidir (EKG). Sağlık personelinin elektrokardiyografi konusunda yeterli deneyim ve bilgiye sahip olması çok önemlidir. Bu çalışmada, 112 acil sağlık personelinin (Paramedik, Acil Tıp Teknisyeni-ATT) EKG hakkındaki bilgi, tutum ve davranış özelliklerinin araştırılması, varsa eksikliklerin saptanması ve sağlık personelinin bu husustaki beklentilerinin belirlenmesi amaçlanmıştır.Yöntem: Bu çalışma, 8-15 Nisan 2016 tarihleri arasında, yüz yüze anket uygulanması yöntemiyle gerçekleştirildi. Anket, açık uçlu ve çoktan seçmeli 51 sorudan oluşmaktaydı. Bulgular: Çalışmaya toplam 122 katılımcı dahil edildi. Katılımcıların yaş ortalaması 27,58± 4,59 yıl, ortalama görev süreleri ise 5,71±3,43 yıl olarak belirlendi. Katılımcılar meslekleri açısından incelendiğinde; %63,1’inin (n=77) acil tıp teknisyeni, %36,9’unun (n=45) paramedik olduğu görüldü. Katılımcıların eğitim durumları incelendiğinde, %36,9’unun (n=45) ön lisans, %63,1’inin (n=77) ise sağlık meslek lisesi mezunu olduğu belirlendi. Katılımcıların tamamına yakını (%98,4) göğüs ağrısı tarifleyen hastalara EKG çektiğini belirtti. Katılımcıların büyük çoğunluğu (%90,2) EKG çekimi sırasında ekstremite derivasyonlarının nasıl yerleştirileceğini biliyor iken, sadece %23‘ü (n=28) göğüs derivasyonlarını doğru yerleştirmeyi biliyordu. Paramedik ve ATT’lerin %74,6’sı (n=91) daha önce EKG eğitimi almış olmalarına rağmen, %94,3’ü (n=115) bu eğitimlerin yinelenmesini istedi. EKG eğitimi almak isteyen katı-lımcıların %87’si (n=114) bu eğitimin doktor tarafından verilmesini isterken, Sorumlu/eğitim hemşiresi ya da Paramedik/ATT tarafından verilmesini isteyenlerin oranı sırasıyla %2,3 (n=3) ve %10,7 (n=14) idi. Meslek gruplarına göre analiz yapıldığında, her iki grubun EKG çekmeden önce hastayı işlem hakkında bilgilendirme davranışları benzerdi (p=0,183). Paramedikler ve ATT’ler arasında EKG kağıdı üzerindeki çizgiler ve fonksiyonlarını tanı-ma açısından fark olmadığı belirlendi (p=0,132) Elektrokardiyogramda ritm analizi, hız ölçümü, dalga paternleri ve ST segment anomalilerinin değerlendirilmesi açısından paramedik ve ATT’ler benzer oranlarda doğru yanıt verdiler. ATT’lerin, paramediklere kıyasla supraventriküler taşikardi ve sinüzal taşikardi tanısı koymada daha fazla hata yaptıkla-rı görüldü (sırasıyla p=0,004-0,035).Sonuç: Bu çalışmada elde edilen veriler ışığında, 112 istasyonlarında çalışan paramedik ve acil tıp teknikerlerinin elekt-rokardiyogram çekilme amacı, ritm analizi, hız ölçümü, dalga paternleri ve ST segment anomalilerinin değerlendirilme-sine yönelik sorulara yüksek oranda doğru yanıt verdikleri belirlenmiş ve bu konudaki eğitimlerin sürekliliğinin önemi bir kez daha ortaya çıkmıştır
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    Acil Serviste Düzenlenen Adli Raporların Değerlendirilmesi
    (2017) Yemenici, Serap; Sayhan, Mustafa Burak; Salt, Ömer; Yılmaz, Ahmet
    Amaç: Acil servis hekimlerinin, tedavi edici görevlerinin yanı sıra adli hekimlik görevleri de bulunmaktadır. Bu çalışmada hekimler açısından çoğu zaman sıkıntı ve endişeye neden olan adli raporların düzenlenmesindeki hata ve eksikliklerin belirlenmesi, mevcut genelge ve yasalar ile uluslararası standartlar çerçevesinde değerlendirilmesi amaçlanmıştır. Materyal ve Metod: Çalışmaya 23 ay süresince üçüncü basamak Erişkin Acil Serviste Acil Tıp Araştırma düzenlenen, adli raporuna ulaşılabilen 18 yaş üzeri 2478 olgu dâhil edildi. Rapolar Olguların kimlik bilgileri, fizik bakı bulguları harici travmatik lezyonların özellikleri, muayene tarihi ve saati, raporun düzenlenme tarihi ve saati, muayene eden doktorun adı ve imzası, teslim alan görevlinin adı ve imzası, lezyonun yaşamsal tehlike oluşturup oluşturmadığı ve basit tıbbi müdahale ile iyileşebilme durumu ile solunum havasındaki alkol yoğunluğu ölçüm sonucunun belirtilip belirtilmediği, adli raporlarda uygunsuz olarak kullanılan kısaltmalar ve okunabilirlik açısından değerlendirildi. Bulgular: Raporların tümünde bir ya da daha fazla eksiklik tespit edildi. En yüksek oranda saptanan eksiklikler; hasta yaşı ve baba adı bilgileri idi (sırasıyla % 83,5, % 82,2). Adli raporda bulunması gereken fizik inceleme bulgularından, genel durum (% 96,4) ve bilinç durumunun (% 95,1) raporlarda yüksek oranlarda yer aldığı görülürken, Harici lezyon tarif edilen toplam 1763 olgunun, 812'sinde (%46,1) lezyonların ayrıntılı tanımlamasının yapılmadığı, 1718'inde(% 97,4) ise lezyonların vücut diyagramında işaretlenmediği tespit edildi. Raporların % 7,6' sında yaralanmanın hayati tehlikeye neden olup olmadığı konusunda, % 8,9' unda basit tıbbi müdahale ile giderilip giderilemeyeceği konusunda görüş belirtilmediği tespit edildi. Sonuç: Adli raporlardaki hata ve eksikliklerin belirlenmesi bu konuya dikkat çekerek, hekimlerin karşılaşabileceği "adli sorumluluğu ihmal" ve "gerçeğe aykırı bilirkişilik" gibi suçlanmaların önlenmesine katkı sağlayacaktır. Bu konuda mezuniyet öncesi ve sonrası eğitim çalışmalarına daha fazla önem verilmesi gerektiği düşüncesindeyiz.
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    The Analysis of Patients Admitted to the Emergency Department Due to Complications Related to Warfarin Treatment
    (Aves, 2014) Sayhan, Mustafa Burak; Oguz, Serhat; Yuksel, Volkan; Huseyin, Serhat; Sayhan, Esin Secgin; Yagci, Gokce
    Objective: Warfarin is the most commonly used oral anticoagulant around the world. The most important complication of warfarin is bleeding. This study was conducted to evaluate the patients who were admitted to our emergency department due to complications related to warfarin treatment. Material and Methods: Eighty-nine patients (32 females, 57 males) were enrolled into this retrospective study. The patients were evaluated according to their age, gender, duration of therapy (year), co-administered drugs, bleeding localization, treatments, amount of blood transfusions, duration of bleeding, initial and after-treatment PT, INR, complete blood count, and aPTT. Results: Mean duration of anticoagulant use was 3.05 +/- 2.87 years. The most common indication of warfarin was atrial fibrillation. The most frequent bleeding localization was the upper gastrointestinal tract. Thirty-four (38.2%) of the patients had major bleeding, and 55 (61.8%) had minor bleeding. Age, co-administered drugs, amount of erythrocyte suspension transfusion, presence of previous warfarin overdose history, Hb levels at admission, and duration of follow-up in the ED were different between the bleeding types. Conclusion: In this study, we found that the bleeding complications of warfarin were associated with the aged population, presence of previous warfarin overdose history, and concomitant drug use.
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    Analysis of Patients Injured During the Local Elections in Sanliurfa Province
    (Elsevier Science Bv, 2012) Gokdemir, Mehmet Tahir; Sogut, Ozgur; Erdogan, Mehmet Ozgur; Kaya, Halil; Sayhan, Mustafa Burak; Karasu, Mehmet
    Objectives Criminal cases constitute a significant part of the patients referred to the emergency department. In this study, we aimed to analysis the cases who admitted to our emergency department resulted in judicial incidents due to the local elections in the surrounding of Sanliurfa. Methods Cases referred to the Emergency Department due to injuries obtained during the local elections held on March 29, 2009 were included in the study. Computer records, hospital treatment order books, judicial records, and autopsy reports were examined. Results In total, 126 people injured during the local elections between March 29, 2009 and March 30, 2009 were referred to the Emergency Department of the Education and Research Hospital, Sanliurfa. The Hospital Disaster Plan was activated, and triage was performed. Of the 126 patients, 119 (94.4%) were male, and 7 (5.6%) were female; the average age was 37 years. The most frequent cause of injury was beating, and deaths were mostly due to cranial trauma caused by firearm injuries. After first evaluation and treatment in the emergency department, of the 98 (77.7%) were discharged, 28 (22.3%) were hospitalized, and 6 died. Conclusions In the present study, our objective was to draw attention to the criminal incidents resulted from mass casualities in the districts of Sanliurfa and its villages and management of those cases in our emergency department.
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    Atypical Presentation of A Foreign Body: Case Report
    (Galenos Publ House, 2011) Sayhan, Mustafa Burak; Kavalci, Cemil; Orak, Murat
    Foreign bodies are seen in all age groups. Foreign bodies are detected as a result of accidents or abuse. Diabetic neuropathy frequently occur as complications of diabetes. Our patient was a 55 year old female patient admitted to our emergency department with the complaint of insect bites. Atwo mm diameter redness was present on the right hip and a 15 cm needle was observed on the pelvis X-ray. The needle was removed surgically. Careful history and physical examination should be carried out especially in diabetic patients.
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    Avascular necrosis of lunate bone: Kienbock disease
    (W B Saunders Co-Elsevier Inc, 2016) Salt, Omer; Sayhan, Mustafa Burak
    [Abstract Not Available]
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    Bilateral femur neck fracture in a young child
    (Int Scientific Literature, Inc, 2010) Gokdemir, Mehmet Tahir; Yar, Umit; Kara, Pinar Hanife; Sayhan, Mustafa Burak; Kavalci, Cemil
    Background: Bilateral femur neck fracture is a very rarely seen situation. Traumas rarely result in such fracture. The aim of this study was to highlight the importance of naked examination of a patient in trauma cases and to report a bilateral femoral neck fracture due to a fall, rarely seen in literature. Case Report: A five-year-old girl was admitted to the department. The case, diagnosed as bilateral femur neck fracture due to a fall after being pushed with force by her sibling and falling from a high place, is reported and a literature review was carried out. The fractures were not diagnosed in the hospital she was first taken to. Conclusions: Thorough physical examination of such trauma patients is extremely important. Traumatic bilateral femur neck fracture is very rarely seen in younger children.
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    Calcified Hydatid Cyst: Original Image
    (Derman Medical Publ, 2015) Kavalci, Cemil; Sezenler, Eylem; Sayhan, Mustafa Burak
    [Abstract Not Available]
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    Cardiac Rupture Due to Fall: a Case Report
    (Aves, 2012) Gokdemir, Mehmet Tahir; Karasu, Mehmet; Sayhan, Mustafa Burak; Kavalci, Cemil; Sogut, Ozgur
    Falls commonly seen in all age groups are important causes of morbidity and mortality. Traumatic cardiac rupture due to falls is rarely seen. A three-year-old boy was admitted to our emergency department in shock with 112 ambulance. The child had fallen from a height of 20 meters. Death was seen as a result of the rupture of the right ventricle at the autopsy.
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    Chilaiditi's syndrome
    (Pakistan Medical Assoc, 2010) Sayhan, Mustafa Burak; Kavalci, Cemil; Bakirci, Tarkan; Gokdemir, Mehmet Tahir
    [Abstract Not Available]
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    Comparison of Different Suture Techniques
    (Derman Medical Publ, 2015) Kavalci, Cemil; Cevik, Yunsur; Durukan, Polat; Sayhan, Mustafa Burak
    Aim: Traumas are frequent causes of presentation to emergency departments. Suturing is usually required in treatment of patients with scalp laceration. This study aimed to investigate different suture methods with respect of patient satisfaction, wound healing, and treatment cost in patients with scalp laceration. Material and Method: A total of 60 patients were included in the study. The patients were divided into 3 groups; traditional suturing (Group 1), stapling (Group 2), and the tissue adhesive (Group 3) groups. Chi-Square and Kruskal-Wallis tests were used for comparison of the groups. A p value less than 0.05 was considered statistically significant. Results: Two-thirds of the patients were male. The patient satisfaction was highest in the Group 3 (p<0.05). Tissue adhesive group had the lowest treatment cost (p<0.05). Discussion: In contrast to existing traditional belief, the alternative suture methods, i.e. tissue adhesives and staples are not expensive. The patient satisfaction was highest in the tissue adhesive group.
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    Comparison of sirolimus and colchicine treatment on the development of peritoneal fibrozis in rats having peritoneal dialysis
    (2015) Sağıroğlu, Tamer; Sayhan, Mustafa Burak; Yağcı, Mehmet A.; Yalta, Tülin Deniz; Sağıroğlu, Gönül; Çopuroğlu, Elif; Oğuz, Serhat
    Background: Continuous ambulatory peritoneal dialysis is a successful treatment modality for patients with end-stage renal disease. Peritoneal fibrosis (PF) is the most critical complication of long-term peritoneal di- alysis (PD). Aims: In our study, we aimed to compare the effects of colchicine and sirolimus on PF induced by hypertonic peritoneal dialysis solutions in rats. Study Design: Animal experiment. Methods: Twenty-four rats were randomly divided into three groups. The control group received an intraperitoneal injection (ip) of saline. The sirolimus group received the PD solution, plus 1.0 mg/kg/day Rapamune®. The colchicine group received the PD solution ip plus 1.0 mg/kg/day of colchicine. Blood sam- ples were taken to measure the serum levels of VEGF, TGF-&#946;, and TNF-&#945;. Peritoneal tissue samples were taken for histopathological evaluation. Results: TGF-&#946; and TNF-&#945; values in the sirolimus group were found to be statistically significantly lower than in the control and colchicine groups, but the differences between the control and colchicine groups were not statistically significant. No statistically significant differences were found between the groups regarding the VEGF values. Vascular neogenesis and peritoneal thickness were compared; the values in the sirolimus group were statistically reduced compared to the values in the control group. Mild fibrosis developed in 75% of all animals in the sirolimus group; there was no moderate or severe fibrosis observed. Fibrosis developed to varying degrees in 100% of the animals in the control and colchicine groups. Conclusion: The present study demonstrates that sirolimus might be beneficial for preventing or delaying the progression of PF and neoangiogenesis. These alterations in the peritoneal membrane may be connected with reduced TNF-&#945; and TGF-&#946; levels.
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    Cutaneous Burn Wound caused by Liquid Ammonia: Case Report
    (Emergency Medicine Physicians Assoc Turkey, 2010) Kiyak, Medeni Volkan; Sayhan, Mustafa Burak; Kavalci, Cemil; Kopal, Can; Unaldi, Mehmet
    Ammonia related injuries are rarely seen but they are associated with high morbidity and mortality. Liquid ammonia burns the skin through a freezing mechanism, a thermal mechanism, and an alkali burn as well. The burn associated with liquid ammonia is multifactorial. In this case report we aimed to point out the pathophysiology and treatment of cutaneous burn wound caused by liquid ammonia.
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    DEMOGRAPHIC PROPERTIES AND FACTORS AFFECTING MORTALITY OF ELDERLY PATIENTS RELATED WITH MOTOCYCLE INJURIES
    (Gunes Kitabevi Ltd Sti, 2013) Sayhan, Mustafa Burak; Sayhan, Esin Secgin; Oguz, Serhat; Kavalci, Cemil; Guler, Ebru
    Introduction: To determine the socio-demographic attributes, trauma scoring systems' relationship to mortality rates and the factors affecting mortality of the victims of motorcycle accidents (VMAs) over 65 who arrive at the emergency department. Materials and Method: A descriptive study was conducted in a university-based hospital. Patients were divided into two groups: survival (group A) and deceased (group B). Results: A total of 108 patients who were VMAs were identified. 96 patients were in group A and 12 were in group B. We especially noted the existence of internal injuries, head injuries, multiple injuries and alcohol intake (p=0.029) as risk factors affecting mortality. The Injury Severity Score (ISS) and Abbreviated Injury Scale (AIS) were found to be higher in group B compared to group A (p=0.003, 0.001, respectively). The Glasgow Coma Score (GCS), Trauma Injury Severity Score (TRISS) and Revised Trauma Score (RTS) were found to be higher in group A compared to group B (p<0.001 for both). Conclusion: Most of the motorcycle-related injuries in elderly involved men, and occurred in urban areas, during the summer and on weekdays, with a mechanism of falling off the motorbike. Skin and musculoskeletal systems were injured most frequently in our study.
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    Early oxidative status in adult patients with isolated traumatic brain injury
    (Tubitak Scientific & Technological Research Council Turkey, 2012) Sogut, Ozgur; Kaya, Halil; Gokdemir, Mehmet Tahir; Solduk, Leyla; Dokuzoglu, Mehmet Akif; Sayhan, Mustafa Burak; Kaya, Atilhan
    Aim: To investigate oxidative and antioxidative status, as well as the Glasgow Coma Scale (GCS) and Revised Trauma Score (RTS), reflecting injury severity and neurological outcome during the early posttraumatic period in patients with isolated traumatic brain injury (TBI). Materials and methods: Fifty-one adult patients with TB! and 45 eligible healthy volunteers as control subjects were enrolled. Plasma total oxidant status (TOS), total antioxidant status (TAS), and the oxidative stress index (OSI) were calculated as biomarkers of early oxidative changes in serum using a novel automated method. Results: TOS levels and OSI values were significantly higher in nonsurvivors compared with those in survivors. However, there was no significant difference in TAS levels between survivors and nonsurvivors. GCS and RTS showed negative correlations with TOS levels, but neither was significantly related to OSI levels. Furthermore, GCS scores were negatively correlated with TAS levels, whereas RTS scores were not significantly related to TAS levels. Conclusion: Patients with isolated TBI are exposed to potent oxidative stress. TOS, as an early oxidative stress biomarker, might reflect the severity of cerebral insult in those patients.
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    The effects of apelin on mesenteric ischemia and reperfusion damage in an experimental rat model
    (2012) Sağıroğlu, Tamer; Oğuz, Serhat; Sağıroğlu, Gönül; Çopuroğlu, Elif; Yalta, Tülin; Sayhan, Mustafa Burak; Yağcı, Mehmet Ali
    Amaç: Barsak iskemi-reperfüzyon (I/R) hasarı yüksek morbidite ve mortalite oranları ile seyreder. Etkili koruyucu veya tedavi edici ajanlar bulmak için sürekli araştırmalar yapılmaktadır. Barsak İ/R hasarının sıçan modelinde apelin 13 (AP)’ün etkilerini araştırmayı amaçladık. Çalışma Planı: 6-8 haftalık ve 280±20 g ağırlığında 24 adet erkek Sprague Dawley sıçan eşit olarak üç gruba ayrıldı (Kontrol, I/R ve I/R+AP). Kontrol grubuna klemp uygulanmadan süperiyor mezenterik arter (SMA) ayrıldı. I/R ve I/R+AP gruplarında atravmatik mikrovazküler bulldog klemp SMA nın aortadan çıkış noktasına yerleştirildi. 60 dk iskemiden sonra, klempler alınarak 3 saat reperfüzyon uygulandı. 3 saat Reperfüzyondan sonra, biyokimyasal incelemeler (malondialdehit (MDA) ve glutatyon (GSH) düzeyleri) ve histopatolojikal incelemeler için doku örnekleri alındı. Bulgular: Kontrol grubu ile karşılaştırıldığında MDA düzeyleri I/R grubunda anlamlı düzeyde yüksekti. MDA düzeyleri I/R grubu ile karşılaştırıldığında I/R+AP grubunda düşük olmasına rağmen, farklılık anlamlı değildi. I/R ile I/R+AP grupları arasında GSH düzeyleri arasında anlamlı farklılık yoktu. I/R+AP grubu histopatolojik medyan değerlendirmeleri I/R grubu ile karşılaştırıldığında anlamlı düzeyde düşüktü (p=0.001). Sonuç: Apelinin oksidatif hasarı üzerinde olumlu etkisi olduğu görüldü, bu istatistiksel olarak anlamlı değildi. Bu yüzden insanlardan kullanılmadan önce, apelinin barsak iskemisinin başlangıç tedavisi ile ilgili bulgular üzerindeki rolü için daha büyük ölçekli hayvan çalışmalarına ihtiyaç vardır.
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    The Effects of Apelin on Mesenteric Ischemia and Reperfusion Damage in an Experimental Rat Model
    (Galenos Publ House, 2012) Sagiroglu, Tamer; Oguz, Serhat; Sagiroglu, Gonul; Copuroglu, Elif; Yalta, Tulin; Sayhan, Mustafa Burak; Yagci, Mehmet Ali
    Objective: Intestinal ischemia-reperfusion (I/R) injury is associated with high morbidity and mortality rates. There is ongoing research to find an effective preventive or treatment agent. We aimed to evaluate the effects of apelin 13 (AP) on intestinal I/R injury in a rat model. Material and Methods: Twenty-four male Sprague-Dawley rats aged 6-8 weeks and weighing 280 +/- 20 g were equally divided into three groups (control, I/R and I/R+AP). The control group underwent superior mesenteric artery (SMA) mobilization alone without any clamping. In the I/R and I/R+AP groups, an atraumatic microvascular bulldog clamp was placed across the SMA at its point of origin from the aorta. In the I/R+AP group, 2 mu g/kg/d apelin was administered intraperitoneally. After 60 minutes of ischemia, relaparotomy was performed to remove the microvascular clamp on the SMA for 3 hours of reperfusion. After 3 hours, tissue samples were obtained for biochemical [malondialdehyde (MDA) and glutathione (GSH) levels] and histopathological analyses. Results: MDA levels were significantly higher in the I/R group compared to the control group. Although MDA levels were lower in the I/R+AP group compared to the I/R group, the difference was not statistically significant. There was also no significant difference between the I/R+AP and I/R groups regarding GSH levels. The median histopathological grade was significantly lower in the I/R+AP group compared to the I/R group (p=0.001). Conclusion: Apelin appeared to have a positive effect on oxidative injury; this did not reach statistical significance. Thus, the role of apelin and associated findings in the initial treatment of intestinal ischemia needs further large-scale animal studies before human use.
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    Effects of Urtica dioica on oxidative stress, proliferation and apoptosis after partial hepatectomy in rats
    (Sage Publications Inc, 2015) Oguz, Serhat; Kanter, Mehmet; Erboga, Mustafa; Toydemir, Toygar; Sayhan, Mustafa Burak; Onur, Hatice
    The present study was performed to investigate the effect of Urtica dioica (UD) on liver regeneration after partial hepatectomy (PH) in rats. A total of 24 male Sprague Dawley rats were divided into three groups: sham-operated, PH and PH+UD; each group contains eight animals. The rats in UD-treated groups were given UD oils (2ml/kg/day) once a day orally for 7days starting 3days prior to hepatectomy operation. At day 7 after resection, liver samples were collected. The levels of malondialdehyde (MDA), superoxide dismutase (SOD) and glutathione (GSH) were estimated in liver homogenates. Moreover, histopathological examination, mitotic index (MI), proliferating cell nuclear antigen labeling, proliferation index (PI), transferase-mediated deoxyuridine triphosphate nick end-labeling assay, apoptotic index (AI) were evaluated at day 7 after hepatectomy. As a result, UD significantly increased MI and PI, significantly decreased AI and also attenuated hepatic vacuolar degeneration and sinusoidal congestion in PH rats. UD treatment significantly decreased the elevated tissue MDA level and increased the reduced SOD activity and GSH level in the tissues. These results suggest that UD pretreatment was beneficial for rat liver regeneration after partial hepatectomy.
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    Evaluation of Intershift Handover in Emergency Department
    (Gazi Univ, Fac Med, 2018) Akpinar, Metin; Salt, Omer; Sayhan, Mustafa Burak; Mutlu, Alparslan
    Objective: Intershift handover (IH) in emergency departments can lead to serious distress in terms of both patient and doctor safety. In the study; it was aimed to determine how patients handed over between the shifts in the emergency services and the deficiencies, defects and errors occurred during this process. Methods: This study was conducted with 462 emergency doctors at 62 private, state, training research and university hospitals in Istanbul, Edirne, Kirklareli and Tekirdag cities where almost one fourth of Turkish population live, by interwiewing face-to-face between April 2016 and June 2016. Results: There were statistically significant difference between the groups who said that the transfer quality depends on the transferer doctor and lecturer and the other groups (respectively p<0.05). 98.1% (n = 453) of the physicians stated that they completely or partially agree with that; the deficiencies during handover the effect negatively the treatment of the patient (p<0.05). Conclusion: In conclusion, it is obvious that; the intershift handover in emergency department is vital. By reducing the number of mistakes made during this period, the quality of treatment of patients can be increased. In order to achieve this, we also think that it would be beneficial to give education to emergency service doctors about patient handover and to use a standardized intershift patient handover form.
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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.