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Article ; Online: Mortality predictors of patients diagnosed with severe hyponatremia in the emergency department.

Gurbuz, Mesut / Acehan, Selen / Satar, Salim / Gulen, Muge / Sevdımbas, Sarper / Ince, Cagdas / Onan, Engin

2024

Abstract: Purpose: To determine the factors affecting mortality as a result of the analysis of the demographic and clinical characteristics and laboratory parameters of patients whose serum Na value was determined to be 125 mEq/L or below at the time of admission ...

Abstract	Purpose: To determine the factors affecting mortality as a result of the analysis of the demographic and clinical characteristics and laboratory parameters of patients whose serum Na value was determined to be 125 mEq/L or below at the time of admission to the emergency department (ED). Method: Patients over 18 years of age who admitted to the ED of a tertiary hospital between September 2021 and September 2022 and whose serum sodium level was determined to be 125 mEq/L and below were included in the study. Demographic and clinical characteristics, admission complaints, medications used, Charles comorbidity index (CCI), laboratory parameters, and outcomes of the patients included in the study were recorded in the data form. Results: Three hundred ninety-nine patients were included in the study. When the 30-day mortality of the patients is examined, the mortality rate was found to be 21.6%. In the analyses performed for the predictive power of laboratory parameters for mortality, it was determined that the highest predictive power among the predictive values determined by the area under the curve (AUC) was the albumin level (AUC 0.801, 95% CI 0.753-0.849, p < 0.001). In the binary logistic regression analysis, urea and albumin were independent predictors of 30-day mortality. Conclusion: According to study data, albumin and urea levels are independent predictors of 30-day mortality in patients diagnosed with severe hyponatremia in the emergency department.
Language	English
Publishing date	2024-01-31
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	390895-1
ISSN	1863-4362 ; 0021-1265
ISSN (online)	1863-4362
ISSN	0021-1265
DOI	10.1007/s11845-024-03615-7
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Article ; Online: Dexketoprofen <em>versus</em> Tenoxicam in Acute Severe Pain Due to Primary Dysmenorrhea.

Satar, Deniz Aka / Satar, Salim / Gulen, Muge / Acehan, Selen / Okcu, Nefise Tanridan / Sahin, Gonca Koksaldi

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP

2024 Volume 34, Issue 2, Page(s) 160–165

Abstract: Objective: To evaluate the analgaesic efficacy of tenoxicam and dexketoprofen in patients admitted to the Emergency Medicine (EM) Clinic with severe acute pain due to primary dysmenorrhea (PD).: Study design: Randomised-controlled trial. Place and ... ...

Abstract	Objective: To evaluate the analgaesic efficacy of tenoxicam and dexketoprofen in patients admitted to the Emergency Medicine (EM) Clinic with severe acute pain due to primary dysmenorrhea (PD). Study design: Randomised-controlled trial. Place and Duration of the Study: Emergency Medicine Clinic, Health Sciences University, Adana City Training and Research Hospital, Adana, Turkiye, from January to December 2022. Methodology: Patients presenting with PD, were divided into two groups of 60 each, administered 50 mg dexketoprofen and 20 mg tenoxicam intravenously. Visual analogue scale (VAS) scores were recorded at the 15th, 30th, 60th, and 120th minutes. VAS scores and ΔVAS scores were compared with the effectiveness of drugs, the need for rescue drugs and its side-effects. Results: Intravenous (IV) dexketoprofen was administered to 60 of the patients and IV tenoxicam was administered to another 60. At the time of admission, mean VAS scores of the patients were 8.8 ± 0.9 for the dexketoprofen group and 8.6 ± 0.8 for the tenoxicam group. The VAS scores of the dexketoprofen group were found to be statistically significantly lower after 30 minutes with lower need for rescue analgaesics. ΔVAS scores of the dexketoprofen group were statistically significantly higher from the 30th minute. Conclusion: According to the VAS scoring, IV dexketoprofen was a more effective drug than IV tenoxicam in patients who were admitted to the EM clinic with severe pain due to PD. Key words: Dexketoprofen, Primary dysmenorrhea, VAS score.
MeSH term(s)	Female ; Humans ; Acute Pain/drug therapy ; Anti-Inflammatory Agents, Non-Steroidal/therapeutic use ; Double-Blind Method ; Dysmenorrhea/drug therapy ; Ketoprofen/analogs & derivatives ; Pain, Postoperative/drug therapy ; Piroxicam/analogs & derivatives ; Tromethamine
Chemical Substances	Anti-Inflammatory Agents, Non-Steroidal ; dexketoprofen trometamol (N674F7L21E) ; Ketoprofen (90Y4QC304K) ; Piroxicam (13T4O6VMAM) ; tenoxicam (Z1R9N0A399) ; Tromethamine (023C2WHX2V)
Language	English
Publishing date	2024-02-12
Publishing country	Pakistan
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	2276646-7
ISSN	1681-7168 ; 1022-386X
ISSN (online)	1681-7168
ISSN	1022-386X
DOI	10.29271/jcpsp.2024.02.160
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Article ; Online: A fatal case of acetamiprid poisoning with turquoise urine.

Gulen, Muge / Satar, Salim / Ince, Cagdas

Journal of forensic and legal medicine

2022 Volume 87, Page(s) 102335

Abstract: Acetamiprid is a member of neonicotinoid insecticides with a low risk of toxicity in humans. However, ingestion of large amounts may cause severe poisoning. This is the first case reported in the literature in which severe toxicity and death occurred ... ...

Abstract	Acetamiprid is a member of neonicotinoid insecticides with a low risk of toxicity in humans. However, ingestion of large amounts may cause severe poisoning. This is the first case reported in the literature in which severe toxicity and death occurred after acetamiprid ingestion. A 57-year-old male patient consumed 50g/250mL of an insecticide formulation containing acetamiprid for suicidal purposes. The ambulance team performed cardiopulmonary resuscitation on the patient who had a cardiac arrest. His heart beat returned after a 15-min cardiopulmonary resuscitation, and afterward, he had tachycardia, hypotension, respiratory failure, high gap metabolic acidosis with a high lactate, hypokalemia, hypocalcemia, mydriasis, and coma. The patient underwent supportive treatment for a variety of symptoms. However, he died despite all supportive treatment. This case demonstrates that ingestion of large amounts of the acetamiprid and late presentation can be fatal despite all supportive care.
MeSH term(s)	Fatal Outcome ; Heart Arrest ; Humans ; Insecticides ; Male ; Middle Aged ; Neonicotinoids ; Poisoning/diagnosis ; Respiratory Insufficiency
Chemical Substances	Insecticides ; Neonicotinoids ; acetamiprid (5HL5N372P0)
Language	English
Publishing date	2022-03-17
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	2268721-X
ISSN	1878-7487 ; 1752-928X
ISSN (online)	1878-7487
ISSN	1752-928X
DOI	10.1016/j.jflm.2022.102335
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Article ; Online: Poisoining with Tricyclic Antidepressants and Current Treatment

Muge Gulen

Arsiv Kaynak Tarama Dergisi, Vol 25, Iss 4, Pp 608-

2016 Volume 621

Abstract: Poisoning with tricyclic antidepressants is one of the main causes of morbidity and mortality compared to all the antidepressants. Main toxic effects are on the cardiovascular system and central nervous system and manifests itself as anticholinergic ... ...

Abstract	Poisoning with tricyclic antidepressants is one of the main causes of morbidity and mortality compared to all the antidepressants. Main toxic effects are on the cardiovascular system and central nervous system and manifests itself as anticholinergic symptoms. There is no antidote known to be used in the treatment. But sodium bicarbonate treatment is effective in preventing ventricular arrhythmias and hypotension, and resolving metabolic acidosis. There are some treatments that has been used for relief of symptoms and some of them still are in research stage. The drugs that are used can be customized according to the patients symptoms. [Archives Medical Review Journal 2016; 25(4.000): 608-621]
Keywords	Tricyclic antidepressants ; poisoining ; emergency ; Medicine ; R ; Medicine (General) ; R5-920
Language	Turkish
Publishing date	2016-12-01T00:00:00Z
Publisher	Cukurova University Faculty of Medicine
Document type	Article ; Online
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Article ; Online: Uncommon presentation of COVID-19: Gastrointestinal bleeding.

Gulen, Muge / Satar, Salim

Clinics and research in hepatology and gastroenterology

2020 Volume 44, Issue 4, Page(s) e72–e76

Abstract: The COVID-19 outbreak has become a pandemic that is threatening global health. The typical clinical manifestations were fever, cough, dyspnea, and myalgia or fatigue. Digestive symptoms such as nausea, vomiting, diarrhea, abdominal pain usually accompany ...

Abstract	The COVID-19 outbreak has become a pandemic that is threatening global health. The typical clinical manifestations were fever, cough, dyspnea, and myalgia or fatigue. Digestive symptoms such as nausea, vomiting, diarrhea, abdominal pain usually accompany respiratory symptoms. However gastrointestinal bleeding as the first symptom is not reported. Here we reported a case of COVID-19 with gastrointestinal bleeding as the initial symptom to the emergency department with a real-time reverse transcriptase polymerase chain reaction test positive, and normal thorax tomography. The case demonstrate that; clinicians should be alerted to patients about COVID-19 when referring to atypical symptoms and every patient undergoing endoscopy should be considered potentially infected or can infect others.
MeSH term(s)	Betacoronavirus ; COVID-19 ; Coronavirus Infections/complications ; Coronavirus Infections/diagnosis ; Diarrhea/etiology ; Electrocardiography ; Gastrointestinal Hemorrhage/etiology ; Humans ; Lung/diagnostic imaging ; Male ; Melena/diagnosis ; Middle Aged ; Myocardial Ischemia/diagnosis ; Pandemics ; Pneumonia, Viral/complications ; Pneumonia, Viral/diagnosis ; Real-Time Polymerase Chain Reaction ; SARS-CoV-2 ; Tachycardia, Sinus/diagnosis
Keywords	covid19
Language	English
Publishing date	2020-05-21
Publishing country	France
Document type	Case Reports
ZDB-ID	2594333-9
ISSN	2210-741X ; 2210-7401
ISSN (online)	2210-741X
ISSN	2210-7401
DOI	10.1016/j.clinre.2020.05.001
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Article ; Online: Envenomation by Trachinus draco and Pain Management.

Gulen, Muge / Sari, Sezai

Wilderness & environmental medicine

2020 Volume 31, Issue 3, Page(s) 332–336

Abstract: We report a case of a 42-y-old female patient who sustained a sting to the neck from a Trachinus draco fish. She subsequently developed complications including arytenoid membrane edema secondary to either the local anesthetic agent administered to the ... ...

Abstract	We report a case of a 42-y-old female patient who sustained a sting to the neck from a Trachinus draco fish. She subsequently developed complications including arytenoid membrane edema secondary to either the local anesthetic agent administered to the wound or the dracotoxin itself. The patient was examined in the emergency department after the sting. Local anesthesia with lidocaine was administered to the areas of injury at another hospital before presenting to our hospital emergency department. The patient reported that her pain partially decreased but hoarseness developed and she had difficulty breathing after the local anesthetic was administered. Laryngeal examination by our hospital's otolaryngologist revealed edema of the patient's right arytenoid membrane without evidence of vocal cord swelling. Computed tomography of the neck revealed edema in the right arytenoid membrane on the side of the neck where the local anesthetic had been injected. The patient, who was given supplementary treatment, was discharged without any complications on the seventh day of hospitalization. The principle treatment for these types of stings includes immersion in hot water, analgesic therapy, and observation for signs of local and systemic envenomation. We recommend using caution when injecting local anesthetic agents in the neck because of underlying vital structures.
MeSH term(s)	Adult ; Analgesics/adverse effects ; Analgesics/therapeutic use ; Animals ; Bites and Stings/drug therapy ; Bites and Stings/pathology ; Edema/chemically induced ; Edema/diagnosis ; Edema/drug therapy ; Female ; Fish Venoms/adverse effects ; Fishes ; Humans ; Injections, Subcutaneous ; Pain Management ; Vocal Cords/pathology
Chemical Substances	Analgesics ; Fish Venoms
Language	English
Publishing date	2020-08-13
Publishing country	United States
Document type	Case Reports
ZDB-ID	1238909-2
ISSN	1545-1534 ; 1080-6032
ISSN (online)	1545-1534
ISSN	1080-6032
DOI	10.1016/j.wem.2020.04.008
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Article ; Online: Which one predicts mortality better in acute ischemic stroke: negative vs positive acute-phase reactants.

Koca, Ahmet Naci / Acehan, Selen / Satar, Salim / Gulen, Muge / Sevdimbas, Sarper / Gorur, Mehmet / Ozturk, İlker

Neurological research

2024 , Page(s) 1–9

Abstract: Aim: The aim of the study is to investigate the relationship between negative acute-phase reactants and positive acute-phase reactants with in-hospital mortality in patients diagnosed with acute ischemic stroke (AIS) in the emergency department (ED).: ...

Abstract	Aim: The aim of the study is to investigate the relationship between negative acute-phase reactants and positive acute-phase reactants with in-hospital mortality in patients diagnosed with acute ischemic stroke (AIS) in the emergency department (ED). Methods and materials: Patients aged 18 and older who presented to the ED of a tertiary hospital with AIS were included in the study. Demographic and clinical characteristics, laboratory parameters, acute-phase reactants, National Institutes of Health Stroke Scale (NIHSS), and outcome data of the included patients were recorded on a standard data form. Results: A total of 588 patients were included in the study. When the in-hospital mortality of patients was examined, the mortality rate was 17.7%. In the analysis for predicting mortality, it was determined that albumin had the highest predictive power between the area under the curve (AUC) and the determined predictive values (AUC: 0.759, 95% CI 0.707-0.810, Conclusion: According to the study data, albumin and TF levels, which are negative acute-phase reactants, are independent determinants of in-hospital mortality in patients with acute ischemic stroke in the emergency department.
Language	English
Publishing date	2024-03-31
Publishing country	England
Document type	Journal Article
ZDB-ID	424428-x
ISSN	1743-1328 ; 0161-6412
ISSN (online)	1743-1328
ISSN	0161-6412
DOI	10.1080/01616412.2024.2337513
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Article ; Online: Uncommon presentation of COVID-19

Gulen, Muge / Satar, Salim

Clinics and Research in Hepatology and Gastroenterology

Gastrointestinal bleeding

2020 Volume 44, Issue 4, Page(s) e72–e76

Keywords	Gastroenterology ; covid19
Language	English
Publisher	Elsevier BV
Publishing country	us
Document type	Article ; Online
ZDB-ID	2594333-9
ISSN	2210-741X ; 2210-7401
ISSN (online)	2210-741X
ISSN	2210-7401
DOI	10.1016/j.clinre.2020.05.001
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Article ; Online: Comparison of syncope risk scores in predicting the prognosis of patients presenting to the emergency department with syncope.

Ince, Cagdas / Gulen, Muge / Acehan, Selen / Sevdimbas, Sarper / Balcik, Muhammet / Yuksek, Ali / Satar, Salim

Irish journal of medical science

2023 Volume 192, Issue 6, Page(s) 2727–2734

Abstract: Background: Various scores have been derived for the assessment of syncope patients in the emergency department (ED).: Aim: We aimed to compare the effectiveness of Canadian Syncope Risk Scores (CSRS), San Francisco Syncope Rules (SFSR), and ... ...

Abstract	Background: Various scores have been derived for the assessment of syncope patients in the emergency department (ED). Aim: We aimed to compare the effectiveness of Canadian Syncope Risk Scores (CSRS), San Francisco Syncope Rules (SFSR), and Osservatorio Epidemiologico sulla Sincope nel Lazio (OESIL) risk scores in predicting the risk of major adverse cardiac events (MACE) and mortality among syncope patients within 30 days of the initial ED visit. Methods: We performed a prospective, observational case series study of adults (≥ 18 years) with unexplained syncope/near-syncope who presented to ED. Demographic characteristics of the patients and clinical and laboratory data were recorded in the standard data collection form of the study. Our primary outcome was a 30-day mortality. Results: A total of 421 patients (mean age 50.9 ± 20.8, 51.5% male) were enrolled. The rate of MACE development in the 30-day follow-up of the patients was 12.8% (n = 54). While 20.2% (n = 85) of the patients were hospitalized, two of the patients died in the emergency room and the 30-day mortality was 5.5% (n = 23). CSRS was found to have the highest predictive power of mortality (AUC: 0.869, 95% CI 0.799-0.939, p < 0.001). If the cut-off value of CSRS was 0.5, the sensitivity was found to be 82.6% and the specificity was 81.9%. Also CSRS (OR: 1.402, 95% CI: 1.053-1.867, p = 0.021) was found to be an independent predictor of the 30-day mortality. Conclusion: The CSRS may be used as a safety risk score for a 30-day risk of MACE and mortality after discharge from the emergency department.
MeSH term(s)	Adult ; Female ; Humans ; Male ; Canada ; Emergency Service, Hospital ; Prognosis ; Prospective Studies ; Risk Assessment ; Risk Factors ; Syncope/diagnosis ; Syncope/etiology
Language	English
Publishing date	2023-05-12
Publishing country	Ireland
Document type	Journal Article ; Observational Study
ZDB-ID	390895-1
ISSN	1863-4362 ; 0021-1265
ISSN (online)	1863-4362
ISSN	0021-1265
DOI	10.1007/s11845-023-03395-6
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Article ; Online: Response to Comment on Treatment of carbon monoxide poisoning: high-flow nasal cannula versus non-rebreather face mask.

Yesiloglu, Onder / Gulen, Muge / Satar, Salim / Acehan, Selen / Akoglu, Haldun

Clinical toxicology (Philadelphia, Pa.)

2021 Volume 59, Issue 8, Page(s) 769

MeSH term(s)	Cannula ; Carbon Monoxide Poisoning/therapy ; Carboxyhemoglobin ; Humans ; Masks ; Respiration, Artificial
Chemical Substances	Carboxyhemoglobin (9061-29-4)
Language	English
Publishing date	2021-02-08
Publishing country	England
Document type	Letter ; Comment
ZDB-ID	204476-6
ISSN	1556-9519 ; 0009-9309 ; 0731-3810 ; 1556-3650
ISSN (online)	1556-9519
ISSN	0009-9309 ; 0731-3810 ; 1556-3650
DOI	10.1080/15563650.2021.1877725
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