Hocagil, Hilal | Hocagil, Abdullah Cüneyt Cüneyt | Karacabey, Sinan | Akkaya, Tuğba | Şimşek, Gözde | Sanrı, Erkman

Makale | 2015 | Ulusal Travma ve Acil Cerrahi Dergisi21 ( 5 ) , pp.344 - 351

AMAÇ: Micropower impulse radar (MIR) teknolojisi ile çalışan Pneumoscan cihazının acil serviste pnömotoraks (PTX) tanısı koyabilmedeki etkinliğini değerlendirmeyi amaçladık. GEREÇ VE YÖNTEM: Pnömotoraks şüphesi bulunan ve toraks bilgisayarlı tomografisi (BT) endikasyonu olan hastalar çalışmaya dahil edildi. Toraks tomografisindeki bulgular ile Pneumoscan cihazının sonuçları karşılaştırıldı. Katagorik değişkenlerin kıyaslanmasında ki-kare ve Fisher kesin testi kullanıldı. BULGULAR: Çalışma grubunu oluşturan 115 hastanın toplam 12'sinde BT ile PTX tespit edildi. Pneumoscan'da 10 doğru pozitif sonuç, 36 doğru negatif sonuç, 67 yanlış p . . .ozitif sonuç, iki yanlış negatif sonuç vardı. Pneumoscan ile toraks BT'nin pnömotoraksı tespit edebilirliği arasında istatistiksel olarak anlamlı bir fark bulunmamıştır (p=0.33). Cihazın pnömotoraksı tespit etmedeki sensitivitesi %83.3, spesifitesi %35.0 olarak bulundu. Gö- ğüs tomografisinde görülen pnömotoraksın boyutu ile cihazımızın pnömotoraksı belirlemesi arasında anlamlı bir farklılık bulunamamıştır (p=0.470). Bilgisayarlı tomografide PTX'lerin sağ ya da sol hemitoraksta olması ile cihazın pnömotoraksı tespit etmesi arasında anlamlı bir farklılık bulunamamıştır (p=1.00). Pneumoscan'ın doğru pozitif olarak tespit ettiği 10 hastanın, tomografide ölçülen göğüs duvar kalınlığı ortalama 50.3 mm iken, yanlış negatif iki hastanın göğüs duvar kalınlığı ise 56.5 mm olarak bulunmuştur. Ancak göğüs duvar kalınlığı ile cihazın tanı koyması arasındaki ilişki istatistiksel olarak anlamlı değildi (p=0.766). Pneumoscan'ın yanlış pozitif olarak PTX var dediği 67 olgunun %46.3'ünde (n=31) BT'de bronşiektazi, konsolidasyon, sıvı ve kitle gibi PTX dışı bulguları vardı. Tomografide ek bulgu olup olmaması ile cihazın pnömotoraks tespit edip etmesi arasında anlamlı bir farklılık bulunamamıştır (p=0.472). TARTIŞMA: Çalışmamızla pnömotoraksı olan hastaları ayırt etme konusunda etkin olan Pneumoscan cihazının acil serviste kullanımı, yüksek yanlış pozitiflik oranından dolayı tartışmalı hale gelmiştir. Yanlış pozitif tanı oranındaki bu yükseklik bazı hastalara gereksiz chest tube takma girişimine neden olabilir. Ayrıca pnömotoraksın büyüklüğünü gösteremeyen Pneumoscan cihazı, geleneksel tanısal görüntüleme yöntemlerinin aksine verilecek tedaviyi ve prognozu belirlemede yardımcı olamamaktadır. Bulgular cihazın acil serviste kullanımının etkin olmadığını göstermiştir. İlerleyen yıllarda artan deneyim ve çalışmalar ile bu sonuç değişebilir. BACKGROUND: This study aimed to discuss the effectiveness of Pneumoscan working with micropower impulse radar (MIR) technology in diagnosing pneumothorax (PTX) in the emergency department. METHODS: Patients with suspicion of PTX and indication for thorax tomography (CT) were included into the study. Findings of the Thorax CT were compared with the results of Pneumoscan. Chi-square and Fisher's exact tests were used in categorical variables.RESULTS: One hundred and fifteen patients were included into the study group; twelve patients presented with PTX diagnosed by CT, 10 of which were detected by Pneumoscan. Thirty-six true negative results, sixty-seven false positive results, and two false negative results were obtained, which resulted in an overall sensitivity of 83.3%, specificity of 35.0% for Pneumoscan. There was no statistically significant difference between the effectiveness of Pneumoscan and CT on the detection of PTX (p=0.33). There was no difference between the size of PTX diagnosed by CT and PTX diagnosed by Pneumoscan (p=0.47). There was no statistically significant difference between Pneumoscan and CT on detecting the localisation of the PTX (p=1.00). For the 10 cases diagnosed by Pneumoscan, mean chest wall thickness was determined as 50.3 mm while mean chest wall thickness for two false negatives diagnosed by Pneumoscan was 56.5 mm. However, no statistically significant difference was found between the chest wall thickness and the effectiveness of Pneumoscan on the detection of the PTX (p=0.77). Among sixty-seven false positives diagnosed by Pneumoscan, 46.3% had additional medical signs such as bronchiectasis, pulmonary consolidation, pulmonary edema or pulmonary tumor when they had a reading with CT. The relationship between having additional medical signs at the reading with CT and the effectiveness of Pneumoscan on the detection of the PTX was investigated and no significant difference was found (p=0.472).CONCLUSION: Using Pneumoscan to detect PTX is controversial since the device has a high false positive ratio. Wherein, false positive diagnosis can cause unjustifiable chest tube insertion. In addition, the device failed to show the size of the PTX, and therefore, it did not aid in determining the treatment and prognosis on contrary to traditional diagnostic methods. The findings could not demonstrate that the device was efficient in emergency care. Further studies and increasing experience may change this outcome in upcoming years Daha fazlası Daha az

Alpay, Atilla | Özcan, Özlem | Uğurbaş, Sılay Cantürk | Uğurbaş, Suat Hayri

Makale | 2012 | Ulusal Travma ve Acil Cerrahi Dergisi18 ( 2 ) , pp.118 - 124

AMAÇ Türkiye’nin Batı Karadeniz bölgesindeki göz yaralanmalarının klinik özelliklerini ve görsel prognozunu belirlemek, ulusal istatistiklere veri oluşturmaktır. GEREÇ VE YÖNTEM Zonguldak Karaelmas Üniversitesi Hastanesi Acil Servisi’ne 2001-2010 yılları arasında başvuran 281 göz yaralanması olgusu geriye dönük olarak incelendi. BULGULAR Göz yaralanmalarının büyük kısmı (%42,7) 30-50 yaşları arasında meydana gelmişti. Yaralanmaların en sık (%28,8) nedeni kırsal alanda ahşap kaynaklı maddelerle yaralanmalar iken, 30-50 yaş arası erkeklerde en sık neden işyeri yaralanmalarıydı. Kornea-skleral kesiler ilk ve son görme keskinliği açısın . . .dan en ciddi yaralanma olarak belirlendi. SONUÇ Göz yaralanmaları hala sık ve önlenebilir bir körlük sebebidir. Alınacak basit tedbirler ve halkın eğitimi sayesinde iş gücü kaybı, ekonomik kayıp ve psikolojik sorunlara yol açan bu önemli problemin önüne geçilebilir. Trafikte emniyet kemeri takılması, iş yerlerinde ve kırsal alanda çalışırken koruyucu gözlük takılması konusunda halkın bilinçlendirilmesi alınacak tedbirlerin başında gelmektedir. BACKGROUND We aimed to investigate the clinical aspects and visual prognosis in eye injury and to constitute data in the west Black Sea region in Turkey for national statistics. METHODS A retrospective analysis of 281 eye trauma cases admitted to the Emergency Department of Zonguldak Karaelmas University Hospital between 2001 and 2010 was performed. RESULTS A majority of eye injuries (42.7%) affected individuals aged 30 to 50 years. The most frequent cause of injury in the rural areas was wooden objects. The most frequent cause of injury in males aged 30 to 50 years was work-site injuries. Corneal-scleral lacerations were found to be the most serious injuries with regard to initial and final visual acuities. CONCLUSION Eye injuries are still the most common and preventable cause of blindness. Simple precautions and public education might prevent this health problem, which causes economic and labor force loss and psychological problems. One of the basic precautions would be raising public awareness on wearing a seat belt inside the car and protective eyeglasses at the work site and while working in rural areas Daha fazlası Daha az

Tanrıkulu Y. | Yılmaz G. | Tanrıkulu C.Ş. | Temi V. | Köktürk F. | Çağsar M. | Yalçın B.

Makale | 2015 | Ulusal Travma ve Acil Cerrahi Dergisi21 ( 6 ) , pp.440 - 445

BACKGROUND: Acute appendicitis (AA) is one of the most common surgical emergencies, whosepostoperative morbidity and mortality increase significantly when the appendix perforates. The identification of factors that lead to perforation in these patients might effectively reduce morbidity. In this study, factors associated with perforation in AA were examined. METHODS: The study included sixty patients divided into equal non-perforated and perforated groups. Preoperative body mass index (BMI) and prehospital delay of the patients, the appendix location, presence of fluid or abscesses during surgery, and the appendix wall thickness, ro . . .ot and end diameters, and length in the surgery specimen were compared. RESULTS: The patients were comprised of forty males and 20 females, with a median age of 27 (range 16–84) years. BMI was significantly higher in the perforated group than the non-perforated group (p=0.039). There was no difference between the groups in terms of the presence of fluid (p=0.792); the presence of abscess was higher in the perforated group (p=0.017). The most common location of the appendix was retrocecal in the perforated group (p=0.007). While there was no difference in the appendix end diameter, root diameter was significantly higher in the perforated group (p=0.041), as were wall thickness ( Daha fazlası Daha az

Taşcılar, Nida | Özen, Banu | Açıkgöz, Mustafa | Ekem, Süreyya | Acıman, Esra | Gül, Sanser

Makale | 2011 | Ulusal Travma ve Acil Cerrahi Dergisi17 ( 4 ) , pp.371 - 373

Tüm dünyada genç erkekler arasında en sevilen sporlardan biri olan futbol, pek çok ortopedik yaralanmalara yol açabilir. Diseksiyon gibi vasküler yaralanmalar nadir görülmelerine rağmen, tanı konulmadığında ölüme sebebiyet verebilir. Bu yazıda, başına ve boynuna futbol topu çarptıktan sonra travmatik internal karotid arter diseksiyonu oluşarak geniş orta serebral arter infarktı gelişen 31 yaşındaki erkek hasta sunuldu. Hasta dekompresif cerrahi sonrası hafif nörolojik hasarla düzeldi. Soccer, one of the most popular sports worldwide among young men, can result in a wide range of orthopedic injuries. Although vascular injuries such a . . .s dissection occur rarely, they can cause significant mortality if left undiagnosed. We report herein a 31-year-old male who suffered a large middle cerebral artery infarction due to traumatic internal carotid artery dissection after a ball struck his head and neck. He recovered with mild neurologic deficit after decompressive surgery Daha fazlası Daha az

Hocagil H. | Hocagil A.C. | Karacabey S. | Akkaya T. | Şimşek G. | Sanrı E.

Makale | 2015 | Ulusal Travma ve Acil Cerrahi Dergisi21 ( 5 ) , pp.344 - 351

BACKGROUND: This study aimed to discuss the effectiveness of Pneumoscan working with micropower impulse radar (MIR) technology in diagnosing pneumothorax (PTX) in the emergency department. METHODS: Patients with suspicion of PTX and indication for thorax tomography (CT) were included into the study. Findings of the Thorax CT were compared with the results of Pneumoscan. Chi-square and Fisher’s exact tests were used in categorical variables. RESULTS: One hundred and fifteen patients were included into the study group; twelve patients presented with PTX diagnosed by CT, 10 of which were detected by Pneumoscan. Thirty-six true negative . . . results, sixty-seven false positive results, and two false negative results were obtained, which resulted in an overall sensitivity of 83.3%, specificity of 35.0% for Pneumoscan. There was no statistically significant difference between the effectiveness of Pneumoscan and CT on the detection of PTX (p=0.33). There was no difference between the size of PTX diagnosed by CT and PTX diagnosed by Pneumoscan (p=0.47). There was no statistically significant difference between Pneumoscan and CT on detecting the localisation of the PTX (p=1.00). For the 10 cases diagnosed by Pneumoscan, mean chest wall thickness was determined as 50.3 mm while mean chest wall thickness for two false negatives diagnosed by Pneumoscan was 56.5 mm. However, no statistically significant difference was found between the chest wall thickness and the effectiveness of Pneumoscan on the detection of the PTX (p=0.77). Among sixty-seven false positives diagnosed by Pneumoscan, 46.3% had additional medical signs such as bronchiectasis, pulmonary consolidation, pulmonary edema or pulmonary tumor when they had a reading with CT. The relationship between having additional medical signs at the reading with CT and the effectiveness of Pneumoscan on the detection of the PTX was investigated and no significant difference was found (p=0.472). CONCLUSION: Using Pneumoscan to detect PTX is controversial since the device has a high false positive ratio. Wherein, false positive diagnosis can cause unjustifiable chest tube insertion. In addition, the device failed to show the size of the PTX, and therefore, it did not aid in determining the treatment and prognosis on contrary to traditional diagnostic methods. The findings could not demonstrate that the device was efficient in emergency care. Further studies and increasing experience may change this outcome in upcoming years. © 2015 TJTES Daha fazlası Daha az

Tanrıkulu Y. | Tanrıkulu C.Ş. | Sabuncuoğlu M.Z. | Temiz A. | Köktürk F. | Yalçın B.

Makale | 2016 | Ulusal Travma ve Acil Cerrahi Dergisi22 ( 4 ) , pp.344 - 349

BACKGROUND: Acute mesenteric ischemia (AMI) remains fatal in 50-70% of cases. AMI is recognized as a vascular emergency, requiring rapid and efficient clinical evaluation and treatment. In the present retrospective study, the possible utility of the neutrophillymphocyte ratio (NLR) in the early diagnosis of AMI was explored. The potential use of this ratio to distinguish AMI from non-vascular bowel necrosis (NVBN) was investigated. METHODS: A total of 58 AMI, 62 NVBN, and 62 control patients were enrolled between May 1, 2010 and April 30, 2015. Patients who underwent laparotomies and/or bowel resections to treat AMI were included, a . . .s were NVBN patients who underwent segmental bowel resection to treat incarcerated and strangulated hernias. Controls were patients who presented to the emergency room with non-specific abdominal pain. RESULTS: Mortality rate was 51.7% in the AMI and 4.8% in the NVBN groups. White blood cell (WBC) count, C-reactive protein (CRP) level, and red cell distribution width (RDW) were highest in the AMI group. NLR was higher in the AMI and NVBN groups than in the control group ( Daha fazlası Daha az

Taşcilar N. | Özen B. | Açikgöz M. | Ekem S. | Aciman E. | Gül S.

Makale | 2011 | Ulusal Travma ve Acil Cerrahi Dergisi17 ( 4 ) , pp.371 - 373

Soccer, one of the most popular sports worldwide among young men, can result in a wide range of orthopedic injuries. Although vascular injuries such as dissection occur rarely, they can cause significant mortality if left undiagnosed. We report herein a 31-year-old male who suffered a large middle cerebral artery infarction due to traumatic internal carotid artery dissection after a ball struck his head and neck. He recovered with mild neurological deficit after decompressive surgery.

Erkol Z. | Hekimoğlu Y. | Büken B. | Şirin G. | Yılmaz R. | Akkaya H.

Makale | 2016 | Ulusal Travma ve Acil Cerrahi Dergisi22 ( 1 ) , pp.66 - 75

BACKGROUND:In this study, it was aimed to analyze the cases of traffic accident related deaths, buried without performing autopsy, in order to increase awareness of the physicians about declaration liability of forensic cases and also emphasize the declaration of the forensic case and autopsy importance. METHODS: In the First Specialization Board of Council of Forensic Medicine, 542 cases of death, reported between the years 2004–2008, who were involved in traffic accidents and buried without an autopsy performed, were evaluated retrospectively. RESULTS: It was found that 69.4% of the cases (n=376) were males, whereas %30.6 (n=166) . . .were females; mean age was 58.5±20.9 (range, 3–98 years). Age 61 and above was the most frequent age group with 301 cases (55.5%). Of the cases, 336 (62.0%) had died in hospital, 241 (44.5%) had died in 1–12 months following the accident and medico-legal corpse examination was performed only in 123 (22.9%) cases. Three hundred fourty-four (63.5%) of the cases were not reported as forensic cases and death certificate was signed by any physician other than medical examiner without being declared as a legal case. According to the decisions of Board, since an autopsy was not duly performed, the cause of death could not be determined for 95 cases (17.5%) and for 57 cases (10.5%), it was not possible to determine whether there was causality between the accident and death. DISCUSSION: Our findings emphasize the importance of declaration of forensic cases and performing autopsy in time in traffic accident victims. © 2016 TJTES Daha fazlası Daha az

Çınar, Fikret | Evren, Cenk | Uğur, Mehmet Birol | Çorakçı, Serkan | Erdem, Cemile Zuhal

Makale | 2012 | Ulusal Travma ve Acil Cerrahi Dergisi18 ( 6 ) , pp.539 - 541

İzole krikoid kırığına klinikte ender olarak rastlanmaktadır. Yüksekten düşme yakınması ile acil servise yönlendirilen 71 yaşındaki kadın hastaya solunum sıkıntısı nedeniyle acil trakeotomi açıldı. Yapılan incelemede krikoid kartilajda izole kırık tespit edildi. Tedavisinde konservatif yaklaşımın seçildiği hasta yakınmalarının geçmesi üzerine dakanülasyon yapıldıktan sonra taburcu edildi. Isolated cricoid fracture is encountered rarely during the clinical follow-up. A 71-year-old female patient was referred to emergency service with complaints of fall from height, and urgent tracheotomy was performed due to dyspnea. During the exami . . .nation, isolated fractures of the cricoid cartilage were identified. With the conservative approach, the patient remained symptom-free and was discharged after decannulation Daha fazlası Daha az

Yazgan S. | Ayar O. | Akdemir O. | Koban Y.

Makale | 2017 | Ulusal Travma ve Acil Cerrahi Dergisi23 ( 2 ) , pp.167 - 169

Presently described is case of a 42-year-old woman with eye injury that was result of gunshot fired by a man at a wedding celebration. Bullet penetrated inferior quadrant of nasal sclera of left eye 7–12 mm behind limbus. Choroid and vitreous were prolapsed around bullet. Hemorrhage, vitreous prolapse and lens subluxation were present in anterior chamber. Presenting visual acuity (VA) was hand motion. Bullet 14×5 mm in size was carefully extracted from the eye. Fifteen days later, argon laser photocoagulation was performed on retina in area of bullet entry point. VA was 20/25 (Snellen) at final visit. In this case, although foreign . . .body was large, area of penetration was Zone III, and initial VA was poor, early and appropriate surgical repair achieved integrity of the globe and good vision prognosis. © 2017 TJTES Daha fazlası Daha az

Zehir S. | Şahin E. | Zehir R.

Makale | 2015 | Ulusal Travma ve Acil Cerrahi Dergisi21 ( 6 ) , pp.469 - 476

BACKGROUND: The aim of this study was toreport our experience regarding the use of three different methods for intramedullary nailing in the treatment of intertrochanteric fractures. METHODS: Patients with A2 and A3 type fractures operated on for unstable trochanteric fractures were included into this retrospective cohort study. Patients were divided into three groups based on the technique used; Talon distal fix nail/lag screw (n=78; mean age, 78.5±6.6), PFNA nail (n=96; mean age, 77.2±6.8) or InterTan nails (n=102; mean age, 76.8±6.7). Harris hip scores were recorded at the last outpatient visit and survival information was obtain . . .ed by phone interview and civil registry database. RESULTS: Baseline characteristics were similar among groups. Operation time, fluoroscopy time and blood loss were significantly higher in InterTan group. Screw cut-out occurred in eight patients in PFNA group. In-hospital mortality occurred in nine (3.2%) patients. Length of hospital stay and postoperative tip-apex distance was not different among groups. At follow-up, healing time and Harris hip scores were also similar among groups. One-year survival rate was 83.1±4.5% in Talon distal fix nail/lag screw, 84.0±3.8% in PFNA group and 84.4±3.7% in InterTan group (p=0.33). CONCLUSION: New Talon distal fix nail/lag screw was associated with lower cut-out rates than PFNA and shorter operative times than InterTan. Further study is warranted to clearly establish the potential advantages of Talon distal fix over any other technique described herein. © 2015 TJTES Daha fazlası Daha az

Zehir, Sinan | Şahin, Ercan | Zehir, Regayip

Makale | 2015 | Ulusal Travma ve Acil Cerrahi Dergisi21 ( 6 ) , pp.469 - 476

BACKGROUND: The aim of this study was toreport our experience regarding the use of three different methods for intramedullary nailing in the treatment of intertrochanteric fractures.METHODS: Patients with A2 and A3 type fractures operated on for unstable trochanteric fractures were included into this retrospective cohort study. Patients were divided into three groups based on the technique used; Talon distal fix nail/lag screw (n=78; mean age, 78.5±6.6), PFNA nail (n=96; mean age, 77.2±6.8) or InterTan nails (n=102; mean age, 76.8±6.7). Harris hip scores were recorded at the last outpatient visit and survival information was obtaine . . .d by phone interview and civil registry database.RESULTS: Baseline characteristics were similar among groups. Operation time, fluoroscopy time and blood loss were significantly higher in InterTan group. Screw cut-out occurred in eight patients in PFNA group. In-hospital mortality occurred in nine (3.2%) patients. Length of hospital stay and postoperative tip-apex distance was not different among groups. At follow-up, healing time and Harris hip scores were also similar among groups. One-year survival rate was 83.1±4.5% in Talon distal fix nail/lag screw, 84.0±3.8% in PFNA group and 84.4±3.7% in InterTan group (p=0.33).CONCLUSION: New Talon distal fix nail/lag screw was associated with lower cut-out rates than PFNA and shorter operative times than InterTan. Further study is warranted to clearly establish the potential advantages of Talon distal fix over any other technique described herein BACKGROUND: The aim of this study was toreport our experience regarding the use of three different methods for intramedullary nailing in the treatment of intertrochanteric fractures.METHODS: Patients with A2 and A3 type fractures operated on for unstable trochanteric fractures were included into this retrospective cohort study. Patients were divided into three groups based on the technique used; Talon distal fix nail/lag screw (n=78; mean age, 78.5±6.6), PFNA nail (n=96; mean age, 77.2±6.8) or InterTan nails (n=102; mean age, 76.8±6.7). Harris hip scores were recorded at the last outpatient visit and survival information was obtained by phone interview and civil registry database.RESULTS: Baseline characteristics were similar among groups. Operation time, fluoroscopy time and blood loss were significantly higher in InterTan group. Screw cut-out occurred in eight patients in PFNA group. In-hospital mortality occurred in nine (3.2%) patients. Length of hospital stay and postoperative tip-apex distance was not different among groups. At follow-up, healing time and Harris hip scores were also similar among groups. One-year survival rate was 83.1±4.5% in Talon distal fix nail/lag screw, 84.0±3.8% in PFNA group and 84.4±3.7% in InterTan group (p=0.33).CONCLUSION: New Talon distal fix nail/lag screw was associated with lower cut-out rates than PFNA and shorter operative times than InterTan. Further study is warranted to clearly establish the potential advantages of Talon distal fix over any other technique described herei Daha fazlası Daha az