TR Dizin İndeksli Yayınlar Koleksiyonu / TR Dizin Indexed Publications Collection
Permanent URI for this collectionhttps://hdl.handle.net/20.500.14365/4
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Article Determining the Factors Affecting the Satisfaction of Patient in Sedoanalgesia Due to Distal Radius Fracture in Emergency Department(Galenos Publ House, 2025-05-21) Ellidokuz, Hülya; Aksay, Ersin; Oray, Nese Colak; Özgür, Sefer; Güzelce, Mustafa Can; Colak, NeseIntroduction: Patients with distal radius fractures (DRF) are frequently admitted to the emergency departments (EDs). Reduction with procedural sedation and analgesia (PSA) and followed by plaster/splint are the treatment of choice. We aimed to determine the factors affecting the satisfaction in patients with DRF undergoing PSA. Methods: This prospective, observational, cross-sectional study included 70 patients with DRF. The socio-demographic features, comorbidities, level of satisfaction with PSA procedure, physical factors of the environment, physician and patient satisfaction were evaluated. PSA satisfaction scores “1, 2 and, 3” were grouped as “dissatisfied group” and “4-5” points as “satisfied group” with the Likert scale. Patient satisfaction was compared between the groups according to the satisfaction levels. Results: The median satisfaction level was found 4 (interquartile range 4-5). Their satisfaction with the given information about the PSA procedure and the cleanliness of the area where the procedure was performed was higher in the satisfied group than the dissatisfied group (p=0.014 and p=0.007, respectively). Also, as the level of residents of emergency physicians, the satisfaction of the patients increased (p=0.025). There was no significant difference between the groups in terms of age, gender, educational status, comorbidities, fracture type, additional injury, selected sedo-analgesic drugs, Richmond Agitation Sedation Scale and, complications (p>0.05). Satisfaction was high in all physicians. Conclusion: PSA procedure was satisfactory by a majority and can be performed safely in the ED. The residency period of the physician who performed the PSA, satisfaction with the given information about PSA and the cleanliness of the area were affecting the patient satisfaction.Article Citation - WoS: 6Citation - Scopus: 10Comparison of Bpap S/T and Average Volume-Assured Pressure Support Modes for Hypercapnic Respiratory Failure in the Emergency Department: a Randomized Controlled Trial(Galenos Publ House, 2021-09-22) Gören, Nurfer Zehra; Sanci, Emre; Coskun, Feride Fulya Ercan; Gursoylu, Duygu; Bayram, BasakBackground: There is limited research into the utility of average volume-assured pressure support (AVAPS), a volume-assured pressure-controlled mode, especially in patients with hypercapnic respiratory failure. Aims: This study aimed at a randomized comparison of AVAPS and bilevel positive airway pressure spontaneous/timed (BPAP S/T) modes in non-invasive mechanical ventilation (NIMV) application with hypercapnic respiratory failure patients in the emergency department (ED). Study Design: Randomized controlled study. Methods: In this prospective randomized controlled study, 80 patients admitted to ED with hypercapnic respiratory failure requiring NIMV were randomly assigned to AVAPS or S/T groups using the sealed envelope method (33 patients in the S/T group, 47 patients in the AVAPS group). Data of arterial blood gas (ABG), vital parameters, Glasgow Coma Score (GCS), additional treatment needs, and clinical outcomes were evaluated, and the treatment success rates of both groups were compared. Results: A total of 80 patients, 33 in the S/T and 47 in the AVAPS group, were analyzed in the study. The pH values improved in the AVAPS group compared to the baseline (0.07 [0.04-0.10] vs 0.03 [0.00-0.11]). PaCO2 (partial pressure of carbon dioxide) excretion was faster in the AVAPS group than in the S/T group in the first hour (10.20 mmHg [6.20-19.20] vs. 4.75 ([-] 0.83-16.88)). The comparison of blood gas measurements showed no significant differences between the groups regarding the changes in PaCO2 and pH values over time (P=.141 and P=.271, respectively). During the ED follow-up, 3 (6.4%) patients in the AVAPS group and 5 (15.2%) patients in the S/T group needed intubation [Relative risk: 0.42 (95% CI: 0.11 to 1.64), P=.21]. Conclusion: In this study, improvements in blood gas parameters in the AVAPS group were faster compared to the S/T group; however, we did not find any significant difference between the groups in terms of clinical parameters. The AVAPS mode is as effective and safe as BPAP S/T in treating patients with hypercapnic respiratory failure in the ED.Article Can Spesific Biomarkers Be Used To Enlighten the Major Mechanisms of Acute High Dose Diclofenac Sodium-Related Nephrotoxicity?(Galenos Publ House, 2022-06-01) Dogruyol, Sinem; Akbas, Ilker; Kocak, Abdullah Osman; Aygormez, Serpil; Leylek, Habip Emrah; Gur, Sultan Tuna Akgol; Ertener, Ozge; Cokbankir, OzgeAim: The aim of this study was to examine the basic mechanisms that play a role in the acute nephrotoxicity caused by diclofenac sodium. Materials and Methods: Only water was given to the control group; however, the diclofenac sodium group was group intoxicated by giving water-soluble, 240 mg/kg, oral single dose diclofenac sodium. After 24 hours, all animals were sacrificed and histopathological analyzes were performed. The levels of spesific biomarkers [vascular endothelial growth factor (VEGF), nuclear factor-kappa B (NF-kappa B), matrix metalloproteinase-9 (MMP-9), metalloproteinase tissue inhibitor-1 (TIMP-1) and carcinoembryonic antigen (CEA)] that may be related to the nephrotoxicity mechanism were evaluated. Results: As a result of biochemical analysis, we found that VEGF, TIMP-1, NF-kappa B and CEA levels were significantly higher and MMP-9 levels were significantly lower in diclofenac sodium group compared to control group. Nephrotoxicity related histopathological changes were observed in the sections of diclofenac sodium group. Conclusion: This study has shown that the biomarkers we evaluated in the diclofenac sodium-induced acute high-dose intoxication model we created can help us to identify the nephrotoxicity and to explain the nephrotoxicity mechanism with the three main steps (the hemodynamicrelated pathway, the inflammation-related pathway, and the oxidative stress-related pathway). With a simple version of this panel adapted to emergency departments, we may be able to diagnose diclofenac sodium-related nephrotoxicity.