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Öğe 65 Yaş Üstü COVID-19 Hastalarında CoronaVac Aşısının Etkinliğinin Değerlendirilmesi(Van Yüzüncü Yıl Üniversitesi, 2022) Şener, Aslı; Erdoğan, Arife; Gönüllü, HayriyeÖzet: 2019 yılı Aralık ayından başlayarak tüm dünyayı etkisi altına alan Covid-19 pandemisinde alınmış olan çeşitli önlemler ve medikal tedavilere rağmen en önemli önleyici metodun aşı olduğu düşünüldü. Böylelikle aşı üretim çalışmaları çeşitli ülkelerde hız kazandı. Öncelikle Çin de üretilen ve ilk olarak kullanılmaya başlanan corona vac Sinovac Life Sciences (Pekin, Çin) aşısı ülkemizde de 19 Ocak 2021 itibari ile sağlık çalışanlarına yapılmaya başlandı. Aynı tarihlerde huzurevinde kalanlar ve 90 yaş üzerinde olup evinde yaşayanlara, sonrasında sırasıyla 85 yaş ve üzeri, 80 yaş ve üzeri olanlara olmak üzere, Ocak 2021 sonları ve 2021 şubat ayında 65 yaş üzeri kişiler aşılanmaya başlandı. Bu çalışmada 65 yaş üstü olup Covid 19 tanısı alan hastaların demografik, klinik, laboratuar, görüntüleme yöntemleri ve sonuçları incelendi. Hastaların aşılanma durumları ile hastalığın seyri ve sonuçları arasında ki ilişki araştırıldı. Abstract: Despite the various precautions and medical treatments taken in the Covid-19 pandemic, which has affected the whole world since December 2019, the most important preventive method was thought to be vaccination. Thus, vaccine production studies gained momentum in various countries. First of all, the corona vac Sinovac Life Sciences (Beijing, China) vaccine, which was produced in China and started to be used for the first time, started to be administered to healthcare workers as of January 19, 2021 in our country. At the end of January 2021 and in February 2021, people over the age of 65 started to be vaccinated, respectively, those aged 85 and over, and those aged 80 and over, respectively. In this study, demographic, clinical, laboratory, imaging methods and results of patients over 65 years old and diagnosed with Covid 19 were examined. The relationship between the vaccination status of the patients and the course and outcomes of the disease was investigated.Öğe Artificial Intelligence Applications in Emergency Service(Izmir Katip Celebi University, 2021) Erdoğan, ArifeResearch with artificial intelligence has gained importance in recent years. The main reasons for this increase are modern machine learning techniques; deep learning, the availability of large datasets, and advances in computing power and increasing success in these areas. The applicability of artificial intelligence in healthcare has been demonstrated. Algorithms can equate to or even exceed physician performances. Al- based tools have been used to predict various factors in medicine, including risk stratification, diagnosis, and treatment selection. Artificial intelligence technologies will be used more and more in the field of emergency medicine in the coming years. The purpose of this review is to provide an overview of current artificial intelligence research related to emergency medicine.Öğe Evaluation of poisoning cases that admitted to the emergency department for suicidal ideation(2022) Erdoğan, ArifeAim: In this study, we aimed to evaluate the effects of gender, age, time of admission to the emergency department, season, drug used, the time patients were admitted to the emergency department following the drugs administration, and psychiatric illness history on the clinical outcome of patients by examining the patients who admitted to our emer- gency department after taking suicidal drugs. Materials and Methods: The data of the study were obtained as a result of the retrospective examination of the cases who took drugs for suicidal purposes, who admitted to the emergency department of our hospital between January 2019-January 2020. We divided those who were discharged and admitted to the ward as good clinical outcome, and those who were admitted to the intensive care unit and those who died had poor clinical outcome. We statistically analyzed the effects of age, gender, the active substance used, the time of admission to the emergency department, the number of hours after which it was presented, a previous suicide attempt, and a history of psychiatric illness on clinical outcomes. Results: 295 patients were included in the study. 64.4% (190) of the cases were female and 35.6% (105) were male. The mean age of the patients is 32.9, and the majority of them are in the 25-34 age group (31.5%). The fact that the patients were male, admitted to the emergency room 4 hours after taking the drug, admitted to the emergency room between 00.00-07.59, committed suicide with psychiatric medication, had a previous sui- cide attempt and diagnosis of psychiatric illness, had a statistically poor clinical outcome (p<0.001). Conclusion: As a result, the history of the patients, the active substances they took, the hours and duration of their arrival to the emergency department can be used to predict the occurrence of serious clinical pictures in suicidal drug intake.Öğe Evaluation of the prognostic role of NLR, LMR, PLR, and LCR ratio in COVID-19 patients(Wiley, 2021) Erdoğan, Arife; Can, Fatma Ezgi; Gönüllü, HayriyeWe aimed to find the most useful biomarker by examining the prognostic effect of neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR), platelet-lymphocyte ratio (PLR), and lymphocyte-C reactive protein ratio (LCR) in patients with coronavirus disease 2019 (COVID-19). Three hundred and four patients diagnosed with COVID-19 infection in our hospital within 5 months (April-August 2020) were examined. Laboratory values and demographic findings of the patients were analyzed retrospectively. Thirty-six patients were diagnosed with severe cases. The ratio of NLR, LMR, PLR, and LCR of patients with severe and those with nonsevere clinical symptoms were statistically analyzed. The NLR and PLR ratios of those with severe clinical symptoms were significantly higher (p < 0.001), the LCR rate was significantly lower (p < 0.001), and there was no significant difference in the LMR rate (p = 0.199). When we examined other peripheral blood parameters, we found that CRP was high, lymphocyte and monocyte were low (p < 0.001), but neutrophil (p = 0.416) and platelet (p = 0.998) were not statistically different between the groups. According to the results, routine blood values are abnormal in patients with COVID-19. NLR, PLR, and LCR ratios can be used as more significant biomarkers than other values in predicting the prognosis of patients.Öğe Examination of patients admitted to the emergency department with blunt chest trauma(2021) Gönüllü, Hayriye; Tekindal, Mustafa Agah; Erdoğan, ArifeBlunt chest trauma is an important and common cause of morbidity and mortality. It constitutes an important part of the admissions to the emergency department. For this purpose, we evaluated the demographic characteristics, type of trauma, accompanying traumas, trauma scoring systems and results, duration of stay in the emergency department, and hospital outcomes of patients with chest trauma admitted to the emergency department of our hospital. In our study, patients who admitted to the emergency department of our hospital within one year with blunt chest trauma were evaluated retrospectively. Of the 156 patients examined, 114 (73%) were male and the mean age was 52.83±17.9 years. Pneumothorax (35%) and rib fracture (55%) were the most common thoracic injuries. When the duration of hospitalization was examined, the presence of lower extremity and abdomen pathologies, pneumothorax, hemothorax, and (>3) rib fracture prolonged the hospitalization period (p<0.05). Revised Trauma Score (RTS) and Glasgow Coma Score (GCS) were found to be significantly lower in deceased patients (p<0.001). Pneumothorax, hemothorax, (>3) rib fracture and pneumomediastinum increased mortality (p<0.05). Patients with chest trauma can have life-threatening clinics. In the emergency department, it should be evaluated for possible life-threatening pathologies, especially in terms of multi-trauma, and thoracic pathologies and other organ injuries should be managed simultaneously in an efficient and rapid manner. The issues to be considered in the triage, stabilization and follow-up of the patients should be well known.Öğe The importance of procalcitonin in the diagnosis and prognosis of patients with dyspnea in the emergency department Is procalcitonin gold standart in pneumonia?(Bayrakol Medical Publisher, 2021) Erdoğan, Arife; Bora, Ejder Saylav; Kokkoz, Çağrı; Erdoğan, Mümin Alper; Elmalı, FerhanAim: Dyspnea is a common problem in emergency services worldwide. Bacterial pneumonia is a common etiology in patients with acute dyspnea causing mor-bidity and mortality. Early initiation of appropriate antibiotic therapy reduces mortality. However, it is difficult to diagnose pneumonia with symptoms similar to acute heart failure and acute exacerbation of chronic obstructive pulmonary disease, and without definitive diagnostic testing. For this, it is thought that the use of a biomarker that can diagnose pneumonia at the time of admission to the hospital would be clinically useful. Material and Methods: Patients who came to the emergency department with shortness of breath were analyzed retrospectively. Three hundred patients were examined. Serum procalcitonin values of patients diagnosed with pneumonia by chest radiography or thorax CT were compared with other patients. Patients discharged from the emergency department or hospitalized were classified as a good clinical outcome group, patients who were intubated, in need of intensive care, or who died were classified as a poor clinical outcome group, and procalcitonin values were compared. The data were evaluated using the SPSS Statistics Standard statistical package program. A p <0.001 value was considered statistically significant. Results: In patients presenting with dyspnea, pneumonia (150), COPD exacerbation (30), lower respiratory tract infection (LRTI) (18), acute coronary syndrome (ACS) (27), and acute heart failure (AHF) (76) were diagnosed. The PCT values of the patients diagnosed with pneumonia were significantly higher than the other groups (p <0.001). In terms of white blood cell (WBC) values, there was no significant difference between pneumonia patients and other patients. When the neutrophil-lymphocyte ratio (NLR) was examined, it was found to be significantly higher in pneumonia patients (p <0.001). When we examined the progno-sis of pneumonia patients, the PCT values of the patients with a poor prognosis were found to be significantly higher (p <0.001). Discussion: We have seen that PCT has an important role in the diagnosis and prognosis of pneumonia in patients admitted to the emergency department with shortness of breath.Öğe Machine Learning for E-triage(SET Teknoloji, 2022) Bora, Şebnem; Kantarcı, Aylin; Erdoğan, Arife; Beynek, Burak; Kheibari, Bita; Evren, Vedat; Erdoğan, Mümin AlperDue to the rising number of visits to emergency departments all around the world and the importance of emergency departments in hospitals, the accurate and timely evaluation of a patient in the emergency section is of great importance. In this regard, the correct triage of the emergency department also requires a high level of priority and sensitivity. Correct and timely triage of patients is vital to effective performance in the emergency department, and if the inappropriate level of triage is chosen, errors in patients' triage will have serious consequences. It can be difficult for medical staff to assess patients' priorities at times, therefore offering an intelligent method will be pivotal for both increasing the accuracy of patients' priorities and decreasing the waiting time for emergency patients. In this study, we evaluate the machine learning algorithms in triage procedure. Our experiments show that Random Forest approach outperforms the others in e-triage.
