Browsing by Author "Akca, Ali Haydar"

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Comparing the Interpretation of Diffusion-Weighted Magnetic Resonance Images Made by Emergency Physicians and On-Call Radiologists
(Emergency Medicine Physicians Assoc Turkey, 2018) Sasmaz, Muhammed Ikbal; Akca, Ali Haydar; Guven, Ramazan; Altan, Burak; Baraz, Nuri; Kirpat, Vedat; Gunduz, Ali Mahir
Aim: Stroke is a leading cause of adult disability and death worldwide. It is very important to determine the ischemic tissue at risk in stroke patients. Although brain computed tomography (CT) is the first and standard imaging technique, diffusion-weighted magnetic resonance imaging (DW-MRI) is superior to CT and is the optimal imaging technique for the diagnosis of acute ischemic stroke. In our study, we aimed to compare the interpretation of DW-MRI between emergency physicians (EP) and on-call radiologists (OCRs). Materials and Methods: This multi-centered, prospective study was conducted at three central hospitals from June 1, 2016 to May 31, 2017. DW-MRI images of the patients were first interpreted by the EP and then by the OCR. Finally, DW-MRI images were interpreted by a definitive result team comprised of two radiologists who were blinded to the study. Sensitivity, specificity, positive predictive value, negative predictive value, and. coefficient were calculated. Results: In total, 315 patients' DW-MRI images were examined. The interpretation sensitivity and specificity rates of the DW-MRI images for EPs were 95.1% and 98.7%, respectively, whereas those for OCRs were 98.8% and 98%, respectively. There was almost perfect agreement (kappa value > -0.80) regarding DW-MRI interpretations of both OCRs and EPs. Conclusion: Our study showed that EPs were very successful in interpreting DW-MRI after a short-term training.
Comparing the Interpretation of Emergency Department Computed Tomography Between Emergency Physicians and Attending Radiologists: a Multicenter Study
(Wolters Kluwer Medknow Publications, 2018) Guven, R.; Akca, Ali Haydar; Caltili, C.; Sasmaz, M. I.; Kaykisiz, E. K.; Baran, S.; Kirpat, V.
Introduction: Computed tomography (CT) interpretation in the emergency department is one of the vital issues that should be carried out rapidly and accurately. The objective of this study was to examine the interpretation accuracy of emergency physicians (EPs) regarding CT scans at the emergency department for traumatic and nontraumatic purposes. Materials and Methods: The study that was carried out as a prospective, observational study was completed at four centers during 1 year. Results: Accuracy ratios of CT interpretations of EP regarding cranial injuries, thoracic injuries and vertebral spine injuries are above 95% in addition to the fact that the concordance's with the final result are perfect, the concordance with the final results of the CT interpretations of EP for abdominal injuries was moderate (<0.75). Accuracy ratios of the CT interpretations of EP for nontrauma patients were above 90% for brain hemorrhage and chest injuries and that the concordance with the final results was perfect (>= 0.75). The CT interpretation accuracy rates of EP for spontaneous pneumothorax and aortic aneurysm/aortic dissection cases were 100%. CT interpretation rate of EP for pulmonary embolism was 89.4%, whereas the level of concordance with the final results was moderate (<0.75). Whereas the CT interpretation accuracy rates of EP for nontraumatic abdominal injuries varied between 83.3% and 93.1%, their levels of concordance with the final results were moderate (<0.75). Conclusions: The CT interpretations for abdominal traumatic patients in addition to pulmonary embolism and acute nontraumatic abdominal injuries should be carried out more carefully.
Does Chronic Delta Hepatitis Increase Risk of Celiac Disease
(Allied Acad, 2017) Temur, Atilla; Gunduz, Ali Mahir; Dulger, Ahmet Cumhur; Akca, Ali Haydar
Celiac disease is a small intestinal malabsorption syndrome whose importance remains underappreciated. This is underestimated by the fact that it remains under recognized in almost 90% of patients. Hepatitis D virus (HDV) infection is a serious health problem leading to cirrhosis and hepatocellular carcinoma. Furthermore, the impact of on the clinical picture in patients with chronic HDV infection, with regards to laboratory parameters is not clear. So, we examined this relationship using recent hospital-based data. We analyzed data from 50 delta hepatitis patients (mean age 52.5 +/- 12.8 years; 30 male). 21 of them had cirrhosis. Both groups were screened for serum tissue transglutaminase antibodies and immunoglobulin A, and those antibody-positive were further investigated by intestinal biopsy. Histopathological examination was performed according to Marsh classification. Demographic features and laboratory data were compared between groups. There were six (28.5%) seropositivity of TTG IgG among patients with delta hepatitis related cirrhosis. No patient tested positive for TTG IgA in cirrhotic group whereas, there were no positive results for both TTG IgA and G among non-cirrhotic delta hepatitis group. In cirrhotic group, the rate of TTG IgG seropositivity was higher than those without cirrhosis (p=0.036). Seropositivity of TTG IgG was correlated with higher MELD scores (p<0.05). Higher rate of seropositivity of TTG IgG antibodies and CD among patients with chronic HDV-related cirrhosis may reflect a unique phenomenon that requires further investigation to determine underlying causative factors.
Kinesiotaping for Isolated Rib Fractures in Emergency Department
(W B Saunders Co-elsevier inc, 2020) Akca, Ali Haydar; Sasmaz, Muhammed Ikbal; Kaplan, Seyhmus
Introduction: Rib fractures, which are among the most common injuries in blunt thoracic trauma, are usually encountered in Emergency Departments. Kinesiotape (KT) is a drug-free elastic therapeutic tape used for treating various musculoskeletal problems such as injury, dysfunction and pain. We aimed to investigate whether kinesotaping should be used safely and effectively in rib fractures in emergency setting. Materials and methods: This was a prospective, randomized controlled study conducted in an Emergency Department of a University Hospital. Patients diagnosed with isolated rib fractures were included in the study. Pain severity of patients assessed with 0-10 cm visual analog scale (VAS), then patients assigned into 2 treatment groups. One of them received treatment with flurbiprofen 200 mg/day and the other group received kinesiotaping in addition to the same oral therapy. On the 4th day of the procedure, both groups were assessed with VAS in the followup visit. Results: Total of 82 patients presented with rib fractures, 52 of them were excluded. Remaining 30 constituted the study group and randomly allocated to kinesiotaping (n = 16) or control group (n = 14). In both groups, pain intensity on the 4th day was significantly reduced when compared with baseline (p for both<0.01). Additionally, considering the reducing the pain intensity on 4th day, kinesiotaping was significantly superior than the control group (p < 0.01). Conclusion: This study investigated the use of kinesiotaping in emergency departments. When compared to NSAID therapy alone, combined kinesiotaping and NSAID therapy appears to be more effective in terms of pain reduction in rib fractures. (C) 2019 Elsevier Inc. All rights reserved.