Browsing by Author "Dursun, R."
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Article The Dynamics of Prehospital/Hospital Care and Modes of Transport During Civil Conflict and Terrorist Incidents(W B Saunders Co Ltd, 2017) Celik, S.; Dursun, R.; Aycan, A.; Gonullu, H.; Adanas, C.; Eryilmaz, M.; Guloglu, C.Objective: Prehospital and hospital care during incidents of mass violence and civil conflict involve a number of aspects that distinguish it from care during times of peace. We aimed to analyze the dynamics and outcomes of prehospital and hospital care during ongoing conflicts. Study design: Multicentric prospective observational study. Method: Patients enrolled in the study, which was conducted in Turkey, were all injured in armed conflict and taken to level 1 trauma centers. On admittance, patients were requested to complete a semistructured questionnaire containing questions on patient demographics, transport type, weapons used, injury severity score (ISS), and other incident-related factors. We analyzed patient outcomes (mortality, morbidity, complications, and length of hospital stay) and transfers of patients between hospitals. The present study evaluated the cases of 390 victims enrolled over a 9-month period and followed up for 6 months. Results: The majority of patients were transported by ambulances (n = 334, 85.6%); other transport modes were helicopters (n = 32, 8.2%) and private vehicles (n = 24, 6.2%). Nearly half of patients (48.7%) did not benefit by changing hospitals. During transport to hospitals, 4.1% of the vehicles in the study were involved in accidents. Using multiple regression analysis, only ISS (odds ratio [OR]: 1.098, 95% confidence interval [CI]: 1.044-1.156) and the Glasgow Coma Scale (OR: 0.744, 95% CI: 0.639-0.866) were found to affect mortality. In Receiver-operator characteristic analysis, a cutoff value of 22.5 for ISS had a sensitivity of 100% and a specificity of 89.6% for mortality. Conclusions: Despite lower ISS values, patient outcomes were worse in terror incidents/civil conflicts. Transport modes did not significantly affect outcomes, whereas hospital transport was found to be inefficiently used. (C) 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.Article Specific and Non-Spesicific Dermatoses of Pregnancy in the Emergency Department(Yuzuncu Yil Universitesi Tip Fakultesi, 2019) Bilgili, M.A.; Bilvanisi, S.K.; Bilgili, S.G.; Okyay, A.G.; Dursun, R.; Karadag, A.S.Dermatological changes both specific to pregnancy and nonspecific to it may be observed during gestation. In this study, specific and nonspecific dermatoses of pregnancy were investigated in patients admitted with dermatologic complaints to the emergency department. This information will be useful in identifying common and important dermatoses of pregnancy that need to be recognized at the point of primary care, so that the proper initial treatment and referrals can be instituted. Pregnant patients admitted with dermatological complaints to the emergency service were enrolled in the study. We retrospectively collected clinical and laboratory findings, diagnoses, administered treatments and admission rates. Of the 4,280 pregnant patients admitted to the emergency service, 99 pregnant patients had dermatological complaints. While pregnancy-specific dermatoses were detected in 22 % of the patients, dermatoses nonspecific to the pregnancy were found in 78 % of them. Listed in descending order, specific dermatoses of pregnancy were atopic eruption of pregnancy (12%), polymorphic eruption of pregnancy (6%), intrahepatic cholestasis of pregnancy (2%), and pemphigoid gestationis (2%). Urticaria and angioedema were the most frequently diagnosed diseases among the dermatoses nonspecific to the pregnancy. There are many dermatoses are seen in the pregnancy, while urticaria and angioedema are the most common. Atopic eruption of pregnancy and the polymorphic eruption of pregnancy are the most common specific dermatoses. It was seen that the frequency of dermatological causes was quite low among the pregnant patients applying to the emergency service. However, some of these dermatoses may necessitate early diagnosis and immediate treatment. © 2019, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.