Publications (7)5.66 Total impact
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Article: Hemoptysis and breath-holding diving.
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ABSTRACT: We aim to present one case with hemoptysis. Pulmonary barotrauma of descent (lung squeeze) has been described in breath-hold divers when the lung volume becomes smaller than the residual volume, with the effect of increased ambient pressure. We report one case of hemoptysis in a breath-hold diver who dove for exercise of military action. The patient's hemoglobin and hematocrit levels were 7.3 g/dL and 26%, respectively. The computed tomography of thorax obtained 5 hours after the diving event revealed images suggestive of hemoptysis. The diagnosis of hemoptysis was made based on the diver's history and computed tomography findings. All of the divers performed voluntary diaphragmatic contractions at the beginning of their ascent, while their mouths and noses were closed. We suggest that the negative intrathoracic pressure attributable to the forced attempt to breathe along with voluntary diaphragmatic contractions contributes to hemoptysis, since it may damage the pulmonary capillaries.Military medicine 08/2006; 171(7):606-7. · 0.92 Impact Factor -
Article: Missed injuries in military patients with major trauma: original study.
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ABSTRACT: The incidence and subsequent outcomes of missed injuries and the primary factors contributing to each missed injury were analyzed. Records of 709 trauma patients were reviewed between December 2003 and December 2004. Demographic data were compared and analyzed for two patient groups: those with multiple injuries diagnosed in 24 hours and those with multiple injuries diagnosed in >24 hours. Fifty-two missed injuries were determined in 34 (4.8%) patients. There were significant differences between the patients with and without delayed diagnoses, including the mean injury severity scores (23 vs. 16.9), morbidity, and mortality (p < 0.05 for all). Among 69 contributing factors identified, 28 (40.6%) were unavoidable and 41 (59.4%) were potentially avoidable. Missed injuries could usually be encountered in the most seriously injured patients, particularly in those with altered levels of consciousness. Missed injuries were mostly avoidable and most were the result of inadequate clinical examination.Military medicine 07/2006; 171(7):598-602. · 0.92 Impact Factor -
Article: Comparison of laparoscopic and open surgery for total rectal prolapse.
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ABSTRACT: Total rectal prolapse is a devastating disorder causing constipation and anal incontinence. We compared open and laparoscopic surgical approaches in a limited series. The subjects of this study were 23 patients who underwent laparoscopic procedures (LP group) and 17 patients who underwent open procedures (OP group) for rectal prolapse. We assessed the preoperative colonic transit time, postoperative pain scoring, pre- and postoperative anal functions, and changes in constipation and related symptoms. The median operation time was 140.8 min for the LP group and 113.1 min for the OP group (P = 0.037). The median postoperative hospital stay was 4.8 days after the LPs and 9.6 days after the OPs (P = 0.001). Less analgesia was needed in the early postoperative period after the LPs (P = 0.007). While more than 70% improvement in continence was seen in the patients who underwent OPs, it was about 85% in those who underwent LPs. Improvement in constipation and related symptoms were similar in both groups. More than 30% of patients still suffered from hard stools and other symptoms of constipation. The colonic transit times were reduced in about 50% of patients who had suffered constipation in both groups. There was no incidence of recurrence in the median follow-up period. Although transabdominal rectopexy has been performed conventionally for rectal prolapse for many years, laparoscopic rectopexy and laparoscopic resection rectopexy are associated with lower morbidity and less postoperative pain. We eliminated the total prolapse and cured incontinence in almost all patients, with a short hospital stay.Surgery Today 02/2005; 35(6):446-52. · 1.22 Impact Factor -
Article: Non-urgent patients in an Emergency Medical Service.
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ABSTRACT: Emergency Medical Services (ES) are medical-surgical facilities where extremely ill patients, victims of accidents, intoxications and other urgent clinical situations should be rapidly and efficiently attended. However, a worldwide experience is that a large proportion of patients who require attention in an ES do not qualify as emergencies and they obstruct the possibilities of other patients that should be attended immediately. To evaluate the medical records in our ES and to assess whether patients understand what is a true emergency and which is the role of an ES. Patients attended in the ES of Haydarpasa Military Teaching Hospital in 2001-2002 were classified according to their diagnosis. A random sample of patients and relatives were surveyed about why they required medical attention in the ES. 77,134 patients (39,327 female, 51%) were attended. The most common illness diagnosed was upper respiratory tract infection (18,423 patients, 23.9%). The true emergency condition rate in patients presenting to our ES was lower (44%) than the non-emergency condition rate. Improvements in public education are needed to solve this problem. Also, Primary Care facilities should be improved in order to reduce the demand for medical attention in ES by non-urgent patients.Revista medica de Chile 10/2004; 132(9):1085-9. · 0.33 Impact Factor -
Article: [Evaluation of stress factors and burnout in the emergency department staff].
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ABSTRACT: Burnout has been defined as a syndrome of emotional exhaustion, depersonalization, and 1 reduced personal accomplishment. The syndrome have been linked to high levels of absenteeism from work among professionals group. We studied on 22 emergency service and 22 other health staff working at our Hospital. We investigated on health workers with burnout symptoms by the protocol was self-reported (using a poll). Also we used, Maslach Burnout Inventory in order to obtain as valid data as possible to assess the level of burnout. 45.3% showed high levels of burnout on emotional exhaustion subscale, 32.~% on depersonalizaion subscale and 28.1% on personal accomplishment. Seven (31.82%) have been determined to be under serious. stress based on the investigation in emergency services; where as 2 (9.09%) in other health services workers as well (t=1.903; p< 0.05 ). Burnout symptoms were more likely to occur in the emergency personnel than the other health service workers. Sharing experiences with family and friends and with other health staff who understand what health staffs do best, prevents burnout syndrome. Keywords: Burnout, emergency services, stress.Ulusal travma dergisi = Turkish journal of trauma & emergency surgery: TJTES 11/2002; 8(4):215-9. -
Article: Breast schwannoma.
The Breast Journal 12(2):184-5. · 1.64 Impact Factor -
Article: Results of pars plana vitrectomy in closed-globe injuries.
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ABSTRACT: To assess surgical and visual outcomes with pars plana vitrectomy (PPV) in closed-globe injuries resulting in anterior and posterior segment pathologies and evaluate the factors influencing the prognosis. Retrospective observational study. Forty-seven eyes of 47 consecutive patients who underwent PPV because of closed-globe injury between January 1992 and August 2003 were reviewed. Surgical and visual outcomes and prognostic factors were analyzed according to the Ocular Trauma Classification System. Preoperative visual acuity was less than 4/200 in 49% of eyes, classified as grades IV to V. After surgery, this ratio was 23% (P < .05). Final visual acuity was statistically significantly better in grade I (P = .0001), grade II (P = .002), and relative afferent pupillary defect-negative (P = .0001) injuries. Maculopathy was the most common adverse outcome influencing final visual acuity (32%), followed by secondary glaucoma (13%) and proliferative vitreoretinopathy (8%). PPV is a favorable treatment modality in severe closed-globe injuries. Assessment of injuries with respect to the Ocular Trauma Classification System seemed to predict visual outcomes in this series.Ophthalmic Surgery Lasers and Imaging 36(3):182-8. · 0.62 Impact Factor
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2006
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Gulhane Military Medical Academy
- Department of General Surgery
Ankara, Ankara, Turkey
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