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Öğe A society, a disease, a survey and the expected result(2023) Demir, Bilgehan; Karahan, DoğuCOVID-19, which affects the whole world, has affected people, societies and human relations throughout the process. The COVID-19 pandemic both limited people's social lives and changed the perspective of people who carry the virus. Anxiety, fear, haste, loneliness, worry were the most common emotions. In this study, we aimed to evaluate how social warnings affect people, the effects of death risk due to the disease, the side effects of the drugs used on behavior change, and the underlying factors. 189 cases were included in the study. The study was designed in the style of a 20-question questionnaire on the effects of covid-19 and treatment options on the behavior pattern. The responses were evaluated and interpreted as percentages. Variables on family and social behavior related to anxiety, fear, panic, and loneliness caused by COVID-19 and the drugs used in its treatment were observed. Negative effects of COVID-19 were observed in family and community relations. COVID-19 has caused psychological and sociological changes in interpersonal and social behaviors all over the world. There are differences in behavioral patterns among societies. In Turkish society, behavioral changes arising from the characteristic and patriarchal characteristics of the society have been observed. A more detailed assessment of the effects of COVID-19 and subsequent pandemics on the individual and society remains important.Öğe Acilde Nadir Bir Vaka; Gebelikte Uterus Reptürü(2021-10-(14-17)) Pepele, Mustafa Sefa; Demir, Bilgehan; Nogay, Süleyman; Ercan, AbdullahGIRIŞ: Ülkemizde acil servislere başvurular arasında karın ağrıları azımsanamayacak şekilde fazladır. Gebe karın ağrıları daha çok kadın doğum aciline başvuru yapsalar da gebelik ile ilgili bir sorun olmadığı zaman genellikle tekrardan erişkin acile yönlendirilmektedirler. Bu vakamızda bir gün önce kadın doğum acile başvuru yapan bir gebe hastanın taburcu olduktan bir gün sonra acil servisi başvurması sonrası tanı alan uterus rüptürünü vaka olarak sunacağız. VAKA: 30 yaşında bilinen 14 haftalık gebeliği olan hasta acil servise karın ağrısı ve halsizlik şikâyeti ile geldi. Hastanın anamnezinde ağrının dün başladığı ve dün kadın doğum acile başvurduğu ve orada yapılan USG de bir sorun olmadığı söylenerek taburcu edildiği, 3 yıl önce sezaryenle bir doğum yaptığı öneriliyor. Hastanın karın ağrısı artması üzerine acil servise başvuruyor. Hastanın vitallerinde tansiyon arteriyel: 92\56 nabız 110 larda ateş:36,4 hastanın muayenesinde karında yaygın bir defans ve rebaund mevcut. Hastanın hemogram ve biyokimyası alınıyor, tam idrar tetkiki isteniyor. Hasta abdomen USG ye gönderiliyor yapılan USG de batın içi yaygın sıvı görülüyor ve canlı fetüs görülüyor. Kan değerlerinde hb:7,1 mg\dl htc:23 geliyor. Hasta kadın doğuma konsülte ediliyor hasta da acil müdahale düşünülmüyor ve hasta genel cerrahiye konsülte ediliyor. Genel cerrahi tarafından hasta ve hasta yakınlarına tüm riskler anlatılarak tanı amaçlı laparoskopik cerrahiye alınıyor. Operasyon sırasında batın açıldığında uterus rüptürü olduğu görülüyor ve hasta kadın doğuma devir ediliyor. Kadın doğum tarafından hastanın gebeliği sonlandırılıyor ve histeretomi yapılıyor. TARTIŞMA: Gebelikte uterus rüptürü acil bir durumdur (1). Uterus rüptürü insidansı artan sezaryen sayısı ile artmaktadır (2). Ama bizim hastamızda sadece 1 sezaryen doğum mevcuttur ve gebelik haftası çok erkendir. Gebe hastalarda karın ağrısında uterus rüptürünün ayırıcı tanıya dahil edilmesi önemlidir. Tanı koymada en büyük etken ultrason muayenesi ve acil doktorunun muayenesidir. Bu vaka raporunun amacı nadir görülen bir uterus rüptürü olgusu sunmaktı ve uterus rüptürünün teşhisinin ne kadar zor olabileceğini göstermekti.Öğe Akut Aort Diseksiyonunda İnflamatuvar İndeksler ve HALP Skorunun Prognostik Değeri(Acil Tıp Uzmanları Derneği, 2025) Özüağ, Alican; Dolanbay, Turgut; Demir, Bilgehan; Nogay, Süleyman; Mamur, Ömer SerdarGiriş: Aort diseksiyonu kritik bir klinik tablodur ve son yıllarda yapılan çalışmalar, tanısal BT anjiyografinin yanında laboratuvar parametrelerinin prognostik değerini giderek daha fazla vurgulamaktadır. Gereç ve Yöntem: Bu çalışmaya Ocak 2023 – Ocak 2025 tarihleri arasında aort diseksiyonu tanısı alan 23 erişkin hasta dâhil edilmiştir. Hastaların başvuru anındaki laboratuvar verileri ve bu verilerden türetilen skorlar ile mortalite ve yoğun bakım yatış süresi gibi klinik sonuçlar arasındaki ilişki değerlendirilmiştir. Bulgular: Mortalite gelişen hastalarda nötrofil sayısı anlamlı olarak daha yüksek bulunmuştur (p = 0.03) ve mortaliteyi öngörmede %57.1 duyarlılık ve %68.8 özgüllük göstermiştir. HALP skoru ile yoğun bakım yatış süresi arasında anlamlı negatif korelasyon saptanmıştır (r = –0.471, p = 0.023). Buna karşılık, CRP düzeyleri ile yoğun bakımda kalış süresi arasında anlamlı pozitif korelasyon mevcuttur (r = 0.504, p = 0.014). Sonuç: Nötrofil sayısı, HALP skoru ve CRP düzeyleri, aort diseksiyonunun prognozunun öngörülmesinde ve erken risk sınıflandırmasında yararlı biyobelirteçler olarak kullanılabilir.Öğe Bedenin Dışında Bir Hayat(2021-10-(14-17)) Demir, Bilgehan; Pepele, Mustafa Sefa; Kurtoğlu, Ertuğrul; Akdaş, İbrahimRitm bozuklukları nedeni ile kullanılan kardiyak pacemakerlar ilk kez 1969 yılında Mirowski ve arkadaşları tarafından insan vücuduna implante edilmiştir. Gün geçtikçe pacemakerlar hem boyut hem de özellik bakımından geliştirilmiştir. Bu yenilikler sayesinde daha kolay implante edilebilir ve daha kullanışlı olmuştur. Defibrilatörler cilt altına implante edilerek, enfeksiyon riskinden ve çevresel nedenlerden etkilenmekten kurtarılmaktadır. Sunmaya çalıştığımız vakada hasta bir hafta boyunca defibrilatörü cilt dışına çıkmış bir vaziyette gezmiş ve defibrilatörün aksaklık çıkarması nedeni ile acil servise başvurunca defibrilatörün cilt dışında olduğu fark edilmiştir. Hastanın bir enfeksiyona veya daha ciddi bir durumla karşı karşıya kalmaması tamamen bir şans eseridir. Bu vakadaki davranış insanların kendi hayatlarına dikkatsiz olmasında en önemli nedenlerden birinin eğitim yetersizliği olduğu net göstermiştir. İnsanlar bilmediklerinde daha cesur davranışlar sergileyebiliyor, bu örnekte olduğu gibi.Öğe Bir Dokunuş, Bir Ölüm(2021-10-(14-17)) Demir, Bilgehan; Pepele, Mustafa SefaLangerhans hücreli histiyositoz, inflamatuar bir neoplazidir. Genelde ciltte görüldüğünden, en sık kafa derisinde veya gövde de seboreik döküntü olarak gözlemlenir. Beraberinde multisistemik tutulum sık olduğundan organ disfonksiyonu açısından değerlendirilmelidir. 7 yaşında erkek vaka olarak sunmaya çalıştığımız vakamızda rastlantısal olarak tespit ettiğimiz durumun bir malignite olması ve dahi yapmayı düşündüğümüz müdahalenin ölümcül sonuçlarının olabilmesi düşündüğümüzde çok ciddi bir durumun dikkatimizle engellediğimiz ve bu gibi durumlar için tüm hekim arkadaşlar için uyarıcı nitelikte olması gerektiğinden bu vakayı paylaşmak istedik. Bu vaka da olduğu gibi yapacağımız basitte olsa her müdahalede, niçin yapmamız gerekliliği ilgili bir sebebin olması hem doktorluk etiği açısından hem de vicdani boyutu bakımdan şarttır. Daha büyük komplikasyonlar daha küçük ayrıntılara olan dikkatle aşılabilir.Öğe Can serum interleukin 34 levels be used as an indicator for the prediction and prognosis of COVID-19?(Public Library Science, 2024) Karahan, Dogu; Bolayir, Hasan Ata; Bolayir, Asli; Demir, Bilgehan; Otlu, Onder; Erdem, MehmetObjective Interleukin 34 (IL-34) is a molecule whose expression is increased in conditions such as autoimmune disorders, inflammation, and infections. Our study aims to determine the role of IL-34 in the diagnosis, follow-up, and prognosis of Coronavirus Disease-19 (COVID-19).Method A total of 80 cases were included in the study as 40 COVID-19 positive patient groups and 40 COVID-19 negative control groups. The COVID-19-positive group consisted of 20 intensive-care unit (ICU) patients and 20 outpatients. Serum IL-34, c-reactive protein (CRP), ferritin, D-dimer, troponin I, hemogram, and biochemical parameters of the cases were studied and compared between groups.Results IL-34 levels were significantly higher in the COVID-19-positive group than in the negative group. IL-34 levels increased in correlation with CRP in predicting the diagnosis of COVID-19. IL-34 levels higher than 31.75 pg/m predicted a diagnosis of COVID-19. IL-34 levels did not differ between the outpatient and ICU groups in COVID-19-positive patients. IL-34 levels were also not different between those with and without lung involvement.Conclusion While IL-34 levels increased in COVID-19-positive patients and were successful in predicting the diagnosis of COVID-19, it was not found to be significant in determining lung involvement, risk of intensive care hospitalization, and prognosis. The role of IL-34 in COVID-19 deserves further evaluation.Öğe Course of COVID-19 in patients carrying different MEFV mutations of familial Mediterranean fever(2024) Demir, Bilgehan; Karahan, DoğuFamilial Mediterranean fever (FMF) is a genetic auto-inflammatory disease. Mutations in the Mediterranean fever (MEFV) gene cause inappropriate immune system triggering, leading to inflammatory episodes in the peritoneum, pleura, and joints. In the severe Coronavirus disease-19 (COVID-19) picture, the hyperimmune response and inflammatory process develop with exacerbation of the clinical condition. FMF disease, the drugs used in its treatment, and the possible effects of different genetic MEFV mutations on the course of COVID-19 arouse interest. In this study, 158 FMF patients with different MEFV gene mutations were evaluated using an online survey method in terms of COVID-19 course, hospitalization, additional comorbidities, and COVID-19 vaccination status. Participants were asked 21 questions and the data provided were compared between FMF MEFV gene mutations. 104 out of 158 cases did not get COVID-19. 9 of 54 cases who got COVID-19 were hospitalized. No statistically significant difference was found between MEFV gene mutations when evaluated and compared in terms of susceptibility to COVID-19, vaccination status, and presence of additional chronic diseases and comorbidities. The present study provides guidance on the role of FMF genetic mutations in the course of COVID-19. Our study may suggest that FMF MEFV gene mutations do not have a protective role against COVID-19. The results also may suggest that, as an inverse effect, MEFV gene mutations do not increase the risk of hyper-immune response and severe acute respiratory syndrome (SARS), which play a role in the severe course of COVID-19.Öğe Determining the role of HLA-B27 on COVID-19(2023) Karahan, Doğu; Demir, BilgehanAim: Human leukocyte antigen-B27 (HLA-B27) binds antigenic peptides in the structure of some viruses and presents them to cytotoxic T lymphocytes and plays a role in the immune response against these viruses. It has also been found to be associated with auto-immunity as an inverse relationship and is associated with a number of auto-immune inflammatory diseases, especially Ankylosing Spondylitis (AS). Our aim in this study is to determine the role of HLA-B27 in Severe Acute Respiratory Syndrome (SARS)-Cov-2 (Coronavirus Disease-COVID-19). Materials and Methods: 90 HLA-B27 positive and 96 HLA-B27 negative cases were included in the study. COVID-19 Polymerase Chain Reaction (PCR) results and Thorax Computed Tomography (CT) results, hospitalization and death records of the cases were retrospectively analyzed from the system records. Results were compared between HLA B27 positive and negative groups. Results: Of the HLA-B27 positive cases, 32.2% had COVID-19 positivity, 5.6% had COVID-19 lung involvement. 44.8% of HLA-B27 negative cases had COVID-19 positivity and 11.5% had lung involvement. There was no significant difference between the HLA-B27 positive and negative groups in terms of having COVID-19 infection, lung involvement, hospitalization and death rates. Conclusion: The results of our study show that HLA-B27 does not have a protective role in terms of having COVID-19 and lung involvement. Again, since no auto-immunity related SARS was observed in any of the patients, it can be said that it did not increase the severity of the hyper-immunity-related disease and did not increase the risk of death in particular for COVID-19. These results need to be supported by more studies.Öğe Drug intoxications in the emergency department: Our 1-year experience(Kare Publ, 2025) Oksuz, Ersoy; Demir, BilgehanOBJECTIVE: Drug intoxication (DRI), which occurs due to accidental or suicidal use of high doses of drugs, has a high mortality and morbidity rate. emergency departments of hospitals are the units where these patients first come to the hospital, where the first interventions are performed and where the mortality rate is higher than other departments. therefore, DRI is a more important health problem for the emergency department (ED) than other departments of hospitals. In this study, we aimed to retrospectively investigate the demographic characteristics, drugs used and clinical course of patients admitted to the ED of our hospital with the diagnosis of DRI. METHODS: Patients admitted to the ED of Malatya Training and Research Hospital with the diagnosis of DRI were retrospectively screened from the hospital database. The patients' demographic characteristics, medications and clinical conditions were recorded. Patients over the age of 18 years who were diagnosed with DRI and whose medicationuse was identified were included in this study. Patients under the of 18 and those poisoned by other substances such as alcohol, illegal chemicals, or agricultural pesticides were excluded. RESULTS: Demographic characteristics, type of intoxication and clinical course of the patients included in the study are shown in Table 1. In 2023, 282 patients were admitted to the emergency department of our hospital with the diagnosis of DRI. Of these, 60% were women and 40% were men (n=170, n=112, respectively) and there was no statistically significant difference between the numbers of men and women (p=0.156). Fifteen percent of the women were over 50 years of age and 85% were under 50 years of age. this ratio was 55% to 45% in men. there was no statistically significant difference in the age distribution between men and women (p=0.246, p=0.260, respectively), (Table 1). 77% of the patients used overdose drugs for suicidal purposes and 23% accidentally (n=217, n=65, respectively). There was no statistically significant difference in the type of DRI, total number of males and females and age distribution (p=0.26). While 60% of the patients were hospitalized, 25% were admitted to intensive care unit and 35% to service (n=70, n=100, respectively). There were statistically significantly more patients admitted to service (p=0.03). CONCLUSION: The results of our study show that the number of female patients admitted to the ED of our hospital with the diagnosis of DRI, patients under 50 years of age and suicidal use are higher, the most commonly used drugs in these patients are NSAIDs, SSRIs and antipyschotics as a drug group and drugs used in psychiatric disorders. Our study has shown that frequently used and easily accessible drugs are more likely to be abused, and that questioning such drugs, especially in patients presenting to the emergency service with drug intoxication in this region, may be valuable for diagnosis and treatment.Öğe Evaluation of Post-Discharge Attitudes and Behaviors of Patients Affected by The COVİD-19 Pandemic(Acil Tıp Uzmanları Derneği, 2023) Tansel, Gokhan; Taslidere, Bahadir; Demir, Bilgehan; Erdoğan, Özcan[Abstract Not Available]Öğe Investigation of blood parameters as predictors in diagnosing acute scrotum(Kare Publ, 2025) Demir, Bilgehan; Nogay, Suleyman; Dolanbay, Turgut; Polat, Muhammed Eyyub; Akdemir, EnderOBJECTIVE: Acute Scrotum (AS) is defined as pain associated with swelling and redness of the scrotum. This study investigates the hemogram and C-Reactive Protein (CRP) values obtained from patients diagnosed with AS, based on the hypothesis that blood parameters can be used as biomarkers in the diagnosis of Testicular Torsion (TT). The aim was to evaluate the predictability of these parameters in diagnosing AS in both pediatric and adult age groups. METHODS: Demographic data and blood parameters including Hemoglobin (Hb), Platelet (PLT), CRP, and White Blood Cell (WBC) levels of patients who presented to our Emergency Department with the diagnosis of AS (TT, epididymitis, varicocele) and received medical and surgical treatment were analyzed. The importance of these parameters in diagnosis was assessed. RESULTS: A total of 26 patients were included in the study. The mean age of the cases was 15.8 +/- 3.6 years. 20 of the patients (76.9%) were in the pediatric age group, while 6 (23.1%) were in the adult age group. 93.1% (27) of the cases were unilateral, while 6.9% (2) had bilateral acute scrotum symptoms. The highest incidence of cases occurred in spring with 9 cases (31%), followed by winter and summer with 7 cases each (24.1%), and autumn with 6 cases (20.7%). Significant differences in age, platelet, and hemoglobin levels were observed between the pediatric and adult age groups. CONCLUSION: In conclusion, this study highlights significant age-related differences in the diagnosis and treatment of AS. The higher requirement for surgical intervention in pediatric patients further emphasizes the importance of early diagnosis and timely intervention. However, further studies with larger sample sizes are needed to validate these findings and better understand the etiological differences. Additionally, a more specific analysis of blood parameters in subgroups (such as epididymitis, orchitis, TT) under the term acute scrotum may contribute to the literature.Öğe Investigation of the Effect of Gender on Blood Parameters in Acute Renal Failure in Patients Presenting to the Emergency Department of a Hospital(Acil Tıp Uzmanları Derneği, 2025) Demir, Bilgehan; Dolanbay, Turgut; Nogay, Süleyman; Tan, Fatih; Öngenli, Ömer FarukAim: Acute renal failure (ARF) is a sudden change in renal function that prevents the excretion of nitrogenous wastes and disrupts the body's fluid and electrolyte balance. Identification of ARF risk factors and development of indicators that predict mortality are crucial to improve the success of medical care. We aim to evaluate the effect of age and gender factors in patients with ARF and to evaluate the course and frequency of the disease in female patients compared to male patients. Methods: The data of adult patients over 18 years of age who were hospitalized with a diagnosis of ARF between 01.02.2025-01.03.2025 in the emergency department of Malatya Training and Research Hospital were retrospectively analyzed. Blood laboratory parameters were recorded and analyzed to determine whether these data were positively or negatively associated with gender. Results: A statistically significant difference was found between age and gender in patients with ARF (p= 0.004). Female patients with ARF were older than male patients. There was a statistically significant relationship between creatinine level and gender in patients with ARF (p=0,017). Creatinine levels were higher in male ARF patients. There was no statistically significant difference between plt, hb, htc, ALT and HALP score and gender (p values 0.384; 0.078; 0.221;0.221; 0.189; 0.174, respectively). Conclusions: The finding in our study that ARF occurs at older ages compared to men may be explained by the interaction of biological, hormonal, clinical and sociocultural factors. The renal protective effects of estrogen are realized through protection of vascular structure, support of glomerular iltration rate (GFR) and reduction of oxidative stress. However, the decrease in estrogen levels in the postmenopassusal period may be an important factor in the more rapid deterioration of renal function. The pro-inflammatory properties of testosterone and increased oxidative stress, as well as the earlier development of hypertension, atherosclerosis and chronic kidney disease in men, may be another reason why ARF occurs at a younger age in men compared to women.We found that creatinine levels were significantly higher in male patients with ARF compared to female patients. Men are known to have more muscle mass in general compared to women and this may lead to higher creatinine levels in men.Öğe Itchy skin diseases in the emergency department before and after the earthquakes(Mre Press, 2025) Demir, Bilgehan; Sahin, Levent; Kaya, Kismet; Akin, Merve AyyildizBackground: Infectious diseases increase after natural disasters such as earthquakes. Increase in skin diseases may also occur and are not well documented. This before-after study analyzed patients presenting with itching to the emergency department and dermatology outpatient clinic of a tertiary hospital in Malatya, a province severely affected by the February 2023 earthquakes. Patients were divided into two groups: pre-earthquake and post-earthquake. The study aimed to investigate the impact of the earthquake on these presentations. Methods: Patient information was retrospectively identified through records in the hospital information system. Data on age, gender, nationality, diagnosis and clinic of presentation were reviewed for patients presenting with itching complaints during the year before and the year after the earthquake. Statistical analyses with graphical representations were conducted to evaluate significant findings from the comparisons. Results: The study included 3468 patients after applying exclusion criteria. Scabies, contact dermatitis, pityriasis rosea and tinea corporis were more common in the post-earthquake group. Scabies was the most frequently observed diagnosis both before and after the earthquake among both the local and refugee populations. Scabies was particularly prevalent among the refugee population. Conclusions: Post-earthquake living conditions in overcrowded shared spaces and poor hygiene are associated with a rise of itchy skin diseases. Increased hygiene education for earthquake survivors and healthcare staff, improving temporary shelter conditions, ensuring water sanitation and access to clean water, and frequent health monitoring can help reduce the number of cases.Öğe LESSONS LEARNED FROM THE FEBRUARY 6, 2023, KAHRAMANMARAS EARTHQUAKES: A SPECIAL REPORT FROM EMERGENCY PHYSICIANS(Via Medica, 2026) Al, Behcet; Akbas, Ilker; Karakus, Ali; Dolanbay, Turgut; Demir, Bilgehan; Acar, Demet; Lok, UgurINTRODUCTION: To present field-based challenges, observations, and practice-oriented recommendations derived from the experiences of emergency physicians involved in the response to the February 6, 2023, Kahramanmaraş earthquakes. MATERIAL AND METHODS: This Special Report is based on professional experiences, field observations, and expert consensus developed during and after the disaster. Insights were obtained through in-person meetings, online discussions, and post-deployment debriefings with twenty-six emergency medicine physicians deployed across four severely affected cities. Recurrent operational challenges and key themes were identified through iterative, consensus-based synthesis and organized into a phase-based framework encompassing preparedness, acute response, and recovery. RESULTS: The synthesis yielded a practical framework structured across three disaster phases, outlining recurrent challenges and actionable considerations relevant to emergency healthcare delivery. Key issues included coordination and communication gaps, workforce deployment and safety, surge capacity, logistics, and continuity of care across affected regions. CONCLUSIONS: Experience-informed, phase-based guidance can support emergency physicians and health systems in strengthening disaster preparedness and response. This field-derived framework aims to inform future planning, training, and coordination strategies for large-scale emergencies. © 2026 Via MedicaÖğe Prognostic Role of Blood Parameters in Subarachnoid Hemorrhage: A Retrospective Study(Kafkas Üniversitesi, 2025) Demir, Bilgehan; Dolanbay, Turgut; Nogay, Süleyman; Kartal, Bilal[Abstract Not Available]Öğe The Effectiveness of Systemic Immune-Inflammation Index (SII) and Systemic Inflammation Response Index (SIRI) and Model for End-Stage Liver Disease (MELD) Score in Predicting Prognosis in Portal Vein Thrombosis, a Pilot Study(Mdpi, 2026) Yumrutepe, Sevgi; Dolanbay, Turgut; Nogay, Suleyman; Demir, Bilgehan; Polat, Muhammed EyyubBackground/Objectives: Portal vein thrombosis (PVT) is a clinically significant condition in which early risk stratification remains challenging, particularly in emergency settings where rapid decision-making is required. This study aimed to evaluate the prognostic value of the Systemic Immune-Inflammation Index (SII), Systemic Inflammation Response Index (SIRI), and the Model for End-Stage Liver Disease (MELD) score in predicting the need for intensive care in patients with PVT. Methods: A retrospective analysis was conducted on adult patients (>18 years) diagnosed with PVT in the emergency department between January 2018 and December 2024. A total of 29 patients meeting the inclusion and exclusion criteria were included. Demographic characteristics, laboratory parameters, Intensive Care Unit (ICU) admission status, and 90-day mortality were analyzed. The sensitivity and specificity of MELD, SII, and SIRI for predicting ICU admission were calculated. Non-normally distributed variables were expressed as median (interquartile range, IQR) and compared using the Mann-Whitney U test. Results: The mean age of patients was 60.5 +/- 16.2 years, and 18/29 (62.1%) were male. ICU admission was required in 9/29 (31.0%) of cases. MELD score (median 18.7 [11.0-21.9] vs. 7.9 [6.7-13.5], p = 0.003), bilirubin (median 2.4 [1.0-4.2] vs. 0.7 [0.4-1.1], p = 0.016), and SIRI (median 6.4 [2.3-21.3] vs. 1.4 [0.6-9.3], p = 0.038) were significantly higher in ICU-admitted patients. MELD score showed 66.7% sensitivity and 95% specificity, while SIRI had 88.9% sensitivity and 55% specificity for ICU prediction. Conclusions: MELD score, bilirubin, and SIRI are significantly associated with ICU admission in PVT patients. Their integration into emergency department protocols may assist in early risk stratification and resource allocation.Öğe The Importance of Demographic and Biochemical Parameters on Prognosis in Corrosive Substance Poisonings in Infancy and Play Childhood Period(2025) Nogay, Süleyman; DOLANBAY, TURGUT; Demir, Bilgehan; Teksen, Ayse Fulya; Özkan, AsiyeObjective: Corrosive substances are chemicals with strong acidic or alkaline properties that can cause tissue damage. In children, the most common cause of corrosive exposure is accidental ingestion. Our study presents the demographic, clinical, and laboratory characteristics of pediatric patients admitted due to corrosive intake and investigates the prognostic relevance of these parameters. The primary objective is to highlight corrosive poisonings and emphasize predictive markers for risk and complications to guide emergency management. Methods: Data of patients admitted to the emergency department due to corrosive substance ingestion and subsequently hospitalized were retrospectively analyzed. This study aimed to evaluate the prognostic significance of demographic features, the agent’s chemical nature, and laboratory parameters. Results: The median age of the patients was 27 months, with seven being male. Sixteen patients were discharged within two days and no mortality was recorded. In this study, leukocyte counts were significantly elevated in patients who ingested acidic corrosive agents. No statistically significant relationship was found between gender and admission to the intensive care unit (ICU). Similarly, ICU admission did not differ significantly based on whether the agent was acidic or alkaline. Endoscopy rates showed no significant difference according to whether the substance was a household cleaning product. No association was found between product type and gender. Conclusion: Corrosive poisonings during infancy and early childhood generally result from accidental ingestion of small amounts. Inadequate or delayed intervention may lead to severe complications. Prompt diagnosis and appropriate treatment are essential to prevent these outcomes and reduce morbidity.Öğe The Prediction of 28-Day Mortality in Crush Syndrome by Evaluating Lactate/Albumin Ratio in Patients Presented to the Emergency Department After an Earthquake(Wiley, 2025) Demir, Bilgehan; Caltekin, IbrahimIntroduction: Crush syndrome (CS) is a primary cause of mortality among survivors following earthquakes. Determining discharge outcomes and mortality in cases of CS is critical for guiding management strategies. Biomarkers may be utilized to predict survival and mortality in CS cases early and accurately; however, those currently used are primarily intended for disease diagnosis.Objectives: Considering that cases associated with impaired vital signs and organ perfusion show alterations in lactate, albumin, and the lactate/albumin (L/A) ratio, it was hypothesized that the L/A ratio could serve as a prognostic and mortality predictor in CS cases.Methods: Following the February 2023 Kahramanmara & scedil; earthquake, 1145 trauma patients presenting to the hospital emergency department were evaluated. Among these, 62 patients meeting the inclusion criteria were diagnosed with CS. Patient records were retrieved from archives and the hospital management information system. Anamnesis, physical examination findings, laboratory results, consultations, and discharge summaries were retrospectively analyzed.Results: A total of 62 CS cases meeting the inclusion criteria were included in the study. Upon evaluating the patients' initial lactate, albumin, and L/A ratio levels, lactate and L/A ratio levels were significantly higher in the deceased group compared to the survivors, while albumin levels were significantly lower (p = 0.018, p = 0.003, and p = 0.007, respectively). To predict 28-day mortality, a cutoff value of 4.35 was determined for lactate with 73.3% sensitivity and 66% specificity (AUC: 0.735). For the L/A ratio, a cutoff value of 1.2 was identified with 86.7% sensitivity and 70.2% specificity (AUC: 0.811). For albumin, a cutoff value of 3.35 was established with 66% sensitivity and 60% specificity (AUC: 0.721). K, lactate, and albumin showed low correlation with mortality, whereas the L/A ratio demonstrated a moderate correlation with mortality.Conclusion: The serum L/A ratio can serve as a guide in diagnostic decision making for the prediction of CS in patients, and the blood L/A ratio has been found to be a biomarker that can be used to predict 28-day mortality in patients with CS.Öğe The prognostic value of HALP, SII, and SIRI scores in patients with acute calculous cholecystitis(2026) Dolanbay, Turgut; Demir, Bilgehan; Gonultas, Fatih; Gökçe, Hasan; Nogay, Süleyman; Özkan, Asiye; Kaya, DavutAcute cholecystitis (AC) is a common surgical emergency, usually developing secondary to gallstones and characterized by gallbladder inflammation. Although classical biomarkers such as leukocyte count and C-reactive protein (CRP) are widely used for diagnostic purposes, composite inflammation-based indices such as Hemoglobin, albümin, lenfosit ve trombosit (HALP), Systemic immune-inflammation index (SII), and Systemic Inflammatory Response Index (SIRI) have recently emerged as important prognostic markers. This study aims to evaluate the association of HALP, SII, and SIRI scores with clinical outcomes [hospital length of stay, Internal care unit (ICU) requirement, and gallstone presence] in adults hospitalized with acute cholecystitis. A total of 88 patients hospitalized with acute cholecystitis between January 2020 and December 2024 were included. Demographic data, admission laboratory parameters, and HALP, SII, and SIRI scores were retrospectively analyzed. Correlation tests and Receiver Operating Characteristic (ROC) analysis were performed to assess prognostic performance. No statistically significant association was observed between HALP, SII, and SIRI scores and either length of hospital stay or intensive care unit requirement (p>0.05). In contrast, WBC levels showed a positive correlation with both parameters and were significantly higher in patients requiring intensive care (p=0.035). In ROC analysis, the Area Under the Curve (AUC) value for Leukocyte (WBC) was determined as 0.859. The significant increase in CRP and glucose levels in patients with acute cholecystitis acalculus suggests that this variant is associated with a more pronounced inflammatory process. In this study, traditional biomarkers especially WBC were more predictive of prognosis in acute cholecystitis than composite inflammation scores. Further time-series, prospective, and multicenter studies are warranted to validate the clinical utility of indices such as HALP, SII, and SIRI.Öğe The Role of Blood Parameters and Inflammatory Scoring Systems in Prognostic Prediction in Pediatric Appendicitis Patients(Wiley, 2026) Nogay, Suleyman; Gonultas, Fatih; Dolanbay, Turgut; Demir, Bilgehan; Bayrakci, Ercan; Gol, Murat; Ongenli, Omer FarukBackground: Acute appendicitis is one of the most common surgical emergencies in childhood. Its clinical management poses particular challenges in younger age groups. Blood parameters and inflammatory scoring systems have recently been investigated as promising biomarkers for prognostic prediction. However, the number of studies addressing this issue in the pediatric population remains limited. Methods: This study was conducted retrospectively, and pediatric patients diagnosed with acute appendicitis were included. Hematological parameters (WBC, HGB, NEU%, LYM, and PLT), biochemical markers (ALB, CRP, and GLC), and inflammatory indices (NLR, LAR, HALP, SII, SIRI, and WAR) were analyzed. The findings were evaluated in relation to complications (perforation, abscess, and mesenteric inflammation), length of hospital stay, and appendiceal diameter measured by ultrasonography. ROC analyses were performed to assess prognostic factors. Results: The HALP score was found to be significantly higher in patients without perforation (p = 0.048). NEU%, NLR, and SII values were elevated in patients with abscess formation, whereas LYM, LAR, and HALP were higher in those without abscess (p < 0.05). HGB, ALB, and HALP levels were significantly higher in patients without mesenteric inflammation, indicating an inverse relationship with the severity of inflammation. No correlation was observed between blood parameters and length of hospital stay; however, a weak but significant positive correlation was found among WBC, HGB, NEU%, NLR, SII, SIRI, and appendiceal diameter. ROC analysis demonstrated that HGB and HTC had moderate discriminative ability for mesenteric inflammation (AUC = 0.70), whereas GLC, NLR, and SII showed strong discriminative performance for abscess prediction (AUC = 0.84, 0.88, 0.93). Conclusion: Our findings suggest that HALP, NLR, and SII may hold prognostic value in pediatric patients with appendicitis. However, these parameters alone are insufficient and should be interpreted in conjunction with clinical and imaging findings. Validation of the results in larger, multicenter studies is required.
