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Bulut M.,Bursa SEvket Yilmaz Education and Research Hospital | Cebicci H.,Kayseri Education and Research Hospital | Sigirli D.,Uludag University | Sak A.,Bursa SEvket Yilmaz Education and Research Hospital | And 4 more authors.
Emergency Medicine Journal | Year: 2014

Objective: There are a few scoring systems in emergency departments (ED) to establish critically ill patients quickly and properly and to predict hospitalisation. We aim to compare the efficacy of Modified Early Warning Score (MEWS) and Rapid Emergency Medicine Score (REMS) on in-hospital mortality, and as predictor of hospitalisation in general medical and surgical patients admitted to ED. Methods: This is a prospective, multicentre and observational cohort study. The study included general medical and surgical patients admitted to the EDs of three education and research hospitals during a period of 6 months. The primary outcome of the study is the admission of the patient to a ward/an intensive care unit (ICU)/high dependency unit (HDU) and in-hospital mortality. Receiver operating characteristics (ROC) curve analysis was performed to evaluate and compare the performances of two scores. Results: Total patients were 2000 (51.95% male, 48.05% female). The mean age was 61.41±18.92. Median MEWS and REMS values of the patients admitted to the ICU/HDU from ED were 1 and 6, respectively; and there was a significant difference in terms of REMS values, compared with patients discharged from ED. REMS (area under the curve (AUC): 0.642) was found to have a better predictive strength than MEWS (AUC: 0.568) in discriminating in-patients and discharged patients. Additionally, REMS (0.707) was superior to MEWS (AUC 0.630) in terms of predicting inhospital mortality of patients presenting to ED. Conclusions: The efficiency of REMS was found to be superior to MEWS as a predictor of in-hospital mortality and hospitalisation in medical and surgical patients admitted to ED.

Hurmuz P.,Trabzon Numune Education and Research Hospital
Thoracic Cancer | Year: 2010

Malignant pleural mesothelioma is a rare neoplasm arising from the surface serosal cells of the pleural cavity. More than 80% of cases of malignant pleural mesothelioma have been attributed to asbestos exposure. In its natural course median survival is 4 to 12 months. If untreated most of patients die due to local complications of the disease. Surgery improves local control but is not sufficient as a single treatment modality. The recommended treatment strategy for a select group of patients is multimodal therapy that includes surgery, radiotherapy and chemotherapy. © Tianjin Lung Cancer Institute and Blackwell Publishing Asia Pty. Ltd.

Bozkrl E.,Baskent University | Bakner O.,Baskent University | Ertorer E.,Baskent University | Anaforoglu I.,Trabzon Numune Education and Research Hospital | And 2 more authors.
Turkish Journal of Endocrinology and Metabolism | Year: 2015

Purpose: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among women in reproductive age. Confecting results are reported in the studies examining insulin resistance in lean PCOS subjects. We aimed to observe the controversial presence of insulin resistance in lean PCOS subjects with the gold standard method and assess the impacts of family history of type 2 diabetes mellitus (T2DM) on insulin resistance in these patients. Material and Method: Nineteen patients with PCOS and nine age-BMI matched control subjects were recruited into the study. Patients with PCOS were divided into two groups according to their FH of T2DM among their first degree relatives (FHneg vs FHpos). Insulin resistance was evaluated with homeostasis model assessment of insulin resistance (HOMA-IR) and hyperinsulinemic euglycemic clamp technique for all participants. Results: Mean M values were significantly higher in the control group when compared with PCOS patients (p=0.003). There was no statistically significant difference for HOMA-IR and M values when FHneg and FHpos patients were compared. Although HOMA-IR values were similar between all groups, M values were lower in FHneg and FHpos groups compared to the controls (p=0.02 and 0.004 respectively). Discussion: Lean PCOS patients have evident insulin resistance when compared to healthy subjects, and FH of T2DM seems to not affect insulin resistance. Even non-obese PCOS patients should be encouraged for healthy eating style and exercise to prevent the potential risks associated with insulin resistance. Furthermore these patients can see benefits from medical therapies which improve insulin sensitivity. © 2015 Galenos Yayincilik, All rights reserved.

Ersoy K.,Trabzon Numune Education and Research Hospital | Anaforoglu I.,Trabzon Numune Egitim ve Arastirma Hastanesi | Algun E.,Trabzon Numune Education and Research Hospital
Endocrine | Year: 2013

Overt hypothyroidism and subclinical hypothyroidism are thought to be associated with atherosclerosis and a chronic ischemic process. Ischemic modified albumin (IMA) is a novel marker of ischemia. We examined serum IMA levels in patients with subclinical and overt hypothyroidism. We recruited patients who presented to our clinic for thyroid disease control. We compared demographic data, fasting blood sugar, serum lipid levels, and the prevalence of metabolic syndrome by the presence of overt, subclinical, and no hypothyroidism. Cobalt binding to albumin capacity was analyzed using a rapid colorimetric technique and compared among the groups. We assessed 11 men and 74 women with a mean age of 39.9 ± 12 years. Of these, 48 (56.5 %) were euthyroid, 24 (28.2 %) had subclinical hypothyroidism, and 13 (15.3 %) had overt hypothyroidism. The groups did not differ significantly in terms of age; body mass index; waist circumference; systolic and diastolic blood pressures; levels of fasting and nonfasting blood sugar, high- and low-density lipoproteins, and triglycerides; and the presence of metabolic syndrome. Mean serum IMA level also did not differ significantly among the groups: 0.20 ± 0.08 absorbance units (ABSU) in the euthyroid participants, 0.18 ± 0.08 ABSU in those with subclinical hypothyroidism, and 0.20 ± 0.09 ABSU in those with overt hypothyroidism (P = 0.754). Mean IMA values did not differ significantly by sex, cigarette use, the presence of metabolic syndrome, or the presence of thyroid autoantibodies. Serum IMA levels did not differ among patients with overt or subclinical hypothyroidism in this case-control study. © 2012 Springer Science+Business Media, LLC.

Anaforoglu I.,Trabzon Numune Education and Research Hospital | Kose M.,Trabzon Numune Education and Research Hospital | Karyagar S.,Trabzon Numune Education and Research Hospital | Mollamehmetoglu B.,Trabzon Numune Education and Research Hospital | Algun E.,Trabzon Numune Education and Research Hospital
Turkish Journal of Endocrinology and Metabolism | Year: 2013

Coexistence of medullary thyroid carcinoma and primary hyperparathyroidism (PHPT) is well described, however, the association of non-medullary thyroid cancer and PHPT is less recognized. Herein, we report two patients with PHPT and papillary thyroid carcinoma (PTC). Although no definitive data showing increased prevalence of non-medullary thyroid cancer in patients with parathyroid adenomas, possible coexistence of these two conditions should be borne in mind in preoperative evaluation.

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