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DURAK, VAHİDE ASLIHAN

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DURAK

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VAHİDE ASLIHAN

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Now showing 1 - 10 of 13
  • Publication
    Kimura's disease: A rare disease with cervical lymphadenopathy
    (Pakistan Medical Association, 2020-09-01) Durak, Vahide Aslıhan; DURAK, VAHİDE ASLIHAN; Acil Tıp Ana Bilim Dalı; 0000-0003-0836-7862; AAE-9483-2021
    Kimura's disease is a very rare disorder and causes swellings and lymphadenopathy, especially in neck and axillary region. The aetiology is still unknown but allergic reactions or an alteration of immune system should be taken into consideration.Here, we report a 45-year-old Turkish male patient who presented to the Uludag University Medical Faculty Emergency Medicine Department with complaint of enlarged lymph nodes in the neck region and pruritus. His leukocyte count and eosinophil rate were found to be elevated in the emergency laboratory results. During his follow up the nodes were removed and histopathologically evaluated as Kimura's disease.In conclusion, one can say that the diagnosis of Kimura's disease can be very difficult and histopathological features play an important role. However, this diagnosis should not be underestimated in young male patients with lymph nodes in cervical area especially in the emergency department.
  • Publication
    The comparison of pecarn, catch, and chalice criteria in children under the age of 18 years with minor head trauma in emergency department
    (Sage Publications Ltd, 2020-06-14) Gizli, Gizem; Durak, Vahide Aslıhan; Köksal, Özlem; DURAK, VAHİDE ASLIHAN; Tıp Fakültesi; Acil Tıp Ana Bilim Dalı; 0000-0003-0836-7862; AAE-9483-2021
    Introduction: Minor head traumas constitute a significant part of childhood injuries. The incidence of intracranial pathologies in children with minor head trauma varies in the range of 3%-5%, but it is higher among younger infants. The criteria of the Pediatric Emergency Care Applied Research Network, Canadian Assessment of Tomography for Childhood Head Injury, and Children's Head Injury Algorithm for the Prediction of Important Clinical Events are the most frequently accepted clinical decision-making criteria that were developed for selective computerized tomography requests. This study was conducted to assess the diagnostic performances of the Pediatric Emergency Care Applied Research Network, Canadian Assessment of Tomography for Childhood Head Injury, and Children's Head Injury Algorithm for the Prediction of Important Clinical Events criteria in Turkish society, determine their validity, and find the most suitable algorithm for cranial imaging in children with minor head trauma. Methods: This study retrospectively examined the data of patients under the age of 18 years who were admitted to the Emergency Medicine Department of Uludag University Medical Faculty due to minor head trauma; 530 patients were included as they complied with the criteria. The exclusion criteria were being any trauma patients above the age of 18 years, Glasgow Coma Scale <13, pregnant patients, hemorrhagic diathesis, using anticoagulants, patients with penetrant trauma, patients with priorly known brain tumor, and patients with neurological diseases. The patients were divided into group based on the Pediatric Emergency Care Applied Research Network, Canadian Assessment of Tomography for Childhood Head Injury, and Children's Head Injury Algorithm for the Prediction of Important Clinical Events Criteria. Results: Among all patients, 37.40% were female and 62.60% were male. Abnormal computed tomography findings such as epidural bleeding, subdural bleeding, and skull fractures were detected in 44 of the patients. The sensitivity of the Pediatric Emergency Care Applied Research Network criteria was 72.4%, the specificity was 54.5%, the sensitivity of the Canadian Assessment of Tomography for Childhood Head Injury criteria was 57.8%, the specificity was 50%, the sensitivity of the Children's Head Injury Algorithm for the Prediction of Important Clinical Events criteria was 87.7%, and the specificity was 20%. Conclusion: Given the populations to which the rules apply, it is understood that the Children's Head Injury Algorithm for the Prediction of Important Clinical Events criteria is more determinative in detecting pathological computed tomography outcomes compared to Pediatric Emergency Care Applied Research Network and Canadian Assessment of Tomography for Childhood Head Injury.
  • Publication
    Diagnostic accuracy of fresno-quebec rules and risk factors for an associated fracture in patients presenting to the emergency department with anterior shoulder dislocation: A retrospective study
    (Turkish Assoc Trauma Emergency Surgery, 2021-01-01) Durak, Vahide Aslihan; DURAK, VAHİDE ASLIHAN; Atici, Teoman; ATICI, TEOMAN; Tıp Fakültesi; Ortopedi ve Travmatoloji Ana Bilim Dalı; 0000-0003-0836-7862; 0000-0002-3396-3407; AAE-9483-2021
    BACKGROUND: Anterior shoulder dislocation is the most common shoulder injury in patients presenting to the emergency department (ED). Up to 25% of these injuries are fracture-dislocations. In general, the standard approach is to obtain plain radiographs before and after reduction. Fresno-Quebec Rules (FQR) are described to identify the patients who require an x-ray before reduction to reduce radiation exposure and delays in treatment. We aimed to evaluate the efficacy of clinical predictors used in the Fresno-Quebec algorithm for detecting a shoulder fracture-dislocation.METHODS: Records of patients who presented to the Emergency Department with presumed shoulder dislocation were retrieved and retrospectively analyzed according to 'Fresno-Quebec Rule (FQR)'. Sensitivity, specificity, and predictive values of FQR for detecting associated injuries were calculated.RESULTS: Eighty-nine (65.9%) men and 46 (34.1%) women were included. The mean age of patients was 46 years (16-89). Ninety-nine (73.3%) of the cases had their shoulder dislocated for the first time, whereas 36 (26.7%) patients had a recurrent dislocation. Fifty percent of the patients (18 cases) with recurrent dislocation presented with an atraumatic episode. The remaining 18 patients with a history of recurrent dislocations had their shoulder dislocated as a result of trauma, and four (22%) of them had fracture-dislocation. Using the Fresno-Quebec rules yielded 100% specificity for the diagnosis of fracture-dislocation. The severity of the injury mechanism was not predictive in traumatic but recurrent dislocations. Only one of four patients with a fracture-dislocation in the traumatic recurrent dislocation group had high energy trauma.CONCLUSION: FQR has 100% sensitivity in detecting fracture-dislocations in patients admitted to ED with anterior shoulder dislocation. It utilizes simple parameters that are easy to use and recall. Using these rules, 30% of unnecessary radiographs can be avoided, saving time and money and reducing radiation exposure in anterior dislocations.
  • Publication
    Discharge of emergency patients to the clinical wards or intensive care units: An assessment of complications and possible shortcomings
    (Elsevier, 2015-07-01) Durak, Vahide Aslıhan; Armağan, Erol; Özdemir, Fatma; Kahriman, Nezahat; DURAK, VAHİDE ASLIHAN; ARMAĞAN, EROL; ÖZDEMİR, FATMA; Kahriman, Nezahat; Tıp Fakültesi; Acil Tıp Ana Bilim Dalı; 0000-0003-0836-7862; AAE-9483-2021; Y-3674-2018; AAH-8846-2021; IOY-2055-2023; CXL-2354-2022
    Objective: We aimed to evaluate the most common complications and possible shortcomings in the emergency patients who were admitted to the clinical wards or intensive care units.Materials and methods: 1000 patients were included in this study. The patients's complication rates were compared with the clinical diagnosis, age groups, the section of the emergency department initially managed the patients, the time of the shift (daytime or night), the accompanying medical staff and specific type of patient populations. Also the interventions of the complications were recorded.Results: 37.5% of the patients who were included in the study were female and 62.5% were male. The median age of the patients was 54.2 year (min: 1 max:92). The vital signs that were recorded prior to transport of the patients did not interfere with the complication rates (p > 0.05). Complication rates in the night were found to be higher as more admissions took place during the night shift (p < 0.05). The complication rates were found higher in patients who were admitted to coronary care unit. The most frequent complication was the dislocation of the intravenous catheter. Replacing the dislocated intravenous catheter was the most frequently noted intervention. However, initiating inotropic agents to the hypotensive patients was done more frequently in the admitted clinical departments.Conclusion: The overall complication rate was low in this series of patients. The majority of them can be prevented by having in house guidelines. (C) 2015 Elsevier Ltd. All rights reserved.
  • Publication
    The combination of scoring systems and lactate for predicting short-term mortality in geriatric patients with dyspnea
    (Springer, 2023-06-19) Ardıç, Anıl; Köksal, Özlem; Durak, Vahide Aslıhan; Dilektaşlı, Aslı Görek; Özkaya, Güven; KÖKSAL, ÖZLEM; DURAK, VAHİDE ASLIHAN; GÖREK DİLEKTAŞLI, ASLI; ÖZKAYA, GÜVEN; Tıp Fakültesi; Acil Tıp Ana Bilim Dalı; 0000-0003-0836-7862; 0000-0003-0297-846X; 0000-0003-2271-5659; AAK-8332-2020; AAE-9483-2021; CNP-1063-2022; IVU-2672-2023
    BackgroundDyspnea is one of the most common causes for admission to the emergency department. Lactate (L), which can be used as a prognostic marker, was first studied by Broder and Weil and it was shown that a level > 4 mmol/l is associated with a poor prognosis. There are also scoring systems to assess the severity of illness of patients presenting to the emergency department such as the National Early Warning Score (NEWS), Modified Early Warning Score (MEWS), Rapid Emergency Medicine Score (REMS) and VitalPAC Early Warning Score (ViEWS).ObjectivesIn this study, we aimed to investigate the combination of risk scoring systems and lactate in predicting short-term mortality in patients over 65 years of age with the complaint of nontraumatic dyspnea.Materials and methodsThe population of the study consisted of adult patients aged 65 and over who presented to Bursa Uludag University Medical Faculty Emergency Department with dyspnea. Admission NEWS, MEWS, REMS, ViEWS scores and their combined forms with added lactate levels at first admission, and 7-, 14-, and 28-day survival were recorded.ResultsWe found that the modified composite scores with lactate value, and the NEWS, MEWS, REMS, and ViEWS scores could predict the 28-day mortality. Ranking the scores and lactate value predicting 28-day mortality according to the area under the curve (AUC) value revealed that the 28-day mortality was best predicted by the NEWS + lactate with 64.97% sensitivity and 77.53% specificity (p < 0.001). We have shown that increasing lactate levels, NEWS, MEWS, REMS, ViEWS scores and their modified composite scores with lactate above suggested thresholds are independent risk factors for increased mortality in multivariable Cox regression analysis.ConclusionsIn cases with dyspnea, lactate value, NEWS, MEWS, REMS, ViEWS, NEWS-L MEWS-L, REMS-L, and ViEWS-L scores can be used to predict early mortality. Risk scores modified with lactate value were found to be more successful in predicting 28-day mortality.
  • Publication
    Rhinocerebral mucormycosis case in the emergency room
    (Acil Tıp Hekimleri Derneği Türkiye, 2021-12-01) Aslan, Şahin; Omar, Issa; Durak, Vahide Aslıhan; Cıkrıklar, Halil İbrahim; Özdemir, Fatma; ASLAN, ŞAHİN; OMAR, ISSA MALONGO; DURAK, VAHİDE ASLIHAN; ÇIKRIKLAR, HALİL İBRAHİM; ÖZDEMİR, FATMA; Tıp Fakültesi; Acil Tıp Ana Bilim Dalı; 0000-0003-0836-7862; 0000-0002-6665-7166; EMD-3139-2022; GXT-8042-2022; AAE-9483-2021; AAH-8714-2021; JRF-5591-2023
    Introduction: Rhinocerebral mucormycosis is a rare disease, which causes serious and life-threatening fungal infections.The disease usually develops in immunocompromised individuals and usually begins by mimicking cellulite, especially in the face area, and shows a very rapid course.Case Report: A 75-year-old male patient previously admitted to an external center with 3-4 days complaints of headache, numbness in the right half of his face and closure of his left eye was brought to our emergency department for further investigation.The cranial magnetic resonance imaging (MRI) revealed suspected opportunistic fungal infection or malignancy in the ethmoidal and sphenoidal sinuses.The patient was hospitalized with the diagnosis of opportunistic fungal infection after consultations to relevant clinics. Biopsy revealed polypes and mucocele like cystic tissues. The patient, followed-up and treated with rhinocerebral mucormicosis, was transferred to intensive care unit after deterioration of his general condition.After approximately 45 days of follow-up and treatment, the patient was lost due to multiple organ failure.Conclusion: Rhinocerebral mucormycosis is an emergency that requires a multidisciplinary approach. Presence of one or more of the non-traumatic orbital apex syndrome findings should alert emergency physicians. In this and similar infections with high mortality rates, early diagnosis and treatment may lead to good results.
  • Publication
    Serum pNF-H levels in the first six hours after experimental mild traumatic brain injury in rats
    (Verduci Publisher, 2022-01-01) Karesioğlu, E.; Çıkrıklar, H. I.; Durak, V. A.; Aydın, B.; Ardıç, A.; Armağan, E.; KARESİOĞLU, EMİNE; ÇIKRIKLAR, HALİL İBRAHİM; DURAK, VAHİDE ASLIHAN; AYDİN, BİRNUR; Ardıç, Aslıgül; Armağan, Ersin; Tıp Fakültesi; Acil Tıp Bölümü; 0000-0003-0836-7862; 0000-0002-8193-474X; HEI-9103-2022; AAH-8714-2021; AAE-9483-2021; ADT-6417-2022; EKH-5913-2022; CBW-8706-2022
    OBJECTIVE: Mild traumatic brain injury (mTBI) cases with a normal CT scanning account for the vast majority of all TBI patients. The aim of this study was to investigate the course of serum Phosphorylated Neurofilament Heavy Chain (pNF-H) levels in the first six hours after trauma in rats in experimental mTBI.MATERIALS AND METHODS: In this experi-mental animal study, 32 female Sprague-Dawley rats were enrolled equally (n=8) into 3 experimen-tal groups and 1 control group. In experimental groups, animals were exposed to a mTBI with a free fall of 50-gram metal disc from a height of 80 cm. We compared serum pNF-H levels at the 2nd, 4th, and 6th hours after traumatic brain injury in the experimental groups with the control group.RESULTS: Serum pNF-H levels at the 2nd and 4th hours after traumatic brain injury were sta-tistically significantly higher than the control group. Serum pNF-H levels gradually decreased at the 4th and 6th hours compared to the 2nd hour and decreased to a similar level to the control group at the 6th hour after injury.CONCLUSIONS: A high serum pNF-H value, could be used in the diagnosis and management of mTBI patients.
  • Publication
    COVID-19 pandemi sürecinde serebrovasküler hastalık tanısı ile acil servise başvuran hastaların analizi
    (Bursa Uludağ Üniversitesi, 2024-08-20) Uslusoy, Duygu Karakaş; Durak, Vahide Aslıhan; Ulusoy, İbrahim; Aydoğan, Göksel; Çıraklılar, Halil İbrahim; DURAK, VAHİDE ASLIHAN; AYDOĞAN, GÖKSEL; Çıraklılar, Halil İbrahim
    Serebrovasküler hastalık günümüzde yetişkinlerde yaygın ciddi nörolojik durumlardan birisi olmaya devam etmektedir. Akut serebrovasküler hastalık, ister iskemik ister hemorajik olsun, zamana duyarlı ve dinamik seyirli olması nedeniyle hızlı tanı ve tedavi gerektirmektedir. Akut iskemik inme hastalarının prognozunu iyileştirmek için acil servislerde kardiyovasküler ve metabolik stabilizasyon, acil tromboliz, antikoagülan ve antiagregan tedaviler veya mekanik trombektomi gibi uygun tedavi yöntemleri başlanmalıdır. Bu çalışmada COVID-19 pandemi sürecinin acil servise serebrovasküler hastalık tanısıyla başvuran hastalara etkilerinin retrospektif olarak incelenmesi amaçlanmıştır. Acil servise başvuran toplam 543 hasta retrospektif kesitsel olarak incelenerek, pandemi öncesi dönemde (1 Nisan 2019- 1 Mart 2020) başvuran 352 hasta ve pandemi dönemi (1 Nisan 2020- 1 Mart 2021) başvuran 191 hasta çalışmaya dahil edilmiştir.Pandemi öncesi ve sonrası dönemde acile gelen hastaların şikâyet dağılımları karşılaştırıldığında senkop (p=0,024) ve genel durum bozukluğu (p=0,030) şikayetleri açısından istatistiksel olarak anlamlı farklılık bulunurken diğer şikayetler açısından anlamlı farklılık bulunmamıştır. Acile senkop şikâyeti ile gelen hastaların pandemi sonrasında (%12,5) öncesi döneme (%6,82) göre daha yüksek olduğu görülmüştür. Pandemi öncesi dönemdeki hemorajik SVH öykü oranı %2,8 ile pandemi sonrası döneme göre (%0) daha yüksek bulunurken SVH öyküsü olmayanların oranı (%84,3) pandemi sonrası dönemde daha yüksek bulunmuştur. COVID-19 pandemisi retrospektif çalışmaların ve vaka sunumlarının literatüre katkısını bir kez daha göstermiştir. Bu çalışmanın örneklerinin artmasıyla birlikte elde edilen veriler daha da güçlenecek, dünya genelinde fazla sayıda ve her yaş grubundan insanı etkileyen COVID-19 hastalığının serebrovasküler hastalık için bir risk faktörü olup olmadığına ışık tutacaktır.
  • Publication
    Acil serviste Covid-19 salgını öncesi ve Covid-19 salgını döneminde akut koroner sendrom tanısı alan hastaların epidemiyolojik incelenmesi
    (Bursa Uludağ Üniversitesi, 2024-07-26) Aydoğan, Ayşe Armağan; Aydoğan, Göksel; Aydın, Şule Akköse; Durak, Vahide Aslıhan; AYDOĞAN, GÖKSEL; AYDIN, ŞULE; DURAK, VAHİDE ASLIHAN
    Kardiyovasküler hastalıklar; yetişkinlerde mortalite ve morbiditenin başlıca nedeni olup Türkiye'deki tüm ölümlerin ise yaklaşık yarısı kardiyovasküler hastalıklardan kaynaklanmaktadır. Çalışmamız kapsamında, Bursa Uludağ Üniversitesi Tıp Fakültesi Hastanesi Acil Servisi'ne COVID-19 salgını öncesi ve sonrası 1 yıllık süreçte başvuran ve akut koroner sendrom tanısıyla değerlendirilen hastaların epidemiyolojik olarak değerlendirilmesi amaçlanmıştır. Acil servise, COVID-19 pandemisi öncesi 01.04.2019-31.03.2020 ve pandemi sonrası 01.04.2020-31.03.2021 tarihleri arasında başvurarak akut koroner sendrom tanısı konulan hastaların dosyaları retrospektif olarak incelenmiş olup hastaların yaş, cinsiyet, laboratuvar değerleri (tam kan sayımı, troponin, kreatinin kinaz, D-dimer, üre, kreatin, kreatinin kinaz izoenzim-MB), başvuru anındaki COVID-19 PCR, eşlik eden hastalıklar, başvuru şikayeti ve EKG bulguları kaydedilmiştir. Hastaların %72,7’sinin erkek cinsiyette olduğu; %31,8’inin sigara içtiği, %2,6’sının morbid obez olduğu görülmüştür. Hastaların yaş dağılımında, COVID-19 öncesi ve sonrası grup karşılaştırılmasında istatistiksel fark belirlenmiştir Akut koroner sendrom tanısı konulan hastaların %84,4 oranında tipik göğüs ağrısı şikayeti ile hastaneye başvurdukları görülmüş olup COVID-19 sonrası hastalarda; NSTEMI tanıları artarken, STEMI ve USAP tanıları ise azalma saptanmıştır. Hasta sonlanımı olarak bakıldığında ise COVID-19 sonrası hastalarda sevk oranı azalmış ancak ölüm oranının ise arttığı görülmüştür. COVID-19 enfeksiyonları akut koroner sendrom, miyokard enfeksiyonu, kalp yetersizliği ve aritmiler de dahil birçok klinik sonuçla beraber kardiyak oksijen sunum yetersizliği, artmış koagülabilite, enflamasyon, sitokin fırtınasına bağlı olarak kardiyak hasara sebep olmaktadır. Çalışmamızdan elde edilen verilerin ulusal ve uluslararası literatüre katkı sağlamakta olduğunu ve olası risk faktörlerinin belirlenmesi ile acil hekimlerine yol gösterici olacağı düşünülmektedir.
  • Publication
    Association of clinical characteristics with decision making in patients with severe lower extremity trauma
    (Mre Press, 2021-01-01) Durak, Vahide Aslıhan; Ermutlu, Cenk; Atıcı, Teoman; DURAK, VAHİDE ASLIHAN; ERMUTLU, CENK; ATICI, TEOMAN; Tıp Fakültesi; Ortopedi Bölümü ve Travmatoloji; 0000-0003-0836-7862; 0000-0002-3396-3407; AAE-9483-2021; AEQ-5464-2022; A-5095-2018
    Severe lower limb trauma represents a challenge for both the emergency department physicians and the surgeons. These injuries are associated with significant incidence of limb loss and it is not uncommon for the treating physician to make the hard decision between limb salvage, amputation or stump closure for a patient in critical condition. Our aim was to evaluate the epidemiology of traumatic lower extremity amputations and to analyze the factors which may have effect on patient resuscitation, limb salvage and efficient patient management. Patients who were admitted to our institution's emergency department for traumatic lower extremity amputation over an 8 years' period (2012 to 2020) were retrospectively analyzed. Patient files with the possibility of severe lower limb trauma and mangled extremity were retrieved and analyzed using ICD codes recorded/registered during the emergency department admission. Mean time from emergency admission to transfer to operating theater was 184,5 minutes. Replantation of the amputate was performed in 4 patients (19%). 25% of the amputations at the ankle level (1 out of 4) and 37.5% of the transtibial amputates (3 out of 8) were replanted. A multidisciplinary approach is necessary in every aspect of patient management; however, this does not justify a delay in treatment. Time spent during conclusion of necessary consultations does not have negative effects on patient outcome as long as patient is closely monitored and resuscitated in the emergency department.