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    Diagnosis and Treatment of Acute Pulmonary Embolism: A Single Center Experience
    (2022) Ertekin, Ayşe; Balcı, Aydın; Bozkurt, Erhan; Atay, Emre; Aktaş, Ramazan Sami
    Aim: Pulmonary embolism is a potentially life-threatening cardiovascular disease frequently encountered in emergency departments. The computed tomography pulmonary angiography is the imaging modality of choice in the diagnosis of pulmonary embolism. This study aimed to examine the effects of clinical findings and treatment methods on prognosis and mortality by examining patients diagnosed with acute pulmonary embolism in the emergency department. Methods: In this retrospective cohort study, records of patients with acute pulmonary embolism were accessed from the archive. Patients' age, gender, medical complaints, co-morbidities, the treatment method applied to the patients, and the clinical outcomes of the patients were analyzed. The statistical distribution of the patients' demographic and clinical information was calculated. Results: The most common complaint of 206 patients with acute pulmonary embolism was dyspnea. 25.7% patients had massive pulmonary embolism. The blood d-dimer, lactate and troponin T levels of patients with massive pulmonary embolism were found to be higher than patients with sub-massive pulmonary embolism. Thrombolytic therapy was administered to 6.8% of acute pulmonary embolism patients and it was found to be a method that had a statistically positive effect on survival. D-dimer, white blood cell, neutrophil, blood urea nitrogen, lactate and troponin T values were found to be higher in mortal patients. It was determined that 13.1% of the patients died. Conclusion: The sooner the early diagnosis of acute pulmonary embolism, which can be mortal in the emergency department, is made and the treatment is started, the mortality rate will decrease significantly.
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    Is there effect of intervertebral disc herniation on the lumbar spine in early period? A morphometric and stereological study
    (Universidad de la Frontera, 2020) Köksal, Vaner; Avnioğlu, Seda; Atay, Emre
    The degeneration of the Lumbar Intervertebral Disc (LIVD) and the other elements of the spine are an inevitable result of aging. However, it is observed that the same degree of degenerative change does not occur in each individual. In the present study, the purpose was to compare the morphometric changes on the lumbar spine with or without intervertebral disc herniation in early period. Group 1 (the Patient Group) consisted of the patients who were diagnosed with lumbar intervertebral disc hernia and who were not operated at least one month clinical duration. Group 2 (the Control Group) consisted of individuals who were selected randomly, had only back pain, underwent magnetic resonance imaging (MRI), and were determined to have intact intervertebral disc. The sagittal and axial MRI sections of lumbar spine was used for measurements and statistical evaluation. There were no statistically significant differences between the intervertebral disc volumes, vertebral body volumes and intervertebral disc anterior and posterior heights of Group 1 and 2 (p>0.05). In terms of anterior-posterior length, the length of the L5 vertebral body was determined to be more in the Patient Group (p<0.05). A correlation was determined in terms of the increase in L2, L4 and L5 volumes with increasing age; however, there were no statistically significant correlations between age increase and a decrease in the intervertebral disc volumes. There were no correlations between the increase in age and the decrease in intervertebral disc heights (p>0.05). There were no apparent relations between the change on the lumbar vertebra corpus and intervertebral disc in early period. It was concluded that the intact intervertebral disc could protect the lower lumbar vertebra corpus from degenerative changes. Although the herniation of the intervertebral disc is newly formed, it is understood that the physiological process or morphometric changes started earlier. © 2020, Universidad de la Frontera. All rights reserved.