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    Comparison of Effects of Separate and Combined Sugammadex and Lipid Emulsion Administration on Hemodynamic Parameters and Survival in a Rat Model of Verapamil Toxicity
    (INT SCIENTIFIC LITERATURE, INC, 2016) Tulgar, Serkan; Kose, Halil Cihan; Piroglu, Isilay Demir; Karakilic, Evvah; Ates, Nagihan Gozde; Demir, Ahmet; Gergerli, Ruken; Guven, Selin; Piroglu, Mustafa Devrim
    Background: Toxicity of calcium channel blockers leads to high patient mortality and there is no effective antidote. The benefit of using 20% lipid emulsion and sugammadex has been reported. The present study measured the effect of sugammadex and 20% lipid emulsion on hemodynamics and survival in a rat model of verapamil toxicity. Material/Methods: In this single-blinded randomized control study, rats were separated into 4 groups of 7 rats each: Sugammadex (S), Sugammadex plus 20% lipid emulsion (SL), 20% lipid emulsion (L), and control (C). Heart rates and mean arterial pressures were monitored and noted each minute until death. Results: Average time to death was 21.0 +/- 9.57 minutes for group C, 35.57 +/- 10.61 minutes for group S, 37.14 +/- 16.6 minutes for group L and 49.86 +/- 27.56 minutes for group SL. Time to death was significantly longer in other groups than in the control group (p<0.05). Conclusions: Verapamil overdose is has a comparatively high mortality rate and there is no effective antidote. Treatment generally involves gastric decontamination and symptomatic treatment to counteract the drug's negative effects. In animal studies sugammadex and lipid emulsion had a positive effect on survival in patients with calcium channel blocker toxicity. Sugammadex and intralipid increased survival in a rat model of verapamil toxicity. The combination of both drugs may decrease cardiotoxicity. Sugammadex alone or combined with 20% lipid emulsion reduce the need for inotropic agents. The mechanism requires clarification with larger studies.
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    Perceptions and concerns of emergency medicine practitioners about artificial intelligence in emergency triage management during the pandemic: a national survey-based study
    (Front. Public Health, 2023) Ahun, Erhan; Demir, Ahmet; Yiğit, Yavuz; Tulgar, Yasemin Koçer; Doğan, Meltem; Thomas, David Terence; Tulgar, Serkan
    Objective: There have been continuous discussions over the ethics of using AI in healthcare. We sought to identify the ethical issues and viewpoints of Turkish emergency care doctors about the use of AI during epidemic triage. Materials and methods: Ten emergency specialists were initially enlisted for this project, and their responses to open-ended questions about the ethical issues surrounding AI in the emergency room provided valuable information. A 15-question survey was created based on their input and was refined through a pilot test with 15 emergency specialty doctors. Following that, the updated survey was sent to emergency specialists via email, social media, and private email distribution. Results: 167 emergency medicine specialists participated in the study, with an average age of 38.22? years and 6.79? years of professional experience. The majority agreed that AI could benefit patients (54.50%) and healthcare professionals (70.06%) in emergency department triage during pandemics. Regarding responsibility, 63.47% believed in shared responsibility between emergency medicine specialists and AI manufacturers/programmers for complications. Additionally, 79.04% of participants agreed that the responsibility for complications in AI applications varies depending on the nature of the complication. Concerns about privacy were expressed by 20.36% regarding deep learning-based applications, while 61.68% believed that anonymity protected privacy. Additionally, 70.66% of participants believed that AI systems would be as sensitive as humans in terms of non-discrimination. Conclusion: The potential advantages of deploying AI programs in emergency department triage during pandemics for patients and healthcare providers were acknowledged by emergency medicine doctors in Turkey. Nevertheless, they expressed notable ethical concerns related to the responsibility and accountability aspects of utilizing AI systems in this context.