Salgın Sürecinde Görev Alan Hemşirelerde COVID-19 Fobisinin Değerlendirilmesi

Yeni koronavirüs hastalığı (COVID-19), insanlarda solunum yolu enfeksiyonu, pnömoni, böbrek yetmezliği, kalp krizi hatta çoklu organ yetmezliği gibi ciddi sağlık sorunlarına yol açmaktadır. COVID-19 ve neden olduğu enfeksiyonun fiziksel sağlık üzerindeki etkilerinin yanında psikolojik sağlığı da önemli ölçüde etkilediği görülmektedir. COVID-19 dünya genelinde birçok insanda; panik bozukluk, anksiyete bozukluğu, keder, kayıp ve depresyon gibi çok çeşitli psikolojik sorunların da oluşumunu tetiklemektedir. Salgında büyük ölçüde sorumluluk üstlenen sağlık profesyonellerinin ruhsal sağlığı da bu durumdan etkilenmektedir. Bu çalışmanın amacı, salgın sürecinde, bir eğitim ve araştırma hastanesinde görev yapan hemşirelerde, COVID-19 ile ilişkili psikolojik yansımaların ve kaygı düzeylerinin belirlenmesidir. Tanımlayıcı tipteki araştırmanın verileri çevrimiçi anket yöntemiyle, 15 Kasım-15 Aralık 2020 tarihleri arasında elde edildi. Araştırmanın örneklemini bir üniversite hastanesinde salgın sürecinde görev yapan hemşireler oluşturdu (n=110). Veri toplamada tanımlayıcı bilgiler formu ve Corona Virüs Fobisi Ölçeği (COVID-19 Phobia Scale-C19P-S) kullanıldı. Hemşirelerin salgın sürecindeki COVID-19 fobilerinin orta düzeyde olduğu, (ölçek ortalaması=57,55), salgın döneminde hastanede çalışmanın kendilerini ve ailelerini yüksek oranda endişelendirdiği görüldü. Çalışmada, cinsiyet, medeni durum, kronik hastalık tanısı olma, çalışılan birim ile C19P-S ölçek ortalaması arasında anlamlı farklılıklar bulunmamıştır. Bu doğrultuda; çalışma koşullarının iyileştirilmesi, stres ve kaygı düzeylerinin azaltılmasına yönelik destekleyici çalışma planlarının oluşturulması ve psikolojik danışmanlık sağlanması önerilebilir

Prevalence, determinants, and fibrosis risk stratification of metabolic-associated fatty liver disease in a Turkish primary care setting: A retrospective study

Background and Aim: Metabolic-associated fatty liver disease (MAFLD) is a condition that frequently goes unnoticed as it typically remains asymptomatic until progressing to an advanced stage. As a result, it is essential to implement opportunistic screening initiatives within family medicine practices to accurately identify and refer selected at -risk patients to specialized care. This study aims to investigate the prevalence of MAFLD and advanced hepatic fibrosis among primary care patients in Turkiye by utilizing non-invasive tests. Materials and Methods: We performed a retrospective analysis of prospectively collected data from February 1, 2022, to April 14, 2023, at a Family Medicine Outpatient Clinic. The Hepatic Steatosis Index (HSI) was used to identify fatty liver cases, followed by established MAFLD criteria for diagnosis. Patients were then categorized based on advanced fibrosis risk using the fibrosis-4 (FIB-4) index. Results: Among the 450 patients who sought primary care during the study period (286 women and 164 men; mean age: 48.2 +/- 13.7 years), 295 (65.6%) were diagnosed with MAFLD using HSI values and established criteria. Diabetes mellitus emerged as the sole independent predictor of MAFLD. FIB-4 values classified 242 (82%) and 53 (18%) patients with MAFLD at low and intermediate risk of advanced fibrosis, respectively, with none at high risk. Conclusion: MAFLD exhibits a notable prevalence among Turkish patients who presented at a Family Medicine Outpatient Clinic. Given the growing impact of metabolic diseases, primary care providers and non -liver specialists should actively participate in MAFLD screening programs

Outcomes of high-risk breast lesions diagnosed using image-guided core needle biopsy: results from a multicenter retrospective study

PURPOSEThe clinical management of high-risk lesions using image-guided biopsy is challenging. This study aimed to evaluate the rates at which such lesions were upgraded to malignancy and identify possible predictive factors for upgrading high-risk lesions.METHODSThis retrospective multicenter analysis included 1.343 patients diagnosed with high-risk lesions using an image-guided core needle or vacuum-assisted biopsy (VAB). Only patients managed using an excisional biopsy or with at least one year of documented radiological follow-up were included. For each, the Breast Imaging Reporting and Data System (BI-RADS) category, number of samples, needle thickness, and lesion size were correlated with malignancy upgrade rates in different histologic subtypes. Pearson’s chi-squared test, the Fisher–Freeman–Halton test, and Fisher’s exact test were used for the statistical analyses.RESULTSThe overall upgrade rate was 20.6%, with the highest rates in the subtypes of intraductal papilloma (IP) with atypia (44.7%; 55/123), followed by atypical ductal hyperplasia (ADH) (38.4%; 144/375), lobular neoplasia (LN) (12.7%; 7/55), papilloma without atypia (9.4%; 58/611), flat epithelial atypia (FEA) (8.7%; 10/114), and radial scars (RSs) (4.6%; 3/65). There was a significant relationship between the upgrade rate and BI-RADS category, number of samples, and lesion size Lesion size was the most predictive factor for an upgrade in all subtypes.CONCLUSIONADH and atypical IP showed considerable upgrade rates to malignancy, requiring surgical excision. The LN, IP without atypia, pure FEA, and RS subtypes showed lower malignancy rates when the BI-RADS category was lower and in smaller lesions that had been adequately sampled using VAB. After being discussed in a multidisciplinary meeting, these cases could be managed with follow-up instead of excision

The effect of silicon dioxide and zinc borate on the flame retardancy, thermal and mechanical properties of jute/epoxy hybrid composite

With the increase in environmental pollution, studies on the use of sustainable resources are increasing day by day. For this purpose, the use of natural fiber-reinforced polymer composites is encouraged in many areas such as automotive, transportation, construction, and home textiles. However, they are flammable and therefore seriously threaten the safety of people and property. Various flame retardant additives have been used to improve the flame retardancy properties of these composites. In this study, silicon dioxide (SD) and zinc borate (ZB) microparticles in different weight percentages (3, 5, 7, and 10%) were reinforced to give flame retardant properties to jute-epoxy composites. In addition, composites containing both SD and ZB microparticles were produced and they were labeled as HB. Then, thermal conductivity, flammability, water absorption, and mechanical properties of these composites were investigated. The burning rate of the composites decreased as the amount of microparticle increased. 5ZB5SD, including %5 SD and %5 SD microparticles, showed 36.60% less burning rate than the neat jute-epoxy composite. 5ZB showed 10.84% higher tensile strength than the neat jute-epoxy. The impact strength of the specimens increased with the increase in the filling ratio, and 5ZB5SD showed approximately 2.50 times the impact strength of the jute-epoxy composite

Synergistic activities of ceftazidime-avibactam in combination with different antibiotics against colistin-nonsusceptible clinical strains of Pseudomonas aeruginosa

Background: This study aims to analyse the effect of ceftazidime-avibactam plus various antibiotics against multidrug-resistant (MDR) Pseudomonas aeruginosa isolated from Intensive Care Units. Methods: 40 non-duplicate P. aeruginosa isolates were screened for their MICs of ceftazidime, ceftazidime-avibactam, colistin, levofloxacin, doripenem and tobramycin. MICs were determined by the broth microdilution method. The in vitro bactericidal activities of ceftazidime-avibactam compared to studied antibiotics were also determined by time-kill curve assays both at 1xMIC and at 4xMIC against carbapenemase-producing or -not producing six colistin-nonsusceptible MDR clinical strains of P. aeruginosa. Additionally, synergistic interactions were investigated by the time-kill curve assay. Results: The MIC90 values for ceftazidime, ceftazidime-avibactam, colistin, levofloxacin, doripenem and tobramycin against MDR P. aeruginosa isolates were found to be >256, 64, 8, 64, 128, and >256 mg/L, respectively. The minimum bactericidal concentration(90) values for those antibiotics were also >256, 64, 16, 128, 256, and >256 mg/L, respectively. While doripenem, tobramycin and levofloxacin were bactericidal (>3 log(10) killing) against the 2/6, 3/6 and 1/6 P. aeruginosa isolates at 4xMIC concentrations, respectively, levofloxacin and tobramycin were bactericidal against only one isolate (1/6) at 1xMIC concentrations at 24 h. The synergistic interactions of these antimicrobial agents were also achieved with ceftazidime/avibactam + colistin (4/6), ceftazidime/avibactam + tobramycin (3/6), and ceftazidime/avibactam + levofloxacin (3/6) combinations. No antagonism was observed against studied P. aeruginosa strains. Conclusions: The findings of this study suggest that ceftazidime/avibactam with colistin, or tobramycin, were effective against colistin-nonsusceptible strains. This combination therapy could be an alternative antibiotic therapy for resistant P. aeruginosa strains.Istanbul Universit

Evaluation of the synergy of ceftazidime/avibactam in combination with colistin, doripenem, levofloxacin, tigecycline, and tobramycin against OXA-48 producing enterobacterales

This study aims to analyze the effect of ceftazidime/avibactam plus various antibiotics against OXA-48-producing Enterobacterales isolated from Intensive Care Units. Seventy-four non-duplicate OXA-48-producing Enterobacterales isolates were screened for their MICs by the microbroth dilution method. The in-vitro bactericidal and synergistic activities of ceftazidime/avibactam alone or in combination with other antibiotics were determined by time-kill curve assays. According to our results, colistin was the most active drug with higher susceptibility rates in the strains. Colistin, levofloxacin, tobramycin, and doripenem showed bactericidal effects against different isolates. The best synergistic interactions were achieved with ceftazidime/avibactam + colistin, ceftazidime/avibactam + tobramycin, and ceftazidime/avibactam + tigecycline against studied strains used at 1xMIC concentrations at 24 h. No antagonism was observed against studied OXA-48-producing Enterobacterales strains. The findings of this study suggest that ceftazidime/avibactam plus colistin, tobramycin, or tigecycline were more effective against OXA-48-producing Enterobacterales strains. This combination therapy could be an alternative antibiotic therapy for carbapenemase-producing Enterobacterales strains.Bilimsel Araştırma Projeleri Birimi, İstanbul Üniversites

Investigation of ellagic acid rich-berry extracts directed silver nanoparticles synthesis and their antimicrobial properties with potential mechanisms towards Enterococcus faecalis and Candida albicans

The essential goals of this present study are to elucidate the formation mechanism of ellagic acid rich-blackberry, BBE, (Rubus fruticosus L.) and raspberry, RBE, (Rubus idaeus L.) extracts directed silver nanoparticles and to investigate thier antimicrobial properties towards model dental pathogens E. faecalis and C. albicans compared to BBE, RBE, NaOCl, CHX and EDTA. Both %5 w/w of BBE and RBE reacted with 5 mM Ag+ ions at room temperature (25 degrees C) under mild-stirring, the formation of BBE and RBE directed b@Ag NP and r@Ag NP was monitored over time by using an Uv-vis spectrophotometer. Both b@Ag and r@Ag NPs were also complementarily characterized with SEM and FT-IR. In terms of the antimicrobial studies, b@Ag NP, r@Ag NP, %5 BBE and RBE, 5 mM AgNO3, %5 NaOCl, %1,5 CHX and %15 EDTA were separately incubated with E. faecalis and C. albicans suspensions. The results were evaluated with student t-test using GraphPad Prism 8.0.1 statistical software (P < 0.05). While formation of b@Ag NP was confirmed with characteristic absorbance at similar to 435 nm in 20 mM (min) of incubation, r@Ag NP did not give absorbance till 80 mM owing to concentration of ellagic acid acted as a reducing and stabilizng agent for formation of the Ag NPs. Intrestingly, 50 ppm r@Ag NP inactivated similar to 89% and similar to 99% of E. faecalis and C. albicans cell, respectively, similar to 25% and similar to 40% cell inactivations for E. faecalis and C. albicans were observed respectively with 50 ppm b@Ag NP. We showed that 50 ppm r@Ag NP has effective antimicrobial property as much as mostly used %5 NaOCl and %1,5 CHX solutions.Erciyes University FDK-2019-954

Hemşirelik Uygulamalarına Hazır Oluşluk Ölçeği'nin Türk kültürüne uyarlanmsı ve psikometrik özelliklerinin incelenmesi

Amaç: Bu araştırma Hemşirelik Uygulamalarına Hazır Oluşluk Ölçeği’nin Türk kültürüne uyarlanmsı ve psikometriközelliklerinin incelenmesi amacıyla gerçekleştirilmiştir.Yöntem: Metadolojik tasarıma sahip olan araştırmada ölçeğin Türk kültürüne uyarlaması ISPOR tarafından yayımlananguidelines for translation rehberi doğrultusunda gerçekleştirilmiştir. Uyarlanan ölçeğin içerik geçerliğinin değerlendirilmesi için11 uzmandan görüş alınmıştır. Uzman görüşleri sonrasında örnekleme benzer kişilerden oluşan 30 katılımcıyla pilot uygulamagerçekleştirilmiştir. Son haline karar verilen ölçek toplam 471 dördüncü sınıf hemşirelik öğrencisi ile son bir yıl içerisinde mezunolmuş hemşirelere uygulanmıştır. Açıklayıcı faktör analizi ile ölçeğin faktör yapısı belirlenmiştir. Belirlenen yapı doğrulayıcıfaktör analizi ile doğrulanmıştır. Ölçeğin güvenirliği Cronbach a katsayısı ve madde toplam puan korealsyon değerlerihesaplanarak değerlendirilmiştir.Bulgular: Uzman görüşleri analiz edilerek Hemşirelik Uygulamalarına Hazır Oluşluk Ölçeği'nin Ölçek İçerik Geçerlik İndeksi(S-CVI) 0.98 olarak hesaplanmıştır. Açıklayıcı faktör analizi sonucunda Hemşirelik Uygulamalarına Hazır Oluşluk Ölçeği 'nintoplam varyansın %60.60’ını açıkladığı, 5 alt boyut altında toplam 35 maddeden oluştuğu belirlenmiştir. Ölçeğin genelCronbach’a katsayısı 0.966, alt boyutlara ait Cronbach a katsayıları ise 0.819 – 0.952 arasında hesaplanmıştır.Sonuç ve Öneriler: Araştırma kapsamında Türk kültürüne uyarlanan Hemşirelik Uygulamalarına Hazır Oluşluk Ölçeği'ningeçerli ve güvenilir bir ölçüm aracı olduğu belirlenmiştir. Ölçüm aracı kullanılarak son sınıf hemşirelik öğrencileri ve son bir yıliçerisinde mezun olmuş öğrencilerin hemşirelik uygulamalarına hazır oluşlukları değerlendirilebilirPurpose: This research was carried out to adapt the Nursing Practice Readiness Scale to Turkish culture and to examineits psychometric properties.Method: The adaptation of the scale to Turkish culture in the study, which has a methodological design, was carried outin line with the guidelines for translation published by ISPOR. Opinions of 11 experts were taken to evaluate the contentvalidity of the adapted scale. After expert opinions, a pilot application was carried out with 30 participants who were similarto the sample. The scale, which was decided to be final, was applied to a total of 471 fourth-year nursing students andnurses who graduated in the last year. The factor structure of the scale was determined by explanatory factor analysis. Thedetermined structure was confirmed by confirmatory factor analysis. The reliability of the scale was evaluated bycalculating the Cronbach's a coefficient and item-total score correlation values.Results: By analyzing expert opinions, the Scale Content Validity Index (S-CVI) of Nursing Practice Readiness Scale wascalculated as 0.98. As a result of the explanatory factor analysis, it was determined that Nursing Practice Readiness Scaleexplained 60.60% of the total variance and consisted of a total of 35 items under 5 sub-dimensions. The overall Cronbach'scoefficient of the scale was calculated as 0.966, and the Cronbach's a coefficients for the sub-dimensions were calculatedbetween 0.819 and 0.952.Conclusion and Suggestions: It has been determined that Nursing Practice Readiness Scale, which was adapted to Turkishculture within the scope of the research, is a valid and reliable measurement tool. By using the measurement tool, thereadiness of senior nursing students and students who graduated in the last year for nursing practice can be evaluated.</p