Impact of ligating gonadal or adrenal collateral veins with the left renal vein on renal function and histology in right-nephrectomized rats

Background: In cases of trauma to the left renal vein (LRV), its ligation near the inferior vena cava (IVC) is considered, but the consequences are not always good. We investigated the role of collateral venous drainage after ligation of the LRV by studying the renal function and histology after ligation of the LRV near the IVC alone or with ligation of the gonadal or adrenal collaterals, in right-nephrectomized (RN) rats. Material and methods: Ligation of the LRV near the IVC alone (group 1) or with ligation of the adrenal (group 2) or gonadal (group 3) collaterals was studied in RN Wistar rats (n = 18 per group). The renal histopathology (ischemic cortical necrosis) and functional status (urea, creatinine, sodium, and potassium) were compared. Results: In RN rats, the results were better when ligating the LRV near the IVC alone or with the adrenal collaterals [mortality 4/18 (22.2%) and 3/18 (16.7%), respectively] than when ligating the LRV near the IVC plus the gonadal collaterals [mortality 15/18 (83.3%)] (p < 0.0001). All early deaths occurred within three days and resulted from serious histopathological (ischemic cortical necrosis) and functional (increased urea, creatinine, and potassium; decreased sodium) renal damage. Conclusion: In right-nephrectomized rats, the LRV near the IVC and the adrenal collateral can be ligated, while the gonadal collateral should be preserved. Published by Elsevier Ltd on behalf of Surgical Associates Ltd

Seroprevalences of Hepatitis B and Hepatitis C among healthcare workers in Tire State Hospital

Objective: The risk of infection with HBV and HCV in healthcare workers has been increased as risks such as contact with the blood or open wound of the infected people. The aim of the study was to investigate the seroprevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections among healthcare working at Tire State Hospital. Methods: Screening records of total 518 hospital personnel working in the Tire State Hospital between January 2012 and April 2017 were retrospectively reviewed. HBsAg, Anti-HBs and Anti HCV tests on the blood samples obtained for screening were performed in our laboratory using Siemens advia centaur XP chemiluminescence technique. Results: Between January 2012 and April 2017, a total of 518 health workers, ranging in age from 18 to 63 working in the State Hospital, were evaluated in infectious diseases and clinical microbiology clinics. Our personnel were negative for Anti-HBs 61 (11.8%) and anti-HBs positivity was detected in 457 (88.2%) of the obtained samples, 6 (1.2%) of these personnel were positive for HBsAg. It was detected that two cleaning personnel and a nurse were positive for anti-HCV. Conclusion: Hospital workers should be screened for HBV and HCV and individuals without HBV vaccination should be vaccinated. In our country, HBsAg positivity in healthcare workers has decreased especially in recent years. Nevertheless, healthcare workers are still under the risk of HBV and HCV. Therefore, it is important to keep and review the records of hospital workers regularly

The Effect of Clinical Decision Support System on the Rates of Patients Who Reapply to the Emergency Department with the Same Diagnosis

Aim: We aim to decrease readmissions with the same diagnosis within 24 hours in emergency departments when many patients are admitted, such as during a pandemic. Methods: A comparison was made between the quarterly and monthly increases in 2021, 2020, and 2019 during the pandemic period. The root cause analysis determined that non-branch physicians and after-hours visits contributed to the increase in readmissions to the emergency department within 24 hours. A complete digital structure in State Hospital, Hospital Information Management System level 7 has enabled standardized diagnosis by eliminating physician and branch-based differences with the decision support systems established by the Hospital Information System by utilizing digital measures. Cross-sectional and retrospective reapplication rates 2019, 2020, 2021 2nd Period (April, May, June). Quality Standards in Health Emergency Department two data sets were used as The Basic Health Statistics Module data. Result as the 2019, 2020, and 2021 monthly reapplication rates of emergency department 2nd Period (April, May, June) month comparison Application rates 2020-year 2nd Period. Looking at the same months in 2021 and 2020, it is seen that the reapplication rate decreased below 2% within 24 hours. Results: This means that the application rate has returned to pre-pandemic levels. It is aimed at making it easier and more effective to work in situations that lead to collective admissions to emergency hospital services. The same situation has been an example of similar practices within hospital services. Conclusion: The application rate returned to its status outside the pandemic period. Differences in physician-induced approaches to diagnosis and treatment were eliminated, and standardization was achieved

The effects of a nursing care plan incorporated with a decision support system on ventilator associated pneumonia: A case study

The risk of pneumonia is high in patients who are ventilated in intensive care units (ICUs). Without proper and adequate care, this risk and the mortality rate increases. In a study conducted by the infection committee of our hospital (tzmir Tire State Hospital, the first digital (Stage 7) hospital in Turkey in 2016), it was found that the rate of ventilator-associated pneumonia (VAP) cases increased had increased over three years (2015-17) and was well above the national average. In this study, VAP prevalence in our ICU and the associated extra medication costs were calculated. Furthermore, nursing care plans related to VAP were reviewed and improvements were made according to international standards. The care plan was triggered by criteria defined in a clinical decision support system (CDSS) on the hospital information management system (HIS), and monitorization was conducted to ensure that nurses implement the care plan in a comprehensive and timely manner. As a result of the change, the rate of VAP cases. which had risen to 4.5% in 2017, was reduced to 0.5% in 2018. Similarly, we achieved cost reductions of 90.87% for VAP-based extra medications. Based on these results, it can be suggested that CDSS-supported nursing care can significantly reduce the risk of VAP and increase patient safety in the ICU

Moxifloxacin-associated neutropenia

A 32-y-old woman presented with pneumonia. Treatment was started with moxifloxacin. On day 2 of moxifloxacin treatment the patient developed neutropenia. After discontinuing the moxifloxacin, neutrophil counts were normal on day 4. Clinicians should be aware of the possibility of this adverse effect in patients treated with moxifloxacin.A 32-y-old woman presented with pneumonia. Treatment was started with moxifloxacin. On day 2 of moxifloxacin treatment the patient developed neutropenia. After discontinuing the moxifloxacin, neutrophil counts were normal on day 4. Clinicians should be aware of the possibility of this adverse effect in patients treated with moxifloxacin.</p

The site effects in Izmir Bay of October 30 2020, M7.0 Samos Earthquake

Due to the unique soil and morphological conditions prevailing in Izmir Bay basin, structural damage has been governed by site effects. Consistently, during October 30, 2020 M7.0 Samos Earthquake, which took place offshore of Samos Island, structural damage and life losses were observed to be concentrated in Bayrakli region of Izmir Bay, despite the fact that the fault rupture was at a distance of 65–75 km from the city of Izmir. Additionally, strong ground motions recorded in Izmir Bay showed unique site amplifications that were observed surprisingly at both rock and soil sites. Soil amplifications and duration elongations were mostly due to site effects governed by the response of very deep alluvial deposits of low plasticity. Similarly, due to very extensive faulting-induced fracturing and unusually stratified nature of rock sub-layers, unexpected long period amplifications were also observed at rock sites. These earthquake and site resonance effects were more pronounced in the period range of 0.5–1.5 s. When they were superposed with relatively coinciding natural period of 7–9 story residential buildings of Izmir City, it was concluded that the triple resonance effects among incoming rock ground motions, soil deposits, and the damaged buildings, amplified and prolonged the overall system response. Within the confines of this manuscript, the governing role of site effects leading to increased seismic demand was assessed, through a series of 1D equivalent linear, total stress-based site response assessments, the results of which clearly highlighted the variation of seismic demand in Izmir Bay