Evaluation of nutritional status in pediatric intensive care unit patients: the results of a multicenter, prospective study in Turkey

IntroductionMalnutrition is defined as a pathological condition arising from deficient or imbalanced intake of nutritional elements. Factors such as increasing metabolic demands during the disease course in the hospitalized patients and inadequate calorie intake increase the risk of malnutrition. The aim of the present study is to evaluate nutritional status of patients admitted to pediatric intensive care units (PICU) in Turkey, examine the effect of nutrition on the treatment process and draw attention to the need for regulating nutritional support of patients while continuing existing therapies.Material and MethodIn this prospective multicenter study, the data was collected over a period of one month from PICUs participating in the PICU Nutrition Study Group in Turkey. Anthropometric data of the patients, calorie intake, 90-day mortality, need for mechanical ventilation, length of hospital stay and length of stay in intensive care unit were recorded and the relationship between these parameters was examined.ResultsOf the 614 patients included in the study, malnutrition was detected in 45.4% of the patients. Enteral feeding was initiated in 40.6% (n = 249) of the patients at day one upon admission to the intensive care unit. In the first 48 h, 86.82% (n = 533) of the patients achieved the target calorie intake, and 81.65% (n = 307) of the 376 patients remaining in the intensive care unit achieved the target calorie intake at the end of one week. The risk of mortality decreased with increasing upper mid-arm circumference and triceps skin fold thickness Z-score (OR = 0.871/0.894; p = 0.027/0.024). The risk of mortality was 2.723 times higher in patients who did not achieve the target calorie intake at first 48 h (p = 0.006) and the risk was 3.829 times higher in patients who did not achieve the target calorie intake at the end of one week (p = 0.001). The risk of mortality decreased with increasing triceps skin fold thickness Z-score (OR = 0.894; p = 0.024).ConclusionTimely and appropriate nutritional support in critically ill patients favorably affects the clinical course. The results of the present study suggest that mortality rate is higher in patients who fail to achieve the target calorie intake at first 48 h and day seven of admission to the intensive care unit. The risk of mortality decreases with increasing triceps skin fold thickness Z-score

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Constant Current/Voltage Charging of A 250W E-Bike with Wireless Power Transfer

Practical and safely charge of the electric vehicle become important as their use increases. In Turkey,the use of electric bicycles (less than 250 W), which do not require special driving licenses, has increasedremarkably in recent years. In this study, a system for wireless charging has been developed to practice thecharging of e-bikes. The charging of the 36V battery bank on the e-bike is achieved with 72% overall system(DC/DC) efficiency. The air gap is 75 mm due to the wheel diameter and the bicycle chassis. The switchingfrequency on the transmitter side is selected as 20 kHz for inductive power transfer. On the secondary side, acharge regulator is designed to charge the battery according to its characteristic. The constant current andconstant voltage modes can be performed according to battery characteristic. Besides being practical andreliable, the overall performance of the developed system can compete with the conventional cable chargingsystem.Elektrikli araçların kullanımı arttıkça; bu araçların pratik ve güvenli şekilde şarj edilmesi, önemli bir araştırma konusu olmuştur. Türkiye'de özel ehliyet gerektirmeyen elektrikli bisiklet kullanımı (250 W'tan daha az), son yıllarda önemli ölçüde artmıştır. Bu çalışmada elektrikli bisikletler için kablosuz şarj sistemi geliştirilmiştir. E-bisiklet üzerindeki 36V’luk batarya bankı, %72 genel sistem verimiyle (DC-DC) kablosuz olarak şarj edilmiştir. Temassız güç aktarım hava aralığı, tekerlek çapı ve bisiklet şasesi dikkate alınarak 7.5 cm olarak belirlenmiştir. Primer tarafındaki anahtarlama frekansı, endüktif güç aktarımını sağlamak için 20 kHz olarak seçilmiştir. Sekonder tarafta ise batarya karakteristiğine uygun olarak çalışan bir şarj regülatörü geliştirilmiştir. Bu regülatör ile batarya karakteristiğine uygun olarak, sabit akım ve sabit gerilim kipinde şarj yapılabilmektedir. Böylece geliştirilen kablosuz şarj sistemi; pratik ve güvenilir olmasının yanı sıra, performans olarak da geleneksel kablolu şarj sistemi ile rekabet edebilir seviyededir.2-s2.0-8509595131

Is Anti-platelet Treatment Necessary for Penile Mondor's Disease?

Objective: The aim of this study was to determine if anti-platelet treatment would have any effect on the rate and duration of resolution in penile Mondor's disease

Effects of Chronic Renal Failure on Surgical Outcomes of Laparoscopic Nephrectomy for Benign Diseases? A Comparative Study

Objective: The aim of this study was to compare surgical outcomes of laparoscopic nephrectomy (LN) for benign diseases in patients with chronic renal failure (CRF) undergoing hemodialysis with their non-CRF counterparts

The Views of Urology Doctors in Turkey Towards Regional Anaesthesia

Despite regional anaesthesia (RA) being the most appropriate anaesthesia method in several surgeries, primarily urology surgery, it is not widely practised by anaesthetists. We aimed to research the knowledge, opinions and attitudes of urologists towards regional anaesthesia(RA)A questionnaire consisting of 29 questions to be answered with Likert type answers was applied face to face to urology specialists and assistants in hospitals in the center of Ankara. By stating the preferred anaesthesia method it was aimed to evaluate the knowledge and opinions of urologists to RA. A total of 152 urology assistants or specialists were included in the study. The source of the knowledge related to RA was determined as from experience during specialist training in 38%, from observation and learning from anaesthetists when working together in 25% and from medical faculty education in 25%. The most common reasons for selecting RA were determined as a better state of consciousness in the patient compared to general anaesthesia (92.8%), that it is a safe anaesthesia method (86.2%), lower rates of postoperative nausea and vomiting (73.7%) and greater patient satisfaction (73%). Reasons for not selecting RA were determined as the risk of complications developing associated with unwanted movements of the patient (45.4%) and that the patient can follow their own endovision monitor and hear the doctors talking amongst themselves, as they are conscious during surgery (40.8%). The results of this study showed that the majority of urologists knew the advantages of RA and supported the use of RA in appropriate operations. The disadvantages of the RA can be eliminated with anaesthesia applications such as sedation or nerve blockage additional to RA. Periodic training sessions between clinics and meetings may be useful both in terms of updating information and in reducing negative opinions of RA. Inter-clinical meetings and periodic training can be beneficial both in terms of updating information and reducing negative opinions about RA