The effect of local corticosteroid injection on F-wave conduction velocity and sympathetic skin response in carpal tunnel syndrome

The aim of this study was to evaluate the efficacy of steroid injection for the treatment of the carpal tunnel syndrome (CTS), with F-wave parameters and sympathetic skin response (SSR). Seventeen hands of 10 women patients were treated with local steroid injection with 2-month follow-up. All patients underwent single injection into the carpal tunnel. Response to injection was measured nerve conduction studies (NCSs), median nerve F waves, and SSR before and after treatment. To determine the normal values, 42 hands of 21 healthy women were also studied. There was a significant improvement of sensory and motor nerve conduction values when compared to baseline values (P < 0.01). At the end of follow-up period, the median sensory distal latency and the sensory latency differences between the median and the ulnar nerve were improved 35 and 65%, respectively. The maximum, mean F-wave amplitudes and chronodispersion showed a slight improvement with respect to baseline values and controls, but statistical significance was not achieved after treatment. Although no statistically significant improvements were observed in SSR parameters, slightly decreased amplitudes and increased habituation of SSR were noted at the end of the treatment. The present study shows that the local steroid injection results in improvement in NCSs values, but the F-wave parameters were not effectual in short-term outcome of CTS treatment. These findings suggest that the sensory latency differences between the median and the ulnar wrist-to-digit 4 are better parameters in the median nerve recovery after treatment than the median sensory distal latency. Furthermore, the SSR does not seem to be a sensitive method in follow-up of CTS treatment

Hastaların hemşirenin hasta eğitimindeki rolüne yönelik görüşleri

1. Araştırma; kardiyovasküler cerrahi operasyonu geçirmiş hastaların bilgilendirilme durumlarını ve hastaların hemşirenin eğitimci rolü ile ilgili görüşlerini incelemek amacıyla yapıldı. Örneklemi, İstanbul ilinde biri özel diğeri kamu hastanesinde yatan KVC operasyonu geçirmiş 148 hasta oluşturdu. Veriler, hastaların tanıtıcı bilgileri, hastalıkları hakkındaki bilgisi, hasta yakınlarının eğitimi ve hemşirenin hasta eğitimindeki rolünü içeren 34 soruluk bir anket formuyla toplandı. Hastaların %68’i devlet hastanesinde, %32’si özel hastanede yatmaktadır, yaş ortalaması 56,6’dır. Hastaların %65’i erkek, %86’sı evli, %57’si ilköğretim mezunu, %43’ü serbest meslek sahibidir, yarısından fazlası baypas operasyonu geçirmiştir. Yatış süresi ortalaması 10 gündür. Hastaların öğrenim seviyesi yükseldikçe, hastalıkları hakkında bilgilerinin yeterli olduğunu düşünme oranları artmaktadır, daha çok baypas operasyonu geçirmiş hastalar bilgilerinin yetersiz olduğunu düşünmektedir. Hastaların tamamına yakını hastalıkları süresince bilgi aldığını ifade etmiştir. Hastalar hastaneye yatış öncesinde, hastaneye kabulde, ameliyat öncesinde ve taburculuk sürecinde en fazla doktorlar tarafından bilgilendirilmekte, bunu hemşireler izlemektedir. Tüm süreçlerde özel hastanede tedavi gören hastalar daha fazla bilgilendirilmiştir. Hastalar; ameliyat süreci, ameliyat günü yapılacaklar, ayağa kalkma, göğüs kemiğinin korunması konularında daha fazla bilgilendirilmiştir. Hastaların, en fazla sözlü olarak bilgilendirildiği ve broşür verildiği belirlenmiştir. Hastalar, eşleri ve çocuklarına bilgi verilmesini istemişlerdir. Hastalar, hasta eğitimlerinde en fazla, doktor, hastaya bakan hemşire ve eğitim hemşiresinin rol alması gerektiğini ifade etmiştir. Hastaların yarısından fazlası hemşirelerin verdiği bilgileri yeterli bulmuş, çoğu hemşirelerin ilgisinden memnun kalmış, hemşirelere rahatça soru sorabilmiş ve aldıkları cevapları yeterli bulmuştur. Hastaların tamamına yakını hastanede özel bir eğitim hemşiresinin olmasını gerekli bulmuştur. Anahtar Kelimeler: Eğitim Hemşireliği, Hasta Eğitimi, Kardiyovasküler Cerrahi. 1. SUMMARY Patient’s Opinions About Nurse’s Role of Patient Education Survey is performed to investigate informational condition of cardiovascular surgery operation patients and their ideas about nurse’s role of patient education. Study sampling is composed of 148 cardiovascular surgery operation’s patients. Data is obtained by an inquiry form with 34 questions containing information of patient’s demographic information, illness information, patient’s family education and nurses’ role of patient education. It was determined that 68% of patients are treated in public hospital, 32% treated in private hospital, the average age is 56,6. 65% of them are male, 86% are married, 57% are graduated form secondary school, 43% are self-employed, more then 50% had bypass operation. The average hospitalization duration is 10 days. Approximately total amount of patients implied that they were informed about their illnesses. Before treatment, at patient’s acceptance, before operation and discharge, patients are informed mostly by doctors, nurses are following them. At the whole process patients treated in private hospitals are informed more. Patients are informed mostly under the subject of operation period, actions on operation day, stand up and prevention of sternum. It was found that patients are informed mostly in verbal and brochures are given to them. Patients preferred their spouse and children to be informed. Patients think about that doctor, nurse and patient educator should take more role in patient’s education. More half of them found the information given by nurses adequate and most of them are satisfied by nurses’ relation, they could ask easily question and are answered adequately. Approximately total patients think about that an executive educator nurse is necessary in hospital. Key Words: Patient education role of the nurse, patient education, cardiyovascular surgery

Use of waste marble powder in brick industry

The usability of waste marble dust as an additive material in industrial brick were investigated. Marble wastes were collected from marble deposits which are located at Southwest of Turkey and industrial brick mortar was obtained from a brick company in Istanbul. Waste marble dust and brick mortar were prepared for various processes of industrial brick investigation. Waste material in different proportions was mixed with industrial brick mortar starting amount of 0 wt.% up to 80 wt.%. in 41 x 8 x 8 mm rectangular prisms for testing of physico-mechanical properties of the samples having different marble dust composition. These prepared prisms were pressed and sintered at three different temperatures 900, 1000 and 1100 degrees C. Flexural strengths of the test samples were given at three different temperature values of 900, 1000 and 1100 degrees C. Archimedes water displacement test was conducted with different water absorption percentage values at 900, 1000 and 1100 degrees C temperatures. XRD analyses have been carried out for the additives which contain mainly calcite and small amount of dolomite minerals. It was found that the amount of marble dust additive had positive effect on the physical, chemical and mechanical strength of the produced industrial brick. With increasing demands of the construction industry, bricks quality and cost become more important day by day in Turkey. In addition, the usage of marble wastes for the production of industrial bricks has significant important role on the recycling waste marble powder in the brick production along with a great contributions to economy and ecology of the country

First isolation and detection of multiple clones of vancomycin- resistant enterococci in the pediatric unit of Van Yuzuncu Yil University, Turkey [Van Yüzüncü Yil Üniversitesi pediatri servisinde vankomislne direnç li enterokoklarin ilk izolasyonu ve çogul klonlarin tespiti]

Upon isolation of the first vancomycin resistant enterococcus (VRE) from the urine sample of a nine months old patient in pediatric unit of Van Yuzuncu Yil University Hospital (located in eastern part of Turkey), we aimed to search for the presence of VRE isolates in the unit, to determine the resistance genotypes and to evaluate the clonal relationships among isolates. A total of 28 rectal swabs and 28 skin swabs from the patients, 12 skin swabs from the staff giving care to the patients, 15 skin swabs from the mothers of the patients and 96 environmental samples from the pediatric unit were screened. Antibiotic susceptibilities were tested and the resistance genotypes were determined. Molecular typing of the isolates was performed using pulsed-field gel electrophoresis (PFGE). Apart from the first case, 13 more VRE isolates, one being a clinical isolate from the urine of a patient and 12 isolates from the screening samples (8 rectal swabs, one skin swab and three swabs from patients' beds) were obtained. All of the isolates were identified as Enterococcus faecium with similar antibiotic susceptibility patterns. VanA gene was present in all of the isolates. PFGE demonstrated two major clones and five clones closely related with the major ones. This was the first VRE isolation and colonization reported in our region. The isolates belonged to more than one clone. Currently, VRE did not seem to be a significant pathogen in Turkey, however, there may be an underestimation of the problem and continuous surveillance studies should be undertaken in every region

EFFICACY OF COLISTIN AND NON-COLISTIN MONOTHERAPIES IN MULTI-DRUG RESISTANT ACINETOBACTER BAUMANNII BACTEREMIA/SEPSIS

Objective: This retrospective study aimed to investigate the efficacies of colistin and non-colistin monotherapies in multi-drug resistant Acinetobacter baumannii bacteremia (MDR-AB)