Incisional hernia as an unusual cause of hepatic encephalopathy in a 62-year-old man with cirrhosis: a case report

<p>Abstract</p> <p>Introduction</p> <p>Hepatic encephalopathy may be initiated by many factors such as gastrointestinal bleeding, infections, fluid and electrolyte disturbances. Hypokalemia is one of the most commonly encountered electrolyte abnormalities causing hepatic encephalopathy in patients with cirrhosis.</p> <p>Case presentation</p> <p>We present the case of a 62-year-old Caucasian man with decompensated liver cirrhosis having multiple episodes of hepatic encephalopathy precipitated by vomiting. He had an incisional hernia at the right lumbar region. A barium contrast study of the small intestine and magnetic resonance imaging showed that the hernial sac included gastric antrum and bowel. We observed that hepatic encephalopathy coincided with hypokalemia as a result of a large volume of vomiting triggered by the collapsed hernial sac. Hepatic encephalopathy was resolved by administration of intravenous potassium.</p> <p>Conclusion</p> <p>This case illustrates that a hernia causing a large volume of vomiting may be a precipitant factor in the development of hepatic encephalopathy.</p

Percepciones de estudiantes de enfermería sobre el Ambiente de Aprendizaje Clínico y la salud mental: estudio multicéntrico

Objetivo:&nbsp;este estudo teve como objetivo avaliar as percepções dos estudantes de Enfermagem das universidades públicas de três países da União Europeia sobre saúde mental e ambientes de aprendizagem clínica, tema pouco investigado na literatura.&nbsp;Método:&nbsp;a coleta de dados ocorreu por meio de um formulário de dados demográficos, a Escala Ambiente de Aprendizagem Clínica, Supervisão e Professor de Enfermagem e o&nbsp;Mental Health Continuum Short Form. Um total de 571 participantes da Turquia, Lituânia e Portugal foram incluídos no estudo.&nbsp;Resultados:&nbsp;houve uma diferença significativa entre os três grupos em relação ao ambiente de aprendizagem clínica e estado de saúde mental (p &lt;0,001). A supervisão foi o elemento mais valorizado. Os estudantes portugueses apresentaram a média mais elevada nos escores do&nbsp;Mental Health Continuum Short Form e Ambiente de Aprendizagem Clínica, Supervisão e Professor de Enfermagem (p&lt;0,001). Idade, sexo e saúde mental influíram nos escores do Ambiente de Aprendizagem Clínico, Supervisão e Professor de Enfermagem.&nbsp;Conclusão:&nbsp;os resultados indicaram que os escores do&nbsp;Mental Health Continuum Short Form&nbsp;e Ambiente de Aprendizagem Clínica, Supervisão e Professor de Enfermagem obtidos pelos estudantes de Enfermagem portugueses foram mais elevados. Revelou-se também que as percepções dos alunos sobre o ambiente de aprendizagem clínica foram afetadas pela idade e sexo, e que suas percepções sobre saúde mental foram influenciadas pelos escores da escala Ambiente de Aprendizagem Clínica, Supervisão e Professor de Enfermagem.Objective:&nbsp;this study aimed at evaluating the perceptions of Nursing students from public universities in three European Union countries on mental health and clinical learning environments, a topic that has been rarely investigated in the literature.&nbsp;Method:&nbsp;data collection took place using a demographic data form, the Clinical Learning Environment, Supervision and Nurse Teacher Scale, and the Mental Health Continuum Short Form. A total of 571 participants from Turkey, Lithuania and Portugal were included in the study. Results:&nbsp;there was a significant difference among the three groups regarding clinical learning environment and mental health status (p&lt;.001). Supervision was the most valued element. The Portuguese students presented the highest mean in the Mental Health Continuum Short Form and Clinical Learning Environment, Supervision and Nurse Teacher Scale scores (p&lt;.001). Age, gender and mental health were effective in the Clinical Learning Environment, Supervision and Nurse Teacher Scale scores.&nbsp;Conclusion:&nbsp;the results indicated that the Mental Health Continuum Short Form and Clinical Learning Environment, Supervision and Nurse Teacher Scale scores obtained by the Portuguese Nursing students were higher. It was also revealed that the students’ perceptions on the clinical learning environment were affected by age and gender, and that their perceptions on mental health were influenced by the Clinical Learning Environment, Supervision and Nurse Teacher scale scores.Objetivo:&nbsp;este estudio tuvo como objetivo evaluar las percepciones de estudiantes de enfermería de universidades públicas de tres países de la Unión Europea sobre la salud mental y los Ambientes de Aprendizaje Clínico, tema poco estudiado en la literatura.&nbsp;Método:&nbsp;la recolección de datos se realizó mediante un formulario de datos demográficos, la Escala de Evaluación de Ambiente de Aprendizaje Clínico, Supervisión y Profesor de Enfermería y el&nbsp;Mental Health Continuum Short Form. Se incluyeron en el estudio un total de 571 participantes de Turquía, Lituania y Portugal.&nbsp;Resultados:&nbsp;hubo una diferencia significativa entre los tres grupos con respecto al Ambiente de Aprendizaje Clínico y al estado de salud mental (p &lt; 0,001). La supervisión fue el elemento más valorado. Los estudiantes portugueses obtuvieron los puntajes promedio más altos en el&nbsp;Mental Health Continuum Short Form y Ambiente de Aprendizaje Clínico, Supervisión y Profesor de Enfermería (p&lt;0,001). La edad, el sexo y la salud mental influyeron en los puntajes de Ambiente de Aprendizaje Clínico, Supervisión y Profesor de Enfermería.&nbsp;Conclusión:&nbsp;los resultados indicaron que los estudiantes de Enfermería portugueses obtuvieron los puntajes más altos en el&nbsp;Mental Health Continuum Short Form&nbsp;y Ambiente de Aprendizaje Clínico, Supervisión y Profesor de Enfermería. También se reveló que las percepciones de los estudiantes sobre el Ambiente de Aprendizaje Clínico se vieron afectadas por la edad y el género, y que sus percepciones sobre la salud mental fueron influenciadas por los puntajes de la escala de evaluación de Ambiente de Aprendizaje Clínico, Supervisión y Profesor de Enfermería

Risk Factors and Outcome of Increased Red Blood Cell Transfusion in Cardiac Surgical Patients Aged 65 Years and Older

Background The use of blood products is not uncommon during cardiac surgery in elderly patients. We conducted this study to investigate the risk factors and adverse outcomes of increased red blood cell (RBC) transfusion in the patients aged >= 65 years undergoing cardiac surgery

Percepciones de estudiantes de enfermería sobre el Ambiente de Aprendizaje Clínico y la salud mental: estudio multicéntrico

Objective: this study aimed at evaluating the perceptions of Nursing students from public universities in three European Union countries on mental health and clinical learning environments, a topic that has been rarely investigated in the literature. Method: data collection took place using a demographic data form, the Clinical Learning Environment, Supervision and Nurse Teacher Scale, and the Mental Health Continuum Short Form. A total of 571 participants from Turkey, Lithuania and Portugal were included in the study. Results: there was a significant difference among the three groups regarding clinical learning environment and mental health status (p<.001). Supervision was the most valued element. The Portuguese students presented the highest mean in the Mental Health Continuum Short Form and Clinical Learning Environment, Supervision and Nurse Teacher Scale scores (p<.001). Age, gender and mental health were effective in the Clinical Learning Environment, Supervision and Nurse Teacher Scale scores. Conclusion: the results indicated that the Mental Health Continuum Short Form and Clinical Learning Environment, Supervision and Nurse Teacher Scale scores obtained by the Portuguese Nursing students were higher. It was also revealed that the students’ perceptions on the clinical learning environment were affected by age and gender, and that their perceptions on mental health were influenced by the Clinical Learning Environment, Supervision and Nurse Teacher scale scores

Attitudes of cancer patients after diagnosis: How cancer affects social life? A Turkish Oncology Group study

Purpose: Each year, 12.7 million people learn that they have cancer and 8.2 million people die of= cancer worldwide. Cancer is a major public health issue which causes fundamental changes in the lives of patients and their families. The purpose of this study was to evaluate the lives of patients after diagnosis and determine the changes in their lifestyles

Clinical and molecular evaluation of MEFV gene variants in the Turkish population: a study by the National Genetics Consortium

Familial Mediterranean fever (FMF) is a monogenic autoinflammatory disorder with recurrent fever, abdominal pain, serositis, articular manifestations, erysipelas-like erythema, and renal complications as its main features. Caused by the mutations in the MEditerranean FeVer (MEFV) gene, it mainly affects people of Mediterranean descent with a higher incidence in the Turkish, Jewish, Arabic, and Armenian populations. As our understanding of FMF improves, it becomes clearer that we are facing with a more complex picture of FMF with respect to its pathogenesis, penetrance, variant type (gain-of-function vs. loss-of-function), and inheritance. In this study, MEFV gene analysis results and clinical findings of 27,504 patients from 35 universities and institutions in Turkey and Northern Cyprus are combined in an effort to provide a better insight into the genotype-phenotype correlation and how a specific variant contributes to certain clinical findings in FMF patients. Our results may help better understand this complex disease and how the genotype may sometimes contribute to phenotype. Unlike many studies in the literature, our study investigated a broader symptomatic spectrum and the relationship between the genotype and phenotype data. In this sense, we aimed to guide all clinicians and academicians who work in this field to better establish a comprehensive data set for the patients. One of the biggest messages of our study is that lack of uniformity in some clinical and demographic data of participants may become an obstacle in approaching FMF patients and understanding this complex disease