Zapalenie opon mózgowo-rdzeniowych i opieka pielęgniarska zgodnie z modelem opieki opartej na czynnościach życiowych – opis przypadku

Introduction. Meningitis is an infectious disease that seriously affects the health of the individual, can cause mortality and can be treated with emergency intervention. Aim. The aim of this study is to evaluate the holistic and systematic nursing care process of the patient with the diagnosis of meningitis on the basis of the described case, in line with the nursing model. Case Report. This is the case study of a male patient who was treated with the diagnosis of meningitis in the infectious diseases and clinical microbiology clinic. Nursing problems were determined and a care plan was created by interviewing the patient and his physician, observing and assessment with Model of Nursing Based on Activities of Living. Results. The patient, who has fever, chills, nausea, headache, neck stiffness and left ear discharge, was admitted to the Infectious Diseases and Clinical Microbiology clinic and treated. NANDA-I (North American Nursing Diagnosis Association-International) nursing diagnoses determined specifically for the patient by using the Activities of Living Model developed by Roper, Logan and Tierney are acute pain, fever, nausea, lack of knowledge, fatigue, sleep pattern disruption and risk of falling. Conclusions. Accurate and complete data were collected using the nursing model/theory. Nursing interventions applied specifically to the patient were found to be effective. The patient’s problems were improved. Thanks to the interdisciplinary collaboration, a medical diagnosis of meningitis was made and appropriate medical treatment and nursing care was administered. The patient was discharged with recommendations for outpatient control. (JNNN 2022;11(3):130–136)Wstęp. Zapalenie opon mózgowych jest chorobą zakaźną, która poważnie wpływa na zdrowie jednostki, może powodować śmiertelność i może być leczona w trybie nagłym. Cel. Celem pracy jest ocena całościowego i systematycznego procesu opieki pielęgniarskiej nad pacjentem z rozpoznaniem zapalenia opon mózgowo-rdzeniowych na podstawie opisywanego przypadku, zgodnie z modelem pielęgniarskim. Opis przypadku. Jest to studium przypadku pacjenta płci męskiej leczonego z rozpoznaniem zapalenia opon mózgowo-rdzeniowych w poradni chorób zakaźnych i kliniki mikrobiologii klinicznej. Określono problemy pielęgniarskie i stworzono plan opieki poprzez przeprowadzenie wywiadu z pacjentem i jego lekarzem, obserwację i ocenę Model of Nursing Based on Activities of Living. Wyniki. Pacjent z gorączką, dreszczami, nudnościami, bólem głowy, sztywnością karku i wydzieliną z ucha lewego został przyjęty do Kliniki Chorób Zakaźnych i Mikrobiologii Klinicznej i leczony. NANDA-I (North American Nursing Diagnosis Association-International) diagnozy pielęgniarskie określone specjalnie dla pacjenta za pomocą Activities of Living Model opracowanego przez Ropera, Logana i Tierneya to ostry ból, gorączka, nudności, brak wiedzy, zmęczenie, zaburzenia snu i ryzyko upadku. Wnioski. Dokładne i kompletne dane zostały zebrane przy użyciu modelu/teorii pielęgniarskiej. Stwierdzono, że interwencje pielęgniarskie zastosowane specjalnie do pacjenta okazały się skuteczne. Problemy pacjenta uległy poprawie. Dzięki interdyscyplinarnej współpracy postawiono diagnozę medyczną zapalenia opon mózgowo-rdzeniowych oraz udzielono odpowiedniego leczenia i opieki pielęgniarskiej. Pacjent został wypisany z zaleceniami kontroli ambulatoryjnej. (PNN 2022;11(3):130–136

Real-Life Data of Chronic Hepatitis C Patients Treated with Direct-Acting Oral Antivirals: A Single-Center Study

Introduction:Chronic hepatitis C virus (HCV) infection is one of the important causes of liver cancer and cirrhosis all over the worldwide.Methods:The data of the patients diagnosed with chronic hepatitis C infection who applied to the Adult Infectious Diseases and Clinical Microbiology Outpatient Clinic of Erzincan Binali Yildirim University, Mengücek Gazi Training and Research Hospital were retrospectively analyzed. Accordingly, 51 patients treated with direct-acting oral antiviral drugs (DAAs) between January 2016 and May 2021 were included in the study. Patients whose treatment is still ongoing, whose treatment was completed but did not come to the 12th week after treatment, or whose control time has not yet come, were excluded from the study.Results:It was observed that 58.8% of the cases participating in the study were male, 80.4% were infected with genotype 1b, and 74.5% were treatment-naive. When the treatment regimens used in the cases were examined, glecaprevir/pibrentasvir in 7.8%, sofosbuvir (SOF)/ledipasvir (LED), SOF/LED/ribavirin, and SOF/ribavirin in 15.7%, ombitasvir (OBV)/paritaprevir (P)/ritonavir (R)/dasabuvir and OBV/P/R/ribavirin in 76.5% (n=39) appears to be used. A statistically significant difference was found between the alanine aminotransferase, aspartate aminotransferase measurements, and platelet counts of the subjects participating in the study at the beginning, at the 4th week, at the end of the treatment, and at the 12th week (p=0.001). In these cases, a sustained virological response was achieved in 100%. In the follow-up of the cases, no serious side effects that required drug discontinuation were observed.Conclusion:Our study showed that the treatment success of DAAs is 100% and their side-effect profiles are good

Evaluation of epidemiological, clinical, and laboratory characteristics and mortality rate of patients with Crimean-Congo hemorrhagic fever in the northeast region of Turkey

Background & objectives : Crimean-Congo hemorrhagic fever (CCHF), an illness characterized by fever and hemorrhage, is caused by a CCHF virus (CCHFV). It is an important public health problem in Turkey. The objective of this study was to evaluate the demographic, clinical, and laboratory characteristics and mortality rates of CCHF patients in the northeast region of Turkey. Methods : A total of 206 patients, diagnosed with CCHF, from northeast region of Turkey were included and evaluated between 2011 and 2017. Real-time reverse transcriptase polymerase chain reaction (RT-PCR) and immunofluorescence (IFA) methods were used for the diagnoses. Results : Of the patients included in the study, 77.2% were farmers/livestockers, while 22.8% had other occupations. The incidence of tick bite or tick contact with bare hands was 52.9%. About 94.2% of the patients were living in rural areas and 5.8% in city centers. However, all the patients living in city centers had a history of visit to rural areas. The disease was more common in May, June, and July months. The most common symptoms at the time of admission included fatigue, fever, and widespread body pain, while laboratory findings were thrombocytopenia, leukopenia, and anemia. Bleeding, tachycardia, and rash were the most common findings on physical examination. Of all the patients, 95.6% were identified by RT-PCR and 4.4% by IFA methods. Severe cases constituted 22.3% (46) of the included patients. Throughout the course of this study, 7 (3.4%) patients died, and the remaining 96.6% (199) patients were discharged with a full recovery. Disease severity was significantly correlated with mortality rate and duration of hospitalization (p <0.001 and p = 0.013). Interpretation & conclusion : In this study, the mortality rate observed was lower than that reported in the literature because of accessibility of early supportive therapy. It would be beneficial in CCHF treatment to recognize the disease at an early stage, begin supportive treatment quickly, and educate the people living in high-risk areas as well as health care personnel working in these areas