Investigation of health care workers’ stress, depression and anxiety levels in terms of work-related violence

Behaviors and attitudes of the people who are in the same setting, such as service beneficiaries, co-workers and the others, have a determining effect on the mood of the people who provide the service. This effect can become either positive or negative depending on the course of action. Positive mood manifests itself as the feeling of happiness, security, appreciation, pride and etc. However, negative mood manifests itself as feeling of sorrow, disappointment, loneliness, stress, anxiety, depression and etc. Such kind of interactions is much more observed in health sector than any other workplaces due to intensive relations between service providers (health workers) and service beneficiaries (patients). So, this sector is the leading one which workplace violence is intensively observed. This study was carried out in order to investigate the effects of workplace violence on the stress, anxiety and depression levels of health care professionals. With this purpose, a survey was performed on the employees who work in a training and research hospital. According to the findings, significant differences were determined between the stress, anxiety and depression levels of health-care workers and the frequency of exposure to violence. In the light of the study findings, some recommendations were proposed to researchers and decision-makers.// // // // // // // // // // // // // // Annotate Highlight // Annotate Highligh

Identification of Drug-Related Problems and Investigation of Related Factors in Patients with COVID-19: An Observational Study

Objective:Clinical prognosis of coronavirus disease-19 (COVID-19) may be severe and unexpected. Patients may quickly progress to respiratory failure, infections, multiple organ dysfunction, and sepsis. The main objective of this study is to investigate the drug-related problems of patients with COVID-19 and related factors.Method:A prospective observational study was conducted on patients with COVID-19 between September 2020 and May 2021. Patients’ demographics, comorbid diseases, prescribed medicines and laboratory findings were recorded. Drug-related problems (DRPs) were identified by a clinical pharmacist according to recent guidelines, UpToDate® clinical decision support system and evidence-based medicine.Results:The median age of 107 patients was 64 and 50.46% of them were male. The median number of comorbidities was 3 (2-4) per patient. The majority of the patients had at least one comorbidity (88.79%) other than COVID-19 and the most frequent comorbidities were hypertension, diabetes mellitus and coronary artery disease. The total number of DRPs was recorded as 201 and at least one DRP was seen in 75 out of 107 patients. The median number of DRPs was 2 (0-8). In multivariate model, number of comorbidities (odss ratio (OR)=1.952; 95% confidence interval (CI)=1.07-3.54, p<0.05, number of medications (OR=1.344; 95% CI=1.12-1.61, p<0.001), and serum potassium levels (OR=5.252; 95% CI=1.57-17.56, p<0.001) were the factors related with DRPConclusion:This study highlights the DRPs and related factors in patients with COVID 19 in hospital settings. Considering unknown features of the infection and multiple medication use, DRPs are likely to occur. It would be beneficial to consider the related factors in order to reduce the number of the DRPs

A rare cause of parotid abscess; Salmonella enterica subsp. arizonae

Introduction: Salmonella enterica subsp. arizonae is a common gut inhabitant of reptiles and snakes are the most common reservoir. The bacteria cause systemic infections in patients who are immunocompromised and this infection often causes serious complications. Case presentation: We describe the case of a 59 year old man with type 2 Diabetes Mellitus who presented to our hospital with right parotid abscess. The pus culture yielded S. enterica subsp. arizonae. Our patient was treated with intravenous Ceftriaxone 2 g/day addition to oral ciprofloxacin 1 g/day for twenty days and made a full recovery. Conclusions: There are only few cases reported in which S. enterica subsp. arizonae causes infection in the head and neck. It is difficult to expose the likely route of transmission. S. enterica subsp. arizonae should be included in the differential diagnosis of head and neck abscesses in patients who are immunocompromised

Colistin nephrotoxicity increases with age

Background: Colistin (COL) has become the backbone of the treatment of infections due to extensively drug-resistant (XDR) Gram-negative bacteria. The most common restriction to its use is acute kidney injury (AKI). Methods: We conducted a retrospective cohort study to evaluate risk factors for new-onset AKI in patients receiving COL. The cohort consisted of 198 adults admitted to 9 referral hospitals between January 2010 and October 2012 and treated with intravenous COL for >= 72 h. Patients with no pre-existing kidney dysfunction were compared in terms of risk factors and outcomes of AKI graded according to the RIFLE criteria. Logistic regression analysis was used to identify associated risk factors. Results: A total of 198 patients met the inclusion criteria, of whom 167 had no pre-existing kidney dysfunction; the mean patient age was 58.77 (+/- 18.98) y. Bloodstream infections (34.8%) and ventilator-associated pneumonia (32.3%) were the 2 most common indications for COL use. New-onset AKI developed in 46.1% of the patients, graded as risk (10%), injury (15%), and failure (21%). Patients with high Charlson co-morbidity index (CCI) scores (p = 0.001) and comparatively low initial glomerular filtration rate (GFR) estimations (p < 0.001) were more likely to develop AKI, but older age (p = 0.001; odds ratio 5.199, 95% confidence interval 2.684-10.072) was the major predictor in the multivariate analysis. In-hospital recovery from AKI occurred in 58.1%, within a median of 7 days. Conclusions: COL-induced nephrotoxicity occurred significantly more often in patients older than 60 y of age and was related to low initial GFR estimations and high CCI scores, which were basically determined by age

Compliance with Guidelines for Practices of Perioperative Antimicrobial Prophylaxis: A Multicenter Survey

Amaç: Bu çalışmada perioperatif antimikrobiyal profilaksi (PAP) uygulamalarında güncel rehberlere uyum oranlarını ve bu oranları etkileyen faktörleri belirlemeyi amaçladık.Gereç ve Yöntemler: 30 Mayıs - 30 Haziran 2013 tarihleri arasında 15 farklı merkezde uygulanan ankete yedi farklı branştan 410 cerrah katıldı. Çoktan seçmeli ve açık uçlu 40 soru içeren anketler yüz yüze görüşme yöntemiyle uygulandı. Bulgular: Katılımcıların ortalama yaşı 38,01±9,1, %83,4'ü erkek idi. Ankete katılan cerrahların %46,2'si "kurumlarında cerrahi profilaksi rehberi varlığı hakkında bilgisi olmadığını," %34'ü ise "rehberin bulunduğunu ve profilaksi uygulamalarının rehbere uygun olduğunu" belirtti. Ankete katılan cerrahların %56,1'inin kurum içinde cerrahi profilaksi konusunda herhangi bir eğitim toplantısına katılmadığı, son üç yıl içinde cerrahi profilaksi eğitimi alanlarda rehbere uyumun istatistiksel olarak daha yüksek olduğu belirlendi (p <0,001). Kardiyovasküler cerrahlarda uyum diğer branşlardan cerrahlara kıyasla anlamlı olarak daha yüksek saptandı (p=0,012). Uygulanan profilaksinin süresi katılımcıların %56'sında 24 saatten daha uzun idi. Dren kullanılan girişimlerde cerrahların %63,7'sinin cerrahi profilaksiyi dren çekildikten sonra sonlandırdığı belirlendi. Ürologların ikinci kuşak ve üçüncü kuşak sefalosporinleri anlamlı olarak (p<0,001; p=0,002) daha sık kullandığı belirlendi. Cerrahların %87,6'sı cerrahi profilakside kullanılan antibiyotikte rotasyonel değişiklik yapmadığını ifade etti. Merkezlerin %33'ünde 24 saat enfeksiyon konsültasyonu ve mikrobiyoloji laboratuvarı olanağı bulunmadığı belirtildi. Katılımcıların %50'si "Cerrahi profilaksi rehberlerine uyumu engelleyen en önemli nedenler nelerdir?" sorusunu yanıtsız bıraktı. En önemli nedenler; "çalışılan kurumdaki hastane enfeksiyonları ve etken mikroorganizmalar hakkında düzenli bilgi verilmemesi" (%30), "profilaktik ilacın sağlık personeli tarafından planlanan zaman ve dozda uygulanmaması" (%27) ve kurum içi PAP rehberinin hekim tarafından yetersiz bulunması (%17) şeklinde belirlendi.Tartışma ve Sonuç: Kanıta dayalı PAP uygulamalarının yerleşebilmesi için bilimsel rehberler ve kurum içi kılavuzların varlığı kadar cerrahi birimlerin bu kılavuzların hazırlık aşamasına etkin katılımı ve ayrıca düzenli eğitim ve geri bildirim toplantıları ile branşlar arası aktif iletişimin sürdürülmesi de son derece önemlidir.Aim: We aimed to determine the rates of compliance with current guidelines for practices of perioperative antimicrobial prophylaxis (PAP) and the factors affecting these rates.Materials and Methods: Four hundred and ten surgeons from seven different branches attended the survey conducted between May 30 and June 30, 2013, in fifteen different centers. A 40-question questionnaire consisting of multiple choice and open-ended questions was prepared and applied by interviewing the surgeons. Results: The mean age was 38.01 &plusmn; 9.1 years; and 83.4% of the participants were male. Of the surveyed surgeons 46.2% stated that they had no information about the existence of any guidelines for surgical prophylaxis in their institutions and 34% stated that institutional guidelines were available and their prophylaxis practices were in accordance with them. Surgeons who were trained on surgical prophylaxis within the last three years were found to have a statistically higher (p&lt;0.001) rate of compliance with the guidelines. Compared to surgeons from other branches, compliance rates in cardiovascular surgeons were statistically significantly higher (p=0.012). The duration of prophylaxis applied was longer than 24 hours in 56% of the participants. In procedures involving drains, 63.7% of the surgeons stated that they preferred to terminate surgical prophylaxis after removing the drainage tube. It was found that urologists used second and third generation cephalosporins statistically significantly more frequently (p&lt;0.001; p=0.002). Of the surgeons 87.6% stated that they did not rotationally change the antibiotics they used for surgical prophylaxis. It was found that 33% of the centers did not have 24-hour infection consultation and microbiology laboratory facilities. The question &quot;What are the most important reasons for failure in compliance with surgical prophylaxis guidelines?&quot; was left unanswered by 50% of the participants. The most important reasons of incompliance were found to be &quot;lack of regular feedback about hospital infections and the pathogenic microorganisms&quot; (30%), &quot;failure in application of the prophylactic agent in accordance with the timing and dosing determined by the healthcare personnel&quot; (27%), and physicians' view that institutional PAP guidelines were insufficient (17%).Discussion and Conclusion: Besides the existence of institutional guidelines for the establishment of evidence-based PAP practices, it is also crucial to provide active participation of surgical healthcare units in the preparation of these guidelines and to maintain regular training and feedback meetings and active communication between medical branches

Examination of antimicrobial effect of fluoxetine in experimental sepsis model: An in vivo study

Since most infectious diseases can develop into sepsis, it is still a major medical problem. Some in-vivo studies showed promising properties of fluoxetine in the treatment of infections. This study aims the antimicrobial effect of fluoxetine on the inflammatory process used in the treatment of sepsis-modeled rats. Besides, to investigate the efficacy of fluoxetine on modifying the antibiotic effect of imipenem in the inflammatory response. An experimental sepsis model was divided into negative control, positive control, fluoxetine 5 mg/kg, imipenem 60 mg/kg, and combined (fluoxetine; imipenem). Procalcitonin (PCT), high-sensitivity C-reactive protein (hs-CRP), lactate, myeloperoxidase activity (MPO), the inflammation markers interleukin-1 beta (IL-1 beta), interleukin-6 (IL-6), tumor necrosis factor-alfa (TNF-alpha), and monocyte chemoattractant protein-1 (MCP-1) levels were measured by enzyme-linked immunosorbent assay method. Oxidative stress markers, total oxidant status (TOS), total antioxidant status (TAS), total thiol (TT), and native thiol (NT) were measured using photometric methods. Oxidative stress index (OSI) was calculated according to TAS and TOS levels. The statistical analysis was performed by Statistical Package for Social Sciences version 22.0. After treatment with fluoxetine, imipenem, and combined groups, IL-1 beta, IL-6, TNF-alpha, MPO activity, MCP-1, hs-CRP, PCT, lactate, and the oxidative stress markers OSI, and disulfide levels were decreased (p < 0.05). The TT, NT, and TAS levels significantly statistically increased (p < 0.05). This research demonstrates that fluoxetine has effects as anti-inflammatory and antioxidant, and the combined treatment with antibioticum imipenem indicates positive synergistic effects in the experimental sepsis model.Bezmialem Vakif Universit

Retrospective Evaluation of Twenty Seven Patients with Diabetic Foot Infection

Aim: This study analyzed diabetic foot infections (DFI) in patients who were followed up in our clinic

Retrospective Evaluation of Twenty Seven Patients with Diabetic Foot Infection

Aim: This study analyzed diabetic foot infections (DFI) in patients who were followed up in our clinic. Methods: We retrospectively evaluated demographic characteristics and clinical and laboratory findings in 27 patients (12 female, 15 male) with DFI who were followed up in our clinic between June 2013 and January 2014. The foot ulcerations in the patients were classified according to Wagner’s classification. Results: The mean age of the patients was 59 years. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and white blood cell levels were found to be high in 89%, 78% and only 22% of patients, respectively. 78% of patients had grade 2 and lower grade ulcerations. Growth of methicillin-resistant Staphylococcus aureus, Enterobacter cloacae and Enterococcus spp. was encountered in five (28%) of 18 patients in whom deep tissue culture test could be performed. Conclusion: Appropriate diagnosis and treatment planning can be achieved by guiding classifications performed by regarding clinical, neurological and vascular conditions as well as ulcer depth. In follow-up of cases, ESR and CRP tests are very useful in diagnosis and treatment of the complications such as osteomyelitis, which may lead to amputation. Treatment should be conducted with a multidisciplinary approach in tertiary healthcare facilities