Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Factors affecting the recurrence of acute cholecystitis after treatment with percutaneous cholecystostomy

Abstract Background The aim of this study was to determine the recurrence rate of patients who did not have interval cholecystectomy after treatment with percutaneous cholecystostomy and to investigate the factors that may affect the recurrence. Methods Patients who did not undergo interval cholecystectomy after percutaneous cholecystostomy treatment between 2015 and 2021 were retrospectively screened for recurrence. Results 36.3% of the patients had recurrence. Recurrence was found more frequently in patients with fever symptoms at the time of admission to the emergency department (p = 0.003). Recurrence was found to be more frequent in those who had a previous cholecystitis attack (p = 0.016). It was determined that patients with high lipase and procalcitonin levels had statistically more frequent attacks (p = 0.043, p = 0.003). It was observed that the duration of catheter insertion was longer in patients who had relapses (p = 0.019). The cut-off value for lipase was calculated as 15.5, and the cut-off value for procalcitonin as 0.955, in order to identify patients at high risk for recurrence. In the multivariate analysis for the development of recurrence, presence of fever, a history of previous cholecystitis attack, lipase value higher than 15.5 and procalcitonin value higher than 0.955 were found to be risk factors. Conclusions Percutaneous cholecystostomy is an effective treatment method in acute cholecystitis. Insertion of the catheter within the first 24 h may reduce the recurrence rate. Recurrence is more common in the first 3 months following removal of the cholecystostomy catheter. Having a previous history of cholecystitis attack, fever symptom at the time of admission, elevated lipase and procalcitonin are risk factors for recurrence

Can Fear Of Movement, Depression And Functional Performance Be A Predictor Of Physical Activity Level In Patients With Knee Osteoarthritis?

Objectives: This study aims to explore whether fear of movement, depression and functional performance are predictors of physical activity levels in patients with knee osteoarthritis (OA). Patients and methods: A total of 200 patients (80 males, 120 females; mean age 53.23 +/- 5.99 years; range, 40 to 65 years) with knee OA participated in this cross-sectional, correlational-design study. Oxford Knee Score (OKS) was used to evaluate physical function and pain through patient perspective. Six-Minute Walk Test (6-MWT) was used to evaluate functional performance. International Physical Activity Questionnaire-Short Form (IPAQ-SF) was used to assess subjective physical activity level. A 17-item of the self-reported Tampa Scale for Kinesiophobia (TSK) questionnaire was used to determine the fear of movement level. Beck Depression Inventory (BDI) was used as a self-reported measure for depression level. Spearman correlation analysis and the linear regression model with R-square (R-2) were used to correlate and explain the total variance. Results: International Physical Activity Questionnaire-Short Form was significantly correlated to OKS (r=-0.550), 6-MWT (r=-0.561), TSK (r=-0.693) and BDI (r=-0.429) in patients with OA (p<0.001). Linear regression analysis revealed that OKS, 6-MWT test, TSK and BDI were independently associated with IPAQ-SF in predicting physical activity level in patients with knee OA (p <= 0.001; R-2 =0.621). Conclusion: This study increases the understanding of the predictors of physical activity level related to fear of movement, depression and functional performance in patients with knee OA. Improving physical activity levels in OA population is necessary to implement early treatment strategies before the disease progresses and more costly solutions are needed.WoSScopu

The relationship between sleep duration, sleep quality and dietary intake in adults

KILINC, FATMA/0000-0001-8297-958X; Karaismailoglu, Eda/0000-0003-3085-7809WOS: 000494785800001To determine the relationship of specific macro- and micro-nutrients and food groups with sleep duration and sleep quality in adults. This cross-sectional descriptive study was conducted on 2446 adults aged between 20 and 64 years in Turkey. The participants' socio-demographic characteristics, anthropometric measurements, and dietary intake (24-h recall) were taken. The Pittsburgh Sleep Quality Index was used to assess sleep quality. In the study, 48.9% of the participants were male and 51.1% were female, with an average age of 38.7 +/- 12.70 years. Total protein, meat, and processed meat product consumption rates of long sleepers were found to be lower than those of normal sleepers (p < 0.05). Saturated fat intake of short sleepers was higher than that of long sleepers (p < 0.018). Participants with good sleep quality were found to consume higher carbohydrate, fiber, beta-carotene, vitamin E, thiamine, vitamin B-6, total folate, vitamin C, calcium, magnesium, potassium, and iron compared to those with poor sleep quality (p < 0.05). When examined in terms of food groups, fruit consumption was higher in individuals with good sleep quality compared to those with poor sleep quality (p < 0.05). In this study, some macro- and micro-nutrients of the diet were found correlated with sleep duration and quality. Mechanisms mediating the relationship between sleep duration and dietary intake are multi-factorial. Because of the differences in appetite-related hormones, such as leptin and ghrelin, and hedonic factors, future studies will benefit from assessing sleep duration/quality and dietary intake

SALIVARY PRO-INFLAMMATORY CYTOKINES AND SALIVARY BACTERIAL CHALLENGE EFFECT ON DENTAL CARIES: A CLINICO-MOLECULAR CROSS-SECTIONAL STUDY (vol 1, pg 77, 2020)

[No Abstract Available]Dokuz Eylul University, Scientific Research Projects [KB.SAG.025]This work was supported by Dokuz Eylul University, Scientific Research Projects (Project Number: 2014.KB.SAG.025)

Clinical findings of patients with cystic fibrosis according to newborn screening results.

Background Cystic fibrosis (CF) is a lethal recessive genetic disease caused by loss of function associated with mutations in the CF trans-membrane conductance regulator. It is highly prevalent (approximately 1 in 3,500) in Caucasians. The aim of this study was to compare demographic and clinical features, diagnostic tests, treatments, and complications of patients with CF whose newborn screening (NBS) with twice-repeated immune reactive trypsinogen testing was positive, normal, and not performed. Methods In this study, 359 of all 1,488 CF patients recorded in the CF Registry of Turkey in 2018, who had been born through the process of NBS, were evaluated. Demographic and clinical features were compared in patients diagnosed with positive NBS (Group 1), normal (Group 2), or without NBS (Group 3). Results In Group 1, there were 299 patients, in Group 2, there were 40 patients, and in Group 3, there were 20 patients. Among all patients, the median age at diagnosis was 0.17 years. The median age at diagnosis was higher in Groups 2 and 3 than in Group 1 (P = 0.001). Fecal elastase results were higher in Group 2 (P = 0.033). The weight z-score was lower and chronic Staphylococcus aureus infection was more common in Group 3 (P = 0.017, P = 0.004, respectively). Conclusions Frequency of growth retardation and chronic S. aureus infection can be reduced with an early diagnosis using NBS. In the presence of clinical suspicion in patients with normal NBS, further analyses such as genetic testing should be performed, especially to prevent missing patients with severe mutations

Patients eligible for modulator drugs: Data from cystic fibrosis registry of Turkey

Background A better understanding of cystic fibrosis transmembrane conductance regulator biology has led to the development of modulator drugs such as ivacaftor, lumacaftor-ivacaftor, tezacaftor-ivacaftor, and elexacaftor-tezacaftor-ivacaftor. This cross-sectional study evaluated cystic fibrosis (CF) patients eligible for modulator drugs