Učinak cjepiva COVID-19 na pneumotoraks kod gerijatrijskih bolesnika hospitaliziranih u jedinici intezivnog liječenja zbog COVID-19

In our study, we examined the effect of COVID-19 vaccination on the incidence of pneumothorax in intensive care patients over age 65. COVID-19 intensive care patients that presented to our department between April 2020 and May 2021 during the COVID-19 pandemic were evaluated retrospectively. Patients were divided into two main groups, i.e., before and after the vaccination period. Patients were evaluated retrospectively for the following parameters: gender, age, side of pneumothorax, mortality, discharge, comorbidity, and additional pleural complications. The total number of patients was 87, i.e., 66 patients before vaccination and 21 patients after vaccination. When patients in the pre- and post-vaccination period were compared, there was a significant difference in the incidence of pneumothorax between the two groups (p<0.05). Pneumothorax was less common after vaccination. When patients with pneumothorax and tube thoracostomy were evaluated according to pre- and post-vaccination mortality, mortality was significantly higher (89%) in the pre-vaccination period (p<0.05). We consider that COVID-19 vaccines used in patients aged over 65 reduced the incidence of pleural complications, especially pneumothorax. We think that mortality due to pneumothorax in patients over 65 years of age was lower during the vaccination period. In addition, we think that bilateral pneumothorax was more common in the non-vaccinated period. As a result, we think that life-threatening pneumothorax and similar complications could be reduced by increasing the number of vaccines made in the COVID-19 pandemic and spreading it around the world.U našem istraživanju ispitali smo učinak cijepljenja protiv COVID-19 na incidenciju pneumotoraksa kod bolesnika starijih od 65 godina hospitaliziranih u jedinici intenzivnog liječenja. Provedena je retrospektivna analiza bolesnika primljenih u jedinicu intenzivnog liječenja od travnja 2020. do svibnja 2021. godine. Bolesnici su podijeljeni u dvije glavne skupine: prije i nakon cijepljenja, a promatrani su sljedeći parametri: spol, dob, strana pneumotoraksa, smrtnost, otpust iz bolnice, supostojeće bolesti i dodatne pleuralne komplikacije. Ukupno je bilo 87 bolesnika, 66 prije cijepljenja i 21 nakon cijepljenja. Usporedba bolesnika primljenih prije i nakon razdoblja cijepljenja pokazala je značajnu razliku u incidenciji pneumotoraksa (p<0,05). Pneumotoraks je bio rjeđi nakon cijepljenja. Usporedba smrtnosti prije i nakon cijepljenja kod bolesnika s pneumotoraksom i torakostomijom pokazala je značajno veću smrtnost (89%) u razdoblju prije cijepljenja (p<0,05). Smatramo da cjepivo protiv COVID-19 kod bolesnika starijih od 65 godina snižava incidenciju pleuralnih komplikacija, osobito pneumotoraksa. Smrtnost zbog pneumotoraksa kod bolesnika starijih od 65 godina bila je niža tijekom razdoblja cijepljenja. Uz to, obostrani pneumotoraks bio je češći u vremenu prije cijepljenja. Stoga smatramo da se pneumotoraks i slične za život opasne komplikacije mogu smanjiti većom stopom cijepljenja tijekom pandemije COVID-19 širom svijeta

Turkish Version of the Motivation for Changing Lifestyle and Health Behavior for Reducing the Risk of Dementia Scale

Objective: This methodological study evaluates the validity and reliability of the Motivation for Changing Life Style and Health Behavior for Reducing the Risk of Dementia scale in Turkish. Methods: The study enrolled 220 individuals aged 40 years and older between September 2017 and June 2018. The Kendall W analysis and content validity index were used for validity; test-retest and confirmatory factor analyses were used for the reliability analysis. Results: The Turkish version of the Motivation for Changing Life Style and Health Behavior for Reducing the Risk of Dementia scale has valid content. The Cronbach ! coefficient of the scale was.809, and the subscales were in the ranges of.781 to.609. A statistically significant, positive correlation was found between the test and retest scores. Conclusions: These results show that the scale has validity and reliability for use in the Turkish population

Determining Middle-Aged and Older Adults' Health Beliefs to Change Lifestyle and Health Behavior for Dementia Risk Reduction

Background

Surgical management of patients with post-entubation tracheal stenosis (PETS): A single center experience

Post-entubation tracheal stenosis(PETS) is observed in patients who are hospitalized in the intensive care unit due to various etiological reasons and who are exposed to prolonged intubation during follow-up as a result of the pressure applied to the tracheal mucosa to cause necrosis or scarring in the trachea. In our study,we aimed to retrospectively evaluate the results of patients who underwent dilatation with rigid bronchoscopy and those whose conditions did not improve despite dilatation and underwent tracheal resection and reconstruction, and compare the with the literature. This study was conducted to retrospectively analyze the data of 20 patients who underwent surgical intervention due to PETS between 2019-2022.The patients were divided into 2 groups according to the Cotton Myer PETS index of the data obtained as a result of measuring the diameter of the stenotic tracheal segment according to bronchoscopic and CT measurements. When the patients were classified according to the post-intubation tracheal stenosis classification described by Cotton Myer,it was seen that 7 patients were Grade 1.10 patients were Grade 2 and 3 patients were Grade 3. Tracheal resection and reconstruction surgery is a difficult procedure and requires surgical experience due to the lack of experienced anesthesia team in every center.For this reason,we recommend sequential bronchoscopic dilatation in patients with comorbidity who are not suitable for tracheal resection and in grade 1 patients. However, we suggest that tracheal resection and reconstruction surgery should be performed after appropriate preoperative preparation in patients with grade 2 and 3 without comorbidity. [Med-Science 2022; 11(4.000): 1711-4

The effect of transcutaneous electric nerve stimulation on chronic postoperative pain and long-term quality of life

Background: This study aims to investigate the effects of transcutaneous electrical nerve stimulation on early-stage postoperative pain and long-term quality of life in patients undergoing thoracotomy

The Usefulness of Serum Brain Damage Biomarkers in Detection and Evaluation of Hypoxic Ischemic Encephalopathy in Calves with Perinatal Asphyxia

The purpose of the present study was to determine hypoxic brain damage in calves with perinatal asphyxia using brain-specific damage biomarkers. Ten healthy and 25 calves with perinatal asphyxia were enrolled in the study. Clinical examination, neurological status score, and laboratory analysis were performed at admission, 24, 48, and 72 h. Serum concentrations of ubiquitin carboxy-terminal hydrolysis 1 (UCHL1), calcium-binding protein B (S100B), adrenomodullin (ADM), activitin A (ACTA), neuron-specific enolase (NSE), glial fibrillary acidic protein (GFAP) and creatine kinase-brain (CK-B) were measured. Histopathological and immunohistochemical examinations of the brain tissue were performed in 13 nonsurvivor calves. The neurological status score of the calves with asphyxia was significantly (p p p < 0.05) in calves with asphyxia. Histopathological and immunohistochemical examinations confirmed the development of mild to severe hypoxic-ischemic encephalopathy. In conclusion, asphyxia and hypoxemia caused hypoxic-ischemic encephalopathy in perinatal calves. UCHL1 and S100B concentrations were found to be useful markers for the determination of hypoxic-ischemic encephalopathy in calves with perinatal asphyxia. Neurological status scores and some blood gas parameters were helpful in mortality prediction

The frequency of and factors affecting functional gastrointestinal disorders in infants that presented to tertiary care hospitals

This study aimed to determine the prevalence of infantile functional gastrointestinal disorders (FGIDs) based on Rome IV diagnostic criteria, and to determine the associated patient demographic and nutritional characteristics. A total of 2383 infants aged 1-12 months which were evaluated by 28 general pediatricians and pediatric gastroenterologists on the same day at nine tertiary care hospitals around Istanbul, Turkey, between November 2017 and March 2018, were included in the study. Patients included consulted the pediatric outpatient clinics because of any complaints, but not for vaccines and/or routine well child follow-ups as this is not part of the activities in the tertiary care hospitals. The patients were diagnosed with FGIDs based on Rome IV diagnostic criteria. The patients were divided into a FGID group and non-FGID group, and anthropometric measurements, physical examination findings, nutritional status, risk factors, and symptoms related to FGIDs were evaluated using questionnaires. Among the 2383 infants included, 837 (35.1%) had >= 1 FGIDs, of which 260 (31%) had already presented to hospital with symptoms of FGIDs and 577 (69%) presented to hospital with other symptoms, but were diagnosed with FGIDs by a pediatrician. Infant colic (19.2%), infant regurgitation (13.4%), and infant dyschezia (9.8%) were the most common FGIDs. One FGID was present in 76%, and >= 2 FGIDs were diagnosed in 24%. The frequency of early supplementary feeding was higher in the infants in the FGID group aged <= 6 months than in the non-FGID group (P = 0.039)

Antifungal consumption, indications and selection of antifungal drugs in paediatric tertiary hospitals in Turkey: Results from the first national point prevalence survey

WOS: 000452555000048PubMed ID: 30121343Objectives: The aim of this point prevalence survey was to evaluate the consumption, indications and strategies of antifungal therapy in the paediatric population in Turkey. Methods: A point prevalence study was performed at 25 hospitals. In addition to general data on paediatric units of the institutes, the generic name and indication of antifungal drugs, the presence of fungal isolation and susceptibility patterns, and the presence of galactomannan test and high-resolution computed tomography (HRCT) results were reviewed. Results: A total of 3338 hospitalised patients were evaluated. The number of antifungal drugs prescribed was 314 in 301 patients (9.0%). Antifungal drugs were mostly prescribed in paediatric haematology and oncology (PHO) units (35.2%), followed by neonatal ICUs (NICUs) (19.6%), paediatric services (18.3%), paediatric ICUs (PICUs) (14.6%) and haematopoietic stem cell transplantation (HSCT) units (7.3%). Antifungals were used for prophylaxis in 147 patients (48.8%) and for treatment in 154 patients (50.0%). The antifungal treatment strategy in 154 patients was empirical in 77 (50.0%), diagnostic-driven in 29 (18.8%) and targeted in 48 (31.2%). At the point of decision-making for diagnostic-driven antifungal therapy in 29 patients, HRCT had not been performed in 1 patient (3.4%) and galactomannan test results were not available in 12 patients (41.4%). Thirteen patients (8.4%) were receiving eight different antifungal combination therapies. Conclusion: The majority of antifungal drugs for treatment and prophylaxis were prescribed in PHO and HSCT units (42.5%), followed by ICUs. Thus, antifungal stewardship programmes should mainly focus on these patients within the availability of diagnostic tests of each hospital. (C) 2018 International Society for Chemotherapy of Infection and Cancer. Published by Elsevier Ltd. All rights reserved