Delirium i praktyki pielęgniarskie oparte na dowodach naukowych: Aktualne informacje o pandemii Covid-19

Delirium is a complex neuropsychiatric syndrome characterized by an acute onset of cognitive, attention, disorientation and change in the level of consciousness. Delirium is a serious health problem that is common at all ages and medical conditions in many places from the emergency department to the operating room. Delirium symptoms can develop within hours or days and last longer than a month. Nurses have important roles in diagnosing delirium and managing the process with evidence-based practices in patient care. Delirium screening and diagnostic measurement tools used for delirium risk classification and diagnosis should be used by nurses who care for the patient day and night. High mortality in the delirium table, a long stay in the intensive care unit or in the hospital lead to high maintenance costs. The prevalence rates of delirium in patients with Covid-19 have increased. The triggering factors that cause delirium in the Covid-19 pandemic may be social distance and social isolation, deep sedation practices, high fever, prolonged mechanical ventilation, delayed extubation due to aerosol propagation anxiety, inadequate pain assessment, psychological perceptions (mass death), multiple organ dysfunctions. It is known that the application of the ABCDEF (Assessing Pain, Both Spontaneous Awakening and Breathing Trials, Choice of Drugs, Delirium monitoring/management, Early exercise/mobility, and Family Empowerment) care package is effective in the management of delirium. It is recommended to use the ABCDEF care package for delirium management in Covid-19 patients. In this review, evidence-based practices are included in the prevention of delirium and nursing care in the coronavirus (SARS-CoV-2) pandemic affecting the whole world. (JNNN 2022;11(2):74–82).Delirium to złożony zespół neuropsychiatryczny charakteryzujący się ostrym początkiem zaburzeń poznawczych, uwagi, dezorientacji i zmianą poziomu świadomości. Delirium to poważny problem zdrowotny, występujący w każdym wieku i w każdym stanie zdrowia, w wielu miejscach — od oddziału ratunkowego po salę operacyjną. Objawy delirium mogą pojawić się w ciągu kilku godzin lub dni i trwać dłużej niż miesiąc. Pielęgniarki odgrywają ważną rolę w diagnozowaniu delirium i zarządzaniu procesem, stosując w opiece nad pacjentem praktyki oparte na dowodach naukowych. Testy przesiewowe i diagnostyczne wykorzystywane do klasyfikacji ryzyka delirium i diagnozowania powinny być stosowane przez pielęgniarki, które opiekują się pacjentem w dzień i w nocy. Wysoka śmiertelność w grupie chorych z delirium, długi pobyt na oddziale intensywnej terapii lub w szpitalu prowadzą do wysokich kosztów utrzymania. Częstość występowania delirium u pacjentów z Covid-19 wzrosła. Czynnikami wyzwalającymi delirium w pandemii Covid-19 mogą być: dystans społeczny i izolacja społeczna, praktyki głębokiej sedacji, wysoka gorączka, przedłużona wentylacja mechaniczna, opóźniona ekstubacja z powodu lęku przed rozprzestrzenianiem się aerozolu, niewłaściwa ocena bólu, percepcja psychologiczna (masowa śmierć), dysfunkcje wielonarządowe. Wiadomo, że stosowanie pakietu opieki ABCDEF (ocena bólu, próby spontanicznego przebudzenia i oddychania, wybór leków, monitorowanie/zarządzanie w przypadku delirium, wczesne ćwiczenia/mobilność i wzmocnienie pozycji rodziny) jest skuteczne w postępowaniu w przypadku delirium. Zaleca się stosowanie pakietu opieki ABCDEF w leczeniu delirium u pacjentów z Covid-19. W niniejszym przeglądzie uwzględniono oparte na dowodach naukowych praktyki w zapobieganiu delirium i opiece pielęgniarskiej w pandemii koronawirusa (SARS-CoV-2) dotykającej cały świat. (PNN 2022;11(2):74–82)

Yükseköğretimin uluslararasılaşması ve küresel hareketlilik

Book Title: Internationalisation of Higher Education and Global MobilityEditor: Bernhard StreitweiserSeries: Oxford Studies in Comparative EducationPublisher: Oxford: Symposium BooksPublication Date: 2014Paperback: 320ISBN:978-1-873927-42-7Kitabın Orijinal Adı: Internationalisation of Higher Education and Global MobilityKitabın Editörü: Bernhard StreitwieserYayınevi: Oxford: Symposium BooksBasım Yılı: 2014Sayfa Sayısı: 320ISBN: 978-1-873927-42-

Thermal modifications of the heavy axial vector mesons properties

Azizi, Kazem (Dogus Author) -- Conference full title: 10th Conference on Quark Confinement and the Hadron Spectrum, Confinement 2012; Munich; Germany; 8 October 2012 through 12 October 2012We investigate the properties of the heavy axial vector χb1 and χc1 quarkonia at finite temperature. Taking into account the thermal spectral density as well as additional operators coming up at finite temperature and perturbative two-loop order corrections to the correlation function, we obtained the thermal QCD sum rules for considering particles. It is observed that the masses and decay constants almost remain unchanged with respect to the variation of the temperature up to T ≈ 100MeV, however after this point, the decay constants decrease sharply and approach approximately to zero at critical temperature. This situation may be interpreted as a signal for deconfinement phase transition and our results at zero temperature are in good consistency with the existing experimental values

Thermal properties of the heavy axial vector quarkonia

Using the additional operators coming up at finite temperature, we calculate the masses and decay constants of the P wave heavy axial-vector chi(b1) and chi(c1) quarkonia in the framework of thermal QCD sum rules. In the calculations, we take into account the perturbative two loop order alpha(s) corrections and nonperturbative effects up to the dimension four condensates. It is observed that the masses and decay constants almost remain unchanged with respect to the variation of the temperature up to T similar or equal to 100 MeV, however after this point, the decay constants decrease sharply and approach approximately to zero at critical temperature. The decreasing in values of the masses is also considerable after T similar or equal to 100 MeV

Mesons spectral functions at finite temperature

Azizi, Kazem (Dogus Author) -- It was firstly submitted to 3rd International Conference on Hadron Physics, TROIA'11.We investigate the thermal spectral densities for (pseudo)scalar and vector currents in the framework of the real time formalism when mass of two quarks are different. Such spectral densities are necessary for the phenomenological investigation of in-medium properties of hadrons. We use the quark propagator at finite temperature and calculate annihilation and scattering parts of spectral densities for above mentioned currents. The investigations show that the thermal contributions are significantly important. The obtained results at T 0 limit are in good consistency with the vacuum results.Ozyegin University, Middle East Technical University, Canakkale Onsekiz Mart University, HadronPhysics2 Consortium

Decay constants of heavy vector mesons at finite temperature

Azizi, Kazem (Dogus Author) -- 2nd International Conference on Particle PhysicsThis study deals with determination of the decay constants of heavy vector mesons in the framework of the thermal QCD sum rules. We calculate both thermal spectral density and non-perturbative contributions taking into account the traditionally existing operators at T = 0 and also additional operators appearing at finite temperature. Analysis of the obtained thermal sum rules shows that the decay constants almost remain unchanged with respect to the variation of temperature up to T ≅ 100 MeV, however after this point, they start to decrease sharply with increasing temperature

A Rare Cause of Gross Hematuria in Childhood: Renal Lymphangiectasia

Renal lymphangiectasia is a rare disorder characterized by cystic malformation of the lymphatic ducts surrounding the kidney. In this article, an adolescent who presented with painless gross hematuria, hypertension, polycythemia and who was determined to have left perirenal lymphangiectasia and ipsilateral decreased renal function on imaging studies is reported

Sick euthyroid syndrome is associated with poor prognosis in patients with ST segment elevation myocardial infarction undergoing primary percutaneous intervention

Background: Concomitant thyroid and heart disease are frequently encountered in clinical practice. There are many studies evaluating thyroid function in acute and critical conditions. Information on thyroid dysfunction in ST-segment elevation myocardial infarction (STEMI) is limited; its correlation with short and long-term outcome is not fully known.Methods: Four hundred and fifty seven patients diagnosed with STEMI in our emergency department were included in the study. Patients were divided into two groups: patients with normal thyroid function (euthyroid) and patients with thyroid dysfunction. STEMI was diagnosed with 12 derivation surface electrocardiogram. Thyroid hormone levels (TSH, free T3 and free T4) were measured. Patients with other acute coronary syndromes and endocrine pathologies except diabetes mellitus were excluded. Two patient groups were compared in terms of in-hospital and long-term outcome.Results: Out of 457, 72 (15%) patients with thyroid dysfunction were detected. The other patients were euthyroid and constituted the control group. In-hospital cardiogenic shock (15% vs. 3% in the control group; p < 0.01) and death (7% vs. 1% in the control group; p < 0.01) were more frequently observed in the thyroid dysfunction group. In the subgroup analysis, it was observed that patients with sick euthyroid syndrome have the poorest outcome. Other markers for poor outcome were anemia and renal failure.Conclusions: Thyroid dysfunction, particularly sick euthyroid syndrome, was found to be related to in-hospital and long term mortality in patients with STEMI undergoing primary percutaneous intervention

Selenyum ve Kanser

Elzem bir eser element olan ve birçok enzimatik aktivasyonun önemli bir parçası olarak görev yapan selenyum (Se) 1957 yılından itibaren önem kazanmıştır. Metabolizması çeşitli gereksinimlere göre organize edilmektedir. Yapısal komponent olarak Se, protein yapılarına katılmaktadır. Düzeyi, serum selenyum ve serum glutatyon peroksidaz aktivitesinden etkilenmektedir. Hayvansal dokularda “selenometionin” ve “selenosistein” olarak iki formda bulunmaktadır. Genel olarak proteinden zengin besinler iyi selenyum kaynağıdır. Plazmada albumine bağlı olarak taşınmaktadır. Yetersizlik olduğunda selenyumun emilimi artmaktadır. Vücutta toplam olarak 13-20 mg selenyum bulunmaktadır. Eritrositlerdeki selenyum miktarı, uzun dönem selenyum alımının bir göstergesidir; malnütrisyonda ve kanserde serum selenyum düzeylerinin düştüğü bilinmektedir. Organizmada oksidatif yaralanmalara karşı koruyucu olan glutatyon peroksidazın yapısında yer almaktadır. Selenyumun kanser ile ilişkisi üzerine birçok çalışma yapılmaktadır. Birçok kanser türü ile selenyum alım düzeyleri ve serum selenyum seviyeleri ilişkilendirilmiştir. Yapılan çalışmalar sonucunda bazı kanser çeşitlerinde selenyumun serum seviyesi düşük bulunmuştur. Selenyumun antioksidan enzim sistemindeki fonksiyonu ile dejeneratif durumların çoğu arasında bağlantı kurulmuştur. İmmün fonksiyonları arttırması, apoptozisi indüklemesi, hücre proliferasyonunu inhibe etmesi, karsinojen metabolizmasını değiştirmesi gibi birçok potansiyel mekanizmaya sahip olduğu bildirilmiştir. Epidemiyolojik çalışmalar diyetle selenyum alımı ve kolorektal kanser riski arasında ters ilişki olduğunu göstermektedir. Farklı selenyum bileşiklerinin prostat kanser hücrelerinde antiproliferatif yanıtı, apoptoz, hücre içi redoks durumunu değiştirme ve NF-KB sinyal yolunun blokajı ile sağladığını göstermektedir. Hayvan deneyleri, epidemiyolojik çalışmalar ve müdahale çalışmaları; selenyum bileşiklerinin, hem spesifik kanserlerin önlenmesinde hem de son faz kanserlerde antimutajenik etki gösterebileceğini bildirmektedir. Selenyum antikarsinojenik olarak görev alabilmekte ve immün fonksiyonları güçlendirmektedir. Bazı çalışmalar, vücuttaki selenyum düzeyi ile kanser riski arasında negatif korelasyon olduğunu bildirse de, çelişkili sonuçlar literatürde yer almaktadır. Selenyumun kanser ve kanser tedavisindeki etkinliğini belirleyebilmek için daha fazla klinik çalışmaya gereksinim duyulmaktadır. Bu derlemede vücut için elzem bir element olan selenyumun metabolizması ve işlevlerinden bahsedilerek, kanser ile ilişkisini inceleyen çalışmalar üzerinde durulacaktır