Role of carotid body for neuronal protection in experimental subarachnoid haemorrhage

Objective: Carotid bodies are known as main arterialchemoregulatory units. Despite well known that carotidbodies have an important role in cerebral circulation andblood pH regulation, their roles has not been investigatedin subarachnoid haemorrhage. We investigated whetherthere is neuroprotective effect of neuron density of carotidbodies on the brain in subarachnoid haemorrhage.Methods: Twenty hybrid rabbits were studied. Four ofthem were used as reference group (n=4) and the remainingwas obliged to subarachnoid haemorrhage by injectingautologous blood into their cisterna magna (n=16)and sacrificed after one month. All carotid bodies andbrains examined histopathologically using by stereologicmethods. The relationship between the neuronal densityof carotid body and degenerated neuron density of thehippocampus were compared statistically.Results: Five rabbits with subarachnoid haemorrhagedead during the follow-up time (n=5). The average neuronaldensity of carotid body was 4500±500 cells/mm3and of hippocampus 170.000±17.000 cell/mm3 in normalrabbit family. The degenerated neuron density ofthe hippocampus was 20.000±3.000 cells/mm3 in rabbitswith have high neuron density of carotid body and was65.000±8.000 cells/mm3 in rabbits with low neuron densityof carotid body. The differences between the neuronaldensity of carotid body and the degenerated neuron numbersof the hippocampus were significant.Conclusion: The neuron density of carotid body mayplay an important role on the protection of brain in subarachnoidhaemorrhage.Key words: Subarachnoid haemorrhage, carotid body,hippocampus, neurodegeneration, cerebral ischemi

Hemovigilance Questionnaire in Pediatric Emergency and Pediatric Intensive Care Units

Introduction:Hemovigilance is a monitoring procedure that covers all transfusion steps from the collection of blood and blood components to the follow-up of end recipients. This procedure provides information about unexpected and undesirable effects caused by the use of blood products and evaluates them, and aims to prevent their occurrence and recurrence.Methods:Data were collected by filling in the questionnaire form created to determine the level of knowledge of pediatric emergency and pediatric intensive care nurses on blood and blood products transfusion via the online access link.Results:A total of 45 people answered the questionnaire sent. It was learned that 88.9% of the participants in the study completed undergraduate and graduate degrees. Of the responding nurses, 31 (68.9%) reported that there were hemovigilance nurses in their hospitals, and 39 (86.7%) received in-service training on the use of blood and blood products. The questions that the nurses gave the most wrong answers were about the storage periods of blood products. The question “If it is not transfused how long can the blood product be stored in the refrigerator for the longest time?” was answered correctly at a rate of 40%. The correct answer was 33.3% to the question “How long is fresh frozen plasma stored after thawing” and 20% to the question “What are the storage conditions of thrombocyte suspension”. All the nurses answered, “If there is a reaction during transfusion, I will stop the transfusion”.Conclusion:The hemovigilance system has emerged as a tool to increase the quality and safety of transfusions. This study provides data on the knowledge gaps of nurses who care for critically ill children. We think that the educations will contribute to hemovigilance practices by increasing the knowledge level of transfusion with both national-level pieces of training and in-service training for healthcare personnel

Intrahospital Transport Practice in Pediatric Intensive Care Units

Introduction:Critically ill children often require transport during diagnosis and treatment procedures during intensive care hospitalization. With this study, it was aimed to evaluate the practice of transport and the problems encountered during transport in pediatric intensive care units in Turkey.Methods:A questionnaire consisting of 18 questions was filled in with internet access by the head nurses of the pediatric intensive care unit, who agreed to participate in the study. Responses to questions about the characteristics of the participating centers, transport practices, problems encountered during transport, interventions and the registration system were evaluated.Results:A total of 29 tertiary pediatric intensive care units from 8 provinces in Turkey were included in the study. The mean number of beds was 14. In most pediatric intensive care units, 5 to 10 patients (51.7%) were transferred within 1 week. It was observed that the most patients were transported to the inpatient service (89.7%), followed by the operating room (69%). There was a protocol for patient transport in 69% of the units. The transport decision was made by the responsible specialist physician at a rate of 96.6%. 65% of the participants stated that the transport was recorded on a form. Transports were accompanied by 93% nurses, 86% allied health personnel, and 79% doctors. In 20 centers (69%), transport was possible with an invasive mechanical ventilator and 11 (37.9%) with a non-invasive mechanical ventilator. The most common problem encountered during transportation was the inadequacy of the physical conditions of the hospital (48.3%). There were 4 (13.8%) participants who encountered problems during patient transport in the last week. It was stated that the oxygen tube was depleted in one of them, and respiratory arrest developed in another patient.Conclusion:In this study, it was shown that; In our country, there are significant differences in intrahospital transport conditions, transport teams, equipment used during transport between centers. Transport standards should be established and these should take into account the conditions of our country. For these, compliance and monitoring mechanisms should be established

Travayda lavman uygulamasının; travay sürecine, anne ve yenidoğan sağlığına etkisi

TRAVAYDA LAVMAN UYGULAMASININ; TRAVAY SÜRECİNE, ANNE VE YENİDOĞAN SAĞLIĞINA ETKİSİAdı Soyadı: Nazan AYDIN KARAHANDanışman Adı: Doç. Dr. Nurdan DEMİRCİKabul Tarihi: 24.11.2003Program: Yüksek Lisans Anabilim Dalı: Doğum ve Kadın Hastalıkları HemşireliğiÖZETDoğum yapmak için hastaneye başvuran gebelere, travayın erken döneminde, fetal başın inişini kolaylaştırmak, uterus kontraksiyonlarını uyarmak, doğum anında fekal içerikle kontaminasyonu önleyerek anne ve bebekte enfeksiyon riskini azaltmak amacıyla, rutin olarak lavman uygulanmaktadır. Fakat bazı kaynaklar ve araştırmacılar, travayda rutin lavman uygulamanın yararsız hatta zararlı olduğu konusunda yeni görüşler ileri sürmektedir.Çalışmamız, kanıt temelli bakımın rehberliğiyle, travayda lavman uygulamasının; travay sürecine, anne ve yenidoğan sağlığına etkilerini saptamak amacıyla, randomize, kontrollü çalışma tipinde planlanmıştır.Araştırmamızın evrenini Sağlık Bakanlığı Zeynep Kamil Kadın ve Çocuk Hastalıkları Eğitim ve Araştırma Hastanesi'ne 01 Mart - 01 Haziran 2004 tarihleri arasında doğum yapmak için başvuran tüm gebeler, örneklemini ise, 37. gestasyon haftasında veya daha ileri gebeliği olan, gebelikle ilgili herhangi bir komplikasyonu bulunmayan, çoğul gebelik, EMR, vaginal kanaması, pozisyon ve prezantasyon anomalisi olmayan ve çalışmaya katılmaya gönüllü olan 120 gebe kadın oluşturmuştur. Bu kriterlere uyan, 60 primipar ve 60 multipar gebe, iki ayrı grup olacak şekilde randomize edilerek ele alınmıştır. Lavman yapılmayan 30 primipar ve 30 multipar gebe çalışma grubunu, lavman yapılan 30 primipar, 30 multipar gebe kontrol grubunu oluşturmuştur. Hastane protokol numarasının son rakamı tek olan gebeler çalışma grubuna, çift olan gebeler kontrol grubuna alınmış ve gruplarda vaka sayısı tamamlanıncaya kadar bu işleme devam edilmiştir. Araştırmanın uygulanmasına, araştırmanın yapılacağı kurumdan ve Marmara Üniversitesi Tıp Fakültesi Araştırma Etik Kurulundan izin alındıktan sonra başlanmıştır. Araştırmamızda kontrol grubuna tek kullanımlık, gliserin ve sorbitol içeren, hiperosmotik temizleyici lavman (Ticari adı: Kansilak) uygulanmıştırVerilerin toplanmasında, araştırmacı tarafından, literatür bilgisine dayanılarak geliştirilmiş olan, travay ve doğum, erken postpartum dönem ve postpartum döneme ilişkin verilerin toplandığı veri toplama formları, Gebelikte Konstipasyon Tanılama Ölçeği, epizyotomi yara iyileşmesini değerlendiren REEDA Skalası ve Obstetrik Değerlendirme Formu kullanılmıştır. Elde edilen veriler; yüzdelik, standart sapma, Cronbach alpha tutarlılık kat sayıları, Chi Square (ki kare) ve Mann Witney U, Kruskal Wallis testleri kullanılarak değerlendirilmiştir. Çalışmamızda; lavman yapılmayan çalışma grubundaki gebelerin % 71.7'sinin, lavman yapılan kontrol grubundaki,gebelerin ise % 48.3'ünün travayın ekspülsiyon döneminde kontamine olduğu, çalışma grubunda gebelerin % 68.3'üne, kontrol grubunda ise % 80'ine epizyotomi uygulandığı, kontrol grubunda kontraksiyonların frekansının %5 oranında arttığı, süresinin ise % 8.3 oranında uzadığı, primipar ve multipar gebelerde gruplar arasında travay süresi istatistiksel olarak anlamlı farklılık göstermesine rağmen, bu farkın kontrol grubundan kaynaklandığı, loğusaların hiç birinde perineal yara enfeksiyonu görülmediği, çalışma grubunda yalnızca 1 vakada (%0.8) yenidoğan sepsisi görüldüğü saptanmıştır. Bu bulgular, travayda lavman uygulamasının; travay süresi, kontraksiyonlar, anne ve yenidoğanda enfeksiyon görülme sıklığı üzerinde bir etkisi olmadığını, lavmanın ekspülsiyon döneminde kontaminasyonu azaltmasına rağmen, tamamen önüne geçemediğini düşündürmektedir. EFFECTS OF THE USE OF ENEMA IN LABOUR ON MOTHER AND NEWBORN HEALTH DURING THE LABOUR PERIODSUMMARYEnema is routinely applied to pregnant women, in the earlier term of labour, who come to hospital to give birth, in order to decrease the risk of infection for both the mother and baby by easing the descent of fetal head, stimulating uterus contractions, and preventing contamination with the faecal contents. However, some literature and researchers are presenting new viewpoints claiming that applying enema routinely was ineffective, even harmful.Our study, with the guidance of evidence-based care, aims to define the affects of the use of enema in labour on the mother and newborn health during the labour period. Our study was planned as a randomized, controlled type study. The scope of our research covered all pregnant women who have applied to Ministry of Health Zeynep Kamil Women and Pediatric Health Education and Research Hospital for giving birth between dates March 1 and June 1, 2004. The sample consisted 120 pregnant women who accepted to participate, and who were in 37th or further week of gestation week, who had no pregnancy-related complications, and who did not have any of the following conditions: multiple pregnancy, EMR, vaginal bleeding, and position and presentation anomaly. 60 primigravida and 60 multigravida pregnant women that met the criteria were separated in to two groups and were studied in randomized method. 30 primigravida and 30 multigravida pregnant women who have not been applied enema formed the study group, and 30 primigravida and 30 multigravida pregnant women who have been applied enema formed the control group. Women with hospital protocol code ending with odd numbers composed the control group, and those with even numbers the study group, and this process was maintained until the subject number was obtained. Consents were received from the institution and from the Ethical Board of Marmara University Faculty of Medicine, prior to the research studies. Disposable, hyperosmotic cleaner enemas that contain glycerin and sorbitol were used during the research (Trade mark: Kansilak).Constipation Assessment Scale for Pregnancy, REEDA scale that assess episiotomy wound healing, Obstetric Assessment Form, and a data gathering form, developed by the researcher in the light of literature information, which includes data related to labour and preterm birth, early postpartum period and postpartum period, were used for data gathering. The collected data were evaluated by percentage, standard deviation, Cronbach Alpha Consistency coefficients, Chi Square, and Mann Witney U, Kruskal Wallis tests. In our study, we noted that in 71.7% of the pregnant women in the study group to whom enemas were not applied, and in 48.3% of the women who were applied enemas, labours were contaminated in expulsion period. For 68.3% of the women in the study group and 80% in the control group episiotomies were applied. The frequency of contraindications increased with a rate of 5% in the control group, and the period increased 8.3%. Although, in primigravida and multigravida pregnant women, the labour period was statistically significant between the groups, it was defined that this difference stemmed from the control group, and no perineal wound infections was seen puerparae women, with only one report of newborn sepsis (%0.8) from the work group. These findings suggest that the use of enema in in labour had no affect on the labour duration, contractions, infection prevalence in mother and the newborn, and that the use of enema, though it decreases the contamination, does not completely prevent contamination in the expulsion period

Travayda lavman uygulamasının; travay sürecine, anne ve yenidoğan sağlığına etkisi

TRAVAYDA LAVMAN UYGULAMASININ; TRAVAY SÜRECİNE, ANNE VE YENİDOĞAN SAĞLIĞINA ETKİSİ Adı Soyadı: Nazan AYDIN KARAHAN Danışman Adı: Doç. Dr. Nurdan DEMİRCİ Kabul Tarihi: 24.11.2003 Program: Yüksek Lisans Anabilim Dalı: Doğum ve Kadın Hastalıkları Hemşireliği Doğum yapmak için hastaneye başvuran gebelere, travayın erken döneminde, fetal başın inişini kolaylaştırmak, uterus kontraksiyonlarını uyarmak, doğum anında fekal içerikle kontaminasyonu önleyerek anne ve bebekte enfeksiyon riskini azaltmak amacıyla, rutin olarak lavman uygulanmaktadır. Fakat bazı kaynaklar ve araştırmacılar, travayda rutin lavman uygulamanın yararsız hatta zararlı olduğu konusunda yeni görüşler ileri sürmektedir. Çalışmamız, kanıt temelli bakımın rehberliğiyle, travayda lavman uygulamasının; travay sürecine, anne ve yenidoğan sağlığına etkilerini saptamak amacıyla, randomize, kontrollü çalışma tipinde planlanmıştır. Araştırmamızın evrenini Sağlık Bakanlığı Zeynep Kamil Kadın ve Çocuk Hastalıkları Eğitim ve Araştırma Hastanesi'ne 01 Mart - 01 Haziran 2004 tarihleri arasında doğum yapmak için başvuran tüm gebeler, örneklemini ise, 37. gestasyon haftasında veya daha ileri gebeliği olan, gebelikle ilgili herhangi bir komplikasyonu bulunmayan, çoğul gebelik, EMR, vaginal kanaması, pozisyon ve prezantasyon anomalisi olmayan ve çalışmaya katılmaya gönüllü olan 120 gebe kadın oluşturmuştur. Bu kriterlere uyan, 60 primipar ve 60 multipar gebe, iki ayrı grup olacak şekilde randomize edilerek ele alınmıştır. Lavman yapılmayan 30 primipar ve 30 multipar gebe çalışma grubunu, lavman yapılan 30 primipar, 30 multipar gebe kontrol grubunu oluşturmuştur. Hastane protokol numarasının son rakamı tek olan gebeler çalışma grubuna, çift olan gebeler kontrol grubuna alınmış ve gruplarda vaka sayısı tamamlanıncaya kadar bu işleme devam edilmiştir. Araştırmanın uygulanmasına, araştırmanın yapılacağı kurumdan ve Marmara Üniversitesi Tıp Fakültesi Araştırma Etik Kurulundan izin alındıktan sonra başlanmıştır. Araştırmamızda kontrol grubuna tek kullanımlık, gliserin ve sorbitol içeren, hiperosmotik temizleyici lavman (Ticari adı: Kansilak) uygulanmıştır Verilerin toplanmasında, araştırmacı tarafından, literatür bilgisine dayanılarak geliştirilmiş olan, travay ve doğum, erken postpartum dönem ve postpartum döneme ilişkin verilerin toplandığı veri toplama formları, Gebelikte Konstipasyon Tanılama Ölçeği, epizyotomi yara iyileşmesini değerlendiren REEDA Skalası ve Obstetrik Değerlendirme Formu kullanılmıştır. Elde edilen veriler; yüzdelik, standart sapma, Cronbach alpha tutarlılık kat sayıları, Chi Square (ki kare) ve Mann Witney U, Kruskal Wallis testleri kullanılarak değerlendirilmiştir. Çalışmamızda; lavman yapılmayan çalışma grubundaki gebelerin % 71.7'sinin, lavman yapılan kontrol grubundaki,gebelerin ise % 48.3'ünün travayın ekspülsiyon döneminde kontamine olduğu, çalışma grubunda gebelerin % 68.3'üne, kontrol grubunda ise % 80'ine epizyotomi uygulandığı, kontrol grubunda kontraksiyonların frekansının %5 oranında arttığı, süresinin ise % 8.3 oranında uzadığı, primipar ve multipar gebelerde gruplar arasında travay süresi istatistiksel olarak anlamlı farklılık göstermesine rağmen, bu farkın kontrol grubundan kaynaklandığı, loğusaların hiç birinde perineal yara enfeksiyonu görülmediği, çalışma grubunda yalnızca 1 vakada (%0.8) yenidoğan sepsisi görüldüğü saptanmıştır. Bu bulgular, travayda lavman uygulamasının; travay süresi, kontraksiyonlar, anne ve yenidoğanda enfeksiyon görülme sıklığı üzerinde bir etkisi olmadığını, lavmanın ekspülsiyon döneminde kontaminasyonu azaltmasına rağmen, tamamen önüne geçemediğini düşündürmektedir. EFFECTS OF THE USE OF ENEMA IN LABOUR ON MOTHER AND NEWBORN HEALTH DURING THE LABOUR PERIOD SUMMARY Enema is routinely applied to pregnant women, in the earlier term of labour, who come to hospital to give birth, in order to decrease the risk of infection for both the mother and baby by easing the descent of fetal head, stimulating uterus contractions, and preventing contamination with the faecal contents. However, some literature and researchers are presenting new viewpoints claiming that applying enema routinely was ineffective, even harmful. Our study, with the guidance of evidence-based care, aims to define the affects of the use of enema in labour on the mother and newborn health during the labour period. Our study was planned as a randomized, controlled type study. The scope of our research covered all pregnant women who have applied to Ministry of Health Zeynep Kamil Women and Pediatric Health Education and Research Hospital for giving birth between dates March 1 and June 1, 2004. The sample consisted 120 pregnant women who accepted to participate, and who were in 37th or further week of gestation week, who had no pregnancy-related complications, and who did not have any of the following conditions: multiple pregnancy, EMR, vaginal bleeding, and position and presentation anomaly. 60 primigravida and 60 multigravida pregnant women that met the criteria were separated in to two groups and were studied in randomized method. 30 primigravida and 30 multigravida pregnant women who have not been applied enema formed the study group, and 30 primigravida and 30 multigravida pregnant women who have been applied enema formed the control group. Women with hospital protocol code ending with odd numbers composed the control group, and those with even numbers the study group, and this process was maintained until the subject number was obtained. Consents were received from the institution and from the Ethical Board of Marmara University Faculty of Medicine, prior to the research studies. Disposable, hyperosmotic cleaner enemas that contain glycerin and sorbitol were used during the research (Trade mark: Kansilak). Constipation Assessment Scale for Pregnancy, REEDA scale that assess episiotomy wound healing, Obstetric Assessment Form, and a data gathering form, developed by the researcher in the light of literature information, which includes data related to labour and preterm birth, early postpartum period and postpartum period, were used for data gathering. The collected data were evaluated by percentage, standard deviation, Cronbach Alpha Consistency coefficients, Chi Square, and Mann Witney U, Kruskal Wallis tests. In our study, we noted that in 71.7% of the pregnant women in the study group to whom enemas were not applied, and in 48.3% of the women who were applied enemas, labours were contaminated in expulsion period. For 68.3% of the women in the study group and 80% in the control group episiotomies were applied. The frequency of contraindications increased with a rate of 5% in the control group, and the period increased 8.3%. Although, in primigravida and multigravida pregnant women, the labour period was statistically significant between the groups, it was defined that this difference stemmed from the control group, and no perineal wound infections was seen puerparae women, with only one report of newborn sepsis (%0.8) from the work group. These findings suggest that the use of enema in in labour had no affect on the labour duration, contractions, infection prevalence in mother and the newborn, and that the use of enema, though it decreases the contamination, does not completely prevent contamination in the expulsion period

Investigating Children’s Perception of Nurses Through Their Drawings

Hospitalized children can have various fantasies about hospital, health staff, and related tools and equipment. They need to develop new coping strategies for compliance with hospitalization.This study aimed to investigate the perception of nurses by children with acute and chronic illness through their drawings. The study was carried out using a descriptive research model. “Nurses through the eyes of sick children data collection form” was used in data collection procedure. The instruction “draw a picture of a nurse, please” was used to get the children to draw a picture. The majority of the children portrayed nurses as a smiling face. The children with chronic diseases featured nurses more in their drawings and they mentioned more nurse duties. The most important sign of the progression of nursing is that the mentioning of the modern roles of nursing by the children in their drawings and expressions. As children are influenced by their emotions, thoughts, observations, and experiences while drawing pictures, nurses can determine their thoughts about the disease, hospitals, physicians, and nurses by having sick children draw pictures. © The Author(s) 2017