Response to Verd et al. re: "Preterm Infants May Better Tolerate Feeds at Temperatures Closer to Freshly Expressed Breast Milk: A Randomized Controlled Trial"

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Comparison of the cardiovascular risk profile of individuals with obesity and abdominal obesity

Introduction: Obesity is a worldwide public health problem. In the USA, it is the second leading cause of death after smoking and prevalence is increasing throughout the world. Obesity-related health problems have now become more important than some classic health problems such as malnutrition and infectious diseases. The medical importance of obesity emerges through the close relationship with diseases such as diabetes and coronary artery disease in particular, and other various diseases. Materials and Methods: A total of 177 individuals were included in the study comprising 84 (47.5%) males and 93 (52.5%) females, aged 15- 80 years. The patients were separated into 2 groups of abdominal obesity (n = 94) and obesity (n = 83). Abdominal obesity was defined as waist circumference > 94 cm in males and > 80 cm in females, measured at the level of the umbilicus. For the evaluation of cardiovascular risk profile, lipid profiles (cholesterol LDL, HDL, triglyceride) and inflammatory parameters (CRP and fibrinogen) were examined with early morning 12-hour fasting blood tests. Results: A statistically significant difference was determined between the groups in respect of CRP levels with CRP positivity of 41% in the obese group of 41% and 23.4% in the abdominally obese group. (p 0.05). Conclusion: The results of the current study showed no statistically significant difference between obese and abdominally obese patients in respect of HBA1c levels and lipid profile but the levels of fibrinogen and CRP were determined to be statistically significantly different. The levels of fibrinogen and CRP in the obese patients were statistically significantly higher than those of the abdominal obesity group (p < 0.05). This indicates a positive correlation between increased BMI and increasing sub-clinical inflammation markers. From the results of this study, abdominal obesity in particular can be assumed as a major risk factor for cardiovascular disease

Efficacy and Maternal Comfort of Sequential versus Simultaneous Breast Expression by Mothers of Critically III Newborns

WOS: 000418709600009Aim: Expressed breast milk is beneficial for infants in neonatal intensive care unit (NICU) when direct breastfeeding is not possible. Breast expression with manual or electric breast pumps is promoted for the initiation and maintenance of lactation in this critical period. In this study, we aimed to compare the efficacy and maternal comfort of sequential versus simultaneous breast expression in newly delivered mothers whose infants were admitted to NICU. Materials and Methods: Thirty five mothers were followed prospectively for milk expression either sequentially (n=21, group 1) or simultaneously (n=14, group 2) with breast pumps for 10 days. The total amount of milk expressed per day and per each period was recorded together with the duration of breast expression. The mothers' impressions about the easiness and comfort of the procedure, and their satisfaction with the amount of milk were evaluated with a questionnaire at the end of the study. Results: The amounts of expressed milk per day and per each expression period were similar in both groups. However, time spent for each expression period was significantly lower in the simultaneous breast expression group. Mothers in this group gave higher scores with regard to ease of use when compared to mothers in the sequential expression group (4.36 +/- 0.50 vs. 4.00 +/- 0.44, p=0.046). The mothers graded both methods with similar scores in all other parameters. Conclusion: Simultaneous breast expression is time saving while both simultaneous and sequential breast expression are similarly efficient for milk production, and both methods are helpful and tolerable in promoting breastfeeding for NICU mothers

Turkish Validity and Reliability Study of Pressure Ulcer Risk Assessment Scale: Neonatal Braden Q Scale

Amaç: Basınç yaraları, yoğun bakım ünitelerinde sık görülen, hastane yatış süresini uzatan, mortaliteyi arttıran ve tedavi giderlerini yükselten önemli bir bakım sorunudur. Yenidoğan dönemine göre geliştirilmiş olan Neonatal Braden Q Basınç Risk Değerlendirme Ölçeği’nin (NBQBRD) ise ülkemizde henüz güvenilirlik ve geçerlilik çalışması bulunmamaktadır. Konu hakkında, yenidoğan dönemine ait ülkemizde tek geçerlilik ve güvenirlilik çalışması yapılmış ve halen kullanılmakta olan Yenidoğan Cilt Risk Değerlendirme (YCRD) Ölçeğidir. Çalışmamızın amacı Türkiye’de ilk defa yenidoğan yoğun bakım ünitesinde yatarak tedavi gören bebeklerde Türkçe NBQBRD Ölçeği’nin ülkemiz için geçerlilik ve güvenirliğini değerlendirmektir. Yöntem: Yenidoğan yoğun bakım ünitesinde yatarak tedavi gören 114 olguda toplam 201 değerlendirme yapılmıştır. Verilerin toplanmasında; hasta özelliklerine ve çalışmayı sürdüren hemşirelerin bireysel özelliklerine ilişkin soru formu ve Türkçe NBQBRD Ölçeği ile birlikte paralel form testi olarak Türkçe YCRD Ölçeği kullanılmıştır. Aynı vaka eş-zamanlı olarak bakım veren hemşiresi ve araştırmacı tarafından değerlendirilmiştir. Bulgular: Çalışmada Türkçe NBQBRD Ölçeği’nin geçerli ve güvenilir olduğu, Türkçe YCRD Ölçeği ile karşılaştırıldığında klinik hemşireleri ve araştırmacı ölçümlerinin iki ölçek arasındaki korelasyon katsayısının yüksek ve aralarındaki ilişkinin ileri düzeyde anlamlı olduğu görülmüştür. Sonuç: Bu sonuçlar yenidoğan yoğun bakım ünitesinde yatmakta olan bebeklerde basınç ülseri risk değerlendirmesinde Türkçe NBQBRD Ölçeği’nin ülkemizde güvenle kullanılabileceğini göstermiştir.Objective: Pressure sore is a common care problem in intensive care units which prolongs hospital stay, increases mortality and treatment costs. Validity and reliability study of neonatal Braden Q scale, which is developed for the neonatal period, has yet not performed in our country. the only validity and reliability study for the neonatal period in Turkey was performed for the Newborn Skin Risk Assessment Scale which is currently in use. the aim of this study was to assess the validity and reliability of Turkish Neonatal Braden Q Scale in infants hospitalized firstly in the neonatal intensive care unit. Method: A total of 201 assessments were made for 114 patients who were hospitalized in the Neonatal Intensive Care Unit of Ege University Faculty of Medicine, Department of Pediatrics. in the collection of data; a questionnaire form concerning characteristics of patients and individual features of study nurses; and Neonatal Braden Q Scale together with Turkish version of Newborn Skin Risk Assessment Scale were used. the same case was evaluated simultaneously by the patient’s nurse and the investigator. Results: in this study, it was found that the Turkish verison of Neonatal Braden Q Scale is reliable and valid. the correlation coefficient was high between the two scales when clinical nurse’s and responsible investigator’s measurements was compared. Conclusion: in conclusion, Turkish version of Neonatal Braden Q Pressure Ulcer Risk Assessment Scale is reliable for the evaluation of pressure ulcer risk in infants hospitalized in the neonatal intensive care units in our country

Kritik Hasta Yenidoğanların Annelerinde Ardışık ve Eş Zamanlı Süt Sağmanın Etkinlik ve Konforu

Aim: Expressed breast milk is beneficial for infants in neonatal intensive care unit (NICU) when direct breastfeeding is not possible. Breast expression with manual or electric breast pumps is promoted for the initiation and maintenance of lactation in this critical period. in this study, we aimed to compare the efficacy and maternal comfort of sequential versus simultaneous breast expression in newly delivered mothers whose infants were admitted to NICU. Materials and Methods: Thirty five mothers were followed prospectively for milk expression either sequentially (n=21, group 1) or simultaneously (n=14, group 2) with breast pumps for 10 days. the total amount of milk expressed per day and per each period was recorded together with the duration of breast expression. the mothers' impressions about the easiness and comfort of the procedure, and their satisfaction with the amount of milk were evaluated with a questionnaire at the end of the study. Results: the amounts of expressed milk per day and per each expression period were similar in both groups. However, time spent for each expression period was significantly lower in the simultaneous breast expression group. Mothers in this group gave higher scores with regard to ease of use when compared to mothers in the sequential expression group (4.36±0.50 vs. 4.00±0.44, p=0.046). the mothers graded both methods with similar scores in all other parameters. Conclusion: Simultaneous breast expression is time saving while both simultaneous and sequential breast expression are similarly efficient for milk production, and both methods are helpful and tolerable in promoting breastfeeding for NICU mothers.Amaç: Yenidoğan yoğun bakım ünitesinde (YYBÜ) yatan bebeklerde direkt emzirme mümkün olmasa da sağılmış anne sütü çok faydalıdır. Bu kritik dönemde laktasyonun başlatılması ve sürdürülmesi için elle ya da elektrikli süt pompaları kullanılarak süt sağılması önerilir. Bu çalışmada bebekleri YYBÜ'ye yatırılan yeni doğum yapmış annelerde ardışık ve eş zamanlı süt sağmanın etkinlik ve konforunu karşılaştırmayı amaçladık. Gereç ve Yöntemler: Çalışmaya alınan 35 anne, elektrikli pompa kullanarak her iki memeden ardışık (n=21) ya da eş zamanlı (n=14) süt sağdıkları 10 gün içerisinde prospektif olarak izlendi. Süt sağma süresine ek olarak sağılan süt miktarı günlük ve her sağma için ayrı ayrı kaydedildi. Bu uygulamaların kolaylığı ve konforu konusunda annelerin görüşleri ve tatminkarlıkları çalışmanın sonunda bir anket ile değerlendirildi. Bulgular: Günlük ve her sağma girişiminde elde edilen süt miktarları gruplar arasında benzer bulundu. Her iki memeden eş zamanlı süt sağan annelerin süt sağma süreleri anlamlı olarak daha kısa bulundu. Eş zamanlı olarak her iki memeden süt sağan anneler diğerleri ile karşılaştırıldıklarında; kullanım kolaylığı yönünden daha yüksek skorlar verdiler (4,36±0,50'ye karşı 4,00±0,44, p=0,046). Anketin diğer alanlarında her iki süt sağma tekniği de benzer bulundu. Sonuç: Süt sağmak için her iki memenin eş zamanlı sağılması zaman kazandırıcı bir yöntemdir. Bununla beraber hem eş zamanlı hem de ardışık süt sağma yöntemleri; bebekleri YYBÜ'de yatan annelerde laktasyonun sağlanmasında etkin ve iyi tolere edilen yöntemlerdir