Effect of self-care agency on symptoms in patients on peritoneal dialysis

Aim: The aim of the study was to evaluate physical symptoms in patients on peritoneal dialysis treatment and to determine the relationship between the socio-demographic features affecting the symptoms and the disease and self-care. Methods: The sample of this descriptive study included 120 patients who were followed in the peritoneal dialysis clinic of 2 hospitals in the center of Trabzon. The data were collected using the "patient information form," "The Dialysis Symptom Index (DSI)," and "The Self-Care Agency Scale for Chronic Dialysis Patients." Results: In this study, 60.8% of the participants were women. The most common symptom (64.2%) was constipation. There was a significant difference in the mean DSI score between the patients supported during dialysis and those who were not and the mean DSI score was higher in the patients supported during dialysis (P < .05). In addition, there was a significant difference in terms of the mean self-care agency score between the patients supported during dialysis and the patients who were not. Contrary to the DSI mean score, the mean self-care agency score was higher in patients who were not supported during dialysis (P < .05). A significant negative correlation was found between self-care agency and DSI (r = -0.288, P < .01). Conclusion: The study demonstrated that patients lacking self-care agency have to cope with both more symptoms and more severe symptoms

Prevalence of constipation in patients undergoing chemotherapy and the effect of constipation on quality of life

Objective This study was conducted as a descriptive and cross-sectional study to determine the prevalence of constipation and the impact of constipation on quality of life in patients receiving outpatient chemotherapy. Materials and methods The data of the study were collected from 252 patients who applied to the outpatient chemotherapy unit of a university hospital between January 2021 and March 2021. The data were collected using the "Patient Information Form," "Eastern Cooperative Oncology Group (ECOG) Performance Status Scale," "Constipation Severity Scale (CSS)," "Patient Assessment of Constipation Quality of Life Questionnaire (PAC-QOL)," and "The Bristol Stool Form Scale" through face-to-face interview technique. In the analysis of data, numbers, percentile distributions, minimum and maximum values, mean values, and standard deviations, as well as t-test, were used in the comparison of paired groups in normally distributed measurements, while the analysis of variance (ANOVA) was used in the comparison of more than two groups. Results The constipation prevalence of the patients included in the study was 31.7% and the mean constipation severity score was 30.48 +/- 13.87. It was found that the quality of life of the patients due to constipation was (71.79 +/- 18.74) impacted adversely on a moderate level. A significant difference was found between sex, educational status, use of antiemetic and antiulcer medication, presence of hemorrhoid disease, ECOG score, appetite, and mean CSS and PAC-QOL scores (p < 0.05). Conclusion Constipation occurs in one-third of cancer patients receiving ambulatory chemotherapy. The severity of constipation in patients is at a moderate level and it impacts the quality of life moderately

HOPE AND LIFE ENGAGEMENT OF CANCER PATIENTS AT THE ADVANCED STAGE

Introduction: Cancer is a clinical tableau in which many complicated physical and psychological problems are encountered and the individual's defense mechanism against the process is often shaken. With the deterioration of the prognosis and the progression of the disease, individuals whose belief in healing is reduced may lose their life engagement and hope. Objective: The purpose of this cross-sectional and descriptive study is to determine the level of hope and life engagement of individuals with advanced stage cancer. Methods: The study was conducted with 74 advanced cancer patients who were hospitalized in the oncology, palliative care and surgery clinics of the Trabzon Kanuni Training and Research Hospital, fulfilled the research criteria and signed informed consent forms out of their free will. The data were collected using the "Demographic Information Form," which included subjective questions, the "Integrative Hope Scale" consisting of four subscales, and the "Life Engagement Scale" in which the level of life engagement was detected. The data were analyzed by using the SPSS program and “ANOVA,” “Independent t-test” and “Correlation test” were used to analyze the relationship between the hope and life engagement scores and variables. The value p<.05 was accepted as statistically significant. Results: The common hope level mean of the patients included in the study was 104.5±6.8 and the common life engagement mean was 23.9±4.9. Correlating the significant differences in the subscales of the scale, the variables affecting the level of hope were determined as " living place, fear of death, and despair," and the variables affecting life engagement were determined as "education status, living place, ruefulness, and needing psychological support." Conclusions: The psychosocial support and solidarity that the individual receives from other individuals in his environment and health care providers positively affects his selfconfidence, hope and life engagement. On the other hand, contrary to the meaning of "I am not afraid of dying," this statement can be considered an expression of giving up on life. Nurses should focus on the messages underlying what the patients say. Key words: Cancer, Hope, Life Engagemen

Preventing tuberculosis in children receiving anti-tnf treatment

Anti-tumor necrosis factor (TNF) treatment has been a breakthrough in the management of juvenile idiopathic arthritis (JIA). However, they are associated with a significant risk of tuberculosis. We evaluated JIA patients who received etanercept treatment from an eastern Mediterranean country with moderate tuberculosis frequency. JIA patients under anti-TNF treatment, etanercept, were enrolled to the study. Chest X-rays, Tuberculin Skin Test (TST), clinical histories, family screening, and physical examinations were reviewed retrospectively. If TST was above 10 mm in a patient with one Bacillus Calmette-Guerin, cultures and, if needed, thorax computerized tomography were obtained. These patients received 1-2 months of isoniazid (INH) treatment which was followed by an INH prophylaxis for a period of 9 months while etanercept treatment was started. All were re-evaluated within 3 months intervals. A total of 36 patients under etanercept treatment were enrolled to the study. Mean age of the patients was 14.00 years (range 4-22 years). Median duration of disease was 36.00 months (range 4-216 months). Median duration of etanercept therapy was 11.5 months (3-48 months) at final evaluation. Seven patients had an initial TST score above 10 mm. All received INH treatment as outlined above. They had normal examinations and X-rays during follow-up. With proper initial evaluation, anti-TNF treatment is safe even in countries where tuberculosis is moderately frequent. An initial 1-2 months of INH treatment followed by chemoprophylaxis for 9 months is suggested for children with a TST of > 10 mm

Efficacy of colistin and non-colistin monotherapies in multi-drug resistant acinetobacter baumannii bacteremia/sepsis

Objective: This retrospective study aimed to investigate the efficacies of colistin and non-colistin monotherapies in multi-drug resistant Acinetobacter baumannii bacteremia (MDR-AB). Materials and methods: Cases with MDR-AB from 27 tertiary-referral hospitals between January 2009 and December 2012 were included. Patients' data that were on either colistin monotherapy (CM) or non-colistin monotherapy (NCM) were compared. Mortality on Day 14 was the primary endpoint, whereas microbiological eradication and clinical outcome were the secondary ones. Results: Eighty-four cases were included in the study with 36 being in the CM group and 48 in the NCM group. Thirty-eight (45.2%) cases were male and the mean age was 60.2 years. The mean durations of pre-MDR-AB hospital stay and intensive care unit stay were 25.8 days and 20.9 days, respectively. All of the cases had fever (>38°C). The mean Pitt bacteremia score (PBS) of the patients was calculated as 6.8, APACHE 2 score as 18.9 and the Charlson co-morbidity index (CCI) as 3.7 (CM: 3.6 vs. NCM: 3.9). Twenty (55.6%) cases in the CM group and 26 cases in the NCM group (54.2%) (p=0.81) died; 9 cases in the CM group (25%) and 16 cases in the NCM group (33.3%) had treatment failure (P=0.55). Bacteriological eradication was achieved in 20 (55.6%) cases in the CM group and in 36 cases (75%) in the NCM group (P=0.061). Conclusions: No significant difference could be identified between the colistin monotherapy and non-colistin monotherapy options in MDR-AB cases with respect to the results of efficacy and 14-day mortality

Miego apnėja tarp sergančiųjų išemine širdies liga: dažnis, susiję veiksniai, sąsajos su kairiojo skilvelio morfometrijos ir funkcijos rodikliais

The purpose of the study. The purpose of this cross sectional study was to determine prevalence of sleep apnea, characteristics, association with traditional CAD risk factors and to investigate association between sleep apnea and alteration in left ven-tricular morphometry and function in CAD patients. Objectives of the study. 1. To cross-sectionally investigate prevalence of sleep apnea and differ-ences in clinical and polysomnographic characteristics in CAD pa-tients with and without sleep apnea. 2. To explore whether routine clinical features from the study of patients with CAD could predict the presence of sleep apnea by two thresholds for diagnosing (apnea-hyponea index ≥5 and ≥15). 3. To determine whether there are differences in risk factors for the pres-ence of sleep apnea between men and women with CAD. 4. To cross-sectionally investigate the association between sleep apnea and left ventricular morphometry in CAD patients. 5. To identify association between left ventricular diastolic function pa rameters and sleep apnea in CAD patients with left ventricular ejec-tion fraction ≥50%. Statements of the hypotheses. We hypothesised, that in CAD patients: 1. Sleep apnea is common in CAD patients with no previous sleep apnea diagnosis. The traditional CAD risk factors such as age, male gender, obesity and hypertension, is more prevalent among patients with sleep apnea compared with patients without sleep apnea. Significant small correlations between some polisomnographic parameters and the severity of sleep apnea could be found. 2. Using the same set of potential clinical confounders, the prognostic factors of the presence of sleep apnea differ when adapting the two cutoffs of apnea-hypopnea index for sleep apnea diagnosis. 3. The risk factors for the presence of SA in women differ from those in men. 4. Mild to moderate sleep apnea is cross-sectionally [...]

Efficacy of colistin and non-colistin monotherapies in multi-drug resistant acinetobacter baumannii bacteremia/sepsis

Objective: This retrospective study aimed to investigate the efficacies of colistin and non-colistin monotherapies in multi-drug resistant Acinetobacter baumannii bacteremia (MDR-AB). Materials and methods: Cases with MDR-AB from 27 tertiary-referral hospitals between January 2009 and December 2012 were included. Patients' data that were on either colistin monotherapy (CM) or non-colistin monotherapy (NCM) were compared. Mortality on Day 14 was the primary endpoint, whereas microbiological eradication and clinical outcome were the secondary ones. Results: Eighty-four cases were included in the study with 36 being in the CM group and 48 in the NCM group. Thirty-eight (45.2%) cases were male and the mean age was 60.2 years. The mean durations of pre-MDR-AB hospital stay and intensive care unit stay were 25.8 days and 20.9 days, respectively. All of the cases had fever (>38°C). The mean Pitt bacteremia score (PBS) of the patients was calculated as 6.8, APACHE 2 score as 18.9 and the Charlson co-morbidity index (CCI) as 3.7 (CM: 3.6 vs. NCM: 3.9). Twenty (55.6%) cases in the CM group and 26 cases in the NCM group (54.2%) (p=0.81) died; 9 cases in the CM group (25%) and 16 cases in the NCM group (33.3%) had treatment failure (P=0.55). Bacteriological eradication was achieved in 20 (55.6%) cases in the CM group and in 36 cases (75%) in the NCM group (P=0.061). Conclusions: No significant difference could be identified between the colistin monotherapy and non-colistin monotherapy options in MDR-AB cases with respect to the results of efficacy and 14-day mortality