Assesment of Patient Satisfaction of Implantable Venous Port Catheter Use: a Survey-Based Study

DergiPark: 379064tmsjAims: Implantable venous port catheter is a widely used clinical tool with plenty of objectives such as parenteral nutrition, taking blood sample, management of medicines used in chemotherapy. The aim of this study is to evaluate patient satisfaction regarding implantable venous port catheter for chemotherapy treatment.Methods: The data of 19 patients operated from March 2017 to June 2017 were analyzed as a survey based assessment in Trakya University Hospital Department of Thoracic Surgery. Age, gender, satisfaction of having an implantable venous port catheter, the level of pain during implantation, being informed before the operation, fear of having a complication due to the implantable venous port catheter, being uncomfortable about having an implantable venous port catheter and not liking the appearance of implantable venous port catheter were included on the survey. The type and stage of cancer, comorbidity and the vein which is a port catheter was implanted in were recorded from patient charts. Results: The mean age of participants was 61.44 ± 7.493 years. Out of all 10 (52.6%) were male and 9 (47.4%) were female. The most utilized side during insertion was right jugular vein (94.4%). Rectum cancer was the most diagnosed cancer type with six patients. The most seen cancer stage was found to be stage-4-IV (66.7%). Comorbidity was detected in 15 patients (83.3%). 89.5% of patients had indicated that they were informed enough before the procedure. 57.9% of the patients responded to question of fear of complication as “yes”. According to these responses, 52.6% of the patients emphasized their discomfort as “little”.Conclusion: This survey-based assessment study points out that most of the cancer patients are contented for being implanted with an implantable venous port catheter. Having an implantable venous port catheter is safer and easier way for cancer patients. Moreover, it gives patients more freedom of movemen

The Evaluation of Patients With Multiple Level Spinal Fractures Admitted to a Single Institution: a Retrospective Study

DergiPark: 421248tmsjAims: The aim of this study is to evaluate the data of the patients who are diagnosed with multiple level spinal fracturesand to find out the most common level of fractures. Furthermore, this data will be examined regarding patients’age, gender, fracture type, cause of the injury, and type of the treatment in order to get a baseline data to improvefuture outcomes.Methods: The data of 42 patients who were diagnosed with multiple spinal fractures in Trakya University Facultyof Medicine Department of Orthopedics and Traumatology in between 2012 and 2017 was analyzed retrospectively.In order to understand the incidence of multiple spinal fractures in both genders, type of the treatment and cause ofthe injury, descriptive analysis as arithmetic mean ± standard deviation, number and percentages, median (mini¬-mum-maximum) were used.Results: There were 42 patients including 32 (76.2%) men and 10 (23.8%) women with a mean age of 41 years.The most common level of injury was T12 (17.5%). The incidence of T11-L1 fractures is 62.1%. 20 (47.6%) of thefractures were caused by motor vehicle accidents. 26 patients were treated surgically and 13 patients had conservativetreatment.Conclusion: Multiple level spinal fracture is a very important clinical problem. It is seen mostly in men andmiddle-aged population. Thoracolumbar transition (T11-L2) is the most affected region due to the biomechanicsof vertebral column. The most common causes of the multiple spinal fractures are motor vehicle accidents and falls.Management of multiple level spinal fractures are based on surgical or conservative treatment modalities. Choosingthe correct treatment option for a patient with multiple level spinal fractures depends on several factor

Evaluation of Malnutrition Statuses in Systolic Heart Failure Patients

DergiPark: 539664tmsjAims: The aim of this study is to determine the malnutrition statuses of patients with systolic heart failure in Trakya University Hospital and Edirne Sultan 1st Murat State Hospital.Methods: Mini Nutritional Assessment was used to determine the patients’ malnutrition statuses. In addition, patients’ transthoracic echocardiography results, biochemistry tests, hemograms, medications and habits were evaluated with patients’ nutritional scores. One-way ANOVA and Kruskal-Wallis tests were used for comparing the results and Pearson?2 test and Fischer’s exact test were used to obtain categorical data. Results: The total number of subjects in the study was 66 (61 patients from Trakya University Hospital; 5 patients from Edirne Sultan 1st Murat State Hospital). The mean age of all subjects was 65.3 ± 11.1. Out of all patients, 17 of them were female, while 49 of them were male. The mean Mini Nutrition Assessment score was 21.9 ± 4.7. In total, 34 patients had an adequate nutritional status, 25 patients were at risk of malnutrition and 7 patients were malnourished. Conclusion: Although malnourished patients were detected, well – nourished patients were higher. Therefore, it could be said that patients with heart failure are conscious of their health and diet. It is crucial for the health care providers to maintain giving advices on healthy living and nutrition to keep this elderly population well–nourishe

Investigation of the Parameters That May Predict Hemodialysis Frequency

DergiPark: 819242tmsjAims: This study investigates the relationship between the clinical parameters at the beginning of hemodialysis therapy and the changing in the frequency of weekly hemodialysis sessions in ongoing treatment. Methods: The study population was composed of all of the patients that were started chronic hemodialysis treatment between January 2015 and January 2020. The patients were classified as twice-weekly (2/7) and thrice-weekly (3/7) groups according to the hemodialysis schedule at the start of treat- ment. The 3/7 group is additionally subdivided according to the dialysis schedule switches to the thrice-weekly program. Basal demographics and biochemical parameters were obtained from medical records at the start of hemodialysis. Results: The total number of subjects in the study was 433 (141 in the twice-weekly program, 292 in the thrice-weekly program). Forty-six (32.6%) patients in twice-weekly hemodialysis program were shifted to a thrice-weekly program during the follow-up. The female/ male ratio in the 2/7 program is different from the 3/7 program. Serum creatinine and C-reactive protein levels were higher in patients on the 3/7 program. Serum calcium and albumin levels were higher in patients on a 2/7 program. The statistically sig- nificant increments were found in calcium, hemoglobin, hematocrit, urea, creatinine, and potassium levels between the before and after switch results of the 3/7 group which switched from 2/7. Conclusion: Urea, creatinine, and potassium levels can guide the decision to compose a hemodialysis schedule. However, patients' future weekly treatment schedules cannot be predicted by biochemical parameters obtained at the start of hemodialysis

Impact of T Wave Amplitude in Lead Avr on Predicting Appropriate Therapies in Hypertrophic Cardiomyopathy Patients With An Implantable Cardioverter Defibrillator

DergiPark: 420837tmsjAims: Although implantable cardioverter defibrillator reduces mortality in hypertrophic cardiomyopathy patients,inappropriate implantable cardioverter defibrillator shocks are related to increased mortality. The aim of this studyis to investigate whether a new electrocardiographic marker of T wave amplitude in lead aVR can be used to predictappropriate therapy of implantable cardioverter defibrillator (shock or anti-tachycardia pacing) in hypertrophic cardiomyopathypatients.Methods: Thirty-six hypertrophic cardiomyopathy patients, who were admitted to the outpatient clinic for pacemakercontrol, with implantable cardioverter defibrillator were retrospectively examined (mean age: 51 ± 10.2 years,72.2% male). The primary endpoint was appropriate implantable cardioverter defibrillator therapy. All hematological,biochemical and electrocardiogram parameters were measured before implantable cardioverter defibrillator wasimplanted.Results: Over a median follow-up period of 33 months, 9 (25%) patients experienced appropriate implantablecardioverter defibrillator therapy. Heart rate and QRS interval were similar between groups. QT and QTc valueswere higher in patients that received appropriate shocks. Patients who have T wave inversion were higher in therapypositive group. T wave amplitude in lead aVR values were significantly associated with appropriate therapy.Conclusion: Using simple ECG parameters, we may predict arrhythmic episodes before ICD implantation and animprovement of the medical antiarrhythmic therapy might be protective for HCM patients with ICD

The Evaluation of Musculoskeletal System Tumors and Tumor Like Lesions in Thrace Region

DergiPark: 478352tmsjAims: The aim of this study is to evaluate the data belonging to patients who were diagnosed with benign or malignant soft tissue and bone tumors and tumor-like lesions evaluated by musculoskeletal tumor study group of Trakya University Faculty of Medicine in between January 2013 and June 2017 and the relationship between the frequency of benign, malignant bone and soft tissue tumors and tumor-like lesions, with the patients’ age and gender. Methods: The data of 687 patients who were evaluated by the musculoskeletal tumor study group of Trakya University Faculty of Medicine between January 2013- June 2017 were analyzed retrospectively. All of the data was analyzed by using SPSS. Chi-square analysis was used to obtain categorical data in order to point out the distribution of age and gender of patients with musculoskeletal system tumors and tumor-like lesions. Results: The number of patients over the period from January 2013 to June 2017 was 687. The number of patients who were evaluated by biopsy and acquired histopathologic confirmation of their condition was 341. The mean of patients’ ages was 44.3±21.4 (4-92). Among 341 patients, 106 (47.1%) patients were female and 119 (52.9%) patients were male. The mean of females’ ages was 43.7±20.4 (4-92). The mean of males’ ages was 44.7±22.4 (5-90). Conclusion: Benign bone and soft tissue tumors were more common than malignant tumors. Benign bone tumors were predominantly seen in young adults. Our results was consistent with the literature however due to some patients who did not need a pathological sampling, our sample size was smaller than intended. With better archived information, more consistent results could be obtained in further studies

Assessment of the Awareness and Opinions of Turkish Medical Students Towards Violence Against Women: a Questionnaire-Based Study

DergiPark: 963037tmsjAims: This study aims to evaluate the opinions of medical students about violence against women, the education they receive during medical school regarding violence against women, and how they would manage a case of violence victims if they were to encounter it in their medical careers. Methods: In this question- naire-based study, 610 medical students from 37 medical schools were approached, and their opinions towards violence against women were evaluated through an online questionnaire. Demographic data such as age and gender were also gathered. Students were grouped according to their gender (male and female) and study levels; 1st, 2nd, and 3rd grades were grouped as pre-clinical, whereas students in 4th, 5th, and 6th grades were grouped as clinical. In comparing para- metric variables, the Student’s t-test was used, whereas, in non-parametric variables, the Mann-Whitney U test was used. The Chi-square test was used in the comparison of categorical variables. Results: There was a statistically significant difference within both groups (gender and study levels) for questions 5 (Which of the following would you describe as violence? [Multiple answers are allowed.]) and 13 (Do you think female physicians are exposed to violence more?). Our results also demonstrate a statistically significant difference for questions 15 (Is it obligatory for a physician to keep a legal report for a female patient who has been admitted to the emergency department as a victim of violence), 16 (It is not obligatory for a physician to keep a legal report for a female patient who has been admitted to the emergency department as a victim of violence without her consent.), and 17 (A physician is not obliged to complete the physical examina- tion or continue the diagnosis-treatment process of a female patient who has been a subject of violence without her consent.) between pre-clinical and clinical groups, where the clinical group gave the most correct answers. Conclusion: In conclusion, our results gave us a perspective that clinical students' awareness and management of violence against women is higher than pre-clinical students'. These results may be attributed to two factors; lectures on violence against women or the experience students attain during their clinical practices. Female students were keener in participating in our study. Further prospective studies with equal gender distribution investigating the possible impact of lectures about violence against women on physicians' management of similar situations are needed

Analysis of Risk Factors in Patients Who Have Undergone Coronary Artery Bypass Grafting Surgery and Valve Replacement Surgery

DergiPark: 584639tmsjAims: The aim of the study is to investigate differences in usual cardiovascular risk factors’ and comorbidities between the patients who had undergone coronary artery bypass grafting surgery and valve replacement surgery at Cardiovascular SurgeryDepartment of Trakya University School of Medicine. Methods: In this study, patients who had coronary artery bypass graftingsurgery and valve replacement surgery at Cardiovascular Surgery Department of Trakya University School of Medicine between01.01.2018 and 31.12.2018 were analyzed retrospectively. All data regarding the type of cardiovascular operation, habits of smoking, alcohol consumption, family history, chronic diseases and laboratory findings were analyzed using R version 3.5.0. Results:The total number of patients in the study was 130. There were 106 patients who had coronary bypass grafting surgery, 90 (95.4%)of them were male and 16 (4.6%) of them were female. The number of the patients who had valve replacement surgery was 24where 15 (62.5%) of them were female and 9 (37.5%) were male. Differences in patients’ high-density lipoprotein levels, fastingblood glucose levels along with gender, habits of smoking, diabetes mellitus status and alcohol consumption between coronaryartery bypass grafting surgery and valve replacement surgery groups were found statistically significant. Conclusion: Risk factors for cardiovascular disease are very dynamic and multifactorial. In our analysis, there was a significant difference betweenrisk factors for coronary artery bypass and valve replacement surgeries including high-density lipoprotein levels, fasting bloodglucose levels, diabetes mellitus, gender and smoking status. The variability may alter according to the living standards, culture,educational status among patients. Keywords: Coronary disease, coronary artery, surgery, risk factor

Evaluating the Effects of Night Shifts on Attention and Executive Function of Trakya University Residents Using the Tower of Hanoi Test

DergiPark: 700193tmsjAims: This study aims to evaluate the effects of night shifts on attention and executive function among residents working atTrakya University Hospital. Methods: This prospective study was performed between November 2019 – January 2020 on 83residents working at Trakya University Hospital. The Tower of Hanoi test was used to measure the attention and function level oftwo different groups of residents. The first group being residents working with night shifts and the other group being residentswith regular working hours. After the participants finished solving the puzzle, the number of moves and the finishing time wererecorded. The demographic data about smoking, coffee intake, sleep hours, departments, and hand dominance were also recorded. Results: The participants were composed of 36 (43.4 %) female and 47 (56.6 %) male residents. The difference in smokingrate and sleep time between the two groups were found to be statistically significant whereas the difference between the completion time and moves was not statistically significant. Conclusion: Smoking and duration of sleep may affect the Tower of Hanoipuzzle performance. Although residents working with night shifts did not under-perform, the importance of sleep for cognitiveskills such as attention and coordination cannot be underestimated. Stress caused by night shifts may affect reaction time forproblem-solving, but further studies are needed. Keywords: Nightshift, attention, Tower of Hanoi tes