THE EFFECT OF COVID-19 OUTBREAK ON THE MENTAL STATUS OF HEALTH CARE PROFESSIONALS IN THE PEDIATRIC INTENSIVE CARE UNIT

Background: Coronavirus disease 2019 (COVID-19) may affect the mental status of health care professionals. The purpose of our study is to evaluate the mental health effects of the COVID-19 epidemic on health care professionals in the pediatric intensive care units (PICUs). Subjects and methods: Our study was conducted prospectively between 01.04.20 and 10.04.20. The created questionnaire was applied to health care professionals through online platforms. Thus it was involved in 5 different institutions that participated from different regions of Turkey. With the questionnaire, we applied; the participants\u27 age, gender, the general status of contamination and the level of COVID-19 knowledge were questioned. Besides; Beck Anxiety Scale, Acute Stress Scale (PCL-5), STAI-1 and STAI-2 (State and Trait Anxiety Inventory 1-2) scales were used to determine the anxiety levels. Results: A survey of 210 participants, 86 (41%) doctors, 124 (59%) nurses, were included in our study. When we evaluate the Beck anxiety levels, the majority of the participants (44%) were normal, while about one third had mild anxiety. When we evaluated the acute stress scale, all participants had a certain amount of stress levels. The majority (80 people each (38%)) experienced mild and moderate acute stress. Being female and having chronic disease poses a high risk for anxiety (OR, 0.330; 95% CI, 0.087-1.250, p <0.05 and OR, 0.246; 95% CI, 0.068-1.116, p<0.05), preoccupation (OR, 0.603; 95% CI 0.261-1.395, p<0.05 and OR, 0.433; 95% CI, 0.122-1.538, p<0.05) and acute stress (OR, 0.294; 95% CI, 0.033-2.649, p<0.05 and OR, 0.317; 95 % CI 0.060-1.679, p<0.05). Professional definition, marital status and having a child do not pose any risk factors. Conclusion: Our study has shown that the COVID-19 outbreak affects the mental status of health care professionals working at PICU at various levels

THE EFFECT OF COVID-19 OUTBREAK ON THE MENTAL STATUS OF HEALTH CARE PROFESSIONALS IN THE PEDIATRIC INTENSIVE CARE UNIT

Background: Coronavirus disease 2019 (COVID-19) may affect the mental status of health care professionals. The purpose of our study is to evaluate the mental health effects of the COVID-19 epidemic on health care professionals in the pediatric intensive care units (PICUs). Subjects and methods: Our study was conducted prospectively between 01.04.20 and 10.04.20. The created questionnaire was applied to health care professionals through online platforms. Thus it was involved in 5 different institutions that participated from different regions of Turkey. With the questionnaire, we applied; the participants\u27 age, gender, the general status of contamination and the level of COVID-19 knowledge were questioned. Besides; Beck Anxiety Scale, Acute Stress Scale (PCL-5), STAI-1 and STAI-2 (State and Trait Anxiety Inventory 1-2) scales were used to determine the anxiety levels. Results: A survey of 210 participants, 86 (41%) doctors, 124 (59%) nurses, were included in our study. When we evaluate the Beck anxiety levels, the majority of the participants (44%) were normal, while about one third had mild anxiety. When we evaluated the acute stress scale, all participants had a certain amount of stress levels. The majority (80 people each (38%)) experienced mild and moderate acute stress. Being female and having chronic disease poses a high risk for anxiety (OR, 0.330; 95% CI, 0.087-1.250, p <0.05 and OR, 0.246; 95% CI, 0.068-1.116, p<0.05), preoccupation (OR, 0.603; 95% CI 0.261-1.395, p<0.05 and OR, 0.433; 95% CI, 0.122-1.538, p<0.05) and acute stress (OR, 0.294; 95% CI, 0.033-2.649, p<0.05 and OR, 0.317; 95 % CI 0.060-1.679, p<0.05). Professional definition, marital status and having a child do not pose any risk factors. Conclusion: Our study has shown that the COVID-19 outbreak affects the mental status of health care professionals working at PICU at various levels

Evaluation of renal near-infrared spectroscopy for predicting extubation outcomes in the pediatric intensive care setting

BackgroundIn pediatric intensive care units, extubation failure following invasive mechanical ventilation poses significant health risks. Determining readiness for extubation in children can minimize associated morbidity and mortality. This study investigates the potential role of renal near-infrared spectroscopy (RrSO2) in predicting extubation failure in pediatric patients.MethodsA total of 84 patients aged between 1 month and 18 years, mechanically ventilated for at least 24 h, were included in this prospective study. RrSO2 levels were measured using near-infrared spectroscopy before and during an extubation readiness test (ERT). The primary outcome measure was extubation failure, defined as a need for reintubation within 48 h.ResultsOf the 84 patients, 71 (84.6%) were successfully extubated, while 13 (15.4%) failed extubation. RrSO2 was found to be lower in the failed extubation group, also decrease in RrSO2 values during ERT was significantly greater in patients with extubation failure. ROC analysis indicated a decrease in ΔRrSO2 of more than 6.15% from baseline as a significant predictor of extubation failure, with a sensitivity of 0.984 and a specificity of 0.889.ConclusionMonitoring changes in RrSO2 values may serve as a helpful tool to predict extubation failure in pediatric patients. Further multi-center research is warranted to improve the generalizability and reliability of these findings

Evaluation of Inhaled Nitric Oxide Use in Patients with Pediatric Acute Respiratory Distress Syndrome

Objective: Nitric oxide therapy is not routinely used in the treatment of pediatric acute respiratory distress syndrome (PARDS), but it is recommended to be used as an adjunctive therapy in some selected cases. In our study, we aimed to discuss patients with PARDS who were treated with inhaled nitric oxide (iNO) therapy

Effects of Different Transport Temperatures on in vitro Development of Queen Oocytes

Today, many species, especially feline are endangered. For this, domestic cats used as a model for in vitro culture studies. So, many investigators have problems transporting ovaries to their laboratories. In this study effects of different transport temperatures on in vitro maturation of feline oocytes were investigated. Ovaries were collected from 12 ovariectomised queens of 2-3 years old, four of which were at oestrus and eight at anoestrus. One ovary of each pair was brought to the laboratory in PBS at 4 degrees C and other one at 37 degrees C. Two main groups as oestrus and anoestrus were established and each were divided into further 2 subgroups as 4 and 37 degrees C. Oocytes were collected in TCM-medium and matured for 24 h under 5% CO2 at 38.5 degrees C, Matured oocytes were fertilized with fresh semen at a final concentration 1 x 10(6) mL(-1) in Sperm-Talp medium under 5% CO2 for 18-24 h. After removing cumulus oophorus cells and zygotes were divided into groups and in vitro cultured for 72 h in 100 mu L SOF medium under 5% CO2, 5% O-2 and 90% N-2 gas mixture. At the 48th h of incubation, the best cleavage was 44.4% (8/18) at 37 degrees C oestrus group and the lowest was 14% (7/50) in the oestrus group at 4 degrees C. These rates were 22.72% (15/66) and 28.57% (8/28), respectively for the anoestrus group. At the 72 h of culture in 37 degrees C oestrus group 7 embryos stayed at 4-8 blastomere stage and 1 embryo reached 16-32 blastomere stage. This result was significant when compared to the other groups (p<0.001). In 4 degrees C anoestrus group only 5 embryos have reached 4-8 blastomere and no significant difference among the results was observed. It is concluded that cat ovaries oestrus are better transported at 37 degrees C while anoestrus ovaries could be carried at 4 degrees C

Outcome of Candida Parapsilosis Complex Infections Treated with Caspofungin in Children

Background: We aimed to evaluate the correlation of caspofungin E-tests with the prognosis and response to caspofungin therapy of Candida parapsilosis complex bloodstream infections in children hospitalized in a pediatric intensive care unit

Closed–loop oxygen control improves oxygenation in pediatric patients under high–flow nasal oxygen—A randomized crossover study

Background: We assessed the effect of a closed–loop oxygen control system in pediatric patients receiving high–flow nasal oxygen therapy (HFNO). Methods: A multicentre, single–blinded, randomized, and cross–over study. Patients aged between 1 month and 18 years of age receiving HFNO for acute hypoxemic respiratory failure (AHRF) were randomly assigned to start with a 2–h period of closed–loop oxygen control or a 2–h period of manual oxygen titrations, after which the patient switched to the alternative therapy. The endpoints were the percentage of time spent in predefined SpO2 ranges (primary), FiO2, SpO2/FiO2, and the number of manual adjustments. Findings: We included 23 patients, aged a median of 18 (3–26) months. Patients spent more time in a predefined optimal SpO2 range when the closed–loop oxygen controller was activated compared to manual oxygen titrations [91⋅3% (IQR 78⋅4–95⋅1%) vs. 63⋅0% (IQR 44⋅4–70⋅7%)], mean difference [28⋅2% (95%–CI 20⋅6–37⋅8%); P < 0.001]. Median FiO2 was lower [33⋅3% (IQR 26⋅6–44⋅6%) vs. 42⋅6% (IQR 33⋅6–49⋅9%); P = 0.07], but median SpO2/FiO2 was higher [289 (IQR 207–348) vs. 194 (IQR 98–317); P = 0.023] with closed–loop oxygen control. The median number of manual adjustments was lower with closed–loop oxygen control [0⋅0 (IQR 0⋅0–0⋅0) vs. 0⋅5 (IQR 0⋅0–1⋅0); P < 0.001]. Conclusion: Closed-loop oxygen control improves oxygenation therapy in pediatric patients receiving HFNO for AHRF and potentially leads to more efficient oxygen use. It reduces the number of manual adjustments, which may translate into decreased workloads of healthcare providers. Clinical trial registration: [www.ClinicalTrials.gov], identifier [NCT 05032365]

Automated closed–loop FiO2 titration increases the percentage of time spent in optimal zones of oxygen saturation in pediatric patients–A randomized crossover clinical trial

Introduction: We aimed to compare automated ventilation with closed–loop control of the fraction of inspired oxygen (FiO2) to automated ventilation with manual titrations of the FiO2 with respect to time spent in predefined pulse oximetry (SpO2) zones in pediatric critically ill patients. Methods: This was a randomized crossover clinical trial comparing Adaptive Support Ventilation (ASV) 1.1 with use of a closed–loop FiO2 system vs. ASV 1.1 with manual FiO2 titrations. The primary endpoint was the percentage of time spent in optimal SpO2 zones. Secondary endpoints included the percentage of time spent in acceptable, suboptimal and unacceptable SpO2 zones, and the total number of FiO2 changes per patient. Results: We included 30 children with a median age of 21 (11–48) months; 12 (40%) children had pediatric ARDS. The percentage of time spent in optimal SpO2 zones increased with use of the closed–loop FiO2 controller vs. manual oxygen control [96.1 (93.7–98.6) vs. 78.4 (51.3–94.8); P < 0.001]. The percentage of time spent in acceptable, suboptimal and unacceptable zones decreased. Findings were similar with the use of closed-loop FiO2 controller compared to manual titration in patients with ARDS [95.9 (81.6–98.8) vs. 78 (49.5–94.8) %; P = 0.027]. The total number of closed-loop FiO2 changes per patient was 52 (11.8–67), vs. the number of manual changes 1 (0–2), (P < 0.001). Conclusion: In this randomized crossover trial in pediatric critically ill patients under invasive ventilation with ASV, use of a closed–loop control of FiO2 titration increased the percentage of time spent within in optimal SpO2 zones, and increased the total number of FiO2 changes per patient. Clinical trial registration: ClinicalTrials.gov, identifier: NCT04568642

The Effect of Cysteamine and Oviductal Cells in Different Culture Media on the Development of Sheep Embryos

Sheep is a very important source of wool, meat and milk all over the world. Oxidative stress during in vitro culture leads to defects in development of gametes and embryos. Several antioxidants such as cysteamine, L-ascorbic acid, beta mercaptoethanol, cysteine, glutathione, proteins, vitamins are used to supplement culture media to counter the oxidative stress. This study was aimed to detect the effect of cysteamine supplementation to the maturation medium and oviductal cell supplementation to culture medium on the subsequent development rates of sheep embryos with the control group. Oocytes were obtained from slaughtered sheep ovaries. Selected oocytes were incubated with or without 100 mu M cysteamine in TCM-199 medium under 38.5-38.8 degrees C 5% CO2 for 23 h. During IVF fresh semen was collected from ram by electroejaculation, they were washed in H-SOF medium and were fertilized in B-SOF medium with oocytes incubated for 18 hours under 38.5-38.8 degrees C 5% CO2, 5% O-2 and 90% N-2. The oocytes were obtained from maturation medium with/without cysteamine (C+,-) and were cultured in SOF or CR1aa media with/without oviductal cells (Ov+,-) and were grouped as; Group Ia: SOF+(C+ Ov-), Group Ib: SOF+(C+ Ov+), Group Ic: SOF+(C-Ov-) Group Id: SOF+(C-Ov+); Group IIa: CR1aa+(C+ Ov-), Group IIb: CR1aa+(C+ Ov+), Group IIc: CR1aa+(C-Ov-), Group IId: CR1aa+(C-Ov+). Embryos were incubated under 38.5-38.8 degrees C 5% CO2, 5% O-2, 90% N-2 in culture medium for 7 days. Embryo developments were observed and recorded daily. GLM procedure found in SPSS packet program was used for statistical analysis in this study. In conclusion, the addition of cysteamine or oviductal cells in vitro culture media found to have any effect in terms of the capacity of reaching to blastocyst stage in SOF or CR1aa media and no statistical difference is detected between groups

The effect of oviductal cells on in vitro maturation of canine oocytes in different culture media

The aims of this study were to investigate the effect of oviductal cells on in vitro maturation (IVM) of canine oocyte in Tissue Culture Medium 199 (TCM-199) or synthetic oviductal fluid (SOF) supplemented with bovine serum albumin (BSA) or fetal calf serum (FCS) and to compare the maturation rates of oocytes from the diestrus and anestrus stages. Following ovariohysterectomy, 13 pairs of ovaries were collected from bitches in anestrus (n = 10) or diestrus (n = 3) and oocytes were harvested by slicing. The oviducts were flushed with TCM-199 containing 10% FCS and were scraped and squeezed into a tube in order to obtain oviductal cells. Selected oocytes were divided into groups for IVM over 48 h for each of the diestrus and anestrus stages as follows: Group Ia, SOF+BSA; Group Ib, SOF+BSA+oviductal cells; Group IIa, SOF+FCS; Group IIb, SOF+FCS+oviductal cells; Group IIIa, TCM-199+BSA; Group IIIb, TCM-199+BSA+oviductal cells; Group IVa, TCM-199+FCS; and Group IVb, TCM-199+FCS+oviductal cells. Afterwards, oocytes were fixed with acetic acid-ethyl alcohol and stained with aceto-orcein to determine nuclear maturation. When compared between anestrus and diestrus stages for all parameters (undetermined nuclear material, germinal vesicles, germinal vesicle break down, metaphase I, metaphase II, and degenerated) in different media, the differences were found to be significant statistically in Group IIa (22.9%) and Group IIIb (35.7%) for the germinal vesicle stage (P < 0.05) as compared to the other groups. In conclusion, in the oocytes obtained from bitches in diestrus and anestrus supplemented with FCS or BSA in SOF medium without oviductal cells, more positive effects were seen on canine oocyte maturation than with TCM-199 medium supplemented with same protein sources and oviductal cells