Evaluation of factors that affect skin to subarachnoid space distance

Introduction: Lumbar puncture is a procedure frequently used in anesthetic practice. For the success of the procedure, prediction of skin to subarachnoid space distance (SSD) is valuable. In this study, we aimed to evaluate the relationship between SSD with age and body mass index (BMI). Methods: Two hundred and fifty patients, ASA physical status I, II, and III scheduled to undergo elective surgery under spinal anesthesia, were studied. Spinal anesthesia was induced in the sitting position at the L3–4 vertebral level using a midline approach. Furthermore, the level of L3–L4 was identified by palpation, using Tuffier’s line as a guide. Following an intrathecal injection, the spinal needle was grasped between the thumb and the index finger during its removal from the patient’s back. From the grasping point, SSD was measured using rulers. Results: Mean values of SSD at the L3-4 interspace were 55.43±6.47 mm (range 35-74). Statistically significant correlations were observed between SSD with BMI and body weight (ρ=0.650, P<0.001 and ρ=0.651, P<0.001, respectively). Statistically significant correlation was not found between SSD with age, gender and body height (ρ=0.120, P=0.058; ρ=-0.047, P=0.4568 and ρ=0.089, P=0.159, respectively). Conclusions: SSD is affected by BMI and body weight but not by age, gender and body height

Evaluation of factors that affect skin to subarachnoid space distance

Introduction: Lumbar puncture is a procedure frequently used in anesthetic practice. For the success of the procedure, prediction of skin to subarachnoid space distance (SSD) is valuable. In this study, we aimed to evaluate the relationship between SSD with age and body mass index (BMI). Methods: Two hundred and fifty patients, ASA physical status I, II, and III scheduled to undergo elective surgery under spinal anesthesia, were studied. Spinal anesthesia was induced in the sitting position at the L3–4 vertebral level using a midline approach. Furthermore, the level of L3–L4 was identified by palpation, using Tuffier’s line as a guide. Following an intrathecal injection, the spinal needle was grasped between the thumb and the index finger during its removal from the patient’s back. From the grasping point, SSD was measured using rulers. Results: Mean values of SSD at the L3-4 interspace were 55.43±6.47 mm (range 35-74). Statistically significant correlations were observed between SSD with BMI and body weight (ρ=0.650, P<0.001 and ρ=0.651, P<0.001, respectively). Statistically significant correlation was not found between SSD with age, gender and body height (ρ=0.120, P=0.058; ρ=-0.047, P=0.4568 and ρ=0.089, P=0.159, respectively). Conclusions: SSD is affected by BMI and body weight but not by age, gender and body height

HIV prevalence among men who have sex with men in Istanbul

Objectives: The re-emergence of the HIV epidemic among men who have sex with men (MSM) represents a serious health issue. This study aimed to assess the HIV prevalence among MSM in a very low prevalence population of a large city. Methods: A public campaign to raise awareness of HIV infection and to provide access to anonymous testing was conducted in places frequented by MSM and through a mobile phone application. No identity information was requested from individuals contacting the call centre, and anonymous and free HIV testing was offered proactively. Those who agreed to have a test were provided a code number, which was used in blood sampling procedures. Results: Of 1200 subjects who contacted the call centre, 197 consented to undergo HIV testing and visited the laboratory to give a blood sample. Twenty-five subjects were found to have a reactive ELISA result on two different occasions plus a positive Western blot test result. Thus, the HIV prevalence in this group of MSM was 12.7%. Conclusions: MSM remain a high risk group for HIV infection in a low prevalence setting, and thus represent a key target population for diagnostic and therapeutic interventions

Assessment of depression and quality of life in intensive care unit nurses in a tertiary care hospital

Previous studies have shown that intensive care units (ICU) are among the most aggressive, tense and traumatic environments in the hospital. Intensive care units can cause physical and mental frazzle and damage in health care workers as much as they are for patients. In this study, it was aimed to evaluate depression and quality of life in ICU nurses in a tertiary care hospital. One hundred twenty ICU nurses, working more than 2 years in second and tertiary adult intensive care units, was included. The SF-36 Quality of Life Scale was used to assess the quality of life. The Beck Depression Inventory (BDI) was used to assess depression. The demographic data of the participants were also questioned through a separate form. The average age of nurses involved in the study (SS) 31.29 (5.23) and 65% female, 70% married, , 63% have children, and 31% were smokers. There was no statistically significant difference in the quality of life and depression scale scores of the participants according to age, gender, marital status, child ownership status, duration of intensive care study and smoking (p&gt; 0.05). In conclusion, sociodemographic characteristics such as age, gender, marital status, having children, duration of intensive care study and smoking did not affect the quality of life and depression level of intensive care nurses working in a tertiary hospital. [Med-Science 2018; 7(1.000): 101-105

POLYCYTHEMIA VERA: UPDATE ON PATHOGENESIS, DIAGNOSIS AND MANAGEMENT

Polycythemia vera (PV) is a myeloproliferative neoplasm characterized by increased red blood cell mass and usually overproduction of granulocytes and platelets and increased spleen size. JAK2V617F mutation is present in more than 95% of PV patients. Bone marrow examination reveals excessive proliferation of erythroid, myeloid, and megakaryocytic elements. The prognosis of PV depends on the severity of the complications occurring during the clinical course. Thrombotic complications are the main cause of morbidity and mortality in PV. Survival is affected whether appropriate therapy is applied during the erythrocytotic phase of the disease. Uncontrolled erythrocytosis poses very high risk for development of thrombosis. Some studies suggest that PV patients have a normal or near-normal life-expectancy. Most studies, however, report excess mortality caused by thrombotic complications and acute leukemia transformation during course of PV. This review aims to highlight the pathogenesis, diagnosis and current management in PV