It Could Have Been Protected but Wasn't

INTRODUCTION[|]Introduction: Percutaneous injuries create shared occupational risk for all health workers. These injuries can lead to a loss of workforce and a decrease in the quality of health services by causing physical and psychiatric disorders. Our study aimed to identify the epidemiology of incised wounds that have occurred within the past four years effectiveness of preventive measures at the Kahramanmaraş Sütçü İmam University Faculty of Medicine Hospital.[¤]METHODS[|]Method This research was carried out with the retrospective study of incised wound cases that occurred at the KSU Faculty of Medicine Hospital between January 1, 2013 and December 31, 2016. Health personnel were examined in terms of gender, professional group, form of injury, locations of injury, compliance with protective barriers used, and precautions taken. The acquired data were evaluated in Microsoft Excel using numerical and percentage calculations.[¤]RESULTS[|]Findings: Of the injured health personnel, 61% were women and 39% were men. Of the group of injured personnel comprises nurses with 39% (94), followed by intern nurses 27% (65), sanitation personnel with 24% (56), doctors with 8% (18), three laboratory technicians, and two data-entry personnel. The most frequently injured bodily region was the left hand with 51.2% (122), followed by the right hand with 43.6% (104). The most frequent injury took place while covering the tip of a needle with 36%. No type of protective equipment was used for 71% of the health personnel who were included in the study.[¤]DISCUSSION AND CONCLUSION[|]Results: The fact that the most injuries occurred in nursing and sanitation personnel in the study produced the result of the provision of the education necessary to minimize contact with hands of cutting and perforating tools and for the propagation of the use of medical waste containers that provide for distancing the waste materials used, because the most frequent form of injury was recapping needle points. That there was high noncompliance with the use of protective equipment revealed that health workers needed to be subjected to certain, periodic training. In addition to this, the care for injuries and the provision of training in which the infection control committee needed to be referred to in situations of injury was brought to the forefront.[¤

Diagnostic performance of low-dose chest CT to detect COVID-19: A Turkish population study

PURPOSEWe aimed to evaluate the diagnostic performance of low-dose chest computed tomography (CT) in patients under investigation for coronavirus disease 2019 (COVID-19).METHODSThis retrospective study included 330 patients suspected of having COVID-19 from March 15 to April 16, 2020. We examined 306 patients upon initial presentation using both CT and real-time reverse-transcriptase polymerase-chain-reaction (rRT-PCR). The diagnostic performance of CT was calculated using rRT-PCR as a reference. Clinical and laboratory data, CT characteristics, and lesion distribution were assessed for patients with a confirmed diagnosis via rRT-PCR.RESULTSA total of 250 patients were finally diagnosed with COVID-19. Clinical and laboratory findings included myalgia or fatigue (76%), fever (64.8%), dry cough (60.8%), elevated levels of C-reactive protein (86.4%), procalcitonin (62%), and D-dimer (58.2%), increased neutrophil-lymphocyte ratio (NLR) (54.8%), and lymphopenia (34%). Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the initial CT scan were 90.4% (95% IC, 86%–93%), 64.2% (95% IC, 50%–76%), 91.8% (95% IC, 88%–94%), and 60% (95% IC, 49%–69%), respectively. The percentage of patients diagnosed on the initial rRT-PCR test was 51.6% (n=129). Most frequent CT characteristics of COVID-19 in the subgroup of rRT-PCR-positive patients were multiple lesion (97.4%, n=220), followed by bilateral involvement (88.5%, n=200), peripheral distribution (74.3%, n=168), ground-glass opacity (GGO) (69.2%, n=157), subpleural curvilinear opacity (41.6%, n=104), and mixed GGOs (27.6%, n=67).CONCLUSIONrRT-PCR may produce initial false negative results. For this reason, typical CT findings for COVID-19 should be known especially by radiologists. We suggest that patients with typical CT findings but negative rRT-PCR results should be isolated, and rRT-PCR should be repeated to avoid misdiagnosis

Cochlear implantation in inner ear malformations: Considerations related to surgical complications and communication skills

Introduction: There are particular challenges in the implantation of malformed cochleae, such as in cases of facial nerve anomalies, cerebrospinal fluid (CSF) leaks, erroneous electrode insertion, or facial stimulation, and the outcomes may differ depending on the severity of the malformation. The aim of this study was to assess the impact of inner ear malformations (IEMs) on surgical complications and outcomes of cochlear implantation. Methods: In order to assess the impact of IEMs on cochlear implant (CI) outcomes, 2 groups of patients with similar epidemiological parameters were selected from among 863 patients. Both the study group (patients with an IEM) and control group (patients with a normal inner ear) included 25 patients who received a CI and completed at least 1 year of follow-up. Auditory performance, receptive and expressive language skills, and production and use of speech were evaluated preoperatively and at least 1 year after implantation. Types of surgical complications and rates of revision surgeries were determined in each group. Results: In the study group, the most common malformation was an isolated enlarged vestibular aqueduct (EVA) (44.8%). Overall, the patients with IEMs showed significant improvement in auditory-verbal skills. In general, the patients who had normal cochleae scored significantly better compared to patients with IEMs (p < 0.05). The complication rate was significantly lower in the control group compared to the study group (p = 0.001), but the rate of revision surgeries did not differ significantly (p = 0.637). Conclusion: It is possible to improve communication skills with CIs in patients with IEMs despite the variations in postoperative performances. Patients with EVA, incomplete partition type 2, and cochlear hypoplasia type 2 were the best performers in terms of auditory-verbal skills. Patients with IEMs scored poorly compared to patients with normal cochleae. CSF leak (gusher or oozing) was the most common complication during surgery, which is highly likely in cases of incomplete partition type 3

Paecilomyces variotii peritonitis in a patient on continuous ambulatory peritoneal dialysis

WOS: 000406648800023PubMed: 28363816Paecilomyces variotii (P. variotii) is an extremely rare cause of continuous ambulatory peritoneal dialysis (CAPD) peritonitis. When diagnosed, it usually portends poor prognosis. Patient's survival depends on early laboratory diagnosis and proper treatment. We herein report a P. variotii peritonitis in a patient on CAPD which is a quite rare clinical entity. Laboratory diagnosis was confirmed via both morphological analysis and DNA sequencing. Antifungal susceptibility tests were performed and interpreted according to the Clinical Laboratory Standards Institute M38-A2 guidelines. After laboratory diagnosis, the patient was treated succesfully with liposomal amphotericin B and itraconazole combination and the peritoneal catheter was removed. This case is worthy of reporting since P. variotii is an uncommon cause of peritonitis and leads to dilemmas in both laboratory diagnosis and treatment strategies. (C) 2017 Elsevier Masson SAS. All rights reserved

HIV seropositivity in a penal institution in Turkey: a cross- sectional study

WOS: 000458773500011Objective: We aimed to determine the seroprevalence of human immunodeficiency virus (HIV) in a penal institution campus in Turkey, and to query its risk factors. Methods: Participants were selected randomly from blocks of residents who were under judgement process in a penal institution campus. All participants were males aged >= 18 years in this cross-sectional study. Questionnaire conducted on participants included the following: age, marital status, living location, education, income, use of cigarette, use of alcohol, use of illicit drugs, having tattoo, collective personal materials of hygiene, blood transfusion, sexual orientation, use of condom. Blood specimens of participants were tested for anti-HIV antibodies. Results: Among 495 prisoners on remand, three were HIV-positive. Prevalence of HIV infection was determined as 0.61%. All HIV-positives were married and lived in Istanbul. Two of them were primary school graduates, and one of them was a high school graduate. Two of them had yearly income less than 400 USD. All denied use of illicit intravenous drugs. They have extramarital sex, and were not using condoms. Conclusions: It was remarkable that prevalence of HIV infection among prisoners on remand was almost 60-fold higher than those of the general population. Giving information about HIV infection and its routes of transmission to prisoners and screening them on a routine basis on admission to penal institutions are the primary steps to control HIV infection

Treatment of Crimean-Congo Haemorrhagic Fever by Favipiravir in a Patient with Novel Coronavirus Co-Infection

Introduction: Crimean-Congo haemorrhagic fever (CCHF) is a lethal zoonotic disease caused by an RNA virus that is a member of the Nairovirus genus in the Bunyaviridae family from the arbovirus group. CCHF is transmitted by Hyalomma ticks through direct contact with the blood and other bodily fluids of patients or infected animals.Case description: A 65-year-old man was admitted to the emergency unit with dry cough, myalgia and fever. He was treated with favipiravir. He had disseminated intravascular coagulopathy with thrombocytopenia in the setting of COVID-19 infection. He tested positive for both COVID-19 and CCHF. By the end of the fifth day of treatment, his laboratory parameters and clinical symptoms had normalized.Conclusion: Favipiravir is currently on the market for treating COVID-19 infection worldwide. It has also been used to treat CCHF in laboratory animals. To the best of our knowledge this is the first report of CCHF successfully treated with favipiravir, which could be a key drug for treating human CCHF

Can HBsAg be used as a viral replication marker in chronic hepatitis B patients?

WOS: 000419233000005Objective: Monitoring hepatitis B virus (HBV) treatment responses and virus replication is performed with molecular tests. However, these tests are either expensive or invasive. A new and more practical marker is needed. We aimed to evaluate the correlation between serum hepatitis B surface antigen (HBsAg) and alanine aminotransferase (ALT) levels and HBV DNA level in hepatitis B e antigen (HBeAg) +/- patients and detect whether HBsAg can be used as a surrogate replication marker instead of HBV DNA. Material and Methods: A retrospective study was conducted in 59 chronic hepatitis B patients. Serum ALT, HBsAg and HBeAg levels and HBV DNA levels were recorded. The results were analysed with the Mann-Whitney U test and Spearman correlation coefficient. A p value of 0.05). A statistically significant negative correlation was detected between HBsAg and HBV DNA levels in HBeAg-positive patients. No correlation was found between HBsAg and HBV DNA levels in HBeAg-negative subjects (p<0.05). In both HBeAg-positive and - negative individuals, there was a positive correlation between serum ALT and HBV DNA levels (p<0.05). Blant-Alpman graph did not show an appropriate profile. Conclusion: We found a negative correlation between HBsAg and HBV DNA levels in HBeAg-positive patients. However, this correlation is not practical in monitoring treatment response and replication

Vascular compression syndromes: our 24 year endoscope-assisted microvascular decompression experiences

Amaç: Bu çalışmada hemifasiyal spazm, trigeminal nevralji, kokleovestibüler sinir kompresyonu gibi vasküler kompresyon sendromları nedeniyle yapılan endoskop yardımlı mikrovasküler dekompresyon deneyimlerimiz sunuldu. Hastalar ve Yöntemler: Mart 1999 - Haziran 2013 tarihleri arasında kliniğimizde vasküler kompresyon sendromları nedeniyle 55 has- taya (34 kadın, 21 erkek; ort. yaş 44 yıl; dağılım 24-77 yıl) endoskop yardımlı retrosigmoid yaklaşımla mikrosvasküler dekompresyon ameliyatı uygulandı. Tanı öykü, nörolojik muayene, manyetik rezonans görüntüleme bulguları ve odyovestibüler testler ile konuldu. Bulgular: Toplam 49 hastada (%89.1) tam iyileşme, iki hastada (%3.6) kısmi iyileşme, dört hastada (%7.3) ise semptomlarda düzelmeme görüldü. Sadece iki (%3.6) hastada ameliyat sırası komplikasyon olarak beyin omurilik sıvısı kaçağı gelişti. En sık bası yapan damarsal yapı ön ve alt serebellar arter olup, 14 hastada gözlendi. Esansiyel hipertansiyonlu dört hasta eş zamanlı sol medulla oblongata basısı dekomprese edildikten sonra normotansif oldu. Sonuç: Mikrovasküler kompresyon ameliyatı ile vasküler kompresyon sendromlu hastaların semptomlarında anlamlı iyileşme sağlanır. Ameliyat mikroskobuna yardımcı olarak açılı teleskopların kullanılması kraniyal sinire root entry zone bölgesinde bası nedenini sapta- mada önemli yardım sağlamaktadır.Objectives: This study aims to report our experience on endoscope-assisted microvascular decompression experiences performed due to vascular compression syndromes such as hemifacial spasm, trigeminal neuralgia, and cochleovestibular nerve compression. Patients and Methods: Between March 1999 and June 2013, 55 patients (34 females, 21 males; mean age 44 years; range 24 to 77 years) underwent endoscope-assisted microvascular decompression surgery through a retrosigmoid approach due to vascular compression syndromes in our clinic. The diagnosis was based on history, neurological examination, magnetic resonance imaging findings and audio-vestibular tests. Results: A total of 49 patients (89.1%) had complete relief of the symptoms and two had (3.6%) a partial relief, while four had (7.3%) no relief of the symptoms. Only two patients had (3.6%) cerebrospinal fluid leakages as a perioperative complication. The major offending vessels were anterior and inferior cerebellar arteries in 14 patients. Four patients with essential hypertension became normotensive after decompression of the left medulla oblongata as well. Conclusion: Microvascular decompression surgery provides a significant relief of the symptoms in patients with vascular compression syndromes. An angled endoscope as an adjunct to microscope contributes to the diagnosis of the offending vessel in the root entry zone of the cranial nerve

Ebe ve hemşirelerin anne sütü ve emzirme konusundaki bilgi ve tutumlarının, danışmanlık verdikleri annelerin bebeklerini anne sütü ile besleme davranışlarıyla karşılaştırılması

Amaç: Ebe ve hemşireler emzirmeyi özendiren, emziren anneleri destekleyen ve bebek beslenmesi konusunda annelere temel destek sağlayan kişiler olarak görülmektedir. Bu araştırmada; ebe ve hemşirelerin, anne sütü ve emzirme konusundaki bilgi ve tutumları ile danışmanlık verdikleri annelerin bebeklerini anne sütü ile besleme davranışlarının karşılaştırılması amaçlanmıştır. Hastalar ve Yöntemler: Çalışmaya, Edirne il merkezinde yaşayan ve 12-18 aylık bebekleri olan 161 anne ile bunların takiplerini yürütmüş 59 ebe ve hemşire alındı. Çalışmada veriler, anne sütü ve emzirme ile ilgili ebe/hemşireler (54 soru) ve annelere (34 soru) uygulanmak üzere hazırlanılan iki anket aracılığı ile toplandı. Bulgular: Ebe/hemşireler, her anneyle gebelikleri boyunca ortalama 6.5±2.9 kez görüştüklerini bildirdiler. Elli bir ebenin bilgi puanı orta düzeyde iken, yedisinin iyi, birinin de kötü olarak saptandı. Ebe/hemşirelerin 22'si en az altı ay sadece anne sütü verirken, 33'ü en az 12 ay bebeğini emzirmişti. Annelerin 65'i en az altı ay sadece anne sütü verirken, 82'si en az 12 ay bebeğini emzirmişti. Sonuç: Bu çalışmayla, emzirmenin başarılı bir şekilde yapılabilmesi için özellikle ebe/hemşirelerin bu konuda anneleri bilinçlendirmeleri gerektiği bir kez daha vurgulanmıştır. Bunun için, ebe/hemşireler annelere sürekli destek sağlamalıdırlar. Bu da, ebe/hemşirelerin ve diğer sağlık personelinin bu konuda düzenli eğitilmeleri ile sağlanabilir.Objectives: Midwives and nurses are considered as the essential sources of information about feeding and nutrition of the babies, who encourage breastfeeding and support the mother. In this study, it is aimed to compare the knowledge and attitudes of midwives and nurses about breastfeeding with breastfeeding practices of the mothers they provide counseling on baby feeding. Patients and Methods: The present study was carried out on 161 mothers having babies aged 12-18 months who lived in Edirne and on 59 midwives and nurses who had conducted their counseling and follow-up visits. Data were collected via two questionnaires prepared for the midwives and mothers. Results: Midwives/nurses reported that they were visited by each mother for a mean of 6.5&plusmn;2.9 times during their pregnancy. Twenty-two of them had fed their babies only with breast milk for at least six months and 33 of them had suckled their babies for at least 12 months. Of the mothers, 65 had fed their babies only with breast milk for at least six months, while 82 had suckled their babies for at least 12 months. Conclusion: This study stresses the importance that nurses/midwives should enhance mothers' consciousness for a successful breastfeeding. It is important that midwives should provide continuous support to mothers, which can be achieved by continuous professional training to midwives, nurses and other health staff regularly

[Developing of health perception and psychosocial skills in disadventaged students: a school based interventional study from Çanakkale]

AMAÇ: Bu çalışmada, Çanakkale'de bir ilköğretim okulunda dezavantajlı öğrencilerde sağlık algısının ve psikososyal becerilerin geliştirilmesi amaçlandı. YÖNTEM: Müdahale tipteki bu çalışma, "Yerelden Cambridge ve NASA'ya: Dezavantajlı Öğrencilerde Çanakkale Değerleri ve Girişimcilik Bilinci Geliştirme" (TR22.11.SK01.0111) projesinin ilk basamağı olan "İlköğretim Okullarına Danışmanlık Uygulaması" kapsamında 18 Mayıs 2012-18 Haziran 2012 tarihleri arasında Çanakkale Kepez'de bir İlköğretim okulunda yürütüldü. Bahar yarıyılında 5., 6., 7., ve 8. sınıflarda okuyan farklı dezavantajlara sahip 15 öğrenci çalışma grubumuzu oluşturdu. Öğrencilerin psikososyal becerilerini ve sağlık algılarını geliştirecek eğitim çalışmaları yapıldı. Bu çalışmalar 3 hafta boyunca haftada 2 kez okul kütüphanesinde yapıldı. Çalışmada materyal olarak sosyodemografik bilgi formu, sağlık algısı ölçeği ve psikososyal beceri değerlendirme formu kullanıldı. Çalışma verileri, SPSS 15,0 sürümü ile değerlendirildi. BULGULAR: Çalışma grubumuzun %66,6'sı (n=10) kızdı. Öğrencilerin psikososyal beceri gelişimleri incelendiğinde 3 haftalık ölçümlerde ortanca puanlar arasında istatistiksel olarak anlamlı bir fark saptandı (p<0,001). Öğrencilerin sağlık algısı ölçeğine verdikleri yanıtlar incelendiğinde, eğitim süresince yapılan ölçümlerde öğrencilerin olumlu tutumlarında bir artış, buna karşılık olumsuz tutumlarında da bir azalma olduğu gözlendi. SONUÇ: Dezavantajlı öğrencilerle yapılan bu destekleyici eğitim çalışmaları ile öğrenciler interaktif olma, paylaşımcı olma, iletişimci ve girişimci olma, lider olma, sosyal destek sunma, sağlık algısının gelişmesi gibi konularda fiziksel, ruhsal ve sosyal kazanımlar elde etmişlerdir. Çalışma grubumuzda yer alan ve eğitim aktivitelerini başarıyla tamamlayan öğrencilerden 2'si proje kampına seçilmiştir. Proje kampındaki aktiviteleri ve yapılan sınavı başarıyla tamamlayan bir öğrencimiz İngiltere'ye bilimsel gezi programına katılmıştır. Sonuç olarak, sağlık algısının, psikososyal becerilerin ve girişimcilik gibi özelliklerin erken yaşlarda gelişmesi için ilköğretim çağındaki dezavantajlı öğrencilere yönelik profesyonel grup eğitimleri yararlı olabilirAIM: The aim of this study was to develop health perception and psychosocial skills in disadvantaged students in a primary school. METHOD: This interventional study was conducted in a primary school between May 2012 and June 2012 in Kepez, Canakkale within the context of "Consultancy Application in Primary Schools"as the first step of "From Local to Cambridge and NASA: Development of Canakkale Values and Promotional Awareness in Disadvantaged Students" (TR22.11.SK01.0111) project. Fifteen students with different disadvantages at the 5th,6th,7th,and 8th grades in the second semester were included in the study. Training studies were performed to develop psychosocial skills and health perception of students. These studies were performed at the school library twice a week for three weeks. In this study, sociodemographic, health perception evaluation and psychosocial skill evaluation forms were used as material. Study data were analyzed using by SPSS, 15.00 version. RESULTS: Most students (66.6%) were female. Statistically significant difference was defined in psychosocial skill developments of students between the median values measured three weeks apart (p<0.001). When examined responses of students to the health perception scale, it was observed that favorable attitudes of students were increased, whereas unfavorable attitudes were decreased in the measurements during the training. CONCLUSION: Students with disadvantages gained physical, psychological and social skills (being interactive; sharing, communicating, enterprising) features of leadership and social supporting as well as the development of health perception. Two students, who successfully completed these training activities in our study group, were chosen to the project camp. One of these two students, who successfully completed the activities in the project camp and past the final exam was accepted by science trip in the United Kingdom. In conclusion, professional group trainings at early ages may be helpful for developing characteristics of health perception, psychosocial skills, enterprising in disadvantaged students