Symptomatic and asymptomatic candidiasis in a pediatric intensive care unit

<p>Abstract</p> <p>Introduction</p> <p>This study aimed to examine the incidence, epidemiology, and clinical characteristics of symptomatic and asymptomatic candidiasis in a pediatric intensive care unit (PICU), and to determine the risk factors associated with symptomatic candidiasis.</p> <p>Methods</p> <p>This retrospective study included 67 patients from a 7-bed PICU in a tertiary care hospital that had Candida-positive cultures between April 2007 and July 2009. Demographic and clinical characteristics of the patients, Candida isolates, antimicrobial and antifungal treatments, and previously identified risk factors for symptomatic candidiasis were recorded, and symptomatic and asymptomatic patients were compared.</p> <p>Results</p> <p>In all, 36 (53.7%) of the patients with Candida-positive cultures had asymptomatic candidiasis and 31 (46.3%) had symptomatic candidiasis. Candida albicans was the most common Candida sp. in the asymptomatic patients (n = 20, 55.6%), versus Candida parapsilosis in the symptomatic patients (n = 15, 48.4%). The incidence of central venous catheter indwelling, blood transfusion, parenteral nutrition, and surgery was higher in the symptomatic patient group than in the asymptomatic patient group (P < 0.5). Surgery was the only independent predictor of symptomatic candidiasis according to forward stepwise multivariate logistic regression analysis (OR: 6.1; 95% CI: 1.798-20.692).</p> <p>Conclusion</p> <p>Surgery was the only risk factor significantly associated with symptomatic candidiasis and non-albicans Candida species were more common among the patients with symptomatic candidiasis. While treating symptomatic candidiasis in any PICU an increase in the incidence of non-albicans candidiasis should be considered.</p

The Usefulness of Perfusion Index for Predicting Mortality in Pediatric Intensive Care Unit

Introduction:The aim of this study is to the usefulness of the perfusion index to predict mortality in the pediatric intensive care unit.Methods:The study included patients aged >28 days and <18 years old, who were admitted to Mersin University Faculty of Medicine, Department of Pediatric Intensive Care Unit between 2018 and 2019. Characteristic variables of patients, pediatric risk of mortality III and pediatric logistic organ dysfunction scores, the reason for hospitalization, surgical history, underlying disease, mechanical ventilation, transfusion, perfusion index value at the zeroth hour (at the admission) and at the sixth hour, lactate levels, and prognosis were recorded.Results:A total of 372 patients who met the study criteria were included in the study. Median perfusion index values at the zeroth and sixth hours were significantly lower in patients who were exitus than the survivors (p<0.001). Considering mortality and organ failure scores, the median values of pediatric risk of mortality III and pediatric logistic organ dysfunction scores were higher in those who were exitus and when compared with the perfusion index values at the zeroth hour, a negative significance was found between them. In receiver operating characteristic analysis, the specificity and sensitivity values for mortality were 90.1% and 75.9% at a perfusion index cut-off of ≤0.63, respectively.Conclusion:Perfusion index is a reliable method to predict mortality for patients admitted to pediatric intensive care unit

RELATION OF FEMUR FRACTURES LOCATION WITH CLINICAL OUTCOMES IN ELDERLY PATIENTS

ABSTRACT Objectives: This study was designed to investigate the possible relationship between the anatomical location of the PFF (head-neck fractures) and the demographic features, comorbidities, and risk factors of elderly patients. Methods: 233 patients aged 65 years and over, who were admitted to the emergency department with a diagnosis of proximal femur fracture were included in this study. Results: Most patients (59.6%) had a trochanteric fracture. The incidence of trochanteric fractures had a statistically significant positive correlation with age. Falls at ground level were found to be highly associated with trochanteric fractures (92,8%). At least one complication was observed in 57 (41,0%) cases and 31 (22,3%) died in one year, of the patients with trochanteric fractures. Comorbidity was not related to fracture location statistically. Fall ground level (p = 0.013), complication rate (73.7%; p <0.001), and Charlesen comorbidity index (p = 0.019) were statistically significantly associated with death. The logistic regression analysis of variables determined that only the quantity of comorbidities may be related to femoral neck fractures (p = 0.047). Conclusion: Female patients with trochanteric fractures were found to be older than male patients. Fall ground level, mortality, and complications were more frequently seen in patients with trochanteric fractures. Level of Evidence II, Retrospective study

Reporting of Nursing Care Preventing Surgical Site Infection in Colorectal Cancer Patients with Omaha System

Aim: To manage and document the nursing care process related to Surgical Site Infection and control in colorectal cancer patient using the Turkish-Nightingale Notes (T-NN) program and test the usability of the program

The Effects of Peer Education on Reduction of the HIV/Sexually Transmitted Infection Risk Behaviors Among Turkish University Students

This study investigated how HIV/sexually transmitted infection peer education (PE) affected HIV knowledge, perceived prevention self-efficacy, and risky sexual behaviors among Turkish university students (N = 118) who were sexually active but did not use condoms. A methodological and pre-/posttest controlled study design was used, with data collected before PE, just after PE, 3 months after PE, and 6 months after PE. We found significant differences according to group* time interaction in the variables of HIV knowledge, self-efficacy for condom use and refusing sexual intercourse, and vaginal-oral-anal intercourse with condom, talking with the partner about condom use, refusing sexual intercourse with someone not using a condom, and taking alcohol before sexual intercourse. No differences were found according to group* time interaction in self-efficacy for asking potential partners questions, using drugs before and after sexual intercourse, and sexual partner. Peer education was found to reduce risky sexual behaviors among university students. Peer education should focus on safer sexual behaviors to develop strategies to increase self-efficacy. (C) 2012 Association of Nurses in AIDS Car

Screening of Turkish women for postpartum depression within the first postpartum year: The risk profile of a community sample

Objective: To explore the prevalence of postpartum depression (PPD) and potential risk factors giving rise to PPD among Turkish women. Design: A descriptive design and random survey method were used. Sample: Collected from 9 public health centers, the sample consisted of 679 mothers within their first year after delivery. Measurements: The Edinburgh Postpartum Depression Scale (EPDS) and a risk factor questionnaire were used during home visits. Results: The EPDS results revealed a 25.6% prevalence of higher-level depression (12 or above) and a 16.7% prevalence of lower-level depression. Maximum prevalence occurred at 2, 8, 10, and 12 months postpartum. Seventeen independent variables were found to be associated with the elevated scores on EPDS. Strong predictors of depression were as follows: previous psychiatric illness (odds ratio [OR] 15.95); smoking (OR 4.17); lower economic status (OR 4.10); relationship problems with husband (OR 3.49) or mother-in-law (OR 2.53); dissatisfaction in social relations (OR 1.53); previous loss of a baby (OR 7.49); and giving birth to a baby girl (OR 2.54). Conclusions. PPD is common among Turkish women. There is an increased need to educate public and health care practitioners about PPD. Public health nursing interventions, in particular, need to be developed to provide support to postpartum women

Psychometric evaluation of the Turkish version of the Pediatric Symptom Checklist-17 for detecting psychosocial problems in low-income children

Aims. To evaluate the usefulness of Pediatric Symptom Checklist-17 in identifying psychosocial problems in low-income, Turkish children

Influence of Psychosocial Factors on Self-Care Behaviors and Glycemic Control in Turkish Patients With Type 2 Diabetes Mellitus

Purpose: The main purpose of this study was to investigate the direct and indirect effects of psychosocial factors on self-care behavior and glycemic control in Turkish patients with type 2 diabetes mellitus. Method: The study used a cross-sectional questionnaire survey design (N = 350). Data were collected using the Summary of Diabetes Self-Care Activities Scale and the Multidimensional Diabetes Questionnaire. The relationship between the study variables was analyzed using Pearson's correlation coefficient and structural equation modeling. Results: Self-efficacy was associated with social support, outcome expectancies, perceived interference, educational level, and self-care and A1C. According to the structural equation model, self-efficacy was the predictor variable that influenced both self-care and glycemic control. Conclusions: Self-efficacy in achieving desired health outcomes was found to play a central role in Turkish patients. Although interventions are planned and implemented to achieve and maintain self-management in individuals with diabetes, strengthening psychosocial factors, particularly self-efficacy, may contribute to adjustment to disease and good glycemic control in the long term

Psychometric evaluation of the Turkish version of the Pediatric Symptom Checklist-17 for detecting psychosocial problems in low-income children

Aims. To evaluate the usefulness of Pediatric Symptom Checklist-17 in identifying psychosocial problems in low-income, Turkish children

The effectiveness of the COPE healthy lifestyles TEEN program: a school-based intervention in middle school adolescents with 12-month follow-up

Aim. The goal of this study is to assess the applicability and long-term effectiveness of the T-COPE Healthy TEEN program on adolescent health