Quality of life following acute deep vein thrombosis: the cultural adaptation, reliability and validity of the VEINES-QOL/Sym scale: a Turkish version study

Background: This study aims to translate and make cultural adaptation of a widely used Venous Insufficiency Epidemiologic and Economic Study Quality-of-Life Questionnaire (VEINES-QOL/Sym) into Turkish according to international guidelines and to statistically evaluate its validity and reliability by administering it to Turkish-speaking patients with acute deep vein thrombosis (DVT)

Problems, nurses face within the intensive care units illustrated by four case reports

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Huge Intravascular Tumor Extending to the Heart: Leiomyomatosis

Intravenous leiomyomatosis (IVL) is a rare neoplasm characterized by histologically benign-looking smooth muscle cell tumor mass, which is growing within the intrauterine and extrauterine venous system. In this report we aimed to present an unusual case of IVL, which is originating from iliac vein and extended throughout to right cardiac chambers. A 49-year-old female patient, who was treated with warfarin sodium due to right iliac vein thrombosis, was admitted to our department with intermittent dyspnea, palpitation, and dizziness. Physical examination was almost normal except bilateral pretibial edema. On magnetic resonance venography, there was an intravenous mass, which is originated from right internal iliac vein and extended into the inferior vena cava. Transthoracic echocardiography and transesophageal echocardiography revealed a huge mass extending from the inferior vena cava through the right atrium, with obvious venous occlusion. Thoracic, abdominal, and pelvic MR showed an intravascular mass, which is concordant with leiomyomatosis. Surgery was performed through median sternotomy. A huge mass with 25-cm length and 186-gr weight was excised through right atrial oblique incision, on beating heart with cardiopulmonary bypass. Histopathologic assessment was compatible with IVL. Exact strategy for the surgical treatment of IVL is still controversial. We used one-stage approach, with complete resection of a huge IVL extending from right atrium to right iliac vein. In such cases, high recurrence rate is a significant problem; therefore it should be kept in mind

Pilot Study of Application of Combined Transbronchial and Intravenous Ultraviolet C (UVC) and Laser Beam Application for the Treatment of Critical COVID-19 Infection

Objective and background: Light-based antimicrobials, mainly ultraviolet C (UVC) and laser light irradiation, have a potential to inactivate severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The aim of our study was to evaluate the effect of transbronchial and intravenous application of UVC and laser light irradiation on treatment of patients with severe COVID-19. Methods: The clinical outcome of six patients (age 42-69 years) with severe COVID-19 infection who were directly applied UVC (254 nm) transbronchially, and UVC plus green (630 nm) and red laser (535 nm) lights to the blood circulation in addition to standard pharmacotherapy (UVC group) were prospectively evaluated in comparison to six patients (age 50-69 years) treated only with pharmacotherapy (standard treatment group). Results: The patients in UVC group had shorter stay in intensive care unit (median length of stay 1 vs. 8.5 days; p=0.015), more negative PCR results after treatment (5/6 vs. 0/6 patients; p=0.003), higher discharge rate (5/6 vs. 3/6 patients), and lower mortality (1/6 vs. 3/6 patients), as compared to patients in standard treatment group. Serum D-dimer level, which reached up to 2500 ng/mL (six times of baseline value) seven days after treatment in standard treatment group, was much lower in UVC group (1000 ng/mL). Serum ferritin level was 1.5 to 1.9-fold higher and CRP level was up to 1.7-fold higher in standard treatment group during ten days after treatment as compared to UVC group. No adverse effects have been observed. Conclusions: Combined transbronchial and intravenous UVC and laser irradiation may improve outcome of severe COVID-19 cases

Oxaliplatin Induced Digital Ischemia and Necrosis

Introduction. Digital ischemia is a rare complication of several chemotherapeutic medications. We aimed to present a patient with digital ischemia, secondary to a new generation chemotherapeutic drug, oxaliplatin. Case Report. 62-year-old woman presented to our department with severe pain, paresthesia, and distal acrocyanosis on her right hand fingertips. Her complaints started five days after the third cycle of a chemotherapy protocol consisting of 5-fluorourasil (5-FU), folinic acid, and oxaliplatin due to advanced colon carcinoma. On physical examination, hemorrhagic and partly ulcerative lesions were detected at her right hand fingertips. Radial and ulnar pulses were absent at affected side. Digital subtraction angiography revealed severe vascular resistance in the affected extremity. Iloprost trometamol treatment was started with the dosage of 1 ng/kg/min. In addition, low-molecule-weight heparin was used for preventing possible microemboli. Symptomatic relief was provided after five days, and patient was discharged on 7th day of treatment. Discussion. The pathogenesis of oxaliplatin induced vascular toxicity remains unclear. Endothelial damage, increased adherence of platelets, deposition of immune complexes as an immunologic effect of oxaliplatin, and hypercoagulable state may be the reason for arterial thrombosis, digital microemboli, possible digital ischemia, and their several consequences