Hacer İşler, I. Bahceci, Seda Güdül Havuz, Seher Aydoğan, Göksenin Ünlügüzel Üstün, Ç. Öztürk, Eşe Başbulut
The COVID-19 (Coronavirus Disease 2019) outbreak has not yet ended and poses a persistent hazard to individuals, communities, and healthcare systems globally. Similar to numerous other diseases, the immune system of the patient is intricately associated with the advancement and mortality rates of COVID-19. In general, the immune system plays a crucial role in protecting the host against infections and neoplastic cells, and a well-balanced diet can enhance the immune system's ability to effectively defend against infectious agents. There have been suggestions that the administration of zinc supplements may decrease the occurrence of lower respiratory tract infections in children who are deficient in zinc. This study will thus examine the potential of zinc as a preventive and therapeutic agent, either on its own or in conjunction with other techniques, as zinc fulfills all the requirements outlined above. The study cohort was stratified into three distinct groups, namely critical care patients, service patients, and a healthy control group; a total of 24 COVID-19 patients in critical care, 27 ward-treated COVID-19 patients, and 26 healthy individuals. The groups exhibited a notable disparity in age distribution (p<0.001). A statistically significant difference was seen among the groups in relation to the survey results, presence of chronic disease, and length of hospital stay (p<0.001, p<0.001, and p=0.007, respectively). COVID-19 patients (n=51) exhibited markedly reduced zinc levels in comparison to a control group of healthy individuals (n=26). It was observed that the average zinc level in patients diagnosed with COVID-19 was 89 μg/dl (range: 43-123 μg/dl). In comparison, the median zinc level in individuals without COVID-19 was found to be 99.5 μg/dl (range: 79-125 μg/dl). A statistically significant difference was observed between the groups (p=0.023). The study revealed that a total of 13 individuals, accounting for 25.5% of the COVID-19 patients, exhibited a deficiency in zinc levels. The findings of our study indicate that zinc potentially plays a significant role in the context of COVID-19. However, additional research is required to get a comprehensive understanding of the association between COVID-19 and zinc.
{"title":"Evaluation of the Serum Zinc Level in Patients Followed in Hospital with the Diagnosis of COVID-19 in Samsun Province, Türkiye","authors":"Hacer İşler, I. Bahceci, Seda Güdül Havuz, Seher Aydoğan, Göksenin Ünlügüzel Üstün, Ç. Öztürk, Eşe Başbulut","doi":"10.54584/lms.2023.39","DOIUrl":"https://doi.org/10.54584/lms.2023.39","url":null,"abstract":"The COVID-19 (Coronavirus Disease 2019) outbreak has not yet ended and poses a persistent hazard to individuals, communities, and healthcare systems globally. Similar to numerous other diseases, the immune system of the patient is intricately associated with the advancement and mortality rates of COVID-19. In general, the immune system plays a crucial role in protecting the host against infections and neoplastic cells, and a well-balanced diet can enhance the immune system's ability to effectively defend against infectious agents. There have been suggestions that the administration of zinc supplements may decrease the occurrence of lower respiratory tract infections in children who are deficient in zinc. This study will thus examine the potential of zinc as a preventive and therapeutic agent, either on its own or in conjunction with other techniques, as zinc fulfills all the requirements outlined above. The study cohort was stratified into three distinct groups, namely critical care patients, service patients, and a healthy control group; a total of 24 COVID-19 patients in critical care, 27 ward-treated COVID-19 patients, and 26 healthy individuals. The groups exhibited a notable disparity in age distribution (p<0.001). A statistically significant difference was seen among the groups in relation to the survey results, presence of chronic disease, and length of hospital stay (p<0.001, p<0.001, and p=0.007, respectively). COVID-19 patients (n=51) exhibited markedly reduced zinc levels in comparison to a control group of healthy individuals (n=26). It was observed that the average zinc level in patients diagnosed with COVID-19 was 89 μg/dl (range: 43-123 μg/dl). In comparison, the median zinc level in individuals without COVID-19 was found to be 99.5 μg/dl (range: 79-125 μg/dl). A statistically significant difference was observed between the groups (p=0.023). The study revealed that a total of 13 individuals, accounting for 25.5% of the COVID-19 patients, exhibited a deficiency in zinc levels. The findings of our study indicate that zinc potentially plays a significant role in the context of COVID-19. However, additional research is required to get a comprehensive understanding of the association between COVID-19 and zinc.","PeriodicalId":344016,"journal":{"name":"Life and Medical Sciences","volume":"73 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139357877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kemal Tekin, Hasan Karakuş, Sevinç Karabulut, F. Şahiner, R. Gümral
In this study, it was aimed to examine the distribution and positivity rates of the tests reported in the medical immunology laboratory of a tertiary education and research hospital, and to determine the distribution of antinuclear antibody (ANA) test requests, which constitute a significant part of the workload, according to disease diagnosis/preliminary diagnoses and clinical departments, and to examine the possible causes and costs of incorrect-inappropriate test orders, and to consider effective and applicable solution suggestions. In the study, a retrospective review of data on all immunoserology tests (n=94,954 individual parameters) reported approximately over a three-year period starting from September 2016 was presented. When the tests are divided into three main groups; among all test parameters, ANA tests ranked first with a rate of 20.3% (n=19,248). In our study, the positivity rate of ANA tests evaluated by the indirect immunofluorescence antibody (IFA) method was found as 23.1% (n=4,446). The number of reported parameters of specific autoantibody tests (second group), which include many different tests (IFA, ELISA, and immunoblot based), was 67,976, and the overall positivity was 2.96%, varies between 0.8% and 12.7%, depending on the antibody type. In the ELISA-based brucella and antiviral (herpes simplex virus 1 and 2, varicella virus, measles virus, mumps virus, parvovirus B19) IgM and IgG antibody tests in the third group, the highest positivity rate was observed according to the number of tests requested (30.1%, 2,324/7,730). In ANA-positive patients, the most frequently detected ANA-related autoantibodies were anti-dsDNA (9.2%) and anti-SS-A (8.2%). In ANA-negative patients, in simultaneously ordered tests, anti-dsDNA positivity was found to be 3.3%, while positivity rates for other ANA-related specific autoantibodies were in the range of 0.0-0.31%. ANA tests were most frequently ordered from the rheumatology department (34.2%), and also the highest ANA positivity rate (28%) was observed in this unit. The most notable reason for unnecessary test ordering was the test requests by different physicians for the same patient. We consider that evaluation of ANA tests at a dilution of 1:100 may lead to unnecessary second-step testing (specific autoantibodies) due to the low positive results, and that narrow-scope second-step autoantibody test panels will have negative effects on laboratory efficiency.
本研究旨在考察一家三级教研医院医学免疫学实验室报告的检验项目的分布情况和阳性率，并根据疾病诊断/初步诊断和临床科室确定占工作量很大一部分的抗核抗体（ANA）检验申请的分布情况，考察错误-不适当检验单的可能原因和成本，并考虑有效和适用的解决建议。研究中，对自2016年9月起的三年内报告的所有免疫血清学检验数据（n=94954个单项参数）进行了回顾性回顾。如果将检测分为三大类，在所有检测参数中，ANA 检测以 20.3% 的比率（n=19248）位居第一。在我们的研究中，通过间接免疫荧光抗体（IFA）法评估的 ANA 检测阳性率为 23.1%（n=4 446）。特异性自身抗体检测（第二组）包括多种不同的检测方法（IFA、ELISA 和免疫印迹法），报告的参数数量为 67 976 个，总体阳性率为 2.96%，根据抗体类型的不同，阳性率在 0.8% 到 12.7% 之间。在第三组基于 ELISA 的布鲁氏菌和抗病毒（单纯疱疹病毒 1 和 2、水痘病毒、麻疹病毒、腮腺炎病毒、B19 副病毒）IgM 和 IgG 抗体检测中，根据申请检测的次数，阳性率最高（30.1%，2,324/7,730）。在 ANA 阳性患者中，最常检测到的 ANA 相关自身抗体是抗dsDNA（9.2%）和抗 SS-A（8.2%）。在 ANA 阴性患者中，在同时进行的检测中，抗dsDNA 阳性率为 3.3%，而其他 ANA 相关特异性自身抗体的阳性率在 0.0-0.31% 之间。风湿病科最常要求进行 ANA 检测（34.2%），该科室的 ANA 阳性率也最高（28%）。不必要的化验单最显著的原因是不同医生对同一患者提出的化验要求。我们认为，对稀释度为 1:100 的 ANA 检测进行评估可能会因阳性结果较低而导致不必要的第二步检测（特异性自身抗体），而且范围较窄的第二步自身抗体检测板将对实验室效率产生负面影响。
{"title":"Choosing Wisely in Immunology Laboratory: Reviewing of Antinuclear Antibody (ANA) Test Requests and Results Together with Other Tests","authors":"Kemal Tekin, Hasan Karakuş, Sevinç Karabulut, F. Şahiner, R. Gümral","doi":"10.54584/lms.2023.38","DOIUrl":"https://doi.org/10.54584/lms.2023.38","url":null,"abstract":"In this study, it was aimed to examine the distribution and positivity rates of the tests reported in the medical immunology laboratory of a tertiary education and research hospital, and to determine the distribution of antinuclear antibody (ANA) test requests, which constitute a significant part of the workload, according to disease diagnosis/preliminary diagnoses and clinical departments, and to examine the possible causes and costs of incorrect-inappropriate test orders, and to consider effective and applicable solution suggestions. In the study, a retrospective review of data on all immunoserology tests (n=94,954 individual parameters) reported approximately over a three-year period starting from September 2016 was presented. When the tests are divided into three main groups; among all test parameters, ANA tests ranked first with a rate of 20.3% (n=19,248). In our study, the positivity rate of ANA tests evaluated by the indirect immunofluorescence antibody (IFA) method was found as 23.1% (n=4,446). The number of reported parameters of specific autoantibody tests (second group), which include many different tests (IFA, ELISA, and immunoblot based), was 67,976, and the overall positivity was 2.96%, varies between 0.8% and 12.7%, depending on the antibody type. In the ELISA-based brucella and antiviral (herpes simplex virus 1 and 2, varicella virus, measles virus, mumps virus, parvovirus B19) IgM and IgG antibody tests in the third group, the highest positivity rate was observed according to the number of tests requested (30.1%, 2,324/7,730). In ANA-positive patients, the most frequently detected ANA-related autoantibodies were anti-dsDNA (9.2%) and anti-SS-A (8.2%). In ANA-negative patients, in simultaneously ordered tests, anti-dsDNA positivity was found to be 3.3%, while positivity rates for other ANA-related specific autoantibodies were in the range of 0.0-0.31%. ANA tests were most frequently ordered from the rheumatology department (34.2%), and also the highest ANA positivity rate (28%) was observed in this unit. The most notable reason for unnecessary test ordering was the test requests by different physicians for the same patient. We consider that evaluation of ANA tests at a dilution of 1:100 may lead to unnecessary second-step testing (specific autoantibodies) due to the low positive results, and that narrow-scope second-step autoantibody test panels will have negative effects on laboratory efficiency.","PeriodicalId":344016,"journal":{"name":"Life and Medical Sciences","volume":"77 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139358828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The aim of the study is to determine the frequency and distribution of all colonoscopic pathologies, especially colorectal cancer (CRC), in Somalia between 2015 and 2020. For this retrospective and descriptive study, a total of 760 colonoscopy results were analyzed from the medical records of Somalia Turkey Recep Tayyip Erdoğan Training and Research Hospital. We excluded 175 patients with incomplete colonoscopy findings and medical records. Patient characteristics, presence of normal mucosa, presence, characteristics, localization, and histopathology of the lesion were recorded. Abdomino-pelvic computed tomography (CT) scans were evaluated. The median age of 585 patients (male; n=384, 65.6%) included in the study was 44 years (range; 19-94). 20.5% (n=120) had normal colonoscopy findings and 31.8% (n=186) had benign perianal pathologies (most common hemorrhoids; n=139, 23.8%). In 40.9% (n=239/585) of patients, lesions were detected in the colorectum and biopsy was performed. The number of cases with CRC on colonoscopy was 50 (8.5%), the most common histopathological type was adenocarcinoma (n=40/50; 80%) and the most common localization was rectosigmoid colon (n=37/50; 74%). The median age of CRC cases was 53 years (range, 29-85) and 72% (n=36) were male. The most common morphologic type of adenocarcinoma on CT image was mass-forming (n=35/40; 87.5%). In all patients, the tumor had invaded the bowel wall and periintestinal fat infiltration was present. Lymph node metastases were present in 38% (n=19/50) and distant organ metastases in 18% (n=9/50) of patients with CRC. Our study reveals that colonoscopies in Somalia mostly find perianal lesions (most commonly hemorrhoids), the incidence of CRCs is 8.5%, all CRCs are diagnosed at an advanced stage and require neoadjuvant chemoradiotherapy. Community education and screening programs should be developed to detect CRCs early in the precancerous stage and reduce mortality.
{"title":"Incidence and Imaging of Colorectal Cancer Between 2015-2020 in Somalia: A Review of 585 Colonoscopy","authors":"Sadettin Er, Veysel Kaya","doi":"10.54584/lms.2023.37","DOIUrl":"https://doi.org/10.54584/lms.2023.37","url":null,"abstract":"The aim of the study is to determine the frequency and distribution of all colonoscopic pathologies, especially colorectal cancer (CRC), in Somalia between 2015 and 2020. For this retrospective and descriptive study, a total of 760 colonoscopy results were analyzed from the medical records of Somalia Turkey Recep Tayyip Erdoğan Training and Research Hospital. We excluded 175 patients with incomplete colonoscopy findings and medical records. Patient characteristics, presence of normal mucosa, presence, characteristics, localization, and histopathology of the lesion were recorded. Abdomino-pelvic computed tomography (CT) scans were evaluated. The median age of 585 patients (male; n=384, 65.6%) included in the study was 44 years (range; 19-94). 20.5% (n=120) had normal colonoscopy findings and 31.8% (n=186) had benign perianal pathologies (most common hemorrhoids; n=139, 23.8%). In 40.9% (n=239/585) of patients, lesions were detected in the colorectum and biopsy was performed. The number of cases with CRC on colonoscopy was 50 (8.5%), the most common histopathological type was adenocarcinoma (n=40/50; 80%) and the most common localization was rectosigmoid colon (n=37/50; 74%). The median age of CRC cases was 53 years (range, 29-85) and 72% (n=36) were male. The most common morphologic type of adenocarcinoma on CT image was mass-forming (n=35/40; 87.5%). In all patients, the tumor had invaded the bowel wall and periintestinal fat infiltration was present. Lymph node metastases were present in 38% (n=19/50) and distant organ metastases in 18% (n=9/50) of patients with CRC. Our study reveals that colonoscopies in Somalia mostly find perianal lesions (most commonly hemorrhoids), the incidence of CRCs is 8.5%, all CRCs are diagnosed at an advanced stage and require neoadjuvant chemoradiotherapy. Community education and screening programs should be developed to detect CRCs early in the precancerous stage and reduce mortality.","PeriodicalId":344016,"journal":{"name":"Life and Medical Sciences","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139360031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pharmacoepidemiological studies are important for the development of health systems. The aim of this study is to examine the seasonal and branch changes of prescriptions written in the light of national data. Drug and prescription information between 01.01.2016 and 31.12.2022 analyzed retrospectively from electronic data. In addition to gender and age distribution, the specialty and hospital level at which the prescription was written were examined in temporal terms. Prescribed drugs have been classified according to Anatomical Therapeutic Chemical (ATC) codes previously created by the World Health Organization. It was determined that 1,452,128,177 prescriptions were written during the study period. These included a total of 4,602,556,489 drugs with the ATC code. The most written ATC code group was A (alimentary tract and metabolism), followed by M (musculo-skeletal system), and R (respiratory system) group drugs. In terms of specialization, the group that wrote the most prescriptions was family physicians, followed by emergency physicians, and internal medicine specialists. Examining prescription software trends is important when creating healthcare policies. Developing strategies to reduce prescription costs will contribute to the efficient use of resources and improving the quality and sustainability of health services delivery.
药物流行病学研究对卫生系统的发展非常重要。本研究的目的是根据国家数据研究处方的季节性和分支变化。通过电子数据对 2016 年 1 月 1 日至 2022 年 12 月 31 日期间的药物和处方信息进行了回顾性分析。除性别和年龄分布外，还对开具处方的专科和医院级别进行了时间上的研究。处方药根据世界卫生组织之前制定的解剖治疗化学（ATC）代码进行分类。研究期间共开具了 1,452,128,177 份处方。其中包括 4,602,556,489 种带有 ATC 代码的药物。使用最多的 ATC 代码组是 A 组（消化道和新陈代谢），其次是 M 组（肌肉骨骼系统）和 R 组（呼吸系统）。就专业而言，开具处方最多的群体是家庭医生，其次是急诊医生和内科专家。在制定医疗保健政策时，研究处方软件的趋势非常重要。制定降低处方成本的战略将有助于有效利用资源，提高医疗服务的质量和可持续性。
{"title":"A 6-Year Review of the Electronic Drug Prescription System in the Republic of Türkiye","authors":"Ş. Birinci, M. M. Ülgü","doi":"10.54584/lms.2023.35","DOIUrl":"https://doi.org/10.54584/lms.2023.35","url":null,"abstract":"Pharmacoepidemiological studies are important for the development of health systems. The aim of this study is to examine the seasonal and branch changes of prescriptions written in the light of national data. Drug and prescription information between 01.01.2016 and 31.12.2022 analyzed retrospectively from electronic data. In addition to gender and age distribution, the specialty and hospital level at which the prescription was written were examined in temporal terms. Prescribed drugs have been classified according to Anatomical Therapeutic Chemical (ATC) codes previously created by the World Health Organization. It was determined that 1,452,128,177 prescriptions were written during the study period. These included a total of 4,602,556,489 drugs with the ATC code. The most written ATC code group was A (alimentary tract and metabolism), followed by M (musculo-skeletal system), and R (respiratory system) group drugs. In terms of specialization, the group that wrote the most prescriptions was family physicians, followed by emergency physicians, and internal medicine specialists. Examining prescription software trends is important when creating healthcare policies. Developing strategies to reduce prescription costs will contribute to the efficient use of resources and improving the quality and sustainability of health services delivery.","PeriodicalId":344016,"journal":{"name":"Life and Medical Sciences","volume":"112 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139361366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In this study, we aimed to investigate the utilization of primary health care in the diagnosis, treatment and follow-up of patients diagnosed with rheumatic disease. For this purpose, 350 patients with rheumatic disease were included in the survey and 26-question about the demographic information of the patients, utilization of primary health care during and afterwards the diagnosis process of the disease. The mean age of the participants was 48.67±13.26, and 73.7% (n=258) of them were female. The patients were diagnosed with rheumatic disease an average of 6.74±6.07 years ago. Joint pain was the most common complaint with a rate of 79.7%. 22% (n=77) of the patients were referred to first internal medicine outpatient department. First admission rate to a family physician was 12.3% (n=43) and 55.8% (n=24) of these patients were referred to higher care for diagnosis. 69.1% (n=242) of the patients were diagnosed in a tertiary healthcare institution. According to the analysis results, 47.7% of the patients had a prescription from their family physician for their rheumatic diseases, but only 6% (n=21) went to their primary care physician for check-ups for their rheumatic diseases. In our study, the rate of use of primary care services was high when patients' rheumatic disease symptoms first begin and were only prescribed prescription drugs after diagnosis. The tendency to prefer primary care for follow-up was low. Contributing to all processes of the rheumatic disease will reduce the workload of hospitals and contribute to a cost-effective approach. For this, the factors that will eliminate the negative perceptions of patients towards primary care can be reviewed and the rate of patients' preference for primary care can be increased.
{"title":"Utilization Rate of Primary Health Services in the Diagnosis, Treatment, and Follow-Up of Patients Diagnosed with Rheumatic Disease","authors":"Arda Polat, Tuğba Yılmaz, O. Sari","doi":"10.54584/lms.2023.36","DOIUrl":"https://doi.org/10.54584/lms.2023.36","url":null,"abstract":"In this study, we aimed to investigate the utilization of primary health care in the diagnosis, treatment and follow-up of patients diagnosed with rheumatic disease. For this purpose, 350 patients with rheumatic disease were included in the survey and 26-question about the demographic information of the patients, utilization of primary health care during and afterwards the diagnosis process of the disease. The mean age of the participants was 48.67±13.26, and 73.7% (n=258) of them were female. The patients were diagnosed with rheumatic disease an average of 6.74±6.07 years ago. Joint pain was the most common complaint with a rate of 79.7%. 22% (n=77) of the patients were referred to first internal medicine outpatient department. First admission rate to a family physician was 12.3% (n=43) and 55.8% (n=24) of these patients were referred to higher care for diagnosis. 69.1% (n=242) of the patients were diagnosed in a tertiary healthcare institution. According to the analysis results, 47.7% of the patients had a prescription from their family physician for their rheumatic diseases, but only 6% (n=21) went to their primary care physician for check-ups for their rheumatic diseases. In our study, the rate of use of primary care services was high when patients' rheumatic disease symptoms first begin and were only prescribed prescription drugs after diagnosis. The tendency to prefer primary care for follow-up was low. Contributing to all processes of the rheumatic disease will reduce the workload of hospitals and contribute to a cost-effective approach. For this, the factors that will eliminate the negative perceptions of patients towards primary care can be reviewed and the rate of patients' preference for primary care can be increased.","PeriodicalId":344016,"journal":{"name":"Life and Medical Sciences","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139361410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We investigated the reasons for the rejection of spinal interventional pain management techniques (SIPMT) in patients with lower back pain. The patients included in the study applied to an algology outpatient clinic with complaints of chronic lower back pain and were recommended SIPMT. The demographic data, systemic diseases, diagnoses, suggested SIPMT, and reasons why certain patients refused SIPMT, were all evaluated. Among the 196 patients who were recommended SIPMT, 61 (31.1%) refused the treatment. The most common reasons for refusing SIPMT was a belief that the injection would not be a definitive solution (63.9%), belief that the pain would recur after the injection (55.7%), the inability to avoid work that would strain the lower back after the injection (39.3%), and the fear that the pain would worsen (37.7%). Patients have a wide range of concerns about SIMPT. If the wide range of concerns patients have about SIMPT can be more comprehensively considered, refusal of such treatments due to unnecessary concerns can be prevented.
{"title":"The Reasons for the Rejection of Spinal Interventional Pain Management Techniques in Patients with Chronic Lower Back Pain","authors":"S. Kaya, Muge Baran","doi":"10.54584/lms.2023.33","DOIUrl":"https://doi.org/10.54584/lms.2023.33","url":null,"abstract":"We investigated the reasons for the rejection of spinal interventional pain management techniques (SIPMT) in patients with lower back pain. The patients included in the study applied to an algology outpatient clinic with complaints of chronic lower back pain and were recommended SIPMT. The demographic data, systemic diseases, diagnoses, suggested SIPMT, and reasons why certain patients refused SIPMT, were all evaluated. Among the 196 patients who were recommended SIPMT, 61 (31.1%) refused the treatment. The most common reasons for refusing SIPMT was a belief that the injection would not be a definitive solution (63.9%), belief that the pain would recur after the injection (55.7%), the inability to avoid work that would strain the lower back after the injection (39.3%), and the fear that the pain would worsen (37.7%). Patients have a wide range of concerns about SIMPT. If the wide range of concerns patients have about SIMPT can be more comprehensively considered, refusal of such treatments due to unnecessary concerns can be prevented.","PeriodicalId":344016,"journal":{"name":"Life and Medical Sciences","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121298821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Since the World Health Organization declared COVID-19 (Coronavirus Disease 2019) a pandemic on March 11, 2020, SARS-CoV-2 has caused high rates of morbidity and mortality worldwide. The addition of secondary bacterial infections such as pneumonia to the clinical course led to more mortality of the disease. This situation has led to an increase in the use of antibiotics for both prophylactic and therapeutic purposes and has caused concerns about the increase in antibiotic resistance rates and multi-drug resistant strains. 679 COVID-19 patients (Group 1) with a diagnosis confirmed by polymerase chain reaction (PCR) and 366 patients who were followed up in the anesthesia intensive care unit (ICU) during the pandemic but had negative SARS-CoV-2 PCR test results (Group 2) were included in this study; all of them were treated in the ICU of our hospital between April 2020 - May 2022. In order to observe the possible effects of SARS-CoV-2 infection on the distribution of the causative agent and changes in antibiotic resistance patterns, the data of 363 patients (Group 3) who were treated in the anesthesia ICU between April 2017 and May 2019 (pre-pandemic period) were analyzed. Bacterial agents isolated from tracheal aspirate samples and antibiotic resistance rates of 1408 patients in the groups were determined. Pathogenic microorganism growth was detected in the tracheal aspirate samples of 430 (63.3%) of the patients followed in the COVID-19 ICUs. In the patients followed in COVID-19 ICUs, as secondary bacterial pneumonia agents, in order of frequency; Acinetobacter baumannii (39.6%), Klebsiella pneumoniae (35.5%) and Pseudomonas aeruginosa (3.5%) were isolated. A. baumannii and K. pneumoniae isolation rates were significantly higher in COVID-19 patients (Group 1) compared to non-COVID-19 ICU patients (Group 2) and were similarly higher in all patients in the pandemic period (Group 1 + Group 2) compared to the pre-epidemic period (p<0.001). Other remarkable findings were the presence of high antibiotic resistance rates in A. baumannii and K. pneumoniae strains isolated during the pandemic period, compared to the pre-pandemic period, and the observation of multi-drug resistance in the vast majority of isolates. In order to prevent the increased risk of mortality associated with concomitant secondary bacterial infections in patients followed in ICUs due to COVID-19; It is important to evaluate patients quickly in terms of bacterial infections, to take timely and appropriate antibiotic treatment and to take necessary isolation measures.
{"title":"The Effects of SARS-CoV-2 Pandemic on the Distribution of Secondary Bacterial Pneumonia Agents and Antibiotic Resistance Profile in Intensive Care Units","authors":"İsmail Selçuk Aygar","doi":"10.54584/lms.2023.34","DOIUrl":"https://doi.org/10.54584/lms.2023.34","url":null,"abstract":"Since the World Health Organization declared COVID-19 (Coronavirus Disease 2019) a pandemic on March 11, 2020, SARS-CoV-2 has caused high rates of morbidity and mortality worldwide. The addition of secondary bacterial infections such as pneumonia to the clinical course led to more mortality of the disease. This situation has led to an increase in the use of antibiotics for both prophylactic and therapeutic purposes and has caused concerns about the increase in antibiotic resistance rates and multi-drug resistant strains. 679 COVID-19 patients (Group 1) with a diagnosis confirmed by polymerase chain reaction (PCR) and 366 patients who were followed up in the anesthesia intensive care unit (ICU) during the pandemic but had negative SARS-CoV-2 PCR test results (Group 2) were included in this study; all of them were treated in the ICU of our hospital between April 2020 - May 2022. In order to observe the possible effects of SARS-CoV-2 infection on the distribution of the causative agent and changes in antibiotic resistance patterns, the data of 363 patients (Group 3) who were treated in the anesthesia ICU between April 2017 and May 2019 (pre-pandemic period) were analyzed. Bacterial agents isolated from tracheal aspirate samples and antibiotic resistance rates of 1408 patients in the groups were determined. Pathogenic microorganism growth was detected in the tracheal aspirate samples of 430 (63.3%) of the patients followed in the COVID-19 ICUs. In the patients followed in COVID-19 ICUs, as secondary bacterial pneumonia agents, in order of frequency; Acinetobacter baumannii (39.6%), Klebsiella pneumoniae (35.5%) and Pseudomonas aeruginosa (3.5%) were isolated. A. baumannii and K. pneumoniae isolation rates were significantly higher in COVID-19 patients (Group 1) compared to non-COVID-19 ICU patients (Group 2) and were similarly higher in all patients in the pandemic period (Group 1 + Group 2) compared to the pre-epidemic period (p<0.001). Other remarkable findings were the presence of high antibiotic resistance rates in A. baumannii and K. pneumoniae strains isolated during the pandemic period, compared to the pre-pandemic period, and the observation of multi-drug resistance in the vast majority of isolates. In order to prevent the increased risk of mortality associated with concomitant secondary bacterial infections in patients followed in ICUs due to COVID-19; It is important to evaluate patients quickly in terms of bacterial infections, to take timely and appropriate antibiotic treatment and to take necessary isolation measures.","PeriodicalId":344016,"journal":{"name":"Life and Medical Sciences","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133488363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mandibular canal and its neurovascular contents are highly important structures for dental clinicals. Accurate localization of the mandibular canal and determination of its variations are crucial aspects to achieve successful surgical results without complications. Inferior alveolar nerve, artery, and vein could be damaged during surgical interventions and serious complications may occur in post-operative period, such as permanent paraesthesia. Thus, the patients’ health and social life may be seriously affected. The aim of this study was to investigate the prevalence and features of mandibular canal variations in a group Turkish population using cone beam computed tomography (CBCT) and orthopantomography (OPG) techniques. This retrospective study was performed on CBCT and OPG images of 700 patients whose mandibular canal area was clearly observed and aged over 20 years old which were referred to our clinic between 2011-2016. Patients with congenital or acquired deformity affecting the mandible were excluded from the study. In order to make comparative analysis, various measurements were made on both types of imaging. In our study, mandibular canal variation rates were identified as 2.43% (17/700) and 8.57% (60/700) on OPG images and CBCT images, respectively. As a result of our study, it could be said that the mandibular canal variations are not rare cases for the Turkish population. Before risky surgical procedures and when there is a suspicious diagnosis due to inadequacy of OPG imaging method; the CBCT imaging method should be referred in order to prevent complications such as hemorrhage, paresthesia, and traumatic neuroma.
{"title":"The Investigation of Mandibular Canal Variations in the Turkish Society Comparative with Cone Beam Computerized Tomography and Orthopantomography Methods","authors":"Savaş Özarslantürk, İsmail Hakan Avsever","doi":"10.54584/lms.2023.32","DOIUrl":"https://doi.org/10.54584/lms.2023.32","url":null,"abstract":"Mandibular canal and its neurovascular contents are highly important structures for dental clinicals. Accurate localization of the mandibular canal and determination of its variations are crucial aspects to achieve successful surgical results without complications. Inferior alveolar nerve, artery, and vein could be damaged during surgical interventions and serious complications may occur in post-operative period, such as permanent paraesthesia. Thus, the patients’ health and social life may be seriously affected. The aim of this study was to investigate the prevalence and features of mandibular canal variations in a group Turkish population using cone beam computed tomography (CBCT) and orthopantomography (OPG) techniques. This retrospective study was performed on CBCT and OPG images of 700 patients whose mandibular canal area was clearly observed and aged over 20 years old which were referred to our clinic between 2011-2016. Patients with congenital or acquired deformity affecting the mandible were excluded from the study. In order to make comparative analysis, various measurements were made on both types of imaging. In our study, mandibular canal variation rates were identified as 2.43% (17/700) and 8.57% (60/700) on OPG images and CBCT images, respectively. As a result of our study, it could be said that the mandibular canal variations are not rare cases for the Turkish population. Before risky surgical procedures and when there is a suspicious diagnosis due to inadequacy of OPG imaging method; the CBCT imaging method should be referred in order to prevent complications such as hemorrhage, paresthesia, and traumatic neuroma.","PeriodicalId":344016,"journal":{"name":"Life and Medical Sciences","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123319394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The term polypharmacy is generally known as the simultaneous use of five or more medicines. An increase in polypharmacy is also observed with chronic diseases, which increases with age. The main complications of polypharmacy are medicine side effects, inappropriate medicine use, drug-drug interaction, and drug-disease interactions. Family physicians are the most effective physician group in coordinating medicine therapy, as they provide continuous, longitudinal, and comprehensive medical care to the individual. In this study, it was aimed to determine the need of an auxiliary web application regarding family medicine residents' awareness of polypharmacy side effects in geriatric population and to identify the barriers to rational drug use in their daily clinical practice. The research is a cross-sectional observational study, and all residents actively working in the Ankara City Hospital Family Medicine Clinic were planned to be included and were invited to the study. The study was conducted through survey application method under observation. It was determined that geriatric patients mostly referred to their "clinical experience" in rational drug use according to the participants. The obstacles faced by the participants in rational drug use were mostly in that of "not having enough knowledge" and "patient-centered medicine regulation to be difficult and time consuming". 75.3% of respondents (n=70) marked strongly agree and 18.3% marked agree (n=17) for the statement "I would like to have an easily accessible an artificial intelligence aided web application that I can use in my daily practice regarding polypharmacy side effects, such as drug-drug interactions, drug-chronic disease incompatibility, potentially inappropriate medicine (PIM) in the elderly" and the mean value of this proposition was determined as 4.65±0.7. This study showed that the resources used to detect polypharmacy and its complications were not used adequately and appropriately. Moreover, the study results present the need and demand for time-saving and facilitating auxiliary web applications to minimize PIM, drug-drug interaction, drug-chronic disease interaction in the elderly and to evaluate it in the light of current data to provide person-centered and comprehensive care in the clinician's practice.
{"title":"Family Medicine Residents Awareness of Rational Drug Use in Geriatric Patients and Their Need for a Web Application","authors":"","doi":"10.54584/lms.2023.31","DOIUrl":"https://doi.org/10.54584/lms.2023.31","url":null,"abstract":"The term polypharmacy is generally known as the simultaneous use of five or more medicines. An increase in polypharmacy is also observed with chronic diseases, which increases with age. The main complications of polypharmacy are medicine side effects, inappropriate medicine use, drug-drug interaction, and drug-disease interactions. Family physicians are the most effective physician group in coordinating medicine therapy, as they provide continuous, longitudinal, and comprehensive medical care to the individual. In this study, it was aimed to determine the need of an auxiliary web application regarding family medicine residents' awareness of polypharmacy side effects in geriatric population and to identify the barriers to rational drug use in their daily clinical practice. The research is a cross-sectional observational study, and all residents actively working in the Ankara City Hospital Family Medicine Clinic were planned to be included and were invited to the study. The study was conducted through survey application method under observation. It was determined that geriatric patients mostly referred to their \"clinical experience\" in rational drug use according to the participants. The obstacles faced by the participants in rational drug use were mostly in that of \"not having enough knowledge\" and \"patient-centered medicine regulation to be difficult and time consuming\". 75.3% of respondents (n=70) marked strongly agree and 18.3% marked agree (n=17) for the statement \"I would like to have an easily accessible an artificial intelligence aided web application that I can use in my daily practice regarding polypharmacy side effects, such as drug-drug interactions, drug-chronic disease incompatibility, potentially inappropriate medicine (PIM) in the elderly\" and the mean value of this proposition was determined as 4.65±0.7. This study showed that the resources used to detect polypharmacy and its complications were not used adequately and appropriately. Moreover, the study results present the need and demand for time-saving and facilitating auxiliary web applications to minimize PIM, drug-drug interaction, drug-chronic disease interaction in the elderly and to evaluate it in the light of current data to provide person-centered and comprehensive care in the clinician's practice.","PeriodicalId":344016,"journal":{"name":"Life and Medical Sciences","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132651999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Eighteen months of family medicine residency training is completed as in-hospital rotation. In this process, the increase in the possibility of encountering risky situations in terms of hospital acquired infections (HAI) reveals the importance of awareness and immunization status for family medicine residents in preventing HAI. The aim of this study is to evaluate the risk status of family medicine residents about HAI, to investigate their immunization status, and to raise awareness on this issue. This study was conducted on 285 participants, including family medicine assistants who received residency training at Gülhane Training and Research Hospital between 01.08.2021 and 30.03.2022. In the 17-question survey made to the residents who accepted the study, demographic characteristics of the residents and some other information about the HAI were questioned. Afterwards, whether they encountered risky situations, periodic control examinations of the physicians, and their immunization status were questioned. Questions were asked in the form of a 5-point Likert-type table about the use of personal protective methods and their knowledge level about HAI. The answers given to the Likert type questions were scored as 1 worst and 5 as the best, and the total knowledge level score (minimum-maximum:15-75) was obtained. 180 (63.2%) of the participants were female, 196 (68.8%) were in the 24-29 age range. Of the participants, 99.3% (n=283) COVID-19, 96.5% (n=275) hepatitis B, 93.7% (n=267) tetanus, 39.6% (n=113) pneumococcus, 39.3% (n=112) influenza vaccine. The knowledge level score of female residents was higher (p=0.001). There was a significant difference between the age distribution of the participants and their knowledge level (p=0.033). According to this difference, the average knowledge level scores of the participants in the 24-29 age range were higher (p=0.047). It was determined that female residents HAI as a higher risk for family medicine residents (p=0.026). Participants who considered HAI as a risk for family medicine residents had a higher knowledge level (p=0.043). In our study, it was seen that HAI were evaluated as a risk by family medicine residents. On the other hand, the awareness and knowledge level of resident physicians on this issue was not considered sufficient. It was determined that some of the vaccines of the physicians were more careful with the effect of the COVID-19 pandemic. However, it was observed that they did not pay due attention to the periodic health examinations. In order to increase the awareness of family medicine residents about HAI, lessons on infections that may be risky can be planned in the training curriculum. By ensuring regular periodic controls, physicians can be followed up in terms of occupational health risks. In case of encountering risky situations, the use of personal protective methods is encouraged and regular inspection is recommended.
{"title":"Risk Profile, Awareness, and Immunization Status of Family Medicine Assistants on the Agents That Can Be Transmitted from the Hospital in the COVID-19 Pandemic","authors":"Fatoş Zayim Gedik, Tuğba Yılmaz, O. Sari","doi":"10.54584/lms.2023.30","DOIUrl":"https://doi.org/10.54584/lms.2023.30","url":null,"abstract":"Eighteen months of family medicine residency training is completed as in-hospital rotation. In this process, the increase in the possibility of encountering risky situations in terms of hospital acquired infections (HAI) reveals the importance of awareness and immunization status for family medicine residents in preventing HAI. The aim of this study is to evaluate the risk status of family medicine residents about HAI, to investigate their immunization status, and to raise awareness on this issue. This study was conducted on 285 participants, including family medicine assistants who received residency training at Gülhane Training and Research Hospital between 01.08.2021 and 30.03.2022. In the 17-question survey made to the residents who accepted the study, demographic characteristics of the residents and some other information about the HAI were questioned. Afterwards, whether they encountered risky situations, periodic control examinations of the physicians, and their immunization status were questioned. Questions were asked in the form of a 5-point Likert-type table about the use of personal protective methods and their knowledge level about HAI. The answers given to the Likert type questions were scored as 1 worst and 5 as the best, and the total knowledge level score (minimum-maximum:15-75) was obtained. 180 (63.2%) of the participants were female, 196 (68.8%) were in the 24-29 age range. Of the participants, 99.3% (n=283) COVID-19, 96.5% (n=275) hepatitis B, 93.7% (n=267) tetanus, 39.6% (n=113) pneumococcus, 39.3% (n=112) influenza vaccine. The knowledge level score of female residents was higher (p=0.001). There was a significant difference between the age distribution of the participants and their knowledge level (p=0.033). According to this difference, the average knowledge level scores of the participants in the 24-29 age range were higher (p=0.047). It was determined that female residents HAI as a higher risk for family medicine residents (p=0.026). Participants who considered HAI as a risk for family medicine residents had a higher knowledge level (p=0.043). In our study, it was seen that HAI were evaluated as a risk by family medicine residents. On the other hand, the awareness and knowledge level of resident physicians on this issue was not considered sufficient. It was determined that some of the vaccines of the physicians were more careful with the effect of the COVID-19 pandemic. However, it was observed that they did not pay due attention to the periodic health examinations. In order to increase the awareness of family medicine residents about HAI, lessons on infections that may be risky can be planned in the training curriculum. By ensuring regular periodic controls, physicians can be followed up in terms of occupational health risks. In case of encountering risky situations, the use of personal protective methods is encouraged and regular inspection is recommended.","PeriodicalId":344016,"journal":{"name":"Life and Medical Sciences","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129873866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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