Aim: Patients with plantar fasciitis modify their gait patterns due to the heel pain. We aimed to investigate whether there was a significant difference in the plantar pressure distribution after pain relief due to successful treatment response in plantar fasciitis. Methods: 49 patients diagnosed with chronic unilateral plantar fasciitis received a 3-week physical therapy intervention and home exercises. Visual analog scale, plantar pressure measurement by pedobarographic assessment and magnetic resonance imaging were performed before and 1 month after the intervention. At the 1-month follow up, participants were divided into 2 groups according to successful or poor response to treatment. The treatment's success criteria was defined as a percentage decrease in heel pain exceeding 60% compared to the baseline, assessed one month after the initiation of treatment. Results: A total of 44 subjects successfully completed the study. In group 1, characterized by successful responders, there were 24 subjects, while group 2, comprising poor responders, included 20 subjects. After treatment in group 1, the dynamic plantar pressure on the medial forefoot showed a significant increase (p = 0.015). However, there was no significant change in plantar pressure in the poor responders. Plantar fascia thickness correlated positively with thumb dynamic pressures (coronal p = 0.03 r = 0.434, sagittal r = 0.451 p = 0.02). Conclusion: The results suggest that fascial thickness and dynamic forefoot plantar pressures may be related. Medial forefoot plantar pressures increased as a result of gait restoration with significant pain reduction in adults.
目的:足底筋膜炎患者改变他们的步态模式，由于足跟疼痛。我们的目的是研究足底筋膜炎成功治疗后疼痛缓解后足底压力分布是否有显著差异。方法:对49例慢性单侧足底筋膜炎患者进行为期3周的物理治疗干预和家庭锻炼。在干预前和干预后1个月分别进行视觉模拟量表、足底压力测量、足压评估和磁共振成像。随访1个月，根据治疗效果好坏分为两组。治疗的成功标准定义为治疗开始一个月后，与基线相比，足跟疼痛减少的百分比超过60%。结果:44名受试者成功完成研究。第一组以成功应答者为特征，有24名受试者;第二组以不良应答者为特征，有20名受试者。1组治疗后，前足内侧的动态足底压力显著增加(p = 0.015)。然而，反应不良的患者足底压力无明显变化。足底筋膜厚度与拇指动压呈正相关(冠状面p = 0.03 r = 0.434，矢状面r = 0.451 p = 0.02)。结论:筋膜厚度与动态前足足底压力有关。在成人中，由于步态恢复和显著的疼痛减轻，内侧前足足底压力增加。
{"title":"The assessment of plantar pressure distribution in plantar fasciitis and its relationship with treatment success and fascial thickness","authors":"Aslıhan Ulusoy, Lale Cerrahoğlu, Şebnem Örgüç","doi":"10.51271/kmj-0114","DOIUrl":"https://doi.org/10.51271/kmj-0114","url":null,"abstract":"Aim: Patients with plantar fasciitis modify their gait patterns due to the heel pain. We aimed to investigate whether there was a significant difference in the plantar pressure distribution after pain relief due to successful treatment response in plantar fasciitis. Methods: 49 patients diagnosed with chronic unilateral plantar fasciitis received a 3-week physical therapy intervention and home exercises. Visual analog scale, plantar pressure measurement by pedobarographic assessment and magnetic resonance imaging were performed before and 1 month after the intervention. At the 1-month follow up, participants were divided into 2 groups according to successful or poor response to treatment. The treatment's success criteria was defined as a percentage decrease in heel pain exceeding 60% compared to the baseline, assessed one month after the initiation of treatment. Results: A total of 44 subjects successfully completed the study. In group 1, characterized by successful responders, there were 24 subjects, while group 2, comprising poor responders, included 20 subjects. After treatment in group 1, the dynamic plantar pressure on the medial forefoot showed a significant increase (p = 0.015). However, there was no significant change in plantar pressure in the poor responders. Plantar fascia thickness correlated positively with thumb dynamic pressures (coronal p = 0.03 r = 0.434, sagittal r = 0.451 p = 0.02). Conclusion: The results suggest that fascial thickness and dynamic forefoot plantar pressures may be related. Medial forefoot plantar pressures increased as a result of gait restoration with significant pain reduction in adults.","PeriodicalId":369732,"journal":{"name":"Kastamonu Medical Journal","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136100177","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}
Aims: Multiple drug use creates a burden on both the individual and the health system. And this is often observed in advanced age patient groups. Various scales have been developed for the prevention of polypharmacy. We aimed to apply the Beers criteria used for this purpose in the prescriptions of patients who applied to the endocrinology outpatient clinic. Methods: 102 patients aged 65 years and over who applied to the endocrinology outpatient clinic for routine control and who had at least four drugs in their prescription were included in this study. Demographic data and drug use status of the patients were recorded and evaluated. Results: Of the 102 cases included in the study, 70 (68.6%) were women. The most common chronic pathology was diabetes mellitus in 83 (81.4%) cases. Inappropriate drug use was most common in endocrine system drugs. The prescriptions included in the study were evaluated according to the 2019 Beers criteria retrospectively and inappropriate drug use was detected in 42 prescriptions (41.2%). Conclusion: Considering the pharmacodynamic and pharmacokinetic properties of drugs that change with age, the importance of polypharmacy and inappropriate drug use has emerged, and standardized scales have been created to evaluate this situation in elderly patients. In this study, insulins, proton pump inhibitors, and non-steroidal anti-inflammatory drugs seem to be the most commonly administered inappropriate drugs. Applying Beers criteria, one of the polypharmacy scales may be the right approach for a rational and effective treatment in the elderly.
{"title":"Evaluation of drug use in patients over 65 years of age admitted to endocrinology outpatient clinic with beers criteria","authors":"Sinem Gürcü, A. Kalkan","doi":"10.51271/kmj-0104","DOIUrl":"https://doi.org/10.51271/kmj-0104","url":null,"abstract":"Aims: Multiple drug use creates a burden on both the individual and the health system. And this is often observed in advanced age patient groups. Various scales have been developed for the prevention of polypharmacy. We aimed to apply the Beers criteria used for this purpose in the prescriptions of patients who applied to the endocrinology outpatient clinic.\u0000Methods: 102 patients aged 65 years and over who applied to the endocrinology outpatient clinic for routine control and who had at least four drugs in their prescription were included in this study. Demographic data and drug use status of the patients were recorded and evaluated.\u0000Results: Of the 102 cases included in the study, 70 (68.6%) were women. The most common chronic pathology was diabetes\u0000mellitus in 83 (81.4%) cases. Inappropriate drug use was most common in endocrine system drugs. The prescriptions included in the study were evaluated according to the 2019 Beers criteria retrospectively and inappropriate drug use was detected in 42 prescriptions (41.2%).\u0000Conclusion: Considering the pharmacodynamic and pharmacokinetic properties of drugs that change with age, the\u0000importance of polypharmacy and inappropriate drug use has emerged, and standardized scales have been created to evaluate this situation in elderly patients. In this study, insulins, proton pump inhibitors, and non-steroidal anti-inflammatory drugs seem to be the most commonly administered inappropriate drugs. Applying Beers criteria, one of the polypharmacy scales may be the right approach for a rational and effective treatment in the elderly.","PeriodicalId":369732,"journal":{"name":"Kastamonu Medical Journal","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123013981","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}
Enis Fuat Tüfekci, B. Çalışır, Melike Yaşar Duman, Ç. Kılınç
Aims: Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections during pregnancy have a risk of transmission to the newborn. Therefore, pregnant women are routinely screened for HBV and HCV in many countries. This study aimed to reveal the seroprevalence of HBsAg, anti-HBs, and anti-HCV in pregnant women in the Kastamonu region and to compare the obtained data with the results of studies conducted in Turkey. Methods: Pregnant women who applied to Kastamonu Training and Research Hospital Microbiology laboratory between January 2022 and January 2023 for HBsAg, anti-HBs, and anti-HCV tests were included in this study. The pregnant women were separated into two groups ?24 and >24 age groups. The tests were performed using the chemiluminescence microparticle immune assay method on the Abbott Architect i2000SR instrument, and the results were evaluated per the manufacturer’s instructions. Results: HBsAg, anti-HBs, and anti-HCV positivity were 0.5% (n=9/1712), 51.1% (n=874/1712), and 0.1% (n=2/1713), respectively. While there was no significant difference between age groups for HBsAg positivity (p>0.05), anti-HBs positivity was found to be significantly higher in the ?24 age group than in the >24 age group (p=0.002). Conclusion: The results showed that HBsAg and anti-HCV positivity was lower than in most studies conducted in recent years in Turkey, and anti-HBs positivity was higher than in most studies. It is essential to continue routine HBV and HCV screening in pregnant women’s first follow-up and encourage anti-HBs-negative individuals to be vaccinated against HBV.
{"title":"Determination of hepatitis B and hepatitis C seroprevalence in pregnant women in the Kastamonu region, Turkey","authors":"Enis Fuat Tüfekci, B. Çalışır, Melike Yaşar Duman, Ç. Kılınç","doi":"10.51271/kmj-0103","DOIUrl":"https://doi.org/10.51271/kmj-0103","url":null,"abstract":"Aims: Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections during pregnancy have a risk of transmission to the\u0000newborn. Therefore, pregnant women are routinely screened for HBV and HCV in many countries. This study aimed to reveal the seroprevalence of HBsAg, anti-HBs, and anti-HCV in pregnant women in the Kastamonu region and to compare the obtained data with the results of studies conducted in Turkey.\u0000Methods: Pregnant women who applied to Kastamonu Training and Research Hospital Microbiology laboratory between\u0000January 2022 and January 2023 for HBsAg, anti-HBs, and anti-HCV tests were included in this study. The pregnant women\u0000were separated into two groups ?24 and >24 age groups. The tests were performed using the chemiluminescence microparticle immune assay method on the Abbott Architect i2000SR instrument, and the results were evaluated per the manufacturer’s instructions.\u0000Results: HBsAg, anti-HBs, and anti-HCV positivity were 0.5% (n=9/1712), 51.1% (n=874/1712), and 0.1% (n=2/1713),\u0000respectively. While there was no significant difference between age groups for HBsAg positivity (p>0.05), anti-HBs positivity\u0000was found to be significantly higher in the ?24 age group than in the >24 age group (p=0.002).\u0000Conclusion: The results showed that HBsAg and anti-HCV positivity was lower than in most studies conducted in recent years in Turkey, and anti-HBs positivity was higher than in most studies. It is essential to continue routine HBV and HCV screening in pregnant women’s first follow-up and encourage anti-HBs-negative individuals to be vaccinated against HBV.","PeriodicalId":369732,"journal":{"name":"Kastamonu Medical Journal","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114375149","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}
Aims: This study aimed to compare neck ultrasonography to chest X-ray—the gold standard technique—to evaluate the effectiveness in verifying gastric tube placement. Methods: This prospective study reported the data of the 39 mechanically ventilated patients in the intensive care unit. While inserting the gastric tube, a linear ultrasound probe was simultaneously used to visualize the esophagus in the left lateral region of the neck, and obscuration of the posterior esophageal wall was observed during passage of the tube. In addition, ultrasonography was used to detect “dynamic fogging” in the stomach, while auscultation was also used to determine the location of the tube. Chest X-ray images were captured from all patients included in the study. Results: Among 39 patients who had been enrolled in the study, three of them died before chest X-ray, the esophagus could not be visualized in 9 and the stomach could not be visualized in 4 using ultrasonography. The sensitivity, specificity, positive predictive value, negative predictive value of neck ultrasonography in verifying gastric tube placement were 69.7%, 66.7%, 95.8% and 16.7%, respectively and, 51.5%, 100%, 100% and 15.7%, respectively, for stomach ultrasonography. Conclusion: Visualization of gastric tube insertion in the esophagus using neck ultrasonography demonstrated various advantages including non-invasiveness, rapidity, and bedside technique availability, although it has lower sensitivity and specificity due to its operator-dependent nature.
{"title":"Verifiying gastric tube placement using neck ultrasonography in mechanically ventilated patients in the intensive care unit","authors":"M. Dağdelen, İ. Ceylan, F. Kahveci","doi":"10.51271/kmj-0100","DOIUrl":"https://doi.org/10.51271/kmj-0100","url":null,"abstract":"Aims: This study aimed to compare neck ultrasonography to chest X-ray—the gold standard technique—to evaluate the effectiveness in verifying gastric tube placement.\u0000Methods: This prospective study reported the data of the 39 mechanically ventilated patients in the intensive care unit. While inserting the gastric tube, a linear ultrasound probe was simultaneously used to visualize the esophagus in the left lateral region of the neck, and obscuration of the posterior esophageal wall was observed during passage of the tube. In addition, ultrasonography was used to detect “dynamic fogging” in the stomach, while auscultation was also used to determine the location of the tube. Chest X-ray images were captured from all patients included in the study.\u0000Results: Among 39 patients who had been enrolled in the study, three of them died before chest X-ray, the esophagus could not be visualized in 9 and the stomach could not be visualized in 4 using ultrasonography. The sensitivity, specificity, positive predictive value, negative predictive value of neck ultrasonography in verifying gastric tube placement were 69.7%, 66.7%, 95.8% and 16.7%, respectively and, 51.5%, 100%, 100% and 15.7%, respectively, for stomach ultrasonography.\u0000Conclusion: Visualization of gastric tube insertion in the esophagus using neck ultrasonography demonstrated various advantages including non-invasiveness, rapidity, and bedside technique availability, although it has lower sensitivity and specificity due to its operator-dependent nature.","PeriodicalId":369732,"journal":{"name":"Kastamonu Medical Journal","volume":"218 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115018294","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}
D. Özdemir, S. Görgün, A. Çeçen, S. Alkan, Yavuz Çeçen, D. M. Mehel, Asude Ünal
Aims: Endotracheal tube (ETT) design, size, cuff material, cuff pressure, and intubation duration are critical in preventing nosocomial pneumonia. We aimed to evaluate the possible infection focus potential of ETT cuff and pilot balloon, particularly in prolonged intubated patients. Methods: A total number of 66 patients who underwent orotracheal intubation and received conventional mechanical ventilation more than 48 hours in the intensive care unit (ICU), were included in this prospective cohort study. Results:The mean duration of intubation was 10.36±4.82 days. Bacteriologically confirmed positive tracheal aspirate culture was 18.2% (n=12). The most frequent positive culture was detected inside of ETT lumen with a percentage of 83.3% (n=55) and followed by cuff (27.3%, n=18), pilot balloon (13.6%, n=9), respectively. It was documented that rates of lung infections were significantly increased after 14 days (p = 0.017) and rates of cuff positive cultures were significantly increased after 10 and 14 days of incubation (p= 0.001, p=0.004). The same type of bacteriological strains was identified from both pilot balloon (n=9) and ETT cuff (n=9), simultaneously. In the remaining 9-cuff positive patients pilot balloons were sterile and ETT lumens were positive culture with the same strains as identified from the cuff. There was a statistically significant positive correlation between the intubation duration and the number of infected ETT parts (p<0.001). Conclusion: ETT cuff was demonstrated to be a potential infection focus in the present study. In addition, it was observed that ETT cuff colonization increased in proportion to the intubation duration. We suggest changing ETT at appropriate time intervals in order to reduce ventilator-associated pneumonia in intubated patients.
{"title":"The effect of prolonged intubation on ventilator associated pneumonia: endotracheal tube cuff is really steril or not?","authors":"D. Özdemir, S. Görgün, A. Çeçen, S. Alkan, Yavuz Çeçen, D. M. Mehel, Asude Ünal","doi":"10.51271/kmj-0099","DOIUrl":"https://doi.org/10.51271/kmj-0099","url":null,"abstract":"Aims: Endotracheal tube (ETT) design, size, cuff material, cuff pressure, and intubation duration are critical in preventing nosocomial pneumonia. We aimed to evaluate the possible infection focus potential of ETT cuff and pilot balloon, particularly in prolonged intubated patients.\u0000Methods: A total number of 66 patients who underwent orotracheal intubation and received conventional mechanical ventilation more than 48 hours in the intensive care unit (ICU), were included in this prospective cohort study.\u0000Results:The mean duration of intubation was 10.36±4.82 days. Bacteriologically confirmed positive tracheal aspirate culture was 18.2% (n=12). The most frequent positive culture was detected inside of ETT lumen with a percentage of 83.3% (n=55) and followed by cuff (27.3%, n=18), pilot balloon (13.6%, n=9), respectively. It was documented that rates of lung infections were significantly increased after 14 days (p = 0.017) and rates of cuff positive cultures were significantly increased after 10 and 14 days of incubation (p= 0.001, p=0.004). The same type of bacteriological strains was identified from both pilot balloon (n=9) and ETT cuff (n=9), simultaneously. In the remaining 9-cuff positive patients pilot balloons were sterile and ETT lumens were positive culture with the same strains as identified from the cuff. There was a statistically significant positive correlation between the intubation duration and the number of infected ETT parts (p<0.001).\u0000Conclusion: ETT cuff was demonstrated to be a potential infection focus in the present study. In addition, it was observed that ETT cuff colonization increased in proportion to the intubation duration. We suggest changing ETT at appropriate time intervals in order to reduce ventilator-associated pneumonia in intubated patients.","PeriodicalId":369732,"journal":{"name":"Kastamonu Medical Journal","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122922288","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}
Özgür Önen, Y. Yıldız, Miraç Koç, Fatma Mutlu Kukul Güven
Splenic artery aneurysm is a rare and usually asymptomatic disease that is more common among women. It is usually diagnosed as a result of rupture during pregnancy. It may result in mortality if patients with rupture are not diagnosed and treated early. Although the endovascular method is the first choice in treatment, the surgical procedure can also be applied in hemodynamically unstable patients. In this report, we present a case of splenic artery aneurysm rupture that occurred due to the use of enoxaparin in a patient diagnosed with COVID-19 and followed up at home.
{"title":"Splenic artery aneurysm rupture after using enoxaparin for COVID-19: is it a coincidence or complication?","authors":"Özgür Önen, Y. Yıldız, Miraç Koç, Fatma Mutlu Kukul Güven","doi":"10.51271/kmj-0109","DOIUrl":"https://doi.org/10.51271/kmj-0109","url":null,"abstract":"Splenic artery aneurysm is a rare and usually asymptomatic disease that is more common among women. It is usually diagnosed as a result of rupture during pregnancy. It may result in mortality if patients with rupture are not diagnosed and treated early. Although the endovascular method is the first choice in treatment, the surgical procedure can also be applied in hemodynamically unstable patients. In this report, we present a case of splenic artery aneurysm rupture that occurred due to the use of enoxaparin in a patient diagnosed with COVID-19 and followed up at home.","PeriodicalId":369732,"journal":{"name":"Kastamonu Medical Journal","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116456296","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}
Ertan Cömertpay, Sinan Oğuzhan Özsan, Ömer Yeşilyurt, O. Eroğlu, S. Vural, F. Coşkun
Aims: The use of brain computed tomography (CT) in the management of childhood head traumas is increasing every day. However, due to the more prominent harmful effects of radiation caused by CT in children and the increase in health expenditures, rules have been settled to determine brain CT indications, especially in children with mild head trauma. The aim of this study is to contribute to the literature by sharing the demographic characteristics, clinical findings and Brain CT results of pediatric patients who admitted to the emergency department (ED) with head trauma. Methods: The study was conducted retrospectively in children who admitted to Kırıkkale University Hospital ED with head trauma. The demographic characteristics of the patients, their complaints at admission, Glasgow coma score (GCS), examination findings, follow-up and treatment management in the ED, and brain CT results were recorded. Chi-square test was used to compare the data. A value of p<0.05 was considered statistically significant. Results: 234 children with head trauma were included in the study. Mean age of the study group was: 9.13±6.36 /years and 57.3% (n=134) were males. While 7.2% of the children were <2 years old, 92.8% of them were ?2 years old. Mean GCS was 14.92±0.79. Falling from a height was the most common cause of head trauma with 30.8%, followed by falling from the same level with 21.8% and in-vehicle traffic accident with 18.4%. Headache (37.2%), nausea-vomiting (36.8%) and loss of consciousness (13.7%) were the three most common admission symptoms after head trauma. Headache was found to be significantly higher in the ?2 age group and nausea-vomiting in the <2 age group compared to the other group (p=0.006; p<0.001, respectively). While 97.9% of brain CT results were normal, the most common pathological finding was linear fracture (2.1%). In terms of brain CT results, no difference was found between children <2 years and ?2 years of age (p=0.527). Conclusion: Majority of the pediatric patients we evaluated in our study had minor head trauma, and most of the brain CT results were normal. Headache, nausea, vomiting, and loss of consciousness were the three most common symptoms after head trauma. Nausea-vomiting was observed more frequently in children aged <2 years and headache was observed inchildren aged ?2 years after head trauma, compared to other age groups.
{"title":"Evaluation of brain computed tomography results in pediatric traumas","authors":"Ertan Cömertpay, Sinan Oğuzhan Özsan, Ömer Yeşilyurt, O. Eroğlu, S. Vural, F. Coşkun","doi":"10.51271/kmj-0106","DOIUrl":"https://doi.org/10.51271/kmj-0106","url":null,"abstract":"Aims: The use of brain computed tomography (CT) in the management of childhood head traumas is increasing every\u0000day. However, due to the more prominent harmful effects of radiation caused by CT in children and the increase in health\u0000expenditures, rules have been settled to determine brain CT indications, especially in children with mild head trauma. The aim of this study is to contribute to the literature by sharing the demographic characteristics, clinical findings and Brain CT results of pediatric patients who admitted to the emergency department (ED) with head trauma.\u0000Methods: The study was conducted retrospectively in children who admitted to Kırıkkale University Hospital ED with\u0000head trauma. The demographic characteristics of the patients, their complaints at admission, Glasgow coma score (GCS),\u0000examination findings, follow-up and treatment management in the ED, and brain CT results were recorded. Chi-square test\u0000was used to compare the data. A value of p<0.05 was considered statistically significant.\u0000Results: 234 children with head trauma were included in the study. Mean age of the study group was: 9.13±6.36 /years and\u000057.3% (n=134) were males. While 7.2% of the children were <2 years old, 92.8% of them were ?2 years old. Mean GCS was\u000014.92±0.79. Falling from a height was the most common cause of head trauma with 30.8%, followed by falling from the same level with 21.8% and in-vehicle traffic accident with 18.4%. Headache (37.2%), nausea-vomiting (36.8%) and loss of consciousness (13.7%) were the three most common admission symptoms after head trauma. Headache was found to be significantly higher in the ?2 age group and nausea-vomiting in the <2 age group compared to the other group (p=0.006; p<0.001, respectively). While 97.9% of brain CT results were normal, the most common pathological finding was linear fracture (2.1%). In terms of brain CT results, no difference was found between children <2 years and ?2 years of age (p=0.527).\u0000Conclusion: Majority of the pediatric patients we evaluated in our study had minor head trauma, and most of the brain CT\u0000results were normal. Headache, nausea, vomiting, and loss of consciousness were the three most common symptoms after head trauma. Nausea-vomiting was observed more frequently in children aged <2 years and headache was observed inchildren aged ?2 years after head trauma, compared to other age groups.","PeriodicalId":369732,"journal":{"name":"Kastamonu Medical Journal","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131171503","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}
Aims: To investigate the relationship between the presence of perinephric fat stranding (PFS) with three consecutive chest CT severity scores (CT-SS), mortality and intensive care unit admission in COVID-19 patients. Methods: This single-center retrospective study, included 457 (?18 years) COVID-19 patients with positive RT-PCR tests. A radiologist calculated three consecutive CT-SS for COVID-19 pneumonia using a visual scoring system ranging from 0 to 25 points. Grades of PFS on CTs were defined as none, mild, moderate or severe. Firstly, patients were divided into two groups, with and without PFS. The Association of PFS with demographic and laboratory data, CT-SS, and mortality rates were analyzed. We divided patients into four subgroups based on PFS grading and investigated temporal changes of mean CT-SS of three consecutive CTs in each PFS subgroup using a paired-sample test and Wilcoxon signed-rank test. Results: Patients with PFS were associated with older age (p<0.001) and had higher CT-SS (p=0.03). We found a particularly strong association between PFS and mortality (p<0.001) and intensive care unit admission (p=0.001). Statistical associations were found between PFS and elevated serum BUN (p=0.004), creatinine (p=0.007), CRP (p=0.02), and ferritin (p=0.005). In multivariate logistic regression analysis, older age was associated with 1.067-fold (p<=0.001), PFS 1.964-fold (p=0.007), elevated serum creatinine 3.630-fold (p=0.005) higher risks of mortality. In PFS subgroups other than severe, there were significant increases between the first and second CT-SS (p<0.001, p<0.001, p=0.003). Conclusion: Perinephric fat stranding is an important CT finding that can alert clinicians to the poor prognosis of COVID-19 patients in early periods.
{"title":"Association of perinephric fat stranding with CT severity scores and mortality in COVID-19 patients","authors":"Burcu Akman, A. Kaya","doi":"10.51271/kmj-0105","DOIUrl":"https://doi.org/10.51271/kmj-0105","url":null,"abstract":"Aims: To investigate the relationship between the presence of perinephric fat stranding (PFS) with three consecutive chest CT severity scores (CT-SS), mortality and intensive care unit admission in COVID-19 patients. \u0000Methods: This single-center retrospective study, included 457 (?18 years) COVID-19 patients with positive RT-PCR tests. A radiologist calculated three consecutive CT-SS for COVID-19 pneumonia using a visual scoring system ranging from 0 to 25 points. Grades of PFS on CTs were defined as none, mild, moderate or severe. Firstly, patients were divided into two groups, with and without PFS. The Association of PFS with demographic and laboratory data, CT-SS, and mortality rates were analyzed. We divided patients into four subgroups based on PFS grading and investigated temporal changes of mean CT-SS of three consecutive CTs in each PFS subgroup using a paired-sample test and Wilcoxon signed-rank test.\u0000Results: Patients with PFS were associated with older age (p<0.001) and had higher CT-SS (p=0.03). We found a particularly strong association between PFS and mortality (p<0.001) and intensive care unit admission (p=0.001). Statistical associations were found between PFS and elevated serum BUN (p=0.004), creatinine (p=0.007), CRP (p=0.02), and ferritin (p=0.005). In multivariate logistic regression analysis, older age was associated with 1.067-fold (p<=0.001), PFS 1.964-fold (p=0.007), elevated serum creatinine 3.630-fold (p=0.005) higher risks of mortality. In PFS subgroups other than severe, there were significant increases between the first and second CT-SS (p<0.001, p<0.001, p=0.003).\u0000Conclusion: Perinephric fat stranding is an important CT finding that can alert clinicians to the poor prognosis of COVID-19 patients in early periods.\u0000","PeriodicalId":369732,"journal":{"name":"Kastamonu Medical Journal","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123964752","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}
Aims: Real-life experience with ceftazidime/avibactam in the treatment of multidrug-resistant Klebsiella pneumoniae is still limited. This retrospective study aims to evaluate the efficacy of ceftazidime/avibactam in the treatment of critically ill patients with infections due to carbapenem-resistant pathogens. Methods: In our study, patients who were hospitalized in the ICUs of our hospital for more than three days between 01-01-2022 and 31-12-2022, who had only ceftazidime/avibactam susceptibility growth and were started on ceftazidime/avibactam treatment were retrospectively analyzed. 38 patients older than 18 years of age were included in the study. Results: Pneumonia was the most common cause of hospitalization in the ICU, followed by cerebrovascular events and internal diseases, respectively. The mean time from taking the culture samples to obtaining the laboratory results was 4.6 ±1.46 days. After the culture result was confirmed by the laboratory, the mean time between the patient's consultation by infection diseases specialist and initiation of treatment was 1.7±1.3 days. Patients received a mean of 10.6 ±4.63 days of CAZ-AVI treatment as monotherapy (57.9%) or combined therapy (42.1). Clinical response was obtained in 52.6% of the patients, and microbiological response was obtained in 63.2% of the patients. The 90-day all-cause mortality rate of patients receiving CAZ-AVI was 60.5% (n=23), and the mortality rate attributed to 14-day infection was 52.17%. Side effects developed in 18.4% of the patients. None of the developed side effects were such as to require discontinuation of treatment. There was no statistical difference in clinical response and microbiological response in patients receiving combination therapy and monotherapy. Mortality was significantly lower in patients receiving CAZ-AVI monotherapy (p<0.05). Conclusion: We attribute our low clinical success to the late initiation of treatment due to drug reimbursement criteria. Therefore, we think that CAZ-AVI treatment should be started empirically and as soon as possible. We think that our study is valuable in terms of showing that CAZ-AVI treatment should be given in empirical treatment.
{"title":"Ceftazidime/avibactam experience in tertiary hospital in Türkiye","authors":"Alper Tahmaz, Ayşegül Şeremet Keskin","doi":"10.51271/kmj-0101","DOIUrl":"https://doi.org/10.51271/kmj-0101","url":null,"abstract":"Aims: Real-life experience with ceftazidime/avibactam in the treatment of multidrug-resistant Klebsiella pneumoniae is still limited. This retrospective study aims to evaluate the efficacy of ceftazidime/avibactam in the treatment of critically ill patients with infections due to carbapenem-resistant pathogens.\u0000Methods: In our study, patients who were hospitalized in the ICUs of our hospital for more than three days between 01-01-2022 and 31-12-2022, who had only ceftazidime/avibactam susceptibility growth and were started on ceftazidime/avibactam treatment were retrospectively analyzed. 38 patients older than 18 years of age were included in the study.\u0000Results: Pneumonia was the most common cause of hospitalization in the ICU, followed by cerebrovascular events and internal diseases, respectively. The mean time from taking the culture samples to obtaining the laboratory results was 4.6 ±1.46 days. After the culture result was confirmed by the laboratory, the mean time between the patient's consultation by infection diseases specialist and initiation of treatment was 1.7±1.3 days. Patients received a mean of 10.6 ±4.63 days of CAZ-AVI treatment as monotherapy (57.9%) or combined therapy (42.1). Clinical response was obtained in 52.6% of the patients, and microbiological response was obtained in 63.2% of the patients. The 90-day all-cause mortality rate of patients receiving CAZ-AVI was 60.5% (n=23), and the mortality rate attributed to 14-day infection was 52.17%. Side effects developed in 18.4% of the patients. None of the developed side effects were such as to require discontinuation of treatment. There was no statistical difference in clinical response and microbiological response in patients receiving combination therapy and monotherapy. Mortality was significantly lower in patients receiving CAZ-AVI monotherapy (p<0.05). \u0000Conclusion: We attribute our low clinical success to the late initiation of treatment due to drug reimbursement criteria. Therefore, we think that CAZ-AVI treatment should be started empirically and as soon as possible. We think that our study is valuable in terms of showing that CAZ-AVI treatment should be given in empirical treatment.","PeriodicalId":369732,"journal":{"name":"Kastamonu Medical Journal","volume":"5 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114124362","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}
Ali Öztürk, Nurnehir Baltacı Bozkurt, Tuğba Avan Mutlu
Aims: Staphylococcus aureus infection rates, which are the cause of infections, have rapidly risen in both hospitals and society, constituting a concern. In this study, it was aimed to examine the antibiotic susceptibility of S. aureus strains isolated from patients treated in a tertiary state hospital for four years. Methods: A retrospective analysis was performed on S. aureus strains (n=584) identified from clinical samples delivered to the medical microbiology laboratory of Niğde Ömer Halisdemir University Training and Research Hospital for bacterial culture between 2016 and 2019. The isolates were identified by standard laboratory procedure. VITEK 2 automated system (bioMerieux, France) was used to identification and antibiotic susceptibilities of evaluate the strains. Results: Strains were most commonly isolated from wound swab (n=173) and blood culture (n=107). While the highest resistance rate was observed against Erythromycin (n=232), the least amikacin (n=16) resistant strain was determined. Vancomycin and teicoplanin resistance was not observed. Conclusion: Multi-drug resistance and MRSA resistance still exist today. The absence of vancomycin and teicoplanin resistance, in addition to the low level of trimethoprim-sulfamethoxazole resistance, is encouraging. This information about S. aureus's susceptibility may be helpful in determining how to administer antibiotics.
目的:金黄色葡萄球菌的感染率是引起感染的原因，在医院和社会中都迅速上升，令人担忧。在这项研究中，目的是检查从三级国立医院治疗四年的患者分离的金黄色葡萄球菌菌株的抗生素敏感性。方法:回顾性分析2016 - 2019年送到Niğde Ömer Halisdemir大学培训与研究医院医学微生物实验室进行细菌培养的临床样品中鉴定出的金黄色葡萄球菌菌株(n=584株)。采用标准实验室程序对分离株进行鉴定。采用VITEK 2自动化系统(bioMerieux, France)对菌株进行鉴定和药敏评价。结果:伤口拭子(173例)和血培养(107例)中分离到的细菌最多。对红霉素耐药率最高(n=232)，对阿米卡星耐药率最低(n=16)。未见万古霉素和替可普兰耐药。结论:目前仍存在耐多药和MRSA耐药。除了甲氧苄啶-磺胺甲恶唑的低水平耐药性外，没有万古霉素和替柯planin耐药性，这是令人鼓舞的。这些关于金黄色葡萄球菌敏感性的信息可能有助于决定如何使用抗生素。
{"title":"Antibiotic susceptibility of staphylococcus aureus strains isolated from various clinical specimens in a tertiary hospital","authors":"Ali Öztürk, Nurnehir Baltacı Bozkurt, Tuğba Avan Mutlu","doi":"10.51271/kmj-0098","DOIUrl":"https://doi.org/10.51271/kmj-0098","url":null,"abstract":"Aims: Staphylococcus aureus infection rates, which are the cause of infections, have rapidly risen in both hospitals and society, constituting a concern. In this study, it was aimed to examine the antibiotic susceptibility of S. aureus strains isolated from patients treated in a tertiary state hospital for four years.\u0000Methods: A retrospective analysis was performed on S. aureus strains (n=584) identified from clinical samples delivered to the medical microbiology laboratory of Niğde Ömer Halisdemir University Training and Research Hospital for bacterial culture between 2016 and 2019. The isolates were identified by standard laboratory procedure. VITEK 2 automated system (bioMerieux, France) was used to identification and antibiotic susceptibilities of evaluate the strains.\u0000Results: Strains were most commonly isolated from wound swab (n=173) and blood culture (n=107). While the highest resistance rate was observed against Erythromycin (n=232), the least amikacin (n=16) resistant strain was determined. Vancomycin and teicoplanin resistance was not observed.\u0000Conclusion: Multi-drug resistance and MRSA resistance still exist today. The absence of vancomycin and teicoplanin resistance, in addition to the low level of trimethoprim-sulfamethoxazole resistance, is encouraging. This information about S. aureus's susceptibility may be helpful in determining how to administer antibiotics.","PeriodicalId":369732,"journal":{"name":"Kastamonu Medical Journal","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125871130","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：