Pub Date : 2023-06-30DOI: 10.32552/2023.actamedica.842
Hatice Bolek, Sıla Çetik, F. Ceylan, E. C. Bolek, O. A. Uyaroğlu, M. Tanriover
Background: Heart failure (HF) is a common disease which is one of the most common causes of hospitalization. Although mortality rates are decreasing, readmission rates are still quite high. Objectives: We aimed to investigate the risk factors for readmission and death in patients who were hospitalized due to HF. Design and Setting: Retrospective study, Hacettepe University, Ankara, Turkey Methods: Patients hospitalized between 1 January 2014 to 31 December 2018 with the primary diagnosis of HF were included. Outcome variables were risk factors for 30-day all- caused readmission, 30-day HF related readmission, mortality. Results: All-cause 30-day readmission rate was 34.8% and HF-related 30-day readmission rate was 21.2%. The factors associated with increased all-caused 30-day readmission were male gender, hyperlipidemia, chronic liver disease, malignancy. The factors associated with increased HF-related 30-day readmission were hyperlipidemia, chronic liver disease, inflammatory rheumatologic diseases, malignancy. Use of ACE-i was found to be protective against all-cause and HF-related 30-day readmission. Factors associated with mortality were ejection fraction <30%, chronic liver disease, acute kidney injury, hypoalbuminemia at the time of admission. Conclusions: Nearly one third of patients in this cohort who were hospitalized with a primary diagnosis of HF were readmitted in the following 30 days. Having certain chronic diseases and conditions were associated with an increased risk for readmission and mortality. These findings point out to the special needs of HF patients, who require a proactive, integrated and multidisciplinary management strategy to control the risk factors and to improve the inpatient and transitional stages in the hospital.
{"title":"High 30-day readmission rates in hospitalized patients with heart failure: Strengthening the need for a multidisciplinary and integrated approach","authors":"Hatice Bolek, Sıla Çetik, F. Ceylan, E. C. Bolek, O. A. Uyaroğlu, M. Tanriover","doi":"10.32552/2023.actamedica.842","DOIUrl":"https://doi.org/10.32552/2023.actamedica.842","url":null,"abstract":"Background: Heart failure (HF) is a common disease which is one of the most common causes of hospitalization. Although mortality rates are decreasing, readmission rates are still quite high.\u0000Objectives: We aimed to investigate the risk factors for readmission and death in patients who were hospitalized due to HF.\u0000Design and Setting: Retrospective study, Hacettepe University, Ankara, Turkey\u0000Methods: Patients hospitalized between 1 January 2014 to 31 December 2018 with the primary diagnosis of HF were included. Outcome variables were risk factors for 30-day all- caused readmission, 30-day HF related readmission, mortality.\u0000Results: All-cause 30-day readmission rate was 34.8% and HF-related 30-day readmission rate was 21.2%. The factors associated with increased all-caused 30-day readmission were male gender, hyperlipidemia, chronic liver disease, malignancy. The factors associated with increased HF-related 30-day readmission were hyperlipidemia, chronic liver disease, inflammatory rheumatologic diseases, malignancy. Use of ACE-i was found to be protective against all-cause and HF-related 30-day readmission. Factors associated with mortality were ejection fraction <30%, chronic liver disease, acute kidney injury, hypoalbuminemia at the time of admission.\u0000Conclusions: Nearly one third of patients in this cohort who were hospitalized with a primary diagnosis of HF were readmitted in the following 30 days. Having certain chronic diseases and conditions were associated with an increased risk for readmission and mortality. These findings point out to the special needs of HF patients, who require a proactive, integrated and multidisciplinary management strategy to control the risk factors and to improve the inpatient and transitional stages in the hospital.","PeriodicalId":50891,"journal":{"name":"Acta Medica Mediterranea","volume":"84 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80453274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-30DOI: 10.32552/2023.actamedica.884
Mert Eşme, O. Aran, C. Balcı, Ege Temizkan, S. Ceylan, M. Koca, A. Okyar Baş, Berkan Torpil, O. Altuntaş, M. Uyanık, M. Halil, M. Cankurtaran, B. B. Doğu
Introduction: Being able to drive is an important parameter of independence and self-sufficiency. The continued use of cars, which plays an important role in maintaining the mobility of the older individuals, is very important for the protection of the individual’s activity performance. Methods: Driving skills of 31 participants were tested with the help of a driving simulator and cognitive tests were applied to each participant. The study was aimed to reveal the relationship between the cognitive functions and safe driving skills of older patients using the driving simulator and to determine the cognitive test that predicts the safe driving skill best. Results: 31 participants was included in the study. All participants were male. The average age was 72.5±6.The median of MMSE was 29 (IQR; 28-30),the mean of MOCA was 25.52±2.6,the mean value of QMCI was 62.68±9.57, the median of trail making test A was 42.5 sec(22-97), and the median of trail making test B was 98.31 sec(38-313).MOCA test score correlated positively with “the skills expected before starting the vehicle “and driving parameters on the highway(“p: 0.0024, r:0.46”;”p:0.0024, r:0.46”,respectively).The QMCI test was found to have a statistically positive and significant correlation with operational skills and the skills expected before starting the vehicle(“p:0.041, r:0.43”; “p:0.015 r:0.50”,respectively).When the factors affecting operational skills and safe driving skills were analyzed by linear regression analysis, both skills were influenced by the QMCI-orientation step(p:0.001;CI:1.59-3.9). Conclusion: In our study, it is shown that driving skills decrease with aging. QMCI and MOCA, which are easy to apply in clinical practice, will be useful in patients driving vehicles aged 65 and over with the demonstration of a significant relationship with total driving score, safe driving and operational skills.
{"title":"Older patients’ driving safety with the help of DRIVING SIMULATOR: Which cognitive test can predict better driving safety?","authors":"Mert Eşme, O. Aran, C. Balcı, Ege Temizkan, S. Ceylan, M. Koca, A. Okyar Baş, Berkan Torpil, O. Altuntaş, M. Uyanık, M. Halil, M. Cankurtaran, B. B. Doğu","doi":"10.32552/2023.actamedica.884","DOIUrl":"https://doi.org/10.32552/2023.actamedica.884","url":null,"abstract":"Introduction: Being able to drive is an important parameter of independence and self-sufficiency. The continued use of cars, which plays an important role in maintaining the mobility of the older individuals, is very important for the protection of the individual’s activity performance.\u0000Methods: Driving skills of 31 participants were tested with the help of a driving simulator and cognitive tests were applied to each participant. The study was aimed to reveal the relationship between the cognitive functions and safe driving skills of older patients using the driving simulator and to determine the cognitive test that predicts the safe driving skill best.\u0000Results: 31 participants was included in the study. All participants were male. The average age was 72.5±6.The median of MMSE was 29 (IQR; 28-30),the mean of MOCA was 25.52±2.6,the mean value of QMCI was 62.68±9.57, the median of trail making test A was 42.5 sec(22-97), and the median of trail making test B was 98.31 sec(38-313).MOCA test score correlated positively with “the skills expected before starting the vehicle “and driving parameters on the highway(“p: 0.0024, r:0.46”;”p:0.0024, r:0.46”,respectively).The QMCI test was found to have a statistically positive and significant correlation with operational skills and the skills expected before starting the vehicle(“p:0.041, r:0.43”; “p:0.015 r:0.50”,respectively).When the factors affecting operational skills and safe driving skills were analyzed by linear regression analysis, both skills were influenced by the QMCI-orientation step(p:0.001;CI:1.59-3.9).\u0000Conclusion: In our study, it is shown that driving skills decrease with aging. QMCI and MOCA, which are easy to apply in clinical practice, will be useful in patients driving vehicles aged 65 and over with the demonstration of a significant relationship with total driving score, safe driving and operational skills.","PeriodicalId":50891,"journal":{"name":"Acta Medica Mediterranea","volume":"3 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74179815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-30DOI: 10.32552/2023.actamedica.899
S. Ceylan, N. Kertmen, G. Yazici, A. Kars
Objective: Several factors are important in the prognosis of low grade gliomas, besides genetic changes. The present study aims to examine the effect of other factors on prognosis except for genetic changes in low grade gliomas (LGGs). Materials and Methods: Patients diagnosed with “brain malignant neoplasm” who were referred to Hacettepe University Oncology Hospital were screened. Among these patients, 148 patients with a supratentorial low grade gliomas whose data are completely available were included. Patients were followed for at least five years after diagnosis or death within this period. Results: Mean age of diagnosis was 36.2±10.7 years, and 52.7% of patients (n=78) were females, Most common subtype was oligodendroglioma (n=86, 58.1%). Sixty-two of patients relapsed (41.9%). The 5-year mortality rate was 35.1% (n=52). Kaplan-Meier analysis of the variables, the only difference was between histopathological subtypes (p=0.03). Astrocytoma histology was related to wporse prognosis. Cox regression analysis of factors affecting 5-year mortality, advancing age (HR: 1.03, 95% CI: 1.00-1.06, p=0.03), astrocytoma (HR: 2.59, 95% CI: 1.35-4.98, p=0.004) and oligoastrocytoma (HR: 2.13, 95% CI: 1.02-4.43, p=0.04) were identified to increase the mortality risk. Conclusion: The age of the patients and the histopathologic subtype of the tumor must be taken into consideration during the follow-up and treatment of low grade gliomas.
{"title":"Low-grade glial tumors: The experience of an oncology hospital in Türkiye","authors":"S. Ceylan, N. Kertmen, G. Yazici, A. Kars","doi":"10.32552/2023.actamedica.899","DOIUrl":"https://doi.org/10.32552/2023.actamedica.899","url":null,"abstract":"Objective: Several factors are important in the prognosis of low grade gliomas, besides genetic changes. The present study aims to examine the effect of other factors on prognosis except for genetic changes in low grade gliomas (LGGs).\u0000Materials and Methods: Patients diagnosed with “brain malignant neoplasm” who were referred to Hacettepe University Oncology Hospital were screened. Among these patients, 148 patients with a supratentorial low grade gliomas whose data are completely available were included. Patients were followed for at least five years after diagnosis or death within this period.\u0000Results: Mean age of diagnosis was 36.2±10.7 years, and 52.7% of patients (n=78) were females, Most common subtype was oligodendroglioma (n=86, 58.1%). Sixty-two of patients relapsed (41.9%). The 5-year mortality rate was 35.1% (n=52). Kaplan-Meier analysis of the variables, the only difference was between histopathological subtypes (p=0.03). Astrocytoma histology was related to wporse prognosis. Cox regression analysis of factors affecting 5-year mortality, advancing age (HR: 1.03, 95% CI: 1.00-1.06, p=0.03), astrocytoma (HR: 2.59, 95% CI: 1.35-4.98, p=0.004) and oligoastrocytoma (HR: 2.13, 95% CI: 1.02-4.43, p=0.04) were identified to increase the mortality risk.\u0000Conclusion: The age of the patients and the histopathologic subtype of the tumor must be taken into consideration during the follow-up and treatment of low grade gliomas.","PeriodicalId":50891,"journal":{"name":"Acta Medica Mediterranea","volume":"8 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80195902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-30DOI: 10.32552/2023.actamedica.891
Öznur Uzun
Objective: Osteoarthritis (OA) is the most common form of arthritis, resulting from the degradation of articular cartilage, degradation and proliferative reformation of subchondral bone and a low degree of synovitis that leads to a reduced quality of life. There is no established cure for knee OA. Treatment modalities which have an effect on the underlying biological processes responsible for OA pathogenesis may have potential. One such modality drawing attention is platelet-rich plasma (PRP) injections. In this study, we aimed to evaluate the effects of PRP injections retrospectively in patients with knee OA and the outcomes of two different volume injections. Materials and Method: A total of 314 patients were included in the study. After baseline physical examination, each patient was evaluated with VAS score and WOMAC before the procedure. All the patients received two intra-articular injections one month apart with autologous PRP and were followed up for a minimum period of 1 year (range, 12-34 months). Two weeks after the injections, the physical examinations of the patients and their evaluations with VAS scores and WOMAC criteria were repeated. Results: Both VAS scores and WOMAC scores showed significant differences after the first injection (p<0.05). Although both scores increased after the second injection, the differences were not significant (p>0.05). We also showed that as BMI increased both VAS scores and WOMAC scores increased. Conclusion: Although our study showed that PRP injections have favorable improvements in the management of knee OA such as reducing the pain and decreasing joint stiffness, PRP injections in the treatment of knee OA needs more standardized research.
{"title":"Evaluation of the results of intra-articular platelet-rich plasma injections in patients with knee osteoarthritis","authors":"Öznur Uzun","doi":"10.32552/2023.actamedica.891","DOIUrl":"https://doi.org/10.32552/2023.actamedica.891","url":null,"abstract":"Objective: Osteoarthritis (OA) is the most common form of arthritis, resulting from the degradation of articular cartilage, degradation and proliferative reformation of subchondral bone and a low degree of synovitis that leads to a reduced quality of life. There is no established cure for knee OA. Treatment modalities which have an effect on the underlying biological processes responsible for OA pathogenesis may have potential. One such modality drawing attention is platelet-rich plasma (PRP) injections. In this study, we aimed to evaluate the effects of PRP injections retrospectively in patients with knee OA and the outcomes of two different volume injections.\u0000Materials and Method: A total of 314 patients were included in the study. After baseline physical examination, each patient was evaluated with VAS score and WOMAC before the procedure. All the patients received two intra-articular injections one month apart with autologous PRP and were followed up for a minimum period of 1 year (range, 12-34 months). Two weeks after the injections, the physical examinations of the patients and their evaluations with VAS scores and WOMAC criteria were repeated.\u0000Results: Both VAS scores and WOMAC scores showed significant differences after the first injection (p<0.05). Although both scores increased after the second injection, the differences were not significant (p>0.05). We also showed that as BMI increased both VAS scores and WOMAC scores increased.\u0000Conclusion: Although our study showed that PRP injections have favorable improvements in the management of knee OA such as reducing the pain and decreasing joint stiffness, PRP injections in the treatment of knee OA needs more standardized research.","PeriodicalId":50891,"journal":{"name":"Acta Medica Mediterranea","volume":"7 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76484819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-11DOI: 10.32552/2023.actamedica.845
Dorina Esendağlı, D. Köksal, S. Sarınç Ulaşlı, S. Emri
Objective: The relationship between cancer and sarcoidosis has been a research topic for a long time. An increased risk of sarcoidosis and sarcoid-like reactions is suggested in patients with malignant disease. The present study aimed to describe the clinical characteristics and the prognosis of 15 Turkish patients who had a diagnosis of both malignancy and sarcoidosis. Methods: The patients admitted to our department between October 2013 and October 2018 were included in this study. Patient data including, the demographic data, clinical, radiological, pathological findings, and applied treatment modalities were retrieved from hospital database. Results: The study included 14 females and 1 male with a mean age of 53.3±11.4 years. Malignancy was the preceding diagnosis in 13 patients. The mean interval time between two diagnoses was 4±3.6 years. Fourteen patients recovered from their cancer, only 1 patient with relapsed NHL was deceased. The most common type of malignancy was breast (n=7) and endometrium (n=3) carcinoma. Surgery was the primary therapeutic modality in 14 patients. Additionally patients received certain drugs which might contribute to onset of sarcoidosis such as Cyclophosphamide (n=8), Adriamycin (n=8), Trastuzumab (n=2), and Rituximab (n=1). Ten patients were asymptomatic for sarcoidosis and 7 patients had stage I pulmonary sarcoidosis. Two third of the patients (n=10) did not receive any therapy for sarcoidosis. Conclusion: This study involves a few number of patients and according to the analysis of this group the presence of malignancy and sarcoidosis in the same patient might promote good prognosis for both entities. However the onset of sarcoidosis during the follow-up period is a challenging clinical condition and a biopsy is needed for differential diagnosis and management decision. Yet the biopsy might not be enough to differentiate between sarcoidosis and the sarcoid reactions related to malignancy. Future studies are needed to enlighten the underlying pathogenesis.
{"title":"Malignancy and Sarcoidosis: A Single Center Experience from Turkey","authors":"Dorina Esendağlı, D. Köksal, S. Sarınç Ulaşlı, S. Emri","doi":"10.32552/2023.actamedica.845","DOIUrl":"https://doi.org/10.32552/2023.actamedica.845","url":null,"abstract":"Objective: The relationship between cancer and sarcoidosis has been a research topic for a long time. An increased risk of sarcoidosis and sarcoid-like reactions is suggested in patients with malignant disease. The present study aimed to describe the clinical characteristics and the prognosis of 15 Turkish patients who had a diagnosis of both malignancy and sarcoidosis.\u0000Methods: The patients admitted to our department between October 2013 and October 2018 were included in this study. Patient data including, the demographic data, clinical, radiological, pathological findings, and applied treatment modalities were retrieved from hospital database.\u0000Results: The study included 14 females and 1 male with a mean age of 53.3±11.4 years. Malignancy was the preceding diagnosis in 13 patients. The mean interval time between two diagnoses was 4±3.6 years. Fourteen patients recovered from their cancer, only 1 patient with relapsed NHL was deceased. The most common type of malignancy was breast (n=7) and endometrium (n=3) carcinoma. Surgery was the primary therapeutic modality in 14 patients. Additionally patients received certain drugs which might contribute to onset of sarcoidosis such as Cyclophosphamide (n=8), Adriamycin (n=8), Trastuzumab (n=2), and Rituximab (n=1). Ten patients were asymptomatic for sarcoidosis and 7 patients had stage I pulmonary sarcoidosis. Two third of the patients (n=10) did not receive any therapy for sarcoidosis.\u0000Conclusion: This study involves a few number of patients and according to the analysis of this group the presence of malignancy and sarcoidosis in the same patient might promote good prognosis for both entities. However the onset of sarcoidosis during the follow-up period is a challenging clinical condition and a biopsy is needed for differential diagnosis and management decision. Yet the biopsy might not be enough to differentiate between sarcoidosis and the sarcoid reactions related to malignancy. Future studies are needed to enlighten the underlying pathogenesis.","PeriodicalId":50891,"journal":{"name":"Acta Medica Mediterranea","volume":"35 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79683991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-07DOI: 10.32552/2023.actamedica.819
H. Bilge, Ö. Başol, B. Demir, A. Oğuz
Objective: This study was performed to investigate the prognostic role of lactate dehydrogenase/albumin ratio (LAR) and pancreatic ductal adenocarcinoma (PDAC) with initial curable resection treatment. Materials and Methods: This retrospective study was conducted with the data of patients with resectable PDAC. The (ROC) analysis showed that the optimal sill value for pretreatment LAR was 91.43 and this threshold value was used in other analyses. Univariate and multivariate analyses were performed to determine the prognostic factors for overall survival (OS). Results: Our study consisted of 70 patients with a mean age of 59.5±13.2 years and 37 (52,9%) women. OS was 50 months in LAR <91.43 (n = 32) patients and 27,7 months in LAR≥91.43 (n=38) patients, respectively. Kaplan–Meier curves showed that LAR≥91.43 was significantly associated with worse OS (p=0.029). Multivariate analyses proved that LAR was an independent predictor in resectable PDAC patients (p=0.017). Conclusion: Our results showed that a high pre-treatment LAR level was a unfavorable prognosticator in PDAC patients undergoing curative resection. LAR has the potential to be a prognostic biomarker in clinical practice.
{"title":"The Prognostic Significance of Serum Lactate Dehydrogenase to Albumin Ratio in Pancreatic Ductal Adenocarcinoma","authors":"H. Bilge, Ö. Başol, B. Demir, A. Oğuz","doi":"10.32552/2023.actamedica.819","DOIUrl":"https://doi.org/10.32552/2023.actamedica.819","url":null,"abstract":"Objective: This study was performed to investigate the prognostic role of lactate dehydrogenase/albumin ratio (LAR) and pancreatic ductal adenocarcinoma (PDAC) with initial curable resection treatment.\u0000Materials and Methods: This retrospective study was conducted with the data of patients with resectable PDAC. The (ROC) analysis showed that the optimal sill value for pretreatment LAR was 91.43 and this threshold value was used in other analyses. Univariate and multivariate analyses were performed to determine the prognostic factors for overall survival (OS).\u0000Results: Our study consisted of 70 patients with a mean age of 59.5±13.2 years and 37 (52,9%) women. OS was 50 months in LAR <91.43 (n = 32) patients and 27,7 months in LAR≥91.43 (n=38) patients, respectively. Kaplan–Meier curves showed that LAR≥91.43 was significantly associated with worse OS (p=0.029). Multivariate analyses proved that LAR was an independent predictor in resectable PDAC patients (p=0.017).\u0000Conclusion: Our results showed that a high pre-treatment LAR level was a unfavorable prognosticator in PDAC patients undergoing curative resection. LAR has the potential to be a prognostic biomarker in clinical practice.","PeriodicalId":50891,"journal":{"name":"Acta Medica Mediterranea","volume":"44 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76282952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-28DOI: 10.32552/2023.actamedica.855
Burge Atilgan, M. Yıldız, C. Yavuz
Objective: Burnout negatively affects personal well-being by reducing job-related satisfaction besides deeply affecting physician lives outside the working environment. This study aimed to determine residents’ burnout levels and related psychosocial risk factors regarding the work and educational environment during the COVID-19 pandemic at a university hospital. Material and Method: Data were collected using an online questionnaire consisting of questions screening the participants’ sociodemographic, clinical and, educational characteristics and the following scales; Postgraduate Hospital Educational Environment Measure (PHEEM), Maslach Burnout Inventory (MBI), Rosenberg Self Esteem Scale (RSES). Results: Of the 632 residents receiving postgraduate education in clinical fields at the university, 99 (15.7%) participated in study, 77 (77.8%) of which reported that they were from medical branches and 12 (12.1%) from surgical branches.The emotional exhaustion (EE) dimension of burnout emerged as the most strongly related dimension with perceptions of the educational environment (PHEEM) (p<0,001, r=-0,548). The depersonalization (DP) dimension was only moderately associated with the perception of low role autonomy (p=0,006, r=-0,273). The low personal achievement (LPA) dimension of burnout, on the other hand, showed a moderate-high correlation with all the components related to the educational environment and showed the most substantial relationship with the perception of low social support (p<0,001, r=-0,372). Decrease in the organizational commitment with the departments and institutions where residents received training and worked was associated with higher levels of burnout and low self-esteem. 30.7% of the participants perceive their health as moderate/poor, and scored higher in all dimensions of burnout (EE p<0,001, DP p=0,001, LPA p=0,001). Conclusion: In this study, we found that residents’ perceptions about the educational environment are the variables most closely related to their burnout levels. With precautions, residents may be protected from burnout-related physical and mental diseases while academic efficiency increases and the healthcare service become more qualified.
{"title":"Perceptions of Work and Educational Environment as Predictors of Burnout Among Residents During COVID-19 Pandemic","authors":"Burge Atilgan, M. Yıldız, C. Yavuz","doi":"10.32552/2023.actamedica.855","DOIUrl":"https://doi.org/10.32552/2023.actamedica.855","url":null,"abstract":"Objective: Burnout negatively affects personal well-being by reducing job-related satisfaction besides deeply affecting physician lives outside the working environment. This study aimed to determine residents’ burnout levels and related psychosocial risk factors regarding the work and educational environment during the COVID-19 pandemic at a university hospital.\u0000Material and Method: Data were collected using an online questionnaire consisting of questions screening the participants’ sociodemographic, clinical and, educational characteristics and the following scales; Postgraduate Hospital Educational Environment Measure (PHEEM), Maslach Burnout Inventory (MBI), Rosenberg Self Esteem Scale (RSES).\u0000Results: Of the 632 residents receiving postgraduate education in clinical fields at the university, 99 (15.7%) participated in study, 77 (77.8%) of which reported that they were from medical branches and 12 (12.1%) from surgical branches.The emotional exhaustion (EE) dimension of burnout emerged as the most strongly related dimension with perceptions of the educational environment (PHEEM) (p<0,001, r=-0,548). The depersonalization (DP) dimension was only moderately associated with the perception of low role autonomy (p=0,006, r=-0,273). The low personal achievement (LPA) dimension of burnout, on the other hand, showed a moderate-high correlation with all the components related to the educational environment and showed the most substantial relationship with the perception of low social support (p<0,001, r=-0,372). Decrease in the organizational commitment with the departments and institutions where residents received training and worked was associated with higher levels of burnout and low self-esteem. 30.7% of the participants perceive their health as moderate/poor, and scored higher in all dimensions of burnout (EE p<0,001, DP p=0,001, LPA p=0,001).\u0000Conclusion: In this study, we found that residents’ perceptions about the educational environment are the variables most closely related to their burnout levels. With precautions, residents may be protected from burnout-related physical and mental diseases while academic efficiency increases and the healthcare service become more qualified.","PeriodicalId":50891,"journal":{"name":"Acta Medica Mediterranea","volume":"1 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82236239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-28DOI: 10.32552/2023.actamedica.794
H. Göker, Olgu Erkin Çınar, Rashad Ismayilov, Ela Özdemir, Ü. Malkan, Elifcan Aladağ Karakulak, Y. Büyükaşık, N. Sayınalp, I. Haznedaroglu, O. Özcebe, G. Telli Dizman, M. Ç. Sönmezer, A. Inkaya, H. Demiroğlu
Objective: We aimed to delineate the effects of the ABO groups and the main clinical outcomes with the current SARS-CoV-2 variants, i.e., delta and omicron. Materials and Methods: In this retrospective case-control study, the total 360 adult COVID-19 patients who were followed in the pandemic waves of delta and omicron variants and had ABO blood group analysis were included and divided into two groups according to the waves of variant. Demographic characteristics, comorbidities, length of hospitalization and intensive care needs, survival and ABO groups of cases were recorded. These groups were then compared with the ABO group distribution of population-reflecting 1881 healthy individuals and 186 historical alpha variant cases. Results: The demographic characteristics of the case groups and control group were similar. ABO distributions of the delta and omicron wave groups compared to the control group did not show a statistically significant difference. While advanced age (p<0.001) and presence of comorbidity (p=0.006) showed statistically significant differences in terms of overall survival, ABO blood group was not found to be a risk factor for mortality (p=0.114 in delta, and 0.526 in omicron), hospitalization time (p=0.148 in delta, p=0.224 in omicron), and intensive care unit admission (p=0.096 in delta, p=0.229 in omicron). Conclusion: The risk of infection among ABO blood groups, which has been shown in previous studies for the alpha variant against group A and in favor of group O, does not appear to be valid for delta and omicron period patients. Therefore, the anti-infective measures, especially vaccination, should not differ for individuals according to ABO blood group.
{"title":"Exploring the Distribution and Prognostic Effect of the ABO Blood Types of COVID-19 Patients During Delta and Omicron Waves: A Case Control Study","authors":"H. Göker, Olgu Erkin Çınar, Rashad Ismayilov, Ela Özdemir, Ü. Malkan, Elifcan Aladağ Karakulak, Y. Büyükaşık, N. Sayınalp, I. Haznedaroglu, O. Özcebe, G. Telli Dizman, M. Ç. Sönmezer, A. Inkaya, H. Demiroğlu","doi":"10.32552/2023.actamedica.794","DOIUrl":"https://doi.org/10.32552/2023.actamedica.794","url":null,"abstract":"Objective: We aimed to delineate the effects of the ABO groups and the main clinical outcomes with the current SARS-CoV-2 variants, i.e., delta and omicron.\u0000Materials and Methods: In this retrospective case-control study, the total 360 adult COVID-19 patients who were followed in the pandemic waves of delta and omicron variants and had ABO blood group analysis were included and divided into two groups according to the waves of variant. Demographic characteristics, comorbidities, length of hospitalization and intensive care needs, survival and ABO groups of cases were recorded. These groups were then compared with the ABO group distribution of population-reflecting 1881 healthy individuals and 186 historical alpha variant cases.\u0000Results: The demographic characteristics of the case groups and control group were similar. ABO distributions of the delta and omicron wave groups compared to the control group did not show a statistically significant difference. While advanced age (p<0.001) and presence of comorbidity (p=0.006) showed statistically significant differences in terms of overall survival, ABO blood group was not found to be a risk factor for mortality (p=0.114 in delta, and 0.526 in omicron), hospitalization time (p=0.148 in delta, p=0.224 in omicron), and intensive care unit admission (p=0.096 in delta, p=0.229 in omicron).\u0000Conclusion: The risk of infection among ABO blood groups, which has been shown in previous studies for the alpha variant against group A and in favor of group O, does not appear to be valid for delta and omicron period patients. Therefore, the anti-infective measures, especially vaccination, should not differ for individuals according to ABO blood group.","PeriodicalId":50891,"journal":{"name":"Acta Medica Mediterranea","volume":"1 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82319065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-28DOI: 10.32552/2023.actamedica.861
A. Sandal
Objective: This study aimed to investigate hepatic and renal functions in patients who received calcium disodium edetate (CaNa2EDTA) chelation treatment for chronic occupational lead intoxication. Material and Methods: This single-center retrospective descriptive research was conducted in a secondary-level health facility. The study included patients treated with CaNa2EDTA chelation for chronic occupational lead intoxication between September 15, 2020, and May 31, 2021. Demographic and occupational characteristics, as well as and laboratory parameters obtained before and after the chelation therapy were evaluated. Results: All 75 patients were male, and 73.3% had an occupation in metal scrap recycling. Renal parameters were within normal range before and after the chelation. However, mild elevations were observed in liver parameters. After the adjustment for demographic and occupational variables, the odds of having an elevated liver parameter and an elevated alanine transaminase (ALT) result after the chelation therapy were 9.3 (95%CI 2.6–33.2, p<0.001) and 11.4 (95%CI 2.4–53.2, p<0.001) for patients with pre-chelation elevated any liver parameter and pre-chelation elevated ALT result, respectively. Conclusion: The current study documented mild elevations of the liver parameters in patients with chronic occupational lead poisoning after CaNa2EDTA chelation therapy, particularly those with elevated basal liver parameters, although their renal parameters stayed within reference ranges. The results serve as an example of the safe application of CaNa2EDTA chelation for chronic occupational lead poisoning, by monitoring kidney and liver parameters in a secondary-level health facility. Future prospective studies with structured treatment protocols may investigate the risk and determinants of hepatic and renal adverse effects.
{"title":"Retrospective Evaluation of Liver and Kidney Functions in Patients with Chronic Occupational Lead Intoxication Treated with EDTA Chelation Therapy","authors":"A. Sandal","doi":"10.32552/2023.actamedica.861","DOIUrl":"https://doi.org/10.32552/2023.actamedica.861","url":null,"abstract":"Objective: This study aimed to investigate hepatic and renal functions in patients who received calcium disodium edetate (CaNa2EDTA) chelation treatment for chronic occupational lead intoxication.\u0000Material and Methods: This single-center retrospective descriptive research was conducted in a secondary-level health facility. The study included patients treated with CaNa2EDTA chelation for chronic occupational lead intoxication between September 15, 2020, and May 31, 2021. Demographic and occupational characteristics, as well as and laboratory parameters obtained before and after the chelation therapy were evaluated.\u0000Results: All 75 patients were male, and 73.3% had an occupation in metal scrap recycling. Renal parameters were within normal range before and after the chelation. However, mild elevations were observed in liver parameters. After the adjustment for demographic and occupational variables, the odds of having an elevated liver parameter and an elevated alanine transaminase (ALT) result after the chelation therapy were 9.3 (95%CI 2.6–33.2, p<0.001) and 11.4 (95%CI 2.4–53.2, p<0.001) for patients with pre-chelation elevated any liver parameter and pre-chelation elevated ALT result, respectively.\u0000Conclusion: The current study documented mild elevations of the liver parameters in patients with chronic occupational lead poisoning after CaNa2EDTA chelation therapy, particularly those with elevated basal liver parameters, although their renal parameters stayed within reference ranges. The results serve as an example of the safe application of CaNa2EDTA chelation for chronic occupational lead poisoning, by monitoring kidney and liver parameters in a secondary-level health facility. Future prospective studies with structured treatment protocols may investigate the risk and determinants of hepatic and renal adverse effects.","PeriodicalId":50891,"journal":{"name":"Acta Medica Mediterranea","volume":"36 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75770994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-28DOI: 10.32552/2023.actamedica.776
Samuray Zekeriyeyev, U. Canpolat, K. Aytemir
Hyperkalemia is a common clinical condition among heart failure patients especially if there is coexisting older age, potassium-sparing medication, and renal insufficiency. Close follow-up and titration of renin-angiotensin-aldosterone system inhibitors are essential to prevent the development of hyperkalemia. It can also cause significant abnormalities in patients with cardiac implantable electronic devices (CIED) including pacemakers and implantable cardioverter defibrillators (ICD) due to its impact on cardiac electrophysiology. Herein, we presented a pacemaker-dependent heart failure patient with single-chamber ICD in whom bradyarrhythmia signs and symptoms were observed due to T-wave oversensing and managed appropriately.
{"title":"T-wave Oversensing and Symptomatic Bradycardia in a Pacemaker-Dependent Heart Failure Patient due to Drug-induced Hyperkalemia","authors":"Samuray Zekeriyeyev, U. Canpolat, K. Aytemir","doi":"10.32552/2023.actamedica.776","DOIUrl":"https://doi.org/10.32552/2023.actamedica.776","url":null,"abstract":"Hyperkalemia is a common clinical condition among heart failure patients especially if there is coexisting older age, potassium-sparing medication, and renal insufficiency. Close follow-up and titration of renin-angiotensin-aldosterone system inhibitors are essential to prevent the development of hyperkalemia. It can also cause significant abnormalities in patients with cardiac implantable electronic devices (CIED) including pacemakers and implantable cardioverter defibrillators (ICD) due to its impact on cardiac electrophysiology. Herein, we presented a pacemaker-dependent heart failure patient with single-chamber ICD in whom bradyarrhythmia signs and symptoms were observed due to T-wave oversensing and managed appropriately.","PeriodicalId":50891,"journal":{"name":"Acta Medica Mediterranea","volume":"1 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79926102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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