Analysis of Gastrointestinal Symptoms in 281 Cases of Hospitalized Covid 19 Patients, Single-Center Study

Objective: Although Covid-19 which has been identified as the disease caused by SARS COV-2 virus mainly affects the respiratory tract, it was observed that many systems were affected. The gastrointestinal system is one of the main systems involved. The aim of this manuscript was to perform epidemiological, virological, and clinical analysis of 59 Covid 19-positive patients with gastrointestinal symptoms. Method: Covid-19 diagnosed patients have been started to be admitted since March, 20, 2020. Epidemiological, demographical, clinical findings, laboratory analyses as well as hospitalization periods and disease progression of the patients presenting gastrointestinal system (GIS) symptoms admitted between March, 31, 2020 and August, 1, 2020. Results: Totally 710 Covid 19-positive patients hospitalized were screened. Among these patients, those with incomplete medical history and deficient data were excluded. The analysis of 281 patients admitted due to Covid-19 diagnosis with complete data since admission revealed that 59 patients presented GIS symptoms at admission. The aforesaid patients were compared with 222 patients admitted due to Covid-19 without GIS symptoms within the same period. GIS symptoms were detected on 59 (59/281) (20.99%) patients admitted due to Covid-19. Detailed review of these patients revealed that 18 (18/59) (30.50%) patients had nausea-vomiting, 10 (10/59) (16.95%) patients had abdominal pain, and 31 (31/59) (52.55%) patients had GIS bleeding. It was observed that vomiting was added into the clinical presentation in 7 of 18 patients. Although there is not any diarrhea symptom alone, total number of cases with diarrhea+abdominal pain, diarrhea+nausea-vomiting, diarrhea+nausea-vomiting+abdominal pain was 17 (17/59) (28.81%) of 59 patients. Conclusion: According to the results of this study, we have found 20.99% gi symptoms in the hospitalizated patients due to Covid 19. Although GIS symptoms are not associated with disease severity, they are important for the identification and spread of the disease, along with respiratory symptoms.

Evaluation of Radiation Knowledge of Non-Medical Doctor Staffs in Orthopaedics and Traumatology Operation Theatre

Objective: The aim of this study was the determine educational status, anxiety, the use of prevention methods and their knowledge level of nurses, operation theatre staffs and technicians about radiation. Methods: This study is a cross-sectional descriptive survey. The universe of our study consists of non-medical doctor staffs (nurses, technicians and operating theatre personnel) of one university and two training and research hospitals in İzmir. The sample selection was not made in our study and the personnels who accepted to participate in the study constituted the sample of the study (n=97). This was a survey of 21 questions. The survey includes participants’ demographical datas, protection type from radiation, anxiety about radiation, knowledge about radiation and education level about radiation. SPSS v21.0 were used for statistical analysis. Results: In our study, 97 participants completed the questionnaire. 51 of the participants were female (52.6%) and 46 were male (47.4%). Forty-one (42.3%) of the participants were 9 health technician (9.3%), 20 (20.6%) anesthesia technicians and 27 (27.8%) operating theatre staffs. It was found that 85 (87.6%) of the participants had operations requiring fluoroscopy in the operating room. It was learned that 29 (29.9%) participants answered the question examining the knowledge about radiation and 38 (39.2%) were educated about radiation safety. When the relationship between the participants’ answers to the question examining the knowledge about radiation and the educational level about radiation was examined, a statistically significant relationship was found between them (p=0.043). Conclusion: It was thought that non-medical doctor employees in the orthopedics and traumatology operating theatre had a high level of anxiety about radiation, had insufficient knowledge, and that training on radiation should be repeated periodically.

Posttransplantation Vesicoureteral Reflux in Renal Grafts and Their Outcomes in Pediatric Transplantation: Should We Be Afraid ?

Objective: Demographical, pre-transplantation and post-transplantation features and post-treatment results of four pediatric cases, who had vesicoureteral reflux (VUR) in the graft kidney, were discussed. Methods: Transplantation age, primary diagnosis, VUR to pretransplantation in native kidneys, history of bladder dysfunction, bladder capacity, results of urodynamic studies, donor and its features, induction treatments and ongoing immunosuppressive treatments, acute rejection episodes, CMV and BK infections, VUR grade in the renal graft, DMSA results, treatment type and its outcomes, and the renal graft functions of four patients who underwent kidney transplantation at Tepecik Training and Research Hospital between 2008 and 2016 and for whom VUR was determined via voiding cystourethrography (VCUG) due to recurrent urinary tract infections, were evaluated. Results: All of four cases were female. Their mean transplantation age was 8.7 years (5-16). High grade (Grade 4) VUR was determined in the graft kidney in all but one. DMSA included multiple scar foci apart from one case having low grade VUR. Cases were primarily treated endoscopically and then by open surgery. Spontaneous recovery occurred in one case. Graft dysfunction was not observed in any of the cases. Conclusion: VUR is an important risk factor in recurrent urinary tract infections after post-transplantation. A special assessment should be done for the patient in the presence of VUR and conservative and surgical treatments should be executed together. It should be remembered that VUR can be spontaneously regressed by the bladder capacity increasing treatments and prophylaxis.

Urinary Tract Anomalies in Children With Congenital Heart Disease Detected During the Procedure of Cardiac Catheterization

Objective: Congenital heart diseases in childhood are an important cause of morbidity and mortality. The frequency of non-cardiac anomalies in children with congenital heart diseases is between 7-50%. Urinary system anomalies are an important risk factor in children with congenital heart diseases. The aim of this study was to evaluate the presence, types and frequency of urinary system anomalies detected during cardiac catheterization in children with congenital heart diseases. Methods: The cineurography records of 6000 patients who underwent cardiac catheterization due to congenital heart diseases were retrospectively analyzed. Urinary system anomalies detected were examined as renal agenesis, renal ectopia, renal fusion, dysplastic kidney, obstructive uropathy, vesicoureteral reflux, ureter anomaly and bladder anomaly. Patients were grouped as right ventricular outflow tract obstruction, left ventricular outflow tract obstruction, left-to-right shunted hearth disease and, cyanotic or complex heart diseases. The groups were compared in terms of urinary system anomaly types. Results: Seventy-six patients (47 male and 29 female) with urinary system abnormalities were detected. Obstructive uropathy was found in 43 (56.5%) patients, renal agenesis was found in 14 (18.4%) patients, ureter anomaly was found in 14 (18.4%) patients, renal fusion was found in 3 (3.9%) patients, renal ectopia was found 1 (1.3%) patient, vesicoureteral reflux was found in 1 (1.3%) patient. There was no significant difference in term of the urinary system anomaly types among the groups (p>0.05) Conclusion: Urinary system anomalies may also be frequently accompanied in children with congenital heart diseases, so urinary system should also be evaluated during the cardiac catheterization procedure.

Choroidal Thickness in Children with Congenital Heart Disease Measured by Spectral Domain Optical Coherence Tomography

Objective: The main reason for complications in congenital heart diseases (CHD) is decreased blood oxygen saturation and polycythemia which are typical for cyanosis. These parameters may promote the damage of the retina because haemodynamic regulation is essential for the structural and functional integrity of the macular subfields. The aim of this study was to evaluate choroidal thickness (CT) measurements in children with CHD using spectral domain optical coherence tomography (OCT). Methods: This prospective study compared 30 CHD and 30 healthy control children. CT was examined with spectralis spectral-domain OCT (Retinascan RS-3000; Nidek). CT was obtained at the subfovea, 500 μm and 1000 μm nasal to the fovea (N500, N1000) and 500 μm and 1000 μm temporal to the fovea (T500, T1000). Only the right eye values were used for statistical comparisons between the groups. The domain cardiac lesions were divided physiologically into two categories: volume overload and cyanotic. Results: Mean age was 11.0±3.5 years in CHD childrens and 10.9±3.6 years in the control group (p=0.971). Children with CHD had no statistically significant CT measurements compared with healthy controls (p>0.05). Conclusion: Although in high haematocrit, low oxygen saturation or the presence of the volume overload in the history of CHD patients, our data suggests that patients with CHD show normal CT. The reason may be medical and surgical treatment of hypoxia, erythrocytosis and volume overload in CHD patients.

Screening of Diabetes in Pregnancy

The prevalence of gestational diabetes mellitus (GDM) is approximately 6% of pregnant women in the United States. The prevalence ranges is about from 2% to 38% worldwide and varies among racial-ethnic groups, often paralleling the prevalence of type 2 diabetes. The prevalence also varies due to differences in screening practices, population characteristics (eg, mean age and body mass index [BMI] of pregnant women), testing method, and diagnostic criteria. The prevalence is increasing over time, possibly due to increases in mean maternal age and weight, particularly with increasing obesity. In 2010, the International Association of Diabetes and Pregnancy Study Groups proposed new screening and diagnostic criteria for diabetes in pregnancy. Using these criteria, the global prevalence of hyperglycemia in pregnancy is estimated at 17%, with regional estimates ranging from 10% in North America to 25% in Southeast Asia. Different screening programs are carried out in different clinics, and all these differences lead to different results in the frequency of GDM. The criteria of the method and threshold value acceptance depends on the health policies of the countries, the experience of the clinicians and the characteristics of the patient population. In this review, we analyzed the methods recommended for GDM screening in pregnancy.

The Effect of COVID-19 Pandemic on Pain, Physical Activity, and Anxiety in Individuals with Chronic Musculoskeletal Pain

Objective: The COVID-19 pandemic has many features that can potentially trigger and increase chronic pain. The aim of this study was to examine the effects of the pandemic on pain, physical activity and anxiety in individuals with chronic musculoskeletal pain, in both periods of isolation and controlled social life. Methods: Seventy one individuals with chronic musculoskeletal pain were included in the study. Three different periods (pre-pandemic, isolation and controlled social life) were evaluated and analyzed. Pain intensity (Visual Analogue Scale (VAS)), coronavirus anxiety (Coronavirus Anxiety Scale Short Form (CAS-SF)), and physical activity level (International Physical Activity Questionnaire Short Form (IPAQ-SF)) were evaluated. Results: The VAS resting score was significantly higher during the isolation compared to the pre-pandemic period (p = 0.002). The VAS activity score was significantly higher in the isolation period compared to both pre-pandemic (p <0.001) and controlled social life periods (p <0.001). The lowest IPAQ-SF score (p <0.001) and the longest sitting time (p <0.001) were in the isolation period. The CAS-SF scores were significantly higher in the isolation period compared to the controlled social life period (p <0.001). Conclusion: While the measures taken during the isolation period had negative impacts on the severity of pain, physical activity and anxiety levels in individuals with chronic musculoskeletal pain, gradual deconfinement in the controlled social life period led to a decrease in pain intensity and anxiety and an increase in physical activity.

Single Stapling of Right Upper Lobe Vein and Truncus Anterior Artery in Videothoracoscopic Lobectomy

Videothoracoscopic resections are among the mostly preferred minimally invasive thoracic surgical techniques to treat lung cancers especially in the last two decades. In thoracoscopic surgery video camera technology, high-tech equipment and surgical instruments including staplers are required. We have developed a technique for dissection and cutting of truncus anterior and right upper lobe vein in one step with stapler by this way we aimed to provide less operation time and more cost- effectiveness for right upper lobectomies.