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.

Is There Any Other Disease Under The New Diagnosis of Diabetes That Is Difficult To Control?

High levels of growth hormone and insulin-like growth factor 1 contribute to tissue proliferation and hypertrophy in patients with acromegaly mostly due to growth hormone-secreting pituitary adenoma. Some phenotypic features of acromegaly that make us to consider in the differential diagnosis are excessive growth of the hands and feet and coarsening facial features. Growth hormone also induces lipolytic activities and insulin resistance, so patients with acromegaly often present with impaired glucose tolerance and type 2 diabetes mellitus. We wanted to share a case with treatment-resistant hyperglycemia which is the cause of presentation of acromegaly.

Autoimmune Hepatitis in Children

Autoimmune hepatitis is characterized by inflammation in liver histology, circulating autoantibodies, and increased levels of immunglobulin G, in the absence of a known etiology. There are different clinical types described in children. Because of the presentation of autoimmune hepatitis with different clinical findings, establishment of diagnosis may be difficult. In the last two decades, a a 6-fold increase in the incidence of autoimmune hepatitis has been reported thanks to update of diagnostic approaches and the increase in technical possibilities. Autoimmune hepatitis should be considered in the differential diagnosis of any liver disease not caused by viral and metabolic factors. Its association with other clinical conditions such as autoimmune thyroiditis, vitiligo, collagen and connective tissue disorders is already known. Although autoimmune hepatitis is a treatable disorder, it may cause cirrhosis and fulminant hepatitis that need liver transplantation without treatment. In this review, we aimed to present the clinical findings, diagnosis and treatment methods of autoimmune hepatittis in children in the light of current literature.

Spinal Epidural Abscess İn An Adolescent (Case Report)

Spinal infections in immunocompetent children are very rare. But it is a serious infection in the epidural space along the spinal cord. It should be considered in patients with backache, fever, neurological deficits and/or spinal tenderness. There are cases which an etiology could not determined. In the English medical literature, there are only 31 reported pediatric cases in the last two decades. In children with neurologic deficits, surgery combined with systemic antibiotics constitutes the optimal therapy. We report a case of thoracal spinal epidural abscess in a 12-year-old adolescent boy who was immunocompetent and presented with spinal tenderness, back pain and four days of fever. A spinal magnetic resonance imaging demonstrated an epidural abscess between T2 and T10 level. An emergent surgical intervention was applied. Cultures remained negative. He was given systemic antibiotics for six weeks. He recovered without any sequelae.

Prognostic Value of Dysnatremia in COVID-19 Disease

Objective: The infection of Corona 2019 (COVID-19) had first diagnosed in December 2019 and evolved into a worldwide pandemic in March 2020. In Turkey first diagnose was announced in March 2020. Low costed and easily accessible laboratory parameters needed for predicting the prognosis of this disease as its outcome pattern vary greatly from patient to patient. There is promising data on predicting the outcomes with disnatremic results. Methods: In this study we retrospectively investigated all adults with the diagnosis of COVID-19 who attended to Turkan Ozilhan Hospital over a 3 months period. We evaluated the relation of dysnatremia (hyponatremia as <135 mmol/L or hypernatremia as >145 mmol/L) for need of intensive care unit (ICU) treatment, need of intubation for mechanic ventilatory support and inpatient mortality. Results: one thousand seventy tree patients with COVID-19 [53..9% males (793 patients) and 46.1% females (680 patients), were investigated for this study. Their median age was 53.9 years ranging betweent 19-94. The dysnatremic groups had significantly higher rates of need for ICU and intubation The need for ICU was 89 (21.5%) patients in normonatremic group but 38 (76%) patients in hypernatremic and 71 (64%) in hyponatremic patients (p<0.01 for each of them). The mortality rate was 5% in normonatremic patients but 50% in hypernatremic and 28% in hyponatremic patients (p<0.01 for each of them). Conclusion: In this study we aimed to draw attention to the importance of abnormal sodium levels as a predictive marker in COVID-19. In small town hospitals the physicians should be aware of the risks of disnatremic patients with COVID-19 and take precautions while treating them.

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.