Olgular Işığında İleusun Güncel Cerrahi Tedavisi

More than 200 million operations are performed worldwide each year. Most of these patients have comorbid features such as advanced age (1). Postoperative ileus is an annoying condition that usually develops after abdominal surgeries. The incidence of postoperative ileus after colorectal surgery is more common than other surgeries. Incidence rtes vary between 10% and 30% of the incidence of postoperative ileus have been reported (2,3). Various risk factors have been identified for the development of ileus. These risk factors are; It can be summarized as advanced age, open surgical approaches, the difficulty of the operation, operation time intestines, decrease in hematocrit or need for blood transfusion /crystalloid and late mobilization. In most cases, more than one of these risk factors is observed. Ileus pathophysiology; it was defined by Vater et al as impared motility and intestinal wall edema (4). Although some publications argue that mechanical ileus can be treated conservatively within 12 hours by rejecting the rule of thumb (5), what we have experienced in these two cases is that the conservative approach is not sufficient in the treatment of such cases. And perhaps to insistence on conservative treatment may cause irreversible damage to the general condition of the patient. We aimed in this study to examine current surgical treatments in two ileus cases with a complex picture. Keywords: Ileus, abdominal surgery, treatment of ileus

COVID-19 Pandemi Sürecinde Sağlık Çalışanlarının Yaşadıkları Mental Sorunlar

The epidemic of COVID-19, which started in Wuhan province of China and rapidly turned into a pandemic worldwide, affected all individuals in the society in different directions and levels. Depression, anxiety, stress and sleep disorders are among the mental problems experienced by healthcare workers during the epidemic. These problems not only affect the mental state and well-being of the employees negatively, but also affect their job satisfaction and quality service delivery. The purpose of this study to examine the mental problems affecting health workers, what factors affecting these problems, and what mental health support approaches can be done for health workers in cases of epidemics. Accordingly, a detailed literature review was made and published studies on the subject were compiled. It is inevitable that health managers will work to strengthen the workers mentally. Keywords: COVID-19, pandemic, medical workers, mental problems, anxiety, depression.

Çocuk Hastalara Uygulanan Fekal Mikrobiyota Transplantasyonuna Yönelik Hemşirelik Yaklaşımı

Fecal Microbiota Transplantation (FMT) is the process of taking stool from a healthy donor and placing it in the gastrointestinal tract of the sick individual. Today, it has been seen that FMT is mostly used for the treatment of clostridium difficile infection. Depending on the child’s condition, physician preferences, and/or protocol requirements, the route of administration in the FMT procedure can be oral capsule, upper or lower gastrointestinal route. Detailed information about FMT, including all aspects of the process, needs to be provided in writing to children, families and donors. Pediatric nurses should plan the individualized care process with a holistic approach based on child-centered care, family-centered care, atraumatic care models in the management of the FMT process. It is the nurse’s responsibility to increase the child’s comfort, protect his privacy, and prevent complications that may arise in the child. Because the FMT procedure is a specific application, nurses need to have detailed information about a qualified nursing process. In this review, the topics of microbiota, FMT and the nursing process before, during and after the procedure are discussed. Keywords: Child, fecal microbiota transplantation, nursing, pediatrics

Hastanede Yatan COVID-19 Tanılı Hastalarda Görülen Nörolojik Semptomlar ve Hastalık Şiddeti ile İlişkisi

Introduction: Coronavirus disease 2019 (COVID-19) spread rapidly all over the world, causing a pandemic. Neurological findings have also been reported in patients since the beginning of the pandemic. Recent data suggest that severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has both neurotropic and neurovirulent effects. This study aimed to evaluate the presence of neurological findings in hospitalized patients with the diagnosis of COVID-19 and the relationship of these findings with the severity of COVID-19. Material and Methods: Patients, positive for SARS-CoV-2 and had an indication of hospitalization were included in the study. Demographic characteristics, systemic symptoms, laboratory values and computed chest tomography findings of the patients were recorded. Neurological findings of the patients were evaluated by an experienced neurologist, and the relationship between these findings and the disease severity was analyzed. Results: The median age of 66 patients (33 females, 33 males) included in the study was 34.5. Of the patients, 33 (50%) had mild, 28 (42.4%) had moderate, 5 (7.6%) had severe COVID-19. The most common symptom was fever (48.5%). At least one neurologic symptom was detected in 43 patients (65.2%). Dysgeusia (27.3%), hyposmia-anosmia (27.3%), headache (25.8%) and muscle pain (24.2%) were the most common neurological symptoms. Among mild COVID-19 patients, individuals with neurological symptoms had longer hospitalization periods, than the patients without neurological symptoms (p=0.017). Conclusion: Neurological symptoms were observed in the majority of patients with COVID-19 in this study. Besides this study revealed that neurological symptoms may occur not only in aged intensive care patients with COVID-19, but also in young patients, with mild COVID-19. Therefore the hospitalization period may be prolonged in this patient group. In conclusion, regardless of its severity, physicians should keep in mind that COVID-19 may be a potential risk factor for neurological disorders. Keywords: COVID-19, pandemic, neurological symptoms, nervous system invasion

Kraniovertebral Bileşke Kemiklerinin Morfometrik Özellikleri

Introduction: The craniovertebral junction comprises the occipital bone, atlas, axis and supporting ligaments. Surgical interventions for treatment of instability, require knowledge of morphometric properties of this area. Therefore, the aim of the present study was to evaluate adult dried human skulls to analyze morphometric features of the bones that joined the craniovertebral junction. Materials and Methods: Morphometric analysis was performed on dry bones which found in the excavations. 9 occipital bone, 18 atlas and 16 axis were measured. Differences between measurements were determined using t-tests and were considered significant at p<0.05. Results: The distance between both tips of the transverse processes (p<0.001), the distance between both outermost edges of the transverse foramen (p=0.011), the distance between both innermost edges of the transverse foramen (p=0.013), the maximum transverse diamater of the vertebral canal (p=0.014), the maximum anteroposterior diameter of the vertebral canal (p=0.014) and the width of the inferior articular facet (left p<0.001 and right p=0.005) were found significantly shorter in females atlases. The width of the dens axis (p<0.001), the height of the corpus axis (p=0.034), the distance from lateral most edge of the transvers process to midline (left p=0.049), the length of the inferior articular facet (left p=0.004, right p=0.005), the width of the superior articular facet (right p=0.007) were found significantly shorter in females axises. Conclusion: Morphometric analysis is very important in the development and improvement of surgical techniques. In this context, the results of our study can contribute to developments in this area. Keywords: Atlas, axis, occipital bone, craniovertebral junction

Tietze Sendromu: Bir Olgu Sunumu

Tietze’s Syndrome: A Case Report Tietze syndrome (TS) is a rare inflammatory arthropathy characterized by tenderness, pain, and non-purulent swelling of the costosternal, costochondral and sternoclavicular joints. It often involves the costosternal joints and sternoclavicular jointinvolvement is rare. In this case report, we present a 72-year-old female patient suffering from pain and swelling in the right upper chest wall fo rabout 2 years. Physical examination revealed tenderness in the right sternoclavicular joint and an approximately 2x2 cm moderate swelling. Ultrasonic imaging of the swelling area revealed increased echogenicity and edema in the right sternoclavicular joint area. Laboratory findings were normal. The patient was diagnosed with TS and a local injection of a corticosteroid and local anesthetic mixture was administered. The patient’s complaints decreased significantly after the infiltration. In this case report, we present a TS case with sternoclavicular joint involvement that we treated with local injection. Keywords: Tietze’s syndrome, sternoclavicularjoint, costochondritis

COVID-19 Pandemi Sürecinde İdeal Vücut Ağırlığının Önemi

The Importance of Ideal Body Weight in the COVID-19 Pandemia Period Obesity is an important public health problem that is common worldwide. With obesity, there is an increase in many diseases, including hypertension, cardiovascular diseases and diabetes, which are risk factors for COVID-19. In 2009, obesity was first defined as a risk factor for disease severity and mortality in infected individuals in the pandemic caused by H1N1 Influenza A virus affecting the upper respiratory tract. Then, Middle East Respiratory Syndrome Coronavirus (MERS-CoV), which emerged in 2012, was also found to be more common in individuals with obesity. These findings, which show that obesity increases the risk of disease severity and death in viral respiratory infections, suggest that obesity may increase the risk of another viral respiratory disease, COVID-19. Studies show that individuals with obesity suffer from COVID-19 disease more severely than individuals with normal body weight, and their intensive care unit needs are higher. Obesity is a risk factor for more severe COVID-19 disease due to a low-grade inflammatory condition and weakened immunity. There are studies in the literature showing that obesity as well as low body weight negatively affect the outcomes of COVID-19 disease. These studies revealed that COVID-19 patients with low body weight are at greater risk of mechanical ventilation and death. It has been observed that low body mass index and low body weight especially in infected elderly individuals increase the severity of COVID-19. Therefore, individuals having ideal body weight can prevent the negative consequences of COVID-19 disease. In addition, healthy nutrition plays an important role in the optimal functioning of the immune system and weight control. Keywords: COVID-19, obesity, underweight, immunity, nutrition

Kabızlık ve Üfürümle Tespit Edilen Williams-Beuren Sendromu

Williams-Beuren Syndrome Detected with Constipation and Murmur Williams-Beuren syndrome (WBS) is a rare disease that occurs as a result of microdeletion of 11.23 of the long arm of chromosome 7, with a frequency of 1/20.000-30.000. Typical facial appearance, mental retardation, various congenital cardiovascular anomalies and endocrinological disorders may accompany this syndrome. In cases suspected as a result of clinical and laboratory findings, the diagnosis is made by showing the deletion of the mentioned region using the fluorescent in situ hybridization (FISH) method. We detected WBS in a 17-month-old male patient who presented with chronic constipation and had peripheral pulmonary stenosis in echocardiography performed with accompanying clinical findings, and aimed to emphasize the importance of multidimensional evaluation and early diagnosis. Keywords: Congenital heart disease, pulmonary stenosis, microdeletion syndromes, constipation, Williams-Beuren syndrome

COVID-19 ile Olası İlişkili İnkomplet Kawasaki Hastalığı: Olgu Sunumu

Incomplete Kawasaki Disease Probable Associated with COVID-19: A Case Report Kawasaki disease is an acute systemic inflammatory disease affecting the medium and small vessels mostly in children under 5 years old. Although SARS-CoV2 less severely affects children, with the rapid spread of disease some new clinical aspects like Kawasaki-like disease have been reported in children affected by COVID-19. Here in we present a child with incomplete Kawasaki disease probably associated with COVID-19. Keywords: Kawasaki-like disease, incomplete Kawasaki, SARS-CoV2, COVID-19

Genişletilmiş Alternatif Bir Kompulsif Satın Alma Davranışı Ölçme Aracı Önerisi

An Extended Alternative Compulsive Buying Behavior Assessment Tool Proposal This research aims to combine the two primarily used scales to measure compulsive buying behavior to achieve a broader-based measuring instrument. After applying the combined scale on 776 attendants, a reliability test and factor analysis have been conducted on the collected data. Five dimensions have been obtained by the factor analysis, and this structure has been tested by confirmatory factor analysis. Finally, the extended measuring instrument has been constituted, with 25 questions, five dimensions, and a high-reliability score of Cronbach’s Alpha. Keywords: Compulsive buying behavior, scale, consumer behavior, structural equation modeling