The diagnosis of acute appendicitis in pregnant versus non-pregnant women: A comparative study / O diagnóstico de apendicite aguda em mulheres grávidas versus não grávidas: um estudo comparativo

Summary Objective: To investigate whether the diagnosis of acute appendicitis is affected by pregnancy or not. Method: A retrospective study with the analysis of the medical records of all women suspected of having appendicitis who underwent appendectomy at our hospital between June 2010 and March 2015 were reviewed. The patients were divided into two groups according to whether they were pregnant or not during the surgery: group I, pregnant women, and group II, non-pregnant women. Results: During the study period, 38 pregnant women and 169 non-pregnant women underwent appendectomy. The time from admission to the operation was not statistically different (2.17±1.47 days in group I vs. 1.98±1.66 day in group II; p=0.288). The pregnant group had longer hospital stay than the non-pregnant group (p=0.04). Ultrasonography (USG) was used as the first diagnostic modality in 36/38 patients in group I and 161/169 in group II. The non-visualized appendix on ultrasound was seen in 17 patients in group I and 51 patients in group II, which was not statistically different. Sensitivity and specificity of USG in diagnosis of acute appendicitis were 61.29 and 80.00% in group I, and 93.0 and 31.6% in group II, respectively. Conclusion: Although the diagnosis of appendicitis in pregnant women is not delayed, careful assessment of these patients suspected of having appendicitis should be encouraged when USG examination is normal or nondiagnostic.

Resumo Objetivo: investigar se o diagnóstico de apendicite aguda é afetado por gravidez ou não. Método: estudo retrospectivo com análise dos prontuários médicos de todas as mulheres que tiveram suspeita de apendicite e foram submetidas à apendicectomia em nosso hospital entre junho de 2010 e março de 2015. As pacientes foram divididas em dois grupos, de acordo com a presença de gravidez durante a cirurgia: grupo I, mulheres grávidas; grupo II, mulheres não grávidas. Resultados: durante o período do estudo, 38 mulheres grávidas e 169 mulheres não grávidas foram submetidas à apendicectomia. O tempo desde a internação até a cirurgia não foi estatisticamente diferente (2,17±1,47 dias no grupo I vs. 1,98±1,66 dia no grupo II, p=0,288). O grupo das grávidas apresentou uma estadia hospitalar mais longa que o grupo das não grávidas (p=0,04). A ultrassonografia foi usada como primeira modalidade de diagnóstico em 36/38 pacientes no grupo I e em 161/169 no grupo II. O apêndice não visualizado na ultrassonografia foi visto em 17 pacientes no grupo I e 51 pacientes no grupo II, e não foi estatisticamente diferente. A sensibilidade e especificidade da ultrassonografia no diagnóstico de apendicite aguda foram 61,29 e 80,00% no grupo I e 93,0 e 31,6% no grupo II, respectivamente. Conclusão: embora o diagnóstico de apendicite em mulheres grávidas não seja protelado, recomenda-se uma avaliação cuidadosa quando o exame de ultrassonografia for normal ou não diagnóstico nessas pacientes.

Sexual perception: an overlooked psychological barrier to nursing

Patient care is one of the most important functions of nursing. Nurses are responsible legally and ethically to take care of male patient without any discrimination. Sexuality perceptions and embarrassment effect negatively on intimate care particularly between male patients and female nurses. In this study we aimed to; determine nurses' attitudes, towards male patient and evaluate some factors that can improve this situation. This cross sectional study was performed from March-June 2009, in Gulhane Military Medical Academy School of Nursing. A total of 300 female nursing students voluntarily participated out of 310 students, and responded to the questionnaires. The questionnaire comprised of 29 questions 8 questions were about socio-demographic characteristics of participants, and 21 questions were about attitude towards male patient. Results showed that [71.3%] students indicated that performing any application to a male patient was as easy as performing on a female patient 78.3% indicated that same age male patients were the most difficult age group for taking care. Calculated attitude point of Year III students about body cleaning, rectal lavage, perineal cleansing, rectal tube application, and naso-gastric tube applications are higher than other students'. Similarly; the attitude was more positive among the students that chose their school intentionally, than others as regards taking care of a male patient which was considered as easy as performing to a female patient. Many students have negative attitudes towards specific physical care needs of male patients, especially genital area related applications. Applied education methods, professionalism and providing ethical information and insight can resolve this gap

Analysis of patients followed-up at the emergency internal medicine outpatients department of Gulhane military hospital in 2003 for suicide attempt

To retrospectively evaluate the suicide attempt cases monitored and treated at a training hospitals emergency medicine department internal medicine clinic. A total of 151 cases were monitored and treated for a suicide attempt between January 1, 2003 and December 31, 2003. Cases were evaluated for sociodemographic characteristics, diagnoses made, suicide method used and time of suicide attempts and for significant relations between these variables. Of the study group, 59.6% were male, 70.2% were single, 60.3% were retired or unemployed, 51.75% were privates [Non Professional Soldiers] and 36.4% were high school graduates. The mean age was 27.36 +/- 11 for the females and 22.27 +/- 4.56 for the males. No diagnosis was made in 54.3% of the cases while 25.2% had depressive disorder and 14.6% had antisocial personality disorder. Antidepressants made up 27.8% and nonsteroidal anti-inflammatory drugs 21.2% of the drugs taken for suicide. Suicide is an increasing health problem in Turkey. Establishing a suicide surveillance program based on technology provides collection of detailed and standardized data. Analyzing this data will improve effective suicide prevention efforts

Determining ethical sensitivity of a group of military physicians

Military physicians must face a constant competition between their professional ethics and their organizational ethics more than their civilian counterparts. The objective of this study was to measure the sensitivity of the Military Physicians regarding the ethics-related situations which they come across during patient care and treatment. A group of physicians were selected who joined the Turkish Army for compulsory military service in December 2008. They were applied the "Moral Sensitivity Questionnaire", which was formed by Kim Lutzen. It was found that the physicians, who read the publications concerning ethics, agreed more with the "Structuring moral meaning" compared to the physicians who did not read such publications. It was also found that the physicians who came across ethical problems agreed more with following the "rules" approach. The physicians had high levels of autonomy with respect to patient care and treatment. Their aim was to provide benevolence for their patients; that they valued patient participation in patient care and treatment; and that they refrained from conflict and acted in collaboration