TURKISH DIALYSIS HEALTHCARE PROVIDERS' PSYCHOLOGICAL RESPONSE TO COVID-19

Objective: COVID-19 has been a stressful experience for healthcare providers (HCPs) and created additional distress for dialysis HCPs due to patients' higher risk of infection, symptom severity, and death. This study aims to investigate Turkish dialysis HCPs' levels of psychological difficulties during COVID-19's initial outbreak. Materials and Methods: The study has recruited physicians, nurses, and healthcare workers in dialysis centers. The participants completed an online survey that includes the screening questionnaire, Depression Anxiety Stress Scale-21 (DASS-21), and Multidimensional Scale of Perceived Social Support (MSPSS). The study conducts the chi-square test, Fisher's exact test, Mann-Whitney U test, Kruskal Wallis H test, Spearman correlation, and linear regression analyses. Results: The study involves 953 respondents, with nurses making up the majority (n=465, 48.8%), followed by healthcare workers (n=402;42.2%) and physicians (n=86;9%). HCPs' most significant concerns were getting infected with COVID-19 and transmitting the disease to their loved ones. Single participants, those without children, those who had trouble finding equipment, and those worried about being able to find equipment in the future, being in contact with COVID-19 (+) people, those whose tobacco and alcohol use increased, and those who declared sleep, appetite, and/or somatic problems had higher DASS-21 scores. When compared respectively to healthcare workers and physicians, nurses were found to be more worried about getting COVID-19 (94.6% compared to 90.6% and 84.7%;p < 0.001), experience equipment shortages (52.9% compared to 29.4% and 26.3%;p<0.001), have sleep (62.2% compared to 43.5% and 34%;p<0.001) and somatic problems (58.4% compared to 50% and 28.2%;p<0.001), and higher DASS-21 scores (Range=5-21 compared to 3-15 and 0-12;p<0.001). Conclusion: Worries and lifestyle changes associated with the outbreak are seen to have been be related to psychological difficulties. An adequate level of knowledge, self-protection, and social support are essential issues for HCPs. While this study recommends that HCPs express and share their worries, institutions should also focus on the psychological status of their staff and provide immediate interventions. © 2023 The authors.

Is laparoscopic surgery risk for surgical teams during the coronavirus disease pandemic? An in vitro study with a laser and high-speed camera.

OBJECTIVE: Laparoscopic surgery has been suggested to pose a risk of infection to the surgical team due to aerosol and gas leakage during the coronavirus (COVID-19) pandemic. However, there have been no studies on the risk of gas and aerosol leakage in laparoscopic surgery. We aimed to answer the question "Is the aerosol and gas leakage in laparoscopy is hazardous in terms of coronavirus infection?" with this study. MATERIALS AND METHODS: In this study, gas and aerosol leaks were documented by simulating the entry and exit maneuvers from a trocar during laparoscopic surgery using a high-speed camera, fog, and laser in a model representing the abdomen. RESULTS: The maximum gas and aerosol leakage were found during wet gauze extraction from the 10 mm trocar, and its velocity reached 7.5 m/s. The fastest aerosol leakage rate was observed when a 5 mm grasper was extracted from the 5 mm trocar. The results of the subsequent trials were consistent with these values. CONCLUSIONS: Higher leakage speeds were observed than the velocity of the exhaled air in a resting person. The surgical crew members, who work very close to the trocars and each other, are at serious risk of infection with COVID-19 which can spread as fast as exhalation speed through trocars. Since there is an evident risk of infection for the surgical crew from laparoscopic surgery of a patient whose intraabdominal fluids are infected with COVID-19, patients must be evaluated elaborately for COVID-19 preoperatively and infected patients should undergo surgery conventionally.

Impact of COVID-19 pandemic on maxillofacial trauma etiology

Objective: Maxillofacial trauma (MFT) is a frequent presentation in the emergency department (ED) which requires a multidisciplinary approach. Although, its etiology and diversity of injuries are almost similar worldwide, the causes may differ among the countries depending on the sociocultural and environmental factors and local traffic regulations. This study aims to evaluate etiologies of maxillofacial traumas (MFTs) in ED and to compare etiologies of MFTs during COVID-19 pandemic with the previous year. Patients and Methods: Totally 84 (61 males, 23 females) patients admitted to ED of our center with MFT between March 15th - April 30th, 2020 were included. The control group consisted of 148 (112 males, 36 females) MFT patients admitted to ED in the previous year (March 15th-April 30th, 2019). Data including age, sex, cause of trauma, treatment, and COVID-19 infection status within 14 days after ED admission were compared between groups. Results: Mean age was 31.88 +/- 2.53 years in the patient group and 31.40 +/- 1.74 years in the control group. Number of patients admitted to ED with MFTs decreased by 43.3% during pandemic compared to the previous year. Majority of MFTs occurred at home, followed by public places, traffic, and workplaces in both time periods. During pandemic, the rate of home accidents increased and MFTs occurred in the public places decreased. Conclusion: COVID-19 pandemic-mandated social restrictions lead to a decrease in the number of MFTs. However, home accidents are the main cause of MFTs. Spread of COVID-19 infection in the hospital setting can be minimized with necessary precautions.