Effectiveness of Fan Therapy for the Management of Dyspnea.

Context: In addition to pharmacological approaches, clinicians use nonpharmacological approaches in the management of dyspnea, one of which is fan therapy. It's a simple, cost-effective intervention that patients can easily use independently, without requiring professional support. The field needs further research on the outcomes of fan use. Objective: The study intended to determine the effectiveness of fan therapy in relieving dyspnea for patients with dyspnea symptoms. Design: The research team conducted a single-group, pretest-posttest study. Setting: The study occurred at the Prof. Dr. Murat Dilmener Emergency Hospital, which is an additional service building of the Bakirkoy Dr. Sadi Konuk Training and Research Hospital in Istanbul, Turkey. Participants: Participants were 81 patients with respiratory distress who received inpatient treatment at the hospital between March 2022 and June 2023. Intervention: The research team used a hand fan for 5 minutes to cool participants' faces. Outcome Measures: At 15 minutes post fan therapy, the research team: (1) measured patients' dyspnea levels using with Modified Borg Scale (MBS), (2) oxygen saturation, (3) respiratory rate, (4) pulse rate, (5) body temperature, (6) blood pressure, and (7) respiratory-muscle-use status. Results: Between baseline and post intervention, participants' oxygen saturation (P = .001) significantly increased and respiration rates (P = .014), systolic blood pressure (P = .003), diastolic blood pressure (P = .001), use of accessory respiratory muscles (P = .003), and MBS values (P = .001) significantly decreased. At baseline, a high dyspnea level was significantly negatively correlated with an age >67 (P = .019), BMI >25.0 (P = .044), an oxygen saturation of <95 (P = .005), and respiratory rate >20/pm (P = .001) and significantly positively correlated with a severe need for oxygen support (P = .035), a pulse rate >100/pm (P = .001), and hypertension (P = .005). Post intervention, a high dyspnea level was significantly positively correlated with smoking (P = .008), a need for oxygen support (P = .001), a severe need of oxygen support (P = .017), and hypertension (P = .001) and significantly negatively correlated with oxygen saturation <95 (P = .002). Conclusions: Fan therapy directed to the face can be effective in reducing the dyspnea level. With the therapy being a simple, reliable, and cost-effective method that nurses, patients, and their families can use, the current research team concludes that clinicians can use it together with pharmacological methods for patients experiencing dyspnea.

Comparison of chest computed tomography findings of RT-PCR negative and RT-PCR positive cases in COVID-19 patients.

OBJECTIVE: The purpose was to compare the results of the RT-PCR test, with the findings of Chest CT and to determine the features of CT for the diagnosis of COVID-19 and how to approach RT-PCR negative patients. MATERIAL METHOD: Chest CT findings of 569 COVID-19 diagnosed patients, followed up at the pandemic wards between March and June 2020 were retrospectively examined. Patients were grouped according to RT-PCR results, gender, and age. RESULTS: 284 (49%) were RT-PCR(+), 285 (50.8%) were RT-PCR(-) of total 569 patients. 11 (1.9%) of RT-PCR(+) had no involvement in Chest CT while all the RT-PCR(-) patients were CT(+). The distribution of lesions in CT were; 544 (95.6%) bilateral, 553 (97.2%) multilobar, 557(98%) peripherally 151 (26.5%) posteriorly localized. The most common findings were; 539 (94.7%) ground-glass opacity (GGO), 365 (64.1%) consolidation, 160 (28.1%) crazy paving interlobular septal thickening. CO-RADS mean value was 5.4 ± 0.7. GGO and reticulation in RT-PCR(-) patients were 280 (98.2%) and 24 (8.4%); while they were 259 (91.2%) and 12 (4.2%) in RT-PCR(+) patients, were significantly higher (p < 0.05). No significant difference was observed, in CT findings for gender. Only the findings of crazy paving interlobular septal thickening and reticulation in 18-64 age group were significantly higher than that in 65-94 age group, 105 (24.8%)-55 (37.9%), 19 (4.5%)-17 (11.7%) respectively (p < 0.05). CONCLUSION: The typical findings of COVID-19 pneumonia in Chest CT are: GGO, consolidation and crazy paving in bilateral, peripheral, posterior localization. CT plays an essential role for diagnosis, isolation and treatment in cases of COVID-19 and RT-PCR negative test should be verified by CT.

Comparison of systemic immune-inflammation index (SII), early warning score (ANDC) and prognostic nutritional index (PNI) in hospitalized patients with malignancy, and their influence on mortality from COVID-19.

INTRODUCTION: We evaluated several biological indicators based on inflammation and/or nutritional status, such as systemic immune-inflammation index (SII), early warning score (ANDC) and prognostic nutritional index (PNI) in hospitalized COVID-19 patients with and without malignancies for a prognostic significance. METHODOLOGY: This is a retrospective and observational study on 186 patients with SARS-CoV-2, who were diagnosed with COVID-19 by real-time PCR testing and hospitalized due to COVID-19 pneumonia. 75 patients had various malignancies, and the rest (111), having a similar age and comorbidity profile based on propensity score matching, had no malignancy. RESULTS: None of the measures as neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, monocyte to lymphocyte ratio, SII, PNI or ANDC was found to be significantly different between two groups. Odds ratio for the mortality, OR 2.39 (%95 CI 1.80-3.16) was found to be significantly higher for the malignancy group, even though the duration of hospitalization was statistically similar for both groups. PNI was found to be significantly lower for deceased patients compared with survivors in the malignancy group. Contrarily, ANDC was found to be significantly higher for deceased patients in the malignancy group. CONCLUSIONS: PNI and ANDC have independent predictive power on determining the in-hospital death in COVID-19 malignancy cases. It is suggested that ANDC seems to be a more sensitive score than SII in COVID-19 cases with malignancies.