Frontline nurses caring for COVID-19 patients: Experiences from the perspective of Turkish nurses.

Background: Nurses were affected by this pandemic more than any other healthcare professionals because they were working on the frontline continuously. Aims: The current study explored how nurses who care for patients with COVID-19 assess this process which they experienced, how they coped with the process, and their psychological experiences. The study was conducted by reaching out to the nurses working at pandemic clinics using the snowball sampling method. A total of 40 nurses were interviewed using telephone. The study employed a descriptive qualitative approach. The data were obtained through telephonic interviews that were performed by the researcher using interview forms. Materials and Methods: The interview notes were analyzed using the content analysis method according to Colaizzi's phenomenological method. Results: As a result of the content analysis, four themes emerged with the following headings: Initial reactions, factors that made an adaptation to the period of pandemic challenging, factors that facilitated the adaptation, and what the period of pandemic taught. Conclusions: It is suggested for nurses that their rotation should be planned effectively, and their social support should be enhanced. They should be provided with adequate personal protective equipment and human resource planning should be improved until the end of the COVID-19 pandemic.

Hemoglobin A1c-related histologic characteristics of symptomatic carotid plaques.

BACKGROUND: The aims of our study were to compare the histomorphological characteristics of carotid plaques and glycosylated hemoglobin (HbA1c), which are risk factors for ischemic stroke, in patients who underwent carotid endarterectomy for carotid artery stenosis. Moreover, we aimed to identify the structures that were histologically affected by symptomatic carotid plaques in cases with elevated HbA1c. MATERIALS AND METHODS: A total of 64 patients who presented with ischemic stroke and had not previously been diagnosed with diabetes were retrospectively evaluated. All stroke risk factors were reviewed. Carotid plaques were graded separately by two different pathologists through microscopic assessment of the following parameters: plaque rupture, lipid core, fibrous cup thickness, inflammation, intraplaque hemorrhage, thrombus, calcification, necrotic core, and neovascularization. An HbA1c value <6.3% was accepted as normal or indicative of prediabetes (group 1), whereas patients with values ranging between 6.3-7.4%, 7.5-8.4%, and >8.4% were categorized into the effectively controlled (group 2), less effectively controlled (group 3), and uncontrolled (group 4) groups, respectively. RESULTS: The mean age of the patients was 73.0 ± 4.5 years in group 1, 69.7 ± 2.3 years in group 2, 66.0 ± 8.5 years in group 3, and 62.7 ± 7.1 years in group 4. A negative correlation was present between age and HbA1c. Smoking, hypertension, low-density lipoprotein cholesterol levels, and triglyceride levels were not significantly different among the four groups. According to the HbA1c classifications, the fibrous cup thickness was 2.64 ± 0.3 mm in group 1, 1.85 ± 0.4 mm in group 2, 1.68 ± 0.5 mm in group 3, and 1.45 ± 0.6 mm in group 4. The fibrous cup became thinner as the HbA1c value increased. Other parameters of unstable carotid plaques did not differ among the HbA1c groups. CONCLUSIONS: Increased HbA1c values seem to contribute to plaque instability through the formation of a thin fibrous cup. Thus, of the carotid artery plaque parameters including fibrous cup thickness, plaque rupture, lipid core, inflammation, intraplaque hemorrhage, thrombus, calcification, necrotic core, and neovascularization, fibrous cup thickness is the only histomorphological feature that affected by HbA1c.

CSF flow patterns in the brain in patients with neuro-Behçet disease and Behçet disease.

OBJECTIVE: In the etiopathogenesis of Behcet disease (BD) and Neuro-Behcet disease (NBD), vascular eclipse occurs in both the arteries and veins. The disease affects all vascular structures. The present study evaluates the use of Phase Contrast (PC) Cerebral Spinal Fluid (CSF) Flow Magnetic Resonance Imaging (MRI), a non-invasive technique for measuring CSF dynamics, for determining the level of aqueducts that are influenced in BD and NBD. PATIENTS AND METHODS: The quantitative evaluation of CSF flow in BD and NBD was performed using images obtained at the level of the cerebral aqueduct on the semi-axial plane. The PC-MRI angiography technique was used. RESULTS: There is no distinctive difference between BD and NBD that can be distinguished by the aqueduct diameters of both conditions. A clear increase in aqueduct diameter occurred BD and NBD group when compared to the control group. While there were no differences found between the BD group and the control group regarding peak velocity, average velocity, forward flow, reverse flow, net forward flow, and flow, there were distinctive increases in these various factors in the NBD group. CONCLUSIONS: Using the non-invasive PC-MRI technique, this study found that in BD and NBD patients, changes occurred in CSF flow figures. Increases in CSF parameters were also observed in NBD patients, a finding which may be helpful for future distinction between BD and NBD during diagnosis.

Cancer patients and oncology nursing: Perspectives of oncology nurses in Turkey.

BACKGROUND AND AIM: Burnout and exhaustion is a frequent problem in oncology nursing. The aim of this study is to evaluate the aspects of oncology nurses about their profession in order to enhance the standards of oncology nursing. MATERIALS AND METHODS: This survey was conducted with 70 oncology nurses working at Hacettepe University Oncology Hospital. Data were collected between January-April 2012. Each participant provided a study form comprising questions about sociodemographic information; about difficulties, positive aspects and required skills for oncology nursing; and questions evaluating level of participation and clinical perception of oncology nursing. RESULTS: Mean age of nurses was 29.9 ± 5.7 years. More than half of the participants were married (51.4%) and 30% had at least one child. Percent of nurses working in oncology for their entire work life was 75.8%. Most frequently expressed difficulties were exhaustion (58.6%), coping with the psychological problems of the patients (25.7%), and frequent deaths (24.3%); positive aspects were satisfaction (37.1%), changing the perceptions about life (30%), and empathy (14.3%); and required skills were patience (60%), empathy (57.1%), and experience (50%). For difficulties of oncology nursing, 28.3% of difficulties could be attributed to job-related factors, 30.3% to patient-related factors, and 77% of difficulties to individual factors. The independent predictors of participation level of the nurses were self-thoughts of skills and positive aspects of oncology nursing. CONCLUSION: According to the findings of this study, nurses declared that working with cancer patients increase burnout, they are insufficient in managing work stress and giving psychological care to patients, but their job satisfaction, clinical skills and awareness regarding priorities of life has increased.

Olfactory disfunction and its relation olfactory bulb volume in Parkinson's disease.

OBJECTIVE: Olfactory dysfunction is the most frequently seen non-motor symptom of Idiopathic Parkinson's disease (IPD). The aim of this study is to analyze selective olfactory dysfunction, and olfactory bulb volume (OBV) in subtypes of IPD, and compare them with those of the healthy controls. PATIENTS AND METHODS: Our study included 41 patients with IPD and age and gender matched 19 healthy controls. IPD patients were either tremor dominant (65.9%; TDPD) or non-tremor dominant (34.1%; NTDPD) type. All patients underwent neurological, ear, nose, and throat examinations, and orthonasal olfaction testing. Magnetic resonance imaging (MRI) technique was used to measure the volume of the olfactory bulb. RESULTS: A significant decrease in olfactory identification scores was found in the patient group. The patients had difficulty in discriminating between odors of mothballs, chocolate, Turkish coffee and soap. OBV did not differ between the patient, and the control groups. In the TDPD group, odor identification ability was decreased when compared to the control group. However, odor test results of NTDPD, control and TDPD groups were similar. OBV estimates of the TDPD group were not different from those of the control group, while in the NTDPD group OBVs were found to be decreased. In all patients with Parkinson's disease OBV values did not vary with age of the patients, duration of the disease, age at onset of the disease, and Unified Parkinson's Disease Rating Scale motor scores (UPDRS-m). CONCLUSIONS: Olfactory function is a complex process involving olfactory, and cortical structures as well. In Idiopathic Parkinson's disease, changes in OBV do not seem to be directly related to olfactory dysfunction.

P50 sensory gating in hypoxemic chronic obstructive pulmonary disease patients.

PURPOSE: Chronic obstructive pulmonary disease (COPD) is a condition characterized by progressive airway obstruction and recurrent attacks. Multisystem involvement with extrapulmonary manifestations has been seen in COPD patients. Numerous neurological involvement like cerebrovascular diseases, polyneuropathies, motor neuron diseases and cognitive impairement has been reported in COPD patients. Cognitive dysfunction is usually associated with hypoxia or hypercapnia in COPD patients. To our knowledge there is no study about sensory gating in COPD patients. We performed p50 test to COPD patients and we investigate sensory gating in COPD patients. PATIENTS AND METHODS: 25 male patients with COPD and 17 healthy male subjects for controls included to this study. The patients were diagnosed with COPD according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria. p50 amplitude and latency, percentage of P50 suppression, N100 amplitude and latency and the N100 suppression percentage of the COPD patients and controls presented were measured and compared. RESULTS: We found that the conditioning amplitudes (S1) did not differ between COPD patients and controls (p > 0.05) but (S2) amplitude was significantly increased in COPD patients (p < 0.05). COPD patients showed significantly lower P50 and N100 suppression percentage than controls (p < 0.05). CONCLUSIONS: COPD patients showed a disturbance cognitive function such as attention with p50 suppression rate decrease. P50 sensory gating test can be useful to analyze the pre-attention period of cognitive impairment in the early phase of COPD patients.

Increased mean platelet volume in cervicocephalic artery dissections.

AIM: We aimed to investigate the role of platelets in the pathogenesis of cervicocephalic artery dissections by measuring the mean platelet volume (MPV) and platelet count. METHODS: Thirty-four patients with evidence of cervicocephalic artery dissection were included in the study. Cervicocephalic artery dissection patients were divided into two subgroups as vertebral artery dissections and carotid artery dissections. There were 30 control subjects with similar baseline characteristics. The platelet count and MPV were compared between groups. RESULTS: The analysis showed a significant difference between the MPV values of the cervicocephalic artery dissection group and the control group (p < 0.05). However, when we compared subgroups with controls, we found a significantly higher MPV values only in the vertebral artery dissection group. We did not find any significant difference for total platelet count between the cervicocephalic artery dissection groups and controls. CONCLUSIONS: MPV is a marker of platelet function and activation. Increased MPV may be a result of dissection. In addition, it may be a risk factor for dissection-related stroke. Our study supports the notion that platelet reactivity is important in the pathogenesis of the cervicocephalic artery dissections, especially in vertebral artery dissections.