A Comparative Analysis of Spiritual Care Needs Among Cancer Patients Receiving Home Care and Their Caregivers in Turkey.

This study was conducted to determine and compare the spiritual care needs of cancer patients and their caregivers. A comparative descriptive, cross-sectional design was employed in this study. The study comprised 102 patients who were registered in the hospital's home care unit, as well as their caregivers (total number = 204). The data were collected using a personal information form and the Spiritual Care Needs Inventory. The cancer patients had a mean age of 69.5 years, while their caregivers' mean age was 53.1 years. According to the results, the cancer patients needed more spiritual care than their caregivers (p < 0.01). Patients' spiritual care needs differed significantly by employment status (p < 0.05). However, gender, educational level, and marital status did not have a significant difference in the spiritual care needs of the patients and their caregivers (p > 0.05). Moderately positive and significant (p < 0.05) correlations between patients and their caregivers were found for the total Spiritual Care Needs Inventory scores (r = 0.449), the meaning and hope subscale (r = 0.378), and the caring and respect subscale (r = 0.546). It is important to evaluate the spiritual needs of patients with cancer and their caregivers. In this evaluation, it is essential to elicit the perspectives of cancer patients and their caregivers concerning spiritual needs and religion. Effective spiritual care for patients and their caregivers can only be provided if their beliefs and priorities are taken into consideration.

[Peritonitis due to Kocuria rosea in a continuous ambulatory peritoneal dialysis case]. / Sürekli ayaktan periton diyalizi yapilan bir olguda Kocuria rosea'ya bagli peritonit.

Micrococcus strains which are the normal flora members of skin, mucosa and oropharynx, may lead to infections associated with intravenous catheter, chronic ambulatory peritoneal dialysis, venticular shunt and prosthetic valve. In this paper, a case of peritonitis due to Kocuria rosea of Micrococcea family, in a patient undergoing continuous ambulatory peritoneal dialysis (CAPD), was presented. Fiftysix years old female patient was admitted to the hospital by complaints of abdominal pain, nausea and fever. The patient was undergoing CAPD due to chronic renal failure for one and a half year and turbidity was detected in the peritoneal fluid during dialysis. Examination of the peritoneal fluid revealed 1800 cells/mm3, with no evidence of bacteria in Gram and Ziehl-Neelsen stained smears. No bacterial growth was detected in conventional culture media, however, bacteria was isolated from the peritoneal fluid culture on second day by Bactec (Becton Dickinson, USA) automated blood culture system. By means of API identification system (bioMerieux, USA), the causative agent was identified as Kocuria rosea. The patient was successfully treated with intraperitoneal teicoplanin (4 x 40 mg) for 14 days. In conclusion, in patients undergoing CAPD, rare pathogens should be considered in case of peritonitis and peritoneal fluid samples should be inoculated into automated culture systems.

[Two Crimean-Congo hemorrhagic fever cases without history of tick contact from Ankara region]. / Ankara bölgesinde kene temasi öyküsü olmayan iki Kirim-Kongo kanamali atesi olgusu.

Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne viral disease presenting with flu-like symptoms, fever, hemorrhage and petechia. The virus (CCHFV) is a member of the Nairovirus genera of Bunyaviridae family and can be transmitted to humans by Hyalomma tick-bite, by exposure to infected blood and fomites of patient with CCHF or contact with animal tissue in viremic phase. In this study we present two cases with CCHF but without history of tick bite or exposure to infected fomites, even not coming from endemic areas. The first case was a 67 years old male patient presented with fever, fatique and shortness of breath. Physical examination revealed rales in right lower segments of lung. Laboratory findings showed elevation of liver enzymes with thrombocytopenia and prolonged prothrombin time. Serological markers for viral hepatitis, cytomegalovirus (CMV) and Epstein-Barr virus (EBV) were negative. The patient was found to be IgM and RNA positive for CCHFV by ELISA and polymerase chain reaction (PCR) methods, respectively. His history indicated a contact with livestock. The second patient was a 60 years old male dealing with husbandry. He had fever, fatique and myalgia. Physical examination revealed petechial rash on legs. Laboratory findings showed elevated liver enzymes, prolonged phrothrombin time and thrombocytopenia. Viral hepatitis markers, CMV-IgM and EBV-IgM were found negative. He was also found to be IgM and RNA positive for CCHFV in the reference laboratory. In conclusion, CCHF should be considered in the differential diagnosis of patients who contact with livestock and present with fever, fatigue, rash, elevated liver enzymes, thrombocytopenia and prolonged prothrombin time eventhough they do not reside in endemic areas for CCHF.

Prevalence of Coxiella burnetii antibodies in blood donors in Ankara, Central Anatolia, Turkey.

The aims of this study were to determine the prevalence of Coxiella burnetii antibodies among blood donors and to examine the epidemiological characteristics of C. bumetii infection in Ankara, Turkey. A total of 601 serum samples were collected from blood donors aged 18-61 years. Donor samples were stratified by age, sex, and residence (rural or urban). IgG and IgM antibodies to the C. bumetii phase II antigen were determined using a commercial ELISA. Blood samples reactive in the ELISA were also analysed using a commercial indirect immunofluorescence assay (IFA). The prevalence of anti-phase II IgG was 32.3%, and 17 (2.8%) were IgM positive. Seropositivity in men was higher than in women (33.2% vs. 21.7%, OR:1.88; 95% CI: 0.88-4.14) and the difference in seroprevalence rates between genders was not related to occupational exposure to domestic animals. 87.6% of seropositive donors reported no contact with farm animals. Our results revealed that C. burnetii infection is highly endemic in Ankara and that the majority of seropositive cases are not linked to specific occupational exposure in this area. In conclusion, the high rate of C. burnetii phase II antibodies among blood donors is a reflection of the high prevalence of Q fever in this area of Turkey and indicates the need for further studies, not only to determine the risk of transfusion-transmitted Q fever, but also to elucidate the epidemiology of Q fever in Turkey. These studies should be conducted through improved collaboration between the veterinary and medical services.