[Evaluation of the effectiveness of patient-controlled analgesia in children with sickle cell anemia from the perspective of healthcare professionals and parents]. / Orak hücre anemili çocuklarda, hasta kontrollü analjezi yönteminin etkinligini, kullanicilarin degerlendirmesi.

OBJECTIVES: This study evaluated the efficacy of patient-controlled analgesia (PCA) used by children with sickle cell anemia (SCA) based on the attitudes of parents and healthcare professionals. METHODS: A total of 86 individuals were involved in the study: 54 parents of children with SCA who were receiving treatment and 32 healthcare providers (doctors, nurses). To evaluate the effectiveness of the PCA method, a questionnaire was prepared to determine the level of knowledge of the participants about the PCA method and their perception of its advantages and disadvantages. RESULTS: According to 65.6% (n=21) of the healthcare providers, PCA should be used during acute phase of pain. The great majority of the participants (93%; n=80) thought that pain was effectively controlled both during the day and at night. PCA reduced the fear of unavailability of analgesic drugs in 83.3% (n=45) of parents and in 87.5% (n=28) of healthcare providers. More parents (37%) reported a reduction in the fear of return of pain than healthcare providers (9.4%) (p<0.05). Most parents (87%; n=47) reported that they preferred to wait until their child complained of severe pain to use on-demand doses of analgesic due to concerns about overdose and addiction. Resolving machine alarms (48%; n=26) and the length of time required to refill the machine (48%; n=26) were reported as disadvantages of PCA method. CONCLUSION: In this study, parents and healthcare professionals found PCA to be effective in relieving pain in children with SCA; however, fears and biased knowledge of users about the analgesic drug are thought to inhibit reaching sufficient dosage. Educational courses for users about PCA and the drugs used may increase the effectiveness of PCA method.

Low-exposure cadmium is more toxic on osteoporotic rat femoral bone: mechanical, biochemical, and histopathological evaluation.

This study aimed to investigate the effects of low-exposure Cd on normal and osteoporotic bone. For this purpose, 12-week-old Sprague-Dawley female rats were assigned randomly to a control group, a Cd group, and an ovariectomy (OVX)+Cd group. OVX+Cd rats underwent bilateral ovariectomy via ventral incision. Twelve weeks after ovariectomy, cadmium chloride (CdCl(2)) was given to rats (Cd and OVX+Cd groups) as intraperitoneal (ip) injection of 0.5mg/kg three times a week for 18 weeks and distilled water was given to control group via ip route for 18 weeks. Bone mineral density (BMD) was measured at mid-diaphysis femoral region by dual-energy X-ray absorbsiometry. Cross-sectional area of the femoral shaft was evaluated by computerized tomography. Biomechanical measurements were performed at the mid-diaphysis of the left femur. Collagen fibers were evaluated at light microscopic level. BMD, cortical thickness, cortical area, and femur length were not changed in Cd and OVX+Cd groups in comparision to controls. In the OVX+Cd group, strength, displacement, energy, stress, strain, and toughness were significantly lower than those of the control group. The Cd concentration of bone was significantly increased in the OVX+Cd group compared to that in the control group. Collagen fiber intensity was decreased in all groups except control group. The results of the present study indicate that the administration of low-dose Cd does not affect normal bone biomechanical parameters, but it has a significant effect on osteoporotic bone.