Medical Science and Discovery

Assessment of communication needs and planning communication actions during health crises

2020-12-30T18:44:46+03:00

Health crisis communication (HCC) is a challenging and urgent task of the emergency preparedness planning of any welfare state. In this paper, some particular reasons for that will be more specifically analyzed. The action flow of HCC includes the phases of preparedness, warning, response, recovery, and evaluation. For a successful HCC detailed guidelines are also needed, along with profound knowledge of how the crisis stakeholders should deal with the psychological needs of the citizens and the mass media, as well as with some specific technical items. The ultimate implication of HCC is that the public is aware of its right to make informed choices after having been actively involved in the procedure of risk decisions making.

Experimental model for the evaluation of metabolic status after gastric bypass in obese rats

2020-12-30T18:44:43+03:00

Objective: Obesity is an exceedingly current pathology with many clinical, molecular, and psychological implications. The number of obese people has doubled in the past ten years, and we can observe an early onset of obesity. Bariatric surgery is an effective treatment for severe obesity and type 2 diabetes mellitus (T2DM); Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) are the two most prevalent types of this procedure . Nevertheless, no single mechanism has emerged that thoroughly explains the metabolic benefit and subsequent long-term effects after surgery. Webster's new collegiate dictionary defines the noun model as: 'a descriptive or analogy used to help visualize something that cannot be directly observed.' Sustained by this definition, the animal models in nutritional research are fundamental to improve human conditions. Due to the recent boost in experimental surgery, our aim in this study is to set the main technical characteristics of the gastric bypass operation and specific animal care in the metabolic surgery field we have been undertaking in our center.

Materials and methods: We chose Wistar rats fed with a high caloric diet (HCD) 82g / 100 g fat, 53/100 g saturated fat, 64/100 g carbohydrates. After 7-15 weeks of this diet, depending on the protocol understudy, a consistent three-fold greater weight gain is achieved than the usual range of the free eating chow. After approximately three months on an HCD, the obese rats manifest biochemical features of the metabolic syndrome.

Results: The weight loss for group B (By-pass) was 125 ± 16.16 g, and for group BS (By-pass + Sulodexid), it was 133.10 ± 14.38 g. Although the weight loss was higher in group BS, it is not statistically significantly higher than in group B (p = 0.345), despite administering a pharmacologically active substance in group BS. Although small (approximately 40-50 g), the difference between the control group and groups B and BS is statistically significant with p = 0.016 and 0.026 and Pearson index of 0.674 and 0.628, respectively. Statistical significance also kept the difference between group C and group S (p = 0.028, Pearson Coefficient = 0.621).

Conclusions: First of all, Metabolic surgery is the most effective weight-loss method and improvement or even remission of some diseases associated with obesity. Like today's high-calorie diet, the diet administered, mostly of adolescents, generates both obesity and its associated diseases: diabetes, hypertriglyceridemia, hypercholesterolism, thus increasing mortality and overall morbidity. Second, metabolic surgery radically improves the parameters targeting obesity (weight,% EBWL) and its associated conditions: diabetes mellitus, hypertriglyceridemia, hypercholesterolemia, strongly associated with decreasing life expectancy of the general population. Parameters targeted by gastric bypass: glycemia, TGL, CHO, hepatic steatosis, testicular atrophy registering significant improvements.

Correlation between severity of diabetes mellitus, polyneuropathy and nasal mucociliary clearance

2020-12-30T18:44:42+03:00

Objective: To examine the relationship between the severity of polyneuropathy and nasal mucociliary clearance times in patients with polyneuropathy and investigate how the presence and severity of electrophysiological polyneuropathy might affect mucociliary clearance in patients with diabetes mellitus.

Material and Methods: This prospective cross-sectional study was carried out in the Neurol-ogy and Ear, Nose and Throat (ENT) clinics in a tertiary hospital. The study included three groups of patients with 20 participants in each group (Group 1, patients with diabetic poly-neuropathy; Group 2, patients with non-diabetic polyneuropathy; and Group 3, diabetes melli-tus patients with a normal nerve conduction study) Nasal saccharin test was performed on all patients.

Results: There was a statistically significant difference in the duration of nasal mucociliary clearance among the groups (p= 0.001). There was a positive, statistically significant (p = 0.007) correlation between the nasal mucociliary clearance duration and the severity of poly-neuropathy. The nasal mucociliary clearance duration increased with the severity of polyneuropathy.

Conclusion: Patients with diabetes mellitus are a special group, and preventable problems should be taken into consideration when examining nasal pathologies. It should be kept in mind that nasal mucociliary clearance dysfunction can be both a cause and a result in management of diabetes mellitus patients, and thus it should be evaluated carefully.

The treatment of chronic wounds with boric acid polyurethane sponges combined with negative pressure wound treatment: a multi-center, prospective, randomized study

2020-12-30T18:44:45+03:00

Objective: This study aimed to compare the outcomes of the use of polyurethane boric acid sponges and sponges containing silver nitrate over the negative pressure wound treatment.

Materials and methods: The patients were separated as Group 1 (n:30) treated with boric acid group, and Group 2 (n:34) treated with silver nitrate group (Group 2). The wound healing of each patient was evaluated quantitatively on a cellular basis from a table of macroscopic and histopathological scoring.

Results: No statistically significant difference was determined between the groups applied with boric acid and silver nitrate in respect of the culture results from the first visit (p:0.705). In the final evaluation of wound dimensions on day 21, a significant reduction was seen in wound width (p=0.001), wound length (p=0.003), and wound depth (p<0.001) in the boric acid group, and no significant results were obtained in the silver nitrate group. In the quantitative cellular evaluations, a statistically significant difference was determined in favor of the boric acid group in respect of inflammatory cell count, angiogenesis, granulation, and re-epithelialization (p<0.001 for all).

Conclusion: Sponges with boric acid can have a positive effect on chronic wound recovery by improving cellular proliferation, cellular differentiation and cellular migration in addition to antimicrobial properties when used in combination with the negative pressure wound treatment system. Therefore, boric acid sponges seem to be a good alternative to silver nitrate sponges.

Changes in liver function in patients with covid-19 and the demographics of the disease in a mid-sized city of Turkey: A retrospective analysis

2020-12-30T18:44:39+03:00

Objective: To define the clinical characteristics of patients hospitalized with COVID-19 in ICU and ward and to evaluate the significance of liver function test results. A new disease caused by SARS-CoV-2 has been devastating the world affecting millions of patients worldwide and leading the significant mortality and morbidity.

Material and Methods: The demographic features of a cohort of 125 hospitalized patients between March 2020 and May 2020 were recorded. The clinical characteristics, laboratory findings, and mortality rates were analyzed.

Results: A total of 125 patients hospitalized for COVID-19 diagnosis where 113 (90.4%) were followed-up in the ward and 12 (9.6%) were in ICU were included in the study. The mean age of the patients was 44.05±16.95 and 88 (70.4%) of the patients were male. The most common symptoms were in the following order: cough in 80 patients (64%), dyspnea in 40 (32%) and fever in 33 (26.4%). The leukocyte and neutrophil counts were significantly higher in ICU patients with COVID-19 compared to patients in the ward (p=0.002, p<0.05; respectively). The CRP and D-Dimer levels were found elevated in ICU patients with COVID-19 than in the ward (p<0.05; p<0.05, respectively). The AST level of patients with COVID-19 in ICU was significantly heightened than patients in the ward.

Conclusion: The present study revealed that patients with elevated AST level were at great risk of progressing to severe disease those require close monitoring.

Clinical characteristics and postoperative complications of patients who underwent laparoscopic sleeve gastrectomy due to obesity A Single Center Experience

2020-12-30T18:44:37+03:00

Objective: Obesity, which is considered as a chronic disease today, has become an epidemic problem especially in developed countries. Laparoscopic sleeve gastrectomy (LSG) is currently one of the most common bariatric procedures in obesity treatment. This study aimse aims to present our demographic, clinical, histopathological and postoperative early and late complications of patients who underwent LSG.

Material and Methods: Patients who underwent LSG due to obesity between March 2018 and December 2019 in our clinic were included in the study. The patients' age, gender, comorbid diseases, preoperative body mass index (BMI) and length of hospital stay, postoperative complications and pathology results were recorded retrospectively.

Results: Of the 278 patients included in the study, 201 (72.3%) were female, 77 (27.6%) were male and the mean age was 36.2 (min: 18-max: 60 years). The mean BMI of the patients was 46.4 (min: 35.2-max: 75.1). The average hospital stay of the patients was 4.2 days (3-13 days). When the early and late complications of the patients are examined; It was observed that 25 (8.9%) patients developed early postoperative complications, and 2 (0.7%) patients developed late postoperative complications.

Conclusion: LSG is a reliable surgical method with low mortality and morbidity rates. It is important that we do not have mortality and that our morbidity is within acceptable limits. Bariatric surgery is an effective and reliable application in the treatment of obesity and metabolic surgery today, in terms of its results, if the right patient is selected and performed in experienced centers.

Idiopathic temporal bone encephalocele: Diagnosed and treated during cochlear implantation

2020-12-30T18:44:40+03:00

Objective: Meningoencephaloceles of the temporal bone are rare entities. There are two main categories, congenital and acquired. Acquired meningoencephaloceles are more common due to iatrogenic injury to the tegmen tympani which is a common complication during mastoidectomy.

Case Presentation: We present a case of an idiopathic meningoencephalocele that was diagnosed and treated successfully during cochlear implantation via transmastoid approach. Fascia lata graft was used to reconstruct the deficit of tegmen tympani. Audiological outcome has been improved.

Conclusions: Idiopathic Meningoencephaloceles present without specific clinical symptomatology and as a result diagnosis delay significant. In literature, there are various surgical approaches with mixed results.