We conclude that the tenth rib line is better than Tuffier's line for accuracy with palpation. However, it must be confirmed by further studies including more than one examiner for palpation and also include different patient populations.
OBJECTIVE: We aimed to develop a simple, rapid urine test based on the level of foaming that occurs in the urine sample due to the excretion of peptide structures containing amino acids specific to the antigenic structure of COVID-19. In this study, we present the preliminary results of the first clinical study with a newly developed urine foaming test (UFT). METHODS: This study was conducted in a tertiary hospital in Istanbul. After obtaining the approval of the ethics committee, urine samples were taken from three groups of patients whose informed consent was obtained. The groups were created according to the COVID-19 Diagnostic Guide of Ministry of Health: A: outpatients with suspected COVID-19, B: inpatients for follow-up and treatment, C: patients treated in intensive care unit (ICU). Also, 30 healthy volunteers were included as the control group D. Urine samples taken from all groups were delivered to the laboratory. 2.5 ml urine sample was added to the test tube and shaken for 15 seconds and the level of foam formed was visually evaluated according to the color scale. Other data of the patients were obtained from the hospital information management system and the physician caring for the patient. The clinical status, PCR test results, computed tomography (CT), if any, laboratory tests, and UFT results were compared and the level of statistical significance was expressed as p≤0.05 in the 95% confidence intervals (CI). Performance characteristics, such as sensitivity, specificity, positive and negative predictive value of the UFT, were statistically calculated according to the RT-PCR result and/or CT. RESULTS: A statistically significant difference was observed between UFT distributions of the control, outpatient, inpatient and ICU patients (p=0.0001). The results of UFT orange and red in inpatients and ICU patients were statistically significantly higher than in the control and outpatient groups. The diagnostic accuracy of UFT was detected in all group, the pooled sensitivity was 92% (95% CI: 87–95%) and specificity was 89% (95% CI: 80–98%). CONCLUSION: Our preliminary results suggest that the UFT is useful, particularly in predicting the clinical severity of COVID-19. The UFT could be recommended as a point of care test, rapid and non-invasive method in the diagnosis and follow-up of COVID-19.
Bu çalışmada kalp cerrahisi yapılması planlanan hastalarda komplikasyonları önlemek amacıyla cerrahi sonrası ağrıyı en aza indirgeyen en uygun analjezik yöntem değerlendirildi. Ça lış ma pla nı: Ocak 2016-Haziran 2016 tarihleri arasında Amerikan Anesteziyoloji Derneği Fiziksel Durum Sınıf III ve ejeksiyon fraksiyonu %50 üzerinde olup elektif koroner arter baypas greftleme yapılan toplam 60 hasta (27 erkek, 33 kadın; ort. yaş 63 yıl; dağılım, 49-77 yıl) çalışmaya alındı. Hastalar yoğun bakım ünitesine kabullerinin ardından iki gruba ayrıldı. Grup 1'e (n=30) intravenöz hasta kontrollü analjezi protokolü ile intravenöz fentanil sitrat uygulanırken, Grup 2'ye (n=30) sternum ile cilt altı dokusu arasına yerleştirilen kateter ile %0.1'lik bupivakain hidroklorür analjezi protokolü uygulandı. Bul gu lar: Grup 1'de ikinci saatteki ağrı şiddet skorları ve görsel analog ölçeği skorları 24, 36. ve 48. saatler haricinde Grup 2'den daha yüksekti (p<0.05). Grup 1'de yoğun bakım ünitesinde yatış süresi ve idrar kortizol düzeyleri Grup 2'ye kıyasla daha yüksekti (sırasıyla 78±12 saat ve 631±505 µg/24. saate kıyasla 66±13 saat ve 401±297 µg/24. saat, p<0.05). Grup 2'ye kıyasla Grup 1'de cerrahi sonrası yoğun bakım ünitesinde yatış sırasında 10. ve 16. saatlerdeki parsiyel oksijen basıncı düzeyleri daha düşük iken, 24. saatte parsiyel karbondioksit basınç düzeyleri daha yüksekti (p<0.05). So nuç:Bupivakain protokolü, ağrının etkilerini azaltarak ve yoğun bakım ünitesinde yatış süresini kısaltarak, kan gazı analizinde daha iyi sonuçlar sağlayan, nispeten daha kullanışlı bir analjezi yöntemidir. İdrarda serbest kortizol düzeylerinin düşüklüğü de, bu bulguyu doğrulamaktadır. Anah tar söz cük ler: Bupivakain, yoğun bakım ünitesi, yatış süresi, hasta kontrollü analjezi protokolü, idrar kortizol.
OBJECTIVE: This study aims to evaluate the patient clinics by studying Variant of Concern (VOC) Polymerase Chain Reaction (PCR) on conventional PCR-positive samples in a training and research hospital COVID test center in Istanbul. METHODS: The study is a descriptive type and VOC PCR from all samples (from a total of 1300 samples) which detected positive by conventional PCR in a training and research hospital COVID test center between February 2 and 9, 2021. The United Kingdom mutation (VOC 202012/01, B.1.1.7) has been studied. Clinics parameters of the patients were evaluated from Public Health Management System (HSYS) records. The statistical significance was taken as p<0.05 in the analysis. RESULTS: Within the scope of the research, 1300 PCR-positive COVID-19 patients were evaluated. VOC mutation was positive in 26.1% of all patients (339 persons), and 5.8% of patients (75 persons) were hospitalized. While 3.2% (11 persons) of those with VOC positivity were hospitalized, 6.7% (64 persons) of VOC negatives were hospitalized (p=0.020). About 18.2% of hospitalized VOC positives (two persons) and 23.4% of VOC negatives (15 persons) are in intensive care. CONCLUSION: When VOC mutation was examined in all admitted and hospitalized patients, it was detected that VOC mutation was less frequent in hospitalized patients. No relationship between hospitalization and intensive care stay and VOC mutation was detected. It is recommended to determine with studies the contagiousness of patients with VOC mutations.
Aim: Covid-19 is one of the most important pandemics in the world history. Chronic diseases, which are risk factors that increase the case fatality rates, have been the leading cause of death all over the world. In this study, it was aimed to detect coexisting diseases in patients hospitalized with the diagnosis of Covid-19. Material and Method: It was carried out with the data of 229 inpatients in an intensive care unit between 01.06.2020 - 30.06.2020. Among the inclusion criteria of the study; it is necessary to have a diagnosis confirmed by PCR test, to be hospitalized in the relevant intensive care unit on the date of the study and to have data accessible through the hospital automation system. According to literature; chronic diseases of the patients and their effects on the covid-19 process were evaluated. Statistical analyzes were performed using the Statistical Package for Social Sciences (SPSS) version 24.0 (IBM Corp .; Armonk, NY, USA).Results: It was seen that the average age of the patients were 61.4±15.9 years old. While the average symptom duration was 8.2±5.3 days; total hospitalization period was 13.1±5.9 days. The length of stay of 75 patients who were sent to intensive care unit was determined as 10.1±7.1. The most common chronic disease among patients was hypertension with 47.2%. This was followed by diabetes mellitus (32.8%) and heart disease (27.5%), respectively. In the presented study, cough (59.4%), fever (58.5%) and shortness of breath (45.9%) were found to be the most common symptoms. Leukopenia, impairments in liver and muscle enzymes, abnormal C-reactive protein, ferritin and d-dimer levels were the important laboratory findings.Conclusion: Particular attention should be paid to the elderly Covid-19 patients with chronic diseases, especially DM, HT and cancer.
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