Search

The most important criteria that show the development of countries is maternal-infant mortality rates. Maternal mortality rate represents obstetric risk. According to the Report of the World Health Organization; around 830 women die every day due to preventable causes related to pregnancy and childbirth. Complications during pregnancy and childbirth are among the leading causes of death and disability among women of reproductive age in developing countries. Placental anomalies and gestational diabetes are among the factors that may cause high risk during pregnancy. Placenta previa was seen a prevalence of 1/200-250 in all pregnancy; gestational diabetes in Turkey is 1.2-4.5%, 90% of diabetic pregnancies are diabetes that occurs during pregnancy.In this study, the nursing care process of a pregnant woman diagnosed with placenta previa and gestational diabetes in a high-risk pregnancy clinic was aimed to evaluate with a holistic and systematic nursing care plan. The fact that a pregnant woman with two important health risks needs a comprehensive nursing care emphasizes the importance of this case., Ülkelerin gelişmişliğini gösteren ölçütlerden en önemlisi, o ülkedeki anne-bebek ölüm oranlarıdır. Anne ölüm oranı obstetrik riski temsil etmektedir. Dünya Sağlık Örgütü’nün raporuna göre; her gün yaklaşık 830 kadın gebelik ve doğumla ilgili önlenebilir nedenlerden dolayı ölmektedir. Gebelik ve doğum sırasındaki komplikasyonlar, gelişmekte olan ülkelerde üreme çağındaki kadınlar arasında ölüm ve sakatlığın önde gelen nedenlerindendir. Gebelikte yüksek riske neden olabilecek faktörler arasında plasental anomaliler ve gestasyonel diyabet yer almaktadır. Plasenta previa 1/200-250 gebelikte bir görülürken; gestasyonel diyabetin Türkiye’deki prevalansı %1,2-4,5’dir. Diyabetik gebeliklerin %90’ı gebelikte oluşan diyabettir. Bu çalışmada; plasenta previa ve gestasyonel diyabet tanıları ile yüksek riskli gebelik kliniğinde yatan bir gebenin hemşirelik bakım sürecinin, bütüncül ve sistematik bir bakım planı ile değerlendirilmesi hedeflenmiştir. İki önemli sağlık riski bulunan gebenin kapsamlı bir hemşirelik bakım gereksiniminin olması bu olgunun önemini vurgulamaktadır.

Background Presence of fragmented QRS (fQRS) complex in a 12-lead electrocardiogram (ECG) has been shown to represent alternation of myocardial activation owing to myocardial scar. The aim of this study was to investigate whether presence of fQRS complex predicts in-hospital and long-term mortality in patients with acute pulmonary embolism (APE). Methods This study included 186 consecutive patients with APE. Computed tomography pulmonary angiography (CTPA) was used to diagnose APE. ECG was obtained immediately after admission. Results Patients were divided into two groups: patients who had fQRS on their ECG (n = 52), and patients who did not have fQRS on their ECG (n = 134). The fQRS was associated with not only in-hospital mortality (P = 0.02) but also long-term mortality (P = 0.01). Furthermore, the fQRS was found to be a significant predictor of in-hospital and long-term mortality in multivariable Cox analyses. Conclusion In this study, fQRS was found to be predictors of both in-hospital and long-term mortality. Electrocardiography can be used to detect high-risk patients in APE; moreover, it bears little risk, is inexpensive, and easy to perform.

Uyarel, Hüseyin ( Balikesir Author ), Amaç:Çözünebilir CD40 ligand (çCD40L) enflamasyon ve trombotik sürecin farklı fazlarında salınan ve aterosklerozda rol alan kimyasal bir göstergedir. Bu çalışmada proenflamatuvar ve protrombotik etkili çCD40L ile metabolik sendrom (MS) arasındaki ilişki araştırılmıştır. Gereç ve Yöntem: Çalışmamıza çeşitli kardiyak şikayetlerle kardiyoloji polikliniğine başvuran hastalar alınmıştır. Bu hastalar National cholesterol education program (NCEP)’ın Adult treatment panel III(ATP-III) kriterlerine göre metabolik sendrom (MS) olan ve olmayan iki gruba ayrılmıştır. Bu hastalarda ELİSA yöntemi ile çCD40L ve ayrıca tam kan sayımı ve kan biyokimyası çalışılmıştır. Bulgular: Çalışmaya 82 hasta dahil edildi. 39 hasta (%47) bayan ve 43 hasta (%53) erkek idi. 29 hastada %(35) MS tespit edildi. çCD40L seviyeleri MS olanlarda, MS olmayanlara göre önemli derecede yüksek tespit edildi. (1,27±0,89 ng/dl, 1,7±0,77 ng/dl, p =0,016). Ayrıca MS varlığı ile çCD40L seviyeleri arasında önemli derecede intermediate linear istatiksel korelasyon saptandı (r = 0,25, p = 0,025). Lojistik regresyon analizinde , çCD40L seviyeleri (odds ratio [OR]; 6.17, 95% confidence interval [CI]; 2,09-18,2, p, Aim: Soluble CD40 ligand (sCD40L) is a chemical indicator which released during different phases of inflammation and thrombotic process and plays a role in atherosclerosis. In this study, we researched the relationship between sCD40L and metabolic syndrome (MS) that has proinflammatory and prothrombotic effects. Material and Method: Two different study groups as one group with MS and the other group without MS were constituted among the patients presented to our cardiology policlinics for various cardiac reasons according to the adult treatment panel III (ATP-III) criteria of national cholesterol education program (NCEP). In these patients, we studied sCD40L levels with ELISA method in addition to complete blood count and blood chemistry. Results: Eighty-two patients were included into the study. Thirty-nine patients (47%) were female and 43 patients (53%) were male. MS was determined in 29 patients (35%). sCD40L levels were sig nificantly higher in patients with MS than patients without MS (1.27±0.89 ng/dl, 1.7±0.77 ng/dl, p =0.016). Furthermore, an intermediate linear statistically significant correlation was observed between the presence of MS and sCD40L levels (r=0.25, p=0.025). In logistic regression analysis, sCD40L levels (odds ratio [OR]; 6.17, 95% confidence interval [CI]; 2.09 -18.2, p

Uyarel, Hüseyin (Balikesir Author), Introduction: Patients undergoing primary angioplasty for ST-segment elevation myocardial infarction (STEMI) may be at increased risk of contrast-induced nephropathy (CIN) because of inadequate prophylaxis. We investigated the incidence, predictive factors, and outcomes of CIN after primary percutaneous coronary intervention (PCI). Material and methods: 2521 consecutive STEMI patients (mean age 56.5 +/-11.8, years, 2091 male, baseline creatinine 0.97 +/-0.3 mg/dl) undergoing primary PCI were retrospectively enrolled in the present study. Results: Contrast-induced nephropathy was defined as an increase in serum creatinine level >= 0.5 mg/dl or >= 25% from baseline within 72 h of radiocontrast administration. 630 patients (25%) developed CIN. Patients with baseline creatinine > 1.5 mg/dl developed CIN more often than those with creatinine = 6 h (OR 1.46, 95% Cl 1.07-2.00, p = 0.02), use of intra-aortic balloon pump (OR 2.46, 95% Cl 1.30-4.67, p = 0.006), radiocontrast medium volume > 250 ml (OR 1.34, 95% Cl 1.01-1.78, p = 0.04), age >= 75 years (OR 2.07, 95% Cl 1.36-3.12, p = 0.001), anterior infarction (OR 1.26, 95% Cl 0.99-1.60, p = 0.05). Higher in-hospital mortality rate was observed in patients developing CIN (9.5 and 1.2%, p < 0.001). Cox regression analysis showed that CIN was a predictor of long-term cardiovascular mortality (hazard ratio [HR] 1.90, 95% Cl 1.16-3.12, p = 0.01) and major cardiovascular events (HR 1.34, 95% Cl 1.04-1.72, p = 0.025). Conclusions: Contrast-induced nephropathy in patients with STEMI undergoing primary PCI is associated with a markedly increased risk of major cardiovascular events as well as in-hospital and long-term mortality.