The Use of Complementary and Alternative Medicines Among Surgical Patients: A Survey Study.

PURPOSE: The use of complementary and alternative medicine (CAM) has increased around the world. This study evaluates CAM use in surgery patients. DESIGN: Cross-sectional and descriptive study. METHODS: This study was conducted in a university hospital in Turkey between January 1 and June 30, 2016, on volunteer inpatients who were scheduled for surgery because of various complaints. FINDINGS: In this study, 65.9% of the patients used CAMs, 87.4% of the patients used herbal methods, and 63.7% of the patients used cognitive-behavioral methods. CONCLUSIONS: Health care providers, and nursing staff, in particular, should have adequate knowledge of societal approaches to CAMs, as well as the possible benefits and harms CAM may cause.

The Effect of Cold Vapor Applied for Sore Throat in the Early Postoperative Period.

PURPOSE: This study was conducted for the purpose of determining the effect of cold vapor applied for sore throat in the early postoperative stage. DESIGN: A quasi-experimental design was used. METHODS: The study sample consisted of 60 patients who underwent lumbar disc herniation surgery in the Neurosurgery Clinic of Gazi University Health Research and Practice Center in Ankara, Turkey. The study involved two intervention groups and one control group. The study data were collected through questionnaire and observation forms. FINDINGS: 65% (n = 39) of patients experienced sore throat. There were no statistical differences between the groups in terms of sore throat and hoarseness (P > .05); however, a significant difference was determined in the group to whom oxygen together with cold vapor was applied for dry throat (4th and 8th hours) and swallowing difficulties(8th and 12th hours) (P < .05). CONCLUSIONS: Cold vapor did not have an effect on sore throat on its own; however, it decreased hoarseness and swallowing difficulties when applied together with oxygen.

Effectiveness of Computer Assisted Training of Patients Undergoing Lumbar Disc Herniation Surgery.

AIM: To identify the effects of computer assisted training schemes provided to patients who have undergone surgical intervention for lumbar disc herniation on their level of knowledge, level of anxiety, problems experienced after discharge, and level of functional incapacity. MATERIAL AND METHODS: The study was performed as a randomized controlled invasive study with a pre-testâ€'post-test design. The study was conducted with 62 patients, 31 of which were included in the intervention group and 31 in the control group. Training and counselling were provided to the patients included in the intervention group via a training web-site, while a training guidebook with the same content as the website for patients was given to the patients included in the control group. RESULTS: The patients who have undergone a surgical intervention for lumbar disc herniation, those who were provided computer assisted training were better informed, had better functional capacity, and experienced less anxiety after discharge than those who were only informed through the training guidebook. CONCLUSION: Computer-assisted training was efficient educational tool for patients undergoing lumbar disc herniation surgery.

A retrospective analysis of the diameter of metastatic lymph nodes in apparently early stage endometrial cancer.

AIMS AND BACKGROUND: The objective of this retrospective study was to assess the diameter of metastatic lymph nodes in a population of women with apparently early stage endometrial cancer at laparotomy. METHODS AND STUDY DESIGN: Among 700 cases with endometrial cancer, 27 cases with disease clinically limited to the uterus in the laparotomy and found to have retroperitoneal node metastasis after pathologic examination were included in this study. Pathologic characteristics of the tumors, pelvic and para-aortic node counts and the largest diameter of each metastatic node were evaluated. RESULTS: The median number of nodes removed was 38; median number of pelvic and para-aortic nodes was 29 and 8, respectively. A total of 85 metastatic nodes were identified. Mean diameter of the metastatic para-aortic and pelvic nodes was 6.8 mm and 9 mm, respectively. Nine patients had single metastatic nodes, and the diameters of the single metastatic para-aortic lymph node was 1 mm in one case, 2 mm in one case, 3 mm in one case and 4 mm in one, and 5 mm in two patients. Two cases had isolated para-aortic lymph node metastasis without pelvic lymph node metastasis. Diameters of the metastatic para-aortic lymph nodes were 4 and 5 mm in one case and 4 mm in the other case. CONCLUSIONS: The diameters of metastatic nodes may be as small as 1 mm. By sampling or selective para-aortic and/or pelvic lymphadenectomy, some of the nodes might go undiagnosed, and such understaged cases cannot take adjuvant therapy (chemotherapy-radiotherapy). For correct staging of cases with endometrial cancer, complete systematic para-aortic and/or pelvic lymphadenectomy might be appropriate.

Cross-cultural adaptation, validity, and reliability of the Turkish version of revised American Pain Society patient outcome questionnaire for surgical patients.

OBJECTIVE: This study aims to investigate the validity and reliability of the Turkish Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R-TR). METHODS: A methodological and cross-sectional design was used. This study included a total of 250 surgical patients (98 males, 152 females) between January 2015 and January 2016. Data were collected using a demographic questionnaire and the APSPOQ-R. Language equivalence, content and construct validity, and reliability of the scale were evaluated. RESULTS: The Pearson correlation coefficient of the scale for parallel test reliability was 0.362, and the Cronbach's alpha value was determined as 0.88 in the APS-POQ-R-TR. According to fit indexes of the confirmatory factor analysis [x2/SD=362.53/125=2.90; RMSEA=0.087 (90% CI: 0.077-0.098); CFI=0.95; IFI=0.95; NNFI=0.94], three factors were found to be appropriate for the APSPOQ-R-TR. CONCLUSION: The adaptation of the translated APS-POQ-R in Turkey is reliable and valid to measure and evaluate the quality of postoperative pain management in the Turkish population.

Analysis of metastatic ovarian tumors from extragenital primary sites.

AIMS AND BACKGROUND: The aim of this study was to evaluate patients with metastatic ovarian tumors from extragenital primary sites. METHODS: The medical records of 75 patients were reviewed retrospectively for age at diagnosis, presenting symptoms, preoperative tumor marker levels, preoperative diagnostic workup, operative technique, intraoperative evaluation, frozen-section and pathology results, laterality of metastasis, and primary tumor site. The specific impact of metastasis from colorectal and gastric primary sites on laterality, gross features and dimensions of ovarian mass, volume of ascites and tumor marker levels was investigated. RESULTS: Primary sites were stomach (37.3%), colorectal region (28%), lymphoma (12%), breast (6.7%), biliary system (2.7%), appendix (1.3%) and small intestine (1.3%). It was not possible to identify the primary tumor site in 8 (10.7%) patients. Bilateral metastasis was found in 86.4% patients; 42.7% of the metastatic ovarian tumors were Krukenberg tumors; 50.7% of the ovarian masses were solid. Frozen section was confirmed by postoperative pathological results in 98% of the patients. The mean preoperative serum levels of tumor markers were 298.7 U/mL, 178 U/mL and 113.3 U/mL for CA 125, CA 19-9 and CA 15-3, respectively. CA 125 levels were above 35 U/mL in 81.3% of the patients. The presence of ascites was more frequent in ovarian tumors originating from colorectal and gastric primaries. CONCLUSIONS: Surgery is essential for the diagnosis of the primary tumor and necessary for relief of symptoms. The identification of the primary site is required to plan adequate treatment.

Peritoneal tuberculosis mimicking advanced ovarian cancer: a retrospective review of 22 cases.

OBJECTIVE: To evaluate the clinical, laboratory and diagnostic features in women with peritoneal tuberculosis that resembled advanced ovarian malignancy. METHODS: A retrospective review of women with peritoneal tuberculosis who were managed at TCSB Ankara Etlik Maternity and Women's Health Teaching and Research Hospital from July 1992 to November 2004 was undertaken. RESULTS: Among the 1,826 women treated during the study period, 22 women with peritoneal tuberculosis (1.2%) were identified. The mean age was 36.9 years (range 21-68 years); the mean Ca125 level was 564.95 U/ml (3-2021 U/ml). All patients with peritoneal tuberculosis had ascites, 20 patients (90.91%) had elevated CA125 levels and 17 patients (77.27%) had detectable pelvic masses in the preoperative period. During preoperative diagnostic work-up, pulmonary tuberculosis was diagnosed and antituberculosis therapy had begun in two of 22 patients (9.09%). Among 20 patients, 11 (55%), 8 (40%) and 1 (5%) underwent exploratory laparotomy, diagnostic laparoscopy and laparoscopy converted to laparotomy due to dense pelvic adhesions, respectively. Since frozen section was not available during the surgery in 5 of 20, 3 patients (10%) underwent extended surgery. Frozen section was performed in 15 patients and revealed chronic granulomatous changes and final pathological examination confirmed the diagnosis. CONCLUSION: Our data indicate that the majority of the cases with peritoneal tuberculosis can be diagnosed intraoperatively through the use of frozen section in conjunction with clinical features. Ascites and high levels of Ca125 do not necessarily indicate that the clinical picture is malignant in reproductive women. Laparoscopic tissue biopsy may be a fundamental tool in the management of such cases to avoid extended surgery.