The effect of a hemodialysis patient education program on fluid control and dietary compliance.

INTRODUCTION: Some hemodialysis patients may experience problems in completing activities of daily living and adhering to diet and fluid restrictions due to a decrease in self-care power and a loss of competence. METHODS: The study was conducted with 78 people assigned to the intervention (N = 38) and control groups (N = 40). Data were collected using the sociodemographic characteristics questionnaire, dialysis diet and fluid nonadherence questionnaire (DDFQ), and fluid control in hemodialysis patients scale (FCHPS). The participants in the intervention group were given the "Nutrition Education Booklet for Dialysis Patients". The participants in the intervention group were trained through four education sessions across 4 months, and the measurement tools were administered to them. The participants in the control group were interviewed twice, once at the onset of the study and once 2 months later and the measurement tools were administered to them. FINDINGS: In the intervention group, a decrease was observed in the pre- and postdialysis interdialytic weight gain, ultrafiltration (UF) volume, and blood pressure values of the patients after the training. There was a statistically significant decrease in the mean scores for the frequency and degree of nonadherence to diet restriction, and for the frequency and degree of nonadherence to fluid restriction in the participants in the intervention group compared to the participants in the control group (P < 0.05). There was a statistically significant increase in the mean scores obtained from the FCHPS and its subscales by the participants in the intervention group compared to the participants in the control group (P < 0.05). CONCLUSION: The training given to the hemodialysis patients positively contributed to their adherence to diet and fluid restrictions. The patients' adherence to diet and fluid restriction increased.

Does intrauterine tobacco exposure increase the pain perception of newborns?

BACKGROUND: This study aimed to assess whether there was a difference in the pain-perception levels of newborns born to mothers who smoked during pregnancy and newborns born to mothers who were not exposed to active or passive smoking during pregnancy. MATERIALS AND METHODS: A total of 60 newborns born by normal spontaneous vaginal birth between June 2013 and June 2014 were included in the study: 30 born to mothers who smoked during pregnancy, and 30 born to mothers not exposed to smoking. Mothers or newborns who had taken analgesics or sedative medications in the previous 24 hours, newborns not born at term, and sick newborns were not included in the study. During the routine hepatitis B-vaccination injection given at postnatal 48 hours, the newborns' behavior was monitored and recorded by video camera. The data obtained from the recordings were evaluated according to the Neonatal Pain, Agitation, and Sedation Scale and analyzed with SPSS 20. RESULTS: The median pain score of the group exposed to tobacco smoke in utero was 8.5, while the median pain score of the unexposed group was 6 (P<0.001). CONCLUSION: Exposure to tobacco smoke in utero may increase the pain-perception levels of newborns.

Effect of delivery mode on postpartum neonatal body temperatures.

OBJECTIVE: It is known that general and local anesthesia practices disrupt the delicate balance of thermoregulation center which is already sensitive to very tiny differences of temperatures in a normal subject. We aimed to evaluate and compare the rectal temperatures of newborns born with normal vaginal delivery and cesarean section. METHODS: We performed a prospective study of 106 term newborn - 40 born with normal vaginal delivery (group 1) and 66 born with cesarean section [51 spinal anesthesia (group 2), 15 general anesthesia (group 3)]. Only term babies were included in the study. Babies of eclamptic, pre-eclamptic and diabetic mothers and babies with chronic systemic diseases were excluded. Pregnants who underwent elective cesarean section were included in the study. Adolescent pregnants, pregnants with increased risks and pregnants with complicated operations were excluded. Mothers' temperatures were measured before and after the interventions. Rectal temperatures of the babies were measured immediately after birth. RESULTS: Environmental temperature was maintained at 22-24 °C. Pre-operative mother temperatures were 36.31 ± 0.30 °C in group 1, 36.36 ± 0.26 °C in group 2 and 36.39 ± 0.19 °C in group 3 (p = 0.414). Post-operative mother temperatures were 36.39 ± 0.27 °C in group 1, 36.29 ± 0.31 °C in group 2 and 36.25 ± 0.28 °C in group 3 (p = 0.215). Rectal temperatures of the babies born with normal vaginal delivery were significantly higher than the others. It was lowest in the general anesthesia group (37.5 ± 0.6 °C, 37.2 ± 0.2 °C and 36.8 ± 0.4 °C in group 1, 2 and 3, respectively). The temperature differences between groups were statistically significant p < 0.001). CONCLUSIONS: In conclusion, it is worthy to note that temperatures of the newborns can differ according to the delivery mode. Physicians and health professionals that take care of the newborns should be aware of this difference.