Comparison of Transcutaneous Electrical Nerve Stimulation and Paravertebral Block for Postthoracotomy Pain Relief.

BACKGROUND: Inadequate relief of postthoracotomy pain is a major reason of increased occurrence of postoperative complications. We aimed to investigate and compare the effects of transcutaneous electrical nerve stimulation (TENS) and paravertebral block (PVB) to relieve pain after thoracotomy procedures. MATERIALS AND METHODS: We studied 40 patients who underwent thoracotomy. Patients were randomly allocated to receive either PVB (group P, n = 20) or TENS (group T, n = 20) for postoperative pain. The electrodes of TENS were placed 2 cm under and 2 cm over the thoracotomy cut on both posterior and anterior sides. The surgeon inserted paravertebral catheters using direct vision at the end of the surgery. A patient-controlled analgesia (PCA) device was connected to all patients. Visual analog scales, patient demand, and consumption of tramadol were evaluated postoperatively. RESULTS: Mean visual analog scale (VAS) values were significantly lower in group P for all time points. The patients in group P needed lower amounts of opioid (tramadol) and the difference was statistically significant (258.4 ± 13.52 mg vs. 314.4 ± 8.65 mg, p = 0.005). In addition, the number of demand attempts recorded from the PCA device was significantly lower in group P (14.95 ± 13.64 vs. 26.7 ± 17.34, respectively and p < 0.001). CONCLUSION: TENS has beneficial effects for pain relief after thoracotomy, without any side effects; however, it cannot provide sufficient pain relief when compared with PVB.

Assessment of eating disorders and depression in postpartum women.

OBJECTIVE: To determine the prevalence of eating disorders and orthorexia in postpartum women and examine the relationship with postpartum depression. STUDY DESIGN: Included in this study were 227 postpartum women. The Eating Attitude Test-26 (EAT-26) was used to determine the risk of eating disorders in the women, followed by the Orthorexia 11 Scale (ORTO-11) to identify orthorexia, and the Edinburgh Postpartum Depression Scale (EPDS) to identify postpartum depression. RESULTS: 63 of the women (27.8%) exhibited an orthorexic tendency, which was also related to eating disorders and postpartum depression. Each one-point increase in the EAT-26 score led to a decrease of 0.32 points in the ORTO-11 score. Similarly, each one-point increase in the EPDS score caused a reduction of 0.18 points in the ORTO-11 score. The ORTO-11 score increased by 0.26 points per each live birth. CONCLUSION: An obsessive focus on healthful nutrition may result in the impairment of health and numerous adverse psychological and physiological outcomes in the future. Healthy eating habits should be maintained to improve the quality of life without causing an obsession with healthy eating.

Supplementation use and diet changes during COVID-19 pandemic according to anxiety level and Mediterranean diet adherence.

Aim; This study was planned and conducted to examine the change in food consumption and nutritional supplement use during the COVID-19 pandemic according to individuals' status of anxiety and Mediterranean diet adherence. Methods; This prospective, cross-sectional research was completed online with the participation of 949 people (66.4% women). The Mediterranean Diet Adherence Screener Scale (MEDAS) and Coronavirus Anxiety Scale (CAS) were applied. After this section of the questionnaire was completed, the participants were tasked with answering questions regarding changes in food consumption and use of nutritional supplements during the pandemic. Results; While 50.8% of the participants had low adherence to the Mediterranean diet, 18.2% were considered to have a high adherence. It was observed that legume (p = 0.001), milk and dairy (p = 0.01), and fruit (p < 0.001) consumption of participants with high adherence to the Mediterranean diet increased during the pandemic, and packaged food (p < 0.001) consumption decreased. The increase in the consumption of fruit (p < 0.001) and vegetables (p = 0.018) were significantly higher in the group with anxiety. Age, sex, educational status, positive COVID-19 test, place of residence, CAS score and MEDAS score affect the use of dietary supplements according to binary logistic regression (R2 = 0.106 p < 0.001). The three most commonly used supplements were identified as vitamins C, D and B12. Conclusions: These results can shed light on how to prepare for possible future pandemics when it comes to dealing with anxiety through diet.

Possible predictors for sarcopenia in community-dwelling elderly: neck and calf circumferences.

The aim of this study was to determine the relationship between sarcopenia and calf and neck circumferences. One hundred seventy-seven community-dwelling elderly individuals (over 65 years old) were recruited. A questionnaire was applied via face-to-face interview and the MNA-SF was used to assess nutritional status. In addition, some anthropometric measurements and handgrip strength were assessed by dieticians to determine sarcopenia. Sarcopenia was defined according to the European consensus definition of the EWGSOP-2 criteria. Neck (p<0.001), calf (p=0.001), and waist circumference (p<0.001) were significantly higher in nonsarcopenic elderly women but in men. According to ROC analyses, neck (AUC: 74.7%), calf circumferences (AUC: 74.3%), and BMI (AUC: 80.4%) are possible predictors of sarcopenia in elderly women. This is the first study to demonstrate that neck circumference can be useful for predicting sarcopenia in community-dwelling women over 65 years old. These findings may contribute to the development of new strategies to screen for sarcopenia.

Prevalence of overweight, obesity and abdominal obesity in Health Sciences Faculty students.

OBJECTIVES: This study was carried out in order to determine the prevalence of obesity among the students of the Faculty of Health Sciences and to evaluate the anthropometric measurements of the students. MATERIALS AND METHODS: The population of the study was in total 984 volunteering undergraduate students from Ankara University Faculty of Health Sciences, Child Development, Midwifery, Nursing, Health Management and Social Work departments. The sociodemographic characteristics of the students were obtained with the help of the questionnaire and the anthropometric measurements by the researchers. SPSS package program was used for descriptive statistics, chi-square test and multiple logistic regression analysis for assessment of data. RESULTS: 16.5% of the students participating in the study were overweight and 4.5% were obese. Approximately half of the students who are overweight and obese reported staying in the dormitory. Average BMI value in males is 23.1 kg/m2 and 22.3 kg/m2 in females. 29.1% of females are at risk in terms of abdominal obesity and 30.6% of males in terms of waist/height ratio. Male gender and presence of an obese person in the family increases the risk of being overweight or obese. CONCLUSIONS: Risky health behaviors are observed among university students and in order to avoid such behaviors, it is necessary to provide training especially on subjects such as nutrition and physical activity. Adopting the right nutritional habits and healthy lifestyle is important in individuals who will be the future healthcare professionals, for both their and future generations' health.

The effectiveness of transdermal opioid in the management multiple rib fractures: randomized clinical trial.

BACKGROUND: The most commonly observed pathology in chest traumas is rib fracture, and the most important clinical symptom is severe pain. AIMS: To investigate the effectiveness of intramuscular opioid (IMO), intravenous patient-controlled analgesia (IVPCA) and the Fentanyl transdermal therapeutic system (TTS) in the management of rib fracture pain. STUDY DESIGN: Prospective randomized clinical trial. METHODS: In our prospective and randomised study, we included 45 patients with a diagnosis of multiple rib fractures. There were three groups and intercostal nerve blockage (ICB) in the first day and oral paracetamol for five days was administered to each group as standard. In Group IMO (n=15), 4×40 mg pethidine HCl was administered to the patients, while in Group IVPCA (n=15) this was 5 µg/mL continuous intravenous fentanyl and was 50 µg fentanyl TTS in Group TTS (n=15). The demographics, injury data and vital signs of the patients were recorded. Pain was scored using Visual Analogue Scale (VAS). The pain during lying down (VASl) and mobilisation (VASm) was detected. RESULTS: There were no differences between the three groups regarding age, sex, the trauma pattern, the number and distribution of costal fracture localisations, the presence of additional pathology, complications, thoracal catheter and the duration of thoracal catheter. No significant difference between the groups regarding systolic and diastolic arterial tension, number of breaths and beats in a minute was observed (p>0.05). We observed an improvement in the mean VAS score after treatment in all three groups. The mean VASl score significantly decreased after treatment in each group (p<0.05). The mean VASl and VASm scores measured on the 1(st), 2(nd), 3(rd), 4(th) and 5(th) days were found to be higher in Group IMO than in Groups IVPCA and TTS; however, these differences were not statistically significant (p>0.05). CONCLUSION: In the analgesia of patients with multiple rib fractures, TTS administration with ICB showed similar effectiveness with IVPCA administration with ICB. In the management of pain due to multiple rib fractures, TTS administration is a safe, non-invasive and effective procedure.