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Permanent URI for this collectionhttps://hdl.handle.net/11443/932
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Item Pain management practices in the emergency departments in Turkey(WOLTERS KLUWER MEDKNOW PUBLICATIONS, 2021-01-01) Cetin, Murat; Kaya, Bora; Kilic, Turgay Yilmaz; Hanoglu, Nazife Didem; Gokhan, Servan; Eroglu, Serkan Emre; Akar, Sakine Neval; Cekic, Ozgen Gonenc; Polat, Dicle; Ustsoy, Emre; Cinar, Orhan; Yilmaz, SerkanOBJECTIVES: This study aimed to evaluate pain management practices in the emergency departments (EDs) in Turkey and to evaluate the prevalence and etiologies of oligoanalgesia to identify possible improvement strategies.
METHODS: This multicenter cross-sectional observational study was conducted in 10 tertiary care hospitals in Turkey. Patients who were admitted to the ED with pain chief complaints were included in the study. Both patients and physicians were surveyed with two separate forms by the research associates, respectively. The patient survey collected data about the pain and the interventions from the patients' perspective. The pain was evaluated using the Numerical Rating Scale. The physician survey collected data to assess the differences between study centers on pain management strategies and physician attitudes in pain management.
RESULTS: Ten emergency physicians and 740 patients (male/female: 365/375) enrolled in the study. The median pain score at admission at both triage and ED was 7 (interquartile range: 5-8). The most frequent type of pain at admission was headache (n = 184, 24.7\%). The most common analgesics ordered by physicians were nonsteroidal anti-inflammatory drugs (n = 505, 67.9\%), and the most frequent route of administration was intramuscular injection (n = 396, 53.2\%). About half of the patients (n = 366, 49.2\%) received analgesics 10-30 min from ED admission. The posttreatment median pain score decreased to 3 (P < 0.001). About 79.2\% of patients did not need a second analgesic administration (n = 589), and opioid analgesics were the most frequently administered analgesic if the second application was required. Physicians prescribed an analgesic at discharge from the ED in 55.6\% of the patients (n = 414) and acute pain was present in 7.5\% (n = 56) of the patients.
CONCLUSION: Our study on the pain management practices in the EDs in Turkey suggested that high rate of intramuscular analgesic use and long emergency room stay durations are issues that should constitute the focus of our quality improvement efforts in pain management.Item The Effect of Cannula Material on The Pain of Peripheral Intravenous Cannulation in the Emergency Department: A Prospective, Randomized Controlled Study(ELSEVIER SCIENCE BV, 2012-01-01) Ozsarac, Murat; Dolek, Meral; Sarsilmaz, Munevver; Sever, Mustafa; Sener, Serkan; Kiyan, Selahattin; Yuruktumen, Aslihan; Yilmaz, GulbinObjectives The present study was undertaken to compare the pain of peripheral IV cannulation (IVC) using a 20-G peripheral biomaterial PEU-Vialon cannula or the 20-G compound FEP-Teflon cannula widely used in clinical practice. Methods A prospective, randomized, single-blinded, controlled trial was undertaken at the ED of University Hospital. Eighty-nine noncritically ill adult patients who were receiving an IV line as part of their care were enrolled. In each case cannulas were applicated to the antecubital area. Participants rated their pain on a visual analog scale (VAS). The primary outcome was patients pain score, and the secondary outcome was the provider's perception of safety and satisfaction. Results The two treatment groups did not differ in age, gender or cannulation indication (p>0.05). Mean VAS was 2.80 for PEU and 3.56 for FEP (p=0.061). Mean provider safety scores were 4.84 (4 to 5) in the PEU group and 4.00 (2 to 5) in the FEP group (p=0.0001). Mean provider satisfaction of application scores were 4.65 in the PEU group and 4.56 in the FEP group (p>0.05). Conclusions Althogh provider safety perception is high, perception of pain has not reduced when inserting PEU-Vialon cannula compared with compound of FEP.Item Localisation analysis of nerves in the mouse pancreas reveals the sites of highest nerve density and nociceptive innervation(WILEY, 2020-01-01) Saricaoglu, Oemer Cemil; Teller, Steffen; Wang, Xiaobo; Wang, Shenghan; Stupakov, Pavel; Heinrich, Tobias; Istvanffy, Rouzanna; Friess, Helmut; Ceyhan, Gueralp O.; Demir, Ihsan EkinBackground Neuropathy and neuro-inflammation drive the severe pain and disease progression in human chronic pancreatitis and pancreatic cancer. Mice, especially genetically induced-mouse models, have been increasingly utilized in mechanistic research on pancreatic neuropathy, but the normal ``peripheral neurobiology{''} of the mouse pancreas has not yet been critically compared to human pancreas. Methods We introduced a standardized tissue-harvesting technique that preserves the anatomic orientation of the mouse pancreas and allows complete sectioning in an anterior to posterior fashion. We applied immunohistochemistry and quantitative colorimetry of all nerves from the whole organ for studying pancreatic neuro-anatomy. Key Results Nerves in the mouse pancreas appeared as ``clusters{''} of nerve trunks in contrast to singly distributed nerve trunks in the human pancreas. Nerve trunks in the mouse pancreas were exclusively found around intrapancreatic blood vessels, and around lymphoid structures. The majority of nerve trunks were located in the pancreatic head (0.15 +/- 0.08\% of tissue area) and the anterior/front surface of the corpus/body (0.17 +/- 0.27\%), thus significantly more than in the tail (0.02 +/- 0.02\%, P = .006). Nerves in the tail included a higher proportion of nociceptive fibers, but the absolute majority, ie, ca. 70\%, of all nociceptive fibers, were localized in the head. Mice heterozygous for Bdnf knockout allele (Bdnf(+/-)) exhibited enrichment of nitrergic nerve fibers specifically in the head and corpus. Conclusions \& Inferences Neuro-anatomy of the ``mesenteric type{''} mouse pancreas is highly different from the ``compact{''} human pancreas. Studies that aim at reproducing human pancreatic neuro-phenomena in mouse models should pay diligent attention to these anatomic differences.Item Comparison of paracetamol and diclofenac prescribing preferences for adults in primary care(CAMBRIDGE UNIV PRESS, 2021-01-01) Bayram, Dilara; Aydin, Volkan; Sanli, Abdullah; Abanoz, Mustafa Naci; Sibic, Busra; Pala, Sedat; Atac, Omer; Akici, AhmetIntroduction: The most frequently prescribed analgesic drugs in primary care centers in Turkey are diclofenac and paracetamol, respectively. In this study, we aimed to compare paracetamol-included prescriptions (PIP) and diclofenac-included prescriptions (DIP) generated for adult patients in primary care. Methods: In this cross-sectional study, PIPs (n = 280 488) and DIPs (n = 337 935) created for adults by systematic sampling among primary care physicians working in Istanbul in 2016 (n = 1431) were examined. The demographic characteristics, diagnoses, and additional drugs in PIPs and DIPs were compared. Results: Women constituted the majority in both groups (69.8\% and 67.9\%, respectivelyItem Serum Calcitonin Gene-Related Peptide and Receptor Protein Levels in Patients With Fibromyalgia Syndrome: A Cross-Sectional Study(TURKISH LEAGUE AGAINST RHEUMATISM, 2020-01-01) Korucu, Ragip Ulvi; Karadag, Ahmet; Tas, Ayca; Ozmen, Esma; Hayta, Emrullah; Silig, YavuzObjectives: This study aims to compare the serum calcitonin gene-related peptide (CGRP) and CGRP receptor protein levels between patients with fibromyalgia syndrome (FM) and healthy control subjects. Patients and methods: The study included 88 patients (7 males, 81 femalesItem ISA New Technical Mode in Mammography: Self-Compression Improves Satisfaction(AVES, 2019-01-01) Ulus, Sila; Kovan, Ozge; Arslan, Aydan; Elpen, Pinar; Aribal, ErkinObjective: We aimed to evaluate the mammography experience of patients using a manually controlled self-compression tool compared to their previous experience based on technician performed breast compression by a questionnaire survey study. Materials and Methods: The survey studies of 365 patients who underwent screening or diagnostic mammography between April 2017 and July 2017 at our center were reviewed retrospectively. Each patient had completed a 12-item questionnaire following mammography examinations. Women who never had a mammography before or who had a previous mammography examination more than 2 years ago or who did not want to use the self-compression device were excluded from the study. 106 women were included in the study. Results: Patient satisfaction was high. Regarding the comparison of the experience of the exam to previous ones, 70.8\% said it was a better experience. The examination was found comfortable by 85.4\% of the participants and 75.5\% found the examination more comfortable compared to previous ones. Only 11.3\% were anxious and 52.8\% declared they were less anxious compared to previous examinations. Regarding the attractiveness of the new design, 66.9\% declared they found the new design attractive, 39.7\% found it more attractive than previous examinations, and 27.3\% said the new design decreased anxiety. In the evaluation of impact of patient-assisted compression (PAC) on comfort, 80.2\% said that they found it more comfortable and 64.2\% said that PAC decreased anxiety. Furthermore, 72.6\% said the exam was shorter. Conclusion: Self-compression technique decreases pain and anxiety of women during mammography examinations and promises to enhance compliance of clients and patients with follow-up mammography recommendations.