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Thorax CT findings of temporal changes in a case with COVID-19 pneumonia

Coronavirus disease 19 (COVID-19), which has recently become a worldwide pandemic with high mortality, causes severe pneumonia. The major routes of transmission of this disease are direct inhalation of respiratory droplets or contact with surfaces contaminated with them. Its definitive diagnosis is made by a real-time PCR test. Radiological methods, especially computed tomography (CT), play an important role in supporting the diagnosis and determining disease stage and complications. In this paper, we report the CT findings of COVID-19 pneumonia at different disease stages in a patient diagnosed with the disease, and we provide a discussion of the relevant literature.

 

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Evaluation of the addition tourniquet and ultrasound application to axillary block success, reliability and patient satisfaction

Aim: The purpose of this study was to evaluate axillary brachial plexus blockade with ultrasonography and peripheral nerve stimulator guidance and the effect of tourniquet addition to multi and single injection.

Material and Methods: We randomly allocated 60 patients undergoing hand surgery to the following groups: Group 1 (single tourniquet multi-injection; a rubber tourniquet was applied 8 cm below the nerve stimulator needle entrance area before blockade), Group 2 (double tourniquet single injection; the distal tourniquet was applied in the same way, and a second tourniquet was applied 2 cm above the injection site just after the removal of the nerve stimulator needle), and Group 3 (double tourniquet multi-injection; both tourniquets were applied and axillary block was performed with multi-injection). The same local anesthetic agent was used in all patients. The success rate, the onset of blockade, and patient satisfaction were evaluated.

Results: The success rate was 100% in all groups. The blockade duration was shorter in Group 2. Patient satisfaction was the lowest in Group 3 and the highest in Group 2.

Discussion: Ultrasonography and peripheral nerve stimulator-guided axillary blockade accompanied by tourniquet application may result in better success rate and patient satisfaction and may be safer. Although the axillary block technique has been known and applied for a long time, we believe that it is a regional anesthesia technique, which is still open for innovations and further studies.

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COVID-19 adversely affects the psychological status of healthcare workers in the emergency room

Aim: During the 2019 coronavirus disease (COVID-19) pandemic, healthcare workers experience intense levels of workload and pressure. The exact psychological and mental impacts of this pandemic on healthcare workers and relevant factors remain to be elucidated. Therefore, this study aimed to investigate the stress and anxiety of healthcare workers due to COVID-19.

Material and Methods: This prospective multi-centered survey-based study was conducted on 205 participants working in the emergency room (ER) of two hospitals between May 15 and May 22, 2020.  Besides demographic data such as age, gender, working history in ER, marital status and presence of children, the Perceived Stress Scale (PSS) and the Beck Anxiety Inventory (BAI) were used in the questionnaire. Data were analyzed by either the Kruskal-Wallis test and Mann-Whitney U test, Chi-square test or Fisher’s exact test.

Results: Most of the participants were nurses (35.5%), and  53.2% of all participants were male.  The rate of COVID-19 infection among physicians and nurses was significantly higher than among personnel in other occupations. The rate of the willingness of physicians and nurses to receive psychiatric support was significantly higher than that of other personnel (p < 0.05). Physicians and nurses had higher BAI and PSS scores than other staff, and scores of nurses were significantly higher than physicians (p < 0.05).

Discussion: During the pandemic, the adverse psychological and mental impacts of COVID-19 were prevalent among the healthcare workers. Adequate measures at both organizational and national levels are required to improve the psychological state of frontline healthcare workers during the COVID-19 pandemic.

 

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