Mediastinitis and subcutaneous abscess complicated after EBUS-TBNA of 2R mediastinal lymph node

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUSTBNA) is a minimally invasive diagnostic tool used for the evaluation of mediastinal lymphadenopathy. It is a safe procedure, but complications such as bleeding and infection may occur. We report a case of a patient who developed a subcutaneous abscess abscess and mediastinitis after EBUSTBNA. A 75-year-old male with a history of right nephrectomy due to renal cell carcinoma and lung adenocarcinoma history underwent EBUS-TBNA for the evaluation of a right upper paratracheal lymph node. Two weeks after the procedure, the patient presented to the emergency department with skin induration and erythema on the right clavicular area. A non-contrast neck and thorax CT scan was performed, which revealed an extensive subcutaneous abscess on the right clavicular area, extending to the supraclavicular region. The patient was hospitalized, and empirical intravenous antibiotics were initiated due to deep neck infection. Repeated drainage of the subcutaneous abscess was performed. Bacteriologic examination revealed Streptococcus mitis. The patient showed improvement with antibiotic treatment, and a follow-up ultrasound showed a decrease in the size of the abscess and was discharged approximately four weeks after hospitalization. Although very rare, serious infectious complications may develop after EBUSTBNA, and our case report is an important example regarding its management process.

The Reflection of Ethics Education on Clinical Practices in Undergraduate Nursing Education: A Qualitative Study

Aim:This research aims to reveal the reflections of ethics education given to nursing students in undergraduate education on clinical practices. Method: A focus group interview from qualitative methods was held to obtain and interpret information regarding the reflections of ethics courses. Fifteenvolunteernursing students studyingatthe faculty of health sciences ofa public university in Turkey were included in the research. For the data analysis, the method used to code and categorizefocus group data were adapted from approaches to qualitative data analysis. Results: Six main themes emerged from the data: (1) opinions about ethics courses; (2) ethical issues; (3) the factors that cause ethical issues; (4) the effects of ethics courses on the approach towards ethical problems; (5)contradictory situations between the ethics course and clinical practices; (6) recommendationsabout the ethics course and educators. Conclusion:According to the data obtained in this study, the researcher concluded that the lecturers and teaching methods used are important in ethics education in nursing. Bangladesh Journal of Medical Science Vol. 21 No. 04 October’22 Page : 711-718

Nursing Care Satisfaction among Patients Infected with Covid-19: A Turkish Perspective

The aim of this study was to determine the satisfaction with nursing care among patients diagnosed with Covid-19 and related factors. Materials and Methods. The study was conducted between June and July 2020. The population of the study consisted of 102 patients treated in the Covid-19 clinics of the University Teaching and Research Hospital. The data were collected using the Newcastle Satisfaction with Nursing Care Scale with a total of 19 items, and the Patient Description Form designed to record the sociodemographic characteristics and medical histories. The data were evaluated using the program package IBM SPSS 20.0. To test the significance of the difference between two independent groups, the Student’s t-test was used, and the one-way ANOVA was used to test the significance of the difference between more than two groups. Results. The results showed that most patients were satisfied with nursing care. A higher level of satisfaction was seen in patients treated in the Covid-19 intensive care units, those with chronic conditions, and those who received information about their health state from nurses. Patients’ family type, sharing fears and worries with nurses, getting information from nurses and the quality of nursing care were the variables significantly associated with patient satisfaction with nursing care. Conclusions. Satisfaction with nursing care among Covid-19 patients was moderate. When nurses use effective communication skills to meet patients’ care needs, provide patients with adequate information, allow them to express their feelings, and keep them safe, this will further enhance patient satisfaction.

Cultural Viewpoints of Nursing Students on Patient Privacy: A Qualitative Study

The purpose of this study was to determine the feelings, thoughts, perceptions and cultural standpoint of nursing students concerning patient privacy. This study was conducted as a qualitative descriptive design. The homogeneous sampling method, purposive sampling method for qualitative research samples, was used to determine the study group. Data were collected from 17 nursing students at a state university in Turkey. Individual semi-structured interviews were conducted, and content analysis was used to analyze data. Three main themes emerged from the data: perception of privacy, factors affecting patient privacy and suggested solutions. Four sub-categories emerged: religion, gender, culture and reassuring communication. The perceptions of many of the students relating to the concept of privacy coincided with the concepts of confidentiality and all kinds of information concerning the patient. It was seen that the most effective intervention among the students' solution proposals to ensure privacy was the necessity to make physical improvements in hospitals.

Bilateral inguinal hernia with an uncommon content : A case report

Here we present a sixty-two year old man with bilateral swellings palpated in inguinal areas on physical examination. Ultrasonography and abdominal multi-detector computed tomography revealed a bladder herniation through the right inguinal canal and a sigmoid colon herniation through the left inguinal canal. Radiologic imaging methods are important and can guide clinicians for preemptive or emergent surgery. (Acta gastroenterol. belg., 2016, 79, 495-496).

Does pneumoperitoneum cause bacterial translocation?

Although extensive research has been carried out on the respiratory and renal effects of intra-abdominal pressure increase, there is limited research with regard to its effects on bacterial translocation. The objective of this study was to discuss whether the high intra-abdominal pressure due to carbon dioxide (CO2) insufflation during laparoscopy leads to bacterial translocation. Eighteen male dogs, 7 of which constituted the control group, were used in the study. Two study groups, in which the intra-abdominal pressure was raised to 15 mm Hg and kept at that level for 30 and 120 minutes, respectively, were set. Blood gases and blood pressure values were observed throughout the experiments. Samples of peritoneal smear, portal vein blood, mesenteric lymph node, liver, spleen, and cecum were examined to detect bacterial translocation. Histopathological examinations of all samples were also carried out. No translocation was detected in the samples of peritoneal smear, portal blood, mesenteric lymph node, liver, or spleen, but in the samples of cecum, bacterial colonization for the second group (p<0.05) and for the third group (p<0.05) was significantly higher compared with the control group. There was a considerable difference between the second and third groups (p<0.05). The changes in the mesenteric lymph nodes were interpreted to be a result of bacterial drainage. Histopathological examination disclosed active changes in the mesenteric lymph nodes in all groups, but there was considerable sinus histiocytosis only in the third group. We conclude that the intraabdominal pressure of 15 mm Hg created by carbon dioxide insufflation does not lead to bacterial translocation but causes intraluminal bacterial colonization in the cecum after 30 minutes and after 2 hours.

Mesenteric and omental cysts in children. Analysis of nineteen cases

Mesenteric and omental cysts are infrequently encountered, benign, intraabdominal tumors. Nineteen new patients were analysed. The most common presenting symptoms were abdominal distension (74%) and abdominal pain (63%). A palpable abdominal mass was found in 58 percent of cases. A correct preoperative diagnosis was established in 91 percent of the patients who were examined by abdominal ultrasonography. Of 19 cases documented at laparotomy, 14 patients (74%) had mesenteric, and five patients (26%) omental cysts. Eleven of the former were located in the small bowel mesentery. All of the cysts were completely removed, and in eight of them bowel resection was required. Subtotal gastrectomy was performed in one case. The mortality rate was 0%. After a mean follow-up period of five years, no recurrence was observed. Our study showed that abdominal ultrasonography by experienced professionals is the most reliable diagnostic tool for detecting these lesions.

Primary realignment of posterior urethral ruptures in children

Primary realignment was used in the treatment of 12 children with complete rupture of the posterior urethra; 10 developed strictures but 7 of these responded to dilation. Problems of continence were encountered only in patients who developed strictures. Since primary realignment results in dilatable strictures in most patients, it is suggested that this should be the treatment of choice in children.