Selin Erel

Severe maternal morbidity may require rapid access to critical care, advanced monitoring, blood products, diagnostic imaging and multidisciplinary services [1,2]. How these resources are organised ...

Pregnancy and Motherhood Experiences of Turkish Women Anaesthesiologists in Training and Work Life - Turkish Journal of Anaesthesiology and Reanimation

Background/Aims: Preoperative anxiety is a common and significant issue in pediatric patients undergoing endoscopic interventions. The evaluation aimed to determine whether age-appropriate educational brochures could reduce anxiety in pediatric patients and their caregivers undergoing outpatient endoscopic procedures with sedation. Materials and Methods: Pediatric patients and their caregivers were randomly assigned to either a control group (standard verbal information only) or an intervention group (standard verbal information plus an age-appropriate educational brochure). On the day of the procedure, pediatric anxiety was assessed using the Modified Yale Preoperative Anxiety Scale (m-YPAS), whereas caregiver anxiety was measured using the Amsterdam Preoperative Anxiety and Information Scale (APAIS). Results: A total of 252 pediatric patients (age, 3-17 years; American Society of Anesthesiologists score, I-II) and their caregivers were recruited. Of these, 174 formed the control group and 78 received an educational brochure intervention. The demographic characteristics were similar across the groups, except for caregiver age. While there were no significant between-group differences in caregiver APAIS scores, pediatric patients in the brochure group exhibited significantly lower m-YPAS scores (P < .05) than those in the control group. Conclusion: Providing children with age-appropriate educational brochures prior to sedation for endoscopic procedures significantly reduced their preoperative anxiety. This low-cost, easily implemented intervention may help improve procedural experience in pediatric patients and potentially enhance overall clinical outcomes. Cite this article as: Erel S, Kılıç AG, Eryılmaz NC, Toyran ÜÖ, Gürkan ÖE. Effect of educational brochures on preprocedural anxiety in pediatric endoscopy: A randomized controlled trial. Turk J Gastroenterol. 2025;36(10):680-691.

Background: Existing studies on anesthesiologists’ attitudes toward artificial intelligence (AI) leave a global understanding underexplored. This cross-sectional study aims to investigate Turkish anesthesiologists’ attitudes toward AI, examining its perceived benefits, limitations, and associated ethical concerns. Insights from this study aim to enhance understanding of AI’s role in anesthesiology within a cultural and ethical context. Methods: This nationwide study surveyed Turkish anesthesiologists. Descriptive statistics summarized categorical variables, Pearson’s Chi-square test compared variables between groups. Binary logistic regression analyzed associations between demographic factors and positive attitudes toward AI. Results: Among 293 valid responses, 69.6% of participants expressed positive attitudes toward AI. Gender ( P = 0.01), employment setting ( P < 0.001), and prior AI experience ( P < 0.001) were significant predictors of positive attitudes. AI applications most frequently endorsed included preoperative assessments (93.1%), academic support (95.2%), and medical education (91.2%). Ethical concerns were prominent, with liability ambiguity (87.3%) and privacy issues (62.8%) being the most cited. Logistic regression revealed that participants aged 46–55 were significantly more likely to exhibit positive attitudes (OR = 3.744, P = 0.03), while those with over 15 years of experience were less likely to do so (OR = 0.105, P = 0.04). Conclusions: Turkish anesthesiologists exhibited predominantly positive attitudes toward AI, with prior experience playing a significant role in shaping perceptions. While AI was embraced for academic, educational, and noninvasive tasks, skepticism was present toward its application in invasive procedures. These findings highlight AI’s potential to enhance efficiency and patient safety while underscoring the need for comprehensive legal and ethical frameworks.

The emergence of artificial intelligence (AI)-based linguistic models has revolutionized academic writing, prompting concerns about integrity. In response, AI-powered text authenticity detectors have been developed. This study examines AI tool usage in anesthesiology and intensive care journals. 1268 articles from 86 journals in “Anesthesiology” and “Anesthesiology and Intensive Care” were analyzed using Copyleaks and ZeroGPT. English abstracts published between April 18 and May 18, 2023, were scrutinized. ZeroGPT and Copyleaks found average AI usage at 25.1% ± 27.5 and 10.5% ± 15.9, respectively. 16.8% of articles were “human-written,” while 83.2% were “AI-assisted”. AI assistance correlated positively with abstract length and was more common among nonnative English speakers (P < .001). It was also prevalent in high-impact and science citation index-indexed journals (P < .01; P < .001). This study underscores the widespread adoption of AI tools in academic writing, particularly among nonnative English authors and in high-impact journals, emphasizing the need for improved detection mechanisms and regulatory guidelines.

Background and Objectives: We aimed to evaluate the current uterotonic administration practices among anesthesiologists and obstetricians and gynecologists (OBGYNs) during cesarean section (CS), focusing on variations in approaches for low- and high-risk postpartum hemorrhage (PPH) cases. The objective was to identify key differences and provide evidence that could contribute to the development of standardized national protocols for uterotonic usage. Materials and Methods: A snapshot online survey was employed between October 2021 and January 2022 and distributed to anesthesiologists and OBGYNs from university-affiliated, government, and private hospitals across Turkey, consisting of 23 questions addressing demographic data, institutional PPH rates, first-line uterotonic choices, administration methods, and dose adjustments for low- and high-risk PPH cases. Specific questions also targeted uterotonic usage in the presence of comorbidities such as pre-eclampsia and cardiac disease. Results: There were 204 responses (54% anesthesiologists and 46% OBGYNs) out of 220, yielding a response rate of 92.7%. Oxytocin was the most common first-line uterotonic for CS with low-risk PPH (99.1% of the anesthesiologists and 96.8% of the OBGYNs). In total, 60% of the anesthesiologists favored an intravenous (IV) bolus followed by infusion, while 56.4% of the OBGYNs preferred IV infusion alone (p < 0.001). For CS with high-risk PPH, approximately half of the participants reported increases in oxytocin dose, while 26.4% of the anesthesiologists and 20.2% of the OBGYNs opted for combined oxytocin and carbetocin use. During intrapartum CS, 69.1% of anesthesiologists and 77.7% of OBGYNs reported no change in dose. However, 11.8% of the anesthesiologists indicated combining oxytocin and carbetocin (p < 0.05). In managing pre-eclampsia and cardiac disease, the anesthesiologists were likely to reduce uterotonic doses (15.5%) and avoid methylergonovine (35.5%) compared to the OBGYNs, who reduced doses less frequently (4.3%), but 79.8% of the OBGYNs avoided methylergonovine (p < 0.001). Conclusions: There was considerable variability in uterotonic administration practices between the anesthesiologists and OBGYNs.

Abernethy sendromu portal kanın akımının, konjenital olarak karaciğerden sapması ile karakterize, çoğunlukla çocukluk döneminde tanı alan nadir bir sendromdur (1). Portal venin yokluğu veya küçük portal ven dallarının varlığı olarak sınıflandırılan iki alt tipi vardır. Dalak ve bağırsaklardan gelen kan, karaciğeri dışarıda bırakan bir şant aracılığıyla inferior vena kavaya (İVK) geçer ve pulmoner vazoaktif maddelerin metabolizmasında değişikliğe; pulmoner vazodilatasyona, difüzyon-perfüzyon bozukluğuna ve arteriyel hipoksemiye neden olur. Abernethy sendromu hepato-pulmoner sendromun etiyolojilerinden biri olarak kabul edilir (2). Preoperatif dönemde sendromun sebep olduğu portal akım anomalileri sonucu gelişen karaciğer hastalığı ve bu karaciğer hastalığının diğer organ sistemleri üzerine etkileri değerlendirilmelidir. Özellikle karaciğer yetmezliği mevcutsa kapsamlı bir değerlendirme yapılmalı, zaman varsa sistemsel sorunlar ameliyat öncesinde optimize edilmelidir. Postoperatif dönemde dekompansasyon açısından riskler unutulmamalı, hasta yakın takip edilmelidir. Abernethy syndrome is a rare disorder, typically diagnosed in childhood, characterized by the congenital diversion of portal blood flow from the liver (1). There are two subtypes of this syndrome: the absence of the portal vein and the presence of small portal vein branches. In this condition, blood from the spleen and intestines bypasses the liver via a shunt and flows directly into the inferior vena cava (IVC). This bypass alters the metabolism of pulmonary vasoactive substances, leading to pulmonary vasodilation, diffusion-perfusion mismatch, and arterial hypoxemia. Abernethy syndrome is recognized as one of the etiologies of hepatopulmonary syndrome (2).In the preoperative period, it is crucial to evaluate the liver disease caused by portal flow anomalies and the impact of this liver disease on other organ systems. A thorough assessment is particularly necessary if liver failure is present; systemic issues should be optimized before surgery if time permits. In the postoperative period, the risks of decompensation must not be overlooked, and the patient should be closely monitored.