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The Covid-19 pandemic has tested the health infrastructures of many countries and has enabled them to examine their managerial skills in the face of the pandemic. To control the pandemic, countries have resorted to some public restrictions and measures to prevent the spread of the disease, as well as the detection and treatment of cases. In this study, the effect of public restrictions applied during the pandemic process in the fight against Covid-19 was examined using the Two-Stage Bootstrap Data Envelopment method. In the first stage, the performance of the health infrastructures of the countries in the fight against Covid-19, and in the second stage, the effect of public measures on the performance scores was evaluated. As a result, it has been seen that the most successful countries in the fight against the pandemic are Austria, Denmark, and Lithuania. On the other hand, America, France, and Belgium were found to be the most unsuccessful countries. It has been determined that public measures generally have a positive effect on the performance of countries fighting Covid-19
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Objective: This study aims to determine the prognostic values of bio-markers obtained from complete blood count in the diagnosis of the coronavirus disease of 2019 (COVID-19) patients who came to the pedi-atric emergency department of Diyarbakir Pediatric Hospital. Material and Methods: A total of 190 child patients with COVID-19 with definite diagnosis and 41 healthy children as a control group were included in this study. The lymphocyte count, platelet count, mean platelet volume (MPV), plateletcrit (PCT), C-reactive protein (CRP), neu-trophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) obtained from the patients' complete blood count were evaluated.Results: A statistically significant difference was found between the pa-tient and control groups in the lymphocyte, platelet, NLR, PLR, SII, PCT, and CRP values (p= 0.001, p< 0.0001, p< 0.0001, p= 0.007, p= 0.001, p< 0.0001, and p= 0.002, respectively). A very good positive correla-tion was found between SII and NLR (r= 0.919, p< 0.0001). There was a good level of positive correlation between PLR and NLR and between SII and PLR (r= 0.746, p< 0.0001;r= 0.787, p< 0.0001, respectively), a moderate positive correlation was found between SII and CRP, between WBC and PLR, and between WBC and PLT (r= 0.432, p< 0.0001;r= 0.408, p< 0.0001;r= 0.538, p< 0.0001 respectively). The relationship between CRP and NLR and between PCT and SII was determined to be a weak positive correlation. The area under the curve for NLR, platelet, lym-phocyte was graded as moderate and for PCT very good. Cut-off points were found for the platelet count (<= 285.00;AUC= 0.740;95% CI= 0.644-0.836;p< 0.0001), lymphocyte count (<= 2.665;AUC= 0.727;95% CI= 0.633-0.821;p< 0.0001), NLR (>= 0.28;AUC= 0.707;95% CI= 0.611-0.803;p< 0.0001), and PCT (>= 0.83;AUC= 0.979;95% CI= 0.950-1.000;p< 0.0001).Conclusion: Platelet count, lymphocyte count, NLR and PCT can be used as inflammatory biomarkers that can predict prognosis in COVID-19 infec-tion in children.
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Sarcomatoid urothelial carcinoma is a rare and aggressive variant. Serum beta-hCG levels are used as a tumor marker in gestational trophoblastic diseases and germ cell tumors, but may also be elevated in high-grade bladder cancers. Here, we report two urothelial carcinoma cases with sarcomatoid differentiation that relapsed early after surgery with elevated serum beta-hCG levels. The first case was a 65-year-old female and the second case was a 67-year-old man with sarcomatoid urothelial carcinoma located in the ureter and renal pelvicalyceal system, both of them relapsed with elevated beta-hCG serum level to 146.8 mIU/ mL and 242 mIU/mL, respectively. They died a few months after initial diagnosis;4.9 and 2.5 months respectively. Both sarcomatoid variant and beta-hCG expression were associated with poor prognosis and advanced stage. However, beta-hCG is not used as a tumor marker in urinary tract cancers yet, and its relationship with variant pathologies has not been clarified. We need multi-centered studies to reveal this relationship.Copyright © 2023, Derman Medical Publishing. All rights reserved.
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Objective: This study aims to determine the prognostic values of biomarkers obtained from complete blood count in the diagnosis of the coronavirus disease of 2019 (COVID-19) patients who came to the pediatric emergency department of Diyarbakir Pediatric Hospital. Material and Methods: A total of 190 child patients with COVID-19 with definite diagnosis and 41 healthy children as a control group were included in this study. The lymphocyte count, platelet count, mean platelet volume (MPV), plateletcrit (PCT), C-reactive protein (CRP), neutrophil- lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) obtained from the patients' complete blood count were evaluated.
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Objective: The coronavirus disease-2019 (COVID-19) pandemic can increase anxiety and depression in patients with multiple sclerosis (PwMS). This study aimed to evaluate the predictors of anxiety and depression in PwMS during the COVID-19 pandemic and compare it with the general population (GP). Materials and Methods: The study was conducted in an MS clinic in Istanbul University Istanbul Faculty of Medicine. Data were collected online using a form including sociodemographics and questions on COVID-19-related knowledge and the hospital anxiety and depression scale. Results: This study included 800 participants (GP: 421, MS: 379). Anxiety (42.3% vs. 32.2%, p=0.002) and depression (53.9% vs. 39.6%, p<0.001) were more common, COVID-19-related knowledge was lower (9.1±1.5 vs. 9.9±1.2, p<0.001), and rate of COVID-19 infection was higher (15.4% vs. 6.9%, p<0.001) in the GP than PwMS. Among other factors, COVID-19-related knowledge was a common predictor of anxiety and depression in both GP and MS groups [odds ratio (OR): 0.8, 95% confidence interval (CI) 0.7-0.9, p=0.007 and OR: 0.7, 95% CI 0.7-0.9, p=0.020, for anxiety;OR: 0.7, 95% CI 0.7-0.9, p=0.001 and OR: 0.8, 95% CI 0.7-1.0, p=0.023 for depression, respectively]. Conclusion: This study revealed that PwMS have less anxiety and depression than the GP. Our study shows the importance of COVID-19-related knowledge and the need for psychological support during the pandemic. © 2021 by Turkish Neurological Society.
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Introduction: Although 10-20% of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infected individuals experience life-threatening events, children are most likely to have a significantly milder COVID-19 disease course. However, they might have a pivotal role in the transmission. Raised concerns regarding the vulnerability of those with several comorbidities led to studies evaluating the patients with rheumatic diseases, but they were not found to be significant risk factors for a severe disease course, neither in childhood nor in adulthood. Objectives: We aimed to find out the asymptomatic SARS-CoV-2 seroprevalence among pediatric patients with rheumatic diseases and healthy children and to compare them with each other. Methods: Patients with familial Mediterranean fever (FMF), juvenile idiopathic arthritis (JIA), juvenile systemic lupus erythematosus (jSLE) and healthy children (HC) who remained asymptomatic during the pandemic are examined by ELISA Immunoglobulin (Ig) A and IgG tests in this cross-sectional study. Results: Overall, 149 subjects (90 females) were included in the study. While IgA was positive in 15 subjects (10%) (HC: 8, jSLE: 3, FMF: 2, JIA: 2;p=0.196), IgG was positive in 14 subjects (9.4%) (HC: 7, JIA: 5, FMF: 1, jSLE: 1;p=0.156). Nineteen subjects (12.75%) were IgA or IgG positive (HC: 8, JIA: 5, jSLE: 3, FMF: 3;p=0.644). Although not significant, seropositivity was more often in HC group. The mean age of the IgA and IgG positive subjects was 11.62 ± 5.11 (p=0.391) and 11.18 ± 5.95 (p=0.433) years, respectively. Ten (66.7%) of the IgA positive subjects (p=0.807), and 9 (64.3%) of the IgG positive subjects (p=0.980) were females. Two of the seropositive subjects had a contact history with a confirmed COVID-19 case (FMF:1, IgA: negative, IgG: positive;HC:1, both IgA and IgG positive). During the pandemic, 3 (20%, p=1) of the IgA positive subjects were receiving hydroxychloroquine (HCQ), 2 (13.3%, p=0.738) were receiving colchicine, one was receiving steroids (6.7%, p=0.694), one was receiving conventional disease modifying anti-rheumatic drugs (cDMARDs) (azathioprine: 1) (6.7%, p=0.116), and one was receiving biologic DMARDs (bDMARDs) (adalimumab: 1) (6.7%, p=0.699). On the other hand, 3 (21.4%, p=0.404) of the IgG positive subjects were receiving steroids, 2 (14.3%, p=1) were receiving bDMARDs (adalimumab: 2), 2 (14.3%, p=0.520) were receiving cDMARDs (azathioprine:1, methotrexate: 1), one was receiving colchicine (7.1%, p=0.302), and one was receiving HCQ (7.1%, p=0.467). Both IgA and IgG positivity were not found to be related to age, sex, underlying rheumatic diseases and received treatments of the patients. Conclusion: We revealed that patients with childhood-onset rheumatic diseases, even if they receive immunosuppressive medication such as bDMARDs or cDMARDs, might have an asymptomatic SARSCoV- 2 infection, similarly to their healthy peers.