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In this study, it is aimed to examine the cognitive structures of health management students about Covid-19. The word association test was used to collect data in the study, which was designed according to the phenomenology design. In the test, covid-19 was determined as the key concept and the cognitive structures of the students were revealed through what Covid-19 evokes, what it is like, negative effects, positive effects and how it will shape the future. From the 80 students reached, a data set of 4000 words in total, 800 belonging to each category, was obtained and the data were themed by subjecting them to content analysis. In the analysis, "mask" and "distance" as connotations, "comprehension" and "plague" as analogy, "disruptions with education" and "disorder of psychology" as negative effects, "spending time with family" and "spending time for yourself" as positive effect and, as a future, the codes of "prudent life" and "increase in economic problems" have emerged. All codes were gathered in themes and top themes and interpreted. As a result, when it comes to Covid-19, university students have more connotations of precaution and protection;students likened Covid-19 to infectious or fatal diseases;restrictions and measures were considered at the beginning of the negative effects;as positive effects, the process was seen as an opportunity for development and learning, and there were thoughts that social life would transform in the future due to this epidemic.
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Aim: COVID-19 is a viral pandemic that has affected the whole world in 2020. Our knowledge about this infection is improving each day. The emergency department (ED) management of COVID-19 patients is still unclear. Early warning scores (EWSs) and quick sequential organ failure assessment (qSOFA) are widely used scores in the ED. In this study, we aimed to compare EWSs and qSOFA scores in COVID-19 patients. Material(s) and Method(s): We evaluated patients diagnosed and hospitalized with COVID-19 between 10 April 2020 and 17 April 2020, including 63 COVID-19-positive patients. We calculated both EWSs and qSOFA scores for all patients and compared them by hospitalization unit (clinic or intensive care unit [ICU]), hospitalization length, and outcome. Result(s): EWS was positively correlated with hospitalization length, but we could not find a relationship between qSOFA and hospitalization length. The ICU hospitalization rate increases with high EWSs AND qSOFA scores. The mean EWS of patients hospitalized in the inpatient clinic was 1.39 and that of patients hospitalized in the ICU was 5.7. These scores were significantly different (p=0.000). The mean EWS of the patients who were discharged from the hospital was 1.6, and that of the exitus patients was 11.7 (p = 0.01). These values were 0.06 and 2.25 for qSOFA, respectively. Discussion(s): Both qSOFA and EWSs can predict the hospitalization unit and mortality, but EWSs are superior in determining the hospitalization length of COVID-19 patients.Copyright © 2022, Derman Medical Publishing. All rights reserved.
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There is insufficient data on the impact of severe acute respiratory coronavirus-2 (SARS-CoV-2) on the reproductive tissues, its possible risk of cross-contamination, transmission and adverse effect on in vitro fertilization (IVF) outcome. Until today, there is no report associated with viral RNA in both follicular fluid and embryo culture medium from SARS-COV-2 positive women. In this case report, a 24-year-old woman with SARS-CoV-2 was presented. We investigated the SARS-COV-2 positivity in the follicular fluid and embryo culture medium of mildly symptomatic woman on oocyte pick up (OPU) day. We could not detect viral RNA in neither the follicular fluid nor the embryo culture medium. In addition, although the response of ovarian stimulation was normal, the number and maturity of the retrieved oocytes were low.
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Introduction: In this study, we aimed to retrospectively evaluate the characteristics of mucormycosis cases seen in our clinic during the COVID-19 pandemic, the management of their treatment and the SARS-CoV-2 variants that were dominant at that time. Method(s): The medical records of patients diagnosed with rhino-orbital mucormycosis between March 2020 and July 2022 were retrospectively evaluated. Result(s): Nine patients were diagnosed with rhino-orbital mucormycosis. Of these patients, six were male and three were female, and the patients were between the ages of 65-75 (mean 69.2). After the diagnosis of mucormycosis, antifungal treatment was initiated with liposomal amphotericin-B. Eight patients underwent surgery within 48 hours, only one patient refused to undergo surgery. Conclussions: Mucormycosis is a rapidly progressing opportunistic fungal infection. Therefore, the most basic criteria determining mortality is the early detection of about mucormycosis infection and to diagnose it as soon as possible, especially in patients with an underlying immunosuppressive condition. Once a diagnosis of mucormucosis has been established, risk factors, especially blood sugar regulation, should be corrected. Furthermore, systemic and local antifungal therapy shuold be initiated, and urgent debridement should be performed. Copyright © 2022, Geriatrics Society. All rights reserved.
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Background: The C-reactive protein (CRP)/albumin ratio (CAR) is one of the new tools to assess the severity of inflammation. It is used to determine clinical severity and prognosis in many diseases. Aim: The present study aimed to investigate the relationship between C-reactive protein (CRP)/albumin ratio (CAR) and prognosis in pregnant patients with more severe COVID-19 infection. Retrospective study. Patients and Methods: The study was conducted in a retrospective manner by scanning the files of pregnant patients who had a positive polymerase chain reaction test result and were hospitalized in Adiyaman Training and Research Hospital. The patients were divided into two groups: patients who were admitted to the intensive care unit and patients who were not admitted. CRP/albumin ratio (CAR) levels were compared between these two groups. The cut-off value was determined in the prediction of intensive-care admission and poor prognosis. Results: 117 patient files were reviewed. 13 patients were followed up with intensive care, whereas 104 patients completed their treatment in the service. The CAR levels of the patients admitted to intensive care were significantly higher (P < 0.01). In the estimation of intensive-care admission, the CAR level was determined to be 0.970 in the area under the curve with 100% sensitivity and 86.5% specificity in the receiver operating characteristic (ROC) curve. The cut-off CAR level was calculated as 1.8. Conclusion: CAR is a valuable biomarker for predicting prognosis, as well as follow-ups of pregnant COVID-19 patients.
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C-Reactive Protein , COVID-19 , Humans , Pregnancy , Female , C-Reactive Protein/analysis , Retrospective Studies , Prognosis , AlbuminsABSTRACT
The tourism sector is one of the main economic sectors of both developed and developing countries. It is one of the sectors that feels the most destructive effects of COVID-19 in terms of generating income, providing employment, and covering many sub-sectors. A number of practices, recommendations, and decisions have been put forward to minimize the devastating effects of the pandemic by the international bodies. Although the COVID-19 epidemic has been brought under control in some countries with various vaccination practices and a new normalization process has been entered into, the traces of its destructive effects are still visible in the tourism industry. Therefore, this chapter draws the attention of the reader to comprehensive and up to the present unconventional practices in the industry due to the impacts of COVID-19 on the tourism and hospitality industry. © 2021, IGI Global.
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Objective: Currently the Covid-19 pandemic is studied with great expectations by several epidemiological models with the aim of predicting the future behaviour of the pandemic. Determining the level of disorder in the pandemic can give us insight into the societal reactions to the pandemic the socio-economic structures and health systems in different countries.
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Background: Considering the concerns regarding COVID-19 vaccine safety among patients with rheumatic diseases due to a lack of data, an urgent need for studies evaluating safety profiles of vaccines emerged. Objectives: Vaccination against the coronavirus disease-2019 (COVID-19) started in March 2021 in the group using biological therapy in our country. In this study, post-vaccine real-life data of patients with spondyloarthritis (SpA) followed up with biological therapy were analyzed. Methods: Adult patients diagnosed with SpA who were followed up under biological therapy and vaccinated by CoronaVac inactive SARS-CoV-2 orBNT162b2 messenger RNA (mRNA) COVID-19 (Pfzer-BioNTech) vaccine were included in our observational, multicenter, prospective study. Results: A total of 287 patients (58.2% male;mean age: 47) were included in the study. 202 (%70,4) of patients were being followed up with the diagnosis of AS, 40 (%13,9) of them with PsA, 32 (%11,1) of them with nr-axSpA, 11 (%3,8) of them with enteropathic arthritis, and 2 (%0,7) of them with uSpA. The most common comorbidities were found to be HT (n:65;22.6%) and DM (n:38;13.2%). While 221 (77%) of the patients were receiving biological therapy alone, 27 (9.4%) patients were using methotrexate, 25 (8.7%) patients were using sul-fasalazine, and 12 (4.2%) patients were using lefunomide. The median duration of biological therapy was 40 weeks (19-75 IQR). The most commonly used treatment was infiximab (26.8%), adalimumab (23.3%) was the second (Table 1). It was determined that 207 (72.1%) of the patients preferred inactivated virus vaccine, while 80 (27.9%) preferred mRNA vaccine. When the time between the biological treatment and the day of vaccination is examined, detected median time between biological treatment and the frst dose of vaccination is 11.5 days (5-19 IQR), between the frst dose of vaccination and biological treatment is 14 days (7-21 IQR), between treatment and the second dose of vaccine is 14 days (5-23.5 IQR), and between the second dose of vaccine and the next biological treatment is 12.5 days (7-15 IQR). While 25 (8.7%) of the patients had COVID-19 infection before vaccination, 7 (2.4%) patients were found to have COVID-19 after vaccination (p<0.001). While two of the patients who had COVID-19 infection in the pre-vaccination period required hospitalization, none of the patients who had COVID-19 in the post-vaccination period required hospitalization. The rate of patients who developed side effects after the frst dose of the vaccine was 20.6%. The side effects seen, respectively, were detected as pain-redness at the injection site (16%), fatigue (11.8%), headache (8.4%), muscle-joint pain (7.3%) and fever (5.6%). The rate of patients reporting side effects after the second dose of the vaccine was 17.1%. The incidence of side effects after mRNA vaccine was found to be statistically signifcant compared to inactivated virus vaccine in terms of both doses (p=0.011, p<0.001). Major side effects such as myocarditis, ana-phylaxis-angioedema, myocardial infarction, and thrombosis were not observed in any of the patients included in the study. There was no evidence of disease activation in the median follow-up of 209 days (145-280 IQR) after vaccination. Conclusion: During the follow-up of the patients during the study, no major vaccine-related side effects, post-vaccine disease activation and the need for treatment change were not detected. In order to more accurately evaluate the efficacy of the vaccination program in the patient population using biologic agents, larger-scale studies including unvaccinated individuals are needed.
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Aim: Patients with chronic diseases were forced into lockdown due to the coronavirus disease-2019 pandemic. Extended quarantine could lead to physical inactivity and psychiatric problems. We investigated the effects of quarantine and social isolation during the pandemic on the motor and non-motor symptoms (NMS) of Parkinson's disease (PD) patients with and without deep brain stimulation (DBS). Methods: This study included 168 patients with PD who were in quarantine for 2 months (between April 1, 2020 and May 31, 2020). Eighty-three patients had undergone bilateral subthalamic DBS surgery. A questionnaire with three parts was administered via phone: 1) motor symptoms, 2) NMS, and 3) the reasons for impairment. Results: Of the patients, 54.7% reported impairment in at least one motor symptom and 58.9% reported impairment in at least one NMS. Increased tremors, difficulty with turning in bed, and insomnia were significantly more pronounced in patients without DBS. Patients with DBS complained less of being bored due to staying at home and had less deterioration due to lack of exercise and slower disease progression. Conclusion: Half of the symptoms of patients with PD worsened during quarantine, but patients with DBS tolerated the lockdown better. Telemedicine and online physiotherapy programs should be recommended to prevent rapid disease progression.
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Massive Open Online Courses (MOOCs) are considered learning environments that eliminate many learning barriers. Online courses in MOOCs have become an opportunity for everyone during the lockdown of the COVID-19 outbreak. However, usability issues may cause problems such as high dropout rates and lack of learner's motivation. Therefore, in this study, the usability of Coursera, one of the most known MOOCs in the world, was evaluated. The evaluation was performed with ISO 9241-11 standard. The environment's effectiveness, efficiency, and satisfaction were evaluated with the authentic tasks requested to be done in Coursera. Additionally, the findings were supported by eye-tracking metrics such as fixation duration, fixation counts, heat maps, and gaze plots. Twelve individuals (six females, six males) participated in the authentic tasks, and three individuals (two females, one male) participated in the eye-tracking phase. Results of the study revealed that most participants successfully performed the authentic tasks and are generally satisfied with the usability of the environment. However, considering eye-tracking findings and Coursera Usage Satisfaction Survey, some usability problems such as inadequate language support and the difficulty of using the search feature emerged. In the end, possible reasons were discussed, and the suggestions were presented for usability improvements. © 2022, Ozgen Korkmaz. All rights reserved.
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Introduction: Healthcare-associated infections (HAI) are the most frequent adverse event in healthcare. Hand Hygiene (HH) is a crucial intervention to prevent the transmission of HAIs that should be learned in the early years of education by health care workers. Since COVID 19 pandemic hit education systems worldwide and face-to-face (f2f) training stopped, there is a need for innovative and effective distance educational interventions. Objectives: This pre-test, post-test intact group experimental design educational intervention study aims to create a unique online HH training program/competition which motivates students to participate and learn with high satisfaction. Methods: HH training program/competition was developed with the involvement of all 8 health sciences faculties and 11 medical colleges' representatives in one f2f[jc1] and two online meetings. Pre/posttests, skills training guides and WHO guidelines-based ppt presentations were developed. Materials were made accessible at the "flipgrid" application. Students registered and attended 2 h long synchronous pre-test, demonstration sessions through Zoom and Facebook stream followed by a post-test. They then recorded and uploaded their correct handwashing practice. We used Google forms to collect students' feedback (0 very bad-10 very good). Results: The total target students number was 14.180. 812 and 1412 students completed pre and post-test respectively and 1.900 during the stream. All 212 students who uploaded videos were evaluated, ranked between 0 and 100, receiving written feedback. Post-test scores were high (x = 81.0 ± 2.3). There were significant differences between mean total scores (t = 26.5;p < 0.000) of the pre-post test. The mean score of the evaluated videos was found as (x = 72.0 ± 1.4). 842 students provided feedback;general satisfaction was very high (x = 9.57 ± 1.11). Conclusion: This study suggests that the organization of nationwide online HH training/competition for health students is feasible and associated with acceptable participation rates and learning levels, with high satisfaction. Technology,internet access and digital literacy levels remain under-researched in this study to explain nationwide 10% participation.
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Recent data show that no age group is excluded from the possibility of SARS-CoV-2 infection. However, it is more likely to affect the elderly with comorbidities such as cardiovascular and pulmonary diseases, diabetes, and hypertension that can lead to the progression of COVID-19. Dyslipidemia is often found with these comorbid diseases. According to recent findings, lipoproteins, and particularly high- density lipoprotein cholesterol (HDL-C), may play a role in regulating the entry of the SARS-CoV-2 virus into the host cell. In fact, HDL-C has many beneficial properties, including anti-inflammatory, anti-oxidative, anti-thrombotic, anti-infectious, anti-apoptotic, intercellular communication, and pro-vasodilator capacities. HDL-C has an affinity for binding and neutralization of the pathogen. The link between COVID-19 and lipid-dependent pathologies has not yet been fully understood. We draw attention to the molecules and functions involved in HDL-C. Because many therapeutic compounds that regulate HDL-C functions and metabolism can be used in the treatment of COVID-19 recently.
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Viruses invade cells to reproduce, and they require an iron-filled cell for efficient reproduction. Together with other viruses, the coronavirus disease-2019 (COVID-19) virus can alter the expression of proteins involved in iron homeostasis. For example, in COVID-19 patients, an increase in pro-inflammatory cytokines such as interleukin-6 may stimulate the synthesis of hepcidin, the regulatory hormone of iron metabolism, thereby suppressing ferroportin-mediated cellular iron export. Increased serum levels of ferritin in COVID-19 virus infection is associated with a poor prognosis and may be partly due to the virus itself. Some viruses selectively infect iron acceptor cells (e.g. macrophages) by binding to transferrin receptor 1 during cell entry. Moreover, human airway secretions in the major route of entry of COVID-19 include transferrin and lactoferrin, and this glycoproteins can bind iron and maintain a chemically inert form. Understanding how iron metabolism and viral infection interact in the COVID-19 outbreak may suggest new ways to control the disease.