Epidemiological investigation of bovine tuberculosis infection dynamics in Turkey

A national epidemiological research project was carried out to define the dynamics affecting the epidemiology of bovine tuberculosis (bTB) infection in Turkey and to identify the risk factors. Official veterinarian (OV) and breeder original questionnaires were produced separately as part of this study to collect thorough data regarding the disease from the field. The number of questionnaires that needed to be filled out was decided by 95% confidence interval (CI) and 5% margin of error. The findings of 371 OV and 317 breeder questionnaires completed online across the country were analyzed. In addition, 28 outbreaks determined by random method were visited. To observe regional differences and field conditions, the opinions of OVs who monitored the disease and breeders were compiled. It was observed that the data obtained from both questionnaires was largely compatible. The main factors in the epidemiology of bTB infection were found to be effective fight, development of state policy, providing adequate financing, animal purchase, ear tagging and records, animal traders, animal markets, animal movements, conditional slaughtering, slaughterhouses, postmortem inspection, premise conditions, socio-economic impact, evaluation of raw milk, disease-free premises, compensation payments, and quarantine processes.

Clinical course of COVID-19 in children with rheumatic disease under biologic therapy from Turkey

Introduction: What a biological disease-modifying antirheumatic drugs (bDMARDs)? and/or underlying rheumatological diseases, which we frequently use in our pediatric rheumatology practice, affect the clinical course of COVID-19 has not been fully demonstrated. Objectives: Here, we aimed to reveal the course of COVID-19 infection in patients with rheumatic disease and receiving bDMARD treatment. Methods: This was a retrospective, multicenter study in patients with a biological treatment had been initiated. This real-life study is based on secondary data collection from medical records of patients evaluated at the 14 Pediatric Rheumatology Clinics in Turkey from April 2020 to April 2021. The diagnosis of COVID-19 was confirmed in 101 patients by nasal PCR and in 10 patients by antibody test. Results: The study population of 112 patients consisted of 70 females (63.6%). The mean age of patients was 12.87 ± 4.69 years. The primary diagnosis of patients was as follows;59 juvenile idiopathic arthritis, 33 systemic autoinflammatory diseases, 10 vasculitis, 8 connective tissue diseases. The mean duration of primary disease was 4.62±3.65 years. Nineteen patients had also additional comorbid diseases (hypertension, Chron's disease, hereditary spherocytosis, and chronic renal failure, astma, cardiomyopathy, adrenal insufficiency in individual patients). Prior to COVID-19 infection, 35 patients (31.8%) were using canakinumab, 10 were infliximab (9.1%), 25 were adalimumab (21.8%), 18 were etanercept (16.4%), 9 were tocilizumab (8.2%), 4 were anakinra (3.6%), 6 were rituximab (5.5%), 1 was abatacept (0.9%), and 3 was tofacitinib (2.7%). The median exposure time of a biologic drug was 13.5 months. Additionally, 66 patients were using DMARD, and 27 patients were also receiving corticosteroid. 70 (63.6%) patients had at least one COVID-19-related symptom (fever, cough, diarrhea, myalgia, anosmia and/or rash), while 40 (36.4%) patients were asymptomatic. Respiratory findings were seen in 26% of all patients, 7 patients also had pathology in computed tomography. Hospitalization was required in 25 patients (22.7%) at median of 6 days (IQR: 4-10). Five patients developed MIS-C and 2 of these patients were followed up in the pediatric intensive care unit. Laboratory tests revealed that fourteen patients had elevated acute phase reactants, ten had elevated D-dimer levels, 5 had lymphopenia (< 1000/mm3), and five had hyperferritinemia. Conclusion: In patients with underlying comorbidities, COVID-19 can have a severe course regardless of the use of bDMARD. In the light of these findings, it would not be correct to say that the currently used bDMARDs worsen the course of COVID-19 infection or to say whether they affect the severity of the disease, but still, the disease findings-modifying effects of these drugs, especially high fever and myalgia, have been observed.

Discrimination based on sexual orientation and gender identity and the COVID-19 pandemic

Although the physical distance rule applied to slow the pace of the COVID-19 pandemic is an important part of the public health approach, this distance reduces positive social interactions for sexual minorities and can cause mental distress. Lesbian, gay, bisexual, trans, intersex (LGBTI +) people who have to stay at home are increasingly exposed to violence during pandemic. The discrimination experienced by subgroups who may have special needs within the LGBTI + group, such as young people, the elderly, those in need of care or individuals living with HIV, is multiplied throughout the pandemic and the process becomes difficult for these groups. In the epidemic, the prolongation of the psychiatric care process of trans people and the delay in starting hormone therapy disrupt the transition process and negatively affect the mental health of trans people. Considering the risks associated with the pandemic, it is important to take early measures to prevent permanent mental health problems. It is important to provide access to remote support via telemedicine. Despite the possibility of LGBTI+ youth being trapped in traumatic environments, it is critical to monitor and report domestic violence. It is necessary to attach importance to studies on multiple discrimination and to protect the health of LGBTI+ people with special needs.

Cytokine storm and oxidative stress in severe COVID-19

Some patients infected with the SARS-CoV-2 virus show rapid progress to acute respiratory distress syndrome, multi-organ failure, and death. Acute respiratory distress syndrome is a large concern of death in COVID-19. Current therapeutic strategies focus on the virus itself and antiviral drugs are used to manage the disease. Unfortunately, the benefits of antiviral drugs are not satisfactory in every patient. It seems that the excessive inflammatory response rather than the virus titer is more relevant to the death. A brisk immune response generally destroys the virus but can cause significant local and longterm damage in tissues. In severe COVID-19, acute respiratory distress syndrome and multi-organ failure are associated with cytokine storm. Cytokine storm triggers the production of reactive oxygen species storm in immune system cells to destroy the virus. Although a certain amount of reactive oxygen species is helpful in the regulation of immune response and killing viruses, an excessive amount of reactive oxygen species damages the cellular lipids, proteins, and DNA. Extensive damage by reactive oxygen species results in apoptosis. Apoptotic death of endothelial and epithelial cells in the lungs plays important role in the development of acute respiratory distress syndrome in COVID-19 patients. Here, we will summarize the current molecular understanding of the vicious circle between the cytokine storm and oxidative stress that is an executive factor for cells. © 2021 Nova Science Publishers, Inc.

Defining Appropriate Government Strategies to Reduce Unemployment During COVID-19 Pandemics

The unemployment problem became more significant, especially after COVID-19 pandemics. This situation affected both developing and developed countries in a negative manner. Hence, the policies implemented by the states to prevent unemployment were also carefully considered during this process. Within this scope, various suggestions of ILO and OECD institutions have been made regarding these strategies. This study aims to identify the significant strategies countries should develop to reduce unemployment. For this purpose, 10 basic strategies offered by OECD to reduce the unemployment problem are considered. Moreover, an evaluation has been carried out by considering fuzzy DEMATEL methodology. The findings demonstrate that ensuring adequate income protection is the most appropriate criterion to minimize the unemployment problem in the COVID-19 process. During the pandemic period, economic rescue packages were announced by many governments and institutions. Despite all this support, millions of people lost their jobs in this process. Considering the analysis results obtained in this study, it would be appropriate for governments to focus primarily on the unemployed. In this framework, the implementation of strategies that will prevent citizens from being unemployed will contribute to the solution of this problem. Despite all these efforts, there may still be people losing their jobs in this process. Therefore, income-generating policies should be implemented especially for these people. For this purpose, the duration of unemployment benefits may be extended. In this way, it will be easier to combat the unemployment problem caused by the COVID-19 pandemic. © 2021, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Evaluation of colorectal surgical patients and treatment modalities in a covid-19 pandemic hospital: A cross-sectional study

Objectives: The COVID-19 pandemic has emerged as a significant threat to healthcare systems, and has resulted in treatment algorithms being changed in general surgery clinics, as is the case in all other medical disciplines. In the present study we analyze the outcomes of patients who have undergone elective colorectal surgery in our hospital since the COVID-19 outbreak, as well as the precautionary procedural changes that have been made. Methods: The present study evaluates the approaches applied for the treatment of elective colorectal cancer patients in a pandemic hospital. In this cross-sectional study, conducted in a tertiary-level public hospital in Istanbul, Turkey, a retrospective review is made of the files of patients who underwent elective colorectal surgeries between 11.03.2020, as the date on which first case of COVID-19 was officially identified in Turkey, and 01.05.2020, in the general surgery clinic of a tertiary healthcare facility that has been designated a pandemic hospital. Results: A total of 18 patients underwent a surgical resection in accordance with oncological principles between the defined dates, having been diagnosis with a colorectal malignancy. None of the operated patients were considered suspicious for COVID-19 preoperatively, nor did they have any contact history. Furthermore, there were no suspicions or signs of COVID-19 during the 14-day follow-up of the discharged patients. Conclusion: It was established in the present study that patients undergoing colorectal surgery and patients with COVID-19 infections in the same hospital can be treated successfully without cross-infection through the application of appropriate isolation principles. These successful findings were supported by a 14-day follow-up after discharge.