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1.
Cellular Microbiology ; 2022 (no pagination), 2022.
Article in English | EMBASE | ID: covidwho-2194245

ABSTRACT

Objective. The objective of this study was to evaluate the cases of COVID-19 infection in people >18 years old and to investigate attitudes against vaccination and vaccine hesitancy and the factors affecting them. Methods. The data collection form used in the study was prepared by the researchers by screening the relevant literature. People over the age of 18 who agreed to participate in the study were invited to the family health center, and a questionnaire was applied by face-to-face interview method. The application time of a survey was 5-10 minutes. A total of 229 people were reached. Percentage of reaching was 95,4%. Results. The mean age of the participants was 44,13+/-14,18 years. 31,9% of the participants in the study had COVID-19 infections. 69,9% of those who had COVID-19 infection caught the disease in the last year, and 93,2% were followed at home. Among the people with whom the participants lived, 21,6% of those who had COVID-19 infection were hospitalized and 5,7% died. Of the participants who expressed their opinion, 32,1% think that COVID-19 vaccines have serious side effects. Postvaccine side effects developed in 32,9% of the participants who had the COVID-19 vaccine, and 11,0% had a postvaccine infection. Conclusion. The results of our study revealed that the COVID-19 vaccine was highly accepted among the adult population in Turkey during the pandemic period. However, through this study, we found concerns about the side effects of the vaccine, the lack of confidence in the vaccine ingredient, and the effectiveness of the vaccine. Copyright © 2022 Volkan Medeni and Irem Medeni.

2.
Springer Protocols Handbooks ; : 151-160, 2022.
Article in English | EMBASE | ID: covidwho-2173510

ABSTRACT

Turkey coronaviral enteritis caused by turkey coronavirus (TCoV) continues to infect turkey flocks, resulting in significant economic loss. Determining and understanding genetic relationships among different TCoV isolates or strains is important for controlling the disease. Using two-step RT-PCR assays that amplify the full length of TCoV spike (S) gene, TCoV isolates can be sequenced, analyzed, and genotyped. Described in this chapter is the protocol on PCR amplification and sequencing analysis of full-length TCoV S gene. Such protocol is useful in molecular epidemiology for establishing an effective strategy to control the transmission of TCoV among turkey flocks. Copyright © Springer Science+Business Media New York 2016

3.
Neurology Asia ; 27(3):599-607, 2022.
Article in English | EMBASE | ID: covidwho-2067765

ABSTRACT

Objective: This study aimed to determine if the coronavirus disease 2019 (COVID-19) pandemic had any impact on admission patterns for subarachnoid hemorrhage (SAH) during 1st and 2nd waves and in-between in a tertiary institution in southeastern Turkey. Method(s): Three periods were determined during the pandemic: First and second peaks (April 1-May 1, 2020 and November 18-December 18, 2020, respectively) and the slowdown period (July 5-August 4, 2020) where the daily new cases hit its lowest. We retrospectively collected data of the patients with SAH who were admitted to our institution within these periods during 2020 (the pandemic) and 2019 (the year before the pandemic). Demographic data, time between symptom onset and admission, Glasgow Coma Scale (GCS), Fisher score, World Federation of Neurosurgical Societies (WFNS), presence of intracerebral hemorrhage, intraventricular hemorrhage, hydrocephalus, type of SAH (aneurysmal vs non-aneurysmal) were recorded and compared between the pandemic and pre-pandemic periods. Result(s): The number of admissions in first peak, slowdown, and second peak during the pandemic was 11, 15, and 17, respectively. They did not differ significantly from corresponding periods in 2019 (17, 7, and 10, respectively) (all P>0.05). The mean time from onset to admission to hospital was similar between pandemic and 2019 (ranging between 0.40-2.00 days in 2020 compared to ranging between 1.12-2.29 days in 2019). The rate of cases with worse neurological condition on admission turned out to be lower during the first peak of the pandemic compared to previous year (9.1% vs 29.4%, P=0.029), but showed no difference in the remaining two periods. The incidence of accompanying pathologies (intracerebral hemorrhage, intraventricular hemorrhage, and hydrocephalus) was also similar between the periods in 2020 and their counterparts in 2019. Rate of non-aneurysmal cases ranged between 11.1%-45.5% in 2020 compared to 10.0%-57.1% in 2019 (all P>0.05). Conclusion(s): The study showed that hospital admission patterns for SAH was not affected by COVID-19 pandemic in the southeastern Turkey, unlike other reports. This may be due to different behavioral characteristics of the study population and capability of health care system to cope with high number of patient admissions. Copyright © 2022, ASEAN Neurological Association. All rights reserved.

4.
Neurology Asia ; 27(3):725-735, 2022.
Article in English | EMBASE | ID: covidwho-2067764

ABSTRACT

Background & Objective: Tension-type headache (TTH) is the most common primary headache. TTH worsens quality of life and is related to various psychosocial factors. We aimed to examine the severity of headache (intensity, frequency, and duration), analgesic use, quality of life (QoL), and the impact of COVID pandemic-induced stress in TTH patients. Method(s): TTH cases seen at neurology outpatient clinics in 15 centers in Turkey were included in the study. A questionnaire incorporating sociodemographic and medical information, headache features, sleep quality, general quality of life, and impact of the pandemic event was administered to the subjects. Result(s): A total of 975 TTH patients were evaluated. Headache severity was higher in women as well as in patients with a history of COVID-19 contact. Women, those with chronic diseases, and cases with a COVID-19 contact history had worse perceptions of quality of life and were affected to a greater extent by the pandemic. The factors affecting the impact of the pandemic were female gender and difficulty in access to health services for headache. Co-existing chronic diseases and lost productive time due to headaches were negative determinants for both QoL and the impact of the pandemic. Conclusion(s): Our results show that the COVID pandemic severely worsened the headache burden, quality of life and mental health of TTH patients. These findings can guide us in the clinical approach to TTH cases. Copyright © 2022, ASEAN Neurological Association. All rights reserved.

5.
Cardiology in the Young ; 32(Supplement 2):S229, 2022.
Article in English | EMBASE | ID: covidwho-2062111

ABSTRACT

Background and Aim: Chest pain is a one of the most common com-plaints in children admitted to the Hospitals. Although it was among the most common reasons for referral to the pediatric car-diologist before COVID-19 era, this tendency is changed during covid pandemic. The primary objective of this study was to inves-tigate the aetiological causes, clinical characteristics and the follow up symptoms in terms of changing habits of parents and children admitted to the ED for acute chest pain during pandemic. Method(s): We reviewed the medical records of children under the age of 18 who presented with chest pain as the chief complaint from 1 January 2020 to 1 April 2021, at Istanbul University-Cerrahpasa Pediatric Emergency Clinic retrospectively from the hospital data-base. The study population comprised 128 boys and 119 girls. Result(s): All the children underwent ECG examination. While the ECG results of 239 children were normal, 6 sinus tachycardia, 1 supra-ventricular tachycardia and 1 incomplete left bundle branch block were observed. 33 patients had an echocardiography. Eight patients with an abnormal Echo result already had been examined and diag-nosed prior to their emergency admission. Blood samples were taken from 48 children for troponin. 17 samples wereabove the cut-off value which was set to 0.004 g/dl A total of 32 SARS-Cov2 swab samples were taken from suspicious cases and analyzed with RT-PCR. Consequently, 8 of these children were Covid-19 positive. 7 patients had no history of chronic disease, while 1 patient had ALL. All of these patients had mild symptoms and none of them required hospitali-zation. The total number of children who were referred to a pediatric cardiologist for a further examination together with the follow-up patients of the pediatric cardiology department is 52 Conclusion(s): In conclusion, Chest pain is a common referral com-plaint in children and is rarely due to cardiac diseases. To date car-diac reasons of chest pain was the major concern of patients and families attending the ED. However we found that Patient/family concerns regarding 'vulnerability to the severe covid infection has emerged as an important discourse during the pandemic on attend-ences to ED because of chest pain.

6.
Journal of Pediatric Gastroenterology and Nutrition ; 75(Supplement 1):S47-S48, 2022.
Article in English | EMBASE | ID: covidwho-2058252

ABSTRACT

Background: 30-50% of pediatric acute liver failure (PALF) is of unknown cause, or indeterminate PALF (iPALF), which frequently results in transplantation. A subset of iPALF is characterized by T-cell activation. Some children with acute severe hepatitis of unknown etiology (SH-u) can evolve to iPALF. Hemophagocytic Lymphohistiocytosis (HLH) is a well-defined hyper-inflammatory condition characterized by marked T-cell activation and frequent severe liver involvement. We postulated SH-u evolving to iPALF has hyper-inflammatory immune signatures that are identifiable before fulfilling PALF criteria, and might overlap with those seen in HLH. We compared the immune dysregulation signatures of children with HLH to children with SH-u, PALF cases with known etiologies, and healthy pediatric controls (HC). Method(s): Between 2019-2021, we prospectively enrolled 14 patients hospitalized with SH-u and 7 patients with PALF of known etiologies. Age dependent standard of care diagnostic studies were performed. SH-u was defined as ALT> 500, INR < 2, and no hepatic encephalopathy. HLH enrollees fulfilled the 2004 diagnostic criteria. High dimension T-cell immunophenotyping, cytokine and chemokine profiling (71-plex) was done for SH-u, HLH (n=5), and HC (n= 16) peripheral blood samples. T cell activation was prospectively identified by co-expression of surface activation markers HLA-DR and CD38. Based on immune studies in HC, CD8 effector memory (EM) activation of >9% distinguished patients with significant T cell activation from HC. This cutoff of >9% was therefore used to identify SH-u patients with T cell activation. Normally distributed data were compared by either a two-tailed t-test or an ordinary One-Way Anova test with Turkey's multiple comparison test. Non-normally distributed data were compared by either the Mann-Whitney test or Kruskal-Wallis test with Dunn's multiple comparisons test. P Values < 0.05 were deemed significant. Result(s): Subjects ranged in age from 4 days to 19 years old. There were no age or sex differences between the groups. One SH-u patient had prior COVID infection, but no subject met MIS-c criteria. Two SH-u patients ultimately evolved to PALF criteria with INR> 2. All patients with SH-u had higher CD8 EM T-cell activation (mean +/- SEM = 43.7+/-6.3%;range 9.2 to 81.3;p<0.0001), which was significantly higher than HC (2.9+/-0.5%) and PALF of known etiology (4.0+/-0.9%) . However, the amplitude of T-cell activation was lower in the SH-u group relative to the HLH group (90.3+/-2.7%;p<0.0001), as shown in Figure 1. A similar trend in T cell activation was noted in the CD4 compartment. Overall, the activation in the CD8 compartment was much greater than in CD4. SH-u patients had a decreased CD4/CD8 ratio compared to the PALF group. Despite higher T cell activation in patients with SH-u compared to PALF, ferritin, often used to screen for hyper-inflammation, was lower in the SH-u group when compared to PALF group (1240+/-609 vs. 39517+/-32149;p<0.05) and very significantly lower than HLH (32415 +/- 14845;p =0.002). 50% of patients with SH-u etiology had ferritin < 500 mg/L. Cytopenia (hemoglobin < 9 g/dL, ANC < 1000/mL, platelets < 100,000/mL) is characteristic of patients with HLH. Despite overlapping T cell activation with HLH, the SH-u cohort had only 2 patients with this feature: one with thrombocytopenia and one with neutropenia. Supportive of this higher T cell activation, we noted chemokines driven by IFN-gamma, CXCL9 and CXCL10, to be elevated in SH-u compared to HCs and comparable to HLH patients. As a proof of concept, 1 patient with SH-u and thrombocytopenia underwent treatment with Emapalumab (an IFN-gamma blocking antibody) along with other immune modulators both with complete liver, immune, and platelet count recovery. Conclusion(s): Our cohort of SH-u was associated with significant T-cell activation. In addition, our patients with HLH and SH-u with T cell activation had similar increased IFN-gamma activity. Despite this T cell activation, ferritin values were significantly lower in SH-u compared to PALF without T cell activation. Ferritin may not be a reliable screening test to identify SH-u patients with significant T cell activation. If validated in a larger well-defined population of SH-u, the results may suggest a role for IFN-gamma blocking agents in a subgroup of SH-u prior to PALF or before bone marrow failure development.

7.
HemaSphere ; 6:3291-3292, 2022.
Article in English | EMBASE | ID: covidwho-2032172

ABSTRACT

Background: Chronic lymphocytic leukemia (CLL) is the most common adult leukemia. Approximately 2% of patients with CLL develop immune thrombocytopenic purpura (ITP) during the course of the disease. When resistant to steroids, this constitutes as indication for treatment of the CLL. Here we report a patient with refractory ITP secondary to CLL successfully treated with venetoclax. Aims: To present an interesting case with CLL related refractory ITP treated successfully with novel agent venetoclax. Methods: Patient data was taken from the patient herself and Hospital records. Informed consent to publish the case is obtained from patient. Permission for off-label venetoclax and eltrombopag was obtained from Ministry of Health of Turkey. Results: 46-year-old female patient presented with lumps on her neck that were present for the last 9 months in November 2020. She has a history of frequent pneumonia and otitis but no constitutional symptoms. Her physical examination reveals multiple 2cm lymphadenopathies on her neck and no organomegaly or other pathological features. Blood work shows mild lymphocytosis (6800/mm3) with no serious cytopenias. Peripheral blood smear, flow cytometry and bone marrow biopsy were all compatible with CLL. She was classified as Binet A CLL and was followed up with no treatment after appropriate vaccinations against capsulated pathogens. In July and August 2021 she received two doses of mRNA vaccination against COVID-19. On 1st November 2021 she experienced excessive menstrual bleeding and blood work showed platelet count of 23000/mm3, she was started on steroids (1 mg/kg/day) and after 4 days platelet count has risen to 55000/mm3, she discontinued steroids on her own against medical advice. On 13th of November she presented with extensive petechiae and purpura and was again started on steroids and was given the courses of intravenous immunoglobulins (IVIG) without any sustained response. She was refractory to platelet transfusions too. She was transferred to our clinic. She was found to have del11q and del13q. She refused bone marrow examination. She was treated with rituximab, steroids, vincristine, IVIG and eltrombopag for ITP without success (Fig. 1). She had a minimal response to IVIG only. She received two courses of bendamustine (90 mg/kg for two days) also without success. Three courses of plasmapheresis yielded no response either. After mild success with immunadsorbtion apharesis she was started on venetoclax plus rituximab with ramp-up. Sustained response was achieved within the first week of venetoclax therapy. (Figure Presented ) Summary/Conclusion: Gordon et al. reported 2 CLL cases one with ITP and other with Evans syndrome successfully treated with venetoclax. We think, this treatment should be considered in patients with refractory immune cytopenias secondary to CLL and assessed with prospective clinical trials.

8.
Cocuk Enfeksiyon Dergisi ; 16(2):77-86, 2022.
Article in English | EMBASE | ID: covidwho-2010458

ABSTRACT

Objective: Multisystem inflammatory syndrome (MIS-C) in children is a newly defined and serious health problem that develops after SARS-CoV-2 infection. Our aim is to report epidemiological, clinical, laboratory and radiological features of children with MIS-C. Material and Methods: Forty patients who applied to our hospital from October 2020 to February 2021 and met the MIS-C criteria were included in the study. Patients with gastrointestinal involvement (GIS), cardiac involvement and Kawasaki Disease (KD)-like MIS-C were examined clini-cally and laboratory. Results: The mean age of the patients was 8.2 ± 4.2 years and male patients were in the majority (70%). The most common symptoms were fe-ver (100%) and fatigue (90%). Gastrointestinal symptoms were present in 71%, cardiac involvement in %40, Kawasaki-like patients in %52.5, shock symptoms in 59%. Elevated levels of C-reactive protein, D-dimer, and ferritin were found in 100%, 97.5%, and 67.5% of the patients, respec-tively. Patients with cardiac involvement had higher mean age and lower lymphocyte levels. Shock findings were higher in patients with KD-like MIS-C. Also, INR and ferritin levels were higher in KD-like MIS-C patients (p= 0.028). The mean platelet count (p= 0.004) and albumin levels were lower (p= 0.048) in shock group. Conclusion: MIS-C is a hyperinflammatory syndrome with cardiac, GIS, and lung involvement. Cardiac findings were not common in patients presenting with KD-like MIS-C, but a poor prognosis was observed in KD-like MIS-C patients. Patients with cardiac involvement were older and their lymphocyte count was lower.

9.
Journal of Clinical Oncology ; 40(16), 2022.
Article in English | EMBASE | ID: covidwho-2009637

ABSTRACT

Background: Patients with cancer are vulnerable population that suffered during the COVID-19 pandemic from SARS-CoV-2 infection and from the pandemic's impact on healthcare systems. We are presenting the findings of MENA Registry for COVID-19 and Cancer (MRCC) regarding the SARS-CoV-2 infection presentation, diagnosis, treatment, complications, and outcomes. Methods: MRCC was adapted from ASCO COVID-19 Registry and included patients with SARS-CoV-2 infection and underlying cancer diagnosis including a newly diagnosed cancer in the work-up phase or patients with active cancer receiving cancer therapy or supportive care, or within first year of adjuvant chemotherapy or after one year of curative therapy and receiving hormonal therapy. Registry included data on patients from 12 centers in eight countries in the MENA region, namely: Saudi Arabia, Jordan, Lebanon, Turkey, Egypt, Algeria, United Arab Emirates, and Morocco. The data included patient and disease characteristics, COVID-19 presentation, management, and outcomes. The follow up is differential as data get captured at different points of disease trajectory for each patient which may not reflect the final outcome. Results: Data on 1345 patients were captured in the study by December 7, 2021. Median age was 57.1 years (18-98), whereas 56.1% were females. The median follow-up was 98.5 days (0-554). The most common COVID-19 symptoms was fever (50.3%) and 26.8% of patients were asymptomatic. Out of the 959 patients with complete data on hospitalization, 554 (57.8%) were hospitalized and 126 of them (22.7%) were admitted to intensive care unit (ICU). The majority of hospitalized patients (60%) had respiratory complications and 13.9% had sepsis and 8.5% suffered acute renal injury. As shown in Table, more than quarter of the patients died with 47% of death from COVID-19 or related complication and 60.6% died at home. More than half of the patients were fully recovered from infection. Conclusions: Although more than half of the patients recovered form COVID-19 and more are expected to recover with a longer follow up, the death toll and complications remain high in this patient population. Future analysis of the impact of vaccination and better disease management as well as the impact of newer variants would provide a useful insight on managing this vulnerable population.

10.
Annals of the Rheumatic Diseases ; 81:1336, 2022.
Article in English | EMBASE | ID: covidwho-2009112

ABSTRACT

Background: Tofacitinib is a targeted synthetic DMARD that selectively inhibits Janus kinase (JAK) and is approved for the treatment of RA by the FDA in 2012. In recent years, an important safety concern related to incidence of adverse events after treatment with tofacitinib has emerged. Objectives: To evaluate the risk of major adverse cardiovascular events (MACE), venous thromboembolism (pulmonary embolism or deep vein thrombosis), serious infections requiring hospitalization, and herpes zoster with tofacitinib in RA patients aged ≥ 60 years. Methods: HUR-BIO (Hacettepe University Rheumatology Biologic Registry) is a single center biological and targeted synthetic DMARD registry since 2005. We analyzed RA patients aged ≥ 60 years receiving tofacitinib who had at least 1 control visit registered in the HURBIO database. Phone calls were made with these patients for the current health status information until the end of January 2022. The data of the patients who lost the follow-up in our clinic were obtained from the personal health record system of the Republic of Turkey Ministry of Health by patients' permission. The coprimary end points were adjudicated MACE, VTE, serious infections, and herpes zoster. These events were identi-fed using patients' medical records. Crude incidence rates were expressed in patients with frst events per 100 patient-years, with two-sided 95% confdence intervals. Results: A total of 132 RA patients (109, 82.6% female) aged ≥ 60 years received tofacitinib at a dose of 5 mg twice daily. The median (25-75% percentiles) age was 67 (63-73) years and median duration under tofacitinib was 18 (5-33) months. Approximately 70% of patients were biologically naive. During a median follow-up of 1. 5 years, the incidences of serious infection requiring hospitalization and herpes zoster were higher (5.5% [95%CI 3.12-9.86] and 3.4% [1.67-7.17], respectively) while there was no increase in the incidences of MACE and VTE. The causes for hospitalization were as follows: COVID-19 (n=4), pneumonia (n=3), soft-tissue infection (n=3), and GIS infection (n=1). Tw o of these patients deceased. Conclusion: Older patients with RA are at increased infection risk because of age and comorbid conditions. Although adverse events are reported with 10 mg tofacitinib twice daily, clinicians should be careful against the risk of infection at a dose of 5 mg twice daily, especially in elderly patients.

11.
Annals of the Rheumatic Diseases ; 81:1757-1758, 2022.
Article in English | EMBASE | ID: covidwho-2009052

ABSTRACT

Background: Vaccines are the safest and most effective method to prevent invasive and life-threatening infections. Vaccines against infuenza, pneumococcal disease, herpes zoster, and human papillomavirus are the main recommended vaccines for adults. In addition, rheumatology patients are advised to receive adult vaccinations according to the vaccines available in their country and local guidelines. In Turkey, both infuenza and pneumococcal disease vaccines are commercially available. In addition, these vaccines are strongly recommended for rheumatology patients in local guidelines. Although familial Mediterranean fever (FMF) is one of the most common rheu-matological diseases in Turkey, it is often neglected in vaccination recommendations. Objectives: In this study, we surveyed the vaccination practice against infuenza or pneumococcal diseases of adult FMF patients in our cohort. In addition, we evaluated the factors related to favorable vaccination practice. Methods: We included 360 FMF patients over 18 years of age. All patients ful-flled the Tel-Hashomer criteria for FMF. We asked them if they had ever been vaccinated against pneumococcal or infuenza, and how often they received them. In addition, we dichotomised patients in terms of vaccinated against at least one of infuenza or pneumococcal diseases. We then compared the groups for demographic (age gender and comorbidities) and disease related characteristics (disease duration, disease activity calculated by ISSF and colchicine dose). We used qi-square test to compare categorial variables and Mann-Whitney U test to compare continuous variables. P<0.05 was accepted as signifcant. Results: Of 360 FMF patients, 238 (66.1%) were female. The mean age of the patients was 34.5±10.7 years. Disease duration of the patients was 9.38±0.7 years. In addition, the mean ISSF score of the patients was 1.83±1.5. The mean dose of colchicine received by the patient was 1.23 ± 0.47 mg. Only 54 (15.0%) of the patients had at least one comorbidity. In our cohort, 22 (6.1%) patients were vaccinated against infuenza or pneumococcal disease. Only 18 (5.0%) of the patients have been vaccinated against infuenza at least once so far. Half of these patients (9/18) were vaccinated against infuenza each year. In addition, 8/360 (2.2%) patients were fully vaccinated against pneumococcal diseases. Here, six of them received the pneumococcal vaccine after the start of the COVID-19 outbreak. There was no statistically signifcant difference between the groups in terms of demographic and disease related characteristics. Conclusion: We found that vaccination practice of FMF patients in our cohort was unsatisfactory. Few patients follow adult vaccination recommendations. In addition, clinicians should be concerned about the importance of vaccination and guide their patients to get the adult vaccines available in their country.

12.
Jundishapur Journal of Microbiology ; 15(7), 2022.
Article in English | EMBASE | ID: covidwho-1997997

ABSTRACT

Background: Antimicrobial resistance in ESKAPEEc (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobac-ter baumannii, Pseudomonas aeruginosa, Enterobacter species, and Escherichia coli) pathogens causing bloodstream infections is a growing threat to clinicians and public health. Objectives: Our purpose was to determine the prevalence and susceptibility of ESKAPEEcs causing bloodstream infection over five years (2016 to 2020) at a large tertiary hospital in Istanbul, Turkey. Methods: Of 2591 unique isolates obtained from blood culture specimens, 1.281 (49.4%) were positive for ESKAPEEc pathogens. The ESKAPEEc rates increased from 2016 to 2019 and decreased during the COVID-19 pandemic. Results: The most common pathogen was K. pneumoniae (34.3%). Carbapenem resistant K. pneumoniae was 61.8% and A. baumannii was 90.4%. The percentages of methicillin-resistant S. aureus and vancomycin-resistant E. faecium were 38.6% and 29.4%, respectively. Conclusions: Our findings showed a high incidence of ESKAPEEc and antimicrobial resistance in bloodstream infections. Antibiotic policies and restrictions in health care settings and the community will play an essential role in the solution in the future.

13.
International Journal of Academic Medicine and Pharmacy ; 4(2):47-51, 2022.
Article in English | EMBASE | ID: covidwho-1989066

ABSTRACT

COVID-19 has affected many countries in the world and has been known as one of the fast-spreading pandemics viruses. This research was carried out to investigate the thoughts of the senior nursing students about their profession during the COVID-19 pandemic period. A cross-sectional methodology of 112 senior nursing students in Turkey participated. The majority students (72.3%) do not think to change their thoughts toward profession after the COVID-19 pandemic even when they get the chance to do. 39.3% of the students stated that they could take care of a patient diagnosed with COVID-19, 34.8% of them were undecided about taking care of the patient and 25.9% of them stated that they could not take care of the patient with COVID-19. The students reported anxiety scores (67.1% ) of 5 or more on anxiety levels. Findings indicate that the COVID-19 pandemic period does not have a negative effect on the thoughts of the nursing students towards their profession. However, the students reported that they lacked information about COVID-19. Can contribute to the use of post-graduate and in-service education opportunities to complete the students' lack of training about COVID-19.

14.
Eastern Journal of Medicine ; 27(3):485-491, 2022.
Article in English | EMBASE | ID: covidwho-1988326

ABSTRACT

The pandemic caused many psychological problems such as anxiety disorder, panic disorder, phobias, depression, post-traumatic stress disorder, and other mood disorders. We aimed to assess the level of information about COVID and the depression rate among the healthcare workers. Our study was conducted on 89 healthcare workers. This survey was held among healthcare workers who worked in COVID-19 service during the pandemic in Turkey. As a guideline to adequately identify depression rates we used Beck Depression Inventory. Each question was scored in the Beck depression questionnaire. The service period length of the healthcare personnel participating in the study were 0-2 years in 34 (38.2%), 2-5 years in 25 (28.1%), 5-10 years in 12 (13.5%), and >10 years in 18 (20.2%) healthcare workers. There was a statistically significant difference between the service period of healthcare workers and their COVID-19 knowledge scores (p<0.05). Thirty (33.7%) of 89 healthcare workers had minimal depression, 30 (33.7%) had mild depression, 19 (21.3%) had moderate depression, and 10 (11.2%) had severe depression. There was no statistically significant difference between the knowledge levels of healthcare professionals and their depression scores (p>0.05). The survey results about COVID-19 highlighted that psychological support should be ensured, adequate education/training should be provided. Additionally, psychosocial needs should be determined, and psychosocial services should be given to healthcare workers.

15.
Journal of Pediatric Infectious Diseases ; 2022.
Article in English | EMBASE | ID: covidwho-1984504

ABSTRACT

Objective Health care utilization has declined significantly during the coronavirus disease 2019 (COVID-19) pandemic. We aimed to analyze the impact of COVID-19 lockdowns on pediatric admissions in a Turkish medical center. Methods This retrospective study was conducted by analyzing the numbers and records, including diagnoses, of patients admitted to our pediatric department between March 11, 2020 (the day of the first confirmed COVID-19 case in Turkey) and June 11, 2020 and comparing it with the diagnoses and numbers for the same period in 2019. The most common reasons for admissions were investigated. Results Totally, 89,607 patients were included. Patient visits reduced drastically by 63.11 to 36.89% during the lockdown period compared to the preceding year. In addition to the impact of COVID-19 lockdowns on the total volume of patients, we observed significant variations in the distribution of diagnoses among children. The percentage of respiratory, gastrointestinal, immunological, and ophthalmologic diseases and allergic reactions statistically decreased (p < 0.001). In contrast, the relative percentage of neonatal, urogenital, neurological, cardiovascular, hematological, and dermatological diseases significantly increased (p < 0.001) among emergency department (ED) admissions. Notably, the percentage of respiratory diseases among ED patients decreased by 66.81 to 33.19%. Conclusion COVID-19 strongly affected health care utilization. The public must be educated about the safety of hospital environments, and families should be encouraged to visit hospitals in case of emergencies. Additionally, changes in public health advice may help alter health care consumption patterns.

16.
Acta Medica Mediterranea ; 38(4):2499-2504, 2022.
Article in English | EMBASE | ID: covidwho-1979800

ABSTRACT

Introduction: An important part of the employees who are fighting against Covid-19 on the front line are emergency physicians (EP). Material and methods: In our study, we evaluated the fear of Covid-19 and job satisfaction of adult and pediatric emergency physicians in the western part of Turkey from their perspective at the beginning and in the fourth month of the pandemic. It was observed that the satisfaction of the physicians with the working conditions in the 4th month of the pandemic was higher than it was before the pandemic. Results: Physicians' scores regarding fear of Covid-19 at the beginning of the pandemic were higher than in the fourth month of the pandemic. Being female, having children, and age was determined as factors that increased the fear of Covid-19. Conclusions: Despite the high fear of Covid-19, the reason for the high satisfaction because of the arrangements made at the beginning of the pandemic stemmed from the heavy workload normal conditions that before the pandemic. The high rate of emergency service use by patients who do not need emergency service resources is the most important reason for these heavy working conditions. We think that studies should be conducted to increase the awareness of patients on this issue, necessary sanctions should be imposed, working conditions of the emergency services should be improved, and working in these services should be made attractive. Arrangements to be made considering the data about the satisfaction of the physicians will help them feel safe and reduce their fear of Covid-19 and other diseases.

17.
European Journal of Neurology ; 29:792, 2022.
Article in English | EMBASE | ID: covidwho-1978461

ABSTRACT

Background and aims: Ocrelizumab is a humanized monoclonal antibody effective against CD20 positive B cells, approved by the FDA in 2017 to treat RRMS and PPMS. Despite these clinical studies, real-life data on ocrelizumab are limited. Methods: We conducted a retrospective single-center study in Turkey. We obtained medical record data of patients who received at least one infusion of ocrelizumab and were followed for one year before and after treatment initiation. Results: 240 MS patients were included in our study (58.75%) RRMS, (21.25%) SPMS, and (20%) PPMS). Median follow-up was14 months (range, 4-42). 92% of all patients received another DMT or immunosuppressant (98.58% of RRMS, 100% of SPMS, 64.58% of PPMS) prior to treatment with ocrelizumab. ARR before and after initiation of ocrelizumab for both the RRMS and SPMS groups (RRMS, 0.8 vs. 0.1;SPMS, 0.44 vs. 0.04). The most common reason for switching to ocrelizumab was clinical and/or radiological activity. NEDA status at year one was achieved in 88.54% of the RRMS population, and disability progression was found at 12.77% in the same MS subtype. Despite premedication (97.91%), infusion-related reactions were reported in (15.41%). The most common infection in our study was COVID-19 infection (18.33%), followed by urinary and upper respiratory tract infections. Conclusion: According to the first real-world preliminary study in the Turkish MS population using ocrelizumab, it is a well-tolerated, safe, and effective treatment agent in suppressing disease activity in both RRMS and progressive MS forms.

18.
Bipolar Disorders ; 24:35, 2022.
Article in English | EMBASE | ID: covidwho-1978421

ABSTRACT

Introduction: Beyond a significant psychological burden in lives of patients with bipolar disorders, the COVID-19 outbreak created a significant obstacle in accessibility to mental health services, which raised a need for a country-wide network of healthcare providers for bipolar disorders in Turkey. The Bipolar Disorders Chapter of Turkey organized a training program for excellence in diagnosis and management of bipolar disorders in order to train early career psychiatrists who carry out mental services all over the country. Method: We announced a training program consisting of four modules including interactive Zoom lessons giving the theoretical baseline 48 hours), and a supervision module that includes case discussions with experts (96 hours). The lectures and discussions were moderated by leading specialists in bipolar disorders in Turkey. The theoretical modules focused on diagnosis and classification, pharmacological treatment, psychosocial interventions, and special populations (elders, pregnants, patients with comorbidity etc.) in bipolar disorders. Results: We trained 40 early career psychiatrists (14 men, 26 women;between ages of 27-40) from 18 different cities of Turkey. 37 of them have successfully completed the four modules, passed the final examination, and qualified for the supervision module. Most participants agreed that the program enhanced their clinical skills perfectly (satisfaction over 90%). Conclusion: This might be a good example of a postgraduate training program for clinicians serving patients with bipolar disorders. Such training programs might create a basis for building country-wide networks of healthcare professionals for bipolar disorders.

19.
Iranian Journal of Pediatrics ; 32(2), 2022.
Article in English | EMBASE | ID: covidwho-1969719

ABSTRACT

Background: Coronavirus disease 2019 (COVID-19) has been infecting children since December 2019 and has caused a severe epi-demic and millions of deaths worldwide. COVID-19 has severe clinical effects and is more complicated to manage in patients with underlying diseases, such as congenital heart disease (CHD), past surgical operations, arrhythmia, and end-organ damage. Objectives: This study aimed to evaluate the clinical course, follow-up, and treatment process of patients with CHD and COVID-19 in Inonu University Faculty of Medicine, Department of Pediatrics, Turkey during March 2020-February 2021. Methods: This retrospective study was performed on patients with CHD and COVID-19 in the Department of Pediatrics at Inonu University Faculty of Medicine during March 2020-February 2021, selected by making full count sampling. Admission complaints, clinical findings, biochemical parameters, echocardiography results, hospitalization times, treatments, and clinical follow-up findings were retrieved from patients’ files. Results: 11 patients with underlying CHD and COVID-19 were evaluated retrospectively during the study. Ten patients were hospitalized and treated due to COVID-19. Treatment of seven of these patients continued in the intensive care unit (ICU), and five were followed up under a mechanical ventilator. Two patients died during follow-up in the ICU. Conclusions: The clinical course of COVID-19 is severe, and the mortality rate is high in patients with serious diseases, such as underlying CHD. Therefore, COVID-19 in patients with CHD requires more serious and careful follow-up.

20.
BMJ Global Health ; 7:A7-A8, 2022.
Article in English | EMBASE | ID: covidwho-1968252

ABSTRACT

Background Forcibly displaced people represent a huge humanitarian problem globally. At the end of 2020, the total number was 82,4 million;from those, 34,4 million were refugees, asylum seekers, and Venezuelan displaced abroad. Forcibly displaced people were identified as priority populations during the pandemic due to their risk of being the last served populations with healthcare. This paper aimed to identify if this population was prioritized in the COVID-19 national response plans of a sample of 86 countries. Methods This study is part of a document analysis of 86 COVID-19 national response plans, assessing the degree of comply to quality parameters of effective priority setting. One of the parameters included was the degree to which vulnerable populations such as forcibly displaced people were explicitly prioritized for receiving COVID-19 related interventions or for continuity of non-COVID healthcare services. The analysis involved assessing whether and how forcibly displaced people were prioritized in the COVID-19 national response plans. This was compared with the displaced populations identified in the host countries' UNHCR Forced Displacement 2020 report. Results Only five countries among 86 analyzed prioritized forcibly displaced people in their COVID-19 national response plans. Among the top ten forcibly displaced people hosting countries, Uganda was the only one with an explicit prioritization of this vulnerable group. Although Turkey, Colombia, and Germany account for nearly one-fifth (6,6 million) of refugees, asylum seekers and Venezuelans displaced abroad, none of the COVID-19 response plans of these countries prioritized these populations. Discussion Few countries recognized forcibly displaced people as a vulnerable population in their COVID-19 response and preparedness plans. Governments may have incorporated actions and interventions for these vulnerable groups after publishing the COVID-19 response plans. It would be essential to evaluate the impact of this lack of prioritization on the health and wellbeing of these population groups.

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