Makale Arama

Aim: The clinical course of COVID-19 cases and the severity of symptoms vary according to the case.
However, it has been seen in the cases examined that it poses a greater risk for those with chronic
diseases and elderly individuals. In order to protect elderly individuals from COVID-19, governments
have introduced some restrictions. It is thought that the wrong evaluation of these restrictions may lead
to attitudes of ageism. This study aimed to determine the relationship between society's fear of COVID-19
and attitudes towards ageism.
Patients and Methods: This work is designed in descriptive type. This study was conducted with
volunteers between the ages of 18-65 683 people. The data of the study were collected using the Fraboni
Scale of Ageism and COVID-19 Fear Scale. Data were collected on 1-20 Jun e 2020.
Results: The mean Fraboni Scale of Ageism and COVID-19 Fear Scale scores were 67.87±6.15 and
18.81±6.16, respectively. The results showed a weak and negative correlation between COVID19 fear
and ageism.
Conclusion: In general, individuals had a positive attitude towards the elderly and had low levels of
COVID-19 fear.

Aim: In this study, it was aimed whether biochemical parameters, vital signs and neutrophil-lymphocyte ratio
(NLR) values could be used in determining the indication for intensive care hospitalization in COVID-19
patients.
Patients and Methods: This retrospective observational study was conducted in the emergency department
of a university hospital. Patients with positive SARS-CoV-2 PCR test who applied to our hospital on 1-31 July
2020 were included in the study. Laboratory results, demographic findings and clinical results of the patients
were collected electronically. The patients were divided into 3 groups as discharged, admitted to the service
or intensive care unit. The incidence and severity of symptoms, comorbidities, laboratory values, and NLR
values were compared between the groups.
Results: A total of 489 patients were included in the study. The mean age of the included patients was 48.69
+ 17.25 years, of which 260 (53.16%) were female. While 248 (50.9%) of these patients were discharged,
207 (42.3%) were taken to the service and 33 (6.7%) to the intensive care units. Age, heart rate, urea,
creatinine, CRP, D-dimer and NLR values of the patients admitted to the intensive care unit were higher
than the other groups, while oxygen saturation was statistically significantly lower in this group. Concomitant
systemic diseases such as Diabetes Mellitus, Essential Hypertension, Chronic Obstructive Pulmonary
Disease were more common in those hospitalized in the intensive care unit. In multivariable analysis, oxygen
saturation (OR:0.803) and neutrophil-lymphocyte ratio (OR:1.09) were found to be independent predictors of
the indication for hospitalization in the intensive care unit.
Conclusion: As a result of our study, we think that especially low oxygen saturation and high neutrophillymphocyte
ratio can be used in determining the indication for intensive care hospitalization in patients who
apply to the emergency department due to COVID-19.

Aim: In this pre-and post- study, we aimed to compare changes in urological consultations and emergencies
between before and after the pandemic at the same time period o f 2019 and 2020 as two groups.
Patients and Methods: Patient files were retrospectively screened and numbers of consultations, surgeries
and admissions were evaluated. The two groups compared in terms of triage color codes, and final decisions.
Patients’ demographic data such as age and gender, triage color code, consultation order clinic, type of visit
(regular vs control), and operational data (type of surgery, prophylaxis status, place of OR etc) were recorded.
Results: A total of 89,674 patients presented to the emergency department in the 50-day period in 2019 and
53,745 patients in the same period of time in 2020. The number of patients presenting to the emergency
department decreased by 40.07% within the same period compared to the previous year. The percentage of
patients with the green triage code was decreased in 2020 by 30% compared to 2019, while the percentage
of yellow triage code was increased in 2020 by 28.9% compared to 2019. There was a dramatic fall in urology
visits in 2020 by 85.91%.
Conclusion: The COVID-19 pandemic is still ongoing, and it seems likely to continue for some time, despite
all efforts including vaccination programs and novel drugs that will also become available in a short time. The
number of patients cosulted with urology outpatient clinic has decreased during the pandemic.

Aim: The aim of this study is to examine whether the timing of surgery in our elderly patients with a
diagnosis of hip fracture changed before and after the pandemic, and whether this situation caused an
increase in mortality .
Patients and Methods: The patients who were operated with the diagnosis of hip fracture between March
2019 and March 2020 in our hospital database were accepted as in the pre-pandemic period, and the
patients who were operated with the diagnosis of hip fracture between April 2020 and April 2021 were
considered as in pandemic period. Both groups were statistically compared in terms of age, gender,
waiting time for surgery , length of hospital stay and one year mortality .
Results: When the factors af fecting mortality were examined, the time elapsed until surgery significantly
increased mortality. While the mean waiting time for surgery was 27.6±19.4 hours in all patients, it was
25.7±19.1 hours in Group 1 and 29.6±19.6 hours in Group 2 and there was a significant difference between
the two groups (p=0.043). The cut-off value of the waiting time for surgery, which caused mortality, was
determined as “23.35” hours. While no significant increase in mortality was found in Group 1 (p=0.340),
the increased delay for surgery in Group 2 affected mortality significantly (p=0.027).
Conclusion: In this study, it was found that the increase in the delay of admission for surgery over 23.35
hours in the elderly population after hip fractures was directly associated with one year of mortality
and also we think that the waiting time for surgery in the pandemic conditions is one of the factors that
negatively af fect mortality in these patients.

Since the identification of SARS-CoV-2, a multisystem inflammatory syndrome (MIS-C) that appears in
children after COVID-19 disease and mimics Kawasaki disease was reported in the UK in April 2020,
while it is associated with Covid-19 in adults. Multisystem inflammatory syndrome (MIS-A) was reported
in June 2020. MIS-A patients have been reported to be up to 50 years of age in the literature and are more
likely to have some underlying health condition and have recently had an identifiable respiratory disease
compared to MIS-C. On the other hand, MIS-A patients and MIS-C patients have many overlapping clinical
features, but the severity of cardiac dysfunction, incidence of thrombosis, and MIS-A mortality may be
higher in MIS-A. While it is clear that neutrophilia, lymphopenia, and thrombocytopenia are common in
MIS-C/A, these features, together with elevations in troponin and BNP/NT-proBNP, have been considered
measures of disease activity .

\r\n Prognostic importance of thrombocyte indices in children with carbon monoxide poisoning

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\r\n Abstract

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\r\n Objective: Carbon monoxide (CO) poisoning is still being a major cause of morbidity and mortality all over the world. Although the role of platelet functions in CO poisoning is not clear, increased platelet activation and aggregation had been reported previously. Increased thrombotic tendency due to endothelial damage, increased platelet stickiness, and alterations in the fibrinolytic pathway occurs in CO poisoning. The aim of our study was to determine whether platelet indices provide clinical benefit or not in children with CO poisoning.

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\r\n Materials and Methods: We retrospectively reviwed the records of children with the diagnosis of CO poisoning who admitted to the pediatric emergency departments of Konya Beyhekim State Hospital and Necmettin Erbakan University Meram Medical Faculty. A total of 92 children with CO poisoning and 62 age- and gender-matched healthy controls were included in the study.

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\r\n Results: While mean platelet volume (MPV) and platelet distribution width (PDW) levels were significantly higher (9,34±0,55 vs 9,78±0,97fL, p=0.001 ; 11,46±2,64 vs 10,57±1,41, retrospectively, p=0.007), platelet count and plateletcrit (PCT) (324,05±82,07 vs 357,27±89,70 x10⁹ p=0.015 ; 0,31±0,06 vs 0,33±0,07, retrospectively, p=0.039) were significantly lower in patients with CO poisoning. MPV levels were also significantly higher in patients with a carboxy hemoglobin (COHb) level higher than 20, when compared with COHb levels between 10-20 (9,40±0,84 vs 10,08±1,22 fL, p=0.003).

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\r\n Conclusion: Our results showed that platelet indices MPV and PDW are markedly elevated in patients with CO poisoning while platelet count and PCT were decreased. MPV and PDW levels, which reflect the changes in platelet activation and function, may predict the development of especially thromboembolic complications in the course of CO poisoning.  MPV and PDW levels may be useful in prognostic estimation of CO poisoning.

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\r\n Keywords: carbon monoxide; children; platelet indices; poisoning

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Aim: Hypoxemia is a vital criterion used to determine prognosis in coronavirus disease (COVID-19)
cases. This study thus examined the effectiveness of capillary refill time (CRT) in defining hypoxiadependent
disease severity in COVID-19 patients.
Patients and Methods: This prospective study was conducted with COVID-19 patients and an agematched
healthy group. The optimum test ambiance was provided, and a stable smartphone platform
was used to record the measurements (in ms) to standardize our method. The captured videos were then
evaluated using a video processing program.
Results: In total, 39 patients with COVID-19 and 40 control groups participated in this study. The patients
were further divided into the moderate (n = 25) or severe group (n = 14) according to disease severity.
The mean oxygen saturation of both moderate/severe groups was above 94%. Per disease severity, the
CRT measurements were higher in the severe group than in the moderate group (p = 0.009). In patients
without lymphopenia (n = 18), CRT values were found to be increased in the severe group (p = 0.008).
The use of CRT in patients with Covid-19 was practicable (AUC: 0.91; 95% CI 0.848-0.978; P = 0.001).
Conclusions: Our results show that CRT prolongation can occur in patients with COVID-19. In patients
without lymphopenia and with normal O2 levels, detecting CRT prolongation may be a criterion for early
admission to ICU.

Aim: The literature revealed that group of COVID-19 patients who experience anosmia and ageusia
symptoms is younger, is predominantly female, and experiences a milder course of the disease. This
study aimed to evaluate the relationship of the presence of anosmia and ageusia symptoms with the
severity of pneumonia and laboratory test results in hospitaliz ed patients with COVID-19.
Patients and Methods: A retrospective evaluation was made of patients who were hospitalized by
the Department of Pulmonology between October 2020-March 2021 and underwent thorax computed
tomography (CT). Thorax CT findings of the patients were scored with a severity score for each lobe and
a total score was obtained. Pneumonia was classified according to the shape, distribution and appearance
of the lesions, and laboratory test results were obtained. These findings were compared according to the
presence of anosmia and ageusia symptoms.
Results: Evaluation was made of a total of 177 patients, comprising 89(50.2%) males and 88(49.8%)
females with a mean age of 53.0±14.5 years (range, 18-89 years). The number of patients who experienced
at least one of the symptoms of anosmia and ageusia (Group 1) was 67(37.9%) and the rest (Group 2)
did not experience any of these symptoms. The Group 1 patients who experienced these symptoms was
younger (p=0.009). No difference was determined between groups regarding the total pneumonia score
and involvement patterns (p> 0.05). The groups were similar in terms of laboratory results(p> 0.05) .
Conclusion: The prevalence of anosmia and ageusia in hospitalized patients is not a small number and
is more common in the younger population. No association was seen between the presence of these
symptoms and milder pneumonia severity and laboratory results. These symptoms do not have prognostic
value for the severity of the disease in hospitalized patients.

Objective: To determine the effect of COVID-19 infection on anxiety level in pregnant women.

Material and Methods: In this study, a questionnaire and Beck anxiety scale were applied to pregnant women who referred to outpatient clinic for routine pregnancy control in June 2020 to determine their concerns that may be related to COVID-19. Pregnant women admitted with obstetric emergencies and obstetric risk were not included in the study.

Results: 177 pregnant women were included in the study and the pregnant women were divided into four groups according to their score on Beck anxiety scale. Anxiety level of pregnant women was 44.6%. The possibility of not being with his family at the time of birth and the fear of death due to COVID-19 were statistically significantly associated with higher anxiety levels.

Conclusions: In this process, it is important to provide psychosocial support in addition to the follow-up of pregnant women by a multidisciplinary team consisting of perinatology, newborn and intensive care specialists.