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COVID-19 is a viral infection caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that killed a large number of patients around the world. A hyperinflammatory state resulting in a cytokine storm and adult respiratory distress syndrome seems to be the major cause of the death. Many mechanisms have been suggested in the pathogenesis of COVID-19 associated cytokine storm (COVID-CS). Insufficient viral clearance and persistence of a strong cytokine response despite inadequate antiviral immunity seem to be the main mechanisms underlying the pathogenesis. The diagnosis of COVID-19 is based on relatively constant clinical symptoms, clinical findings, laboratory tests, and imaging techniques, while the diagnosis of COVID-CS is a rather dynamic process, based on evolving or newly emerging findings during the clinical course. Management of COVID-19 consists of using antiviral agents to inhibit SARS-CoV-2 replication and treating potential complications including the cytokine storm together with general supportive measures. COVID-CS may be treated using appropriate immunosuppressive and immunomodulatory drugs that reduce the level of inappropriate systemic inflammation, which has the potential to cause organ damage. Currently corticosteroids, IL-6 blockers, or IL-1 blockers are most widely used for treating COVID-CS.

[Abstract Not Available]

COVID-19 pandemisi bireylerde ve toplumda önemliölçüde psikososyal strese neden olmaktadır. Yaşanılansosyal izolasyon süreçleri, koronavirüslerin nörotrofikpotansiyeli ve enflamatuar süreçler nedeniyle de pandemi ortamında psikotik belirtilerin ortaya çıkmasında vealevlenmesinde artış olabileceği düşünülmektedir. Aynızamanda pandemi ortamı psikoz açısından koruyucuetkenlerin (sosyal destek ağı, toplum ruh sağlığıuygulamaları, fiziksel aktivite) kısıtlanmasına nedenolmaktadır. Bununla birlikte bulaş riski psikotik belirtileryaşayan bireylerin başvurularını azaltmaktadır. Bu durummevcut problemin yeterince tespit edilememesine,psikozun kalıcılaşması, daha ağır seyretmesi ve dahafazla yıkıcı etkisinin olması ile sonuçlanabilir. Yakındönemde yaşanan koronavirüs salgınlarında (SARS CoV1 ve MERS CoV) virüse maruz kalan kişilerde psikotikbelirtilerin görüldüğü bildirilmiştir. Salgınlarla ilişkili uzundönemli yeti yetimi nedenleri arasında ruhsal bozukluklarönemli bir yer kaplamaktadır. Bu yazıda COVİD-19 pandemisinde bildirilen psikotik belirtiler ile ilgili bilimselkaynaklarda yer alan kısıtlı veri gözden geçirilecektir.Ayrıca pandemi ortamındaki psikososyal stres, koronavirüsler ve psikotik belirtiler arasındaki olası ilişkiler,konu üzerine yapılmış araştırmalardan edinilen verilerışığında tartışılacaktır.

Objective: Burnout during residency may require reorganization of health services during the COVID-19 pandemic. This study mainly aimed to compare the burnout levels between resident doctors who cared and those who did not care for COVID-19 patients at the.. University Hospital, which has been serving as a pandemic hospital during the COVID-19 outbreak. Methods: The study was designed as a cross-sectional study. One hundred resident doctors were recruited to the first phase of the current study between April 1, 2020 and June 30, 2020 (T1).These participants were then followed-up and re-called to participate in the second phase of the study between October 30, 2020 and November 30, 2020 (T2). Eighty-four resident doctors were available and agreed to participate in the second phase of the study. Once the participants accepted to participate in the study, they were asked to complete the Evaluation Form, the Patient Health Questionnaire-9 (PHQ-9), the Beck Anxiety Inventory (BAI), and the Maslach Burnout Inventory (MBI). Results: In both T1 and T2 periods, the resident doctors who provided care to COVID-19 patients had significantly higher BAI and PHQ-9 scores compared to the scores of those who did not care for COVID-19 patients (P <.05). Moreover, in the T2 period, the Maslach Burnout Inventory-Emotional Exhaustion (MBI-EE) and Maslach Burnout Inventory-Depersonalization (MBI-DP) scores of the resident doctors who cared for COVID-19 patients were detected as significantly higher than the scores of those who did not care for COVID-19 patients. Conclusions: This study demonstrated that resident doctors who cared for COVID-19 patients face increased problems of burnout, anxiety, and depression levels.

Dünya Sağlık Örgütü tarafından 11 Mart 2020 tarihinde “küresel salgın” olarak ilan edilen Yeni Koronavirüs Hastalığı (COVID-19) küresel ölçekte turizm faaliyetlerini durma noktasına getirmiştir ve konaklama sektörü salgının en çok etkilediği alanlardan biri olmuştur. Bu süreçte, farklı motivasyonlarla sahip olunan, genellikle rekreatif amaçlarla ve yılın belirli dönemlerinde kullanılan ikinci konutların fonksiyonlarında ve anlamlarında bir değişim gözlenmiştir. Konuya giriş niteliğindeki bu çalışmada, salgın sürecinde ortaya çıkan bu değişimi Türkiye özelinde anlamak, olgunun mevcut ve muhtemel etkileri üzerinden bir değerlendirme yaparak sonraki çalışmalara bir zemin hazırlamak amaçlanmıştır. Bu kapsamda Türkiye’de resmi kurumlar tarafından salgını önlemek amacıyla getirilen kısıtlamalar, konuyla ilgili basın haberleri ve yerel yöneticilerin açıklamaları değerlendirilerek yorumlanmıştır. Türkiye’de salgının ortaya çıktığı ve yayılma hızının yüksek olduğu ilk dönemde ikinci konutlar; daha korunaklı, izole ve insanlar arası etkileşimin daha az olacağı düşüncesiyle bir “kaçış mekânı” olarak görülmüş ve birçok insanın riskli olarak gördüğü şehir merkezlerinden kıyılardaki, kırsal alanlardaki ve yaylalardaki ikinci konutlara gitmesiyle sonuçlanmıştır. Bu durum salgının farklı mekânlara yayılma riskini ve yeni önlemleri beraberinde getirmiştir. Normalleşme sürecinin ilk adımlarının atıldığı ve kısıtlamaların kısmen hafifletildiği yeni dönemde ise özellikle iç turizmde yaz tatiline yönelik planlar yeniden başlamıştır. Ancak hastalığın henüz tamamen bitmemiş olması ve virüsün yayılımının yeniden hızlanması riski sebebiyle, “sıfır temas” konseptli ikinci konutlar izole tatil yapmak isteyen tüketicilerin yoğun ilgisiyle karşılaşmıştır. Bu talep hem kiralık hem de satılık ikinci konutlarda ciddi fiyat artışlarını da beraberinde getirmiştir. The novel coronavirus disease (COVID-19), which was declared as pandemic by the World Health Organization on 11 March 2020, has brought tourism activities to a halt on a global scale and accommodation sector has been one of the most affected areas of the pandemic. Within this period, a change has been observed in the functions and meanings of the second homes, which are generally used for recreational purposes and at limited times of the year. in this study, we aimed to understand this phenomenon in Turkey and to prepare a ground for the next studies by making an evaluation over its current and possible effects. in this context, offical restriction, the news in the press and the statements of local administrators in Turkey were evaluated. Second homes were seen as an escape place for people who want to be isolated and avoid disease in the early period of the COVID-19 pandemic in Turkey, which resulted in human mobility from city centers to the second homes in coastal, rural and mountain areas. This situation brought the risk of spreading the virus to different places and new measures have been taken. Plans for summer holidays, especially in domestic tourism, have started again with the easing of the restrictions in Turkey. However, due to the fact that the pandemic has not completely finished yet and the risk of the virus spreading again still prevails, the second homes presented as “zero contact” have received intense interest from consumers who want to have an isolated holiday. This demand brought serious price increases in second homes for both rent and sale in Turkey.

ABSTRACT: We report 3 patients with COVID-19 findings in 68Ga-PSMA PET/CT taken for staging. The first patient, A 64-year-old man with prostate cancer, who had COVID-19 in November 2020 and whose treatment was completed, was observed to continue with COVID-19 findings in 68Ga-PSMA PET/CT in December 2020 before surgery. Other patients were asymptomatic for the disease. It was determined that a PSMA uptake in the lungs corresponding to the CT findings of COVID-19 had increased in 68Ga-PSMA PET/CT.

Critically ill patients with COVID-19 in the intensive care units (ICU) are at elevated risk for candidemia. Prolonged ICU and COVID-19 management are important contributing factors. Improved infection control and antibiotic stewardship practices to curb irrational antimicrobial utilization are needed. Background We evaluated the epidemiology of candidemia among coronavirus disease 2019 (COVID-19) patients admitted to intensive care units (ICUs). Methods We conducted a retrospective multicenter study in Turkey between April and December 2020. Results Twenty-eight of 148 enrolled patients developed candidemia, yielding an incidence of 19% and incidence rate of 14/1000 patient-days. The probability of acquiring candidemia at 10, 20, and 30 days of ICU admission was 6%, 26%, and 50%, respectively. More than 80% of patients received antibiotics, corticosteroid, and mechanical ventilation. Receipt of a carbapenem (odds ratio [OR] = 6.0, 95% confidence interval [CI] = 1.6-22.3, P = .008), central venous catheter (OR = 4.3, 95% CI = 1.3-14.2, P = .02), and bacteremia preceding candidemia (OR = 6.6, 95% CI = 2.1-20.1, P = .001) were independent risk factors for candidemia. The mortality rate did not differ between patients with and without candidemia. Age (OR = 1.05, 95% CI = 1.01-1.09, P = .02) and mechanical ventilation (OR = 61, 95% CI = 15.8-234.9, P < .0001) were independent risk factors for death. Candida albicans was the most prevalent species overall. In Izmir, Candida parapsilosis accounted for 50% (2 of 4) of candidemia. Both C parapsilosis isolates were fluconazole nonsusceptible, harbored Erg11-Y132F mutation, and were clonal based on whole-genome sequencing. The 2 infected patients resided in ICUs with ongoing outbreaks due to fluconazole-resistant C parapsilosis. Conclusions Physicians should be aware of the elevated risk for candidemia among patients with COVID-19 who require ICU care. Prolonged ICU exposure and ICU practices rendered to COVID-19 patients are important contributing factors to candidemia. Emphasis should be placed on (1) heightened infection control in the ICU and (2) developing antibiotic stewardship strategies to reduce irrational antimicrobial therapy. M. H. N. was funded by the National Institute of Health (Grants R21 AI160098 and R21 AI152018). National Institute of Health [R21 AI160098, R21 AI152018]

BACKGROUND: The novel coronavirus disease 2019 (COVID-19) has resulted in major changes in health-care systems and emer-gency surgical interventions. Here, we examined patients with acute appendicitis who presented to emergency departments and com-pared diagnosis, treatment, and post-treatment processes before and during the pandemic period and investigated how the pandemic affected management of acute appendicitis. METHODS: A national, multicenter, and cohort study model was designed that included patients older than 18 years of age diag-nosed with acute appendicitis clinically and/or radiologically, with patients compared before (pre-pandemic period: January 1-April 30, 2019) and after (pandemic period: January 1-April 30, 2020) the pandemic. Our investigation included comparisons of pre-operative imaging methods, presence of plastron appendicitis/abscess, conservative/surgical approach, type of anesthesia given, laparoscopic/open surgical approach, bowel resection rates, drain insertion rates, and presence of post-operative complications RESULTS: For the two study groups, 8972 patients from 69 centers were examined, with 4582 patients operated in the pre-pan-demic period and 4234 patients operated in the pandemic period. During the pandemic period, 63.6% of patients underwent open surgery, whereas 34.4% had laparoscopic surgery. Although 60 patients (1.3%) requested non-operative follow-up in the pre-pandemic period, 94 patients (2.2%) requested this in the pandemic period. When conditions of patients were evaluated regardless of their own wishes, 114 patients (2.4%) before and 163 patients (3.8%) during the pandemic received non-operative follow-up. CONCLUSION: Our study did not show the direct correlation between the application of COVID-19-related restrictions and the severity of acute appendicitis. Although non-operative management rates have been increased during the COVID-19 period, the incidences of both complicated and the uncomplicated appendicitis were similar during the COVID-19 crisis period. Given this infor-mation non-operative management can be employed for patients diagnosed with appendicitis.

[No Abstract Available]

Artificial intelligence applications are known to facilitate the diagnosis and treatment of COVID-19 infection. This research was conducted to investigate and systematically review the studies published on the use of artificial intelligence in the COVID-19 pandemic. The study was conducted between April 25 and May 6, 2020 by scanning national and international studies accessed in "Web of Science, Google Scholar, Pubmed, and Scopus" databases with the keywords ("Coronavirus" or "COVID-19") and ("artificial intelligence" or "deep learning" or "machine learning"). As a result of the scanning process, 1495 (Google Scholar: 1400, Pubmed: 58, Scopus: 30, WOS: 7) studies were accessed. The studies were first examined according to their titles, and 1385 studies, which were not related to the research topic, were not included in the scope of the research. 50 articles, which did not meet the inclusion criteria, were excluded. The abstract and complete texts of the remaining 60 studies were scanned for the study's inclusion and exclusion criteria. A total of 10 studies, consisting of reviews, letters to the editor, meta-analysis studies, animal studies, conference presentations, studies not related to COVID-19, and incomplete studying protocols, were excluded. There were 50 studies left. 9 articles with duplication were identified and excluded. The remaining 41 studies were examined in detail. A total of 26 studies were found to meet the criteria for the systematic review study. In this systematic review, AI applications were found to be effective in COVID-19 diagnosis, classification, epidemiological estimates, mode of transmission, distribution, the density of lesions, case increase estimation, mortality/mortality risk, and early scans. © 2022 Tehran University of Medical Sciences. All rights reserved.