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Item Increased Severe Cases and New-Onset Type 1 Diabetes Among Children Presenting With Diabetic Ketoacidosis During First Year of COVID-19 Pandemic in Turkey(FRONTIERS MEDIA SA, 2022-01-01) Kiral, Eylem; Kirel, Birgul; Havan, Merve; Keskin, Mehmet; Karaoglan, Murat; Yildirim, Ahmet; Kangin, Murat; Talay, Mehmet Nur; Urun, Tuba; Altug, Umit; Kesici, Selman; Tufan, Erennur; Kacmaz, Ebru; Bozan, Gurkan; Azapagasi, Ebru; Uysal Yazici, Mutlu; Ozturk, Zeynelabidin; Yesilbas, Osman; Karaguzel, Gulay; Kaya, Gulay; Barlas, Ulkem; Duyu, Muhterem; Boyraz, Merve; Sevketoglu, Esra; Akcay, Nihal; Hancili, Suna; Guven, Ayla; Dursun, Oguz; Tekerek, Nazan Ulgen; Ozcifci, Gokcen; Yazici, Pinar; Turanli, Eda; Kendirli, Tanil; Kahveci, Fevzi; Yetimakman, Ayse Filiz; Citak, Agop; Sik, Guntulu; Bingol, Ibrahim; Aygun, Fatih; Durak, Cansu; Yilmaz, Resul; Bugrul, Fuat; Sari, Yusuf; Tekguc, Hakan; Albayrak, Hatice; Yener, Nazik; Agin, Hasan; Soydan, Ekin; Yildizdas, Dincer; Dilek, Semine Ozdemir; Yalindag, Nilufer; Incekoy-Girgin, Feyza; Alacakir, Nuri; Tutunculer, Filiz; Arslanaoglu, Mehmet Ozgur; Aydin, Can; Bilgin, Muzaffer; Simsek, Enver; Dinleyici, Ener CagriIntroductionThere have been some significant changes regarding healthcare utilization during the COVID-19 pandemic. Majority of the reports about the impact of the COVID-19 pandemic on diabetes care are from the first wave of the pandemic. We aim to evaluate the potential effects of the COVID-19 pandemic on the severity of diabetic ketoacidosis (DKA) and new onset Type 1 diabetes presenting with DKA, and also evaluate children with DKA and acute COVID-19 infection. MethodsThis is a retrospective multi-center study among 997 children and adolescents with type 1 diabetes who were admitted with DKA to 27 pediatric intensive care units in Turkey between the first year of pandemic and pre-pandemic year. ResultsThe percentage of children with new-onset Type 1 diabetes presenting with DKA was higher during the COVID-19 pandemic (p < 0.0001). The incidence of severe DKA was also higher during the COVID-19 pandemic (p < 0.0001) and also higher among children with new onset Type 1 diabetes (p < 0.0001). HbA1c levels, duration of insulin infusion, and length of PICU stay were significantly higher/longer during the pandemic period. Eleven patients tested positive for SARS-CoV-2, eight were positive for new onset Type 1 diabetes, and nine tested positive for severe DKA at admission. DiscussionThe frequency of new onset of Type 1 diabetes and severe cases among children with DKA during the first year of the COVID-19 pandemic. Furthermore, the cause of the increased severe presentation might be related to restrictions related to the pandemicItem Allergic diseases and immunodeficiencies in children, lessons learnt from COVID-19 pandemic by 2022: A statement from the EAACI-section on pediatrics(WILEY, 2022-01-01) Munblit, Daniel; Greenhawt, Matthew; Brough, Helen A.; Pushkareva, Anna; Karimova, Diana; Demidova, Anastasia; Warner, John O.; Kalayci, Omer; Sediva, Anna; Untersmayr, Eva; Rodriguez del Rio, Pablo; Vazquez-Ortiz, Marta; Arasi, Stefania; Alvaro-Lozano, Montserrat; Tsabouri, Sophia; Galli, Elena; Beken, Burcin; Eigenmann, Philippe A.By the April 12, 2022, the COVID-19 pandemic had resulted in over half a billion people being infected worldwide. There have been 6.1 million deaths directly due to the infection, but the pandemic has had many more short- and long-term pervasive effects on the physical and mental health of the population. Allergic diseases are among the most prevalent noncommunicable chronic diseases in the pediatric population, and health-care professionals and researchers were seeking answers since the beginning of pandemic. Children are at lower risk of developing severe COVID-19 or dying from infection. Allergic diseases are not associated with a higher COVID-19 severity and mortality, apart from severe/poorly controlled asthma. The pandemic disrupted routine health care, but many mitigation strategies, including but not limited to telemedicine, were successfully implemented to continue delivery of high-standard care. Although children faced a multitude of pandemic-related issues, allergic conditions were effectively treated remotely while reduction in air pollution and lack of contact with outdoor allergens resulted in improvement, particularly respiratory allergies. There is no evidence to recommend substantial changes to usual management modalities of allergic conditions in children, including allergen immunotherapy and use of biologicals. Allergic children are not at greater risk of multisystem inflammatory syndrome development, but some associations with Long COVID were reported, although the data are limited, and further research is needed. This statement of the EAACI Section on Pediatrics provides recommendations based on the lessons learnt from the pandemic, as available evidence.Item Attitudes of patients with spondylarthritis or rheumatoid arthritis regarding biological treatment during COVID-19 pandemic: A multi-center, phone-based, cross-sectional study(TURKISH LEAGUE AGAINST RHEUMATISM, 2021-01-01) Zateri, Coskun; Birtane, Murat; Aktas, Ilknur; Sarikaya, Selda; Rezvani, Aylin; Altan, Lale; Dursun, Nigar; Dursun, Erbil; Tastekin, Nurettin; Celiker, Reyhan; Ozdolap, Senay; Akgun, KenanObjectives: In this study, we aimed to investigate the medical treatment attitudes of patients with spondylarthritis or rheumatoid arthritis (RA) who were using biological drugs during the novel coronavirus-2019 (COVID-19) pandemic. Patients and methods: In this multi-center, cross-sectional study, a total of 277 patients (178 males, 99 femalesItem Coronaphobia: A barrier to ongoing cancer treatment?(WILEY, 2022-01-01) Sonmez, Ozlem; Tezcanli, Evrim; Tasci, Elif Senocak; Kazanci, Hande Busra; Altinok, Ayse; Toklucu, Elvan; Tasci, Yusuf; Aydogdu, Cise; Aydin, Aysegul Bakir; Yuce, Sabiha; Oyan, BasakIntroduction Increased stress levels caused by the pandemic might cause delays in cancer treatment. We conducted a survey among cancer patients undergoing treatment to evaluate their psychological wellbeing and treatment adherence during Coronavirus disease 19 (COVID-19) pandemic. Material and Methods Patients receiving active chemotherapy at a private oncology center between January and May 2021 were included. Healthy volunteers were employees of a district health directorate with no history of cancer or chronic disease. Treatment adherence was described as compliant if the prescribed treatment was received within a week and the information was gained from patient charts. Hospital anxiety and depression scale (HADS) and COVID-19 phobia scale (CP19-S) were administered to participants. Results 402 participants were includedItem Did Dermatological Hospital Referrals and Practice of Dermatologists Change in Between Pre-covid and Covid Era? A Short-term Preliminary Evaluation(WOLTERS KLUWER MEDKNOW PUBLICATIONS, 2022-01-01) Kavak, Ayse; Erfan, Gamze; Aydingoz, IkbalEsen; Demir, Figen; Tukenmez-Demirci, Guelsen; Biyik-Ozkaya, Dilek; Demircioglu, Deniz; Yilmaz, Murat; Karapicak, Rabia; Sahin, SedefObjective: In this descriptive study, we aimed to evaluate features of dermatology referrals before and after Covid-19 pandemic. Materials and Methods: The patients referred to dermatology outpatient clinics of Acibadem Group Hospitals in Istanbul between the time intervals 2019 March 1st and August 31st (Group G1) and 2020 March 1st and August 31st (Group G2) were included in this study. G1 and G2 groups were compared in terms of age, gender, mean duration of complaints, the most common five anatomic regions and the most common five dermatoses. Results: Referral rate after Covid-19 pandemic was decreased by 40\%. Face (p=.0013, OR= 1.20, 95\% CI=1.07-1.34), scalp (p=.02, OR=1.23, 95\% CI=1.02-1.48) and hand (p=.04, 95\% OR=1.24, 95\% CI=1.00-1.54) were more common locations in 2020 (group G2) than in 2019 (G2 group). The most common five dermatoses were contact dermatitis (8.3\%), acne (8,1\%), wart (7,0\%), seborrheic dermatitis (5,7\%) and pyoderma (5,5\%) in G1 (2019), while the order was contact dermatitis (10,6\%), acne (7,5\%), seborrheic dermatitis (6,5\%), wart (6,4\%) and pyoderma (4,9\%) in G2 (2020). Contact dermatitis showed a significant increase after pandemic (p=.0017, OR=1.29, 95\% CI=1.10-1.51). In 2020, psoriasis and lichen planus showed a two-fold increases (P <.001, OR=2.00, 95\% CI=1.43-2.79 and p=.03, OR=1.92, 95\% CI=1.09-3.38, respectively), whereas frequency of molluscum contagiosum decreased significantly (p=.03, OR=0.49, 95\% CI=0.26-0.92). Conclusion: Although we found some remarkable results, relatively short-term period design with the limited patient population of this study needs to be verified in more comprehensive studies.Item Anxiety and Stress Levels Associated With COVID-19 Pandemic of University Students in Turkey: A Year After the Pandemic(FRONTIERS MEDIA SA, 2021-01-01) Durbas, Atahan; Karaman, Hueseyin; Solman, Cagla Hamide; Kaygisiz, Nisanur; Ersoy, OzdalThe outbreak of COVID-19 has been affecting the daily lives of almost everyone and puts huge psychological pressure on people worldwide, including Turkey. Anxiety and stress levels among university students were already a public health concern. Our study aims to demonstrate the anxiety and stress levels of university students in Turkey after the outbreak of COVID-19 according to the Coronavirus Anxiety Scale (CAS) and COVID Stress Scale (CSS). CAS is a brief mental health screener to identify probable cases of dysfunctional anxiety associated with the COVID-19 pandemic, and CSS was developed to understand and assess COVID-19-related distress. An online questionnaire was administered to active 1,265 university students in Turkey between February 27 and March 8, 2021, via Google forms. The questionnaire consists of three parts that assess participants' demographic information, anxiety, and stress levels related to the pandemic. According to CAS and CSS analysis, anxiety and stress levels were associated with each other and influenced university students during the COVID-19 pandemic. Both were associated with gender and family member loss. The academic year of students had a relationship with anxiety. It was observed that the danger factor was the highest stressor in university students in Turkey related to the novel coronavirus, followed by contamination fears. Both factors were shown as moderate stressors. As a result of the study, it was revealed that anxiety and stress associated with the COVID-19 pandemic are now included in the social, academic, and physical burdens of the university years, which are decisive and important in terms of mental development and psychological health of the person. It is essential to ascertain the long-term effects of COVID-19 and take effective precautions to support the physical and mental health of today's university students accordingly.Item Clinical Outcome and Characteristics of Turkish Breast Cancer Patients who had SARS-Cov-2 Infection(KARE PUBL, 2022-01-01) Isiklar, Aysun; Zengin, Rehile; Balci, Veysel; Sesin Kocagoz, Ayse; Basaran, GulOBJECTIVE COVID-19 pandemic has placed an unprecedented burden on health-care system. Patients with cancer are reported to have a higher risk of infection and a more complicated COVID-19 course. Breast cancer (BC) is the most common cancer in women in Turkey. We report clinical outcomes and characteristics of patients with COVID-19 who were on treatment for BC at our center. METHODS We reviewed medical records of BC patients who had COVID-19 between July 2020 and 2021 at our center. We recorded pathological, clinical, treatment characteristics, and the clinical outcome of COVID-19 infection. RESULTS A total 82 BC patients had COVID-19 between July 2020 and 2021. All patients were female, with a median age of 49 (43-64 years). 85\% of all patients had early and 14.6\% of them had advanced stage BC. COVID-19 had a mild clinical course in 73\%, hospitalization was required in 27\% of patients. Twenty-five patients who required hospitalization were discharged and three patients died due to COVID-19. All of the patients who died from COVID-19 had metastatic BC (p=0.002). Metastatic disease (p=0.002) and chemotherapy within 7 days of COVID-19 diagnosis (p=0.024) have been associated with increased mortality. CONCLUSION Majority of BC patients with COVID-19 have a mild course, patients with risk factors that increase mortality should be followed more carefully.Item `Stepchildren of the Ministry': an examination of the difficulties endured by family physicians in Istanbul during tie course of the COVID-19 pandemic(CSIRO PUBLISHING, 2022-01-01) Yasin, Yesim; Bozkurt, Seray Basak; Yilidrim, Cansu; Arzak, Atakan; Dondurur, Hakan; Eken, Adar; Kara, Ismail JanIntroduction. Efforts to contain the SARS-CoV-2 virus would fall short without strong primary health care. Aim. In this study, we aimed to understand family physicians' experiences of coronavirus disease 2019 (COVID-19) in Istanbul, focusing on their coping strategies in order to draw lessons for the future management of pandemics. Methods. Twelve community-based physicians working in Istanbul participated in semi-structured interviews between January and May 2021. Purposive sampling was used to ensure a range of physicians' characteristics. Individual interviews were conducted with each participant on an online platform. Participants were asked 26 open-ended questions. Phenomenological analysis was performed to describe experiences of physicians. Results. The physical conditions of participants' health centres were insufficient to provide service safely during the COVID-19 pandemic. Most physicians were uncomfortable about the quality and quantity of personal protective equipment received from the Ministry of Health and took additional measures themselves. Vaccine supply was thought to be insufficient and there were problems with the associated software. Many family physicians highlighted the inadequate communication from the Ministry. Insufficient knowledge about the disease caused anxiety and fear for the physicians and hindered their performance at the beginning of the pandemic. Physicians who live with their families were more anxious than those who did not. Discussion. Despite challenges, routine procedures have mostly been continued, but newly added responsibilities during the COVID-19 pandemic have had significant impact on physicians' lives.Item An Examination of the Factors Affecting Community Pharmacists' Knowledge, Attitudes, and Impressions About the COVID-19 Pandemic(GALENOS PUBL HOUSE, 2021-01-01) Yilmaz, Zekiye Kubra; Sencan, NazliObjectives: Coronavirus disease-2019 (COVID-19)-related cases and deaths are ongoing throughout the world, but there is still no effective drug in its treatment, and the vaccine supply is not adequate for the global population. It is important that pharmacists have sufficient knowledge and awareness to prevent and control the disease. COVID-19 has been widely covered in the media, which has been a source widely used by healthcare professionals. This study aimed to assess the knowledge, attitudes, and impressions of community pharmacists about COVID-19 and the factors affecting them. Materials and Methods: The questions in this survey were formed using the guideline created by the World Health Organization, a guide composed by the Turkish COVID-19 Scholarly Commission, and data disclosed to the public on the website of the Ministry of Health. The questionnaire was designed with Google forms and then applied to community pharmacists all over Turkey by sharing the survey link. Results: Analyses of 393 questionnaires showed that Ministry of Health/government statements, the internet (scientific sources), and the media were the preferred sources of information (96.7\%, 89.6\%, and 84\%, respectively). ``Ways to avoid COVID-19{''} was the most searched title (96.9\%). It was determined that the names of the two drugs most frequently mentioned by the participants to be used in the treatment of COVID-19 in Turkey were hydroxychloroquine and azithromycin (57.5\%