Background: We investigated potential predictive factors for mortality and disease severity from demographic and clinical data, comorbidities, and laboratory findings in patients with confirmed COVID-19 who were consecutively admitted to our tertiary hospital. Methods: In this retrospective, single-center, observational study, we enrolled consecutive 540 adult patients who had COVID-19 confirmed by a molecular method. Patients were categorized into three groups based on disease severity. Patients’ demographic and clinical characteristics, mortality rates, and mortality-associated factors were analyzed. Results: The overall mortality rate was 4.3% (23/540). Disease severity was mild in 40.9% (n = 221), severe in 53.7% (n = 290), and critical in 5.4% (n = 29) of the patients. There were significant differences among groups in terms of median white blood cell (WBC), hemoglobin, neutrophil, lymphocyte, and thrombocyte counts, as well as C-reactive protein (CRP), procalcitonin, lactate dehydrogenase (LDH), creatinine, albumin, D-dimer, ferritin, troponin, and fibrinogen levels. Furthermore, there were significant differences between surviving and non-surviving patient groups in terms of median WBC, hemoglobin, neutrophil, and lymphocyte counts, as well as CRP, procalcitonin, LDH, creatinine, albumin, D-dimer, and ferritin levels. CRP level (odds ratio [OR]: 1.020, 95% confidence interval [CI]: 1.009– 1.032; p < 0.001), and CURB-65 score (OR: 4.004, 95% CI: 1,288– 12,447; p = 0.017) were independently associated with disease severity and mortality. Conclusion: On admission, WBC, neutrophil, lymphocyte, and platelet counts can be used to predict disease severity in patients with COVID-19. CRP, ferritin, LDH, creatinine, troponin, D-dimer, fibrinogen, and albumin levels can also be used to predict disease severity in these patients. Finally, elevated CRP level and high CURB-65 score were predictors of disease severity and mortality.

OBJECTIVE: This study aimed to investigate the predictive power of serum systemic inflammatory markers including neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), monocyte-eosinophil ratio (MER), and C-reactive protein (CRP) levels for distinguishing uncomplicated and complicated acute appendicitis in adult patients admitted to the emergency METHODS: This retrospective, cross-sectional, observational, and single-center study enrolled 212 consecutive adult patients with acute appendicitis who were admitted to the ED of our tertiary care university hospital between January 1, 2019 and December 31 2021. Patients were divided into two groups (Group I, uncomplicated acute appendicitis; Group II, complicated appendicitis) according to their surgical findings and histopathological examination. Systemic inflammatory markers measured on admission were compared among patients to identify factors associated with complicated acute appendicitis. RESULTS: A total of 132 patients, 83 male (62.9%) and 49 female (37.1%), were included in the study. The mean age was 34.7 +/- 13.40 years. Based on the histopathological examination, the number of patients in Group I was 103 (78.03%) and 29 (21.96%) in Group II. Laboratory findings on admission revealed no significant differences between Groups I and II patients in terms of mean serum NLR, MER, and CRP values (p=0.096, p=0.248, and p=0.297, respectively). However, the mean serum PLR in Group II patients was statistically significantly higher than those in Group I (p=0.032). The mean serum monocyte and monocyte fraction (%) values were significantly lower, and the mean serum neutrophil fraction (%) value was higher in Group II patients compared to those with Group I. Receiving operator characteristic (ROC) analysis identified a serum PLR cutoff value of >= 133.73 for distinguishing uncomplicated and complicated acute appendicitis in adult patients, with 60% sensitivity and 58.4% specificity. In addition, ROC analysis revealed a cutoff monocyte fraction (%) level of <= 6, with 72% sensitivity and 64% specificity, for distinguishing uncomplicated and complicated acute appendicitis in adult patients. CONCLUSION: Our findings indicate that the mean serum NLR, MER, and CRP values measured on admission to ED in adult patients with acute appendicitis could not predict complicated acute appendicitis. However, mean serum PLR and neutrophil and monocyte counts can be useful in distinguishing complicated cases.

Amaç: Bu çalışmada İstanbul’da sağlık alanında (tıp, diş hekimliği, eczacılık, hemşirelik, ebelik, fizik tedavi ve rehabilitasyon, diyetisyenlik, odyoloji, sağlık yönetimi) yükseköğrenim görmekte olan öğrencilerin aşı tereddüdü düzeyini, dağılımını ve öğrenim yılına göre değişimini ortaya koymak amaçlanmıştır.Yöntem: Çalışmamız bir anket çalışmasıydı ve belirlenen fakülte ve bölümlerde kayıtlı (T.C. Ölçme, Seçme ve Yerleştirme Merkezi 2019 verilerine göre) 17.488 üniversite öğrencisinin %10’una ulaşmak hedeflendi. Anket Google Formlar® platformunda çevrimiçi olarak gerçekleştirildi.Bulgular: Çalışma toplam 1559 öğrenci içerdi. Öğrencilerin %15,1’i “Gerekli durumlarda (riskli maruziyet, rutin korunma) kendinize tereddüt etmeden aşı yaptırabiliyor musunuz?” sorusuna “Hayır” yanıtını verdi. Bu oranın öğrenim yılı arttıkça azaldığı görüldü (χ2=21,523; p<0,001). Aşı tereddüdü tıp (%9,2) ve ebelik (%11,2) öğrencilerinde en düşük, fizik tedavi (%31,3) ve odyoloji (%30,4) öğrencilerinde ise en yüksek düzeydeydi. Aşı tereddüdü düzeyi eğitim düzeyine göre anlamlı farklılık gösterdi (χ2=63,034; p<0,001); öğrenim yılı arttıkça aşılara duyulan güven artmaktaydı. Ancak öğrencilerin %78,6’sının grip aşısına dair tereddütleri olduğu ve bunun öğrenim yılı ile anlamlı biçimde değişmediği (p=0,053) görüldü. Kızamık ve suçiçeği aşıları ile ilgili tereddütlerin başlıca nedeni “hastalığı geçirmenin aşı olmaktan daha koruyucu” olduğu düşüncesi; hepatit B, tetanos ve kuduz aşıları ile ilgili tereddütlerin başlıca nedeni ise “yan etkilerden duyulan kaygı” idi.Sonuç: Sağlık çalışanları arasındaki aşı tereddüdü toplumun aşılanma tutumu üzerinde oldukça etkilidir. Öğrenim yılı arttıkça azalmakla birlikte, sağlık öğrencilerinde aşı tereddüdü düzeyi yüksek görünmektedir. Bu tereddütlerin yükseköğretim sırasında belirlenip doğru bilgilendirmeyle giderilmesi son derece önemlidir. Sağlık yükseköğretimindeki içerik ve yöntemler bu gözle yeniden değerlendirilmelidir.

We investigated the relationship between thoracic diameters and chest compression-related thoracoabdominal injury in patients with non-traumatic out-of-hospital cardiac arrest who had a return of spontaneous circulation after cardiopulmonary resuscitation. A total of 63 consecutive adult non-traumatic out-of-hospital cardiac arrest patients were enrolled in this prospective study. Computed tomography was performed on each patient and the anteroposterior diameter, skin-to-skin anteroposterior diameter, and transverse diameter of the chest were measured. Patients were divided into two groups based on the presence or absence of cardiopulmonary resuscitation-related thoracoabdominal injury. Age, sex, and duration of cardiopulmonary resuscitation, anteroposterior diameter, skin-to-skin anteroposterior diameter, and transverse diameter were compared between the groups. The primary outcome was the relationship between thoracic diameters and cardiopulmonary resuscitation-induced thoracoabdominal injuries. Thoracoabdominal injuries were detected in 46% (n=29) of the patients and consisted of rib fractures in 22 (34.9%) patients, pulmonary contusion in 7 (11.1%), and sternal fracture in 3 (4.8%) patients. There were no significant differences in cardiopulmonary resuscitation duration between patients with and without thoracoabdominal injuries (p=0.539). Similarly, there were no significant differences in anteroposterior diameter, skin-to-skin anteroposterior diameter, or transverse diameter between patient groups (p=0.978, p=0.730, and p=0.146, respectively) or between patients who died within the first 28 days and those who survived for longer than 28 days (p=0.488, p=0.878, and p=0.853, respectively). The iatrogenic thoracoabdominal injuries caused by cardiopulmonary resuscitation performed according to the cardiopulmonary resuscitation guidelines were independent of thoracic diameters. Therefore, the cardiac compression depth of 5–6 cm recommended by the current cardiopulmonary resuscitation guidelines is reliable for patients with different thoracic diameters.

OBJECTIVE: We explored the epidemiological characteristics of suicide attempts and identified suicide trends and associated factors.METHODS: This retrospective, cross-sectional, observational, and single-center study included consecutive 412 patients who were admitted to Emergency Department for follow-up and treatment after a suicide attempt between June 2019 and June 2022. We assessed patient demographics, suicidal behavior, previous suicide attempts, psychiatric disorders, drug use, visits to the psychiatry clinic within the past 6 months, the persistence of suicidal ideation, and clinical outcomes.RESULTS: The study population consisted of 259 females (62.86%) and 153 males (37.14%), with a mean age of 29.50 +/- 11.51 (range: 13-72) years. Females attempted suicide more often than males, but suicide completion was more common in males. Overall, 79.37% (n=327) of the suicide attempters were aged <40 years and most were 20-29 years old (n=147, 35.68%). Non-fatal suicide attempts were more common in single, unemployed, and poorly educated individuals, but this was not the case for suicide completers. However, there was no significant difference in marital status, education, and occupation among suicide completers. Drug poisoning was the major form of suicide attempt (n=345, 83.74%). Mental disorders, family or relationship conflicts, and separation from a partner were common causes of suicidal ideation. Patient numbers were particularly high in the autumn (i.e., September), and at night.CONCLUSION: Females, young adults, singletons, the unemployed, and individuals with psychiatric disorders and low education levels are more likely to attempt suicide, particularly during hours when they are likely to be alone.