Vibration-controlled transient elastography for non-invasive screening of liver fibrosis and steatosis in Turkish patients with psoriasis: A cross-sectional study.

Background and Aim: The prevalence of fibrosis and steatosis in patients with psoriasis, as determined by vibration-controlled transient elastography (VCTE), has not been evaluated in Turkiye to date. The present cross-sectional study aims to present the first systematic screening results, focusing on two primary objectives: 1) establishing the prevalence of fibrosis and steatosis, and 2) identifying independent predictors for liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) values in this patient population. Materials and Methods: Patients were eligible for inclusion if they had a confirmed diagnosis of psoriasis by a qualified dermatologist based on characteristic signs and symptoms and histopathological examination, and had undergone VCTE for LSM and CAP measurements. Results: The diagnosis of severe fibrosis and cirrhosis - identified by LSM values of 10.0-13.9 and ≥14.0 kPa, respectively - was significantly prevalent (7.0% and 10.1%, respectively) among a sizeable cohort of relatively young Turkish patients with psoriasis (n=328; mean age: 49.5±12.7 years). Additionally, severe steatosis, as diagnosed by VCTE and characterized by a CAP value exceeding 290 dB/m, was identified in up to 43.3% of patients. Although body mass index (BMI) was the only variable found to be an independently associated with LSM, multivariable linear regression analysis failed to identify any statistically independent predictor of CAP values. Conclusion: The prevalence of hepatic fibrosis and steatosis in Turkish patients with psoriasis is far from negligible, with BMI identified as an independent risk factor for fibrosis.

Changes in the etiology of chronic liver disease by referral to a FibroScan center: Increasing prevalence of the nonalcoholic fatty liver disease.

Background and Aim: Chronic liver disease (CLD) is a leading cause of morbidity and mortality worldwide with a wide etiological spectrum. FibroScan® is used for follow-up of fibrosis and steatosis. This single-center study aims to review the distribution of indications by referral to FibroScan®. Materials and Methods: Demographic characteristics, CLD etiologies, and FibroScan® parameters of the patients who were referred to our tertiary care center between 2013 and 2021 were retrospectively evaluated. Results: Out of 9345 patients, 4946 (52.93%) were males, and the median age was 48 [18-88] years. Nonalcoholic fatty liver disease (NAFLD) was the most common indication (N=4768, 51.02%), followed by hepatitis B (N=3194, 34.18%) and hepatitis C (N=707, 7.57%). Adjusting for age, sex, and CLD etiology, the results revealed that patients with older age (Odds ratio (OR)=2.908; confidence interval (CI)=2.597-3.256; p<0.001) and patients with hepatitis C (OR=2.582; CI=2.168-3.075; p<0.001), alcoholic liver disease (OR=2.019; CI=1.524-2.674, p<0.001), and autoimmune hepatitis (OR=2.138; CI=1.360-3.660, p<0.001) had increased odds of advanced liver fibrosis compared to NAFLD. Conclusion: NAFLD was the most common indication for referral to FibroScan®.

Has the cancer-related death trend been changing in Turkey? An evaluation of the period between 2009 and 2019.

BACKGROUND: The objective of this study was to determine the trend of cancer-related death rates between 2009 and 2019 in Turkey for all cancers combined and the five cancer types with the highest mortality: lung, stomach, pancreas, breast, and colon cancers. METHODS: Cancer mortality data were obtained from the Turkish Statistical Institute (TURKSTAT) and standardized by age using the World Health Organization (WHO) standard population ratios. The change in cancer-related mortality over the years was evaluated using Joinpoint Regression Analysis (JRA). RESULTS: Total cancer-related deaths increased by 2.2% annually between 2009 and 2014 and decreased by 2.9% annually between 2014 and 2019 (p < 0.05). Among men; lung cancer-related deaths increased by 2.4% annually between 2009 and 2014 and decreased by 3.4% annually between 2014 and 2019 (p < 0.05), stomach cancer-related deaths decreased by 5.1% annually between 2014 and 2019 (p < 0.05), colon cancer-related deaths increased by 5.8% annually between 2009 and 2015 and decreased by 3.3% annually between 2015 and 2019 (p < 0.05), pancreatic cancer-related deaths increased annually by 5.6% in 2009-2013 (p < 0.05). Among women; lung cancer-related deaths increased by 2.5% annually between 2009 and 2016 (p < 0.05), stomach cancer-related deaths increased annually by 2.3% between 2009 and 2014 and decreased annually by 4.5% between 2014 and 2019 (p < 0.05), colon cancer-related deaths increased by 2.5% annually between 2009 and 2017 (p < 0.05), pancreatic cancer-related deaths increased by 7.4% annually between 2009 and 2013 (p < 0.05) and breast cancer-related deaths increased by 2.2% annually between 2009 and 2019 (p < 0.05). CONCLUSION: Mortality data in Turkey are collected only by TURKSTAT, which raises concern regarding the incompletion of the data. While this might lead to underestimation, the trend shows that there has been a decrease in total cancer-related deaths in Turkey. Pancreatic cancer, on the other hand, gains a higher proportion in cancer-related deaths in Turkey as in the world. Increasing deaths from lung and breast cancer in women remind of the importance of tobacco control interventions and cancer screening programs.

Long COVID in Hospitalized COVID-19 Patients: A Retrospective Cohort Study.

BACKGROUND: We aimed to evaluate the Long COVID frequency, and related factors in patients followed up after hospitalization. METHODS: This retrospective cohort study included 133 inpatients with COVID-19 PCR test positivity from Nigde Province, Turkey between 01.01.2021 and 28.02.2021. The characteristics of the patients were recorded by examining the files, and the symptom questioning was made by telephone interviewing with the patients approximately four months after the date of diagnosis. The presence of at least one symptom lasting more than four weeks was described as Long COVID. RESULTS: The frequency of Long COVID was 64.7%. The most common Long COVID symptoms were fatigue (45.9%), respiratory distress (25.6%), and muscle / joint pain (24.8%), respectively. In comparison analysis to identify factors associated with Long COVID; Long COVID was found to be more frequent among women (P=0.04); patients with severe COVID-19 (P<0.01), patients with prolonged hospital stay (P=0.03), patients with the comorbid disease (P=0.03), and Diabetes Mellitus patients (P=0.02). Additionally, the frequency of Long COVID increased as the depression score stated by the person increased after COVID-19 disease (P=0.02). CONCLUSION: The treatment of COVID-19 patients should not end when they are discharged from the hospital. On the contrary, these patients, especially high-risk patients, should be followed up in post-COVID clinics and rehabilitated physically and psychosocially with a multidisciplinary approach following the recovery period of the acute illness.

AIDS-related deaths in Turkey between 2009 and 2018.

The prevalence of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) is increasing day by day in the region, including Turkey. The study aimed to examine AIDS-related deaths in Turkey between 2009 and 2018 according to the national death registration system records. In this descriptive study, data on AIDS-related deaths were obtained from the Turkish Statistical Institute. The data consist of the cause of death codes, year of death, age and gender. Findings were presented using numbers and percentages. Seven hundred twenty-one AIDS-related deaths were reported in Turkey between 2009 and 2018. AIDS-related deaths in Turkey increased more than twice at the end of 10 years. The male/female death ratio is 4.5. Deaths under the age of 15 were 4.2% in total; however, they were increased to 10.2% in 2018. AIDS-related deaths are decreasing in the world but increasing in Turkey. The data from the Ministry of Health do not match the data of the national death registration system. Establishing a strong and accurate HIV/AIDS reporting system and identifying the causes and risk groups of this increase in AIDS-related deaths are critical.

Cause-of-death distributions and mortality trends in Turkey between 2009 and 2017.

BACKGROUND: Making the right decisions in the field of public health depends on the reliable recording of statistical data such as death and birth. There have been radical changes and innovations in the death registration since 2009 in Turkey to improve reporting. AIMS: To examine the distribution and the trend of causes of death between the years 2009 and 2017 in Turkey. STUDY DESIGN: Descriptive study. METHODS: In this study, the causes of death were evaluated in three groups used in the Global Burden of Disease study. Group I included infectious, maternal, perinatal, and nutritional conditions; group II included noncommunicable diseases; and group III included injuries. Age-standardized mortality rates were calculated per 100,000 according to age, sex, and cause of death. Joinpoint regression was used to evaluate the trend in mortality rates. In addition, the leading causes of death were also determined. RESULTS: In total, age-standardized mortality rates increased significantly on average annually (1.5% per year). When the trends of causes of death were examined according to gender, there was a significant increase in deaths from group I in both genders and a significant increase in deaths from group III in males, whereas there was no statistically significant change in deaths from group II between 2009 and 2017. CONCLUSION: A significant quantitative improvement in death registration was seen in Turkey between the years 2009 and 2017. This is due to the increase in the number of reported deaths. The change in the distribution of causes of death is noteworthy. This research can provide the basis for further researches that will examine the change in causes of death.

A qualitative study of hand hygiene compliance among health care workers in intensive care units.

INTRODUCTION: Studies indicate that adherence to hand hygiene guidelines is at suboptimal levels. We aimed to explore the reasons for poor hand hygiene compliance. METHODOLOGY: A qualitative study based on the Theory of Planned Behavior as a framework in explaining compliance, consisting four focus group discussions and six in-depth interviews. RESULTS: Participants mostly practiced hand hygiene depending on the sense of "dirtiness" and "cleanliness". Some of the participants indicated that on-job training delivered by the infection control team changed their perception of "emotionally" based hand hygiene to "indication" based. Direct observations and individual feedback on one-to-one basis were the core of this training. There was low social cohesiveness and a deep polarization between the professional groups that led one group accusing the other for not being compliant. CONCLUSIONS: The infection control team should continue delivering one-to-one trainings based on observation and immediate feedback. But there is need to base this training model on a structured behavioral modification program and test its efficacy through a quasi-experimental design. Increasing social cohesiveness and transforming the blaming culture to a collaborative safety culture is also crucial to improve compliance. High workload, problems related to work-flow and turnover should be addressed.

Sleep quality and anxiety level in employees.

OBJECTIVE: The aim of this study was to measure the sleep quality and anxiety level of a group of employees, as well as determine the relationship between sleep quality and anxiety and other factors. METHODS: A total of 130 of 185 employees at a university campus were enrolled in this cross-sectional study. A descriptive questionnaire, the Pittsburgh Sleep Quality Index, and the Beck Anxiety Inventory were the data collection instruments. In addition to univariate analysis, the relationship between the 2 scales was examined with Spearman correlation analysis. RESULTS: Of the participants, 38.9% had poor sleep quality. Gender, income level, presence of a chronic disease, regular medication use, and relationship with family and the social environment were found to affect both sleep quality and anxiety. A decrease in sleep quality was associated with an increase in the level of anxiety. CONCLUSION: Poor sleep quality and a high anxiety level are common in this country, as in the rest of the world. Socioeconomic interventions and psychosocial support to improve the status of individuals with risk factors, such as chronic disease, will reduce anxiety and improve sleep quality and overall psychosocial health. Further prospective studies should be conducted with different groups of participants and with larger samples to expand knowledge of the relationship between sleep quality and anxiety.