Relationship between initial symptoms and prognosis of patients with Covid-19.

OBJECTIVE: Aims to describe the initial symptoms most related to the prognosis of Covid-19. DESIGN: This is a retrospective cross sectional, quantitative, data analyzed study. SITE: This study was made in the family medicine centers (n=82) of Çorlu district of Tekirdag province, in Turkey. PARTICIPANTS: The study included patients (n=1.506) who had a positive PCR test for Covid-19 from March to September 2020. And we asked them their initial symptoms which bring them to the family medicine centers before the test. MAIN MEASUREMENTS: The participants' age, gender, presence of chronic disease, and initial symptoms which they come to a healthcare facility were evaluated. These variables were analyzed in terms of length of hospital stay, intensive care unit admission and mortality rates. RESULTS: The most common initial symptom in Covid-19 patients was cough. The presence of a chronic disease, the shortness of breath, malaise, the loss of smell and taste, and vomiting were found to be associated with an increased mortality rate. Advanced age, the presence of cough, malaise, the loss of smell and taste, and vomiting as the initial symptoms were found to have increased the likelihood of being admitted to the intensive care unit. CONCLUSIONS: The authors advise placing more attention on the initial symptoms of cough, malaise, the loss of smell and taste and vomiting in Covid-19 patients. Because these symptoms are related with severe prognosis indicators.

Routine Pediatric Vaccination During Pandemic: Attitudes of Parents.

OBJECTIVE: To examine the effects of a pandemic on children's routine vaccination between 0 months and 24 months and to determine the affecting factors on vaccination during the pandemic. MATERIALS AND METHODS: Our study was conducted between July 17, 2020, and August 1, 2020, among 513 mothers whose children were aged between 0 months and 24 months old. A total of 21 questions were asked to participants' sociodemographic characteristics and attitudes and behaviors towards pediatric vaccines during the pandemic. RESULTS: The rate of vaccination for children was 82.8% (n = 425), unvaccinated children was 3.9% (n = 1). 13.3% (n = 68) of vaccinated children had "delayed" vaccination. 76.2% (n = 391) of the participants stated "they were concerned about COVID-19 infection'' while visiting a healthcare center for vaccination. The 3 most common affecting factors for vaccination; 43.9% (n = 340 ) "pediatric vaccines are vital and must be administered," 23.6% (n = 183) they had vaccine appointment and have been informed "vaccination service would continue as usual," 22.7% (n = 176 ) have been informed that "required precautions have been taken". It was found that reasons for not to be vaccinated in the pandemic; 63.2% (n = 12) "fear of COVID-19," 15.8% (n = 3) "quarantined as the whole family" and 10.5% (n = 2) "vaccine hesitancy." CONCLUSION: Healthcare providers should inform parents that vaccination is vital, and vaccination must always be administered on time during a pandemic. During a pandemic, continuing appointments for vaccination services, calling to inform the parents that required precautions to minimize the spread of infection have already been taken, and alleviating parents' concerns would prevent vaccination rates from decreasing in this period.

The association between COVID-19 anxiety levels and tobacco use among patients within a smoking cessation polyclinic.

INTRODUCTION: The aim of this study was to investigate the impact of the COVID-19 pandemic on the anxiety level of smokers and the relationship between smoking behavior and COVID-19 anxiety level. METHODS: Our study was planned as a descriptive cross-sectional survey. A 32-question face-to-face questionnaire containing the Coronavirus Anxiety Scale (CAS) and the Fagerström test for nicotine dependence (FTND) was administered to 349 patients who had applied to the smoking cessation polyclinic between 15 May 2021 and 1 August 2021. SPSS 25.00 was used for statistical analysis. RESULTS: A total of 349 individuals participated in the study. The mean CAS and FTND total scores were 0.89±2.13 (range: 0-20) and 6.34±2.53 (range: 0-10), respectively. There was a statistically significant difference between CAS total score and gender (p=0.005), marital status (p=0.006), changes in the amount of smoking during the pandemic (p=0.011), and impact of the COVID-19 pandemic on smoking cessation (p<0.001). The impact of the COVID-19 pandemic on smoking cessation was statistically significantly different between knowing that the rate of intensive care unit (ICU) admissions due to COVID-19 infection is higher in smokers, smokers are heavily infected with COVID-19 and the mortality rate due to COVID-19 infection is higher in smokers (p<0.001). CONCLUSIONS: Anxiety due to the COVID-19 pandemic may cause a change in the amount of smoking and the decision to quit smoking. Healthcare professionals should transform COVID-19 anxiety into an opportunity to improve health and quit smoking, one of the healthy behaviors.

15-year evaluation of changes in the HBsAg positivity rate in pregnant women in Turkey: the prominent effect of national vaccination.

Background: The detection of hepatitis B surface antigen positivity in pregnant women before delivery is crucial to preventing mother-to-child transmission of hepatitis B virus. Aims: This study aimed to evaluate the status and rate of testing for hepatitis B surface antigen, rate of hepatitis B surface antigen positivity, hepatitis B surface antigen positivity distribution rate by age, and changes in hepatitis B surface antigen positivity rate in pregnant women over the study period. Methods: We conducted a multicentre, cross-sectional, descriptive study covering the period January 2005 to June 2019 for 2 145 668 pregnant women from 27 provinces in all 7 regions of Turkey, collected using Microsoft Excel before statistical analysis. Results: We found that 1 012 593 (47.1%) pregnant women were tested for hepatitis B surface antigen over the 15-year period, out of which 11 471 (1.1%) were hepatitis B surface antigen-positive. Overall, 97% of the hepatitis B surface antigen positive women were born before 1998, the year that national HBV vaccination was launched in Turkey. The rate of hepatitis B surface antigen positivity in that group was 1.1%, compared with 0.3% among women born after 1998. Conclusion: There was a downward trend in the hepatitis B surface antigen positivity rate among pregnant women in the younger age groups, especially among those born after universal hepatitis B vaccination was inaugurated, and low rate of HBsAg testing during pregnancy.

Prevalence of HBsAg seropositivity during pregnancy and evaluation of vaccination programs: A multicenter study in Turkey.

OBJECTIVE: Hepatitis B virus (HBV) infection remains a global public health problem. Among its modes of transmission, vertical transmission from mother to child during pregnancy is exceedingly important. This study investigated seropositivity for hepatitis B surface antigen (HBsAg) among pregnant women aged 16-49 years and their pregnancy outcomes in several health institutions (university and state hospitals, family health centers) from seven cities in Turkey. METHODS: An Excel form was sent to the sites participating in the study, and the total number of pregnant women who were tested for HBsAg between 2010 and 2017, HBsAg positivity rates, and the ages of HBsAg-positive pregnant women was collected retrospectively. Serum samples were obtained from 204,865 pregnant women from four regions between 2010 and 2017, including 107,463 from Black Sea, 2306 from Marmara, 48,339 from East Anatolia, and 46,757 from Aegean. HBsAg levels were determined on automated devices using chemiluminescence. RESULTS: In the study, the data of 204,865 pregnant women from seven different provinces (Afyonkarahisar, Erzurum, Istanbul, Izmir, Manisa, Mus, and Rize) in different geographical regions were accessed, and HBsAg positivity was found in 2343 pregnant women (1.14%). The highest HBsAg seroprevalence was found in women who were older 26-40 years/1977-1991 birth year range on average. In the data of the present study, the number of pregnant women with HBsAg positivity among pregnant women born after the initiation of the national vaccination program and catch-up vaccination program is only 124 and constitutes 5.3% of all HBsAg-positive pregnant women. CONCLUSION: In this study, it has been found that HBsAg positivity in pregnant women has been decreasing in Turkey and that it is significantly lower, especially in those born after the initiation of the national vaccination program. Continuation of national neonatal HBV vaccination with high compliance is very important.

Recommending immunizations to adolescents in Turkey: a study of the knowledge, attitude, and practices of physicians.

Introduction: The aim of this study was to determine the knowledge, attitudes, and practices of family physicians and pediatricians in regard to adolescent immunization.Methods: The study was conducted from March to May 2017. A total of 665 physicians participated. Participants were asked 31 questions about their personal sociodemographic characteristics and their knowledge, attitudes, and practices around adolescent immunization.Results: The study sample consisted of 348 family physicians (52.3% of the sample) and 317 pediatricians (47.7%). The results showed that 5.4% of family physicians and 10.4% of pediatricians thought that they had enough knowledge about adolescent immunization (p < .01). Overall, 15.8% of family physicians and 12.7% of pediatricians provided adolescents with information about vaccines 'always/most of the time'. A variety of reasons for not providing information about adolescent vaccines was provided, including 'inability to allocate time' (50.2% of family physicians, 69.3% of pediatricians); 'forgetfulness' (34.8% of family physicians, 28.5% of pediatricians); 'lack of knowledge about vaccines' (34.1% of family physicians, 27.4% of pediatricians); and 'no need to immunize adolescents' (15.7% of family physicians, 6.5% of pediatricians) (p < .01). HPV immunization was recommended only to girls by 30.5% of family physicians and 38.8% of pediatricians (p < .01). The percentages of family physicians and pediatricians not recommending that adolescents be immunized with the Tdap vaccine were 53.4% and 42.6%, respectively (p = .016). Meningococcal immunization was not recommended by 20.7% of family physicians and 11.4% of pediatricians (p < .01), and influenza immunization was not recommended by 10.3% of family physicians and 8.2% of pediatricians (p < .01).Conclusion: Family physicians and pediatricians in Turkey have low rates of recommendation of immunization to adolescents. Reasons for not recommending immunization include an inability to allocate time, forgetfulness, and lack of knowledge about vaccines. We conclude that educational programs should be used to improve knowledge of adolescent immunization among family physicians and pediatricians.