Evaluation of antivaccination movement in Turkey: qualitative reports of family physicians.

Background: In Turkey, childhood vaccination rates are decreasing in the context of increasingly visible antivaccination movements. Aims: To evaluate the antivaccination movement based on communication experiences between family physicians and antivaccine parents in Turkey. Methods: We conducted 39 face-to-face in-depth interviews with family physicians in Sakarya Province who had experiences of communicating with antivaccine parents during October-December 2019. With the permission of the participants, audio recording was obtained in all interviews except one; these were transcribed verbatim and checked. A thematic approach was used to analyse the data. Results: The most common concern about vaccination was the possible side-effects, followed by the origin of the vaccines, religious concerns and distrust of vaccines. The physicians said they assumed an inquisitive, informative and anxiety-relieving attitude towards antivaccine parents.They said they were able to persuade most parents to vaccinate their children and that highly educated parents or those whose attitudes and behaviours were strongly influenced by their religious leaders were the hardest to convince. Physicians emphasized the importance of trust in increasing vaccine acceptance and noted the need to educate religious leaders and families to introduce mandatory vaccination policies. Conclusion: Parents had various reasons for refusing childhood vaccinations, however, the family physicians used persuasive methods to convince them to accept the vaccinations. Strengthening the communication and persuasive skills of health care professionals regarding vaccination may help increase acceptance of childhood vaccinations.

Factors affecting the anxiety levels of adolescents in home-quarantine during COVID-19 pandemic in Turkey.

BACKGROUND: The long-term closing of schools and home-quarantine during the COVID-19 pandemic cause negative effects on the physical and mental health of young people. Studies evaluating the mental health of adolescents during the pandemic are limited in the literature. AIM: In our study, it was aimed to determine the results of home-quarantine measures taken for adolescents during the pandemic and the affecting factors. METHOD: This study was conducted as an online cross-sectional self-report questionnaire and included children aged between 12 and 18 years. The data were obtained from the children of volunteer families via Facebook family groups, and Google Forms questionnaires sent by the child psychiatry clinic to their smartphones. Sociodemographic form, State-Trait anxiety scale, and UCLA loneliness survey were used as data collection tools. RESULTS: We examined the data of 745 adolescents. The average age of the study group was 16.83 ± 1.66 years, and 69.5% were females. It was determined that 88.2% of the adolescents followed the developments in the COVID-19 process and obtained most information from the television. State anxiety was related to "Former psychiatric referral" by 4.39-fold, "Having a COVID positive patient in the family or your surroundings" by 3.81-fold, and "The most common medium for obtaining COVID-related information" by 2.41-fold. CONCLUSIONS: Closure of schools and home-quarantine during pandemic causes anxiety and loneliness in young people. The identification of risky groups helps to properly support these individuals by various social connections, including healthcare professionals, families, and schools.

Clinical course of COVID-19 disease in immunosuppressed renal transplant patients

Background/aim: We aimed to identify clinical settings of renal transplant patients with COVID-19. Materials and methods: In this retrospective study, we included kidney transplant inpatients with laboratory confirmed COVID-19 who had been discharged or had died by October 1st, 2020. Characteristics of the patients, including basal and last outpatient biochemical parameters were recorded. Discontinuation or dosage reduction of immunosuppressives and other treatment information was documented. Results: Twenty patients were included in this study, of whom 18 were discharged and 2 died in hospital. The mean duration of hospitalization and follow-up were 9.7 ± 6.4 days and 4.5 ± 2.0 months, respectively. Fourteen patients (70%) were male and mean age was 48.0 ± 10.3 years. At admission, all had immunosuppression withdrawn and were started on methylprednisolone 16 mg/ day (50%) or dexamethasone (50%). Tacrolimus/m-TOR inhibitors were reduced by 50% and all antimetabolites were discontinued. Hemodialysis was needed for 10% of patients. Acute kidney injury was detected in 25% of the patients. With respect to hospitalization time and complications, there was no significant difference between patients who used dexamethasone and those who did not (P > 0.05). The discontinued immunosuppressives were resumed within 2 to 4 weeks after discharge according to the severity of disease. No rehospitalization or acute rejection was detected during the follow-up of the patients. Conclusion: Renal transplant patients are considered a high risk group for COVID-19. It can be said that discontinuation or reducing dosages of immunosuppressives may be effective and safe in kidney transplant patients.

Is the COVID-19 disease associated with de novo nephritic syndrome?

INTRODUCTION: This study aims to determine the incidence of de novo nephritic syndrome (NS) in COVID-19 patients and identify its associated factors. METHODS: All ward patients with COVID-19 pneumonia were investigated. After determining the inclusion and exclusion criteria, the study population was identified. The urine dipstick test and urine protein creatinine ratio (UPCR) measurements were performed. Patients with de novo NS findings, nasopharyngeal swab, and urine RT-PCR tests were performed simultaneously. RESULTS: This descriptive cross-sectional study was conducted with 21 patients with COVID-19. The mean age of the patients was 42.2±8.8 years, and 71.4% of them were male. The mean duration of follow-up was 28.4±9.3 days. The urine RT-PCR test was positive in one patient (4.8%). Improvements were observed in hematuria by 71.4%, and proteinuria by 85.7% at the end of the follow-up. A significant decrease in the measured UPCR was found in comparison to the baseline(P=0.000). Also, improvements were recorded in the complete blood counts, inflammatory parameters, ferritin, and coagulation tests, compared to the baseline. There was a positive correlation between baseline UPCR and ferritin, and a negative correlation between baseline UPCR and sodium values. CONCLUSION: COVID-19-induced de novo nephritic syndrome may occur mainly due to tubulointerstitial involvement and often results in spontaneous remission. However, why these findings were not present in all patients who had no comorbidities is not clear.

Is the COVID-19 disease associated with de novo nephritic syndrome?

SUMMARY INTRODUCTION: This study aims to determine the incidence of de novo nephritic syndrome (NS) in COVID-19 patients and identify its associated factors. METHODS: All ward patients with COVID-19 pneumonia were investigated. After determining the inclusion and exclusion criteria, the study population was identified. The urine dipstick test and urine protein creatinine ratio (UPCR) measurements were performed. Patients with de novo NS findings, nasopharyngeal swab, and urine RT-PCR tests were performed simultaneously RESULTS: This descriptive cross-sectional study was conducted with 21 patients with COVID-19. The mean age of the patients was 42.2±8.8 years, and 71.4% of them were male. The mean duration of follow-up was 28.4±9.3 days. The urine RT-PCR test was positive in one patient (4.8%). Improvements were observed in hematuria by 71.4%, and proteinuria by 85.7% at the end of the follow-up. A significant decrease in the measured UPCR was found in comparison to the baseline(P=0.000). Also, improvements were recorded in the complete blood counts, inflammatory parameters, ferritin, and coagulation tests, compared to the baseline. There was a positive correlation between baseline UPCR and ferritin, and a negative correlation between baseline UPCR and sodium values CONCLUSION: COVID-19-induced de novo nephritic syndrome may occur mainly due to tubulointerstitial involvement and often results in spontaneous remission. However, why these findings were not present in all patients who had no comorbidities is not clear.

RESUMO INTRODUÇÃO: Este estudo tem como objetivo determinar a incidência da síndrome nefrítica de novo (SN) em pacientes com COVID-19 e identificar os fatores associados. MÉTODOS: Todos os pacientes da enfermaria com pneumonia por COVID-19 foram investigados. Após a determinação dos critérios de inclusão e exclusão, a população do estudo foi identificada. Foram realizadas medições do teste da vareta da urina e da razão da creatinina das proteínas na urina (UPCR). RESULTADOS: Este estudo transversal descritivo foi realizado com 21 pacientes com COVID-19. A idade média dos pacientes foi de 42,2±8,8 anos e 71,4% dos pacientes eram do sexo masculino. A duração média do seguimento foi de 28,4±9,3 dias. O teste de RT-PCR na urina foi positivo em um paciente (4,8%). Houve melhorias observadas na hematúria em 71,4% e na proteinúria em 85,7% no final do acompanhamento. E uma diminuição significativa na UPCR medida em comparação à linha de base (p=0,000). Além disso, foram registradas melhorias nas contagens sanguíneas completas, nos parâmetros inflamatórios, nos testes de ferritina e de coagulação, comparados aos valores basais. Houve correlação positiva entre UPCR basal e ferritina, e correlação negativa entre os valores basais de UPCR e sódio. CONCLUSÃO: A síndrome nefrítica de novo induzida por COVID-19 pode ocorrer principalmente devido ao envolvimento túbulo-intersticial e frequentemente resulta em remissão espontânea. No entanto, a questão de por que esses achados não se apresentaram em todos os pacientes que não apresentavam condição comórbida não é clara.