Objective: Association between the COVID-19 pandemic and mental well-being has been researched in several studies. State-Trait Anxiety Inventory is one of the most widely test used for measurement of anxiety. In this study, we aimed to determine the anxiety levels of patients waiting for gastrointestinal endoscopic procedure during the COVİD 19 pandemic Material and Methods: Patients above 18 years of both genders  who were waiting for the gastroenterological endoscopic procedure included in the study. State-Trait Anxiety Inventory applied to the patient waiting in line for the procedure Results: A total of 150 patients were included in the study. During the pandemic, a greater proportion of women (36.9%) feared endoscopy than men (19.7%) (chi-square =0.016). The number of patients (94, 62.7%) reporting they feared visiting the hospital during pandemic (p<0.001, chi-square) had a significantly higher fear of undergoing endoscopy during the pandemic (87.5%, n=49). The median STAI-S score (39 [IQR 30.25 - 47]) was significantly lower in patients who had previously undergone endoscopy than in patients who had not (p=0.028). ). The mean STAI-T score of women (46.11+-7.62) was 5.08 (95% CI 2.67 - 7.48) higher than that of men (41.03+-7.09) (p<0.001, Student's t test). Conclusion: Mortality and morbidity experienced during the COVİD-19 period had devastating effects on the mental health of patients, but some groups were more affected by this situation. Therefore, identifying vulnerable groups, paying special attention to these groups, and providing more intense information will reduce potential concerns.

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The elderly or geriatric patients represent a significant portion of emergency department (ED) admissions. Factors affecting poor outcome in these patients suspected or diagnosed with sepsis include shock, hyperlactatemia, and organ failure. Atypical presentations should be emphasized in the training of triage and ED personnel due to difficulties and pitfalls in diagnostic processes for sepsis. The vital organ functions of the elderly, who are among the highest risk groups in the management of sepsis, may deteriorate rapidly with very few precursors, and aggressive methods should be used rapidly when necessary. Interactions of drug doses in the elderly, problems in excretion and differences in metabolism should be considered in treatment regimens. Healthcare workers should try to eliminate colonization risks such as vascular catheterization, unnecessary vascular access and urinary catheters should be removed. In the long term after recovery from sepsis, heart failure, peripheral vascular disease, dementia, and diabetes are the most common entities recorded in the literature. This review was intended to provide an overview of the overall management and give some practical tips for this fragile group of patients in the post-pandemic era.

Background Rebleeding is associated with poor outcomes in upper gastrointestinal bleeding (UGIB). Identifying predictors of rebleeding can assist in risk assessment. The aim of the study is to investigate the factors affecting rebleeding in patients with UGIB admitted to the emergency department. Methods This retrospective, observational, cross-sectional study was conducted on patients with UGIB presented to the emergency department. Patients who did not arrest in the first 24 h, who were not diagnosed with GI malignancy, and who were clinically diagnosed with UGIB were included in the study. Patient demographic characteristics, hemodynamic parameters, patient parameters, and bleeding that may affect rebleeding were evaluated. The primary endpoint was rebleeding within 7 days. Results The study included 371 patients. A total of 55 patients (14.8%) had rebleeding within 7 days, and 62 patients (16.7%) presented without bleeding manifestations. Rebleeding rates were higher in those who presented with bloody or coffee-ground vomitus, had a diagnosis of cancer, had blood in their nasogastric tube, and had peptic ulcers due to endoscopy. Mean cell hemoglobin concentration, lymphocyte, albumin, and total protein values of patients with rebleeding were low; red blood cell distribution width, neutrophil count, platelet distribution width (PDW), and neutrophil lymphocyte ratio were high. In-hospital mortality and 30-day mortality values of patients with rebleeding were significantly increased. In the multivariate analysis, cancer, PDW, and total protein levels were statistically significant. Conclusion The presence of cancer, low total protein level, and high PDW are effective parameters in predicting 7-day rebleeding in patients with UGIB admitted to the emergency department.