Objectives We aimed to evaluate the ability of lymphocyte-C-reactive protein ratio (LCR) to discriminate between different levels of severity of COVID-19 disease. Methods This retrospective observational single-center study was performed on 61 confirmed (PCR positive) COVID-19 patients between March and June 2020. The study population was separated into three groups: mild/moderate (n=24), severe (n=25) and critically ill (n=12). The optimal cut-off values of the LCR and neutrophil-to-lymphocyte ratio (NLR) in discriminating between patients with different severity levels were calculated by applying the receiver operating curve (ROC) analysis. Results At baseline, the LCR decreased significantly across the three severity groups (mild/moderate > severe > critically ill). ROC analysis showed that a mean LCR of 43.21 was the cut-off value which best discriminated patients with the critically ill disease from severe patients (sensitivity: 84% and specificity: 69%). The discriminative performance of LCR (ROC AUC 0.820) was better than that of NLR (0.751) in this regard. LCR, unlike NLR was able to distinguish severe patients from mild/moderate patients, with a cut off value of 458.19 (sensitivity: 80% and specificity: 45%). Conclusion LCR was observed to be able to distinguish COVID-19 infected patients of different severity (mild/moderate, severe and critically ill) and was superior to NLR in this regard.

Background: Demodex mites are highly found in the skin of patients with rosacea.The diagnosis of Demodex can be made by standardized skin surface biopsy. Dermoscopy is a tool used in the noninvasive diagnosis of various dermatological diseases. Objectives: To determine whether dermoscopic features of demodicosis are associated with the result of standardized skin surface biopsy in patients with rosacea and to compare dermoscopic features of rosacea in Demodex-positive and negative samples and Demodex type. Methods: A total of 30 patients (7 male, 23 female) were included in the study. Dermoscopic examination was performed on both the clinically most severely affected areas and adjacent healthy skin. The skin surface biopsy sample was taken from the same place from where the dermoscopic image was taken. Results: A total of 83 (lesion n = 60, non-lesion n = 23) areas were evaluated. Demodex was detected in 60.2% (n = 50) of the samples. Half of these samples revealed only Demodex folliculorum, and the remaining half revealed D folliculorum and Demodex brevis. Of theDemodex-positive samples, 88% had Demodex tails (P =0.001) and68% Demodex follicular openings (P = 0.002) on dermoscopy. In D folliculorum+D brevis-positive samples, the rate of scale and pustule was higher than D folliculorum-positive samples (P = 0.017 and P = 0032,respectively). Conclusions: The sensitivity and specificity of Demodex tail are higher than Demodex follicular opening and scale and pustule detection with dermoscopy and may indicate the coexistence of both D folliculorum and D brevis.

Background: It is unclear, whether the initial disease severity may help to predict which COVID-19 patients at risk of developing persistent symptoms. Aim: The aim of this study was to examine whether the initial disease severity affects the risk of persistent symptoms in post-acute COVID-19 syndrome and long COVID. Methods: A systematic search was conducted using PUBMED, Google Scholar, EMBASE, and ProQuest databases to identify eligible articles published after January 2020 up to and including 30 August 2021. Pooled odds ratio (OR) and confidence intervals (CIs) were calculated using random effects meta-analysis. Findings: After searching a total of 7733 articles, 20 relevant observational studies with a total of 7840 patients were selected for meta-analysis. The pooled OR for persistent dyspnea in COVID-19 survivors with a severe versus nonsevere initial disease was 2.17 [95%CI 1.62 to 2.90], and it was 1.33 [95%CI 0.75 to 2.33] for persistent cough, 1.30 [95%CI 1.06 to 1.58] for persistent fatigue, 1.02 [95%CI 0.73 to 1.40] for persistent anosmia, 1.22 [95%CI 0.69 to 2.16] for persistent chest pain, and 1.30 [95%CI 0.93 to 1.81] for persistent palpitation. Conclusions: Contrary to expectations, we did not observe an association between the initial COVID-19 disease severity and common persistent symptoms except for dyspnea and fatigue. In addition, it was found that being in the acute or prolonged post-COVID phase did not affect the risk of symptoms. Primary care providers should be alert to potential most prevalent persistent symptoms in all COVID-19 survivors, which are not limited to patients with critical–severe initial disease.

Introduction: Defensive medicine is the practice of physicians to use the unnecessary procedures for diagnosis and treatment in order to protect themselves against medical malpractice cases, or to avoid taking the responsibility of high-risk medical practices which are likely to result in a malpractice case. The present study was carried out to reveal the knowledge and attitudes of research assistants working in internal and surgical medical sciences at Dicle University Medical Faculty Hospital about the defensive medicine applications and the factors affecting work-related stress and burnout levels. Method: The sample of this descriptive-cross-sectional type of study was designed by proportional layer method. The questionnaire, which included the sociodemographic data form, the defensive medicine applications attitude scale and the maslach burnout ınventory, was applied to 200 physicians. Results: Of all the participants whose mean age was 29.4±3.0, 70.5%(n=141) were male, 56%(n=112) were married. The frequency of positive and negative defensive medicine was found as 98%(n=196) and 92 % (n=184) respectively. The points of defensive medicine were significantly high in the males, those working at surgical departments, those in the first two years of the specialist training in medicine, those the malpractice case opened about and smokers. The level of work-related tension was significantly high in the ones working at surgical departments, ones who keep watch for eight times or more per month, those the malpractice case opened about, smokers and alcohol users. The average points which the physicians took from Maslach Burnout Inventory were determined as 31.57±11.67 for emotional exhaustion, 11.75±6.49 for desensitization and 29.46±7.72 for personal accomplishment. Conclusion: In our study, it was concluded that most of the research assistants were not satisfied with the choice of profession and specialty, their knowledge of defensive medicine concept was inadequate and their high burnout rates were found in all burnout dimensions. It was seen that the burnout levels of those who applied more to defensive medicine were higher.

ki-67 score is a solid tumor proliferation marker being associated with the prognosis of breast carcinoma and its response to neoadjuvant chemotherapy. In the present study, we aimed to investigate the way of clustering of prognostic factors by ki-67 score using a machine learning approach and multiple correspondence analysis. In this study, 223 patients with breast carcinoma were analyzed using the random forest method for classification of prognostic factors according to ki-67 groups (<14% and >14%). Also the relationship between subgroups of prognostic factors and ki-67 scores was examined by multiple correspondence analysis. There was a clustering of molecular classification LA, 0-3 metastatic lymph node, age <50, absence of LVI, T1 tumor size with ki-67 <14% and grade III, 10 or more metastatic lymph nodes, and presence of LVI and molecular classification LB, age >50, and T3-T4 tumor size categories with ki-67 >14%. The fact that the low scores of ki-67 correlate with early stage diseases and high scores with advanced disease suggests that 14% threshold value is crucial for ki-67 score.