Comparison of emotional approaches of medical doctors against COVID-19 pandemic: Eastern and Western Mediterranean countries

Background: Pandemics are states of disease that occur worldwide and sharply increase in populations. It causes life events which trigger anxiety, depression, anger, sleep deprivation, emotional distress and stress. World Health Organization (WHO) declared coronavirus disease 2019 (COVID-19) a pandemic on March 11, pointing to the over 118,000 cases in over 110 countries. Many healthcare workers became ill during the pandemic and some among them died. In this study, we aimed to evaluate and compare level of stress against COVID-19 pandemic among doctors from Turkey and Italy. Methods: This research is a cross-sectional study in which Perceived Stress Scale (PSS-10) and Secondary Traumatic Stress Scale (STSS) are administered online via social networks. All data collection tools were delivered to individuals between 1 and 15 June 2020 and filled in online with Google Forms application. In total, 618 individuals were included in this study and all of them were medical doctors. Results: Higher PS and STS levels were found related to female gender, being married, working in pandemic hospital and older ages. Stress levels were found statistically higher in Turkish doctors when compared to Italian doctors for both stress scales (Turkish/Italian PSS:20.18 ± 7.90/ 19.35 ± 6.71, STSS: 44.19 ± 13.29/ 38.83 ± 13.74). Conclusion: The number of doctors per 1000 of population is lower and per capita visits to a physician are higher in Turkey when compared to Italy. Besides pandemic, these heavier working conditions, increased weekly working hours can cause stress for Turkish doctors. Reporting information such this study is important and international collaborations are essential to plan future prevention strategies. We need to strengthen international ties and build more international collaborations rather than staying within our national silos. Additionally, interventions to promote mental well-being in health care professionals exposed to COVID-19 need to be immediately implemented

Proceedings of the 24th Paediatric Rheumatology European Society Congress: Part three

From Springer Nature via Jisc Publications Router.Publication status: PublishedHistory: collection 2017-09, epub 2017-09-0

The frequency and clinical course of SARS-COV2 infection in children with juvenile idiopathic arthritis

Introduction: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), first reported from the Wuhan city of China in December 2019, swept the world in a few months and became a global health emergency of primary international concern continues to be a priority health problem. Recent studies suggest that subjects with autoimmune disorders (JIA, RA, SLE) do not have an increased risk to get Sars-Cov2. Juvenile Idiopathic Arthritis (JIA) is an inflammatory chronic disease concerning joints and others structures. According to International League of Association for Rheumatology (ILAR) seven subtypes of arthritis can be defined in relation with the number of joints and the extra-articular involvement occurring in the first six months of disease. NSAIDs and intra-articular steroids represent the first line treatment for JIA. Systemic steroids, disease modifying anti-rheumatic drugs (DMARDs) and biologic drugs are used in children with severe disease. Objectives: To evaluate the incidence and the impact on the disease course of Sars-cov2 infection in a group of children affected from juvenile idiopathic arthritis in treatment with Methotrexate and/or biological drugs. Methods: This study includes 77 children affected from JIA (55 females, 22 males). JIA diagnosis was made according to ILAR criteria and treatment was assigned with recommendations of the American College of Rheumatology. For each patient we recorded the type and the duration of pharmacological treatment, JIA subtype and relapses (defined according to Wallace criteria). During follow up visit from Nov 1st, 2020 to April 30th, 2021 we investigated in each patient history of Sars-Cov2 infection and related symptoms, diagnostic tests for Sars-Cov2. Results: The mean age at the last follow-up visit was 13.3±5.61 years. Thirteen out of 77 patients was affected Sars-Cov2 infection, none of them needed to be hospitalized. The most common symptom was headache (8 of 13 patients), followed by myalgia (6 of 13), fever (4 of 13), anosmia or dysgeusia (3 of 13), upper respiratory tract symptoms (3 of 13) and nausea (3 of 13). Five out of 13 patients were asymptomatic (38,5%). The mean duration of Sars-Cov2 infection was 12,5 days (confirmed with nose pharyngeal swab). In the group of patients with Sars-Cov2 infection 4 of 13 (30%) were in treatment with MTX, 2 of 13 (15%) with both MTX and biological drugs, 5 of 13(38%) with biological drugs, 2 of 13 (15%) with NSAIDs. In the group of patients without Sars-Cov2 infection 37 of 64 (48%) patients were in treatment with MTX, 32 of 64 (41,5%) with biological drugs, 18 of 64 (28%) with both MTX and biological drugs, 10 of 64 (15,6%) with NSAIDs. We didn’t find a higher risk to contract Sars-Cov2 infection in patients under MTX treatment (48% vs 46.15 %; p value 0.6416), in ones under MTX and biological drugs (28.1% vs 15.4%p value 0.543) or in ones under only biological therapy (50% vs 53.8% ; p value 0.231). We found that in patient with JIA the risk to get Sars-Cov2 infection is not related to the treatment. The percentage of JIA relapses was higher in patients with Sars-Cov2 infection than in the ones without infection (53,8% vs 9%; p value 0.0004). Conclusion: Treatment with MTX or biological drugs did not increase the risk to get Sars-Cov2 infection. The frequency of JIA relapses was higher in patients who got Sars-Cov2 infection than in ones who didn’t get i

A case report of a boy suffering from type 1 diabetes mellitus and familial Mediterranean fever

Background: Type 1 diabetes mellitus could be associated with other autoimmune diseases, such as autoimmune thyroid disease, celiac disease, but the association with Familial Mediterranean Fever is rare, we describe a case of a boy with type 1 Diabetes Mellitus associated with Familial Mediterranean Fever (FMF). Case presentation: A 13 year old boy already suffering from Diabetes Mellitus type 1 since the age of 4 years, came to our attention because of periodic fever associated with abdominal pain, chest pain and arthralgia. The fever appeared every 15-30 days with peaks that reached 40 °C and lasted 24-48 h. Laboratory investigation, were normal between febrile episodes, but during the attacks revealed an increase in inflammatory markers. Suspecting Familial Mediterranean Fever molecular analysis of MEFV gene, was performed. The genetic analysis showed homozygous E148Q mutation. So Familial Mediterranean Fever was diagnosed and colchicine treatment was started with good response. Conclusion: Familial Mediterranean Fever could be associated with other autoimmune diseases such as Ankylosing Spondylitis, Rheumatoid Arthritis, Polyarteritis Nodosa, Behcet disease, Systemic Lupus, Henoch-Schönlein Purpura, and Hashimoto's Thyroiditis. Association of type 1 Diabetes Mellitus and Familial Mediterranean Fever has been newly reported in the medical literature, this is the third association of these two diseases described in the medical literature so far