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OBJECTIVE: During the COVID-19 pandemic, physicians have been working for long hours, with the fear of contracting the disease and infecting their families. Therefore, there are great concerns about the mental health of physicians. In this research, we aimed to reveal the factors that affect the burnout among physicians working during the pandemic. MATERIAL AND METHODS: This is a cross-sectional study involving physicians working during the pandemic in health institutions that admit COVID-19 patients. A questionnaire form consisting of the “Sociodemographic Data Form” and the “Maslach Burnout Inventory (MBI)” was used. The questionnaire was sent to the contact numbers of physicians via the internet. The target population was reached through the communication groups of the Turkish Thoracic Society and other professional associations, the communication groups of health institutions, and also through personal correspondence. Burnout was evaluated with the scores of each participant from the 3 subscales of Emotional Exhaustion (EE), Depersonalization (DP), and Lack of Accomplishment (LA). RESULTS: Of the 1177 physicians who participated in the survey, 893 answered the survey completely. Females comprised 56.70% (n = 506) of the respondents, and the mean age was 38.63 (±11.65). The residents (41%, n = 366) and specialists (31%, n = 277) made up the majority of the physicians. Eighty-six percent (n = 768) of the physicians had difficulty in obtaining personal protective equipment (PPE). It was determined that 81.7% (n = 730) of the 893 physicians were actively working in pandemic units (outpatient clinics, emergencies, inpatient clinics, intensive care units), and burnout was significantly higher in these physicians (P < .01). After excluding other confounding factors by regression analysis, their Maslach total scores and EE scores were found to be significantly high (P = .001). CONCLUSION: Working in pandemic units and facing difficulty in accessing PPE are identified as the most important risk factors for burnout. Hence, we can say that working with PPE, and with the managers’ discretion and support, the physicians’ burnout can be prevented.

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Background: Nicotine addiction is associated with nicotine absorption from the buccal mucosa, and it is stated that the main factor that determines nicotine absorption is saliva pH. In the literature, the effects of changes in saliva pH values after eating and drinking on smoking desire in smokers were not questioned. Aim: To show the effect of saliva pH changes on smoking desire. The secondary aim was to show the impact of coffee and water drinking on saliva pH and smoking on oral-dental health (oral hygiene and gingival bleeding). Study Design: Case–control study. Methods: A questionnaire was administered that included “Socio demographic Data Form” and smoking history and Fagerström Test for Nicotine Dependence (FTND). Oral and dental examinations were performed with mirror sonds and using oral hygiene standard Silness and Leöe plaque index and DMFT Index (Index of Decayed Missing or Filled Teeth). Untreated saliva samples were taken, and baseline saliva flow rate and pH values were measured. To assess pH changes, saliva pH was remeasured after sugar-free instant coffee and water consumption. Smoking desire was evaluated with the Visual Analog Scale (VAS). Results: In this study, 24 (55.8%) females and 19 (44.2%) males were among the 43 smoking and 39 nonsmoking cases. Smoking was signifi cantly associated with poor oral hygiene (in smokers 4.71 (±1.40), in non-smokers 2.30 (±1.59); P < .01). DMFT index was higher in smok ers than in non-smokers (in smokers 6.45 (±3.69), in non-smokers 3.87 (±2.67); P < .01). Gingival bleeding was more prevalent in smokers (0.68 (±0.76)) than non-smokers (1.20 (±0.90); P = .009). Salivary flow rates were lower in smokers (in smokers 2.56 (±1.34), in non-smokers 3.00 (±1.22), P = .06). In both groups, pH values increased after coffee consumption and decreased after water; in smokers basal: 6.67 (±0.41), pH coffee: 6.93 (±0.36), pH water: 6.85 (±0.33); in non-smokers pH basal: 6.84 (±0.37), pH coffee: 7.02 (±0.37), pH water: 6.97 (±0.31), P < .01. The VAS values of smokers at basal 4.73 (±3.21); P < 0.01, after coffee consumption 4.91 (±3.08); P < .01, and after water 3.15 (±2.72); P < .01. Conclusion: The saliva pH increased after coffee consumption and decreased after drinking water. Besides, VAS values decreased significantly after drinking water. The results suggest that a simple behavior such as drinking water may be used in conjunction with behavioral and cognitive therapies to pursue smoking cessation.

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In December 2019, in Wuhan, China, scientists observed a sudden and sharp increase in the number of cases of pneumonia and acute respiratory distress syndrome of an unknown origin. By the end of January 2020, the outbreak had spread to Asia, Europe, America, and Australia. In this article, we have outlined the pandemic action plan of our university hospital.

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OBJECTIVE: To evaluate the rate of pneumococcal pneumonia (PP) among patients with community-acquired pneumonia (CAP) in Turkey and to investigate and compare features of PP and non-PP CAP patients.MATERIAL AND METHODS: This multicenter, non-interventional, prospective, observational study included adult CAP patients (age ≥ 18 years). Diagnosis of PP was based on the presence of at least 1 positive laboratory test result for Streptococcus pneumoniae (blood culture or sputum culture or urinary antigen test [UAT]) in patients with radiographic findings of pneumonia.RESULTS: Four hundred sixty-five patients were diagnosed with CAP, of whom 59 (12.7%) had PP. The most common comorbidity was chronic obstructive pulmonary disease (30.1%). The mean age, smoking history, presence of chronic neurological disease, and CURB-65 score were significantly higher in PP patients, when compared to non-PP patients. In PP patients, 84.8% were diagnosed based ony on the UAT. The overall rate of PP patients among CAP was calculated as 22.8% considering the UAT sensitivity ratio of 63% (95% confidence interval: 45-81). The rate of intensive care treatment was higher in PP patients (P = .007). While no PP patients were vaccinated for pneumococcus, 3.8% of the non-PP patients were vaccinated (P = .235). Antibiotic use in the preceding 48 hours was higher in the non-PP group than in the PP group (31.8% vs. 11.1%, P = .002). The CURB-65 score and the rate of patients requiring inpatient treatment according to this score were higher in the PP group.CONCLUSION: The facts that PP patients were older and required intensive care treatment more frequently as compared to non-PP patients underline the burden of PP.

• ÖZ

Kronik akciğer hastalıklarında pnömokokal infeksiyonlar çok önemli bir mortalite ve morbidite sebebidir. Bununla birlikte hastalıkların tedavisini oldukça zorlaştıran alevlenmeler ve tedavi sırasında kullanılan kortikosteroidler pnömokokal infeksiyon açısından büyük bir risk taşımakta ve tedaviyi olumsuz etkilemektedir. Pnömokokların kronik akciğer hastalıklarının klinik ve ekonomik yükü üzerindeki olumsuz etkisini azaltmanın en akılcı yolu riskli popülasyonun aşılanmasıdır. Aşı önerilen grupların iyi tanımlanmış olması, ulusal ve uluslararası kılavuzlar tarafından önerilmesi ve ülkemizde sağlık otoritelerince aşıların ödeniyor olmasına karşın, Türkiye’de erişkin kronik akciğer hastalıklarında aşılanma oranları beklenenin oldukça altındadır. Hekimler aşılama konusunda hastalarını yönlendirebilecek en önemli ve güvenilir kaynak olarak değerlendirildiğinden pnömokok aşılamasını kronik akciğer tanısı alan tüm hastalarda rutin bir şekilde uygulamak ve günlük pratiğin bir parçası haline getirmek, bu hastalarda görülen pnömokokal infeksiyonların yarattığı klinik ve ekonomik yükün azaltılmasına büyük katkı sağlayacaktır. Bu derlemede kılavuzlar ve güncel literatürler eşiliğinde, pnömokokal hastalıkların kronik akciğer hastalıkları üzerine etkileri, kronik akciğer hastalarında pnömokokal hastalıkların riski ve klinik yükü ele alınarak bu hastalarda pnömoniden korunmanın önemine değinilmiştir. Ülkemizde mevcut olan pnömokok aşıları hakkında genel bilgiler ve etkinlik verileri yanı sıra, uygulama şekilleri ve aşılara erişim yolları da anlatılmıştır.