Cinsiyet farklılığının sigara bırakma üzerine etkisi

Purpose: Although tobacco use is generally perceived as a male gender behavior, the use of tobacco products among women is gradually increasing, especially in developing countries. This study was conducted to investigate the role of gender in smoking cessation. Materials and Methods: The data used in this study were obtained from a survey conducted among patients registered at the smoking cessation outpatient clinic between January 2019 and January 2020. The survey was conducted with those who agreed to participate in the study. All the collected data were analyzed by using SPSS 17.0. The significance level was accepted as p<.05. Results: 322 admissions were registered at the clinic within a year (median age 40 years). 54% (n=174) of the total 322 admissions participated in the study, and 64% (n=206) of the cases were male. The smoking rate in the families of women was significantly higher than that of men (p<0.001). When the polyclinic attendance rate of the participants was questioned, the male patients' attendance rate was higher than that of the female patients, and the rate of quitting smoking was also significantly higher for men. Conclusion: The number of male patients who presented the intention to quit smoking was higher than the number of women. Men had statistically higher clinic continuity and smoking cessation rates. These results show that women do not have sufficient knowledge about the fight against tobacco; therefore, information on smoking cessation should be made widely available to women

Evaluating the risk factors of venous thromboembolism patients

Aim: Pulmonary thromboembolism (PTE) is a serious health problem; nevertheless, diagnosing this disorder using today's technology is easier than it was in the past. However, identifying the risk factors associated with PTE and providing proper prophylaxis is as important as diagnosing it. In the present study, it was aimed to identify risk factors for pulmonary embolism and to determine, which patients will should receive special attention for prophylaxis. Material and Methods: This study included 355 patients with venous thromboembolism. Patient risk factors were evaluated, such as vital signs, laboratory findings, clinical symptoms, diagnosis and treatment methods, mortality rates, Wells scores, and PESI scores were evaluated. Results: Immobilization was the most common risk factor (42.5%) among the patients. Previous surgery (32 patients, 9%) and cancer (69 patients, 19.4%) were among the most common risk factors. In 44 patients (12.4%), no risk factor was identified. There was a significant correlation between pulmonary arterial pressure and PESI scores, and mortality. Discussion: In conclusion, iIt is vital to avoid delays in diagnosing and treating common diseases with high mortality rates, such as VTE and PTE. However, prevention is as important as diagnosis and treatment

Pnömoni tanısı ile hospitalize edilen demanslı hastalarda direkt maliyetin değerlendirilmesi

Pneumonia is an indisputable cause of morbidity and mortality in elderly patients especially if they have dementia. We aimed to compare the cost of pneumonia for hospitalized patients with and without dementia and to investigate the factors affecting the direct cost of hospitalization. Material and Methods: The study group consisted of 58 dementia patients hospitalized for pneumonia compared with a matched cohort of 54 patients without dementia. The data were collected from the hospital record system between May 2017 and June 2019. Demographic features, comorbidities, characteristics of pneumonia and factors contributing to the total cost of hospitalization were analysed retrospectively. Results: The total mean cost of all patients for hospitalization of pneumonia was 653.1±1,059.9 American Dollars. The mean cost in the dementia group is 976.14±1,433.83 and 339.01±180.81 American Dollars for the control group per episode (p=0.001). The mean length of stay is 10.24±6.97 days and 7.24±2.89 days in the dementia and control groups, respectively (p<0.05). The number of consultations, pharmacy costs, examination costs and the total costs of patients with dementia were significantly higher than those without dementia and independent of the parameters associated with the characteristics of pneumonia. Conclusion: This study shows that pneumonia in elderly patients with dementia produces a burdensome financial cost which is lower in a matched population of patients without dementia. Advances in elderly care, precautions for pneumonia and assessment of aspiration risk in dementia patients might be rational solutions for decreasing the cost of pneumonia.Amaç: Pnömoni, özellikle yaşlı hastalarda tartışılmaz bir morbidite ve mortalite nedenidir. Çalışmamızın amacı, pnömoni tanısı ile hospitalize edilen demansı olan ve olmayan hastaların, hastanede yatış maliyetini karşılaştırmak ve direkt maliyete etki eden faktörleri değerlendirmektir. Gereç ve Yöntemler: Çalışmaya, pnömoni tanısı ile interne edilip, tedavi edilen demans tanılı 58 hasta ve benzer özellikteki demans tanısı olmayan 54 hasta dâhil edildi. Hastane kayıt sistemine Mayıs 2017 ile Haziran 2019 tarihleri arasında kaydedilen hasta verileri incelendi. Hastaların demografik özellikleri, komorbiditeleri, pnömoniye ait özellikler ve direkt hastane maliyetine etki eden faktörler retrospektif olarak değerlendirildi. Bulgular: Pnömoni tanısı ile hospitalize edilen hastaların toplam direkt maliyeti 653,1±1.059,9 Amerikan Doları olarak değerlendirildi. Demansı olan hastalarda, yatış başına ortalama maliyet 976,14±1.433,83 Amerikan Doları iken demansı olmayan hastalarda maliyetin 339,01±180,81 Amerikan Doları olduğu gözlendi (p=0,001). Ortalama yatış süresi demanslı hastalarda ve kontrol grubunda sırasıyla 10,24±6,97 gün ve 7,24±2,89 gün idi (p<0,05). Konsültasyon sayısı, ilaç maliyetleri, muayene ücretleri ve toplam maliyetin, demanslı hastalarda pnömoninin klinik özelliklerinden bağımsız olarak kontrol grubuna göre anlamlı ölçüde daha yüksek olduğu gözlendi. Sonuç: Bu çalışmanın sonuçları, pnömoni tanısı ile interne edilen demanslı hastaların, benzer özellikteki demansı olmayan hastalara göre anlamlı oranda fazla direkt finansal maliyeti olduğunu göstermiştir. Yaşlı bakımındaki gelişmeler, pnömoni gelişiminin önlenmesi için alınacak tedbirler ve aspirasyon riskinin değerlendirilmesi ile demanslı hastalarda aşırı maliyet yükünden kaçınılması mümkün olabilmektedir

Factors affecting mortality at home and hospital in oncology patients and the effect of age

Objective: Several factors assessing cancer mortality and impacting the choice of place of death for terminally ill patients have been previously documented. We examined the relationships between several oncological factors, including age, on cancer mortality and the choice of place of death. Material and Methods: All patient data were collected retrospectively from hospital computer records and medical chart reviews. A total of 2,183 patients admitted to our hospital over 6 years (September 2013-December 2019) were included. Results: A total of 2,183 patients were analyzed, of which 58.5% (n=1,277) of patients died. More deaths occurred in the hospital than at home (n=1,032 vs. n=245). The mean age of patients who died at home was more than those who died in the hospital (mean ages: 68.4±12.5 vs. 63.5±12.5; median ages: 69, range 24-100 vs. 63, range 19-97). The hospital mortality rate of patients <65 years old was statistically higher than patients ≥65 years old. Conclusion: We found that a second primary cancer, metastasis, diagnosis from the primary mass, certain cancer diagnoses (such as lungs, stomach, and brain cancers), locally advanced and metastatic stage cancers, certain histological types, late diagnosis (the first application to branches such as chest diseases, emergency, neurosurgery) negatively affected mortality. In addition, we determined that metastatic, locally advanced stage. and patients aged <65 years of age died more frequently in the hospital

Rate of history of tuberculosis among healthcare workers in Turkey: A cross-sectional study

OBJECTIVES: Healthcare workers (HCWs) possess a high risk for both latent tuberculosis infection (LTBI) and active disease. This study aimed to investigate tuberculosis (TB) disease history in hospital staff working in healthcare institutions in the Eastern Black Sea Region of Turkey. MATERIAL AND METHODS: This study included 460 HCWs employed in 5 hospitals in the Eastern Black Sea Region of Turkey. Between May 01 and July 31, 2016, the participants were asked to answer a questionnaire, including data about TB history. The data about family TB history, Bacilli Calmette-Guerin (BCG) vaccination, or tuberculin skin test (TST) application before starting work were also evaluated. RESULTS: Of the 460 participants, 69.3% were women (n=319) and 30.7% (n=141) were men. The mean age was 32 (17-63) years. A total of 8 participants (1.7 %) had TB history. There was no statistically significant relationship between TB history and age, sex, body mass index (BMI), smoking habits, or presence of comorbidities (p>0.05 for all variables); family history of TB (p0.05). The duration of work (years) was higher in participants with a TB history. The p value was very close but did not reach the limits of significance (p=0.059). CONCLUSION: In this study, the rate of TB among HCWs was 1.7% (8 of 460 HCWs). Family history of TB and TST positivity are strong predictors of TB in HCWs

Thyroid gland disease as a comorbid condition in COPD

Introduction. Chronic obstructive pulmonary disease (COPD) is one of the most common causes of morbidity and mortality worldwide. The disease is characterized by progressive airway inflammation, which not only affects the airways but also has systemic effects that are associated with comorbidities. Although comorbid conditions such as hypertension and coronary artery disease are very well-known in COPD patients, diseases of the thyroid gland have not been sufficiently studied. Therefore, thyroid diseases are not considered among the comorbid conditions of COPD. The purpose of this study was to determine the thyroid gland disease (TGD) prevalence in COPD and associated factors. Materials and Method. The study included 309 (297 (96%) male) patients. The patients were subjected to spirometry and thyroid function tests (TFT) in the stable period. The thyroid gland disease they were diagnosed with was recorded after face-to-face meetings and examining their files. Results. The mean age of the patients who were included in the study was 65.9 +/- 9.8 (40-90). Thyroid disease was determined in 68 (22%) individuals. There were hypothyroidism in 7 (2%), euthyroidism in 45 (15%), and hyperthyroidism in 16 (%5) patients. No relationship was found between the severity of airflow limitation and the prevalence of TGD. Conclusion. Thyroid abnormalities are commonly observed in COPD. The most frequently encountered TGDs are euthyroid multinodular goiter, euthyroid sick syndrome (ESS), and toxic multinodular goiter

Common variable immunodeficiency at adult age

Common Variable Immunodeficiency (CVID) is a heterogeneous group of diseases progressing with recurrent infections. This disease should be considered in cases experiencing recurrent lung infection, otitis media, rhinosinusitis, and urinary tract infection. Since it is generally seen in the childhood age group, the diagnosis in adults may be delayed. A Common Variable Immunodeficiency case, which was followed up in our clinic and characterized by recurrent upper respiratory tract infection and pneumonia, was presented to raise awareness on this issue. CVID should be kept in mind in patients who are admitted to outpatient clinics with recurrent infections, who do not respond despite appropriate treatments, and who develop complications

Is it worth using thrombolytic therapy in elderly patients with pulmonary embolism

Objective: Antithrombotic treatment is avoided in geriatric population owing to its side effects. Thus, we aimed to examine complication rates related to thrombolytic treatment in geriatric patients with pulmonary thromboembolism (PTE). Materials and Methods: The study included patients aged >65 years who received thrombolytic treatment for a diagnosis of PTE. Patient files were screened retrospectively to extract data on etiology, clinical risk scores, laboratory values, thrombolytic treatment-related complications, and early mortality development. Results: The study included 68 patients (female: 70.6%; mean age: 77.8 years). The Simplified Pulmonary Embolism Severity Index score was high in all patients. Early mortality risk classification at admission was high, medium-high, and medium-low risk in 64.7%, 23.5%, and 11.8% patients, respectively. In-hospital mortality was 30.9%. The causes of death were secondary to PTE in 85.7% patients, respiratory failure in 9.6%, and sepsis in 4.7%. Complication-related mortality was not observed. The only independent risk factor for mortality was change in consciousness. Conclusion: Mortality and complication rates in geriatric patients receiving thrombolytic treatment are not as high as expected

A novel biomarker in the diagnosis of parapneumonic effusion: neutrophil gelatinase-associated lipocalin

Background: The protein neutrophil gelatinase-associated lipocalin (NGAL) is a mediator synthesized and released by neutrophils. Its physiological function is as yet unclear. Levels in blood increase in several inflammatory diseases. High serum values indicate poor prognosis for several diseases. Pleural effusion may appear as the result of various pathologies. The most common cause is heart failure (HF). Other common causes include parapneumonic (PPE) and malignant (MPE) pleural effusions, and pulmonary embolism. Tubercular effusion (TE) is commonly encountered in Turkey and similar developing countries. The purpose of this study was to investigate the effectiveness of NGAL, a current inflammation marker, in discriminating between different etiological diseases that cause pleural effusion. Methods: The study was performed at the Recep Tayyip Erdoğan University Faculty of Medicine Chest Diseases Clinic. One hundred patients were included in the study, 25 with parapneumonic effusion, 25 with heart failure-related effusion, 25 with tubercular effusion and 25 with cancer-related effusion. NGAL was measured in patients' serum and pleural fluids. Results: Serum NGAL levels in PPE (171 ± 56 ng/ml) were significantly higher (p < 0.001) than those in HF (86 ± 31 ng/ml), CA (103 ±42 ng/ml) and TE (63 ± 19 ng/ml). Pleural NGAL levels were also significantly higher in PPE compared to HF, MPE and TE (p < 0.001). Serum NGAL levels exhibited a positive correlation with white blood cel (WBC), neutrophil, C-reactive protein (CRP), sedimentation, serum LDH, creatinine, pleural leukocyte and pleura neutrophil numbers. The most significant correlation was between NGAL level and WBC (p < 0.001, r= 0.579). Both serum and pleural NGAL levels are highly effective in differentiating patients with PPE from those without PPE (AUC: 0.910 and 0.790, respectively). Conclusions: NGAL can be used in the diagnosis of diseases with an acute inflammatory course. Serum and pleural NGAL levels can differentiate PPE from other diseases causing pleural fluid with high sensitivity and specificity. © 2014 Gümüs et al

Evaluation of thiol/disulfide homeostasis in bronchiectasis

Purpose. Thiols are sulfhydryl-containing organic compounds that have an important role in preventing cellular oxidative stress. This study compares the blood oxidative stress marker levels in bronchiectasis cases during their stable periods with healthy controls. Materials and Methods. Seventy-seven patients (49 patients with stable bronchiectasis/28 healthy controls), followed up by the chest disease clinic, were included in the study. Peripheral blood thiol-disulfide parameters (NT: native thiol (-SH); TT: total thiol (-SH + SS); SS: disulfide (-SS); SS-SH: disulfide/native thiol index; SS-TT: disulphide/total thiol index; SH-TT: native thiol/total thiol index), and ischemia-modified albumin (IMA) levels were examined in the stable bronchiectasis group and the control group. Thiol-disulfide homeostasis was evaluated using a novel and automated assay. Findings and Result. Blood native thiol levels in patients with stable bronchiectasis were found to be significantly higher compared with healthy controls. A positive correlation between the total airway disease score and IMA levels was present. Our findings revealed that native thiol levels, which constitute a part of the antioxidant defense system, are increased in patients with stable bronchiectasis