Elderly and aged asthma have different characteristics: results of a multicenter study

Background/aim: Characteristics of asthma in the elderly population is not well-known. The aim of the present study was to evaluate asthma in the elderly population, to compare disease characteristics between patients diagnosed <60 (aged asthma) and ≥60 (elderly asthma) years of age. Materials and methods: The study was a prospective, multicenter, cross-sectional type. A questionnaire was filled out to patients 60 years of age and over, that have been followed for asthma for at least 3 months. Asthma Control Test (ACT), eight-item Morisky Medication Adherence Scale (MMAS-8) was filled out, inhaler device technique was assessed. Results: A total of 399 patients were included from 17 tertiary care centers across the country. Mean age was 67.11 years and 331 (83%) were female. The age at asthma diagnosis was ≥60 in 146 (36.6%) patients. Patients diagnosed ≥60 years were older (p < 0.001), had higher education level (p < 0.001), more commonly had first-degree relative with asthma (p = 0.038), asthma related comorbidities (p = 0.009) and accompanying rhinitis/rhinosinusitis (p = 0.005), had better asthma control (p = 0.001), were using less controller medications (p = 0.014). Inhaler technique was correct in 37% of the patients with no difference in between the groups. Treatment compliance was better in elderly asthma patients (p < 0.001). In the multivariate logistic regression analysis, having well-controlled asthma (odds ratio = 1.61, CI = 1.04-2.51), and high medication adherence rate (odds ratio = 2.43, CI = 1.48-4.0) were associated with being in the elderly asthma group. Conclusion: The characteristics of asthma are different among patients aged 60 years and over which seems to be related to onset age of asthma. In our cohort, the elderly asthma patients had higher education level, and treatment adherence and asthma control was better. Patients diagnosed ≥60 years of age did not have more severe disease

Skin prick test results in patients with chronic allergic rhinitis: Housewives are risky occupational group for the development of allergic rhinitis due to house dust mites

Background/Aims: Allergic Rhinitis (AR) is a common disorder that negatively effects the quality of life with symptoms due to the inflammation of nasal epithelium. Objective of this study is to determine the general demographical and clinical features of patients with AR, who had positive skin prick test (SPT) results.  Methods: Patients diagnosed as AR with positive SPT results were analyzed. The allergens tested were: grasses, cereals+grasses , trees 1 (early flowering), trees 2 (late flowering), house-dust mites ( Dermatophagoides pteronyssinus (DP), Dermatophagoides farinae (DF), tyrophagus putrescentiae (TP), lepidoglyphus destructor (LD) and acarus siro (AS). Results: Of the total 202 patients, 145  female (with a mean age of 32.42 ±12.81 years) and 57  male (with a mean age of 28.44 ± 11.5 years) were included in the study. The most common allergens determined were; DF, DP, cereals+grasses and grasses. Tyrophagus significantly was more common in females (p:0.04). Nasal discharge, dyspnea, itching and weakness-tiredness were reported to be more common in females compared with males. DF, DP, TP and LD were statistically significantly more common in housewives (p&lt;0.05). Dyspnea, wheezing and itching were statistically significantly more common in housewives (p&lt;0.05).Conclusions: Housewives are risky occupational group for the development of allergic rhinitis due to house dust mite

Association between atopy, mastoid pneumatization and tympanometric findings

WOS: 000347292000004PubMed: 24647495The purpose of this study was to reveal whether the presence of atopy plays any unfavorable role in the development of a healthy middle ear as evaluated by tympanometry or in the degree of mastoid pneumatization as measured by mastoid volume. 33 atopic patients with positive skin prick test results (atopic group) and 30 healthy subjects (control group) were included in this study. Tympanometric tests were performed in all participants, and the results were classified as type A to C. Mastoid cell volumes were measured by three-dimensional temporal computed tomography. Both the right and left mastoid volumes were significantly lower in the atopic group than in the control group. Tympanogram types among all participants showed that the number of individuals with abnormal tympanograms was significantly higher in the atopic group than in the control group. Moreover, the presence of atopy was found to be associated with an almost 4.5-fold increased risk of having an abnormal tympanogram. Individuals with abnormal tympanograms (type BB or CC) demonstrated significantly lower right and left mastoid volumes than did individuals with normal type A tympanograms. Atopic individuals demonstrated significantly lower right and left mastoid volumes than did subjects in the control group. This study suggests a direct association between atopy and mastoid cell volumes. It was found that the mastoid cell systems of atopic individuals are less pneumatized, and tympanometric measurements are worse in atopic subjects. Therefore, the authors suggest that when a medical or surgical treatment is planned for ear disease in atopic individuals, atopy is an important factor that should be taken into consideration.Continuous Education and Scientific Research AssociationExcept data collection, preparation of this paper including design and planning was supported by Continuous Education and Scientific Research Association

Smoking Prevalence and Associated Factors among Students of Balıkesir University

Objective: This study aimed to investigate the smoking prevalence and associated factors among the students of Balıkesir University and determine the level of nicotine dependence in smokers. Methods: Six faculties and two graduate schools located at the Balıkesir University campus were enrolled. The cluster method was used as the sampling method. To observe the rates of smoking initiation while studying at the university, first-year and final year students were compared. Results: A total of 1096 students were enrolled, with a mean age of 20.4±2.2 years. The regular smoking prevalence rate was 25.5%, occasional smoking rate was 9.5%, alcohol consumption rate was 28.0%, and drug abuse rate was 5.0%. The mean age for attempting to smoke was 16.6±2.2 years. The leading causes of smoking were curiosity, spiritual space, affection, and to comply with friends. According to the Fagerström questionnaire, the level of nicotine dependence was low in 53.0% of the participants, moderate in 8.7%, and high in 28.4%. The average smoking prevalence rate was 23.6% in first-grade students, whereas it was 44.8% in last-grade students. The factors that influence smoking were as follows: being in the last grade, mother, siblings, and friends who smoke, higher allowance, use of alcohol and drugs. Smoking was found to be more prevalent among males. Conclusion: Last-grade students had a higher smoking prevalence rate than the first-grade students. Family, social environment, and smoking behavior of friends have an influence on smoking. All risk factors, including past history and university period, should be considered together in tobacco control

Effects of Varenicline on Cardiovascular Parameters and Oxidative Stress

Objective: Pharmacotheraphy is recommended for smoking cessation in clinical practice. However, the cardiovascular safety of smoking cessation drugs has been questioned. Our goal is to evaluate the effects of the smoking cessation drug varenicline on some cardiovascular parameters and oxidative stress in subjects. Methods: Twenty-six smokers without cardiovascular diseases and 25 healthy subjects were enrolled in the study. Total oxidant status (TOS), total antioxidant status (TAS), and urotensin II levels were determined in blood samples. Echocardiography was performed in all individuals. Smokers were assessed with the measurements mentioned above at the beginning of the treatment (V0 group) and at the end (third month, V3 group). The same measurements were performed once in the control group (C). Results: Aortic strain and distensibility measurements in the V0 group were found to be significantly lower than those in the C group. No significant changes were observed after varenicline treatment. TOS values in the V0 group were found to be higher than those in the V3 and C groups, but these differences were not statistically significant. However, TAS values of the V3 group were found to be significantly lower than those of the V0 group. There were no differences between the groups in terms of diastolic dysfunction and urotensin II levels. Conclusion: Our study revealed that varenicline may decrease TAS in smokers thanks to smoking cessation. Varenicline does not seem to have negative effects on aortic stiffness. Further studies are needed to confirm these results

Effects Of Allergen Specific Immunotherapy On The Allergens Excluded From The Treatment

Aim: Specific immunotherapy is one of the alternative treatments of the allergic diseases. The efficacy of specific immunotherapy was investigated in patients receiving allergen specific immunotherapy with the diagnosis of allergic rhinitis and/or asthma. Methods: Six child and 11 adult pollen sensitive patients were included in the study. Patients were treated with specific immunotherapy at least 24 months and more. All patients challenged with the mixed inhalant allergen extracts. Some of them were not selected for the specific immunotherapy. Results: The challenge procedure was tolerated in all patients. Adverse reactions and systemic allergic reactions were not occured. Conclusion: Allergen specific immunotherapy may alter the natural course of the allergic diseases, and we can treat allergic rhinitis and/or asthma with specific immunotherapy

Antiinflammatory effects of adalimumab, tocilizumab, and steroid on lipopolysaccharide-induced lung injury

Background/aim: Acute lung injury (ALI) is a major cause of death in the intensive care unit. Lipopolysaccharide (LPS) induced lung injury is the most widely used experimental ALI model and provides opportunities for new targeting therapy. In this study, we investigated the effects of tocilizumab, adalimumab, and methylprednisolone in LPS-induced acute lung injury. Materials and methods: Lung injury was established by intratracheal instillation of LPS. The rats were randomly divided into six groups: LPS, control, and treatment groups (adalimumab, tocilizumab, methylprednisolone, adalimumab + tocilizumab). Bronchoalveolar lavage (BAL) and lung tissues were collected at 48 h and 96 h following LPS administration from each group. For histological analysis, hematoxylin-eosin (H&E) staining was performed. The sections were obtained for immunohistochemical analysis. IL-6 and TNF-alpha immunoreactivity were measured. Results: Intratracheal LPS application resulted in inflammatory cell infiltration of interstitial and alveolar spaces and thickening of the alveolar wall. All treatment groups showed significantly amelioration compared to LPS at 48 h. Interestingly, adalimumab and adalimumab + tocilizumab groups showed a significant amelioration of the lung histoarchitecture, compared to the prednisolone group at 96 h (p = 0.028, p = 0.025, respectively). Compared to the control group, LPS stimulation resulted in a significant increase in IL-6 and TNF-alpha immunoreactivity (p 0.05). Conclusion: Adalimumab and/or tocilizumab significantly reduce the release of proinflammatory cytokines and improve the tissue inflammation in the experimental model of ALI. Our results suggest that adalimumab and/or tocilizumab have a more potent antiinflammatory effect on lung injury than the steroid