The impact of anti-smoking laws on high school students in Ankara, Turkey

ABSTRACT OBJECTIVE: To determine the factors affecting the smoking habits of high school students, their thoughts about changes resulting from anti-smoking laws, and how they are affected by those laws. METHODS: In this cross-sectional study, 11th-grade students at eight high schools in Ankara, Turkey, were invited to complete a questionnaire. RESULTS: A total of 1,199 students completed the questionnaire satisfactorily. The mean age of the respondents was 17.0 &#61617; 0.6 years; 56.1% were female, of whom 15.3% were smokers; and 43.9% were male, of whom 43.7% were smokers (p < 0.001). The independent risk factors for smoking were male gender, attending a vocational school, having a sibling who smokes, having a friend who smokes, and poor academic performance. Of the respondents, 74.7% were aware of the content of anti-smoking laws; 81.8% approved of the restrictions and fines; and 8.1% had quit smoking because of those laws. According to the respondents, the interventions that were most effective were the (television) broadcast of films about the hazards of smoking and the ban on cigarette sales to minors. The prevalence of smoking was highest (31.5%) among students attending vocational high schools but lowest (7.5%) among those attending medical vocational high schools. Although 57.1% of the smokers were aware of the existence of a smoking cessation helpline, only 3.7% had called, none of whom had made any attempt to quit smoking. CONCLUSIONS: Although most of the students evaluated were aware of the harmful effects of smoking and approved of the anti-smoking laws, only a minority of those who smoked sought professional help to quit

Effect of host risk factors in identifying mortality in COVID-19 pneumonia and a new COVID-19 mortality index: Co-AMSCA

BACKGROUND AND AIM: The purpose of the study was to examine the host risk factors related to mortality in patients hospitalized with coronavirus disease 2019 (COVID-19) pneumonia and to find a COVID-19 mortality score based on these factors. METHODS: Subjects hospitalized with COVID-19 pneumonia between March 11, 2020, and October 1, 2020, were retrospectively analyzed. The age, gender, smoking status, body mass index, blood group, severity of pneumonia, comorbidity, reverse transcriptase-polymerase chain reaction positivity, use of angiotensin-converting enzyme (ACE) inhibitors, radiological changes, and mortality rates of the patients who had proven COVID-19 pneumonia were recorded. Patients were divided into two groups according to mortality status, and the two groups were compared. The cutoff values, sensitivity and specificity values, and odds ratios were calculated to predict mortality of the new scoring system. RESULTS: A total of 422 patients (51 mortal and 371 nonmortal) participated in the study. The univariate regression analysis showed that age, male gender, smoking, comorbidity, and using ACE inhibitors were prognostic host risk factors for COVID-19-related mortality. A new scoring model with the combination of risk factors named Co-AMSCA was created in the study. The cutoff value of the system was found to be 3.5 with 88.4% sensitivity and 65.5% specificity. The mortality risk in patients with a Co-AMSCA mortality score above 3.5 points was 7.8 times higher than that in patients whose score was lower than 3.5 points. In multivariate logistic regression analysis, older age and smoking were significant risk factors for mortality. CONCLUSIONS: A mortality score was created based on host risk factors, which are easy to calculate and do not need laboratory tests and do not waste the time of the clinicians. This study showed that by using Co-AMSCA scoring model, it is possible to achieve a mortality prediction in COVID-19 patients who are hospitalized due to pneumonia

Skin prick test results and prevalence of allergic symptoms in workers exposed to toluene

Karabulut, Ismail/0000-0002-1339-5385WOS: 000300203500009Aim: To determine the distribution of allergens and allergic symptoms according to occupation groups in those who were exposed to toluene and presented with allergic rhinitis symptoms. Materials and methods: Of the 2005 patients who were administered an allergy test with the prediagnosis of allergic rhinitis, the files of 138 patients who were exposed to toluene were analyzed retrospectively. Results: The mean age of the patients was 35 10 years. Distributions of symptoms and allergens of 57 patients (41.3%) with negative skin prick test and 81 patients (58.7%) with positive skin prick test were analyzed according to occupation groups. There was no significant difference between the groups in terms of symptoms at baseline except for the symptom of runny nose (P > 0.05). The groups were compared in terms of complaints that started at the age of 16 or later, which was found as 76.5% in the positive group and 91.2% in the negative group. Conclusion: The occupation of the patient must be considered in patients who present with allergic symptoms; in particular, patients with negative skin prick test should be investigated in terms of occupational exposure

QUANTITATIVE CT IN MORTALITY PREDICTION IN PULMONARY FIBROSIS WITH OR WITHOUT EMPHYSEMA

Aim: We aimed to evaluate the quantitative CT analysis of patients with CPFE in comparison with IPF and emphysema. Methods: Patients with CPFE(n:36), IPF(n:38) and emphysema(n:32) were retrospectively included in the study with the approval of the ethics committee. Results: There was a positive correlation between total lung volume and FVC%, TLCO% and 6 MWT, and negative correlation between mMRC and mortality. Negative correlation was found between right, left lung density and FVC%, TLCO% and 6 MWT, and positive correlation between mortality. Also, total lung volume, right and left lung densities were significant in predicting mortality and cut-off values are -778 and > -775, respectively (p = 0.040, 0.020, 0.013). Conclusion: Quantitative CT are guiding in predicting mortality of the disease

Correlation between chest CT severity scores and clinical and biochemical parameters of COVID‐19 pneumonia

Abstract Background The COVID‐19 pandemic, which first appeared in Wuhan, China, in December 2019 and spread rapidly around the globe, continues to be a serious threat today. Rapid and accurate diagnostic methods are needed to identify, isolate and treat patients as soon as possible because of the rapid contagion of COVID‐19. In the present study, the relation of the semi‐quantitative scoring method with computed tomography in the diagnosis of COVID‐19 in determining the severity of the disease with clinical and laboratory parameters and survival of the patients were investigated along with its value in prognostic prediction. Material and method A total of 277 adult patients who were followed up in the chest diseases clinic because of COVID‐19 pneumonia between 11.03.2020 and 31.05.2020 were evaluated retrospectively in the present study. Both lungs were divided into five regions in line with their anatomical structures, and semiquantitative radiological scoring was made between 0 and 25 points according to the distribution of lesions in each region. The relations between semiquantitative radiological score and age, gender, comorbidity, and clinical and laboratory parameters were examined. Results A significant correlation was detected between advanced age, lymphopenia, low oxygen saturation, high ferritin, D‐dimer, and radiological score in the univariate analysis performed in the present study. The cut‐off value of the semiquantitative radiology score was found to be 15 (AUC: 0.615, 95% CI: 0.554–0.617, p = 0.106) in ROC analysis. The survival was found to be better in cases with a radiology score below 15, in Kaplan–Meier analysis (HR: 4.71, 95% CI: 1.43–15.46, p < 0.01). In the radiological score and nonparametric correlation analyses, positive correlations were detected between CRP, D‐dimer, AST, LDH, ferritin, and pro‐BNP, and a negative correlation was found between partial oxygen pressure and oxygen saturation (p = 0.01, r = 0.321/0.313/0.362/0.343/0.313/0.333/−0.235/−0.231, respectively) Conclusion It was found that the scoring system that was calculated quantitatively in thorax HRCTs in Covid‐19 patients is a predictive actor in determining the severity and prognosis of the disease in correlation with clinical and laboratory parameters. Considering patients who have a score of 15 and above with semiquantitative scoring risky in terms of poor prognosis and short survival and close follow‐up and early treatment may be effective to reduce mortality rates

Predictive value of platelet-to-lymphocyte ratio in exacerbation of chronic obstructive pulmonary disease

Aim: We aimed to assess the platelet-to-lymphocyte ratio (PLR) and platelet parameters in patients with chronic obstructive pulmonary disease (COPD). Methods: A total of 60 stable COPD patients, 50 acute exacerbation COPD patients and 50 healthy controls were enrolled in this study. Results: The platelet distribution width and PLR were higher and the mean platelet volume was lower in the COPD patients during acute exacerbation compared with the stable patients and controls. The PLR was negatively correlated with the forced expiratory volume in 1 s. Conclusion: The PLR may be used as a useful and easily accessible tool for evaluating the ongoing inflammation during stable period and the disease severity during acute exacerbations in COPD patients

The comparison of exacerbation and pneumonia before and after conjugated pneumococcal vaccination in patients with chronic obstructive pulmonary disease, and the effect of inhaled corticosteroid use on results

The comparison of exacerbation and pneumonia before and after conjugated pneumococcal vaccination in patients with chronic obstructive pulmonary disease, and the effect of inhaled corticosteroid use on results Introduction: Pneumococcal infections and exacerbations are important causes of mortality and morbidity in chronic obstructive pulmonary disease (COPD). The use of inhaled corticosteroids and pneumococcal vaccination are suggested for the control of the disease progression and exacerbations. The aim of this study is to assess the effect of pneumococcal conjugate vaccine on pneumonia and exacerbation in COPD patients using inhaled corticosteroids (ICSs). The secondary aim is to analyze the effect of ICS use and different ICS types, if administered, on exacerbation and pneumonia incidence in the study population. Materials and Methods: Medical records of 108 adult patients with COPD who were vaccinated with the pneumococcal conjugate vaccine (PCV13) were retrospectively evaluated. The number of acute exacerbations and pneumonia within one year before and after vaccination were evaluated in all included COPD patients. The comparison analysis was also performed based on the ICS types. Results: There were statistically significant differences between the mean numbers of pneumonia and exacerbations before and after vaccination (p 0.05). Conclusion: This study revealed that PCV13 provides a significant decrease in both exacerbation and pneumonia episodes in COPD patients. On the other hand, the use of ICSs and the types of ICSs were not found to have adverse effects on pneumonia and acute exacerbations in vaccinated COPD patients

Erişkin kronik akciğer hastalıklarında pnömokok infeksiyonu ve aşı ile korunma

Pneumococcal infections are an important cause of mortality and morbidity in Chronic Lung Diseases. However, exacerbations, which make the treatment of diseases very difficult, and corticosteroids used during treatment carry a great risk of pneumococcal infection and adversely affect the treatment. The most rational way to reduce the negative impact of pneumococcal infections on the clinical and economic burden of Chronic Lung Diseases is vaccination of the risky population. Although, vaccination recommendations are well defined, recommended by national and international guidelines and are paid by health authorities, in Turkey, vaccination rates in adults with chronic lung disease is far below the expected. Since physicians are considered to be the most important and reliable resource that can guide their patients in vaccination, applying pneumococcal vaccination routinely in all patients with chronic lung diagnosis and making it a part of daily practice will greatly contribute to reducing the clinical and economic burden of pneumococcal infections in these patients. In this review, the effects of pneumococcal diseases on chronic lung diseases, the risk and clinical burden of pneumococcal diseases in chronic lung diseases are discussed in the light of guidelines and current literature, and the importance of protection from pneumonia in these patients is emphasized. In addition to general information and efficacy data about pneumococcal vaccines available in our country, application methods and access routes to vaccines are also described. © Telif Hakkı 2020 Tüberküloz ve Toraks

Pneumococcal infections and protection with vaccination in adult chronic lung diseases

Pneumococcal infections are an important cause of mortality and morbidity in Chronic Lung Diseases. However, exacerbations, which make the treatment of diseases very difficult, and corticosteroids used during treatment carry a great risk of pneumococcal infection and adversely affect the treatment. The most rational way to reduce the negative impact of pneumococcal infections on the clinical and economic burden of Chronic Lung Diseases is vaccination of the risky population. Although, vaccination recommendations are well defined, recommended by national and international guidelines and are paid by health authorities, in Turkey, vaccination rates in adults with chronic lung disease is far below the expected. Since physicians are considered to be the most important and reliable resource that can guide their patients in vaccination, applying pneumococcal vaccination routinely in all patients with chronic lung diagnosis and making it a part of daily practice will greatly contribute to reducing the clinical and economic burden of pneumococcal infections in these patients. In this review, the effects of pneumococcal diseases on chronic lung diseases, the risk and clinical burden of pneumococcal diseases in chronic lung diseases are discussed in the light of guidelines and current literature, and the importance of protection from pneumonia in these patients is emphasized. In addition to general information and efficacy data about pneumococcal vaccines available in our country, application methods and access routes to vaccines are also described