The effects of mold sensitivity on the clinical characteristics of adult asthmatic patients

Introduction: The effects of mold sensitivity on the development and course of asthma have been researched previously, although study results vary. We sought to evaluate the characteristics of our mold-sensitive patients in comparison with those of other adult asthmatic patients. Materials and methods: Data were collected retrospectively from adult asthmatic patients who underwent regular follow-ups at our tertiary care outpatient clinic for immunology and allergic diseases. Patients were grouped and compared according to three categories of aeroallergen sensitivity status determined via a skin prick test. The study variables were demographic data, asth-ma-onset age, comorbid conditions, asthma-related emergency department visits and hospitalizations, systemic corticosteroid burst, asthma control assessment tests, and pulmonary function tests. Results: In total, 242 patients’ data were evaluated. Their mean age was 48.6 ± 15.4 years, with female predominance (81.4%). Mold-sensitive asthmatics composed 34.7%, while the aeroallergen-sensitive group without molds (33.1%) and the non-sensitized group (32.2%) composed the rest. The mold-sensitive group had a higher rate of polysensitization (92.8%) than the sensitized group without molds. In multinomial logistic regression analysis, mold sensitivity was positively associated with shorter asthma duration, absence of sinonasal polyposis, presence of allergic rhinitis, and generally well-controlled asthma compared to the non-sensitized group. Also, mold sensitivity was positively associated with shorter asthma duration, drug allergy, and absence of systemic corticosteroid bursts compared to the sensitized group without molds in logistic regression analysis. Conclusion: Our mold-sensitive asthmatic patients demonstrated better asthma symptom control. It should be considered that mold sensitization in adult asthmatics is not always a poor prognostic factor

Factors associated with current smoking in COPD patients: A cross-sectional study from the Eastern Black Sea region of Turkey

INTRODUCTION Even though smoking is a major reason for the development and progression of chronic obstructive pulmonary disease (COPD)-and quitting smoking is the only way to stop its progression-a significant number of smokers still continue to smoke after being diagnosed with COPD. The aim of this study is to compare the clinical and demographic characteristics of COPD patients who are current and former smokers and to find factors associated with their current smoking status. METHODS For this study, data were collected between June 2015 and August 2016; COPD patients who had been regularly visiting Hopa State Hospital’s outpatient clinic over the last year or longer were included. Their demographic, clinical and functional data were recorded. Patients completed a pulmonary function test, six-minute walk test (6-MWT), COPD assessment test (CAT), and modified Medical Research Council (mMRC) dyspnea scale. Comparisons were then made according to their smoking status. RESULTS In total 100 patients were included in the study; with a mean age of 63.4±10.7 years and mostly males (94%). Regarding smoking status, 49% were current smokers and 51% were former smokers. Multivariate logistic regression analysis revealed that current smoking was negatively associated with age (odds ratio, OR=0.93, 95% confidence interval, CI=0.88–0.96) and Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage (OR=0.32, 95% CI=0.13– 0.79), and was positively associated with six-minute walk distance (OR =1.005, 95% CI=1.001–1.009) and CAT score (OR=1.07, 95% CI=1.009–1.13). CONCLUSIONS Nearly half of the COPD patients in the study continued smoking even after having been diagnosed with COPD. The younger patients, with better lung function, better exercise capacity and poor quality of life were associated with current smoking

Long-term outcomes of smoking cessation outpatient clinic: A single-center retrospective cohort study from the Eastern Black Sea Region of Türkiye

INTRODUCTION In Türkiye, smoking cessation outpatient clinics (SCCs) provide access to free smoking cessation treatments and provide important treatment support to smokers. Additionally, in order to increase the effectiveness of these clinics, it is important to conduct due diligence and monitor their outcomes. Therefore, we aimed to evaluate the long-term outcomes of our SCC as well as the associated factors with quit success and treatment adherence of smokers. METHODS Smokers admitted to the outpatient smoking cessation clinic of a tertiary care hospital in the Eastern Black Sea Region of Türkiye between January 2018 and May 2019, were evaluated. All patients included in the study were aged ≥18 years and started smoking cessation treatment. RESULTS Mean age of the 425 participating patients was 38 ± 12 years, 73.4% of whom were males. In the second year, 20.5% of the patients were successful in quitting smoking. Unsuccessful quitting was positively associated with treatment non-adherence (OR=7.71; 95% CI: 3.44–17.31), presence of nicotine withdrawal symptoms (OR=7.09; 95% CI: 3.60–13.97) and being a student (OR=6.82; 95% CI: 1.31–35.59) with the highest risks. According to the multivariable logistic regression analysis, being a student, having higher scores on nicotine dependence test and presence of withdrawal symptoms, were positively associated with failure to quit smoking. Low cessation medication use duration, experiencing sleep-related side effects and digestive system related side effects during smoking cessation treatment, were negatively associated with success to quit (p<0.05). CONCLUSIONS The rate of successful quitters in the long-term was 20.5%. Considering the factors associated with quit status, interventions and followed methods of SCCs need to be updated

Role of tobacco exposure in the course of COVID-19 disease and the impact of the disease on smoking behavior

Background The effect of COVID-19 on smoking behavior is not fully known. Studies evaluating the link between smoking and COVID-19 have controversial results. This study aims to evaluate patients' smoking status with COVID-19 and the effect of COVID-19 on smoking behavior. Methods Data were collected from 150 COVID-19 patients with a positive polymerase chain reaction test for SARS-CoV-2 between 11 March 2020 and 15 May 2020 in Rize, Turkey. Patients were interviewed by phone calls 2 months after their recovery. After 9 months, a follow-up was performed for those who quit smoking. Results Of the participants, 19 (12.7%) were current smokers before the COVID-19 diagnosis, and 15 (78.9%) of them stated that they quit smoking after their diagnosis. After nine months of follow-up, 11 of those 15 participants (57.8%) sustained abstinence. Conclusion Smoking cessation rates are high in people with COVID-19. Besides, the frequency of sustaining abstinence in the long term was also high in these individuals. The COVID-19 pandemic should be viewed as an open opportunity to strengthen and prioritize smoking cessation activities

Mid-term outcomes of a smoking cessation program in hospitalized patients in Türkiye

INTRODUCTION 'Teachable moments', such as inpatient treatment periods, can be turned into opportunities for smokers to acquire healthy living behaviors. This study was conducted to evaluate the outcomes of smoking cessation interventions in an inpatient hospital setting. METHODS Data were collected for this single-arm prospective intervention cohort study between October 2021 and March 2022 from hospitalized patients at Recep Tayyip Erdo & gbreve;an University Training and Research Hospital in T & uuml;rkiye. Smoker patients received smoking cessation counseling and brief smoking cessation interventions during their hospitalization and were informed about how to apply to our hospital's smoking cessation outpatient clinic after discharge. They were followed via phone on the 3rd, 5th, and 7th day and the 1st, 3rd, 6th, and 12th month after their discharge, regarding their quit status as well as admissions to smoking cessation clinics. Quitters were confirmed by exhaled air carbon monoxide testing. Logistic regression analysis was performed to evaluate the presence of admission to the emergency department and family physicians at follow-up at 1st year. The model was adjusted in terms of age, sex, presence of malignancy, and education level. RESULTS Of the 183 patients included in the study, 163 participants completed periodic follow-up during one year, with quit rate of 47.2%. The rate of anxiety was higher among non-quitters compared to quitters (9.4% vs 1.2%) (p=0.024). Non-quitters were 19 times more likely to have emergency department admissions (AOR=19.64; 95% CI: 8.08-47.68) and eight times more likely to have family doctor visits (AOR=8.43; 95% CI: 4.05-17.53) than quitters. CONCLUSIONS This cessation program evaluated the quit rates of hospitalized patients in the first year and revealed that the rate of anxiety was higher in non-quitters compared to quitters. It would be an important approach to include psychiatric support in this practice

Management of patients with connective tissue disease-associated interstitial lung diseases during the COVID-19 pandemic

The novel coronavirus disease (COVID-19) is similar to connective tissue disease-associated interstitial lung diseases (CTD-ILD) in many aspects. However, patients with CTD-ILD have required particular attention during the pandemic since they are at high risk due to -immunosuppressive treatments. Thus, prompt decisions for diagnosis and treatment initiation have become more important than earlier for these patients during the pandemic. Radiological perspectives have become inevitable for the differential diagnosis of this group -during the pandemic, particularly to obtain rapid and accurate results that allow the physicians to start treatment immediately. However, in addition to radiological images, a definitive diagnosis also requires access to extensive information regarding patient history, including characteristics of comorbidities, and clinical and serological findings. Consequently, the differential diagnosis of COVID-19 and CTD-ILD can yield accurate treatment regimens that differ greatly between the 2 diseases, and also prevent the spread of the outbreak with COVID-19 patients treated under isolation

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

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

Treatment adherence and short-term outcomes of smoking cessation outpatient clinic patients

INTRODUCTION Previous studies have shown that adherence to treatment is fundamental to success in smoking cessation. However, smoking cessation medication regimens are limited significantly by the struggle to adhere to them. This study was conducted to evaluate the factors associated with treatment adherence and quitting success in a group of patients that applied to our smoking cessation outpatient clinic (SCC). METHODS Patients that applied to SCC between April 2015 and December 2016 who were evaluated, found suitable for smoking cessation interventions and started pharmacological treatment were included in this study. Only those who could be reached by phone three months after their first application became participants. Those who had used the prescribed treatment for at least 30 days were grouped as treatment-adherent. RESULTS In total, data for 346 patients were evaluated. Mean (±SD) age was 44.3±13.9 years; most of them were male (63%), primary school graduated (36.1%), self-employed (43.7%), and had no comorbid diseases (71%). Bupropion was started in 52% of the patients, that rate was 35.8% for varenicline and 12.1% for a combination of the nicotine patch and gum. Mean days for treatment use was 20.9±18.5; 59% of the patients were non-adherent to their treatment and 51.7% had only one control visit number. Adverse reactions due to treatment were recorded in 25% of participants, and at their third month 37.9% of them had quit smoking. In multivariate logistic regression analysis, increase in control visit number, absence of adverse reaction, and varenicline use, were each associated with higher treatment adherence (p<0.001) and only being in the treatment-adherent group was associated with quit success (OR=3.01, 95% CI: 1.88–4.81, p=0.001). CONCLUSIONS This study showed that most patients did not use their prescribed SC treatments adequately; a main factor that affects quit success is treatment adherence. There is a need for closer monitoring and follow-up to ensure adequate use of treatment of patients

Turkish thoracic society early career members task force group’s virtual congress notes: european respiratory society international congress 2020

In this article, Early Career Task Force Group members of the Turkish Thoracic Society summarize the European Respiratory Society 2020 virtual congress. Current developments in the field of respiratory diseases were compiled with the addition of sessions specific to coronavirus disease 2019 this year. Almost all of the congress sessions were examined, and the important and striking results of the congress were highlighted. Congress sessions were attended by expert researchers, and the prominent messages of each session were highlighted in short summaries. They were then grouped under relevant titles and ranked in order of meaning and relation. It was finalized by a team of researchers