RESUMEN
We aimed to determine the effects of environmental tobacco smoke (ETS) exposure before starting to smoke on cigarette quitting therapies and to determine source environment/individuals for ETS exposure. 230 individuals were contacted. We investigated person/s with ETS exposure before starting to smoke, places/duration of exposure, sources of exposure, therapy methods/durations recommended. Training seminar was also assumed as a therapy method. Those who were administered nicotine replacement and/or bupropion for a minimum of one week, 169 patients who only attended the training programme were evaluated. 68 patients who stopped smoking defined as controls, 101 patients who did not were defined as cases. There was no difference between case and control groups in terms of ages at initiation of smoking, ages at initiation of regular smoking, number of cigarettes per-day, total package-year and nicotine dependence score. 218 patients were found to have ETS exposure before starting to smoke. The highest ETS exposure was determined to be indoors (85.7%) and of paternal origin (77.2%). The rates of cigarette smoke exposure of maternal origin were 32.7% in cases, 25.4% in controls (p= 0.009 OR= 2.8). The mother being a smoker was found to increase the risk of not being able to stop smoking by 2.8 times. The number of people causing ETS exposure was higher in cases compared to controls (p= 0.044). ETS exposure have negative effects on the outcomes of cigarette quitting therapies. Indoor ETS exposure is the leading source of exposure. Therefore, indoor ETS exposure should be prevented, mothers should be trained concerning this matter.
Asunto(s)
Contaminación del Aire Interior/efectos adversos , Educación del Paciente como Asunto , Cese del Hábito de Fumar/estadística & datos numéricos , Contaminación por Humo de Tabaco/efectos adversos , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Casos y Controles , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Persona de Mediana Edad , Nicotina/metabolismo , Adulto JovenRESUMEN
Nosocomial infections are an important cause of preventable morbidity and mortality; they also result in significant socioeconomic cost. Nosocomial pneumonia (NCP) is defined as pneumonia, which occurs 48 hours after hospitalization or after discharge from the hospital. It is the second or third most frequent infection among all hospital acquired infections, and the mortality of NCP is higher than the other hospital acquired infections. Patients, diagnosed as NCP were retrospectively analyzed in order to detect microbiological agent and prognostic factors. We evaluated 173 patients, 67.0% of them were male and 33.0% female. Comorbid diseases were present in 94.2% and a medical procedure had been applied in 75.1% of cases. A single agent was isolated in 79.2% of the cases while a mixt infection was present in 13.3%. In 7.5% of the cases, cultures were negative. Endotracheal aspirates were the most common materials (38.9%) used for detected microorganism and sputum cultures were used in 16.8% of the cases. Most commonly encountered microorganism were Pseudomonas aeruginosa, Acinetobacter spp. and Staphylococcus aureus respectively. NCP developed on approximately 18th day of hospitalization. Overall mortality rate was 45.2%. The effects of diabetes mellitus and chronic pulmonary diseases on mortality rate were analized by logistic regression analysis and it's evaluated that the mortality rates increase 3.7 times with diabetes mellitus and 2.4 times with chronic pulmonary diseases. There was no effect of mechanical ventilation history on mortality.
Asunto(s)
Infección Hospitalaria/epidemiología , Neumonía Bacteriana/epidemiología , Acinetobacter/aislamiento & purificación , Adolescente , Adulto , Anciano de 80 o más Años , Infección Hospitalaria/etiología , Infección Hospitalaria/microbiología , Infección Hospitalaria/mortalidad , Femenino , Hospitalización/estadística & datos numéricos , Humanos , Masculino , Registros Médicos , Persona de Mediana Edad , Neumonía Bacteriana/etiología , Neumonía Bacteriana/microbiología , Neumonía Bacteriana/mortalidad , Pseudomonas aeruginosa/aislamiento & purificación , Estudios Retrospectivos , Staphylococcus aureus/aislamiento & purificación , Turquía/epidemiologíaRESUMEN
UNLABELLED: In our country quartz is widely used for denim sandblasting and new cases with silicosis are defined. Silicosis is a preventable occupational lung disease caused by inhaled dust containing crystalline silica and no effective treatment for silicosis is available (1). CASE 1: A 23-years old man was admitted to the hospital with dyspnea on effort and cough. He had worked in a denim manufacturing factory for three years at sandblasting and dyeing. Physical examination revealed decreased breath sounds. Chest X-ray showed bilateral reticulonodular densities predominantly at middle and lower zones and minimal pneumothorax. Hypoxemia was determined in arterial blood gas analysis (BGA). Pulmonary function tests (PFTs) showed restrictive disorder. Lymphocytic alveolitis was demonstrated in the bronchoalveolar lavage fluid. Open lung biopsy revealed interstitial fibrosis and foreign particles which were seen more clearly under polarized light in interstitial areas. The patient was diagnosed as accelerated silicosis. CASE 2: A 25-years old man was admitted to the hospital with shortness of breath and haemopthysis. Two years ago, he had worked at the same place for 1.5 years. Bilateral reticulonodular densities at middle and lower zones and minimal unilateral pneumothorax were seen in chest X-ray. Restrictive disorder at PFT and hypoxemia in BGA were observed. Because of the similarity of complaints, radiological findings and occupational history with the former patient, no other further and invasive procedure was planned and the patient was diagnosed as accelerated silicosis. CONCLUSION: The usage of sandblasted denims increase recently and denim sandblasting is being frequently made especially in small work places. Since there is no definite treatment for silicosis, it is important to take necessary precautions to improve the conditions of the factories.
Asunto(s)
Silicosis/diagnóstico , Adulto , Tos/etiología , Diagnóstico Diferencial , Disnea/etiología , Humanos , Masculino , Radiografía , Silicosis/complicaciones , Silicosis/diagnóstico por imagen , Silicosis/patología , Industria Textil , TurquíaRESUMEN
A 54 years old man who admitted with thoracolomber pain and pain at left knee had history of left pneumonectomy four months ago for squamous cell lung carcinoma. At physical examination swelling and hotness at the left knee, swelling and redness of the distal phalanx of the right third finger were found. Distal phalanx was not observed at the X-ray which was taken for suspect of metastasis. Incision biopsy was performed from this lesion and microscopic findings of the material were evaluated as metastatic squamous cell carcinoma. Bone metastasis are seen frequently at bronchial carcinoma, but hand metastasis are seen in 0.2% of all cases. This case is represented because of the rare metastatic localisation of bronchial carcinoma.
Asunto(s)
Neoplasias Óseas/diagnóstico , Neoplasias de los Bronquios/diagnóstico , Carcinoma de Células Escamosas/diagnóstico , Neoplasias Óseas/diagnóstico por imagen , Neoplasias Óseas/secundario , Neoplasias de los Bronquios/diagnóstico por imagen , Neoplasias de los Bronquios/patología , Neoplasias de los Bronquios/cirugía , Carcinoma de Células Escamosas/diagnóstico por imagen , Carcinoma de Células Escamosas/secundario , Carcinoma de Células Escamosas/cirugía , Diagnóstico Diferencial , Dedos , Humanos , Rodilla , Masculino , Persona de Mediana Edad , Metástasis de la Neoplasia , RadiografíaRESUMEN
Eosinophilic lung disease is characterised by eosinophilic infiltration of lung tissue besides peripherical blood and bronchoalveolar lavage (BAL) fluid eosinophilia. A 48 year-old male who attended our clinics with cough and sputum lasting for 2-3 months, has been evaluated for micronodular interstitial infiltration bilaterally in all lung areas. Eosinophilia was detected in hemogram but BAL fluid was not diagnostic. Transbronchial lung parenchymal biopsy was compliant with chronic eosinophilic pneumonia. No special cause has been found after evaluation and the case was accepted to be idiopathic. Because of unfamiliar clinical, radiological and pathological findings, we decided to present this case.