Impact of pre-test information on patient compliance with the spirometry protocol: a randomized controlled clinical trial.

OBJECTIVE: This study evaluated the effect of brochure-based and video-assisted information provided before spirometry on patient compliance. PATIENTS AND METHODS: This was a randomized controlled clinical trial. Before the test, subjects in intervention groups were shown a leaflet outlining the steps of the spirometry protocol and a video prepared for the same purposes. The control group was given standard routine information by the technician before spirometry. RESULTS: The study included 450 patients. We found a significant correlation between compliance status and age, female sex, being a non-smoker, having no known lung disease, investigating respiratory disease as an indication for spirometry, having first-time spirometry, and receiving pre-test information via leaflets. Variables of age, sex, smoking, indication for spirometry, diagnosis, and previous spirometry, which were found in multivariate analysis to be associated with 'compliance with the test protocol' were further processed using regression analysis which identified 'previous spirometry' as the most decisive variable affecting 'compliance with the test protocol'. CONCLUSIONS: Providing information via brochure-based and video-supported information did not contribute to compliance with the testing protocol, leading us to the conclusion that such informative tools do not provide an additional contribution. Previous spirometry experience was the most decisive parameter influencing adherence to the test protocol.

Battery-induced Esophageal Foreign Body Injury, Complications and Treatment Outcome

ABSTRACT Objective: To assess the severity caused by button batteries in esophagus. Methods: A total of 32 patients admitted with ingesting button batteries were retrospectively evaluated. Chest X-ray was ordered for diagnosis. Hospital stays, interventions, complications and mortality of the patients were collected. The time between the patients ingested the buton battery and its removal was defined as its duration in esophagus. All the patients underwent rigid esophagoscopy under general anaesthesia. Buton batteries at the first narrowing were removed by magyl clamp. Results: Of 32 patients, 21 were females, with a mean age of 22 months. The mean duration of ingestion was 17 hours. The mean hospital stay was 10 days. Of the patients, 75% were admitted within 24 hours. Complication rate was 19% and mortality rate was 6%. There was a strong correlation among the number of the cases and the coming years (p < 0.001). The regression was between the number of cases per year (outcome variable) and the years of the study (explanatory variable), (p< 0.001, R = 0.644, Figure 3). There was a significant finding that more cases (90%) were admitted in the last 12 years compared with the number in first 12 years (p < 0.001). There were no complications in cases in which the button battery was impacted in esophagus for less than 24 hours; however, eight cases whose duration was more than 24 hours resulted in complications in six patients and fatality in two patients (p < 0.001). Conclusion: Batteries should be removed upon its diagnosis. Otherwise, the injury in the esophageal mucosa may be caused by delay and can cause an increase in morbidity and mortality.

Factors Associated with High-grade Smear Positivity Levels in Pulmonary Tuberculosis

ABSTRACT Objective: The high-grade level of smear acid-resistant bacilli (ARB) positivity has been linked to increased infectiousness in pulmonary tuberculosis (TB). The ability to predict infectiousness is important in the management of the disease. The present study aimed to investigate the relationship between smear results, the clinical features, and the levels of radiological involvement of TB. Methods: A total of 245 cases diagnosed with pulmonary TB were admitted to the study. Data including age, sex, case definition, numbers and characteristics of symptoms, smear results, smear positivity grades, and levels of radiological involvement were recorded. Relations between smear results and other data were determined via cluster tree and regression analysis. Results: The group with only coughing had higher rates of both positive smear and high smear positivity levels (p = 0.014 and p = 0.02, respectively) compared to the group without coughing. Similarly, the groups with moderate or high radiological involvement showed significantly higher rates of both positive smear and high smear positivity level when compared to the group exhibiting low radiological involvement (p < 0.001). Conclusion: Patients with coughing and a moderate to high level of radiological involvement should be closely monitored due to their high-level risk of transmission.

Prognostic factors influencing survival in 35 patients with malignant peritoneal mesothelioma.

Malignant mesothelioma is a rare but highly lethal form of cancer that affects the serosal membranes. Malignant peritoneal mesothelioma (MPM) is the second most common form of malignant mesothelioma (pleural mesothelioma is the most common). The aim of this study was to evaluate prognostic factors influencing the survival of patients with MPM. A retrospective analysis was performed on 35 patients who were admitted to our hospital between March 2005 and July 2013. The patients' demographic and clinical data, laboratory results, radiological signs, Eastern Cooperative Oncology Group (ECOG) performance status (PS), and treatment outcomes were evaluated. The mean age of the 35 patients was 59.0±14.4 years, the mean survival time was 16.2±12.9 months, and the majority of the histopathological types of MPM were epithelial (68.6%). 82.9% of the patients had been exposed to asbestos, and the mean duration of exposure was 28.3±14.5 years. The most frequent symptoms were abdominal distention/pain, weight loss, dyspnea, and chest pain. The mean interval between the onset of symptoms and the diagnosis was 4.6±3.3 months. Platinum-based combination chemotherapy in combination with supportive care was used in the treatment of 68.6% of the patients, while supportive treatment alone was used in the others. Our results revealed that patients who were >60 years old (p=0.019), who were exposed to asbestos >20 years (p=0.033), who had an ECOG PS of 3 (p=0.000) were more likely to have a poor MPM prognosis.In conclusion, increased age, duration of environmental asbestos exposure and ECOG PS are important factors that influence the prognosis of MPM patients.