Eosinopenia and neutrophil-to-lymphocyte count ratio as prognostic factors in exacerbation of COPD.

Exacerbations of Chronic Obstructive Pulmonary Disease (AECOPDs) are one of the most important clinical aspects of the disease, and when requiring hospital admission, they significantly contribute to mortality among COPD patients. Our aim was to assess the role of eosinopenia and neutrophil-to-lymphocyte count (NLR) as markers of in-hospital mortality and length of hospitalization (LoH) among patients with ECOPD requiring hospitalization. We included 275 patients. Eosinopenia was associated with in-hospital deaths only when coexisted with lymphocytopenia, with the specificity of 84.4% (95% CI 79.6-88.6%) and the sensitivity of 100% (95% CI 35.9-100%). Also, survivors presented longer LoH (P < 0.0001). NLR ≥ 13.2 predicted in-hospital death with the sensitivity of 100% (95% CI 35.9-100%) and specificity of 92.6% (95% CI 88.8-95.4%), however, comparison of LoH among survivors did not reach statistical significance (P = 0.05). Additionally, when we assessed the presence of coexistence of eosinopenia and lymphocytopenia first, and then apply NLR, sensitivity and specificity in prediction of in-hospital death was 100% (95% CI 35.9-100) and 93.7% (95% CI 90.1-96.3), respectively. Moreover, among survivors, the occurrence of such pattern was associated with significantly longer LoH: 11 (7-14) vs 7 (5-10) days (P = 0.01). The best profile of sensitivity and specificity in the prediction of in-hospital mortality in ECOPD can be obtained by combined analysis of coexistence of eosinopenia and lymphocytopenia with elevated NLR. The occurrence of a such pattern is also associated with significantly longer LoH among survivors.

E-cigarette use among young adults in Poland: Prevalence and characteristics of e-cigarette users.

PURPOSE: Electronic cigarette (e-cigarette) use is one of the most popular alternatives to conventional cigarette smoking. This study aimed to investigate the prevalence of cigarette and e-cigarette use among university students from Poland, with particular emphasis on ever and current cigarette and e-cigarette use as well as smoking initiation age. PATIENTS AND METHODS: A cross-sectional survey was conducted between 2017 and 2018 in a group of university students in 5 academic centers in Poland. The questionnaire addressed 46 questions about personal attitudes toward cigarette smoking and e-cigarette use. RESULTS: Data were collected from 7324 participants (67.3% females, aged 21.9 ± 2.1 years), with an overall response rate of 70.1%. Among participants, 71.2% had ever smoked a cigarette, and almost half of the respondents (45%) declared ever use of an e-cigarette. The mean age of first use of a cigarette was significantly lower (16.5 ± 2.5 y-old) than of an e-cigarette (18.6 ± 2.2 y-old; p < 0.001). Exclusive cigarette smoking was declared by 12.9%, 1.3% were e-cigarette users and 1.5% were dual users. Those in the medical field were less likely to try e-cigarettes (odds ratio, OR = 0.73) or to currently smoke conventional cigarettes (OR = 0.82). Older participants were more likely to have ever smoked conventional cigarettes (OR = 1.06), but less likely to have ever used e-cigarettes (OR = 0.88). CONCLUSIONS: In this study, we found a high proportion of young adults who have tried e-cigarettes with both regional and demographic differences. The education profile influences cigarette smoking and e-cigarette use behaviors.

Smoking Cessation and Vaping Cessation Attempts among Cigarette Smokers and E-Cigarette Users in Central and Eastern Europe.

Our aim is to assess the smoking cessation and vaping cessation activity, including quit attempts and willingness to quit among university students in Central and Eastern Europe, as well as to investigate personal characteristics associated with smoking cessation and vaping cessation attempts. Data were collected by questionnaire which included 46 questions on cigarette and e-cigarette use. Questionnaires were obtained from 14,352 university students (aged 20.9 ± 2.4 years; cooperation rate of 72.2%). For the purposes of this analysis, only data from exclusive cigarette smokers (n = 1716), exclusive e-cigarette users (n = 129), and dual users (216) were included. Of all cigarette smokers, 51.6% had previously tried to quit smoking and 51.5% declared a willingness to quit cigarette smoking in the near future. Among all e-cigarette users only 13.9% had ever tried to quit using the e-cigarette and 25.2% declared a willingness to give up using e-cigarette in the near future. The majority of the group did not use pharmacotherapy to quit cigarette (87.5%) or e-cigarette (88.9%) use. Our results indicate that while most university students have some desire to quit conventional smoking, those who use e-cigarettes do not have the same desire.

The Prevalence of Cigarette and E-cigarette Smoking Among Students in Central and Eastern Europe-Results of the YUPESS Study.

Electronic cigarettes (e-cigarettes) are an alternative to traditional tobacco cigarette smoking. The aim of this study was to assess the prevalence of cigarette smoking and e-cigarette use among university students from Central and Eastern Europe and to investigate personal characteristics associated with cigarette and e-cigarette smoking. A questionnaire-based cross-sectional survey was performed between 2017-2018 among university students in five European countries: Belarus, Lithuania, Poland, Russia, and Slovakia. The questionnaire included 46 questions related to the frequency and habits of traditional cigarettes and e-cigarettes use. Completed questionnaires were obtained from 14,352 students (8800 medical; aged 20.9 ± 2.4 years) with an overall response rate of 72.2%. Two-thirds of the respondents had smoked a traditional tobacco cigarette and 43.7% had used an e-cigarette. Overall current smoking status included 12.3% traditional cigarette smokers, 1.1% e-cigarette users, and 1.8% were dual users with the remainder being non-smokers. Smoking status differed between the research centres (p < 0.001). Females were less likely to try either cigarettes (OR = 0.83) or e-cigarettes (OR = 0.62) and were less likely to be current cigarette (OR = 0.64), e-cigarette (OR = 0.34), or dual users (OR = 0.33) than males. Perception of e-cigarettes significantly differed between smokers and non-smokers (p < 0.001). Among university students, cigarettes are more popular than e-cigarettes.

Monocyte to large platelet ratio as a diagnostic tool for pulmonary embolism in patients with acute exacerbation of chronic obstructive pulmonary disease.

INTRODUCTION    A higher prevalence of pulmonary embolism (PE) has been noted among patients with chronic obstructive pulmonary disease (COPD), particularly in those with acute exacerbations of COPD (AECOPD). Due to a similar clinical presentation and the lack of highly specific laboratory tests, there is a common overuse of computed tomography pulmonary angiography (CTPA). The introduction of an additional, simple, and inexpensive diagnostic tool to help in the diagnosis of PE in patients with AECOPD would be of special interest for everyday clinical practice. OBJECTIVES    The aim of the study was to assess the usefulness of the monocyte to large platelet ratio (MLPR) as a diagnostic tool for PE in patients with AECOPD.  PATIENTS AND METHODS    We performed a retrospective evaluation of patients with AECOPD and suspicion of PE who underwent CTPA. The MLPR was investigated as a marker of thrombosis. Receiver operating characteristics (ROC) curve analyses were preformed to measure the accuracy of the MLPR in comparison with CTPA results and to identify the cutoff value for the MLPR. RESULTS    A total of 101 patients (56 men and 45 women; median age, 72 years; range, 37-94 years) were included in the study. The MLPR showed an excellent accuracy in comparison with CTPA results: the area under the ROC curve was 0.945 (95% confidence interval [CI], 0.904-0.986). The MLPR was characterized by a good accuracy of qualitative test parameters, with high sensitivity (100%; 95% CI, 79.6-100) and specificity (85.7%; 95% CI, 75.9-92.6). CONCLUSIONS    The MLPR measurement appears to be a reliable, simple, inexpensive, and widely available test that may help in the differential diagnosis of PE in patients with AECOPD.