Correlation of Indeterminate Lesions of COVID-19 Pneumonia Detected on Computed Tomography with RT-PCR Results.

BACKGROUND: The typical findings of COVID-19 pneumonia include multilobar groundglass opacities and consolidation areas observed predominantly in the basal and peripheral parts of both lungs in computed tomography. OBJECTIVE: The current study aimed to correlate indeterminate lesions of COVID-19 pneumonia detected on computed tomography with the results of the reverse transcription-polymerase chain reaction (RT-PCR) test. METHODS: Patients with high-resolution computed tomography images that were reported to contain indeterminate lesions in terms of COVID-19 pneumonia were included retrospectively in the study. The lesions were categorized and the patterns were classified. The RT-PCR-positive and the RTPCR- negative patients were compared. P<0.05 was accepted as the statistical significance limit. RESULTS: The RT-PCR-positive patients exhibited a higher rate of peripheral lesions. Limited consolidation areas were not detected in the RT-PCR-positive patients. In the RT-PCR-negative patients, the rates of acinar nodules and the tree-in-bud pattern were significantly higher. The RTPCR- negative patients had higher nodular contour features and lesion coalescence. In the subgroup consisting of lesions with ground-glass opacities and/or ground-glass opacity around the nodule, the rate of nodular contour positivity was significantly higher in the RT-PCR- positive patients. CONCLUSION: COVID-19 pneumonia should be suspected when peripheral indeterminate lesions are detected. When indeterminate lesions, such as tree-in-bud pattern, acinar nodules and limited consolidation area are detected, alternative diagnoses should be considered first, even if there are ground glass opacities accompanying these lesions.

Medical treatment of a symptomatic acute pulmonary vein stenosis following antral pulmonary vein isolation.

Pulmonary vein (PV) stenosis is a rare but serious complication of PV isolation. It usually develops 3-6 months after the procedure, but may rarely develop in the acute phase. We present a case of symptomatic PV stenosis within 48 hours after antral PV isolation. Following the initiation of medical treatment including a glucocorticoid, acute changes in the PV wall regressed and the patient's complaint of dyspnea at rest improved rapidly. In addition, long-term renin-angiotensin-aldosterone system (RAAS) blockers were given. The complaint did not recur during follow-up and PV stenosis was mild at 6 months.

[Optical Coherence Tomography Findings in Cannabis Users]. / Kannabis Kullanan Olgularda Optik Koherens Tomografi Bulgulari.

OBJECTIVE: In this study, we aimed to evaluate the effects of cannabis use on the retinal nerve fiber layer (RNFL) and the macular ganglion cell - inner plexiform layer GCL-IPL using optical coherence tomography (OCT). METHOD: This prospective, comparative study included 26 cannabis users who were evaluated at the Psychiatry Outpatient Unit of Mus State Hospital and 27 age and gender matched healthy controls. OCT was performed on both groups. The RNFL and GCL - IPL thicknesses, measured automatically by OCT, were recorded and compared between the groups. RESULTS: The sociodemographic parameters of the two groups did not differ. The mean retinal nerve fiber thickness and thickness at the superior, nasal, inferior quadrants were not significantly different; but there was a significant difference at the temporal quadrant (p=0,022). In the analysis of macular ganglion cell - inner plexiform layer, the mean values as well as the infetotemporal, inferior, inferonasal and superonasal quadrants did not show significant differences. But there was a statistically significant decrease in the superior and superotemporal quadrants (p=0,006, p=0,027). CONCLUSION: These findings suggest that cannabis use leads to the thinning on retinal layers. As it is an easily observable part of the brain, evaluating retinal nerve fiber and ganglion cell layer with OCT may be important for monitoring toxic and degenerative effects in cannabis users.

Domestic Violence Among Women Attending to Psychiatric Outpatient Clinic.

OBJECTIVE: Domestic violence (DV) is defined as all kinds of abusive behaviors between spouses or relatives living in the same house. Domestic violence is most commonly directed towards women and children. This study aims to review the extent of domestic violence among women consulting to psychiatric outpatient clinic, and to identify its relation with sociodemographic risk factors and psychological symptoms. METHOD: Self-reported Domestic Violence Questionnaire and Symptom Checklist-90-R (SCL-90-R) information was collected from women who admitted to psychiatric outpatient clinic at Marmara University Research and Educational Hospital, and accepted to participate in the study. RESULTS: 300 women participated in the study. Mean age of participants was 36.24±10.88, 75.7% of them were married, and mostly live within nuclear families. 70.1% of the participants reported verbal violence, and 49.0% reported physical violence. 65.3% of those who have experienced verbal violence have also experienced physical violence. 26.1% of them reported as not having experienced domestic violence before. The nature and extent of domestic violence, women's attitudes towards it, and its relation with experience of domestic violence during childhood have been explored. Participants' educational levels, current age and age of marriage, style of marriage, educational level and age of spouse were not found to be associated with experiencing of domestic violence. Both verbal and physical domestic violence were significantly associated with the economic status of women (p<0.05). The mean SCL-90-R score was 1.40±0.68 with the highest mean subgroup score under depressive symptoms category (1.80±0.79). Mean SCL-90-R score showed significant association with the experience of domestic violence (p≤0.001). CONCLUSION: Most of the women participated in the study have experienced domestic violence. Both verbal and physical violence increased with lower economic status. Psychiatric symptoms increased with the experience of domestic violence. Considering its high prevalence and detrimental psychological effects, domestic violence should be inquired by clinicians as part of the psychiatric interview.

Efficacy of bright light therapy in bipolar depression.

For 30 years, bright light therapy (BLT) has been considered as an effective, well-tolerated treatment for seasonal affective disorder (SAD). Because of low response rates, new treatment strategies are needed for bipolar depression (BD), which resembles SAD in certain respects. Few placebo-controlled studies of BLT efficacy have been carried out for BD. Accordingly, this study evaluates the efficacy and safety of BLT as an add-on treatment for BD. Thirty-two BD outpatients were randomly assigned to BLT (10000lx) or dim light (DL, < 500lx). During a two-week period, light was administered each morning for 30min. The Hamilton Rating Scale for Depression and the Montgomery-Ǻsberg Depression Rating Scale assessed clinical outcome, and the UKU Side Effects Rating Scale evaluated side effects. No significant difference was observed in baseline depression scores in the two groups. Response rates for BLT and DL were 81% and 19%, and remission rates were 44% and 12.5%, respectively. Analyses showed statistically significant reductions in depression scores for the BLT group compared with the DL group on all scales. Side effects were similar in both groups, with headache as the most common side effect. The results suggest that BLT is an effective and safe add-on treatment for BD.

Executive Functions of Obsessive Compulsive Disorder and Panic Disorder Patients in Comparison to Healty Controls.

INTRODUCTION: Patients with obsessive compulsive disorder (OCD) have impaired cognitive functions, including attention, verbal and visual memory, and visual-spatial abilities as well as executive function But some studies did not show any disturbance in executive function of patients with OCD. To date, only few studies have been conducted on neuropsychological functioning of patients with panic disorder (PD). There are limited studies to reach a definite conclusion on executive functions of patients with OCD and those with PD. In this study, we aimed to measure executive functions of patients with OCD and those with PD compared with those of healthy controls. Although there are many studies on cognitive functions of patients with OCD, there appears to be no consistency in results and no findings have been obtained to enable us to reach definite conclusions. Although there are very few studies on neuropsychological functions of patients with PD, impairments on a set of cognitive functions have been demonstrated. To date, no finding with respect to impairment in executive functions of patients with PD has been published. PD and OCD are disorders manifesting similar characteristics, with the presence of anxiety and avoidance behavior. Besides this, patients with OCD also have symptoms such as obsessions and compulsions that are characteristics of this disorder. We aim to compare executive functions in the three groups (patients with OCD, those with PD, and healthy controls) in this study. METHOD: Seventeen patients with OCD and 15 patients with PD who were diagnosed according to Diagnostic and Statistical Manual of Mental Disorder -IV-TR (DSM-IV-TR) and 26 healthy control subjects were included in this study. Patients who used medication as well as those with medical illnesses and Axis-I comorbidities were excluded. The healthy control group subjects were matched with the patients in terms of age, gender, and education. Structured Clinical Interview for DSM-IV Axis-I Disorders-Clinical Version (SCID-I), Hamilton Depression Rating Scale (HDRS), and Yale-Brown obsessive compulsive scale tests (Y-BOCS) were administered to the patients. Trail Making Tests (TMT), verbal fluency tests (Controlled Oral Word Association Test and Categorical Naming), Stroop Test, and Wisconsin Card Sorting Test (WCST) were administered to the study groups. RESULTS: According to our results, there was no statistically significant difference between the three study groups with respect to executive functions. There was also no significant correlation between executive tests' results and Y-BOCS'in the OCD group. CONCLUSION: The results of the PD group are in line with that reported in literature. The results of the OCD group can be explained by a lack of medication usage and any comorbidity including depression. A small sample size is the major limitation of our study.

Social Anxiety and Quality of Life in Vitiligo and Acne Patients with Facial Involvement: A Cross-Sectional Controlled Study.

BACKGROUND: Vitiligo and acne vulgaris, commonly affecting the face, have significant psychological effects and impair the quality of life of the affected individuals. Because of their negative effect on physical appearance, these conditions may act as a potential barrier to social relationships and cause social anxiety. OBJECTIVE: The objective of the study was to investigate the social anxiety, quality of life, anxiety, and depression levels of acne and vitiligo patients with facial involvement and compare these levels with healthy controls. METHODS: Thirty-seven vitiligo and 37 acne patients, aged older than 18 years, with facial involvement and 74 age- and sex-matched healthy control subjects were included in the study. The patients and healthy controls were asked to complete the Liebowitz Social Anxiety Scale, the Hospital Anxiety and Depression Scale, and the Dermatology Life Quality Index. Disease severity was evaluated both objectively by the physician and subjectively by the patients using a visual analog scale. RESULTS: Social anxiety, depression, and anxiety levels of vitiligo and acne patients were significantly higher than healthy controls (p < 0.05). Quality of life was impaired in both patient groups (Dermatology Life Quality Index scores for vitiligo: 5.6 ± 5.1; acne: 6.4 ± 6.2). There was no correlation between psychiatric scale scores and disease severity. Quality of life was negatively correlated with social anxiety and depression levels in both patient groups in our study. CONCLUSION: Vitiligo and acne patients had higher levels of social anxiety, anxiety, and depression compared with healthy control subjects. Considering that increased psychosocial morbidity was regardless of age, sex, and disease severity and was correlated with quality of life impairment, evaluation of the psychosocial morbidity, in particular social anxiety, may be valuable in all vitiligo and acne patients.

[Deleterious Results of Safety Seeking Behaviours in Panic Disorder: Polydipsia and Diabetes Mellitus Type 2]. / Panik Bozuklugunda Güvenlik Saglama Davranislarinin Medikal Sonuçlari: Polidipsi ve Tip 2 Diabetes Mellitus.

Panic disorder is an anxiety disorder that involves recurrent panic attacks, which emerge when a harmless stimulus is interpreted as "catastrophic". In an attempt to avoid the panic attack or prevent confrontation, the patient exhibits a dysfunctional attitude and behavior, such as evasion and safety-seeking behavior (SSB). Dysfunctional behavior leads to an increase in the recurrence of panic attacks and affects the patient's life in a negative way. According to the cognitive behavioral therapy model, SSB contributes to the continuation of unrealistic beliefs (e.g. physical experiences) regarding and prevents the patient from grasping new information that may potentially contradict the unrealistic cognitions. In this paper, we present a case with a primary diagnosis of panic disorder. Interestingly, this patient developed diabetes mellitus (DM) type 2 and psychogenic polydipsia (PPD) as a consequence of his SSB. PPD is a common occurrence in patients with psychiatric disorders, especially in schizophrenia. Up to now, no case of a panic disorder with either DM or PPD has been reported in the literature. While it is accepted that major depression poses a risk for DM type 2, panic disorder may also increase this risk. Treatment of the panic disorder with cognitive behavioral therapy (CBT) resulted in improvement of PPD and DM type 2. In conclusion, the role of SSB in medical disorders accompanied by psychiatric disorders should be kept in mind when treating these patients.

Association between I/D polymorphism in the ACE gene and sarcoidosis in Turkish patients.

Sarcoidosis is a chronic inflammatory disease with a complex pathogenesis and unknown etiology characterized by noncaseating granulomas that invade the lungs, eyes, liver and other organs. Insertion (I)/deletion (D) polymorphism in the gene encoding the angiotensin-converting enzyme (ACE) has been studied to examine the genetic predisposition to sarcoidosis in different populations, but the results have been inconsistent and inconclusive. This study aimed to determine the frequencies of the genotypes and alleles of I/D polymorphism in the ACE gene in Turkish patients as a distinct ethnic group and to investigate whether such polymorphism is associated with predisposition to sarcoidosis. Genomic DNA samples obtained from 154 individuals (70 patients with sarcoidosis and 84 healthy controls) were used in the study. The DNA was amplified using polymerase chain reactions using allele-specific primers. The amplified products were analyzed by 2 % agarose gel electrophoresis followed by UV transillumination. The allele frequencies and genotype distribution of the groups were analyzed using the Chi square test. There were no significant differences between the controls and sarcoidosis cases with respect to genotype distribution (χ(2) = 4.202, p = 0.122) and allele frequencies (χ(2) = 1.358, p = 0.244). Our results suggest that I/D polymorphism in the ACE gene does not cause a genetic predisposition to sarcoidosis in Turkish patients.

Effect of aspirin desensitization on T-cell cytokines and plasma lipoxins in aspirin-exacerbated respiratory disease.

The pathogenesis of aspirin-exacerbated respiratory disease (AERD) is thought to be based on, mainly, overproduction of eicosanoid lipid mediators and on defective anti-inflammatory regulators. Aspirin desensitization treatment, the mainstay of controlling asthma and rhinitis in AERD patients, however, is the least understood aspect of the disease. The study was designed to determine the effect of aspirin desensitization on T-lymphocyte cytokine expression and on plasma lipoxin levels in AERD. Spirometry, skin-prick test and asthma control test were documented and intracellular cytokine expression in T lymphocytes and plasma lipoxin levels were measured in 23 AERD patients, 17 aspirin-tolerant asthmatic (ATA) patients, and 16 healthy controls. In the AERD group nasal symptom and smell scores were assessed. Of the 23 AERD patients 15 accepted to undergo aspirin desensitization protocol and 14 of them were desensitized successfully. In the desensitized AERD group, cytokine and lipoxin measurements were repeated after 1-month aspirin treatment. CD4(+) IL-10 levels were higher in AERD patients than in healthy controls and CD4(+) interferon (IFN) gamma levels were higher in AERD and ATA patients than in controls. Plasma lipoxin-A4 and 15-epi-lipoxin-A4 levels were similar among the three study groups. In the AERD group, subjects underwent aspirin desensitization followed by a 1-month aspirin treatment. Clinical parameters improved and CD4(+) IFN-gamma levels decreased significantly. No significant change in lipoxin levels was recorded. CD4(+) IFN-gamma and CD4(+) IL-10 levels in AERD patients after 1-month aspirin desensitization treatment were similar to the healthy controls. The study confirms aspirin desensitization is effective clinically in AERD patients and suggests that IFN gamma and IL-10 expression in CD4(+) T lymphocytes may be related to the mechanism of action.

Is there a genetic predisposition for Turkish patients with sarcoidosis in the 329-bp region containing the BTNL2 rs2076530 polymorphism?

BACKGROUND/AIM: Sarcoidosis is a complex, multifactorial immune disorder with unknown etiology. A single nucleotide polymorphism (G→A, rs2076530) in the butyrophilin-like 2 (BTNL2) gene results in a truncating protein formation. It has been previously reported that this variation may be a risk factor for sarcoidosis in certain ethnic groups. This study was conducted to determine whether there is any genetic predisposition for the BTNL2 rs2076530 polymorphism in the 329-bp region in Turkish patients with sarcoidosis. MATERIALS AND METHODS: DNA samples were obtained from volunteers including 53 Turkish patients with sarcoidosis and 52 healthy controls. Analysis of the 329-bp region was carried out by polymerase chain reaction and sequencing of genomic DNA. RESULTS: We did not find any genetic variation except the rs2076530 polymorphism in the 329-bp region. The AA genotype was associated with an increased risk of sarcoidosis in a recessive model [P = 0.027, OR 2.56 (95% CI 1.02-6.49)], but it did not include a risk for sarcoidosis in a dominant model (P = 0.885). CONCLUSION: Our results emphasize the recessive characteristic of the rs2076530 polymorphism in Turkish patients with sarcoidosis. The lack of any genetic variation except rs2076530 in the 329-bp region is another significant finding for Turkish patients.

Cytokine expression before and after aspirin desensitization therapy in aspirin-exacerbated respiratory disease.

Aspirin exacerbated respiratory disease (AERD) is induced by acetylsalicylic acid (ASA) and/or nonsteroidal antiinflammatory drugs (NSAIDs). Effects of desensitization on many mediators have been examined previously, but few studies addressed the influence of desensitization on T lymphocytes and T lymphocyte-derived cytokines. This study was performed to examine peripheral blood lymphocyte (PBL) cytokine expression in aspirin-sensitive patients who have asthma before and after aspirin desensitization. In this study, the release of interleukin-2 (IL-2), interleukin-4 (IL-4), and interferon-gamma (IFN-γ) by CD4+ T lymphocytes prior to aspirin desensitization were also measured at intracellular levels, and expression of these cytokines after 1 month aspirin desensitization was evaluated. Twelve patients with AERD were included in the study. Two different control groups were formed, one consisted of 15 healthy people and second 12 aspirin tolerant asthmatic (ATA) patients using aspirin. A blood sample was collected prior to desensitization, and the tests were repeated by taking a second blood sample 1 month after the 4-day desensitization treatment. The proportion of lymphocytes secreting IFN-γ in the study group was 15.61 ± 4.40 % before desensitization and 15.08 ± 5.89 % after desensitization. The rate of IFN-γ secreting CD4+ T lymphocytes was 20.51 ± 4.41 % in the normal control group and 16.07 ± 5.7 % in the ATA group (p = 0.021). The ratio of CD4+ T lymphocyte secreting IFN-γ was reduced in patients with AERD before desensitization compared to normal control group (p = 0.040). The levels of IL-2, IL-4, and the subsets of lymphocyte were not different before and after desensitization compared to control groups.

Bronchial hyperresponsiveness in seasonal allergic rhinitis patients is associated with increased IL-18 during natural pollen exposure.

BACKGROUND: The mechanism of bronchial hyperresponsiveness (BHR) is not certain in seasonal allergic rhinitis (SAR) patients. OBJECTIVE: We aimed to investigate the effects of natural pollen exposure on IL-18 and its relationship with BHR. METHODS: Thirty-two SAR patients with grass pollen sensitivity, 14 nonallergic rhinitis (NAR) patients and 17 normal-controls were included. Sixteen SAR patients had BHR during pollen season and off-season. Serum IL-18 levels were measured in SAR patients during pollen season between May-August and off-season between November-February. IL-18 levels were measured in NAR patients and normal controls once. RESULTS: During pollen season, SAR patients with BHR had significantly increased levels of IL-18 than those without BHR (279.2 ± 161.1 versus 145.3 ± 101.0 pg/ml, p=0.012). Serum IL-18 levels were not different between SAR patients with and without BHR during off-season (233.8 ± 139.7 versus 183.2 ± 162.9 pg/ml, p=0.16). Serum IL-18 levels in SAR patients during pollen season (212.3 ± 148.8 pg/ml) and off-season (208.5 ± 151.5 pg/ml) were not different than those NAR patients (224.8 ± 180.1 pg/ml, p=0.98 and p=1.0, respectively) and normal controls (174.8 ± 76.0 pg/ml, p=0.60 and p=0.76, respectively). CONCLUSION: The results suggested us that BHR in SAR patients is associated with increased IL-18 during natural pollen exposure.

Inflammatory markers in exhaled breath condensate in patients with asthma and rhinitis.

INTRODUCTION: The present study investigates the lower airway inflammation using malondialdehyde and total protein measurement in exhaled breath condensate in mild asthma, persistent rhinitis, and concomitant asthma and rhinitis. PATIENTS AND METHODS: Asthmatics with mild disease, patients with persistent rhinitis symptomatic for at least one year and healthy controls were included. Asthmatics and rhinitis patients were all newly diagnosed and were free of corticosteroid therapy. Participants were nonsmokers, had no respiratoy tract infection within the previous month. Rhinitis patients with asthmatic symptoms and positive bronchial challenge were grouped as patients with persistent rhinitis and concomitant asthma. Malondialdehyde and total protein were measured in the exhaled breath condensate collected from the subjects. RESULTS: No statistical difference was found in the malondialdehyde and total protein levels in exhaled breath condensate between the four study groups which are; 53 patients with persistent rhinitis, 12 with mild asthma, 16 persistent rhinitis patients with concomitant asthma and 13 healthy controls (p> 0.05). Atopy and nasal eosinophilia were not related to malondialdehyde and total protein levels in exhaled breath condensate. CONCLUSION: Lower airway inflammation is not a disease specific process and is not a prerequisite concerning patients with mild asthma or rhinitis or patients with coexistence of both diseases.

Nasal eosinophilia can predict bronchial hyperresponsiveness in persistent rhinitis: evidence for united airways disease concept.

BACKGROUND: Nasal eosinophils may be indicative of bronchial hyperresponsiveness (BHR) in rhinitis concerning the "united airways disease" theory. This study was designed to evaluate the relationship between nasal eosinophilia and BHR in persistent perennial rhinitis patients. METHODS: Thirty-seven patients (12 males and 25 females, mean age: 33.3 ± 10.4 years) were included in the study. Skin-prick test, nasal symptom score, nasal smears, methacholine bronchial challenge test, and nasal rhinometry were obtained in all patients. Eosinophil count in nasal smears was expressed as a percentage of the total cells. None of the patients had asthma. RESULTS: There was no difference between the number of atopic and nonatopic patients having BHR (4/20 versus 4/17; chi-squared = 0.07; p > 0.05). Total nasal flow was lower and percentage of nasal eosinophils was higher in the patients with BHR than in patients without BHR (p = 0.012 and p = 0.009, respectively). A cutoff point of 68% nasal eosinophils yielded a sensitivity of 100% (63.1-100) and a specificity of 58.6% (38.9-76.5) to determine the presence of BHR. Positive likelihood ratio for the value of eosinophils above cutoff value was 2.42 (1.8-3.3). CONCLUSION: This study shows the relationship between nasal eosinophils and BHR in persistent perennial rhinitis patients. Nasal eosinophil percentage below cutoff value indicates that a patient does not have BHR.

Autologous serum skin test response in chronic spontaneous urticaria and respiratory diseases and its relationship with serum interleukin-18 level.

Autologous serum skin test (ASST) is mostly used in chronic spontaneous urticaria (CSU) to show autoreactivity. Interleukin-18 (IL-18) has also been shown to be involved in autoimmune conditions. To investigate the role of autoreactivity assessed by ASST in CSU and respiratory diseases and to investigate whether this autoreactive state is related to IL-18 level or other clinical covariates. Fifty-five patients with CSU (mean age: 40.3 ± 12.3 years), 70 patients with persistent asthma (mean age: 43.7 ± 9.6 years), 21 patients with seasonal allergic rhinitis (SAR) (mean age: 35.5 ± 11.8 years) and 20 normal controls (mean age: 37.7 ± 9.8) were included. All subjects underwent a laboratory examination and skin prick test. ASST was performed and serum IL-18 levels were measured in all subjects. Positive response to ASST and serum IL-18 levels were higher in CSU patients than those with respiratory diseases (asthma and SAR) (P = 0.034 and 0.002, respectively) and normal controls (P = 0.004 and 0.031, respectively). Considering all patients, IL-18 levels were higher in patients with positive ASST (301.8 ± 194.4 vs. 241.8 ± 206.3 pg/ml, P = 0.036) than ASST negative patients. ASST response was associated with disease severity in CSU (P = 0.037) and asthma patients (P = 0.001). Multivariate analysis showed that positive response to ASST was significantly associated with diagnosis of CSU (OR: 3.13, 95% CI: 1.25-7.87) and female gender (OR: 3.98, 95% CI: 1.19-13.38). ASST response could be related with activity of the disease. A positive ASST response found in respiratory diseases patients suggests that it may occur as a result of some inflammatory events during the diseases' process.

Occupational exposures as risk factors for asthma and allergic diseases in a Turkish population.

PURPOSE: There has been no community-based epidemiological study on the relation of occupational exposures with asthma, rhinitis, and eczema in Turkey. We examined the relationship between occupational exposures and adult-onset asthma, wheezing, allergic rhinitis, and eczema in a Turkish adult population. METHODS: The data was collected from 1,047 adults, selected randomly from five distant family health centers. Questionnaires were filled by family practitioners with the help of interviews. The data included physician-diagnosed asthma, allergic rhinitis, eczema, wheezing, and occupational exposures. RESULTS: Wheezing in all the subjects was associated with past exposure to irritants (OR: 1.7, 95%CI: 1.0-2.9), wood/coal smoke (OR: 2.3, 95%CI: 1.0-5.3), metal dust (OR: 2.6, 95%CI: 1.2-5.7), volatile fumes (OR: 2.5, 95%CI: 1.1-5.3), and paper dust (OR: 3.7, 95%CI: 1.5-8.9). Past exposure to dust (OR: 4.1, 95%CI: 1.2-14.2) and to irritants (OR: 6.5, 95%CI: 2.0-20.4) were associated with increased prevalence of wheezing in nonsmokers, whereas current exposure to irritants was associated with decreased prevalence of wheezing (OR: 0.1, 95%CI: 0.01-0.9) in these subjects. In subjects who were regular smokers, exposure to metal dust (OR: 2.8, 95%CI: 1.2-6.5), volatile fumes (OR: 2.3, 95%CI: 1.0-5.3), and paper dust (OR: 3.3, 95%CI: 1.3-8.6) were the main causes for wheezing. Physician-diagnosed eczema was associated with occupational exposure to chemical fumes (OR: 3.7, 95%CI: 1.3-10.6). CONCLUSION: The present study showed that occupational exposures were associated with wheezing and eczema prevalence in the studied population. Nonsmokers could be more vulnerable to respiratory effects of occupational exposures due to healthy smokers effect.

Immediate type drug hypersensitivity reactions and associated risk factors in an adult Turkish men population.

The study aimed to assess the prevalence and associated risk factors of immediate-type hypersensitivity reactions (HRs) to drugs in workers. The data consisted of 1152 questionnaires obtained from adult men that consisted of questions on HRs induced by drugs. The prevalence of self-reported drug HRs was 3.6% for all reactions. HRs were most common to beta-lactam antibiotics (51.2%) followed by nonsteroid antiinflammatory drugs (NSAIDs) (41.5%). Multivariate analysis showed that family atopy was associated with drug HRs to both antibiotics (Odds Ratio (OR) 95% Confidence Interval (CI) (3.32 (1.15-9.56)) and NSAIDs (3.70 (1.09-12.51)). Drug HRs of any type were associated with atopic family history (3.23 (1.43-7.24)), ever asthma diagnosis (2.74 (1.07-7.02)), ever allergic rhinitis (2.70 (1.25-5.84)), and ever eczema (3.80 (1.55-9.30)). Drug related skin manifestations were associated with family history of atopic diseases (4.07 (1.76-9.41)), ever allergic rhinitis (2.84 (1.24-6.5)), ever asthma diagnosis (3.16 (1.19-8.39)), and ever eczema diagnosis (4.59 (1.82-11.57)). Systemic manifestations of drug HRs were associated with only asthma diagnosis (4.66 (1.25-17.41)). Risk groups should be followed closely as candidates for immediate type HRs to antibiotics and NSAIDs in also relatively healthy and young aged adult men.