Vitamin D Deficiency and Radiological Findings in Adult Non-Cystic Fibrosis Bronchiectasis.

OBJECTIVES: Vitamin D may play an important role in immunity and its deficiency has been related to increased respiratory infections. The aim of this study was to detect the prevalence of vitamin D deficiency and to investigate the relationship between radiological and clinical effects on adult bronchiectasis (BR) patients. MATERIALS AND METHODS: A total of 130 patients with BR and 73 healthy individuals (control group) were enrolled in this study. Radiological severity was assessed using Modified Reiff Score. RESULTS: The mean age of patients was 41.9±9.1 years (range, 18-85). The mean 25-hydroxyvitamin D (25(OH)D) level was 14.7±9.6 ng/mL in BR patients and 19.8±6.9 ng/mL in the control group (p=0.001). Moreover, 95 (73.1%) adult BR patients were categorized as vitamin D deficient. Patients in the vitamin D deficiency group had significantly higher Modified Medical Research Council scores than those in the group without vitamin D deficiency (p=0.036) The mean modified Reiff score was higher in the vitamin D deficient group than the without vitamin D deficiency group (6.9±3.8 vs 4.9± 2.7, p=0.001). Additionally, the vitamin D deficient group had lower forced vital capacity% predicted value (p=0.02). This model showed that Reiff score (OR, 1.285[1.039-1.590]; p=0.021) was independently related to vitamin D deficiency. CONCLUSION: We found that vitamin D deficiency is commonly seen in adult BR patients in a stable period. Moreover, it might be related to severe radiological findings on chest computed tomography and worse lung functions.

Engaging nurses in smoking cessation: Challenges and opportunities in Turkey.

This paper discusses the training of nurses in smoking cessation as part of routine patient care in Turkey. Formative research was carried out prior to training to identify challenges faced by smokers when trying to quit. Site visits to government hospitals and cessation clinics were conducted to observe health care provider-patient interactions involving behavior change. Four culturally sensitive cessation training workshops for nurses (n = 54) were conducted in Istanbul. Following training, nurses were debriefed on their experiences delivering cessation advice. Challenges to cessation counseling included lack of time and incentives for nurse involvement; lack of skills to deliver information about the harm of smoking and benefits of quitting; the medicalization of cessation through the use of pharmaceuticals; and hospital policy which devalues time spent on cessation activities. The pay-for-performance model currently adopted in hospitals has de-incentivized doctor participation in cessation clinics. Nurses play an important role in smoking cessation in many countries. In Turkey, hospital policy will require change so that cessation counseling can become a routine part of nursing practice, incentives for providing cessation are put in place, and task sharing between nurses and doctors is clarified. Nurses and doctors need to receive training in both the systemic harms of smoking and cessation counseling skills. Opportunities, challenges and lessons learned are highlighted.

Fagerstrom test for nicotine dependence: reliability in a Turkish sample and factor analysis.

Fagerstom Test for Nicotine Dependence (FTND) has often been used as a measure of physical dependence on nicotine. In this study, we aimed to verify the usefulness of FTND and Heaviness of Smoking Index (HSI) in a sample of Turkish smokers and present relationship among interrelated items in our Turkish version of FTND by factor analysis. One hundred sixty nine smokers, 104 (61.5%) males, 65 (38.5%) females smoker were administered the Turkish translation of FTND. Fifty-two current smokers selected randomly from 169 were administered the questionnaire for test- retest reliability analysis. The Turkish version of FTND had moderate reliability (Cronbach alpha: 0.56). One FTND item (question 3: hate- most to give up) performed poorly on construct reliability tests. Factor 1 was loaded by questions 1 (first cigarette after awakening), 4 (number of cigarettes per day), 5 (smoking status during the first hours), 6 (smoking if ill), 2 (refrain from smoking in forbidden places) and factor 2 was separately loaded by question 3. Question 3 did not have significant correlation with the total score and the response to this question was significant between test and retest. The Turkish version of FTND may become a measuring tool in the assessment of smoking cessation programs. However, question 3 must be used attentively and preferably an explanation should be made to enable a clear understanding of the question to the Turkish smokers as they take the test.

A case report of endobronchial semi-invasive aspergillosis.

Pulmonary aspergillosis may be classified under three main categories. These are invasive pulmonary aspergillosis, allergic bronchopulmonary aspergillosis and aspergilloma. Sometimes more than one form of the disease may be present at the same time. Semi-invasive aspergillosis is different from aspergilloma in that there is local invasion of the lung tissue. We have observed a previously healthy 42 year old female with a solitary pulmonary nodule on her radiograms. A diagnosis of endobronchial semi-invasive aspergillosis was established in this patient. We aimed to present this case report with a review of the literature.