Evaluation of the relationship between anxiety and nutritional habits in Turkish patients with multiple sclerosis during the Covid-19 outbreak / Avaliação da relação entre ansiedade e hábitos nutricionais em pacientes turcos com esclerose múltipla durante o surto da Covid-19

ABSTRACT Objective The Coronavirus disease 2019 is a global public health problem that has led to psychological disorders (depression, anxiety, etc.), especially in fragile individuals such as those affected by multiple sclerosis. This study investigated the relationship between anxiety and nutritional habits during the Coronavirus disease 2019 outbreak in multiple sclerosis patients. Methods This cross-sectional study was an online survey of multiple sclerosis patients living in Turkey. The total sample consisted of 294 multiple sclerosis patients. A questionnaire containing general demographic data, the Beck Anxiety Inventory, and nutritional attitudes and habits was applied to multiple sclerosis patients. Results Moderate or severe anxiety scores were found in 42.2% of multiple sclerosis patients. Weight gain was reported in 40.5% of them during the outbreak. A statistically significant difference was found in the distribution of individuals' Beck Anxiety Inventory scores for consumption of nuts/seeds, rice/pasta, cake/cookies, and water. A 1-unit increase in Beck Anxiety Inventory scores led to a 1.04 times increased consumption of bread and rice/pasta and a 1.05 times increased consumption of cake/cookies either before or after controlling for potential confounders. A 1-unit increase in Beck Anxiety Inventory scores led to a 1.06 times decreased consumption of water and a 1.04 times decreased consumption of meat and poultry, fruit (fresh), and rice/pasta, either before or after controlling for potential confounders. Conclusion During the Coronavirus disease 2019 outbreak, anxiety led to changes in multiple sclerosis patients' nutritional habits and food preferences. The continuous surveillance of psychological consequences and nutritional counseling during outbreaks should become routine as part of preparedness efforts worldwide.

RESUMO Objetivo A doença do Coronavírus - 2019, causada pelo Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2), é um problema de saúde pública global e tem levado os indivíduos desenvolverem distúrbios psicológicos (depressão, ansiedade, etc.), especialmente indivíduos frágeis, como aqueles afetados por esclerose múltipla. O objetivo deste trabalho foi investigar a relação entre ansiedade e hábitos nutricionais em pacientes com esclerose múltipla durante o surto de coronavírus. Métodos Este estudo transversal é resultado de uma pesquisa online com pacientes com esclerose múltipla que vivem na Turquia (n=294). Um formulário de questionário contendo dados demográficos gerais, o Inventário de Ansiedade de Beck e atitudes e hábitos nutricionais foi aplicado a pacientes com esclerose múltipla. Resultados Escores de ansiedade moderados ou graves foram encontrados em 42,2% dos pacientes com esclerose múltipla. O ganho de peso foi relatado em 40,5% durante o surto. Foi encontrada diferença estatisticamente significativa na distribuição dos escores do Inventário de Ansiedade de Beck dos indivíduos para o consumo de nozes/sementes, arroz/massa, bolo/biscoitos e água. Um aumento de uma unidade nas pontuações do Inventário de Ansiedade de Beck levou a um aumento de 1,04 vezes no consumo de pão e arroz/massa e 1,05 vezes no consumo de bolo/biscoitos antes ou depois de controlar possíveis fatores de confusão. Um aumento de uma unidade nas pontuações do Inventário de Ansiedade de Beck levou a uma redução de 1,06 vezes no consumo de água e 1,04 vezes no consumo de carnes e aves, frutas (frescas) e arroz/massa antes ou depois de controlar possíveis fatores de confusão. Conclusão Durante o surto de coronavírus, a ansiedade levou a mudanças nos hábitos nutricionais e nas preferências alimentares dos pacientes com esclerose múltipla. A vigilância contínua das consequências psicológicas e o aconselhamento nutricional para surtos devem se tornar rotina como parte dos esforços de preparação em todo o mundo.

Smoking and comorbidities are associated with COVID-19 severity and mortality in 565 patients treated in Turkey: a retrospective observational study

SUMMARY OBJECTIVE: We aimed to explore the prevalence of smoking rates and comorbidities and evaluate the relationship between them and disease severity and mortality in inpatients with COVID-19. METHODS: COVID-19 patients were divided into the following groups: clinic group, intensive care unit (ICU) group, survivors, and non-survivors. Non-COVID-19 patients were included as a control group. The groups were compared. RESULTS: There was no difference between patients with and without COVID-19 in terms of smoking, asthma, diabetes, dementia, coronary artery disease (CAD), hypertension, chronic renal failure and arrhythmia (p>0.05). Older age (Odds ratio (OR), 1.061; 95% confidence interval (CI): 1.041-1.082; p< 0.0001), chronic obstructive pulmonary disease (COPD) (OR, 2.775; 95% CI: 1.128-6.829; p=0.026) and CAD (OR, 2.696; 95% CI: 1.216-5.974; p=0.015) were significantly associated with ICU admission. Current smoking (OR, 5.101; 95% CI: 2.382-10.927; p<0.0001) and former smoking (OR, 3.789; 95% CI: 1.845-7.780; p<0.0001) were risk factors for ICU admission. Older age (OR; 1.082; 95% CI: 1.056-1.109; p<0.0001), COPD (OR, 3.213; 95% CI: 1.224-8.431; p=0.018), CAD (OR, 6.252; 95% CI: 2.171-18.004; p=0.001) and congestive heart failure (CHF) (OR, 5.917; 95% CI 1.069-32.258; p=0.042), were significantly associated with mortality. Current smoking (OR, 13.014; 95% CI: 5.058-33.480; p<0.0001) and former smoking (OR, 6.507; 95% CI 2.731-15.501; p<0.0001) were also risk factors for mortality. CONCLUSION: Smoking, older age, COPD, and CAD were risk factors for ICU admission and mortality in patients with COVID-19. CHF was not a risk factor for ICU admission; however, it was a risk factor for mortality.

RESUMO OBJETIVO: Buscamos explorar as taxas de prevalência de tabagismo e de comorbidades e avaliar a relação entre elas e a severidade e mortalidade da doença em pacientes hospitalizados com COVID-19. MÉTODOS: Pacientes com COVID-19 foram divididos nos seguintes grupos: grupo clínico, grupo da unidade de terapia intensiva (UTI), grupo de sobreviventes e não-sobreviventes. Pacientes sem COVID-19 foram incluídos em um grupo de controle. Os grupos foram comparados. RESULTADOS: Não houve diferença entre os pacientes com e sem COVID-19 em termos de tabagismo, asma, diabetes, demência, doença arterial coronariana (DAC), hipertensão arterial, insuficiência renal crônica e arritmia (p>0,05). Idade mais avançada (odds ratio (OR), 1,061; 95% de intervalo de confiança (IC): 1,041-1,082; p< 0,0001), doença pulmonar obstrutiva crônica (DPOC) (OR, 2,775; 95% IC: 1,128-6,829; p=0,026) e DAC (OR, 2,696; 95% IC: 1,216-5,974; p=0,015) estavam significativamente associados com a admissão na UTI. O tabagismo atual (OR, 5,101; 95% IC: 2,382-10,927; p < 0,0001) e tabagismo prévio (OR, 3,789; 95% IC: 1,845-7,780; p< 0,0001) foram fatores de risco para admissão na UTI. Idade mais avançada (OR; 1,082; 95% IC: 1,056-1,109;< 0,0001), DPOC (OR, 3,213; 95% IC: 1,224-8,431; p=0,018), DAC (OR, 6,252; 95% IC: 2,171-18,004; p=0,001) e insuficiência cardíaca congestiva (ICC) (OR, 5,917; 95% IC 1,069-32,258; p=0,042) estavam significativamente associados com mortalidade. O tabagismo atual (OR, 13,014; 95% IC: 5,058-33,480; p<0,0001) e o tabagismo prévio (OR, 6,507; 95% IC 2,731-15,501; p<0,0001) também foram fatores de risco para mortalidade. CONCLUSÃO: O tabagismo, a idade avançada, DPOC e DAC foram fatores de risco para admissão na UTI e mortalidade em pacientes com COVID-19. ICC não foi um fator de risco para admissão na UTI; no entanto, foi um fator de risco para mortalidade.

Morphometric analysis of calcaneal (heel) spurs in ancient and modern Anatolian populations / Análisis morfométrico de los espolones calcáneos en poblaciones de Anatolia antiguas y modernas

SUMMARY: Heel spurs are the bony protrusion seen especially on the dorsal and plantar face of the calcaneus bone at the attachment site of the muscles. It was aimed herein to obtain data about the life styles, daily lives, and especially the socioeconomic structures of modern and ancient Anatolian populations by evaluating the prevalence, location, age, and gender differences of heel spurs on the calcaneus and comparing these findings between the populations. Herein, the 251 calcaneus bones of 137 skeletons, which had been previously analyzed paleodemographically and dated to the Middle Ages, and 68 calcaneus bones belonging to a modern population, whose gender was unknown but lived in Anatolia, were examined in terms of heel spurs. In the current study, the presence of dorsal, plantar, or both dorsal/plantar heel spurs on these in 251 calcaneus bones was 43.9 %, 11.1 %, and 10.3 %, respectively. The presence of dorsal, plantar, or both dorsal/plantar heel spurs was determined as 22 %, 3 %, and 1.5 %, respectively, among the 68 calcaneus bones belonging to the modern population. When a comparison was made of the current study with studies in the literature on modern and prehistoric populations, a higher prevalence of heel spurs was found in prehistoric samples than in modern populations. It is our belief that this situation may have derived from the heavy labor force, environmental, or sociocultural differences in ancient Anatolian populations, insufficiency of vital materials due to inadequate industrial conditions, and the solution of anatomical disruption. In addition, the findings determined herein will guide the development of future and industrial studies on the foot and foot structure.

RESUMEN: Los espolones del talón son la protuberancia ósea que se ve especialmente en la cara dorsal y plantar del hueso calcáneo en el sitio de inserción de los músculos. El objetivo de este trabajo consistió en obtener datos sobre los estilos de vida, la vida cotidiana y, especialmente, las características socioeconómicas de las poblaciones anatolias modernas y antiguas mediante la evaluación de la prevalencia, la ubicación, la edad y las diferencias de sexo de los espolones calcáneos y comparar estos hallazgos entre los poblaciones. La muestra consistió en 251 calcáneos correspondientes a 137 esqueletos, que habían sido previamente analizados paleodemográficamente y fechados en la Edad Media; también se incluyeron 68 calcáneos pertenecientes a una población moderna de Anatolia, sin distinción de sexo. De la muestra de 251 calcáneos, se encontraron espolones calcáneos dorsales, plantares y dorsales/plantares, en el 43,9%, 11,1 % y 10,3 %, respectivamente. La presencia de espolones calcáneos dorsales, plantares y dorsales/plantares se determinó en el 22%, 3% y 1,5%, respectivamente, entre los 68 calcáneos pertenecientes a la población moderna. Cuando se realizó una comparación del estudio actual con la literatu- ra sobre poblaciones modernas y prehistóricas, se encontró una mayor prevalencia de espolones calcáneos en muestras prehistóricas que en poblaciones modernas. Creemos que esta situación puede haberse derivado a la gran fuerza de trabajo, y las diferencias ambientales o socioculturales en las antiguas poblaciones de Anatolia, la insuficiencia de materiales vitales debido a las condiciones industriales inadecuadas produjo la alteración anatómica. Además, los hallazgos aquí determinados guiarán el desarrollo de estudios futuros e industriales sobre la estructura del pie.

Case for diagnosis. Single-digit clubbing

Abstract A 58-year-old female patient presented with a single-digit clubbing on the second finger of her right hand two years previously. After investigation with imaging and incisional biopsy, superficial acral fibromyxoma was diagnosed. A brief review on single-digit clubbing and its causes is presented, focusing on superficial acral fibromyxoma.

Clinical and epidemiological characteristics and associated factors of hair graying: a population-based, cross-sectional study in Turkey

Abstract Background Hair graying is common in humans; but there is scarce data about its epidemiology. Objective This study aimed to evaluate the clinical and epidemiological characteristics and associated factors of hair graying. Methods A total of 1541 volunteers between 15 and 65 years old were included in this population-based, cross-sectional study. A questionnaire on characteristics and associated factors of hair graying was filled in by face-to-face interview method. Results One thousand sixty three participants (69.0%) had hair graying. The mean onset age of hair graying was 32.9 ± 9.8 years. It was 31.7 ± 9.5 years in females, whereas 33.7 ± 10.0 years in males (p = 0.001). The most common involved area of hair graying at the onset and at the time of the interview was temporal region. When it was evaluated by gender, it was temporal in males whereas parietal in females. Hair graying was more severe in males than in females and in late-onset hair graying than early-onset hair graying (respectively, p = 0.000, p < 0.001). The most common involved area at the onset and at the present was temporal in severe hair graying; whereas parietal in mild hair graying. In logistic regression analysis, age, educational status, presence of hair loss, skin type, family history of early-onset hair graying and anxiety were independently related to hair graying (p < 0.05). Study limitations The study was performed in only Turkish individuals. The recall biases were another limitations. Conclusion Male gender, late-onset and temporal-onset of hair graying may be considered to be poor prognostic factors for hair graying. There is need for further epidemiological studies in people with different ethnic origin to illuminate the clinical and epidemiological characteristics and associated factors of hair graying.

Higher incidence of metabolic syndrome components in vitiligo patients: a prospective cross-sectional study

Abstract Background/Objectives: To investigate the association between vitiligo and metabolic syndrome. Methods: A prospective cross-sectional study was conducted between 2014 and 2016. Study (n = 155) and control groups (n = 155) were evaluated for metabolic syndrome according to National Cholesterol Education Program Adult Treatment Panel III and the International Diabetes Federation criteria. Study group was divided into three groups according to their vitiligo area severity index and vitiligo disease activity score values (Group 1: 6.89 for VASI score, Group A: −1-0, Group B: 1-2 and Group C: 3-4 for vitiligo disease activity score respectively). MetS rates according to both criteria were compared between the vitiligo disease activity score and vitiligo area severity index groups. Results: Metabolic syndrome rates were 37.4% and 40% in the study group and 19.4% and 26.5% in the control group according to National CholesterolEducation Program Adult Treatment Panel III and International Diabetes Federation criteria, respectively (p < 001 and p = 0.011). Metabolic syndrome was more frequent in vitiligo area severity index Groups 2 and 3 compared to vitiligo area severity index Group 1, and in vitiligo disease activity score Group C compared to vitiligo disease activity score Groups A and B. Study limitations: Single center experience, absence of more specific oxidative-stress markers and lack of long-term follow-up of the patients. Conclusions: Frequency of metabolic syndrome was higher in patients with non-segmental vitiligo and the rate was higher in active/severe form of the disease.

Platelet to lymphocyte and neutrophil to lymphocyte ratios as strong predictors of mortality in intensive care population

SUMMARY OBJECTIVE: Patients in intensive care units (ICU) have greater morbidity and mortality. We aimed to study neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) in the ICU population. METHODS: Medical and laboratory data of patients treated in ICU were retrospectively analyzed. Patients were divided into deceased and survived groups. RESULTS: The NLR of survived and deceased groups were 3.6 (0.2-31) and 9.5 (1-40), respectively (p<0.001). The PLR of the survived group (111 [16-537]) was significantly lower than the PLR of the deceased (209 [52-1143]), (p<0.001). An NLR higher than 4.9 had 84% sensitivity and 67% specificity is selecting deceased patients (AUC:0.80, p<0.001). A PLR higher than 112 had 83% sensitivity and 52% specificity in predicting deadly cases (AUC:0.76, p<0.001). Both PLR and NLR were significantly and positively correlated with c reactive protein levels. CONCLUSION: We suggest that physicians should pay particular attention to the treatment of patients in ICU with elevated NLR and PLR.

RESUMO OBJETIVO: Pacientes em unidades de terapia intensiva (UTI) apresentam maior morbimortalidade. Nosso objetivo foi estudar a razão de neutrófilos para linfócitos (NLR) e de plaquetas para linfócitos (PLR) na população de UTI. MÉTODOS: Dados médicos e laboratoriais dos pacientes tratados em UTI foram analisados retrospectivamente. Os pacientes foram divididos em grupos de falecidos e de sobreviventes. RESULTADOS: O NLR de indivíduos sobreviventes e falecidos foi de 3,6 (0,2-31) e 9,5 (1-40), respectivamente (p < 0,001). A PLR dos pacientes sobreviventes (111 [16-537]) foi significativamente menor do que a PLR do grupo dos falecidos (209 [52-1143]), (p < 0,001). Uma RNL maior que 4,9 teve 84% de sensibilidade e 67% de especificidade na previsão de casos mortais. (AUC: 0,80, p < 0,001). Uma PLR superior a 112 apresentou sensibilidade de 83% e especificidade de 52% na previsão de casos mortais (AUC: 0,76, p <0,001). Ambos, PLR e NLR, foram significativamente e positivamente correlacionados com os níveis de proteína reativa c. CONCLUSÃO: Sugerimos que os médicos prestem atenção especial ao tratamento de pacientes em UTI com valores elevados de RNL e RPL.

The prevalence of bruxism and related factors in patients with multiple sclerosis: a comparative study / A prevalência do bruxismo e fatores relacionados em pacientes com esclerose múltipla: um estudo comparativo

ABSTRACT Objective: To determine the prevalence of bruxism and related factors in patients with multiple sclerosis (MS). Methods: Diagnosed with relapsing-remitting MS under the 2010-revised McDonald diagnostic criteria, 182 patients without MS exacerbations during the previous three months were included in the patient group, and 145 healthy individuals made up the control group in the study. Demographic data of the participants in both groups were determined. In the patient and control groups, the diagnosis of definite bruxism was made using the International Classification of Sleep Disorders (Diagnosis and Coding Manual, Second Edition). Results: Bruxism was found in 29.7% (n = 54) of the patients and in 12.4% (n = 18) of the controls, and the difference was statistically significant (p < 0.001). Of all patients, the onset of bruxism was found in 70.4% (n = 38) after the diagnosis and in 29.6% (n = 169) prior to the diagnosis of MS. Compared with those without bruxism, the mean age (p = 0.031) and the score of the Expanded Disability Status Scale (p = 0.001) were also significantly higher among MS patients with bruxism. Between MS patients with and without bruxism, no significant differences were found in terms of sex, marital status, educational status, employment, cigarette smoking, total number of exacerbations, number of exacerbations within the previous year, and drugs used. Conclusions: The frequency of bruxism was found to be higher in the patients with MS than in the controls. Bruxism is associated with age and the Expanded Disability Status Scale score in MS patients.

RESUMO Objetivo: Neste estudo, pretendeu-se determinar a prevalência de bruxismo e fatores relacionados em pacientes com esclerose múltipla (EM). Métodos: Diagnosticados com EM remitente recidivante sob os critérios de McDonald Diagnostic revisados em 2010, 182 pacientes sem ataques de EM durante os últimos três meses foram incluídos no grupo de pacientes, e 145 indivíduos saudáveis constituíram o grupo de controle no estudo. Os dados demográficos dos participantes dos dois grupos foram determinados. Nos grupos de pacientes e controle, o diagnóstico de bruxismo definitivo foi feito usando a Classificação Internacional de Distúrbios do Sono (1) (Manual de Diagnóstico e Codificação Segunda Edição). Resultados: O bruxismo foi detectado em 29,7% (n = 54) dos pacientes e observado dentro de 12,4% (n = 18) dos controles, e a diferença foi estatisticamente significante (p <0,001). De todos os pacientes, o tempo inicial de bruxismo foi encontrado em 70,4% (n = 38) após o diagnóstico e em 29,6% (n = 169) antes do diagnóstico. Em comparação com aqueles sem bruxismo, os níveis de idade média (p = 0,031) e o escore da Escala de Status de Incapacidade Expandida (p = 0,001) também foram significativamente maiores entre os pacientes com esclerose múltipla com bruxismo. Entre os pacientes com esclerose múltipla com e sem bruxismo, não foi encontrada diferença significativa em termos de sexo, estado civil, status educacional, emprego, tabagismo, número total de ataques, número de ataques no último ano e medicamentos utilizados. Conclusões: A freqüência de bruxismo foi maior em pacientes com esclerose múltipla do que nos controles. O bruxismo está associado à idade e ao escore da Escala de Status de Incapacidade Expandida (EDSS) em pacientes com EM.

The relationship between malnutrition and quality of life in haemodialysis and peritoneal dialysis patients

SUMMARY BACKGROUND One of the most important factors affecting the quality of life of chronic kidney disease (CKD) patients is nutrition. Prevention of malnutrition increases patients' quality and length of life. In this study, we aimed to determine the frequency of malnutrition, quality of life, and the relationship between them in patients with end-stage renal disease (ESRD). METHOD The study was conducted with a total of 60 CKD patients including 50 haemodialysis patients and 10 peritoneal dialysis patients. Patients' data associated with socio-demographics, body mass index (BMI), waist circumference, triceps skin-fold thickness (TSFT), pre-dialysis systolic and diastolic blood pressure, Kt/V and urea reduction ratio (URR) values, laboratory parameters, Mini-Nutritional Assessment-Short Form (MNA-SF) and European Quality of Life 5-Dimensions (EQ5D) scale were recorded. FINDINGS Of the total 60 patients; 27 were male (45%), 33 were female (55%), 83.3% were receiving haemodialysis treatment (HD), and 16.7% were receiving peritoneal dialysis treatment (PD). The mean MNA-SF score was 10.4 ± 2.8 in the HD group and 10.5 ± 2.9 in the PD group; there was no difference between the scores of the HD and PD groups. The mean EQ5D score was 0.60 ± 0.29 in the HD group and 0.68 ± 0.33 in the PD group, no significant difference was found between the HD group and the PD group. The quality of life was found lower in malnourished group (p=0.001). CONCLUSION The quality of life needs to be increased by early diagnosis and treatment of malnutrition in patients at risk.

RESUMO INTRODUÇÃO O estado nutricional é um dos principais determinantes da qualidade de vida de pacientes com doença renal crônica (DRC) e a prevenção da desnutrição aumenta o tempo e a qualidade de vida nessa população. O objetivo do presente estudo foi determinar a prevalência de desnutrição, a qualidade de vida e a inter-relação entre esses fatores em pacientes com DRC em terapia dialítica. MÉTODOS Incluímos 60 pacientes com DRC estágio 5 sob terapia dialítica (50 pacientes em hemodiálise [HD] e 10 em diálise peritoneal [DP]). Os pacientes foram analisados com relação aos seus dados sociodemográficos, índice de massa corporal (IMC), circunferência abdominal, dobra cutânea triciptal, pressão arterial sistólica e diastólica pré-diálise, Kt/V e índice de remoção de ureia, parâmetros laboratoriais, miniavaliação nutricional (MNA) e questionário EuroQol-5 Dimensions (EQ-5D). RESULTADOS Do total de pacientes, havia 27 homens (45%) e 33 mulheres (55%), 83,3% em HD e 16,7% em DP. O MNA médio foi 10,4 ± 2,8 nos pacientes em HD e 10,5 ± 2,9 naqueles em DP, não havendo diferença significativa entre os grupos. O EQ-5D médio foi 0,60 ± 0,29 nos pacientes em HD e 0,68 ± 0,33 naqueles em DP, não havendo diferença estatisticamente significativa entre os grupos. A qualidade de vida foi pior nos pacientes desnutridos (p=0,001). CONCLUSÃO O diagnóstico e o tratamento precoce da desnutrição são necessários para melhorar a qualidade de vida dessa população.

Relationship between premenstrual syndrome and basic personality traits: a cross-sectional study

ABSTRACT BACKGROUND: Although many studies have investigated premenstrual syndrome and related factors, there is still only a limited number of studies investigating the relationship between premenstrual syndrome and basic personality traits. This study was conducted to investigate the association between premenstrual syndrome and basic personality traits among university students. DESIGN AND SETTING: Cross-sectional analytical study conducted in a city in western Turkey. METHODS: The Premenstrual Syndrome Scale, the Basic Personality Traits Scale and a questionnaire on sociodemographic characteristics developed by the present researchers were applied to 490 female students at the College of Health Sciences of a state university. RESULTS: Premenstrual syndrome was more common among students living in rural areas (65.1%), students with chronic diseases (74.1%), students who suffered from menstrual cramps (61.1%), students who used cigarettes (72.1%) and students with alcohol intake (65.5%). In the final model of the logistic regression analysis, presence of pain during the menstrual period increased the risk of presence of PMS by a factor of 1.554 (95% confidence interval, CI: 1.033-2.336; P = 0.034) and high scores on the total basic personality traits scale increased it by a factor of 1.016 (95% CI: 1.002-1.030; P = 0.029). The prevalence of premenstrual syndrome was found to be higher among students who were less extrovert (P = 0.007) and less conscientious (P = 0.001); and among students with higher neuroticism (P = 0.000) and negative valance (P = 0.000). CONCLUSION: This study demonstrates that personality may be associated with premenstrual syndrome.

Polygamy, sexual behavior in a population under risk for prostate cancer diagnostic: an observational study from the Black Sea Region in Turkey

ABSTRACT Aim: Although prostate cancer (PCa) is the most common cancer type in men, a replaceable risk factor has not yet been established. In our study, we assessed the relationship between the number of sexual partners, age of first sexual experience and age of first masturbation and prostate cancer incidence. Materials and Methods: In Ordu University Department of Urology between January 2013 and September 2016, in PSA elevation and rectal examination, patients with prostate biopsy were evaluated due to nodule palpation in the prostate. At younger ages and at present, their first masturbation ages, first sexual debut ages, and total sexual partner numbers were recorded. The correlation between the obtained data and PCa frequency was evaluated. Results: The study included 146 patients with PCa identified on biopsy and 171 patients with benign biopsy results who answered the questions. 66.7% of the ones whose biopsy results were benign and 40.6% of cancer suspects had only one sexual partner. The median number of sexual partners was 1±4 (1-100) in the benign group and 2±6 (1-500) in the malignant group (p=0.039). There was a negative correlation between age of first sexual debut and number of partners (r: −0,479; p <0.001). Conclusion: In our study, it appears that there may be an association between the number of sexual partners and prostate cancer in the patient group with PSA level above 4ng/mL. Avoidance of sexual promiscuity or participation in protected sex may be beneficial to protect against prostate cancer.

Prevalence of smoking, alcohol consumption and metabolic syndrome in patients with psoriasis

Abstract: Background: Coexistence of obesity, hypertension, insulin resistance and dyslipidemia is defined as metabolic syndrome (MBS), which is among the important risk indicators for cardiovascular diseases, diabetes and stroke. Smoking and alcohol consumption are the other factors which lead to an increase in the risk of cardiovascular disease. Objective: To investigate the prevalence of metabolic syndrome, smoking and alcohol consumption in psoriasis patients and the relationship between disease severity and these factors. Methods: This cross-sectional study enrolled 563 patients with chronic plaque-type psoriasis, all of which completed a questionnaire and underwent a complete physical examination. Data about MBS components, psoriasis severity/duration, smoking and alcohol consumption, and cardiovascular diseases were recorded. Results: A total of 563 patients with ages ranging from 18 to 78 years were evaluated. Metabolic syndrome was found in 12.6% of the patients [central obesity (38.7%), hypertension (14.3%), dyslipidemia (18.6%), diabetes (9.2%)], while 50.3% had smoking, and 3.3% had alcohol consumption. Patients with metabolic syndrome were older and more likely to have a longer disease duration than those without metabolic syndrome (p<0.05 for each). The prevalence of metabolic syndrome was higher in women than in men. Psoriasis was more severe in patients with central obesity, diabetes and smoking than in those without (p<0.05 for each). Study Limitations: Retrospective design. Conclusions: Our results indicate that MBS is a risk factor for psoriasis patients with advanced age. The relationship between disease severity and obesity, diabetes, and smoking in psoriasis patients indicates that the patients should be informed about the potential metabolic risks and receive therapies for behavioral changes besides anti-psoriatic treatment in order to minimize these risks.

Prevalence and associated factors of external punctal stenosis among elderly patients in Turkey / Prevalência e fatores associados à estenose externa do ponto lacrimal em pacientes idosos na Turquia

ABSTRACT Purpose: To estimate the prevalence of external punctal stenosis (EPS) in the elderly population and investigate associated factors. Methods: A total of 278 patients ≥65 years of age were evaluated for evidence of EPS from January to July 2016. Associated systemic, ocular, demographic, and lifestyle factors were investigated. Multiple logistic regression analyses were applied to evaluate the factors related to having EPS. P values <0.05 were considered statistically significant. Results: The prevalence of EPS in this study population was 63.3%, with a mean age of 70.67 ± 7.85 (65-92 years). The ocular factor that was most commonly related to EPS was chronic blepharitis (48.9%). EPS was also associated with taking glaucoma medications (95% CI, 0.08-0.96, p=0.043), smoking history (95% CI, 0.13-0.84, p=0.021), ectropion (95% CI, 0.004-0.26, p=0.001), complaints of tearing (95% CI, 1.11-3.52, p=0.02), and outdoor occupational activity (95% CI, 3.42-9.97, p<0.05). Conclusions: EPS is more common in elderly patients than in the general population. Outdoor occupational activity, taking antiglaucomatous medications, ectropion, and smoking are significantly associated with EPS. In addition, surgical treatment decisions should be made after complete evaluation and interviewing the patients.

RESUMO Objetivo: Estimar a prevalência de estenose externa do ponto lacrimal (EEPL) na população idosa e investigar os fatores associados. Métodos: Foram avaliados 278 pacientes ≥65 anos com estenose externa do ponto lacrimal de janeiro a julho de 2016. Todos os fatores sistêmicos, oculares, demográficos e de estilo de vida associados foram investigados. Foram utilizadas análises de regressão logística múltipla para avaliar os fatores relacionados a estenose externa do ponto lacrimal, valores de p<0,05 foram considerados estatisticamente significativos. Resultados: A prevalência de estenose externa do ponto lacrimal foi de 63,3%, com idade média de 70,67 ± 7,85 (65-92 anos). O fator ocular mais relacionado com estenose externa do ponto lacrimal foi blefarite crônica. (IC de 95%, 0,08-0,96, p=0,043), história de tabagismo (IC 95%, 0,13-0,84, p=0,021), ectrópio (IC 95%, 0,004-0,26, p=0,001), queixa de lacrimejamento (95% IC, 1,11-3,52, p=0,02) e atividade ocupacional ao ar livre (IC 95%, 3,42-9,97, p<0,05). Conclusão: A estenose externa do ponto lacrimal é um distúrbio mais comum em pacientes idosos do que na população em geral. Atividade ocupacional ao ar livre, medicação antiglaucomatosa, ectrópio e tabagismo foram significativamente associados com estenose externa do ponto lacrimal. A decisão sobre tratamento cirúrgico deve ser dada após a avaliação completas dos fatores associados em cada paciente.

Arterial stiffness and 25-hydroxyvitamin D levels in chronic kidney disease patients

Summary Objective: Arterial stiffness refers to arterial wall rigidity, particularly developing in central vessels. Arterial stiffness increases in early stage chronic kidney disease (CKD), and it is a strong predictor of cardiovascular and all cause mortality. Vitamin D has beneficial effects on blood pressure, vascular endothelial function and arterial stiffness. 25-hydroxyvitamin D (25(OH)D) deficiency is quite common worldwide and in the CKD population. We aimed to evaluate the prevalence of 25(OH)D deficiency and its relation with arterial stiffness in CKD. Method: Our study included 101 patients (51 male, 50 female), with stages 3B-5 CKD not on dialysis. A single-cuff arteriograph device (Mobil-O-Graph) was used to evaluate arterial stiffness parameters of pulse wave velocity (PWV) and augmentation index (Alx@75). The patients were divided into two groups: group I vitamin D non-deficient [25(OH)D > 15 ng/mL] and group II vitamin D deficient [25(OH)D ≤ 15 ng/mL]. Results: Overall, the mean 25(OH)D level was 14.1±7.9 ng/mL and 70 patients (69.4%) were vitamin D deficient. The mean Alx@75 value was significantly higher in group II (28.6±10.8% vs. 23.3±13.5%, p=0.038). PWV was higher in group II, but the difference was not significant. Group II exhibited significantly lower serum albumin (p<0.001), hemoglobin (p=0.005), calcium (p=0.041) and estimated glomerular filtration rate (eGFR) (p=0.041), but significantly higher 24-hour proteinuria (p=0.011) and more females (p=0.006). Vitamin D was negatively correlated with Alx@75 augmentation pressure, parathyroid hormone, proteinuria and body mass index, and positively correlated with albumin, hemoglobin, eGFR, calcium and transferrin. 25(OH)D was independently associated with Alx@75 (beta=-0.469, p=0.001) and albumin (beta=0.447, p=0.002). Conclusion: In CKD patients 25(OH)D deficiency was common, particularly in females. Level of 25(OH)D was independently associated with Alx@75.

Association of risk factors with smoking during pregnancy among women of childbearing age: an epidemiological field study in Turkey / Associação de fatores de risco com tabagismo durante a gravidez em mulheres em idade fértil: estudo epidemiológico de campo na Turquia

ABSTRACT CONTEXT AND OBJECTIVE: Smoking during pregnancy is an important risk factor for maternal and infant health that is preventable. This study aimed to investigate the risk factors associated with smoking behavior during pregnancy. DESIGN AND SETTING: A household-based probability sample survey of 1,510 women was conducted in the center of the city of Sivas, Turkey, between September 2013 and May 2014. METHODS: The prevalence of smoking during pregnancy was estimated according to independent variables by means of regression analysis. RESULTS: The prevalence of smoking during pregnancy was 16.5%. Logistic regression showed that being at a relatively young age (odds ratio, OR = 1.92, P = 0.025 for 15-24 age group; and OR = 2.45, P = 0.001 for 25-34 age group), having a low educational level (OR = 1.76, P = 0.032), being unmarried (OR = 1.48, P = 0.002) and living in an extended family (OR = 1.98, P = 0.009) were the factors associated with the risk of smoking during pregnancy. CONCLUSIONS: Systematic attention should be paid to socioeconomic inequalities, to support women towards quitting smoking before or at an early stage of their pregnancies. Younger women and particularly those in lower socioeconomic groups should be targeted. This will lead to better pregnancy status, especially among young women.

RESUMO CONTEXTO: Fumar durante a gravidez é um fator de risco importante para a saúde materna e infantil e que pode ser evitado. O estudo teve como objetivo investigar os fatores de risco associados com o comportamento de fumar durante a gravidez. TIPO DE ESTUDO E LOCAL: Inquérito por amostragem probabilística de base domiciliar de 1.510 mulheres foi realizado no centro da cidade de Sivas, Turquia, entre setembro de 2013 e maio de 2014. MÉTODOS: A prevalência do hábito de fumar durante a gravidez foi estimada de acordo com as variáveis independentes por meio da análise de regressão. RESULTADOS: A prevalência do hábito de fumar durante a gravidez foi de 16,5%. A regressão logística mostrou que estar em idade relativamente jovem (odds ratio, OR = 1,92, P = 0,025 por grupo de idade 15-24e OR = 2,45, P = 0,001 para a faixa etária 25-34), com alto nível de escolaridade (OR = 1,76, P = 0,032), sendo solteira (OR = 1,48, P = 0,002) e vivendo em família grande (OR = 1,98, P = 0,009) foram os fatores associados ao risco de fumar durante a gravidez. Parto prematuro e baixo peso ao nascer foram mais frequentes entre as fumantes. CONCLUSÕES: Atenção sistemática deve ser dada às desigualdades socioeconômicas para apoiar mulheres a parar de fumar antes ou na fase inicial da gravidez, tendo como alvo mulheres mais jovens, e particularmente aquelas de grupos socioeconômicos mais desfavorecidos. Isso conduzirá a um melhor estado de gravidez em mulheres, especialmente às jovens.

Frequency, severity and related factors of androgenetic alopecia in dermatology outpatient clinic: hospital-based cross-sectional study in Turkey

Abstract: BACKGROUND: Androgenetic alopecia (AGA) is a patterned hair loss occurring due to systemic androgen and genetic factors. It is the most common cause of hair loss in both genders. In recent years, many studies investigating the relation between systemic diseases and androgenetic alopecia presented controversial results. OBJECTIVES: In this study we aimed to investigate the frequency of androgenetic alopecia, the presence of accompanying systemic diseases, the relation between body mass index and androgenetic alopecia severity and the association of hyperandrogenemia signs with androgenetic alopecia in patients who referred to our outpatient clinic. METHODS: Patients who referred to our clinic between October 2013 and May 2014 were included in the study. Diagnosis of androgenetic alopecia was made upon clinical findings. Presence of seborrhea and acne in both genders, and hirsutism in women, were examined. Age, gender, smoking habit and alcohol consumption, age of onset of androgenetic alopecia, family history, accompanying systemic diseases and abnormalities of menstrual cycle were recorded. RESULTS: 954 patients (535 women, 419 men) were included in the study. Androgenetic alopecia prevalence found was 67.1% in men and 23.9% in women. Androgenetic alopecia prevalence and severity were correlated with age in both genders (p=0,0001). Frequency of accompanying systemic diseases were not significantly different between patients with and without androgenetic alopecia (p=0,087), except for hypertension, which was significantly more frequent in men with androgenetic alopecia aged between 50 and 59 years. Study limitations: Despite the exclusion of other causes of alopecia, differentiation of Ludwig grade 1 AGA from telogen effluvium based on clinical features alone is difficult. CONCLUSIONS: In our study the rate of androgenetic alopecia was found to be higher than the other studies made in Asian and Caucasian populations.

Health related quality of life in Turkish polio survivors: impact of post-polio on the health related quality of life in terms of functional status, severity of pain, fatigue, and social, and emotional functioning / Qualidade de vida relacionada com a saúde em sobreviventes turcos da pólio: impacto pós-pólio na saúde relacionada com a qualidade de vida em termos de estado funcional, gravidade da dor, fadiga e funcionamento social e emocional

ABSTRACT Objective: To determine the impact of postpolio-syndrome on quality of life in polio survivors. Methods: Forty polio survivors were included in the study. Twenty-one patients fulfilling the Halstead's postpolio-syndrome criteria participated in postpolio-syndrome group. The remaining nineteen patients formed non-postpolio-syndrome group. Control group was composed of forty healthy subjects. Quality of life was evaluated by Nottingham Health Profile, depression by Beck Depression Scale and fatigue by Fatigue Symptom Inventory. Isometric muscle strength was measured by manual muscle testing. Results: Total manual muscle testing score was 26.19 ± 13.24 (median: 29) in postpolio-syndrome group and 30.08 ± 8.9 (median: 32) in non-postpolio-syndrome group. Total manual muscle testing scores of non-postpolio-syndrome group were significantly higher than that of postpolio-syndrome group. Patients with postpolio-syndrome reported significantly higher levels of fatigue and reduced quality of life in terms of physical mobility, pain and energy when compared with patients without postpolio-syndrome and control group. It was not reported a statistically significant difference in social and emotional functioning and sleep quality between postpolio-syndrome, non-postpolio-syndrome and control groups. Also it was not found any statistically significant difference in Beck Depression Scale scores among the groups. Conclusions: Postpolio-syndrome has a negative impact on quality of life in terms of functional status, severity of pain and energy. The identification, early recognition and rehabilitation of postpolio-syndrome patients may result in an improvement in their quality of life.

RESUMO Objetivo: Determinar o impacto da síndrome pós-pólio na qualidade de vida nos sobreviventes da pólio. Métodos: Quarenta sobreviventes da pólio foram incluídos no estudo. Participaram do grupo de síndrome pós-pólio 21 pacientes que atenderam aos critérios de síndrome pós-pólio de Halstead. Os 19 restantes formaram o grupo não síndrome pós-pólio. O grupo controle foi composto por 40 indivíduos saudáveis. A qualidade de vida foi avaliada pelo Nottingham Health Profile, a depressão pela Escala de Depressão de Beck e a fadiga pelo Inventário de Sintomas de Fadiga. A força muscular isométrica foi medida por teste muscular manual. Resultados: O escore total do teste muscular manual foi 26,19 ± 13,24 (mediana: 29) no grupo de síndrome pós-pólio e 30,08 ± 8,9 (mediana: 32) no grupo não síndrome pós-pólio. Escores totais de teste muscular manual de grupo não síndrome pós-pólio foram significativamente maiores do que os do grupo de síndrome pós-pólio. Os pacientes com síndrome pós-pólio relataram níveis significativamente maiores de fadiga e qualidade de vida reduzida em termos de mobilidade física, dor e energia quando comparados com pacientes sem síndrome pós-pólio e grupo controle. Não se relatou uma diferença estatisticamente significativa no funcionamento social e emocional e na qualidade do sono entre grupos de síndrome pós-pólio, não síndrome pós-pólio e controle. Além disso, não se encontrou diferença estatisticamente significativa nos escores da Escala de Depressão de Beck entre os grupos. Conclusões: A síndrome pós-pólio tem um impacto negativo na qualidade de vida em termos de estado funcional, gravidade da dor e energia. A identificação, o reconhecimento precoce e a reabilitação dos pacientes com síndrome pós-pólio podem resultar em uma melhoria da qualidade de vida.

Otoacariasis: demographic and clinical outcomes of patients with ticks in the ear canal / Otoacaríase: desfechos demográficos e clínicos de pacientes com carrapatos no conduto auditivo externo

ABSTRACT INTRODUCTION: Otoacariasis, the attachment of ticks and mites within the ear canal is a common phenomenon especially in rural areas. OBJECTIVE: To determine the clinical and demographic features of cases with detected ticks in the ear canal, which is a common health problem, and identify tick species. METHODS: Data of patients who had otoacariasis were collected. We also investigated all ticks at the Veterinary Department of Kafkas University. RESULTS: We present the data of patients with otoacariasis. All ticks were identified as otobius. Otobius ticks were found not related with any complications. CONCLUSION: It is very important to detect ticks in the ear canal as they act as vector of some diseases. Identifying species of ticks may help clinicians to prevent further complications associated with vector-borne diseases.

Resumo Introdução: A otoacaríase, fixação de carrapatos duros e moles no interior do conduto auditivo, é fenômeno comum, especialmente em áreas rurais. Objetivo: Determinar as características clínicas e demográficas de casos de carrapatos detectados no conduto auditivo externo, um problema de saúde frequente, e identificar as espécies do ácaro. Método: Coletaram-se dados dos pacientes com otoacaríase, e todos os carrapatos foram investigados no Departamento de Veterinária da Universidade Kafkas. Resultados: Os dados de pacientes com otoacaríase são apresentados. Todos os carrapatos foram identificados como pertencentes ao gênero Otobius e constatou-se não haver relação entre os carrapatos e qualquer tipo de complicação. Conclusão: É muito importante detectar carrapatos no conduto auditivo externo, pois esses ácaros funcionam como vetores para algumas doenças. A identificação da espécie do ácaro pode ajudar o clínico a prevenir complicações associadas às doenças transmitidas por esse vetor.

Sociodemographic status of severely disabled and visually impaired elderly people in Turkey / Estado sociodemográfico de pacientes idosos com incapacidades graves e deficiência visual na Turquia

ABSTRACT Purpose: To identify the prevalence of ophthalmologic diseases in elderly patients who had been classified as severely disabled and to identify the ophthalmologic conditions leading to visual impairment and blindness. Methods: The medical records of 2806 patients who had applied to the Health Board of the Erzurum Region Training and Research Hospital between January 2011 and December 2012 were reviewed. One hundred ninety-nine patients aged >64 years who were classified as severely disabled with disability rates of over 50%, and who were unable to care for themselves or to move and/or communicate without help were included in the study. Results: The most frequently seen disabilities were neurological (47.2%) and those resulting from eye diseases (17.1%). The most common ophthalmologic diseases were cataract, glaucoma, and age-related macular degeneration. The mean right and left eye visual acuities were 1.17 ± 1.10 logMAR and 1.13 ± 1.0 logMAR, respectively. Of the 60 patients with ophthalmologic diseases or conditions, 33 were blind (visual acuity worse than 20/400) and 10 were visually impaired (visual acuity worse than 20/70 but better than 20/400). Cataracts were the main cause of blindness. The mean age of the patients who were still being followed up at the time of application to the disability board was significantly lower than that of the others (p =0.015). Seventy-nine percent of the blind patients were from rural areas, and 88% of these had no regular follow-up. Among the blind and visually impaired, significantly more patients from urban areas had social security insurance (SSI) than those from rural areas (p =0.043). Nearly 64% of the blind patients were women. The follow-up rate was significantly lower in women (p =0.025). According to multinomial logistic regression analysis, the visually impaired and blind patients were more likely to have lower follow-up rates than the other types of severely disabled patients (OR: 0.231, 95% Cl: 0.077-0.688, p=0.009). Conclusions: Blindness gives rise to severe disability, and the most common ophthalmologic diseases that cause severe disabilities in elderly patients are cataract, glaucoma, and age-related macular degeneration. Sociodemographic factors that may affect the accessibility of visually impaired and blind people to health services include their place of residence and gender.

RESUMO Objetivo: Identificar a prevalência de doenças oftalmológicas em pacientes idosos que tinham sido considerados como incapacitados graves, e para identificar as condições oftalmológicas que levam à deficiência visual e cegueira. Métodos: Prontuários de 2806 pacientes que tinham solicitado ao conselho de saúde do hospital de treinamento e pesquisa da região de Erzurum entre janeiro de 2011 e dezembro de 2012, foram revistos. Cento e noventa e nove idosos com mais de 64 anos, que foram considerados como incapacitados graves nos quais as taxas de incapacidade são mais de 50% e não são capazes de cuidado próprio e não são capazes de mover-se e/ou comunicar-se sem ajuda, foram incluídos no estudo. Resultados: As deficiências mais frequentemente observados são neurológicas (47,2%) e doenças oculares (17,1%). As doenças oftalmológicas mais frequentemente observadas foram catarata, glaucoma e degeneração macular relacionada à idade. Média de acuidade visual em olho direito e esquerdo foram 1,17 ± 1,10 e 1,13 ± 1,0 logMAR, respectivamente. Dos 60 pacientes, 33 apresentaram cegueira (acuidade visual pior que 20/400), 10 tinham deficiência visual (acuidade visual pior do que 20/70, melhor do que 20/400). A catarata foi a principal causa de cegueira. A idade média dos pacientes com acompanhamento no momento da solicitação ao conselho foi significativamente menor do que os demais (p=0,015). Setenta e nove por cento dos pacientes cegos eram da área rural e 88% deles não tinham acompanhamento regular. Entre cegos e deficientes visuais, a taxa de posse do seguro de segurança social (SSI) foi significativamente maior em pacientes de área urbana (p=0,043). Quase 64% dos pacientes cegos eram mulheres. A taxa de acompanhamento foi significativamente menor nas mulheres (p=0,025). De acordo com a análise de regressão logística multinominal, os pacientes com deficiência e cegos visuais eram mais propensos a ter menor taxa de acompanhamento do que os outros pacientes com deficiência grave (OR: 0,231, 95% Cl: 0,077-0,688, e p=0,009). Conclusões: A cegueira gera incapacitação grave. As doenças oftalmológicas mais frequentemente observadas que causam deficiência grave em pacientes idosos são a catarata, glaucoma e degeneração macular relacionada à idade. O local de residência e o gênero são fatores sociodemográficos que podem ter impacto sobre o acesso à saúde de pessoas com deficiência visual e cegos.

The impact of anti-smoking laws on high school students in Ankara, Turkey / O impacto das leis antifumo em alunos do ensino médio em Ancara, Turquia

ABSTRACT OBJECTIVE: To determine the factors affecting the smoking habits of high school students, their thoughts about changes resulting from anti-smoking laws, and how they are affected by those laws. METHODS: In this cross-sectional study, 11th-grade students at eight high schools in Ankara, Turkey, were invited to complete a questionnaire. RESULTS: A total of 1,199 students completed the questionnaire satisfactorily. The mean age of the respondents was 17.0  0.6 years; 56.1% were female, of whom 15.3% were smokers; and 43.9% were male, of whom 43.7% were smokers (p < 0.001). The independent risk factors for smoking were male gender, attending a vocational school, having a sibling who smokes, having a friend who smokes, and poor academic performance. Of the respondents, 74.7% were aware of the content of anti-smoking laws; 81.8% approved of the restrictions and fines; and 8.1% had quit smoking because of those laws. According to the respondents, the interventions that were most effective were the (television) broadcast of films about the hazards of smoking and the ban on cigarette sales to minors. The prevalence of smoking was highest (31.5%) among students attending vocational high schools but lowest (7.5%) among those attending medical vocational high schools. Although 57.1% of the smokers were aware of the existence of a smoking cessation helpline, only 3.7% had called, none of whom had made any attempt to quit smoking. CONCLUSIONS: Although most of the students evaluated were aware of the harmful effects of smoking and approved of the anti-smoking laws, only a minority of those who smoked sought professional help to quit.

RESUMO OBJETIVO: Determinar os fatores que afetam os hábitos de fumar de estudantes do ensino médio, seus pensamentos sobre as mudanças resultantes das leis antifumo e como eles são afetados por essas leis. MÉTODOS: Neste estudo transversal, alunos do 11º ano de oito escolas de ensino médio em Ancara, Turquia, foram convidados para preencher um questionário. RESULTADOS: Preencheram o questionário 1.199 estudantes de forma satisfatória. A média de idade dos participantes foi de 17,0  0,6 anos; 56,1% eram mulheres; das quais 15,3% eram fumantes; e 43,9% eram homens, dos quais 43,7% eram fumantes (p < 0,001). Os fatores de risco independentes para o tabagismo foram ser homem, frequentar escola técnica, ter um irmão/irmã que fuma, ter um amigo que fuma e ter baixo desempenho acadêmico. Dos participantes, 74,7% conheciam o conteúdo das leis antifumo; 8,1% aprovavam as restrições e multas, e 8,1% haviam cessado o tabagismo devido a essas leis. Na opinião dos participantes, as intervenções mais efetivas foram a exibição de curtas na TV sobre os malefícios do tabagismo e a proibição da venda de cigarros a menores. A prevalência do tabagismo foi maior (31,5%) nos estudantes de escolas técnicas, mas menor (7,5%) nos estudantes de escolas técnicas médicas. Embora 57,1% dos fumantes soubessem da existência de um serviço telefônico de ajuda para a cessação tabágica, somente 3,7% haviam ligado para esse serviço, mas nenhum tentou parar de fumar. CONCLUSÕES: Embora a maioria dos alunos avaliados conhecesse os efeitos deletérios do tabagismo e aprovasse as leis antifumo, apenas uma minoria dos fumantes procurou ajuda profissional para a cessação tabágica.