Kursat Ozdilli

Quality of life, symptom experience and distress of lung cancer patients undergoing chemotherapy

UNLABELLED The diagnosis of lung cancer in the advanced stage of illness, the poor prognosis associated with the disease, and the side effects of chemotherapy all have an impact on various dimensions of quality of life (QoL). THE PURPOSE OF THE RESEARCH The current study was designed to describe the QoL and symptom distress of lung cancer patients undergoing chemotherapy and to explore the relationships between demographic/treatment-related characteristics and QoL. METHODS AND SAMPLE The sample consisted of 154 lung cancer patients undergoing chemotherapy. The symptom experiences and QoL of lung cancer patients undergoing chemotherapy were evaluated using the Memorial Symptom Assessment Scale and Quality of Life Index - Cancer Version. RESULTS The lung cancer patients had low QoL scores. The scores on the Health and Functioning subscale were the lowest (20.33 ± 5.59), while those of the Family subscale were the highest (27.66 ± 2.77). The most common physical symptoms experienced by lung cancer patients were lack of energy, coughing, pain, lack of appetite, and nausea, while the psychological symptoms were feeling nervous, difficulty sleeping, feeling sad, and worrying. There was a negative relationship between the symptom distress and quality of life scores (r=-0.45; p<0.000). Females and those with low income levels and performance status experienced greater symptom distress. CONCLUSIONS Lung cancer patients receiving chemotherapy suffer many limitations due to the symptoms and disruptions to their QoL, arising from both the disease process and its treatment. Lung cancer patients need to be assessed regularly and supported.

Comparison of the health-promoting lifestyles of nursing and non-nursing students in Istanbul, Turkey.

Undertaking a health-related course at university can facilitate an awareness of health-promoting lifestyles. We carried out a descriptive and cross-sectional study with 1616 university students in Istanbul, Turkey. Students from the nursing schools were compared to those from the schools of social sciences using a Turkish version of the Health-promoting Lifestyle Profile (HPLP) II after a validation study. The nursing students had more positive health-promoting lifestyles than those of the non-nursing students. Furthermore, fourth-year nursing students had higher scores in most of the subscales of the HPLP II than did the students from the lower years; conversely, the fourth-year non-nursing students had lower scores. The sociodemographic variables, self-perceived health status, relations with family and friends, and self-perceived academic performance were associated with the HPLP. The implications are discussed for the curricula and on-campus facilities that focus on health promotion activities.

Influence of cytokine gene polymorphisms on graft rejection in Turkish patients with renal transplants from living related donors.

BACKGROUND Certain cytokine gene polymorphisms (CGPs) have been shown to be associated with renal transplant rejection episodes or graft outcomes. We sought to evaluate the relationships between gene polymorphisms and acute rejection episodes (RG, n = 19) versus stable graft function (NRG, n = 71) in transplant recipients compared with healthy control subjects (HCG, n = 150). The follow-up time period was 18 months. Using polymerase chain reaction sequence-specific primers with the Heidelberg kit we genotyped 22 single nucleotide polymorphisms distributed across 13 cytokine and cytokine receptor genes. RESULTS Interleukin (IL)-2 TT/GT haplotype was found in 36.8% of RG patients and 6.7% of HCG but not among the NRG (P < .0001; .0007). The IL-2 GG/TT haplotype was observed among 13 NRG and nine HCG patients (P = .007); the IL-2 GG/GG haplotype, 18.7% HCG and 4.2% NRG patients (P = .0033); and the IL-2 TT/TT haplotype, five NRG and eight HCG patients, but none of the RG cohort (P > .05). The transforming-growth factor-beta 1 CG/CC haplotype was noted in 15 NRG (21.1%) and four HCG but no RG patients (P < .0001). The IL-2 +166 GT genotype was detected in 36.8% of RG, 8.5% of NRG, and 14.7% of HCG patients (P = .005, .0244). The IL-2 -330 GG genotype was demonstrated in 32 healthy controls and three nonrejection transplant patients (P = .0007). Significant differences were concluded between NRG and HCG for IL-6 565 AG, IL-1beta -511 TT and +3962 CC/CT/TT genotypes. DISCUSSION We observed significant differences among the frequencies of IL-2 gene polymorphisms among RG and NRG subjects, which agreed with previous clinical, but not in vitro studies.

A psychometric validation study of the Quality of Life and FAMCARE scales in Turkish cancer family caregivers.

PurposeThe aim of this study was to assess the psychometric validation of the Quality of Life and FAMCARE scales in Turkish family caregivers of cancer patients.MethodsThis is a descriptive study involving 100 family caregivers of cancer patients. The validity and reliability study of the scales was performed in two phases. Phase I focused on the construction of the Turkish version of the instruments and pilot testing. Phase II was the psychometric assessment of the scales.ResultsThe caregivers stated that the two questionnaires were easy to read and to understand. However, the psychometric validation performed afterwards revealed that both the ordering of the factor loadings and content of the scales were influenced by prevailing characteristics of Turkish society. Caregivers were satisfied with the care their patients received, and family concerns were the most negatively affected quality-of-life (QOL) dimensions. Factors affecting the QOL and satisfaction with care were age, co-residence, relationship to patient, gender of the patients and caregivers, stage of the disease of the patient and marital status of the caregivers.ConclusionPsychometric validation of the Quality of Life and FAMCARE scales demonstrates that these culturally adapted scales are valid and reliable tools to assess the QOL and satisfaction of Turkish family caregivers of cancer patients.

The Effect of Air Pollution and Meteorological Parameters on Chronic Obstructive Pulmonary Disease at an Istanbul Hospital

In this study, the relation between emergency admissions for chronic obstructive pulmonary disease (COPD) at an Istanbul University Hospital between the years 1997 and 2001 and the meteorological and air pollution parameters has been analysed. Admissions were calculated for each month, and the relations between the number of admissions for each month and the corresponding months meteorological parameters (pressure, temperature, moisture) and the average pollution values (CO, SO2, NO, NO2, PM10) were determined. There were 1586 patients included in this study. COPD admissions had a negative significant correlation with temperature (r =-0.72, p<0.001), a positive significant correlation with pressure (r=0.41, p=0.001) and humidity (r=0.34, p=0.007), and also had a positive significant correlation with SO2 (r=0.64, p<0.001), NO (r=0.40, p=0.002), CO (r=0.57, p<0.001) and PM10 (r=0.27, p=0.03). No significant relationship was found for NO2. When the meteorological and clinical parameters were evaluated, it was found that the only variable related to the COPD admissions was temperature. These results for COPD admissions were found to be considerably higher in seasons other than summer (p <0.001). When summer seasonal values were taken as reference (RR=1), RR=1.24 (95% CI: 1.049–1.475) for autumn, RR=1.86 (95%CI: 1.541–2.115) for spring and RR=2.08 (95% CI: 1.793–2.434) for winter. Air pollution and meteorological parameters should be seen as a widespread public health problem, which can trigger admission and even death due to COPD.

Respiratory Problems in Tannery Workers in Istanbul

Tannery workers are exposed to many chemical and physical hazards. The current study involved 730 workers from 23 leather factories located in the Tuzla Organized Industry Region, Istanbul. Participants were interviewed and underwent clinical examination. After the basic physical examination, respiratory functions were measured by spirometer and the workers questioned about asthma. Health problems included gastrointestinal complaints (7.30%), bronchitis (3.11%) and asthma (3.0%). Signs of bronchial obstruction — wheeze and rhonchus — were detected in 71 (9.72%) workers. A deficit in the values of FVC%, FEV 1%, FEV1/FVC%, PEF%, FEF25— 75% was set nominally at 80% of the respiratory function test parameters. Decreased pulmonary function results were found for FVC% in 36 (4.93%) workers, FEV1 in 71 (9.72%), FEV1/FVC in 18 (2.59%), PEF in 183 (25.1%) and FEF25—75% in 204 (27.94%). The number of those with respiratory obstruction detected by spirometry was 294 cases (40.27%), more than the number of cases, 263 (36.02%), who claimed res- piratory problems in the questionnaire. This study was a contribution towards efforts to improve the factory envi- ronment and control workplace risks. Together with med- ical examinations before and during employment and provision of continuous health services and training will reduce the risk of occupational disease to a minimum. Introduction Leather production is one of the worlds oldest trades, consisting of a chemical process that turns animal hides into the much less perishable material, leather. As part of this process, after the removal of the epidermis and subcu- taneous tissue, the dermal collagen fibres are stabilized by means of chemical treatment known generically as tanning [1]. Employees who work in tanneries are liable to be affected by their exposure to lots of hazardous materials and processes during tanning. These hazards can be grouped into four categories: biological, physical and chemical hazards and work accidents.

MEDROXYPROGESTERONE ACETATE INDUCES C6 GLIOMA CHEMOSENSITIZATION VIA ANTIDEPRESSANT-LIKE LYSOSOMAL PHOSPHOLIPIDOSIS/MYELINOSIS IN VITRO

The authors have previously shown that medroxyprogesterone acetate (MPA) inhibits growth and increases drug sensitivity in C6 glioma with myeloid bodies. Myeloid bodies can occur in cells either due to robust toxicity with mitochondrial membrane disruption or due to milder events such as seen in lysosomal-phospholipidosis. Exact patterns of myelinosis accompanying to MPA chemo-sensitization is important, because uncoupling of nuclear versus mitochondrial toxicity of anti-neoplastics by MPA would lead to safer employment of glioma chemotherapy with reduced neurotoxicity. By monitoring and comparing cell kinetics with fine structural features of cell death, the authors estimated subcellular effects accompanying growth-inhibitory drug actions in C6 glioma. The analysis revealed that MPA induced mainly lysosomal phospholipidosis, while inhibiting clonogenicity alone and augmenting procarbazine efficacy. It induced apoptosis in combination with cisplatin. It reduced mitochondrial-damage-based early cytotoxicity of methotrexate, yet it did not hinder its anti-clonogenic efficacy. Progesterone analogues—similar to antidepressants—inhibit cholesterol esterification, and this efficacy relates with their P-glycoprotein inhibition. Reducing esterification and plasma-membrane localization of cholesterol may lead MPA induction of lysosomal phospholipidosis, growth indolency, and drug sensitization in glioma.

Biological Hazards in Tannery Workers

A total of 431 workers from 14 leather factories located in the Tuzla Organized Industry Region, Istanbul were involved in the study. Subjects were interviewed and examined individually with regard to asthma symptoms. Physical examinations were undertaken and respiratory function measured by spirometer. Moreover, the atmosphere of the working areas in the factories was assessed microbiologically. The fungal genera most often detected were Penicillium spp., followed by Aspergillus spp., Alternaria spp., Scopulariopsis spp., and Cladosporium spp. multiplying at differing rates. The number of those physically examined with indications of peripheral respiratory obstruction was 176 (40.8%) while those with suspected asthma following questioning was 153 (35.5%). The obstruction demonstrated by the use of respiratory function tests was associated with the mold isolated from the environment and was included in the logistic model that was developed as a risk factor for increasing obstruction. Workers employed in tanneries encounter many health problems. These may be reduced by: improving the factory environment, environmental control of allergens, elimination of allergen reservoirs, control of humidity and reducing exposure to excessive heat or cold. In addition there should be air filtration and vacuum cleaning to control dust mites and control of other workplace risks not necessarily associated with tanning. Importantly, workers should have medical examinations before employment and periodic examinations during training and employment to reduce the risk of occupational diseases to a minimum.

Assessment of Nasal Swab Samples, Environmental Microbiological Analyses and Respiratory Function Tests of Bakery Workers Working Under Modern Conditions: A Brief Report

Studies have shown that bakery workers may develop asthma and rhinitis as a result of their occupation and approximately 30% of bakery workers and wheat farmers will become sensitised. This ratio can change depending on the exposure time and a history of atopy. The present study has looked at the relationship between nasal and environmental flora and pulmonary function in such workers to see if it can explain the occurrence of asthma and rhinitis. Workers from three of the largest bakery companies in Istanbul were recruited, a total of 372 people; 223 bakery workers and 149 administrative employees of the same companies as a control group. Face to face interviews were conducted to determine asthma status and all were given physical examinations with nasal flora samples collected by sterile swabs. Aerial samples were taken from administrative and product departments for microscopic examination. Compared to administrative staff, bakery workers had insignificantly more asthma symptoms (p> 0.05).C. albicanswas isolated from four (1.9%) nasal samples from bakery workers and one (0.7%) from the control group (p> 0.05). A statistically significant level of wheeze (X2= 4.65, p= 0.03, OR= 2.32 95% CI (1.06–5.07)), suggesting bronchial obstruction, was detected in 28 (13.1%) bakery workers and in nine people (6.1%) from the control group. Looking at smoking and non-smoking groups, a significant decrease was observed for PEF (%) in the smokers and FEV1/FVC (%) in the non-smokers. These results suggest that pulmonary function of bakery workers is slightly impaired even with modern engineering controls.

High soluble CD30 levels and associated anti-HLA antibodies in patients with failed renal allografts

Introduction Serum soluble CD30 (sCD30), a 120-kD glycoprotein that belongs to the tumor necrosis factor receptor family, has been suggested as a marker of rejection in kidney transplant patients. The aim of this study was to evaluate the relationship between sCD30 levels and anti-HLA antibodies, and to compare sCD30 levels in patients undergoing hemodialysis (HD) with and without failed renal allografts and transplant recipients with functioning grafts. Methods 100 patients undergoing HD with failed grafts (group 1), 100 patients undergoing HD who had never undergone transplantation (group 2), and 100 kidney transplant recipients (group 3) were included in this study. Associations of serum sCD30 levels and anti-HLA antibody status were analyzed in these groups. Results The sCD30 levels of group 1 and group 2 (154 ± 71 U/mL and 103 ± 55 U/mL, respectively) were significantly higher than those of the transplant recipients (group 3) (39 ± 21 U/mL) (p<0.001 and p<0.001). The serum sCD30 levels in group 1 (154 ± 71 U/mL) were also significantly higher than group 2 (103 ± 55 U/mL) (p<0.001). Anti-HLA antibodies were detected in 81 (81%) and 5 (5%) of patients in groups 1 and 2, respectively (p<0.001). When multiple regression analysis was performed to predict sCD30 levels, the independent variables in group 1 were the presence of class I anti-HLA antibodies (β = 0.295; p = 0.003) and age (β = -0.272; p = 0.005), and serum creatinine (β = 0.218; p = 0.027) and presence of class II anti-HLA antibodies (standardized β = 0.194; p = 0.046) in group 3. Conclusions Higher sCD30 levels and anti-HLA antibodies in patients undergoing HD with failed renal allografts may be related to higher inflammatory status in these patients.