Clinician's perspective regarding medication adherence in patients with obstructive lung diseases and the impact of COVID-19

SUMMARY OBJECTIVE: Failure to achieve high levels of medication adherence in obstructive lung diseases is a major cause of uncontrolled disease. The purpose of this study is to reveal clinicians' opinions on the level of patient adherence and the change in adherence during the COVID-19 pandemic. METHODS: A questionnaire containing multiple-choice questions about treatment adherence in patients with obstructive lung diseases was voluntarily applied to doctors working in a tertiary hospital for chest diseases. RESULTS: Eighty-one doctors (mean age, 37.2 years [standard deviation, 9.7 years]; 57 (70.4%) women) answered the questionnaires. Almost all clinicians participating in the study reported that they always or frequently asked patients if they adhered to treatment. Most clinicians think that in 20-50% of patients with asthma and less than 20% of patients with chronic obstructive pulmonary disease, a decrease in medication adherence appears in the first year of treatment. Most clinicians think the main reason for patients with obstructive lung diseases not adhering is patients' reluctance to be treated regularly. Regarding the impact of the COVID-19 pandemic on patients' drug adherence, 43.2% of clinicians observed that adherence increased after the start of the pandemic. CONCLUSIONS: Adherence to medication is not at the desired levels in patients with obstructive lung diseases. However, when faced with a serious health threat, such as the COVID-19 pandemic, patients realize the severity of their illness and begin using their treatments more regularly.

Inca bone in human skulls of the west anatolian population / Hueso interparietal en cráneos humanos de la población de anatolia occidental

The Inca bones are rarely seen among other inter sutural bones and are accepted as variants of the normal. The incidence of the Inca bones has been researched in different populations. The aim of this study was to investigate the rate and types of the Inca bones in West Anatolian population. One hundred fifty-one skulls of West Anatolian subjects of unknown ages and sex were examined. None of the specimens showed signs of prior cranial surgery, bony malformation or trauma. The skulls were classified as adults with teeth eruption. The Inca bones were macroscopically determined and analysed. The samples were photoghraphed with Canon 400B (55 mm objective). We follow previous criteria and nomenclatures of the Inca bones. The incidence of Inca bones of examined skulls was 1.98% (3/151). We observed 1 incomplete lateral asymmetric, 1 complete undivided and 1 complete asymmetric bipartita Inca bones. Inca ossicles are accessory bones found in human skulls due to ossification failure. Inca bones can be used in personal identification by comparing the ante- and post-mortem radiographs. There are some regional variations in frequencies within each restricted geographical area. In the present study, the incidence of the Inca bones is 1.98% in West Anatolian population. The frequency of the Inca bones in the skulls belonging to Hellenistic Roman periods of Cyprus and Constantinople in Natural History Museum of Turkey was 1.59%. The variation in Anatolia's population at different times and regions, because of the migrations, may cause the differences between frequencies in these studies. Evaluation of the presence of the Inca bones may be usefull in identification in forensic medicine and paleodermographical studies.

Los huesos interparietales no son frecuentes entre otros huesos suturales interrelacionados y se reconocen como variantes de la normalidad. La incidencia de los huesos interparietales ha sido investigada en diferentes poblaciones. El objetivo de este estudio fue investigar el índice y tipo de hueso interparietal en la población de Anatolia Occidental. Fueron examinados 151 cráneos de individuos de Anatolia Occidental de edades y sexo desconocido. En las muestras no se observaron signos de cirugía craneal previa, malformación ósea o trauma. Los cráneos fueron clasificados como adultos con erupción dental. Los huesos interparietales fueron clasificados y analizados macroscópicamente y se realizaron fotografías de las muestras con equipo Canon 400B (objetivo de 55 mm). Se utilizó la norma para los criterios y nomenclatura de los huesos interparietales. La incidencia de los huesos interparietales en los cráneos examinados fue de 1,98% (3/151). Se registró una asimetría incompleta lateral, una sin división y una asimétrica bipartita total en los huesos examinados. Los huesos interparietales se utilizan en la identificación de individuos mediante la comparación de radiografías ante-mortem y post-mortem. Existen algunas variaciones de región en las frecuencias dentro de cada área de posición limitada. En el presente estudio la incidencia de los huesos interparietales es de 1,98% en la población de Anatolia Occidental. En el Museo de Historia Natural de Turquía, el índicede huesos interparietales en cráneos pertenecientes a los períodos romano helenístico de Chipre y Constantinopla fue de 1,59%. La variación en la población de Anatolia en diferentes épocas y regiones debido a las migraciones, puede ser el motivo de las diferencias en las investigaciones. La evaluación de la presencia de huesos interparietales puede ser útil para la identificación en la medicina forense y estudios paleodemográficos.