Are elderly people exhibiting greater sensitivity to the nature of communication due to sneezing and nasal discharge?

OBJECTIVE: Communication with elderly has always presented specific challenges which do not affect other groups. The aim of the study was to investigate how elderly patients perceive communication with doctors due to sneezing and nasal discharge, in particular during COVID-19 pandemic having personal protective equipment, including goggles, face shield, mask and hazard suits affects the quality of communication. SUBJECTS AND METHODS: 100 patients (50 male and 50 female), all over the age of 65 years, were enrolled as the study group. Elderly patients attending the otorhinolaryngology department, for any reason, were invited to participate in the study, which was carried out during the COVID-19 pandemic. A control group, consisting of 50 patients (male and female), and aged between 25 and 35 years, was also recruited in the same way. Communication questionnaire and Social Communication Skills Rating Scale were applied to all participants. RESULTS: The results indicate that patients sneezing, with nasal discharge symptoms, and doctors' use of personal protective equipment, including goggles, facial shields, masks and hazard suits and the precautions in behavior designed to protect the doctor during the COVID-19 pandemic were associated with negative effects on doctor-patient communication. CONCLUSIONS: It is a cultural expectation that seniors be invariably treated with respect. In the extraordinary circumstances of the current pandemic, clinicians need to pay even more attention than usual to how they communicate, to ensure that communication remains both effective and respectful at all times.

Supracoronary myotomy for myocardial bridges in the setting of hypertrophic cardiomyopathy: off-pump experience.

Myocardial bridges (MB) are rarely observed but well known pathology of the major epicardial coronary arteries which are embedded in the overlying myocardial tissue. It is most frequently found in young patients with hypertrophic cardiomyopathy (HCM). Myocardial bridges are associated with myocardial ischemia and infarction, cardiac arrhythmias and sudden death. The present case series report the outcomes of three symptomatic patients with hypertrophic cardiomyopathy who underwent myocardial muscle debridges. They were operated using beating heart technique without cardiopulmonary bypass. The authors conclude that off-pump supracoronary muscle myotomy is a feasible treatment modality in the young age group with non-obstructive hypertrophic cardiomyopathy.

Correlation of environmental mite levels and the symptoms of allergic rhinitis regarding the efficacy of preventive education.

Allergic rhinitis is still a commonly investigated disease all over the world. Allergens are usually in the nature of glycoprotein or protein which interact with antibodies resulting in the formation of specific Ig E in the body 1. It is presumed that some environmental factors play an important role in their clinics. In allergic rhinitis, symptoms usually occur after the interaction of nasal mucosa with allergens. Allergens may be indoors, outdoors or in both environments. House-dust contains most of the indoor allergens. Mites are the most egregious allergen in house dust. D. pteronyssinus is commonly seen in European countries, D. farinae is mostly seen in North America. House-dust mites play an important role in allergic sensitization of individuals in Turkey. Perennial allergic rhinitis is a common chronic disorder that results most frequently from sensitivity to house-dust mites. National and international guidelines for the management of allergic rhinitis recommend that house and dust mite avoidance measures be considered for all patients with house-dust mite provoked rhinitis. Symptoms of allergic rhinitis are related to the environmental mite level in which patients live. The aim of this study is to show the relationship between mite levels and symptoms of allergic rhinitis diagnosed patients and the change of mite levels in the environment after appropriate education.

Efficacy of long-term sublingual-oral immunotherapy in allergic rhinitis.

Aim of the study was to evaluate the clinical efficacy of sublingual-oral immunotherapy in allergic rhinitis induced by various allergens and to demonstrate its effects using objective methods such as skin prick tests and specific IgE analysis. The first 100 patients diagnosed with allergic rhinitis and treated with sublingual-oral immunotherapy took part in the study and were followed for 2 years. Baseline findings were statistically compared with data obtained at the end of the study period. All symptoms including nasal discharge, sneezing, nasal congestion, and itching, as well as all clinical findings, including lower turbinate colour, turbinate congestion, and nasal discharge, observed by the physician, were significantly decreased after sublingual-oral treatment for two years (p < 0.001). A significant reduction in skin test reactivity was found when the initial and the final tests were compared. The difference between before and after treatment levels of specific IgE levels for D. pteronyssinus, D. farinea, and grasses were significant (p < 0.001), but were not significant for cereals (p=679 ns). As far as concerns the correlation between the recovery of clinical findings and age, as well as the correlation between the recovery of clinical findings and sex, neither of these were statistically significant (age: r = -0.076, p = 0.453, sex: r = -0.004, p = 0.97). The efficacy of the treatment, determined by means of symptom evaluations, was higher than expected in our study. A certain effect of this recovery might be due to the placebo effect, but it is supported by the improvement in skin tests and specific IgE levels.