Rates and associates of influenza and pneumococcus vaccination in diabetes mellitus:A nationwide cross-sectional study(TEMD vaccination study)

BACKGROUND Vaccination against influenza and pneumococcus is effective in reducing morbidity and mortality in patients with diabetes.AIM To investigate the prevalence of influenza and pneumococcal vaccinations and to search for the independent associates of vaccination in Turkish patients with diabetes.METHODS In this cross-sectional,nationwide,multicenter study,adult patients with type 1 diabetes(T1DM)(n=454)and type 2 diabetes(T2DM)(n=4721),who were under follow-up for at least a year in the outpatient clinics,were consecutively enrolled.Sociodemographic,clinical,and laboratory parameters of patients were recorded.Vaccination histories were documented according to the self-statements of the patients.RESULTS Patients with T1DM and T2DM had similar vaccination rates for influenza(23.6%vs 21.2%;P=0.240)and pneumococcus(8%vs 7%;P=0.451)vaccinations.Longer diabetes duration and older age were the common independent associates of having vaccination for both types of diabetes patients.Higher education level,using statin treatment,and having optimal hemoglobin A1c levels were the common independent associates of influenza and pneumococcal vaccination in patients with T2DM.CONCLUSION TEMD Vaccination Study shows that patients with T1DM and T2DM had very low influenza and pneumococcal vaccination rates in Turkey.The lower rates of vaccination in certain populations urges the necessity of nationwide vaccination strategies targeting these populations.

Gastric metastasis of small cell lung carcinoma:A rare but noteworthy entity to consider

Small cell lung carcinoma(SCLC)is an aggressive malignancy known for its propensity for early and extensive metastatic spread.Gastric metastasis,where cancer cells disseminate from the lung to the stomach,is a rare but increasingly recognized complication of SCLC.This review provides a comprehensive overview of gastric metastasis in SCLC,addressing its clinical significance,diagnostic challenges,management strategies,and prognosis.Additionally,it examines the broader metastatic patterns of SCLC and compares them with other malignancies known for gastric metastasis.Gastric metastasis in SCLC,though infrequent,is clinically significant and often indicates advanced disease with a poor prognosis.SCLC typically metastasizes to the liver,brain,bones,and adrenal glands,with the stomach being an unusual site.The incidence of gastric meta-stasis ranges from 1%to 5%in autopsy studies,although this may be underes-timated due to diagnostic difficulties and asymptomatic early lesions.Diagnosing gastric metastasis presents several challenges,including the asymptomatic nature of many cases,limitations of conventional imaging techniques,and difficulties in distinguishing metastatic lesions from primary gastric cancer via endoscopy.Histopathological diagnosis requires careful examination to identify SCLC cells through their characteristic small cell morphology and neuroendocrine markers.Management of gastric metastasis in SCLC typically involves a multidisciplinary approach.Systemic therapy,pri-marily chemotherapy,remains the cornerstone of treatment,with palliative care addressing symptoms and complications.Surgical intervention is usually reserved for specific cases requiring symptomatic relief.The prognosis for patients with gastric metastasis from SCLC is generally poor,reflecting the advanced stage of the disease.Median survival is significantly re-duced compared to patients without gastric metastasis.This review emphasizes the need for enhanced awareness and early detection to improve patient outcomes and highlights the importance of ongoing research into better diagnostic and therapeutic strategies.

Development of an assessment scale for treatment compliance in type 2 Diabetes Mellitus in Turkish population:Psychometric evaluation

Objectives:Compliance to treatment is important for the management of type 2 diabetes mellitus(DM)and the prevention of complications.The purpose of the study was to develop a scale and test its psychometric properties for the treatment compliance of the diabetic Turkish population.Methods:This multicenter study was conducted in four training and research hospitals.The convenience sample consisted of 350 patients with type 2 DM.The items of the scale were determined after a literature review and qualitative interviews with the patients.Items were psychometrically analyzed.Content validity of the scale was evaluated using opinions from experts and a pilot study.Principal component analysis and the varimax rotation technique were used to evaluate construct validity in exploratory factor analysis.Criterion validity was evaluated with the Attitudes Towards Diabetes Scale,a subgroup of the Diabetes Care Profile scale.Reliability was evaluated with Cronbach'sαcoefficient and test-retest analysis of internal consistency.Results:The scale consisted of 7 factors that explained 47.36%of the total variance.The KMO test was conducted to determine whether the sample size was sufficient before the factor analysis.The KMO test result of the data was 0.75.The Cronbach'sαvalue of the sample was 0.77.The test-retest reliability analysis result was r=0.991.We found a positive correlation between total scores of the developed scale and the Attitudes Towards Diabetes Scale(r=0.31).Conclusion:The results of the study demonstrated that the scale with 30 items is a valid and reliable scale for the evaluation of patient compliance with type 2 DM treatment.Thus,by using this scale,nurses and healthcare providers can evaluate the treatment compliance of patients with type 2 DM.