The most common type of inappropriate COPD treatments is overtreatment, generally with ICS. As treatment protocols following COPD guidelines change over time, there is still a low rate of adherence by clinicians in their clinical practice to guideline recommendations. Awareness of these guidelines by pulmonary specialists should be improved.

Older chronic obstructive lung disease and asthmatic patients have more difficulty with the correct use of inhaler devices. Cognitive impairment might be an important parameter that can affect inhalation device technique. Socioeconomic status, smoking, pulmonary symptoms and admissions to hospital were also thought to have effects on the adherence to inhalation therapy. The type of chronic respiratory disease (chronic obstructive lung disease/asthma) is not a major factor influencing therapy adherence. Assessment of cognitive functions, choosing suitable inhalation devices and educational programs for inhaler use could improve the success of inhaler technique in elderly patients. Geriatr Gerontol Int 2017; 17: 999-1005.

No abstract

Sexual dysfunction is a common problem in chronic obstructive pulmonary disease (COPD). We aimed to assess the presence of erectile dysfunction (ED) in COPD patients. Ninety-three outpatients who had been diagnosed as COPD and followed in Bolvadin State Hospital, Afyon, Turkey, were included in the study. All patients underwent pulmonary function tests and arterial blood gas analysis. They completed International Physical Activity Questionnaire (IPAQ), Medical Research Council (MRC) Dyspnea Scale, Short Form 36-item Scale (SF-36), and International Index of Erectile Function (IIEF) Questionnaire. The mean age of 10 (10.8%) mild, 46 (49.5%) moderate, 28 (30.1%) severe, and 9 (9.7%) very severe COPD patients was 61.4 + 9.8 years. Varying degrees of ED were detected in 67.7% of COPD patients. All patients with hypoxemia had ED. IPAQ score and all SF-36 parameters were low in patients with ED, while MRC score was high. Forced expiratory volume in one second, forced vital capacity, partial pressure of oxygen in blood, oxygen (O 2 ) saturation, IPAQ score, and role-physical parameters were statistically low in ED patients (p ¼ 0.04, 0.02, <0.01, <0.01, 0.02, and 0.04, respectively); MRC score was statistically higher in patients with ED (p ¼ 0.02). Patients with moderate and severe ED had statistically lower score of mental health (p < 0.01 and p ¼ 0.02, respectively). There was a positive correlation between IIEF score and IPAQ scores (p < 0.01), MRC scores (p ¼ 0.01), general health (p < 0.01), role-physical (p < 0.01), role-emotional (p < 0.01), physical functioning (p < 0.01), and mental health (p < 0.01) parameters in SF-36. ED is frequently seen in COPD patients. Hypoxemia, smoking, and limitation of physical activity are thought to be associated with ED in COPD as mechanisms. Quality of life and the functional capacity are negatively affected with the presence of ED. It is important for a physician to question the sexual functions in patients with COPD. The presence of ED may be routinely considered in the daily practice of pulmonologists in COPD patients. Keywords COPD, sexual functions, erectile dysfunction IntroductıonSince chronic obstructive pulmonary disease (COPD) is a chronic disease of middle-aged or older people, comorbidities are frequently seen. With decreasing sexual interest, testosterone levels and sexual function by aging, and the presence of chronic illnesses, erectile dysfunction (ED) is one of these comorbid diseases.ED is a frequent type of sexual dysfunction among mature and aging men, which is characterized by the inability to have an erection during sexual activity. A broad-based public study (Massachusetts Male Aging Study) revealed an ED prevalence as high as 52% in males between the fourth and seventh decade of life.1 Dunn et al. demonstrated that 34% of males (mean age 50) within the general population complained about sexual problems and the most common complaint was ED.2 Both studies showed that ED prevalence increases with age.The mechanism of ED is not exactly clarified in...

OBJECTIVES:Migraine is a diseases characterized with severe headaches, with neurological and systemic findings. The purpose of this study is to investigate the prevalence of migraine and to examine whether there is a relationship between atopic disorders, parental history and migraine in asthma patients. MATERIAL AND METHODS:A total of 288 asthma outpatients, who had the diagnosis by an early or late test of reversibility showing a reversible airway obstruction according to hospital database were included. The presence of headache, atopic symptoms and parental history about asthma, atopic disorders and migraine were asked. The patients with headache were consultated by neurology department and investigated about the presence of migraine. The diagnosis of migraine headache was made if patients fulfilled the International Headache Society (IHS) criteria. RESULTS:60.4% of patients described a headache. There were 94 patients (32.6%) with headaches meeting the IHS criteria for migraine. Only 12 patients had migraine with aura. There were atopic symptoms in 86.8% of patients. According to parental history, there were asthma in 47.9%, atopic symptoms in 39.6% and migraine in 22.2% of parents. Patients with atopic symptoms were found to have significantly high rate of headaches (65.3%) "p=0.007". The prevalence of migraine was significantly high in patients with parental atopic symptoms (54%) "p=0.002". Multiple logistic regression analysis identified that gender, parental history of asthma, allergia and migraine, and smoking were independent risk factors for presence of migraine in asthmatics. CONCLUSION:There is a high prevalence of migraine headaches in patients with asthma. The coexistence of asthma and headaches may be related with a similar pathophysiological mechanism; parental history, common genetic compounds and smoking may play role in this mechanism. The headaches in asthma patients, atopic symptoms and family history should be questioned, and clinicians should be careful about the presence of migraine.