Severity of sickle cell diseases restricts smoking

Mehmet Rami Helvaci1, Celaletdin Camci1, Eulis Khoerun Nisa2, Tugce Ersahin3, Aynur Atabay3,
Israa Alrawii4, Yagmur Ture2, Abdulrazak Abyad5, Lesley Pocock6

1 Specialist of Internal Medicine, MD, Turkey
2. Manager of Writing and Statistics
3. Assistant of Emergency Medicine, MD
4.Manager of Writing and Statistics, MD
5 Middle-East Academy for Medicine of Aging, MD, Lebanon
6 medi-WORLD International, Australia

Corresponding author:
Prof Dr Mehmet Rami Helvaci, MD
07400, ALANYA, TurkeyPhone: 00-90-506-4708759
Email: mramihelvaci@hotmail.com

Received: January 2024; Accepted: February 2024; Published: March 2024
Citation: Helvaci MR et al. Severity of sickle cell diseases restricts smoking. Middle East Journal of Nursing 2023; 18(1): 29-44 DOI: 10.5742/MEJN2023.9378043

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ABSTRACT

Background: The hardened red blood cells-induced capillary endothelial damage initiates at birth, and terminates with multiorgan failures even at childhood in sickle cell diseases (SCDs).

Methods: All patients were studied.

Results: The study included 334 cases (164 females). There were 27 patients (8.0%) with tonsilectomy and 307 patients without (91.9%). The mean age and female ratio were similar in both groups (p>0.05 for all). Although smoking (11.1% versus 14.3%), white blood cells and platelets counts of peripheric blood, thalassemias (51.8% versus 66.7%), painful crises per year, digital clubbing, leg ulcers, pulmonary hypertension, chronic obstructive pulmonary disease, rheumatic heart disease, avascular necrosis of bone, cirrhosis, stroke, and mortality were all higher in patients without tonsilectomy, the mean hematocrit value was lower in them, but the differences were nonsignificant probably due to the small sample size of the tonsilectomy group (p>0.05 for all).

Conclusion: SCDs are severe inflammatory processes on vascular endothelium particularly at the capillary level, and terminate with an accelerated atherosclerosis and end-organ failures in early years of life. There may be an inverse relationship between prevalence of tonsilectomy and severity of SCDs, and the tonsils may act as chronic inflammatory foci accelerating the chronic endothelial damage all over the body. The relatively suppressed hemoglobin S synthesis in the SCDs secondary to the associated thalassemias may decrease severity of sickle cell-induced chronic endothelial damage, inflammation, edema, fibrosis, and end-organ failures. On the other hand, severity of SCDs may restrict smoking habit due to some immediately felt harmfull effects on health.

Key words: Sickle cell diseases, smoking, thalassemias, immunosuppression, tonsilectomy, chronic endothelial damage, atherosclerosis