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In this study, the effect of cigarette smoking-one of the major risk factors for cardiovascular diseases-on the development of Frank's sign (DELC) was investigated. Rather than smoking status alone, cumulative smoking exposure was considered to cause vascular damage and thereby influence the formation of DELC. Consequently, these findings may enable family physicians and other clinicians to approach patients rapidly and non-invasively within the framework of preventive medicine.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| smokers | Smoking individuals aged between 40 and 59 years. |
| |
| non-smokers (control group) | Individuals aged between 40 and 59 years who do not smoke |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| To obtain bilateral ear photographs | Other | Digital photographs obtained from both ears in a well-lit environment were evaluated by the study researchers. The presence of Frank's sign and its staging according to the Modified Patel-Lopez classification were confirmed by a positive assessment from at least two researchers |
| Measure | Description | Time Frame |
|---|---|---|
| Analysis of the relationship between DELC (diagonal earlobe crease) and smoking consumption | The presence of DELC as unilateral, bilateral, or absent was evaluated with respect to smoking status categorized as current, non-smoker, or former. Categorical variables were presented as counts and percentages. Comparisons between groups were performed using the chi-square test. Differences with p-values < 0.05 were considered statistically significant. | maximum duration: 10 minutes |
| Association between smoking and DELC stage in patients with unilateral and bilateral DELC | The presence of unilateral and bilateral DELC in the right and/or left ear was assessed across smoking status groups defined as current, non-smoker, and former. Categorical variables were presented as counts and percentages. Comparisons between groups were performed using the chi-square test. Differences with p-values < 0.05 were considered statistically significant. | maximum duration: 10 minutes |
| Measure | Description | Time Frame |
|---|---|---|
| Relationship between the participants' chronic diseases, medication use, family history, and the presence of DELC (diagonal earlobe crease) | The presence of chronic diseases (hypertension, diabetes, hyperlipidemia, and cardiovascular diseases), obesity, history of angiography, medication use, and family history of cardiovascular diseases and premature death was evaluated in individuals with unilateral and bilateral DELC as well as in those without DELC (absent). Categorical variables were presented as counts and percentages. Comparisons between groups were performed using the chi-square test. Differences with p-values < 0.05 were considered statistically significant. |
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Inclusion Criteria:
Exclusion Criteria:
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The study population consisted of all individuals aged 40-59 years presenting to the clinics of the Department of Family Medicine at Samsun University Faculty of Medicine (Smoking Cessation, Family Medicine, Traditional and Complementary Medicine, Home Health Services, and Obesity Clinics)
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| Name | Affiliation | Role |
|---|---|---|
| Onur Öztürk | Amasya University | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Samsun University Training and Research Hospital (Samsun City Hospital) | Samsun | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 30511968 | Background | Linden OE, He JK, Morrison CS, Sullivan SR, Taylor HOB. The Relationship between Age and Facial Asymmetry. Plast Reconstr Surg. 2018 Nov;142(5):1145-1152. doi: 10.1097/PRS.0000000000004831. | |
| 38512009 | Background | Teul IB, Swiniarska B, Flis W, Wronka I. Fluctuating asymmetry of human morphometric features as a marker of developmental instability caused by adverse environmental conditions. Folia Morphol (Warsz). 2024;83(4):893-901. doi: 10.5603/fm.98782. Epub 2024 Mar 21. |
| Label | URL |
|---|---|
| 3\. T.C. Sağlık Bakanlığı. Sağlık istatistikleri yıllığı 2023 \[Internet\]. Ankara: Sağlık Bilgi Sistemleri Genel Müdürlüğü; 2025 \[cited 2025 Apr 4\]. | View source |
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I am reluctant to share it because of some ethical considerations.
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Jan 5, 2025 | Feb 5, 2026 | Prot_SAP_000.pdf |
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| ID | Term |
|---|---|
| D000073865 | Cigarette Smoking |
| D002318 | Cardiovascular Diseases |
| D012907 | Smoking |
| ID | Term |
|---|---|
| D000073869 | Tobacco Smoking |
| D001519 | Behavior |
| D064424 | Tobacco Use |
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|
| To take a medical history | Other | The participants' sociodemographic data, histories of chronic diseases, medication use, family histories, and smoking habits were recorded by the researchers via face-to-face interviews (average duration: 5 min) |
|
| maximum duration: 10 minutes |
| Analysis of the relationship between DELC and the presence of cardiac/noncardiac diseases and medication use | Diseases and medications were categorized as cardiac and non-cardiac. In individuals with unilateral and bilateral DELC, as well as in those without DELC (absent), the presence of cardiac and non-cardiac diseases was first evaluated, followed by the presence of cardiac and non-cardiac medication use. Categorical variables were presented as counts and percentages. Comparisons between groups were performed using the chi-square test. Differences with p-values < 0.05 were considered statistically significant. | maximum duration: 10 minutes |
| Demographic characteristics of the participants | Demographic characteristics like sex, marital status and smoking status of the participants were evaluated | maximum duration: 10 minutes |
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