The prevalence of microalbuminuria and relevant cardiovascular risk factors in Turkish hypertensive patients

PubMed ID: 22257801Objectives: A growing body of data illustrates the importance of microalbuminuria (MAU) as a strong predictor of cardiovascular risk in the hypertensive population. The present study was designed to define the prevalence of MAU and associated cardiovascular risk factors among Turkish hypertensive outpatients. Study design: Representing the Turkish arm of the multinational i-SEARCH study involving 1,750 sites in 26 countries around the world, a total of 1,926 hypertensive patients from different centers were included in this observational and cross-sectional survey study. Patients with reasons for a false-positive MAU test were excluded. The prevalence of MAU was assessed using a dipstick test, and patients were inquired about comorbidities, comedication, and known cardiovascular risk factors. Results: The overall prevalence of MAU was 64.7% and there was no difference between genders. Most of the patients (82.5%) had uncontrolled hypertension, 35.6% had dyslipidemia, and 35.5% had diabetes, predominantly type 2. Almost one-third of the patients (26.4%) had at least one cardiovascular-related comorbidity, with 20.3% having documented coronary artery disease (CAD). Almost all patients (96.8%) had one or more risk factors for cardiovascular disease in addition to hypertension, including family history of myocardial infarction or CAD, diabetes, dyslipidemia, lack of physical exercise, and smoking. A trend towards higher MAU values in the presence of CAD was determined. Conclusion: Microalbuminuria tests should be routinely used as a screening and monitoring tool for the assessment of subsequent cardiovascular morbidity and mortality among hypertensive patients. © 2011 Turkish Society of Cardiology

Factors related to depression and anxiety in adults with bronchiectasis

Elif Yelda Özgün Niksarlioglu,1 Gülcihan Özkan,2 Gülşah Günlüoğlu,1 Mehmet Atilla Uysal,1 Sule Gül,1 Lütfiye Kilic,1 Ayse Yeter,1 Güngör Çamsarı1 1Department of Chest Disease, Yedikule Chest Disease and Thoracic Surgery Training and Research Hospital, 2Department of Chest Disease, Yeniyüzyıl University Gaziosmanpasa Hospital, Istanbul, Turkey Introduction and background: Patients with chronic lung diseases frequently have depressive and anxiety symptoms, but there are very few studies looking at this in patients with bronchiectasis. Aim: This study aimed to investigate depression and anxiety and related factors among patients with non-cystic fibrosis bronchiectasis.Patients and methods: This was a prospective study of 133 patients with bronchiectasis. Patients with confirmed diagnosis of bronchiectasis with high-resolution computed tomography were enrolled in the study. Patients that were clinically stable in the previous 4 weeks were evaluated with the Hospital Depression and Anxiety scale. Symptoms, pulmonary function tests, and medical treatments were recorded.Results: The mean age of patients was 49.5±14.5 years (range, 18–77 years), and 81 (60.9%) patients were females. Twenty-eight (21.1%) patients had depression, and 53 (39.8%) had anxiety. Depression score was related to family situation (living with a partner), previous depression history and admission to an emergency department within the last year. Anxiety score was related to female gender, the family situation (living with a partner), previous depression history, and admission to an emergency department within the last year (P<0.05). Depression was positively correlated with hemoptysis, admission to an emergency department within the last year and living with a partner. Anxiety was positively correlated with education level, previous depression history, admission to an emergency department within the last year, and living with a partner.Conclusion: Patients with non-cystic fibrosis bronchiectasis are at increased risk for depression and anxiety. Untreated and undetected depressive/anxiety symptoms may increase physical disability, morbidity, and health care utilization. It is important for clinicians to be aware of the presence of depression and anxiety in bronchiectasis. Keywords: anxiety, bronchiectasis, depression, risk facto

Body pain during daily activities in patients on peritoneal dialysis

Objective. To review the prevalence of body pain during daily activities in patients on peritoneal dialysis (PD) and to correlate it with various demographic and renal osteodystrophy markers such as calcium (Ca), phosphorus (P), intact parathyroid hormone (iPTH), and vitamin D 3 levels. Methods. A cross-sectional study was conducted involving 530 chronic PD patients (44.3% female, 55.6% male) from 24 centers in Canada, Greece, and Turkey. Pain severity scoring during daily activities was performed using the pain scoring table of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Results. The overall prevalence of pain was 52.9% (61.3% in females and 49.5% in males, p < 0.05). Morning stiffness was reported by 23.6% of the patients, and diminished range of movement by 20%. The mean age, weight, and body mass index were higher in patients with pain than in those without (p < 0.05). There was no statistically significant difference between patients with pain and those without pain with respect to their mean serum iPTH, Ca, P, Ca x P, ionized Ca, or bone alkaline phosphatase levels (p > 0.05). Mean serum 25-hydroxyvitamin D 3 [25(OH)D 3] levels were lower in patients with pain compared to those without pain (p < 0.05). Conclusions. A high percentage of the PD patients (53%) had body pain; iPTH levels and other biochemical parameters of renal osteodystrophy were not different between those with and without pain. Patients with pain had lower 25(OH)D 3 levels than did those without. Factors such as age, gender, obesity, and metabolic factors may interact to cause varying degrees of articular/bone pain in patients on PD. Since vitamin D deficiency aggravates the signs and symptoms of joint disease such as pain and stiffness, one should attempt to correct levels of 25(OH)D 3, as well as 1,25(OH) 2D 3 levels, in these patients

Patient and physician delay in the diagnosis and treatment of non-small cell lung cancer in Turkey.

AIM: The early diagnosis and treatment of lung cancer are important for the prognosis of patients with lung cancer. This study was undertaken to investigate patient and doctor delays in the diagnosis and treatment of NSCLC and the factors affecting these delays. MATERIALS AND METHODS: A total of 1016 patients, including 926 (91.1%) males and 90 (8.9%) females with a mean age of 61.5±10.1 years, were enrolled prospectively in this study between May 2010 and May 2011 from 17 sites in various Turkish provinces. RESULTS: The patient delay was found to be 49.9±96.9 days, doctor delay was found to be 87.7±99.6 days, and total delay was found to be 131.3±135.2 days. The referral delay was found to be 61.6±127.2 days, diagnostic delay was found to be 20.4±44.5 days, and treatment delay was found to be 24.4±54.9 days. When the major factors responsible for these delays were examined, patient delay was found to be more frequent in workers, while referral delay was found to be more frequent in patients living in villages (p<0.05). We determined that referral delay, doctor delay, and total delay increased as the number of doctors who were consulted by patients increased (p<0.05). Additionally, we determined that diagnostic and treatment delays were more frequent at the early tumour stages in NSCLC patients (p<0.05). DISCUSSION: The extended length of patient delay underscores the necessity of educating people about lung cancer. To decrease doctor delay, education is a crucial first step. Additionally, to further reduce the diagnostic and treatment delays of chest specialists, multidisciplinary management and algorithms must be used regularly

Patient and physician delay in the diagnosis and treatment of non-small cell lung cancer in Turkey

Aim: The early diagnosis and treatment of lung cancer are important for the prognosis of patients with lung cancer. This study was undertaken to investigate patient and doctor delays in the diagnosis and treatment of NSCLC and the factors affecting these delays. Materials and methods: A total of 1016 patients, including 926 (91.1%) males and 90 (8.9%) females with a mean age of 61.5. ±. 10.1 years, were enrolled prospectively in this study between May 2010 and May 2011 from 17 sites in various Turkish provinces. Results: The patient delay was found to be 49.9. ±. 96.9 days, doctor delay was found to be 87.7. ±. 99.6 days, and total delay was found to be 131.3. ±. 135.2 days. The referral delay was found to be 61.6. ±. 127.2 days, diagnostic delay was found to be 20.4. ±. 44.5 days, and treatment delay was found to be 24.4. ±. 54.9 days. When the major factors responsible for these delays were examined, patient delay was found to be more frequent in workers, while referral delay was found to be more frequent in patients living in villages (. p<. 0.05). We determined that referral delay, doctor delay, and total delay increased as the number of doctors who were consulted by patients increased (. p<. 0.05). Additionally, we determined that diagnostic and treatment delays were more frequent at the early tumour stages in NSCLC patients (. p<. 0.05). Discussion: The extended length of patient delay underscores the necessity of educating people about lung cancer. To decrease doctor delay, education is a crucial first step. Additionally, to further reduce the diagnostic and treatment delays of chest specialists, multidisciplinary management and algorithms must be used regularly. © 2015 Elsevier Ltd