Relationship between epicardial fat tissue thicknessand CRP and neutrophil-lymphocyte ratio in metabolicSyndrome patients over 65 years

Objective: There are no data evaluating the association of neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP) withepicardial fat tissue thickness (EFTT) in elderly metabolic syndrome (MS) patients. In this study, we aimed to investigate the rela tionship of EFTT with CRP and NLR in patients with MS over 65 years. Methods: A cross-sectional study was performed. Fifty patients (patient group) with MS and 25 subjects (control group) withoutMS were allocated in the study. All parameters were compared in patient and control groups. The correlations between NLR, CRP,and EFTT were evaluated. Results: White blood cell and neutrophil levels were higher in MS group (p=0.020 and p=0.019, respectively). Both transverse andlongitudinal EFTT were increased in MS patients (p<0.001). There was a significant correlation between the EFTT and NLR but notwith CRP in the MS group (r=0.4, p=0.003). Conclusion: Our study showed that both longitudinal and transverse EFTT are associated with NLR in patients older than 65 yearswith MS. In geriatric MS patients, higher NLR level may be an indicator of increased visceral fat around the myocardium

Evaluation of Serum Scube-1 Levels and Affecting Factors in Smokers

Purpose: Serum signal peptide-CUB-EGF domain-containing protein-1 (SCUBE-1), an indicator of platelet activation, is a bio-chemical marker used to evaluate the risk for cardiovascular diseases. This study aimed to evaluate the alteration of plasma levels of SCUBE-1 in smokers compared to healthy controls and determine the affecting factors. Materials and Methods: This study was designed as an experimental, single-centered study with a control group. The study included smokers aged 18-65 years who were admitted to the Smoking Cessation Clinic of a tertiary hospital and a control group consisting of healthy volunteers admitted to the Family Medicine Outpatient Clinic and had never smoked. Sociodemographic data of all participants and smoking histories and addiction levels of smokers were questioned. Exhaled carbon monoxide (CO) levels were measured. Plasma SCUBE-1 levels were studied and compared from samples obtained from venous blood. Results: A total of 82 individuals, consisting of the "smoker" patient group (n=44) and the "non-smoker" control group (n=38), were included in the study. The mean SCUBE-1 value was 1.28±0.70 ng/ml in smokers, 1.54±1.09 ng/ml in non-smokers. There was no statistical difference between groups in terms of SCUBE-1 (p=0.500). There was no statistically significant correlation between SCUBE-1 levels and exhaled CO level, smoking characteristics and addiction levels. Conclusion: Although the plasma SCUBE-1 value was not found to be significantly higher in smokers, it is thought that whether it will be useful in the evaluation of cardiovascular disease risk and thrombosis susceptibility can be clarified with further studies that will also examine the disease development process in these people

Determine Type 2 Diabetes Development Risk In Adult Patients Presenting to Family Medicine Department of Gaziosmanpaşa Taksim Training and Research Hospital Using Diabetes Risk Assessment Test

Aim:We aimed to determine type 2 diabetes development risk in adult patients presenting to Family Medicine Department of Gaziosmanpaşa Taksim Hospital using ADA (American Diabetes Association) diabetes risk assessment test, to identify factors associated with high risk, and to evaluate whether ADA type 2 diabetes risk assessment test is applicable.Materials and Methods:The study was conducted between March 2017 - September 2017 with 3131 patients aged above 18 years, who were not pregnant, with the purpose of assessment of type 2 diabetes risk. In order to determine type 2 diabetes risk and measurement of anthropometric parameters, individuals height, weight and waist circumference were determined and ADA type 2 Diabetes Risk Test Survey was used to determine the risk of type 2 diabetes. Analysis of numerical data was made with calculation of mean and standard deviation, frequency and proportion values, whereas categorical data was analysed with chi-square test.Results:The rate of participants with a high risk of type 2 diabetes was 32%. According to analysis results, advanced age, obesity, history of gestational diabetes, presence of diabetes in the first degree relatives, presence of hypertension, physical inactivity and presence of chronic illness were determined as independent factors associated with increased the risk of type 2 diabetes.Conclusion:ADA type 2 diabetes risk score is an appropriate and convenient scoring system to determine the risk of diabetes. Utilization of ADA type 2 diabetes risk score should be a routine practice in healthcare facilities in Turkey to identify and follow-up high-risk individuals, and studies aimed at prevention of diabetes should be conducted

Comparison of the frailty among older adults between the nursing home living versus own home living

Introduction: This study aims to evaluate elder people according to their living place and gender in terms of frailty with the FRAIL Scale.Methods: An observational cross sectional study was conducted between December 2019 and March 2020 with 113 patients aged ≥ 65 years who were admitted to a family health center in Istanbul. Patients registered at the nursing home address and patients living at their home address were assigned to the groups by the simple randomization method. A questionnaire including the demographic data and the FRAIL Scale which would evaluate the frailty was performed face-to-face. The Chi-square test was used for the statistical analysis.Results: It was observed that 51.3% of 113 individuals over 65 years in the study were male (n = 24), and the mean age was 73.13 ± 6.52 years. Frailty was found to be 21.2% (n = 24), according to the mean score of the FRAIL Scale (1.24 ± 1.26). The frailty rate (29.8%) of own home living elderly was found to be higher than the nursing home living elderly (12.5%) (p = 0.049). The frailty rate of own home living men (27.6%) was higher than the nursing home living men (3.4%) (p = 0.038). In FRAIL scale components, fatigue 19.5% (n = 22), resistance 38.9% (n = 44), ambulation 36.3% (n = 41), disease 10.6% (n = 12), weight loss 18.6% (n = 21) of the scale component were included in the fragility measurement. In the analysis of the answers, the internal consistency of the scale was moderate level (Cronbach alpha = 0.552).Conclusions: According to this study, one out of every five elderly was frail. Based on the fact that the elderly especially own home living men, are more fragile, and nursing home living women are seen at an older age, the results drew attention to the importance of nursing homes in the course of frailty in the future.Keywords: Nursing home, frailty, elderly, reliabilit

What is the Role of Computer Game Addiction in the Sleep Disturbance Risk Among Children of COVID Lock Down? A Cross-sectional Study

Objective:In this study, it was aimed to examine the risk of sleep disturbance in children and its relationship with computer game addiction during the Coronavirus disease-2019 lock down.Materials and Methods:In our cross-sectional observational study, 343 children and their mothers who applied family medicine clinics of a tertiary hospital between 1 October 2020 and 1 January 2021 were included. A structured questionnaire including the socio-demographic data of the mother and the child, and the Children’s Sleep Disturbance Scale and the Children’s Computer Game Addiction Scale were applied.Results:One-hundred sixty-five (48.1%) girls and 178 (51.9%) boys aged 8-12 years and their mothers participated in the study. The risk of sleep disturbance was observed at a rate of 74.1% (n=254) and it was strongly correlated with computer game addiction (p<0.001, r=0.787). Game addiction scores of boys (58.66±16.68) and primary school children (60.37±16.41) were higher than game addiction of girls (52.91±17.57), and of secondary school children (55.06±17.39) (p=0.023, p=0.040, respectively). Computer game addiction score (61.89±14.77) of children with sleep disturbance risk was significantly higher (p<0.001) than children without sleep disturbance risk (38.79±11.84). Among the children with a risk of sleep disturbance, the proportion of time spent on the computer compared to the pre-pandemic period (70.1%), the proportion of going late to bed-time (70.0%), and the proportion of being own computer or tablet (71.7%) were found to be higher than the proportions in children (48.3%, 58.4%, 37.1%, respectively) without sleep disturbance (p<0.001, p=0.004, p<0.001, respectively). The level of computer game addiction was significantly increased in children who spent less time with their mothers (58.68±16.97) and less time for games (58.05±18.11) compared to other children (p=0.002). In the logistic regression analysis, it was shown that the game addiction score was 1.128 times higher in children with sleep disturbance risk [Odds ratio=1.128 (1.094-1.162; p<0.001)].Conclusion:Our study showed that three of four children had a risk of sleep disorders during the pandemic period and were associated with an increased level of computer game addiction and drew attention to the importance of the time spent with the mother

The Relationship Between Frailty and Treatment Compliance in Diabetic and Geriatric Patients Using Insulin

Aim:Understanding and detecting frailty makes convenience to healthcare providers for deciding on appropriate therapy and follow-up strategy. In this study, we tried to determine the relationship between compliance to therapy, hypoglycemia and frailty in the elderly diabetic patients under insulin therapy.Materials and Methods:One hundred sixty-seven patients diagnosed with diabetes mellitus and under insulin therapy were recruited for the study. Criteria of frailty according to the Cardiovascular Health Study (CHS) were used to determine frailty. According to CHS, patients fulfilling three or more criteria out of five were regarded as frail elderly. Hypoglycemia rates and compliance to treatment were compared between the groups.Results:44.3% of our patients were regarded as frail elderly and the rate of hypoglycemia was higher in this group. A dignificant relationship between subgroups of frailty and insulin was detected. Frailty rate was 28.6% in the basal insulin therapy group, 37.1% in the basal-bolus therapy group and 40% in the premixed insulin group. In the frail elderly group, the rate of moderate hypoglycemia was significantly higher than in the non-frail group (40.2% vs 20%). Severe hypoglycemic episodes were observed more frequently in the frail elderly group than in the non-frail group (24.6% vs 12.7%).Conclusion:Frailty increases the risk of moderate and severe hypoglycemia. Before planning and starting insulin therapy, frailty must be detected and taken into consideration

The association between erectile dysfunction and subclinical hypothyroidism in males with type 2 diabetes mellitus

Aim: Overt hypothyroidism is known to affect sexual functions, but data on subclinical hypothyroidism (SCH) are insufficient. We aimed to investigate the relationship between erectile dysfunction (ED) and SCH in men with type 2 Diabetes Mellitus. Methods: This cross-sectional study included 117 diabetic patients aged between 45-70 years who applied to our outpatient clinic between March and June 2018. Biochemical blood tests and levels of hormones were analyzed. International erectile function index-5 (IIEF-5) questionnaire was applied for the assessment of ED. According to the IIEF-5 questionnaire scores, patients were grouped as severe ED (n=47), moderate ED (n=46), and no ED (n=24). Patients were also grouped according to the level of thyroid-stimulating hormone (TSH) into 3 groups; 0.27-2.49 mU/l (n=58), 2.5-4.2 mU/l (n=33), and >4.2 mU/l (n=26). Statistically significance level was set at 0.05. Results: 40% of the patients had severe ED and 39% moderate ED, while 21% had no ED. The TSH levels were significantly different between the ED groups (p<0.001). A significant negative correlation was found between the IIEF-5 score and the TSH levels (p<0.001, r=-0.453). The IIEF-5 score, and duration of ED were significantly different between the TSH groups (both; p<0.001). Conclusions: SCH is closely associated with ED in diabetic men. So, we recommend conducting thyroid function tests in diabetic men with ED and screening for ED in men with SCH

Relationship between epicardial fat tissue thickness and CRP and neutrophil-lymphocyte ratio in metabolic syndrome patients over 65 years

Objective: There are no data evaluating the association of neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP) with epicardial fat tissue thickness (EFTT) in elderly metabolic syndrome (MS) patients. In this study, we aimed to investigate the relationship of EFTT with CRP and NLR in patients with MS over 65 years. Methods: A cross-sectional study was performed. Fifty patients (patient group) with MS and 25 subjects (control group) without MS were allocated in the study. All parameters were compared in patient and control groups. The correlations between NLR, CRP, and EFTT were evaluated. Results: White blood cell and neutrophil levels were higher in MS group (p=0.020 and p=0.019, respectively). Both transverse and longitudinal EFTT were increased in MS patients (p<0.001). There was a significant correlation between the EFTT and NLR but not with CRP in the MS group (r=0.4, p=0.003). Conclusion: Our study showed that both longitudinal and transverse EFTT are associated with NLR in patients older than 65 years with MS. In geriatric MS patients, higher NLR level may be an indicator of increased visceral fat around the myocardium

Yoğun bakım ünitesindeki hastalarda APACHE II, SAPS II, MODS, SOFA ve GKS gibi prognostik ve organ yetmezliği skorlama sistemleri ile serum amino asit düzeyleri arasındaki ilişki

Objective: This study aimed to investigate the relationship between the prognostic and organ failure scoring systems and quantitative amino acid levels in patients in the intensive care unit (ICU). Methods: A total of 45 patients over 45 years old, who were admitted to the ICU, were included in the study. Physical examinations of all patients were performed, and blood tests (including serum amino acids) were analyzed. Sequential organ failure assessment (SOFA), multiple organ dysfunction score (MODS), simplified acute physiology score II (SAPS II), acute physiology and chronic health evaluation II (APACHE II), and glasgow coma scale (GCS) scores of patients were calculated. Risk ratios were determined according to the mortality and organ failure scores of patients, and patients were grouped as high-risk and low risk. All these parameters were compared between these groups, and the relationship between amino acid levels and risk scores was evaluated. Statistical significance level was determined as a p-value of <0.05. Results: This study was carried out on 45 patients, 23 females and 22 males. The mean age of the patients was 74 +/- 11 years. In high-risk patients compared to low-risk group; methionine, ornithine, and phenylalanine levels according to APACHE II; beta-alanine, cystine, 3-methyl histidine, phenylalanine, and proline levels according to SAPS II; alanine, beta-alanine, phenylalanine, glycine, histidine, methionine, and ornithine levels according to GCS were significant different (p<0.05 for all). We found a significant positive correlation between the APACHE II score and beta alanine (r=0.466; p=0.001), citrulline (r=0.394; p=0.007), ethanolamine (r=0.366; p=0.013), histidine (r=0.353; p=0.017), 3-methyl histidine (r=0.450; p=0.002), ornithine (r=0.445; p=0.002), phenylalanine (r=0.548; p<0.001). There was a significant positive correlation between the SAPS II score and beta alanine (r=0.403; p=0.006), cystathionine (r=0.341; p=0.022), ethanolamine (r=0.356; p=0.017), 3-methyl histidine (r=0.402; p=0.006), ornithine (r=0.349; p=0.019), phenylalanine (r=0.525; p<0.001) and between the MODS score and alanine (r=0.340; p=0.022), beta alanine (r=0.407; p=0.006), cystathionine (r=0.352; p=0.018), ethanolamine (r=0.358; p=0.0169), histidine (r=0.495; p=0.001), 3-methyl histidine (r=0.407; p=0.006), methionine (r=0.462; p=0.001), ornithine (r=0.360; p=0.015), phenylalanine (r=0.621; p<0.001), proline (r=0.445; p=0.002). We found a significant positive correlation between the SOFA score and alanine (r=0.547; p<0.0019), beta-alanine (r=0.354; p=0.0179), arginine (r=0.423; p=0.004), cystathionine (r=0.423; p=0.004), ethanolamine (r=0.437; p=0.003), glycine (r=0.399; p=0.007), histidine (r=0.512; p<0.001), 3-methyl histidine (r=0.327; p=0.028), leucine (r=0.376; p=0.011), methionine (r=0.585; p<0.001), ornithine (r=0.467; p=0.001), phenylalanine (r=0.644; p<0.001), proline (r=0.523; p<0.001), threonine (r=0.371; p=0.012). Also, there was a significant negative correlation between GCS score and beta alanine (r=-0.390; p=0.008), ethanolamine (r=-0.364; p=0.014), glycine (r=-0.360; p=0.015), ornithine (r=-0.510; p=0.000), phenylalanine (r=-0.433; p=0.003). Conclusion: This study found significantly higher methionine, ornithine, phenylalanine, beta-alanine, cystine, 3-methyl histidine, proline, alanine, glycine, and histidine levels in patients with high-risk scores.Amaç: Bu çalışmada yoğun bakım ünitesindeki (YBÜ) hastalarda prognostik ve organ yetmezliği skorlama sistemleri ile serum aminoasit düzeyleri arasındaki ilişki araştırıldı. Gereç ve Yöntem: Çalışmaya 45 yaş üstü herhangi bir nedenden dolayı dahiliye YBÜ’ye interne edilen 45 hasta dahil edildi. Tüm hastaların fizik muayeneleri yapıldı ve kan tetkikleri (kantitatif amino asitler dahil) analiz edildi. Hastaların sıralı organ yetmezliği değerlendirmesi (SOFA), çoklu organ disfonksiyon skoru (MODS), Basitleştirilmiş akut fizyoloji skoru II (SAPS II), akut fizyoloji ve kronik sağlık değerlendirmesi II (APACHE II), ve glasgow koma skalası (GCS) skorları hesaplandı. Kantitatif aminoasit düzeyleri ölçüldü. Hastaların mortalite ve organ yetmezliği skorlarına göre risk oranları belirlendi ve hastalar yüksek riskli ve düşük riskli olarak gruplandırıldı. Tüm parametreler bu gruplar arasında karşılaştırıldı ve amino asit seviyeleri ile risk skorları arasındaki ilişki değerlendirildi. İstatistiksel analizde p40 puan) diye iki gruba ayrıldığında beta-alanin (p=0,038), sistin (p=0,038), 3-metil histidin (p=0,024), fenilalanin (p=0,011) ve prolin (p=0,027); GKS skoruna göre yüksek riskli (≤8 puan), orta riskli (8-13 puan) ve düşük riskli (≥13 puan) diye üç gruba ayrıldığında alanin (p=0,031), beta-alanin (p=0,035), fenilalanin (p=0,006), glisin (p=0,005), histidin (p=0,007), metiyonin (p=0,044) ve ornitin (p=0,007) düzeyleri arasında anlamlı farklılık saptandı. APACHE II skoru ile beta alanin (r=0,466; p=0,001), sitrulin (r=0,394; p=0,007), etanolamin (r=0,366; p=0,013), histidin (r=0,353; p=0,017), 3-metil histidin (r=0,450; p=0,002), ornitin (r=0,445; p=0,002), fenilalanin (r=0,548; p<0,001) arasında pozitif yönlü orta düzeyde; SAPS II skoru ile beta alanin (r=0,403; p=0,006), sistatyonin (r=0,341; p=0,022), etanolamin (r=0,356; p=0,017), 3-metil histidin (r=0,402; p=0,006), ornitin (r=0,349; p=0,019), fenilalanin (r=0,525; p<0,001) arasında pozitif yönlü orta düzeyde, glisin, valin arasında pozitif yönlü zayıf düzeyde; MODS skoru ile alanin (r=0,340; p=0,022), beta alanin (r=0,407; p=0,006), sistatyonin (r=0,352; p=0,018), etanolamin (r=0,358; p=0,0169), histidin (r=0.495; p=0,001), 3-metil histidin (r=0,407; p=0,006), metiyonin (r=0,462; p=0,001), ornitin (r=0,360; p=0,015), fenilalanin (r=0,621; p<0,001), prolin (r=0,445; p=0,002) arasında pozitif yönlü orta düzeyde; SOFA skoru ile alanin (r=0,547; p<0,0019), beta-alanin (r=0,354; p=0,0179), arginin (r=0,423; p=0,004), sistatyonin (r=0,423; p=0,004), etanolamin (r=0,437; p=0,003), glisin (r=0,399; p=0,007), histidin (r=0,512; p<0,001), 3-metil histidin (r=0,327; p=0,028), lösin (r=0,376; p=0,011), metyonin (r=0,585; p<0,001), ornitin (r=0,467; p=0,001), fenilalanin (r=0,644; p<0,001), prolin (r=0,523; p<0,001), treonin (r=0,371; p=0,012) arasında pozitif yönlü orta düzeyde, GKS skoru ile beta alanin (r=-0,390; p=0,008), etanolamin (r=-0,364; p=0,014), glisin (r=-0,360; p=0,015), ornitin (r=-0,510; p=0,000), fenilalanin (r=-0,433; p=0,003) arasında negatif yönlü orta düzeyde anlamlı korelasyon saptadık. Sonuç: Bu çalışmada risk skoru yüksek ve prognozu kötü olan hastalarda metiyonin, ornitin, fenilalanin, beta-alanin, sistin, 3-metil histidin, prolin, alanin, glisin, histidin düzeylerinin yüksek olduğunu saptadık. Sonuçlarımız, kritik hastalarda bozulmuş enerji metabolizması ile kas proteini yıkımı arasında yakın ve anlamlı bir ilişki olduğunu düşündürtmektedir

Did healthy life awareness affect the behavioral or cognitive avoidance attitude from COVID-19? An observational study

Aim: This study purposed to evaluate the healthy life awareness (HLA) level versus the COVID-19 avoidance attitudes. Materials and Methods: A single-centered observational study was conducted in the Family Medicine Clinics of a tertiary hospital between April 30, 2021 and July 30, 2021. The HLA scale was used to determine the participants' HLA levels. In addition, the avoidance attitudes from the COVID-19 scale score assessed attitudes toward avoiding COVID-19. Data were analyzed with E-Picos (MediCRES) Statistical Programme. Results: Of the 311 participants aged 30.79 ± 8.37 years, 58.52% (n = 182) were female and 41.48% (n = 129) were male. A negative relationship between the HLA and cognitive avoidance scores (r = −0.255, P < 0.001) and a positive relationship between HLA and behavioral avoidance scores (r = 0.119, P = 0.036) have been indicated. The results of a binary logistic regression, taking the presence of a higher HLA score as the dependent variable, have shown that high awareness was observed in women, approximately 1.7 times more than in men [odds ratio (OR): 1.684, 95% confidence interval (CI) = 1.058–2.696; P = 0.030]. Participants with high HLA had 1.06 times higher behavioral avoidance scores than others (OR: 1.066, 95% CI = 1.012–1.455; P = 0.049). As the cognitive avoidance score increased, the presence of high HLA decreased by nearly 33%. (OR: 0.666, 95% CI = 0.512–0.867; P = 0.002). Conclusion: This study emphasized that a higher HLA was associated with increased behavioral avoidance and decreased cognitive avoidance from COVID-19. HLA has led to doing what needed to be done without being affected by negative discourses