HEALTH RISKS OF MUSLIM PILGRIMAGE

Hajj, the pilgrimage to Mecca and surrounding holy sites is a religious exercise, which every physically able Muslim must undertake once in his of her lifetime. Every year 1.5 million Muslim pilgrims converge in Saudi Arabia for the world's largest annual gathering. This unique event, which might possess some public health implications on a global scale, is exhausting both physically and mentally for every pilgrim due to extreme heat and crowded accommodation. Therefore it's essential that the physicians are aware of the health risks and surroundings of the pilgrims in order to provide appropriate preparation. Apart from mandatory meningococcus vaccination, immunizations against pneumococcus and influenza should be recommended, appropriate physical training to increase their endurance beforehand must be emphasized and education about hygiene possible complications should be provided. To minimize the health risks that arise due to gathering of masses there are many standard precautions in effect however recent issues such as Middle East Respiratory Syndrome Coronavirus (MERS-CoV), Ebola hemorrhagic fever and cholera epidemics mandate new precautions. In this article we aim to address the health risks pilgrims face and how physicians can provide better counseling before this travel

COMPREHENSIVE GERIATRIC ASSESSMENT IN PRACTICE: WHAT DO PATIENTS SAY?

Objective: Comprehensive Geriatric Assessment (CGA) is one of the cornerstones of geriatric medicine. In this study, we aimed to find out how satisfied patients aged 60 and over with the application of CGA and whether they would express these complaints if geriatric-syndromes were not questioned

Risk of sarcopenia in hospitalized patients and related clinical factors: a multicenter study from Turkey

Key summary points Aim To evaluate sarcopenia risk in hospitalized older patients. Findings The percentage of patients at risk of sarcopenia defined by the SARC-F was 48.8%. Sarcopenia risk was associated with unfavorable health care outcomes including dependency, malnutrition, and dysphagia. Message Sarcopenia risk is related with unfavorable outcomes in hospitalized patients and it is important to recognize sarcopenia at an early stage and to prevent its progression, before dependency develops. Purpose To investigate the risk of sarcopenia in hospitalized older patients and to assess the associations between sarcopenia risk and health care outcomes including dependency, malnutrition, and dysphagia. Methods This multicenter cross-sectional study was a part of the annual National Prevalence Measurement of Quality of Care (LPZ) in Turkey. Hospitalized patients age 65 and older were included in the study. The SARC-F was used to assess risk of sarcopenia. Dependency was appraised according to the Care Dependency Scale (CDS). Nutritional status was established with respect to the Malnutrition Universal Screening Tool (MUST). Dysphagia was screened by two structured questions. Results A total of 492 patients were included in the analysis. Two hundred and forty patients (48.8%) were at risk of sarcopenia. Sarcopenia risk was more prevalent among women (p = 0.007) and patients with risk of sarcopenia were older (p 0.001). Hospital stay was longer and malnutrition and dysphagia were more prevalent in patients with sarcopenia risk than without (all p 0.001). All nutritional interventions were applied mostly to patients with sarcopenia risk than without. In multivariate analysis, advanced age (OR: 1.068, CI 1.032-1.104, p 0.001), female gender (OR: 2.414, CI 1.510-3.857, p 0.001), and dependency (OR: 5.022, CI 2.922-8.632, p 0.001) were independently associated with sarcopenia risk. Conclusions Sarcopenia risk is related with unfavorable outcomes in hospitalized patients. Primarily older female patients are at risk for sarcopenia. It is important to recognize sarcopenia at an early stage and to prevent its progression, before dependency develops. The SARC-F may be a useful tool for screening sarcopenia risk in hospitalized patients.This work was supported by Nutricia Turkey. The funding played no role in study design, collection, analysis, interpretation of data, writing the manuscript, or the decision to submit for publication.Nutricia Turke

Risk of sarcopenia in hospitalized patients and related clinical factors: a multicenter study from Turkey

Key summary point

Risk of sarcopenia in hospitalized patients and related clinical factors: a multicenter study from Turkey

Key summary point

Best Practice Recommendations for Geriatric Dysphagia Management with 5 Ws and 1H

Background: Dysphagia is a geriatric syndrome. Changes in the whole body that occur with aging also affect swallowing functions and cause presbyphagia. This condition may progress to oropharyngeal and/or esophageal dysphagia in the presence of secondary causes that increase in incidence with aging. However, no study has been published that provides recommendations for use in clinical practice that addresses in detail all aspects of the management of dysphagia in geriatric individuals. This study aimed to answer almost all potential questions and problems in the management of geriatric dysphagia in clinical practice. Methods: A multidisciplinary team created this recommendation guide using the seven-step and three-round modified Delphi method via e-mail. The study included 39 experts from 29 centers in 14 cities. Results: Based on the 5W and 1H method, we developed 216 detailed recommendations for older adults from the perspective of different disciplines dealing with older people. Conclusion: This consensus-based recommendation is a useful guide to address practical clinical questions in the diagnosis, rehabilitation, and follow-up for the management of geriatric dysphagia and also contains detailed commentary on these issues