Secondary prevention of coronary heart disease in elderly population of Turkey: A subgroup analysis of ELDERTURK study

Background: Secondary prevention plays an important role after acute coronary event due to high risk of adverse events in elderly. In present study we aimed to evaluate the lifestyle, management of risk factors and medical treatment for secondary protection in elderly patients with known coronary heart disease (CHD). Methods: ELDERTURK is a non-interventional, multi-centered, observational study, which included total of 5694 elderly patients ( > 65 years) from 50 centers in Turkey. In this study elderly patients from the ELDERTURK population with known CHD were evaluated for cardiovascular risk factors, comor- bidities and medication usage. Results: A total of 2976 (52.3% of study) out of 5694 patients included in the ELDERTURK study were evaluated. All had known CHD with a mean age of 73.4 ± 6.2 years and 60.3% were male. 13.0% of patients were smokers, 42.4% were overweight and 21.1% were obese. Only 23.6% of patients reported to do regular exercise, 73.4% had history of hypertension, 47.4% had dyslipidemia and 33.9% had diabetes mellitus. The rate of patients with systolic blood pressure > 140 mmHg were 31.1% and only 13.9% of patients had a recommended ≤ 70 mg/dL level of low-density lipoprotein cholesterol. Anti- platelet, statin, beta-blocker and angiotensin-converting enzyme inhibitor/angiotensin receptor blocker usage was limited to 27.3%. Conclusions: The ELDERTURK study shows that many patients with CHD have a high prevalence of modifiable risk factors and unhealthy lifestyle. Apart from this, many patients are not receiving thera- peutic intervention and as a consequence most were not achieving the recommended goals.   

The prevalence of cardiovascular diseases, risk factors, and cardiovascular drug therapy in very elderly Turkish patients admitted to cardiology clinics: A subgroup analysis of the ELDER-TURK study

WOS: 000435148100007PubMed ID: 29853696Ojective: The aim of this study was to determine the baseline clinical characteristics and the cardiovascular drug usage of patients aged >= 80 years who were admitted to cardiology clinics and to compare the cardiovascular disease and risk factors with patients aged 65-79 years who participated in the Epidemiology of Cardiovascular Disease in Elderly Turkish Population (ELDER-TURK) study. Methods: The ELDER-TURK study included 5694 patients aged over 65 years who were followed up at cardiology clinics between March 2015 and December 2015. The prevalence of cardiovascular diseases and the risk factors of 1098 patients aged >= 80 years (Group II) were compared with 4596 patients aged 65-79 years (Group I). Result: The mean age of Group I was 71.1 +/- 4.31 years (male: 50.2%) and the mean age of Group II was 83.5 +/- 3.12 years (male: 47.5%). The prevalence rate was 71.3% for hypertension, 24.6% for diabetes mellitus (DM), 44.7% for coronary artery disease (CAD), 35.9% for atrial fibrillation (AF), and 15.5% for renal failure. A statistical difference in the prevalence of comorbid conditions and cardiovascular disease risk factors, such as DM, CAD, renal failure, and AF was seen in the very elderly group (p<0.001, p=0.002, p<0.001, p<0.001, respectively). In all, 28.7% of the very elderly were using a beta-blocker, 10.1% an angiotensin system inhibitor, 28.4% an angiotensin receptor blocker, and 32.7% a mineralocorticoid receptor antagonist. Conclusion: Valuable data about the prevalence of cardiovascular and comorbid diseases and medication usage among Turkey's very elderly patients who were admitted to cardiology clinics was gathered and analyzed.Turkish Society of CardiologyThe study was funded by Turkish Society of Cardiology

Investigation of ABCA1 C69T polymorphism in patients with type 2 diabetes mellitus.

Introduction: Non insulin dependent diabetes mellitus is the most common type of diabetes. Genetic factors, lipid profiles, hypertension are potential risk factors for diabetes mellitus. Adenosine binding cassette transporter proteins 1 (ABCA1) plays a role in cholesterol metabolism, especially high density lipoprotein (HDL-cholesterol). There are multiple mechanisms by which HDL-cholesterol can be atheroprotective, it is clear that the relative activity of ABCA1 plays a major role. We aimed to investigate association of ABCA1 C69T gene polymorphism with lipid levels in Turkish type 2 diabetic patients

Effectiveness of Palliative Care Workers in Patient Nutrition

Objective: It is important to evaluate the nutrition of patients in palliative care centers. Most patients are unrecognized and lacking treatment, as there is no consensus on ways to scan, diagnose, treat and follow the malnutrition, and the lack of adequate awareness and training of healthcare professionals. This study aims to evaluate the approaches and awareness of healthcare professionals in Turkey who Methods: A survey, prepared by researchers, conducted to assess the effectiveness of healthcare professionals in patient nutrition, was conducted on a virtual basis in all healthcare professionals who were fully employed, accessible and volunteered with palliative care patients. The data was evaluated through descriptive and analyzing statistical methods. Results: The average age of the 105 medical professionals who participated in our study was 36.4 +/- 9.3 (25-59), of whom 68 (64.8%) were women and 37 (35.2%) were men. Sixty-seven (63.8%) of the participants, most of whom were physicians, were specialists, 30 (28.6%) were assistants and general practitioners, and 8 (7.6%) were nurses. When asked how many of their patients they started feding products, 38 people (36.2%) said, with 41-60%. If you think you've got enough recognition of nutritional content, there were 28 people who said yes (26.7%), 30 people who said no (28.6%), and 47 people (44.8%) who said sometimes. When asked what they considered the most when planning a feeding product, 95 people (90.5%) said that they cared about the patient's request, compared to the calories and content of the product. Conclusions: Our study found that participants were largely absent from knowledge and awareness, and observed differences in patient attitudes. Most participants require neutral education and continuity in order to have awareness

The relation between elbow range of motion and patient satisfaction after open release of stiff elbow

Objective: The aim of this retrospective study was to find out whether a cut off value existed for elbow flexion and extension after open surgical release of elbow contracture that would correlate with subjective patient satisfaction. Methods: The study enrolled 77 patients (53 males and 24 females with a mean age of 35.1 (18–77) years at the time of operation) with elbow contracture who attended regular follow-up appointments for more than 12 months. The mean follow up period was 44.2 months (12–186). The preoperative and postoperative modified MAYO elbow scores, objective parameters of increase in both flexion and extension end point measurements and improvement in total ROM were compared in order to determine the cut off degree of ROM in both flexion and extension that significantly correlated with patient satisfaction. Results: Of the 77 participating patients, 26 patients had an extrinsic (33.8%) and 51 patients had an intrinsic elbow contracture (66.2%). Surgeries performed involved 40 cases of lateral release and 37 cases of both lateral and medial (progressive) release. The median preoperative total flexion-extension arch (ROM) was 45° (20°–65°). The median postoperative total flexion-extension arch (ROM) was 110° (97.5°–125°). The modified MAYO elbow score improved from 60 to 85 points postoperatively. The postoperative flexion cut off value was 115° for an excellent or good postoperative modified MAYO elbow score. Conclusion: Post-operative flexion cut off value was 115° and had a positive effect on the postoperative patient satisfaction. The cut off value for postoperative extension was 20° but it was not a significant variable on patient satisfaction as was the total increase in ROM. Level of significance: Level IV Therapeutic Study. Keywords: Contracture release, Elbow contracture, Elbow flexio

Bladder cancer diagnosis from bladder wash by Fourier transform infrared spectroscopy as a novel test for tumor recurrence

This study proposes Fourier Transform Infrared (FTIR) spectroscopy as a more sensitive, rapid, non-destructive and operator-independent analytical diagnostic method for bladder cancer recurrence from bladder wash than other routinely used urine cytology and cystoscopy methods. A total of 136 patients were recruited. FTIR spectroscopic experiments were carried out as a blind study, the classification results of which were then compared with those of cytology and cystoscopy. Firstly, 71 samples (n=37; bladder cancer and n=34; control) were studied with transmittance FTIR spectroscopy. After achieving successful differentiation of the groups, to develop a more rapid diagnostic tool and check the reproducibility of the results, the work was continued with different samples (n=65 as n= 44;bladder cancer and n=21; control), using the reflection mode (ATR) of FTIR spectroscopy by a different operator. The results revealed significant alterations in moleculer content in the cancer group. Based on the spectral differences, using transmittance FTIR spectroscopy coupled with chemometrics, the diseased group was successfully differentiated from the control. When only carcinoma group was taken into consideration a sensitivity value of 100% was achieved. Similar results were also obtained by ATR-FTIR spectroscopy. This study shows the power of infrared spectroscopy in the diagnosis of bladder cancer

ASSOCIATED POSTERIOR PELVIC INJURY PATTERNS IN TRANSVERSE-ORIENTED ACETABULAR FRACTURE

<div><p>ABSTRACT Objective: Our study analyzed the incidence of posterior pelvic injury patterns and their influence on the surgical treatment of transverse-oriented acetabular fractures . Methods: Fifty-one transverse-oriented acetabular fracture cases admitted between 1999 and 2013 were evaluated retrospectively. Comparative studies were performed for groups organized by acetabular fracture type, degree of sacroiliac separation, and postoperative reduction quality . Results: Associated posterior pelvic injuries were found in 34 (66.7%) of the 51 patients. There were 32 sacroiliac separations in the 34 patients with associated posterior pelvic injury, and ipsilateral sacroiliac separations were more frequent in this subgroup. Measurements guided by computerized tomography showed that 16 sacroiliac separations were ≤0.5 cm (mean=0.43±0.14 cm), 10 were 0.5-1 cm (mean=0.73±0.17 cm), and the remaining 6 were >1 cm (mean=1.55±0.15 cm). In the group of 34 patients with associated posterior pelvic injury, acetabular reduction was anatomic in 19 (55.9%) patients, imperfect in 10 (29.4%) patients, and poor in 5 (14.7%) patients. For isolated acetabular fractures, reduction rates were as follows: 12 (70.6%) anatomic, 3 (17.6%) imperfect, and 2 (11.8%) poor. The rate of anatomic reduction was significantly higher when sacroiliac separation was ≤0.5 cm (p=0.027) . Conclusion: Associated posterior pelvic injuries, especially ipsilateral sacroiliac joint separation, accompany most transverse-oriented acetabular fractures and may influence the quality of acetabular reduction. Level of Evidence III, Therapeutic Studies Investigating the Results of Treatment.</p></div

Pretreatment with Methylprednisolone Improves Myocardial Protection during On-Pump Coronary Artery Bypass Surgery

Background: This study was undertaken to determine whether methylprednisolone could improve myocardial protection by altering the cytokine profile toward an antiinflammatory course in patients undergoing elective coronary artery bypass grafting (CABG) surgery with cardiopulmonary bypass (CPB)