Mehtap Kartal

The effect of physical activity and body mass index on menopausal symptoms in Turkish women: a cross-sectional study in primary care

BackgroundConsidering the fact that, due to recent evidence, many women no longer prefer hormone replacement therapy, it is especially important to develop intervention options to alleviate menopausal symptoms. Although there is conflicting evidence concerning effectiveness, there is an indication that physical activity and weight control may be useful for alleviating symptoms. The aim of this study was to investigate the effect of physical activity and body mass index on menopausal symptoms among menopausal women in Turkey.Methods305 women between the ages of 45 and 60 who visited the health center for various reasons were recruited into this cross-sectional study. Menopausal women, who visited one of five family physicians working in the same area, were included in the analyses. The Menopause Rating Scale, International Physical Activity Questionnaire and a generic medical and socio-demographic information questionnaire were used.ResultsWomen who were physically active had lower total menopausal (p < 0.001), somato-vegetative (p = 0.004), psychological (p = 0.002), and urogenital (p < 0.001) symptom scores than women who were less active. No differences in vasomotor symptoms were recorded related to physical activity level; significant differences were found for most menopausal symptoms, including sleep (p = 0.009) and sexual (p = 0.043) problems, joint and muscular discomfort (p < 0.001) and vaginal dryness (p = 0.016). BMI was not associated with total menopausal symptoms and with the subscales, excluding depressive mood (p = 0.009). A significant increasing trend in the rate of depressive mood was observed from normal through overweight to obese participants. The mean scores of the total menopausal symptoms were lower among the participants who were well educated, currently working and without chronic diseases.ConclusionsPhysical activity may play an important role in alleviating menopausal symptoms. As part of preventive medicine, primary care physicians should also stress lifestyle changes, including physical activity, to manage menopausal symptoms.

Diagnosis, treatment characteristics, and survival of women with breast cancer aged 65 and above: a hospital-based retrospective study

BackgroundBreast cancer incidence in women increases with age, while survival rates decrease. Studies interpret this result as meaning higher comorbidity, diagnosis at later stages of the disease, and less effective treatment in the elderly. The aim of this study is to evaluate the diagnosis and treatment characteristics of breast cancer and their effect on the survival of women aged 65 and above.MethodsThe data within the files of 1064 women with breast cancer, who were followed-up in Dokuz Eylul University Medical Faculty Hospital between 2000 and 2006, were reviewed retrospectively. The survival probabilities at years 1 and 5 were calculated by life table analysis. The Kaplan-Meier test was used for calculating mean survival time, and the differences between groups were evaluated by log-rank test. The backward elimination method was used for multivariate analysis, and a −2 log-likelihood ratio was used for comparison of different models.ResultsOf the patients, 25.3% were aged 65 and above at the time of the diagnosis. Patients in this group had more comorbidities and were more likely to be diagnosed at advanced stages than younger patients. Additionally, they had lower rates of surgical treatment, chemotherapy or radiotherapy. One and 5-year survival probabilities among age groups were 96.1% and 84.5%, respectively, for <65 years, 93.5% and 84.8%, respectively, for 65–69, 98.7% and 84.0%, respectively, for 70–74, and 85.5% and 59.6%, respectively, for 75 years and above. In the multivariate model, age, clinical stage, and comorbidity were found to be negatively associated with the survival rate.ConclusionsThe survival of women with breast cancer aged 65 and above was affected negatively by age at diagnosis, clinical stage, and the presence of comorbidity. Early diagnosis also is very important for elderly women. Additionally, because of higher comorbidity, their evaluation and treatment should be planned by an interdisciplinary team.

What is Health Literacy? How to measure it? Why is it important?

Health literacy, when the doctor gives a medical information to a patient, it is the ability of the patient to understand, interprete the medical information and act appropriately according to this ability. Patients confront with complicated informations and treatments. Limited health literacy effects diagnosis and treatments in negative way and causes unnecessarily hospitalizations and emergency service usage, unnecessary diagnostic tests, increased hospitalizations. Initially, health literacy seems like a nonphysical concept but then lots of scales have been improved for its measurement. Institute of Medicine published “Health Literacy: Prescription to End Confusion” and assessed all scales of health literacy and divided into four main groups: These are TOFHLA (Test of Functional Health Literacy in Adults), REALM (Rapid Estimate of Adult Literacy in Medicine), HALS (Health Activities Literacy Scale), NVS (Newest Vital Sign). It is important to improve health literacy of people for health promotion. With the educataion of health workers, barriers for limited health literacy can be defined and some interventions can be done to improve health literacy levels of community.

Health promotion lifestyle profile scores are not associatedwith obesity in high school students.

BACKGROUND/AIM Obesity is a cause of preventable morbidity and mortality with an increasing prevalence. Health promoting lifestyle activities maintain or improve an individuals health and in adolescence many habits are configured. The aim of this study was to determine the prevalence of overweight and obesity among adolescents and the relation between obesity and health promoting behaviors. MATERIALS AND METHODS This is a cross-sectional study including 848 high school students aged 15-17. All students were administered a questionnaire including the Health Promotion Life-Style Profile Scale. Weight and height were measured and body mass index was calculated. Descriptive analysis, Pearsons chi-square test, Kruskal-Wallis and Mann-Whitney U tests, and multivariate logistic regression analysis were used. P < 0.05 was considered statistically significant. RESULTS Of the included students, 80.8% (n = 685) had normal ranges of body mass index, 10.1% (n = 86) were overweight, and 9.1% (n = 77) were obese. The Health Promotion Life-Style Profile Scale average score was found to be 126.7 ± 20.4. There was no significant difference between Health Promotion Life-Style Profile Scale and obesity (P = 0.921). CONCLUSION Adolescence is an era of development when individuals start to implement their own features to life. According to this study adolescents do not perform health promoting lifestyles whether they are obese or not.

İzmir’de bir eğitim ve araştırma hastanesinde evde bakım hizmetlerinin değerlendirilmesi

Amac: Evde saglik hizmeti (ESH) alan hastalarin, demografik ozelliklerini, saglik ve bagimlilik durumlari ile aldiklari ve ihtiyac duyduklari hizmetleri tanimlamaktir. Hastalar ve Yontem: Izmir’de bir egitim arastirma hastanesi evde bakim biriminden Ocak-Agustos 2010 arasinda ESH alan 120 hastanin dosyalari geriye donuk olarak incelenmistir. Bulgular: ESH ihtiyaci olanlarin cogu kadin (%61,8), ortalama yaslari 72,6±16,4 (aralik: 16-105) yil olup %75,5’i 65 yas ve uzerindeyken %79,2’si yataga bagimlidir. Sirasiyla %21,7 ve %31,7’sinin kisisel hijyen ve beslenme durumlari yetersiz olarak degerlendirilmistir. En sik gorulen hastaliklar hipertansiyon (%19,3), serebrovaskuler hastaliklar (%13,5) ve Alzheimer hastaligi (%9,5)’dir. Aile bireyleri, beslenme (%30,3), sanitasyonhijyen (%21,2) ve genel bakim (%18,2) konularinda egitim almak ihtiyaci duyduklarini belirtmislerdir. Sonuc: Bu calisma, tum taraflar icin, ozellikle aile hekimleri icin, tibbi ve hemsirelik alanlari ile sosyal yardim kapsamindaki alanlarda ESH’nin farkli yonlerini gostermektedir. ESH icin basvuranlarin cogu kadin, yasli, fonksiyonel durumu bozuk ve yataga bagimlidirlar. Bakim verenler, sadece ekonomik anlamda degil, hastalarina daha iyi hizmet verebilmek icin egitim anlaminda da hizmet almak ihtiyacindadirlar.

Yaygın anksiyete bozukluğu: Birinci basamakta görülme sıklığı ve tanı güçlükleri

1) Dokuz Eylül Üniversitesi T›p Fakültesi, Aile Hekimli¤i Anabilim Dal›, Aile Hekimli¤i Uzman›, ‹zmir 2) Dokuz Eylül Üniversitesi T›p Fakültesi, Aile Hekimli¤i Anabilim Dal›, Aile Hekimli¤i Uzman›, Yard. Doç. Dr., ‹zmir K ayg› bozukluklar› kategorisinde yer alan, afl›r› endifle ve belirgin tetikte olma davran›fl› ile seyreden Yayg›n anksiyete bozuklu¤u (YAB), 1980’ler öncesinde “anksiyete nevrozu” olarak adland›r›l›yordu. Bu bariz adland›rmaya ra¤men hastal›¤›n ba¤›ms›z, farkl› ve tedavi edilebilir bir psikiyatrik hastal›k olarak de¤erlendirilmesi ile ilgili bir karmafla söz konusudur. Avrupa’da kullan›lan ICD (International Classification of Disease) ve Amerika’da tercih edilen DSM (Diagnostic and Statistical Manual of Mental Disorders) YAB’› farkl› ölçütlerle de¤erlendirilmektedirler (Tablo 1 ve Tablo 2). 1990’larda yap›lan çok say›da çal›flma ile daha uygun tan› araçlar› gelifltirilmekle birlikte kavramsal alt yap›daki bu farkl›l›k halen sürmektedir. Yaflanan bu sürece ra¤men depresyon ve panik bozukluk gibi psikiyatrik hastal›klarla karfl›laflt›r›ld›¤›nda YAB’nun genel popülasyonda yaflam boyu prevalans› DSM kriterlerine göre %5, daha genifl kriterleri olan ICD-10 kullan›ld›¤›nda ise %6.5’tur. Türkiye Ruh Sa¤l›¤› Profili Araflt›rmas›nda YAB’nun son 12 aydaki s›kl›¤› %0.7 olarak bulunmuflDerleme | Review Türk Aile Hek Derg 2009; 13(4): 206-209 doi:10.2399/tahd.09.206