Reci Meseri

High prevalence of cardiovascular risk factors in a Western urban Turkish population: a community-based study.

OBJECTIVE Cardiovascular diseases (CVD) are the largest cause of morbidity and mortality in Turkey and in the World. Heart of Balçova Project is a community- based health promotion project that aims to reduce CVD incidence and prevalence through risk factor modification in the individual and population level. This paper presents results of the baseline survey that aimed to define CVD risk factors and risk of developing coronary heart disease (CHD) in the Balçova population. METHODS The study population included 36,187 people over 30 years of age residing in Balçova in 2007. Individuals were interviewed at their homes. Anthropometrics and blood pressure were measured and in total 12914 fasting blood samples were collected for lipid and glucose analyses. CHD risk was estimated using Framingham risk equation. Students t test, Chi-square for trend test and ANOVA were used to compare mean levels and percentages of risk factors between age groups and gender. RESULTS In total 5552 men and 10528 women participated in the study. Smoking prevalence was 38.6% in men and 26.8% in women. The prevalence of obesity was 29.4% among men and 44.2% among women and obesity prevalence increased until the age group 75 years old. While 14.6% of men and 12.6% of women had diabetes, 39.8% of men and 41.8% of women had hypertension. The prevalence of high total cholesterol was 56.0% in men and 50.6% in women. Men had a higher risk of developing CHD compared to women in the following 10 years (13.4% vs 2.5%). CONCLUSION The prevalence of preventable risk factors for CHD is very high in Balçova population. Community-based interventions should be planned and implemented targeting both the high-risk individuals and whole population.

Comparison of the effects of dexmedetomidine administered at two different times on renal ischemia/reperfusion injury in rats

BACKGROUND AND OBJECTIVES We investigated the effect of dexmedetomidine on ischemic renal failure in rats. METHODS In the present study, 26 male adult Wistar albino rats weighting 230-300 g were randomly separated into four groups: sham-operated (n=5), ischemia reperfusion (IR) (IR group, n=7), IR/reperfusion treatment with dexmedetomidine (Dex. R group, n=7) and IR/pre-ischemic treatment with dexmedetomidine (Dex. I group, n=7). In the first group, sham operation was achieved and renal clamps were not applied. For the IR group, renal ischemia was induced by occlusion of the bilateral renal arteries and veins for 60 min followed by reperfusion for 24h. For the Dex. R and Dex. I groups, the same surgical procedure as in the IR group was performed, and dexmedetomidine (100 mcg/kg intraperitoneal) was administrated at the 5th min after reperfusion and before ischemia. At the end of reperfusion, blood samples were drawn, the rats were sacrificed, and the left kidney was processed for histopathology. RESULTS The blood urea nitrogen (BUN) levels in groups Dex. R and Dex. I were significantly lower than in the IR group (p=0.015, p=0.043), although urine flow was significantly higher in group Dex. R (p=0.003). The renal histopathological score in the IR group was significantly higher than in the other groups. There was no significant difference between the Dex. R and Dex. I groups. CONCLUSIONS The results were shown that administration of dexmedetomidine reduced the renal IR injury histomorphologically. Administration of dexmedetomidine in the reperfusion period was considered as more effective due to increase in urinary output and decrease in BUN levels.

How do delivery mode and parity affect pelvic organ prolapse

To determine the association between mode of delivery, parity, and pelvic organ prolapse, as assessed by the pelvic organ prolapse quantification system.

Overactive bladder and its effects on sexual dysfunction among women

To evaluate the relation between overactive bladder (OAB) and sexual dysfunction in sexually active nurses without stress urinary incontinence and pelvic organ prolapse.

Quality of life scores improve in women undergoing colpocleisis: a pilot study

OBJECTIVE To evaluate the quality of life and surgical outcomes in women who had undergone colpocleisis. STUDY DESIGN This was a prospective small cohort study conducted between August 2010 and September 2011. Twelve women with pelvic organ prolapse were offered obliterative vaginal surgery and were informed about the surgical procedure. Ten women accepted this operation and were included in the study. Before and after colpocleisis, cases were evaluated by urogynecological examination, and quality of life was assessed by the Turkish language validated prolapse quality of life questionnaire (P-QOL), in which a low total score indicates a good quality of life. RESULTS The mean age was 74.9±4.5 (range 68-85). The general score of the P-QOL was reduced during the follow-up period, reflecting a significant effect on quality of life and clinical improvement in women with the colpocleisis operation. There was no morbidity due to colpocleisis or recurrent pelvic organ prolapse in follow-up period. CONCLUSION In our small cohort including elderly women, colpocleisis provided high levels of surgical outcomes as well as a significant improvement in quality of life without significant morbidity.

Renal Ischemia/Reperfusion Injury in Diabetic Rats: The Role of Local Ischemic Preconditioning

Background. The aim of this study was to evaluate the effects of local ischemic preconditioning using biochemical markers and histopathologically in the diabetic rat renal IR injury model. Methods. DM was induced using streptozotocin. Rats were divided into four groups: Group I, nondiabetic sham group (n = 7), Group II, diabetic sham group (n = 6), Group III, diabetic IR group (diabetic IR group, n = 6), and Group IV, diabetic IR + local ischemic preconditioning group (diabetic IR + LIPC group, n = 6). Ischemic renal injury was induced by clamping the bilateral renal artery for 45 min. 4 h following ischemia, clearance protocols were applied to assess biochemical markers and histopathologically in rat kidneys. Results. The histomorphologic total cell injury scores of the nondiabetic sham group were significantly lower than diabetic sham, diabetic IR, and diabetic IR + LIPC groups. Diabetic IR group scores were not significantly different than the diabetic sham group. But diabetic IR + LIPC group scores were significantly higher than the diabetic sham and diabetic IR groups. Conclusion. Local ischemic preconditioning does not reduce the risk of renal injury induced by ischemia/reperfusion in diabetic rat model.

Evaluation of education, attitude, and practice of the Turkish anesthesiologists in regional block techniques.

Background The demand for regional blocks from both patients and surgeons has significantly increased in anesthesia practice during the last 30 years. Although the studies show that the complications are rare, regional blocks still have serious difficulties which can be prevented by training programs. Objectives The purpose of this study was to determine the factors affecting the educational methods, attitude and practice of the Turkish anesthesiologists in regional blocks during and following residency programs. Patients and Methods Anesthesiologists were asked to answer a questionnaire. Educational proficiency was determined by at least 50 spinal, 50 epidural and 50 peripheral block applications during residency. Specialists were asked for the numbers of spinal, epidural and peripheral blocks (PBs) they applied in 2009. The mean and median values were calculated. Results One hundred and eighty-eight anesthesiologists (84.3 %) agreed to participate in the study. While all participants had made their first attempts in neuraxial blocks (NBs) when they were residents, this ratio was detected as 96.8% for PBs. All participants learned neuraxial and PBs on patients in the operating theater. Education proficiency ratios for spinal, epidural and PBs were 98.1 %, 92.5 % and 62.3 %, respectively. Age, perception of adequate training, nerve block rotation, adequate application in education, following innovations were the factors which significantly affected the number of PBs in practice according to univariate analysis. The participants who consider their applications on NBs were adequate (P = 0.029) and the ones working in state or private hospitals (P = 0.017), applied NBs significantly above the median number. Conclusions Anesthesiologists had adequate education and practice of NB applications but a significant proportion of participants (51.8%) lacked both in PBs applications. We believe that NBs are more easily learned than PBs during residency training program.

Is overactive bladder microvasculature disease a component of systemic atheroscleorosis

To evaluate the relationship between overactive bladder (OAB) and systemic atherosclerosis in a cohort of women.

Association of sarcopenia with depressive symptoms and functional status among ambulatory community-dwelling elderly

OBJECTIVE Sarcopenia, functional disability, and depression are common problems in the elderly. Sarcopenia is associated with physical disability, functional impairment, depression, cardiometabolic diseases, and even mortality. This study aims to determine the association of sarcopenia with depression and functional status among ambulatory community-dwelling elderly aged 65 years and older. MATERIALS AND METHOD The sample of this cross-sectional study consisted of 28,323 people, aged 65 years and older, living in Bornova, Izmir. Multi-stage sample selection was performed to reach 1007 individuals. However, 966 elderly people could be reached, and 861 elderly people who can walk were included in the study. The data were collected by the interviewers at home through face-to-face interview. RESULTS The mean age was 72.2 ± 5.8 (65-100) years. The prevalence of functional disability, depressive symptoms, and sarcopenia were 21.7%, 25.2%, and 4.6%, respectively. In multivariate analysis depression was associated with sarcopenia, being illiterate and divorced, perception of the economic situation as poor/moderate, increased number of chronic diseases, and having at least one physical disability. IADL associated functional disability with sarcopenia, being illiterate/literate and female, increased age and number of medications, and the BMI. CONCLUSION Sarcopenia in ambulatory community-dwelling elderly is significantly associated with depressive symptoms and functional disability. Elderly people at high risk of sarcopenia should be screened for functional disability and depression. Appropriate interventions should also be implemented.

Blood donation: Great opportunity for screening diabetes risk

Dear editor, Hyperglycemia is a major cause of mortality and morbidity worldwide. According to the International Diabetes Federation (IDF), in 2011, 366 million people have DM, estimated to reach a total of 552 millions in 2030[1]. DM prevalence is rapidly increasing in Turkey according to the Turkey Diabetes Epidemiology Project (TURDEP), estimated at 7.2 % in the TURDEP-I in 2002, compared to a nearly double rate of 13.7 % in 2011 according to TURDEP-II [2]. Early detection of DM and maintaining blood glucose at a desired level is crucial for the prevention of complications. Communitybased, large-scale studies which require a fasting blood sample may miss young adult working males [3, 4]. Blood donations might represent an opportunity to screen adults, especially young working male population for the risk of diabetes. Thus, aim of this study was to determine the risk of diabetes among blood donors and the effecting factors. In this cross-sectional study, sample consisted of volunteers coming to a university hospital blood center. A capillary venous blood sample was drawn for a complete blood count to routinely evaluate the eligibility of volunteers. Random capillary blood glucose (RCBG) was assessed at that time using a glucometer, without causing any additional invasive interference. Diabetes risk was the dependent variable while socio-demographic characteristics, presence of classical diabetes symptoms and obesity were proposed as independent variables. Risk of diabetes was defined as a blood glucose ≥140 mg/dL. Weight, height and waist circumference were measured and anthropometric indices calculated to identify obesity. Of the 348 participants, 81.6 % were male; mean age was 35.0 ± 11.0. RCBG was 140–199 mg/dL in 11.8 % and ≥200 mg/dL in 3.7 % of patients, with a diabetes risk prevalence of 15.5 %. Seven participants had RCBG ≥200 mg/dl with at least one accompanying symptom. Mean age of subjects at risk for diabetes, 42.2 ± 10.9 was significantly higher than that of healthy participants (33.7 ± 10.5) (p< 0.001). As education status increased diabetes risk decreased significantly (p= 0.001). Symptoms also showed