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Assessment of geriatric patients at the internal medicine intensive care unit (IMICU)
(Springer, 2013) Sahin, S.; Timur, O.; Alp, A.; Oven, B.; Duman, S.; Akcicek, F.
Background: The aim of this study was to evaluate the general characteristics of geriatric patients hospitalized at the internal medicine intensive care unit (IMICU). Methods: All patients aged above 65 years and admitted to the intensive care unit of the internal medicine department at Ege University Hospital October 2010 to February 2011 were included in the study. Files of the patients were accessed retrospectively and the following information was recorded: age, gender, main cause of intensive care admission, number of chronic diseases, laboratory results, drug use and other therapeutic procedures, length of stay, outcomes in terms of survival and mortality. Secondary outcomes were defined to compare patients admitted to the intensive care unit from the emergency ward with those transferred from the internal medicine wards. Results: The total number of patients admitted to the internal medicine intensive care unit during the study period was 357, of whom 171(47.99%) were aged above 65 years, a mean age of 74 +/- 6.6 years without any statistically significant difference between gender (P = 0.859). Days of hospitalization at the intensive care were 15.7 +/- 4.8, in patient mortality was found to be 17.7%, The mean number of chronic diseases per patient was 2.2 +/- 1.3. and the most frequent chronic diseases were arterial hypertension 57%. The most frequent pathology of the patients was found to be renal dysfunction 38.6% (n = 66), followed by anaemia 38.0% (n = 65) and liver dysfunction 11.7% (n = 20). The ratio of haemodialysis (HD) was found as 11.7%. When the patients were assessed in terms of invasive interventions by grouping them into those admitted from the emergency unit and those transferring from the internal medicine departments, it was seen that foley, intravenous catheterization, nasogastric tube insertion and HD were significantly higher for the patients admitted from the emergency unit. Mortality rate was found to be significantly higher for same group (44% versus 17, P < 0.001). Conclusion: The proportion of elderly in the intensive care unit is increasing. In the present study renal dysfunction is the most common organ failure. Infection seems to be one of the common problems in IMICU. Organ failure and invasive intervention needs are high in elderly patient admitted from the emergency ward to intensive care. (c) 2012 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved.
Assessment of geriatric patients at the internal medicine intensive care unit (IMICU)
(Springer, 2013) Sahin, S.; Timur, O.; Alp, A.; Oven, B.; Duman, S.; Akcicek, F.
Background: The aim of this study was to evaluate the general characteristics of geriatric patients hospitalized at the internal medicine intensive care unit (IMICU). Methods: All patients aged above 65 years and admitted to the intensive care unit of the internal medicine department at Ege University Hospital October 2010 to February 2011 were included in the study. Files of the patients were accessed retrospectively and the following information was recorded: age, gender, main cause of intensive care admission, number of chronic diseases, laboratory results, drug use and other therapeutic procedures, length of stay, outcomes in terms of survival and mortality. Secondary outcomes were defined to compare patients admitted to the intensive care unit from the emergency ward with those transferred from the internal medicine wards. Results: The total number of patients admitted to the internal medicine intensive care unit during the study period was 357, of whom 171(47.99%) were aged above 65 years, a mean age of 74 +/- 6.6 years without any statistically significant difference between gender (P = 0.859). Days of hospitalization at the intensive care were 15.7 +/- 4.8, in patient mortality was found to be 17.7%, The mean number of chronic diseases per patient was 2.2 +/- 1.3. and the most frequent chronic diseases were arterial hypertension 57%. The most frequent pathology of the patients was found to be renal dysfunction 38.6% (n = 66), followed by anaemia 38.0% (n = 65) and liver dysfunction 11.7% (n = 20). The ratio of haemodialysis (HD) was found as 11.7%. When the patients were assessed in terms of invasive interventions by grouping them into those admitted from the emergency unit and those transferring from the internal medicine departments, it was seen that foley, intravenous catheterization, nasogastric tube insertion and HD were significantly higher for the patients admitted from the emergency unit. Mortality rate was found to be significantly higher for same group (44% versus 17, P < 0.001). Conclusion: The proportion of elderly in the intensive care unit is increasing. In the present study renal dysfunction is the most common organ failure. Infection seems to be one of the common problems in IMICU. Organ failure and invasive intervention needs are high in elderly patient admitted from the emergency ward to intensive care. (c) 2012 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved.
Association of osteopontin and tumor necrosis factor-alpha levels with insulin resistance in obese patients with obstructive sleep apnea syndrome
(Editrice Kurtis S R L, 2011) Sarac, F.; Basoglu, O. K.; Gunduz, C.; Bayrak, H.; Avci, C. Biray; Akcicek, F.
Objective: The aims of this study were to compare the tumor necrosis factor (TNF)-alpha and osteopontin levels, to identify the relationship between insulin resistance (IR) and osteopontin levels in obese patients with and without obstructive sleep apnea syndrome (OSAS). Method: The study population included 62 obese patients (35 males, 27 females) with OSAS and was compared with 26 obese patients (16 males, 10 females) without OSAS as a control group. Polysomnographic evaluation, spirometric tests and arterial blood gas sampling were performed on the obese patients with OSAS. Plasma levels of INF-alpha and osteopontin were measured by enzyme-linked immunosorbent assays during the process. IR was estimated using the homeostasis model assessment (HOMA). Results: Mean plasma levels of fasting glucose, insulin, HOMA, liver function test, hematocrit, leukocyte, TSH, free T(4), fibrinogen, INF-alpha, and osteopontin were similar in the 2 groups. In patients with OSAS, mean osteopontin levels were positively correlated with mean fasting insulin levels (r=0.306, p=0.01), HOMA (r=0.299, p=0.01), apnea-hypopnea index (r=0.377, p=0.03) and Epworth Sleepiness Scale (r=0.299, p=0.01). However, mean INF-alpha levels were negatively correlated with Epworth Sleepiness Scale (r=-0.298, p=0.01) in the patients with OSAS. Conclusions: It was observed that INF-alpha and osteopontin levels showed no difference between obese patients with and without OSAS. However, osteopontin levels increased with fasting insulin, IR, OSAS severity, and daytime sleepiness. (J. Endocrinol. Invest. 34: 528-533, 2011) (C) 2011, Editrice Kurtis
Can Palosuran, as an Urotensin II Receptor Antagonist, Protect Kidneys from Calcineurins
(Lippincott Williams & Wilkins, 2012) Bozkurt, D.; Olukman, M.; Hur, E.; Bicak, S.; Tuna, S.; Sen, S.; Akcicek, F.; Duman, S.
No relationship between lipoprotein-associated phospholipase A2, proinflammatory cytokines, and neopterin in Alzheimer's disease
(Pergamon-Elsevier Science Ltd, 2016) Savas, S.; Kabaroglu, C.; Alpman, A.; Sarac, F.; Yalcin, M. A.; Parildar, Z.; Özkınay, Ferda; Kumral, E.; Akcicek, F.
Objective: Lipoprotein-associated phospholipase A2 (Lp-PLA(2)) is a reported risk factor for dementia. However, the relationship between Alzheimer's disease (AD) and Lp-PLA(2) is still debatable and, to the best of our knowledge, no study has evaluated the associations between levels of Lp-PLA(2), proinflammatory cytokines, and neopterin in AD. Methods: In total, 59 patients with AD and 38 non-demented individuals were included in the case-control study. Fasting serum concentrations of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), neopterin, and Lp-PLA(2) were determined using ELISA. The associations between AD and each of the variables were analyzed by logistic regression. Results: The median Lp-PLA(2) levels in AD and controls were similar (P = 0.29, not significant). Median serum neopterin and IL-6 levels were significantly higher in patients with AD than in controls (P = 0.0001 and P = 0.03, respectively). In regression analyses, median neopterin levels, a lower level of education, and female gender were significantly associated with AD when compared with controls (OR, 31.44, 95% CI 3.59-275.28, P=0.002; OR, 4.35, 95% CI 1.13-16.61, P = 0.032; OR, 7.25, 95% CI 1.88-28.00, P = 0.004, respectively). Conclusion: In contrast to previous evidence suggesting its role in dementia and AD, Lp-PLA(2) enzyme levels were higher in the controls, and no relationship between Lp-PLA(2) and either proinflammatory cytokines or neopterin was identified in AD. Elevated neopterin levels may be considered inflammatory markers of AD. (C) 2016 Elsevier Inc. All rights reserved.
Phosphorus control in peritoneal dialysis patients
(Elsevier Science Inc, 2008) Yavuz, A.; Ersoy, F. F.; Passadakis, P. S.; Tam, P.; Evaggelos, D. M.; Katopodis, K. P.; Oezener, C.; Akcicek, F.; Camsari, T.; Ates, K.; Ataman, R.; Vlachojannis, G. J.; Dombros, N. A.; Utas, C.; Akpolat, T.; Bozfakioglu, S.; Wu, G.; Karayaylali, I.; Arinsoy, T.; Stathakis, C. P.; Yavuz, M.; Tsakiris, D. J.; Dimitriades, A. C.; Yilmaz, M. E.; Gueltekin, M.; Sueleymanlar, G.; Oreopoulos, D. G.
Hyperphosphatemia is independently associated with an increased risk of death among dialysis patients. In this study, we have assessed the status of phosphate control and its clinical and laboratory associations in a large international group of patients on chronic peritoneal dialysis (PD) treatment. This cross-sectional multicenter study was carried out in 24 centers in three different countries ( Canada, Greece, and Turkey) among 530 PD patients (235 women, 295 men) with a mean +/- s.d. age of 55716 years and mean duration of PD of 33 +/- 25 months. Serum calcium (Ca2+),ionized Ca2+, phosphate, intact parathyroid hormone (iPTH), 25-hydroxy vitamin D-3, 1,25-dihydroxy vitamin D3, total alkaline phosphatase, and bone alkaline phosphatase concentrations were investigated, along with adequacy parameters such as Kt/V, weekly creatinine clearance, and daily urine output. Mean Kt/V was 2.3 +/- 0.65, weekly creatinine clearance 78.5 +/- 76.6 l, and daily urine output 550 +/- 603 ml day(-1). Fifty-five percent of patients had a urine volume of <400 ml day(-1). Mean serum phosphorus level was 4.9 +/- 1.3 mg per 100 ml, serum Ca2+ 9.4 +/- 1.07 mg per 100 ml, iPTH 2677356 pg ml(-1), ionized Ca2+ 1.08 +/- 0.32 mg per 100 ml, calcium phosphorus (Ca x P) product 39 +/- 19 mg(2) dl(-2), 25(OH) D3 8.3 +/- 9.3 ng ml(-1), 1,25(OH)(2)D-3 9.7 +/- 6.7 pg ml(-1), total alkaline phosphatase 170 +/- 178 Ul(-1), and bone alkaline phosphatase 71 +/- 108 Ul(-1). While 14% of patients were hypophosphatemic, with a serum phosphorus level lower than 3.5 mg per 100 ml, most patients (307 patients, 58%) had a serum phosphate level between 3.5 and 5.5 mg per 100 ml. Serum phosphorus level was 5.5 mg per 100 ml or greater in 28% (149) of patients. Serum Ca2+ level was >= 9.5 mg per 100 ml in 250 patients (49%), between 8.5 and 9.5 mg per 100 ml in 214 patients (40%), and lower than 8.5 mg per 100 ml in 66 patients (12%). Ca x P product was > 55 mg(2) dl(-2) in 136 patients (26%) and lower than >55mg(2) dl(-2) in 394 patients (74%). Serum phosphorus levels were positively correlated with serum albumin (P<0.027) and iPTH (P = 0.001), and negatively correlated with age (P<0.033). Serum phosphorus was also statistically different (P=0.013) in the older age group (465 years) compared to younger patients; mean levels were 5.1 +/- 1.4 and 4.5 +/- 1.1mg per 100 ml, respectively, in the two groups. In our study, among 530 PD patients, accepted uremic-normal limits of serum phosphorus control was achieved in 58%, Ca x P in 73%, serum Ca2+ in 53%, and iPTH levels in 24% of subjects. Our results show that chronic PD, when combined with dietary measures and use of phosphate binders, is associated with satisfactory serum phosporus control in the majority of patients.
POLYMORPHISMS IN HETEROZYGOUS AND HOMOZYGOUS PERILIPIN GENE, C.1113T > C AND C.1119C > T, ARE INCREASED IN OBESE WOMEN
(Editura Acad Romane, 2012) Sarac, F.; Berdelli, A.; Atan, M.; Yilmaz, C.; Akcicek, F.
Background. Obesity involves both genetic and environmental influences, but the mechanisms of the genetic effects are not well understood. Objective. The aims of the study were to investigate the frequency of perilipin gene polymorphism in order to identify the relationship between insulin resistance and gene polymorphism in obese women. Subjects and methods. Study population included 31 obese women and 10 women with normal weight as a control group. All of the entire coding exons of PLIN gene were amplified by polymerase chain reaction (PCR). Insulin resistance (IR) was estimated using the homeostasis model assessment (HOMA-IR). Results. In the obese group, 29 (93.6%) patients were homozygous and 1 patient (3.2%) was heterozygous for the c.580C>.G (p.Pro194A1a) (rs.6496589) mutation and I patient (3.2%) was Pro194A1a. Homozygous.Val156Leu. heterozygous mutation at exon 5 at PLIN gene (p=0.072). As for exon 8 at PLIN gene in obese group, 6 patients (19.3%) had heterozygous for the c.1113T>C (Pro371Pro) (rs2304796) mutation, and 12 patients (38.7%) had heterozygous for the c.1113T>C and c.1119C>T (p.Val373Val) (rs2304795) mutation, and 4 patients (12.9%) had homozygous for the c.1113T>C and c.1119C>T mutations (p=0.009). In obese patients with no nucleotide substitution at exon 8, mean levels of systolic and diastolic blood pressures were higher than those of obese subjects with gene polymorphism. However, there were no statistically significant differences for HOMA-IR levels between obese women with and without perilipin gene polymorphism. Conclusions: Perilipin gene polymorphisms such as heterozygous and homozygous for the c.1113T>C and c.1119C>T (rs2304795) at exon 8 were associated with obesity risk. However, no relationship was found between insulin resistance and polymorphisms of perilipin gene in obese women.
Prevalence and risk factors of sarcopenia in elderly nursing home residents
(Springer, 2015) Tasar, P. T.; Sahin, S.; Karaman, E.; Ulusoy, M. G.; Duman, S.; Berdeli, A.; Akcicek, F.
Introduction: Several studies have attempted to define the diagnostic criteria of the geriatric syndrome sarcopenia. Studies of sarcopenia prevalence in Turkey are limited; one reason for this is the absence of standard diagnostic reference values. The aim of this study was to investigate the prevalence of sarcopenia and its influencing factors in the local elderly nursing home residents in accordance with the EWGSOP consensus report. Materials and methods: The study included a total of 211 nursing home residents. Anthropometric measurements, muscle mass, muscle strength and physical performance were examined. Muscle mass of the nursing home residents was compared to an 18-45-year-old healthy control group. Descriptive values for numerical variables are given as mean, standard deviation; categorical variables are shown as frequency and percentage. Results: A total of 211 nursing home residents were included in the study. The average age was 77.30 +/- 7.20; the participants were 58.8% women and 37.4% young-old. The prevalence of sarcopenia in Turkish nursing home residents was found to be 33.6%. Among sarcopenic participants, 32.4% were women and 67.6% were men. In our study, sarcopenia was more prevalent in men, the young-old, and patients with Parkinson's or chronic obstructive lung disease, while sarcopenia was seen less in obese patients. No relationship was found between the Barthel index and sarcopenia. Conclusions: Sarcopenia prevalence was 33.6% when the diagnostic criteria described by the EWGSOP were used. Sarcopenia prevalence was higher in men and the young-old age groups. Sarcopenia was more frequent in nursing home residents with malnutrition or risk of malnutrition. (C) 2015 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved.
Prevalence and risk factors of sarcopenia in elderly nursing home residents
(Springer, 2015) Tasar, P. T.; Sahin, S.; Karaman, E.; Ulusoy, M. G.; Duman, S.; Berdeli, A.; Akcicek, F.
Introduction: Several studies have attempted to define the diagnostic criteria of the geriatric syndrome sarcopenia. Studies of sarcopenia prevalence in Turkey are limited; one reason for this is the absence of standard diagnostic reference values. The aim of this study was to investigate the prevalence of sarcopenia and its influencing factors in the local elderly nursing home residents in accordance with the EWGSOP consensus report. Materials and methods: The study included a total of 211 nursing home residents. Anthropometric measurements, muscle mass, muscle strength and physical performance were examined. Muscle mass of the nursing home residents was compared to an 18-45-year-old healthy control group. Descriptive values for numerical variables are given as mean, standard deviation; categorical variables are shown as frequency and percentage. Results: A total of 211 nursing home residents were included in the study. The average age was 77.30 +/- 7.20; the participants were 58.8% women and 37.4% young-old. The prevalence of sarcopenia in Turkish nursing home residents was found to be 33.6%. Among sarcopenic participants, 32.4% were women and 67.6% were men. In our study, sarcopenia was more prevalent in men, the young-old, and patients with Parkinson's or chronic obstructive lung disease, while sarcopenia was seen less in obese patients. No relationship was found between the Barthel index and sarcopenia. Conclusions: Sarcopenia prevalence was 33.6% when the diagnostic criteria described by the EWGSOP were used. Sarcopenia prevalence was higher in men and the young-old age groups. Sarcopenia was more frequent in nursing home residents with malnutrition or risk of malnutrition. (C) 2015 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved.
Prevalence and risk factors of sarcopenia in elderly nursing home residents
(Springer, 2015) Tasar, P. T.; Sahin, S.; Karaman, E.; Ulusoy, M. G.; Duman, S.; Berdeli, A.; Akcicek, F.
Introduction: Several studies have attempted to define the diagnostic criteria of the geriatric syndrome sarcopenia. Studies of sarcopenia prevalence in Turkey are limited; one reason for this is the absence of standard diagnostic reference values. The aim of this study was to investigate the prevalence of sarcopenia and its influencing factors in the local elderly nursing home residents in accordance with the EWGSOP consensus report. Materials and methods: The study included a total of 211 nursing home residents. Anthropometric measurements, muscle mass, muscle strength and physical performance were examined. Muscle mass of the nursing home residents was compared to an 18-45-year-old healthy control group. Descriptive values for numerical variables are given as mean, standard deviation; categorical variables are shown as frequency and percentage. Results: A total of 211 nursing home residents were included in the study. The average age was 77.30 +/- 7.20; the participants were 58.8% women and 37.4% young-old. The prevalence of sarcopenia in Turkish nursing home residents was found to be 33.6%. Among sarcopenic participants, 32.4% were women and 67.6% were men. In our study, sarcopenia was more prevalent in men, the young-old, and patients with Parkinson's or chronic obstructive lung disease, while sarcopenia was seen less in obese patients. No relationship was found between the Barthel index and sarcopenia. Conclusions: Sarcopenia prevalence was 33.6% when the diagnostic criteria described by the EWGSOP were used. Sarcopenia prevalence was higher in men and the young-old age groups. Sarcopenia was more frequent in nursing home residents with malnutrition or risk of malnutrition. (C) 2015 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved.
Sarcopenia assessment project in the nursing homes in Turkey
(Nature Publishing Group, 2014) Halil, M.; Ulger, Z.; Varli, M.; Doventas, A.; Ozturk, G. B.; Kuyumcu, M. E.; Yavuz, B. B.; Yesil, Y.; Tufan, F.; Cankurtaran, M.; Saka, B.; Sahin, S.; Curgunlu, A.; Tekin, N.; Akcicek, F.; Karan, M. A.; Atli, T.; Beger, T.; Erdincler, D. S.; Ariogul, S.
BACKGROUND/OBJECTIVES: Sarcopenia and sarcopenic obesity (SO) are geriatric syndromes leading to physical disability, poor quality of life and death. The aim of this study was to investigate the prevalence of sarcopenia and SO in nursing homes in Turkey and to define local disparities for diagnosing sarcopenia and SO. SUBJECTS/METHODS: This cross-sectional multicenter study was performed in 711 patients in 14 nursing homes. Comprehensive geriatric assessment tests, handgrip strength and calf circumference (CC) measurements were carried out. Sarcopenia was both defined by handgrip strength and CC criteria. RESULTS: According to handgrip strength measurement, 483 (68%) of patients were sarcopenic (male: 72%, female: 63.8%), 228 were non-sarcopenic. The prevalence of SO was 22% (13.7% in men, 30.2% in women). Patients (82.5%) who were diagnosed as sarcopenic by the handgrip strength test were not sarcopenic according to CC sarcopenia criteria. Therefore, we tried to determine the optimal CC value fOr diagnosing sarcopenia in our population. CONCLUSIONS: Both sarcopenia and SO were prevalent among Turkish nursing home elderly residents. Most of the patients with sarcopenia were obese or overweight. We showed that di'agnosing sarcopenia with CC measurement underestimated the sarcopenia prevalence assessed by handgrip strength. So we concluded that, although different assessment methods are recommended for the diagnosis of sarcopenia local disparities should be considered.
Severe vitamin D deficiency in chronic renal failure patients on peritoneal dialysis
(Dustri-Verlag Dr Karl Feistle, 2006) Taskapan, H.; Ersoy, F. F.; Passadakis, P. S.; Tam, P.; Memmos, D. E.; Katopodis, K. P.; Ozener, C.; Akcicek, F.; T Camsari; Ates, K.; Ataman, R.; Vlachojannis, J. G.; Dombros, N. A.; Utas, C.; Akpolat, T.; Bozfakioglu, S.; Wu, G.; Karayaylali, I.; Arinsoy, T.; Stathakis, C. P.; Yavuz, M.; Tsakiris, D. J.; Dimitriades, A. D.; Yilmaz, M. E.; Gultekin, M.; Oreopoulos, D. G.
The aim of this study was to evaluate the prevalence of vitamin D deficiency in chronic renal failure (CRF) patients on peritoneal dialysis (PD) and to correlate the findings with various demographic and renal osteodystrophy markers. Method: This cross-sectional, multicenter study was carried out in 273 PD patients with a mean age of 61.7 +/- 10.9 years and mean duration of PD 3.3 +/- 2.2 years. It included 123 female and 150 male patients from 20 centers in Greece and Turkey, countries that are on the same latitude, namely, 36 - 42 degrees north. We measured 25(OH)D(3) and 1.25(OH)(2)D(3) levels and some other clinical and laboratory indices of bone mineral metabolism. Results: Of these 273 patients 92% (251 patients) had vitamin D deficiency i.e. serum 25(OH)D(3) levels less than 15 ng/ml, 119 (43.6%) had severe vitamin D deficiency i.e. serum 25(OH)D(3) levels, less than 5 ng/ml, 132 (48.4%) had moderate vitamin D deficiency i.e. serum 25(OH)D3 levels, 5 - 15 ng/ml, 12 (4.4%) vitamin D insufficiency i.e. serum 25(OH)D3 levels 15 - 30 ng/ml and only 10 (3.6%) had adequate vitamin D stores. We found no correlation between 25(OH)D(3) levels and PTH, serum albumin, bone alkaline phosphatase, P, and Ca x P. In multiple regression analyses, the independent predictors of 25(OH)D(3) were age, presence of diabetes (DM-CRF), levels of serum calcium and serum 1.25(OH)(2)D(3)- Conclusion: We found a high prevalence (92%) of vitamin D deficiency in these 273 PD patients, nearly one half of whom had severe vitamin D deficiency. Vitamin D deficiency is more common in DM-CRF patients than in non-DM-CRF patients. Our findings suggest that these patients should be considered for vitamin D supplementation.
Trimethylaminuria (fish malodour syndrome) in chronic renal failure
(Lithographia, 2012) Hur, E.; Gungor, O.; Bozkurt, D.; Bozgul, S. M. K.; Dusunur, F.; Caliskan, H.; Berdeli, A.; Akcicek, F.; Basci, A.; Duman, S.
Trimethylaminuria (fish malodour syndrome) is a rare genetic metabolic disorder presented with a body odour which smells like a decaying fish. This odour is highly objectionable, that can be destructive for the social, and work life of the patient. Trimethylamine is derived from the intestinal bacterial degradation of foods that are rich of choline and carnitine. Trimethylamine is normally oxidised by the liver to odourless trimethylamine N-oxide which is excreted in the urine, so, uremia may worsen the condition. Uremia itself may cause more or less unpleasant odour. Poor uremic control may worsen the odour. We reported this case because Trimethylaminuria is not usually considered in the differential diagnosis of malodour in chronic renal failure and it is the first case that shown the association with Trimethylaminuria and chronic renal failure in the literature. Hippokratia. 2012; 16 (1): 83-85
Turkish nursing homes and care homes nutritional status assessment project (THN-malnutrition)
(Elsevier Masson, 2013) Cankurtaran, M.; Saka, B.; Sahin, S.; Varlt, M.; Doventas, A.; Yavuz, B. B.; Halil, M.; Curgunlu, A.; Diger, Z.; Tekin, N.; Akcicek, F.; Karan, M. A.; Atli, T.; Beger, T.; Erdincler, D. S.; Ariogul, S.
Background and aim: Malnutrition is related with serious morbidity and mortality in institutionalized older adults. The aim of this study is to determine the frequency of malnutrition in nursing homes and care homes and to identify the factors associated with malnutrition in these settings. Methods: This multicenter study was conducted in 14 centers of nursing homes/care homes in three different cities. Total number of 1797 residents aged >= 65 years was enrolled. Malnutrition screening was made by Mini Nutritional Assessment Short Form (MNA-SF) and full MNA. Statistical analyses were conducted by SPSS 15.0. Results: The median age (min-max) of the study population was 78.0 (65.0-108.0) and 917 (51%) were female. MNA-SF score of the residents was 11(0-14). According to the MNA-SF 850(49.3%) residents had normal nutritional status, 654 (38.3%) residents were at malnutrition risk, and 204 (11.9%) had malnutrition. Number of medications, gender, duration of stay in the institution, frequency of family visits, social security status, type of nursing home (government or not), daily life activities (ADL), Geriatric Depression Scale (GDS) and MMSE scores, get up & go test, hypertension, dementia, depression, and Parkinson disease were associated with malnutrition. Regression analyses revealed that get up&go test, GDS, hypertension, and ADL were independently related to malnutrition diagnosed by MNA-SF. Conclusion: This study provides important information on the prevalence and associated factors of malnutrition in a large multicentered setting of nursing homes and care homes. It will direct the screening plans and interventions taken in order to detect, prevent, and manage malnutrition in these settings. (C) 2013 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved.

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