Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Neutrophil to Lymphocyte Ratio As A Predictor of Severe Coronary Artery Disease and Left Ventricular Systolic Dysfunction of Any Degree in Geriatric Patients Presenting to Emergency Department with Acute Coronary Syndrome(2017) Ciftci, Orcun; Kayipmaz, Afsin Emre; Aydos, Tolga Resat; Muderrisoglu, Ibrahim Haldun; 0000-0002-1832-9336; 0000-0001-8926-9142; AAJ-7279-2020; AAC-2597-2020; W-5233-2018Introduction: We examined the role of the neutrophil-to-lymphocyte ratio (NLR) for predicting severe coronary artery disease and left ventricular systolic dysfunction of any degree in geriatric patients presenting to emergency department with non-ST-elevation acute coronary syndrome. Materials and Method: We retrospectively reviewed data for patients aged >= 65 years with non-ST-elevation acute coronary syndrome who underwent coronary angiography between April 2011 and January 2016. Patients were divided into Group 1 (101 patients; severe [>50%] lesions in one or more epicardial artery or branch) and Group 2 (65 patients; no severe lesions). The key clinical parameters, including NLR were compared among the groups and the power of NLR as a predictor of severe coronary artery disease and left ventricular systolic dysfunction of any degree was determined. Results: Group 1 included more patients who were male, older, or smoked; these had higher troponin I, mass CK-MB, NLR, but a lower left-ventricular ejection fraction. NLR was an independent predictor of severe coronary disease and left ventricular systolic dysfunction of any degree with good sensitivity and moderate specificity. Conclusion: Neutrophil-to-lymphocyte ratio is a simple, rapid, and cheap parameter that can predict severe coronary artery disease and left ventricular systolic dysfunction of any degree in geriatric patients with non-ST-elevation acute coronary syndrome.Item A Study Which Investigates the Relationship of Age, Trunk Strength, and Balance Parameters with Fall Risk(2016) Sencan, Savas; Ayas, Sehri; Saracgil Cosar, Sacide Nur; 0000-0002-5078-6529; AAJ-7520-2021Introduction: Age-related neural and sensory deteriorations and decline of the musculoskeletal systems affect balance and increase the risk of fall. Our objective in this study is to determine how balance and the risk of fall are affected by increasing age, and search the role of trunk muscle strength on balance. Materials and Method: A total of 90 female voluntary participants were divided into the age groups of 20-39, 40-59 and >= 60 years (n = 30 for each group). Static balance abilities and the fall risks of the subjects were determined using a computer-aided static posturography device and their trunk muscle strength at 60 degrees/s and 120 degrees/s were assessed using the isokinetic dynamometer equipment. Results: When the 20-39 age groups are compared with 40-59 and 3 60 age groups regarding the balance measurements, higher index values at low and medium frequency oscillations were detected. Assessment of the correlation between age and Fourier indexes showed that more balance scores were found to deteriorate with increasing age. The deterioration in the balance parameters was observed to be correlated with the trunk flexor and extensor muscle strength, reducing with increasing age. Conclusion: It was determined that static balance parameters tend to deteriorate and the risk of falls increases with increasing age. The decreasing trunk muscle strength was found to be related to the decline in balance ability and an increased risk of falling.Item Europathic Pain in Elderly: A Multicenter Study(2016) Kutsal, Yesim Gokce; Eyigor, Sibel; Dogan, Asuman; Zardoust, Sasan; Durmus, Bekir; Evcik, Deniz; Gunaydin, Rezzan; Sahin, Nilay; Aydeniz, Ali; Oztop, Pinar; Gokkaya, Kutay O.; Hizmetli, Sami; Borman, Pinar; Paker, Nurdan; Demir, Gulseren; Kayalar, Gulseren; Aydin, Ezgi; Ozyemisci, OzdenIntroduction: Aging brings with it an increase in the prevalence of pain. For effective pain treatment, it is important to determine pain prevalence, its nature, and the factors affecting it. However, epidemiologic information on neuropathic pain in the elderly is inadequate. In our cross-sectional multicenter study, we aimed to determining the prevalence of neuropathic pain in elderly patients and the relationship of neuropathic pain with socio-demographic and clinical factors. Materials and Method: Thirteen centers in different regions of Turkey. The study included 1163 individuals over age 65. Physicians conducted face-to-face interviews to obtain clinical and socio-demographic data and The Douleur Neuropathic 4 (DN4) and The Self-completed Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) pain scales were used to assess neuropathic pain. Patients who scored >= 4 or >= 12 on the DN4 and S-LANSS scales, respectively, were determined to be experiencing neuropathic pain. Results: Neuropathic pain was found in 52.5% of the patients (n=610) in this study. Approximately 67.5% of the patients with neuropathic pain were in the 65-74 age group, and 72.1% (n=440) were females. Of the patients who were experiencing neuropathic pain, 48.4% were graduates of primary school, 91.6% engaged in very little or no physical activity, and 56.7% were taking four or more medications. Conclusions: Neuropathic pain prevalence was 52.5% in the elderly over age 65 who had presented with pain complaints. Neuropathic pain was more frequently seen in women, patients with comorbidities, those with poor levels of ambulation, those using walking aids, and those using multiple drugs. Interrogating the elderly for neuropathic pain seems important for effective treatment.Item CAN CHOLECYSTECTOMY BE PERFORMED AS SAFELY IN ELDERLY PATIENTS AS IT IS IN YOUNG PATIENTS?(2020) Arslan, Baha; Yilmaz, Tugbahan; Erol, Varlik; Tuncali, Bahattin; Gulay, Huseyin; 0000-0002-9590-0276; 0000-0002-7898-2943; 0000-0002-0442-6178; 0000-0003-4461-4904; AAJ-6354-2021; AAJ-7840-2021; AAJ-6407-2021; AAD-6127-2021Introduction: In this study, we aimed to compare the surgical outcomes between elderly and young patients undergoing surgery for gallstone disease and determine variations in patient characteristics, if any. Materials and Method: Data of patients who underwent surgery for gallstone disease at a single center between 2010 and 2018 were analyzed retrospectively. Two patient groups were evaluated: patients <65 years and >= 65 years. Patient characteristics, preoperative outpatient clinic data, surgical data, and postoperative data were collected. Results: In total, 1,198 patients with a mean age of 54.77 +/- 15.03 (15-91) years were assessed. Comorbid conditions, including cardiovascular disease, pulmonary disease, renal disease, and diabetes mellitus were significantly more common in elderly patients (p<0.001). Acute cholecystitis in the preoperative period was noted in 15.36% of young patients and in 30.4% of elderly patients (p<0.001). Need for emergency surgery was higher in elderly patients than in young patients [13.86% (47) and 9.31% (80), respectively] (p=0.021). Laparoscopic cholecystectomy and open cholecystectomy were performed in 98.37% and 1.04% of young patients, respectively, and in 92.62% and 3.53% of elderly patients, respectively (p<0.001). Among factors affecting the length of hospital stay in elderly patients, the duration of hospitalization was significantly longer in elderly patients who underwent emergency surgery, open surgery, needed additional surgery, and who had high American Society of Anesthesiologists scores (p<0.001, p<0.001, p=0.013, p<0.001, respectively). Conclusion: Complications rates associated with cholecystectomy are similar between young and elderly patients when appropriate surgical preparations are performed. Surgery for gallstone disease can be performed safely in elderly patients with low morbidity and mortality rates.Item THE OUTCOMES OF USING FIXED-DOSE NOMOGRAM-GUIDED UNFRACTIONATED HEPARIN THERAPY IN ELDERLY PATIENTS IN COMPARISON WITH YOUNGER PATIENTS(2020) Acibuca, Aynur; Muderrisoglu, Ibrahim Haldun; 0000-0002-3444-8845; ABG-4047-2020Introduction: In elderly patients, the dosing of unfractionated heparin is difficult because of changing metabolism, which affects the determination of a therapeutic level. The aim of this study was to evaluate the effects of unfractionated heparin therapy in an older population and to determine whether there was any difference from a younger population in terms of the activated partial thromboplastin time results and complication rates when using a standard nomogram. Materials and Methods: A total of 120 patients aged <80 years (Group 1) and 120 patients aged >= 80 years (Group 2), all of whom had been given unfractionated heparin therapy for selected indications in the coronary care unit, were randomly selected and retrospectively enrolled in the study. Infusion time up to a maximum of 48 hours was included, and activated partial thromboplastin time results in that period were categorised as subtherapeutic, therapeutic, or supratherapeutic. The rates of the patients' subtherapeutic, therapeutic, and supratherapeutic results were compared between groups. Results: The peak activated partial thromboplastin time level was higher in patients aged >= 80 years (58.85 [51.28] vs 76.50 [57.45], p<0.001). The supratherapeutic activated partial thromboplastin time percentage (0 [0.25] vs 0.20 [0.43], p<0.001) and numbers of first activated partial thromboplastin time in the supratherapeutic range (10% vs 24.2%, p=0.004) were significantly higher in the older group. Conclusion: Over-anticoagulation may be a problem in the elderly population when using standard nomograms. It was concluded that improvements should be made for a nomogram specific to an older population.Item Prevalence and associated factors of external punctal stenosis among elderly patients in Turkey(2017) Ulusoy, Mahmut Oguz; Atakan, Mehmet; Kivanc, Sertac Argun; 29160539Purpose: To estimate the prevalence of external punctal stenosis (EPS) in the elderly population and investigate associated factors. Methods: A total of 278 patients >= 65 years of age were evaluated for evidence of EPS from January to July 2016. Associated systemic, ocular, demographic, and lifestyle factors were investigated. Multiple logistic regression analyses were applied to evaluate the factors related to having EPS. P values <0.05 were considered statistically significant. Results: The prevalence of EPS in this study population was 63.3%, with a mean age of 70.67 +/- 7.85 (65-92 years). The ocular factor that was most commonly related to EPS was chronic blepharitis (48.9%). EPS was also associated with taking glaucoma medications (95% CI, 0.08-0.96, p=0.043), smoking history (95% CI, 0.13-0.84, p=0.021), ectropion (95% CI, 0.004-0.26, p=0.001), complaints of tearing (95% CI, 1.11-3.52, p=0.02), and outdoor occupational activity (95% CI, 3.42-9.97, p<0.05). Conclusions: EPS is more common in elderly patients than in the general population. Outdoor occupational activity, taking antiglaucomatous medications, ectropion, and smoking are significantly associated with EPS. In addition, surgical treatment decisions should be made after complete evaluation and interviewing the patients.Item EFFECTS OF LOWER GASTROINTESTINAL TRACT SURGERY ON SURVIVAL IN ELDERLY AND OCTOGENARIAN PATIENTS(2018) Aydin, Huseyin Onur; Avci, Tevfik; Tezcaner, Tugan; Karagulle, Erdal; Yildirim, Sedat; 0000-0003-3795-5794; 0000-0002-8522-4956; 0000-0002-3641-8674; 0000-0001-5225-959X; 0000-0002-5735-4315; S-8185-2018; C-6247-2017; AAD-9865-2021; AAF-1698-2021; AAF-4610-2019Introduction: Life expectancy has significantly increased in the last decade. The decision to perform surgery has always been challenging in elderly patients. We aimed to evaluate outcomes in patients who underwent surgery for lower gastrointestinal tract diseases and investigate factors influencing morbidity and mortality, particularly in octogenarian patients, and the effects of age on prognosis and survival in the postoperative period. Materials and Method: This study included patients aged >= 70 years who underwent lower gastrointestinal tract surgery; patients were divided into three groups as 70-75 years, 75-79 years, and >= 80 years. Age, gender, type of surgery, ASA score, length of hospital stay, morbidity, 30-day mortality, and overall survival were evaluated. Results: The surgery was performed to 598 patients due to lower gastrointestinal tract diseases. There was a significant increase in the ASA score with increasing age (Chi-square=35.472; p<0.001). The survival rate was significantly higher in patients with malignancies than in those with benign diseases, and in patients who underwent elective surgery than in those who underwent emergency surgery (p<0.001). When patients were examined according to age groups, the overall survival was similar across groups (p=0.217). Conclusion: There was no significant difference between octogenarian and younger patients for complications and survival. Thus, planned surgical interventions in elderly patients will not negatively affect survival and surgical interventions and can be safely performed in these patients.