Fakülteler / Faculties
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Item The Prevalence and Recognition Rate of Delirium in Hospitalized Elderly Patients in Turkey(2014) Aki, Ozlem Erden; Derle, Eda; Karagol, Arda; Turkyilmaz, Canan; Taskintuna, Nilgun; https://orcid.org/0000-0003-2122-1016; 24236908; AAI-8830-2021Objective. Delirium is frequently observed, but generally under recognized in elderly hospitalized patients. The aims of this study were to determine the prevalence of delirium in elderly patients hospitalized at a university hospital, and to determine the recognition rate by hospital staff during hospitalization. Methods. The study included 108 consecutive patients aged >= 65 years that were hospitalized in the medical and surgical inpatient departments at Baskent University Hospital, Ankara, Turkey. All the patients were evaluated using the Mini Mental State Examination (MMSE) upon admission and Confusion Assessment Method (CAM) on a daily basis during hospitalization. Written documents and consultation requests from psychiatry and/or neurology departments were reviewed for recognition of delirium by hospital staff. Results. Among the 108 patients in the study, delirium was noted in 18 (16.7%) during their hospital stay. Consultation from psychiatry or neurology departments was requested for 5 of the 18 patients, only 1 with a delirium diagnosis, indicating that 17 of the cases (94.4%) were not recognized by their primary physicians. Conclusions. The delirium non-recognition rate in elderly hospitalized patients was very high. We think that hospital staff must be trained to recognize the symptoms of delirium and identify high-risk patients.Item Treatment of Patients with Multiple Myeloma Over 65 Yr: More Tolerability or Better Response?(2015) Tarkun, Pinar; Atalay, Figen; Atesoglu, Elif Birtas; Mehtap, Ozgur; Simsek, Melih; Terzi, Esra; Geduk, Ayfer; Balli, Fatih; Batman, Adnan; Baydemir, Canan; Hacihanefioglu, Abdullah; 0000-0003-4384-2913; 25220635; B-5507-2014ObjectiveTwo-thirds of newly diagnosed patients with multiple myeloma (MM) are over 65yr and/or physically unfit. Such patients are not eligible for high-dose chemotherapy or stem cell transplantation. The treatment aims in these patients should be to prolong survival by obtaining the best possible response, while maintaining good tolerability. The aim of our study was to evaluate the response to treatment and treatment-related toxicities in patients treated with conventional and novel protocols. MethodsThe records of 138 elderly (65yr) patients with MM were retrospectively evaluated. ResultsThe median overall survival(OS) of the patients was 46months. The median progression-free survival (PFS) was 18months. The OS and PFS of the patients treated with the conventional protocols did not differ significantly from those treated with the novel protocols. The statistical analysis of the quality of the response to the treatment with the conventional and novel therapies showed that complete remission (CR), combined with a very good partial response (VGPR), was significantly higher in the latter. However, the toxicities were higher in the novel treatment group. ConclusionThe novel drug protocols significantly increased the quality of the responses of elderly patients with MM to therapy, but they did not increase the patients' tolerability.Item Characterization of Echocardiographic Measures of Cardiac Structure and Function in Healthy Octogenarians(2014) Balcioglu, Akif Serhat; Durakoglugil, Murtaza Emre; Okyay, Kaan; Tavil, Yusuf; Abaci, Adnan; https://orcid.org/0000-0001-6134-8826; https://orcid.org/0000-0001-5268-4262; 24506515; Q-3547-2019; AAK-7355-2020Background: Currently, there is not enough echocardiographic information regarding aging-associated changes in the octogenarian population. We aimed to characterize echocardiographic measures of structure and function among a group of healthy octogenarians. Methods: Approximately 350 octogenarians, residing in nursing homes, were screened in Ankara, Turkey. According to inclusion criteria, 40 octogenarians were enrolled. These subjects underwent conventional and tissue Doppler echocardiography according to the guidelines of the American Society of Echocardiography (ASE). The population was also separated into various groups according to gender, body mass index (BMI, <25 vs. 25-29.9), and blood pressure (<80/120 mmHg vs. 80-89/120-139 mmHg). All measurements were indexed by dividing to body surface area (BSA) for standardization. Results: Left ventricular mass (LVM), posterior wall thickness, right ventricular diameter, tricuspid E/A ratio, and septal e'-wave velocity were significantly higher in men, which lost significance after adjusting for BSA. There was no significant difference between groups formed by BMI and blood pressure. Moreover, mild global left and right ventricular dysfunction including a prominent diastolic counterpart, however, with normal ejection fraction was revealed using conventional and tissue Doppler techniques. Finally, we checked our results with the current reference values of the ASE and observed the following differences: ventricular septum, relative wall thickness, LVM, and mass index values were above ASE reference range, posterior wall measurements were close to upper range. On the contrary, left ventricular diameters and volumes were below ASE reference range. Conclusions: We described echocardiographic measures of structure and function in a group of healthy octogenarians.Item Sleep Quality in The Elderly Either Living at Home or In A Nursing Home(2014) Daglar, Gulseren; Pinar, Sukran Ertekin; Sabanciogullari, Selma; Kav, Sultan; https://orcid.org/0000-0003-0361-7498; V-9745-2019Objective Changes in sleep duration, pattern, and quality occur with ageing. The aim of this study was to analyse the sleep quality and affecting factors in the elderly living either at home or in nursing homes. Design Descriptive and cross-sectional study Setting Sivas, a central Anatolian city in Turkey. Subject This study was carried out with 112 individuals; 52 were living in a nursing home and 60 at home. Main outcome measures A personal information form and Pittsburgh Sleep Quality Index (PSQI). Results There was no statistically significant difference between mean scores and sleep qualities of both groups (p > 0.05). The sleep quality of the individuals in both groups was not significantly influenced by personal variables such as age, gender, education, income, having children, and having a physical illness (p > 0.05). Individuals in both groups who reported their sleep as inadequate had sleep problems, and those who reported their sleep was affected for various reasons and who perceived their health as poor had significantly worse sleep quality (p < 0.05). Conclusion The sleep quality of the elderly living either at home were at similar levels and more than half of individuals in both groups had poor sleep quality.Item Adding Taxane to Platin-5-Fluorouracil Combination Does Not Improve Survival Rate in Patients >= 65 Years of Age with Advanced Gastric Cancer: A Retrospective-Multicenter Study(2018) Gunaldi, Meral; Kose, Fatih; Demirci, Nebi Serkan; Gunduz, Seyda; Ozdemir, Nuriye; Kocoglu, Hakan; Okuturlar, Yildiz; Sedef, Ali Murat; Erdem, Dilek; Goksu, Sema Sezgin; https://orcid.org/0000-0002-0156-5973; 29745086; G-4827-2016Purpose: Advanced gastric cancer (AGC) has a dismal prognosis. Platin-5-fluorouracil (CF) combination chemotherapy is the most widely used protocol and addition of a taxane (TCF) seems to increase survival and toxicity rates. We aimed to evaluate efficacy and toxicity of TCF as compared to CF in patients older than 65 years and compare them with the patients younger than 65 years. Methods: A total of 341 patients with AGC have been treated at six different oncology centers in Turkey between 2010 and 2014 and evaluated retrospectively. The characteristics of the patients whose tumors were histologically confirmed and whose survival data were available were registered and analyzed. The study group consisted of 234 patients younger than 65 years (group 1) and 107 patients older than 65 years (group 2). All of the data obtained from the patients were statistically analyzed. Results: The median age of the patients was 58.2 years and the mean follow-up time 14.4 months. For the entire group, progression-free survival (PFS) and overall survival OS) were 9 and 13 months, respectively. Using TCF over CF regimen increased the OS by 4.2 months (i.e., group 1 and 2 together). For group 2, patients with liver metastases and without surgery of the primary tumor were treated with significantly more TCF as compared to CF, respectively. Although TCF yielded significantly higher PFS and OS in group 1 (p=0.0001 and p=0.017), there was no significant difference in group 2 as compared to CF. Also, grade 3-4 toxicity was statistically defined as one of the possible reasons of worsened OS in patients older than 65 years and receiving TCF. Conclusions: The addition of taxanes to CF backbone leads to a significant increase in both PFS and OS in patients younger than 65 years of age but the triplet regimen with taxanes does not provide superior survival in patients older than 65 years of age.Item Association of Mini Nutritional Assessment with anthropometric measurements and muscle strength in elderly people: a neglected risk group(2021) Hoca, Mustafa; Turker, Perim F.Aim: Elderly individuals that are one of the neglected risk group are at a higher risk for health problems owing to inadequate and unbalanced nutrition. Nutritional status is also an important determinant of health in people over 65 years of age. Screening and diagnostic instruments are important in the recognition of the elderly people in evaluating the results of malnutrition. Unfortunately, there is no gold standard for the detection of malnutrition in elderly people. In this study, we aimed to assess the association of Mini Nutritional Assessment with anthropometric measurements and muscle strength in elderly people. Materials and Methods: A cross-sectional study included 210 elderly volunteers. Anthropometric measurements were taken, body mass index (BMI) values were calculated and muscle strength was evaluated by a hand dynamometer. Nutritional status was assessed using the Mini Nutritional Assessment (MNA) screening tool. The study was approved by Research Ethics Committee. Results: Elderly individuals with a BMI value of >= 30 kg/m(2) had significantly lower right and left hand grip strengths than BMI values of 18.5-24.9 kg/m(2) and 25-29.9 kg/m(2). However, elderly individuals with a BMI of >= 30 kg/m(2) had significantly higher waist/ hip ratio, waist/height ratio, body fat percentage, waist, hip, calf, neck and mid-upper arm circumferences than BMI values of 18.5-24.9 kg/m(2) and 25-29.9 kg/m(2). Additionally, a positive and statistically significant correlation was determined between the right- and left-hand grip strengths and the MNA score in women. Conclusion: To improve the nutritional status, elderly people should be monitored at regular intervals by obtaining anthropometric and muscle strength measurements and performing nutritional status screening tests.Item Outcome of Elderly Nasopharyngeal Carcinoma Patients: A Single Center Study(2020) Basaran, Hamit; Cengiz, Mustafa; Yazici, Gozde; Ozdemir, Yurday; Suslu, Nilda; Gullu, Ibrahim H.; Ozyigit, Gokhan; 0000-0002-2218-2074; AAG-5629-2021Objective: This study aimed to assess the efficiency of radiotherapy and evaluate its outcomes for elderly (> 65 years) patients who have undergone treatment for nasopharyngeal carcinoma (NPC). Methods: Forty- five (male, 35; female, 10) elderly patients with a diagnosis of undifferentiated NPC who were treated at our institution between 1994 and 2012 were retrospectively evaluated. The primary endpoint was the relationship between the patients' characteristics and overall survival (OS); progression-free survival (PFS), locoregional progression-free survival (LR-PFS), and toxicity analysis were the secondary endpoints. Results: The patients had a median age of 74.2 years. At a median follow-up period of 64 months, the median OS, PFS, and LR-PFS were 45 (95% confidence interval [CI]: 5.887-84.113), 34 (95% CI: 0.0-70.504), and 45 (95% CI: 20.092-69908) months, respectively. The 2-, 3-, and 5-year OS rates were 61.5%, 53.1%, and 50.0%, respectively, and the 2-, 3-, and 5-year PFS rates were 57.6%, 46.8%, and 43.7%, respectively. Patients with T stage (T3-T4 vs.T1-T2) or N stage (N0-1 vs. N2) had significantly shorter OS (p<0.05), PFS (p<0.05), and LR-PFS (p<0.05) outcomes, respectively, which were also confirmed using a multivariate analysis (p<0.05). Conclusion: Our results demonstrated that the established prognostic factors, including T and N stages, were important prognostic indicators of NPC in elderly patientsItem Prostate Biopsy in the Elderly: Histologic Findings and Treatment Necessity(2014) Akman, Ramazan Yavuz; Koseoglu, Hikmet; Oguzulgen, Ahmet Ibrahim; Sen, Erhan; Yaycioglu, Ozgur; 25374232The aim of this study is to determine results of high prostate specific antigen (PSA) or abnormal digital rectal examination driven prostate biopsies performed in our Department in men aged 75 or more and to show the characteristics of pathology results. The hospital records of the patients who had high PSA or abnormal digital rectal examination driven prostate biopsy in two common university based research hospitals have been reviewed retrospectively. Patients aged 75 years or older at the date of biopsy whose records provided pathology results and full medical history were evaluated for the study. A total of 103 patients were evaluated with a mean age of 79.4 +/- 3.4 years. More than half of the patients (55.1%) were in their seventh decade and the rest were in the eighth decade. Median PSA value was 15.0 (range 2.1-4500) ng/ml. In most of the biopsies (67%), PSA levels were lower than 20 ng/ml. In almost half of the patients (48%), digital rectal examination was abnormal. In 68.9% of the patients, there were at least one or more associated co-morbid diseases. Gleason scores were 7 or higher in 73%, and 8 or higher in 37% of the patients with prostate cancer. Four of the 70 (6%) patients had bone metastases. Castrations were applied to most of the patients with prostate adenocarcinoma (% 79). High percentage of high grade (Gleason 7 or more) prostate adenocarcinoma in the elderly refutes the perception of prostate cancer in this age group as clinically insignificant. Therefore, it is to be kept in mind that prostate cancer in the elderly an be clinically significant and prostate biopsies are to be performed when necessary.Item Use and Outcomes of Noninvasive Ventilation for Acute Respiratory Failure in Different Age Groups(2016) Ugurlu, Aylin Ozsancak; Sidhom, Samy S.; Khodabandeh, Ali; leong, Michael; Mohr, Chester; Lin, Denis Y.; Buchwald, Irwin; Bahhady, Imad; Wengryn, John; Maheshwari, Vinay; Hill, Nicholas S.; 26374908BACKGROUND: The prevalence of chronic disease and do-not-intubate status increases with age. Thus, we aimed to determine characteristics and outcomes associated with noninvasive ventilation (NIV) use for acute respiratory failure (ARF) in different age groups. METHODS: A database comprising prospective data collected on site on all adult patients with ARF requiring ventilatory support from 8 acute care hospitals in Massachusetts was used. RESULTS: From a total of 1,225 ventilator starts, overall NIV utilization, success, and in-hospital mortality rates were 22, 54, and 18% in younger (18-44 y); 34, 65, and 13% in middle-aged (45-64 y); 49, 68, and 17% in elderly (65-79 y); and 47, 76, and 24% in aged (>= 80 y) groups, respectively (P < .001, P = .08, and P = .11, respectively). NIV use for cardiogenic pulmonary edema and subjects with a do-not-intubate order increased significantly with advancing age (25, 57, 57, and 74% and 7, 12, 18, and 31%, respectively, in the 4 age groups [P < .001 and P = .046, respectively]). For subjects receiving NIV with a do-not-intubate order, success and in-hospital mortality rates were similar in different age groups (P = .27 and P = .98, respectively). CONCLUSIONS: NIV use and a do-not-intubate status are more frequent in subjects with ARF >= 65 y than in those < 65 y, especially for subjects with cardiogenic pulmonary edema. However, NIV success and mortality rates were similar between age groups.