The decreased levels of NOx and eNOS found in this study indicate the co-existence of endothelial dysfunction and hypertension once more. In the absence of microalbuminuria, the increased miR-21 expression in patients with iCIMT made us conclude that this miRNA might be involved in the early stages of atherosclerotic process in hypertensive patients.

No abstract

Objective: Polypharmacy, quite common in elderly patients, is an important issue, resulting in increased morbidity and mortality. This study aimed to examine polypharmacy rates and drug usage characteristics in elderly patients. Second aim of this study was to compare our results with other published studies. Methods:In a retrospective design, we reviewed hospital records of 1,205 patients (≥65 years) who presented to our geriatric clinic, which serves as a tertiary center at the University of Istanbul, Cerrahpasa School of Medicine, who were examined in detail in terms of polypharmacy between 2003 and 2012, and who had follow-up care for at least a year. Demographic characteristics, polypharmacy, drugs used at presentation and final evaluation, and comorbid conditions were recorded. The definition of ≥ 5 drugs usage for polypharmacy and ≥ 9 drugs usage for excessive polypharmacy were considered in this study.Multivariate binary logistic regression analysis was performed for independent predictive factors.Results: Of patients, 854 were females (70%). The average age was 75.2±6.9. The number of comorbidities was 2.46±1.30. The number of drugs used at first admission and final evaluation was 3.8±2.7 and 4.3±2.8 (p<0.001), polypharmacy rates of 40% and 45% (p<0.001). Also, the rate of excessive polypharmacy was found 8% at final assessments. The rates of patients using one drug, two drugs, three drugs and four drugs were 6%, 11%, 13% and 15%, respectively. Polypharmacy rate in females was statistically significant higher than males (33% vs. 12%; p=0.026). The most common prescribed drugs were found as anti-platelet therapies (70%), calcium channel blockers (68%), anti-osteoporotic drugs (57%), statins (53%), and beta-blockers (49%) in all patients respectively. The most common five comorbidities were hypertension (67%), diabetes mellitus (27%), osteoporosis (27%), hyperlipidemia (25%), and depression (20%). Depression was an independent predictive factor for polypharmacy than other comorbid diseases in the regression analysis (odds ratio (OR): 4.5; 95% confidence interval (CI): 3.2-6.5; p<0.001). Conclusions:The polypharmacy rate was found to be as high as 45% in elderly patients. Before starting an additional medication in elderly patients, particularly with depression, the indication should be clearly specified, and several aspects should be taken into consideration, including functional capacity of the patient, the drugs already used, and possible interactions of the new drug.

Bir palyatif bakım merkezinde yatan hastaların klinik özelliklerini incelemek ve uzun yatış süresi, hastaneden taburculuk durumu ile ilişkili faktörleri araştırmaktır. Gereç ve Yöntem: Kesitsel ve retrospektif bir çalışmadır. Palyatif bakım merkezinde 1 Ağustos 2015-30 Temmuz 2017 tarihleri arasında yatan hastaların dosyaları incelendi. Tüm hastaların demografik özellikleri, komorbid durumları, ilaç sayıları, yatış şikayetleri, ilk yatışındaki nutrisyon, bası yarası ve ağrı durumları değerlendirildi. Hastaların uzun yatış süresi (≥ 15 gün) ve taburculuk durumları (eve taburcu, ileri yoğun bakım merkezine sevk ve ölüm) ile ilişkili faktörler için değişkenler Spearman korelasyon testi ile analiz edildi. Bulgular: Çalışmaya alınan 319 hastanın (%55 Erkek, %45 Kadın) ortalama yaşı 71±15,8 ve ortalama yatış süresi 15,4±15,7 gündü. En sık üç komorbid hastalık malnütrisyon %59, malignite %44 ve enfeksiyon hastalığı %33 idi. En sık yatış şikayetleri oral alım bozukluğu %35, genel durum bozukluğu %19 ve ateş %17 idi. Uzun yatış süresi ile ilişkili pozitif faktörler ileri evre bası yarası (r=0,366; p<0,001), serebrovasküler hastalık (r=0,175; p=0,002), hipertansiyon (r=0,158; p=0,005) ve diabetes mellitusdur (r=0,129; p=0,021). Taburculuk durumu (ileri yoğun bakıma sevk ve/veya ölüm) ile ilişkili pozitif faktörler ise, malignite (r=0,234; p<0,001), opioid kullanımı (r=0,204; p<0,001), parenteral beslenme tipi (r=0,20; p<0,001) ve halsizlikyorgunluk semptomudur (r=0,115; p=0,041). Sonuç: İleri evre bası yarası hastanede yatış süresini uzatan en önemli faktördür. Hastaların taburculuk durumu için en etkili faktörler ise malignite, opioid kullanımı, parenteral beslenme tipi ve halsizlik-yorgunluk semptomunun varlığıdır.

Neutrophil and platelet to lymphocyte ratios in people with subjective, mild cognitive impairment and early Alzheimer's disease *P < 0.05. † Kruskal-Wallis test (Mann-Whitney U-test) was used for comparisons between two groups. ‡ One-way ANOVA (Tukey's post-hoc test) was used. AD, mild Alzheimer's disease; HC, healthy controls; MCI, mild cognitive impairment; NLR, neutrophil-lymphocyte ratio; PLR, platelet-lymphocyte ratio; P-value 1 , comparison between AD and HC; P-value 2 , comparison between MCI and HC; P-value 3 comparison between SCD and HC; SCD, subjective cognitive decline. Inflammation in cognitive impairment

This study is the first studying the association of plasma PNX level and cognitive complaints or decline. The knowledge about the role, interaction, and physiological functions of PNX is lacking. Lower plasma PNX level might be important in prodromal stages as MCI and the predictive role of PNX should be investigated in further studies.

No abstract

No abstract