No abstract

Amaç: Kırılganlık, nöromüsküler, metabolik ve immün sistemde ilerleyen yaşla birlikte fizyolojik rezervlerin azalmasına bağlı olarak meydana gelen güçsüzlük halidir. Kırılgan hastalar tüm sağlık çalışanları için takip ve tedavide en karmaşık ve en zorlayıcı sorunlara neden olan hasta grubunu oluşturmaktadır. Bu çalışmanın amacı; üç farklı kırılganlık ölçeği kullanılarak 65 yaş ve üstündeki hastanede yatan geriatrik hastalarda kırılganlık prevalansının araştırılmasıdır. Gereç ve Yöntem: Bu çalışma iç hastalıkları ve geriatri kliniklerinde yatan 65 yaş ve üstündeki hastalarda yapılmıştır. Çalışmaya 399 hasta dahil edilmiştir. Hastalarda kırılganlık prevalansının belirlenmesinde, Cardiovaskuler Health Study (CHS), Woman's Health and Aging Study (WHAS) ve Gerontopole kırılganlık ölçekleri kullanılmıştır. CHS ve WHAS ölçeklerinde beş kriterden üçü patolojik olanlar, Gerontopole ölçeğinde ise altı kriterden biri patolojik olan hastalar kırılgan kabul edilmiştir.

As compared to the maternal KISS-1 level, the maternal IGFBP-1 level during the first trimester might be a better biomarker of fetal growth. Additional larger scale studies are needed to further delineate the utility of IGFBP-1 as a marker of abnormal birth weight.

Objective:Ischemia-modified albumin (IMA) is a sensitive biomarker of myocardial ischemia. However, data on IMA levels in acute heart failure (HF) are still lacking. In this study, we aimed to evaluate serum IMA levels in acute decompensated HF and the effects of dobutamine and levosimendan treatments on IMA levels.Methods:This was a prospective, multicenter study that included 70 patients hospitalized with acute decompensated HF and left ventricular ejection fraction <35%. Blood samples for IMA measurements were obtained on admission and 24-48 h after the initiation of HF therapy. Twenty-nine patients were treated with standard HF therapy, 18 received levosimendan, and 23 received dobutamine in addition to standard of care. A single serum specimen was also collected from 32 healthy individuals each. IMA concentrations were measured by the albumin cobalt binding colorimetric assay, and the results were given in absorbance units (AU). Independent and paired sample t-tests, Mann-Whitney U test, and Wilcoxon signed-rank test were used for the analysis.Results:In patients with acute decompensated HF, the serum concentration of IMA was significantly higher than those of healthy subjects (0.894±0.23 AU vs. 0.379±0.08 AU, p<0.001). Overall, the IMA levels significantly decreased after 24-48 h of HF therapy (0.894±0.23 AU and 0.832±0.18 AU, p=0.013). Furthermore, the IMA levels were also found to significantly decrease with standard HF therapy (1.041±0.28 vs. 0.884±0.15 AU, p=0.041), with levosimendan (0.771±0.18 vs. 0.728±0.18 AU, p=0.046) and also with dobutamine (0.892±0.18 vs. 0.820±0.13 AU, p=0.035).Conclusion:Patients with acute decompensated HF had elevated IMA levels, and appropriate HF therapy significantly reduced the serum IMA levels. Dobutamine or levosimendan did not increase the IMA levels, suggesting a lower potential in inducing myocardial ischemia when used in recommended doses.

Background/aim: Frailty is a complex, multifactorial, and important geriatric syndrome characterized by decline in physiological reserves and functional deficiency in multiple systems. The aim of the current study is to investigate the prevalence of frailty and to determine the correlation between quality of life (QoL) and falling risk in geriatric hospitalized patients.Materials and methods: A total of 420 patients, aged 65 years and above, were enrolled in the study. All participants were hospitalized at a university hospital in the internal medicine clinics. The Cardiovascular Health Study (CHS) frailty scale, Health-Related Quality of Life Short Form (SF-36) scale, and Hendrich II Fall Risk Model were administered to the patients. Demographic data of patients, number of chronic diseases, and information on used medication were also collected. Results:The median age of patients was 71.9 ± 6.3 years and 49.5% of the patients were female. By applying the CHS frailty scale, the proportion of frail patients was determined to be 65.5%. There were statistically significant differences among quality of life mean scores of robust, prefrail, and frail patients (P < 0.001). Frail patients had the lowest scores in all SF-36 subgroups. Eighty-three (19.8%) patients were in the low-risk group while 337 (80.2%) were high-risk according to the Hendrich II Fall Risk Model. The rate of patients with high falling risk and poor QoL reached a maximum in the frail group (96%). Conclusion:Frailty is an important geriatric syndrome in elderly hospitalized patients. Poor QoL and high falling risk are issues commonly experienced with frailty.