Evaluation of smoking cessation practice by physicians for hospitalized patients in a tertiary hospital.

OBJECTIVE: To investigate physicians' smoking cessation practice, consultation for smoking intervention for hospitalised patients and its determinants. METHODS: The cross-sectional study was conducted at Duzce University Hospital, Duzce, Turkey, from January to April 2013, and comprised hospitalised patients. The survey, including smoking habits and 5As (Ask, Advise, Assess, Assist and Arrange) steps of smoking intervention practiced by physicians was applied to those patients discharged from the hospital. SPSS 20 was used for statistical analysis.. RESULTS: Of the 502(31.6%) participants, 264(52.6%) were women and 238(47.4%) were men. The overall mean age was 52.8±18.2 years. Besides, 269(53.6%) respondents were at the level of elementary school education; 289(57.6%) had chronic disease; 119(23.7%) were current and 106(21.1%) were former smokers. The frequency of current smokers among men with chronic disease was significantly lower compared to those who did not have chronic disease (p=0.017). In women, the factor was insignificant (p=0.642). The physicians practiced the steps of "Ask, Advise, Assess, Assist and Arrange" on 354(70.5%), 240(47.9%), 194(38.7%), 88(17.6%) and 29(5.8%) patients for active smoking. Consultation during hospitalization significantly increased patient's effort to quit smoking after discharge (p=0.012). CONCLUSIONS: Smoking intervention by physicians for hospitalised patients was associated with the status of patient's gender, education level and chronic disease.

Effects of the degree of obesity on achieving target blood pressure and metabolic deterioration in obese individuals: a population-based study.

BACKGROUND/AIMS: This study aimed to evaluate the severity of obesity and its impact on achieving target blood pressure and metabolic derangement in obese individuals. METHODS: This cross-sectional and population-based study was conducted between January and December 2012. A total of 1837 consecutive obese patients admitted to our outpatient clinic were enrolled. The anthropometric and blood pressure measurements, bioelectrical impedance fat analysis, blood sample analysis, impaired glucose status, metabolic syndrome, and insulin resistance of 1265 obese patients were compared between groups of patients separated by severity of obesity. RESULTS: Only approximately one-third of patients with previous hypertension achieved normal blood pressure. In addition, the majority of patients without previous hypertension had higher blood pressure at the end of the study compared with baseline. The percent of patients with an impaired fasting blood glucose ≥100 mg/dL was 38.5%. The frequency of impaired glucose tolerance was 39.1% in the patients who underwent OGTT Body mass index (BMI) was associated with impaired blood glucose, hypertension, insulin resistance, and the development of metabolic syndrome. The incidences of metabolic syndrome, insulin resistance, impaired glucose tolerance, and uncontrolled blood pressure were significantly different between groups of differing obesity severity (p<0.001, p<0.001, p=0.041, and p<0.001, respectively). CONCLUSION: The severity of obesity was associated with the failure to achieve target blood pressure and metabolic syndrome. Based on our data, blood pressure and metabolic parameters in obese patients should be monitored frequently and treated with caution.