The effectiveness of the trans-theoretical model in managing adult obese and overweight individuals.

Background & Objective: The prevalence of obesity is gradually increasing in our country and worldwide. Being obese and overweight are risk factors for chronic diseases. Obesity has a multifactorial etiology, so treatment should involve lifestyle changes, psychological strategies, pharmacologic treatment, and bariatric surgery. The present study aimed to investigate the effectiveness of the trans-theoretical stages of change (TTM SOC) model in managing adult obese and overweight patients. Methods: This prospective cohort study was conducted with 133 adults who were admitted to the Family Medicine Outpatient Clinic of Adana City Research and Training Hospital between April 1, 2017, and April 30, 2019. Socio-demographic characteristics, blood pressures, anthropometric measurements, and laboratory data were compared between the baseline and the first, third, and sixth months. Results: Body mass index (BMI) was higher among those with a low educational level. The mean age, the number of medications used, and the metabolic parameter values were significantly lower among the participants who did not have a chronic disease. Blood pressures, weight, BMI, plasma glucose and insulin, HOMA-IR, and triglyceride were statistically significantly higher at the baseline compared to follow-up values. Fasting plasma glucose was higher at the baseline in diabetic patients. The results were compared with Student t and One Way ANOVA tests. The Pearson correlation coefficient was used to demonstrate the association between baseline and repeated metabolic measurements. Conclusion: The trans-theoretical model is effective in managing adult obese and overweight individuals and also in glycemic control in obese Type-2 diabetics.

The frequency of sarcopenia has increased in patients with glomerulonephritis.

AIM: Sarcopenia is defined as the loss of muscle mass and muscle strength, and its frequency increases in kidney patients. However, sarcopenia frequency in patients with glomerulonephritis is unknown. The present study aimed to investigate the frequency of sarcopenia in patients with glomerulonephritis and compare the results with the healthy population for the first time in the literature. PATIENTS AND METHODS: A total of 110 participants, including 70 patients previously diagnosed with glomerulonephritis and 40 healthy individuals, were included in the study. The diagnosis of sarcopenia was made based on the EWSGOP 2 Criteria. RESULTS: The mean age of the glomerulonephritis patients group was 39.3 ± 1.5. In the anthropometric measurements of the patients, walking speed was low in 50 patients (71.4%), muscle strength was decreased in 44 patients (62.9%), and sarcopenia was detected in 10 patients (14.3%) according to the EWGSOP 2 Criteria. Considering the anthropometric measurements of the control group, sarcopenia was not detected in any of the subjects according to the EWGSOP 2 Criteria. CONCLUSION: The result of the present study revealed that the rate of sarcopenia was significantly higher in glomerulonephritis patients compared to the healthy population and that sarcopenia can also be observed even in middle age in this population. We think it would be beneficial for clinicians treating glomerulonephritis to be more careful regarding sarcopenia and keep these parameters in mind during treatment.

The Relationship Between Sarcopenia And Proteinuria, What Do We Know?

Sarcopenia is one of the most common geriatric syndromes in the elderly. It is defined as a decrease in muscle mass and function, and it can lead to physical disability, falls, poor quality of life, impaired immune system, and death. It is known that, the frequency of sarcopenia increases in the kidney patient population compared to healthy individuals. Although it is known that kidney disease can lead to sarcopenia; our knowledge of whether sarcopenia causes kidney disease is limited. Prior studies have suggested that protein energy wasting may be a risk of de novo CKD. Proteinuria is an important manifestation of kidney disease and there is a relationship between sarcopenia and proteinuria in diabetes, geriatric population, kidney transplant, and nephrotic syndrome. Does proteinuria cause sarcopenia or vice versa? Are they both the results of common mechanisms? This issue is not clearly known. In this review, we examined the relationship between sarcopenia and proteinuria in the light of other studies.

The associations between serum paraoxonase 1 activity and carotid atherosclerosis in renal transplant patients.

BACKGROUNDS AND AIMS: Paraoxonase 1 (PON1) is a novel marker that has been shown to exert protective functions on atherosclerosis by preventing oxidative modification of serum lipoproteins. In this study, we investigated the effects of PON1 on CA-IMT in renal transplant patients. METHODS: A total of 98 adult renal transplant recipients was enrolled in the study. CA-IMT was determined by B-mode Doppler ultrasonography. PON-1 activity was assessed by the rate of enzymatic hydrolysis of paraoxon to p-nitrophenol. RESULTS: Mean age was 39.4 ± 9.6 years and 10% of the patients were diabetic. Time after transplant was 76 ± 59 months. Mean PON1 level was 62.1 ± 43.3 U/l. PON1 levels were negatively correlated with CA-IMT and positively with HDL cholesterol. Mean CA-IMT was 0.62 ± 0.10 mm (0.40 - 0.98). CA-IMT was positively correlated with age, male gender and negatively with proteinuria and PON1 levels. In linear regression analysis, PON1 levels were associated with CA-IMT. CONCLUSION: Reduced PON1 activity is significantly associated with increased carotid atherosclerosis in renal transplant patients.

The risk of overweight and obesity in children after tonsillectomy: a cross-sectional study.

The aim of this cross-sectional study was to determine the prevalence of tonsillectomy among secondary school children and to investigate whether tonsillectomy with or without adenoidectomy is a risk factor for childhood obesity. A total of 27 secondary schools with 12,296 students between the ages 11 and 17 were screened in Denizli, Turkey. We determined 129 students who had undergone tonsillectomy; each student was matched with two healthy control subjects of the same age and sex (n = 258). A 28-item questionnaire on nutrition and physical exercise was completed by the parents. Age-adjusted body mass index and waist circumference percentiles of Turkish boys and girls were used for the assessment of overweight and obesity. The prevalence of tonsillectomy was 1.0 %. There was no significant relationship between having tonsillectomy and being overweight or obese and physical exercise and screen time (p > 0.05 for each). Logistic regression analyses suggested no significant effect of tonsillectomy on overweight or obesity of the subjects (p > 0.05). It seems that tonsillectomy had no effect on overweight and obesity among children.

Investigation of the risk factors associated with osteoporosis in postmenopausal women

Objective: Osteoporosis is a substantial global public health issue. The objective of this study was to evaluate the risk variables associated with osteoporosis among patients seeking care at an outpatient menopausal clinic in a tertiary university hospital. Material and Methods: In this retrospective, cross-sectional study postmenopausal women who attended the outpatient menopause clinic of Baskent University Hospital between June 01, 2014, and August 31, 2015, were enrolled. Patients' datasheets were reviewed and data including age, body mass index, parity, duration and age of menopause, history of smoking and oral contraceptive pills (OCPs) use, natural or surgical menopause, and calcium-containing food consumption were collected through a standardized questionnaire. Bone mineral density (BMD) was measured at the femur neck and lumbar spine by dual energy X-ray absorptiometry. Results: A total of 1,148 women with a mean age of 53.5±6.7 years, mean duration of menopause 7.1±6.2 years and mean age of menopause 46.3±5.1 years were identified. Of these, 235 (20.5%) were diagnosed as having osteoporosis. The average femur and lumbar T-values showed a decrease in normal weight patients compared to overweight, obese, and morbidly obese patients (F=22,337, p<0.001 and F=50,195, p<0.001, respectively). The mean femur T-values were higher in participants who used OCPs, regularly consumed a calcium-rich diet, and performed regular physical activity (p<0.05, p<0.01 and p<0.05). Positive correlations were noted between giving birth and femur T-values (r=0.065, p=0.027), between natural menopause and lumbar T-values (r=0.060, p=0.043), and between consuming a calcium-rich diet and femur T-values (r=0.087, p=0.003 and r=0.064, p=0.031, respectively). Conclusion: Using OCPs, lifelong physical activity, and a healthy diet rich in calcium are important factors for the prevention of low lumbar spine and femoral BMD and by implication, osteoporosis.

Challenges in access to health services and its impact on quality of life: a randomised population-based survey within Turkish speaking immigrants in London.

BACKGROUND AND AIM: There are a significant number of Turkish speaking immigrants living in London. Their special health issues including women's health, mental health, and alcohol and smoking habits has been assessed. The aim of this study was to explore the ongoing challenges in access to health care services and its impact on Quality of Life of immigrants. MATERIAL AND METHODS: This cross-sectional population-based study was conducted between March and August 2010 with Turkish immigrants (n = 416) living in London. Of these, 308 (74%) were Turkish and 108 (26%) were Turkish Cypriots. All healthy or unhealthy adults of 17-65 years of age were enrolled. A structured questionnaire with 44 items in five subcategories and 26-items WHOQOL BREF were used. RESULTS: Mean duration of stay for Turkish Cypriots (26.9 ± 13.9 years) was significantly longer than Turkish immigrants (13.3 ± 7.5) (p < 0.001). Turkish immigrants (n = 108, 36.5%) need interpretation more often when using health services than Turkish Cypriots (n = 16, 15%) (p < 0.001). Multivariate analyses suggested significant effects of older age, non-homeownership, low socioeconomic class, poor access to health services, being ill, poor community integration and being obese on physical well-being and also significant effects of low income and poor community integration on perceived overall Quality of Life (WHOQOL) of the participants. CONCLUSIONS: The results of this study demonstrate how the health and well-being of members of the Turkish speaking community living in London are affected by social aspects of their lives. Providing culturally competent care and interpretation services and advocacy may improve the accessibility of the health care.

Influence of Knowledge and Beliefs of Housewives on Attitudes About Organ Donation.

OBJECTIVES: Reluctance of families of deceased donors to provide approval for donation is a factor in low rates of deceased donor organ transplants. Decisions of women may be important for family approval. We investigated the influence of knowledge and beliefs of housewives on attitudes toward organ donation. MATERIALS AND METHODS: This cross-sectional study was conducted with 212 housewives attending Directorate of Religious Affairs centers and public education centers in Adana province between May and June 2018. A structured questionnaire to assess sociode-mographic information, knowledge, and beliefs about organ donation, as well as the Attitudes Toward Organ Donation Scale, was applied through face-to-face interviews. RESULTS: Mean age of participants was 42.9 ± 13.1 years, 68 (32.1%) had no formal education, and 125 women (59.0%) identified as low income. Of the women, 40 (18.9%) were single, 147 (69.3%) were married, 25 (11.8%) were divorced∕widowed, 104 (49.1%) were attending religious affairs centers, and 108 (50.9%) were attending public education centers. Mean score for the question "What is the religious drawback of donating organs?" was significantly higher in participants attending a Quran course (2.5 ± 1.4), and mean score of Attitudes Toward Organ Donation Scale decreased significantly as mean score for this question increased; the score for "Are you aware that the organ donation-related procedures are conducted within the law?" was 2.2 ± 1.2 (P < .001). Scores increased as knowledge level increased (r = 0.360, P < .001), and scores decreased as perception of organ donation as religiously objectionable increased (r = -0.258, P < .001). CONCLUSIONS: Participants with sufficient knowledge about organ donation, without religious objection to organ donation, and with awareness of the lawful status of organ donation had positive attitudes toward organ donation. Efforts toward improvement of community knowledge could increase rates of deceased donor organ donation.

Prevalence of obsessive-compulsive disorder in Turkish university students and assessment of associated factors.

BACKGROUND: Many students who begin university at risky periods for OCD development cannot meet the new challenges successfully. They often seek help and apply to the university health center for psychiatric distress. We aimed to determine the prevalence and associated factors of Obsessive Compulsive Disorder (OCD) at students of the Cukurova University in this cross sectional study. METHODS: This study was performed in the Cukurova University Faculty of Education with a population of 5500 students; the representative sample size for detecting the OCD prevalence was calculated to be 800. After collecting sociodemographic data, we questioned the students for associated factors of OCD. The General Health Questionnaire-12 (GHQ-12) and Composite International Diagnostic Interview (CIDI, Section K) were used for psychiatric evaluation. Logistic regression analysis was performed to evaluate the linkage between OCD and associated factors. RESULTS: A total of 804 university students were included in this study. The GHQ-12-positive students (241 students, 29.9%) were interviewed using Section K of the CIDI (222 students, 27.6%). OCD was diagnosed in 33 (4.2%) students. The Logistic regression analysis of the data showed significant associations between OCD and male gender (p:0.036), living on government dormitory (p: 0.003), living on students' house/parental house (p:0.006), having private room in the parental house (p:0.055) and verbal abuse in the family (p:0.006). CONCLUSION: This study demonstrates a higher prevalence of OCD among a group of university students compared to other prevalence studies of OCD in Turkish society. Furthermore, our findings also suggest relationships between OCD and sociodemographic factors, as well as other environmental stress factors.

Mental health screening and increased risk for anxiety and depression among treatment-seeking smokers.

BACKGROUND: The aim of this study was to compare the risk for mental health disorders between smokers and non-smokers and to assess the risk for depression and anxiety according to addiction severity. METHODS: This cross-sectional study assesses the mental health status and relationship with the severity of nicotine addiction in a sample of smokers admitted to Pamukkale University Hospital Smoking Cessation Clinic (n = 101) from 1 June 2012 to 31 August 2012 compared to a group of non-smokers from the general population (n = 101). We conducted semi-structured face-to-face interviews to collect sociodemographic data; we assessed the participants' mental health status with the General Health Questionnaire-12 (GHQ-12) and the Hospital Anxiety and Depression Scale (HADS), and we measured nicotine addiction severity with the Fagerström Test. RESULTS: The risk for mental illness reported by smokers based on the GHQ-12 was significantly higher than that for non-smokers (p = 0.001). The anxiety and depression scores according to HADS were higher among smokers (16.8% and 22.8%, respectively) than non-smokers (4.0% and 5.0%, respectively) (p = 0.006 and p = 0.001, respectively). The nicotine addiction severity was higher in smokers with higher anxiety and depression scores (p = 0.008). CONCLUSIONS: We found high scores for mental illness in treatment-seeking smokers compared with non-smokers. The risk for anxiety and depression was higher among smokers. Increased nicotine addiction severity was associated with increased risk for mental illness and increased scores of anxiety and depression.