The predictive role of laboratory parameters in cardiovascular risk assessment in obese.

The significance of cardiovascular diseases in mortality is indisputable. It is well-established that cardiovascular diseases are more prevalent among individuals with obesity. This study aimed to determine the predictive value of easily accessible hematological and biochemical parameters in assessing cardiovascular risk among obese patients. The study was designed as an observational retrospective. Department of Family Medicine, study was carried out between 25/06/2022 to 30/10/2022. The data of 439 obese patients were analyzed retrospectively. Using the online Heart Score system, the patients were classified into low, medium, high, and very high cardiovascular risk categories. The hemogram and certain biochemistry values of the patients at the time of admission were examined. Receiver operating characteristic (ROC) analyses were conducted to discriminate cardiovascular risk classes based on laboratory values. Markers with high diagnostic value, including a high area under the curve (AUC) value, sensitivity, and specificity, were presented. Significant differences were observed between the groups in terms of age, systolic blood pressure, diastolic blood pressure, total cholesterol, low-density lipoprotein, glucose, HbA1c, hemoglobin, platelet count, neutrophil (NEU) count, and platelet-lymphocyte ratio parameters (P < .05). The white blood cell count and NEU count of patients in the high-risk groups were found to have significantly higher AUC values compared to the moderate-risk group (AUC values of .737 and .779, respectively). The white blood cell and NEU parameters were found to have a positive predictive value in estimating the degree of cardiovascular risk. These parameters can potentially serve as biomarkers in identifying individuals at high risks for cardiovascular diseases.

Can We Persuade Those Who Hesitate to Get the COVID-19 Vaccine?

OBJECTIVE: Coronavirus disease (COVID-19) vaccine studies are continuing in many centers. However, the public's preference for vaccination against COVID-19 is not clear. This study aims to determine the knowledge level of people about vaccines developed against the COVID-19 and their preferences for vaccination. METHODS: Participants' knowledge of COVID-19 vaccines was evaluated with a questionnaire. Participants were selected by a stratified method using age, gender, education, and occupation group. RESULTS: The study includes 1508 participants with a mean age of 38.97 ± 14.50 (min = 18, max = 82); 24.7% (n = 373) of the participants stated that they wanted to be vaccinated, 34.5% (n = 521) did not want to be vaccinated, and 40.7% (n = 614) stated that they were undecided about vaccination; 39.11% (n = 444) of the participants stated that they were afraid of the vaccine's side effects, and 19.55% (n = 222) thought that the vaccines produced were used for malicious purposes and hesitated to vaccinate; 7.57% (n = 86) of the participants stated that they thought the vaccines were rushed too much and not yet reassuring. CONCLUSIONS: The study results show that individuals are hesitant and unwilling to get the COVID-19 vaccine. Persuasion interventions and information are necessary, as the rate of those who accept vaccination is very low.

The Use of Predictive Laboratory Tests in Rapid Triage of COVID-19 Pandemic Outpatient Clinic Patients.

BACKGROUND: Patients who come to the emergency pandemic outpatient clinic with a pre-diagnosis of COVID-19 are still a burden on the health system. Rapid triage of patients is important to reduce transmission. The aim of this study is to evaluate the biochemistry and hemogram results of real-time reverse transcription-polymerase chain reaction (RT-PCR) positive and negative patients in the emergency pandemic outpatient clinic and to investigate predictive values of the initial tests that will help to make rapid diagnosis. METHODS: Patients who applied to the emergency pandemic outpatient clinic with the suspicion of COVID-19 between November 01, 2020 and January 01, 2021 were evaluated with RT-PCR and laboratory examinations. RESULTS: A total of 551 patients were included in the study. The mean age of the patients was 50.31 ± 18.47 (min. 18 - max. 94), and 47.2% (n = 260) of the patients included in the study were male and 52.8% (n = 291) were female. In the comparison of hemogram parameters, we found that mean platelet volume (MPV) was significantly higher (p = 0.023), whereas white blood cell (WBC), platelet counts (PLT), lymphocyte and neutrophil values were significantly lower in RT-PCR positive patients (p < 0.001). There were no significant differences between the PCR positive and negative patients in terms of other parameters. In the comparison of biochemical parameters, we found that lactate dehydrogenase LDH (p = 0.001), creatinine (p = 0.002), and AST (p < 0.001) values were significantly higher in PCR positive patients, while there were no significant differences in terms of other biochemical parameters (p > 0.05). CONCLUSIONS: Our study results show that the practical quick-look hemogram and MPV can be used as a specially evaluated parameter in the rapid management of the first application COVID-19 patients. In addition, biochemically high levels of LDH and creatinine can be used to guide the clinician in terms of early hydration of the patient with a pre-diagnosis of COVID-19 to alleviate acute kidney damage.

The evaluation of both the expression and serum protein levels of Caspase-3 gene in patients with different degrees of SARS-CoV2 infection.

To evaluate the effects of Caspase-3 (CASP3) gene expression and serum levels on preventing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. A total of 41 individuals (male: 21; female: 20) with SARS-CoV-2 infection were included in the current study. Hemograms were examined from patient blood samples, and CASP3 gene expression levels were detected. Also, human CASP3 levels were determined from the serum samples of patients. The mean age of patients was 56.220 ± 18.937 years. Significant differences were detected among all groups for CASP3  2-ΔΔCt (p = 0.014) and CASP3 concentration (p = 0.024). The relationship between CASP3 2-ΔΔCt levels and hemoglobin (p = 0.023), between CASP3 2-ΔΔCt levels and C-reactive protein (CRP) (p = 0.001), between CASP3 2-ΔΔCt levels and ferritin (p = 0.003), between CASP3 2-ΔΔCt levels and lactate dehydrogenase (p = 0.001), and between CASP3 2-ΔΔCt levels and SpO2 (p = 0.006) were statistically significant. Also, the relationship between CASP3 concentration levels and SpO2 was statistically significant (p < 0.046). The CASP3 gene and/or its products have an important function to prevent injury caused by SARS-CoV-2 infection. They play crucial roles in maintaining cellular homeostasis and viability. Perhaps CASP3 levels may provide information about the severity of the disease.

A short-form suggestion for the Turkish version of the European Health Literacy Survey Questionnaire: a development and validation study in university students.

The European Health Literacy Survey Questionnaire was translated into Turkish following a validity and reliability study, but there is no comprehensive short form available. We aimed to suggest a short form of the 47-item Turkish version of European Health Literacy Survey Questionnaire in this study. Data were obtained from a cross-sectional study that included a total of 686 students, 345 male and 341 female, conducted in nine different faculties of a university using the Turkish version of European Health Literacy Survey Questionnaire. The development process of the short form was conducted using principal component analysis with exploratory factor analysis, and correlation and regression analyses. The validation process was done using confirmatory factor analysis and regression analysis. Based on the results, a 12-item short form was developed, retaining the conceptual framework of the European Health Literacy Survey Questionnaire. The short form was shown to have adequate psychometric properties with high reliability, good validity, a high and moderate level of correlation, and a good model fit with the independent dataset in this cross-sectional study. The short form developed in this study was demonstrated to be a valid and reliable tool to measure health literacy easily and rapidly in Turkey.

Chronobiological evaluation and an intervention study on timing of food intake in the treatment of obesity.

BACKGROUND: The chronotype of patients who cannot reach their ideal weight despite diet and exercise may play a role in this resistance. In this study, the relationship between BMI and chronobiological preferences was examined and a weight loss programme was applied to refractory obese patients with evening type (ET). METHOD: The study included 50 obese (BMI ≥ 30 kg/m2 ), 50 overweight (BMI = 25-29 kg/m2 ) and 50 normal weight (BMI < 25 kg/m2 ). The patients were asked to fill out a questionnaire including questions about sociodemographic characteristics, breakfast and night eating habits, as well as the morningness-eveningness quastionnaire (MEQ). In the second stage of the study, awareness interviews were held with ET obese patients in terms of eating time and habits. RESULTS: A statistically significant difference was observed between the BMI averages and the MEQ scores of ET, intermediate type (IT) and morning type (MT) groups (P = .0001). There was a statistically significant difference between the ET, IT and MT groups in terms of the distribution of late-night eating habits (P = .0001). The habit of skipping breakfast and taking more calories at dinner was found to be high in the ET patients (respectively; P = .021, P < .001). According to the results of the 3-month follow-up and intervention, the ET patients lost an average of 9.07±4.30 kg and a significant decrease was observed in the BMI scores (P < .001). CONCLUSIONS: The study results support the idea that an individualised weight loss programme according to the patient's chronotype preferences may increase the success rate of obesity treatment. A weight loss programme that includes the timing of food intake and regulation of eating habits in evening-type obese patients can be used in the treatment of obesity.

How do older age, gender and risk groups affect protective behaviours and mental health in the COVID-19 pandemic?

BACKGROUND: COVID-19 infection is severe in the presence of older age, male gender and risk factors. The aim of this study was to examine the relationship between the level of anxiety created by immensely spreading COVID-19-related information and age, gender and the presence of risk factors. MATERIAL AND METHODS: The data used in this study were obtained by collecting a 25-question questionnaire created through Google forms with various communication tools. RESULTS: The data of 929 people who answered the questionnaire were used. The level of anxiety increased with age significantly, upon hearing that a person from their age group was harmed by the virus (P < .001). The feelings of being depressed and hopeless significantly increased as the age increased (P < .001). There was no significant difference between the genders in terms of feeling depressed and feeling of lack of joy in life (P = .066, P = .308, respectively). Participants with chronic diseases stated that they felt more depressed and hopeless and a lack of joy in life more frequently (P < .001). CONCLUSION: Our results indicated that individuals with older age and having risk factors were more vulnerable to the stress caused by the pandemic. It is necessary for healthcare providers to identify high-risk groups by considering these situations, in order to make early psychological interventions.

The effect of COVID-19 lockdown on glycemic control in patients with type 2 diabetes mellitus in Turkey.

BACKGROUND AND AIMS: A national lockdown to prevent the spread of coronavirus disease (COVID-19) in Turkey was introduced in March 2020. We think that lockdowns may lead to weight gain and worsening of glycemic parameters in patients with type 2 diabetes mellitus (DM). The purpose of this study was to investigate how type 2 DM patients were affected by the lockdown. METHOD: Type 2 DM patients unable to attend regular follow-ups due to lockdown over a 75-day period between March and June 2020 and who again attended polyclinic follow-up when the lockdown was lifted were included in the study. These patients' glycemic control and weight status were compared with the pre-lockdown period. In addition, patients' general habits, and adherence to diet and exercise were evaluated, while their general health was assessed using the Short-Form 36-item survey. RESULT: The research involved 101 type 2 DM patients, 57 men (56.5%) and 44 women (44.5%), with a mean age of 55 ± 13. Patients' mean pre-lockdown weight was 84.7 ± 16.4 kg, rising to 85.5 ± 16.8 kg post-lockdown, although the increase was not statistically significant (p = 0.781). In terms of glycemic parameters, Hba1c rose from 7.67 ± 1.76 to 8.11 ± 2.48, and fasting glucose from 157.9 (83-645) mg/dl to 163.2 (84-550) mg/dl, none of which were statistically significant (p = 0.253, p = 0.079, respectively). CONCLUSION: In addition to weight gain among type 2 DM patients during the Covid 19 lockdown, statistically insignificant increases were also observed in such glycemic parameters. This was a small sample and further studies with larger sample are needed.