Metabolic syndrome and glucose tolerance status.

AIM: To determine justifiability of oral glucose tolerance test (OGTT) in non diabetic patients with metabolic syndrome (MetS). METHODS: It was included 398 patients attended to Outpatient Clinics of Sisli Etfal Training and Research Hospital. Eligible patients were assigned as patients with MetS according to International Diabetes Federation (IDF) criteria. RESULTS: After OGTT, there were 7 (2%) diabetic patients, 119 (30%) patients had impaired glucose tolerance (IGT) and 272 (68%) were normal. Height, weight, waist circumference, fasting glycemia, high density cholesterol were not different between IGT and non IGT group. CONCLUSION: OGTT is necessary in MetS non diabetic situation for detection early prediabetic patients.

Use of knee height for the estimation of stature in elderly Turkish people and their relationship with cardiometabolic risk factors.

The determination of the approximately truest value in height measurement is important in many fields, but it is difficult to perform true measurements, especially in the elderly individuals. We planned to investigate the following items in geriatric Turkish population: to calculate the decrease in height with advancing age by using the standing height measurement and estimated height derived from the knee height; to evaluate the significance of difference between the two measurement methods in the calculation of body mass index (BMI) and waist/height ratio (WHtR); to determine the cut-off value of WHtR according to estimated height in elderly individuals. We studied 551 cases aged between 19 and 97 years. Knee height was measured using a sliding caliper in a sitting position. Linear regression analysis was carried out to derive predictive equations for the estimation of stature with adults (≤ 50 years of age) according to the gender. This equation was then used to estimate height among elderly subjects. Of the cases, 60.3% were <60 years (mean: 48.75 ± 7.50); 39.7% of the cases were >60 years (mean: 69.51 ± 7.12). Estimated BMI (EBMI) measurements in the females and males >60 years were in average 1.23 kg/m(2) and 0.92 kg/m(2) higher than their real BMIs, respectively. EBMI measurements in the females <60 years were 0.32 kg/m(2) higher than their real BMIs (p<0.01). There is a statistically significant difference between WHtR in the females of both age groups, and in the males >60 years, as compared to our estimated WHtR (EWHtR) measurements (p<0.01). The cut-off point of WHtR was 0.61 and 0.58 in the female and male cases of >60 years in our study, respectively. WHtR seemed to be a better anthropometric index that could predict most cardiometabolic risk factors in our study. EWHtR emerged to be a better cardiometabolic risk index especially in the elderly group.

A geriatric patient with diffuse idiopathic skeletal hyperostosis.

The most frequent health problems seen in senility are chronic and degenerative diseases. A 75-year-old male patient with the complaints of weight loss and difficulty in swallowing was admitted to our hospital from a nursing home. Upper system fiber-optic gastrointestinal endoscopy was performed and a mass at the junction of the hypopharynx and esophagus just below recessus piriformis obstructing almost the whole of the lumen and blocking the distal passage was detected. Computed tomography revealed marked narrowing secondary to osseous hypertrophy in the air column of the hypopharynx and proximal esophagus. Diffuse idiopathic skeletal hyperostosis or Forestier's disease is an idiopathic disease characterized by the ossification of the anterior longitudinal ligament of vertebra and some of the extraspinal ligaments. In the present case we aim to discuss an elderly patient who suffered from dysphagia and weight loss and the diagnostic stages.

Penicillin sensitivity among hospital nurses without a history of penicillin allergy.

AIM: This paper reports a study to document the prevalence of penicillin sensitivity among nurses who had no previous history of sensitivity and worked in an inner city hospital in Turkey. BACKGROUND: Frequent and prolonged exposure to any drug including penicillin may increase the risk of hypersensitivity to these drugs. Local administration of drugs increases the likelihood of sensitization. Nurses are the main group of healthcare workers who prepare and administer antibiotics to patients, so they may be at highest risk for sensitization. Skin testing with major and minor determinants of penicillin has proved useful for identifying penicillin-specific IgE antibodies in sensitized individuals. METHOD: Skin prick tests were performed with benzyl penicilloyl polylysine (PPL) and a mixture of minor antigenic determinants (MDM) solution with 83 nurses who had been handling beta-lactam antibiotics. The study was conducted in 2004. FINDINGS: Ten nurses (12%) had positive skin reactions to penicillin antigens. Six were sensitive to PPL (7 x 2%) and four were sensitive to MDM (4 x 8%). CONCLUSION: Occult sensitization to beta-lactam antibiotics, without symptoms, may develop in hospital nurses. It is possible that these healthcare workers might be at increased risk of hypersensitivity reactions should they be exposed to beta-lactams, administered for therapeutic purposes. Further research is needed to explore this important issue.