Determination of prevalence, characteristics, management and related factors for pain in the older adults: pain among nursing home residents

This study aimed to determine pain assessment approaches and pain management strategies in elderly people in a nursing home.The cross-sectional-descriptive study sample consisted of 147 older adults living in a nursing home in Turkey in 2019. They all agreed to participate in the study (n = 147); however, as our research was about older adultswith pain problems, the study was completed with a total of 108 older adultsexperiencing pain problems. The participants' average age was 73.60 ± 6.97 years. Geriatric pain scale scores were higher for women aged 75 years and over, those who had a chronic disease and those who received analgesics, and there was a statistically significant difference between the mean scores (p < 0.05). Nurses must pay attention to pain assessment and management in nursing homes because of the adverse effects of pain on older adults' health status, vital functions, and well-being.

Prevalence and associated factors of external punctal stenosis among elderly patients in Turkey / Prevalência e fatores associados à estenose externa do ponto lacrimal em pacientes idosos na Turquia

ABSTRACT Purpose: To estimate the prevalence of external punctal stenosis (EPS) in the elderly population and investigate associated factors. Methods: A total of 278 patients ≥65 years of age were evaluated for evidence of EPS from January to July 2016. Associated systemic, ocular, demographic, and lifestyle factors were investigated. Multiple logistic regression analyses were applied to evaluate the factors related to having EPS. P values <0.05 were considered statistically significant. Results: The prevalence of EPS in this study population was 63.3%, with a mean age of 70.67 ± 7.85 (65-92 years). The ocular factor that was most commonly related to EPS was chronic blepharitis (48.9%). EPS was also associated with taking glaucoma medications (95% CI, 0.08-0.96, p=0.043), smoking history (95% CI, 0.13-0.84, p=0.021), ectropion (95% CI, 0.004-0.26, p=0.001), complaints of tearing (95% CI, 1.11-3.52, p=0.02), and outdoor occupational activity (95% CI, 3.42-9.97, p<0.05). Conclusions: EPS is more common in elderly patients than in the general population. Outdoor occupational activity, taking antiglaucomatous medications, ectropion, and smoking are significantly associated with EPS. In addition, surgical treatment decisions should be made after complete evaluation and interviewing the patients.

RESUMO Objetivo: Estimar a prevalência de estenose externa do ponto lacrimal (EEPL) na população idosa e investigar os fatores associados. Métodos: Foram avaliados 278 pacientes ≥65 anos com estenose externa do ponto lacrimal de janeiro a julho de 2016. Todos os fatores sistêmicos, oculares, demográficos e de estilo de vida associados foram investigados. Foram utilizadas análises de regressão logística múltipla para avaliar os fatores relacionados a estenose externa do ponto lacrimal, valores de p<0,05 foram considerados estatisticamente significativos. Resultados: A prevalência de estenose externa do ponto lacrimal foi de 63,3%, com idade média de 70,67 ± 7,85 (65-92 anos). O fator ocular mais relacionado com estenose externa do ponto lacrimal foi blefarite crônica. (IC de 95%, 0,08-0,96, p=0,043), história de tabagismo (IC 95%, 0,13-0,84, p=0,021), ectrópio (IC 95%, 0,004-0,26, p=0,001), queixa de lacrimejamento (95% IC, 1,11-3,52, p=0,02) e atividade ocupacional ao ar livre (IC 95%, 3,42-9,97, p<0,05). Conclusão: A estenose externa do ponto lacrimal é um distúrbio mais comum em pacientes idosos do que na população em geral. Atividade ocupacional ao ar livre, medicação antiglaucomatosa, ectrópio e tabagismo foram significativamente associados com estenose externa do ponto lacrimal. A decisão sobre tratamento cirúrgico deve ser dada após a avaliação completas dos fatores associados em cada paciente.

Helicobacter Pylory infection in patients with esophageal squamous cell carcinoma

OBJECTIVE: Esophageal squamous cell carcinoma is one of the most common esophageal diseases in the developing world, but the relationship between esophageal squamous cell carcinoma and Helicobacter pylori infection remains a neglected topic. The primary objective of this study was to determine the association between Helicobacter pylori infection and esophageal squamous cell carcinoma. A second purpose was to determine the incidence and factors associated with Helicobacter pylori infection following esophagectomy. METHOD: The microorganism was identified by testing the gastric biopsy materials from 95 esophageal squamous cell carcinoma patients (66 females; 39 were esophagectomized) for urease activity in a medium containing urea and a power of hydrogen detection reagent and comparing the results with those from a healthy population. Differences in patient characteristics were assessed with chi-square tests and t-tests for categorical and continuous factors, respectively. RESULTS: The patients with esophageal squamous cell carcinoma had a significantly lower prevalence of Helicobacter pylori compared with the healthy population (p<0.001). The naive and esophagectomized patients, in contrast, showed no significant differences in Helicobacter pylori infection (p>0.005). Patients with esophageal squamous cell carcinoma showed a significant association between leukocytosis and hypoglobulinemia and the presence of Helicobacter pylori infection (p=0.023 and p=0.045, respectively). CONCLUSION: These results suggest that Helicobacter pylori is not an etiological factor in patients with esophageal squamous cell carcinoma. We found a statistically significant negative correlation between esophageal squamous cell cancer and Helicobacter pylori infection. These findings may guide new strategies for esophageal squamous cell carcinoma therapy.

Approach of Turkish ophthalmologists to micronutrition in age-related macular degeneration / Abordagem dos oftalmologistas turcos em relação a micronutrição na degeneração macular relacionada à idade

Purpose: To evaluate the knowledge and behaviors of ophthalmologists in Turkey concerning micronutrition support in patients with age related macular degeneration (ARMD). Methods: This study involved 1,845 ophthalmologists. A scientific poll was sent to all participants by email. The survey covered the following: demographic features, subspecialty knowledge about micronutrition preference for prescribing micronutrition to age related macular degeneration patients, and the reason for this preference. If a participant indicated that he or she prescribed micronutrition, the participant was also asked to indicate the source of the treatment and supplemental treatments. Results: Of 1,845 ophthalmologists, 249 responded to the survey. Of the respondents, 9% (22) never, 43% (107) sometimes, 37% (92) frequently, and 11% (27) always used micronutrition. The most frequent prescribing subgroup was general ophthalmology (22%), followed by the retina-uvea subspecialty (13.9%). The micronutrition prescribing ratio was 54.8% in retina-uvea specialists when the "frequent" and "always" responses were combined. There was no statistically significant difference between subgroups with respect to prescribing micronutrition. Among the ophthalmologists prescribing micronutrition, 57.1% of them did not use the Age-Related Eye Disease Study-1 (AREDS) criteria, and only 31.3% prescribe micronutrition according to AREDS criteria. The results for the general ophthalmologist and retina-uvea specialist subgroups were similar, 56.3% vs 20.2%, and 54.1% vs 36.1%, respectively. Micronutrition was not recommended for the following reasons: expensive (55.4%), low patient expectancy (40%), no effect (30%), and low patient drug compliance (25.4%). Moreover, 55.2% of the clinicians recommended physical activities, dietary changes, and smoking cessation; 7.3% did not recommend these behavioral changes. Conclusion: This survey demonstrated that micronutrition preference in ...

Objetivo: Avaliar o conhecimento e comportamento dos oftalmologistas na Turquia sobre o suporte micronutricional em pacientes com degeneração macular relacionada à idade (DMRI). Métodos: Este estudo continha 1.845 oftalmologistas, e uma pesquisa científica foi enviado a todos os participantes por e-mail. O levantamento abrangeu as seguintes informações: características demográficas, conhecimento na subespecialidade sobre a preferência micronutricional para a prescrição micronutrientes a pacientes com degeneração macular relacionada à idade, e a razão por trás dessa preferência. Se um participante respondeu que prescreveu micronutrientes, foi solicitado que indicasse a origem do tratamento, bem como tratamentos suplementares. Resultados: Duzentos e quarenta e nove de 1.845 oftalmologistas responderam à pesquisa. Destes oftalmologistas 9% (22) nunca haviam usado micronutrição, 43% (107), utilizava eventualmente, 37% (92) usavam com frequência, e 11% (27) sempre usou. O subgrupo de prescrição mais frequente era composto por oftalmologistas gerais (22%), seguido por subespecialistas em retina e/ou úvea (13,9%). A frequência de prescrição de micronutrientes foi de 54,8% dentre os subespecialistas em retina e/ou úvea quando resultados de resposta foram combinados em "frequente" e "sempre." Não houve diferença estatisticamente significativa entre os subgrupos com relação à prescrição de micronutrientes. Entre os oftalmologistas que prescreviam micronutrição, 57,1% deles não usavam os critérios The Age-Related Eye Disease Study-1 (AREDS) e 31,3% deles prescreviam de acordo com critérios AREDS. A utilização dos critérios teve distribuição semelhante entre os oftalmologistas gerais e os especialistas, 56,3% vs 20,2%, e 54,1% vs 36,1%, respectivamente. A micronutrição não era recomendada pelas seguintes razões: preço (55,4%), baixa expectativa de paciente (40%), nenhum efeito (30%), e baixa aderência do paciente à droga (25,4%). Além disso, 55,2% ...

Scorpion stings in Turkey: epidemiological and clinical aspects between the years 1995 and 2004 / Picadas de escorpião na Turquia: aspectos epidemiológicos e clínicos entre os anos de 1995 e 2004

The most important health-threatening scorpions found in Turkey are; Androctonus crassicauda, Leiurus quinquestriatus, Mesobuthus gibbosus and M. eupeus species, all of which belong to the Buthidae family. The epidemiological and clinical findings of scorpion stings in Turkey were evaluated between the years 1995 and 2004 based on data recorded in the National Poison Information Center (NPIC). A total of 930 cases were recorded. The cases mostly occurred in the month of July. The gender distribution was 50.22 percent female and 45.48 percent male. It was shown that the 20-29 age group presented more scorpion stings. Most of the stings occurred in Central Anatolia and Marmara regions of Turkey. Patients at the hospital showed signs of localized (pain, hyperemia, edema and numbness) and systemic effects (hyperthermia, nausea and vomiting, tachycardia, shivering and lethargy) but no lethality was notified. According to records, 33 percent of the poisoned patients were treated with antivenin in healthcare facilities.

Os mais importantes escorpiões que comprometem a saúde na Turquia são: Androctonus crassicauda, Leiurus quinquestriatus, Mesobuthus gibbosus e M. eupeus, todos eles pertencentes à família Buthidae. Os achados clínicos e epidemiológicos da picada de escorpiões na Turquia foram avaliados no período entre os anos de 1995 a 2004 baseados em dados do Centro Nacional de Informações de Envenenamentos (NPIC). Foram registrados 930 casos que ocorreram principalmente no mês de julho. A distribuição por sexo foi 50,22 por cento femininos e 45,48 por cento masculinos. Demonstrou-se que o grupo etário de 20 a 29 anos apresentou maior número de picadas de escorpião. A maior parte das picadas ocorreu na Anatólia Central e na região de Marmara, na Turquia. Os pacientes hospitalizados mostraram sinais localizados (dor, hiperemia, edema e confusão mental) e sistêmicos (hipertermia, náusea e vômitos, taquicardia, arrepios de frio e letargia), mas não houve notificação de letalidade. De acordo com os prontuários 33 por cento dos pacientes foram tratados com antiveneno nas unidades de saúde.

HBV, HCV and HIV seroprevalence among blood donors in Istanbul, Turkey: how effective are the changes in the national blood transfusion policies?

The national blood transfusion policies have been changed significantly in recent years in Turkey. The purpose of this study was to determine the prevalence of HBV, HCV, and HIV in blood donors at the Red Crescent Center in Istanbul and to evaluate the effect of changes in the national blood transfusion policies on the prevalence of these infections. The screening results of 72695 blood donations at the Red Crescent Center in Istanbul between January and December 2007 were evaluated retrospectively. HBsAg, anti-HCV, and anti-HIV-1/2 were screened by microparticle enzyme immunoassay (MEIA) method. Samples found to be positive for anti-HIV 1/2 and anti-HCV were confirmed by Inno-Lia HCV Ab III and Inno-Lia HIV I/II Score, respectively. The seropositivity rates for HBsAg, anti-HCV, and anti-HIV-1/2 were determined as 1.76 percent, 0.07 percent, and 0.008 percent, respectively. Compared to the previously published data from Red Crescent Centers in Turkey, it was found that HBV and HCV seroprevalances decreased and HIV seroprevalance increased in recent years. In conclusion, we believe that the drop in HBV and HCV prevalence rates are likely multifactorial and may have resulted from more diligent donor questioning upon screening, a higher level of public awareness on viral hepatitis as well as the expansion of HBV vaccination coverage in Turkey. Another factor to contribute to the decreased prevalence of HCV stems from the use of more sensitive confirmation testing on all reactive results, thereby eliminating a fair amount of false positive cases. Despite similar transmission routes, the increase in HIV prevalence in contrast to HBV and HCV may be linked to the increase in AIDS cases in Turkey in recent years.

Use of analgesics in adults with pain complaints: prevalence and associated factors, Turkey / Uso de analgésicos por adultos com queixas de dor: prevalência e fatores associados, Turquia / Uso de analgésicos em adultos que padecen dolores: prevalência y factores asociados, Turquia

OBJECTIVE: Use of analgesics has been increasingly recognized as a major public health issue with important consequences in Turkey. The objective of the study was to determine the prevalence and patterns of analgesics usage and associated factors in adults with pain complaints. METHODS: A cross-sectional study was conducted in 15 cities selected from five demographic regions in Turkey. The study sample population comprised 1.909 adults 18-65 age groups suffering from pain. The sampling method was multi-step stratified weighted quota-adjusted sampling. Data were collected by face-to-face interviews using a semi-structured survey questionnaire consisting of 28 questions. Odds ratios were produced by logistic regression analyses. RESULTS: The prevalence of analgesic use was 73.1 percent, and it was higher in females (75.7 percent; p<0.05), in subjects 45-54 years (81.4 percent; p<0.05), in subjects in rural areas (74.6 percent; p<0.05), in subjects in northern region (84.3 percent; p<0.05), in illiterate subjects (79.1 percent; p>0.05), and in subjects of lower socioeconomic status (74.1 percent; p>0.05). One in ten of the participants used non-prescription analgesics. Non-prescription analgesics were more prevalent among the 55-65 age groups (18.1 percent; p<0.05), among female (11.6 percent; p>0.05), among the urban population (10.7 percent; p>0.05), and in subjects of lower middle socioeconomic status (13.2 percent; p<0.05). Logistic regression showed statistically significant ORs only for age groups, duration of education, socioeconomic status, and demographic regions (p<0.05). CONCLUSIONS: The results showed that the prevalence of analgesic use and prescription analgesic use is high in Turkey, and their use is related to sociodemographic characteristics.

OBJETIVO: O uso de analgésicos tem sido amplamente reconhecido com um grande problema de saúde pública com importantes conseqüências na Turquia. O objetivo do estudo foi determinar a prevalência e os padrões de uso de analgésicos por adultos e os fatores associados às queixas de dores. MÉTODOS: Estudo transversal conduzido em 15 cidades selecionadas de cinco regiões demográficas da Turquia. A amostra estudada incluiu grupos etários de 1.909 adultos (18-65 anos) que sofrem de dores. O método de amostragem seguiu estratificação com pesos ajustados para cada estrato amostrado. Os dados foram coletados em entrevistas face-a-face, usando um questionário de levantamento semi-estruturado, composto por 28 questões. Foram calculados os odds raios por meio de regressão logística. RESULTADOS: A prevalência de uso de analgésicos foi de 73,1 por cento, sendo significativamente (p<0,05) maior em mulheres (75,7 por cento; p<0,05), em sujeitos de 45-54 anos (81,4 por cento; p<0,05), naqueles residentes em área rural (74,6 por cento; p<0,05), na região norte (84,3 por cento; p<0.05), em analfabetos (79,1 por cento; p>0,05), e em sujeitos de status socioeconômico mais baixo (74,1 por cento; p>0,05). Um em cada dez participantes usou analgésico sem prescrição médica. A não-prescrição foi mais prevalente entre sujeitos do grupo etário 55-65 (18,1 por cento; p<0,05), entre mulheres (11,6 por cento; p>0,05), entre a população urbana (10,7 por cento; p>0,05), e em sujeitos de classe econômica média-baixa (13,2 por cento; p<0,05). A regressão logística mostrou OR significantes apenas para grupos etários, anos de estudo, status socioeconômico e região demográfica (p<0,05). CONCLUSÕES: Os resultados mostraram que a prevalência de uso de analgésico e sua prescrição de uso são altas na Turquia, e esses usos são relacionados a características sociodemográficas.

OBJETIVO: El uso de analgésicos ha sido reconocido como el mayor problema de salud pública con importantes consecuencias en Turquía. El objetivo del estudio fue determinar la prevalencia y patrones de uso de analgésicos y factores asociados en adultos que padecen de dolores. MÉTODOS: Se condujo un estudio transversal en 15 ciudades seleccionadas de cinco regiones demográficas en Turquía. La muestra poblacional comprendió 1.909 adultos agrupados en edades entre 18-65 años que sufrían de dolor. Se realizó un muestreo multi-etapa estratificado ajustado. Los datos fueron colectados en entrevistas cara a cara usando un cuestionario semi-estructurado que consistía de 28 preguntas. Los Odds ratio fueron obtenidos por análisis de regresión logística. RESULTADOS: La prevalencia en el uso de analgésicos fue de 73,1 por ciento y fue superior en mujeres (75,7 por ciento; p<0,05), en individuos con edades entre 45-54 años (81,4 por ciento; p<0,05), en individuos de áreas rurales (74,6 por ciento; p<0,05), en individuos de la región norte (84,3 por ciento; p<0,05), en analfabetas (79,1 por ciento; p<0,05) y en individuos de clase social baja (74,1 por ciento; p<0,05). Uno de cada diez de los participantes usa analgésicos sin prescripción médica. La no prescripción médica fue más prevalente en los grupos entre 55-65 años (18,1 por ciento; p<0,05), entre mujeres (11,6 por ciento; p<0,05), entre la población urbana (10,7 por ciento; p<0,05) y en individuos de clase media y baja (13,2 por ciento; p<0,05). La regresión logística mostró ORs significativos estadísticamente sólo para grupos etarios, duración de la educación, status socioeconómico, y regiones demográficas (p<0,05). CONCLUSIONES: Los resultados mostraron que la prevalencia del uso de analgésico y prescripción para el uso de analgésicos es alta en Turquía, y su uso esta relacionado con características sociodemográficas.