Relationship between anaemia and cognitive functions in elderly people.

BACKGROUND: The primary goal of the present study was to investigate the effects of anaemia on the cognitive functions and daily living activities in elderly people. METHODS: This sectional study was performed using 180 elderly people. Face-to-face interviews and questionnaires were conducted to evaluate daily activities. To evaluate cognitive functions we used the Folstein's Mini-Mental State Examination (MMSE). RESULTS: The mean age of the anaemic group and the nonanaemic group were 76.0+/-11.7 and 72.5+/-15.2 years, respectively. The average haemoglobin level among the anaemic population was 10.4 g/dL compared with 13.6 g/dL among the nonanaemic population; a statistically significant difference. There was more impairment in functional status (Katz ADL) (6.8+/-4.3 vs 9.3+/-3.7) and cognition (MMSE) (17.9+/-6.4 vs 21.7+/-6.7) in anaemic than nonanaemic groups, respectively. Albumin and body mass index were lower and the percentage of two or more comorbidities was higher in anaemic group compared to the nonanaemic group, which was a statistically significant variation. The anaemic group was more dependent in terms of bathing, dressing, toileting and transferring. CONCLUSION: In the elderly anaemic group, the dependency for daily activities that require physical effort was higher compared to the nonanaemic group. The MMSE score in the elderly anaemic group was lower than subjects who had normal haemoglobin levels. We conclude that anaemia may impair cognitive functions and some daily living activities in the elderly.

Investigation of vasoactive ion content of herbs used in hemorrhoid treatment in Turkey.

OBJECTIVES: The aim of the present study is to determine anion and cation contents of the herbals used in Turkish folk remedy to explore the rationale of their use in hemorrhoid treatment in the context of the vasoactivity of these elements. DESIGN: Herbs used in the treatment of hemorrhoid were determined by the way of literature search. These herbs were obtained from certified herb sellers. Ground herb samples were placed in individual tubes containing methanol and incubated for 48 hours at 30 degrees C. At the end of the incubation, supernatants were analyzed for their ion concentrations by using ion chromatography. RESULTS: The difference between ion levels between systemic and locally used herbs, was not statistically significant (p>0.05). Anion concentrations (except nitrate) of locally used herbs were slightly higher than systemically used herbs (p>0.05). Cation levels (except magnesium) of systemically used herbs were slightly higher than locally used herbs (p>0.05). It was shown that the concentration of vasoconstrictor effective ions was higher than the concentration of vasodilator effective ions (p<0.001). While vasoconstrictor ion concentration of systemically used herbs was 88.06 +/- 147.42 mg, vasodilator ion concentration of locally used herbs was 90.15 +/- 136.94 mg. The difference between vasodilator concentrations of groups was more evident; 5.39 +/- 9.80 mg and 14.32 +/- 66.48 mg for locally and systemically used herbs respectively. CONCLUSIONS: This study showed that herbal remedies used for the treatment of hemorrhoid in Turkey contain vasoactive and especially vasoconstrictor ions. Vasoconstrictor agents could amplify each others' effects as it has been previously shown, therefore, it is probable that the vasoconstrictor ion contents could contribute to the curative effects of herbals in the treatment of hemorrhoids.

Hemoglobin is inversely related to flow-mediated dilatation in chronic kidney disease.

The microcirculation is regulated by oxygen gradients and by endothelial release of nitric oxide, which can react with hemoglobin to form S-nitroso derivatives. Here we induced flow-mediated dilatation of the brachial artery in response to ischemia in 141 non-diabetic patients with stage 3-4 chronic kidney disease who had no history of smoking, cardiovascular events or use of erythropoietin-based agents. Patients with hemoglobin concentrations above the cohort median of 11.6 g/dl were found to have significant reductions in flow-mediated dilatation compared to those below the median. This inverse relationship remained significant after adjustment for potential confounders, including insulin sensitivity, glomerular filtration rate, proteinuria, body mass index, serum urate, etiology of underlying renal disease, treatment with anti-hypertensive drugs, and traditional Framingham risk factors. Given that hemoglobin can act as an important nitric oxide carrier and buffer, our studies suggest that the mechanism by which hemoglobin influences the endothelium-dependent microcirculation requires its nitrosylation; however, more direct studies need to be performed.

Complementary and alternative medicine use among Turkish diabetes patients.

OBJECTIVES: To measure the frequency of complementary and alternative medicine (CAM) use among patients with diabetes mellitus, to determine demographic characteristics making it more likely to using CAM, and to find out how benefits, if any, were perceived by patients. DESIGN: A 24-item survey questionnaire administered to 371 return patients with diabetes mellitus. SETTING: Outpatient clinic of the Department of Endocrinology and Metabolism department of Gülhane Military Medical Academy, Ankara, Turkey. MAIN OUTCOME MEASURES: Questionnaire-based measures of demographics, motives, expectations, and effects of using CAM, and types and reported perceived benefits of CAM practiced on patients with diabetes mellitus. RESULTS: Forty-one percent of patients (n=152) used at least one of CAM practices; and age, birthplace, educational status, duration of diabetes and family type were significant factors in such behaviour. CONCLUSIONS: Patients born in cities, having more education and longer duration of diabetes, at relatively young ages and living in large families were more likely to use CAM. More than half of those using CAM (n=80, 52.7%) reported as benefits the feelings of either strengthening of body, or being in good psychological condition, or disappearance of several symptoms.

Could rice be used as an anticaking agent in table salt?

The aim of the study was to examine whether powdered rice could be used as an anticaking agent in table salt. Salts free from anticaking food additives were selected and powdered rice was added at different concentrations (0%, 1%, 2%, 5%, 10% and 20%). The samples were placed away from direct light and airflow, and left exposed in the laboratory at room temperature and below 30% humidity. The weight of the samples was measured using an electronic laboratory balance and recorded daily for 4 days. At the end of the experiment, all the samples were dried at 105 °C in order to determine exact dryness. All the salt samples containing powdered rice lost weight (0.56±0.08%), while the other salt samples free of powdered rice gained weight (10.31±0.63%) (P<0.001). A statistically significant difference was found between the first two (1% and 2%) and last three concentrations (5%, 10% and 20%) (P<0.001). Adding powdered rice to salt as an anticaking agent during salt manufacturing at a concentration of 1% could take the place of other anticaking food additives used in table salt production.

The frequency and effecting factors of consanguineous marriage in a group of soldiers in Ankara.

This cross-sectional study was carried out to investigate the frequency of consanguineous marriage in a group of army conscripts in Ankara and the factors affecting this. Of 4153 soldiers, 387 were married. The rate of marriage between first cousins was found to be 19.1%, and the overall rate of consanguineous marriage was 24.1%. Consanguineous marriage was found to be significantly prevalent among soldiers who were born in and still living in the Eastern region; among those who lived in villages; among those whose parents as well as themselves had low educational levels; and among those whose marriages were arranged by their families. Neither the payment of bride-price nor the presence of consanguinity between parents was a significant factor for consanguineous marriage. In addition, the age of the soldier and the age at marriage were significantly lower among soldiers married to first cousins than among soldiers whose marriages were not consanguineous.

Association between cigarette smoking and depressive symptoms among military medical students in Turkey.

An association has been documented between two important health concerns, smoking and depression. A cross-sectional study was carried out to explore whether this relationship exists in a sample of Turkish military medical undergraduates. Of a total of 779 military medical undergraduates, 690 agreed to participate in the study. The students completed a self-administered questionnaire including the Turkish adaptation of the Beck Depression Inventory (BDI) and gave a smoking history. It was determined that the smokers among medical students were 2.2 times more likely to have depressive symptoms than nonsmokers. This result extends the significant association between smoking and depressive symptoms in the literature to a sample of Turkish military medical undergraduates.

How would military hospitals cope with a nuclear, biological, or chemical disaster?

In any nuclear, biological, or chemical (NBC) attack, it is clear that the hospitals may be overwhelmed with casualties. In these deliberate accidents, there will be an additional problem of contamination. Military hospitals must be prepared for NBC disasters with a detailed incident plan. Within this plan, decontamination facilities and shower systems are needed primarily to protect the hospital from self-contamination. Physical and collective protection measures of the staff should be taken into account, with evacuation routes under such an attack. Within this conjunction, the required equipment, including protective suits, detection means, drugs, antidotes, and vaccines, should be provided and stored properly. Qualified personnel should be assigned to the NBC first-aid and rescue team organized within the hospital, equipped, and trained according to such a possible task. Medical staff must be aware of the effects of the agents, and must be experienced in decontamination and first-aid to victims exposed to these agents. Therefore, this information must be put into practice by giving attack scenarios and responses to the hospital administration. It can be conclusively pointed out that military hospitals especially should be better prepared than any other civilian health unit to such attacks of weapons of mass destruction.

Role of urinary zinc and copper on calcium oxalate stone formation.

INTRODUCTION: It is considered that many factors may play a role in urolithiasis. Experimental and clinical studies have shown that zinc has an inhibitory effect on urolithiasis. MATERIALS AND METHODS: In this study, urinary zinc and copper were measured in 27 healthy controls and 30 calcium oxalate stone formers. RESULTS: Urinary zinc excretion was significantly higher (p < 0.001) in stone formers than healthy controls (2,575 +/- 274 and 960 +/- 80 mg/day, respectively). There was no significant difference in urinary copper excretion between healthy controls and stone formers (32.3 +/- 3.5 and 33.3 +/- 3.2 microg/day, respectively). CONCLUSIONS: According to our results, the potent inhibitory effect of urinary zinc excretion on urolithiasis could be reviewed.

Evaluations over the medical emergency responding to chemical terrorist attack.

The use of chemical warfare agents intentionally has become a great concern in the arena of the cold war. On the other hand, there has always been a threat on civilian population due to their mass destruction effects, including psychological damage and a great deal of discussion how to respond to it in terms of medical management. It is very important to provide the best lifesaving medical care and triage in a chemical-contaminated area. Mass casualties exposed to chemical agents require immediate medical intervention to save their lives and should be classified in accordance to medical care priorities and available medical sources, including antidotes and sophisticated health facilities. Establishing the decontamination area for chemical casualties where it is located at the suitable place with respect to the wind direction is necessary. To overcome the mass destruction effects of chemical warfare agents following the terrorist attack, we must have the emergency medical response plan involving experienced triage officers and medical care providers to be able to perform medical management in the chemical-contaminated area and health facilities.

Do spinal cord injuries adversely affect serum lipoprotein profiles?

OBJECTIVES: Previous reports indicate that dyslipidemia is very common in persons with spinal cord injury. This study aimed to examine the relationship between spinal cord injury and serum lipoprotein profiles. METHODS: We assessed 28 healthy control subjects matched for age and sex and 60 persons (46 men and 14 women; mean age, 28.1 years) with spinal cord injury having a mean duration of injury of 3.6 +/- 0.8 years (range, 1-13 years). RESULTS: Serum low-density lipoprotein cholesterol level was higher (109 +/- 37, 91 +/- 23.7 mg/dL, respectively) (p = 0.04) and serum high-density lipoprotein cholesterol level was lower (33 +/- 7.1, 44 +/- 7.4 mg/dL, respectively) (p < 0.001) in the patients with spinal cord injury than in the control. Apolipoprotein A-I level was significantly low (94 +/- 10.3, 103 +/- 11.5 mg/dl) (p = 0.003) and apolipoprotein B level was significantly high (93 +/- 15.6, 81 +/- 13.7mg/dL) (p = 0.004) in the group of spinal cord injury. No significant difference was observed the other parameters of these two groups. CONCLUSION: Our results have shown that serum lipoprotein level should not be ignored for the follow-up of the patients with spinal cord injury.

Relation between Machiavellianism and job satisfaction in a sample of Turkish physicians.

Job satisfaction is affected by many factors. A consistent negative correlation between Machiavellianism and Job satisfaction was shown by many previous studies. To estimate this association in a sample of Turkish people, 361 physicians were selected among the total number of 5,959 working in Ankara City Center. A self-administered questionnaire including the Mach IV scale and Job Satisfaction scale developed by Kasapoglu was applied to the subjects. Student t test and Pearson correlation were used for analysis. The correlation of -.25 between Job Satisfaction and Machiavellianism scores was significant and consistent with the mean scores on Job Satisfaction between the Machiavellian and Nonmachiavellian groups. Although the present association is small, the inverse value is consistent for Mach IV scale scores with job satisfaction in the literature.

The quality of groundwater for certain chemicals in military fields in Ankara.

OBJECTIVE: The goal of this study was to determine the quality of groundwater for certain chemicals from all wells for the military units in Ankara (the capital city of Turkey) to evaluate special situations like a nuclear, biological, and chemical attack. METHOD: The quality of underground water has been evaluated chemically by examining 34 different water specimens. Various chemical parameters and heavy metals have been assessed in these samples by using an ion meter and atomic absorption spectrophotometer. RESULTS: Nitrate and chloride have been assessed at a higher rate with the levels exceeding maximum contaminant levels. Mercury, arsenic, aluminum, iron, conductivity, and salinity have also had levels exceeding maximum contaminant levels for each of them according to the levels set by the World Health Organization. CONCLUSION: This study has given us some powerful clues that underground water in Ankara is at a growing risk to be contaminated mainly with nitrate and chloride. Although more detailed investigations are necessary for a better evaluation, it is clear that preventive measures should be implemented or improved.

Smoking prevalence in military men, and factors affecting this.

The aim of the present study was to determine smoking prevalence among noncommissioned officers and privates and the factors affecting it. This study was carried out in a division of 20,000 soldiers. One of every 10 names on the roster was chosen at random. Responses were received from 1,822 subjects (91.1%), all male, in the final month of their 18-month military service with a mean age of 20.3 +/- 2.2 years. Individuals performing their military service were surveyed using a self-administered, anonymous, personal, and voluntary questionnaire. It was determined that 1,160 (63.7%) of the participants were smokers: 180 (9.9%) were occasional smokers, and 980 (53.8) were heavy smokers. For the fathers of the participants, these rates were 15.4% and 40.5%, respectively. The frequency of smoking was found to be higher in subjects who had high incomes, who had high levels of education, whose fathers smoked, and who were raised in environments in which there were many smokers. It was determined that 31.4% of subjects had begun smoking within the previous 2 years during their period of military service.