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Background: Dysfunction of the mammalian target of the rapamycin (mTOR) signaling pathway by mTOR inhibitors in kidney transplant recipients (KTRs) may contribute to sarcopenia in addition to metabolic factors and infammation. Our study aimed to investigate the association of mTOR inhibitors with sarcopenia ın KTRs treated with and without mTOR inhibitors. Methods: The study included 22 KTRs who had been on mTOR inhibitors for at least 6 months and 51 KTRs who had never been on mTOR inhibitors. Handgrip strength (HGS) was used to test muscle strength. Bioimpedance analysis (BIA) and muscle ultrasonography (US) were used to determine muscle mass. Results: The study population’s mean age was 39.05 ± 13.29 years, and 41.1% of the participants were female. One out of every 3 patients was under treatment with mTOR inhibitors, either everolimus or sirolimus. Sarcopenia was found in 32.9% of the whole population, according to EWGSOP2 criteria. There was no diference in the prevalence of sarcopenia (P = .68) and its components (P > .05) between the mTOR-inhibitor-using and mTOR-inhibitor-free groups. In regression analysis, mTOR inhibitors were not associated with sarcopenia (P = .68). Conclusion: Muscular strength, mass, and physical performance did not difer between the mTOR-inhibitor-using and mTOR-inhibitor-free groups, implying that changes in molecular pathways may not necessarily translate into clinical manifestations in real life.

Abstract Background Frailty is a geriatric syndrome that is characterized by increased vulnerability to intrinsic and extrinsic stressors due to decreased biologic reserves. Muscle ultrasound (US) is a valid and reliable method for assessing muscle quantity in older adults. The study aims to examine the relationship between frailty definitions and US-derived muscle parameters. Methods We conducted a cross-sectional study with type 2 diabetes mellitus outpatients in a tertiary hospital, and all participants underwent a comprehensive geriatric assessment. For frailty assessment, the Fried Frailty Phenotype (FFP), the Clinical Frailty Scale (CFS), and the Edmonton Frailty Scale (EFS) were performed. Muscle US measurements included Gastrocnemius Medialis (GM) muscle thickness, GM fascicle length, GM pennation angle, Rectus Femoris (RF) muscle thickness, Rectus Femoris cross-sectional area (RFCSA), Rectus Abdominis (RA) muscle thickness, External Oblique (EO) muscle thickness, Internal Oblique (IO) muscle thickness, and Transverse Abdominis (TA) muscle thickness. Results In all, 373 participants were included in the study. The median age of participants was 72.7 ± 5.9 years, and 64.6% of them were female. According to the FFP, 18.2% of the participants were living with frailty, 56% of them were pre-frail; 57.4% of them were living with frailty according to the CFS; 25.2% of them were living with frailty, and 20.6% of them were pre-frail according to the EFS. The FFP, CFS, and EFS scores were related to muscle thickness of GM, RF, and RA, fascicle length of GM, and pennation angle of GM and RFCSA. Particularly, GM pennation angle, RF muscle thickness, and RFCSA were associated with an increased risk of frailty. Besides muscle thickness of GM, RF, and RA, fascicle length of GM, pennation angle of GM, and RFCSA were significant for predicting the presence of frailty. Conclusions US-derived regional muscle measurements are associated with frailty definitions (in both physical, cumulative deficit, and multidimensional models) in a diabetic geriatric population.

Objective: With this study, it was aimed to determine the reasons and results of young adults who apply with psychological problems in a primary care institution of a university and to evaluate the relationship between sociodemographic characteristics. Method: The descriptive and retrospective study was conducted in Hacettepe University Faculty of Medicine, Department of Family Medicine and Sıhhiye Health Center. All students between the ages of 18-35, who were registered in the specified date range in our study, and who came to a psychologist interview at least 3 times at regular intervals were evaluated. In our study, the data of the patients were collected by examining the data forms recorded by the psychologist. The personal data of the patient was not used in the data form. Results: In the study, 276 applications were evaluated retrospectively. It was observed that 83.3% of the applicants were women, and the mean age was 20.99±2.176. When evaluated in terms of application reasons; it was determined that 35.5% of them applied due to anxiety, stress, obsessive-compulsive disorder [OCD] problems, 35.9% of them had communication problems and psychosocial problems. For the treatment of 65.2%, it was decided to follow up with a psychologist [who did not require referral to a psychiatrist]. When the relationship between the outcome of the applications and the reasons for the application is evaluated; 54.8% of mood problems were referred to a psychiatrist and were followed up by a psychologist after the medication was started; it was determined that 51.1% of the patients who applied with communication and psychosocial problems were followed up by a psychologist without the need for referral to a psychiatrist. Conclusion: As a result, university students have high levels of anxiety, stress, OCD problems, communication problems, and psychosocial problems; it was found that women, those living in dormitories and those with a diagnosis of psychiatric illness applied more frequently. Students should be encouraged to benefit from the health centers, which are created for them, where primary care preventive health care is at the forefront.

Abstract Background Frailty is an important geriatric syndrome that can be seen as a way of recognizing and distinguishing the complex health conditions of older people. Due to the time limitation, short and simple instruments are most feasible in clinical practice, and several quick screening tools have been developed and validated, Groningen frailty indicator (GFI) is one of these scales. We aimed to validate and evaluate the reliability of the GFI in outpatient older adults in the Turkish population. Methods A total of 101 older patients were enrolled to the study. GFI was scored by a geriatrician for every patient at first admission to the geriatric outpatient clinic. Fried Physical Frailty Phenotype (FPFP) was performed as a reference test. Results The median age (IQR) was 72.0 (10.0) and 62.4% of the study population (n = 63) was female. Based on the GFI, 34 patients (33.7%) were defined as robust, and 67 patients (66.3%) were defined as living with frailty. There was a statistically significant concordance between GFI and FPFP (Cohen’s kappa: 0.415 p

Purpose: Insomnia, a frequent geriatric syndrome, is thought to be linked with coronary artery disease and increased mortality. The aim of our study was to examine the relationship between sleep duration and coronary artery disease (CAD) and cardiovascular risk factors. Materials and Methods: In this study, patients who applied to the geriatric outpatient clinic for comprehensive geriatric assessment were retrospectively evaluated. Patients were divided into two groups according to the six hours of ideal sleep assumption: those who slept less than six hours and those who slept six hours or more. Results: A total of 2255 patients (age 72±6 years, 63.3% female) were included in this study. Patients who were sleeping less than 6 hours were older (14.4% vs. 10.3%; p=0.005) and most of them were female (69.5% vs. 60.2%; p

Abstract Introduction Physical phenotype and the cumulative deficit model are two well-known concepts of frailty. One of the main components of frailty is loss of muscle mass and function, which may also include swallowing muscles, therefore is a risk factor for dysphagia. Since dysphagia is seen starting from the early stages of Alzheimer’s Disease (AD), in this study we aimed to reveal the relationship between frailty and dysphagia and dysphagia-related quality of life through Swallow Quality of Life (SwalQoL) tool in patients with AD and compare them with cognitively intact older adults. Methods Comprehensive geriatric assessment, dysphagia evaluation by Eating-Assessment Tool (EAT-10) and SwalQoL questionnaire, and frailty assessment via FRAIL and Clinical Frailty Scale (CFS) were performed on all 101 participants of the study. Thirty-five patients were cognitively intact, 36 patients were diagnosed with mild AD, and 30 patients were diagnosed with moderate AD. Results Sex distribution was similar between the groups, however, there was a statistically significant age difference. The prevalence of frailty increased according to both frailty indexes as the cognitive status deteriorated. All parameters of SwalQoL except fear and sleep parameters deteriorated as cognitive status impaired. In quantile regression of the total score of the SwalQoL questionnaire and multivariable logistic regression of EAT-10, frailty, as defined by CFS and FRAIL, was associated with dysphagia and poor quality of life regardless of age, presence of dementia, as well as nutritional status. Conclusion Swallowing difficulties in AD negatively affects the quality of life, and it is closely related to frailty in mild-to-moderate AD.

Generating memory T cell responses besides humoral immune responses is essential when it comes to the efficacy of a vaccine. In this study, the presence of memory T cell responses after aluminum-adjuvanted inactivated whole-virion SARS-CoV-2 vaccine (CoronaVac) in seronegative and seropositive elderly individuals were examined. CD4+ and CD8+ memory T cell proliferation and IFN-γ production capacities were evaluated. Additionally, clinical frailty scale (CFS) and FRAIL scales of the individuals were scored. CD4+ memory T cell responses more prominent than CD8+ memory T cells. In seronegative individuals, 80% of them had memory CD4+ and IFN-γ, whereas 50% of them had memory CD4+ and all of them had IFN-γ responses. Additionally, 40% of seronegative patients and 50% of seropositive patients had memory CD8+ responses. To sum up, humoral immune responses are not associated with memory T cell responses, and in seronegative individuals, memory T cell responses can be detected.

Objective: In this study, it was aimed to evaluate the sleep quality and depression status of dementia patients during the Covid-19 pandemic. Materials and Methods: Patients aged 65 and over with dementia who applied to our polyclinics or those who can be reached from their relatives and those who agreed to participate in our research; a questionnaire consisting of sociodemographic information, “Cornell Scale for Depression in Dementia" and "Pittsburgh Sleep Quality Index" was applied. Results: All of 64 (43.5%) of the participants were male and 83 (56.5%) were female. It was found that 68.7% of the participants had poor sleep quality and 31.3% had good sleep quality. 76.2% of the participants suggested depression, 2.8% did not. Pittsburgh Sleep Quality Index score and Cornell Scale for Depression in Dementia score did not differ according to educational status, occupation and gender. Conclusion: In periods such as the pandemic period, which may cause behavioral changes and lifestyle changes, efforts should be made to minimize the changes in the depression status and sleep quality of groups with specific diseases such as dementia, and if necessary, the control examination time intervals should be shortened.

Aims: With this study; it was aimed to determine the use of various medications or nutritional supplements to support immune system and opinions, usage status and attitudes towards the drugs currently used / recommended for the treatment of COVID-19, and the factors affecting drug use during the COVID-19 pandemic according to the condition of having COVID-19. Methods: The descriptive research was conducted in Family Medicine outpatient clinics. Data were collected with a questionnaire prepared by the researchers through the internet (sites on social media) due to the pandemic. The e-questionnaire form was shared on the internet a total of 10 times at 6-day intervals. Results: 1484 people participated, 60.8% were female, 51.5% was a healthcare professional. While 23.3% had a known disease; 19.3% of them had COVID-19 infection, 79% of them received outpatient medication. Although not recommended, it was observed that the most used drugs were Vitamin C and antipyretic drugs, followed by vitamin D and antibiotics. 87.5% who have had COVID-19 infection stated that they used the drugs as suggested/written on to them. The reasons of those who did not use drugs: fear of its side effects, not seeing it necessary, using herbal products and observing and using it if necessary. People who had live a person under the age of 18 living in the same household (p=0.042), who had a chronical disease (p=0.014) and who were regularly drug users (p=0.003) were reported that they used drugs as suggested / written on them. Conclusion: Infodemic causes the spread of false information about the disease and its treat-ment both among the public and in scientific circles. The results of our study also support this situation. The healthcare system should be structured in accordance with the pandemic condi-tions in order to explain the importance of the use of medicines.

Aims: The aim of this study was to evaluate the relationship between fat phobia, body image perception and theirs effects on healthy lifestyle behaviors. Materials and Methods: This descriptive study consisted of 548 individuals. Data was collected by using the socio-demographic form, Fat Phobia Scale (FPS) and Body Perception Scale (BPS). Results: FPS mean score of participants was 2.88±0.35, BPS mean score was 139,59±28,77. Participants who do regular physical activity, have regular diet, pay attention to the content of meal and constantly dieters were had higher BPS and who do regular physical activity, dont regularly consume three main meals had higher FPS scores. Conclusion: Determining fatphobia levels and body image perceptions would be beneficial at giving healthy lifestyle behavior counseling to people by being more careful in practice.

Background. The conflict in Syria following the anti-regime demonstrations that started in March 2011 created one of the greatest humanitarian crises. The United Nations High Commissioner for Refugees (UNHCR) reports that refugee and resettlement experiences can influence the critical stages of intellectual, social, emotional and physical development of children. There is a lack of sufficient information about the prevalence of developmental delay in forcibly displaced children. In this study, we aimed to describe the impact of the Syrian crisis on the development of children after resettlement, factors that are associated with developmental problems and domains in which developmental delays are more likely to occur. Methods. Refugee children (n=60) between the ages of 18-72 months admitted to the Yenimahalle Community Health Center Immigrant Health Unit to receive primary health care services between 1 November 2018- 1 March 2019 were included in this study. The control group included 60 Turkish children between 18-72 months admitted to the İsmail Ulucan Family Health Center which is in the same building. Developmental assessments were conducted by the researchers using the Denver II Developmental Screening Test (DDST-II). Sociodemographic characteristics of the child, family and caregivers as well as risk factors related to development were collected using a questionnaire. The interviews with refugee families were conducted with an interpreter. Results. Developmental delay was more frequent in refugee children compared to Turkish children. The DDST-II were normal in 82.1%, questionable in 10.7% and abnormal in 7.1% of Turkish children; in the study group, 22.2% of the patients were found to be normal, 33.3% were questionable and 44.4% were abnormal. The differences were statistically significant (p < 0.05). Multiple logistic regression analysis revealed that, being a forcibly displaced refugee was the single significant risk factor for developmental delay alone. In the DDST II subdomain analysis, it was seen that high monthly income reduces the risk of caution-delay in personal-social domain. It was found that birth weight below 2500 g increased the risk of caution-delay in the fine-motor and gross-motor domain and being a forcibly displaced refugee and consanguinity increased the risk of caution -delay in the language domain. Conclusions. This study showed that being a forcibly displaced refugee was the most important risk factor for developmental delay. We emphasized the importance of surveillance and screening development in these highrisk children as well as early intervention services.

Abstract We carefully studied the article titled “A practical laboratory index to predict institutionalization and mortality – an 18-year population-based follow-up study” written by Heikkilä et al. and published in BMC Geriatrics on 25 February 2021 with great interest. We would like to make some comments regarding this article and tool. Laboratory Index (LI) has been executed with the data of 728 patients who had followed-up in our center, however the LI score was not able to predict the 10-year and 18-year mortality. Therefore, a question mark has been aroused in our minds at some points. Neither frailty nor comorbidities were considered in this index. For a geriatric patient, it would be inadequate to evaluate laboratory results regardless of the clinical status. Similarly, it would not be appropriate to predict mortality only on the basis of laboratory results without considering the clinical status of the patient. We think that although the recent study has a great impact, it can be improved by incorporating data on the comorbidities and frailty status of the patients into the analysis.

INTRODUCTION: Youth are at high risk for reproductive health problems and adolescent health monitoring has entered a new routine during family medicine follow-ups Our study was planned in order to determine the students' knowledge level and educational needs on reproductive health who have just begun to Faculty of Nursing. METHODS: A questionnaire was applied by face-to-face interview method to the students who had recently registered to Hacettepe University Nursing Faculty in the 2019-2020 academic year in this descriptive study. In the evaluation of the data, the mean and standard deviation for continuous variables and frequency table for qualitative data were used. The Chi-square test was used to test the relationship between qualitative data. Statistical analysis was done with the SPSS v.23 package program. RESULTS: 120 students were included in the study. The school (75.80%) was in the first place among students' sources of information on reproductive health. The most common contraceptive method was the pill (80.80%). The most common answer to the question of what sexually transmitted diseases are was the Human Immunodeficiency Virus (85.80%). The most wanted topic to learn was sexually transmitted diseases with 51.70%. There was no statistically significant relationship between students' age, gender, economic status, the school they graduated from, and their level of knowledge. DISCUSSION AND CONCLUSION: Young people don't have sufficient and correct knowledge about reproductive health. More attention should be given to planning their training. In addition, the family physician, who monitors adolescents between the ages of 10-21 and provides counseling services on reproductive health, plays an especially important role to acquire accurate and reliable information.

Frequency of application to primary health care servces with syncope is quite high. Especially in the presence of recurren syncope attacks, even if the healing process is fast, the etiology should be investigated, and the necessary research and clinical tests should be done to make a differential diagnosis. In our case, we presented a patient who was admitted to our Family Medicine Outpatient Clinic due to syncope and was diagnosed with cardiovascular syncope due to pericardial effusion.

Amaç: Bu çalışmada üniversiteye yeni kayıt olmuş öğrencilerin adölesan ve genç erişkin dönemde sağlık hizmetlerinden yararlanma ve bazı sağlık taramalarına dair hizmet alma durumlarını değerlendirmek amaçlanmıştır. Yöntem: Tanımlayıcı nitelikte bu araştırma Aile Hekimliği Polikliniklerinde 15 Eylül 2019 ile 30 Ekim 2019 tarihleri arasında yapılmıştır. 2019 yılında Hemşirelik fakültesine kayıt olan ve tarafımıza başvuran öğrencilerinden çalışmaya katılmak isteyen gönüllüler evreni oluşturmaktadır. Kayıt olan öğrencilerin %92,3’üne ulaşılmıştır. Başvuran öğrencilere toplamda 17 soruluk anket formu uygulanmıştır. Bulgular: 120 katılımcının %71,7’si kadın; %28,3’ü erkekti. Öğrencilerin %18,3’ü son bir yıl içinde herhangi bir şikâyetle üç ve daha üstü kez sağlık merkezine başvurduğunu; %15,8’i ise sağlık kurumuna hiç başvurmadığını bildirmiştir. Katılımcıların %71,7’i aile hekimine bir şikayet nedeni ile, %31,7’si genel kontrol amaçlı başvuru yapmıştır. %30,0’u kontrol amaçlı bir göz hekimine, %29,2’si bir diş hekimine başvuru yapmıştır. Öğrencilerin %59’una son üç yılda herhangi bir sebeple (şikayetle yada kontrol için) başvurduğu doktoru tarafından yaşına uygun yapılması gereken sağlık taramalarından bahsedilmiş, %61,7’sinin vücut ağırlığı ve boy uzunluğu ölçülmüş, %77,1’inin kan basıncı ölçümü yapılmış, %80,7’sinden tarama amaçlı tetkik istenmişti. Sonuç: Bu sonuçlara göre bu yaş grubunun en sık başvurduğu hekimler olan aile hekimleri başta olmak üzere hekimlerin sağlık taramaları için her fırsatı değerlendirmesinin önemi bir kez daha vurgulanmaktadır.

This study aimed to investigate the lifetime prevalence and risk factors for allergic rhinitis and asthma in geriatric outpatients in three big cities of our country. Elderly patients visiting geriatric outpatient clinics at university hospitals were included in this study. Two questionnaires were completed by trained investigators in face-to-face interviews of 236 people aged 65100 years. The median age was 73.71±7.09 year, and 63% participants were female. The prevalence of allergic rhinitis and asthma was found 15.3 % (n=36) and 10.2 % (n=24), respectively. The frequency of allergic rhinitis and asthma was high in females, in those with low education levels, in city, in persons having family history of atopy and in smokers, but it wasnt statistically significant. Allergic diseases affect the elderly as well as young people. Female sex, low educational level, smoking, and living in a city are among the important risk factors for allergic rhinitis and asthma in the elderly. [Med-Science 2020; 9(2.000): 334-7]

Objective: Frailty syndrome, defined as increased vulnerability to stressors, is an important cause of the negative health consequences of older adults. Defining related factors and struggling with these factors can be an important way for the prevention of frailty. This study aims to investigate the related factors of frailty using comprehensive geriatric assessment in community dwelled older adults attended the geriatric medicine outpatient clinic. Materials and Methods: A total of 1001 patients aged 65 years and over were included in this study. Demographical characteristics, chronic illnesses, medications, were evaluated and recorded. Comprehensive geriatric assessment and anthropometric measurements were performed for each patient. The frailty status of patients was determined using the Edmonton frailty scale (EFS) and Fried's frailty index (FFI). The rate of frailty and associated factors were examined. Results: Frailty rate was detected as 15.4% and 11.8% according to the FFI and EFS, respectively. Advanced age, educational status lower than university level, having dementia, depression, diabetes mellitus, coronary artery disease, higher malnutrition risk, lower activities of daily living scores, lower handgrip strength and absence of hyperlipidemia were the independently associated factors of frailty by FFI or EFS. Conclusion: Frailty is a common geriatric syndrome that has interaction with other geriatric syndromes and cardiovascular diseases. Most of the related factors of frailty are reversible or preventable. A comprehensive assessment is essential for the prevention of frailty.

Purpose: It is a question whether masked hypertension (MH) leads to end-organ damage in the geriatric age group. The aim of this study is to evaluate the associations between MH and end-organ damage such as left ventricular hypertrophy (LVH) and proteinuria in geriatric population. Materials and methods: One hundred and two patients who were admitted to the outpatient clinic were included in the study. These patients were also included in the GMASH-Cog study in 2016, which examined the relationship between MH and cognitive function. All patients underwent ambulatory blood pressure measurement procedures. Cardiac functions of all patients were determined by echocardiography. Spot urine albumin/creatinine ratio (ACR) was measured in all patients. Results: Forty four of 102 patients (43%) were diagnosed with MH. ACR was 9.61 mg/gr in the MH group and 7.12 mg/gr in the normal group (p = .021). In addition, left ventricular mass index (LVMI) was found to be higher in the MH group than in the normal group. Mean LVMI scores were 107.76 ± 16.37 in patients with MH and 100.39 ± 19.32 in the normotensive group (p = .046). Conclusion: MH is associated with end-organ damage in geriatric patients. Urinary albumin excretion and LVH which are the parameters of end-organ damage were significantly higher in MH patients. MH may cause end-organ damage and should not be overlooked in geriatric patients.

Background: Age‐related changes in cardiovascular system are well‐known. Arrhythmias in elderly patients constitute most of the urgencies, consultations, or hospitalizations. QT dispersion (QTd) is a simple noninvasive arrhythmogenic marker to demonstrate the electrical instability of the heart. The aim of this study was to investigate how QTd changes with increasing age by calculating the QTd in the elderly and younger subjects. Methods: One hundred and forty‐six consecutive subjects (62 males and 84 females; age range: 18–82 years) were enrolled in the study. Sixty‐seven of the subjects were 65 years and over (mean age, 70 ± 4), 79 were younger than 65 (mean age, 37 ± 11). A 12‐lead ECG was recorded. The longest and the shortest QT intervals were measured manually on these ECG recordings. QTd was calculated from the formula, QTd = QTmax − QTmin. Results: Demographic features were similar between the two groups. QTd of the elderly group was found to be significantly higher than the younger group (35.6 ± 15.6 in elderly, 24.2 ± 12.4 in younger group, P < 0.001). A positive relationship was found between QTd and age (r = 0.415, P < 0.001). QTd was greater in female than in male (31.9 ± 16.7 ms vs 26.0 ± 11.3 ms, respectively, P = 0.018). Conclusions: Our study shows that QTd increases with advancing age. We think that long‐term follow‐up of these patients would be useful to show if there is any relationship between the clinical outcomes and the increase in QTd.