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Öğe Depression, anxiety and coping strategies in cancer patients: A case control study(Ankara Yildirim Beyazit University, 2019) Ersoy, S.; Inci, H.; Inci, F.; Engin, V.S.; Adahan, D.Objectives: Psychiatric disorders frequently accompany chronic diseases especially cancer. The aim of this study was to investigate the depression and anxiety levels and the coping strategies in cancer patients. Materials and Methods: This was a case control study conducted in Karabuk University Research Hospital (KURH) between January 2018 and December 2018. Case group constituted of patients with an established diagnosis of cancer and control group included healthy individuals. Coping Strategies Questionnaire (COPE), Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) were performed for all participants. Statistical analyzes were carried out using Minitab 17 Statistical Software. Case versus control comparison for continues variables was conducted using Mann Whitney U test. Degree of relationship between continues variables were measured using Spearman's rank correlation. Chi-Squared test was used to evaluate cross tabulated categorical data. Results: 94 individuals were included in the study. Both cancer and control groups consisted of 23 males and 24 females. Mean age was found 59.77±12.01 years for cancer patients and 59.06±12.36 for control group. BDI and BAI scores of the patients were significantly higher compared to healthy individuals. Considering the cut-off values; 60% (28/47) of the cancer patients were found depressed and 62% (29/47) of them were found to have anxiety while in the control group both the depression and anxiety prevalence was 28% (13/47) (p=0.004 and p=0.002 respectively). Both groups were similar regarding the coping strategies total score (p=0.779). Turning to religion, humor, mental disengagement, denial and substance use were seen more frequently in cancer patients compared to control group (p=0.004, p=0.001, p=0.005, p=0.001 and p=0.004 respectively); whereas active coping, restraint coping, acceptance and behavioral disengagement were significantly more frequent in control group (p=0.001, p=0.039, p=0.026 and p=0.055 respectively). Humor, mental disengagement, denial and substance use were positively correlated with BDI scores (r=0.30 p=0.003, r=0.38 p=0.001, r=0.29 p=0.004, r=0.22 p=0.03 respectively). Turning to religion, humor, mental disengagement and substance use were positively correlated with BAI scores (r=0.24 p=0.015, r=0.25 p=0.013, r=0.31 p=0.001, r=0.23 p=0.024 respectively). Conclusion: The results of the current study revealed that cancer patients had higher levels of depression and anxiety compared to healthy individuals and they had higher risk of being depressed or anxious. Furthermore, the patients developed different strategies in order to cope with the burden of this catastrophic disease. Therefore, cancer is a multifaceted condition which must be approached in a multidimensional manner, by taking psychological features of each individual into account. © 2019 Ankara Yildirim Beyazit University. All rights reserved.Öğe The effects of intermittent fasting on nighttime blood pressure levels(Ondokuz Mayis Universitesi, 2022) Yilmaz, Yücel, A.H.; Adar, A.; Korkut, B.; Kalem, P.; Inci, H.; Adahan, D.Hypertension, a preventable disease with a high prevalence, is frequently seen in obese patients with cardiovascular risk factors. Our study aimed to investigate the effect of an intermittent fasting regimen on nighttime blood pressure levels. Patients who applied to Karabuk University Faculty of Medicine Training and Research Hospital Cardiology and Family Medicine Polyclinic between January and March 2021 and were followed up for 24 hours on an outpatient basis were included in this self-controlled interventional study. Patients underwent a second 24-hour Holter blood pressure follow-up after one month of diet, and the results were compared. The study was conducted with 30 subjects who adhered to a one-month intermittent fasting regimen. 63.3% of the patients were male, and the mean age was 54.60 ± 9.71 years. One month later, 13 patients whose nighttime blood pressure improved were assigned to Group 1 and 17 patients to Group 2. There was no important variance between the groups in terms of gender, age, height, waist circumference and BMI (p=0.609, p=0.105 and p=0.087, in order of). Mean VA and BSA were considerably lower in Group 2 (p=0.027 and p=0.045, in order of). HT duration was longer in Group 1 (p=0.001). There was no important variance between the groups in terms of smoking, alcohol use, average daily sleep time, salt intake awareness and exercise habits. The rate of snacking habits in Group 2 was statistically considerably higher (p=0.033). Intermittent fasting may be beneficial in preventing nocturnal hypertension. © 2022 Ondokuz Mayis Universitesi. All rights reserved.Öğe The effects of smoking cessation on the ratios of neutrophil/lymphocyte, platelet/lymphocyte, mean platelet volume/lymphocyte and monocyte/high-density lipoprotein cholesterol(2023) Inci, H.; Besler, M.S.; Inci, F.; Adahan, D.The amount of smoking, level of smoking addiction and smoking cessation have effects on blood cells, blood lipid levels, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), mean platelet volume (MPV)/lymphocyte ratio (MPVLR) and monocyte/high- density lipoprotein (HDL) ratio (MHR). Methods In this self-controlled experimental study, we included individuals who applied to a smoking cessation clinic and quit smoking. Their sociodemographic and clinical characteristics, the amount of cigarettes consumed (pack/year), their Fagerstrom test for nicotine dependence (FTND) results, haemogram values before and 6 months after quitting smoking, NLR, PLR, MPVLR, MHR and blood lipid levels before and after the treatment were compared retrospectively. Results The mean (SD) age of the 239 individuals who participated in the study was 41.7 (10.9) years and 55.2% of them were women. Their mean FTND score was 7.06 (2.0), and most of them (47.7%) had a very high level of addiction. After the smoking cessation treatment, their neutrophil, platelet, MPV, red cell distribution width, platelet distribution width (PDW), cholesterol, triglyceride, low- density lipoprotein, NLR, PLR, MPVLR, MHR and HDL values increased (p<0.05). The amount of smoking and level of dependence were negatively correlated with HDL, and positively correlated with other parameters. Conclusion After smoking cessation, in addition to dyslipidaemia, the NLR, PLR, MPVLR and MHR values also decreased, and the difference was found to correlate with the level of addiction and the amount of smoking.Öğe IS LOW SERUM VITAMIN D LEVEL ASSOCIATED WITH CANCER?(Verduci Publisher, 2020) Inci, F.; Inci, H.; Karatas, F.; Adahan, D.Objective: The aim of this study is to determine the importance of serum Vitamin D (VD) levels in cancer pathogenesis and to investigate its relationship with cancer subtypes. Patients and Methods: This study included 4914 individuals, 1027 cancer patients and 3887 healthy subjects. The cancer patients were divided into five groups by cancer subtypes. The cancer patients and those in the control group were compared in terms of serum VD levels. Results: In the patients with cancer, the mean serum VD level was found to be significantly lower than that in the control group (16.1 +/- 10.6 ng/mL vs. 19.6 +/- 10.4 ng/mL, p = 0.000). The VD levels were higher in breast cancer (BC) group than those in other cancer groups. The mean serum VD level was significantly lower in the BC group compared to the control group (18.1 +/- 11.3 ng/mL vs. 19.6 +/- 10.4 ng/mL, p = 0.004). In the ROC analysis, the cut-off VD value was determined as 15.2 ng/mL between those with and without cancer (area 0.634, OR: 95% CI 0.612-0.656, p = 0.000). VD <15.2 ng/mL was independently associated with cancer (OR, 2.096; 95% CI: 1.595 - 2.756, p = 0.000). Moreover, the decreased VD level was found to be independently associated with the increased cancer risk (OR, 1.048; 95% CI: 1.032- 1.065, p = 0.000). Conclusions: Although there was no difference in VD levels among the cancer patients and there was less difference in the BC patients compared to the healthy individuals, the VD level was significantly lower in all cancer patients compared to healthy people. In addition, there was an independent positive association between VD levels and cancer, with the VD values below 15.2 ng/mL increasing the cancer risk.Öğe A New Period in Family Medicine Life Point of Care Ultrasonography in Diagnosing Deep Vein Thrombosis in Family Medicine(Universidade de Sao Paulo. Museu de Zoologia, 2023) Korkut, B.; Keskin, N.K.; Atis, S.E.; Çekmen, B.; Çelik, E.; Adahan, D.Objective: Point-of-care ultrasound (POCUS) is one of the diagnostic imaging used in the diagnosis of deep venous thrombosis (DVT) in patients with suspected DVT. The study aimed to evaluate the efficacy of POCUS in family practice for the diagnosis of DVT in suspected moderate or high risk individuals. Materials and Methods: This is a prospective, single-blind study that was used as the POCUS method in the femoral and popliteal vein regions of patients who applied to the family medicine outpatient clinic with a suspi cion of D VT. Moderate-to-high-risk patients aged ?18 years presented with DVT symptoms to the family medicine outpatient clinic were included in the study. The primary outcome was to determine the effectiveness of POCUS in DVT diagnosis by family physici ans. Results: Overall, 63.5% (n = 80) of the patients were females, with a mean age of 54 ± 15 years. The sensitivity and specificity of the procedure were 69.23% and 99.12%, respectively. Further, POCUS had a positive predictive value of 90.00% and a negative predictive value of 96.55%. The overall accuracy was calculated as 96.03%. No statistically significant difference was observed in terms of the accuracy of DVT diagnosis in ultra sonography performed by family physicians and radiologists (p = 0.375). Conclusion: POCUS is a feasible method in the diagnosis of deep venous thrombosis in family medicine practice. In patients with suspected DVT the procedure performed by family physicians was more successful in excluding DVT diagnosis than in diagnosing DVT. © 2023, Universidade de Sao Paulo. Museu de Zoologia. All rights reserved.Öğe Socio-demographic characteristics of caregivers of home health care patients(Ankara Yildirim Beyazit University, 2019) Dagdeviren, T.S.; Dagdeviren, M.; Demir, N.; Atatorun, M.; Özsahin, O.A.; Adahan, D.Objectives: In this study, it is aimed to determine the socio-demographic characteristics of caregivers of the patients receiving Home Health Service (HHS). Materials and Methods: The caregivers of the patients receiving care from HHS have been included in this cross-sectional study. A data collecting form has been used to evaluate the socio-demographic and clinical characteristics of the caregivers. Results: Primary caregivers of the 80 patients who benefits from HHS have been included in the study. Of the 80 caregivers, 85.00% (n: 68) are female and 15.00% (n: 12) are male. 63.75% of the patients are between 35-64 years of age. 86.25% are satisfied with the care, 70.00% feels self-sufficient with their care, 56.25% needs care-related training-consulting. It is stated that 41.25% of caregivers feel exhausted, 43.75% feels weakness-helplessness, 42.50% experience communication problems with the patient, 78.75% needs help. The percentage of pre-maintenance health status very good-good is 90.00%, while the percentage of those who are in good health after the maintenance is 20.00%. The most challenging conditions are determined as bathing with 46.25% and diapering with 41.25%. Of the caregivers, 27.50% use antidepressants, 15.00% use sleeping pill, and only 21.25% have good sleep quality. When caregivers are asked to give Home Health Services a score out of 10, their score is 9.0±1.0. Conclusion: The scope and function of home health services is important for caregivers as well as for patients. Determining the care needs of caregivers and supporting them in this direction is important for the quality and integrity of the service provided. © 2019 Ankara Yildirim Beyazit University. All rights reserved.
