A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

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Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults

There is concern about an emerging diabetes epidemic in Turkey. We aimed to determine the prevalence of diagnosed and undiagnosed diabetes, prediabetes and their 12-year trends and to identify risk factors for diabetes in the adult Turkish population. A cross-sectional, population-based survey, ‘TURDEP-II’ included 26,499 randomly sampled adults aged ≥ 20 years (response rate: 87 %). Fasting glucose and biochemical parameters were measured in all; then a OGTT was performed to identify diabetes and prediabetes in eligible participants. The prevalence of diabetes was 16.5 % (new 7.5 %), translating to 6.5 million adults with diabetes in Turkey. It was higher in women than men (p = 0.008). The age-standardized prevalence to the TURDEP-I population (performed in 1997–98) was 13.7 % (if same diagnostic definition was applied diabetes prevalence is calculated 11.4 %). The prevalence of isolated-IFG and impaired glucose tolerance (IGT), and combined prediabetes was 14.7, 7.9, and 8.2 %, respectively; and that of obesity 36 % and hypertension 31.4 %. Compared to TURDEP-I; the rate of increase for diabetes: 90 %, IGT: 106 %, obesity: 40 % and central obesity: 35 %, but hypertension decreased by 11 % during the last 12 years. In women age, waist, body mass index (BMI), hypertension, low education, and living environment; in men age, BMI, and hypertension were independently associated with an increased prevalence of diabetes. In women current smoking, and in men being single were associated with a reduced risk. These results from one of the largest nationally representative surveys carried out so far show that diabetes has rapidly become a major public health challenge in Turkey. The figures are alarming and underscore the urgent need for national programs to prevent diabetes, to manage the illness and thus prevent complications. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s10654-013-9771-5) contains supplementary material, which is available to authorized users

Open reduction and bioabsorbable pin fixation for late presenting irreducible supracondylar humeral fracture in children

The objective was to evaluate the availability and efficacy of internal fixation with absorbable poly-D,L-lactic acid (PDLLA) pins for the treatment of late presenting irreducible Gartland type III supracondylar fracture of the humerus in children. Fifty-six cases of late presenting irreducible Gartland type III supracondylar fracture of the humerus in children were treated by open reduction and bioabsorbable PDLLA pin fixation from March 2005 to March 2008. The outcome of treatment was evaluated by the Mayo Elbow Performance Score (MEPS) and the criteria of Flynn. Fifty-six patients were followed up from 24 to 36 months (mean: 22 months). No displacement of bone fracture occurred, and all fractures healed within a normal time without wound infection; there were no cases of Volkmann’s ischaemic contracture, myositis ossificans or iatrogenic injury of the ulnar nerve. No residual vascular deficits or iatrogenic nerve injury were noted; cubitus varus deformity occurred in one case. There were 49 excellent, four good and three fair results according to the MEPS; the rate of excellent and good outcome was 94.6%. All children but one had excellent cosmetic results according to the criteria of Flynn. All of the children and their parents stated that they would choose this treatment again. Treatment of late presenting irreducible Gartland type III supracondylar fracture of the humerus in children with bioabsorbable PDLLA pins provides sufficient stability and satisfactory efficacy. The absorbable implant has become popular for its avoidance of a second operation to remove the internal fixation, and the degree of patient satisfaction is high