2014-06-28, IDIZ, O, Aysan, E, FIRAT, D, ERSOY, YELİZ EMİNE, CENGIZ, MB, AKBULUT, H, ISıK, A, MUSLUMANOGLU, M, AYŞAN, MUSTAFA ERHAN, ERSOY, YELIZ EMINE

We evaluated the effects of local flax seed oil and glycerol application for reducing adhesion formation after thyroidectomy. Material/Method: We randomly assigned 18 female Wistar albino rats (median weight: 275 g, median age: 4.5 mth) to 3 groups: 0.1 ml 0.9% NaCl, glycerol, and flax seed oil were sprayed in a perithyroidal area after thyroidectomy operation on all animals as anti-adhesive barriers. Rats were sacrificed on the postoperative 14th day and adhesions were evaluated macroscopically and microscopically. Results: The median macroscopic adhesion score was 3.0±0.0 in the 0.9% NaCl group, 1.33±0.52 in the glycerol group, and 1.67±0.53 in the flax seed oil group. The median histopathological fibrosis scores were 2.33±0.82, 0.67±0.52, and 0.83±0.75, respectively. Both glycerol and flaxseed oil group macroscopic and microscopic scores were significantly lower than the 0.9% NaCl group (p<0.05). There was no significant difference among the groups (p>0.05). Conclusions: Glycerol and flax seed oil both decrease the incidence of post-thyroidectomy adhesion in rats, but glycerol is more effective.

2022-03-01T00:00:00Z, Kıskaç, Muharrem, Soysal, PINAR, Smith, Lee, Capar, Emre, Zorlu, Mehmet, SOYSAL, PINAR

Background: Obesity is pathophysiologically complex in older adults compared to that in young and middle-aged adults. The aim of the present study was to determine the appropriate body mass index (BMI) range based on geriatric evaluation parameters in which complications can be minimized in older adults. Methods: A total of 1,051 older adult patients who underwent comprehensive geriatric assessment were included. The patients’ demographic characteristics, comorbid diseases, number of drugs, BMI, basic and instrumental activities of daily living (BADL and IADL), Tinetti balance and walking scale, Mini Nutritional Assessment, Geriatric Depression Scale-15, Mini-Mental State Examination, Time Up and Go test, and handgrip strength measurement were extracted from patient records. Results: Of the patients who took part, 73% were female, and the mean age was 77.22±7.10 years. The most negative results were observed in those with a BMI <25 kg/m2 and in those with a BMI >35 kg/m2 . Receiver operating characteristic (ROC) analysis of the optimum BMI cutoff levels to detect the desirable values of geriatric assessment parameters was found to be 31–32 and 27–28 kg/m2 for female and male, respectively. Conclusion: Older adults with BMI <25 and >35 kg/m2 were at a higher risk of a decrease in functional capacity, and experienced gait and balance problems, fall risk, decrease in muscle strength, and malnutrition. Data from this study suggest that the optimum range of BMI levels for older adults is 31–32 and 27–28 kg/m2 for female and male, respectively.

2022-11-01, GÜRSU M., ÖZTÜRK S., ARICI M., Sahin I., Goekcay Bek S., Yilmaz M., Koyuncu S., Karahisar Sirali S., Ural Z., Dursun B., et al., GÜRSU, MELTEM

Background: We aimed to study the characteristics of peritoneal dialysis (PD) patients with Coronavirus disease-19 (COVID-19), determine the short-term mortality and other medical complications, and delineate the factors associated with COVID-19 outcome.Methods: In this multicenter national study, we included PD patients with confirmed COVID-19 from 27 centers. The baseline demographic, clinical, laboratory, and radiological data and outcomes at the end of the first month were recorded.Results: We enrolled 142 COVID-19 patients (median age:52 years). 58.2% of patients had mild disease at diagnosis. Lung involvement was detected in 60.8% of patients. 83 (58.4%) patients were hospitalized, 31 (21.8%) patients were admitted to intensive care unit and 24 needed mechanical ventilation. 15 (10.5%) patients were switched to hemodialysis and hemodiafiltration was performed for four (2.8%) patients. Persisting pulmonary symptoms (n=27), lower respiratory system infection (n=12), rehospitalization for any reason (n=24), malnutrition (n=6), hypervolemia (n=13), peritonitis (n=7), ultrafiltration failure (n=7) and in PD modality change (n=8) were reported in survivors. 26 patients (18.31%) died in the first month of diagnosis. The non-survivor group was older, comorbidities were more prevalent. Fever, dyspnea, cough, serious-vital disease at presentation, bilateral pulmonary involvement, and pleural effusion were more frequent among non-survivors. Age (OR:1.102; 95%CI: 1.032-1.117; p: 0.004), moderate-severe clinical disease at presentation (OR:26.825; 95%CI: 4.578-157.172; p<0.001) and baseline CRP (OR:1.008; 95%CI; 1.000-1.016; p:0.040) were associated with first-month mortality in multivariate analysis.Conclusions: Early mortality rate and medical complications are quite high in PD patients with COVID-19. Age, clinical severity of COVID-19, and baseline CRP level are the independent parameters associated with mortality.

2021-05-25T00:00:00Z, Adıgüzel, Yasemin, İlhan, Nesrin, ADIGÜZEL, YASEMIN

Covid-19 Pandemisinde Bir Risk Faktörü: Yaşlılarda Kırılganlık Yasemin ADIGÜZEL1, Nesrin İLHAN2 1 Arş. Gör., Bezmialem Vakıf Üniversitesi Sağlık Bilimleri Fakültesi Hemşirelik Bölümü, yadiguzel1@bezmialem.edu.tr. 2 Doç. Dr., İstanbul Medeniyet Üniversitesi Sağlık Bilimleri Fakültesi Hemşirelik Bölümü Halk Sağlığı Hemşireliği Anabilim Dalı, nesrin.ilhan@medeniyet.edu.tr. Koronavirüs hastalığı (Covid-19), tüm dünyaya yayılarak 11 Mart 2020 tarihinde DSÖ tarafından pandemi ilan edilmiştir(1). Covid-19, herkesi enfekte edebilmekle birlikte en çok orta yaşlı ve yaşlı yetişkinleri etkilemektedir(2,3). Yapılan çalışmalarda yaşlıların Covid-19’a karşı daha savunmasız olduğu ve enfeksiyon ile ölüm oranlarının yaşlılarda daha yüksek olduğu bulunmuştur(2,4,5). Covid-19 pandemisinde yaşlı bireylerde ölüm oranlarının artmasıyla yaşlılar için sokağa çıkma kısıtlamaları yapılmıştır (3,6). Bu durum, azalmış işlevsel yetenek ve ilerleyici geriatrik kırılganlık oluşum riskiyle mücadele eden yaşlıların başa çıkmaları gereken başka sorunlar doğurmuştur(7). Bu sorunlar; uzun süre evde hareketsiz kalma, sosyal ilişkilerin azalması, stres, anksiyete ile kendileri ve yakınları için hastalık ve ölüm korkusudur(7,8,9,10). Özellikle bu bireylerin kısıtlamada olası düşme ve yaralanma durumlarını ve kronik hastalıkları yönetememe sebebiyle yaşadıkları rahatsızlıkları Covid-19 ile enfekte olma korkusuyla göz ardı etmeleri muhtemeldir. Bu durum, onları kırılganlık riskine karşı daha savunmasız hale getirmektedir(7).Kırılganlık; yaşa bağlı olarak fizyolojik rezervlerin azalması, çoklu organ veya sistemlerde fonksiyonel kayıp ve stresörlere karşı savunmasızlığın artması olarak tanımlanan geriatrik bir sendrom olmakla birlikte dünyada ve ülkemizde giderek artarak küresel bir sağlık yükü oluşturmaktadır(11,12). Kırılganlığın etiyolojisi bilinmemekle birlikte, kronik inflamasyon ile kas- iskelet ve endokrin sistemde değişiklikler, hücresel yaşlanma, apopitozis, kardiyovasküler sistem hastalıkları, kadın cinsiyet, komorbiditeler, genetik, çevresel faktörler (stres, malnütrisyon vb.), ırk, eğitim, sosyoekonomik durum, depresyon, sigara, alkol kullanımı ve polifarmasi kırılganlığın patogenezinde rol oynamaktadır(11,13,14). Kırılganlığın oluşumunda rol oynayan bu faktörler Covid-19 pandemisinde de devam etmektedir. Bu durum mevcutta kırılgan olan yaşlıların şiddetli kırılganlık dönemine girmesine sebep olabileceği gibi kırılgan olmayan yaşlılar için de risk oluşturmaktadır(10). İngilitere’deki ve İtalya-daki hastaneleri kapsayan gözlemsel bir kohort çalışmasında Covid-19-un, kırılgan yaşlılar için daha şiddetli sürebileceği ve prognozunun kötü ilerleyebileceği tespit edilmiştir(15). Türkiye-deki tüm hastanelerde ulusal çapta yürütülen bir kohort çalışmasında ise 18.234 Covid-19 hastasının % 67,4’ünün kırılgan, % 15,4’ünün ise şiddetli kırılganlık döneminde olduğu tespit edilmiştir(16). Kısıtlamaların bir sonucu olarak, toplumda yaşayan beş yaşlı yetişkinden dördünün yaşam alanı hareketliliğinde önemli bir azalma yaşanmaktadır ve bu durum kırılganlık, sarkopeni ve kronik hastalık riskini artırmaktadır(10). Bu süreçte yaşlı bireyin fonksiyonel bağımsızlığının ve işlevselliğinin korunması için kronik hastalıklarını yönetme, farmakolojik tedavilerine uyumu sağlama, fiziksel güç ve direnci artıran egzersizler yapma, beslenmenin düzenlenmesi, kilo kontrolü ve bakım verenlerin dijital ortamlarla bakımı desteklemesi gibi alanlarda yapılacak girişimlerle kırılganlığın önlenmesi sağlanabilir(11,17). Kırılganlığın önlenmesi için Covid-19 pandemisinde ve getirdiği kısıtlamalarda yaşlı bireylerin gerek fiziksel gerekse ruhsal açıdan takip edilmesi, telefon ve diğer dijital ortamlarda temaslarının desteklenmesi, çevirim içi sosyal destek, ruhsal destek faaliyetlerinin yürütülmesi önemlidir. Tele-Sağlık ve Tele-hemşirelik uygulamalarının yaygınlaştırılmasıyla pandemi döneminde yaşlıların günlük yaşam aktivitelerinde bağımsızlıkları desteklenebilmektedir(18). Yaşlıların telefon, bilgisayar ve internete erişememeleri, sınırlı dakika kullanımları onların yakınlarıyla etkileşim kurmasını ve online alışveriş imkanlarını kullanmalarını zorlaştırabilir. Bunlar ve benzeri durumların devlet kurumları ve yerel yönetimler aracılığıyla destelenmesiyle yaşlıların sosyal fonksiyonelliği desteklenebilir(17,19). Yaşlılarda kırılganlığın değerlendirilmesi ve semptomların belirlenerek önlenmesi önemlidir. Kırılganlığın değerlendirilmesinde; Fried Kırılganlık Ölçeği, Edmonton Kırılganlık Ölçeği, FRAIL İndeksi, CSHA Kırılganlık Ölçeği ve Tilburg Kırılganlık Ölçeği gibi araçlar kullanılmaktadır. Bu araçlar sayesinde kırılganlık erken evrede belirlenebilmektedir(11,13). Covid-19 pandemisinde de yaşlıların kırılganlıktan korunması, kırılganlığın değerlendirilmesi ve Covid-19 ile enfekte olduklarında kırılgan yaşlıya özgü girişimleri alabilmeleri için hemşirelerin kırılganlığın farkında olmaları önemlidir.Anahtar Kelimeler: Yaşlılık, Kırılganlık, Kırılgan Yaşlı, Covid-19, Hemşire.

2015-09-01, Kahraman, Feyza Ustabas, Vehapoglu, Aysel, Ozgen, Ilker Tolga, Terzioglu, Sule, Cesur, YAŞAR, Dundaroz, Rusen, VEHAPOĞLU TÜRKMEN, AYSEL, USTABAŞ KAHRAMAN, FEYZA, ÖZGEN, İLKER TOLGA, TERZİOĞLU, ŞULE, CESUR, YAŞAR, İŞCAN, AKIN

Objective: Malnutrition continues to be a leading cause of stunted growth in many countries. This study aimed to investigate serum nesfatin-1 and orexin-A levels in underweight children and the potential correlations of these levels with anthropometric and nutritional parameters. Methods: The study enrolled 44 prepubertal children (between 2 and 12 years of age) with thinness grades of 1-3 and 41 healthy age- and gender-matched children. The demographic, clinical and laboratory parameters including nesfatin-1 and orexin-A concentrations were compared between the two groups. The correlations of nesfatin-1 and orexin-A with biochemical and anthropometric parameters were investigated. The receiver operating characteristic (ROC) analysis were also performed for evaluating nesfatin-1 and orexin-A in distinguishing children with malnutrition from healthy controls. Results: Thyroid-stimulating hormone, vitamin B12 and insulin levels were significantly lower in the study group than controls (p=0.001, p=0.049 and p=0.033, respectively). Mean nesfatin-1 levels in the malnourished group was also significantly lower compared to the healthy controls (3871.2 ± 1608.8 vs. 5515.0 ± 3816.4 pg/mL, p=0.012). No significant difference was observed in the orexin-A levels between the two groups (malnourished vs. control groups: 1135.7 ± 306.0 vs. 1025.7 ± 361.6 pg/mL, p=0.141). Correlation analyses revealed a positive correlation of nesfatin-1 and a negative correlation of orexin-A with body mass index (BMI) z-score. ROC analysis demonstrated that nesfatin-1 and orexin-A cannot be used to distinguish children with malnutrition from healthy controls (AUC: 0.620, p=0.061 for nesfatin-1 and AUC: 0.584, p=0.190 for orexin-A). Conclusion: The positive correlation of nesfatin-1 and the negative correlation of orexin-A with BMI suggest that these neuropeptides may be a part of a protective mechanism in the maintenance of nutritional status and that they may have a role in regulating food intake in undernourished children.

2023-02-01, Toker K., TOKER, KEREM

As our planet moves towards the middle of the 21st century, it faces a dizzying digital transformation process. This transformation brings along with it unique and innovative solutions to numerous social, organizational, and managerial issues. The most tangible of these solutions so far is the vision of Society 5.0 announced by the Japanese government in 2016. Within this scope, the purpose of this chapter is to develop conceptual insight into the reasons for the emergence, components, and goals of Society 5.0. Up-to-date research and current reports on the topic have been examined in this context, and a conceptual framework is formed. The findings show that many digital tools of Society 5.0 are already used in economies, but policymakers discuss these tools’ human-centered reuse. As a result, a positive futuristic perspective has been drawn that humanity will continue its life on a more habitable planet for decades to come and unite digital and physical space. Keywords: Society 5.0, Social Economy, Digital Transformation

2016-03-01, Vehapoglu, AYSEL, TURKMEN, Serdar, Terzioglu, Sule, VEHAPOĞLU TÜRKMEN, AYSEL, TERZİOĞLU, ŞULE

Objective: The hypothalamus plays a crucial role in the regulation of feeding behavior. The anorexigenic neuropeptide alpha-melanocyte-stimulating hormone (α-MSH) and the orexigenic neuropeptide agouti-related protein (AgRP) are among the major peptides produced in the hypothalamus. This study investigated the plasma concentrations of α-MSH and AgRP in underweight and obese children and their healthy peers. The associations between α-MSH and AgRP levels and anthropometric and nutritional markers of malnutrition and obesity were also assessed. Methods: Healthy sex-matched subjects aged 2 to 12 years were divided into 3 groups, as underweight (n=57), obese (n=61), and of normal weight (n=57). Plasma fasting concentrations of α-MSH and AgRP were measured by enzyme-linked immunosorbent assay. The differences between the three groups as to the relationships between plasma concentrations of α-MSH and AgRP and anthropometric data, serum biochemical parameters and homeostatic model assessment of insulin resistance were evaluated. Results: Obese children had significantly lower α-MSH levels than underweight (1194±865 vs. 1904±1312 ng/mL, p=0.006) and normal weight (1194±865 vs. 1762±1463 ng/mL, p=0.036) children; there were no significant differences in the α-MSH levels between the underweight and normal weight children (p=0.811). Also, no significant differences were observed between the underweight and obese children regarding the AgRP levels (742±352 vs. 828±417 ng/mL, p=0.125). We found a significant positive correlation between plasma α-MSH and AgRP levels across the entire sample. Conclusion: This study is the first to demonstrate body weight-related differences in α-MSH and AgRP levels in children. Circulating plasma α-MSH levels in obese children were markedly lower than those of underweight and normal-weight children. This suggests that α-MSH could play a role in appetite regulation.

2021-09-01, Akdemir O. C., Soysal Ö., AKDEMİR, OSMAN CEMİL

An esophageal stricture refers to the abnormal narrowing of the esophageal lumen. It often presents as dysphagia commonly described by patients as difficulty in swallowing. It is a serious sequela to many different disease processes and underlying etiologies. Benign means that it is not caused by cancer of the esophagus, and subjects to inflammation, esophagitis, and scar tissue, which causes the esophagus to narrow. Its recognition and management should be prompt.These strictures have a negative impact on the quality of life of patients, mainly because of dysphagia and may lead to severe complications, such as malnutrition, weight loss and aspiration. Endoscopic dilation with bougies or balloons is initial standard treatment for such lesions.Esophagectomy is rarely needed for benign conditions. Usually reserved for end-stage disease, when the esophagus is either severely non-functional or when quality of life is very poor. In these circumstances esophagectomy is a good option to consider and it is associated with encouraging success rates and improved quality of life. Depending on the specific disease leading to organ failure, peculiar technical issues should be carefully evaluated in order to avoid complications and optimize results

2023-05-25, Yurtsever I., Atasoy B., Bozkurt S., Yıldız G. B., Balsak S., Yabul F., Donmez Z., Selvitop R., Karaman O., Toluk Ö., et al., TOLUK, ÖZLEM, ALKAN, ALPAY

2023-02-01, Toker K., TOKER, KEREM

The structural basis of the social economy is non-profit organizations. Therefore, understanding the structure and management principles of non-profits is essential to create a global economy based on solidarity. However, despite the critical importance and role of non-profit organizations, studies on non-profit organizations are not holistic from a managerial perspective. For this reason, a holistic approach that covers all economic, political, and social components is needed when analyzing the social economy and NPOs Toward this aim, in this section, nonprofits are examined based on their organizational structure and management principles. This examination will compare for-profit and non-profits organizations’ mission, organizational structure, performance criteria, etc. The lack of profit in non-profit organization’s (NPO) mission stands out as the most crucial difference that shapes their management characteristics and organizational structure.Keywords: Social Organizations, Social Economy, Organizational Structure, Non-profit Organizations