16 - Barış, Adalet ve Güçlü Kurumlar

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16 - Barış, Adalet ve Güçlü Kurumlar

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Barış, Adalet ve Güçlü Kurumlar Sürdürülebilir kalkınma için barışçıl ve kapsayıcı toplumlar tesis etmek, herkes için adalete erişimi sağlamak ve her düzeyde etkili, hesap verebilir ve kapsayıcı kurumlar oluşturmak. Barış, istikrar, insan hakları ve hukukun üstünlüğüne dayalı etkin yönetim olmadan, sürdürülebilir kalkınma olmasını bekleyemeyiz. Gittikçe artan ölçüde bölünmüş bir dünyada yaşıyoruz. Bazı bölgelerde barış, güvenlik ve refah sürekli iken, diğer bazı bölgelerde ise bitmek bilmeyen çatışma ve şiddet sarmalı var. Ancak bu, hiçbir şekilde kaçınılmaz sonuç değildir ve mutlaka çözümlenmelidir.

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Open Access
Serum endocan levels in women with restless legs syndrome.
(2015-11-19) CELIK, K; ÇıKRıKÇıOĞLU, MA; HALAC, G; KILIC, ERDEM; AYHAN, S; OZARAS, N; Karatoprak, CUMALİ; YILDIZ, KEMALETTİN; YILDIZ, RS; ZORLU, MEHMET; CAKIRCA, MUSTAFA; KıSKAÇ, MUHARREM; KILIÇ, ERDEM; YILDIZ, KEMALETTİN; ZORLU, MEHMET; KARATOPRAK, CUMALİ; ÇAKIRCA, MUSTAFA; KISKAÇ, MUHARREM
Background: Endocan is a recently introduced marker of endothelial dysfunction. The objective of this study was to compare serum endocan levels in patients with restless legs syndrome (RLS) and control subjects in order to elucidate whether RLS is associated with endothelial dysfunction. Methods: A total of 31 drug naïve female patients with RLS and 31 age- and BMI-matched women were included in the study. Patients with pathological or physiological conditions or with a history of medication use that could potentially influence endothelial functions were excluded, as well as those with alcohol or drug abuse history. The two groups were compared with routine blood tests and serum endocan levels. Results: Patients with RLS had lower serum endocan levels than the controls (P=0.037). There was a negative bivariate correlation between RLS severity score and serum endocan levels (r=-0.406, P=0.023). While white blood cell count was significantly higher in RLS group, 25-hydroxy vitamin D3, vitamin B12, transferrin saturation rate, and HDL-cholesterol were significantly lower. Creatininemia and diastolic blood pressure were also marginally insignificantly lower in RLS group. Due to the presence of differences between two groups in these variables, a linear regression analysis was performed that showed a positive association between endocan and creatininemia (β=0.310, P=0.022), and a negative association between endocan and RLS (β=-0.502, P,0.001). Conclusion: The results of this study seem to suggest that patients with RLS may have better endothelial functions when compared with the general population and that these patients may be better protected against atherosclerosis
Open Access
Global overview of health systems oversight and financing for kidney care
(2018-02-01) Bello, Aminu K.; Alrukhaimi, Mona; Ashuntantang, Gloria E.; Bellorin-Font, Ezequiel; Gharbi, Mohammed Benghanem; Braam, Branko; Feehally, John; Harris, David C.; Jha, Vivekanand; Jindal, Kailash; Johnson, David W.; Kalantar-Zadeh, Kamyar; Kazancioglu, RÜMEYZA; Kerr, Peter G.; Lunney, Meaghan; Olanrewaju, Timothy Olusegun; Osman, Mohamed A.; Perl, Jeffrey; Rashid, Harun Ur; Rateb, Ahmed; Rondeau, Eric; Sakajiki, Aminu Muhammad; Samimi, Arian; Sola, Laura; Tchokhonelidze, Irma; Wiebe, Natasha; Yang, Chih-Wei; Ye, Feng; Zemchenkov, Alexander; Zhao, Ming-hui; Levin, Adeera; KAZANCIOĞLU, RÜMEYZA
Reliable governance and health financing are critical to the abilities of health systems in different countries to sustainably meet the health needs of their peoples, including those with kidney disease. A comprehensive understanding of existing systems and infrastructure is therefore necessary to globally identify gaps in kidney care and prioritize areas for improvement. This multinational, cross-sectional survey, conducted by the ISN as part of the Global Kidney Health Atlas, examined the oversight, financing, and perceived quality of infrastructure for kidney care across the world. Overall, 125 countries, comprising 93% of the world's population, responded to the entire survey, with 122 countries responding to questions pertaining to this domain. National oversight of kidney care was most common in high-income countries while individual hospital oversight was most common in low-income countries. Parts of Africa and the Middle East appeared to have no organized oversight system. The proportion of countries in which health care system coverage for people with kidney disease was publicly funded and free varied for AKI (56%), nondialysis chronic kidney disease (40%), dialysis (63%), and kidney transplantation (57%), but was much less common in lower income countries, particularly Africa and Southeast Asia, which relied more heavily on private funding with out-of-pocket expenses for patients. Early detection and management of kidney disease were least likely to be covered by funding models. The perceived quality of health infrastructure supporting AKI and chronic kidney disease care was rated poor to extremely poor in none of the high-income countries but was rated poor to extremely poor in over 40% of low-income countries, particularly Africa. This study demonstrated significant gaps in oversight, funding, and infrastructure supporting health services caring for patients with kidney disease, especially in low- and middle-income countries.
Open Access
Development and Validation of the Turkish Version of the Colorectal Anal Distress Scale-8
(2017-01-01T00:00:00Z) Aydin, Serdar; Pasa, Tugce Irem; Bidak, Merve; Batmaz, Gonca; Dansuk, Ramazan
Objective: Pelvic floor disorders are common and include a wide spectrum of conditions such as pelvic organ prolapse, urinary incontinence, fecal incontinence, voiding and/or defecation dysfunction, sexual dysfunction, and several chronic pain syndromes. There is a need for a validated and reliable inventory to evaluate colorectal anal distress in women with pelvic floor disorders. The aim of this study was to investigate the reliability and validity of the Turkish version of the CRADI-8 for the evaluation of colorectal distress.
Open Access
Orthostatic hypotension and health outcomes: an umbrella review of observational studies
(2019-11-07) Veronese, Nicola; Smith, Lee; Torbahn, Gabriel; Jackson, Sarah E.; Yang, Lin; SOYSAL, PINAR; Rivasi, Giulia; Rafanelli, Martina; Petrovic, Mirko; Maggi, Stefania; Isik, Ahmet Turan; Demurtas, Jacopo; SOYSAL, PINAR
Purpose Orthostatic hypotension (OH) is associated with older age and many negative clinical outcomes in geriatric practice. We aimed to capture the breadth of outcomes that have been associated with the presence of OH and systematically assess the quality, strength and credibility of these associations using an umbrella review with integrated meta-analyses. Methods We systematically searched several major databases from their commencements through to 16th May 2019 for meta-analyses of observational studies of OH and any health-related outcome. We used these metrics to categorize the strength of evidence of significant outcomes (p < 0.05) from class I (convincing) to class IV (weak), according to the pre-established criteria. Results From 975 abstracts, seven meta-analyses of 12 outcomes were included. For each outcome, the median number of studies was four, and the median number of participants was 46,493, with a median of 3630 incident cases. There was suggestive (class III) evidence that OH was associated with significantly higher risk of coronary heart disease (HR = 1.32, 95% CI 1.12-1.56), stroke (HR = 1.22, 95% CI 1.08-1.38), congestive heart failure (HR = 1.30, 95% CI 1.09-1.55), all-cause mortality (RR = 1.50, 95% CI 1.24-1.81), falls (OR = 1.84, 95% CI 1.39-2.44), and dementia (HR = 1.22, 95% CI 1.11-1.35). Conclusion The current evidence base indicates that OH is significantly associated with a range of adverse cardiovascular, cognitive, and mortality outcomes in older people, although the strength of this evidence remains only suggestive. Further research in larger samples and with lower risk of bias is required to build a fuller picture of the impact of OH on health.
Open Access
Risk Factors for Cervical Cancer: Results from a Hospital-Based Case-Control Study
(2011-01-01T00:00:00Z) Reis, Nesrin; Beji, Nezihe K.; KILIÇ, Dilek
The aim of this study was to investigate risk factors for cervical cancer in Turkish women. In a hospital-based case-control study in Istanbul, 209 patients with histologically confirmed cervical cancer were compared with 1050 controls, who were admitted to the different departments of the same hospital. Odds ratios (OR) and 95% confidence intervals (Cl) were obtained from multivariate logistic regression analysis, fitted by the method of maximum likelihood.
Open Access
Global capacity for clinical research in nephrology: a survey by the International Society of Nephrology
(2018-02-01) Okpechi, Ikechi G.; Alrukhaimi, Mona; Ashuntantang, Gloria E.; Bellorin-Font, Ezequiel; Gharbi, Mohammed Benghanem; Braam, Branko; Feehally, John; Harris, David C.; Jha, Vivekanand; Jindal, Kailash; Johnson, David W.; Kalantar-Zadeh, Kamyar; Kazancioglu, RÜMEYZA; Levin, Adeera; Lunney, Meaghan; Olanrewaju, Timothy Olusegun; Perkovic, Vlado; Perl, Jeffrey; Rashid, Harun Ur; Rondeau, Eric; Salako, Babatunde lawal; Samimi, Arian; Sola, Laura; Tchokhonelidze, Irma; Wiebe, Natasha; Yang, Chih-Wei; Ye, Feng; Zemchenkov, Alexander; Zhao, Ming-hui; Bello, Aminu K.; KAZANCIOĞLU, RÜMEYZA
Due to the worldwide rising prevalence of chronic kidney disease (CKD), there is a need to develop strategies through well-designed clinical studies to guide decision making and improve delivery of care to CKD patients. A cross-sectional survey was conducted based on the International Society of Nephrology Global Kidney Health Atlas data. For this study, the survey assessed the capacity of various countries and world regions in participating in and conducting kidney research. Availability of national funding for clinical trials was low (27%, n = 31), with the lowest figures obtained from Africa (7%, n = 2) and South Asia (0%), whereas high-income countries in North America and Europe had the highest participation in clinical trials. Overall, formal training to conduct clinical trials was inadequate for physicians (46%, n = 53) and even lower for nonphysicians, research assistants, and associates in clinical trials (34%, n = 39). There was also diminished availability of workforce and funding to conduct observational cohort studies in nephrology, and participation in highly specialized transplant trials was low in many regions. Overall, the availability of infrastructure (bio-banking and facilities for storage of clinical trial medications) was low, and it was lowest in low-income and lower-middle-income countries. Ethics approval for study conduct was mandatory in 91% (n = 106) of countries and regions, and 62% (n = 66) were reported to have institutional committees. Challenges with obtaining timely approval for a study were reported in 53% (n = 61) of regions but the challenges were similar across these regions. A potential limitation is the possibility of over-reporting or under-reporting due to social desirability bias. This study highlights some of the major challenges for participating in and conducting kidney research and offers suggestions for improving global kidney research.
Open Access
Insulin resistance in severe acne vulgaris
(2015-01-01T00:00:00Z) Emiroglu, NAZAN; Cengiz, FATMA PELİN; KEMERIZ, Funda; EMİROĞLU, NAZAN; CENGİZ, FATMA PELIN
Introduction: Acne vulgaris is a pilosebaceous gland disease that usually affects people from puberty to young adulthood. It is seen especially on the face, neck, trunk and arms. Its severity differs from patient to patient and its pathogenesis is multifactorial. The main pathogenic factors of acne are high sebaceous gland secretion, follicular hyperproliferation, high androgen effects, propionibacterium acnes colonization and inflammation. Diet is always thought a probable reason for acne and many studies are done about acne and diet.
Open Access
The Effect of Intraspinal Bupivacaine versus Levobupivacaine on the QTc Intervals during Caesarean Section: A Randomized, Double-blind, Prospective Study
(2014-03-01T00:00:00Z) Dogan, Zafer; Yildiz, Huseyin; Akcay, Ahmet; Coskuner, Ismail; ARIKAN, DENİZ CEMGİL; Silay, Emin; Akbudak, Ilknur H.; Kaya, Hakan; ÖKSÜZ, HAFİZE
The aim of this study was to describe whether or not spinal anaesthesia with bupivacaine versus levobupivacaine has any effects on the QTc interval during caesarean section. Sixty healthy pregnant women scheduled for elective caesarean section were randomized to spinal anaesthesia with either bupivacaine (the bupivacaine group) or levobupivacaine (the levobupivacaine group). ECG recordings were performed prior to spinal anaesthesia at baseline (T1), 5min. after spinal anaesthesia, but before uterine incision (T2), and after skin closure (T3). QT intervals were calculated and corrected with the patients- heart rate according to the Bazett formula. Compared with baseline values, mean maximum QTc intervals at T2 and T3 were significantly longer in the levobupivacaine group, but only at T2 in the bupivacaine group. In addition, compared with the bupivacaine group, the QTc maximum interval at T3 was significantly longer in the levobupivacaine group. At T2, the QTc maximum intervals were longer than baseline in both groups. By the end of the surgery, the prolongation of the QTc interval had disappeared in the bupivacaine group but not in the levobupivacaine group.
Open Access
Association between urinary incontinence and frailty: a systematic review and meta-analysis
(2018-10-01T00:00:00Z) Veronese, Nicola; SOYSAL, PINAR; Stubbs, Brendon; Marengoni, Alessandra; Demurtas, Jacopo; Maggi, Stefania; Petrovic, Mirko; Verdejo-Bravo, Carlos; SOYSAL, PINAR
PurposeUrinary incontinence (UI) and frailty are common geriatric syndromes. Although literature increasingly supports a relationship between these two conditions, no systematic review and meta-analysis has been performed on this topic. Therefore, we aimed to investigate the potential association between UI and frailty, through a meta-analytic approach.MethodsA systematic search in major databases was undertaken until 15th March 2018 for studies reporting the association between UI and frailty. The prevalence of UI in people with frailty (vs. those without) was pooled through an odds ratio (OR) and 95% confidence intervals (CIs), with a random-effects model. The other outcomes were summarized descriptively.ResultsAmong 828 papers, 11 articles were eligible, including 3784 participants (mean age 78.2years; 55.1% women). The prevalence of UI was 39.1% in people with frailty and 19.4% in those without. A meta-analysis with five studies (1540 participants) demonstrated that UI was over twice as likely in frail people versus those without (OR 2.28; 95% CI 1.35-3.86; I-2=61%). One cross-sectional study, adjusting for potential confounders and one longitudinal study confirmed that UI is significantly associated with frailty. In two cross-sectional studies, using adjusted analyses, frailty was more common in people with UI.ConclusionUrinary incontinence is twice as common in older people with frailty compared to older people without frailty. Screening and the development of interventions for UI and frailty could prove useful for this common comorbidity.
Open Access
The Relationship between Range of Motion and Function of Upper Extremity in Obstetric Brachial Plexus Palsy Patients Treated with Tendon Transfer
(2017-12-01) Aydın, Atakan; HOŞBAY, ZEYNEP; TANRIVERDİ, MÜBERRA; Tarakçı, Ela; Razak ÖZDİNÇLER, Arzu; HOŞBAY, ZEYNEP; TANRIVERDİ, MÜBERRA
Obstetric brachial plexus palsy (OBPP) refers to upper limb paralysis secondary to a sustained traction or compression injury to the brachial plexus during birth. The reported incidence in developed countries is 2 per 1000 live births. The assessment and planning of appropriate treatment is important in the early stages of OBPP. The aim of our study was to examine the relationship between the range of motion and upper extremity function of the shoulder in patients with OBPP who were treated by tendon transfer. This study included 48 patients who had shoulder tendon transfer at least 6 months ago in Istanbul Medical Faculty, Department of Plastic and Reconstructive Surgery, Department of Surgery of the Hand. Range of motion measurements were performed using a universal goniometer and the modified mallet classification was used to categorize global shoulder function. Pediatric evaluation of disability inventory (PEDI) and Canadian occupational performance measure (COPM) were used to evaluate functional ability, activity and participation. When examining relationships between range of motion and functional scores, there was a statistically significant relationship between COPMP score and external rotation, and no relationship was found between other motion functional scores. The study demonstrated that, the use of the pattern of development and motivation of patients to participate is also important among range of motion and muscle strength for upper extremity function.