03 - Sağlık ve Kaliteli Yaşam

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03 - Sağlık ve Kaliteli Yaşam

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AMAÇ 3: SAĞLIKLI BİREYLER Çocuk ölüm oranlarının azaltılması, anne sağlığının iyileştirilmesi, HIV/AIDS, sıtma ve diğer hastalıklar ile mücadelede büyük aşama kaydetmiş durumdayız. 1990 yılından bu yana, önlenebilir çocuk ölümlerinde dünya genelinde %50’yi aşan azalma olmuştur. Anne ölümleri de dünya genelinde %45 azalmıştır. 2000 ile 2013 arasında HIV/AIDS bulaşma oranı %30 azalmış, 6,2 milyonu aşkın insan sıtmadan kurtarılmıştır. Bu ölümler; önleme ve tedavi, eğitim, aşı kampanyaları, cinsel ve üreme sağlığı hizmetleri vasıtasıyla önlenebilir. Sürdürülebilir Kalkınma Amaçları; AIDS, verem, sıtma ve diğer bulaşıcı hastalık salgınlarını 2030 yılına kadar ortadan kaldırmaya yönelik cesur bir taahhüttür. Amaç, herkesin genel sağlık hizmeti, güvenli ve erişilebilir ilaç ve aşıya kavuşmasını sağlamaktır. Aşı araştırma ve geliştirmelerinin desteklenmesi, bu sürecin vazgeçilmez bir parçasıdır.

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Open Access
Can CA-125 Predict Lymph Node Metastasis in Epithelial Ovarian Cancers in Turkish Population?
(2014-01-01T00:00:00Z) Sudolmus, Sinem; Koroglu, Nadiye; Yildirim, Gokhan; Ulker, Volkan; Gulkilik, Ahmet; DANSUK, RAMAZAN; DANSUK, RAMAZAN
Objective. The role of single preoperative serum CA-125 levels in predicting pelvic or paraaortic lymph node metastasis in patients operated for epithelial ovarian cancer has been investigated. Methods. 176 patients diagnosed with epithelial ovarian carcinoma after staging laparotomy between January 2002 and May 2010 were evaluated retrospectively. Results. The mean, geometric mean, and median of preoperative serum CA-125 levels were 632,6, 200,29, and 191,5 U/mL, respectively. The cut-off value predicting lymph node metastases in the ROC curve was 71,92 U/mL, which is significant in logistic regression analysis (P = 0.005). The preoperative log CA-125 levels were also statistically significant in predicting lymph node metastasis in logistic regression analysis (P = 0.008). Conclusions. The tumor marker CA-125, which increases with grade independent of the effect of stage in EOC, is predictive of lymph node metastasis with a high rate of false positivity in Turkish population. The high false positive rate may obscure the predictive value of CA-125.
Open Access
Multiple myeloma mimicking metastatic lung cancer
(2015-01-01) Furuncuoglu, Yavuz; Cirak, Yalcin; Turk, HACI MEHMET; BASAR, Melih; Ortapamuk, Hulya; KAUR, Ahmet Cemil; TÜRK, HACI MEHMET
Multiple myeloma is a hematological malignancy characterized by a clonal proliferation of plasma cells in the bone marrow. Extramedullary dissemination of multiple myeloma is uncommon. Only in rare cases, the malignant plasma cells of multiple myeloma had infiltrated the lung parenchyma. In this case report, we presented a case of multiple myeloma with lung plasmacytoma, in a 42-year-old patient, hospitalized for pain and infiltrative mass in the right lung. The results of his initial evaluation with computed tomography and positron emission tomograpy scanning, resembled lung tumor with bone metastasis. Surprisingly, biopsies from lung tumor and bone metastasis, revealed malignant plasma cells. We found M spike in protein electrophoresis and lambda monoclonal band in immune electrophoresis. A bone marrow biopsy evaluation was done and justified multiple myeloma diagnosis before hematology referral. Multiple myeloma diagnosis at the age of 42 is quite rare.
Open Access
Ala-9Val polymorphism of Mn-SOD gene in sickle cell anemia
(2011-01-01T00:00:00Z) Sogut, S.; Yonden, Z.; Kaya, H.; Oktar, S.; Tutanc, M.; Yilmaz, H. R.; Yigit, A.; Ozcelik, N.; Gali, E.
Oxidative stress may be contributory to the pathophysiology of the abnormalities that underlie the clinical course of sickle cell anemia. We looked for a possible genetic association between the functional polymorphism Ala-9Val in the human Mn-SOD gene and sickle cell anemia. One hundred and twenty-seven patients with sickle cell anemia and 127 healthy controls were recruited into the study. Alanine versus valine polymorphism in the signal peptide of the Mn-SOD gene was evaluated using a primer pair to amplify a 107-bp fragment followed by digestion with the restriction enzyme NgoMIV. In the sickle cell anemia patients, the frequency of Val/Val genotype was approximately 1.4-fold lower and that of Ala/Val was 1.3-fold higher compared to the controls. No significant difference in genotype frequencies was found between patients and controls (chi(2) = 4.561, d.f. = 2, P = 0.101). The Val-9 was the most common allele in patient and healthy subjects. No significant difference in allele frequencies was found between patients and controls (chi(2) = 1.496, d.f. = 1, P = 0.221). We conclude that the Mn-SOD gene polymorphism is not associated with sickle cell anemia.
Open Access
Predictive value of elevated D-dimer in patients undergoing primary angioplasty for ST elevation myocardial infarction
(2013-10-01T00:00:00Z) Akgul, Ozgur; Uyarel, Huseyin; Pusuroglu, Hamdi; Gul, Mehmet; Isiksacan, Nilgun; Turen, Selahattin; Erturk, Mehmet; Surgit, Ozgur; ÇETİN, MUSTAFA; Bulut, Umit; Baycan, Omer F.; Uslu, Nevzat
The aim of this study was to evaluate the prognostic value of D-dimer in patients with STEMI undergoing primary percutaneous coronary intervention (PCI). The prognostic value of D-dimer has been documented in patients with acute coronary syndrome without ST-segment elevation. However, its value in acute ST-segment elevation myocardial infarction (STEMI) remains unclear. We prospectively enrolled 453 consecutive STEMI patients (mean age 55.6 +/- 12.4 years, 364 male, 89 female) undergoing primary PCI. The study population was divided into tertiles based on admission D-dimer values. The high D-dimer group (n=151) was defined as a value in the third tertile [>0.72ug/ml fibrinogen equivalent units (FEU)], and the low D-dimer group (n=302) included those patients with a value in the lower two tertiles (0.72ug/ml FEU). Clinical characteristics, in-hospital and 6-month outcomes of primary PCI were analyzed. The patients of the high D-dimer group were older (mean age 60.1 +/- 13.5 versus 52.4 +/- 10.6, P0.72ug/ml FEU) was found to be a powerful independent predictor of 6-month all-cause mortality (odds ratio: 10.1, 95% confidence interval: 1.24-42.73, P=0.03). These results suggest that a high admission D-dimer, level was associated with increased in-hospital cardiovascular mortality and 6-month all-cause mortality in patients with STEMI undergoing primary PCI. (C) 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins.
Open Access
Fetal exposure to a diabetic intrauterine environment resulted in a failure of cord blood endothelial progenitor cell adaptation against chronic hypoxia
(2015-01-01T00:00:00Z) Dincer, U. Deniz
Gestational diabetes mellitus (GDM) has long-term health consequences, and fetal exposure to a diabetic intrauterine environment increases cardiovascular risk for her adult offspring. Some part of this could be related to their endothelial progenitor cells (EPCs). Understanding the vessel-forming ability of human umbilical cord blood (HUCB)-derived endothelial colony-forming cells (ECFCs) against pathological stress such as GDM response to hypoxia could generate new therapeutic strategies. This study aims to investigate the role of chronic hypoxia in EPCs functional and vessel-forming ability in GDM subjects. Each ECFC was expressed in endothelial and pro-angiogenic specific markers, namely endothelial nitric oxide synthase (eNOS), platelet (PECAM-1) endothelial cell adhesion molecule 1, vascular endothelial-cadherin CdH5 (Ca-dependent cell adhesion molecule), vascular endothelial growth factor A, (VEGFA) and insulin-like growth factor 1 (IGF1). Chronic hypoxia did not affect CdH5, but PECAM1 MRNA expressions were increased in control and GDM subjects. Control hypoxic and GDM normoxic VEGFA MRNA expressions and hypoxia-inducible factor 1-alpha (HIF1a) protein expressions were significantly increased in HUCB ECFCs. GDM resulted in most failure of HUCB ECFC adaptation and eNOS protein expressions against chronic hypoxia. Chronic hypoxia resulted in an overall decline in HUCB ECFCs- proliferative ability due to reduction of clonogenic capacity and diminished vessel formation. Furthermore, GDM also resulted in most failure of cord blood ECFC adaptation against chronic hypoxic environment.
Open Access
Management of Patients with Granulomatous Mastitis: Analysis of 31 Cases
(2012-01-01T00:00:00Z) KAYAHAN, Munire; Kadioglu, HÜSEYİN; MUSLUMANOGLU, Mahmut; KADIOĞLU, HÜSEYİN
Background: Granulomatous mastitis is a benign recurrent disease. Accurate diagnosis is only by histopathology. Patients and Methods: 31 cases with histological diagnosis were retrospectively analyzed. Results: Mean follow-up was 42.4 months for recurrent and 27.8 months for non-recurrent cases. Etiology was tuberculosis in 1 case. 5 cases (16%) relapsed. 6 patients (19.3%) treated with abscess drainage healed completely, but 50% relapsed. Relapses were treated with excision or steroids. Steroid therapy was the initial treatment in 12 cases (38.7%), with 1 relapse (8.3%) which was treated in the same manner. 2 patients had incomplete response necessitating excision, and another 2 developed abscesses which were treated with steroids or excision after drainage. Surgical excision was preferred in 12 cases (38.7%) due to suspicion for carcinoma in 8 patients (25.8%) and/or low probability of poor cosmetic outcome. All healed without complication, and recurrence was observed in 1 case (8.3%) which was treated with re-excision. Conclusion: Both excision and steroid therapy had low and similar relapse rates, but excision was superior to steroid therapy in providing strict diagnosis with much faster healing and fewer complications. In refractory cases, and when deformity is inevitable, steroid therapy should be preferred.
Open Access
Neural precursor cell-expressed developmentally down-regulated 4-like: a new biomarker in the pathophysiology of endometrial cancer
(2018-09-01T00:00:00Z) YILMAZ, ERCAN; GÜL, MEHMET; MELEKOĞLU, RAUF; Coskun, Ebru Inci; Sahin, NURHAN; GÜL, SEMİR; BAŞTEMUR, AYŞE GÜLÇİN; Ciplak, Baris; ŞAHİN, NURHAN
Objectives Endometrial cancer is the most frequent tumor of the female genital tract. Ubiquitin is a small protein (8.5 kDa) found in all eukaryotic cells, binds to substrate proteins via a three-phase enzymatic pathway referred to as ubiquitination and plays an important role in cellular stability. Neural precursor cell-expressed developmentally down-regulated 4-like (NEDD4L) functions in the last phase of this enzymatic process. In this study, we investigated NEDD4L protein expression in endometrial cancer.
Open Access
Serum obestatin and omentin levels in patients with diabetic nephropathy
(2017-02-01) ZORLU, MEHMET; KISKAC, MUHARREM; Gueler, ERAY METİN; GUELTEPE, I.; YAVUZ, E.; CELIK, K.; KOCYIGIT, ABDÜRRAHİM; ZORLU, MEHMET; KISKAÇ, MUHARREM; GÜLER, ERAY METİN; KOÇYİĞİT, ABDÜRRAHİM
Introduction: Diabetic nephropathy is the leading cause of chronic kidney disease and accounts for almost 45% of all new patients requiring renal replacement therapy. Omentin and obestatin, two novel proteins were suggested to be associated with insulin resistance, type 2 diabetes and cardiovascular risk factors. Thus, we postulated that they may also have an association with diabetic nephropathy which is known to be an independent cardiovascular risk factor. In order to investigate such an association we compared serum omentin and obestatin levels in type 2 diabetic patients with normoalbuminuria (NA) and macroalbuminuria (MA). Materials and Methods: A total of 81 type 2 diabetic patients were separated into two groups according to their proteinuria status; patients with NA (n = 39) and patients with MA (n = 42). Two groups were compared in terms of serum omentin and obestatin levels. Results: While serum omentin levels did not differ among two groups (P = 0.407), serum obestatin levels were significantly higher in MA group (P = 0.001). Conclusion: The results of this study showed that higher serum levels of obestatin were associated with macro albuminuria suggesting that obestatin may have a role in underlying pathogenic mechanisms that leads to diabetic nephropathy
Open Access
The Effect of Obesity on Brain Diffusion Alteration in Patients with Obstructive Sleep Apnea
(2014-01-01) KILICARSLAN, Rukiye; Alkan, ALPAY; Sharifov, RASUL; Akkoyunlu, MUHAMMED EMİN; Aralasmak, AYŞE; KOCER, Abdulkadir; KART, Levent; ALKAN, ALPAY; SHARIFOV, RASUL; AKKOYUNLU, MUHAMMED EMİN; ARALAŞMAK, AYŞE
Purpose: We investigated diffusion alterations in specific regions of the brain in morbid obese, obese, and nonobese OSA patients and searched whether there is a correlation between BMI and ADC values. Materials and methods: DWIs of 65 patients with OSA were evaluated. The patients were classified according to BMI as morbid obese (n = 16), obese (n = 27), and nonobese (control, n = 22) groups. ADC measurements were performed from 24 different regions of the brain in each patient. The relationship of BMI with ADC values was searched. Results: The ADC values in hypothalamus, insular cortex, parietal cortex, caudate nucleus, frontal white matter, and posterior limb of internal capsule were all increased in obese patients (n = 43) compared to control group. The ADC values of midbrain, hypothalamus, orbitofrontal cortex, and parietal cortex were significantly increased in morbid obese compared to obese patients. In obese patients, the degree of BMI was positively correlated with ADC values of orbitofrontal cortex, parietal cortex, and hypothalamus. Conclusion: We observed increasing brain vasogenic edema with increasing BMI, suggesting that the main reason of brain diffusion alteration in patients with OSA could be obesity related.
Open Access
Urinary Tract Effects of HPSE2 Mutations
(2015-04-01T00:00:00Z) Stuart, Helen M.; Roberts, Neil A.; Hilton, Emma N.; McKenzie, Edward A.; Daly, Sarah B.; Hadfield, Kristen D.; Rahal, Jeffery S.; Gardiner, Natalie J.; Tanley, Simon W.; Lewis, Malcolm A.; Sites, Emily; Angle, Brad; Alves, Claudia; Lourenco, Teresa; Rodrigues, Marcia; Calado, Angelina; Amado, Marta; Guerreiro, Nancy; Serras, Ines; Beetz, Christian; Varga, Rita-Eva; Silay, Mesrur Selcuk; Darlow, John M.; Dobson, Mark G.; Barton, David E.; Hunziker, Manuela; Puri, Prem; Feather, Sally A.; Goodship, Judith A.; Goodship, Timothy H. J.; Lambert, Heather J.; Cordell, Heather J.; Saggar, Anand; Kinali, Maria; Lorenz, Christian; Moeller, Kristina; Schaefer, Franz; KARABAY BAYAZIT, AYSUN; Weber, Stefanie; Newman, William G.; Woolf, Adrian S.
Urofacial syndrome (UFS) is an autosomal recessive congenital disease featuring grimacing and incomplete bladder emptying. Mutations of HPSE2, encoding heparanase 2, a heparanase 1 inhibitor, occur in UFS, but knowledge about the HPSE2 mutation spectrum is limited. Here, seven UFS kindreds with HPSE2 mutations are presented, including one with deleted asparagine 254, suggesting a role for this amino acid, which is conserved in vertebrate orthologs. HPSE2 mutations were absent in 23 non-neurogenic neurogenic bladder probands and, of 439 families with nonsyndromic vesicoureteric reflux, only one carried a putative pathogenic HPSE2 variant. Homozygous Hpse2 mutant mouse bladders contained urine more often than did wild-type organs, phenocopying human UFS. Pelvic ganglia neural cell bodies contained heparanase 1, heparanase 2, and leucine-rich repeats and immunoglobulin-like domains-2 (LRIG2), which is mutated in certain UFS families. In conclusion, heparanase 2 is an autonomic neural protein implicated in bladder emptying, but HPSE2 variants are uncommon in urinary diseases resembling UFS.