Goal: 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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Publication Metadata only Kanser ve D vitamini ilişkisi/ The relationship between cancer and vitamin D(2021-08-01T00:00:00Z) Usul, Melisa; GÜNEŞ BAYIR, AYŞE; GÜNEŞ BAYIR, AYŞEPublication Open Access Synthetic DNA Vaccines Adjuvanted with pIL-33 Drive Liver-Localized T Cells and Provide Protection from <i>Plasmodium</i> Challenge in a Mouse Model.(2020-01-10T00:00:00Z) Reeder, SM; Reuschel, EL; Bah, MA; Yun, K; Tursi, NJ; Kim, KY; Chu, J; Zaidi, FI; Yilmaz, I; Hart, RJ; Perrin, B; Xu, Z; Humeau, L; Weiner, DB; Aly, Ahmed Sayed Ibrahım; ALY, AHMED SAYED IBRAHıMThe need for a malaria vaccine is indisputable. A single vaccine for Plasmodium pre-erythrocytic stages targeting the major sporozoite antigen circumsporozoite protein (CSP) has had partial success. Additionally, CD8+ T cells targeting liver-stage (LS) antigens induced by live attenuated sporozoite vaccines were associated with protection in human challenge experiments. To further evaluate protection mediated by LS antigens, we focused on exported pre-erythrocytic proteins (exported protein 1 (EXP1), profilin (PFN), exported protein 2 (EXP2), inhibitor of cysteine proteases (ICP), transmembrane protein 21 (TMP21), and upregulated in infective sporozoites-3 (UIS3)) expressed in all Plasmodium species and designed optimized, synthetic DNA (synDNA) immunogens. SynDNA antigen cocktails were tested with and without the molecular adjuvant plasmid IL-33. Immunized animals developed robust T cell responses including induction of antigen-specific liver-localized CD8+ T cells, which were enhanced by the co-delivery of plasmid IL-33. In total, 100% of mice in adjuvanted groups and 71%–88% in non-adjuvanted groups were protected from blood-stage disease following Plasmodium yoelii sporozoite challenge. This study supports the potential of synDNA LS antigens as vaccine components for malaria parasite infection.Publication Open Access COVİD-19 PANDEMİSİNDE Hastalık/Hastane Yönetimi-COVID-19 VE SOLUNUM REHABİLİTASYONU(2021-09-01T00:00:00Z) Aydın, Teoman; AYDIN, TEOMANPublication Open Access Comparative Evaluation of Orthostatic Hypotension in Patients with Diabetic Nephropathy.(2021-07-20T00:00:00Z) Aytaş, Gamze; Elçioğlu, Ömer C; Kazancıoğlu, Rümeyza; Gürsu, Meltem; Artan, A Serra; Yabacı, Ayşegül; Soysal, PINAR; Bilgi, Kadir; Özçelik, Semra; KAZANCIOĞLU, RÜMEYZA; ELÇİOĞLU, ÖMER CELAL; GÜRSU, MELTEM; YABACI TAK, AYŞEGÜL; SOYSAL, PINAR; ÖZÇELİK, SEMRAIntroduction: Orthostatic hypotension (OH) affects 5-20% of the population. Our study investigates the presence of OH in diabetic nephropathy (DNP) patients and the factors affecting OH in comparison with nondiabetic chronic kidney disease (NDCKD) patients. Method: Patients presented to the nephrology clinic, and those who consented were included in the study. DNP was defined by kidney biopsy and/or clinical criteria. NDCKD patients of the same sex, age, and eGFR were matched to DNP patients. Demographic parameters and medications were obtained from the records. OH was determined by Mayo clinic criteria. The same researcher used an electronic device to measure blood pressure (BP). All samples were taken and analyzed the same day for biochemical and hematologic parameters and albuminuria. Results: 112 (51 F, 61 M, mean age: 62.56 ± 9.35 years) DNP and 94 (40 F, 54 M, mean age: 62.23 ± 10.08 years) NDCKD patients were included. There was no significant difference between DNP and NDCKD groups in terms of OH prevalence (70.5 vs. 61.7%, p = 0.181). Male patients had significantly higher OH prevalence than female patients (74.7 vs. 60.0%, p = 0.026). There was no significant difference in change in systolic BP between the groups (24.00 [10.00-32.00] mm Hg vs. 24.00 [13.75-30.25] mm Hg, p = 0.797), but the change in diastolic BP was significantly higher in the DNP group (8.00 [2.00-13.00] mm Hg vs. 6.00 [2.00-9.00] mm Hg, p = 0.025). In the DNP group, patients with OH had significantly higher uric acid levels than those without OH (7.18 ± 1.55 vs. 6.36 ± 1.65 mg/dL, p = 0.017). And, 73.7% of patients on calcium channel blockers developed OH (p = 0.015), and OH developed in 80.6% of 36 patients on alpha-blockers (p = 0.049). Conclusion: OH prevalence is very high in CKD, and etiology of CKD does not have a statistically significant effect on the frequency of OH, despite a difference that could be meaningful clinically. Therefore, patients with CKD are checked for OH, with or without concurrent diabetes mellitus. Evaluation of postural BP changes should be a part of nephrology practice.Publication Open Access Impacts of Demographic and Clinical Characteristics on Disease Severity and Mortality in Patients with Confirmed COVID-19(2021-01-01T00:00:00Z) Az, Adenn; Sogut, Ozgur; Akdemir, Tarik; Ergenc, Huseyin; Dogan, Yunus; ÇAKIRCA, MUSTAFA; ÇAKIRCA, MUSTAFABackground: We investigated potential predictive factors for mortality and disease severity from demographic and clinical data, comorbidities, and laboratory findings in patients with confirmed COVID-19 who were consecutively admitted to our tertiary hospital. Methods: In this retrospective, single-center, observational study, we enrolled consecutive 540 adult patients who had COVID-19 confirmed by a molecular method. Patients were categorized into three groups based on disease severity. Patients’ demographic and clinical characteristics, mortality rates, and mortality-associated factors were analyzed. Results: The overall mortality rate was 4.3% (23/540). Disease severity was mild in 40.9% (n = 221), severe in 53.7% (n = 290), and critical in 5.4% (n = 29) of the patients. There were significant differences among groups in terms of median white blood cell (WBC), hemoglobin, neutrophil, lymphocyte, and thrombocyte counts, as well as C-reactive protein (CRP), procalcitonin, lactate dehydrogenase (LDH), creatinine, albumin, D-dimer, ferritin, troponin, and fibrinogen levels. Furthermore, there were significant differences between surviving and non-surviving patient groups in terms of median WBC, hemoglobin, neutrophil, and lymphocyte counts, as well as CRP, procalcitonin, LDH, creatinine, albumin, D-dimer, and ferritin levels. CRP level (odds ratio [OR]: 1.020, 95% confidence interval [CI]: 1.009– 1.032; p < 0.001), and CURB-65 score (OR: 4.004, 95% CI: 1,288–12,447; p = 0.017) were independently associated with disease severity and mortality. Conclusion: On admission, WBC, neutrophil, lymphocyte, and platelet counts can be used to predict disease severity in patients with COVID-19. CRP, ferritin, LDH, creatinine, troponin, D-dimer, fibrinogen, and albumin levels can also be used to predict disease severity in these patients. Finally, elevated CRP level and high CURB-65 score were predictors of disease severity and mortality.Publication Open Access The relationship of neutrophil to lymphocyte ratio with testicular cancer(2020-01-01) İlktaç, Abdullah; Akbulut, Habib; Akçay, Muzaffer; Ersöz, Cevper; Doğan, Bayram; İLKTAÇ, ABDULLAH; DOĞAN, BAYRAM; ERSÖZ, CEVPER; AKÇAY, MUZAFFER; AKBULUT, HABİBPurpose: To assess the relationship between testicular germ cell tumors (TGCT) and neutrophil to lymphocyte ratio (NLR) and to determine whether this ratio can be used as a serum tumor marker. Material and Methods: Sixty-one patients with testicular germ cell tumors were included into the study. Patients were grouped as localized and non-localized. Histologically patients were categorized as seminoma and nonseminomatous germ cell tumors. Complete blood cell count was measured the day before surgery and at the postoperative 1st month. Preoperative and postoperative mean NLR values were compared. Results: Thirty-six patients (59%) had seminomas and 25 patients (41%) had nonseminomatous testicular cancer. Forty-fi ve patients (73.8%) had localized and 16 patients (26.2%) had non-localized testicular cancer. There was a statistically signifi cant difference between preoperative and postoperative mean NLR of the localized patients (p=0.001) but no such difference was detected for non-localized patients (p=0.576). Nineteen patients with localized seminomas had normal preoperative serum tumor markers. There was a signifi cant difference between preoperative and postoperative mean NLR in this group of patients (p=0.010). Twenty-six patients with localized tumors had preoperative increased serum tumor markers which normalized after orchiectomy. Mean NLR of these patients signifi cantly decreased from 3.10±2.13 to 1.62±0.59 postoperatively (p=0.010). Conclusions: NLR appears to be a useful marker for TGCT. It is successful in predicting localized and non-localized disease in early postoperative period.Publication Metadata only Determination of Pharmaceutical Care Needs of COVID-19 Patients in the 1st Wave of Pandemic(2021-09-08T00:00:00Z) Gökçe, Naçize; Bektay, Muhammed Yunus; İzzettin, Fikret Vehbi; BEKTAY, MUHAMMED YUNUS; İZZETTİN, FIKRET VEHBITurkey In 2020 COVID-19 pandemic spread all over the world. A multidisciplinary approach isnecessary for the treatment. The aim of this study is to determine the pharmaceutical care need of COVID-19 patients in the 1st wave of the pandemic. A retrospective, observational study was conducted. After ethical approval was given with 13/274 number, prescription records were investigated by a clinical pharmacist (CP). drug-related problems (DRP)identified through prescription examination. Study was held in 2 branches (i) hospitalized patients (HP) where CP is present and (ii) ambulatory care patients (AP). In this study 183HP and 182 AP patients prescriptions were examined. Half of the participants were female89 (%48.6), 83 (%45.6) for HP and AP respectively. The mean±SD age for HPs and APs were42±18, 42,5±16 respectively. Many participants had multiple comorbidities, in HPs 91(%49.5) at least have 2 or more existing diseases. The median medication number of HPsand APs were 7, 5 respectively. CP identified DRP events for HPs and APs 144, 306respectively. The most common DRP for HPs was using ondansetron instead of metoclopramide. On the other hand, the most prevalent DRP for APs was lack of any gastroprotective medication. DRPs are probable events. Our results demonstrated that HPshad a lower number of DRPs. This points out that CP is a valuable asset to prevent DRPs. In conclusion, every setting where a clinical pharmacist is present should be involved in the healthcare and take responsibility.Publication Metadata only How to overcome barriers to publication in low- and middle-income countries: Recommendations from early career psychiatrists and researchers from around the world(2021-12-01T00:00:00Z) El Halabi, Sarah; Abbas, Zargham; Adesokun, Fisayo; Adiukwu, Frances; Ashrafi, Agah; de Filippis, Renato; Handuleh, Jibril; Jaguga, Florence; Karaliuniene, Ruta; KILIÇ, ÖZGE; Nagendrappa, Sachin; Ojeahere, Margaret; Ogunnubi, Oluseun Peter; Ori, Dorottya; Orsolini, Laura; Pereira-Sanchez, Victor; Pinto da Costa, Mariana; Ransing, Ramdas; Shoib, Sheikh; Ullah, Irfan; Vadivel, Ramya; Vahdani, Bita; Ramalho, Rodrigo; KILIÇ, ÖZGEThere is an increasing movement toward international collaboration and global discussion in mental health. If provided with the right opportunities, early career psychiatrists (ECPs) and researchers in mental health can contribute meaningfully to this discussion. However, they often experience multiple barriers when attempting to add their voices via academic publications. We represent a diverse group of ECPs and researchers from all six World Health Organization regions. In this piece, we discuss these barriers, grounded in our first-hand experiences, and put forth a series of recommendations. The most potentially beneficial and immediate way forward is ensuring a much-needed mentorship and support, particularly for low- and middle-income countries. In this regard, international organizations, especially those with a particular focus on education, such as the Section on Education in Psychiatry of the World Psychiatric Association, can play a pivotal role.Publication Metadata only Indirect Effect Of A Dentistry And Medical School Hospital Before And After Covid-19 On The Environment(2021-03-20T00:00:00Z) Ekinci, Esma; Armagan, Sara; KILIÇ, BANUDünya Sağlık Örgütü (WHO)’ne göre küresel ısınma tüm dünyada insanların karşılaştığı ciddi sorunlardan biridir.(WHO 2011) Gelecek nesiller için dünyanın uzun bir süre daha var olması önem taşımaktadır. Dolayısıyla bir diş hekimi olarak çevre dostu bir yöntem kullanarak doğanın ko runmasına yönelik katkı sağlamak bizim sorumluluğumuzdur. Küresel ısınmanın en önemli sebeplerinden biri de çevresel kirliliktir. Yapılan çeşitli araştırmalara göre, diş hekimliğinin çevreye etkisi değerlendirilmiştir. Birleşik Krallık Ulusal Sağlık Sistemi (NHS)’ne göre karbon ayakizine en büyük katkıyı dental servislere yapılan giriş çıkışlar ve tedarik süreci oluşturmaktadır. Diş hekimliği klinikleri, diğer sağlık kuruluşlarına kıyasla daha az atık üretiyor olsa da, son on yılda dental atıklarda önemli bir artış gözlenmektedir. Çeşitli ülkelerde yapılan akademik araştırmalarda, Covid-19 sürecinden bağımsız olarak değerlendirilen kliniklerden esinlenerek Bezmialem Vakıf Üniversitesi Diş Hekimliği ve Tıp Fakültesi Hastanelerinde bir çalışma yapılmıştır. Bu çalışma, Covid-19 öncesi ve sonrası bir diş hekimliği ve tıp fakültesi hastanesinin kullandığı ve harcadığı materyallerin (2019-2020 yıllarının Haziran-Aralık ayları arasındaki dezen-fektan, sabun, kağıt, hasta sayısı, doğalgaz, elektrik ve geri dönüşüm atıkları) derlenmesiyle sağlık sektörünün karbon ayakizinin bu süreçte hangi yönlerde değişime uğradığını belirtmektedir. Matery-allerin belirlenen süreçlerdeki hem yıllık değişimi hem de hasta başına düşen birim değişimi dikkate alınmıştır. Sağlık sektöründeki bireyler olarak bu süreci nasıl değerlendirmiş olduğumuzu gösteren bu çalışma, gelecekte benzer pandemilerin yaşanması durumunda öngörülecek durumları ve dikkat edilmesi gereken noktaları göz önüne sermiştirPublication Metadata only Correlation of host inflammatory cytokines and immune-related metabolites, but not viral NS1 protein, with disease severity of dengue virus infection(2020-08-01T00:00:00Z) Soe, Hui Jen; Manikam, Rishya; Raju, Chandramathi Samudi; Khan, MOHAMMAD ASİF; Sekaran, Shamala Devi; KHAN, MOHAMMAD ASİFSevere dengue can be lethal caused by manifestations such as severe bleeding, fluid accumulation and organ impairment. This study aimed to investigate the role of dengue non-structural 1 (NS1) protein and host factors contributing to severe dengue. Electrical cell-substrate impedance sensing system was used to investigate the changes in barrier function of microvascular endothelial cells treated NS1 protein and serum samples from patients with different disease severity. Cytokines and metabolites profiles were assessed using a multiplex cytokine assay and liquid chromatography mass spectrometry respectively. The findings showed that NS1 was able to induce the loss of barrier function in microvascular endothelium in a dose dependent manner, however, the level of NS1 in serum samples did not correlate with the extent of vascular leakage induced. Further assessment of host factors revealed that cytokines such as CCL2, CCL5, CCL20 and CXCL1, as well as adhesion molecule ICAM-1, that are involved in leukocytes infiltration were expressed higher in dengue patients in comparison to healthy individuals. In addition, metabolomics study revealed the presence of deregulated metabolites involved in the phospholipid metabolism pathway in patients with severe manifestations. In conclusion, disease severity in dengue virus infection did not correlate directly with NS1 level, but instead with host factors that are involved in the regulation of junctional integrity and phospholipid metabolism. However, as the studied population was relatively small in this study, these exploratory findings should be confirmed by expanding the sample size using an independent cohort to further establish the significance of this study.