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SOYSAL, PINAR

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    PublicationOpen Access
    STEM CELLS FOR TREATMENT OF CARDIOVASCULAR DISEASES: AN UMBRELLA REVIEW OF RANDOMIZED CONTROLLED TRIALS.
    (2021-01-09T00:00:00Z) Demurtas, Jacopo; Fanelli, Giuseppe Nicolò; Romano, Simone Lorenzo; Solari, Marco; Yang, Lin; Soysal, Pınar; Sánchez, Guillermo F López; Grabovac, Igor; Smith, Lee; Zorzi, Alessandro; Luchini, Claudio; Veronese, Nicola; SOYSAL, PINAR
    AIMS Stem cells are a promising therapy for various medical conditions. The literature regarding their adoption for the clinical care of cardiovascular diseases (CVD) is still conflicting. Therefore, our aim is to assess the strength and credibility of the evidence on clinical outcomes and application of stem cells derived from systematic reviews and meta-analyses of intervention studies in CVD. METHODS and RESULTS Umbrella review of systematic reviews with meta-analyses of randomized controlled trials (RCTs) using placebo/no intervention as control group. For meta-analyses of RCTs, outcomes with a random-effect p-value< 0.05, the GRADE (Grading of Recommendations Assessment, Development and Evaluation) assessment was used, classifying the evidence from very low to high. From 184 abstracts initially identified, 11 meta-analyses (for a total of 34 outcomes) were included. Half of the outcomes were statistically significant (p < 0.05), indicating that stem cells are more useful than placebo. High certainty of evidence supports the associations of the use of stem cells with a better left ventricular end systolic volume and left ventricular ejection fraction (LVEF) in acute myocardial infarction; improved exercise time in refractory angina; a significant lower risk of amputation rate in critical limb ischemia; a higher successful rate in complete healing in case of lower extremities ulcer; and better values of LVEF in systolic heart failure, as compared to placebo. CONCLUSION and RELEVANCE The adoption of stem cells in clinical practice is supported by a high certainty of strength in different CVD, with the highest strength in acute myocardial infarction and refractory angina.
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    PublicationOpen Access
    Determinants of Mortality Among Elderly Subjects with Chronic Kidney Disease
    (2021-07-01T00:00:00Z) Soysal, Pınar; Heybeli, Cihan; Kazancıoğlu, Rümeyza; SOYSAL, PINAR; KAZANCIOĞLU, RÜMEYZA
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    PublicationOpen Access
    Physical activity and exercise in dementia: an umbrella review of intervention and observational studies
    (2020-12-26T00:00:00Z) Demurtas, Jacopo; Schoene, Daniel; Torbahn, Gabriel; Petrovic, Mirko; Maggi, Stefania; Marengoni, Alessandra; Cesari, Matteo; Lamb, Sarah; Soysal, Pınar; Sieber, Cornel; Shenkin, Susan; Grande, Giulia; Schwingshack, Lukas; Smith, Lee; Veronese, Nicola; SOYSAL, PINAR
    Objectives The aim of this umbrella review was to determine the effect of physical activity/exercise on improving cognitive and noncognitive outcomes in people with MCI (mild cognitive impairment) and dementia. Design Umbrella review of systematic reviews (SR), with or without meta-analyses (MAs), of randomized controlled trials (RCTs) and observational studies. Settings and Participants People with MCI or dementia, confirmed through validated assessment measures. Any form of physical activity/exercise was included. As controls, we included participants not following any prespecified physical activity/exercise intervention or following the same standard protocol with the intervention group. Methods The protocol was registered in PROSPERO (CDR 164197). Major databases were searched until December 31, 2019. The certainty of evidence of statistically significant outcomes was evaluated using the Grading of Recommendations Assessment, Development and Evaluation approach. SRs' findings, without a formal MA, were reported descriptively. Results Among 1160 articles initially evaluated, 27 SRs (all of RCTs, 9 without MA) for a total of 28,205 participants with MCI/dementia were included. In patients with MCI, mind-body intervention (standardized mean difference [SMD] = 0.36; 95% confidence intervals [CI] 0.20–0.52; low certainty) and mixed physical activity interventions (SMD = 0.30; 95% CI 0.11–0.49; moderate certainty) had a small effect on global cognition, whereas resistance training (SMD = 0.80; 95% CI 0.29–1.31; very low certainty) had a large effect on global cognition. In people affected by dementia, physical activity/exercise was effective in improving global cognition in Alzheimer disease (SMD = 1.10; 95% CI 0.65–1.64; very low certainty) and in all types of dementia (SMD = 0.48; 95% CI 0.22–0.74; low certainty). Finally, physical activity/exercise improved noncognitive outcomes in people with dementia including falls, and neuropsychiatric symptoms. Conclusions and Implications Supported by very low-to-moderate certainty of evidence, physical activity/exercise has a positive effect on several cognitive and noncognitive outcomes in people with MCI and dementia, but RCTs, with low risk of bias/confounding, are still needed to confirm these relationships.
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    PublicationOpen Access