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SOYSAL, PINAR

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Start date: 2011 × Has files: true × Rights: info:eu-repo/semantics/openAccess ×

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Now showing 1 - 10 of 40
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    PublicationOpen 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, SEMRA
    Introduction: 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.
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    PublicationOpen Access
    Association between physical multimorbidity and sleep problems in 46 low-and middle-income countries
    (2022-06-01T00:00:00Z) Smith, Lee; Il Shin, Jae; Jacob, Louis; Schuch, Felipe; Oh, Hans; Tully, Mark A.; Lopez Sanchez, Guillermo F.; Veronese, Nicola; SOYSAL, PINAR; Yang, Lin; Butler, Laurie; Barnett, Yvonne; Koyanagi, Ai; SOYSAL, PINAR
    Background: Little is known about the association between multimorbidity (i.e., two or more chronic conditions) and sleep problems in the general adult populations of low- and middle-income countries (LMICs). Thus, we aimed to assess this association among adults from 46 LMICs, and to quantify the extent to which anxiety, depression, stress, and pain explain this association. Methods: Cross-sectional, predominantly nationally representative, community-based data from the World Health Survey were analyzed. Nine chronic physical conditions (angina, arthritis, asthma, chronic back pain, diabetes, edentulism, hearing problems, tuberculosis, visual impairment) were assessed. To be included in the analysis, sleep problems had to have been experienced in the past 30 days and to have been severe or extreme; they included difficulties falling asleep, waking up frequently during the night or waking up too early in the morning. Multivariable logistic regression and mediation analyses were conducted to explore the associations. Results: Data on 237,023 individuals aged ≥18 years [mean (SD) age 38.4 (16.0) years; 49.2% men] were analyzed. Compared with no chronic conditions, having 1, 2, 3, and ≥4 conditions was associated with 2.39 (95%CI=2.14, 2.66), 4.13 (95%CI=3.62, 4.71), 5.70 (95%CI=4.86, 6.69), and 9.99 (95%CI=8.18, 12.19) times higher odds for sleep problems. Pain (24.0%) explained the largest proportion of the association between multimorbidity and sleep problems, followed by anxiety (21.0%), depression (11.2%), and stress (10.4%). Conclusions: Multimorbidity was associated with a substantially increased odds for sleep problems in adults from 46 LMICs. Future studies should assess whether addressing factors such as pain, anxiety, depression,
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    PublicationOpen Access
    An umbrella review of systematic reviews with meta-analyses evaluating positive and negative outcomes of hydroxychloroquine and chloroquine therapy.
    (2020-12-11T00:00:00Z) Celotto, Stefano; Veronese, Nicola; Barbagallo, Mario; Ometto, Francesca; Smith, Lee; Pardhan, Shahina; Barnett, Yvonne; Ilie, Petre Cristian; Soysal, PINAR; Lagolio, Erik; Kurotschka, Peter Konstantin; Tonelli, Roberto; Demurtas, Jacopo; SOYSAL, PINAR
    Background & aims: Hydroxychloroquine (HCQ) and chloroquine (CQ) are anti-malarial drugs frequently used in the rheumatologic field. They were recently identified as potential therapeutic options for Coronavirus Disease (COVID-19). The present study aims to map and grade the diverse health outcomes associated with HCQ/CQ using an umbrella review approach. Methods: Umbrella review of systematic reviews of observational and intervention studies. For observational studies, random-effects summary effect size, 95% confidence interval, and 95% prediction interval were estimated. We also assessed heterogeneity, evidence for small-study effect, and evidence for excess significance bias. The quality of evidence was then graded using validated criteria from highly convincing to weak. The evidence from randomized controlled trials (RCTs) was graded using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) tool. Results: From 313 articles returned in the literature search, six meta-analyses were included (n = 25 outcomes). Among meta-analyses (MAs) of observational studies, HCQ/CQ are weakly associated with a reduced risk for cardiovascular events and diabetes when used for autoimmune diseases and with spontaneous abortion; they are also associated with a higher risk of death in COVID-19 patients. Among MAs of RCTs, HCQ/CQ are associated with an improvement of articular manifestations of rheumatic diseases. Conclusions: There is high evidence of the efficacy of HCQ/CQ in the rheumatologic field. The lack of evidence for efficacy and the risk of death associated with the use of HCQ/CQ for COVID-19 indicate the inappropriateness of their inclusion in recent COVID-19 therapy guidelines and the urgent need for RCTs to determine eventual appropriateness as a COVID-19 therapy. Keywords: COVID-19; Chloroquine; Hydroxychloroquine; umbrella review.
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    PublicationOpen Access
    The Prevalence and Indications of Intravenous Rehydration Therapy in Hospital Settings: A Systematic Review
    (2022-12-31) Gawronska J.; Koyanagi A.; López Sánchez G. F.; Veronese N.; Ilie P. C.; Carrie A.; Smith L.; Soysal P.; SOYSAL, PINAR
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    PublicationOpen Access
    Social environmental impact of COVID-19 and erectile dysfunction: an explorative review.
    (2021-09-24T00:00:00Z) Pizzol, D; Shin, J I; Trott, M; Ilie, P-C; Ippoliti, S; Carrie, A M; Ghayda, R A; Lozano, J M O; Muyor, J M; Butler, L; McDermott, D T; Barnett, Y; Markovic, L; Grabovac, Igor; Koyanagi, A; Soysal, PINAR; Tully, M A; Veronese, N; Smith, L; SOYSAL, PINAR
    Background: To date, no attempt has been made to collate literature on the relationship between the social environmental impact of COVID-19 and erectile dysfunction. The aim of this explorative review was to assess and compare the prevalence of erectile dysfunction (ED) in male healthcare workers and males during the COVID-19 pandemic. Methods: A systematic review of major databases from inception to February 2021 was conducted. Prevalence data were extracted, and a random-effects meta-analysis was undertaken. Outcomes: The pooled prevalence of ED amongst healthcare workers working in COVID-19 specific environments, and non-healthcare during the COVID-19 pandemic. Results: Of 52 initial studies, six were included for the final analysis. The pooled prevalence of ED in healthcare workers working in a COVID-19 environment was 63.6% (95% CI 20.3-92.3%), and in non-healthcare workers during the COVID-19 pandemic was 31.9% (95% CI 19.5-47.6%). Conclusion: The prevalence of ED in healthcare workers working in COVID-19 environments was higher than representative samples and is of concern. Sexual health (and by extension, overall health), should be a priority when considering ways to care for this population. Considering the social environmental impact of COVID-19 on sexual health and in particular on ED, it is important to provide adequate psychological support systems and to promote quality of life with particular attention to sexual health.
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    PublicationOpen Access
    Delirium as the first clinical presentation of the coronavirus disease 2019 in an older adult
    (2020-09-01T00:00:00Z) SOYSAL, PINAR; Kara, Osman; SOYSAL, PINAR
    The coronavirus disease 2019 (COVID‐19) outbreak, which started in China in December 2019 and spread all over the world, affects people from all age groups, but it is more fatal in the elderly. The most common clinical presentations of COVID‐19 in the elderly are fever, dry cough, and chest distress, with a frequency of 94.5%, 69.1%, and 63.9%, respectively. 1 However, many hospitals screened for COVID‐19 based on the presence of only fever and cough. Therefore, elderly patients with these symptoms did not necessarily meet the criteria for screening, although it is well known in geriatric practice that older people do not always have a fever response to infectious diseases. In elderly patients, common infections, such as pneumonia and urinary tract infections, sometimes present only as acute mental state changes such as latergia and confusion. 2 As with other infections, it is quite possible that COVID‐19 can have this type of atypical presentation, but there is not yet any relevant information in the literature. In published studies that have investigated the clinical findings of elderly patients with COVID‐19, atypical presentations have not been addressed. Here, we present a case of an elderly male patient with COVID‐19 who had atypical presentation.
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    PublicationOpen Access
    Triple Test Plus Rapid Cognitive Screening Test: A Combination of Clinical Signs and A Tool for Cognitive Assessment in Older Adults.
    (2019-08-15) Isik, AT; Koc, Okudur; Dokuzlar, O; Kaya, D; SOYSAL, PINAR
    Less time-consuming, easy-to-apply and more reliable cognitive screening tests are essential for use in primary care. The aim of this study was to investigate the diagnostic value of the Turkish version of the Rapid Cognitive Screen (RCS-T) and Triple Test individually and the combination of RCS-T with each sign and Triple Test to screen elderly patients for cognitive impairment (CI). A total of 357 outpatients aged 60 or older, who underwent comprehensive geriatric assessment, were included in the study. Presence or absence of attended alone sign (AAS), head-turning sign, and applause sign was investigated. The mean age of the patients was 74.29 ± 7.46. Of those, 61 patients (28 men, 33 women) had Alzheimer's disease (AD), 59 patients had mild cognitive impairment (MCI) (29 men, 30 women), and 237 (80 men, 157 women) were cognitively robust. The sensitivity of the combination of RCS-T and negative for AAS for CI, AD and MCI is 0.79, 0.86 and 0.61, respectively; the specificity was 0.92, 0.93 and 0.92, respectively; and the positive and negative predictive values revealed good diagnostic accuracy. The combination of RCS-T and negative for AAS is a simple, effective and rapid way to identify possible CI in older adults.
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    PublicationOpen Access
    Handgrip strength and health outcomes: Umbrella review of systematic reviews with meta-analyses of observational studies.
    (2020-06-19T00:00:00Z) Soysal, PINAR; Hurst, C; Demurtas, J; Firth, J; Howden, R; Yang, L; Tully, MA; Koyanagi, A; Ilie, PC; López-Sánchez, GF; Schwingshackl, L; Veronese, N; Smith, L; SOYSAL, PINAR
    Purpose: The aim of the present study was to assess both the credibility and strength of evidence arising from systematic reviews with meta-analyses of observational studies on handgrip strength and health outcomes. Methods: An umbrella review of systematic reviews with meta-analyses of observational studies was conducted. We assessed meta-analyses of observational studies based on random-effect summary effect sizes and their p values, 95% prediction intervals, heterogeneity, small-study effects, and excess significance. We graded the evidence from convincing (Class I) to weak (Class IV). Results: From 504 articles returned in a search of the literature, 8 systematic reviews were included in our review, with a total of 11 outcomes. Overall, 9 of the 11 of the outcomes reported nominally significant summary results (p < 0.05), with 4 associations surviving the application of the more stringent p value (p < 10-6). No outcome presented convincing evidence. Three associations showed Class II evidence (i.e., highly suggestive): (1) higher handgrip values at baseline were associated with a minor reduction in mortality risk in the general population (n = 34 studies; sample size = 1,855,817; relative risk = 0.72; 95% confidence interval (CI): 0.67-0.78), (2) cardiovascular death risk in mixed populations (n = 15 studies; relative risk = 0.84; 95%CI: 0.78-0.91), and (3) incidence of disability (n = 7 studies; relative risk = 0.76; 95%CI: 0.66-0.87). Conclusion: The present results show that handgrip strength is a useful indicator for general health status and specifically for early all-cause and cardiovascular mortality, as well as disability. To further inform intervention strategies, future research is now required to fully understand mechanisms linking handgrip strength scores to these health outcomes.
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    PublicationOpen Access
    What is the relationship between frailty and orthostatic hypotension in older adults?
    (2019-03-01) KOCYIGIT, SE; ISIK, AT; DOKUZLAR, O; AYDIN, AE; BULUT, EA; Soysal, PINAR; SOYSAL, PINAR
    Background Frailty and orthostatic hypotension (OH), which is common in older adults, is associated with morbidity and mortality. The relationship between them remains unclear. The aim of the study is to determine whether there is a relationship between frailty and OH. Methods A total of 496 patients who were admitted to the geriatric clinic and underwent comprehensive geriatric assessment were retrospectively reviewed. In a cross-sectional and observational study, OH was measured by the Head-up Tilt Table test at 1, 3, and 5 min (respectively, OH1, OH3, and OH5) and the frailty was measured by the Fried’s frailty scale. Results The mean age of all patients was 75.4 ± 7.38. The prevalence of females was 69.8%. When the frail people were compared with the pre-frail and the robust ones, the frailty was associated with OH1. There was no relationship between the groups in terms of OH1 when the pre-frail group was compared with the robust group. OH3 were higher in the frail group than in the pre-frail group (P < 0.05) and the OH5 were higher in the frail group than in the pre-frail and robust group (P < 0.05), but OH3 and OH5 were not associated with frailty status when they were adjusted for age (P > 0.05). Slowness and weakness were associated with OH1 (P < 0.05), whereas the other components of the Fried’s test were not. Conclusions Frailty may be a risk factor for OH1. The 1st min measurements of OH should be routinely evaluated in frail older adults to prevent OH-related poor outcomes.
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    PublicationOpen Access
    New horizons in digital innovation and technology in dementia: potential and possible pitfalls.
    (2022-07-26T00:00:00Z) Frisardi, Vincenza; Soysal, PINAR; Shenkin, Susan D; SOYSAL, PINAR