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 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 Metadata only Inflammation, Frailty and Cardiovascular Disease(2020-01-01T00:00:00Z) SOYSAL, PINAR; Arik, Ferhat; Smith, Lee; Jackson, Sarah E.; IŞIK, AHMET TURAN; SOYSAL, PINARChronic inflammation, which is called -inflamm-aging-, is characterized by an increased level of inflammatory cytokines in response to physiological and environmental stressors, and causes the immune system to function consistently at a low level, even though it is not effective. Possible causes of inflammaging include genetic susceptibility, visceral obesity, changes in gut microbiota and permeability, chronic infections and cellular senescence. Inflammation has a role in the development of many age-related diseases, such as frailty. Low grade chronic inflammation can also increase the risk of atherosclerosis and insulin resistance which are the leading mechanisms in the development of cardiovascular diseases (CVD). As it is well known that the risk of CVD is higher in older people with frailty and the risk of frailty is higher in patients with CVD, there may be relationship between inflammation and the development of CVD and frailty. Therefore, this important issue will be discussed in this chapter.Publication Open 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, PINARBackground & 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.Publication Metadata only Prevalence of depressive symptoms in elderly cancer patients receiving chemotherapy and influencing factors.(2018-09-01T00:00:00Z) ATAG, E; MUTLAY, F; Soysal, PINAR; SEMIZ, HS; KAZAZ, SN; KESER, M; ELLIDOKUZ, H; KARAOGLU, A; SOYSAL, PINARPublication Metadata only Body mass index categories and anxiety symptoms among adults aged ≥ 50 years from low and middle income countries.(2021-10-18T00:00:00Z) Smith, Lee; Pizzol, Damiano; López-Sánchez, Guillermo F; Oh, Hans; Jacob, Louis; Yang, Lin; Veronese, Nicola; Soysal, PINAR; McDermott, Daragh; Barnett, Yvonne; Butler, Laurie; Koyanagi, Ai; SOYSAL, PINARPublication Open 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, PINARAIMS 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.Publication Open 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, PINARBackground: 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.Publication Open 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, PINARThe 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.Publication Metadata only The Challenges of COVID-19 Treatment in Older Patients and Potential Drug Interactions(2020-12-01T00:00:00Z) Ateş Bulut, Esra; Soysal, Pınar; Işık, Ahmet Turan; SOYSAL, PINARPublication Metadata only Anxiety symptoms among informal caregivers in 47 low- and middle-income countries: a cross-sectional analysis of community-based surveys.(2021-11-14T00:00:00Z) Smith, Lee; Shin, Jae Il; Oh, Hans; López Sánchez, Guillermo F; Underwood, Benjamin; Jacob, Louis; Veronese, Nicola; Soysal, PINAR; Butler, Laurie; Barnett, Yvonne; Tully, Mark A; Koyanagi, Ai; SOYSAL, PINAR