Browsing by Author "Yucel, Cigdem"

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Biomonitoring of Oxidative-Stress-Related Genotoxic Damage in Patients with End-Stage Renal Disease
(TOXICS, 2024-02-09) Yuzbasioglu, Yucel; Hazar, Merve; Dilsiz, Sevtap Aydin; Yucel, Cigdem; Bulut, Mesudiye; Cetinkaya, Serdar; Erdem, Onur
Chronic kidney disease (CKD), a common progressive renal failure characterized by the permanent loss of functional nephrons can rapidly progress to end-stage renal disease, which is known to be an irreversible renal failure. In the therapy of ESRD, there are controversial suggestions about the use of regular dialysis, since it is claimed to increase oxidative stress, which may increase mortality in patients. In ESRD, oxidative-stress-related DNA damage is expected to occur, along with increased inflammation. Many factors, including heavy metals, have been suggested to exacerbate the damage in kidneys; therefore, it is important to reveal the relationship between these factors in ESRD patients. There are very few studies showing the role of oxidative-stress-related genotoxic events in the progression of ESRD patients. Within the scope of this study, genotoxic damage was evaluated using the comet assay and 8-OHdG measurement in patients with ESRD who were undergoing hemodialysis. The biochemical changes, the levels of heavy metals (aluminum, arsenic, cadmium, lead, and mercury) in the blood, and the oxidative biomarkers, including superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), and malondialdehyde (MDA) levels were evaluated, and their relationship with genotoxic damages was revealed. Genotoxicity, oxidative stress, and heavy-metal levels, except mercury, increased significantly in all renal patients. DNA damage, 8OHdG, and MDA significantly increased, and GSH significantly decreased in patients undergoing dialysis, compared with those not having dialysis. The duration and the severity of disease was positively correlated with increased aluminum levels and moderate positively correlated with increased DNA damage and cadmium levels. In conclusion, this study revealed that the oxidative-stress-related DNA damage, and also the levels of Al and Cd, increased in ESRD patients. It is assumed that these changes may play an important role in the progression of renal damage. Approaches for reducing oxidative-stress-related DNA damage and heavy-metal load in ESRD patients are recommended.
Sexual Health/Reproductive Health-Related Problems of Lesbian, Gay, Bisexual and Transgender People in Turkey and Their Health-Care Needs
(2020) Taskın, Lale; Erenel, Ayten Senturk; Sozbir, Sengul Yaman; Gonenc, Ilknur Munevver; Yucel, Cigdem; Dikmen, Hacer Alan; Cetinkaya, Sahika Simsek
Aim: To determine sexual and reproductive health problems and needs of lesbian, gay, bisexual and transgender people based on their experiences and to develop solutions. Method: A mixed method, which includes quantitative (descriptive) and qualitative (phenomenological) methods, was used (n=106). An online questionnaire was used to collect the data. Results: Of the participants, 42.5% stated that they had experienced problems receiving sexual and reproductive health-care services, and 77.8% of those who stated they had problems indicated that the attitude of the health-care professionals was discriminatory or unfavorable. In the qualitative analysis, two themes were created: "Experiences during Health-care Services" and "Recommendations for Health Services." Conclusion: It was determined that lesbian, gay, bisexual and transgender individuals have sexual problems, sexually transmitted diseases, and suffer from sexual harassment. However, it was found that they do not receive sufficient health-care due to health-care professionals' attitudes, homophobia, and disregard of privacy or confidentiality. In line with the results of the present research and the suggestions of the participants, it is suggested that training programs should be organized for health-care professionals providing services for lesbian, gay, bisexual and transgender people to raise awareness and ultimately promote more effective services.
Validity and Reliability of the Turkish Version of the Optimality Index-US (OI-US) to Assess Maternity Care Outcomes
(2015) Yucel, Cigdem; Taskin, Lale; Low, Lisa Kane; 26299370
Background: although obstetrical interventions are used commonly in Turkey, there is no standardized evidence-based assessment tool to evaluate maternity care outcomes. The Optimality Index-US (OI-US) is an evidence-based tool that was developed for the purpose of measuring aggregate perinatal care processes and outcomes against an optimal or best possible standard. This index has been validated and used in Netherlands, USA and UK until now. Objective: the objective of this study was to adapt the OI-US to assess maternity care outcomes in Turkey. Design: translation and back translation were used to develop the Optimality Index-Turkey (OI-TR) version. To evaluate the content validity of the OI-TR, an expert panel group (n= 10) reviewed the items and evidence-based quality of the OI-TR for application in Turkey. Following the content validity process, the OI-TR was used to assess 15O healthy and 15O high-risk pregnant women who gave birth at a high volume, urban maternity hospital in Turkey. The scores between the two groups were compared to assess the discriminant validity of the OI-TR. The percentage of agreement between two raters and the Kappa statistic were calculated to evaluate the reliability. Findings: content validity was established for the OI-TR by an expert group. Discriminant validity was confirmed by comparing the OI scores of healthy pregnant women (mean OI score= 77.65%) and those of high-risk pregnant women (mean OI score =78.6O%). The percentage of agreement between the two raters was 96.19, and inter-rater agreement was provided for each item in the OI-TR. Conclusion: OI-TR is a valid and reliable tool that can be used to assess maternity care outcomes in Turkey. The results of this study indicate that although the risk statuses of the women differed, the type of care they received was essentially the same, as measured by the OI-TR. Care was not individualised based on risk and for a majority of items was inconsistent with evidence based practice, which is not optimal. Implications for practice: use of the OI-TR will help to provide a standardized way to assess maternity care process and outcomes of maternity care in Turkey which can inform future research aimed at improving maternity care outcomes. (C) 2015 Elsevier Ltd. All rights reserved.