Sağlık Bilimleri Enstitüsü / Health Science Institute
Permanent URI for this collectionhttps://hdl.handle.net/11727/1393
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Item Investigating The Effects of Poverty on Health and Quality of Life in Poor People Aged 65 and Over in Etimesgut District, Ankara(2014) Yilmaz, Fikriye; Celik, Cansu; Numanoglu Tekin, Rukiye; https://orcid.org/0000-0002-4884-3803; AAZ-4775-2020Introduction: The purpose of this research was to examine the effects of poverty on health and quality of life of poor people aged 65 and over in Etimesgut District, Ankara. Materials and Method: A questionnaire was administered to 116 people over the age of 65 who were deemed a priority group for assistance by the Etimesgut Social Assistance and Solidarity Foundation in Ankara. The questionnaire comprised questions related to socio-demographic characteristics, health status and health care utilization of elderly people, along with the World Health Organization Quality of Life Instrument-Older Adults Module. Research data were evaluated using the Chi-Square Test, Independent Samples T Test, One-Way Analysis of Variance, Mann-Whitney U Test and Kruskal-Wallis Test. Results: The average monthly income of the elderly participants was 168.94 +/- 54.67 Turkish liras and they lived completely under the poverty line determined for Turkey. However, it was found that women, illiterate participants and those receiving the old age pension were poorer, and of those whose income was below average, more delayed/did not seek help when they were ill. Statistical analysis revealed that total quality of life scores of participants aged 65-74 and literate participants were higher; the "social participation" scores of participants whose income was below average and those received an old-age pension were lower. Conclusion: Poverty has negative effects on the health status, health care utilization and quality of life of elderly people.Item Relationship Between Exercise Perception With Physical Activity Level, Body Awareness, and Illness Cognition in Renal Transplant Patients: A Pilot Study(2019) Tigli, Ayca; Soy, Ebru Hatice Ayvazoglu; Aytar, Aydan; Moray, Gokhan; Haberal, Mehmet; https://orcid.org/0000-0002-0993-9917; https://orcid.org/0000-0003-2498-7287; https://orcid.org/0000-0002-3462-7632; 30777573; AAC-5566-2019; HIR-3735-2022; AAE-1041-2021; AAJ-8097-2021Objectives: Transplantation offers better quality of life and long-term survival benefits. Further knowledge is needed regarding exercise in daily life of transplant recipients. Here, we investigated the relationship between exercise perception and physical activity level, body awareness, and illness cognition in renal transplant patients. Materials and Methods: Our study included 53 renal transplant recipients (Standardized Mini-Mental Test score = 26.35 +/- 1.36; age = 41.11 +/- 13.52 year, body mass index = 25.96 +/- 5.26 kg/m(2), elapsed time after transplant = 3.68 +/- 1.53 year). Perceived benefits and barriers to exercise, physical activity level, body awareness, and illness cognition were assessed with the Exercise Benefits/Barriers Scale, International Physical Activity Questionnaire, Body Awareness Questionnaire, and Patient Illness Perception Questionnaire, respectively. Correlations were established with Spearman test for nonparametric data, with regression analysis used to find determinants of physical activity levels. Results: We observed correlations between physical activity level and perceived benefits and barriers to exercise. There was a positive relationship between body awareness and perceived benefits and barriers to exercise and also illness cognition, with significant correlation between perceived benefits and barriers to exercise and illness cognition (P < .05). Perceived benefits and barriers to exercise (P = .006, R = 0.373, R2 = 0.139, beta = 0.373, t = 2.867, F = 8.22) were determining factors for physical activity level. Conclusions: Psychologic and physical factors, including negative emotions and body dissatisfaction, are risk factors for poor quality of life. Although it is important to increase quality of life, tools to enhance body awareness and to develop strategies to alter motor behaviors in daily living activities are needed. Treatment and assessment strategies on body awareness and illness perception should be considered, with emphasis on the importance of physical activity posttransplant.Item Exposure of Pregnant Women to Violence by Partners and Affecting Factors in Turkey(2016) Alan, Hacer; Koc, Gulten; Taskin, Lale; Eroglu, Kafiye; Terzioglu, FusunThis study aims to determine the exposure of women to violence by their partners during pregnancy and the factors affecting this condition. The current study conducted as descriptive included a total of 442 pregnant women who were married and at the last trimester of their pregnancy. The data were collected using a semi-structure questionnaire and face to face interview with the pregnant women and were evaluated using descriptive statistics, chi-square test, and logistic regression analysis. Of the pregnant women, 39.8 % experienced at least one type of violence, and the most common type of violence experienced was verbal violence (31.4 %). Among the participants, 18.2 % exposed to violence expressed that their partners perpetrated violence because of jealousy, and 30.1 % reported that they just cried when exposed to violence. According to the results of the logistic regression analysis, insufficient prenatal care increases all types of violence in pregnancy. Working with pregnant women and their partners together under the scope of prenatal care services, and especially planning the attempts to prevent violence by discussing the causes of violence with couples, will facilitate more successful violence prevention programs.Item Scenarios to Manage The Hepatitis C Disease Burden and Associated Economic Impact of Treatment in Turkey(2017) Ormeci, Necati; Malhan, Simten; Balik, Ismail; Ergor, Gul; Razavi, Homie; Robbins, Sarah; 29027109Hepatitis C virus (HCV) infection is a significant health problem. The aim of this study is to evaluate the cost-effectiveness of HCV treatment and estimate its economic burden in Turkey. An Excel-based disease progression model was used to estimate the HCV-infected population for 2015-2030. Direct costs in US dollars (USD) including diagnostic, laboratory, and healthcare costs were provided by experts in the country. Indirect costs were estimated as lost productivity using the World Health Organization (WHO) disability-adjusted life years (DALYs) metric from the Global Burden of Disease study. Three scenarios were developed to estimate the cost-effectiveness of HCV treatment through 2030: Base 2016, Increase Treatment and SVR (where SVR is sustained virological response), and WHO Targets. Additionally, the WHO Targets scenario was assessed at three different treatment price points: 10,900 USD, 16,730 USD (base cost), and 27,285 USD. Cumulative total direct and indirect costs (2015-2030) for the WHO Targets scenario were estimated to be 10.8 billion USD, or a 1.5 % increase compared with Base 2016. However, by the following decade, due to a marked decline in DALYs, cumulative direct and indirect costs were estimated to be 45 % less when compared with Base 2016. At a threshold of 9125 USD, all scenarios were cost-effective. By implementing the WHO Targets scenario, Turkey would be able to lower HCV prevalence by 80 % and reduce the total number of liver-related deaths by > 65 % by 2030. Treating HCV infection in the country is cost-effective if healthcare and indirect costs are taken into consideration.Item The Effects of Clinical Pilates Exercises on Patients with Shoulder Pain: A Randomised Clinical Trial(2017) Atilgan, Esra; Aytar, Aydan; Caglar, Aslican; Tigli, Ayca Aytar; Arin, Gamze; Yapali, Gokmen; Kisacik, Pinar; Berberoglu, Utku; Sener, Hulya Ozlem; Unal, Edibe; 29037638; HIR-3735-2022Aim: The purpose of this study was to determine the effect of Clinical Pilates exercises on patients with shoulder pain. Material and methods: Thirty-three patients, experiencing shoulder pain continuously for at least four weeks were selected as study subjects. The patients were randomly divided into two groups, namely Clinical Pilates exercise (n = 17) group and conventional exercise (n = 16) group. The patients were treated for five days a week, the total treatment being carried out for 10 days. The assessment of pain and disability amongst the patients were done at the baseline and at the end of the treatment sessions, using Visual Analogue Scale (VAS) and Shoulder Pain and Disability Index (SPADI). Results: The clinical Pilates exercise group showed a significant improvement in all scores used for assessment (p < 0.05), while the conventional exercise group demonstrated a significant improvement only in the SPADI total score (p < 0.05). A comparison of scores for the VAS, SPADI-Pain and SPADI-Total between the two groups, revealed a significant improvement in the Clinical Pilates exercise group (p < 0.05). Conclusion: It was demonstrated by the study that Clinical Pilates exercise is an efficient technique for patients experiencing shoulder pain, as it helps reduce pain and disability among them. (c) 2017 Elsevier Ltd. All rights reserved.Item Sagittal skeletal correction using symphyseal miniplate anchorage systems: Success rates and complications(2019) Cubuk, Secil; Kaya, Burcak; Sahinoglu, Zahire; Ates, Ufuk; Ozcirpici, Ayca Arman; Uckan, Sina; 30413832ObjectivesAim of this study is to evaluate success rates and complications related with symphyseal miniplate anchorage systems used for treatment of Class2 and Class3 deformities.MethodsAtotal of 58miniplates applied to 29growing patients were evaluated. The first group comprised 24symphyseal miniplates applied to 12patients and Forsus Fatigue Resistant Devices were attached to the head of the miniplates for mandibular advancement. The second group consisted of 34symphyseal miniplates applied to 17patients and intermaxillary elastics were applied between acrylic appliances placed on the maxillary dental arch and the symphyseal miniplates for maxillary protraction. Success rate and complications of the symphyseal plate-screw anchorage system were evaluated.ResultsThe overall success rate of symphseal miniplates was 87.9%. Six miniplates showed severe mobility and 2miniplates broke during orthodontic treatment. Infection, miniplate mobility and mucosal hypertrophy were statistically different between the two groups.ConclusionsSymphyseal miniplates were generally used as successful anchorage units in most patients. Infection, mobility, and mucosal hypertrophy occurred more frequently in Class2 deformity correction. However, the success rates regarding the two treatment modalities were comparable. ZusammenfassungZieleZiel der vorliegenden Studie ist es, Erfolgsraten und Komplikationen im Zusammenhang mit symphysealen Miniplattenverankerungssystemen zur Behandlung von Klasse-II- und -III-Anomalien zu bewerten.MethodenAusgewertet wurden insgesamt 58Miniplatten, die bei 29Patienten im Wachstum inseriert wurden. In der ersten Gruppe wurden 24symphyseale Miniplatten bei 12Patienten inseriert. Zur Korrektur der Unterkieferrucklage wurden Forsus-Apparaturen an den Miniplatten verankert. In der zweiten Gruppe wurden 34symphyseale Miniplatten bei 17Patienten inseriert. Zur Protraktion des Oberkiefers wurden intermaxillare Elastics verwendet, die zwischen Acrylgeraten im Oberkiefer und den symphysealen Miniplatten eingehangt wurden. Untersucht wurden Erfolgs- und Komplikationsraten des symphysealen Platten-Schrauben-Verankerungssystems.ErgebnisseDie Gesamterfolgsrate der symphsealen Miniplatten betrug 87,9%. Bei 6Miniplatten zeigte sich eine hohe Mobilitat, 2frakturierten wahrend der kieferorthopadischen Behandlung. Das Auftreten von Infektion, Miniplattenmobilitat und Schleimhauthypertrophie war zwischen den beiden Gruppen statistisch unterschiedlich.SchlussfolgerungenSymphyseale Miniplatten wurden in der Regel bei den meisten Patienten als erfolgreiche Verankerungseinheiten eingesetzt. Infektion, Mobilitat und Schleimhauthypertrophie traten haufiger bei Klasse-2-Korrekturen auf, die Ergebnisse beider Behandlungsmethoden unterschieden sich jedoch nur geringfugig.Item Parathyroidectomy improves cardiovascular risk factors in normocalcemic and hypercalcemic primary hyperparathyroidism(2019) Beysel, Selvihan; Caliskan, Mustafa; Kizilgul, Muhammed; Apaydin, Mahmud; Kan, Seyfullah; Ozbek, Mustafa; Cakal, Erman; 31068134BackgroundParathyroidectomy has ameliorated cardiovascular risk factors in patients with hypercalcemic primary hyperparathyroidism (PHPT), but the effect of parathyroidectomy on normocalcemic PHPT is not exactly known. This case-controlled study aimed to investigate the effect of parathyroidectomy on cardiovascular risk factors in patients with normocalcemic and hypercalcemic PHPT.MethodsSubjects with normocalcemic PHPT (n=35), age- and sex-matched hypercalcemic PHPT (n=60) and age- and sex-matched control (n=60) were included. Cardiometabolic disorders were investigated with traditional cardiometabolic risk factors and the Framingham cardiovascular risk score (CRS) before and 6months after parathyroidectomy.ResultsDiabetes, dyslipidemia, hypertension, obesity, insulin resistance, osteoporosis, having fractures were similarly increased in the hypercalcemic and normocalcemic PHPT groups (p>0.05) compared with the controls (p<0.05). Blood pressures, glucose metabolism (glucose, insulin, HOMA-IR) and lipid profiles were similarly increased in the PHPT groups (p>0.05) compared with the controls (p<0.05). After parathyroidectomy, blood pressures, serum total cholesterol, and HOMA-IR were decreased in both PHPT groups (p<0.05). CRS was lower in the controls (5.743.24, p<0.05). After parathyroidectomy, CRS was decreased in the normocalcemic (11.98 +/- 10.11 vs. 7.37 +/- 4.48) and hypercalcemic (14.62 +/- 11.06 vs. 8.05 +/- 7.72) PHPT groups. Increased blood pressures were independent predictors of serum iPTH.Conclusion p id=Par4 The normocalcemic and hypercalcemic PHPT groups had similarly increased cardiovascular risk factors, even independently of serum calcium. Parathyroidectomy ameliorated the increased cardiovascular risk factors in both normocalcemic and hypercalcemic PHPT.Item The effects of enteral supplementation of glutamine and arginine in lipopolysaccharide (LPS) induced sepsis(2019) Bakir, Binnur Okan; Oztezcan, Serdar; Saka, Mendane; Karalti, Iskender; Ozkan, Ferda; Ok, Mehtap Akcil; AAZ-8170-2020Sepsis is the leading cause for death in critically ill patients. While the exact mechanisms are not clear, multiple organ dysfunction syndrome induced by sepsis might cause mitochondrial dysfunction. Spesific nutrients may help regulating immunological and inflammatory responses. Glutamine and arginine amino acids have both important roles in growth, tissue repair, cell renewal and collagen synthesis. There are different results of studies with immunmodulatory nutrients in critically ill patients such, they have no effect on mortality or decrease sepsis incidance. The aim of this study is to evaluate the effects of enteral supplementation of glutamine, arginine and glutamine and arginine combination in lipopolysaccharide (LPS) induced sepsis. Twenty eight male Sprague Dawley rats were randomly divided into four groups: Glutamine, Arginine, Glutamine + Arginine and Control. Glutamine group received 500 mg/kg/day glutamine, Arginine group recieved 500 mg/kg/day arginine, Glutamine + Arginine group received 250 mg/kg/day glutamine and 250 mg/kg/day arginine containing suspension. Rats were fed for 10 days and 3 mg/kg LPS was implemented. 24 hours later, all rats were sacrified. C-Reactive Protein (CRP), Interleukin (IL)-1 beta, IL-6, Tumor Necrosis Factor-alpha(TNF-alpha), Aspartat aminotransferase (AST) and Alanine aminotransferase(ALT) levels were studied, livers were examined histopathologically. Serum TNF-alpha levels were significantly lower in Glutamine + Arginine group in comparison with Control group. Liver histopathology analysis showed that apsis, hepatocyte damage, kupffer cell proliferation and portal inflammation were more frequent and severe in control group than all groups. These results revealed that enteral supply of glutamine, arginine and their combination have positive effects on liver damage and inflammation.Item Maternal genetic contribution to pre-pregnancy obesity, gestational weight gain, and gestational diabetes mellitus(2019) Beysel, Selvihan; Eyerci, Nilnur; Ulubay, Mustafa; Caliskan, Mustafa; Kizilgul, Muhammed; Hafizoglu, Merve; Cakal, Erman; 31114636IntroductionPre-pregnancy obesity, gestational diabetes mellitus (GDM), and gestational weight gain (GWG) are associated with each other. This is the first study to investigate whether genetic variants were associated with having GDM, and whether genetic variants-related GDM were associated with adiposity including pre-pregnancy obesity and excessive GWG in Turkish women.Patients and methodsWomen with GDM (n=160) and without GDM (n=145) were included in case-controlled study. Genotyping of the HNF1A gene (p.I27L rs1169288, p.98V rs1800574, p.S487N rs2464196), the VDR gene (p.BsmI rs1544410, p.ApaI rs7975232, p.TaqI rs731236, p.FokI rs2228570), and FTO gene (rs9939609) SNPs were performed by using RT-PCR.ResultsThe FTO AA genotype was associated with an increased risk of having GDM (AA vs. AT+TT, 24.4% vs. 12.4%, OR=2.27, 95% CI [1.23-4.19], p=0.007). The HNF1A p.I27L GT/TT genotype was associated with increased GDM risk (GT+TT vs. GG-wild, 79.4% vs. 65.5%, OR=2.02, 95% CI 1.21-3.38], p=0.007). However, all VDR gene SNPs and the HNF1A p.A98V, p.S487N were not associated with having GDM (p>0.05). The FTO AA genotype was associated with an increased risk for pre-pregnancy overweight/obesity (OR=1.43, 95% CI [1.25-3.4], p=0.035), but not associated with excessive GWG after adjusting for pre-pregnancy weight (p>0.05). Pre-pregnancy weight, weight at delivery, and GWG did not differ in both VDR and HNF1A gene carriers (p>0.05). HOMA-IR and HbA1c were increased in both p.I27L TT and FTO AA genotype carriers (p<0.05).ConclusionThe adiposity-related gene FTO is associated with GDM by the effect of FTO on pre-pregnancy obesity. The diabetes-related p.I27L gene is associated with GDM by increasing insulin resistance.Item The VDR gene FokI polymorphism is associated with gestational diabetes mellitus in Turkish women(2019) Apaydin, Mahmut; Beysel, Selvihan; Eyerci, Nilnur; Pinarli, Ferda Alparslan; Ulubay, Mustafa; Kizilgul, Muhammed; Ozdemir, Ozhan; Caliskan, Mustafa; Cakal, Erman; 31096931BackgroundThe association between the vitamin D receptor (VDR) gene and gestational diabetes mellitus (GDM) has not been investigated in Turkish pregnant women. We aimed to investigate associations between VDR gene BsmI (rs15444410), ApaI (rs7975232), FokI (rs19735810), and TaqI (rs731236) single nucleotide polymorphisms (SNPs) and GDM.Material-methodsThis case-control study comprised 100 women with GDM and 135 pregnant women without GDM. The VDR polymorphism was evaluated using Sanger-based DNA sequencing.ResultVDR gene ApaI, BsmI, and TaqI SNPs did not differ between women with and without GDM (each, p>0.05). ApaI, BsmI, and TaqI were not associated with GDM risk. The VDR gene FokI CT/TT genotype was associated with an increased GDM risk (CT vs. CC, OR=1.84, 95% CI: [1.05-3.23], p=0.031; TT vs. CC, OR=3.95, 95% CI: [1.56-9.96], p=0.002; CT/TT vs. CC, OR=2.29, 95% CI: [1.35-3.89], p=0.002; and CT/CC vs. TT, OR=3.02, 95% CI: [1.23-7.38], p=0.012). The FokI-TT genotype was more associated with younger age and higher glucose, HbA1c, and HOMA-IR than the CC and CT genotype. FokI-T was positively correlated with log-HOMA-IR (r=0.326, p=0.004). FokI SNPs were independently associated with GDM after adjusting for BMI and age (=1.63, 95% CI: [1. 2-4.2], p=0.012). There were no associations between the FokI, ApaI, BsmI and TaqI haplotypes and GDM.ConclusionVDR gene FokI SNPs were independently associated with having GDM in Turkish women. VDR gene FokI SNPs might contribute to insulin resistance of developing GDM.