Dahili Tıp Bilimleri Bölümühttps://hdl.handle.net/11655/982024-03-28T12:59:21Z2024-03-28T12:59:21Z40-69 Yaş Arası Hipertansif Bireylerde SCORE2 Eşitliği ile Kardiyovasküler Ölüm Risklerinin Hesaplanması ve Kardiyovasküler Risk FarkındalığıKaradağ, Kübrahttps://hdl.handle.net/11655/348252024-03-22T08:44:26Z2024-01-01T00:00:00Z40-69 Yaş Arası Hipertansif Bireylerde SCORE2 Eşitliği ile Kardiyovasküler Ölüm Risklerinin Hesaplanması ve Kardiyovasküler Risk Farkındalığı
Karadağ, Kübra
Calculation of Cardiovascular Death Risks and Cardiovascular Risk Awareness ith SCORE2 Equation. in Hypertensive Individuals Aged Between 40 and 69 years
The aim of this study is to calculate the cardiovascular diseases risk with a current risk score SCORE2, in individuals have hyperttension which is one of the most important preventable risk factors of cardiovascular diseases diagnosis who applied to family medicine outpatient clinics and to examine the awareness levels of them about cardiovascular diseases risk factors. The study was conducted via a face-to-face survey form with 231 participants diagnosed with hypertension/newly diagnosed with hypertension who applied to Hacettepe Family Medicine outpatient clinics between 26.10.2022 and 26.03.2023, In the first part of the survey there were 20 questions about sociodemographic characteristics and the general health status of the participants, in the second part there was Cardiovascular Disease Risk Awareness Assessment Scale (CVDRAAS) consists of 22 questions. 64.5% of the participants in the study were women and the mean age was 54.18 years. 34.89% of women were obese and 4.69% of them were morbidly obese. While 32.92% of men were obese, there was no one who was morbidly obese. The mean systolic and diastolic blood pressure of the participants were 126.29 mmHg and 80.61 mmHg, respectively. The mean values of total cholesterol, LDL-C, HDL-C and Non-HDL-C were 210.81mg/dL, 136.38 mg/dL, 53.59 mg/dL and 156.41 mg/dL, respectively. A 2 of the participants were using medication. 42.35% of the participants were treated with monotherapy. According to the SCORE2 risk model, diastolic blood pressure was found to be significantly higher in the high-risk group than in the very high-risk group. Both SCORE2 and SCORE risk scores of daily smokers were found to be significantly higher than never smoke and ex-smokers. Both SCORE2 and SCORE risk scores of those who had smoked before but quit were found to be significantly higher than those who had never smoked. According to the SCORE risk model, rheumatological disease rates of patients in the very high risk group were found to be significantly higher than those in the other group. The rate of people using psychiatric drugs was found to be very high and significantly higher in those in the high-risk group compared to other groups. SCORE2 scores of the individuals participating in the study were found to be significantly higher than their SCORE scores. 8.3% of the participants who were determined to be in the very high risk group according to SCORE2 were evaluated in the low or medium risk group according to SCORE, while 20.8% were evaluated in the high risk group. Also, 55.3% of those in the high risk group in SCORE2 were evaluated in the low or medium risk group in SCORE risk scoring. The "Healthy eating intentions" score in CVDRAAS of individuals with known diseases other than hypertension is lower than that of individuals with no known diseases other than hypertension, and the "Heart attack/stroke" knowledge level of those who exercise 1-2 times a week is lower than those who do not exercise at all, 3 times a week and the "Perceived benefits" score of those who exercised more was found to be significantly higher than those who did not exercise at all, and the "Heart attack/stroke" knowledge level of those who preferred their meals with less salt was found to be significantly higher than those who preferred salty meals. As a result, our study showed that; the SCORE2 risk model is a more sensitive assessment than SCORE and is more convenient to use. Cardiovascular disease risk awareness in society is not yet at the desired level. To increase this awareness and for the early diagnosis of patients at risk, family physicians should inform all their patients, whether hypertensive or not, about cardiovascular diseases and they should provide accurate information about diet, exercise, and smoking cessation, and routinely screen patients at risk
2024-01-01T00:00:00ZTürkiye'de İsteyerek Düşüklerin Özellikleri ve Belirleyicileri: Türkiye Nüfus ve Sağlık Araştırması 2018 İleri AnaliziAydoğdu Boğa, ŞebnemAydoğdu Boğahttps://hdl.handle.net/11655/348242024-03-22T08:43:54Z2023-11-15T00:00:00ZTürkiye'de İsteyerek Düşüklerin Özellikleri ve Belirleyicileri: Türkiye Nüfus ve Sağlık Araştırması 2018 İleri Analizi
Aydoğdu Boğa, Şebnem; Aydoğdu Boğa
. In this research, it was aimed to evaluate the relationship between women's characteristics and induced abortion. For this purpose, DHS Türkiye 2018 women's data set and the "event" data set (pregnancies, live births, stillbirths, spontaneous and induced abortions, use of contraceptive methods) defined from this data set were used. 7.7% of the women participating in the study had one induced abortion and 2.8% had two or more induced abortions. 5.8% of pregnancies in the last five years ended up with induced abortion. The number of induced abortions per hundred pregnancies is calculated to be higher in pregnancies belonging to women living in urban areas, with the highest wealth, work with social security, have been married for 30 years or more, have not had a live birth before, have never used any contraceptive method, approve of an induced abortion, can choose a induced abortion, want a child within two years, have had an induced abortion before. Pregnancies of women aged 35 and over ended up with induced abortion three times more than those of women aged 20-34. Pregnancies of women living in the east region ended up with induced abortion 1.9 times more than those of women living in the west. Pregnancies of women have been married for 15 years or more ended up with induced abortion 11 times more than those of women have been married for less than 5 years. Pregnancies of women have only daughters are 20% less likely to end up with an induced abortion than those of women have only sons. Pregnancies of women disapprove of an induced abortion are 70% less likely to end up with an induced abortion than those of women approves. Women living in the west and Istanbul regions, who graduated from high school or above, with the highest wealth were more likely to have their last induced abortion in private institutions. More than half of the pregnancies that ended up with induced abortion did not use any contraceptive method in the previous month. Only one-third of women who had an induced abortion used a modern method after the abortion. It has been suggested that health policies should be sufficiently inclusive in providing services to women who want to have an induced abortion and family planning services be provided with a comprehensive consultancy service.
2023-11-15T00:00:00ZKIRIKKALE İLİNDE ÇALIŞAN MİNİBÜS ŞOFÖRLERİNİN İŞ SAĞLIĞI ve GÜVENLİĞİ KOŞULLARI ile İŞ-YAŞAM DENGESİÖzyürek Ucael, Derenhttps://hdl.handle.net/11655/348232024-03-22T08:43:26Z2023-01-01T00:00:00ZKIRIKKALE İLİNDE ÇALIŞAN MİNİBÜS ŞOFÖRLERİNİN İŞ SAĞLIĞI ve GÜVENLİĞİ KOŞULLARI ile İŞ-YAŞAM DENGESİ
Özyürek Ucael, Deren
This descriptive study aimed to assess the working conditions and work-life balance of minibus drivers in Kırıkkale province concerning occupational health and safety. The research was conducted in-person within Kırıkkale province during May to July 2022. The study delved into the sociodemographic traits, health status, work experience, and occupational health and safety aspects of 280 out of 339 minibus drivers. Additionally, the outcomes of the work-life balance scale were analyzed. All participants were male, averaging 45.92 years old, with 40.9% having worked as minibus drivers for over two decades. A notable 34.3% reported lacking social security coverage, and 38.9% claimed their general health declined since becoming minibus drivers. 54.3% of them work more than 14 hours a day, 65.0% of them work at night. 46.6% stated that they were exposed to violence while working as a minibus driver. The regression analysis revealed that verbal violence was the most prevalent form of violence encountered. Moreover, for each increase in years of minibus driving, the likelihood of violence exposure rose by 1.031 times (CI:1.004-1.059). Working night shifts increased this risk 1.97 times (CI:1.144-3.422), while communication difficulties with passengers escalated the likelihood by 4.26 times (CI: 1.047-17.347). Minibus drivers experiencing insufficient family income, heavy workload, irregular meals, traffic congestion, noncompliance with traffic rules, noise, engine vibrations, exhaust fume exposure, prolonged sitting, driving fatigue, and exhaustion scored lower on the work-life balance scale. Also, those without social security, night-shift workers, individuals with sleep issues, and those unable to allocate time for personal matters exhibited lower work-life balance scores. In order to cultivate favorable working conditions for minibus drivers, it is imperative to meticulously identify issues and consider the drivers' requirements and preferences.
2023-01-01T00:00:00ZNEFRİN MUTASYONU OLAN KONJENİTAL NEFROTİK SENDROMLU HASTALARDA NEFREKTOMİNİN HASTA SAĞKALIM ÜZERİNE ETKİSİNİN RETROSPEKTİF ARAŞTIRILMASIUğurlu, Yükselhttps://hdl.handle.net/11655/348212024-03-22T08:42:16Z2024-02-19T00:00:00ZNEFRİN MUTASYONU OLAN KONJENİTAL NEFROTİK SENDROMLU HASTALARDA NEFREKTOMİNİN HASTA SAĞKALIM ÜZERİNE ETKİSİNİN RETROSPEKTİF ARAŞTIRILMASI
Uğurlu, Yüksel
Congenital nephrotic syndrome is a glomerular disease characterized by protein loss from the kidneys. The onset of the disease occurs in the antenatal period, and patients are diagnosed within the first three months of life. Postnatally, these patients exhibit nephrotic-level proteinuria. Due to protein loss, they experience hypoalbuminemia (serum albumin <2.5 g/dL), edema, and hyperlipidemia. The loss of proteins such as thyroid-binding globulin, antithrombin III, immunoglobulin G, complement C3 and C5, Factor B and D can lead to complications like hypothyroidism, thrombosis, and increased susceptibility to infections. Sepsis is the most common cause of death in these patients.
The management of the disease aims to maintain intravascular volume, manage edema, ensure healthy growth and development, and prevent complications, ultimately leading to kidney transplantation. Continuous protein loss necessitates a high-calorie, protein-rich diet to support normal growth. Continuous albumin replacements may be required to manage edema. Antithrombotic or anticoagulant prophylaxis is recommended for thrombosis prevention. Considering susceptibility to infections, especially to encapsulated bacteria, penicillin G prophylaxis is advised. Due to thyroid-binding globulin loss, initiating levothyroxine is recommended.
The curative treatment for the disease is kidney transplantation, which can be considered for patients with a body weight above 10 kg. While previous studies suggested nephrectomy in patients weighing between 7-10 kg, recent views favor avoiding nephrectomy unless there is a failure to achieve clinical euvolemia or impaired growth.
In our clinic, we observed that patients who underwent nephrectomy had better clinical outcomes. To scientifically test this observation, we conducted a study in collaboration with ten university hospitals' pediatric nephrology departments across Türkiye, collecting and analyzing data from a total of 29 patients with NPHS1 mutation and congenital nephrotic syndrome, some of whom underwent nephrectomy.
Out of the 29 patients, 16 underwent nephrectomy, while 13 were managed conservatively. There was no statistically significant difference in general demographic characteristics between those who underwent nephrectomy and those who did not. However, the group that underwent nephrectomy required more monthly albumin, indicating persistent protein loss. Although serum albumin levels significantly increased after nephrectomy, they did not reach normal levels, likely due to the unilateral nature of most nephrectomies.
Examining renal functions, patients who underwent nephrectomy had a median age of two years for the development of end-stage renal failure and the initiation of renal replacement. Compared to the non-nephrectomy group, the nephrectomy group required renal replacement approximately one year earlier. Growth assessment revealed a significant decline in height "z" scores for the nephrectomy group. Despite a statistically significant decrease in monthly albumin infusion needs, nephrectomy patients had fewer hospitalizations and infections, but an increased incidence of central venous catheter-related thrombosis.
For patients managed conservatively, serum albumin levels showed a statistically significant increase over time, although levels were lower than those in the nephrectomy group. There was no significant change in renal functions, height, or weight "z" scores. While monthly albumin infusion needs decreased over time, there was no statistically significant reduction in hospitalization or infection rates, and no central venous catheter-related thrombosis occurred.
In conclusion, nephrectomy may be considered for congenital nephrotic syndrome patients who experience frequent complications, require frequent hospitalizations, and struggle to maintain euvolemia. Earlier literature suggested nephrectomy for growth-impaired children, but our study indicates that nephrectomy may worsen growth outcomes. Based on our findings, routine nephrectomy for every congenital nephrotic syndrome patient is not recommended. Still, it may be beneficial for selected patients, and its application should be considered based on individual patient characteristics.
2024-02-19T00:00:00Z