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Öğe Öğe Effect of sleep quality on hemodynamic response to exercise and heart rate recovery in apparently healthy individuals(The Canadian Society for Clinical Investigation, 2014) Yuksel M.; Yildiz A.; Demir M.; Bilik M.Z.; Ozaydogdu N.; Aktan A.; Isik F.Purpose: Poor sleep quality has an unfavorable impact on autonomic nervous system activity, especially that of the cardiovascular (CV) system. The heart rate (HR) and blood pressure (BP) at rest and during exercise, along with the heart rate recovery (HRR), were examined in poor sleepers and compared with individuals with good sleep quality. Methods: A total of 113 healthy individuals were enrolled to the study. All participants performed treadmill stress testing. Sleep quality of participants was assessed by using the Pittsburgh Sleep Quality Index (PSQI) questionnaire: 48 subjects were categorized as 'poor sleepers' (PSQI score > 6 points), and the rest were grouped as 'good sleepers'. Results: The poor sleepers showed higher resting HR (p<0.001), higher diastolic BP (p=0.006), similar systolic BP (p=0.095), more frequent hypertensive response to exercise (p=0.046) and less HR increase with exercise (chronotropic incompetence) (p=0.002) compared with individuals who reported good sleep quality. In addition, the poor sleepers demonstrated reduced heart rate recovery at the 1st and 3rd minute of recovery (p=0.005 and 0.037, respectively) compared with good sleepers. Multivariate logistic regression analysis revealed that only resting diastolic BP was the independent predictor of HRE. The PSQI score was positively correlated with resting HR; while it was negatively correlated with HR response to exercise, HRR1 and HRR index-1. Conclusion: This cross-sectional study emphasizes the effect of poor sleep quality on unfavorable cardiovascular outcome indicators of the treadmill stress test. © 2012 CIM.Öğe Factors associated with mortality among tuberculosis patients in southeast Turkey(A. CARBONE Editore, 2015) Yilmaz S.; Taylan M.; Sen H.S.; Abakay O.; Demir M.; Kaya H.; Yilmaz Z.Introduction: Tuberculosis (TB) is a disease caused by bacillus mycobacterium tuberculosis. Tuberculosis is a preventable and treatable disease that, despite the rapid advances in active therapy, continues to cause global mortality. In this study, we investigated the risk factors associated with mortality in patients undergoing treatment for TB. Materials and methods: Records of 2,450 tuberculosis patients who were followed-up with in tuberculosis dispensaries in the city of Diyarbakir, southeast Turkey, between January 2005 and December 2011 were reviewed retrospectively. Case definitions and treatment outcomes were classified according to WHO criteria. Results: Of the 2,450 registered TB patients, 1,339 were male (54.7%) and 1,111 were female (45.3%). Their mean age was 32.15±17.87 years, and 51 (2.1%) of them died. Mortality rates were higher in pulmonary TB (PTB) patients, males, relapse patients, category 2 patients, those >65 years old, TB meningitis patients, and patients who self-administered their therapy. According to Kaplan-Meier analysis, the mortality rates were significantly higher in patients aged >65 years, in those with Category II and in those TB meningitis. The significant independent risk factors for mortality during anti-TB treatment were advanced age, TB meningitis and gastrointestinal TB. Conclusion: Mortality was increased in the elderly, males, those with relapse, and in category II and extrapulmonary TB patients. Based on these data, we suggest that tuberculosis control programs should pay more attention to the high-risk groups determined in the current and previous studies. Treatment regimens for these risk groups should be considered for revision.Öğe Fibulin-3 as a diagnostic biomarker in patients with malignant mesothelioma(Asian Pacific Organization for Cancer Prevention, 2015) Kaya H.; Demir M.; Taylan M.; Sezgi C.; Tanrikulu A.C.; Yilmaz S.; Bayram M.Background: New tumour biomarkers are being intensely investigated for malignant mesothelioma (MM). Fibulin-3 is produced in MM but its role remains uncertain. The aim of this study was to evaluate the validity of measuring serum fibulin-3 in the diagnosis and prognosis of MM. Materials and Methods: This prospective study was performed on 43 patients and 40 healthy controls who were admitted to our hospital between January 2012 and January 2014. Data from MM patients, including demographic and clinical features, routine laboratory data, levels of serum fibulin-3, and treatment outcomes were defined as potential prognostic factors. The receiver operating characteristic (ROC) curve for fibulin-3 was used to detect the cut-off value with highest sensitivity and specificity. Univariate survival analysis was performed using the Kaplan-Meier method in patients with MM. Afterwards, the possible factors identified with univariate analyses were entered into the cox regression analysis. Results: Our results revealed that patients with MM had significantly higher serum levels of fibulin-3 than controls. The results showed that the best cut-off point was 36.6 ng/ml with an AUC (area under the curve)=0.976, sensitivity=93.0% and specificity=90.0. In our study, the initial significant poor prognostic factors were advanced stage, high white blood cell count, high platelet count, high C-reactive protein (p<0.05 for each variable). Later, according to multivariate analysis the results showed only advanced stage as significant parameter (p=0.040). Conclusions: We determined that real use for serum fibulin-3 was not for prognosis but for diagnosis in MM. Also advanced stage was associated with poor MM prognosis.Öğe Fiscal Policies Adopted during the Global Pandemic and Their Effectiveness(Peter Lang AG, 2021) Demir M.; Geyik O.; Dr.The outbreak, which was mostly regional and had limited effects at the beginning, soon became a pandemic on a global scale, affecting the entire world. The fact that COVID-19 has been a global pandemic, without a doubt, caused its social and economic outcomes to also be experienced on a global scale. The fact that the pandemic has been threatening public health, as well as economic systems and functions, has made it difficult to fight it, making it a requirement to adopt public policies. Public policies and policy tools determined by the public have been the main driver of the response against the pandemic in almost every country. The success of measures adopted to combat the pandemic has been an area widely discussed recently. Similar measures in many countries have differed significantly. While some countries have been able to prevent deepening the crisis by managing the pandemic successfully, others have not been able to succeed despite adopting the same public policies, deepening the crisis. This study evaluates the COVID-19 pandemic and analyzed the fiscal policies adopted in China, the US, Germany, the UK, Turkey, and Spain to counter the pandemic and the effectiveness of these policies. © Peter Lang GmbH Internationaler Verlag der Wissenschaften Berlin 2021.Öğe The value of new inflammatory parameters in Malignant mesothelioma prognosis(Acta Medica Mediterranea, 2015) Tanrikulu A.C.; Hocanli I.; Yilmaz A.; Meteroglu F.; Taylan M.; Demir M.; Kaya H.Aim: Malignant mesothelioma (MM) has a poor prognosis. Inflammation is associated with MM prognosis and symptoms. Several inflammatory markers were investigated to estimate MM prognosis. We investigated the role of available inflammatory index and markers for MM prognosis. We developed the advanced mesothelioma index (AMI) to assess the degree of inflammation in MM. Materials and methods: We performed a retrospective study of 202 MM patients (116, male, 86 female) evaluated at Dicle University. Demographic parameters and laboratory data were collected. The AMI was calculated as Body Mass Index*serum albumin value (g/dl)/platelet-to-lymphocyte ratio. Results: The mean age of patients was 59.04 years. A total of 135 (66.8%) patients showed epithelial-type histopathological subtypes and 177 patients had pleural MM. The mean survival time was 13.1±11.5 months in the all MM patients. Twenty-four potential prognostic factors were associated with a poor outcome and then analyzed in the univariate analysis. Eighteen of them were definitely associated with a poor prognosis. These 18 potential prognostic factors were analyzed in the multivariate analysis. Based on the results of the multivariate analysis, only patients with an AMI<0.5 had an associated poor prognosis. An AMI<0.5 increased the mortality rate by 10.47. Furthermore, low AMI was associated with other bad inflammatory markers (such as high platelet count, high C reactive protein level, low Body Mass Index, low albumin and low hemoglobin). Conclusion: Our findings indicate that the AMI can be used to assess the degree of systemic inflammation.
