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Öğe Data on prevalence of dyslipidemia and lipid values in Turkey: Systematic review and meta-analysis of epidemiological studies on cardiovascular risk factors(TURKISH SOC CARDIOLOGY, 2018) Kayikcioglu, Meral; Tokgozoglu, Lale; Kilickap, Mustafa; Goksuluk, Huseyin; Karaaslan, Doruk; Ozer, Necla; Abaci, Adnan; Yilmaz, Mehmet Birhan; Barcin, Cem; Ates, Kenan; Bayram, Fahri; Sahin, Mahmut; Ural, DilekObjective: Dyslipidemias, primarily hypercholesterolemia, are independent and strong predictors of cardiovascular (CV) events. The frequency of dyslipidemia is very important in terms of determining CV prevention policies. In order to determine the up-to-date frequency of CV risk factors in Turkey, a meta-analysis of the epidemiologic studies carried out in the last 15 years was performed. This article presents the results on the dyslipidemia data including hypercholesterolemia principally. Methods: Epidemiological studies conducted during the last 15 years and having the potential to represent the general population in Turkey were searched in databases (Ovid Medline, Web of Science Core Collection, and Turkish Academic Network and Information Center [ULAKBIM]) and web pages (Ministry of Health, Turkey Statistical Institute, Turkish Society of Cardiology, Nephrology and Endocrinology Associations). A total of 7 studies including lipid data were found. Systematic review and meta-analysis of the studies with low bias score were performed. Crude values of the prevalence of hypercholeterolemia, hypertriglyceridemia and low HDL and mean lipid levels were calculated. Random effects model was used in meta-analysis. Results: The prevalence of hypercholesterolemia defined as a LDL-cholesterol > 130 and/or >= 130 mg/dL, was 29.1% (95% CI 23.6-35.0) in the general population, 30.2% in females (%95 CI 24.7-36.1), and 27.8% in males (95% CI 22.3-33.6). The prevalence of low HDL-cholesterol (<= 50 mg/dL for females and <= 40 mg/dL for males) was calculated as 46.1% (95% CI 42.4-49.9) in the whole group, 50.7% (95% CI 47.7-53.6) in females and 41.1% (95% CI 36.1-46.3) in males. The prevalence of hypertriglyceridemia (> 150 mg/dL) was 36.5% (95% CI 30.6-42.5) in general, 32.0% (95% GA 26.6-37.8) in females and 41.3% (95% CI 34.9-47.8) in males. Conclusion: Dyslipidemia constitutes a major public health problem in Turkey. In the adult population, almost 3 of 10 have hypercholesterolemia, one of 2 has a low HDL-cholesterol, and 1 of 3 has high triglycerides levels.Öğe Data on prevalence of hypertension and blood pressure in Turkey: Systematic review, meta-analysis and meta-regression of epidemiological studies on cardiovascular risk factors(TURKISH SOC CARDIOLOGY, 2018) Kilickap, Mustafa; Barcin, Cem; Goksuluk, Huseyin; Karaaslan, Doruk; Ozer, Necla; Kayikcioglu, Meral; Ural, Dilek; Yilmaz, Mehmet Birhan; Abaci, Adnan; Arici, Mustafa; Altun, Bulent; Tokgozoglu, Lale; Sahin, MahmutObjective: Cardiovascular risc factors may show significant changes over the years. A systematic review and meta-analysis of epidemiological studies conducted in Turkey was performed to assess the latest profile and temporal changes in cardiovascular risk factors. Presented here are the data on hypertension (HT) and blood pressure (BP). Methods: Ovid Medline, the Web of Science Core Collection, and the Turkish Academic Network and Information Center (ULAKBIM) were searched for epidemiological studies conducted in Turkey during the last 15 years. In addition, the web pages of the Ministry of Health, the Turkish Statistical Institute, and associations of cardiology, nephrology, and endocrinology were searched for appropriate studies. Regional studies were excluded. The studies included were assessed with a bias score developed by our team, then categorized as having a low risk or a high risk of bias. The crude values of HT prevalence and BP were pooled using a random effects model. Meta-regression was performed to explain heterogeneity and to assess temporal changes. Results: The agreement between the 2 authors on the selection and bias scoring of the studies was perfect (Kappa >= 0.95). There were 7 (n=73218) studies providing HT prevalence data, and 8 (n=75879) studies with BP data. The heterogeneity between the studies was high. Meta-analysis of the studies with a low risk of bias indicated that the crude prevalence of HT is higher in women, but that BP levels were similar in both sexes. The HT prevalence and BP value decreased between 2003 and 2012; however, the number of hypertensives stabilized at approximately 15 million, and the number of uncontrolled hypertensives, despite some decrease, was around 11 million. Conclusion: Despite some improvement, HT is still an important public health problem in Turkey.Öğe Data on prevalence of metabolic syndrome in Turkey: Systematic review, meta-analysis and meta-regression of epidemiological studies on cardiovascular risk factors(TURKISH SOC CARDIOLOGY, 2018) Abaci, Adnan; Kilickap, Mustafa; Goksuluk, Huseyin; Karaaslan, Doruk; Barcin, Cem; Kayikcioglu, Meral; Ozer, Necla; Yilmaz, Mehmet Birhan; Sahin, Mahmut; Tokgozoglu, LaleObjective: The incidence of metabolic syndrome varies greatly in developed and developing countries. In the last 10 to 15 years, important studies have been performed examining the incidence of metabolic syndrome in Turkey. This article is a meta-analysis of the studies that investigated the incidence of metabolic syndrome this country. Methods: Epidemiological studies from the last 15 years that provided information about the incidence of metabolic syndrome in Turkey were screened in the Ovid Medline, the Web of Science Core Collection, and the Turkish Academic Network and Information Center (ULAKBIM) databases. In addition, web pages of the Ministry of Health, the Turkish Statistical Institute, and the associations of the related medical discipilnes were screened for appropriate studies. A bias tool that is developed by our team was used to categorize the included studies as having low- or high risk of bias. A random effects model was used in the meta-analysis. Linear and nonlinear meta-regression analyses were performed to evaluate heterogeneity and temporal variations in prevalence rates. Results: Four studies (n=34893) were identified that provided information about the status of metabolic syndrome in Turkey using the Adult Treatment Panel III definition. There was excellent interobserver agreement regarding the selection of studies and the scoring of the selected research with respect to bias. The meta-analysis revealed a prevalence of 32.9% (95% confidence interval [CI]: 30.2-35) overall, 38.3% (95% CI: 35.8-40.8) in women, and 26.8% (95% CI: 23.4-30.3) in men. Two studies (n=8568) provided data according to the International Diabetes Federation definition of metabolic syndrome. The random effects model used in the meta-analysis of these studies demonstrated a prevalence of metabolic syndrome of 43.3% (95% CI: 41.9-44.7) overall, 50.4% (95% CI: 49.0-51.9) in women, and 35.4% (95% CI: 32.5-38.5) in men. Conclusion: In Turkey, the incidence of metabolic syndrome is 1 in every 4 men, and 1 in every 3 women. The rate is particularly high among women. Studies designed to prevent the development of metabolic syndrome are needed.Öğe Data on prevalence of obesity and waist circumference in Turkey: Systematic review, meta-analysis and meta-regression of epidemiological studies on cardiovascular risk factors(TURKISH SOC CARDIOLOGY, 2018) Ural, Dilek; Kilickap, Mustafa; Goksuluk, Huseyin; Karaaslan, Doruk; Kayikcioglu, Meral; Ozer, Necla; Barcin, Cem; Yilmaz, Mehmet Birhan; Abaci, Adnan; Sengul, Sule; Arinsoy, Turgay; Erdem, Yunus; Sanisoglu, Yavuz; Sahin, Mahmut; Tokgozoglu, LaleObjective: Obesity is the most important epidemic of the 21st century and its incidence is increasing steadily in Turkey. The aim of this study was to assess the current status and temporal change in the prevalence of obesity in Turkey with a systematic review and meta-analysis of epidemiological studies conducted in the last 15 years. Methods: Ovid Medline, the Web of Science Core Collection and the Turkish Academic Network and Information Center (ULAKBIM) databases, as well as the web pages of the Turkish Ministry of Health, the Turkish Statistical Institute, and cardiology, nephrology and endocrinology associations were searched for epidemiological studies conducted within Turkey the last 15 years. Research focusing on local data was excluded. Studies included in the analysis were assessed with a special bias score and categorized as having low or high risk of bias. Body mass index (BMI), waist circumference, obesity and prevalence of abdominal obesity were calculated as crude values. Meta-regression analysis was performed to assess heterogeneity and change over time. Results: The agreement between the two investigators on the selection and bias scoring of the studies was excellent (kappa=0.95), but the heterogeneity between the studies was high. BMI (10 studies, n=93.554) was calculated as 28.2 kg/m(2) for women and 26.5 kg/m(2) for men. The prevalence of obesity (12 trials, n=106.553) was 33.2% in females and 18.2% in males. In 6 studies (n=66.591) that included a measurement of waist circumference, the values were 89.72 cm in women and 93.57 cm in men. Especially in women, the prevalence of abdominal obesity (5 studies, n=62331) was greater than that of general obesity (50.8% in women vs 20.8% in men). Meta-regression analysis revealed that the variance of the obesity prevalence between the studies could partly be explained by the age differences, but there was no temporal change in the prevalence of obesity during the years the studies were conducted. Conclusion: The prevalence of obesity, especially abdominal obesity, is considerably high in Turkish women and increases with advancing age. This finding points out that nationwide action plans against obesity, especially for women, should be designed and implemented by health policy makers.Öğe Data on smoking in Turkey: Systematic review, meta-analysis and meta-regression of epidemiological studies on cardiovascular risk factors(TURKISH SOC CARDIOLOGY, 2018) Ozer, Necla; Kilickap, Mustafa; Tokgozoglu, Lale; Goksuluk, Huseyin; Karaaslan, Doruk; Kayikcioglu, Meral; Yilmaz, Mehmet Birhan; Barcin, Cem; Abaci, Adnan; Sahin, MahmutObjective: Smoking is one of the most important public health problems and preventable causes of mortality in Turkey. Major healthcare policies have been implemented to combat this problem over the past 10 years. The aim of this study was to conduct a systematic review and meta-analysis of epidemiological studies performed in the country in the last 15 years to determine the prevalence of smoking in Turkey. Methods: Ovid Medline, the Web of Science Core Collection, and the Turkish Academic Network and Information Center (ULAKBIM), as well as the websites of the Ministry of Health and the Turkish Statistical Institute were searched for the appropriate epidemiological studies. Studies included in the analysis were evaluated by a self-developed bias score regarding their potential to represent Turkey and standardization of measurements. The meta-analysis and meta-regression analysis were performed using a random effects model. Results: Ten epidemiological studies (n=122383) that included data about smoking were found. Eight of them (all with low bias score) included separate data about the smoking habit of women (n=49524) and men (n=37684). The smoking prevalence was determined to be 30.5% for the whole group, 15.7% for women, and 46.1% for men, when occasional smokers were included. Although the change observed in crude prevalence values over time was not statistically significant, when the data of the 3 studies that gave prevalence values according to age categories were standardized according to age, the incidence of smoking between 2003 and 2012 decreased 6.8% (20.2%) when occasional smokers were included and 8.4% (26.3%) when they are excluded. Conclusion: Despite implementation of major healthcare policies and some success in decreasing rate of smoking, one-third of the Turkish population aged over 15 years and nearly half of the men are smokers. It is essential to continue and to strengthen measures to combat smoking.Öğe Effects of apixaban, rivaroxaban, dabigatran and enoxaparin on histopathology and laboratory parameters in Achilles tendon injury: An in vivo study(Wolters Kluwer Medknow Publications, 2021) Avci, Sema; Gungor, Huseyin; Kumru, Alper Serhat; Sahin, Mahmut; Gezer, Arzu; Gok, Uzeyir; Kara, HakiObjectives: To compare the effects of apixaban, rivaroxaban, dabigatran and enoxaparin on histopathology and blood parameters in rats with Achilles tendon injury. Materials and Methods: Thirty adult, male Wistar albino rats weighting 220-240 g were randomly divided into five (one control and four treatment) groups and placed in a controlled environment. The Achilles tendon was incised and re-sutured in each rat, after which each group was provided the following treatment for 28 days: a) 2 ml saline to the control group, b) apixaban in 1 ml of saline (10 mg/kg/day) +1 ml of saline, c) rivaroxaban in 1 ml of saline (2 mg/kg/day) +1 ml saline, d) dabigatran in 1 ml of saline (30 mg/kg/day) +1 ml of saline, e) enoxaparin (80 mu g/kg/day) + 2 ml of saline. Results: Hemogram, biochemical and coagulation parameters differed significantly between the control and treatment groups (P < 0.05). Compared with the control group, in the apixaban group, type I and type III collagen immunoreactivity were severe and moderate, respectively. In the rivaroxaban and dabigatran groups, both type I and type III collagen immunoreactivity were medium and severe, respectively. In the enoxaparin group, type I and type III collagen immunoreactivity were mild and severe, respectively. Conclusion: The higher concentration of type I collagen in the apixaban and dabigatran indicates faster tendon healing in these groups, and the higher concentration of the type III collagen in the enoxaparin group indicates slower healing in this group.Öğe Effects of Mebendazole on the Caspase-mediated Apoptosis mechanism in Cancer cell culture(Univ Zulia, Facultad Ciencias Veterinarias, 2024) Sahin, Mahmut; Kara, HakiThis study was conducted to compare Mebendazole in terms of its apoptosis-inducing and tubulin-inhibitory effects when combined with vincristine and paclitaxel, both of which are used in cancer treatment. Lung fibroblast cells (MRC-5) and small cell lung carcinoma (NCI-H209) cell lines were used in the study. Concentrations of Mebendazole, vincristine, and paclitaxel at 0.5 pM, 1 pM, 1.5 pM, and 2 pM were separately applied to these cell lines, as well as in combinations. After the cells were kept in the culture medium for 24 hours following drug administration, cell proliferation, apoptotic DNA levels, caspase 3, 8, and 9 levels, and in vitro wound healing experiments were performed. It was determined that Mebendazole suppressed cell proliferation and cell healing, increased caspase-3, caspase-8, caspase-9 levels and apoptotic DNA formation in NCI- H209 cancer lung cells. Compared to the groups given Mebendazole and vincristine alone, it was observed that cell proliferation was more suppressed and, the level of apoptosis increased in cancerous cells in the groups given the combination of the two drugs. According to the findings obtained from the present study, it was believe that Mebendazole may possess therapeutic activity against cancerous lung cells (NCI-H209) due to its apoptosis-inducing and cell proliferation- suppressive effects.Öğe Highlights from ACC.17 scientific sessions(TURKISH SOC CARDIOLOGY, 2017) Yilmaz, Mehmet Birhan; Sahin, Mahmut…Öğe Temporal changes in the epidemiology of diabetes mellitus in Turkey: A systematic review and meta-analysis(TURKISH SOC CARDIOLOGY, 2018) Yilmaz, Mehmet Birhan; Kilickap, Mustafa; Abaci, Adnan; Barcin, Cem; Bayram, Fahri; Karaaslan, Doruk; Goksuluk, Huseyin; Kayikcioglu, Meral; Ozer, Necla; Suleymanlar, Gultekin; Sahin, Mahmut; Tokgozoglu, Lale; Satman, IlhanObjective: Diabetes mellitus (DM) is a serious public health problem. Despite various epidemiological studies reporting prevalence of DM in Turkey, there is no meta-analysis or systematic review evaluating these studies as a whole and assessing temporal changes in the prevalence of DM. In this meta-analysis, the studies that have been conducted in the last 15 years and which provide information on the prevalence of DM in our country are examined. Methods: Epidemiological studies on cardiovascular risk factors in adult Turkish population that had been conducted within the last 15 years and having the capacity of either representating or potentially representing the country, were searched through Ovid, Medline and Web of Science Core Collection the Turkish Academic Network and Information Center (ULAKBIM) databases. Additionally, websites of Ministry of Health and related societies were investigated for additional studies. Random effects model was used in meta-analysis of low bias risk studies. Meta-regression was performed to evaluate the temporal change in DM prevalence. Results: There were 8 studies which provided information with regard to DM prevalence (n=84656). Four of these studies (n=56853) had low bias risk and four had high bias risk (n=27803). When compared with low bias risk studies, those with high bias risk had very large variation of DM prevalence (between 4% to 15%). Meta-analysis of the low bias risk group yielded a crude DM prevalence of 13.5% (95% CI: 11.6-15.5%) in the whole group, 14.2% (95% CI: 12.3-16.2%) in females, 12.6% (95% CI: 10.5-14.9%) in males. In meta-regression analysis of low bias risk group, mean age difference among the studies and the time period in which the study was undertaken were partially able to explain the inter-study heterogeneity (R2 values were 52% and 78%). Conclusion: This meta-analysis shows that DM is a highly prevalent public health problem in our country. Contrary to studies, which compare the recent studies with previous ones and report an increasing prevalence of DM, the present meta-analysis-despite its limitations-provides findings that the temporal increase of DM prevalence is at least paused over time. This situation underlines the need for new studies.Öğe Turkish registry for diagnosis and treatment of acute heart failure: TAKTIK study(Turkish Soc Cardiology, 2016) Eren, Mehmet; Zoghi, Mehdi; Tuncer, Mustafa; Cavusoglu, Yuksel; Demirbag, Recep; Sahin, Mahmut; Serdar, Osman AkinObjective: The goal of this study was to develop a national database of patients hospitalized in Turkey with acute heart failure (AHF) using evaluations of diagnostic and therapeutic approaches. Methods: Patient data were collected using an Internet-based survey. A total of 588 patients were enrolled from 36 participating medical centers across the country. Results: Mean age was 62 +/- 13 years and 38% of the patients were female. Ratio of de novo AHF to study cohort was 24%. Coronary heart disease and hypertension were found in 61% and 53% of the patients, respectively. Valvular heart disease was the underlying cause in 46% of heart failure patients. The most frequent factor associated with decompensation was noncompliance with treatment, observed in 34% of patients. Systolic blood pressure was 125 +/- 28 mmHg and heart rate was 93 +/- 22 beats/minute in the cohort. The most common findings on physical examination were inspiratory fine crackles (84%), peripheral edema (64%), and cold extremities in 34%. Mean ejection fraction (EF) measured at admission was 33 +/- 13%. Preserved EF (>=%40) was present in 20% of patients. On admission, 60%, 46%, and 40% of patients were using angiotens-in-converting enzyme inhibitor/angiotensin receptor blocker, beta-blocker, or aldosterone antagonist, respectively. In-hospital events were reported as 3.4% death, 1.6% stroke and 2% myocardial infarction. Conclusion: Compared to previous data collected around the world, AHF patients in Turkey were younger, had more frequently valvular heart disease as the underlying cause, and were more noncompliant with medical treatment, but overall mortality was lower. Drugs shown to reduce mortality, and which also form the basis of guideline-directed medical therapy, are still used inadequately.
