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Ünsal B, Demetrovics Z, Reinhardt M. Stronger together: Community participation, structural stigma, and depressive symptoms of sexual and gender minority individuals living across 28 European countries. Eur J Public Health 2022. [PMCID: PMC9594195 DOI: 10.1093/eurpub/ckac129.194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Background Although previous studies demonstrated that structural stigma (i.e., discriminatory state laws, public policies, and attitudes) predicts adverse mental health outcomes among sexual and gender minority (SGM) populations, less is known how protective factors interact with structural stigma. Thus, we aimed to examine the associations between structural stigma, community participation, and depressive symptoms in a large sample of SGM adults. Methods Discriminatory laws, policies, and attitudes affecting SGM people were assessed to measure each country's structural stigma levels (i.e., sexual and gender). Data from the 2019 EU-LGBTI-II-Survey assessing community participation levels and depressive symptoms of sexual minority men (n = 62.825), women (n = 38.912), and gender minority adults (n = 15.801) in 28 European countries were analyzed by using multilevel models. Results The results demonstrated that structural stigma was positively, and community participation was negatively associated with depressive symptoms of sexual minority men (β = .147, p < .001; β = -.020, p < .05), women (β = .149, p < .01; β = −.040, p < .01), and gender minority adults (β = .085, p < .05; β = -.088, p < .001), respectively. Unlike sexual minority women and gender minority adults, for sexual minority men, a statistically significant interaction was found (β = .018, p < .05) such that participating to the community predicted lower depressive symptoms only in lower-stigma countries. Conclusions The results highlight the need for changes in discriminatory laws, social policies, and negative attitudes that impact depressive symptoms of SGM individuals. Although community participation protects individuals from depression, these findings suggest that sexual minority men in higher-stigma countries benefit less from community participation. Thus, interventions aiming to increase SGM individuals’ community participation should consider structural factors and gender differences.
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Affiliation(s)
- B Ünsal
- Institute of Psychology, ELTE Eötvös Loránd University , Budapest, Hungary
| | - Z Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University , Budapest, Hungary
| | - M Reinhardt
- Institute of Psychology, ELTE Eötvös Loránd University , Budapest, Hungary
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Özdemir EÇ, Erciyas K, Ünsal B, Sezer U, Taysi S, Araz M. THE EFFECTS OF CHRONIC PERIODONTITIS AND OBESITY ON TOTAL ANTIOXIDANT/OXIDANT STATUS AND OXIDATIVE STRESS INDEX. Acta Endocrinol (Buchar) 2022; 18:294-300. [PMID: 36699178 PMCID: PMC9867810 DOI: 10.4183/aeb.2022.294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Objective Both obesity and periodontal diseases are significant diseases that affect the quality of life. Recent studies have focused on the relationship between obesity and periodontal disease. The aim of this study is to determine the pathophysiological relationship between obesity and periodontal disease by evaluating the clinical periodontal parameters and oxidative status. Subjects and Methods The study included 80 individuals divided into four groups including 20 individuals in each group as following; periodontally healthy patients with normal weight, (NH), patients with chronic periodontitis and normal weight (NCP), periodontally healthy patients with obesity (OH) and patients with chronic periodontitis and obesity (OCP). Clinical periodontal parameters were recorded, and serum, saliva and gingival crevicular fluid (GCF) samples were obtained. Local and systemic levels of total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index (OSI) were assessed biochemically. Results No statistically significant difference was found among the groups regarding TAS, TOS and OSI values in serum and saliva samples (p>0.05). GCF-TAS values in NH group were statistically significantly higher compared with other groups (p<0,05) . GCF TOS values increased in obese groups (OH, OCP) compared with non-obese groups (NH, NCP) (p<0.05). Our results suggest that obesity and chronic periodontitis do not effect oxidant/antioxidant levels in serum and saliva. Conclusions Many factors such as daily living conditions of the individual, stress and nutritional habits TAS and TOS levels of the individual may affect oxidative stress parameters. However, these factors could not be standardized in the study.
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Affiliation(s)
- E. Çetin Özdemir
- Kahramanmaraş Sütçü İmam University, Faculty of Dentistry, Periodontology Dept., Kahramanmaraş, Turkey
| | - K. Erciyas
- Gaziantep University, Faculty of Dentistry, Periodontology Dept., Gaziantep, Turkey
| | - B. Ünsal
- Gazi University, Faculty of Dentistry, Periodontology Dept., Ankara, Turkey
| | - U. Sezer
- Istanbul Gelişim University, Faculty of Dentistry, Periodontology Dept., Istanbul, Turkey
| | - S. Taysi
- Gaziantep University, Faculty of Medicine, Biochemistry Dept., Gaziantep, Turkey
| | - M. Araz
- Gaziantep University, Faculty of Medicine, Endocrinology and Metabolic Diseases Dept., Gaziantep, Turkey
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Idilman R, Baykam N, Kaymakoğlu S, Tabak F, Bahçecioğlu HI, Bektaş A, Bulut C, Günşar F, İnan D, Karaosmanoğlu HK, Karasu Z, Kuşçu F, Mete B, Özbakır Ö, Özdoğan OC, Parlak M, Sırmatel F, Topalak Ö, Ünsal B, Guidelines Study Group VH. Turkey 2017 Clinical Practice Guidelines on recommendations for screening diagnosing and managing hepatitis C virus. Turk J Gastroenterol 2018; 28:90-93. [PMID: 29303105 DOI: 10.5152/tjg.2017.21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The present guideline updates the Turkish recommendations for the screening, diagnosis and management of Hepatitis
C virus (HCV) infection prepared by the Turkish Association for the Study of the Liver (TASL) and Viral Hepatitis
Society (VHS). The aim of this guidance was to provide updates recommendations to physicians, who are interested
in HCV care on the optimal screening, diagnosis and pre-treatment management for patients with HCV infection
in Turkey. These recommendations, produced by panel experts, were aimed to addresses the management issues
ranging from diagnosis and linkage to care, to the optimal treatment regimen in patients with HCV infection. Recommendations
are based on evidence and opinions of more than 70% of the panelists. This guidance is supported by
the memberships of two societies and not by pharmaceutical companies. This guidance will be updated frequently
as new data become available.
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Affiliation(s)
- Ramazan Idilman
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Nurcan Baykam
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Sabahattin Kaymakoğlu
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Fehmi Tabak
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Halil I Bahçecioğlu
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Ahmet Bektaş
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Cemal Bulut
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Fulya Günşar
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Dilara İnan
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Hayat K Karaosmanoğlu
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Zeki Karasu
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Ferit Kuşçu
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Birgül Mete
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Ömer Özbakır
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Osman C Özdoğan
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Mehmet Parlak
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Fatma Sırmatel
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Ömer Topalak
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Belkis Ünsal
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
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Yurtlu DA, Aslan F, Ayvat P, Isik Y, Karakus N, Ünsal B, Kizilkaya M. Propofol-Based Sedation Versus General Anesthesia for Endoscopic Submucosal Dissection. Medicine (Baltimore) 2016; 95:e3680. [PMID: 27196474 PMCID: PMC4902416 DOI: 10.1097/md.0000000000003680] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 04/18/2016] [Accepted: 04/21/2016] [Indexed: 12/20/2022] Open
Abstract
The main objective of this study is to evaluate general anesthesia or propofol-based sedation methods at gastric endoscopic submucosal dissection (ESD) procedures.The anesthetic method administered to cases undergoing upper gastrointestinal ESD between 2013 and 2015 was retrospectively investigated. Procedure time, lesion size, dissection speed, anesthesia time, adverse effects such as gag reflex, nausea, vomiting, cough, number of desaturation episodes (SpO2 < 90%), oropharyngeal suctioning requirements, hemorrhage, perforation, and amount of anesthetic medications were recorded.There were 54 and 37 patients who were administered sedation (group S) and general anesthesia (group G), respectively. The demographics of the groups were similar. The calculated dissection speed was significantly high in group G (36.02 ± 20.96 mm/min) compared with group S (26.04 ± 17.56 mm/min; P = 0.010). The incidence of nausea, cough, number of oropharyngeal suctioning, and desaturation episodes were significantly high in group S compared with that in group G (P < 0.5). While there was no difference between the groups in terms of hemodynamic parameters, in group S the use of propofol and in group G the use of midazolam and fentanyl were significantly higher (P < 0.05). Anesthesia time, postoperative anesthesia care unit, and hospital stay durations were not significantly different between the groups.General anesthesia increased dissection speed and enhanced endoscopist performance when compared with propofol-based sedation technique.
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Affiliation(s)
- Derya Arslan Yurtlu
- From the Anesthesiology and Reanimation Department (DAY, PA, YI, NK, MK); and Gastroenterology Department (FA, BÜ), Katip Çelebi University, İzmir Atatürk Education and Research Hospital, İzmir, Turkey
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Cekic C, Arabul M, Alper E, Pakoz ZBK, Saritas E, Ünsal B. Evaluation of the relationship between serum ghrelin, C-reactive protein and interleukin-6 levels, and disease activity in inflammatory bowel diseases. Hepatogastroenterology 2014; 61:1196-1200. [PMID: 25436282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND/AIMS Ghrelin is a 28 aminoasid peptide hormone, have generally focused upon this peptide’s role upon growth and energy metabolism. Recently, studies investigating ghrelin’s effect upon inflammation and immune response have gained importance. We aimed to compare the effectiveness of ghrelin levels, Creactive protein and interleukin-6 levels in establishing disease activity. METHODOLOGY 52 cases with ulcerative colitis and 33 with Crohn’s disease, total 85 patients, were included in this study. The serum ghrelin levels of the patients in remission and of those with active disease were compared. RESULTS The mean serum ghrelin level in active patients (1243 ± 648 pg/ml), was found to be higher than those in remission (466 ± 214 pg/ml) (p<0.001). In establishing the disease activity, CRP is a the most effective marker compared to the other two inflammatory markers. AUC values were established as; CRP: 0.947 (95% CI,0.903-0.992),ghrelin:0.934(95% CI, 0.884-0.984) and interleukin-6: 0.756 (95% CI, 0.648- 0.864). DISCUSSION Serum ghrelin level can be used with CRP as an important marker in establishing the mucosal damage in inflammatory bowel diseases.
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Arabul M, Celik M, Aslan O, Torun S, Beyazit Y, Alper E, Kandemir A, Ünsal B. Hepcidin as a predictor of disease severity in acute pancreatitis: a single center prospective study. Hepatogastroenterology 2013; 60:595-600. [PMID: 23665668 DOI: 10.5754/hge12770] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND/AIMS Predicting the severity of acute pancreatitis is limited to clinical, laboratory and radiological risk factors. Hepcidin levels increase in acute inflammation. We aimed to assess the relationship between hepcidin and C-reactive protein (CRP), white blood cells (WBC) and multi-detector computerized tomography (MDCT) in predicting the severity of pancreatitis. METHODOLOGY We undertook a prospective review of 59 consecutive patients with acute pancreatitis admitted to our clinic. Biochemical values were measured from blood samples taken within 2 hours of admission and from between 2 and 72 hours related to the time of symptom onset. RESULTS In predicting severe acute pancreatitis, hepcidin was superior to CRP and WBC (Area Under the Curve (AUC)=0.79, p=0.003; AUC=0.69, p=NS; AUC=0.53, p=NS, respectively). CONCLUSIONS In this study, hepcidin was found to be superior to CRP in predicting the severity of pancreatitis.
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Affiliation(s)
- Mahmut Arabul
- Department of Gastroenterology, Izmir Katip Celebi University, Atatürk Training and Research Hospital, Izmir, Turkey.
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Alper E, Arabul M, Buyrac Z, Baydar B, Ustundag Y, Celik M, Ünsal B. The use of radial endosonography findings in the prediction of cholangiocarcinoma in cases with distal bile duct obstructions. Hepatogastroenterology 2013; 60:678-683. [PMID: 24046829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND/AIMS We retrospectively collected the data of radial endosonographic (EUS) imaging findings of the patients with the distal bile duct obstructions due to different benign and malignant conditions. We aimed to assess and analyze the EUS findings in the distal bile duct obstruction which can predict or detect the existence of cholangiocarcinoma originating from the distal bile duct wall. METHODOLOGY We gathered the data of 192 cases with distal biliary stricture due to various causes which all were diagnosed. RESULTS With EUS, The sensitivity and specificity for diagnosis of cholangiocarcinoma in lesions were respectively as following: Firstly, small hypoechoic mass which interrupts to see lumen and choledoch wall with total occlusion at distal choledoch: 75.8%, 88.1%. Secondly, hypoechoic and irregular thickening than surrounding regions at distal choledoch wall: 68.1%, 87.3%. Thirdly, appearance of lumen prompt termination at distal choledoch: 57.1%, 87.6%. Lastly, appearance where lumen narrows short segment: 13.6 %, 59.3 %. CONCLUSIONS EUS findings including hypoechoic mass appearance completely occluding the lumen or heterogeneously increased irregular wall-thickness in the distal bile duct were found to be highly predictive and sensitive for detecting malignancy originating from the distal bile duct.
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Alper E, Buyraç Z, Baydar B, Cengiz O, Vatansever S, Aslan F, Akça S, Ünsal B. Evaluation of flow and structure abnormalities of splanchnic system veins in cirrhotic patients without portal hypertension. MINERVA GASTROENTERO 2011; 57:123-127. [PMID: 21587151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
AIM The aim of this study was to evaluate hemodynamic and anatomic alterations of the splanchnic venous system and the efficiency and safety of color Doppler radial endosonography in the assessment of cirrhotic patients by comparing Child A cirrhotic patients without portal hypertension findings versus a non-cirrhotic group. METHODS The study was carried out between January 2009 and February 2010; the study population was 38 cirrhotic patients without portal hypertension and 140 control patients. RESULTS Hepatopedal flow was monophasic in all the control patients; the flow pattern was chaotic and irregular in 8% of the cirrhotic patients; in the cirrhotic patients the portal vein diameter was increased and the flow velocity reduced; no differences in flow volume were observed between the two groups. Splenic vein diameter and flow velocity were normal. In the majority of the Child A cirrhotic patients without portal hypertension, no changes were seen in portal vein diameter or flow volume; in some patients no significant increase portal vein diameter was observed and showed the flow volumes were unchanged. CONCLUSION Radial Doppler endosonography may be efficient and safe for assessing the splanchnic system.
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Affiliation(s)
- E Alper
- Atatürk Research and Training Hospital, Izmir, Turkey
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