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    Premature Deaths and Socio-economic Status: The Role of Fine Particulate Matter in Türkiye (2019)
    (Galenos Publ House, 2025) Aykac, Nilufer; Karakaya, Selin Cakmakci; Koncak, Merve Ercelik; Seren, Orbay Tutku; Olcay, Sabri Serhan; Cagac, Nil Kader; Marim, Feride
    OBJECTIVE: Air pollution, particularly particulate matter (PM), is a leading environmental risk factor contributing to global morbidity and premature mortality. The World Health Organization's (WHO) AirQ+(c) software is a vital tool for assessing the health impacts of air pollution. Our study used this software to estimate premature deaths attributable to long-term particulate matter (PM2.5) exposure in T & uuml;rkiye in 2019 and explored its relationship with each province's socio-economic status. MATERIAL AND METHODS: We conducted an ecological study using annual average PM2.5 levels from air quality stations. Due to limited PM2.5 measurements (only 16% of stations), we derived PM2.5 values from PM10 data using WHO's conversion coefficient for T & uuml;rkiye. RESULTS: We identified the provinces with the highest PM2.5 concentrations and associated mortality: I & gbreve;d & imath;r, & Scedil;& imath;rnak, & Ccedil;orum, D & uuml;zce, and Kahramanmara & scedil;had the highest concentrations, while Erzurum, & Ccedil;orum, I & gbreve;d & imath;r, Sinop, and K & uuml;tahya had the highest mortality rates per 100,000 population. No significant correlation was found between premature deaths and the socio-economic development index of each province. Our study estimated 37,768 premature deaths attributed to long-term PM2.5 exposure in adequately monitored provinces. CONCLUSION: In 2019, T & uuml;rkiye faced persistent air pollution, with PM2.5 levels exceeding WHO's 2021 limits across all provinces and stations. T & uuml;rkiye lacks specific PM2.5 limits legislation. Our findings provide a fresh insight into the literature, highlighting policy reform needs. However, data deficiencies hindered analysis in some provinces, affecting nearly 20% of the population aged 30 and above and 31% of the total surface area. Therefore, the actual burden of air pollution-related deaths may be higher than our estimates, underscoring the need to address these challenges urgently.
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    Unclear Issues Regarding COVID-19
    (2020) Yüksel, Aycan; Karadoğan, Dilek; Gündüz, Canan; Akyıl, Fatma Tokgöz; Töreyin, Zehra Nur; Marim, Feride; Akgün, Metin
    Scientists from all over the world have been intensively working to discover different aspects of Coronavirus disease 2019 (COVID-19) since the first cluster of cases was reported in China. Herein, we aimed to investigate unclear issues related to transmission and pathogenesis of disease as well as accuracy of diagnostic tests and treatment modalities. A literature search on PubMed, Ovid, and EMBASE databases was conducted, and articles pertinent to identified search terms were extracted. A snow-ball search strategy was followed in order to retrieve additional relevant articles. It was reported that viral spread may occur during the asymptomatic phase of infection, and viral load was suggested to be a useful marker to assess disease severity. In contrast to immune response against viral infections, cytotoxic T lymphocytes decline in SARS-CoV-2 infection, which can be partially explained by direct invasion of T lymphocytes or apoptosis activated by SARS-CoV-2. Dysregulation of the urokinase pathway, cleavage of the SARS-CoV-2 Spike protein by FXa and FIIa, and consumption coagulopathy were the proposed mechanisms of the coagulation dysfunction in COVID-19. False-negative rates of reverse transcriptase polymerase chain reaction varied between 3% and 41% across studies. The probability of the positive test was proposed to decrease with the number of days past from symptom onset. Safety issues related to infection spread limit the use of high flow nasal oxygen (HFNO) and continuous positive airway pressure (CPAP) in hypoxic patients. Further studies are required to elucidate the challenging issues, thus enhancing the management of COVID-19 patients.