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Cost-effectiveness analysis of anidulafungin vs fluconazole for the treatment of invasive candidiasis (IC) in Turkey

Neoh CF, Senol E, Kara A, Dinleyici EC, Turner SJ, Kong DCM

Mycoses, 2017 Nov;60(11):714-722.
PMID: 28699297 DOI: 10.1111/myc.12651

Anidulafungin has been shown to be non-inferior to, and possibly more efficacious, than fluconazole in treating patients with invasive candidiasis (IC). This study aimed to determine the cost-effectiveness of anidulafungin vs fluconazole for treatment of IC in the Turkish setting. A decision analytic model was constructed to depict downstream economic consequences of using anidulafungin or fluconazole for treatment of IC in the Turkish hospitals. Transition probabilities (ie treatment success, observed or indeterminate treatment failures) were obtained from a published randomised clinical trial. Cost inputs were from the latest Turkish resources. Data not available in the literature were estimated by expert panels. Sensitivity analyses were performed to assess the robustness of the model outcome. While anidulafungin [TL 17 171 (USD 4589)] incurred a higher total cost than fluconazole [TL 8233 (USD 2200) per treated patient, treatment with anidulafungin was estimated to save an additional 0.58 life-years, with an incremental cost-effectiveness ratio of TL 15 410 (USD 4118) per life-years saved. Drug acquisition cost and hospitalisation were the main cost drivers for anidulafungin and fluconazole arms respectively. The model findings were robust over a wide range of input variables except for anidulafungin drug cost. Anidulafungin appears to be a cost-effective therapy in treating IC from the Turkish hospital perspective.

Matched MeSH terms: Turkey
Fulltext The impact of SLCO1B1 genetic polymorphisms on neonatal hyperbilirubinemia: a systematic review with meta-analysis

Liu J, Long J, Zhang S, Fang X, Luo Y

J Pediatr (Rio J), 2013 07 11;89(5):434-43.
PMID: 23850112 DOI: 10.1016/j.jped.2013.01.008

OBJECTIVE: To determine whether three variants (388 G>A, 521 T>C, and 463 C>A) of the solute carrier organic anion transporter family member 1B1 (SLCO1B1) are associated with neonatal hyperbilirubinemia.
DATA SOURCE: The China National Knowledge Infrastructure and MEDLINE databases were searched. The systematic review with meta-analysis included genetic studies which assessed the association between neonatal hyperbilirubinemia and 388 G>A, 521 T>C, and 463 C>A variants of SLCO1B1 between January of 1980 and December of 2012. Data selection and extraction were performed independently by two reviewers.
SUMMARY OF THE FINDINGS: Ten articles were included in the study. The results revealed that SLCO1B1 388 G>A is associated with an increased risk of neonatal hyperbilirubinemia (OR, 1.39; 95% CI, 1.07-1.82) in Chinese neonates, but not in white, Thai, Latin American, or Malaysian neonates. The SLCO1B1 521 T>C mutation showed a low risk of neonatal hyperbilirubinemia in Chinese neonates, while no significant associations were found in Brazilian, white, Asian, Thai, and Malaysian neonates. There were no significant differences in SLCO1B1 463 C>A between the hyperbilirubinemia and the control group.
CONCLUSION: This study demonstrated that the 388 G>A mutation of the SLCO1B1 gene is a risk factor for developing neonatal hyperbilirubinemia in Chinese neonates, but not in white, Thai, Brazilian, or Malaysian populations; the SLCO1B1 521 T>C mutation provides protection for neonatal hyperbilirubinemia in Chinese neonates, but not in white, Thai, Brazilian, or Malaysian populations.

Matched MeSH terms: Turkey
Is survival enough for quality of life in Sagliker Syndrome-uglifying human face appearances in chronic kidney disease?

Sagliker Y, Acharya V, Golea O, Sabry A, Bali M, Eyupoglu K, et al.

J Nephrol, 2008 Mar-Apr;21 Suppl 13:S134-8.
PMID: 18446747

It is known that secondary hyperparathyroidism (SH) and particularly skeletal changes is a severe condition in chronic kidney disease (CKD). Sagliker syndrome (SS) is a very prominent feature in CKD including uglifying human face appearances, short stature, extremely severe maxillary and mandibulary changes, soft tissues in the mouth, teeth-dental abnormalities, finger tip changes and severe psychological problems.

Matched MeSH terms: Turkey
Fulltext Effect of pentoxifylline on tumor necrosis factor-alpha and interleukin-6 levels in neonatal sepsis

Selim K, Hüseyin C, Ibrahim KH, Hasan BU, Kazim U, Hüseyin K

Med J Malaysia, 2004 Aug;59(3):391-4.
PMID: 15727386

Several pharmacological agents have been found to alter systemic concentrations and/or the activity of different cytokines via a variety of mechanisms, including changes in biosynthesis, secretion, and/or stability. Pentoxifylline (PTX), which is a methylxanthine derivative for example, has multiple effects on the immune system, but inhibition of pro-inflammatory cytokine release predominates. In this study we aimed to evaluate the influence of PTX on plasma levels of tumor necrosis factor (TNF) alpha and interleukin (IL)-6 in newborn infants with sepsis. The study included 20 infants with neonatal sepsis. In all subjects blood samples for serum C-reactive protein, TNF alpha and IL-6 determinations were received before giving PTX and at the 12th and 24th hours following PTX. In addition, white blood cell was counted before giving PTX and on the 3rd and 7th day following PTX. The infants were randomly divided into two groups. Firstly, PTX was used in infants who were successively admitted to the clinic and the subsequent infants were accepted as a control group. Of 20 infants, 13 infants received PTX and seven infants did not. We did not find any difference in the leukocyte count, serum C-reactive protein level, TNF alpha and IL-6 levels between the two groups of patients (P>0.05). While three infants died in the group of receiving PTX, death was not recorded in the group of non-receiving PTX (P>0.05). Our findings showed that PTX treatment did not affect leukocyte counts, serum CRP levels, TNF alpha and IL-6 levels and death ratio in newborn infants with sepsis. The last result may be due to the fact that the number of patients in the study was very small. We think that more extensive and controlled studies should be performed about this subject.

Matched MeSH terms: Turkey
The first serological report for genotype C bovine parainfluenza 3 virus in ruminant species of mid-northen Turkey: Traces from the past

Yazici Z, Gumusova S, Tamer C, Muftuoglu B, Ozan E, Arslan S, et al.

Trop Biomed, 2019 Sep 01;36(3):803-809.
PMID: 33597501

Bovine parainfluenza 3 virus (BPI3V)is one of the most important respiratory pathogens and a leading cause of serious respiratory illnesses in cattle, both independent of and in connection with other pathogens involved in the bovine respiratory disease complex (BRDC). In this study, we aimed to identify the historical circulation of genotype C bovine BPI3V (BPI3Vc) in Turkey using the archival serum samples of domestic ruminants that had been collected from six provinces of northern Anatolia in Turkey between 2009-2010. A total of 896 sera from cattle (n=442), sheep (n=330), and goats (n=124) were randomly selected and screened with a virus neutralization test in order to detect antibodies for BPI3Vc. The overall seropositivity rate was 21.09%, with seropositivity rates for cattle, sheep, and goats of 21.04%, 20.00%, and 24.19%, respectively. Neutralizing antibody titers for selected samples ranged between 1/4 to 1/512. This study represents the first serological study conducted using the first BPI3V isolate of Turkey.

Matched MeSH terms: Turkey
Effects of probiotics on salivary Streptecoccus mutans and Lactobacillus levels in orthodontic patients

Alp S, Baka ZM

Am J Orthod Dentofacial Orthop, 2018 Oct;154(4):517-523.
PMID: 30268262 DOI: 10.1016/j.ajodo.2018.01.010

INTRODUCTION: In this study, we aimed to determine the effect of regular probiotic consumption on microbial colonization in saliva in orthodontic patients and to comparatively evaluate the difference between the systemic consumption of probiotic products and the local application.
METHODS: This study included 3 groups with 15 orthodontic patients in each. The control group included patients who had no probiotic treatment, the subjects in the kefir group consumed 2 × 100 ml of kefir (Atatürk Orman Ciftligi, Ankara, Turkey) per day, and the subjects in the toothpaste group brushed their teeth with toothpaste with probiotic content (GD toothpaste; Dental Asia Manufacturing, Shah Alam, Selangor, Malaysia) twice a day. Samples were collected at 3 times: beginning of the study, 3 weeks later, and 6 weeks later. The salivary flow rate, buffer capacity, and Streptococcus mutans and Lactobacillus levels in the saliva were evaluated. Chair-side kits were used to determine the S mutans and Lactobacillus levels.
RESULTS: A statistically significant decrease was observed in the salivary S mutans and Lactobacillus levels in the kefir and toothpaste groups compared with the control group (P <0.05). A statistically significant increase was observed in the toothpaste group compared with the control and kefir groups in buffer capacity. Changes in the salivary flow rate were not statistically significant.
CONCLUSIONS: The regular use of probiotics during fixed orthodontic treatment reduces the S mutans and Lactobacillus levels in the saliva.

Matched MeSH terms: Turkey
Lower CYP2C9 activity in Turkish patients with Behçet's disease compared to healthy subjects: a down-regulation due to inflammation?

Goktaş MT, Hatta F, Karaca O, Kalkisim S, Kilic L, Akdogan A, et al.

Eur J Clin Pharmacol, 2015 Oct;71(10):1223-8.
PMID: 26233334 DOI: 10.1007/s00228-015-1899-7

BACKGROUND: We previously reported on a Swedish patient with Behçet's disease (BD) who was an ultra-rapid metaboliser of drugs catalysed by CYP2C9. Was this extreme metabolism caused by the disease?

AIM: This study aims to compare the genotype/phenotype of CYP2C9 in patients with BD and healthy subjects. As the occurrence of BD is high in Turkey, all subjects were recruited from this country.

METHODS: Genotyping of CYP2C9 was performed using standard PCR-RFLP and allele-specific PCR methods. Phenotyping of CYP2C9 was performed by administration of a 50-mg single oral dose of losartan and by calculating the urinary metabolic ratio (MR) of probe drug to its metabolite E-3174. Quantitation was performed by HPLC.

RESULTS: The frequency of CYP2C9*2 and *3 was not significantly different between the Behçet's disease patients (12.5 and 8.7%) and the healthy subjects (8.9 and 8.2%). The geometric mean losartan MR was higher in the 52 patients (1.75) than in the 96 healthy subjects (1.02) (p = 0.002; t-test). Within the genotypes *1/*1, there was a significant difference of MR between patients and healthy subjects (P = 0.006). All but three of the Behçet's disease patients were treated with colchicine. In nine subsequent patients, we found no significant effect of 2 weeks of treatment with colchicine on the CYP2C9 MR.

CONCLUSION: Contrary to expectation, the CYP2C9 activity was lower in Turkish BD patients compared to healthy subjects. As this seems not to be due to colchicine treatment, our hypothesis is that inflammation related to BD might have caused the down-regulation of the CYP2C9 activity due to immune cytokine reactions. The ultra-rapid metabolism of CYP2C9 substrate drugs in the Swedish patient was not due to her BD.

Matched MeSH terms: Turkey
Development and human resources in the Islamic world: a study of selected countries

Duza MB

Popul Sci, 1987;7:1-30.
PMID: 12315536

"The present paper attempts to provide an analytical profile of development and human resources in [12] selected [Islamic] countries." The countries--Bangladesh, Somalia, Pakistan, Indonesia, Egypt, Turkey, Malaysia, Algeria, Iraq, Saudi Arabia, Kuwait, and United Arab Emirates--vary in income levels from low to high and in population size from 1 million to 159 million. Using data from the World Bank and the Population Council, comparisons are made on the basis of mortality and fertility levels, family size, income, urbanization, labor force size and growth, education, nutrition, and health. Governmental policy changes and future directions are discussed.

Matched MeSH terms: Turkey
Availability and affordability of cardiovascular disease medicines and their effect on use in high-income, middle-income, and low-income countries: an analysis of the PURE study data

Khatib R, McKee M, Shannon H, Chow C, Rangarajan S, Teo K, et al.

Lancet, 2016 Jan 2;387(10013):61-9.
PMID: 26498706 DOI: 10.1016/S0140-6736(15)00469-9

BACKGROUND: WHO has targeted that medicines to prevent recurrent cardiovascular disease be available in 80% of communities and used by 50% of eligible individuals by 2025. We have previously reported that use of these medicines is very low, but now aim to assess how such low use relates to their lack of availability or poor affordability.
METHODS: We analysed information about availability and costs of cardiovascular disease medicines (aspirin, β blockers, angiotensin-converting enzyme inhibitors, and statins) in pharmacies gathered from 596 communities in 18 countries participating in the Prospective Urban Rural Epidemiology (PURE) study. Medicines were considered available if present at the pharmacy when surveyed, and affordable if their combined cost was less than 20% of household capacity-to-pay. We compared results from high-income, upper middle-income, lower middle-income, and low-income countries. Data from India were presented separately given its large, generic pharmaceutical industry.
FINDINGS: Communities were recruited between Jan 1, 2003, and Dec 31, 2013. All four cardiovascular disease medicines were available in 61 (95%) of 64 urban and 27 (90%) of 30 rural communities in high-income countries, 53 (80%) of 66 urban and 43 (73%) of 59 rural communities in upper middle-income countries, 69 (62%) of 111 urban and 42 (37%) of 114 rural communities in lower middle-income countries, eight (25%) of 32 urban and one (3%) of 30 rural communities in low-income countries (excluding India), and 34 (89%) of 38 urban and 42 (81%) of 52 rural communities in India. The four cardiovascular disease medicines were potentially unaffordable for 0·14% of households in high-income countries (14 of 9934 households), 25% of upper middle-income countries (6299 of 24,776), 33% of lower middle-income countries (13,253 of 40,023), 60% of low-income countries (excluding India; 1976 of 3312), and 59% households in India (9939 of 16,874). In low-income and middle-income countries, patients with previous cardiovascular disease were less likely to use all four medicines if fewer than four were available (odds ratio [OR] 0·16, 95% CI 0·04-0·57). In communities in which all four medicines were available, patients were less likely to use medicines if the household potentially could not afford them (0·16, 0·04-0·55).
INTERPRETATION: Secondary prevention medicines are unavailable and unaffordable for a large proportion of communities and households in upper middle-income, lower middle-income, and low-income countries, which have very low use of these medicines. Improvements to the availability and affordability of key medicines is likely to enhance their use and help towards achieving WHO's targets of 50% use of key medicines by 2025.
FUNDING: Population Health Research Institute, the Canadian Institutes of Health Research, Heart and Stroke Foundation of Ontario, AstraZeneca (Canada), Sanofi-Aventis (France and Canada), Boehringer Ingelheim (Germany and Canada), Servier, GlaxoSmithKline, Novartis, King Pharma, and national or local organisations in participating countries.

Matched MeSH terms: Turkey
Combination of phenolic profiles, pharmacological properties and in silico studies to provide new insights on Silene salsuginea from Turkey

Zengin G, Rodrigues MJ, Abdallah HH, Custodio L, Stefanucci A, Aumeeruddy MZ, et al.

Comput Biol Chem, 2018 Dec;77:178-186.
PMID: 30336375 DOI: 10.1016/j.compbiolchem.2018.10.005

The genus Silene is renowned in Turkey for its traditional use as food and medicine. Currently, there are 138 species of Silene in Turkey, amongst which have been several studies for possible pharmacological potential and application in food industry. However, there is currently a paucity of data on Silene salsuginea Hub.-Mor. This study endeavours to access its antioxidant, enzyme inhibitory, and anti-inflammatory properties. Besides, reversed-phase high-performance liquid chromatography-diode array detector (RP-HPLC-DAD) was used to detect phenolic compounds, and molecular docking was performed to provide new insights for tested enzymes and phenolics. High amounts of apigenin (534 μg/g extract), ferulic acid (452 μg/g extract), p-coumaric acid (408 μg/g extract), and quercetin (336 μg/g extract) were detected in the methanol extract while rutin (506 μg/g extract) was most abundant in the aqueous extract. As for their biological properties, the methanol extract exhibited the best antioxidant effect in the DPPH and CUPRAC assays, and also the highest inhibition against tyrosinase. The aqueous extract was the least active enzyme inhibitor but showed the highest antioxidant efficacy in the ABTS, FRAP, and metal chelating assays. At a concentration of 15.6 μg/mL, the methanol extract resulted in a moderate decrease (25.1%) of NO production in lipopolysaccharide-stimulated cells. Among the phenolic compounds, epicatechin, (+)-catechin, and kaempferol showed the highest binding affinity towards the studied enzymes in silico. It can be concluded that extracts of S. salsuginea are a potential source of functional food ingredients but need further analytical experiments to explore its complexity of chemical compounds and pharmacological properties as well as using in vivo toxicity models to establish its maximum tolerated dose.

Matched MeSH terms: Turkey

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