Sağlık Turizmi ve Uluslararası Hastalar İçin Türkiye Pazarı

Günden güne hem kamu, hem de özel hastanelerin sayısı artmaktadır. Ulusal hastalara ait sabit bir pazar olması, sağlık sektöründe büyük bir rekabeti de beraberinde getirmektedir. Türkiye coğrafik konumu, iklimi, termal kaynakları, doğal güzellikleri, kaliteli tıp personeli ve yüksek teknoloji kullanan aletlere sahip hastaneleri ile sağlık turizmi için büyük bir potansiyele sahiptir. Sağlık turizminin 2011 yılı verilerine göre dünyadaki pazar payı yaklaşık olarak 400 milyar dolardır. Bu çalışma ile Türkiye’nin bu pazardaki mevcut durumunu ortaya koyarken; gelecekte bu pazardaki payını daha da artırabilmek için gereken öneri ve düzenlemelerin geliştirilmesi amaçlanmıştır. Hastalara ait veriler Sağlık Bakanlığı ile Kültür ve Turizm Bakanlığı’nın resmi sitelerinden alınmıştır. 2010 yılında, sağlık turizmi için 109-678 hasta Türkiye’ye gelmiştir (Özel hastane: 77.003; kamu hastanesi: 32.675 kişi). Hastaların geldikleri ülke ve aldıkları sağlık hizmetine göre farklı dağılımlar sergilediği görülmektedir. Kamu hastanelerinin yanı sıra özel hastanelerin sayısı da günden güne artmakta ve bu sektörde önemli bir yer almaktadırlar. Sağlık sektöründe pazarı arttırmak için Sağlık Bakanlığı ile Kültür ve Turizm Bakanlığı sağlık turizmine gereken önemi vermelidir. Bu yolla oluşan döviz girdisi sağlık sektöründe pazar payını arttırırken; ortaya çıkan yeni iş olanakları işsizliği azaltacaktır. Sağlık sektörünün ayakta kalması için sağlık turizmi gün geçtikçe daha önemli hale gelmektedir

The effect of femoral nerve block on fracture healing via expressions of growth factors and β-catenin

Introduction. Many patients of all ages are admitted to hospital due to bone fractures. The etiology of fracture has a very wide spectrum, ranging from motor accidents to pathological conditions such as tumors, osteoporosis, and others. Bone fracture healing is a well-programmed and well-organized process, but is also long and intractable. The outcome of this process is therefore affected by many factors, such as the patient’s age, ethnicity, nutritional status, and extent of the fracture. At present, regional analgesic techniques are frequently applied in order to avoid the complications of systemic opioid administration, central block applications. Femoral block is one of the regional analgesic techniques frequently applied by anesthesiologists when the lower extremities are involved. In this study, we evaluated the effect of femoral nerve block on the healing of an experimental non-stabilized femur fracture via expression of TGF-β, VEGF, and β-catenin and bone histomorphometry in rats. Material and methods. In the control group, only the femoral fracture was performed and the bone was not fixated, similarly as in other groups. In the One-Day Block group, a one-time femoral nerve block was applied after the femoral fracture. In the Three-Day Block group, a daily femoral nerve block was performed for three days after the femoral fracture. On Days 4, 7, and 13, femurs were excised. The bone sections were stained with hematoxylin-eosin to evaluate bone tissue and Safranin O to assess callus tissue, cartilaginous tissue, and new bone areas. TGF-β, VEGF, and β-catenin were assessed by immunohistochemistry. Results. Histomorphometric analysis revealed that femoral block application had a positive impact on bone healing. TGF-β expression in the One-Day and Three-Day Block Groups was significantly higher than in the control group at all times, as was also the case with VEGF expression. On day 13, β-catenin expression was significantly higher in the Three-Day Block group than the others. Conclusions. The results of the study suggests that the applications of a femoral nerve block for perioperative analgesia, for either one day or three days, resulted in better and more rapid bone healing

Hastane Hizmetleri Hakkında Sağlık Çalışanlarının Algıları ile Hastaların Değerlendirmelerinin Karşılaştırılması

Amaç: Sağlık hizmetlerinin kalitesi ülkelerin sosyo-ekonomik kalkınma dü- zeylerinin de bir göstergesidir. Bu kapsamda standartlara uygun tanı, tedavi ve bakım hizmetlerinin, hastaların ihtiyaç ve beklentilerine cevap verecek şekilde kaliteli ve hızlı şekilde sunulması gerekmektedir. Sağlık çalışanları ile hastalar arasındaki etkileşim de sağlık hizmeti kalitesini doğrudan etkileyebilmektedir. Bu çalışmada, sağlık çalışanlarının hizmet algıları ile hastaların aldıkları sağlık hizmetini değerlendirmeleri arasında ilişki olup olmadığı bir saha araştırması ile incelenmiştir. Çalışma Planı: Hastane etik kurulu ve yönetiminden izin alınarak sağlık çalı- şanları ve hastalardan oluşan örneklem grubuna anket uygulanarak araştırma verileri toplanmıştır. Hasta grubu ayaktan ve yatarak tedavi gören hastalar olarak iki ayrı grupta incelenmiştir. Bulgular: Ayaktan tedavi gören hastaların aldıkları hizmeti değerlendirmelerinin, doktorların verdikleri sağlık hizmet algılarından daha olumsuz olduğu ortaya çıkmıştır. Yatarak tedavi gören hastaların aldıkları hizmeti de- ğerlendirmeleri ise, sağlık çalışanlarının (doktorlar ve hemşireler) hizmet algıları ile benzer olduğu görülmüştür. Sonuç: Hastaların aldıkları sağlık hizmetlerini değerlendirmeleri ve bu değerlendirmelerin sonucunda sağlık çalışanlarına da verdikleri hizmetlerin hastalar tarafından nasıl değerlendirildiği ile ilgili geri bildirim yapılması, sunulan sağlık hizmetleri konusunda daha özenli olunmasını sağlayarak kaliteli sağlık hizmeti sunumunun gerçekleştirilmesine olanak sağlayacaktır

Anaesthesia recommendations for patients suffering from Alkaptonuria

Alkaptonuria (AKU) is a rare autosomal recessive disorder with an incidence of 1:250 000 to 1:1000 000 live births. AKU is caused by a deficiency of the enzyme homogentisate 1,2-dioxygenase (HGO). This enzyme converts homogentisic acid (HGA) to maleylacetoacetic acid in the tyrosine degradation pathway. Accumulated HGA is rapidly cleared in the kidney and excreted in the urine. HGA blood levels are kept very low through rapid kidney clearance, but over time HGA is deposited in cartilage throughout the body and converted to a pigment-like polymer. This occurs through an enzyme-mediated reaction in collagenous tissues like ligaments, tendons, cartilage, and sclera

The effect of femoral nerve block on fracture healing via expressions of growth factors and beta-catenin

WOS: 000392717800006PubMed ID: 27654016Introduction. Many patients of all ages are admitted to hospital due to bone fractures. The etiology of fracture has a very wide spectrum, ranging from motor accidents to pathological conditions such as tumors, osteoporosis, and others. Bone fracture healing is a well-programmed and well-organized process, but is also long and intractable. The outcome of this process is therefore affected by many factors, such as the patient's age, ethnicity, nutritional status, and extent of the fracture. At present, regional analgesic techniques are frequently applied in order to avoid the complications of systemic opioid administration, central block applications. Femoral block is one of the regional analgesic techniques frequently applied by anesthesiologists when the lower extremities are involved. In this study, we evaluated the effect of femoral nerve block on the healing of an experimental non-stabilized femur fracture via expression of TGF-beta, VEGF, and beta-catenin and bone histomorphometry in rats. Material and methods. In the control group, only the femoral fracture was performed and the bone was not fixated, similarly as in other groups. In the One-Day Block group, a one-time femoral nerve block was applied after the femoral fracture. In the Three-Day Block group, a daily femoral nerve block was performed for three days after the femoral fracture. On Days 4, 7, and 13, femurs were excised. The bone sections were stained with hematoxylin-eosin to evaluate bone tissue and Safranin O to assess callus tissue, cartilaginous tissue, and new bone areas. TGF-beta, VEGF, and beta-catenin were assessed by immunohistochemistry. Results. Histomorphometric analysis revealed that femoral block application had a positive impact on bone healing. TGF-beta expression in the One-Day and Three-Day Block Groups was significantly higher than in the control group at all times, as was also the case with VEGF expression. On day 13, beta-catenin expression was significantly higher in the Three-Day Block group than the others. Conclusions. The results of the study suggests that the applications of a femoral nerve block for perioperative analgesia, for either one day or three days, resulted in better and more rapid bone healing.Turkish Regional Anesthesia Association at 13th National Regional Association CongressThis study was awarded with Best Free Paper by Turkish Regional Anesthesia Association at 13th National Regional Association Congress, 2013

Effects of ozone on spinal cord recovery via the Wnt/beta-catenin pathway following spinal cord injury in Rats

WOS: 000417623700014AIM: At the cellular level, spinal cord injury (SCI) provokes an inflammatory response that generates substantial secondary damage within the spinal cord but may also contribute to its repair. Besides intracellular antioxydant increase after exactly estimated oxidative stress; oxygen formation and transport is also advanced by ozone. The Wnt family of proteins contributes to the development of the nervous system, influencing cell proliferation. In the present study we evaluated the effect of ozone on spinal cord injury in rats. MATERIAL and METHODS: Twenty-one male Sprague-Dawley rats were used. The rats were randomly allocated into three groups (control, trauma and trauma+ozone). SCI was inflicted using Allen's spinal cord trauma method. The study was performed to determine the effects of ozone therapy on rats with SCI in terms of locomotor strength clinically and neuronal injury, white matter cavitation, edema, number of blood vessels, and expression of beta-catenin immunohistochemically. RESULTS: Comparison of the locomotor strength scores revealed a significant improvement on day 7 in trauma+ozone group. The groups were compared with regard to edema, neuronal injury, and white matter cavitation. Average beta-catenin levels were significantly different between the control group (68.11 +/- 0.43), trauma+ozone group (37.96 +/- 2.16), and trauma group (25.46 +/- 1.07) (F = 1677.74, df = 2, p < 0.0005). CONCLUSION: The results of this study indicated that ozone therapy accelerates the healing process, increases vascularity, and reduces neuronal damage in rodents, suggesting that ozone therapy may be an adjuvant treatment in patients with SCI

Assessment of association between the potential immunomodulatory activity and drinking olive leaf tea in the coronavirus disease-2019 pandemic: An observational study

Objective: During the Coronavirus Disease-2019 (COVID-19) pandemic, in addition to the current measures, the healthy immune system plays an essential role and various natural agents have been recommended to boost innate immunity. The aim of this study was to investigate any association between the potential immunomodulatory activity and drinking olive leaf tea (OLT) in the COVID-19 pandemic.Design: The study was conducted among the workers in a tractor factory where OLT was served in routine. Drinking at least one cup of OLT per day for a minimum of 1 month was the inclusion criteria used in the study. The workers who had a history of vaccination and COVID-19 were excluded from the study, and lymphocyte subsets, interleukin (IL)-2, IFN-gamma, COVID-19-specific IgM and IgG levels were analyzed in all the participants to determine the asymptomatic individuals among the participants and compare the immunological parameters.Results: The study was conducted among 336 workers, 183 of them were OLT drinkers and 153 were OLT nondrinkers. The results showed higher values of CD3(-)/CD16/56 (natural killer [NK]) cells, CD3(+)/CD16/56 (natural killer T [NKT]) cells, total NK (NK+NKT) cells, and serum IFN-gamma, and IL-2 levels in OLT drinkers compared to the nondrinkers. Although all the OLT drinkers and nondrinkers included in the study reported no history of COVID-19, specific COVID-19 IgG levels were found positive in 60% of OLT drinkers and 38% OLT nondrinkers.Conclusions: Peripheral NK and NKT cell values and IL-2 and IFN-gamma secretion levels were found higher in the OLT drinking group. There were positive correlations between the OLT drinking frequency and NK cell counts. Moreover, the number of individuals who had "asymptomatic" COVID-19 infection was higher in the OLT drinking group than in the nondrinking cohort.Clinical Trail: The trial has been registered in the ClinicalTrials.gov database (CTR NCT05222347)