The relationship between medical innovation and health expenditures

Onur Başer (MEF Author)Objectives: It is widely accepted that medical innovation includes many costly activities, and that it is a key driver of rising health care expenditures. Understanding the relationship between medical innovation and health care expenditures is critical for health policy makers to effectively make resource allocation decisions. This study seeks to investigate the relationship between medical innovation and health care expenditures. Methods: We assessed data from the World Intellectual Property Organization and World Bank statistics for the year 2014, which included data from 72 countries. The number of patent publications in the categories of medical technology, biotechnology, and pharmaceuticals were included as medical innovation indicators; public heath, health care costs per capita, and total health care costs (percentage of gross domestic product [GDP]) were included as indicators of health care-related expenditures. A canonic correlation analysis (CCA) was performed to examine the degree of association between the sets of medical innovation and health care expenditure variables. Results: Study results indicate that there is a strong positive correlation between medical innovation and health care expenditure variables (rc= 0.68, p<0.001). Conclusions: In light of this study, health policy makers should manage the relationship between medical innovation and health care expenditures with a focus on accessibility. Improved communication channels in the social system, increased international cooperation, and the determination of a proper balance between the benefits and costs of innovation may help to continue improving medical innovation and enhance health care accessibility. We hope that the study results offer an increased awareness of the relationship and balance between innovation and expenditure, and will help to create an improved health system.WOS:000396606300046Science Citation Index Expanded - Social Sciences Citation IndexQ1Meeting AbstractUluslararası işbirliği ile yapılmayan - HAYIRKasım2016YÖK - 2016-1

The effect of feed made from fish processing waste silage on the growth of rainbow trout (Oncorhynchus mykiss)

This study researched the degree to which the growth of rainbow trout (Oncorhynchus mykiss) was influenced by pellet feed made from silage produced from waste generated by the fish food processing industry. During the 90 day trial, a completely random parcel method was used with three repetitions. The average weight of the rainbow trout was 54.05±235 g, while their average length was 17.46±0.11 cm. One hundred (100) trout were stocked (25 kg/m3) in each fiberglass fish feeding tank. Four different experimental groups were formed; feed without silage (control) and pellets with 25, 50 and 100% silage. Fish were fed twice per a day until they were satisfied (ad libitum). At the end of the study, the group that was fed with feed made from 50% silage increased the most in weight, followed by the control group and the groups fed with 25 and 100% silage, respectively. The average weight differences between the groups were found to be significant (P&lt;0.05). In conclusion, it can be said that replacing the fish meal in food used to feed trout with 50% fish silage has a positive effect on growth, and that silage can be used in trout food at the aforementioned ratio.Key words: Fish meal, fish silage, growth, feed efficiency, rainbow trout

Chitosan/Poly(2-ethyl-2-oxazoline) films with ciprofloxacin for application in vaginal drug delivery

Chitosan (CHI) and chitosan/poly(2-ethyl-2-oxazoline) (CHI/POZ)-based films were prepared by casting from aqueous solutions of polymer blends with different compositions. Ciprofloxacin was used as a model drug in these formulations. The weight, thickness, folding endurance and transparency of blend films were measured and characterised. All films had a uniform thickness (0.06 ± 0.01 mm) and exhibited sufficient flexibility. The surface pHs of films ranged from 3.76 ± 0.49 to 4.14 ± 0.32, which is within the pH range suitable for vaginal applications. The cumulative release of the drug from the films in experiments in vitro was found to be 42 ± 2% and 56 ± 1% for pure CHI and CHI/POZ (40:60) films, respectively. Drug-free chitosan/poly(2-ethyl-2-oxazoline) films showed weak antimicrobial activity against Escherichia coli. Drug-loaded CHI and CHI/POZ films showed good antimicrobial properties against both Gram-positive Staphylococcus aureus and Gram-negative bacteria Escherichia coli. Mucoadhesive properties of these films with respect to freshly excised sheep vaginal mucosa were evaluated using a tensile method. It was established that all films were mucoadhesive, but an increase in POZ content in the blend resulted in a gradual reduction of their ability to stick to vaginal mucosa. These films could potentially find applications in vaginal drug delivery

Phenolic composition, antioxidant capacity of Salvia verticcilata and effect on multidrug resistant bacteria by flow-cytometry

Background: Antioxidants are of great importance for preventing oxidative stress that may cause several degenerative diseases. Studies have indicated phytochemicals have high free-radical scavenging activity, which helps to reduce the risk of chronic diseases. The aim of the present study is the determination of antioxidant properties, polyphenolic content and multidrug resistant bacteria of Salvia verticcilata L.Materials and Methods: Methanol was used as the extraction solvent. The total phenolic content was calculated using Folin-Ciocalteau method and phenolic composition was determined by HPLC. The radical scavenging activity of plant was evaluated in vitro based on the reduction of the stable DPPH free radical. The reducing capacity was identified by using the FRAP method. The ability of Salvia verticcilata L. to increase the permeability of multidrug resistant bacterial cells was conducted by flow cytometric assay on Listeria innocua and E-coli.Results: The amount of total phenolics was found to be 347.5 mg GA/g extract. The IC50 value and FRAP assay are 0.61, and 0.944 respectively, Free radical scavenging effect and FRAP values are less than synthetic antioxidant compounds (BHA and BHT). Eight phenolic compounds were found in Salvia verticcilata L. Intense concentration of S. verticcilata L. has destroyed 97 % of living cells for Listeria innocua and 94.86% for E-coliConclusion: This studyshows that methanolic extracts of Salvia verticcilata L. is a potential source of natural antioxidants and antimicrobial agent and can form the basis for pharmacological studies.Key words: Salvia verticcilata, medicinal plant, antioxidant, phenolic composition, multidrug resistan

The influence of shift work on metabolic health

Recently, the world literature has been actively discussing the effect of circadian rhythm and sleep disturbances on human metabolic health. One of the most socially significant causes of circadian disorders is the shift work schedule. Shift work schedules began to occur more often due to the high demand for flexibility and labor productivity in modern society. Shift work is characteristic of medical personnel, law enforcement officials, rescue services, transport, the media and others. Shift workers make up about 17% of all workers in Europe. Globally, approximately 2.5 billion people work in shifts. Shift work was identified as an important professional risk. The connection between work with rotation of day and night shifts with overweight and obesity, with circadian rhythms and sleep disorders was proved. The review systematizes information regarding the role of the shift chart in the development of obesity and the metabolic syndrome, and considers mechanisms that mediate its effect on the regulation of energy balance

Quality and Safety Aspects of Infant Nutrition

Quality and safety aspects of infant nutrition are of key importance for child health, but oftentimes they do not get much attention by health care professionals whose interest tends to focus on functional benefits of early nutrition. Unbalanced diets and harmful food components induce particularly high risks for untoward effects in infants because of their rapid growth, high nutrient needs, and their typical dependence on only one or few foods during the first months of life. The concepts, standards and practices that relate to infant food quality and safety were discussed at a scientific workshop organized by the Child Health Foundation and the Early Nutrition Academy jointly with the European Society for Paediatric Gastroenterology, Hepatology and Nutrition, and a summary is provided here. The participants reviewed past and current issues on quality and safety, the role of different stakeholders, and recommendations to avert future issues. It was concluded that a high level of quality and safety is currently achieved, but this is no reason for complacency. The food industry carries the primary responsibility for the safety and suitability of their products, including the quality of composition, raw materials and production processes. Introduction of new or modified products should be preceded by a thorough science based review of suitability and safety by an independent authority. Food safety events should be managed on an international basis. Global collaboration of food producers, food-safety authorities, paediatricians and scientists is needed to efficiently exchange information and to best protect public health. Copyright (C) 2012 S. Karger AG, Base

Neonatal Nav1.5 protein expression in human colorectal cancer: immunohistochemical characterization and clinical evaluation

Voltage-gated Na+ channels (VGSCs) are expressed widely in human carcinomas and play a significant role in promoting cellular invasiveness and metastasis. However, human tissue-based studies and clinical characterization are lacking. In several carcinomas, including colorectal cancer (CRCa), the predominant VGSC is the neonatal splice variant of Nav1.5 (nNav1.5). The present study was designed to determine the expression patterns and clinical relevance of nNav1.5 protein in human CRCa tissues from patients with available clinicopathological history. The immunohistochemistry was made possible by the use of a polyclonal antibody (NESOpAb) specific for nNav1.5. The analysis showed that, compared with normal mucosa, nNav1.5 expression occurred in CRCa samples (i) at levels that were significantly higher and (ii) with a pattern that was more delineated (i.e., apical/basal or mixed). A surprisingly high level of nNav1.5 protein expression also occurred in adenomas, but this was mainly intracellular and diffuse. nNav1.5 showed a statistically significant association with TNM stage, highest expression being associated with TNM IV and metastatic status. Interestingly, nNav1.5 expression co-occurred with other biomarkers associated with metastasis, including hERG1, KCa3.1, VEGF-A, Glut1, and EGFR. Finally, univariate analysis showed that nNav1.5 expression had an impact on progression-free survival. We conclude (i) that nNav1.5 could represent a novel clinical biomarker (‘companion diagnostic’) useful to better stratify CRCa patients and (ii) that since nNav1.5 expression is functional, it could form the basis of anti-metastatic therapies including in combination with standard treatments

Quantitative super-resolution solid immersion microscopy via refractive index profile reconstruction

Solid Immersion (SI) microscopy is a modern imaging modality that overcomes the Abbe diffraction limit and offers novel applications in various branches of visible, infrared, terahertz, and millimeter-wave optics. Despite the widespread use, SI microscopy usually results in qualitative imaging. Indeed, it presents only the raw distributions (in the image plane) of the backscattered field intensity, while unlocking the information about the physical properties of an imaged object, such as its complex refractive index (RI) distribution, requires resolving the inverse problem and remains a daunting task. In this paper, a method for resolving the SI microscopy inverse problem is developed, capable of reconstructing the RI distribution at the object imaging plane with subwavelength spatial resolution, while performing only intensity measurements. The sample RI is retrieved via minimization of the error function that characterizes discrepancy between the experimental data and the predictions of analytical model. This model incorporates all the key features of the electromagnetic-wave interaction with the SI lens and an imaged object, including contributions of the evanescent and ordinary-reflected waves, as well as effects of light polarization and wide beam aperture. The model is verified numerically, using the finite-element frequency-domain method, and experimentally, using the in-house reflection-mode continuous-wave terahertz SI microscope. Spatial distributions of the terahertz RIs of different low-absorbing optical materials and highly absorbing biological objects were studied and compared to a priori known data to demonstrate the potential of the novel SI microscopy modality. Given the linear nature of the Maxwell’s equations, the developed method can be applied for subwavelength-resolution SI microscopy at other spectral ranges