Optimizing the Access to Healthcare Services in Dense Refugee Hosting Urban Areas: A Case for Istanbul

With over 3.5 million refugees, Turkey continues to host the world's largest refugee population. This introduced several challenges in many areas including access to healthcare system. Refugees have legal rights to free healthcare services in Turkey's public hospitals. With the aim of increasing healthcare access for refugees, we looked at where the lack of infrastructure is felt the most. Our study attempts to address these problems by assessing whether Migrant Health Centers' locations are optimal. The aim of this study is to improve refugees' access to healthcare services in Istanbul by improving the locations of health facilities available to them. We used call data records provided by Turk Telekom.Comment: version to submit for D4R competitio

Methemoglobinemia presenting in a circumcised baby following application of prilocaine: a case report

<p>Abstract</p> <p>Introduction</p> <p>Local anesthesia with prilocaine has become a routine part of ambulatory circumcision procedures. Methemoglobinemia is a rare but potentially lethal complication of local anesthetics.</p> <p>Case presentation</p> <p>We report the case of a 40-day-old Turkish boy who presented with cyanosis after receiving local anesthesia with prilocaine. His methemoglobin level revealed severe methemoglobinemia (methemoglobin = 44%). His cyanosis resolved after intravenous administration of methylene blue.</p> <p>Conclusion</p> <p>Although the association between prilocaine use and methemoglobinemia has generally restricted the use of prilocaine in babies, it is still widely used in ambulatory procedures, especially during circumcision in the neonatal period. Prilocaine should not be used in babies who are less than 3 months old because of the risk of methemoglobinemia; other local anesthetics may be used for this age group. Furthermore, general anesthesia by mask ventilation may be favored for babies less than 3 months of age instead of local anesthetics.</p

Effects of Atmospheric Pressure Plasma Treatments on Some Physical Properties of Wool Fibers

WOS: 000269379900002Knitted wool fabrics were treated with argon and air atmospheric plasma. Pilling, bursting strength, thermal resistance, thermal conductivity, air permeability, water vapor permeability and friction properties were investigated. The surfaces of untreated and plasma-treated wool fabrics were analyzed by scanning electron microscopy to compare the morphological changes. The outcomes showed that atmospheric plasma treatments affected the physical properties of wool fabrics such as thermal properties, water vapor permeability, air permeability and friction properties. While there was an increase in thermal resistance, water vapor permeability and friction properties; pilling tendency, bursting strength, thermal conductivity and air permeability values decreased

A New Tc-99m Labeled Peptide: Tc-99m beta-Casomorphin 6, Biodistribution and Imaging Studies on Rats

WOS: 000388115200003Peptide radiopharmaceuticals have an increasing significance in nuclear medicine practice. beta-casomorphin is a digestive peptide with 6 amino acids (Tyr-Pro-Phe-Pro-Gly-Pro). N terminal amino acid chain mainly tyr-pro-phe-pro structured exogen opioid peptid type beta cosomorphin are beta-receptor agonistic activity with priority. Animal studies show that beta-casomorphins can act as opioid receptor agonists. The aim of this study was to label beta-casomorphin with (99m) Tc and to examine its usefulness as an opioid receptor binding radiopharmaceutical in Albino Wistar rats and cancer cells. beta-casomorphin was labeled with (99m) Tc radionuclide using bifunctional chelating agent. Quality control studies were done by Instant Thin layer chromatography (ITLC) and High performance liquid chromatography (HPLC) methods. Binding efficiency of the compound was more than 99%. It was observed as stable for at least 3 h at room temperature. Lipophilicity was also performed for labeled molecule. Imaging studies for (99m) Tc labeled molecule was done in rats by using gamma camera. For biodistribution studies; (99m) Tc labeled molecule was injected to the rats from tail vein and radioactivity per gr weight of each organ was measured as count per second (cps). Receptor specificity was evaluated in imaging and biodistribution studies in experimental animals. Cell labeling studies were also performed on breast and ovarien cancer cells. In terms of evaluating the biodistribution of (99m) Tc-beta-casomorphin molecule in rats, uterus and ovary displayed high involvement. It was also confirmed by cell labeling studies. If the radiopharmaceutical is radiolabeled with therapeutic radionuclides it would be useful for therapy for uterus, ovary and breast tumors.Scientific and Technological Research Council of Turkey (TUBITAK)Turkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK) [TBAG-104T241]This work was supported by the Scientific and Technological Research Council of Turkey (TUBITAK), the author wish to thank TUBITAK for financial support (Grant No: TBAG-104T241)

Treatment delays and in-hospital outcomes in acute myocardial infarction during the COVID-19 pandemic: A nationwide study

© 2020 by Turkish Society of Cardiology.Objective: Delayed admission of myocardial infarction (MI) patients is an important prognostic factor. In the present nationwide registry (TURKMI-2), we evaluated the treatment delays and outcomes of patients with acute MI during the Covid-19 pandemic and compaired with a recent pre-pandemic registry (TURKMI-1). Methods: The pandemic and pre-pandemic studies were conducted prospectively as 15-day snapshot registries in the same 48 centers. The inclusion criteria for both registries were aged ≥18 years and a final diagnosis of acute MI (AMI) with positive troponin levels. The only difference between the 2 registries was that the pre-pandemic (TURKMI-1) registry (n=1872) included only patients presenting within the first 48 hours after symptom-onset. TURKMI-2 enrolled all consecutive patients (n=1113) presenting with AMI during the pandemic period. Results: A comparison of the patients with acute MI presenting within the 48-hour of symptom-onset in the pre-pandemic and pandemic registries revealed an overall 47.1% decrease in acute MI admissions during the pandemic. Median time from symptom-onset to hospital-arrival increased from 150 min to 185 min in patients with ST elevation MI (STEMI) and 295 min to 419 min in patients presenting with non-STEMI (NSTEMI) (p-values <0.001). Door-to-balloon time was similar in the two periods (37 vs. 40 min, p=0.448). In the pandemic period, percutaneous coronary intervention (PCI) decreased, especially in the NSTEMI group (60.3% vs. 47.4% in NSTEMI, p<0.001; 94.8% vs. 91.1% in STEMI, p=0.013) but the decrease was not significant in STEMI patients admitted within 12 hours of symptom-onset (94.9% vs. 92.1%; p=0.075). In-hospital major adverse cardiac events (MACE) were significantly increased during the pandemic period [4.8% vs. 8.9%; p<0.001; age- and sex-adjusted Odds ratio (95% CI) 1.96 (1.20-3.22) for NSTEMI, p=0.007; and 2.08 (1.38-3.13) for STEMI, p<0.001]. Conclusion: The present comparison of 2 nationwide registries showed a significant delay in treatment of patients presenting with acute MI during the COVID-19 pandemic. Although PCI was performed in a timely fashion, an increase in treatment delay might be responsible for the increased risk of MACE. Public education and establishing COVID-free hospitals are necessary to overcome patients' fear of using healthcare services and mitigate the potential complications of AMI during the pandemic

Familial Mediterranean fever (FMF) in Turkey - Results of a nationwide multicenter study

Familial Mediterranean fever (FMF) is an autosomal recessive disease that is prevalent among eastern Mediterranean populations, mainly non-Ashkenazi Jews, Armenians, Turks, and Arabs. Since a large proportion of all the FMF patients in the world live in Turkey, the Turkish FMF Study Group (FMF-TR) was founded to develop a patient registry database and analyze demographic, clinical, and genetic features