scholarly journals Dimensions of Health Tourism in Turkey

2019 ◽  
Author(s):  
Emre Kol
Keyword(s):  
Heart Surgery ◽  
Open Heart Surgery ◽  
Aesthetic Surgery ◽  
World Health ◽  
Health Tourism ◽  
Economic Dimension ◽  
Vitro Fertilization ◽  
Eye Surgery ◽  
The World

Recently, many people in various countries have preferred private healthcare organizations in Turkey for treatment. The most important reason for this situation is that medical operations performed with modern techniques in source countries are also performed in Turkey and at affordable prices. Because of the low cost, high quality, and technology standards, foreign patients prefer Turkish health institutions in almost every field such as plastic and aesthetic surgery, hair transplantation, eye surgery, in vitro fertilization, open-heart surgery, dermatological diseases, checkups, cancer treatments, otorhinolaryngology, dialysis, cardiovascular surgery, gynecology, neurosurgery, orthopedics, dentistry, spa, physiotherapy, and rehabilitation. The 2013 report of the United Nations World Tourism Organization (UNWTO) states that the number of international patients in Turkey has increased in recent years but is still behind the numbers of patients traveling for treatment purposes around the world. Important achievements, particularly in the fields of transplantation, genetic testing, eye surgery, cardiology, orthopedics, plastic surgery, and dentistry, bring Turkey to the forefront of health tourism. This study emphasizes the economic dimensions of health tourism by discussing the improvement of health tourism in Turkey. Advantages, disadvantages, and future opportunities for health tourism in Turkey are examined in terms of diversification of the country’s tourism, economic dimensions, and alternative tourism opportunities. In this context, the study mentions the notion of health tourism, boosting health tourism around the world and in Turkey, and the place and economic dimension of Turkey within world health tourism.

Monitoring of r-Hirudin Anticoagulation during Cardiopulmonary Bypass – Assessment of the Whole Blood Ecarin Clotting Time

1997 ◽  
Vol 77 (05) ◽  
pp. 0920-0925 ◽  
Author(s):  
Bernd Pötzsch ◽  
Katharina Madlener ◽  
Christoph Seelig ◽  
Christian F Riess ◽  
Andreas Greinacher ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Whole Blood ◽  
Heart Surgery ◽  
Ex Vivo ◽  
Open Heart Surgery ◽  
Clotting Time ◽  
Blood Samples ◽  
Alternative Approach ◽  
Ecarin Clotting Time

SummaryThe use of recombinant ® hirudin as an anticoagulant in performing extracorporeal circulation systems including cardiopulmonary bypass (CPB) devices requires a specific and easy to handle monitoring system. The usefulness of the celite-induced activated clotting time (ACT) and the activated partial thromboplastin time (APTT) for r-hirudin monitoring has been tested on ex vivo blood samples obtained from eight patients treated with r-hirudin during open heart surgery. The very poor relationship between the prolongation of the ACT and APTT values and the concentration of r-hirudin as measured using a chromogenic factor Ila assay indicates that both assays are not suitable to monitor r-hirudin anticoagulation. As an alternative approach a whole blood clotting assay based on the prothrombin-activating snake venom ecarin has been tested. In vitro experiments using r-hirudin- spiked whole blood samples showed a linear relationship between the concentration of hirudin added and the prolongation of the clotting times up to a concentration of r-hirudin of 4.0 µg/ml. Interassay coefficients (CV) of variation between 2.1% and 5.4% demonstrate the accuracy of the ecarin clotting time (ECT) assay. Differences in the interindividual responsiveness to r-hirudin were analyzed on r-hirudin- spiked blood samples obtained from 50 healthy blood donors. CV- values between 1.8% and 6% measured at r-hirudin concentrations between 0.5 and 4 µg/ml indicate remarkably slight differences in r-hirudin responsiveness. ECT assay results of the ex vivo blood samples linearily correlate (r = 0.79) to the concentration of r-hirudin. Moreover, assay results were not influenced by treatment with aprotinin or heparin. These findings together with the short measuring time with less than 120 seconds warrant the whole blood ECT to be a suitable assay for monitoring of r-hirudin anticoagulation in cardiac surgery.

Natural products from the traditional Moroccan pharmacopoeia: A potential lead for the prevention and treatment of COVID-19

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 1278-1285
Author(s):  
Mohamed Yafout ◽  
Amine Ousaid ◽  
Ibrahim Sbai El Otmani ◽  
Youssef Khayati ◽  
Amal Ait Haj Said
Keyword(s):  
Medicinal Plants ◽  
Plant Extracts ◽  
Molecular Mechanisms ◽  
Scientific Literature ◽  
Treatment Protocol ◽  
World Health ◽  
The World ◽  
Health Organization ◽  
Promising Source

The new SARS-CoV-2 belonging to the coronaviruses family has caused a pandemic affecting millions of people around the world. This pandemic has been declared by the World Health Organization as an international public health emergency. Although several clinical trials involving a large number of drugs are currently underway, no treatment protocol for COVID-19 has been officially approved so far. Here we demonstrate through a search in the scientific literature that the traditional Moroccan pharmacopoeia, which includes more than 500 medicinal plants, is a fascinating and promising source for the research of natural molecules active against SARS-CoV-2. Multiple in-silico and in-vitro studies showed that some of the medicinal plants used by Moroccans for centuries possess inhibitory activity against SARS-CoV or SARS-CoV-2. These inhibitory activities are achieved through the different molecular mechanisms of virus penetration and replication, or indirectly through stimulation of immunity. Thus, the potential of plants, plant extracts and molecules derived from plants that are traditionally used in Morocco and have activity against SARS-CoV-2, could be explored in the search for a preventive or curative treatment against COVID-19. Furthermore, safe plants or plant extracts that are proven to stimulate immunity could be officially recommended by governments as nutritional supplements.

Treatment Options in COVID-19: The Role of Bioavailable Antiviral Ribonucleoside Analog on NHC in vitro

2020 ◽  
Author(s):  
Lara Bittmann
Keyword(s):  
World Health Organization ◽  
Clinical Picture ◽  
Treatment Options ◽  
World Health ◽  
Wuhan City ◽  
The World ◽  
Novel Coronavirus ◽  
Health Organization

On December 31, 2019, WHO was informed of cases of pneumonia of unknown cause in Wuhan City, China. A novel coronavirus was identified as the cause by Chinese authorities on January 7, 2020 and was provisionally named "2019-nCoV". This new Coronavirus causes a clinical picture which has received now the name COVID-19. The virus has spread subsequently worldwide and was explained on the 11th of March, 2020 by the World Health Organization to the pandemic.

Synthesis of Novel 1,2,3-Triazole Derivatives of Isocoumarins and 3,4-Dihydroisocoumarin with Potential Antiplasmodial Activity In Vitro

2020 ◽  
Vol 16 ◽  
Author(s):  
Lucas da Silva Santos ◽  
Matheus Fillipe Langanke de Carvalho ◽  
Ana Claudia de Souza Pinto ◽  
Amanda Luisa da Fonseca ◽  
Julio César Dias Lopes ◽  
...  
Keyword(s):  
Triazole Ring ◽  
Antiplasmodial Activity ◽  
World Health ◽  
Dipolar Cycloaddition ◽  
Terminal Alkynes ◽  
The World ◽  
Ic50 Values ◽  
Derivatives Of ◽  
Active Substances

Background: Malaria greatly affects the world health, having caused more than 228 million cases only in 2018. The emergence of drug resistance is one of the main problems in its treatment, demonstrating the urge for the development of new antimalarial drugs. Objective: Synthesis and in vitro antiplasmodial evaluation of triazole compounds derived from isocoumarins and a 3,4- dihydroisocoumarin. Method: The compounds were synthesized in 4 to 6-step reactions with the formation of the triazole ring via the Copper(I)-catalyzed 1,3-dipolar cycloaddition between isocoumarin or 3,4-dihydroisocoumarin azides and terminal alkynes. This key reaction provided compounds with an unprecedented connection of isocoumarin or 3,4-dihydroisocoumarin and the 1,2,3-triazole ring. The products were tested for their antiplasmodial activity against a Plasmodium falciparum chloroquine resistant and sensitive strains (W2 and 3D7, respectively). Results: Thirty-one substances were efficiently obtained by the proposed routes with an overall yield of 25-53%. The active substances in the antiplasmodial test displayed IC50 values ranging from 0.68-2.89 μM and 0.85-2.07 μM against W2 and 3D7 strains, respectively.

scholarly journals Seroprevalence of SARS-CoV-2, Symptom Profiles and Sero-Neutralization in a Suburban Area, France

Viruses ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1076
Author(s):  
Anne Gégout Petit ◽  
Hélène Jeulin ◽  
Karine Legrand ◽  
Nicolas Jay ◽  
Agathe Bochnakian ◽  
...  
Keyword(s):  
Odds Ratio ◽  
World Health Organisation ◽  
World Health ◽  
Preventive Effect ◽  
Neutralization Activity ◽  
Symptom Profiles ◽  
The World ◽  
Household Members ◽  
Total Immunoglobulin

The World Health Organisation recommends monitoring the circulation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We investigated anti–SARS-CoV-2 total immunoglobulin (IgT) antibody seroprevalence and in vitro sero-neutralization in Nancy, France, in spring 2020. Individuals were randomly sampled from electoral lists and invited with household members over 5 years old to be tested for anti–SARS-CoV-2 (IgT, i.e., IgA/IgG/IgM) antibodies by ELISA (Bio-rad); the sero-neutralization activity was evaluated on Vero CCL-81 cells. Among 2006 individuals, the raw seroprevalence was 2.1% (95% confidence interval 1.5 to 2.9), was highest for 20- to 34-year-old participants (4.7% (2.3 to 8.4)), within than out of socially deprived area (2.5% vs. 1%, p = 0.02) and with than without intra-family infection (p < 10−6). Moreover, 25% of participants presented at least one COVID-19 symptom associated with SARS-CoV-2 positivity (p < 10−13), with highly discriminant anosmia or ageusia (odds ratio 27.8 [13.9 to 54.5]); 16.3% (6.8 to 30.7) of seropositive individuals were asymptomatic. Positive sero-neutralization was demonstrated in vitro for 31/43 seropositive subjects. Regarding the very low seroprevalence, a preventive effect of the lockdown in March 2020 can be assumed for the summer, but a second COVID-19 wave, as expected, could be subsequently observed in this poorly immunized population.

scholarly journals A Potential Relationship Between Estrogen Receptors Polymorphisms, Sperm Function and in vitro Fertilization Success: A Preliminary Study*

2021 ◽  
Vol 75 ◽  
pp. 304-317
Author(s):  
Joanna Talarczyk-Desole ◽  
Mirosław Andrusiewicz ◽  
Małgorzata Chmielewska ◽  
Anna Berger ◽  
Leszek Pawelczyk ◽  
...  
Keyword(s):  
In Vitro Fertilization ◽  
Estrogen Receptors ◽  
Strong Association ◽  
Fertilization Success ◽  
World Health ◽  
Semen Parameters ◽  
Sperm Function ◽  
Allele Distribution ◽  
Vitro Fertilization

Background: Estrogen receptor 1 (ESR1) and 2 (ESR2) play an important role in regulating fertility in the human reproductive system. Polymorphisms of these receptor genes have been implicated in male infertility in both Chinese and Caucasian populations. However, studies have produced inconsistent results. Spermatozoa defects that result in conception deficiencies could be related to estrogens, their receptors, or genes involved in estrogen-related pathways. This study aims to explore the potential association between the ESR1 and the ESR2 polymorphisms in relation to semen parameters of Caucasian males as well as fertilization success. Materials/Methods: A total of 116 males were included in this study. Forty couples underwent conventional in vitro fertilization, while 76 couples were treated by intracytoplasmic sperm injection. Standard semen analyses were performed according to the World Health Organization criteria. Polymerase chain reaction and restriction fragment length polymorphisms were used to determine genotype and allele distributions. Results: A strong association between the ESR1 rs2234693 recognized by PvuII enzyme, genotype/allele distribution and fertilization success was shown. The T allele occurrence was significantly lower in the case of fertilization failure (p = 0.02). Additionally, the TT genotype was absent in the same group (p=0.02). In the case of the remaining analyzed polymorphisms, little to no interdependence of genotype/allele distribution and fertilization success was noted. Conclusions: Apart from ESR1 rs2234693, the study failed to demonstrate that fertilization success was associated with the selected polymorphisms. In most cases, we did not discover a relationship between both estrogen receptors polymorphisms and sperm function.

Abstract 346: Lipophilic Statins Attenuate Human Atrial Fibroblast Viability In Vitro

2012 ◽  
Vol 111 (suppl_1) ◽  
Author(s):  
Kiranjit K Sran ◽  
Yun Li ◽  
Saeid Ghavami ◽  
Melanie Ngo ◽  
Rakesh C Arora ◽  
...  
Keyword(s):  
Cell Death ◽  
Cell Viability ◽  
Heart Surgery ◽  
Cardiac Fibrosis ◽  
Therapeutic Option ◽  
Open Heart Surgery ◽  
Myocardial Cell ◽  
Dependent Manner ◽  
Vitro Effect

Cardiovascular diseases (CVD) leading to heart failure are associated with myocardial cell loss and cardiac fibrosis. Hydroxymethylglutaryl-Coenzyme-A Reductase (HMGR) inhibitors ("statins") are widely used to limit cardiovascular events in patients with hypercholesterolemia and CVD by altering their lipid profile. HMGR inhibition reduces cholesterol precursor L-mevalonate production, whose depletion induces autophagy, apoptosis, and endoplasmic reticulum stress in various cell types. However it is unclear if this is a class effect or a phenomenon specific to various compounds. We examined the in vitro effect of HMGR inhibition on human atrial fibroblast (hATF) viability with particular reference to hydrophilic vs lipophilic compounds. Hypothesis- Lipophilic statins induce cell death in primary hATF via mevalonate depletion; whereas hydrophilic statins do not have any effect on hATF viability. IRB approval was obtained for collection of hATF from consenting patients undergoing open heart surgery. Cells were treated with atorvastatin, simvastatin or pravastatin (0.1, 1.0 or 10 λM) for 24, 48, 72 or 96 hours. Expression of proteins involved in the regulation of apoptosis and autophagy was assessed using immunoblotting. Cell viability was assessed using MTT assay. Treatment of hATF with 0.1 - 10 λM atorvastatin or simvastatin (lipophilic statins) resulted in progressively reduced cell viability in time and dose-dependent manner. Viability could be rescued by coincubation with mevalonate. Expression of key apoptotic cascade proteins -Bcl2, Bax and cleaved Caspase3 showed a clear induction of apoptosis. Also, there was an increase in Atg5-12 expression at 24h indicating induction of early autophagic response. Pravastatin (hydrophilic statin) did not affect cell viability or autophagy and apoptosis. We conclude that statin-induced cell death is mediated by mevalonate depletion, which activates intrinsic apoptotic pathways in hATF. Lipophilic statins impair the viability of hATFs in vitro, whereas hydrophilic statins have no effect on cell growth and cell viability of hATFs. This may represent an additional pleiotropic effect of statins, and may represent a novel therapeutic option for the prevention and treatment of cardiac fibrosis.

HEART PUMP AND OXYGENATOR

PEDIATRICS ◽  
1957 ◽  
Vol 19 (6) ◽  
pp. 1124-1128
Author(s):  
W. T. Mustard
Keyword(s):  
World War Ii ◽  
Artificial Heart ◽  
Heart Surgery ◽  
Human Subjects ◽  
Open Heart Surgery ◽  
World War ◽  
Heart Pump ◽  
The World ◽  
Cardiac Bypass ◽  
Selection Of

THIS PAPER is a general review of the development of the artificial heart-lung to facilitate open-heart surgery. At the close of World War II many centers began investigating the possibility of total cardiac bypass. Oven the past decade, pump oxygenerators of various types have become popular and recent clinical successes throughout the world have given further impetus to the study of problems posed by the artificial heart-lung apparatus. The subject divides itself into three separate parts, the first two being concerned with the maintenance of life in an experimental animal during a total cardiac bypass. One must take all the blood from the animal and return it to the animal by means of a pump. Secondly, one must oxygenate the blood before returning it. The third part of the problem confronting the surgeon is the selection of cases and correction of defects in human subjects. The pumping mechanism must duplicate as nearly as possible the action of the chambers of the heart. Pumping action must be smooth so as to prevent hemolysis and to avoid turbulence with thrombosis. It is not difficult to construct a pump with which hemolysis can be kept to relatively negligible amounts. Most of the pumps in use throughout the world give an hemolysis of less than 50 mg of hemoglobin per 100 ml of blood, which is perfectly safe. Turbulence with thrombosis can be overcome by removing valves inside the stream and placing valves outside of, rather than within the stream of blood. Furthermore, heparinization of the blood lessens the tendency to thrombosis.

scholarly journals A Review of the Preclinical and Clinical Efficacy of Remdesivir, Hydroxychloroquine, and Lopinavir-Ritonavir Treatments against COVID-19

2020 ◽  
Vol 25 (10) ◽  
pp. 1108-1122 ◽  
Author(s):  
Dawid Maciorowski ◽  
Samir Z. El Idrissi ◽  
Yash Gupta ◽  
Brian J. Medernach ◽  
Michael B. Burns ◽  
...  
Keyword(s):  
Gastrointestinal Symptoms ◽  
High Risk Group ◽  
Capital City ◽  
World Health ◽  
Atypical Pneumonia ◽  
Live Animal ◽  
The World ◽  
Novel Coronavirus ◽  
Health Organization

In December of 2019, an outbreak of a novel coronavirus flared in Wuhan, the capital city of the Hubei Province, China. The pathogen has been identified as a novel enveloped RNA beta-coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The virus SARS-CoV-2 is associated with a disease characterized by severe atypical pneumonia known as coronavirus 2019 (COVID-19). Typical symptoms of this disease include cough, fever, malaise, shortness of breath, gastrointestinal symptoms, anosmia, and, in severe cases, pneumonia.1 The high-risk group of COVID-19 patients includes people over the age of 60 years as well as people with existing cardiovascular disease and/or diabetes mellitus. Epidemiological investigations have suggested that the outbreak was associated with a live animal market in Wuhan. Within the first few months of the outbreak, cases were growing exponentially all over the world. The unabated spread of this deadly and highly infectious virus is a health emergency for all nations in the world and has led to the World Health Organization (WHO) declaring a pandemic on March 11, 2020. In this report, we consolidate and review the available clinically and preclinically relevant results emanating from in vitro animal models and clinical studies of drugs approved for emergency use as a treatment for COVID-19, including remdesivir, hydroxychloroquine, and lopinavir-ritonavir combinations. These compounds have been frequently touted as top candidates to treat COVID-19, but recent clinical reports suggest mixed outcomes on their efficacies within the current clinical protocol frameworks.

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