Browsing by Author "Dinç, M"

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    Economic burden of short-acting beta-2 agonist (SABA) overuse among asthma patients in Türkiye: a cost analysis with respect to the updated GINA treatment recommendations
    Yorgancioglu, A; Aksu, K; Cura, C; Yaman, Y; Dinç, M; Malhan, S
    BackgroundThis cost of illness study aimed to determine economic burden of short-acting beta 2-agonist (SABA) overuse in T & uuml;rkiye from payer perspective with respect to the updated GINA 2022 treatment recommendations.MethodsA total of 3,034,879 asthma patients comprised the study population, via estimations extrapolated from the T & uuml;rkiye arm of the global SABINA III study. The economic burden (costs related to the drug use and severe exacerbations) was compared in subgroups of overall (>= 0 canisters/year) vs. GINA-recommended (0-2 canisters/year, hypothetical population) SABA use and in subgroups of appropriate use (0-2 canisters/year, real population) vs. overuse (>= 3 canisters/year) of SABA with extrapolation of SABINA T & uuml;rkiye data to the T & uuml;rkiye asthma population.ResultsRecommended SABA use was predicted to prevent 127,505 of 157,512 severe exacerbations per year in mild asthma patients and 2,668,916 of 3,262,800 severe exacerbations per year in moderate-severe asthma patients. Annual cost burden of not applying recommended SABA use (overall [>= 0 canisters/year] vs. GINA-recommended [0-2 canisters/year] SABA use) in mild asthma and moderate-severe asthma patients was calculated to be 20.43 million and 427.65 million in terms of severe exacerbations, and to be 829,352 and 7.20 million in terms of drug costs, respectively. The total annual economic burden arising from not applying recommended SABA use was estimated to be 456.11 million. Appropriate use (0-2 canisters/year) vs. overuse (>= 3 canisters/year) of SABA was associated with decreased frequency of severe exacerbations per year in mild asthma (from 129,878 to 27,634) and moderate-severe asthma (from 2,834,611 to 428,189) patients. SABA overuse in mild and moderate-severe asthma patients was estimated to yield an additional annual cost of 16.38 million and 385.59 million, respectively in terms of severe exacerbations, and a total 11.30 million additional drug cost. The overall annual economic burden arising from SABA overuse was estimated to be 413.27 million.ConclusionsThe estimated annual total economic burden arising from not applying recommended SABA use (456.11 million) and SABA overuse (413.27 million) with respect to the updated GINA 2022 treatment recommendations indicates the substantial cost burden of SABA overuse to the Turkish National Health System, corresponding up to 26% of the total direct cost of asthma reported in our country.
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    Visceral Leishmaniasis Caused by Leishmania Tropica
    Özbilgin, A; Tunali, V; Çavus, I; Tetik, AV; Dinç, M; Yalçin, T; Gündüz, C; Beyaz, M; Köse, S
    PurposeIn Turkey, the main causative agent of visceral leishmaniasis (VL) is Leishmania. infantum and the main causative agent of cutaneous leishmaniasis (CL) is Leishmania tropica. In this study, we aimed to discuss the possible mechanisms, clinical aspects, and threat of visceralizing L. tropica.MethodsThis study includes seven cases of VL caused by L. tropica.Five patients were male (71%) and four were adults (57%).ResultsAll the VL patients complained of fever and splenomegaly. Fatigue, pancytopenia, and hepatomegaly were present in six patients each (86%), while weight loss and gastrointestinal system (GIS) symptoms were present in 5 patients (71%).ConclusionsIn this study, we have evaluated seven cases of visceralized L. tropica (VLT) in the context of the changing leishmaniasis epidemiology in Turkey. We have evaluated the possible mechanisms of visceralization; inter- and intraspecies genetic exchange with all the old world leishmaniasis agents present in the region, stress induced by inappropriate use of drugs, and possible ongoing adaptation mechanisms of Leishmania spp. The threat posed by VLT is significant as L. tropica is the most widespread and most common cause of leishmaniasis in Turkey. We do not know the vectorial capacity of the sand flies for the transmission of VLT strains or if these strains are in circulation in Turkey. Future studies should be carried out to investigate these issues as the transition of L. tropica from a mild disease-causing agent to a mortal one poses a significant public health concern for Turkey and Europe.