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    Securing sustainable funding for viral hepatitis elimination plans
    (WILEY, 2020-01-01) Hatzakis, Angelos; Lazarus, Jeffrey V.; Cholongitas, Evangelos; Baptista-Leite, Ricardo; Boucher, Charles; Busoi, Cristian-Silviu; Deuffic-Burban, Sylvie; Chhatwal, Jagpreet; Esmat, Gamal; Hutchinson, Sharon; Malliori, Minerva-Melpomeni; Maticic, Mojca; Mozalevskis, Antons; Negro, Francesco; Papandreou, George A.; Papatheodoridis, George V.; Peck-Radosavljevic, Markus; Razavi, Homie; Reic, Tatjana; Schatz, Eberhard; Tozun, Nurdan; Younossi, Zobair; Manns, Michael P.
    The majority of people infected with chronic hepatitis C virus (HCV) in the European Union (EU) remain undiagnosed and untreated. During recent years, immigration to EU has further increased HCV prevalence. It has been estimated that, out of the 4.2 million adults affected by HCV infection in the 31 EU/ European Economic Area (EEA) countries, as many as 580 000 are migrants. Additionally, HCV is highly prevalent and under addressed in Eastern Europe. In 2013, the introduction of highly effective treatments for HCV with direct-acting antivirals created an unprecedented opportunity to cure almost all patients, reduce HCV transmission and eliminate the disease. However, in many settings, HCV elimination poses a serious challenge for countries' health spending. On 6 June 2018, the Hepatitis B and C Public Policy Association held the 2nd EU HCV Policy summit. It was emphasized that key stakeholders should work collaboratively since only a few countries in the EU are on track to achieve HCV elimination by 2030. In particular, more effort is needed for universal screening. The micro-elimination approach in specific populations is less complex and less costly than country-wide elimination programmes and is an important first step in many settings. Preliminary data suggest that implementation of the World Health Organization (WHO) Global Health Sector Strategy on Viral Hepatitis can be cost saving. However, innovative financing mechanisms are needed to raise funds upfront for scaling up screening, treatment and harm reduction interventions that can lead to HCV elimination by 2030, the stated goal of the WHO.
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    A new hereditary colorectal cancer network in the Middle East and eastern Mediterranean countries to improve care for high-risk families (vol 17, pg 209, 2018)
    (SPRINGER, 2018-01-01) Ghorbanoghli, Zeinab; Jabari, Carol; Sweidan, Walid; Hammoudeh, Wail; Cortas, George; Sharara, Ala I.; Abedrabbo, Amal; Hourani, Ijad; Mahjoubi, Bahareh; Majidzadeh, Keivan; Tozun, Nurdan; Ziada-Bouchaar, Hadia; Hamoudi, Waseem; Diab, Osama; Khorshid, Hamid Reza Khorram; Lynch, Henry; Vasen, Hans
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    A new hereditary colorectal cancer network in the Middle East and eastern mediterranean countries to improve care for high-risk families
    (SPRINGER, 2018-01-01) Ghorbanoghli, Zeinab; Jabari, Carol; Sweidan, Walid; Hammoudeh, Wail; Cortas, George; Sharara, Ala I.; Abedrabbo, Amal; Hourani, Ijad; Mahjoubi, Bahareh; Majidzadeh, Keivan; Tozun, Nurdan; Ziada-Bouchaar, Hadia; Hamoudi, Waseem; Diab, Osama; Khorshid, Hamid Reza Khorram; Lynch, Henry; Vasen, Hans
    Colorectal cancer (CRC) has a very high incidence in the western world. Data from registries in the Middle East showed that the incidence of CRC is relatively low in these countries. However, these data also showed that CRC incidence has increased substantially over the past three decades and that a high proportion of cases are diagnosed at an early age (< 50 years). In view of these findings, more attention should be paid to prevention. Because of the often limited financial resources, focused screening of individuals with hereditary CRC, in particular those with Lynch syndrome, appears to be the most cost-effective strategy. During recent meetings of the Palestinian Society of Gastroenterology and the Mediterranean Task force for Cancer Control (MTCC) in Jericho, and the Patient's Friends Society of Jerusalem in Hebron the issue of hereditary CRC in the Middle East was discussed and the idea was conceived to establish a network on hereditary colorectal cancer (HCCN-ME) with the goal of improving care for high-risk groups in the Middle East and (Eastern) Mediterranean Countries.
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    Prevalence of hepatitis B and C infections in rheumatoid arthritis and ankylosing spondylitis: A multicenter countrywide study
    (AVES, 2014-01-01) Yilmaz, Neslihan; Karadag, Omer; Kimyon, Gezmis; Yazici, Ayten; Yilmaz, Sema; Kalyoncu, Umut; Kasifoglu, Timucin; Temiz, Hakan; Baysal, Birol; Tozun, Nurdan
    Objective: Immunosuppressive therapies, especially tumor necrosis factor-a inhibitors, are frequently used in treatment of rheumatoid arthritis (RA) and ankylosing spondylitis (AS). These therapies can induce viral reactivation in concurrent hepatitis B virus (HBV)- or hepatitis C virus (HCV)positive patients. On the other hand, the prevalence of HBV and HCV infections is not exactly known in RA and AS patients. The aim of this study was to investigate the prevalence of HBV and HCV infections in RA and AS patients. Material and Methods: A group of 1517 RA and 886 AS consecutive patients followed by six different rheumatology outpatient clinics of Turkey were recruited in this study. The prevalence of HBV surface antigen (HBsAg) and HCV antibody (anti-HCV) were retrospectively investigated. Results: The mean age was 49.0 +/- 13.2 years in RA and 37.3 +/- 10.5 years in AS patients. HBsAg prevalence was 35 (2.3\%) in RA and 27 (3\%) in AS patients. Anti-HCV prevalence was 17 (1.1\%) and 10 (1.1\%), respectively. In the RA group, both HBsAg and anti-HCV positive patients were older than negative ones (p < 0.05), and the highest prevalence was found in those 60-69 years (p < 0.05). Conclusion: In previous national data, the prevalence of HBsAg has been reported as 3.99\% and shown to increase with age. In this study we have found a lower HBV infection prevalence in both RA and AS patients according to Turkish national data. This result may explain by being younger age of our patients. In another conclusion, lower prevalence could be related to, joint complaints may less consulted to Rheumatologist in HBV positive.
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    The effects of pegylated interferon alpha 2b on bile-duct ligation induced liver fibrosis in rats
    (MEXICAN ASSOC HEPATOLOGY, 2009-01-01) Canbakan, Billur; Akin, Hakan; Tahan, Gulgun; Tarcin, Orhan; Eren, Fatih; Atug, Ozlen; Tahan, Veysel; Imeryuz, Nese; Yapicier, Ozlem; Avsar, Erol; Tozun, Nurdan
    Objective. To test the effects of peginterferon in an unrecoverable model of bite-duct ligation (BDL) induced liver fibrosis. Material and methods. Thirty-seven Wistar rats were divided into five groups: group 1, BDL + peginterferon (n = 8)
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    Subtracted Adulthood Mass Index - a new index to predict NAFLD risk in non-obese individuals
    (KARE PUBL, 2021-01-01) Kiyak, Ata; Elibol, Serra; Barutcu, Ozlem; Saruc, Murat; Tozun, Nurdan
    Background and Aim: Nonalcoholic fatty liver disease (NAFLD) is a common chronic liver disease. The aims of the current study are to determine the relationship between NAFLD in non-obese individuals and weight gain during adulthood and develop a new index for the identification of NAFLD risk. Materials and Methods: For this cross-sectional study, 362 patients who underwent abdominal ultrasonography (USG) in our clinic were included. Seventy-eight individuals were obese (>30 kg/m(2)). A history of weight gain during adulthood and systemic metabolic diseases was collected at the time of the study. A new index termed ``Subtracted Adulthood Mass Index{''} (SAMI) was created to estimate the risk of NAFLD development for non-obese people. SAMI is the ratio of the difference between the individual's current weight and his/her weight at 20 years old to his/her height squared (kg/m(2)). Results: When the SAMI cut-off was set at 3 kg/m(2), the sensitivity for predicting NAFLD risk was 85.2\%, the specificity was 66.9\%, the PPV was 79.1\%, and the NPV was 75.4\%. Conclusion: In this innovational study, a new index named SAMI was developed to identify non-obese people who are at risk of developing NAFLD. The SAMI is easy to calculate and appropriate for clinical use.