Araştırma Çıktıları

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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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    Current Trends in Tolerance Induction in Cow's Milk Allergy: From Passive to Proactive Strategies
    (FRONTIERS MEDIA SA, 2019-01-01) Sackesen, Cansin; Altintas, Derya Ufuk; Bingol, Aysen; Bingol, Gulbin; Buyuktiryaki, Betul; Demir, Esen; Kansu, Aydan; Kuloglu, Zarife; Tamay, Zeynep; Sekerel, Bulent Enis
    This review addresses the current strategies of inducing tolerance development in infant and childhood cow's milk protein allergy (CMPA). The change in prevention strategies for CMPA has been emphasized based on the lack of evidence to support the efficacy of food allergen avoidance in infancy and the concept of the dual-allergen-exposure hypothesis, which suggests that allergen exposure through the skin leads to sensitization, whereas early oral consumption of allergenic food protein induces oral tolerance. The new approach is based on the likelihood of early introduction of allergenic foods to the infant's diet to reduce the development of food allergies through oral tolerance induction. The latest treatment guidelines recommend the continuation of breast feeding and the elimination of cow's milk and products from the maternal diet in exclusively breast-fed infants with CMPA, the use of an extensively hydrolyzed infant formula (eHF) with proven efficacy in CMPA as the first elimination diet in formula-fed infants with CMPA and the use of amino acid-based formula (AAF) in severe cases, such as anaphylaxis, enteropathy, eosinophilic esophagitis, and food protein-induced enterocolitis syndrome (FPIES), as well as cases of multiple system involvement, multiple food allergies, and intolerance to extensively hydrolyzed formula (eHF). In conclusion, this paper presents the current knowledge on tolerance development in infants and children with CMPA to increase the awareness of the clinicians concerning the new approaches in CMPA treatment Tolerance development is considered a relatively new concept in CMPA, inducing a shift in interventions in CMPA from a passive (avoidance of responsible allergen) toward a proactive (tolerance induction) strategy.
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    Turkish Neonatal Society guideline on prevention and management of bronchopulmonary dysplasia
    (TURKISH PEDIATRICS ASSOC, 2018-01-01) Arsan, Saadet; Korkmaz, Ayse; Oguz, Suna
    Scientific and technological advances in perinatology and neonatology have led to an increased rate of survival and decreased incidences of various neonatal morbidities. However, the incidence of bronchopulmonary dysplasia has remained almost the same for years in very-low-birth-weight preterm infants. Although bronchopulmonary dysplasia is the leading cause of chronic respiratory morbidity in small preterms, no substantial improvement has been achieved in prevention and treatment strategies to date. Currently, postnatal very-low-dose corticosteroids, caffeine, and vitamin A seem to be the drugs of choice, and stem cell therapy appears to be the most promising treatment modality for the future. In this guideline, which was prepared by the Turkish Neonatal Society, recent evidence-based recommendations for the prevention and treatment of bronchopulmonary dysplasia are summarized.