Search

Hemophilia A is the second most common bleeding disorder causing patients to have lifelong follow-up and treatment. Despite being a rare disease, hemophilia A has a high economic burden on individuals and the public. The purpose of this study was to estimate the total disease cost of hemophilia A in Turkey. Data used in this analysis were collected through literature review, including studies conducted in Turkey in December 2018. A disease burden analysis was performed by modeling hemophilia A-related costs among patients, their relatives, and the social security system. Two expert panels were held to evaluate real-world data sources and to provide further information. All direct medical and non-medical costs were calculated annually from the Social Security Institution of the Republic of Turkey perspective, while indirect costs were estimated from the patient and community perspective. For the calendar year of 2018, the number of hemophilia A patients in Turkey were estimated to be 5,055, with an average weight of 64.7 kg. The average annual direct medical, direct non-medical, and indirect costs of hemophilia A were calculated as €93,268 ($109,286; ₺502,717), €2,533 ($2,968; ₺13,655), and €7,957 ($9,323; ₺42,888) per patient, respectively, with a total annual cost of €103,759 ($121,578; ₺559,259). For the management of patients with inhibitors (4.9%), the average annual total cost was calculated to be €325,439 ($381,330; ₺1,754,117) per patient. The total annual disease burden of hemophilia A in 2018 was estimated to be about €524 million ($614 million; ₺2.82 billion), which corresponded to 1.6% of the total health expenditure in Turkey. The most important reason hemophilia A has a significant economic burden in Turkey is that replacement therapy is expensive. The major cost contributor was identified as factor replacement therapy. With inhibitor development, the average annual cost increased more than 3-fold. [ABSTRACT FROM AUTHOR]

The eastern Pontide tectonic belt (EPTB) contains greater than 350 identified Kuroko type volcanogenic massive sulfide deposits/mineralization/occurrences (VMSD). The deposits are associated with Late Cretaceous felsic volcanics consisting mainly of dacitic and rhyolitic lavas and pyroclastics that outcrop within a narrow zone running parallel to the eastern Black Sea coast and represent the axial zone of a paleo-magmatic arc. The Cerattepe deposit is the second-largest and is a hybrid VMS system with some epithermal features. To date, no geochemical research constrains the origin and timing of mineralization in the Cerattepe VMS deposit. Here, we provide Cu, O, H and S, isotope analysis of ores and alteration minerals to understand the hydrothermal history of the deposit and date the massive ore with Re-Os geochronology. Secondary weathering mobilized and redistributed metals in the deposit. The copper isotope signatures of shallow ores in the gossan follow patterns resulting from oxidative weathering of copper minerals with gossan Fe oxides of δ65Cu = −2.59‰, enrichment zone copper sulfide of d65Cu = +2.23 and +1.73‰, and primary ores of δ65Cu = +0.71 and +0.41‰. At the boundary of the enrichment zone, further cycling and migration of enrichment zone copper are evidenced by two samples having larger ranges of the δ65Cu = +3.59‰, and −2.93‰. Evidence for a magmatic source for fluids and S are evidenced by the O and H isotope values from quartz veins (δ18O = +7.93‰ to +10.82‰, and δD = −78‰ and −68‰) and sulfides that possess δ34S ratios of –5 and 0‰ from drill core samples. 187Os/188Os–187Re/188Os ratios from drill core sulfide samples of Cerattepe VMS deposit yields a 62±3 Ma isochron age and a highly radiogenic Os initial ratio. This age is compatible with silicate alteration ages from a proximal deposit and clearly shows mineralization occurs at a much younger time than previously proposed for VMS mineralization in the eastern Pontides. The new Re-Os age and source of Os imply that mineralization in the area occurs at a distinctly younger interval in the back-arc basin and metals could be sourced from the surrounding host rocks. [ABSTRACT FROM AUTHOR]