Conjunctival Impression Cytology and Bulbar Surface Epithelium Changes in Patients with Psoriasis

In this study, we evaluated bulbar surface epithelium changes with conjunctival impression cytology (IC) in patients with psoriasis. Our study group consisted of 32 psoriatic patients (64 eyes), who were followed up at Dermatology Department of Dicle University Hospital. Control group comprised 32 healthy volunteers (64 eyes) who had no abnormality on routine ophthalmological examination and were in the same age and sex distribution. Specimens for conjunctival IC were obtained with a cellulose acetate filter paper from the upper bulbar conjunctiva and fixed with 70 % ethyl alcohol, 37 % formaldehyde and 20:1:1 glicial asetic acid solution. Specimens were stained with periodic acid Schiff’s and Hematoxylin-eosin. The grades of Nelson system were evaluated with light microscopy. Of the patients with psoriasis, 39 % had grade 0, 36 % grade I, and 25 % grade II conjunctival IC differentiation compared with 78, 22, and 0 %, respectively in the control group (p< 0.001). Snake-like appearance of nuclear chromatin in conjunctival epithelial cells was demonstrated in 3 % of eyes in group I but in no eyes in group II. In conclusion, we showed that there could be early conjunctival changes and squamose metaplasia as well as increased goblet cell density in patients with psoriasis when compared with control group

Clinical course of psoriasis patients that discontinued biologics during the COVID-19 pandemic

BackgroundSince psoriasis is a chronic disease, it is not recommended to discontinue the treatment agents used. However, in real life, the treatment of psoriasis patients may be interrupted for various reasons. During the pandemic period, the treatment of many patients was also interrupted. ObjectivesTo evaluate relapse and clinical worsening in psoriasis patients whose biological therapy was interrupted during the pandemic and reveal associated factors. MethodsThe study included patients aged >= 18 years, who were followed up with moderate and severe chronic psoriasis controlled by the last biological agent [Psoriasis Area Severity Index (PASI) 75 response achieved] but had to discontinue their treatment during the pandemic. The patients' demographic and clinical characteristics, clinical course after the discontinuation of these agents, presence of clinical worsening, and relapse were evaluated. Risk factors were analyzed with the logistic regression analysis. ResultsThe study included 169 patients, with a mean age of 47.3 +/- 14.5 (18-87) years. The mean biologics-free time was 18.2 +/- 12.3 (2-56) weeks. Clinical worsening was detected in 41.4% and relapse in 48.5% of the patients. The significant risk factors for clinical worsening and relapse in both univariate and multivariate analyses were alcohol use during the biologics-free period, total time off biologics, and the presence of an additional triggering factor. The use of secukinumab and ustekinumab was found to be a protective factor against clinical worsening in multivariate analyses. ConclusionAs the biologics-free period is prolonged, the likelihood of clinical worsening and relapse increases, therefore, we do not recommend discontinuing biological agents

Evaluation of the efficacy, safety, and side effects of secukinumab in patients with moderate-to-severe psoriasis: Real-world data from a retrospective multicenter study

Background: Clinical studies have demonstrated that IL-17A inhibition with secukinumab is effective for clearing the skin of patients with psoriasis and has a favorable safety profile. Objective: The authors aim to determine whether secukinumab is effective and safe for the treatment of moderate-to-severe chronic psoriasis based on clinical experience with this drug. Method: The authors conducted a multicenter retrospective study in nine referral centers and included patients with psoriasis who had received secukinumab between March 2018 to November 2020. Data on demographic characteristics, Psoriasis Area and Severity Index (PASI) scores, and previous treatments were collected from medical records. Patients were evaluated at 12, 24, and 52 weeks with respect to response to treatment and side effects. Results: In total, 229 patients were recruited for the study. A PASI score improvement of ≥90 points over the baseline was achieved by 79%, 69.8%, and 49.3% of patients at weeks 12, 24, and 52, respectively. The most common adverse events wereCandida infections and fatigue. In total, 74 (32%) patients discontinued treatment by week 52, including due to adverse events, or secondary ineffectiveness. Study limitations: Retrospective design. Conclusions: These findings suggest that secukinumab therapy is reasonably effective in patients with moderate-to-severe psoriasis. Comorbidities and time length of the disease can affect the response to treatment. The rates of adverse events were high in this patient population

Patient use of complementary and alternative medicine for psoriasis vulgaris and factors believed to trigger the disease: A multicenter cross-sectional study with 1621 patients

Introduction: Due to the chronic recurrent nature of psoriasis vulgaris (PV) and lack of definitive treatment for the disease, patients often resort to alternative treatments. Physicians seem to have low awareness of this issue. Objectives: To elicit the perceptions of 1,621 PV patients on complementary and alternative medicine (CAM) and examine factors reported to worsen PV. Methods: The patients sociodemographic characteristics, Psoriasis Area Severity Index (PASI), Dermatology Life Quality Index (DLQI), disease duration, and severity were recorded, and the patients CAM use was questioned in detail. The patients were also asked about factors that worsened PV and their experiences with a gluten-free diet. Results: Of the patients, 56.51% had used CAM. The mean age, illness duration, PASI scores and DLQI of those using CAM were significantly higher. CAM use was significantly higher in those with facial, genital involvement, and arthralgia/arthritis. The patients mostly referred to CAM when PV became severe (46.4%). Of the CAM users, 45.52% used herbal topicals. The physicians of 67.03% did not inquire whether they used CAM. Of the participants, 37.73% considered that stress worsened their disease. Gluten-free diet did not affect PV symptoms in 52.22%. Conclusions: Patients CAM use is often overlooked by dermatologists. Our results showed that more than half the patients used CAM and did not share this information with their physicians. Therefore, the awareness of physicians should be increased and patients should be asked about the use of CAM and directed to the appropriate medical treatment options by physicians

Habits of using social media and the internet in psoriasis patients

Introduction: Psoriasis significantly affects the patients quality of life, which often leads patients to seek online information about this disease. Objectives: To explore the habits of patients with psoriasis related to their use of social media (SM) and the internet to obtain information about their disease. Methods: 1,520 patients completed the survey and the Dermatology Life Quality Index (DLQI) questionnaire. The Psoriasis Area Severity Index scores (PASI) and clinical data of the patients were recorded by their physicians. Results: Of the 1,114 patients that reported using SM and internet, 48.38% regularly and 31.14% sometimes resorted to obtain information about psoriasis. The use of SM and internet for psoriasis was statistically significantly higher among young people (P = 0.000), those with university or higher education (P = 0.009), higher DLQI (P = 0.000) and PASI (P = 0.011) scores, facial (P = 0.050), scalp (P = 0.032), hand (P = 0.048), genital (P = 0.001) and inverse (P = 0.000) involvement, and arthralgia/arthritis (P = 0.006). The participants mostly used the Google (86%) and Facebook (41%). More than half of the participants (62.8%) expected dermatologists to inform society that psoriasis is not contagious. Conclusions: Internet and SM being widely available and offering substantial information to be easily accessed make it very attractive for patients to use these platforms to investigate diseases, including psoriasis. If what is presented on SM conflicts with what the physician says, patients mostly trust the latter, but at the same time, they tend not to share the results of their online inquiries with their physicians

Epidemiology of pemphigus in Turkey: One-year prospective study of 220 cases

Pemphigus is a group of rare and life-threatening autoimmune blistering diseases of the skin and mucous membranes. Although they occur worldwide, their incidence shows wide geographical variation, and prospective data on the epidemiology of pemphigus are very limited. Objective of this work is to evaluate the incidence and epidemiological and clinical features of patients with pemphigus in Turkey. All patients newly diagnosed with pemphigus between June 2013 and June 2014 were prospectively enrolled in 33 dermatology departments in 20 different provinces from all seven regions of Turkey. Disease parameters including demography and clinical findings were recorded. A total of 220 patients were diagnosed with pemphigus during the 1-year period, with an annual incidence of 4.7 per million people in Turkey. Patients were predominantly women, with a male to female ratio of 1:1.41. The mean age at onset was 48.9 years. Pemphigus vulgaris (PV) was the commonest clinical subtype (n=192; 87.3%), followed by pemphigus foliaceus (n=21; 9.6%). The most common clinical subtype of PV was the mucocutaneous type (n=83; 43.2%). The mean Pemphigus Disease Area Index was 28.14±22.21 (mean ± Standard Deviation).  The incidence rate of pemphigus in Turkey is similar to the countries of South-East Europe, higher than those reported for the Central and Northern European countries and lower than the countries around the Mediterranean Sea and Iran. Pemphigus is more frequent in middle-aged people and is more common in women. The most frequent subtype was PV, with a 9-fold higher incidence than pemphigus foliaceus.   </p

Reproducibility of endometrial intraepithelial neoplasia diagnosis is good, but influenced by the diagnostic style of pathologists

Endometrial intraepithelial neoplasia (EIN) applies specific diagnostic criteria to designate a monoclonal endometrial preinvasive glandular proliferation known from previous studies to confer a 45-fold increased risk for endometrial cancer. In this international study we estimate accuracy and precision of EIN diagnosis among 20 reviewing pathologists in different practice environments, and with differing levels of experience and training. Sixty-two endometrial biopsies diagnosed as benign, EIN, or adenocarcinoma by consensus of two expert subspecialty pathologists were used as a reference comparison to assess diagnostic accuracy of 20 reviewing pathologists. Interobserver reproducibility among the 20 reviewers provided a measure of diagnostic precision. Before evaluating cases, observers were self-trained by reviewing published textbook and/or online EIN diagnostic guidelines. Demographics of the reviewing pathologists, and their impressions regarding implementation of EIN terminology were recorded. Seventy-nine percent of the 20 reviewing pathologists' diagnoses were exactly concordant with the expert consensus (accuracy). The interobserver weighted kappa values of 3-class EIN scheme (benign, EIN, carcinoma) diagnoses between expert consensus and each of reviewing pathologists averaged 0.72 (reproducibility, or precision). Reviewing pathologists demonstrated one of three diagnostic styles, which varied in the repertoire of diagnoses commonly used, and their nonrandom response to potentially confounding diagnostic features such as endometrial polyp, altered differentiation, background hormonal effects, and technically poor preparations. EIN diagnostic strategies can be learned and implemented from standard teaching materials with a high degree of reproducibility, but is impacted by the personal diagnostic style of each pathologist in responding to potential diagnostic confounders

Farklı kanatlı türlerinde yumurta kalite özelliklerinin sayısal görüntü analizi ile belirlenmesi

Bu çalışma, farklı kanatlı türlerinde yumurta kalite özelliklerinin sayısal görüntü analizi ile belirlenebilmesinin araştırılması amacıyla yürütüldü. Çalışmada bıldırcın (Coturnix coturnix japonica), kaya keklik (Alectoris graeca), halkalı sülün (Phasianus colchicus) ve tavuk (Denizli x Leghorn) türlerine ait yumurtalar kullanıldı. Yumurta kalite özelliklerine ait değerler klasik metot ve sayısal görüntü analizi metotlarıyla belirlendi. Sayısal görüntü analizi ile yumurta boyu, yumurta eni ve şekil endeksine ait değerler bütün yumurtalarda klasik metot değerine genel olarak %98.44-98.54 oranları arasında yakın saptandı. İç kalite özelliklerinden ak yükseklik (%32.24) ve sarı çapı (%13.44) değerleri sayısal görüntü analizi ile klasik metottan yüksek hata oranında belirlendi. Sonuç olarak sayısal görüntü analiz metoduyla ölçüm skalasına sahip düzenekler ve referans noktasına sahip görüntüler kullanılarak yumurta kalite özellik değerlerinin klasik metoda oldukça yakın olarak belirlenebileceği ortaya konuldu.The present study was aimed at the investigation of egg quality characteristics of different poultry species by digital image analysis. The material of the study was comprised of eggs of the Japanese quail (Coturnix coturnix japonica), rock partridge (Alectoris graeca), ring-necked pheasant (Phasianus colchicus) and cross-chickens (Denizli x Leghorn F1). Values pertaining to egg quality characteristics were obtained using the conventional method and digital image analysis. Egg length, egg width and shape index values measured by digital image analysis were shown to correspond closely with values measured using the conventional method, within an accuracy range of 98.44-98.54%. As regards internal egg quality characteristics, high error rates were determined for albumen height (32.24%) and yolk diameter (13.44%) values measured by digital image analysis, in comparison to values obtained with the conventional method. In result, it was demonstrated that egg quality characteristics could be determined by digital image analysis, in close correspondence with the conventional method, provided that devices equipped with measurement scales and images with reference points are used

BIST 100 endeksindeki yükseliş ve düşüşlerde dolar kuru ve yabancı yatırımcı etkisi

Özellikle 20. yüzyıldan itibaren ortaya çıkmaya başlayan sosyal, ekonomik ve teknolojik değişimler zamanla bütün ekonomik birimleri etkileyerek ülkeleri birbirine daha fazla yakınlaştırmış ve sınırları ortadan kaldırarak tek bir küresel piyasanın ortaya çıkmasını sağlamıştır. Dünya genelinde başlayan finansal küreselleşme ile finansal liberalizasyon süreçleri, yabancı yatırım kavramını da beraberinde getirmiştir. Yabancı portföy yatırımı ve uluslararası sermaye akımının, özellikle Türkiye gibi gelişmekte olan ülkelerin makroekonomik yapılarına etki ettiği göz ardı edilmemelidir. Bununla birlikte bir dünya parası haline gelen dolar kuru da Türkiye için yabancı sermaye akımı kadar önemlidir. Dolar kuru hem ülkenin makroekonomik yapısına etki etmekte hem de enflasyon, faiz oranı gibi önemli ekonomik değerlerin belirlenmesinde rol oynamaktadır. Dolar kurunun ekonomi üzerinde bu kadar belirleyici role sahip olmasının dolaylı olarak yabancı yatırımcı hareketlerine ve borsaya da etki ettiği düşünülmektedir. Bu çalışma ile yabancı yatırımlar ve dolar kuru ile BIST 100 endeksi ilişkisinin incelenmesi hedeflenmiştir.--------------------Especially the social, economic and technological changes that started to emerge from the 20th century onwards have affected all economic units and brought countries closer to each other and created a single global market by removing the borders. Financial globalization and financial liberalization processes, which started around the world, brought the concept of foreign investment. The impact of the foreign portfolio investment and international capital flows especially to macroeconomic structure of the developing countries such as Turkey should not be overlooked. However, the dollar exchange rate, which has become a world currency is just as important as foreign capital flows to Turkey. The dollar rate both affects the macroeconomic structure of the country and plays a role in determining important economic values such as inflation and interest rates. The fact that dollar exchange rate has such decisive role on the economy is thought to have indirectly affected foreign investors’ movements and the stock market. The aim of this study is to investigate the relationship between foreign investment and dollar exchange rate and BIST 100 index

BIST 100 endeksindeki yükseliş ve düşüşlerde dolar kuru ve yabancı yatırımcı etkisi

Özellikle 20. yüzyıldan itibaren ortaya çıkmaya başlayan sosyal, ekonomik ve teknolojik değişimler zamanla bütün ekonomik birimleri etkileyerek ülkeleri birbirine daha fazla yakınlaştırmış ve sınırları ortadan kaldırarak tek bir küresel piyasanın ortaya çıkmasını sağlamıştır. Dünya genelinde başlayan finansal küreselleşme ile finansal liberalizasyon süreçleri, yabancı yatırım kavramını da beraberinde getirmiştir. Yabancı portföy yatırımı ve uluslararası sermaye akımının, özellikle Türkiye gibi gelişmekte olan ülkelerin makroekonomik yapılarına etki ettiği göz ardı edilmemelidir. Bununla birlikte bir dünya parası haline gelen dolar kuru da Türkiye için yabancı sermaye akımı kadar önemlidir. Dolar kuru hem ülkenin makroekonomik yapısına etki etmekte hem de enflasyon, faiz oranı gibi önemli ekonomik değerlerin belirlenmesinde rol oynamaktadır. Dolar kurunun ekonomi üzerinde bu kadar belirleyici role sahip olmasının dolaylı olarak yabancı yatırımcı hareketlerine ve borsaya da etki ettiği düşünülmektedir. Bu çalışma ile yabancı yatırımlar ve dolar kuru ile BIST 100 endeksi ilişkisinin incelenmesi hedeflenmiştir. -------------------- Especially the social, economic and technological changes that started to emerge from the 20th century onwards have affected all economic units and brought countries closer to each other and created a single global market by removing the borders. Financial globalization and financial liberalization processes, which started around the world, brought the concept of foreign investment. The impact of the foreign portfolio investment and international capital flows especially to macroeconomic structure of the developing countries such as Turkey should not be overlooked. However, the dollar exchange rate, which has become a world currency is just as important as foreign capital flows to Turkey. The dollar rate both affects the macroeconomic structure of the country and plays a role in determining important economic values such as inflation and interest rates. The fact that dollar exchange rate has such decisive role on the economy is thought to have indirectly affected foreign investors’ movements and the stock market. The aim of this study is to investigate the relationship between foreign investment and dollar exchange rate and BIST 100 index