UPPER RESPIRATORY TRACT INFECTİONS IN PATIENTS WITH PSORIASIS: DEMOGRAPHIC AND CLINICAL FEATURES

Amaç: Literatürde psoriyazisli olgularda bakteriyel veya viral boğaz enfeksiyonlarının deri lezyonlarının oluşumu ve/veya alevlenmesini tetikleyebildiği bildirilmiştir. Bu çalışmada psoriyazis vulgaris klinik alt tiplerinde Üst Solunum Yolu Enfeksiyonu (ÜSYE) sıklığının değerlendirilmesi ve ÜSYE olan olgulardaki klinik ve demografik özelliklerin ÜSYE olmayan olgularla karşılaştırılması amaçlanmıştır. Gereç ve yöntem: Retrospektif olarak planlanmış çalışmamızda kliniğimizde yatan 258 psoriyazis vulgaris olgusunun dosyası psoriyazis klinik tipi, demografik veriler, psoriyazis alan şiddet indeksi ve eşlik eden ÜSYE'ları açısından taranmıştır. Klinik olarak plak psoriyazisli olgular "stabil", guttat psoriyazisli veya guttat saçılımları olan plak psoriyazisli olgular ise "aktif" psoriyazis olarak tanımlanmıştır. Bulgular: Toplam 258 psoriyazis olgusunun 188 (%72,9)'inin aktif psoriyazis, 70 (%27,1)'inin ise stabil psoriyazis klinik özelliklerini taşıdığı saptanmıştır. Toplam 103 (%39,9) olguda ÜSYE belirlenmiş olup, aktif psoriyazisli olgularda %45,2 olarak saptanan ÜSYE sıklığının stabil psoriyazisli olgulara (%25,7) göre istatistiksel olarak anlamlı şekilde daha fazla olduğu gösterilmiştir. Aktif grupta ÜSYE olan olgularda yaş ortalamasının anlamlı olarak daha düşük olduğu, ayrıca ÜSYE saptanan aktif ve stabil psoriyazisli olgularda psoriyazis başlangıç yaşının daha düşük, aile öyküsünün daha fazla, son alevlenme sürelerinin daha kısa ve psoriyazis alan şiddet indeksi değerlerinin 10 olduğu saptanmıştır. Sonuç: Aktif psoriyazisli olgularda ÜSYE sıklığının stabil olgulara göre daha fazla görülmesi nedeniyle guttat psoriyazis ve guttat saçılımlı plak psoriyazis olgularında ÜSYE araştırılmasının yararlı olacağı görüşündeyiz. Objective: In the literature, it has been reported that bacterial or viral infections of the throat can trigger the occurrence and/or exacerbation of the skin lesions in patients with psoriasis. The aim of our study was to evaluate the frequency of Upper Respiratory Tract Infection (URTI) and compare the clinical and demographic features of cases with and without an URTI in clinical subtypes of psoriasis vulgaris. Material and method: In this retrospective study, the files of 258 psoriasis vulgaris inpatients were evaluated for clinical type of psoriasis, demographic data, psoriasis area severity index and accompanying URTIs. Clinically, the patients of plaque psoriasis were defined as "stable" psoriasis, and those of guttate psoriasis or guttate flare of plaque psoriasis were defined as "active" psoriasis. Results: Of the 258 psoriasis patients, 188 (72.9%) patients were in active group and 70 (27.1%) of them were in stable group. Of all the patients, 103 (39.9%) were determined to have URTI. In patients with active psoriasis, the frequency of URTI was statistically higher (45.2%) than the stable group (25.7%). In active group, mean age was significantly lower in patients with URTI. Additionally, it was determined that the mean onset age of psoriasis was earlier, family history was more common, the time of the last exacerbation of lesions was shorter and the psoriasis area severity index values were ≥ 10 in both active and stable psoriasis patients with URTI compared to those of without URTI. Conclusion: Because of the higher frequency of URTI in patients with active psoriasis than stable psoriasis, we assumed that it would be beneficial to investigate of URTI in guttate psoriasis or guttate flare of plaque psoriasis

Navigating exodus: understanding the migration dynamics of health care professionals from Turkey

Objectives: We aimed to determine the reasons for the emigration of health workers who left Turkey and the difficulties experienced before and after the migration. Methods: This is an exploratory qualitative study of open-text fields focusing on migrant health workers from Turkey. Answers given to five open-ended questions directed to the participants in our survey, with 513 participants between April and June 2022, were used. Data were analyzed following content analysis. Results: A total of 506 responses were analyzed. The mean age of the participants was 39.9 ± 8.8 years (54.2% men, 77.5% medical doctors). Almost all participants reported that the political atmosphere in Turkey forced them to migrate. Some participants were unable to do their jobs due to the increasing violence in the health system in recent years. Most participants saw migration as the only way out, as they did not feel free and safe. Comparatively, they were in a better economic situation in Turkey and had a higher standard of living. Conclusion: Migration creates a sense of security while at the same time accepting a lower standard of living. To organize the sustainable migration of professionals, it is beneficial to ask what framework conditions need to be created and to access the labor market in particular

The effects of exogenous l-carnitine on lipid peroxidation and tissue damage in an experimental warm hepatic ischemia-reperfusion injury model

AbstractBackground: l-Carnitine is the essential endogenous factor for the transport of long-chain fatty acids from the cytoplasm to within the mitochondrion where the β-oxidation process takes place. l-Carnitine is a superoxide scavenger and an antioxidant that possesses an anti-ischemic action and a stabilizing effect on cell membranes. It may be of help in liver ischemia reperfusion injury. Results regarding the effects of l-carnitine on liver ischemia and reperfusion injury are few and conflicting.Objective: The aim of this study was to investigate the efficacy of exogenous l-carnitine on lipid peroxidation and protecting liver at different stages of experimental total warm hepatic ischemia-reperfusion (TWHIR) procedure in rats.Methods: This experimental study in healthy, weanling, male Wistar rats (weighing 180–200 g) was conducted at the Experimental Animal Research Laboratory of the Faculty of Medicine of Mersin University, Mersin, Turkey. Rats were randomly divided into 5 groups: (A) Control group; (B) TWHIR procedure only; (C) l-carnitine administered 2 hours before the TWHIR procedure; (D) l-carnitine administered just before the TWHIR procedure; and (E) l-carnitine administered after total warm hepatic ischemia but just before the reperfusion procedure. Total warm hepatic ischemia (via the Pringle maneuver) and reperfusion were performed for 45 and 30 minutes, respectively. l-Carnitine (200 mg/kg) was administered intravenously. At the end of each procedure a blood sample was drawn and total hepatectomy was performed following reperfusion. Malondialdehyde (MDA) and myeloperoxidase (MPO) levels of both plasma and liver tissue, total antioxidant capacity (TAOC), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels in plasma, and histopathologic examination were analyzed to assess lipid peroxidation and damage in liver tissue.Results: Thirty-four rats (mean [SD]age, 59.26 [1.2]days; mean [SD] weight, 194.1 [5.1] g) were used in the study. There was a significant difference observed between groups A (n = 5) and B (n = 5) for all evaluation parameters. The TWHIR procedure performed in group B was associated with significant increases versus baseline in ALT, AST, MDA, and MPO in plasma, and MDA and MPO in liver tissue, but a significant decrease of TAOC in plasma. ALT, AST, serum and liver MDA, and MPO levels of group B were significantly higher than all groups administered l-carnitine. l-Carnitine administration between total warm hepatic ischemia and reperfusion was associated with a significant attenuation in all parameters. The liver MDA levels of groups C (n = 8) and D (n = 8) were significantly lower than that of group E (n = 8) (mean [SD]: C, 16.53 [3.32] and D, 18.28 [1.67] vs E, 23.05 [3.52]; P = 0.001 and P = 0.016, respectively). The mean (SD) liver MPO level of group C (1.09 [0.16]) was significantly lower than that of groups D (2.12 [0.25]) and E (2.11 [0.28]) (both, P = 0.001). The TAOC of group B (0.77 [0.12]) was significantly lower than that of groups C (1.34 [0.19]) and D (1.08 [0.20]) (P = 0.001 and P = 0.015, respectively). The TAOC of group C was significantly higher than that of the other l-carnitine groups (E, 0.94 [0.13]) (P = 0.023 vs group D; and P = 0.001 vs group E). Histopathologic scores of groups A, C, and E were significantly lower than that of group B, but the difference between groups B and D was not statistically significant.Conclusions: In this experimental study, administration of exogenous l-carnitine was associated with significantly decreased lipid peroxidation in plasma and liver tissue when administered prior to a TWHIR procedure. In addition, l-carnitine seemed to be more effective with regard to decreasing lipid peroxidation in liver tissue when administered before warm hepatic ischemia. l-Carnitine was associated with significantly decreased leukocyte sequestration in plasma and liver tissue. A significant increase in TAOC was associated with l-carnitine administered prior to ischemia. These observations suggest that l-carnitine might have a protective effect against ischemia-reperfusion injury in rat liver tissue

Helicobacter pylori infection: approach of primary care physicians in a developing country

<p>Abstract</p> <p>Background</p> <p>The aim of the study was to assess the knowledge and practices of primary care physicians in diagnosis and management of <it>Helicobacter pylori (H. pylori) </it>infection in developing country.</p> <p>Methods</p> <p>This convenient sample based, cross sectional study was conducted in primary care physicians of Karachi, Pakistan from March 2008 to August 2008 through a pretested self-designed questionnaire, which contained 11 items pertaining to <it>H. pylori </it>route of transmission, diagnosis, indication for testing, treatment options, follow up and source of information.</p> <p>Results</p> <p>Out of 509 primary care physicians, 451 consented to participate with the response rate of 88.6%. Responses of 426 primary care physicians were analyzed after excluding 19 physicians. 78% of the physicians thought that contaminated water was the source of spread of infection, dyspepsia was the most frequent indication for investigating <it>H. pylori </it>infection (67% of the physicians), while 43% physicians were of the view that serology was the most appropriate test to diagnose active <it>H. pylori </it>infection. 77% of physicians thought that gastric ulcer was the most compelling indication for treatment, 61% physicians preferred Clarithromycin based triple therapy for 7–14 days. 57% of the physicians would confirm <it>H. pylori </it>eradication after treatment in selected patients and 47% physicians preferred serological testing for follow-up. In case of treatment failure, only 36% of the physicians were in favor of gastroenterologist referral.</p> <p>Conclusion</p> <p>The primary care physicians in this study lacked in knowledge regarding management of <it>H. pylori </it>infection. Internationally published guidelines and World gastroenterology organization (WGO) practice guideline on <it>H. pylori </it>for developing countries have little impact on current practices of primary care physicians. We recommend more teaching programs, continuous medical education activities regarding <it>H. pylori </it>infection.</p

Effect of expanded polystyrene beads on the properties of foam concrete containing polypropylene fiber

In this study, foam concrete was produced using 3 different volumes of EPS beads (up to 100%), 3 different volumes of polypropylene(PP) fiber (up to 0.1)%, sand and 40% pre-produced foam which is fixed by volume. The water-cement ratio was 0.4 and the sand-cement ratio was chosen as 1. The foam concrete were cast into molds with a size of 100 x 100 x 500 mm and 150 x 150 x 150 mm prism. Unit weight, ultrasonic pulse, water absorption, splitting tensile strength, bending strength and compressive strength tests were achieved. Foam concrete were kept in laboratory standard conditions. According to the results of study, unit weight and ultrasonic pulse velocity vary between 970-1350 kg/m3 and 1.6-2.6 km/sec, respectively. The water absorption of the foam concrete decreased up to 65% as the EPS beads ratio increased. Since EPS beads do not contribute to the strength and act like a void, splitting tensile strength in specimens containing EPS beads decreased by up to 70%. The use of fiber contributes to the splitting tensile strength, especially in specimens that do not contain EPS beads, and it increased the strength by 78%. Similarly, the flexural strength of the PP fiber addition increased by up to 70%. As the EPS beads ratio increased, the flexural strengths decreased by 77%. With the addition of PP fiber, the compressive strength increased by 55%. However, since EPS beads' strength is negligible, it caused a 60% decrease in compressive strength