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

The interrelations of radiologic findings and mechanical ventilation in community acquired pneumonia patients admitted to the intensive care unit: a multicentre retrospective study

BACKGROUND: We evaluated patients admitted to the intensive care units with the diagnosis of community acquired pneumonia (CAP) regarding initial radiographic findings. METHODS: A multicenter retrospective study was held. Chest x ray (CXR) and computerized tomography (CT) findings and also their associations with the need of ventilator support were evaluated. RESULTS: A total of 388 patients were enrolled. Consolidation was the main finding on CXR (89%) and CT (80%) examinations. Of all, 45% had multi-lobar involvement. Bilateral involvement was found in 40% and 44% on CXR and CT respectively. Abscesses and cavitations were rarely found. The highest correlation between CT and CXR findings was observed for interstitial involvement. More than 80% of patients needed ventilator support. Noninvasive mechanical ventilation (NIV) requirement was seen to be more common in those with multi-lobar involvement on CXR as 2.4-fold and consolidation on CT as 47-fold compared with those who do not have these findings. Invasive mechanical ventilation (IMV) need increased 8-fold in patients with multi-lobar involvement on CT. CONCLUSION: CXR and CT findings correlate up to a limit in terms of interstitial involvement but not in high percentages in other findings. CAP patients who are admitted to the ICU are severe cases frequently requiring ventilator support. Initial CT and CXR findings may indicate the need for ventilator support, but the assumed ongoing real practice is important and the value of radiologic evaluation beyond clinical findings to predict the mechanical ventilation need is subject for further evaluation with large patient series

Profiling of Bacteria Capable of Precipitating CaCO3 on the Speleothem Surfaces in Dupnisa Cave, Kirklareli, Turkey

This study aimed to identify the bacteria which take part in the CaCO3 precipitation on the speleothem surfaces of Dupnisa Cave. In addition, this study highlighted the CaCO3 precipitation ability of the bacteria with negative urease activity. 150 isolates with microbial induced calcium carbonate precipitation features were selected and identified. They were belonging to Proteobacteria (53.3%), Firmicutes (32.7%) and, Actinobacteria (4.7%) phyla. The dominant bacterial species on all surface samples were Bacillus mycoides (9.3%), Bacillus zhangzhouensis (5.3%), and Serratia quinivorans (4%). Our results showed that most of the bacteria which can precipitate calcium carbonate on the B4 medium at the first 3 days, have urease negative activity. Within this study, it has been emphasized that other mechanisms enabling the precipitation of CaCO3 besides the urease mechanism should also be investigated. EDS analyses confirmed that the crystals were predominantly composed of calcium, carbon, and oxygen. In addition, the EDS highlighted that the two strains of Bacillus mycoides, isolated from two different surfaces, produced crystals of different morphology. Our study results to the identification of the bacteria which contribute to the Dupnisa Cave walls formation. Besides, our results showed that the Dupnisa Cave is housing bacteria with biotechnological and engineering applications potentials

Exploring Adoption of Augmented Reality Smart Glasses: Applications in the Medical Industry

This study explores the use of augmented reality smart glasses (ARSGs) by physicians and their adoption of these products in the Turkish medical industry. Google Glass was used as a demonstrative example for the introduction of ARSGs. We proposed an exploratory model based on the technology acceptance model by Davis. Exogenous factors in the model were defined by performing semi-structured in-depth interviews, along with the use of an expert panel in addition to the technology adoption literature. The framework was tested by means of a field study, data was collected via an Internet survey, and path analysis was used. The results indicate that there were a number of factors to be considered in order to understand ARSG adoption by physicians. Usefulness was influenced by ease of use, compatibility, ease of reminding, and speech recognition, while ease of use was affected by ease of learning, ease of medical education, external influence, and privacy. Privacy was the only negative factor that reduced the perceived ease of use, and was found to indirectly create a negative attitude. Compatibility emerged as the most significant external factor for usefulness. Developers of ARSGs should pay attention to healthcare-specific requirements for improved utilization and more extensive adoption of ARSGs in healthcare settings. In particular, they should focus on how to increase the compatibility of ARSGs. Further research needs to be conducted to explain the adoption intention of physicians

Soft tissue chondroma of the index finger: Clinical, histological and radiological findings in a unique case

A chondroma is a benign, slow-growing cartilaginous tumor. When arising in the medullary cavity of a bone it is referred to as an enchondroma-a very common bone tumor. When occurring in soft tissue without any connection to bone, which is extremely rare, it is known as a soft-tissue chondroma (STC). A 38-year-old female presented with a 2- year history of right index finger pulp swelling in the absence of trauma. On physical examination a firm, immobile nodule, approximately 1 cm in diameter, was observed on the palmar side of the right index finger. The overlying skin was normal. Plain X-ray showed a dense, soft tissue shadow without calcification in the right index finger pulp, but the adjacent bones were intact. MRI showed a 1-cm diameter, well-demarcated lesion with intermediate signal intensity on T1-weighted images and high signal intensity on T2-weighted images. MRI also showed that the tumor had no bony involvement and that the adjacent bones were normal. Histopathological examination of the biopsy specimen showed lobules of mature hyaline cartilage with chondrocytes in the lacunae in the dermal and subdermal layers. Mitotic figures and an increase in cellular atypism were not observed. Based on the histopathological and radiological findings, the mass was thought to be an STC and total excision was performed. Examination of the excised mass confirmed the diagnosis of STC. STC should be considered in patients with a slowly growing, mildly painful cutaneous mass

Soft tissue chondroma of the index finger: Clinical, histological and radiological findings in a unique case

A chondroma is a benign, slow-growing cartilaginous tumor. When arising in the medullary cavity of a bone it is referred to as an enchondroma-a very common bone tumor. When occurring in soft tissue without any connection to bone, which is extremely rare, it is known as a soft-tissue chondroma (STC). A 38-year-old female presented with a 2- year history of right index finger pulp swelling in the absence of trauma. On physical examination a firm, immobile nodule, approximately 1 cm in diameter, was observed on the palmar side of the right index finger. The overlying skin was normal. Plain X-ray showed a dense, soft tissue shadow without calcification in the right index finger pulp, but the adjacent bones were intact. MRI showed a 1-cm diameter, well-demarcated lesion with intermediate signal intensity on T1-weighted images and high signal intensity on T2-weighted images. MRI also showed that the tumor had no bony involvement and that the adjacent bones were normal. Histopathological examination of the biopsy specimen showed lobules of mature hyaline cartilage with chondrocytes in the lacunae in the dermal and subdermal layers. Mitotic figures and an increase in cellular atypism were not observed. Based on the histopathological and radiological findings, the mass was thought to be an STC and total excision was performed. Examination of the excised mass confirmed the diagnosis of STC. STC should be considered in patients with a slowly growing, mildly painful cutaneous mass

RELATIONSHIPS BETWEEN NATURAL AND ARTIFICIAL AGING OF PURE INK DYE: MODEL STUDY USING CRYSTAL VIOLET

Inks in written documents fade over time due to physicochemical changes caused by exposure to environmental factors like oxygen, humidity, light, and heat. This fading is examined in detail with advanced analytical methods. The age of a document can be determined from the amount of ink fading. In this study, a ballpoint pen ink containing Crystal Violet as the major component was prepared and changes to pure crystal violet over time were examined. Ink samples were prepared by printing from a cartridge filled with this crystal violet solution onto paper and exposed to artificial daylight for 33 hours. Changes in the ink composition were analyzed using High Performance Liquid Chromatograpy. Additionally, inks from naturally aged documents were analyzed in the same manner, and the dye ratios were investigated to compare the parameters for dye aging in dark, or only weakly exposed to daylight, rooms. We found that the dye ratio and degradation product peaks on the chromatogram contained useful information related to ink aging rather than the absolute amounts of crystal violet, methyl violet, and tetramethyl pararosaniline. A chromatogram from a real case sample (fraudulent documents that were exposed to high intensity light) that tricked expert witness on ink dating was obtained and presented

The Effects of Different Breastfeeding Training Techniques Given for Primiparous Mothers Before Discharge on the Incidence of Cracked Nipples

WOS: 000403888100011PubMed ID: 28472588Objective: This research investigated the effects of different breastfeeding training techniques for primiparous mothers before discharge on the incidence of cracked nipples. Materials and Methods: This was a controlled intervention study that was carried out between 2015 and 2016 on 90 mothers living in Izmir. The mothers were divided into three groups: the demonstration-based training group, brochure group, and routine care-receiving group. The mothers in the "brochure group" were provided with breastfeeding training brochures. Mothers in the demonstration-based training group received one-to-one training using designed doll and puppet tools. Results: The rate of cracked nipples at age 2 weeks was 63.3% in the routine care-receiving group, 56.7% in the brochure group, and 20% in the demonstration-based training group. At the end of the fourth week, the rate was 30% in the routine care-receiving group and less than 10% in the other two groups (p < 0.005). The LATCH scores were higher in the demonstration-based training group than in the other two groups (p < 0.05). There was no significant difference between the groups in the percentage of exclusive breastfeeding. Conclusion: The results documented that breastfeeding training based on one-to-one demonstration utilizing specially designed audiovisual tools was more effective than the other two methods in the prevention of nipple cracks

Comparison of efficacy of chemical peeling with 25% trichloroacetic acid and 0.1% retinoic acid for facial rejuvenation

Introduction : Skin aging is a problem which negatively affects the psyche of the person, social relations, as well as work life and health and which compels the patients to find appropriate treatment methods. Numerous treatment methods have been developed in order to delay aging and to reduce the aging effects in addition to having a younger, healthier and more beautiful facial appearance. Aim : To compare the efficiency, cosmetic results and possible adverse effects of the peeling treatment with 25% trichloroacetic acid (TCA) and 0.1% retinoic acid for facial rejuvenation in patients presenting with skin aging. Material and methods: Fifty female patients in total presenting with medium and advanced degree skin aging were subject to this study. Two separate treatment groups were formed; the first group underwent chemical skin treatment with 25% TCA while the other group was applied with 0.1% retinoic acid treatment. Following the 4 months’ treatment the patients were controlled three times in total for post lesional hypopigmentation, hyperpigmentation, scars, skin irritation and other possible changes per month. The pretreatment and first follow-up visit, and final control images were comparatively evaluated by three observers via specific software. Results : The healing rates of the group subject to retinoic acid were statistically higher (p < 0.05) compared to patients in the TCA group in the final follow-up visit following the treatment according to the first and second observers. On the other hand, according to the third observer, patients applied with retinoic acid presented with higher healing rates compared to those treated with TCA, however; this rate was not statistically significant (p > 0.05). The frequency of TCA- and retinoic acid-associated adverse effects was similar in both groups (p > 0.05). As a result of both treatments, a reduction in the quality of life scores as well as a pronounced recovery (p = 0.001) in the quality of life of those patients with skin aging was observed. Conclusions : The photo aging treatment option with 0.1% retinoic acid is cheaper and more feasible for patients compared to 25% TCA, and it is also as reliable and effective as TCA

Correlation Between Gamma-Glutamyl Transferase Activity and Glutathione Levels in Molecular Subgroups of Breast Cancer

Objective: The gamma-glutamyl cycle catalyzed by gamma-glutamyl transferase (GGT) plays an important role in glutathione (GSH) homeostasis in the cell. In cells continuously exposed to the drug, the main phase of the enzymatic detoxification is the conjugation of the drug with GSH catalyzed by glutathione-S-transferase (GST). Conjugation of drugs with GSH is the first step in the development of chemotherapeutic drug resistance. In this study, we aimed to investigate the relationship between GGT and GSH in molecular subgroups of breast cancer patients