Evaluation of the importance of immunological profile for pemphigus vulgaris in the light of necessity to modify compensation theory

According to the “desmoglein compensation theory,” anti-Dsg1 and anti-Dsg3 profiles are crucial for the clinical outcome of pemphigus vulgaris. However, recent studies have highlighted several cases with an incompatibility between the antibody profile and clinical manifestation. Data of 37 patients who had been diagnosed pemphigus vulgaris in our Department between January 2014-June 2016 were retrieved from our clinical database. Patients with ABSIS skin involvement scores, oral mucosa extent and severity scores, anti-Dsg1 and Dsg3 antibody profile were included in this retrospective study. Patients with discordance between clinical manifestations and immunological profile were considered as atypical clinical phenotype. Patients with missing data were excluded. In all 37 patients, Dsg1 and Dsg3 antibody titers at the baseline did not correlate with the concurrent ABSIS scores. At follow up, we detected statistically significant correlations between anti Dsg-1 profile and ABSIS skin involvement scores (p=0.006; r=0.588) and between anti-Dsg3 and ABSIS mucosal extent and severity scores (p=0.058; r=0.431). After treatment, the reduction of Dsg-1 antibody titers was statistically significant in remittent patients (p=0.027). We did not detect statistically significant reduction of Dsg-3 antibodies. Four subjects had incompatible antibody profile and clinical activity. Discordance between phenotype-antibody profile and clinical activity-Dsg titers support the idea that non-Dsg antigens may also be the target for pemphigus autoimmunity. </p

Gen ifade veritabanlarında içerik tabanlı arama

Büyük ölçekli gen ifade veritabanlarında zaman serisi mikrodizi deneylerinin içerik tabanlı aranması problemi ilk defa bu çalışmada araştırılmaktadır. Probleme bir bilgi geri getirim görevi olarak yaklaşılmış ve bir deneyin tamamı sorgu olarak ele alınıp önceki deneyler içerisinde aranmıştır. Metadata (üstveri) açıklamalarından daha ziyade içerik benzerliğine göre uygun deneylerin veri tabanı içerisinden bulunup getirilmesi gerekmektedir. Bu çalışmada, farklı parmak izi oluşturma yöntemleri ve uzaklık hesaplama şemalarının karşılaştırılması çeşitli zaman noktaları içerisindeki genlerin farklı ifade olma durumlarına dayalı geri getirim çatısı üzerinden sunulmuştur. Bizim oluşturduğumuz veri tabanı üzerinde yapılan tüm deneyler için, sonuçlar Pearson Bağıntı Katsayısı ve Tanimoto Uzaklığı’nın Öklid Uzaklığına göre farkı ifadeye dayalı parmak izlerinin karşılaştırılmasında yaklaşık %15 daha iyi olduğunu göstermektedir

Good versus poor prescribers: the comparison of prescribing competencies in primary care

Aim: To compare the competencies of primary care physicians (PCPs) with poor and good prescribing performance in frequently encountered indications. Background: Primary care centers are one of the mostly visited health facilities by the population for different health issues. Methods: In this cross-sectional study, we analyzed 6 125 487 prescriptions generated by 1431 PCPs which were selected by systematic sampling in 2016 in Istanbul. We defined PCPs as poor prescriber (n = 227) or good prescriber (n = 210) in terms of their prescribing performance per WHO/INRUD criteria. We compared solo diagnosis prescriptions of these two groups in 'percentage of prescriptions in compliance with clinical guidelines' and also rational prescribing indicators. Findings: Poor prescribers and good prescribers significantly differed in each of the prescribing indicators for their all solo diagnosis prescriptions. Hypertension had the highest difference of the average cost per encounter (Delta = 284.2%) between poor prescribers (US$43.99 +/- 63.05) and good prescribers (US$11.45 +/- 45.0), whereas headache had the highest difference between the groups in the percentage encounters with an antibiotic (14.9% vs. 1.5%). Detailed analysis of the prescribing performances showed significantly higher values of each WHO/INRUD indicators for all examined diagnoses. We found significantly higher percentages of guideline-compliant drugs in good prescribers compared to that in poor prescribers in hypertension (40.8% vs 34.8%), tonsillopharyngitis (57.9% vs 50.7%), and acute sinusitis (46.4% vs 43.6%). Conclusion: This study shows that the prescribing performances of PCPs are not rational enough in terms of drug selection and prescription content. Furthermore, even the physicians who have good prescribing practice appear as not satisfactorily rational in compliance with current pharmacotherapy competencies

Risk Perception and Management Strategies in Agricultural Production: A Case Of Adana Province Of Turkey

This study aims to determine and analyze farmers’ risk perceptions and risk management strategies in agricultural production. Data were obtained in 2015 production year from face-to-face interviews of 99 farmers in Yüregir and Karaisalı district of Adana province of Turkey. Factor analysis was used in data reduction to identify a small number of factors related to risk sources and risk strategies in this study. Then, multiple regression model was used to evaluate the influence of socioeconomic characteristics on the farmers’ risk perceptions and risk management strategies using factor loadings. The results of this study show that the most important risk source that the farmers' perceive is availability of many middlemens in agriculture and food market and risk management strategy that the farmers' perceive is producing at the lowest cost. The result of factor analysis showed that the risk scale consists of 5 factors explaining 60.66% of total variance. The internal consistency coefficient Cronbach Alfa of the scale is 0.918 and KMO is 0.869. The risk management scale consists of 4 factors explaining 64.23% of total variance. The internal consistency coefficient Cronbach Alfa of the scale is 0.944 and KMO is 0.910. According to the results, perceptions are farmer-specific, a number of socio-economic variables are found to be related to risk and risk management. Improving of risk management strategies is useful for farmers as well and might help them to avoid many risks and reduce losses

Good versus poor prescribers: The comparison of prescribing competencies in primary care

Aim: To compare the competencies of primary care physicians (PCPs) with poor and good prescribing performance in frequently encountered indications. Background: Primary care centers are one of the mostly visited health facilities by the population for different health issues. Methods: In this cross-sectional study, we analyzed 6 125 487 prescriptions generated by 1431 PCPs which were selected by systematic sampling in 2016 in Istanbul. We defined PCPs as poor prescriber (n = 227) or good prescriber (n = 210) in terms of their prescribing performance per WHO/INRUD criteria. We compared solo diagnosis prescriptions of these two groups in 'percentage of prescriptions in compliance with clinical guidelines' and also rational prescribing indicators. Findings: Poor prescribers and good prescribers significantly differed in each of the prescribing indicators for their all solo diagnosis prescriptions. Hypertension had the highest difference of the average cost per encounter (Delta = 284.2%) between poor prescribers (US$43.99 +/- 63.05) and good prescribers (US$11.45 +/- 45.0), whereas headache had the highest difference between the groups in the percentage encounters with an antibiotic (14.9% vs. 1.5%). Detailed analysis of the prescribing performances showed significantly higher values of each WHO/INRUD indicators for all examined diagnoses. We found significantly higher percentages of guideline-compliant drugs in good prescribers compared to that in poor prescribers in hypertension (40.8% vs 34.8%), tonsillopharyngitis (57.9% vs 50.7%), and acute sinusitis (46.4% vs 43.6%). Conclusion: This study shows that the prescribing performances of PCPs are not rational enough in terms of drug selection and prescription content. Furthermore, even the physicians who have good prescribing practice appear as not satisfactorily rational in compliance with current pharmacotherapy competencies

Pili Annulati With Fragility: Electron Microscopic Findings Of A Case

Pili annulati (PA) is typically characterized by shinny beads seen along the hair shaft. PA is accepted to belong to the classification of hair shaft abnormalities without fragility. Herein, we described a 14-year-old, fair skin with dark-haired girl diagnosed as PA with fragility which was demonstrated by weathering features in electron microscopic examinations. The patient had shinny beaded, easily breakable hairs since the age of four. A few broken hairs were observed by a light pull test. Transmitted light microscopy revealed periodic dark bands in the hair shaft. These dark bands disappeared after application of 10% aqueous potassium hydroxide. Multiple cavities within hair shaft and severe cuticular damages representing the weathering pattern were observed in electron microscopic examinations. All these findings were found to be consistent with presence of fragility in PA. This case provides evidences of fragile hair structure of PA which may be due to pathological cavities within hair shafts.PubMe

THE EFFECT OF EXTRACORPOREAL ELECTROMAGNETIC SHOCK-WAVES ON THE MORPHOLOGY AND CONTRACTILITY OF RABBIT URETER

Purpose: Although extracorporeal shock wave lithotripsy (ESWL) is known to cause pathologic changes in various organs, little is known about its effects on the ureter, the target organ in ESWL of ureteral stones in situ. In this study, we sought to determine the short-term effects of ESWL on the ureter