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

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Obsesif-Kompulsif Bozuklukta Genetik Çalismalar

Obsessive-compulsive disorder (OCD) is characterized by repetitive, intrusive ideations, image or urges (obsession) and/or rigid, ritualistic and time-consuming behaviours (compulsions). Early evidences on inheritance of OCD have been obtained from family and twin studies. Segregation analysis provides basic support for existence of a major gene locus. In only published linkage analysis, it was reported that multipoint linkage was found on chromosome 9p. Recently, genetic studies have centered on plausible candidate genes, which are thought to be involved in the etiology of OCD. Preliminary findings from the studies of several candidate genes have contributed to previous clinical findings, especially related to serotonergic and dopaminergic systems. Also, the candidate genes of opioid, glutamatergic systems as well as the genes of immune system and neurodevelopmental progress give hope to researchers for future investigation of these systems. In this review, the family, twin, segregation, linkage, and candidate genes studies of OCD will be reviewed

Effects of isotretinoin on the olfactory function in patients with acne

BACKGROUND: Isotretinoin is a synthetic analog of vitamin A. Recent studies support a role for retinoic acid in the recovery of olfactory function following injury in mice

Relationship of levetiracetam and obsessive-compulsive disorder: a case report

Levetiracetam has gained wide acceptance in the treatment of epilepsy due to its broad-spectrum efficacy, the lack of significant drug–drug interactions, and a relatively benign side effect profile. However, in recent years, the treatment of epilepsy using levetiracetam has been associated with psychiatric side effects such as anxiety, irritability, hostility, depression, hallucinations, and, in some rare cases, obsessive-compulsive disorder. In this case report, we present and discuss onset of obsessive-compulsive disorder symptoms in a 55-year-old epileptic female patient, who did not have any previous psychiatric disorder, including obsessive-compulsive disorder, and who received levetiracetam treatment

Quality of Life and Associated Risk Factors in Caregivers of Patients with Obsessive Compulsive Disorder

INTRODUCTION: Obsessive compulsive disorder (OCD) is a chronic disease that affects social relationships, and occupational and academic performance of patients and their relatives due to cognitive, emotional, and behavioural aspects of the disease. Quality of life (QoL) in relatives of patients with OCD has previously been reported and compared with caregivers of patients with other psychiatric conditions. However, there are few studies available in the literature regarding the causality of QoL in caregivers of patients with OCD. OBJECTIVE: The aim of this study was to evaluate QoL of caregivers of patients with OCD and predictors of QoL of the family caregivers. METHODS: The study population comprised of 68 patients with OCD and their caregivers. The dependent variable of this study is “QoL of caregivers” as assessed by the short version of the World Health Organization Quality of Life questionnaire (WHOQOL-BREF-TR). The Structured Clinical Interview for DSM-IV/Clinical Version (SCID-I/CV), Yale-Brown obsessive-compulsive scale (Y-BOCS), Y-BOCS symptom checklist, Hamilton Depression Rating Scale (HAM-D), and WHOQOL-BREF-TR were completed by the patients, whereas the SCID-I/CV, WHOQOL-BREF-TR, and Burden Assessment Scale (BAS) were completed by the caregivers. Student’s t-test, MWU, ANOVA, Kruskal–Wallis ANOVA, and Spearman’s correlations were used in univariate analyses, and multiple linear regression tests were run in multivariate analyses. Critical VIF values were taken as 5.0 for detecting collinearity among independent variables in the regression analyses. Type 1 error was taken as 0.05 in the analyses. RESULTS: Linear regression analysis showed that caregivers’ sex, education level, occupational status, disease burden, and patients’ sex, physical QoL, and disease severity were predictors of caregivers’ QoL. Moreover, disease burden was the only common predictor that affected all four dimensions (physical, psychological, social relations, environmental) of the caregiver’s QoL, and as the perceived disease burden increased, the caregiver’s QoL deteriorated

DETERMINATION GAMMA İRRADİATİON EFFECTS ON SOME PHYSICOCHEMICAL, ANTIMICROBIAL PROPERTIES OF DIFFERENT TYPES OF GRAPE SEEDS

Bu araştırmada ışınlama işlemininüzüm çekirdeğinin fizikokimyasal, mikrobiyolojik, antimikrobiyal özelliklerine ve yağ asitleri bileşimine etkisinin belirlenmesi amaçlanmıştır.Tekirdağ Bağcılık Araştırma İstasyonu Müdürlüğü'nden temin edilen beş çeşit üzüm çekirdeği örneği (Alicante bouschet, Cabernet franc, Cinsault, Merlot, Shiraz)1,0 kGy, 3,0 kGy, 5,0 kGy ve 7,0 kGy dozlarındaki gama ışınlama işlemine tabi tutulmuştur. Işınlama işleminden hemen sonra üzüm çekirdeklerinde meydana gelen mikrobiyolojik (toplam mezofilik aerobik bakteri, S. aureus, maya ve küf, koliform grubu bakteri, Salmonella) ve kimyasal (kuru madde, yağ, kül, toplam şeker, invert şeker) değişimler incelenmiştir. Işınlama işleminin üzüm çekirdeği yağları üzerindeki % asitlik, peroksit sayısı, yağ asitleri bileşimi, sterol kompozisyonu, antimikrobiyal aktiviteleri, fenolik ve antioksidan kapasite değerlerine etkisi belirlenmiştir.Uygulanan ışınlama dozu ile ters orantılı olarak üzüm çekirdeklerinin mikroorganizma sayılarında azalma gözlemlenmi?tir. 5 kGy?lik ışınlama dozundatoplam mezofilik aerobik bakteri (TMAB) sayısı, S. aureus, maya ve küf sayılarının belirlenemeyecek seviyelere kadar indigi tespit edilmiştir. Işınlama doz oranındaki artışa paralel olarak tüm örneklerin % asitlik ve peroksit sayılarında belli oranda artışlar meydana gelmiştir. Yağ asitleri bileşimleri incelendiğinde; tüm üzüm çekirdeği çeşitlerinin yağlarında ışınlama dozu artışına paralel olarak önemli doymuş yağ asitlerinden olan palmitik (C16:0) ve stearik (C18:0) asit miktarlarının arttığı, doymamış yağ asitlerinden olan oleik (C18:1) ve linoleik (C18:2) asit miktarlarının da azaldığı görülmüştür.Üzüm çekirdeği yağı örnekleri sterol kompozisyonları açısından ele alındığında ise; tüm örneklerde en yüksek düzeyde ?- sitosterol tespit edilmiş olup, ?-sitosterol miktarının ışınlama dozu arttıkça azaldığı görülmüştür. 1kGy, 3kGy, 5kGy, 7kGy dozlarında uygulanan gama ışınlaması işleminin kontrol grubuna kıyasla üzüm çekirdeğinin ve yağlarının antimikrobiyal aktivitesinde istatistiksel olarak önemli değişikliğe neden olmadığı tespit edilmiştir. Işınlama dozu arttıkça üzüm çekirdeği ve yağının toplam fenolik madde içeriğinde ve antioksidan kapasite değerinde azalma olduğu tespit edilmiştir.In this research, it has been aimed to determine the effects of irradiation on grape seeds' some microbiological, physicochemical, antimicrobial properties and composition of fat acids. The grape seed samples (Alicante bouschet, Cabernet franc, Cinsault, Merlot, Shiraz) obtained from Tekirdağ Viticulture Research Station subjected to gamma radiation at 1,0 kGy, 3,0 kGy, 5,0 kGy ve 7,0 kGy doses. Microbiological (total aerobic mesophilic bacteria, S. aureus, yeast and mould, total coliforms, Salmonella) and chemical (dry matter, fat, ash, total sugar, invert sugar) changes occurring in grape seed were examined immediately after the irradiation process. The irradiation effects on acidity, peroxide value, fatty acid composition, the sterol composition, antimicrobial activity, phenolic content, antioxidant activity of grape seed oil were determined.Gamma irradiation resulted in overall reduction in microbial loads. Total aerobic mesophilic bacteria, S. aureus, yeast and mold counts was determined as down to undetectable levels at 5 kGy doses of gamma irradiation. ?-sitosterol content with a highest percentage among sterols decreased due to gamma irradiation. The data obtained showed that increasing the dose of irradiation resulted in the decrease of oleic acid (C18:1), linoleic acid (C18:2) and increase of palmitic (C16:0), stearic acid (C18:0) content. The acidity and peroxide value in all the types were significantly increased with the increase of dose of irradiation. In contrast, antimicrobial activity of grape seeds and oils exhibited non-significant changes. Phenolic content and antioxidant capacity of grape seed reduced when irradiation dose was increased

Arhrogryposis Tip-7

Fotografi bisa bekerja sebagai alat untuk mengungkapkan pandangan personal, tidak hanya merekam secara mekanis. Pandangan personal mengenai ruang yang dalam hal ini adalah Kota Pariaman menjadi bahasan pokok dalam penciptaan ini. Fotografi ekspresi dijadikan sebagai metode untuk merumuskan pandangan tersebut. Topographic Photography dijadikan sebagai pendekatan untuk merekam apa yang terlihat di permukaan. Ruang-ruang yang ditinggalkan di kota ini, seperti rumah-rumah, benda yang ditemui sepanjang jalan menjadi objek untuk menceritakan pandangan terhadap kota ini. Rangkaian karya foto yang dihasilkan dalam penciptaan ini menawarkan pandangan persolan terhadap suatu ruang yang dibahasakan melalui realitas yang ada