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

Inborn errors of OAS-RNase L in SARS-CoV-2-related multisystem inflammatory syndrome in children

Multisystem inflammatory syndrome in children (MIS-C) is a rare and severe condition that follows benign COVID-19. We report autosomal recessive deficiencies of OAS1, OAS2, or RNASEL in five unrelated children with MIS-C. The cytosolic double-stranded RNA (dsRNA)-sensing OAS1 and OAS2 generate 2'-5'-linked oligoadenylates (2-5A) that activate the single-stranded RNA-degrading ribonuclease L (RNase L). Monocytic cell lines and primary myeloid cells with OAS1, OAS2, or RNase L deficiencies produce excessive amounts of inflammatory cytokines upon dsRNA or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) stimulation. Exogenous 2-5A suppresses cytokine production in OAS1-deficient but not RNase L-deficient cells. Cytokine production in RNase L-deficient cells is impaired by MDA5 or RIG-I deficiency and abolished by mitochondrial antiviral-signaling protein (MAVS) deficiency. Recessive OAS-RNase L deficiencies in these patients unleash the production of SARS-CoV-2-triggered, MAVS-mediated inflammatory cytokines by mononuclear phagocytes, thereby underlying MIS-C

Türkiye’nin Doğu Akdeniz Bölgesi’nden toplanan incir (Ficus carica L.) genotipleri arasındaki morfolojik farklılıklar

Özet: Ficus carica L. Türkiye’deki en önemli meyve türlerinden biridir. Bu araştırmada, Türkiye’nin Doğu Akdeniz bölgesinde yer alan Hatay’dan 76 incir genotipi 2008 ve 2009 yıllarında toplanmış ve hem bitkilerin hem de meyvelerin morfolojik farklılıkları değerlendirilmiştir. İki genotip yellop ürünü ve 74 genotip ana ürün olarak belirlenmiştir. Yellop ürünü için Bardak ve Dolap ve ana ürünü için Kabak 2, Kabak 1, Mor 1, Sarı 1 ve Siyah 1 genotipleri sofralık incir ticareti için oldukça ümitvar bulunmuştur. İncir genotiplerinin tanımlanmasında bitki ve yaprak özelliklerinden tepe tomurcuğu baskınlığı, yan dal oluşumu, yaprak şekli, lop sayısı, merkezi lop uzunluğu, yaprak alanı ve yaprak genişliği; meyve özelliklerinden meyve uzunluğu, pH, meyve et rengi h°, meyve sapının daldan kopma durumu, meyve çapı, boyun uzunluğu, meyve ağırlığı ve antioksidan kapasitesi oldukça başarılı olarak saptanmıştır. Araştırma alanındaki incir genotiplerinin birbirinden ayırt edilmesinde 64 özellik yerine 37’si daha kullanışlı olarak tespit edilmiştir. Genetik kaynakların objektif olarak sınıfl andırılmasında mümkün olduğunca tekrar edilebilir parametrelerin kullanılması gerektiği önerilmiştir.Abstract: Ficus carica L. is one of the most important fruit species in Turkey. For this study, 76 fi g accessions were collected from Hatay, in the Eastern Mediterranean Region of Turkey, in 2008 and 2009; the morphological diversity of plants and fruits was evaluated. Of the samples studied, 2 accessions were determined to be fi rst crop (breba) and the other 74 accessions were identifi ed as main crop. Th e fruit quality characteristics of Bardak and Dolap for the fi rst crop and Kabak 2, Kabak 1, Mor 1, Sarı 1, and Siyah 1 for the main crop were very promising for the fresh fi g market. Th e following fruit characteristics were found to be very successful discriminants for the fi g accessions: apical dominancy, lateral shoot formation, leaf shape, number of lobes, length of central lobe, leaf area, and leaf width for plant and leaf characteristics, and fruit length, pH, fruit fl esh color h°, abscission of the stalk from the twig, fruit width, fruit neck length, fruit weight, and antioxidant capacity. From the plant and fruit characteristics, 37 out of 64 traits were shown to be more useful in separating the fi g accessions in the study area. It is suggested that for the nomenclature classifi cation of genetic sources, reproducible parameters should be used as much as possible

The Effects of Strain Rate and Temperature on the Deformation Behavior of Cold-Rolled TRIP800 Steel

WOS: 000307048800007In the present study, the influences of temperature and strain rate on the deformation behavior of cold-rolled TRIP800 steel were investigated. Microstructural observation and tensile tests were performed and volume fractions of retained austenite were measured at various temperatures and strain rates. The results reveal that both temperature and strain rate affect the volume fractions of retained austenite that transforms into martensite. The strain-induced transformation of retained austenite is retarded with increasing temperature and the retained austenite becomes more stable against straining. The amount of retained austenite that transforms into martensite is not influenced significantly by strain rate. The variation in mechanical properties with temperature and strain rate was related to the effects of dynamic strain aging, tempering of banite, high temperature softening, and the volume fractions of retained austenite

Determination of mulbery fruit characteristics grown inthe Antakya district of Hatay province

Çalışmada, yapılan anket ve gözlemler sonucunda Antakya ve civar köylerinde Beyrudi, Hatuni, Yabani ve Sami olmak üzere 4 farklı dut tipi tespit edilmiştir. Bu tiplerin meyveleri, Mayıs ayı ortası ile Haziran ayının ilk haftası arasında derilmiştir. En erken Hatuni tipi, en geç Sami tipi olgunlaşmıştır. Bu tiplerden alınan meyve örneklerinde, meyve ağırlığı, meyve eni ve meyve boyu, sap uzunluğu, meyvelerde SÇKM, pH ve titre edilebilir asitlik değerleri gibi bazı pomolojik özellikler incelenmiştir. Tiplerin meyve ağırlığı 4.25-1.13 g; SÇKM içerikleri %16.01-13.73; titre edilebilir asit içerikleri % 1.00- 0.06 değerleri arasında bulunmuştur. Sonuç olarak, yapılan gözlem ve pomolojik analiz sonuçlarına göre Beyrudi ve Hatuni tiplerinin sofralık, Sami tipinin şurupluk, Yabani tipinin de kurutmalık veya pestil yapımında değerlendirilebileceği söylenebilir.In the study, the mulberry types; Beyrudi, Hatuni, Yabani and Sami; were found by extensive survey and observation carried out in Antakya and nearby villages. These types were harvested between the mid of May and the beginning of June. Hatuni type was the earliest (17 May) and Sami type was the latest (4 June). To determine the fruit characteristics of each type, fruit weight, fruit size, fruit length, fruit peduncle length, total soluble solid (TSS), fruit juice pH and titratable acidity (TA) were tested. Fruit weight, TSS and TA content of the types were determined as 4.25-1.13 g, 16.01-13.73%, 1.00-0.06%, respectively. Based on the survey result and pornological analyses it is concluded that Beyrudi and Hatuni were suitable for fresh consumption, Sami for mulberry syrup, and Yabani for mulberry leathery dry pulp (pestil) and drying

Determination of germination ratde coefficients of loquat seeds and their embryos stratified in various media for different duration

In this paper, the effects of stratification, stratification period and stratification media on the coefficients of germination rates of the seeds and embryos of Gold Nugget and Tanaka loquat cultivars were investigated. Seeds were stratified at 4¼C (cool) and at room temperatures. Both the seeds and embryos obtained from the stratified seeds germinated quicker than those of the unstratified seeds. Germination rate coefficient of the seeds, stratified at room temperature (8.56) were higher than that of the seeds stratified at 4¼C (7.21). The embryos of the seeds, stratified at 4¼C, showed higher germination rate coefficients (15.48) than that of the seeds, stratified at room temperature (13,40). Seeds, stored 30 days in both storage media, stratified or unstratified, and their embryos, obtained from them, germinated in shorter period than that of those, stored 15 days

Yenidünyaların [Eriobotrya japonica Lind.] Daldırılması,çelik ve farklı anaçlarda değişik aşı yöntemleri ile çoğaltılmaları üzerinde araştırmalar

TEZ916Tez (Doktora) -- Çukurova Üniversitesi, Adana, 1990.Kaynakça (s. 276-295) var.xix, 295 s. : rnk. res ; 30 cm.