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

Prospective Observational Study on acute Appendicitis Worldwide (POSAW)

Background: Acute appendicitis (AA) is the most common surgical disease, and appendectomy is the treatment of choice in the majority of cases. A correct diagnosis is key for decreasing the negative appendectomy rate. The management can become difficult in case of complicated appendicitis. The aim of this study is to describe the worldwide clinical and diagnostic work-up and management of AA in surgical departments.Methods: This prospective multicenter observational study was performed in 116 worldwide surgical departments from 44 countries over a 6-month period (April 1, 2016-September 30, 2016). All consecutive patients admitted to surgical departments with a clinical diagnosis of AA were included in the study.Results: A total of 4282 patients were enrolled in the POSAW study, 1928 (45%) women and 2354 (55%) men, with a median age of 29 years. Nine hundred and seven (21.2%) patients underwent an abdominal CT scan, 1856 (43.3%) patients an US, and 285 (6.7%) patients both CT scan and US. A total of 4097 (95.7%) patients underwent surgery; 1809 (42.2%) underwent open appendectomy and 2215 (51.7%) had laparoscopic appendectomy. One hundred eighty-five (4.3%) patients were managed conservatively. Major complications occurred in 199 patients (4.6%). The overall mortality rate was 0.28%.Conclusions: The results of the present study confirm the clinical value of imaging techniques and prognostic scores. Appendectomy remains the most effective treatment of acute appendicitis. Mortality rate is low.</p

Global validation of the WSES Sepsis Severity Score for patients with complicated intra-abdominal infections : a prospective multicentre study (WISS Study)

Background: To validate a new practical Sepsis Severity Score for patients with complicated intra-abdominal infections (cIAIs) including the clinical conditions at the admission (severe sepsis/septic shock), the origin of the cIAIs, the delay in source control, the setting of acquisition and any risk factors such as age and immunosuppression. Methods: The WISS study (WSES cIAIs Score Study) is a multicenter observational study underwent in 132 medical institutions worldwide during a four-month study period (October 2014-February 2015). Four thousand five hundred thirty-three patients with a mean age of 51.2 years (range 18-99) were enrolled in the WISS study. Results: Univariate analysis has shown that all factors that were previously included in the WSES Sepsis Severity Score were highly statistically significant between those who died and those who survived (p <0.0001). The multivariate logistic regression model was highly significant (p <0.0001, R-2 = 0.54) and showed that all these factors were independent in predicting mortality of sepsis. Receiver Operator Curve has shown that the WSES Severity Sepsis Score had an excellent prediction for mortality. A score above 5.5 was the best predictor of mortality having a sensitivity of 89.2 %, a specificity of 83.5 % and a positive likelihood ratio of 5.4. Conclusions: WSES Sepsis Severity Score for patients with complicated Intra-abdominal infections can be used on global level. It has shown high sensitivity, specificity, and likelihood ratio that may help us in making clinical decisions.Peer reviewe

Prospective Observational Study on acute Appendicitis Worldwide (POSAW)

Acute appendicitis (AA) is the most common surgical disease, and appendectomy is the treatment of choice in the majority of cases. A correct diagnosis is key for decreasing the negative appendectomy rate. The management can become difficult in case of complicated appendicitis. The aim of this study is to describe the worldwide clinical and diagnostic work-up and management of AA in surgical departments.info:eu-repo/semantics/publishedVersio

Reduction of postoperative adhesions by trimetazidine: an experimental study in a rat model

Trimetazidine (TMZ) reduces intracellular acidosis and inhibits oxygen-derived free radicals and neutrophile infiltration in ischemia and hypoxia, which are the primary steps of adhesion formation. Our aim is to study the anti-adhesion potential of trimetazidine in a rat uterine horn model

Synthesis, molecular structure, spectral analysis and nonlinear optical studies on 4-(4-bromophenyl)-1-tert-butyl-3-methyl-1H-pyrazol-5-amine: A combined experimental and DFT approach

4-(4-bromophenyl)-1-tert-butyl-3-methyl-1H-pyrazol-5-amine (BPTBMPA) crystal was synthesized for the first time and its structural characterization was performed by X-ray diffraction method. The spectroscopic characterization was also performed by the applying of FT-IR, UV-Vis, H-1 and C-13 NMR spectroscopies. In order to support experimental results, density functional theory calculations have been performed. All of the obtained theoretical results are in a perfect agreement with the experimental ones. The negative HOMO and LUMO energies demonstrated that the molecular structure of BPTBMPA is stable. The small energy gap between the HOMO and LUMO is an indicator of intramolecular charge transfer which is responsible for nonlinear optical properties. Natural bond orbital analysis also indicates the presence of molecular charge transfer within BPTBMPA. Obtained chemical hardness parameter demonstrates that BPTBMPA has considerable electron donor groups. Finally, it has been showed that BPTBMPA exhibits considerable nonlinear optical properties. (C) 2015 Elsevier B.V. All rights reserved

Association Between Genetic Variants of DNA Repair Genes and Coronary Artery Disease

Polymorphisms in DNA repair genes may be associated with differences in the repair efficiency of DNA damage and may influence an individual's risk of atherosclerosis. Genetic research on coronary artery disease (CAD) has traditionally focused on investigation aimed at identifying disease-susceptibility genes. The aim of this study was to investigate the relationship between AP-endonuclease-1 (Asp148Glu), XRCC1 (Arg399Gln), XRCC3 (Thr241Met), XPD (Lys751Gln), XPG (Asp1104His), and hOGG1 (Ser326Cys), gene polymorphisms and the risk of developing CAD in a Turkish population. The study population consisted of 197 patients with acute coronary syndrome (ACS) with chronic CAD and 135 healthy subjects' age and sex matched. Gene polymorphisms were determined by the polymerase chain reaction-restriction fragment length polymorphism method. We demonstrated for the first time, a positive association of XRCC3 and hOGG1 DNA repair gene variants with CAD risk. XRCC3 Thr/Thr genotype and Thr allele frequencies were significantly increased in ACS and chronic CAD patients compared with the control group (p < 0.05). It was also observed that there is a protective role of XRCC3 Met alleles against both ACS and chronic CAD (p < 0.05). hOGG1 Cys alleles were found significantly higher in ACS patients than in the control group and carriers of the Cys allele had a 1.7-fold increased risk for ACS. In addition, we confirmed the association of XRCC3 Thr241Met and hOGG1 Ser326Cys gene variants with CAD by haplotype analysis. We found that CAD risk is associated with XRCC3 Thr: hOGG1 Cys haplotype, whereas XRCC3 Met: hOGG1 Ser haplotype was found to be protective against the disease. The preliminary results suggested that XRCC3 and hOGG1 genetic variants may be risk factors by affecting the enzyme's function that may lead to development of CAD

Association Between Genetic Variants of DNA Repair Genes and Coronary Artery Disease

Polymorphisms in DNA repair genes may be associated with differences in the repair efficiency of DNA damage and may influence an individual's risk of atherosclerosis. Genetic research on coronary artery disease (CAD) has traditionally focused on investigation aimed at identifying disease-susceptibility genes. The aim of this study was to investigate the relationship between AP-endonuclease-1 (Asp148Glu), XRCC1 (Arg399Gln), XRCC3 (Thr241Met), XPD (Lys751Gln), XPG (Asp1104His), and hOGG1 (Ser326Cys), gene polymorphisms and the risk of developing CAD in a Turkish population. The study population consisted of 197 patients with acute coronary syndrome (ACS) with chronic CAD and 135 healthy subjects' age and sex matched. Gene polymorphisms were determined by the polymerase chain reaction-restriction fragment length polymorphism method. We demonstrated for the first time, a positive association of XRCC3 and hOGG1 DNA repair gene variants with CAD risk. XRCC3 Thr/Thr genotype and Thr allele frequencies were significantly increased in ACS and chronic CAD patients compared with the control group (p < 0.05). It was also observed that there is a protective role of XRCC3 Met alleles against both ACS and chronic CAD (p < 0.05). hOGG1 Cys alleles were found significantly higher in ACS patients than in the control group and carriers of the Cys allele had a 1.7-fold increased risk for ACS. In addition, we confirmed the association of XRCC3 Thr241Met and hOGG1 Ser326Cys gene variants with CAD by haplotype analysis. We found that CAD risk is associated with XRCC3 Thr: hOGG1 Cys haplotype, whereas XRCC3 Met: hOGG1 Ser haplotype was found to be protective against the disease. The preliminary results suggested that XRCC3 and hOGG1 genetic variants may be risk factors by affecting the enzyme's function that may lead to development of CAD.Research Foundation of the University of IstanbulIstanbul University [UDP-17986/02082011]This work was supported by the Research Foundation of the University of Istanbul (Project No. UDP-17986/02082011)

Primer Progresif Afazide Kelime-Obje Asosiyasyon Bozukluklarının Göz İzleme Ve Mrg Yöntemleriyle İncelenmesi

GİRİŞ VE AMAÇ:Primer progresif afazi (PPA), lisan işlevlerinin belirgin bozulduğu ve erken dönemde diğer kognitifbecerilerin görece korunduğu nörodejeneratif bir hastalıktır. PPA hastalarının bir bölümünde (semantik PPA)kelime-obje asosiasyonunun bozulmasına bağlı kelime anlama bozuklukları görülürken diğer hastalarda kelimebulma güçlüğü (logopenik PPA), tutuk konuşma ve/veya agramatizm (agramatik PPA) gibi semantik olmayan bozukluklarön planda olabilir. Bu çalışmada klinik olarak saptanabilen semantik bozukluğu olmayan PPA hastalarındakelime-obje asosiasyonundaki etkilenmenin erken evrede tespit edilmesi ve ilişkili atrofi alanlarının saptanmasıamaçlanmıştır.YÖNTEM:Nöropsikolojik testlerle yapılan ön değerlendirmeye göre kelime anlama (semantik) becerileri görece korunan11 PPA hastası ve 10 sağlıklı kontrol çalışmaya dahil edildi. Katılımcılara dokunmatik ekran üzerinde gerçekleştirilenbir kelime-obje eşleştirme görevi verildi. Yirmi dört denemeden oluşan ve her denemede ekran üzerindekieliptik bir düzlemde yer alan 16 obje resminin (bir hedef ve 15 çeldirici) bulunduğu deney sırasında göz hareketlerigöz takip sistemi kullanılarak kaydedildi. 3T Manyetik Rezonans Görüntüleme cihazı kullanılarak elde edilen yapısalgörüntüler FreeSurfer programı aracılığıyla işlenerek kortikal kalınlık haritaları oluşturuldu.BULGULAR:Hem kontrol (M=%99.5) hem de PPA (M=%91) grubu kelime-obje eşleştirme görevini başarı ile tamamladı.Ancak göz hareketlerinin analizi PPA grubunun kontrol grubuna oranla daha fazla sayıda çeldiriciye (p&lt;0.01),daha çok kez (p=0.008) ve daha uzun süre (p&lt;0.001) baktığını göstermektedir. Kortikal kalınlık analizi sonucundaPPA grubunda inferior frontal gyrus (IFG) ve temporoparietal birleşimin (TPJ) yanı sıra anterior temporal lobda (ATL)anlamlı atrofi tespit edildi.TARTIŞMA VE SONUÇ:Bulgular geleneksel nöropsikolojik yöntemlerle yapılan değerlendirmelerde semantik bozukluksaptanmayan PPA hastalarında kelime-obje asosiyasyonundaki subklinik etkilenmenin göz hareket takip sistemiyletespit edilebileceğini göstermektedir. Kortikal kalınlık ölçümlerinde agramatik ve logopenik PPA hastalarınaözgü IFG ve TPJ atrofisinin yanı sıra semantik PPA hastalarına özgü sol ATL atrofisinin de tespit edilmiş olması buhastalarda ileride karma tip PPA’ya dönüşebilecek nörodejeneratif bir sürecin varlığını göstermektedir.Anahtar Kelimeler: primer progresif afazi, nörodejenerasyon, göz izleme, kortikal kalınlık, kelime-obje asosiasyon