The Course and Prognosis of Pemphigus: A Review of 42 Patients

Pemphigus is a rare, chronic and life-threating autoimmune disease. The objective of this retrospective study was to evaluate the course and prognosis of pemphigus patients treated in our clinics. Medical records of 42 patients followed up regularly, and diagnosed at the Department of Dermatology, Faculty of Medicine, University of Dicle, from July 1994 to January 2004 were reviewed retrospectively. Of 42 patients with pemphigus, 38 had been treated with combination of methylprednisolone and azathioprine. Four patients had been treated with methylprednisolone alone. The initial doses ranged from 80 to 300 mg of methylprednisolone and 100-150 mg of azathioprine daily. No remission was obtained in 5 cases treated with combined therapy of methylprednisolone and azathioprine. Of 42 patients, 5 died during the study period. All of the patients who died were those patients with pemphigus vulgaris. In 4 patients, death occurred due to reasons related to the disease or treatment. Twenty nine patients were in complete remission with no therapy for duration varying between 4 months and 8 years

2D-DIGE as a strategy to identify serum biomarkers in Mexican patients with Type-2 diabetes with different body mass index

"Obesity and type 2 diabetes (T2D) are the most prevalent and serious metabolic diseases affecting people worldwide. However racial and ethnic disparities seems to be a risk factor for their development. Mexico has been named as one of the largest populations with the highest prevalence of diabetes and obesity. The aim of this study was to identify novel T2D-associated proteins in Mexican patients. Blood samples were collected from 62 Mexican patients with T2D and they were grouped according to their body mass index (BMI). A panel of 10 diabetes and obesity serum markers was determined using MAGPIX. A comparative proteomics study was performed using two-dimensional difference in-gel electrophoresis (2D-DIGE) followed by mass spectrometry (LC-MS/MS). We detected 113 spots differentially accumulated, in which 64 unique proteins were identified, proteins that were involved in metabolism pathways, molecular transport, and cellular signalling. Four proteins (14-3-3, ApoH, ZAG, and OTO3) showing diabetes-related variation and also changes in relation to obesity were selected for further validation by western blotting. Our results reveal new diabetes related proteins present in the Mexican population. These could provide additional insight into the understanding of diabetes development in Mexican population and may also be useful candidate biomarkers.

The factors wich effected qualty of life in patient with rheumatoid arthritis

Yüksek Lisans TeziRomatoid artrit (RA), kronik, ağrılı, eklemlerde ilerleyici sorunlara neden olan, deformitelere bağlı sakatlıklar oluşturan, yaşam kalitesini azaltan ve beklenen yaşam süresini kısaltan bir hastalıktır. Bu hastalık kişinin hem fiziksel hem de psikososyal yaşamında bozulmaya yol açmaktadır. Bu çalışmanın amacı romatoid artritte yaşam kalitesine etkisi olan faktörleri değerlendirmeyi amaçladık. Trakya Üniversitesi Tıp Fakültesi Araştırma Hastanesi Fizik Tedavi ve Rehabilitasyon Anabilim Dalı Romatolojik Hastalıklarda Rehabilitasyon polikliniğine başvuru yapan kırk üç hasta çalışmaya alındı. Hastaların demografik özellikleri yaş, cinsiyet, boy, kilo, VKİ (Vücut kitle indeksi), medeni durum, meslek, eğitim seviyesi ve hastalık süreleri yanı sıra sabah tutukluğunun süresi, şiş ve hassas eklem sayıları, eritrosit sedimantasyon hızı ve CRP düzeyleri değerlendirildi. Ağrı değerlendirmesi, DAS-28, fonksiyonel durum sağlık değerlendirim anketi yapıldı. Sf-36 alt parametrelerinden fiziksel fonksiyonun eğitim seviyesi ile ters ilişkili, genel ağrı, gece ağrısı, istirahat ve hareketle ağrı, HAQ, duruöz el indeks skoru, şiş ve hassas eklem, DAS-28, CRP düzeyi ile ilişkili olduğu tespit edildi. SF-36 ile ilişkili olarak vücut ağrısı ise ağrının VAS ile değerlendirildiği tüm parametrelerle ilişkili gözlendi. Ağrı eğitim seviyesi ile ters ilişkili idi. Bunun yanı sıra vücut ağrısı HAQ, Duruöz el indeksi, hassas eklem, Ritchie indeksi, DAS-28, ESR ve CRP ile ilişkili idi. Genel sağlık durumu değerlendirildiğinde ise eğitim seviyesi ile ters ilişki, boy, ağrının tüm parametreleri, HAQ, Duruöz el indeksi ile doğru ilişkili tespit edildi. Romatoid artritte hastalalıkla ilgili bir çok parametrenin yaşam kalitesini etkilediği gözlemlenmiştir. Yeni tedavi yöntemleri ile bu etkileşimi en aza indirecek programların düzenlenmesine ihtiyaç vardır. Anahtar kelimeler: Romatoid artrit, Yaşam kalitesi, Sf-36AbstractR.A is a chronic, pain causing disease which not only shortens the expected lifetime, but also decreases the quality of life with the progressive problems and deformities leading up to disability regarding the joint system. This disease unfortunately causes deterioration both in the physical and psychosocial life of the sufferer. The aim of this study is to find out the factors that affect the quality of life in patients with R.A. Forty-three patients which appealed to the Rheumatology & Rehabilitation departments in School of Medicine of Trakya University were recruited to the study. Patients?s demographic characteristics such as age, gender, height, weight, BMI (body mass index), maritual status, occupation and educational levels along with the duration of disease and duration of morning stiffness were evaluated. The number of swollen and tender joints, ESR and CRP levels were assessed as well. Pain assessment, DAS 28 and functional health status evaluation questionnaire were performed. Physical function which is a sub-parameter of SF-36 was found to be negatively correlated with the educational level. On the other hand it was found to be positively correlated with the general and night pain, rest and motional pain, HAQ, Duruoz hand index scoring, number of sensitive/swollen joints, DAS-28 nd CRP levels. In relation with the SF- 36, body pain was associated with all of the parameters which were evaluated with VAS. Pain was negatively correlated with the educational level. Besides, body pain was associated with HAQ, Duruoz hand index, sensitive joint, Ritchie index, DAS-28, ESR and CRP levels. It has been shown that a lot of parameters related with the disease may effect the quality of life in patients with RA. Thus, new treatment modalities are needed to reduce these interactions. Key words: Rheumatoıd Arthrıtıs, Quality of life, Sf-3

The Frequency of Osteoporosis in Hemodialysis and Continuous Ambulatory Peritoneal Dialysis Patients According to PTH Levels after Active Vitamin D Therapy during the Two Years Period

Aim: Osteoporosis is a skeletal disorder that is characterized by low bone mass, micro-structuraldegeneration of bone and high risk of fracture. In this study our aim was to detect the frequencyof osteoporosis in hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD)patients according to Parathyroid Hormone (PTH) after vitamin D therapy during the two yearsperiod.Materials and method: 18 HD patients (12 male, 6 female) and 12 CAPD patients (8 male, 4female) undergoing to dialysis therapy in dialysis center of Medicine Faculty Hospital in DicleUniversity were enrolled to the study. The patients were evaluated with bone mineral densitywhich was measured by left heel quantitative ultrasound before and after the active vitamin Dtherapy. The blood samples were collected for biochemical analysis in the morning after 12hours fasting period before and after the active vitamin D therapy. Results: After the therapy T and Z scores bone mineral density and ALP values were increasedin the group that PTH values were between 120-250 pg/ml and more than 250 pg/ml. But theseparameters were decreased in the group that PTH were lower than 120 pg/ml. Osteoporosispercentage were 23 % in PTH value 250 pg/ml in the initial measurement. After the therapy these were 30 %, 0% and 20 % relatively.Conclusion: Before the treatment there was not a statistical difference between T score of 3groups. After the treatment there was a statistically significant difference. Especially T scorewas better after the therapy in the second group that PTH values were between 120-250 pg/ml

Red Blood Cell Distribution Width Level: A Predictive Marker for Early Detection and Monitoring of Diabetic Nephropathy Progression

Chronic inflammation may be one of the factors that contribute to the development of diabetic nephropathy (DN). However, erythropoiesis, erythrocyte circulatory half-life and erythrocyte deformability may be influenced by inflammation. Thus, red blood cell distribution width (RDW) levels increase in inflammatory conditions. We investigated the RDW values and related factors in patients with uncomplicated type 2 diabetes mellitus (DM) and diabetic patients with DN. We carried out a retrospective study on patients with type 2 DM admitted to our hospital. Subjects were divided into three groups. Group 1 consisted of healthy subjects. Group 2 consisted of patients with uncomplicated type 2 DM. Patients with various stages of DN were included in Group 3. The RDW values in group 1 subjects were significantly lower than those in group 2 and 3 patients (p<0.05). The RDW values of group 3 patients were higher than those in the other two groups (p<0.05). While the RDW values had positive correlation with blood pressure, serum creatinine, HbA1c, body mass index, proteinuria, platelet (PLT), triglyceride, low density lipoprotein (LDL), total cholesterol (TC), and fasting blood glucose (r values: 0.95, 0.72, 0.56, 0.86, 0.82, 0.76, 0.88, 0.84, 0.88, 0.86, respectively) (p<0.05 for all), there was negative correlation between estimated glomerular filtration rate (eGFR), albumin, high density lipoprotein (HDL) and RDW levels (r values: −0.92, −0. 88, −0.78, respectively) (p value < 0.05 for all)

The frequency of osteoporosis in hemodialysis and continuous ambulatory peritoneal dialysis patients according to PTH levels after active vitamin D therapy during the two years period

Aim: Osteoporosis is a skeletal disorder that is characterized by low bone mass, micro-structural degeneration of bone and high risk of fracture. In this study our aim was to detect the frequency of osteoporosis in hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) patients according to Parathyroid Hormone (PTH) after vitamin D therapy during the two years period. Materials and method: 18 HD patients (12 male, 6 female) and 12 CAPD patients (8 male, 4 female) undergoing to dialysis therapy in dialysis center of Medicine Faculty Hospital in Dicle University were enrolled to the study. The patients were evaluated with bone mineral density which was measured by left heel quantitative ultrasound before and after the active vitamin D therapy. The blood samples were collected for biochemical analysis in the morning after 12 hours fasting period before and after the active vitamin D therapy. Results: After the therapy T and Z scores bone mineral density and ALP values were increased in the group that PTH values were between 120-250 pg/ml and more than 250 pg/ml. But these parameters were decreased in the group that PTH were lower than 120 pg/ml. Osteoporosis percentage were 23 % in PTH value 250 pg/ml in the initial measurement. After the therapy these were 30 %, 0 % and 20 % relatively. Conclusion: Before the treatment there was not a statistical difference between T score of 3 groups. After the treatment there was a statistically significant difference. Especially T score was better after the therapy in the second group that PTH values were between 120-250 pg/ml. © 2010 Düzce Medical Journal