An expert system for the differential diagnosis of erythemato-squamous diseases

Cataloged from PDF version of article.This paper presents an expert system for differential diagnosis of erythemato-squamous diseases incorporating decisions made by three classification algorithms: nearest neighbor classifier, naive Bayesian classifier and voting feature intervals-5. This tool enables doctors to differentiate six types of erythemato-squamous diseases using clinical and histopathological parameters obtained from a patient. The program also gives explanations for the classifications of each classifier. The patient records are also maintained in a database for further references. (C) 2000 Elsevier Science Ltd. All rights reserved

Granulomatous skin infections

Granulomatous skin disorders are a heterogeneous group of disorders characterized by granuloma formation on histopathology. They may be triggered by various stimuli, including infectious and non-infectious stimuli (foreign bodies, malignancy, metabolites, and chemicals), of different etiological origins. Although pathophysiological mechanisms are still poorly understood, infectious granuloma formation may occur if the patient’s immune system could not eliminate an agent. Clinically, localized or disseminated infectious granuloma formation can be related to the infectious agent’s pathogenicity or the patient’s immunity. Typical infectious agents causing infectious granulomatous reactions are mycobacteria, fungal infections, or parasites, such as leishmaniasis. This review aims to summarize granulomatous skin diseases encountered more frequently in our clinical experience because of infectious causes

Diagnosis of gastric carcinoma by classification on feature projections

Cataloged from PDF version of article.A new classification algorithm, called benefit maximizing classifier on feature projections (BCFP), is developed and applied to the problem of diagnosis of gastric carcinoma. The domain contains records of patients with known diagnosis through gastroscopy results. Given a training set of such records, the BCFP classifier learns how to differentiate a new case in the domain. BCFP represents a concept in the form of feature projections on each feature dimension separately. Classification in the BCFP algorithm is based on a voting among the individual predictions made on each feature. In the gastric carcinoma domain, a lesion can be an indicator of one of nine different Levels of gastric carcinoma, from early to late stages. The benefit of correct classification of early levels is much more than that of late cases. Also, the costs of wrong classifications are not symmetric. In the training phase, the BCFP algorithm learns classification rules that maximize the benefit of classification. In the querying phase, using these rules, the BCFP algorithm tries to make a prediction maximizing the benefit. A genetic algorithm is applied to select the relevant features. The performance of the BCFP algorithm is evaluated in terms of accuracy and running time. The rules induced are verified by experts of the domain. (C) 2004 Elsevier B.V. All rights reserved

Menopause status and attitudes in a Turkish midlife female population: an epidemiological study

<p>Abstract</p> <p>Background</p> <p>It is a well accepted status that socio-cultural characteristics may affect the onset of menopause and its characteristics. The aims of this study were to describe the prevalence rates of menopausal symptoms and these symptoms related factors, and to assess the women's attitudes towards some climacteric issues.</p> <p>Methods</p> <p>This survey was conducted between Jan., 1^st2008 and March, 31^st2008 to research the menopause status of the female population in a city of western Turkey. The study group consisted of 1551 women selected with a multistage area sampling method: a random sample of individuals aged 40-65 years. The questionnaire included questions pertaining to women's sociodemographic characteristics, women's menopausal status, some statements about the climacteric, use of hormones at menopause or before menopause, and some climacteric myths. The data was analyzed by Chi-square (x²) analysis and percent (%) ratios with a significant value of <it>P </it>< 0.05.</p> <p>Results</p> <p>The mean age of the women was 49.1 years. Over 90% of the women were of the negative opinion that the climacteric is "the end of youth", "the end of fecundity", and "the end of unclean days". Most women said that cessation of menstrual periods was the most positive thing because they do not have to wait for monthly bleedings, use sanitary equipment, or take birth control methods. There were significant connections between age groups and nearly all the items, with the exception of the items "the end of life" and "the end of fecundity". Among the women, hot flushes were the most common complaint occurring in 96.5% of women: being severe in 32.9%, moderate in 43.1% and mild in 20.4%. This was followed by low backache or muscle pain 95.0% (25.9% severe, 46.0% moderate and mild 23.1%), headache 91.7% (21.9% severe, 34.9% moderate and 34.9% mild) and feeling tired 91.0% (15.3% severe, 38.6% moderate and 37.1% mild).</p> <p>Conclusions</p> <p>Most of the women in this study had mixed ideas of opinions concerning the climacteric, and the majority was also suffering from climacteric complaints. This data could assist healthcare providers in the provision of culturally competent health care to midlife Turkish women.</p

Nutrition

In recent years, nutritional support is an indispensible therapy with medication. The appropriate diet should be chosen for the patients. Indications and complications should not be overlooked when making these choices. Different nutrition modules should be applied for different patient groups. Chemotherapy associated cachexia and catabolism is common in oncology patients. In these patients lipid and carbohydrate balanced nutrition should be provided. Protein, carbohydrate and fat distribution at meals is important in diabetic patients. Intensive care patients are exposed to many stress factors and these patients are susceptible to infection. Lipid-weighted diet should be preferred in mechanical ventilation patients, especially those with respiratory insufficiency. In addition, glutamine amino acid supplementation, which strengthens immunity in these patients, has been shown to reduce mortality and morbidity. In patients with chronic renal failure, protein restriction should be made to provide nitrogen balance, minerals and vitamin replacements should not be forgotten. In chronic diseases of liver, salt restriction, diet protein, carbohydrate and fat ratio should be balanced. It is known that with all these treatments, there are many complications decreased that can develop secondary to chronic diseases

Experience with oral tofacitinib in severe alopecia areata with different clinical responses

Background: Alopecia areata (AA) and generalized form, universalis (AU) are common causes of noncicatricial alopecia, targeting anagen hair follicles. A dominant interferon-gamma transcriptional signaling and cytotoxic T lymphocytes were accused as the main drivers of disease pathogenesis. Tofacitinib is a Janus kinase inhibitor that has been proven to interfere with the positive feedback loop between the follicular cell and the cytotoxic T lymphocytes in AA. There is an increasing number of studies reporting success with tofacitinib in AA. Aims: We aimed to assess oral tofacitinib's safety and efficacy in 13 recalcitrant AA and AU patients. Methods: This is a retrospective pilot study performed between 2017 and 2020. The demographic features and the treatment responses were evaluated with Severity of Alopecia Tool score changes. Results: Thirteen recalcitrant alopecia areata patients (3 AA, 10 AU), aged between 17 and 49, were included in the study. The treatment duration was 3-15 months. All three AA patients responded well; however, the therapy was unsuccessful in five of ten AU patients. Relapse was observed in one of the AA and three of the AU responders. Acneiform lesions and elevation of transaminases were the major side effects. Conclusion: Tofacitinib seems to be more promising and thriving in the treatment of AA than AU. Starting the therapy earlier can bring more successful results. Unfortunately, even in the cases that fully respond to treatment, relapse can be observed after discontinuation of the treatment. It is essential to inform patients about this situation in reducing the frustrations that may occur later

Analysis of the Center for Epidemiologic Studies Depression Scale (CES-D) in Children and Adolescents from the Perspective of the Item Response Theory

Analysis of the Center for Epidemiologie Studies Depression Scale (CES-D) in children and adolescents from the perspective ofthe item response theory.CES-Depresyon Ölcegi'nin çocuk ve ergenlerde kullanimmin madde cevap kurami ile incelenmesi

Perspectives of dermatology specialists and residents on COVID-19 vaccines: a questionnaire-based survey

AbstractBackground: To evaluate the perspectives of dermatology specialists and residents on coronavirus disease 2019 (COVID-19) vaccines.Methods: Present questionnaire-based study was conducted on dermatology resi dents and specialists between January 5 and 20. A non-validated online questionaryevaluating the attitude of the participants about the COVID-19 vaccine was per formed. In the first step of the study, data related to the demographic features, all par ticipants' clinical characteristics, and working conditions were recorded. Thereafter answers given to 12 specific questions were recorded. The study population was divided into two groups: dermatology residents (n = 138) and specialists (n = 159). Mentioned variables were compared between the two defined groups. Furthermore, a correlation analysis was performed to assess the relationship between vaccination acceptance and various study parameters.Results: Majority of the cases had positive attitudes against COVID-19 vaccines. However, there were significant differences between the resident and specialist groups related to the source of information, working conditions, degree of concern, and type of vaccines. Statistically significant negative, weak correlations were observed for age and duration of medical practice (r = -.128, P = .028; r = -.132, P = .041 respectively). Statistically significant positive weak correlations were observed for chronic diseases, level of knowledge about COVID-19 vaccines, number of information sources about COVİD-19, and previous COVİD-19 infection (r = .133, P = .021; r = .207, P < .001; r= .335, P < .001; r = .176, P = .002 respectively).Conclusion: The acceptance of COVID-19 vaccination may be affected by working conditions, medical experience, level of knowledge and the presence of risk factors for severe disease among dermatology residents and specialists

Changing trends in dermatology practice during COVID-19 pandemic: A single tertiary center experience

The aim of this study was to evaluate the changing trends in dermatology clinical practice at a tertiary center during the coronavirus disease 2019 (COVID-19) pandemic. This retrospective cohort study was conducted on patients who were admitted to Ufuk University Hospital with dermatologic complaints/diseases before and during the pandemic. The patients were divided into two groups: (a) the pre-pandemic period (March-May 2019) and (b) the Pandemic period (March-May 2020). Demographic features, clinical characteristics, dermatologic diseases/complaints, dermatologic procedures/interventions, hospitalization rate, and use of biologic agents were compared between the two groups. Total number of hospital admissions have decreased from 1165 to 717. Admission rates for acne, dermatophytosis, and benign neoplasm of the skin significantly lower during the pandemic period (Pvalues were .02, .04, and .006, respectively). Contact dermatitis, acne accompanying dermatitis, cicatricial hair loss, lichen planus, and zona zoster infection rates were significantly higher (Pvalues were .007, <.001, .009, .04, and .03, respectively). Rates of biopsy and electrocautery procedures were decreased significantly (Pvalues were <.001 and .002, respectively). The hospitalization rate was similar between the groups (P= .51). However, the use of biologic agents significantly decreased during the pandemic period (P= .01). Updated clinical protocols should be established for the new normal period in accordance with these findings

Turner syndrome and associated problems in turkish children: A multicenter study

Objective: Turner syndrome (TS) is a chromosomal disorder caused by complete or partial X chromosome monosomy that manifests various clinical features depending on the karyotype and on the genetic background of affected girls. This study aimed to systematically investigate the key clinical features of TS in relationship to karyotype in a large pediatric Turkish patient population. Methods: Our retrospective study included 842 karyotype-proven TS patients aged 0-18 years who were evaluated in 35 different centers in Turkey in the years 2013-2014. Results: The most common karyotype was 45,X (50.7%), followed by 45,X/46,XX (10.8%), 46,X,i(Xq) (10.1%) and 45,X/46,X,i(Xq) (9.5%). Mean age at diagnosis was 10.2±4.4 years. The most common presenting complaints were short stature and delayed puberty. Among patients diagnosed before age one year, the ratio of karyotype 45,X was significantly higher than that of other karyotype groups. Cardiac defects (bicuspid aortic valve, coarctation of the aorta and aortic stenosi) were the most common congenital anomalies, occurring in 25% of the TS cases. This was followed by urinary system anomalies (horseshoe kidney, double collector duct system and renal rotation) detected in 16.3%. Hashimoto’s thyroiditis was found in 11.1% of patients, gastrointestinal abnormalities in 8.9%, ear nose and throat problems in 22.6%, dermatologic problems in 21.8% and osteoporosis in 15.3%. Learning difficulties and/or psychosocial problems were encountered in 39.1%. Insulin resistance and impaired fasting glucose were detected in 3.4% and 2.2%, respectively. Dyslipidemia prevalence was 11.4%. Conclusion: This comprehensive study systematically evaluated the largest group of karyotype-proven TS girls to date. The karyotype distribution, congenital anomaly and comorbidity profile closely parallel that from other countries and support the need for close medical surveillance of these complex patients throughout their lifespan. © Journal of Clinical Research in Pediatric Endocrinology