Erythema multiforme: A retrospective study of etiologies, clinical manifestations, and treatments.

Background/purpose: Erythema multiforme (EM) is considered a hypersensitivity reaction associated with drugs and infections, and remains underestimated due to the lack of precise classification and diagnostic criteria. The aim of this study was to evaluate the triggering factors and clinical manifestations of EM and to present our experience in the diagnosis and management of this disorder. Materials and methods: All patient records were reviewed, and records of patients admitted, diagnosed, and treated with EM were retrieved. Data on age, gender, medical history, triggering factor(s), clinical form, mucosal/cutaneous involvement, affected oral site(s), recurrence, and treatment were collected. The data were analyzed statistically at a significance level set at P < 0.05. Results: A total of 36 EM patients were studied. The triggering factor was identified as infection in 25 %, drugs in 16.7 %, infections and drugs in 41.7 %, and none in 16.7 % of the 36 EM patients. EM minor was diagnosed in 77.8 % of the patients. Labial mucosa (86.1 %) was the most commonly affected oral site. Most patients were treated with topical steroids (25 %). No significant differences were detected between demographic and clinical characteristics with regards to gender, triggering factor, and the number of affected oral sites (P > 0.05). Conclusion: The results of this study, based on the data from 36 EM patients with oral involvement treated at our clinic, can guide dentists in this regard and may be considered as an epidemiological source for the region.

Evaluation of disease burden, patient journey, unmet diagnosis and treatment needs of patients with HIP and knee osteoarthritis in Turkey: A study through Delphi Methodology.

Objective: To get information-driven insights from expert physicians regarding multiple aspects of the patient journey in knee and hip OA and establish a consensus for future studies and decision tree models in Turkey. Design: 157 questions were asked in total during this three-round modified Delphi-method panel to 10 physical medicine and rehabilitation specialists (2 have rheumatology and 3 have algology subspeciality), one orthopaedic surgeon and one algology specialist from anaesthesia specialty background. A consensus was achieved when 80% of the panel members agreed with an item. Contradictions between different disciplines were accepted as a non-consensus factor. Results: Panellists agreed that American College of Rheumatology classification criteria is mostly sufficient to provide an OA diagnosis in clinical practice, OA patients with ≥5 Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain or physical function score can be defined as moderate-to-severe OA if they have an additional ≥2 Kellgren-Lawrence (KL) score, a minimum improvement of 30% from baseline in WOMAC pain or function subscales or in PGA score can be accepted as moderate treatment response where ≥50% improvement from baseline in those scores as substantial response. Panellists stated that arthroplasty procedures need to be delayed as long as possible, but this delay should not jeopardize a beneficial and successful operation. Conclusions: These findings show that there is a significant disease burden, unmet treatment needs for patients with moderate-to-severe OA in Turkey from experts' perspective. Therefore, an updated systematic approach and decision tree models are needed to be implemented.

Ethanolic extract of cotinuscoggygria leaves attenuates crystalluria and kidney damage in ethylene glycol-induced urolithiasis in rats.

OBJECTIVE: Nephrolithiasis is a common cause of kidney insufficiency. Nephrolithiasis is proven to be the result of various biochemical and inflammatory processes that result in crystal formation and subsequent aggregation. Cotinuscoggygria L. (CCog) is a plant extract which has been used as a Turkish remedy for kidney stones. With this study, we planned to evaluate the effects of CCog extract in ethylene glycol (EG)-induced nephrolithiasis model in rats. METHODS: The study group comprised 32 Wistar albino rats which were divided into Control (C), EG, CCog Prophylaxis (CC+EG+CC), and CCog Treatment (EG+CC) groups. Stone formation was induced by adding EG (0.75%) into rat's drinking water. Normal drinking water was given to Control group for 8 weeks. Throughout the study period of 8 weeks, EG group was given only EG (0.75%) and CC+EG+CC group was given both EG and CCog. In EG+CC group, EG (0.75%) was given for 8 weeks whereas CCog was given for the past 4 weeks. After the 8th week, 24-h urine samples were collected. Rats were then sacrificed and kidney tissue samples were harvested. RESULTS: Metabolites (calcium, citrate) and creatinine in 24 h urine samples were decreased in CC+EG+CC and EG+CC groups. While hyperoxaluria was observed in the EG group, oxalate levels were similar to control levels in the P-CCog and C-CCog groups. The N-acetyl-ß-glucosaminidase and myeloperoxidase activities were both increased in EG group and these parameters were significantly decreased on CCog treatment. CONCLUSION: We can conclude that C. coggygria extract can have beneficial effect on lowering concentration of stone-forming metabolites in urine and consequently protect renal tissues from damage due to nephrolithiasis. C. coggygria extract can be considered as a potential prophylactic and therapeutic option in high-risk stone formers. Furthermore, our data confirm ethnobotanical use of CC against nephrolithiasis.

Comparison of the antimicrobial effects of six different intracanal medicaments on Enterococcus Faecalis

Aim: to investigate the antimicrobial effects of six different intracanal medicaments on Enterococcus faecalis. Material & Methods: An agar well diffusion test was used to determine the efficacy of the experimental medicaments in removing E. faecalis (ATCC 29212). Medicaments were divided into 7 groups; calcium hydroxide (Ca(OH)2) with saline, Ca(OH)2 with anaesthetic solution, Ca(OH)2 with propylene glycol, commercially available premixed Ca(OH)2 paste, chlorhexidine gluconate gel, triple antibiotic paste (metronidazole, ciprofloxacin, doxicycline) with propylen glycol and talk powder with saline as negative control group. The diameters of the growth inhibition zones for each group were measured after 24 and 48 hours. Differences between groups were analysed using Kruskal-Wallis and Mann-Whitney U tests, and intragroup differences were analysed using Wilcoxon sign test. Results: Diameter of the inhibition zone observed for the triple antibiotic paste was significantly larger (p<0.01) and the diameter of the inhibition zone observed for the chlorhexidine gluconate gel was significantly smaller in comparison to the other tested medicaments (p<0.05). Conclusion: All of the tested medicaments were found to be effective on E. faecalis. However the results suggest that the triple antibiotic paste would be the preferred medicament against E. faecalis as it has the greatest antibacterial effect among the tested medicaments.

Effects of intravenous immunoglobulin therapy on behavior deficits and functions in sepsis model.

BACKGROUND: We aim to demonstrate behavioral alterations in a sepsis model using intravenous (IV) immunoglobulin G (IgG) and immunoglobulins enriched with IgA and IgM (IgGAM). METHODS: We divided 48 Wistar albino rats into five groups: control group, sham-operated group (only antibiotic treatment), cecal ligation and puncture (CLP) group (CLP plus antibiotic treatment), IgG group (250 mg/kg IV IgG) and IgGAM group (250 mg/kg IV IgGAM). Intravenous immunoglobulins were given 5 min after the CLP procedure. Experimental animals put into three behavioral tasks 10, 30 and 60 days after the surgery; to evaluate the locomotor activity, an open field test was performed, elevated plus maze test was used to measure anxiety levels, and depressive state was assessed by forced swimming test. The effects of therapy which were acquired from the results of these tests were used to estimate the behavioral changes after CLP. RESULTS: The mortality rate of 50% in the septic rats decreased to 30 and 20% with the administration of IgG and IgGAM, respectively. Significant changes on locomotor activity and depressive-like behavior were reported in the sepsis group; on the other hand, the treatment with immunoglobulins reduced the symptoms. Treatment with immunoglobulins attenuated the sepsis-related anxiogenic-like responses. Behavioral alterations returned to normal on day 60 in all groups. CONCLUSIONS: Sepsis caused deterioration on behavioral parameters. Immunoglobulin treatments alleviated the symptoms of functional disturbances and caused early reversal of behavioral deficits in septic animals.