Analysis of clinical characteristics and factors affecting treatment responses in patients with pyoderma gangrenosum: a multicenter study of 239 patients☆.

BACKGROUND: Pyoderma Gangrenosum (PG) is a chronic disease characterized by recalcitrant skin ulcers. OBJECTIVE: We aimed to evaluate the demographic, clinical characteristics, treatments and factors affecting the treatment responses of patients with PG. METHODS: We performed a multicenter study of 12 tertiary care centers. We analyzed the data of the patients who were followed up with a diagnosis of PG between the years 2012‒2022 retrospectively. RESULTS: We included a total of 239 patients of whom 143 were female and 96 were male, with an average age of 54.2 ±â€¯17.4 years. The most common treatment was systemic steroids (n = 181, 75.7%). Among these patients, 50.8% (n = 92) used systemic steroids as the sole systemic agent, while 49.2% (n = 89) used at least one adjuvant immunosuppressive agent. The independent factors determined in regression analysis to influence response to systemic steroids positively were disease onset age ≥ 30-years, negative pathergy, absence of leukocytosis, negative wound culture, presence of a single lesion, and absence of upper extremity involvement. Biological agents were used in 18.4% (n = 44) of the patients in the present study. We also analyzed pathergy positive PG and early onset (onset age < 30) PG separately due to their distinct clinical features which were revealed during statistical analysis. STUDY LIMITATIONS: Retrospective nature of the present study. CONCLUSIONS: Analyses of the factors influencing treatment responses are addressed in this study. Also, we concluded that investigation for accompanying autoinflammatory diseases of pathergy positive PG and early onset PG is necessary and the patients in these two groups are more resistant to treatment, necessitating more complicated treatments.

The moderating role of intrinsic motivation on the relationship between toxic leadership and emotional exhaustion.

Dysfunctional and destructive leadership behaviors have begun to be seen frequently in today's business world. Likewise, toxic leadership, with incompetent supervision elements results with negative outputs for organizations and heavily for the employees. Employees may experience long-term stress in the work environment and develop emotional exhaustion, resulting in mental breakdown. Hence, this study aims to reveal the effects of toxic leadership on emotional exhaustion within the healthcare industry as a first step. Moreover, we also attempt to reveal the contingency of intrinsic motivation to lessen the reflections of toxic leadership on emotional exhaustion as a second step. Using PLS-SEM, we find that toxic leadership is positively associated with emotional exhaustion. Furthermore, our findings provide empirical evidence supporting the moderator role of intrinsic motivation on the relationship between toxic leadership and emotional exhaustion.

Essential hypertension and hypermetropia: is there really an association?

AIM: To investigate the relationship between hypermetropia and systemic hypertension. METHODS: The study was performed on 2 groups of participants (a total of 1,162 participants). Group 1 comprised 370 patients with arterial hypertension and 205 age- and sex-matched normotensive subjects. Hypertension was defined as systolic blood pressure >or=140 mm Hg and/or diastolic blood pressure >or=90 mm Hg. Spherical equivalents between -0.50 and +0.50 dpt were regarded as emmetropia. Keratometry, anterior chamber depth (ACD) and axial length (AL) were measured with IOL Master (Zeiss, USA). Group 2 comprised 124 myopic, 206 emmetropic and 257 hypermetropic subjects. Differences for mean spherical equivalent, keratometry, ACD and AL measurements between hypertensive patients and control subjects (group 1) were compared using independent-sample t test and Mann-Whitney U test, and distributions of refractions were compared with the chi(2) test. Distributions of hypertensive and normotensive subjects (group 2) among myopic, emmetropic and hypermetropic subjects were compared with the chi(2) test. RESULTS: Mean spherical equivalents of the patients with hypertension and of control subjects were -0.03 +/- 1.63 and 0.22 +/- 1.82 dpt, respectively (p = 0.182). The differences for keratometric values, ACD and AL were not significant (p = 0.151, 0.692 and 0.548, respectively). There was also no significant difference (p = 0.143) for hypertension ratios among myopic (66.1%), emmetropic (57.8%) and hypermetropic (55.6%) subjects. CONCLUSION: There is no association between systemic arterial hypertension and hypermetropia.