Immunohistochemical expression of vitamin D receptor and Wnt signaling pathway molecules in psoriasis.

INTRODUCTION: Psoriasis is a prevalent, complex, immune-mediated illness. There is some evidence in the literature supporting the involvement of the Wnt signaling pathway in psoriasis. No previous studies have focused on the association between the Wnt signaling pathway and vitamin D receptor (VDR) expression in psoriasis. This study investigates the expression of VDR and mediators of the canonical (ß-catenin) and non-canonical (Wnt5a) Wnt signaling pathway in psoriatic lesional skin biopsy specimens compared to controls. METHODS: A cross-sectional study conducted on skin punch biopsy specimens from 42 psoriasis patients were stained with VDR, ß-catenin, and Wnt5a and compared with 42 control biopsies. Patients' demographics, clinical data, and serum vitamin D levels were recorded. RESULTS: VDR showed nuclear localization with significant downregulation in the psoriasis specimens compared to controls. ß-catenin (membranous) and Wnt5a (cytoplasmic) showed significant upregulation in the psoriasis specimens. When the expressions of VDR, ß-catenin, and Wnt5a were compared based on disease severity, no differences were found between mild, moderate, and severe subgroups of the disease. Late-onset psoriasis patients had lower VDR and Wnt5a histoscores compared to the early-onset group. A trend toward a positive correlation was observed between the histoscores of VDR and Wnt5a. CONCLUSION: Our findings confirm the significance of VDR signaling in the pathophysiology of psoriasis and strengthen the relationship between this disease and the Wnt signaling pathway. There was evidence that there is an association between VDR status and Wnt5a expression.

Evaluation of Patients' Satisfaction with the Transition of Internal Medicine Outpatient Clinics to Teleconsultation During COVID-19 Pandemic.

Introduction: The utilization of telemedicine has been steadily rising and became more available during the coronavirus disease 2019 (COVID-19) pandemic to ensure the continuity of care and minimize the risk of exposure to the infection. The aim of this study was to evaluate patients' and caregivers' satisfaction to newly developed teleconsultation services at the internal medical outpatient clinics at a tertiary university hospital during the COVID-19 pandemic. Methods: A cross-sectional satisfaction evaluation was conducted between April 2020 and June 2020. Participants included patients or caregivers who were randomly selected to answer a multi-item questionnaire to measure satisfaction with the quality, effectiveness, and convenience of the service. Results: A total of 901 participants completed the satisfaction survey. Most of the patients were in the age group 45-64 years (43.7%). The main teleconsultation method was telephone call (99.2%) and 798 participants (88.6%) were satisfied with the quality of teleconsultation. There was no difference in satisfaction levels across the various specialty clinics or age groups. The service was viewed as convenient by 636 participants (70.5%) and 481 (56.6%) preferred to continue using telemedicine after the COVID-19 pandemic. Conclusion: The study revealed high level of satisfaction among patients and caregivers with the recently introduced teleconsultation services at internal medicine outpatient clinics during the COVID-19 pandemic, which is a relatively new concept in many countries. This opens the door to further utilize telemedicine as an integrated part to improve patient care beyond the pandemic.